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ev�ret'. 5 ��' �5 � <br /> . TH[ EVERGRELN <br /> CITY OF � <br /> �} r /.. <br /> e�verF�ll DATE �, <br /> , <br /> arv Hau • EYFRETi CIi�Y OF EVERE7 " <br /> WASNING70N 96101 <br /> ����.;{�ECTInN �I.1�,'-J;�� . <br /> - _ Inspectin9Deparinio,��. <br /> �. . License —_._ I'_'�. � _,�. _ ., �.:iv� .. .� . <br /> � � . - Fire Housing [nyuicmii�q . <br /> � "C`T��� � � Building Plumbing }^ r l�•'j)� �/,". <br /> , ;/ <br /> � . � Inspecrors Signaturc ��.� L�- ' i <br /> }g}. tc. ,,, � � -- - -._-- - . <br /> x� I <br /> �',��.'r � ' � -- -- -- - - . � --- - -- <br /> -°,,�'. � - . � . , . <br /> �. ` � . �. . ' � Premises Inspected: <br /> i <br /> , � � Typc of Buiiding or pro���.:••�, <br /> - � Location or qddmss .'' �i -� � <br /> ��' . <br /> . , . Ilen151nsuteied: �� � ��� ��� � <br /> � C . :.e . . . - . , . <br /> Iri,�-P.:t �� - 'i,l It� i �_,. .�! illi rxl u�C _ . ��. . _ __ . _ <br /> �, . . _ _ . �n i���.n.:.. nn ' � -�.,.ir ..� <br /> Jti' Ihil ' . �,. ... i. . . . . i. . � ... <br /> . . . �i.r,�� <br /> . . . . .i nli . <br />