21105 80TH AVE W_180-,h (.j
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FIRE PREVENTION
Serving Brier, Edinonds, and 12,k5 Meridian Ave S INSPECTION REPORT
SNOHOM'ISH CO. t
P EDMONDS
Mountlake Terrace Everett, WA 98208 Xj BRIER
VIRE 0 MOUNTLAKE TERRACE
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Phone (425) 551-1200 [1 UNINCORPORATED
DISnuuT www.FireDistrictl.org Fax (425) 551-1272
[STATIO
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LOCATION
21105 80 th Avenue W 98026 Annual 16-13
BUSINESS NAME: PHONE: SCHEDULED
Willowdale 11 Condos 4256723626 DATE DUE � Mar2016
MAILING LIFIR 1' 422 206
ADDRESS: 21105 80th Avenue W, Edmonds, WA 98026
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BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Cofton, Connie HOME PHONE: 4257120879� CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED: A)
NAME OF INSPECTOR:
FIRE S'�STEIVIS: FE 8/13
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4
4
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5
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I AGREE TO coRRECT THE A'BOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
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CONTACTED:
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2
3
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VIOLATIONS
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CITATION ISSUED
5
1
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:____
RETURN RECEIPT
7
3
7
RECEIVED
6
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DISPOSITION:
18
7
LETTER NEEDED 0 YES NO
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LETTER NEEDED Q YES NO
8
FIRE PREVENTION
Serving Briet; Ed . thonds, wild
.17425 Me;
- -idian Ave S
ANSPECTION REPORT
SNOHOMISH CO. 1
El EDMONDS
I Mountlake Terrace
FIRE
Everett, WA 98208
El 13RIER
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Phone (425) 551-1200
Fax 551-1272
0 MOUNTLAKE TERRACE
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www.FireDistrictl.org
(425)
FREQUENCY
STATION & SHIFT
LOCATION: 21 lWr Nth Avanue'sIV OM6
Antival
16-D
BUSINESS NAME: WilbAdalc 11 Candmi
PHONE: 426fj72362f
SCHEDULEDMar 2014
DATE DUE
MAILING
UFIR4L'21 206
ADDRESS: 2110or 1.1310Lh Awriuc W, Edmandii, WA 0802f-i
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1: Cul.Lori, Cannic
HOME PHONE: 42,157120370
"—CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS F__j
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NAME OF INSPECTOR: D vi 1 0102-
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HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
3
3
4
4
5
5
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7
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
DATE DUE.
I
2nd RE -INSPECTION
DATE DUE.
I '
EXTENSION
GRANTEDTO-
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DATE:
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3
VIOLATIONS
1 5
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1 5
PRE -CITATION
LETTER SENT
NUMBER: CITATION ISSUED
4
2
6
2
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DATE:
CODE
SECTION:
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RETURN RECEIPT
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DATE:
DISPOSITION:
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I
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH
FIRE
CO.
4 Mountlake Terrace, and
Everett, WA 98208
0 EDMONDS
0 BRIER
e Town of Woodway
Phone (425) 551-1200
E]WOODWAY
STRf**40:1T
[I MOUNTLAKE TERRACE
wthwwFireDistrictLorg
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION & SHIFF'*)
LOCATION:
21105 80th Avenue
W
16 C
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BUSINESS NAME:
Willowdale 11 Condos
PHONE: 4256723626
SCHEDULED
DATE DUE 03101113
MAILING
21105 8OTh Ave W #104
UFIR � 422 3206
ADDRESS:
Edmonds
98026
BUSINESS OWNER:
Coffon, Connie
HOMEPHONE: 4257120879
AC71VE
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
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2
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3
3
4
4
5
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6
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
1
3
7
RECEIVED
6
DISPOSITION:
7
4
18
4
18
DATE:
LETTER NEEDED [] YES NO
LE17ER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
INSPECTION REPORT
SNOHOMISH CO. Serving Brier Edinonds 12425 Meridian Ave S
the Town of Woodway Phone (425) 551-1200 E]WOODWAY
[I MOUNTLAKE TERRACE
www.FireDistrictl.org. Fax (425) 551-1272 0 UNINCORPORATED
OEDMONDS
Mountlake, Terrace, and Everett, WA 98208 0 BRIER
DISTRI
17" 1 e' FREQUENCY I STATION 1, SHIF,**)
LOCATION: 21,105 8Qth Avenue W 365 16 6
BUSINESS NAME: Willowdale 11 Condos PHONE: 425672A�6' �S&EDUCEDI.
DATEDUE II' b3/01/12
MAILING 21105 80Th Ave W #104 Jii� ; 422 3 206._
ADDRESS: Edmonds 98026
BUSINESS OWNER: Coffon, Connie HOME PHONE: 4257120879 ACTIVE
EMERGENCY-1: "Clisby, Elaine Presu HOME PHONE: —CURRENT
-2: CITY YES NO
KEY ACCESS HOME PHONE:
BUSINESS
LICENSE,
INITIAL INSPECTi6N-D TE
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NAME OF INSPECTOR: 4,1� -3 7—
FIRE ..'FE, g I I
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
YV
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
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 -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:
11 LETTER NEEDED C] YES [I NO
LETTER NEEDED C] YES El NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 9W2O - (425) 771-0215
FIRE DEPARTMENT
9 C3
8
LOCATION:
21105 80th Avenue
BUSINESS NAME:
Willowdale 11 Condos
MAILING
21105 80Th Ave W #104
ADDRESS:
Edmonds
BUSINESS OWNER:
Coffon, Connie
EMERGENCY- 1:
"Clisby, Elaine Pres"
KEY ACCESS-2:
M,
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4256723626
98026
HOMEPHONE: 4257120879
HOME PHONE:
HOME PHONE:
FREQUENCY
STATION 11 SHIF�
365
16 A
SCHEDULED
03101,114.
DATE DUE I�
LIFIR 1, 422
3206
ACTIVE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE F E &LILW
SYSTEMS: ANNUAL
HAZARDS F U D AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE 11�
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
VIOLATIONS
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
IS .
4
18
DATE:
DISPOSITION:
7
8
�, LETTER NEEDED [] YES Ej NO
LETTER NEEDED 0 YES NO
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
46' t 8
LOCATION: 21105 80th Avenue w
B USINESS NAME: Willowdale Ii Condos
MAILING 21105 80Th Ave W'#1 04
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4256723626
ADDRESS: Edmonds 98026
BUSINESS OWNER: Cofton, Connie HOME PHONE: 42,57120879
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
eo FREQUENCY
STATION & SHIFT
365
16 D
SCHEDULED
0, 03/01/10
DATE DUE
!UFIR o, 422
3206
ACTIVE
PERSON CONTACTED: INITIA INSPECTION.DATE
NAME OF INSPECTOR:
Me vAl L) /0' /yl P% a 1" OP12 f
FIRE I F E
SYSTEMS: ANNUAL
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ENTER CODE ONLY ONCE I�
VIOLATION CODE
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4
4
5
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6
6
7
7
8
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lst RE -INSPECTION
D . ATE 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
5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
7
1
RETURN RECEIPT
RECEIVED
6
7
4
8
A
4
8
DATE:
DISPOSITION:
-1.8
LETTER NEEDED 0 YES C] NO
LETTER NEEDED [-] YES C] NO
FIRE DEPARTMENT COPY