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J <br />5471 <br />everett THE EVERGREEN <br />CITY OF DATE DATE 1 2— 7 �/ <br />0i evereLl <br />CITY HALL • EVERETI CITY OF EVERETT <br />WASHINGION 98201 <br />INSPECTION REPORT <br />Inspecting Department: <br />Electrical V Weights & Was. <br />License <br />Fire <br />'Housinq Engineering <br />Building lumbing <br />Inspectors Signature <br />Premises Inspected: <br />Type of Building or property eo C' Lt� <br />Items In <br />,4 l In <br />Items ap ,raring to need additional inspection <br />in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Form No.424-001 W <br />