176 SUNSET AVE11111111— / 7 le J&4 odi,- -r Pa4C-
Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace. Everett, WA 98208
Phone (425) 551-1200
www.FireDistrict].org Fax (425) 551-1272
LOCATION: 176 Sunset Avenue S 98020
BUSINESS NAME: Goodies Mini Mart
MAILING
ADDRESS: . 176 Sunset Avenue S, Edmonds, WA 98020
BUSINESS OWNER:
PHONE: 4256975141
HOME PHONE:
FIRE -PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY STATION & SHIFT
2016 17-C
SCHEDULED
DATE DUE � Mar 2016
UFIR � 512
.EMERGENCY-1: Mog, Inc. HOME PHONE: CURRENT
YES NO
KEY ACCESS-2: HOME PHONE: CITY
EMAIL: Ltt. 47-5713 37n BUSINESS
ILICENSq 1� F-1
PERSON CONTACTED: INITIAL INSP CTION D
NAME OF INSPECTOR: -Z<�f /6
FIRE SYSTEMS: F'E 8/13
nntp iqQt.qPrvirPH-
HAZARDS FOUND AND LOCATIONS/ COMMUNICATIONS
2
2
3
a,
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities
covered by Snohomish County Fire District 1.
You are to be congratulated on the relative good condition of your occupancy in regards to fire safet ve you
will find the item(s) that were noted during. our inspection which requ.ire attention to bring them into pliance
with the minimum standards adopted by the above jurisdictions.
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation.
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7720; for
Mountlake Terrace or Brier, call (425) 744-6231.
Serving Brier, Edmonds, and
Mountlake Terrace
www.FireDistrict].org
-7 J e,
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
LOCATION: 176 Sunset A%etiue N 2W2D
BUSINESS NAME: Gmdim Mini Marl. PHONE: 426ED7514
MAILING
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
El BRIER
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIFT
Antlual 7-A
711,
SCHEDULED
I DATE DUE lo N.4a, 2014
UFIFt
ADDRESS: -17E Sumel Awn= N. �-drmrmds.. VVA 08020
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: HOME PHONE: ZM-13347,1325 CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS km [:]
LICENSE )ke
INITIAL INSPECTION DATE"'
�-IRE SYS IEMS:
HAZARDS FOUND AND LOCATIONS COMIUNICATIONS
_ ------ ---
....... .....
3 -
--- — - — ------
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
GRANTEDTO:
R�TE DUE DATE DUE: DATE DUE: CITED:
PERSON PERSON PERSON
CONTACTED: CONTACTED:
INSPECTOR:_-- INSPECTOR: INSPECTOR: 2
_4__1____1___ ____
'2ATE EATE _RATE 3
CITATION ISSUED
VIOLATIONS VIOLATIONS PRE -CITATION
LETTER SENT NUMBER:
CODE 5
DATE: SECTION:
�ETURN RECEIPT
RECEIVED 6
-BI—SpoSITI—ON':
7
4 4 — 8 RATE
LETTER NEEDED F
rLE ER NEE�� �OYES �ONO _] YES El NO
FIRE DEPARTMENT COPY
SNOHOMISH CO.
Serving Brier Edinonds 12425 Meridian Ave S
Mountlake Terrace, and Everett, WA 98208
the Town of Woodway Phone (425) 551-1200
www.FireDistrictl.org Fay (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
" FREQUENCY STATION& SHIFT-*)
LOCATION:
176 Sunset Avenue
365 17 C
I
13USINESS NAME:
Goodies Mini Mart
PHONE:
SCHEDULED
4256975141 DATE DUE 11' 03/01/12
MAILING
176 Sunset Ave
LIFIR � 512 3202
ADDRESS:
Edmonds
98020
4)
6 )
BUSINESS OWNER:
Mog, Inc.
HOME PHONE:
-28643476SR4— AC-nVE
EMERGENCY-1:
Lee,Sunyoung
HOME PHONE:
4257738377 CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
El-
LICENSE A—
el—
INITIAL INSPECTION /DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
,444)
3
3
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
I st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
D TE DUE:
EXTENSION
GRANTEDTO:
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-CITAMON
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
.4
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED E] YES El NO
rLETTER NEEDED I-] YES NO
FIRE DEPARTMENT COPY-.1,