210 5TH AVE S STE 207Z407
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FIRE PREVENTION
Serving Brie, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
SN6AO'MISH 4� ..r I DEDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER
FIR.rj- [I MOUNTLAKE TERRACE
Phone (425) 551-1200
13 UNINCORPORATED
D I S T R. www.FireDistrict].org i Fax (425) 551-1272
LOCATION:
210 5 th Avenue S Suite 2,07 98020
.BUSINESS NAME:
Higher Knead Muscle Therapy
PHONE:
4255013307
MAILING
ADDRESS:
210 5th Avenue S, Suite 207, Edmonds, WA 98020'
BUSINESS OWNER: HOME PHONE:
FREQUENCY STATI_0N&_S_H_j_FT_'*'N
20 17-C
SCHEDULED
DATE DUE I' Ap`r�201 6
UFIR 0 593202
EMERGENCY-1:
low HOME PHONE: CURRENT
KEY ACCESS-2: Ledford, Donna HOME PHONE: 4253340852 ClTy YES NO
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NAME OF INSPECTOR: A ) IA)!�A
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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
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
.2
DATE:
DATE:
DATE:
3
VIOLATIONS
5
VIOLATIONS,4-,:`
1
2
3
5
6"
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
5
6
7
DATE:
CODE
�TION:
RETURN RECEIPT
RECEIVED
6
7
4
8
INO
DATE:
Diis7P&6iT7ON
LETTER NEEPED 0 YES [I N&'
LETTER NEEDED [] YES [01
8
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
LOCATION: 210 5th Ave S
BUSINESS NAME: Higher Knead Muscle Therapy
MAILING 210 5th Ave N #207
FIRE PREVENTION
SAFETY SURVEY
207
PHONE: 4255013307
Edmonds 98020
BUSINESS OWNER: Ledford, Donna HOMEPHONE: 4253340852
EMERGENCY-1: Howell, Ledford HOMEPHONE: 4257740121
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION& SHIFT
731
17 B
SCHEDULED
DATE DUE 11
04/01/4-1
UFIR 11, 593
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4202
1, ' INITIAL INSPECTION DATE
PERSON CONTACTED: C,
NAME OF INSPECTOR: C t/kU I (JA,- 0
FIRE FE:��_/ 01
SYSTEMS: ANNUAL
HAzARDS FOUN, AND L�tITIONS / COMMUNICATIONS
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VIOLATION CODE
2
2
3
3
4
4
5
5
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6
7
8
6
7
Ist RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
E DUE:
PERSON
CONTACTED:
INSPECTOR:
DATE:
VIOLATIONS
1 5
2 6
7
4 8
LETTER NEEDED [—I YES F1 NO
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
PERSON
CONTACTED:
JNSPE�IRR:
VIOLATIONS
CITED:
PERSON
CONTACTED:
I
INSPECTOR:
2
DATE:
DATE:
PRE -CITATION CITATION ISSUED
LETTER SENT NUMBER:
CODE
DATE: SECTION:
RETURN RECEIPT
RECEIVED
3
VIOLATIONS
1 5
2
6
5
3
7
6
7
4
18
DISPOSITION:
DATE:
8
LETTERNEEDED E] YES F ] NO
FIRE DEPARTMENT COPY