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I� ORM G <br />CITY OF LV�R�TT <br />Snohomish County, Washinglon <br />UNSAIP E BUILDINGS <br />ST.ATE OF tiV:4SHINGTON ) <br />SS <br />COUNTY OF SNOI-IOMISH ) <br />R�F�RENCE NO, �C-17_-48 <br />AI'FIDA� IT OF SLRVIC� <br />The undersigned, being first duly stivorn on oath, deposes and says: <br />1. That in and during all times herein n:entioned, affiant �vas and no�v <br />is over the age of t�venty-one ycars, a citizen of the Uni'.ed States, a resident <br />of tl:c State of V��ashington and competent to be a witness herein, <br />Z. That affiant served a full� true� correct duplicate original copy <br />of thc following descriUed document: (Cross out inapplicable notices) <br />(a) NOTICL Or UNSAFE BUILDING(S) <br />�.y� �,.,rt.,.-., �. .,.. --- - •,.�.-OF=#3C-�II�I�I-t� <br />l�.��rr-rn rnri�c�., <br />.���uv�=—�v-e�TY c;ou�vGiv ro� <br />A TT l�`� T <br />��T <br />� � C � � <br />- � C � � <br />f1 copy of �vhich is attached her�Yo and Uy this reference <br />made a part hercin as though s�t forth in full l�erein <br />upon cadi of thc follo�ving last :cnown o�vner(s) of <br />record of the Uuilding(s), or structure(s)� or portior.(s) <br />thercof descriUed in said dociunent by thc manner set <br />forcli hereinafter: <br />(aj PERSONe1L SLFVICE <br />By delivering and leaving saic copy with said otvner(s) <br />at the place and time set forll, hercinUclow: <br />Owner Namc Address Servc�. nate Served <br />------_' — — — — <br />