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THE EVERGREEN <br />CITY OF <br />everett <br />cry HALL • LVERE'i <br />WASHINGTON 98201 <br />Inspecting Department: <br />License Electrical <br />Fire Housing <br />Building / Plumbing <br />Inspectors Signature � � <br />Premises Inspected:lyr <br />Type of Building or property <br />/ �t <br />Location or Address <br />Items Inspected: <br />Items appearing to Heed additional inspection: <br />1 �riu <br />DATE ✓ `. /�/ — <br />CITY OF EVERETT <br />INSPECTION REPORT <br />k :eights & Meas. <br />Eno neoring <br />in attendance on the Premises, <br />certify that the above inspection was made. <br />i <br />Signatu <br />Form No. .i?A-0G1 <br />