182 SUNSET AVEISNOHO'WSIPC�
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FIRE PREVENTION
/8z J"xqF_r I Vr' -
INSPECTION REPORT
Serving Brier, Edn?ona and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208 ITEDMONDS
0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
0 UNINCORPORATED
wwwFireDistrictl.org Fax (425) 551-1272
182 Sunset Avenue S 98020
LOCATION:
BUSINESS NAME: J��rse V(,-
MAILING 182 Sunset Avenue S, Edmonds, WA 98020
ADDRESS:
BUSINESS OWNER:
Phugg,,eark
EMERGENCY-lr_,..�—
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED:
N AMEOF INSPECTOR:
Date Last Serviced:
PHONE:
HOME PHONE:
42567OT5'61
HOME PHONE:
HOME PHONE:
f WnQuE CY I STAffV SHIFT
nual
SCHEDULED
DATE DUE 0
LIFIR 0
CURRENT
CITY
BUSINESS
NO
LICENSE
INITIAL INSPECTION DATE
SNOHOMISH CO.
Serving Brier, Edmonds, and
Mountlake Terrace
www.FireDistrictl.org
LOCATION:
182 Sunset Avenue S 98020
BUSINESS NAME:
Jade Palace
MAILING
ADDRESS:
182 Sunset Avenue S, Edmonds, WA 98020
BUSINESS OWNER:
.EMERGENCY-1:
Phung, Mark
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED:
NAME OF INSPECTOR: M((0r't't'CCx_
FIRE SYSTEMS:
FE 1/14 HD 1/14
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12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Far (425) 551-1272
PHONE: 4256728998
HOME PHONE:
HOME PHONE: 4256702561
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
(3 MOUNTLAKE TERRACE
[3 UNINCORPORATED
0' FREQUENCY I STATION &SHIFT
Annual 17-C
SCHEDULED
DATE DUE � Mar 2016
UFIR 1' 513
CURRENT
CITY YE NO
BUSINESS
LICENSE a 1:1
INITIAL JNSPECJION DATE
� /Tq 11 �
HAZARDS FOUND AND LOCATIONS/ COMMUNICATIONS
Ll
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
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 safety. AVove you.
�Om
will find the item(s) that were noted during. our inspection which require attention to bring them into com lia. e
with the minimum standards adopted by the above jurisdictions.
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Any overlooked hazards or violations of the fire regulations does not imply approval of such condi ns or vi tion.
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.
I' SNO
F
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14-25 Meridian Ave S
Vrving Briei; Edmonds,and �11)
Mountlake Terrace Everett, WA 98208
Plione (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
00,
LOCATION: 182 Sunset Amijue N QM20
BUSINESS NAME: Jade, Paiacc PHONE: 42EE729001
MAILING
ADDRESS: 182 Suriscl. Avcnuc N, Edrmndti, WA 98020
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED.�
FREQUENCY STATION 9 SHIFF_*'
Atinual 17-A
SCHEDULED Mar 2014
DATE DUE
UFIW4'-3
BUSINESS OWNER: HOME PHONE:
EMERGENCY-11: Phuw, Mark HOME PHONE: 4L
CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: ci CAL=, BUSINESS
--ml LICENSE �4 1:1
ONTACTED: INITIAL INSPECTION DATE
PERSON CC
NAME OF INSPECTOR:
, 3 Ll
F I RE SYS I I= Nis: F� I'Lq HD 6)00
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HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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2
3
2
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VICLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
DATE �UE:
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
5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6, k
4 18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED F] YES No
1-1 —
fLETTER NEEDED F] YES NO
8
FIRE 6EPARTMENT COPY
FIRE PREVENTION
Serving Briet;,Edino' nds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terraceand
FIRE
Everett, WA 98208
OEDMONDS
0 BRIER
e Town of Woodway
DISTR T www.FireDistrictl.org
Phone (425) 551-1200
0 WdODWAY
[I MOUNTLAKE TERRACE
Fax (425) 551-1272
0 UNINCORPORATED
I` FREQUENCY STATION & SHIFT
LOCATION: 182 SunsetAvenue
3 17 C
BUSINESS NAME: Jade Palace
PHONE: 4256728998
SCHEDULED
DATE DUE 11' 03/01/12
MAILING 182 Sunset Ave
LIFIR � 513 3202
ADDRESS: Edmonds
98020
BUSINESS OWNER: Phung, Mark
HOME PHONE: 4256702561
ACTIVE 49
EMERGENCY4---Pykee-,*ftyert--
HOME PHON-E-_72069"GOW
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
El
LICENSE /A
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE HD 6/09
FE
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
4
2 /VV
V
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
I st 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
6
4 18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTER NEEDED F] YES NO
1
8
FIRE DEPARTMENT COPY
CITY OF EDI
121 5TH AVENUE N. - EDMONDS, WASHING
FIRE DEPARTMENT
4�' t
LOCATION:
182 Sunset Avenue
BUSINESS NAME:
Jade Palace
MAILING
182 Sunset Ave
ADDRESS:
Edmonds
BUSINESS OWNER:
Phung, Mark
EMERGENCY-1:
Dykes, Albert
KEY ACCESS-2:
1�
FIR E PREVENTION
VIONDS SAFETY SURVEY
)N 98020 - (425) 771-0215
PHONE: 4256728998
98020
HOMEPHONE. 4256702561
2069100066
HOME PHONE:
HOME PHONE:
FREQU ENCY
STATION & SHIFT
36,
1 17 6
SCHEDULED
03/01/11
DATE DUE I�
UFIR I,� 513
3202
ACTIVE 49
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: 'q1VD6-1L5Cjr'i 9 -? 0.5,0- 0 3 /Z b/A 6F) I
FIRE HD 6/og q FE7T�
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
ENTER CODE ONLY ONCE 00
VIOLATION CODE
2 0ECK C46?6-1- A-J6_eZ6Cf
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4
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6
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'Ist RE -INSPECTION
DATE DUE:
1
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPE DR:
INSPECTOR:
2
DATE:
DATE:
DATE: __3
1 V 15
1 5
PRE -CITATION
LETTER SENT
NUMBER: -
4
6
2
6
DATE:
CODE
SECTION:
5
3
7
13
7
RETURN RECEIPT
RECEIVED
6
7
4
8
4
10
_
DATE:
DISPOSITION:
1 8
�, LETTER NEEDED i,:] YES E] NO
WTTER NEEDED E] YES [-j NO
1
FIRE DEPARTMENT COPY