144 RAILROAD AVE STE 223fAdt
FIRE PRE ION
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1
12425 Meridian Ave SINSPE
N FtE ORT
TIO PMountlake
sNoxoMisx co.ServingBrier,
Terraceand
Everett, WA 98208
❑BRIER SFIRE❑BRIERthe
DISTRf4T
Town of Woodway
Phone (425) 551-1200
-•r
❑ WOODWAY
❑ AKE TERRACE
wwwFireDistrictl.org
Fax (425) 551-1272
UNINCORPORATED
❑UNINCORPORATED
FREQUENCY STATION & SHIFT
r LOCATION: Railroad Ave
223
731 17 D
BUSINESS NAME:
Vacant
PHONE: 4257748717
SCHEDULED
DATE DUE ► 06/01113
MAILING
144 Railroad Ave #d223
r
UFIR ► 5,$1 6202
ADDRESS:
Edmonds
98020
BUSINESS OWNER:
Duncan, David
HOMEPHONE: 4257764917
EMERGENCY-1:
McNaaghton, Mark
HOME PHONE: 4257712813
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY "":- YES NO
BUSINESS -
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
9-1
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FIRE
FE b A-3
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1�EN
1
2
2
3
3
4
4
5
5
�6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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:
I
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
8
4
18
4
8
DATE:
DISPOSITION:
LETTER NEEDED ❑ YES;''q 'NO
s4 , e•,
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
r Sen'rr?g Brier; Edmonds
12425 Meridian Ave S
INSPECTION REPORT
I SNOHOMISH CO.
FIREMountlake Terrace,and
Everett, WA 98208
❑ EDMONDS
❑ BRIER
STR the Town of Woodway
Phone (425) 551-1200
❑ MOAY
[IOUNTUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
l LOCATION: 144 Railroad Ave
223
731 17
i BUSINESS NAME: Vacant
PHONE: 4257748717
SCHEDULED
DATE DUE 11' 06l01111
MAILING 144 Railroad Ave #223
UFIR ► 591 6202
ADDRESS: Edmonds
98020
BUSINESS OWNER: Duncan, Devil
HOME PHONE: 4257764917
EMERGENCY-1: McN 1i1ghton, Mark
HOME PHONE: 4257712813
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
1:1 EL
LICENSE
.l
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: h
/ FIRE
FE !
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1 ..�.!
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
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
8
4
18
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES [:]NO,
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8
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FIRE DEPARTMENT:COPY