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everett THE EVERGREEN <br />CITY OF <br />everett <br />�e CITY HAIL • EVERETT <br />WASHINGTON 98201 <br />5102 <br />DATE //) i I - <br />CITY OF EVERETT <br />INSPECTION REPORT <br />Inspecting Department: ✓ <br />License Electrical Weights & Meas. <br />Fire __ Housing Engineering <br />Building Plumbing <br />Inspectors Signature 'L� `�I Q <br />Premises Inspected: �C Lt41 L tit rt <br />Type of Building or property C C9 (L, c.t— <br />Location or Address 76 <br />` <br />Items Inspected: / �� �O <br />Items appearing to need additio I inspection: <br />I, , in attendance on the Premises, <br />certify that the above inspection was made. <br />i <br />Signature <br />Form No.424-001 SDI <br />