20810 76TH AVE W (2)-77.
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7 60 4+ ALle", Lj FIRE PREVENTION
Serving Brier, P-amonds, and 12425 Meridian Ave S INSPECTION REPORT
S�TblgbmiSrl Col OEDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER'
FIRE Phone (425) 551-1200' 0 MOUNTLAKE TERRACE
0 UNINCORPORATED
DIST www.FireDistrictl.org Fax (425) 551-1272
LOCATION: 20.81076th AvenueW 98026
Kingswood Apts
BUSINESS N�ME:
MAILING
ADDRESS: 20810 76th Avenue W, Edmonds, WA 98026
BUSINESS OWNER: Biback/Williams, Debra
EMERGENCY-1: Biback, Sheldon/Reva
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED:
NAME OF INSPECTOR:
4252169895
PHONE:
HOME PHONE:
HOME PHONE: 4256400820
HOME PHONE: 16
FREou ENfY STA�18�A SHIFT
AnnUa I
SCHEDULED Apr 2017
DATE DUE 0
IL4=6
UFIR 0
CURRENT
CITY
BUSINESS
LICENSE
I
YES NO
F-1 [--]
SNOHOMISH CO.
FIRE
DI
Serving Brier, Edmonds, and
Mountlake Terrace
www.FireDistrictl.org
LOCATION: 20810 76 th Avenue W 98026
BUSINESS NAME: Kingswood Apts
MAILING
ADDRESS:
20810 76th Avenue W, Edmonds, WA 98026
BUSINESS OWNER:
Biback/Williams, Debra
EMERGENCY-1-
Biback, Sheldon/Reva
KEY ACCESS-2:
EMAIL:
oe
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS: FE 1/14
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 4252169895
HOME PHONE:
HOMEPHONE: 4256400820
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
gQMONDS
BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY STATION & SHIFT
Annual 16-D
SCHEDULED
DATE DUE " Apr 2016
UFIR � 428206
CURRENT YES NO .
CITY
BUSINESS
LICENSE
INITIAL INSPE(?hON DATE
Wle '-pet Sapgmqed- a Z
HAZARDS FOUND AND LOCATIONS/ CBM&UNILCAITIONS
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. Above you
will find the itern(s) that were noted during. our inspection which require attention to bring them into compliance
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.
V
FIRE PREVENTION
Senving Briet; Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIRE
M�untlake. Terrace
Everett, WA 98208
0 EDMONDS
0 BRIER
DISTRT
Phone (41,15) 551-1200
-0 MOUNTLAKE TERRACE
0 UNINCORPORATED
www.FireDistrictl.org
Fax (425) 551-1272
FREQUENCY
STATION& SHIFF"'�
LOCATION:
2081-076th A,,P-tiueW AM
'Atimal
I&B
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BUSINESS NAME:
iejrQbVjMd Apill
PHONE: 42521EBM5
SCHE'ULETpr 2014
DATE DU
MAILING
UF�k&'2Cb
ADDRESS:
0811) 7ELh A,cnLm A bilmoulls, WA VME
BUSINESS OWNER:
BilyrJekillinrm, De -Jim
HOME PHONE:
F-t i--t5-
EMERGENCY-1:
J3jbaCk,&MWarjRC,,8
HOME PHONE: 42GfA(o=
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY lly-Es NO
BUSINESS
(
1:1
El
EMAIL:
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION
NAME OF INSPECTOR:-
FE_Ll
HAZARDS FOUND AND LOCATIONS I COMMUNICATIONS
/V
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
lst 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:
E:
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:
LETTER NEEDED [-] YES No
- LETTER NEEDED [:] YES El NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edmonds
12425?Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.,-
FIR'
Mountlake'Prrac'e, and
bit, �8208 "! .':
)92DMONDS
, ..
O'BRIER
D I S T F.: t
the Town of Woodway
www.FireDistrictl.orjz
Phone (425) 551-1200
Fax (425) 551-1272
E]WOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION 1, SHIFT
qj 366
LOCATION: 20810 76th Avenue W d, 16 A
j
BUSINESS NAME: Kingswood Apts PHONE.. SCHEDULED
DATE DUE 0 /01/13
MAILING np LIFIR 11, 423 4206
ADDRESS:
BUSINESS OWNER: HOMEPHONE: 206S235954 AC-nVE
Siback/.,
EMERGENCY-1: 6achIell2Mp--Mgmnt HOMEPHONE: 206340930f CURRENT YES NO
KEY ACCESS-2: A.%w44A . 4bn-sftvMGfR:. HOME PHONE: 425744-3666 CITY �
I BUSINESS
Of LICENSE
INITIAL IN§PECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE FE I
SYSTEMS: ANNUAL
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HAZARDS FOUND AND LOCATIONS CO NICATIONS
2
2
4-
3
Ix.1
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3
4
4
5
5
6
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I AGREE TO -CORRECT THE ABOVE
VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTED TO:
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CITATION ISSUED
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NUMBER:
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DISPOSITION:
7
4
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18
DATE:
�l LETTER NEEDED [D YES 14%
LETTERNEEDED 0,YES 0 NO
8
fIRE DEPARTMENT COPY
i. a �mm'
FIRE PREVENTION
"
p
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH
FIRE
CO.
Mountlake Terrace,and
Everett, WA 98208
0 EDMONDS
0 BRIER
the Town of Woodway
Phone (425) 551-1200
OWOODWAY
DIST6?:*4we*T
www.FireDistrictl.org
Fax (425) 551-1272
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
�_QQAIION:
20 810 76th Avenue W
r FREQUENCY
366
I STATION & SHIFT")
16 D
BUSINESS NAME:
Kingswood Apts
PHONE: 2063290085
SCHEDULED g4/01A2
DATE DUE 1'
MAILING
3201 W Laurelhurst Dr NE
LIFIR 1. 428 4206
ADDRESS:,
Seattle 96105
BUSINESS OWNER:
ENback. Sheldon/Reva
HOME PHONE: 2065235954
AC-nVE
EMERGtNCY-1:
l3achtel Prop Mgmnt
HOME PHONE: 2063409301
�IUTRyR E IN T
KEY AC6ESS-2:
Myers, Won sRe MGR.
HOME PHONE: 4257743666
YES NO
B USINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: 0 W L 1 /4j 010L
L� I - / 7- 2-0 'Z
FIRE
FE _1� / 17
SYSTEMS:
ANNUAL
HAZARDS FOUND ANbloCATIONS COMMUNICATIONS
2
2
IJ D 01- A
0 A.) �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:
I
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
.4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED C] YES NO
LETTER NEEDED C] YES NO
r
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98M - (425) 771-0215
FIRE DEPARTMENT
4t' t
LOCAT ION: 20810 76th Avenue w
BUSINESS NAM E: Kingswood Apts
MAILING 3201 W Laurelhurst Dr NE
ADDRESS: Seaftle 98105
I,,'
BUSINESS OWNER: BiLback, Sheldon/Reva HOMEPHONE: 2065235954
EMERGENCY-1: Bachte 1. Prop hfigmnt HOME PHONE: 2063409301
KEY ACCESS-2: Myers, MJon site MGR. HOMEPHONE: 4257743666
FIRE PREVENTION
SAFETY SURVEY
PHONE: 2063290085
FREQUENCY
STATION & SHIFT
366
16 C
SCHEDULED
DATE DUE 11
04/01/11
UFIR o. 428
4206
AC-nVE
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR. rz wr'ol" -S -'A-c____
r-imc
VSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / AMMUNICATIONS
1 //o ot..\a 6�_ /-0
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ENTER CODE ONLY ONCE ll�
1
VIOLATION CODE
1
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2
2
3
3
4
4
5
5
6
6
7
7
8
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lst 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
a
DATE:
DISPOSITION:
7
8
\,LETTER NEEDED Ej YES N
[UTTER NEEDED [] YES NO
FIRE DEPARTMENT COPY