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everett THE EVERGREEN U v(1 0 <br /> CITY OF <br /> everett DATE r_�-_�Q - ') I _ <br /> an Hnu • EV[NE1T CITY OF EVERGTT <br /> WASHINGIpN 98701 <br /> INSPECTION REPORT <br /> Inspecting Depariment <br /> License Electrical Weights& hleas. <br /> Fire Housing Engineering __ <br /> Building Plumbin9 � <br /> InSpectorsjignaWrc���L�-✓/2-��`�n-�'"-S7 � �/"'�77+..y_ <br /> — _'�`— <br /> Premises Inspected: .�se���.� ,('�..Q�c�� �'�-<-�-�ri-r.�y�, <br /> Type of Building or properry `.i-?a-�ro� . <br /> __ Location or Address / � G� � �y���-� <br /> ! <br /> Items Inspected: <br /> � d-t-��'( -c��� C-t/�•---(;�. -- <br /> , <br /> - -� «��� - --G���'�.- <br /> hr.ms appeaiinq Io nerd additional inspection� ������� ��---�-�--- <br /> �.�,,i,�-i''a � <br /> �'- _____ . in eitr;nd.�nc�� on ihe Premises <br /> r.ertify that the above in;pr.clion iras in;�,dr. <br /> Signature _ ,1��� <br /> Fonn t.��.q?a � _ � _ . <br />