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everett <br />Le� <br />THE EVERGREEN <br />CITY OF <br />everett <br />CITY HAU. • EVERETT <br />WASHINGTON 98201 <br />6515 <br />DATE e) 7 4- <br />CITY OF EVERETT <br />INSPECTION REPORT <br />Inspecting Department: <br />License Electriral Weights& Meas. <br />Fire Housing Engin ng <br />Building Plumbing <br />Inspectors Signature J <br />Premises Inspected: <br />Type of Building or property <br />Location or Address 13 e) <br />Items Inspected: <br />Items appearing to need additional inspection: <br />I, , in attendance on the rremises, <br />certify that the above inspection was made. <br />Signature <br />Form No. 424-001 X <br />