1005 5TH AVE S (2)SNOHOMISH CO.
a illl�llll^ i OO5 s+�j iqUE s
Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrict].org Fax (425) 551-1272
LOCATION:1005 5 th Avenue S 98020
BUSINESS NAME:EXecutive Condos (&1001)
MAILING
ADDRESS:
1005 5th Avenue S., Edmonds, -WA 98020
BUSINESS OWNER,
ICUIt
EMERGENCY-1:
KEY ACCESS-2:Susan, Paine
EMAIL: �'• '
PERSON CONTACTED:
NAME OF INSPECTOR: kc-L.-
FIRE SYSTEMS: F �/l 7 FIE 11 17 12:00:00 AM
PHONE: 425775
FIRE PREVENTION
INSPECTION REPORT
CLWfAONDS
BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY I STATION & SHIFT
Annual 17-D
SCHEDULED
DATE DUE ► Dec 2018
UFIR ► 427 153
HOME PHONE:
HOME PHONE: ee CURRENT
HOME PHONE: 2063715148 CITY Y S NO
17 BUSINESS
LICENSE
INITIAL INSPECTION DATE
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dRYOM LOCATIONS :COMMUNICATIONS
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3
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30'DAYS X
1St RE -INSPECTION
2nd RE -INSPECTION.
FINAL RE
EXTENSION
-INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE: __m.W..
''"�
GRANTED TO°� ' '-•
DATE DUE:
CITED:
PERSON
PERSON �"r
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PERSON
CONTACTED:
CONTACTED: •
CONTACTED:
INSPECTOR:
INSPECTOR: - "
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INSPECTOR:
2
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DATE:
DATE: r
DATE;
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
3
7
RECEIVED
8
DISPOSITION:
7
4
$
4
$
DATE:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES [-]-NO
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