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THE EVERGREEN <br />CITY OF <br />everett <br />CITY HALL • EVERETT <br />WASHINGTON 98201 <br />6638 <br />DATE !1!:(% <br />CITY OF EVERETT <br />INSPECTION REPORT <br />Inspecting Department: <br />License Electrical <br />Weights & Meas. <br />Fire Housing <br />Engineering <br />Building Plumbing r <br />Inspectors Signature _ cc 4„( <br />Premises Inspected: <br />Type of Building or property <br />Location or Address <br />Items Inspected: GAS N.r ,ra.—cC7R — _ p <br />paitMI--( *I'— ;LII,� K <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—oa1 Sy <br />