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�� i) �) �� <br /> everett THE E'VERGREEN <br /> CITY OF c7�� -z� <br /> everPtt DATE _.[_.—L�_��_-- <br /> CIiY HAII • EVERETT CITY OF EVERETT <br /> W ASHINGiON 98701 <br /> INSP[CTION REPORT <br /> - hispecting Departmenc <br /> LiCen50 Elcr,lliral _ __ ��Jciyhts& �1uas — _ <br /> Fire Ha�sing _ Enyineerin9 ---.-- <br /> �', Boilding �_ /Pylum_bin9 --- <br /> i Inspectors Signaturc—1 � � C�x 7—_ - <br /> �/� <br /> i <br /> �� ,�- � �:- �' � � Premises InsPected: '`��'��`" r ��' . <br /> �'I ��:;��'{F,� . � . , � <br /> Type of Building or property ��--�•-�-'��✓ <br /> Location or Address � j����w /"�t ____ <br /> I�ems Inspected: �, p��f1, ��� i/�„ _ Q,__,_ <br /> C�c r c�^.�� <br /> G �. - <br /> I�ums appearing to need additional inspection � <br /> ��j _�„ 5�� <br /> ��"'�' 1 �'s—tyr��--r•� � i'I�c�.�i�-��'j �-- <br /> � <br /> ��--� . �.a—.� �--� . <br /> � _(�)�(� , in attendanr.e on the Premises, <br /> certity that hr.above inspection was made. � <br /> < <br /> Siqn,� ure _._------ — ---_ . . <br /> I ni m Na. 414 OO1 d?' <br />