110 W DAYTON ST STE 102I",
LOCATION
BUSINESS NAME
MAILING
ADDRESS:
BUSINESS OWNER:
Email.-
EMERGENCY-1:
KEY ACCESS-2:
III I1lI1I I`/0Z FIRE PREVENTION
Serving Brier Edmo 12425 Meridian Ave S INSPECTION REPORT
Mountlake Terrace;0BRIER
and Everett, WA 98208 `."DS
BRIER
the Town of Woodway Phone (425) 5514200 ❑ WOODWAY
❑ MOUNTLAKE TERRACE
www.FireDistrictl.org Fax (425) 551-1272 ❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
110 West Dayton Street Suite 102 08020 4t r 2 Year 113 17-B
Rael & LetSon PHONE: 4257441978 SCHEDULED Sep
110 West Dayton Street, Suite 102, Edmonds, WA 08020
HOME PHONE:
77 HOME PHONE: 1 -
HOME PHONE:
PERSON CONTACTED: [ /,, eL r
NAME OF INSPECTOR: )':"/r 77—
FIRE SYSTEMS: FE �/J�
DATE DUE
UFIR / 501
CURRENT
CITY
YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
l0-/7-1.3
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1 i/ (,C
2
2
3
3
4
4
5
5
6
"l
6
2
J/
r
7
1 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
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
8
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
Kevin Zweber
From:
Thomas A. Flett
Sent:
Saturday, November 09, 2013 10:53 AM
To:
Kevin Zweber
Subject:
FW: Inspection
From: Reception Temp
Sent: Tuesday, October 29, 2013 11:16 AM
To: Thomas A. Flett
Subject: Inspection
Good morning, Tom!
We just received a phone call from Jean at a business called, Real & Letson (110-W. Dayton Suite 102, Edmonds, WA
98020) stating they had their fire extinguisher inspected & they passed. Her phone is 425-744-1978. Also, she wanted
to know if the annual inspection could be done next year in November?
Thank you for your assistance!
Laurie
�CITY OF EDMONDS
4
121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 • (425) 771-0215
FIRE DEPARTMENT
4S'St. 1890
LOCATION: W. Dayton Street
BUSINESS NAME: Rae[ & La#son
MAILING 110 W. Dayton St #102
FIRE PREVENTION
SAFETY SURVEY
102
PHONE: 4257441978
ADDRESS: Edmonds 98020 ��5 � �� 4�5
BUSINESS OWNER: L oos, Jackson HOME PHONE: -
EMERGENCY-1: HOME PHONE: --
KEY ACCESS-2: HOME PHONE:
FREQUENCY
I STATION 8 SHIFT
730
17 C
SCHEDULED
�rd1/Q
DATE DUE ►
UFIR ► 591
9202
PERSON CONTACTED: -1 !` /J INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE
;., Y -�.' i I=10. b.
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS // ENTER CODE ONLY ONCE ► VIOLATION CODE
t 0
FIRE DEPARTMENT COPY