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Fcvreti 4783 <br /> THE EVERGREEN <br /> CITY OF <br /> everett DATE 7 _ <br /> CM Neu • EVEPEn CITY OF EVERETT <br /> Le WASHINGTON 08701 <br /> INSPECTION REPORT <br /> Inspecting Department <br /> License Electrical —_ Weights& Meas. <br /> Fire Horsing Engineering <br /> Building Plumbing <br /> Inspectors Signature �''�i-t" — <br /> .. Premises Inspected: _ <br /> Type of Building or property <br /> 1 <br /> Location or Address <br /> t,.O.,t .4•.s.. moi" .u•-. <br /> Items Inspected: <br /> [ <br /> Itertls�PP, 9.1Oa K&ignafbWctj°n;' <br /> in attendance,on the Premises, <br /> i <br /> certify that the above inspectio •was made. <br /> Signature <br /> Form No.LYL Gel .]r1 <br /> 1 <br />