16111 76TH PL WFIRE PREVENTION
SNOH a� � cti. l Serving Brier Edmonds, and
12425 Meridian Ave S
I �MONTION REPORT
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Mountlake Terrace
Everett, WA 98208
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Phone (425) 551-1200
AKE TERRACE
❑ UNINCORPORATED
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Fax 425 551-1272
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Annual 16-B
FREQUENCY
STATION &SHIFT
J LOCATION: Vacant (Edmonds Marina)
4257432211
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BUSINESS NAME:
PHONE:
SCHEDUL
DATE DUE 8
16111 76th Place W, Edmonds, WA 98026
MAILING
UFIR /
ADDRESS:Evans, Jack
BUSINESS OWNER:
HOME PHONE:
16
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS ❑
LICENSE
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INITIAL INSPECTION D TE
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HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
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DATE:
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