20916 76TH AVE W7(PA iiuc-,
Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
LOCATION: 20916 76 th Avenue W 98026
BUSINESS NAME: Imperial 250 Apts
MAILING
ADDRESS:
20916 76th Avenue W, Edmonds, WA 98026
BUSINESS OWNER:
.EMERGENCY-1:
KEY ACCESS-2:
EMAIL:
01
PERSON CONTACTED:
NAME OF INSPECTOR: /Cal6nll wl',
FIRE SYSTEMS: FE 3/14
1� I I A
PHONE: 2063238090
HOME PHONE:
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
�114,$PECTION REPORT
lffEDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY I STATION& SHIFT
Annual 16-D
SCHEDULED
DATE DUE - ' Apr 2016
LIFIR 0 427206
CURRENT YES NO .
CITY
BUSINESS
LICENSE
INITIAL INSPECTION DATE
nnte
1 1 Samincerl- - I I V
HAZARDS FOUND AND LOCATi6Ns /COMMUNICATIONS
. .. .......
2
.. .
2
3
4
3
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 item(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.
SNOHOMISH CO.
FIRE
DISTO
Vd-h tiuc- w
S4ving Brier, Edmonds, and 'I'�J4-) Meridian Ave S
Mounfiake Terrace Everett, WA 98208
Phone (425) 551-1200
Tm',wwFireDistricti.org Fax (425) 551-1272
LOCATION: 2MI676th Xetuel/V MM
BUSINESSNAME: Imperial250Apbs,
MAILING
ADDRESS: 20DlFj 7ELh Aw-nuoW, I=dmnd� WA ME
BUSINESS OWNER:
EMERGENCY-1:
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED:
NAME OF INSPECTOR:
0 FwsVskw_.
f2i
0 1
0
PHONE: 21M-342380M
HOME PHONE:
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
e FREQUENCY I STATION & SHIFT
Anmol 16a
SCHEDUL
DATE DUE'Wpr 2014
UFA37 2M
c) ry 1=1
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CITY I" YES NO
BUSIPEess [j
LICE SE !a
INITIAL ASRf�QTION DATE
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
IV u -n�!5�
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
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 -CITATION
LETTER SENT
CITATION ISPUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION�
5
3
7
3
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RETURN RECEIPT
RECEIVED
4 18
4
8
DATE:
DISPOSITION:
LETTER NEEDED [-] YES NO
LETTER NEEDED E] YES 0 NO
FIRE DEPARTMENT COPY
Serving Briet; Edinonds
SNOHOMISH CO.
FIREMountlake
Terraceand
DISTR
e Town of Woodway
T
w"ww.FireDistrict.l.org
LOCATION:
20916 76th Avenue
BUSINESS NAME:
Imperial 250 Apts
MAILING
20916 76th Ave W #1
ADDRESS:
Edmonds
BUSINESS OWNER:
"Downing, John (Prop- kligmt Co)"
EMERGENCY-1:
"Albano, Ray #1 (Mgr)"
KEY ACCESS-2:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
W
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 2063238090
98026
HOMEPHONE: 2063238090
HOMEPHONE: 4257765708
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
Tr'_EDMONDS
10 BRIER
E]WOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIFT
366 16 A
SCHEDULED
DATE DUE 11' 04/01113
UFIR � 427 4206
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE El El
INITIAL INSPECTION DATE
FE f
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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
I st 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:
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
14
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED 0 YES Ej NO
L ETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
Serving Brier, Edmonds
SNOHOMISH CO.
F I E
61j) Mountlake Terraceand
W-7,
A%0
DISTRILUT
the Town of Woodway
www.FireDistrictl.org
LOCATION:
20916 76th Avenue
BUSINESS NAME:
Imperial 250 Apts
MAILING
20916 76th Ave W #1
ADDRESS:
Edmonds
BUSINESS OWNER:
"Downing, John (Prop. Mgmt Co)u
EMERGENCY-1:
'Albano, Ray #1 (Mgr)'
KEY ACCESS-2:
I �'
PERSON CONTACTED
NAME OF INSPECTOR
FIRE
SYSTEMS:
0
FIRE PREVENTION
12425 Meridian Ave S
INSPECTION REPORT
Everett, WA 98208
0 EDMONDS
0 BRIER
Phone (425) 551-1200
OWOODWAY
0 MOUNTLAKE TERRACE
Fax (425) 551-1272
0 UNINCORPORATED
W
PHONE: 2063238090
4*10i.i
I` FREQUENCY
STATION & SHIFT_�
366
16 D
I
SCHEDULED
DATE DUE 1'
04/111/12
UFIR � 427
4206
HOME PHONE: 2063238090 ACTIVE
HOME PHONE: 4257765708 CURRENT YES NO
HOME PHONE: CITY
BUSINESS
LICENSE
INITIAL INSPECTION DATE
.2_c) -7- �-o I 'L
FE_�_�Qq
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
AA1W A L
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:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON -7117
CONTACTEDO�9///
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INSPECTOR: I� 21��
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DATE: �� '*'7,� / ' Z
DATE:
DATE:
3
VIOLATIONS
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
8
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY
0
CITY OFEDMONDS
121 5T� AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
4S'
LOCATION: 20916 76th Avenue
BUSINESS NAME: Imperial 250 Apts
MAILING 20916 76th Ave W #1
FIRE PREVENTION
SAFETY SURVEY
PHONE: 2063238090
ADDRESS: Edmonds 98026
BUSIN I ESS OWNER: "Downing, John (Prop. Mgmt Co)n HOMEPHONE: 2063238090
EMERGENCY- 1: "Albano, Ray #1 (Mgr)" HOMEPHONE: 4257765708
K EY ACCESS-2: HOME PHONE:
01 FREQUENCY.
STATION & SHIFT
366
16 6
�
SCHEDULED
DATE DUE 01 04/01/10
LIFIR I� 427
4206
ACTIVE
e- INITIAL INSPECTION DATE
PERSON CONTACTED: I
NAME OF INSPECTOR: 14, lzbjl-cx.)^ q11j11 1)
FIRP I �E I
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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ENTER CODE ONLY ONCE I�
VIOLATION CODE
2
2
3
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4
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5
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8
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1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
E 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
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
7
4
18
4
18
DATE:
DISPOSITION:
8
LETTER NEEDED [] YES C3 No
LETTER NEEDED 0 YES NO
FIRE DEPARTMENT COPY
DATE 5-11.11-5--
SUBJECT
ADDRESS:
CITY OF EDMONDS
FIRE PREVENTION
FILE MEMO/HAZARD FORM
REPORTED BY /*
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