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I <br />everett THE EVERGREEN 4966 <br />CITY OF / ` _ <br />evereft DATE !O� <br />,,e <br />CITY Hglt • EVENET7 CITY OF EVERETT <br />WASHINGTON 98201 <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 property �� S <br />Location or Address �) — p � 7 <br />Items Inspected: <br />_Ce <br />Items appearing to need additional inspection: <br />1• , in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Form No. 424-001 X <br />