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evere� <br />THEEVERGREEN <br />CITY OF <br />evereti <br />CIiV HALL • EVEFER <br />wnsHiNcroN aezoi <br />3510 <br />7,.� u� <br />DATe _ _ <br />Cil'Y OF EVERETT <br />I(JSPECTION REPORT <br />Inspectin9 Department: <br />License -- Elecvical f��� !N„inht; "< n�7n;�s. <br />Fire Housing _ E�yineering <br />Building -- lu in /^� <br />���� <br />Inspecrors Signature "�'E� <br />� — — <br />i Q� � • <br />Premises Inspected:,/''-` � '— �- --7r <br />U O <br />Type of Building or property <br />i <br />. � Location or Address � 9/S_ ��,�7�;�, li <br />t� —_ �I <br />Items Inspectrd: 3� � <br />. / —."------ — <br />Items �nng to neeJ additional ins�iaction- <br />�, _ _, in atiendance on the Premises, <br />certify tha[ ihe above inspection v�as made. <br />Si�7naturc ---- , --_----___.. <br />ru,�„ r�u-asn- ooi ._, <br />