121 5TH AVE N STE 200 (2)F:
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FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
EDMOMountlake Terrace Everett, WA 98208 ❑ ❑ BRIER S
BRIER .
Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE
www.FireDistrictl.org Fax (425) 551-1272 ❑UNINCORPORATED
FREQUENCY STATION & SHIFT
LOCATION: 1.21 5 th Avenue N.Suite 200 98020 Annual 17-B
BuslNEss NAME: COE Development Services PHONE: 4257752525 DATE DUESCHEDULED Feb 2016
MAILING UFIR / 591 203
ADDRESS: 121 5th Avenue N, Suite 200, Edmonds, WA 98020__j
BUSINESS OWNER: HOME PHONE:
. EMERGENCY-1: City Of Edmonds HOME PHONE: CURRENT `YE - S NO
KEY ACCESS-2: HOME PHONE: CITY '
EMAIL: BUSINESS 0
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS: FE 7/15
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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
DATE DUE:
DATE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
CONTACTED:
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VIOLATIONS
— VIOLATIONS -.
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NUMBER:
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CODE
SECTION:
RETURN RECEIPT
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RECEIVED
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DISPOSITION:'
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DATE:
_
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDEDf ❑ YES ❑ NO
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FIRE PREVENTION
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Seri rrtg Brier; Edmonds, and
1. 4. S Meridian Ave S
INSPECTION REPORT
SNCf$(MIL CO.
' Mountlake Terrace
FIRE
Everett, WA 98208
❑ BR ERNDS
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Phone (425) 551-1200
Fax 551-1272
❑ MOUNTLAKE TERRACE
[I UNINCORPORATED
wwwFireDistr•ictl.org
(425)
FREQUENCY STATION & SHIFT
LOCATION: 121 5 th Avenue N Suite 200 98020
Annual 17-A
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BUSINESS NAME: Edmonds Community Services
PHONE: 4257752525
SCHEDULE eb_.20�-5=
DATE DUE
MAILING
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ADDRESS: 121 5th Avenue N, Suite 200, Edmonds, WA 98020
BUSINESS OWNER:
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HOME PHONE:
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON.- •
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
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INSPECTOR:
INSPECfi:
-
INSPECTOR:
2
3
DATE:
DATE:'
DATE:
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE -
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
3
7
RECEIVED
6
DISPOSITION:
7
4
18
4
18
DATE:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier; Edrnonds i 12425 Meridian Ave S INSPECTION REPORT
OHOMISH CO. ,
FIRE Mountlake Terrace,and Everett, WA 98208 ❑BRIER S
❑BRIER
)ISTR T the Town of Woodway Phone (4 25) 551-1200 ❑ WooDwAY
❑ MOUNTLAKE TERRACE
wwwFireDistrictl.org Fa (425) 551-1272 [1 UNINCORPORATED
FREQUENCY STATION & SHIFT
LOCATION: 121 51h Avenue N 200 730 17 C
BUSINESS NAME: Edmonds Co munify Services PHONE: 4257752525 SCHEDULED
DATE DUE ► 02101M
MAILING 121 5fh Ave N UFIR / 591 2202
ADDRESS: Edmonds 98020
BUSINESS OWNER: City Of Edmonds HOME PHONE: ACTIVE
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EMERGENCY-1: rfft _$"T'i' HOME PHONE: ' ' r CURRENT
KEY ACCESS-2: S S r TI �x HOME PHONE: N 2.S 76o CITY YES NO
BUSINESS
3�3 1 LICENSE Li Li
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR: ��� I J / /
FIRE FE of t 3
SYSTEMS: ANNUAL,
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1 � i c� f ►'�
1
2
2
3
3
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE-
2nd RE -INSPECTION y
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
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY