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everett THE EVERGREEN <br />CITY OF <br />Le everett <br />CITY HAIL • EVERETT <br />WASHINGTON 98101 <br />5451 <br />DATE— %l <br />CITY OF EVERETT <br />INSPECTION REPORT <br />Inspecting Department: <br />G <br />License Electrical /�� Weights & Meas. <br />Fire Housing Engineering <br />Building Plumbing __ <br />Inspectors Signature � _ <br />Premises Inspected: D✓ t . <br />Type of Building or property ( o IA^ <br />j <br />Location or Address 2 <br />Items Inspected: <br />4�Da � .St curt P I(Y4 <br />Items appearing to need additional inspection: <br />V ` C 'Q <br />I, , in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Form No. A24-001 X <br />r <br />r <br />