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J <br />everett 5107 <br />THE EVERGREEN <br />CITY OF 7 7 <br />Le everett DATE /6 -2! <br />CITY HALL • EVERETT CITY OF EVERETT <br />WASH114GION 98201 <br />INSPECTION REPORT <br />Inspecting Department: (� <br />License Electrical Weights & Meas. <br />Fire Housing Engineering <br />Building Numbing r;�;7 I <br />Inspectors Signature <br />Premises Inspected: " `- P ` t4i c I., <br />Type of Building or property C-6 ctL K„ <br />Location or Address j ,of�),-�) e"— /,E—/ , w� <br />Items Inspected: ©/ � <br />Items appearing to need additional inspection: <br />C/✓! <br />I, , in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature r <br />Form No. 424-001 W <br />u <br />