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everett 17 ' z <br />THE EVERGREEN <br />CITY OF <br />everett DATEIii,e l�-S—%/ <br />CITY MALL • EVERETT CITY OF EVERETT <br />WASHINGEON 98201 <br />INSPECTION REPORT <br />Inspecting Department: <br />License Electrical Weights & Meas. <br />Fire Housing Engineering <br />Building L Plumbing <br />Inspectors Signature <br />(57 <br />Premises Inspected: <br />Type of Building or property Qlr 17�..-e�� <br />Location or Address <br />Items Inspected: <br />Items appearing to-ooQd additipaal.insW.ctinn: �{,,,,.,( y�-�m e/t- cL-A-C <br />I. , in attendance on the Premises, <br />i <br />certify that the above inspection Was made. <br />Signature <br />Form No. A24- 01 X <br />