Laserfiche WebLink
,,-�.�. <br /> ,���(��� _ � [G�--�"�-- — <br /> Uepartment of La�.,vr and Industries � Pa�a rr.«, Cotumn r'��� Fee / <br /> Factory Assembled Structures : .�.(� � 35.50 <br /> P�Box 44430 <br /> ot�P�e wA sssaa-aa3'o NQTIFICATION TO LOCAL ENFORCEMENT AGENC`Y <br /> www.wa.gov/lni/F'AS/ �� 2-19-10 M 397 <br /> (case seusidve� <br /> The Factory-Built unit identifted beiow requires completion work at the Mfg �/yHITLEY EVERGREEN <br /> site as specified. <br /> Ownds name Mfg�s setial no. 021 0-1 1 0 D`��'�nc. <br /> EVERETT SCHOOL DIST. � �� �� �/ <br /> Installation address Type of construction Occuoancv hTA at site <br /> 10901 - 27TH AVE S.E. VB E <br /> ���, State ZIP+4 County Phone numbcr <br /> EVERETT WA 98208 SNOHOMISH <br /> Installatiou site is in: � City ❑ County <br /> DESCRIBE ITEMS RE UIRING COMPLETION WORK AT THE SITE <br /> BUII,DING DEPARTMEN'T FT ECT'.�iCAL DEPARTMENT <br /> www.wabo.org/ www.wa.gov/tni/electricaU <br /> INS£ItT NAME A.hD ADDRESS IN SHADED AREA [NSERT NAME AND ADDRESS IN SFIADBD AREA <br /> T°: CITY OF EVERETT T0` DEPT OF L&I <br /> BUILDING OfFICIAL 729 100TH ST. S.E. <br /> 3200 CEDAR ST. PO BOX, MAIL STOP TB-26 _ <br /> EVERETT, WA 98201 EVERETT, WA 98208-3727 <br /> 1. FOUNDATION SYSTEM & TIE DOWNS 1. ELECTRICAL SITE CONNECTIONS <br /> 2. SKIRTING, DECK AND RAMPS <br /> 3. PLUMBING SUPPLYNVASTE MANIFOLDING <br /> AND CONNECTIONS <br /> Inspator's name(prinJ/type) Phone:(8 am to 5 pm) Manufa��r�5 name��v��WH ITLEY EVERGREEN, �0 <br /> � � <br /> /{,�� "�--v. -�, � '�� ) '> > 1 C - <br /> Office locatio D=:� Manufac s ture <br /> / / <br /> � ;�� � � .�r /J �� , � /�-.--= <br /> `� �" �- { '� � � �� � � 'ce-Olympiaoffice <br /> For Dept. R��d F��� By Grern-Electrical scction <br /> Use ONLY / / Canary-[aspector <br /> Pink-Building department <br /> F623-Of3-000 (PDF)notification to local enforcement agcncy f I-00 �^�a�^ � �,,, ,�,�� <br />