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R <br />ri <br />everett <br />THE EVERGREEN <br />CITY OF <br />everett <br />CITY HAIL • EVERETr <br />WASHINGTON 99201 <br />7976 <br />DATEV"LV -% L <br />CITY OF EVERETT <br />INSPECTION REPORT <br />Inspecting Depalment: <br />License Electrical Weights & Meas. <br />Fire Housing Engineering <br />Building Plumbing <br />Inspectors Signature— <br />Premises Inspected: <br />Type of Building or property <br />Location or Address 1-30 11- <br />Items Inspected: e--�7{> <br />,,eM <br />Items apppeeeaarr1t�o need additional inspection: <br />I, , in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Form No. 424-001 <br />r.� <br />