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STANDARD STRUCTURALPEST CONTROLINSPECTION REPORT <br /> Washingtun State Pest Control Association <br /> /` ` �,`�""'�"�`,�� f.aRAP�10UNT P�ST CO,U720L <br /> ...�•1�,.v�-oa� <br /> . . � � 'F<. . . r �1 � . ' . . ... . <br /> L V� Rf-IT i5�.7P?0 � TC.CGVA L�5:-51'vl • [IfILI.'fIR7C.'. J7J�O15a <br /> HFLLEVUC <5t.1IlA • OLv:':I.1A91�SIbG <br /> h'e^�ber N �5 _ <br /> Sta:r PesticiAe AppGctlor's License N 2�°�� State Contractor's �/ �23�01�54io <br /> Ins,-ction Date 9-15-19T7 pase Inspectimi Fee $ 115.00 pepo,t y FTR��Ol_y+f� <br /> onr>r/seucr J•A. B'i��ins Pnon= <br /> Proce�cy Add�ess 1101 Clinton Pl�p>>crett, ?y�ash`Q9201 Z�P_ <br /> Ov.rer's Current Address Z�� � i <br /> Orderinp Parry Columbin ?!o»te:i�e <br /> Reiationshi;� I <br /> Otherinfu: <br /> tMPORTANT:The information eontained in this repor[is inronded only tor the person orderin{�the inspection end fuch other persons <br /> .: !�� Si1JII �Lsignate hemin. Thare sh!II I;:� a L,� nf $!i.00 p�v ;:�!:;itienal p�non, f�rin nr 9a�r�rr^,n: ��>n,ry d^'i�n it��d ..s a�;:,rty <br /> rcl•,`,� upo.i this ara any sub;eyuent ieports or cnr;ilica�ions. Th: p:;st wnerol wmpany shall n:;e ba �lieble to any o!h,r pen�n, I <br /> � firm or agency uniess that person is designated heroin, anJ the additional fee paid. Th� o�iginal report will be dclivered to the ordc�ing <br /> par,y and one eopy to each other designated party. AdJitional copies may be obtained for a 51.00 handling iee 6ut will not be sent <br /> to Darties not designated on this report. The oidaring parry shatl bc held responsible tor the paYment of all inspection fees, <br /> OTIIER DESIGNATE�PAP.TIES: <br /> Fec <br /> 1. Name —_ 55.00 <br /> Address <br /> 2 �:ame — —_ 5.00 � <br /> Address -- — I <br /> 3. Lamc _ _ �.�� I <br /> P�dress <br /> -- I <br /> 4. �,ame -- — _ 500 i <br /> �::�Irn:t ----------�-----�------ � <br /> _."_____._"_'.—__ _"______.____"___—__'__'__—' <br /> 'fur.:l { �,: AJd�C;��n;d ., ___'._ <br /> Basr fie:.;:rt F-ee S i_J�) <br /> Total Irso=ction Fca S!;7..Q.1 � <br /> .�:a,,:,:: . <br /> .�, , � I he•eby designate Ih=.atwve person(s1,firms or a�rncies a;interestud parties in Ihis ruport and agrnr to pay the additional fee as prmided. <br /> .�� <br /> } � Date Ordeied 9-12-1`I77 C�lc-�bia �r�rtr.ata <br /> ��i����," ��.- FARTV ORbERING INSPF.CTION AcPOHT <br /> Y. If t�.lephone ordei chr.ck here, pr-�t orJaring party's nar,r aLo��e, <br /> antl initial. <br /> �/ C:'Yfll�HT 1977YIS�CA <br /> PAGE 1 <br />� <br />