1103 5TH AVE S (3)I o 3 Y+vi A v
FIRE PREVENTION
Serving Brier, and
Edmonds,
MeridianAveINSPECTION
12425 MridiAS
REPORT
SiVOHOMi$H CO. o .. of ; ,
MONDS
Mountlake Terrace
FIRE
Everett, WA 98208
BRIER
._
DISTR T
Phone (425) 551-1200
Fax 551-1272
N ORPO TERRACE
❑ UNINCORPORATED
UNINCORPORATED
www.FireDistrictl.org
(425)
FREQUENCY
FREQUENCY STATION & SHIFT
LOCATION-
5 th Avenue S 98020
Annual 17-D
BUSINESS NAME
AptS
PHONE:
PHONE:
4257765700
SCHEDULED
DATE DUE Dec 2018
MAILING
"
UFIR ► 428 153
ADDRESS:1103 5th Avenue S, Edmonds,Wk 98020
BUSINESS OWNERohastad, Dolores
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2Krogh, Nancy ^'
HOME PHONE: 4254781 103
CITY YES NO
M
17
BUSINESS E -
EMAIL: .-,:r
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LICENSE u u
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PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: Z q 1 a,"I
kf LL
Y
FIRE SYSTEMS: *'1'2:00:00"AM
FA 10/177 FE 10/ SP 1 16