15405 91st Avenue SE 2024-11-08 - Laserfiche WebLink

Ca or 2:Sensitive information Washington State Assn of Fire Marshals WASHINF1RETARSHALS Food Truck Inspection Checklist 20211 FC (as of 03-15-2024) The WSAFM Food Truck Inspection Program A single inspection is accepted by participating jurisdictions throughout Washington. This document is a standardized inspection recognized by multiple fire jurisdictions. You may receive a single inspection once every 12 months from any participating jurisdiction, and that inspection will be recognized by all participating jurisdictions. This document must be posted in the vehicle at all times. For a list of participating jurisdictions please visit: www.wsafm.com/Food—Trucks Local permits are still required. You must contact the local fire department where you are vending and, if required, receive a food truck permit prior to operating in that jurisdiction. Many jurisdictions will reduce their permit fees if you have received a valid WSAFM Food Truck Inspection from another jurisdiction. Vehicle and Operator Information Name of Mobile Food Kautzman Kettle Corn Vehicle: Mailing Address: 15405 91st Avenue SE Snohomish Contact Person: Larry Kautzman Phone Number: (425)422-0364 Email: Kautzmankettlecorn@gmail.com L&I Number (VEN): 1Z9Z1EL22NP475514 License Plate#: 97866AG Inspection Agency and Results Date Inspected: Fire Agency: Permit#: FMFV2405-001 Site Address: 15405 91 st Avenue SE Inspector Signature: Applicant: Larry Kautzman Application Date: 05/13/2024 Summary of Inspection - Regional Description: Mobile Preparation vehicle inspect Review Date: 05/13/2024 El Approved — No violations ❑ Not approved — Violations noted must be corrected by -------. When all violations are corrected, email/call your inspector to coordinate sign off and permit issuance. Insp Name: Insp phone or email: Regional Inspection Checklist Documentation PASS FAIL N/A 1. Washington State L&I Approval Insignia ❑ ❑ ❑ 2. Fire Department Permit ❑ ❑ ❑ Cooking System Type-1 Hood (If produces grease laden vapors) PASS FAIL N/A 1. Cooking suppression system is UL300 listed, serviced, and cleaned. ❑ ❑ ❑ • Date of last service: (Semiannually) Washington State Association of Fire Marshals Regional Food Truck Inspection Checklist, 2021 IFC(03152024), page 1 Category 2: For official use only/disclosure permissible by law.