144 RAILROAD AVE STE 306SNOT
Fe
D
tyy /lAjL12004 ACE fTC 3v(v
Serving Briel, _ ..ds 12425 Meridian Ave S
Mountlake Terrace,and Everett, WA 98208
the Town of Woodway Phone (425) 551-1200
www FireDistrictl. org Fax (425) 551-1272
LOCATION:
144 Railroad Avenue
BUSINESS NAME:
^�P'r —T4ne--
MAILING
144 Railroad Ave #306
ADDRESS:
Edmonds
BUSINESS OWNER:
Shields, Particle
EMERGENCY-1:
Carter, Susan
KEY ACCESS-2:
Murray, Jennifer
PERSON CONTACTED:
NAME OF INSPECTOR: W A. -A.
FIRE
SYSTEMS:
306
PHONE: 4257447700
98020
HOMEPHONE: 4257716965
HOMEPHONE: 4256700812
HOMEPHONE: 4256407424
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ WOODWAY
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY
STATION & SHIFT
731
17 D
I
SCHEDULED
DATE DUE ► 06101? 13
UFIR ► 591
11�2
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
FE !� _
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
t 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
6
DATE:
DISPOSITION:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
' SNOHO RISH CO. Serving Brier, Edmonds -
Mountlake Terrace,and
DISTR T the Town of Woodway
www.FireDistrictl.org
LOCATION:
144 Railroad Avenue
BUSINESS NAME:
^N.
MAILING
144 Railroad Ave #306
ADDRESS:
Edmonds
BUSINESS OWNER:
EMERGENCY-1:
�O�rt�r��-
KEY ACCESS 2:
ftfer
PERSON CONTACTED:
"1
NAME OF INSPECTOR:
FIRE
SYSTEMS:
t12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
306
PHONE: ��
98020
HOME PHONE: 42S7111's
HOME PHONE: 4266790alT
HOME PHONE: 42yS. 4
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ WOODWAY
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY I STATION & SHIFT
731 17 B
SCHEDULED
DATE DUE ► 06/01/11
[UFIR ► 591 6202
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE El El
INITIAL INSPECTION DATE
l� 11
FE _I
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1 ¢
c
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:
a
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6 -• -
4
8
4
18
DATE:
DISPOSITION:
'
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY