115 3RD AVE N STE A-� Iil l III I J 3 R D ra N s� FIRE'PREVENTION
Serving Brier, aumurids, and 12425 Meridian Ave S INSPECTION REPORT
8N0fl0Nlll%i CO. ❑ EDMONDS
FIE `� Mountlake Terrace Everett, WA 98208 ❑ BRIER
R " a; ' ❑ MOUNTLAKE TERRACE
DIST "T Phone (425) SSI -1200 ❑ UNINCORPORATED
www.,'PireDistrictl.org Fax (425) 55I-1272
FREQUENCY ST T O & SHIFT
LOCATION: 115 3 rd Avenue N Suite A 98020 2016-�
Morrison, Wynona Msw Acsw 4257789444 SCHEDULED Oct 2016
BUSINESS NAME: PHONE: DATE DUE ►
583202
MAILING UFIR ►
ADDRESS: 115 3rd Avenue N, Suite A, Edmonds, WA 98020
BUSINESS OWNER: Eadle, Richard HOME PHONE:
EMERGENCY-1: HOME W 2067838643
HOME PHONE:
CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: O�
FIRE SYSTEMS: FE TM7 f
Oa�t-i
Date Last Serviced: /
N '
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS i
1
3 3
4 I 4
5 5
6
7
6
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
DATE DUE: _
W
DATE DUE.
GRANTED TO: DATE DUE- CITED:
PERSON
PERSON
PERSON
'
CONTACTED:
CONTACTED:
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR: 2
DATE
DATE
DATE: 9
VIOLATIONS
- VIOLATIONS
PRE -CITATION i CITATION ISSUED
1 S
1 S
LETTER SENT NUMBER; 4
CODE 6
2 6
•
3 7
-
2 6
3 7
DATE SECTION:
RETURN RECEIPT
RECEIVED 6
...._ - ..- ..._ _ -
.... _ ,
DISPOSITION:
7
4 8
4 8
DATE:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
srroxoMisx co.
FIRE
�` Serving Brie, Edmonds, and 12425 Meridian .Ave S
Mountlake Terrace Everett, WA 98208
j� Phone (425) SSI-1200
DIS'
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n�11�h� FireDistrictl. org Fax (4 2S) 551-1272
LOCATION: 115 3rd Avenue N Suite A 98020
BUSINESS NAME: Morrison, Wynona Msw AC5M/ PHONE: 4257789444
MAILING
ADDRESS: 115 3rd Avenue N, Suite A, Edmonds, WA 98020
BUSINESS OWNER: Eadie, Richard HOME PHONE: alb( 54�
FIRE PREVENTION
INSPECTION REPORT
M EDMONDS
❑ BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
2 Year 13 17-B
SCHEDULED Oct201$
DATE DUE
UFIR / 583
EMERGENCY-1: Morrison, W HOME PHONE: 2067838643 CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS ❑
LICENSE
PERSON CONTACTED: 't.� `. e v� �,� INITIAL INSPECTION
jDATE
NAME OF INSPECTOR: �(r► � J l i�
�a-� �C 11 q ti �j � 7
FIRE SYSTEMS: FE 10 /()-j-
H'AZARDSS FOUND AND LOCATIONS / COMMUNICATIONS
4
.........-_.._.......
... ......
4
4
5
5
6
6
7
i
,
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
lDATE DUE'
DATE DUE,
PERSON
GRANTEDTO:
DATE DUE:
CITED -
:PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
DATE:
2
3
DATE:
DATE:
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
6
3
7
3
7
RECEIVED
DISPOSITION:
Q
8
4
8
DATE:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
'SAFETY SURVEY
CITY OF E O S
121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020
(425):771-0215
FIRE DEPARTMENT,
E
st. 18g�
1.5
3rd Avenue. ,,..
N A
LOCATION:
i BUSINESS NAME:
MOrnso , Wynone Msw ACswu
PHONE:
4257789444
MAILING
115 3rd Ave N #A
ADDRESS:
n
Edmonds
98020
' BUSINESS OWNER:
Morrison W
HOME PHONE:
2067338643
EShce Richard/Claire
2065462705
EMERGENCY-1:
HOME PHONE:
KEY ACCESS-2:
HOME PHONE:
FREPTaNCY STATff & eIFT
SCHEDULED 10101 /10
DATE DUE ►
UFIR ► 593 1(202
ACTIVE
f, INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: r l " nt rtX vu, a -7 �—/ //
FIRE
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
00
ENTER CODE ONLY ONCE ►
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
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
7
4
8
4
8
DATE:
DISPOSITION:
I 6
LETTER NEEDED [] YES NO
LETTER NEEDED ❑ YES NO
FIRE DEPARTMENT COPY