|
i � ..
<br /> �
<br /> � �
<br /> �
<br /> � ' ���ret� � �17� ' �
<br /> THE EVEItuH�EEN
<br /> �-�
<br /> . / ._ �., GTYOP
<br /> ' . ' _ . .. ���'�:_.�i�4S DATF _�_�r.'.i�j�_.1'F- 1.^�'1 i__
<br /> , � ` �`�' , CITY HFLI • EVEEEP. CITY OF CVL"AE��T '
<br /> �___.
<br /> W ASHd:i tON 9E701 .
<br /> � li'lSPECTIOfJ f�cPORT
<br /> �. `i InspectingDepattmenC
<br /> \
<br /> � license Eier,trical __ l'1einY,ts Y: A^sas. ____ ,
<br /> i
<br /> IFire � Houcing _✓ Er9inccring _.____ .
<br /> i
<br /> � iOuilding . /l Plur�bing __
<br /> , ��� (/�• /
<br /> I i �nsprctors Signature_ /�.�o�„_ `e(-�'��•...Gt.'�•—�
<br /> i - -- �--�------ --
<br /> j i . '_______—�__�'___ ____ ._4a___'�—__,,,ri:i. _ . �
<br /> i\"..,y �,.:"Cv.,c��-1 t�1 �— a- �J —_ �.
<br /> �� ' Premiseslnspected� w`,T�"�JR� i_ ee�..�3Y. ��
<br /> j TYPe uf k3uilding or propertY `�=-��v�c_�: 1"T�-Z�C�"� . ,
<br /> ,,..•�- r�c F.:S �
<br /> ' � l.r�tiun or Addiess 1��iN �. �.,-( ' .
<br /> � --h�,rt+.SL•xp3cicd: TNt. GTil'_CIQI--f CW.�.I'.:{Z�- �,::���IZY/�1ir`.r`.i-lGl-_`'..l:d'v�C, � �
<br /> � I Abl+1"ClUb�•� 1'l/ab {�:.:i2.P:t1 C_i:A*.tt<..•1i:i 01�. Ot--1 W c.:�6i
<br /> � , n��r-lG TF-�� S� I���S u:� Yrtc� n����y r��=�C::IL �N`. �i-c-{
<br /> . r.{,.n uik0 "rF-1�:: a���`.y, K` F.c-f�:.C-�� ��cc cC:ctfA;r-t
<br /> , �------------------:-_— ----------
<br /> . It^_rnsapp'arinr, tonc^d .�tiditicr,:dinspr.ehen: rit2. yy�tie,�:;�SV-�c3'y
<br /> � 1=�2��f`l ��ca:.kC= l�y--:�r i���tiL.'Fl•iIL. il..lr-1G_. .� �yAb ��., �.:�.',I �, � .
<br /> � tZ'li�•-�`�e� ,��.<, -tt-iil-f twR.. I Lt12 'I-•:'� P-"C I'10� C.^L;i ��' ` `� � �
<br /> . j... 1�C,�:.r'�`� tJ 1� \�
<br /> �r�-�<il rci.o-.;�! -r�r-��S ..�:out� ria� �� �1
<br /> � �-o,r u`L.:� r ^.r--� `� �7.J J�_i o*,il�C",�.. .
<br /> �� � i i-l�12�.. t S. i-C4 �-vi h;'��'•C� G,- � � �l1 ,� � C� 1�:.,
<br /> ' ' �, s rzc,�,�r_�:.i�. `�t-�
<br /> �•-----. � ��� :, �_ � �,. : �,,, �ho ���,,,��:s.
<br /> {ll i 1` �
<br /> _ ----- -- ,� ��,l � ,�'.`.
<br /> ��
<br /> , crrtify th�t the,+hove inspection c:as maJa. �
<br /> � �
<br /> � ..I�r ��hm,
<br /> I^,m •�n_n2n 001 :
<br /> � �
<br />
|