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. . . � . <br /> . <br /> - FORM G <br /> . • .•. • <br /> . \"1 � _ ��_ ' ;' �. �) � _ <br /> CI7'Y Ol� LV]sRETT • ' <br /> Snohomish Cowity, Nr8SI17»sCon . . <br /> . UNSAFE BUIL,nINGS REL'�R7�NCT' NO, 7p_`_? <br /> . 5TA1'L OF W1�SHINGT01i ) ' ' <br /> COUNTl�OF SA'OI-IOMISII ) SS . , A.FFIDA,VIT OP' STRVICL: . <br /> , <br /> T e undcrsigned, bcing first duly swor�i o�i oath� deposes and says: <br /> , 1 7'hat in and diuing all times herein mentiwied, affianl was and now <br /> is over ihe a�e of twenty-one ycars, a citizen of the Uni.ted Sfates, a residcnt <br /> of thc St��lc of Washington and compclent to bc a witness hcrcin, ' <br /> _ 2,� That affiant scrved .a full, true, correcC duplicale origi»al copy <br /> of tlie follo�ving descriUcd ciocu�nent: (Cz•o:;s out inapplicaUlc noticcs) _ <br /> � <br /> I • <br /> (b} NOTICL Ol' PP.LSF:N1'A7'ION OF ].SUTi.l7. NC <br /> . OI�FICIAI_, RL:QUES'J' TO CT.'i'1 CUUIQGIL FOR <br /> " AN O12llL}; <br /> �—�''� '� ,�:I?3.12 <br /> , A. copy of w}�ich is al(acl�ed herelo and by this rcference <br /> madc a parC herein as ihough set forU� in full hercin <br /> upon each of the follo�ving ].a,( loiown owner(s) 'of <br /> record of thc bnilding(s), or struclurc.(s)� or porlion(s) <br /> Lhci•cof dcscribed in said document by thc manner set <br /> fvrth hereinafter: • <br /> (1) y�.�tso�Tn�_, sr�:vicr: . . <br /> : • Ily delivci•irg a�id icavin€; sai.d copy �vitl� said otvncr(s) <br /> at thc p]acc and ti.mc sci forth hcrcinbclow: • <br /> • O�vner Name_ " Address �Served I�ate Scrved <br /> .`-------•----- <br />