100 2ND AVE S STE 310� �
JS IIII��III
D O ZnJp /qU �' f �� 3 /0 FIRE PREVENTION
INSPECTION REPORT
Sensing Briei is
12425 Meridian Ave S
SNOHOMISH CO.
Mountlake Terrace,and
FIRE
Everett, WA 98208
❑ EDMONDS
❑BRIER
the Town of Woodway
DISTR
Phone (425) 551-1200
❑ WOODWAY
❑ TERRACE
� wwwFireDistrictl.org
Fax (425) 551-1272
❑UNINCORPORATED
UNINCORPORATED
F
FREQUENCY STATION & SHIFT
LOCATION: 100 2nd Avenue S
310
731 17 B
I
BUSINESS NAME: BIB danvvich Wealth Mn mnt
9 9
PHONE: 2065224478
SCHEDULED A
DATE DUE ► 11f01.12
MAILING 100 2nd Ave S #310
UFIR ► 591 1202
ADDRESS: Edmonds
98020
BUSINESS OWNER: BocgdanaviCh, Jefffey
HOME PHONE:
AGTiVE
425 • Z 6S - 5 Z � 3
EMERGENCY-1: na 9<j, A-4ssw
HOME PHONE: �1,898
CURRENT
KEY ACCESS-2: k
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE r+l
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: U� C �� Qt 1 1 C
�Z ' i 1— 1 Z
FIRE
FE . H 117
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
I
9
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
a
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
5
4
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY