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everett 1049 <br />THE EVERGREEN <br />CITY OF <br />everett DATE�,e _�� 7( <br />CITY HAIL • EVERETT CITY OF EVERETT <br />WASHINGTON 98201 <br />INSPECTION REPORT <br />Inspec'ing Department: - <br />License Electrical %- Weights & Meas. <br />Fire Housing _-_ Engineering <br />Building Plumbing <br />Inspectors Signature_�.lX_C — -- <br />Premises Inspected: <br />Type of Building or property 1195 <br />Location or Address <br />Items Inspected: <br />I � ^ <br />lic—( Act <br />i <br />Items appearing to need additional INspection: <br />_t <br />Yl1Gre°p C41SeoLnn <br />I <br />�lt�cr oCL co v! ( �r1�i ltr f5 F7rac���K <br />in attendance on the Premises, <br />r.,:;rtif y that the above inspection was made. <br />Signature <br />Form No. 424-001 .� <br />