120 W DAYTON ST STE D2 (2)I Zo Li DA y rvAJ J i f ►'- D Z-
` SNOHOMISH CO. Serving Briei. ids 12425 Meridian Ave S
Mountlake .Teri ace, and+ Everett, WA 98 208
FIRE the Town o Woodwa -
DISTR T f y Phone (4..5) 551 1..00
www.FireDistrictl.org org Fax (425) 551-1272
LOCATION: 120 W. Dayton Street
BUSINESS NAME: Harbor Square Convention Center
MAILING 120 W. Dayton St #66
ADDRESS: Edmonds
BUSINESS OWNER: Port 0! Edmonds
'EMERGENCY-1:
KEY ACCESS-2: Conner, .Ian
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
_-~
D2
PHONE: 4257741511
98020
HOME PHONE:
HOME PHONE:
HOME PHONE: 4257426069
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ WOODWAY "
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
EQUENCY
365
I STATION & SHIFT
17 D
:DULED
DUE ►• 09#01/11
► 122
9202
ACTIVE
323.., .
CURRENT
CITY
YES •; I; _ NO
BUSINESS
❑ 0
LICENSE
INITIAL INSPECTION DATE
FE
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
I •.i ij
3
3
4 ;.t
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE
EXTENSION
-INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
INSPECTOR:
INSPECTOR:
. INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
- -
cl
RETURN RECEIPT
3
7
3
7
RECEIVED
5
DISPOSITION:
4
8
4
$
DATE:
7
LETTER NEEDED ❑ *ES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
e
6
FIRE DEPARTMENT COPY
CITY OF EDMONIJIS
121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 • (425) 771-0215
J FIRE DEPARTMENT
LOCATION: 120 W. Dayton Street
BUSINESS NAME: Harbor Square Convention Center
MAILING 120 W. Dayton St #66
FIRE PREVENTION
SAFETY SURVEY
D2
PHONE: 4257741511
II
ADDRESS: Edmonds 98020
BUSINESS OWNER: Port of Edmonds HOME PHONE:
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: Conner, Jan HOME PHONE: 4257426069
FREQUENCY
STATION 8 SHIFT
365
17 C
SCHEDULED
09/01I10
DATE DUE ►
UFIR ► 122
9 202
ACTIVE 323
PERSON CONTACTED:
INITIAL INSPECTION DATE
�^'�—
NAME OF INSPECTOR: S b C"
FIRE FE I f ! D
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1,1� v
ENTER CODE ONLY ONCE ►
VIOLATION CODE
1
2
2 L
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 -ORATION
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
8
LETTER NEEDED EYES [] NO
LETTER NEEDED C YES 0 NO
FIRE DEPARTMENT COPY