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M <br />everett THE EVERGREEN <br />CITY OF <br />everett <br />CITY HAu • EVERETT <br />WASHINGION 98201 <br />DATE �"L��G/7/ <br />—T� <br />CITY nF tVEF T <br />INSPE..IJN REPORT <br />Inspecting Department: <br />License Electrical Weigh .. & Meas. <br />Fire Housing G' C, Engineering <br />Building Plumbing <br />Inspectors Signature <br />I <br />i <br />Premises Inspected: <br />Type of Building or property <br />Location or Address <br />Items Inspected —,.L,. z- <br />1�14i <br />Items appearing to need additional inspection <br />in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Form No. 424-001 .0 <br />IIi <br />