209 DAYTON ST STE 103;2C?,q 5-rE /03
e2nll
FIRE PREVENTION
SNOHOMISH CO.
Serving Brier, Edmonds, and 124251* Meridian Ave S
INSPECTION REPORT
F
Mountla.ke Terrace Everett, WA '98208
0 EDMONDS
Q BRIER
DI TR: T
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
[3 UNINCORPORATE D
www.FireDistrictl.org Fax (425) 551-1272
. .
e FREQUENCY T"
LOCATION: 209 Dayton
Street Suite 103 98020
FSTATION&SHIFT
1 7.
2016 17 C
BUSINESS NAME:
-F�inanc
PHONE
2063671641
SCHEDULED
DATE DUE � Feb 2016
MAILING
LIFIR 1" 591
ADDRESS:
209 Dayton Street, Suite 103, Edmonds, WA 98020
BUSINESS OWNER:
HOME PHONE.,S(I)C) So
EMERGENCY-1- HOME PHONE:
KEY ACCESS-2:' Ljunggren, Jerry HOME PHONE: 36.05095342
CURRENT. YES NO
CITY
EMAIL:
BUSINESS
LICENSE A:�,J
'PERSON CONTACTED:
INITIAL INS PECTION DATE
NAME OF INSPECTOR:
r<\
0
FIRE SYSTEMS: FE
nnfim hq4�t qinnfirt�-d-
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
'2
2
p
3
3
4
4
5
.6.
5
6.
7
7
1,AGREE To cbRRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
I st RE -INSPECTION
A DL�E,
�E
PERSON
CONTACTED:
INSPECTOR:
DATE:
2nd RE-INSPECTIOR
DATE DUE,
EXTENSION
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
�.VIOLATIONS
of
PERSON
CONTACTED:
INSPECTOR:
PERSON
CONTACTED:
INSPECTO14:
2
3
DATE:
DATE:
VIOLATIONS
5
VIOLATIONS:�
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
4
18
DATE:-
DISPOSITION:
7
�,LETTER NEEDED YES NO
LETTER NEEDED [] YES 0 NO
8
4, FIRE PREVENTION
CITY�;-,OF EDMONDS SAFETY SURVEY
1215- AVENUE N. - EDMONDS, WASHINGTON.98020 (425) 771-0215
FIRE DEPARTMENT
FREQUENCY STATION & SHIFT
LOCATION: 209 Dayton St 103 730 17 c
A- 2063540866-Z— SCHEDULED
BUSINESS NAME: C(THONE: DATE DUE 1� 02/01/69
"i �-j
MAILING 209 Dayton St #103 Y'n UFIR 11, 591 2202
ADDRESS: Edmonds 98020
BUSINESS OWNER: 4ft-ob �,ill HOME PHONE:
57
LIU In Tc cy) c
EMERGENCY- 1: Nelson, MaMn HOME PHONE: 4�) 7�
KEY ACCESS-2: HOME PHONE:
PERSON CONTACTED: I INITIAL INSPECTION DATE
NAME OF INSPECTOR: , Pf)IA'1� L12o V13101
FIRE I FE ji2f
SYSTEMS:
ANNUAC
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
ENTER CODE ONLY ONCE 11�
VIOLATION CODE
� �'Zvkn�a_
j(e�)�L 0'4
2
2
3
3
4
— - ----------
—4
5
5
6
6
7
7
8
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
PERSON
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
CONTACTED:
CONTACTED:
INSPECTOR:
DATE,
CONTACTED:
I
INSPECTOR:
INSPECTOR:
2
DATE,
..... . ... ....... ............. . .. . . ... ........
DATE,
PRE-CITA11ON CITATION ISSUED
3
VIOLATIONS
...........
VIOLATIONS
1 5
1
5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
6
7
7
RECEIVED
DISPOSITION:
7
4
[4
��T —
LETTER NNEEDEID
O',YES 0 NO
DATE:
8
k. LETTER NEEDED C) YES Cj- NO
FIRE DEPARTMENT COPY