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Request for Mandatory Housin6 Code Inspection <br />Pa6e 2 Of 2 <br />The Hausins Inspect:r may 6ain access to the buildin5(s), including <br />to ach housing uni.t, in order to make tl�e inspection by contactin�: <br />�R��.y e. ����5 $�as ss�, ���� <br />Name ress — <br />/Lifl��s�:���� �s�. <br />�ei� - �r-fl�-e- �j �M � S 9 - SS S.� <br />onven on ime an a e one <br />A check payable to the Everett City Treasurer in the amount <br />of $�p`�•° e is attached, based on the 1986 inspection fes <br />of $ for each unit to a maeimum of $1,000. <br />truly yours, <br />r� <br />e_ (�{� <br />. <br />Si6ne i�ee of Requestin6 Mailins Address i other than above <br />Party contact person) <br />(tK L- `� � �i- � � S <br />Printed or Typed Name phone if other than above contact <br />person) <br />