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evereit 5690 <br />' THE EVERGREEN <br />CITY OF <br />everett DATE <br />CITY HALL • EVERETT CITY OF EVERETT <br />WASHINGTON 98201 <br />INSPECTION REPORT <br />Inspecting Department: <br />License Electrical Weights & Meas. <br />,.- Fire Housing Engineering <br />_ Building Plumbing <br />Inspectors Signature <br />rI Premises Inspected: �l�� Tom"--� /Jl ✓J- <br />Type of Building or property '•=rvu-,.— <br />Location or Address <br />' Items Inspected: /0 QJ� <br />Items appearing to need additional inspection: <br />in attendance on the Premises, <br />certify that he above inspection was made. <br />Sign: <br />ture <br />Form No. 424-001 .10 <br />4 <br />