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evere±t THE EVERGREEN 8089 <br />CITY OF % Z <br />everett DATE <br />CITY HAlt • EVERETT CITY OF EVERETT <br />�e WASHINGTON 90201 <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 Build'ng or property <br />Location or Address <br />Items Inspected: <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 />