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everetl THE EVERGREEN 1315 <br />CITY OF <br />everett DATE <br />CITY HALL • EVERETT CITY OF EVERETT <br />WASHINGTON 98201 <br />INSPECTION REPORT <br />Inspecting Department: <br />License Electrical Weights& Meas. <br />Fire Housing Engineering <br />Building Plumbing O . <br />Inspectors Signature — j <br />V / <br />Premises Inspected: ('AL' ,L"L, ,.. <br />Type of Building or property <br />i <br />Location or Address <br />Itemslnspected: <br />Items appearing <br />itional inspect <br />1• _ , in attendance on the Premises, <br />certify that the above inspection -,+as made. <br />Signature <br />Fmm No. 424--001 39 <br />j <br />