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everelf THE EVERGREEN <br />CITY OF <br />everett <br />CITY HALL • EVERETT <br />WASHINGTON 99201 <br />2382 <br />DATE_ <br />CITY OF EVER ETT <br />INSPECTION REPORT i <br />Inspecting Department: <br />License Electrical Weights & Meas. <br />Fire Housing Engineering <br />Building ZumL�bingInspectors Signature <br />Premises Inspected: <br />i <br />Type of Building or property <br />Location or Address <br />Items Insped: <br />/lilrcP �J — 17� <br />Items appearing to need additional inspection <br />1, , in attendance on the Premises, <br />certify that the above inspection was made. <br />I <br />I <br />Signature,( <br />ignature / <br />Form No. 424-001 M <br />