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MOBILE FOOD PREPARATION Permit Number: FMFV2405-001 <br /> Permit Type: MOBILE FOOD PREPARATION <br /> VEHICLE PERMIT VEHICLE <br /> FVERIETT City of Everett Permit Subtype: <br /> WASHINGTON Date Issued: 5/14/2024 <br /> PERMIT INFORMATION: <br /> SITE ADDRESS: 15405 91st Avenue SE PARCEL#: <br /> DESCRIPTION: REGIONAL FIRE MARSHALS MOBILE PREPARATION VEHICLE TENANT: <br /> INSPECTION <br /> FIRE INSPECTION OF OUR FOOD TRAILER UNIT <br /> CONTACT INFORMATION: <br /> OWNER: Larry Kautzman PHONE: (425)422-0364 <br /> MAILING ADDRESS: 19405-91st Ave SE Snohomish,WA 98296 EMAIL: Kautzmankettlecorn@gmail.com <br /> APPLICANT: Larry Kautzman PHONE: (425)422-0364 <br /> MAILING ADDRESS: 19405-91st Ave SE Snohomish,WA 98296 EMAIL: Kautzmankettlecorn@gmail.com <br /> CONTRACTOR: Larry Kautzman PHONE: (425)422-0364 <br /> MAILING ADDRESS: 15405-91st Ave SE Snohomish,WA 98296 EMAIL: Kautzmankettlecorn@gmail.com <br /> STATE CONTRACTOR'S LIC#: EVERETT BUSINESS LIC#: <br /> PERMIT FEES: <br /> DESCRIPTION COMMENTS QUANTITY FEE AMOUNT DATE PAID <br /> FIRE REVIEW FEE 0 $100.00 5/14/2024 <br /> Percent Credit Card Fee 0 $2.30 5/14/2024 <br /> TOTAL:$102.30 <br /> PERMIT DETAILS: <br /> Name of Mobile Food Vehicle: KAUTZMAN KETTLE CORN Cooking Suppression System: <br /> Vehicle Description:VENDING TRAILER Portable Fire Extinguishers: 5/13/2024 12:00:00 AM <br /> License Plate Number: 97866AG LP Tanks:3/13/2022 12:00:00 AM <br /> List of Cooking Appliances: KETTLE CORN MACHINE Date of Last Fire Inspection: 5/2/2023 12:00:00 AM <br /> L& I Number: 1Z9Z1EL22NP475514 Fire Jurisdiction of Last Inspection: Everett Fire Department <br /> PERMIT CONDITIONS: <br /> CONDITION TYPE CONTACT DATE ADDED DATE REQUIRED DATE SATISFIED STATUS REMARKS <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> By purchasing this permit and commencing work,the owner/applicant hereby agrees to hold and save harmless the City of Everett from any and <br /> all claims for damages, costs,expenses, or causes of action that may arise because of installation and maintenance of the improvement or other <br /> right-of-way use here to applied for and further agrees to remove same upon notice from the City and to replace public property damaged <br /> thereby. <br /> E V E R E T T Permit No.: FMFV2405-001 Page 1 of 2 <br /> WASHINGTON <br />