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everett 3331 <br />THE EVERGREEN <br />CITY OF <br />everett DATE,,e _(�i <br />CITY HALL • EVERER CITY OF EVERETT <br />WASHINGTON 99201 <br />INSPECTION REPORT <br />Inspecting Department <br />License Electrical Weights & Meas. <br />Fire Housing Engineering <br />Building Plumbing <br />Inspectors Signature <br />Premises Inspected: <br />Type of Building or propertyf <br />Location or Address a •Z, -L , <br />ItemsInspected, /4—(ZL gi,,4N ,O <br />Items appearing to need additional inspection: <br />I, — , in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Form Na 424-001 X <br />