Loading...
111 SUNSET AVE N STE 103.pdfJuoJICT— iqvc—_ A) At /03 77w 177 ,77 Serving Brier, Edmonds, and 12425 Meridian Ave S SNOHOMISH M Mountlake Terrace Everett, WA 98208 Phone (425) 551-1200 www.FireDistrictl.org Fax (425) 551-1272 111 Sunset Avenue N Suite 103 98020 e' FM?fNCY STAJ?t& SHIFT LOCATION: I Wallace Enviromental 2062295993 SCHEDULED BUSINESS NAME: PHONE: nAYC n"C I0 I U FIR MAILING 111 Sunset Avenue N, Suite 103, Edmonds, WA 98020 ADDRESS: FIRE PREVENTION INSPECTION REPORT EDMONDS BRIER MOUNTLAKE TERRACE [3 UNINCORPORATED Date Last Serviced: HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 7 ....... ......................... ........... ............ .......................................................................... ...... ...... .................... - . ........... . ....... . ................. ... . .......... .. .. ........... 2 2 .............. .......... ....................... ......... ... .................. ..................... ......................... .................. ........ . . . .......... ............. ....... ........... .. ................... 3 3 .... ..... . ............ ....................... ........... ................... ................. ........... ....... ......................... ...... . ......................... .......... ........... .......................... .. .......... ... ................ . ............... ..................... 4 4 ........... ............................................................................................... ............... ­ ................. .. ........ . ........ .............. I... ........................................................... .................. ........................................................... - .......... ...... .............. ..................... ......................... ..... ....................... .................... ...... .......................... ............... ........................ - .......... .......... .................. ........................... ....... .......... ..................... . . ..... ............... I— .......................... .............. I .......... .............................. ............ ............ ............... ......................... ..... ...... ........... ........ ... ------ . ............. ....... ............ .......... . . ­,­ . ........ .. ............ ........... I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION 2nd RE -INSPECTION 'FINAL RE -INSPECTION EXTENSION VIOLATIONS RATE DUE: DATE,DUE: GRANTEDTO: CITED: DATE DUE: ......................... . ............. ..................................................... .......... PERSON PERSON PERSON CONTACTED: CONTACTED: CONTACTED: -- ---- - — ----------- - . .. . ........ . .. .... .... ... ...... .......... ................ . ... ... ............ I SPECTOR: INSPECTOR: 2 INSPECTOR: . . .. . ........... DATE: DATE: 3 VIOLATIONS 5 PRE -CITATION 4 LETTE NUMBER: CODE 16 6 DATE: SECTION: .... . ...... .......... . ------- RETURN RECEIPT 6 3 RECEIVED ............ .. .. ........... . ........ .. J� 7 DISPOSITION: 7 4 8 DATE. . ........ . LETTERNEEDED YES []NO LETTER NEEDED YES [3 NO .#- , I BUSINESS OWNER: HOME PHONE: EMERGENCY-1: Wallace, Megan HOME PHONE: 2062295993 RREN 17 U T YES NO KEY ACCESS-2: HOME PHONE: ITY USI 7CBN E LIC S SS 0 11 EMAIL: EN E e- INITIAL INSPECTION DATE PERSON CONTACTED: NAME OF INSPECTOR: FIRE aYSTEMS. t-t