1067 5TH AVE S (2)I If
t IIII�lIII I O �7-. Ads- s FIRE',PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave.S INSPECTION REPORT
Mountlake Terrace Everett, WA 98208 ' ❑ BRIER ❑ S
BRIER
Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
www.FireDistrictl.org Fax (425) 551-1272
1067 5 th Avenue S 98020
ARF EOUE CY
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ST SHIFT
LOCATION:
Gardenview Apts
4257768801
SCHEDULED Dec
2016
BUSINESS NAME:
PHONE:
DATE DUE ►
MAILING
1067 5th Avenue S, Edmonds, WA 98020
UFIR ►
ADDRESS:
Condo's?? Denise
BUSINESS OWNER:
HOME PHONE:
Lowell/MCintosh
4257451310
EMERGENCY-1:
HOME PHONE:
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HOME PHONE:
CITY
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INITIAL INSPECTION DATE
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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-INSP CTION
EXTENSION VIOLATIONS
DATE DUE:
DATE DUE.
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SNOHOMISH CO. .�
FIRE
DISTF
Serving Brier, Edmonds, and
Mountlake Terrace
www.FireDistrictl.org
LOCATION: 1067 5 th Avenue S 98020
BUSINESS NAME: Gardenview.Apts
MAILING
ADDRESS: 1067 5th Avenue S, Edmonds, WA 98020
FIRE PREVENTION
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FREQUENCY I STATION & SHIFT
Annual 17-B
SCHEDULED
DATE DUE ► Dec 2015
UFIR ► 422 153
PHONE: Am-15-6'1
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INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
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INITIAL INSPECTION DATE
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FIRE SYSTEMS: FE 5/14
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VIOLATIONS
DATE DUE:
DATE DUE:
-
GRANTEDTO:
DATE DUE:
CITED:
PERSON
CONTACTED:
PERSON
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INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
CITATION ISSUED , t
3
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DISPOSITION:
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LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
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FIRE PREVENTION
Serving Brier; Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
❑ EDMONDS
F���Mountlake Terrace
Everett, WA 98208
❑BRIER
441,
I
DITRIn,
Phone (425) 551-1200
❑ AKE TERRACE
❑ UNINCORPORATED
Ww FireDistrictl.org
Fax (425) 551-1272
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FREQUENCY
STATION & SHIFT
LOCATION: IW7 5 th Avatwe S 08020
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17-A
BUSINESS NAME: Garde lIAcw APIss
PHONE: 4207 ;S801
Dm 2014
DATE DULED►
MAILING
UFIR ► 4 1:>�
ADDRESS: 1DE7 5h AV'Cf1Uc S, EdfT10ruk, WA 98020
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1: LalAcIUIIAdrAu8h
HOME PHONE: 425,7451310
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS
❑
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
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FIFE SYS H- ms: FE �5_ d1_4
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2
2
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1 AGREE TO CORRECTTHE 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:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES [__I NO
B
FIRE DEPARTMENT COPY