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� <br /> � <br /> � <br /> . i <br /> ' roizi;� c <br /> - CITY Ol� LvrRrz�r � <br /> Snohomicl� County9 Weishingtmi <br /> UNSAI'E ]3UILDINGS REI'�RT;NCI. NO� ���.�' <br /> STA7'L Ol� 1Y.ASI]Ii�GTO\ } • <br /> COUN'1'Y OF SATOIlONI5I1 ) SS . ��''FIlll�.V1'1' OL' S]?1:VICI; <br /> 1'he undersigned, being fisct duly cworn on oath� deposes and s;ys: <br /> 1� That i�i and duri�ig all timcc hci•ein �ne�ttioned� affiant �vas and uo�v <br /> is over the age of Lweniy-onc ycars� a citizen of ihe United SYates, a residcnt <br /> of the Statc of 1Vashi��glon and cmnpctent to be a �vitness hcreine <br /> 2. That affianC Ferved a full� truc� correct duplicate ori�;ina) coi�y <br /> of ihe following descriUed docwnent: (Cross out i.napplicaUle notices) <br /> (a) N01'IC1� O)� UNSAPL };UIL,DWG(S} <br /> `'��. . <br /> • � _ <br /> A copy oi w7�ich i:; at(ached hcrclo and Ly Ihis rcfcrcncc <br /> madc a puC hcrcin :xs though set furtU in full hcroi�� <br /> upon each of thc follo�ving last kno�-rn U\tq1CT�c) of <br /> record of ihc building(,), or strucitu�c(s), or portio�i(s) <br /> thcreof dcscribcd in said docwncut bq thr manner set <br /> fortl� hcrcinaftcr: <br /> (a) k'ERSONAL SERVIC7�: <br /> • By delivcring cuid lcaving said col,y wilh said o���ncr(s} <br /> at thc place and time set forih herei�ibelo�v: <br /> . O�vncr Namc " Address Served Datc Servod <br /> ;r-� '_ — ------- . - --- <br /> � <br /> }�': ,� '— ------' --_ .._. <br /> � <br /> , i ,� ,:. , � � ` -- ---------�-- <br />