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I everett THE EVERGREEN <br />Le <br />CITY OF <br />everett <br />CITY HALL • EVERETT <br />WASHINGTON 99I01 <br />In acting Department <br />License Electrical <br />Fire Housing <br />6036 <br />DATE '/ T �o 7 -?-- <br />CITY OF EVERETT <br />INSPECTION REPORT <br />Weights& Meas. <br />Engineering <br />Building Plumbing <br />Inspectors Signature <br />Premises Inspected: <br />Type of Building or property e <br />Location or Address 1 1 ,2-6 <br />Items Inspected: '14` ! <br />It%tee?ms appearing to need additional inspection: <br />in attendance on the Premises, <br />certify that the above inspection was made. <br />Signatualm <br />_ <br />Form No. 424-001 X <br />