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THE EVERGREEN CITY OF 22103 <br />l'Yt'f('1� everen INSPECTION R�j/E(PORT <br />CITY HALL/ LVE RE T7 WAS1408701 DATE �i- // <br />Inspecting Department: Housing Mechanical / <br />Budding _ Plumbing _ Sewer Gas Electrical_ <br />Inspeclors Signature (-Y <br />Name of owner or bulldinfiX.4 <br />Address of building <br />Typo of Cmnstruclion: RrGJrrit i,il f......„... :,d <br />Type if inslmminn roq W6le l <br />_ <br />Report or insprn:lion <br />DISPOSITION <br />I WAS IN ATTENDANCE WIIFN INS9EC'f ION WAS MADE <br />•4ffillo.� <br />