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f ' <br /> evere" r 1 ii r� <br /> THE EVERGREEN <br /> CITY OF /�z <br /> everett DATE _ <br /> CITY HALL • EVERETT CITY OF EVERETT <br /> 'Ilt e�1111 WASHINGTON 98701 <br /> INSPECTION REPORT <br /> Inslwcting Department: <br /> License Electrical Weights& Meas, <br /> Fire Housing Engineering <br /> -. - Building -- Plumbing /7 <br /> Inspectors Signature �1"�Y3— <br /> - 11 <br /> Premises Inspected: <br /> Type of Building or propertyC�-/ <br /> Location or Address <br /> itemshtspected: <br /> Items appeatiny to need additional inspection: <br /> l / �!'/i'1 '�"'' f attendance on the Premises, <br /> certify that the above inspection was made. <br /> Signature <br /> 1 n,n.No 494 001 .B <br /> v <br />