21000 70TH AVE Wo c) -7
08
FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian -Ave S _NSPECTION REPORT
MEDMONDS
Mountlake Terrace Everett, WA 98208 UIBRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRA . CE
[3 UNINCORPORATED
www.FireDistrict].org Fax (425) 551-1272
FREQUENCY
STATION & SHIF�'�
LOCATION:
21000 70 th Avenue W 98026
2946*
BUSINESS NAME:
PHONE:
SCHEDULED
James Auto Service
4257128589
DATE DUE
MAILING
LIFIR 0
ADDRESS:
573207
21000 70th Avenue W, Edmonds, WA 98026
BUSINESS OWNER
HOME PHONE:
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I AGREE TO cbRRECT 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:-
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DISPOSITION:
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%,,LETTER NEEDED YES NO
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FIRE PREVENTION
ir&0=4 Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
0�101i
SNOHOMISH CO.
Mountlake Terraceand
FIRE
Everett, WA 98208
P EDMONDS
0 BRIER
*�Qlff , the Town of Woodway
DISTR T
Phone (425) 551-1200
E]WOODWAY
[I MOUNTLAKE TERRACE
www.FireDistrict].org
Fax (425) 551-1272
C1 UNINCORPORATED
r-FREQUENCY STATION & SHIFF"�
LOCATION: 21000 70th Avenue
W
366 16 A
BUSINESS NAME:
James Auto Service
PHONE
4257128589
SCHEDULED
DATE DUE 1' 07/01113
MAILING
21000 70Th Ave W
LIFIR
573 7207
ADDRESS:
Edmonds
98026
BUSINESS OWNER: Oh, James Y_
HOME PHONE: 2062007575
ACTIVE
EMERGENCY-1:
Ostin, Kim
HOMEPHONE: 2064229202
'CURRENT
YES NO
KEY ACCESS-2:
HOME PHONE:
CITY . . "
BUSINESS
LICENSE F-1
PERSON CONTACTED: e7k
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
7XA-.,
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FIRE
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SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS/ COMMUNICATIONS
45 &-v A,,6e
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS )c
'Ist RE-INSPE MON
DATE 0
2nd RE -INSPECTION
DATE DUE:
1
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
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CONTACTED: A__Wzn
PERSON
CONTACTED:
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CONTACTED:
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INSPECTOR:
INSPECTOR:
INSPECTOR:
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DATE:
D TE:
DATE:
3
VIOLA IONS
15
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
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DATE:
CODE
SECTION:
5
3
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RETURN RECEIPT
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6
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DATE:
DISPOSITION:
7
LETTERNEEDED [-] YES NO
LETTERNEEDED F] YES NO
1
8
FIRE DEPARTMENT COPY
APPLICATION FOR PERMIT
FOR MATERIALS OR PROCESSES
March 12, 2012
Please verify and correct the following information:
Name of Company (DBA):
James Auto Service
Edmonds Location :
21000 70th Avenue W
In conformity with the
terms of the International
Fire Code, application is
Storage and handling of Class 1, 11, and III flammable
hereby made to store, use
and/or combustible liquids and repair garage.
or maintain the following
activity, storage or pro-
cesses:
Mailing Address:
21000 70th Ave. W.
Edmonds, WA 98026
EFD UFIR #:
5730000713207
(for office use)
Your Signature
Your Name (print)
Your Title
Please make corrections, attach $40 payable to the City of Edmonds and mail to:
Fire Marshal
Department of Fire Prevention
121-5 th Avenue North
Edmonds, WA 98020
FOR OFFICE USE ONLY
Rec'd 30 It 2-
_1 31 - � _ - -
Check#-
6
id
APPLICATION FOR PERMIT
FOR MATERIALS OR PROCESSES
March 7, 2011
Please verify and correct the following information:
9fjIt U 1-�� 11 tj/ -
E-
MAR 2 PAID
EDMONDS FIRE DEPT.
Name of Company; DBA
James Auto Service
Edmonds Location
21000 70th Avenue
�In-eonformity-witf-Ahe term s-ef-
-Storage and-h�arildling-of-Class-1,-117-and-ttl4tammabl--and/or— — -
the International Fire Code,
combustible liquids and repair garage.
application is hereby made to
store, use or maintain the
following activity, storage or
processes:
Mailing Address:
21000 70th Ave. W.
Edmonds WA 98026
EFID UFIR
5730000713207
(for office use)
Your Signature
Your Name (print)
-C,
Your Title
\,3 V\ e�)<-
Please make corrections, attach $40 payable to the City of Edmonds, and mail to:
Fire Marshal
Department of Fire Prevention
121-5 th Avenue North
Edmonds, WA 98020
CITY OF EDMONDS
DEPARTMENT OF FIRE PREVENTION
PERMIT
January 1, 2011 573-000-0713-207 December 31, 2011
Date of Issue UFIR Number Date of Expiration
This PERMIT is issued to: I James Auto Service
located at: 121000 70th Avenue W Edmonds, WA
To engage in the business, occupation or pr cess of:
And shall constitute permission to maintain, store, use or handle materials or to conduct
procdss which produce conditions hazardous to life or property or to install equipment used in
connection with such activities as follows:
Storage and handling of Class 1, 11, and III flammable and/or combustible liquids and
repair garage.
I Allowed Occupant Load: 1 --7]
Pursuant to the provisions of the International Fire Code, any violation of the Code may be
grounds for the revocation of this PERMIT.
This permit does not take the place of any
license required by law and is not
transferable. Any change in the use or
occupancy of premises shall require a new
permit.
This Permit Must Be Posted At All Times in The Premises'ldentified Above
City of Edmonds Community Development Code 19.25.020
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
LOCATION: 21000 70th Avenue w
BUSINESS NAME: James Auto SeMce
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257128589
MAIL-INU z I UUU I u I rl /Ave VV
ADDRESS: Edmonds 98026
BUSINESSOWNER: Oh, James Y. HOMEPHONE: 2062007575
EMERGENCY-1: Ostin, Kim HOMEPHONE: 2064229202
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION IL SHIF-""
366
16 13
�
SCHEDULED
DATE DUE 0- 07/01/10
LIFIR ll� 573
7207
ACTIVE
PERSON CONTACTED: INITIA INSPECTION DATE
NAME OF INSPECTOR:
FIRE FE I
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE ll�
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
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lst RE-INSPE )N
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
E:
DP
3
VIOLATIONS
1 5
VIOL IONS
1 5
PRE -CITATION
LETTER SENT
CRATION 1' SUEDZ�
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
7
4.
18
4
8
DATE:
DISPOSITION:
\� LETTER NEEDED [] YES NO
UETTER NEEDED [] YES No
-------------
FIRE DEPARTMENT COPY
September 18, 1995
TW Tom Goodland
17905 Interurban
Snohomish, WA 98290-8319
Subject: RETRACTED REQUIREMENT: 21000 70th Ave W
Dear Mr. Goodland:
The fire department retracts the requirement for an adequate fire door assembly to
separate the office and repair areas of James Auto Service.
Consideration is made for attached "administrative and clerical offices and similar rooms
which do not exceed 25 percent of the floor area of the major use..." (LJBC 302.1
exception 2.2). There is no welding on -site as you had mentioned on the phone. The
occupancy most resembles an S-3 type repair garage, however final classification is
established by the Building Official.
I stand corrected and apologize for any inconveniences this may have caused.
Sincerely,
John Westfall
Senior Inspector
cc: Building Official
'x .
September 6, 1995
Mr. Tom Goodland
17905 Interurban
Snohomish, WA 98290-8319
Subject: James Auto Service* 21000 70th Ave W
Dear Mr. Goodland:
The fire department requires an adequate fire door assembly to separate the office and
repair areas of James Auto Service.
According.to Table 3-B of the Uniform Building Code (UBC), a I hour separation is
required between business office spaces ("B" occupancies) and repair garage areas using
open flame or welding C114" occupancies). UBC 302.3 defines a one -hour fire -resistive
separation and requires all openings between areas to be protected by a one -hour rated fire
assembly. A fire assembly of a fire door includes all required hardware, anchorage,
frames and sills. Upon installation, the fire department asks that all connected and
surrounding voids be packed with a fire -rated insulation material to maintain continuous
protection with the surrounding wall.
Please contact my office at #771-0215 x301 to identify the anticipated installation date.
Above stated references are available upon request.
q1j I /j� . 6 v. Sincerely,
— /1/&)— 4 P/-)T� -Vyqt L- Ok '0 oc"e .
/Vb John Westfall,
SeniorInspector
L.O. 6oe&1'_ LvL16�4'
2, 5/
cc: Building Official Fi-"-)
4 1 C' NZ
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4th Floor Administraflys 0611ding
PS, ERV '01y: tUAMAlij-
Everett, Washingtop -98201
(206) 259�9657
Date,
19
�Icupancy
1, fdress
City -i-
-Fli..;- -,PREVENTION7-
r
4th Floor Administrddffi4eveddil n
Everett, Washingto 11M -
1206)-25W95
Date 192e
Occupancy
Address 7 0 0 9 -2 f L, 7 t" t7 'N JA C,
Wrier or Manager
Owner or Manager 0? -if') 40 10 P
�!F.son notified of violations
Person notified of violations
Under authority of Chapter 1.209 UFC Under authority of Chapter 1.209 UFC
an inspection of the premises was made by the undersigned
an inspection of the premises was made by the undersigned
violations of fire standards were noted as follows: �.and violations of fire standards were noted as follows:
n jo -0,1 A A, jg::,
R%-� A
. - -* — /- / - &--V / X' I S 42, 1 4 - C
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lie --megee-l-W A"A-�> A Ag -r
),U ARE HEREBY REQUIRED TO CORRECT THE ABOVE VIOLATIONS WITKIN'
AT WHICH TIME A REINSPECTION WILL BE MADE.
SEC. 1.212 U..F.C.
—8111241- IFENTMER . j �
Fire Marshall Inspector- I -ell-I
.11,144 4,0) 4 4!�
Ae C-6 A-V>'r 11cf- k'&VY "ClWi-
UEC 27-Zc)i 13
YOU ARE HEREBY REQUIRED TO CORRECT THE ABOVE VIOLATIONS WITH14
AT WHICH TIME A REINSPECTION WILL BE MADE.
SEC. 1.212 U..F.C.
BILL FENTER
Fire Marshal Inspoor WIWW3;�
September 9, 1976
Shannon Towing
tO 70th W.
I&Y,,onds, WA 98020
I 'Re;, --Auto Rebuild Shop, Class'E-4, Type V-N, Fire Zone III
o��";�p t I oil en
j T�
f�e submitted plans have been reviewed by this office and, with the following
Cof-rections*, will comply with the Uniform Fire Codes, 1973 Edition. Omissions
or oversights are not to be construed as approval. Any omission.or oversight
SL"bSequently noted will require correction.
Parapet walls shall be a minimum of 30" above the roof.
I
Additional exit door required. Suggest locating between overhead
doors on north side.
.3. Mininium of one Class 2A-10BC fire extingUisher required suggest
locating by exit door (item 2). Mount so handle is not more than
5' above floor. (Recomiend installing two units 2A-10BC rated).
Co No convenience outlets are shown in the shop area. These should
be provided in such locations to exclude the use of extension cords.
All wiring shall be in conduit and no outlet installed lower than
18" from the floor grade.
5. No device which generates a spark or glow capable of igniting
gasoline vapors shall be installed or used within 18" of the floor.
raminded that, by adopted codes of Snohomish County, no building or structure
4',.ATI be used or occupied until the building official has issued a certificate
frf occupancy which includes an inspection by this office. If we can be of further
osistance, please call 743-1116.
-J. Ltttlejohn
Fire Marshal
SNOHOMISH CC
FIRE
DIST
fjjjjjjjj
0 10 -7 0 4-h 0 oe-1.
LJ
FIRE PREVENTION
.Serving Brier, Edm` nds �:and
12425 Meridian Ave S
I�SPECTION REPORT
Mountlake Terrace
Everett, WA 98208
X�EDMONDS
0 BRIER
Phone (425) 551-1200
[3 MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
[3 UNINCORPORATED
FREQUENCY STATION & SHIFF*�
QO
70 th Avenue W 98026
2()16*
BUIS ECjE"-
PHONE:
SCHEDULED
�
The Whole Pup
----4257763083
DATE DUE
, hil 90116
MAILING
UFIR
ADDRESS:
"1 556207
t ve e W,
21010.70t venue-W, monds, WA 98026
BUSINESS OWNER:
HOME PHONE:
Howell, I i
V
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L42,T- a I -)SOO
EMERGENCY-1.:
HOME PHONE:
C URREN T
KEY ACCESS-2:
Fa'ith's CG LL
HOME PHONE:
IT y YES �NO
EMAIL:
U
BC SINESS b1b
LICENSE
PERSON CONTACTED: I :Sig
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE SYSTEMS:. FE
L1at%kWd6f1D'AQ0Q0CATIONS COMMUNICATIONS
2 \1 r
2
3
4.
3
4
6
6
7
7
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
Vj,. \IV
1 st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
PATE DUE:
EXTENSION
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
I VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
E:
DATE:
3
VIOLATIONS
2 6
VIOLATIONS;-
2
6
7
PRE -CITATION
DATE:
RETURN RECEIPT
RECEIVED
CODE
SECT] N:
CITATION ISSUED
5
6
3
7
3
4
'8
4
8
DATE:
1
DISPOFITION:
7
8
\,,LETTER NE EDED [] YES 0 NO
�j
LETTER NEEDED [] YES 0 NO
Serving Brier, Edmonds
Mountlake Terraceand
the Town of Woodway
www.FireDistrictl.org
LOCATION:
21010 70th Ave W
BUSINESS NAME:
The Whole Pup
MAILING
ADDRESS:
21010 70th Ave W
Edmonds
BUSINESS OWNER:
Fadh's CCR LLC
EMERGENCY-1-.
Howell, Cindi
KEY ACCESS-2:
Conway, Terry
PERSON CONTA CTED:
57zw,NAME OF INSPECTOR:
FIRE
(;Y,;Tpmq.
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 4257763083
98026
HOMEPHONE: 4257763983
HOME PHONE: 4253456552
HOME PHONE: 42577438.81
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
O"WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCYj-1 STATION & SHiFr-'N
365 16 A
SCHEDULED
DATE DUE 1' 07f01/13
UFIR � 556 7207
k,
CILIRRENT-'�
CITY �ES NO
BUSINESS/4.
LICENS.E
INITIAL INSPECTIONDATE
7 h �',// 3
FE I
AWN-JiF
HAZARDS FOUND AND 0 ATIONS1, COMMUNICATIONS
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I* AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS, X UNA IV
1 st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RL-INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED: ILI
PERSON
ZONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
IVA
DATE: 5- j V
DATE:
DATE:
3
OLATIONS
1 15
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
-NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
18
1-4.
DATE:
DISPOSITION:
1� LETTER NEEDED C] YES [I N10
I LET�E_RINEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY
SN'
I �'
HOMISH CO. Serving Briet; � Edinonds
IREMountlake Terraceand
)I I the Town of Woodway
S T R-1, Tltil 7 www.FireDistrictl.org
LOCATION:
21010 70th Ave W
BUSINESS NAME:
The Whole Pup
MAILING
21010 70th Ave W
ADDRESS:
Edmonds
BUSINESS OWNER:
Fafth! s CCR LLC
EMERGENCY-1:
Howell, Cindi
KEY ACCESS-2:
Conway, Terry
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
1- 6 �A _� Fir-,
D DWL) _,0 b
FIRE PREVENTION
12425 -Meridian Ave -S - - -
INSPECTION REPORT
Everett, WA 98208
0 EDMONDS
0 BRIER
Phone (425) 551-1200
0WOODWAY
[I MOUNTLAKE TERRACE
Fax (425) 551-1272
0 UNINCORPORATED
PHONE: 4257763033
FREQUENCY
STATION & SHIF"'
365
16 D
I
SCHEDULED n-if 1/12
fla
DATE DUE 1'
UFIR � 556
7207
98026
HOME PHONE- 42674��
4253458�20F5�?>
HOME PHONE: 42577438 URRENT
HOME PHONE: 81 ITY YES NO
USI
FBNESS
LICENSE F]
uo 0 INITIAL INSPECTION DATE
FIE 7 117-
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
A) 0 V) OL ATi
o A-'
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
D E DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
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
13
7
RETURN RECEIPT
RECEIVED _
6
4
18
4
8
DATE:
DISPOSITION:
7
LE17ER NEEDED F] YES El NO�
LETTER NEEDED YES NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
1, 'SNOHOMISH
Serving Brier, Edmonds
12425. Meridian Ave. S,
INSPECTION REPORT
CO.
TIRE
Mountlake Terraceand
Everett, WA 98208
0 EDMONDS
0 BRIER
STR
e Town of Woodway
T
Phone (425) 551-1200
0 WOODWAY
[I MOUNTLAKE TERRACE
wt`ww.FireDistrict1.org
Fax (425) 551-1272
0 UNINCORPORATED
"_ FREQUENCY
STATION & SHIFF*)
LOCATION:
21010 70th Ave W
365
16 C
I
BUSINESS NAME:
The Whole Pup
PHONE: 4257763083
SCHEDULED
DATEDUE 11' 07/01/11
MAILING
21010 70th Ave W
UFIR � 556 7207
ADDRESS:
Edmonds
98026
BUSINESS OWNER:
FaitlYs CCR LLC
HOMEPHONE: 4257763983
EMERGENCY-1:
Howell, Cindi
HOME PHONE: 4253456552
CURRENT
KEY ACCESS-2:
Conway, Te"
HOMEPHONE: 4257743881
CITY YES NO
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE
FE3 Ij
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / C(lMMUNICATIONS
c f;c?
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
11st 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 E] YES [I NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
LOCATION: 21010 70th Ave W
BUSINESS NAME:
The Whole Pup
MAILING
21010 70th Ave W
ADDRESS:
Edmonds
BUSINESS OWNER:
Fafths CCR LLC
EMERGENCY-1:
flowell, Cindi
KEY ACCESS-2:
Conway, Teffy
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257763033
98026
HOMEPHONE: 4257763983
I
HOME PHONE: 4253456552
HOME�HONE: 4257743881
_F_
FREQUENCY
STATION & SHIFT
365
16 6
SCHEDULED
DATE DUE 0' 07/01/10
UFIR 0- 556
7207
e- INITIAL INSPECTION DATE
PERSON CONTACTED: -.14.y 1,1b1w'd11_4_
NAME OF INSPECTOR: �_IA/.e-1
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE lo
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
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
1 5
VIOLATIONS
1- 5
PRE-CITAT10N
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:
8
LETTER NEEDED E] YES C] NO
I LETT�R NEEDED YES. NO
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FIRE DEPARTMENT COPY