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Inspecting Depar[meni: <br />THEEVERGREEN <br />CITY OF <br />everQtt <br />CIfY HAII • EVERETi <br />WAS!{INGTON 90201 <br />1' :'. U 'ri <br />�aTE - -,/� ljl__ <br />� — -- - <br />CIT1' OF [VER�TT <br />m�sF�cnr,r� �Er�cF�r <br />Licen,e __ Elo::tric;:l -------__ !'d�.��ph,; �i P.1�_�as. <br />Pire Housing __ Engimzcrini� _._ <br />[3uildin9 � Plumbing _ <br />Inspec[ors5igna[ur����(i( r�%^������,L.s.-yt �_ <br />�remises Inspectad: <br />���� �� <br />TYpe of Building or property 7`L�,/.�.�+ �'� <br />Location or Hddress_ �2 O�/ bv�� ���L <br />�/ L � <br />Items In_pected: � <br />, "� c�c��c�-�n _ `�/5��� � <br />Itcros appcoring to nsed ndditional insp�cticn� � - <br />��—�'G <br />�, in attendanc�- o:� tl�.: IO:,�.ii-:�,-, <br />o,rtify that the above insp�ction v✓as made. <br />. . :. �^ei4�: �. <br />Si�nature�'CLCN�P� � ��G�''-'4� ss <br />Fonn Na. c,4-. p01 _" <br />