Laserfiche WebLink
Adult Family Hom�( AFH)nLOC�AZ BU�LD�INGSINSPECTION CHECKUST <br />APPIICATlO�! NUMBER: ���D � J `� r <br />—' —_ __---._ --- -_—.__._--_ _ _�� <br />SECiIONS 7. 2. 3• AND 4 tAUST BE COMPLETED BY 4PPLICAhT BEFORE INSPECTION 1VILL BE PROCESSED <br />10415 ROSEWOOD AVE., EVERETT, WA98204 <br />;Itt.+DURE>s <br />�_- -- �- '� ' <br />VITALIY TSINKEVICH <br />vuorE_�iv o�vr,eR r,nr�� _ -- --- — - - <br />ss�ssc�;i,.�r��r..re�a------- ---- <br />onniwe vr+or+e. (425)268-3358 <br />ABSOLUTE COMFORT AFH LLC unrir+evnoue �425) 513-0973 <br />AFN l ICF'1:Ci' I:A'if. r, .�::q:[•�'1 _ _ _ _ _ _ . ._ _ _ — — _ — <br />�_'_ —.__—.—_ _'__ . <br />I • • � ' _.__— — — I <br />On a separate sheet of paper (8 Vz x 11) draw a floor plan (including all <br />floors) of your prospective AFH. Include all sleeping room$ (bedrooms) <br />indicating which bedroom is: A, B, C D, E and F. <br />Label all components for exiting i.e., stairs, ramps, platforms, lifts and <br />elevators. <br />tE BLOCK <br />1 r�rtdY ����d�•r penallY �f V�'q�rY Ihr.I Ilic �nlnrmahon I,r.v;hiYl by nm �y Uuc and conat tu the ttitit of nry knowlMqr. and thdt I <br />,nn n�w5�in'1 or l dm authoutrd by lhe owner Ui IIiP. dhJVC V��'����ses to ra�u�tl nisPechon !or Ihr• oprration ol an AduU F.unJy <br />Hwne al Ihis location. I ayn'r• to holA hannless thr �unuLrtion ronAuchnq sud� inspethons, at nry requesl, at to any ddim <br />(�nduAing msts, sxDensc:, dnd altorneYs'lees mcurrcA in [hc mvrsU9aunn o( 5udi daun). whKh maY bc maAe by airy pe�sun, <br />�urnd.rt un'h ind,utl'in9 �i6� Ili i11n'and r npI0Yn5 � u�.r�n II i10�dr��uaCy nof tlie� infnrntatinn aupPhal to�Ithr��unt�dlctmn�atiPa pa�t Inf <br />tm apphcaliun " — <br />- � � �'� C���//�,S <br />1„e,r.irin F_.—.--C %•�l( �� _ lS i rl ,�"C�L� I� ' �nrf _-- r <br />�ROPERTYOWNEH ❑APPLICANT ❑LICENS[[ <br />EffecUvc: 2U1� luly 0�\ <br />Updated: 7013 lune1 <br />�' ; � 1 <br />, <br />�� .. � <br />` . <br />� <br />