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Ml <br />everett THE EVERGREEN CITY OF 21666 <br />Leeverett INSPEC ON7REPORT <br />CIIV HALL/ EVERE TT WASH. 98301 DATE / <br />I nspect Ing Department. ''H�o.u�s6�g� _MnL anical <br />Puitding __ plumbi,31 �timper Gas Ele,rical__ <br />I n%"wetors Signature u <br />Name of owner or building yy <br />Addren of building <br />l YPo oI Con%nuct!on: Residrnllal _ t:nrnnv*rial <br />Type of Inspr!ction requcsmd - <br />Report or inspection <br />