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evere" THE EVERGREEN 6913 <br />CITY OF Al / everett DATE �Y_j _T� r ry 1 <br />CM Iuu . tvulm CITY OF EVERETT <br />WAS, ING10N 98701 <br />INSPECTION REPORT <br />Inspecting Deparlment: <br />License Electrical Weights & Me25. <br />Fire Housing Engmeering <br />Building PlumhingT <br />Inspectors Signature —, �- <br />1 �_ <br />Premises Inspected: <br />Type of Building or propv+rly <br />Location or Address <br />Items Inspected: <br />Items appearing to r& additional inspection: <br />in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Fonn Na. 424 001 .0 <br />