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everett 3711 <br />THE EVERGREEN <br />CITY OF <br />DATE 3 �� <br />Le everett / <br />CITY "it • EVEErn CITYOF EVERETT <br />W ASHINGTON 98201 <br />INSPECTION REPORT <br />Inspecting Deportment: <br />License __ Electrical Weights &Meas. <br />Fire Housing Engineering <br />Building Plumbing ! // <br />Inspectors Signature <br />Premises Inspected: <br />Type of Building or proueltti <br />Location or Address 15// (O /�� <br />Items Inspected:`' <br />Items apleanng to need additional inspection: (-,L/ OV4 <br />in atterJance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Foam N. 424 -001 Y <br />