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THEEVEFiGR4EN <br />CITY OF <br />��I�-`'. u°i��� <br />QfY 1!A:l • CYEBE7T <br />\YASkINGiDN 73'1U1 <br />0 <br />p <br />UATF ��� / '_I �f .--- � <br />_ � <br />; <br />CITYOFEVL'RLTT � <br />ItJS�GCfION REI'OR1' i <br />Insper.tinp Departmr.nC <br />�icense Electrir.al l'Jeights & Is�eos. <br />�. — <br />Pirc --- Hou;ir.y /�� Enginecring — <br />�_ � <br />f3uildin9 ----. Pluml�i+;9 ., � -"? <br />s'i� , � �:-� • �;,,-, <br />InSPectorSSlgnature._�����'. '�%.��/�, � �:'�ii <br />r ' <br />Premi;cs Inspectcd: " . ,.-) -- --�- <br />,�. <br />TyG= of [3uildin� or propnrty ,� ., . �' - � � �.. •'.�. � . , � <br />.i /� <br />� � <br />Loc,,;ion or Addres: -� " �� f�- . <br />- - -----�. ',%�- _ _==�i-- ----- <br />Items Inspecle�: .- / . . � ! <br />� ^.�� l . `' �' � �, „ _ � _�> , <br />i. �-!.� / ,' � /i - r, / [ .. .-�i".; . <br />Item:.ppcaiig ro nr:ed additional impection� � ��' <br />�' / � � � 'l/ "�� _ /" ' <br />.�_r��LG� %'rf-.C- '� — = C�a_' � vG!'!f' ' <br />� .. ; �! <br />•• � + � / � �/j • ` -�`_ , <br />!J � <br />,r;_..,;,,f. Fl.-iy l_ :7 �=�c�'rt"..f �i..i�- _ , �'r: •C'�.,. . <br />/ •' 1 � <br />�'-- , in :�ucndanr,e vn the Premi;es, <br />cer[ify thnt thr. a6ove in;pec[ion was made, <br />Signanvc <br />Fonn No.42a-o�l J <br />1 <br />1 <br />• <br />