21031 76TH AVE W (2),)1031
i - A
SNOHOMISH CO. /
FIRE
DISTI
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:
21031 76 th Avenue W 98026
BUSINESS NAME:
Chameleon Studios LLC
MAILING
ADDRESS:
21031 76th Avenue W, Edmonds, WA 98026
BUSINESS OWNER:
PHONE:
HOME PHONE:
4257723692
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
OMOUNTLAKE TERRACE
0 UNINCORPORATED
00 FREQUENCY STATION& SHIFT
2816 4A
SCHEDULED
DATE DUE
LIFIR
549207
EMERGENCY-1: HOME PHONE: CURRENT
KEY ACCESS-2: Jacobs, Brian HOME PHONE: 4257723692 CITY YES NO
EMAIL: BUSINESS F-1 [:]
LICENSE L-J
PERSON CONTACTED: INITIAL IN?PECTION DATE
NAME OF INSPECTOR: I (_-0 I 1 (0
FIRE SYSTEMS: FE
L)aMMW*i6D/AQBQ10CATIONS / COMMUNICATIONS
2 lqy
2
3
4__ ------
5
3
4
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.
ds
SNOHOMISH CO. Serving Brier, Edmon' 134herr afAveY
Mountlake Terraceand Everett, WA 98208
FIRE the Town of Woodway Phone (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
DISTR -
LOCATION: 21031 76th Ave W
BUSINESS NAME: Chameieon Studios LLC PHONE: 4251723692
MAILING
ADDRESS:
BUSINESS OWNER: Jacobs, Brian
EMERGENCY-1: Jacobs,Azan
KEY ACCESS-2:
PERSON CONTACTED:
NAME OF INSPECTOR:
SYSTEMS:
HOMEPHONE: 4257723692
4257725968
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
(41,14 HIFT_�
FRE%ENCY
(I
SCHEDULED 05,101f`13
DATE DUE I`
UFIR � 549 5207
CURRENT
CITY YES NO
BUSINESS
LICENSE 1:1 E]
INITIAL INSPECTION DATE
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
V U
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:
E)(TENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
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
4
'8
4 '8
DATE:
DISPOSITION:
7
LETTER NEEDED E] YES El NO
LETTER NEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY
Aet:N* -
FIRE PREVENTION
I
Serving Briet; Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
�FIRE
Mountlake Terraceand
Everett, WA 98208
EIEDMONDS
0 BRIER
DISTR=ftoff
T
e To w n of Wo 6'dw' ay
twww. FireD 1.
Phone (425) 551-1200
E]WOODWAY
[1 MOUNTLAKE TERRACE
is tr ic t o rg
Fax (425) 551-1272
0 UNINCORPORATED
0' FREQUENCY
STATION& SHIF*)
LOCATION
: 21031
76th Ave W
730
I
16 C
BUSINESS NAME:
Chameleon
Studios LLC
PHONE: 4257723692
SCHEDULED I
DATEDUE 1' 05/01111 '
I
MAILING
FIR "' 549 5 207
IU
ADDRESS:
BUSINESS OWNER: Jacobs, Brian
HOMEPHONE: 4257723692
EMERGENCY-1: Jacobs,Azan
HOME PHONE: 4257725963
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
El D
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
4
FIRE
FE -I-
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
6LA5'(&_� e-,10 I C-d LIP A r ra tc
UvkoLbl— -h) 04(jn_s S
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
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:
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
'8
4
'8
DATE:
DISPOSITION:
LETTERNEEDED F] YES [I NO
LETTERNEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY
�J'
A 1 wo
JW OF EDMONDS
1215THAVENUEN. - EDMONDS, WASHINGTON 98020 - (425)771-0215
FIRE DEPARTMENT
LOCATION: 21031 76th Ave W
BUSINESS NAME: Muse in the Garden/0013
MAILING 21031 76th Ave W
ADDRESS: Edmonds
BUSINESS OWNER: Sherburne, Craig
EMERGENCY-1: onner, Dawn
KEY ACCESS-2:
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257782292
98026
HOMEPHONE: 2068507380
4254449912
HOME PHONE:
HOME PHONE:
FREQUENCY � STATION 1, SHIFT
730 16 6
SCHEDULED
DATE DUE 0' 05/01/10
LIFIR I� 547 - 5207
e INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
r(mr- .1 F I_- �
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE I�
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
lst RE -INSPECTION
DATE DUE:
j
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
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
8
DATE:
DISPOSITION:
8
t,' LETTER NEEDED 0 YES 0 NO
LETTER NEEDED C] YES NO
FIRE DEPARTMENT COPY