21107 80TH AVE W_1j . i 111111111 1 U
8
FIRE PREVENTION
ie' INSPECTION REPORT
Serving hr' r, Edmo 'ds, and IN25 Meridian Ave S MEDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
www.FireDistrictl.org Fax (425) 551-1272 E 1 3 UNINCORPORATED
e' FREOUENCY
STATION & SHIFT
LOCATION:
21107 80 tli Avenue W 98026
Annual
16-B
BUSINESS NAME:
Willowdale Condos
PHONE:
4257715892
SCHEDULED
DATE DUE o Mar2016
MAILING
UFIR 0 422 206
ADDRESS:
21107 80th Avenue W, Edmonds, WA 98026
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
Mcclenahan, Diane
HOME PHONE:
4257715892 "CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
YES NO
EMAIL:
BUSINESS
E]
LICENSE
PERSON CONTACTED: A)A
INITIAL INSPECTION DATE
NAME'OF INS PECTOR:
FIRE SYSTEM,S:
n.qtp I qqt*.Rimrvir_tmH-
FE 8/09
HAZARDS FOUND AND LOCATIONS /COMMUNICATIONS
2 A-1 7 rn L
1)
2.
3 CQ 114
4
3
4
4
__5
6
6 .
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INS PECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
LO�N IA�T�D_*.____
PERSON
CONTACTED:
PERSON
C ONTACTED:
1
INSPECTOR,
2
INSPECTOR:
INSPECTOR:
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATION st�
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
6
3
L7_,_
3
7
RETURN RECEIPT
RECEIVED
DISPOSITION:
7
8
4
8
DATE:
�'LETTER NEEDED YES El NO
LETTER NEEDED [] YES [3 NO
8
FIRE PREVENTION
Serving Brier E&'nonds,;
�afid 12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terrace
FIRE
Everett, WA 98208
OEDMONDS
0 BRIER
DISTRT
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
El UNINCORPORATED
www.FireDistrictl.org
Fax (425) 551-1272
r FREQUENCY
STATION & SHIFT-)
LOCATION: 21107 Ofj th Avanua',A] 93026
I&D
BUSINESS NAME: Willa'Adalc Cal
PHONE: 496=,9 �,3,
SCHEDULED
DATE DUE l' NIIiar 2014
MAILING
UFIR�;22 20b
ADDRESS: 2110-7 813h Averiuc W. EcIrTmInd4i, WA
080,11f 0/19
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1: Niu-1criahan, Diaric
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES No
EMAIL:
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: 20 V)L—) A)
6 Z 0 L
Oil
�-IRE SYS IENAS: FE S I
HAZARDSF LIND AND LOCATIONS /COMMUNICATIONS
u,,�
2
L
2
3
4
4
5
V
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
a DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
INSPECTOR: 11
INSPECTOR:
INSPECTOR:
2
DATE: 4/�o_
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
6
3
7
3
7
RECEIVED
DISPOSITION:
ELE
ELETTER
8
DATE:
7
-8
ER NEEDED [—] YES El No
NEEDED _] YES El NO
8
FIRE DEPARTMENT COPY
A
-Sir
7
CITY OF EDMONDS
'121 5TH AVENUE N. - EDMONDS, WASH1146tON 98020 (425) 771-0215
FIRE DEPARTMENT
4t� t
JS9
LOCATION: 211117 80th Avenu6`� w
BUSINESS NAME: Willowdale Condos
MAILING 21107 80Th Ave W #103
FIRE.'PREVENTION
SAFETY SURVEY
PHONE: 4257715892
ADDRESS: Edmonds 98026
BUSINESS OWNER: "Mcclenahan, Diane' HOMEPHONE: 4257715892
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION 1, SHIFT
365
16 D
I
SCHEDULED
DATE DUE 11-
03/01110
LIFIR Po 422
3206
Ar-'-nVE
01 INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: --4
7
o cl 21 z
FIRE FEG
Al_gD
SYSTEMS: ANNUAL
FIRE DEPARTMENT COPY
08/25/98 15:42;56 PRINT REQUESTED BY TERMINAL EFPC04
Incident History for: #EF9800207S Xref: #EP98020983
Case Numbers: $EF98002400 $LF98003222
Entered 08/23/98 16:39:09 BY SCT003 SC737
Dispatched 08/23/98 16:39:24 BY SCT004 SC710
Enroute 08/23/98 16:41:45
Onscene 08/23/98 .16:43:16
Closed 08/23/98 18:02:34
Initial Type: APTFIR Initial Alarm Level: I Final Alarm Level: 1
Final Type: APTFIR (APARTMENT FIRE) Pri: 1 Dispo:
Police BLK: E036 Fire BLK: EF206 Map Page: 45SA-6 Group: EF1 Beat: MD01 Src: T
My
Loc jj Ll__O',71��# EDM btwn 211 PL SW & 212 ST SW (V)
Loc Info: UNIT 101
Name: NP VELASQUEZ PATRICIA Addr: 21107 80 AV W 4104 EDM Phone: 4256739472
!1639 -��.SC737 ENTRY NO FURTHER INFORMATION
/1639 (SC710 DISP E16 #EF0418 LUCAS,GREG
4EF1540-TURNER, AMY
#EF1530 YOAKUM, ANDRE -HAZMAT TECH
/1639 $ASNCAS E16 $EF98002400
/1639 ASST E17 4EF0232 SCHMITT,ROBERT
#EF1425 ANDERSON, TODD
#EF1602 MCALLISTER, BRIAN
/1639 ASST L15 #LF0114 ANDERSON,VH
#LF0623 JOHNSTON,MA - HAZMAT TECH
#LF0806 PONS, PHILIP
*WARNING OVERRIDE- W/CHECK FOR MANNING
/2.639 $ASNCAS L15 $LF98003222
/1639 ASST E20 #EF0447 HERYLA,MICHAEL
#EF1531 KINDIG, WAYNE
#EF1082 FLETT,THOMAS
/16.39 ASST A14 #LF0216 JESKE,RC - RESCUE TECH
#LF0807 MILLER, KEVIN
OLF0752 WRIGHT, JERRY -RESCUE TECH
/1639 ASST CH17 #EF1696 TAYLOR,KEVIN M
/1639 (SC737 SUPP LOC: 21107 80 AV W #101 EDM
/1639 (SC731 CHANGE 2ND CALLER STATES THAT THE SECOND FLOOR IS ON F
IRE
/1639 (SC737 SUPP LOC: 21107 80 AV W #101 EDM,
TXT: FLAMES COMING OUT OF THE BEDROOM WINDOW
/1640 CROSS #EP98020983
/1640 CHANGE NO NMAE APTS
/1641 CHANGE CALLER DID NOT BELIEVE ANYONE WAS INSDIE APT
/1641 (SC710 ENROUT A14
ENROUT E17
/1642 ENROUT E16
/1642 ENROUT L15
/1642 ENROUT CH17
/1642 ENROUT E20
/1643 ONSCNE E16 SMALL AMOUNT OF SMOKE FROM 2ND STORY WINDOW
/1644 CHANGE ATTACKIING W/PRECONNECT, PASSING COMMAND, NEXT -
IN ENGINE, MAKE E16-S SUPPLY
/1645 ONSCNE E20 [80 AV COMMAND]
LAYING SUPPLY
/1645 (SC706 SUPP TXT: TWO OFCRS ENROUTE
/1645 (SC710 ONSCNE A14 [N OF APT COMPLEX]
/1645 (SC706 SUPP TXT: ONE OFCR ON SCENE, ONE ENROUTE� ADVISE IF A
DDITIONAL NEEDED
CITY OF EOMONDB
CIVIC CENTER - EDMONDS, WASHINGTON 98020 * (206) 775-2525
FIRE DEPARTMENT
June 29, 1982
Attention -Harold Dudley
Willowdale :ffe Apartment
706 Driftwood Lane
Edmonds, WA 98020
Dear Mr. Dudley,
SUBJECT: REVISION IN THE FIRE AND LIFE SAFETY CODE
HARVE H. HARRISON
4-
Due to recent changes in the new Edmonds Community DevelODment
Code and the Life Safety Code, the Fire Marshal's Office will
be enforcing the following requirements.
The following will effect all apartments and condominums within
the.limits of the City of Edmonds.
1. Smoke detectors in each living unit. W.A.C. Chapter
212-10
The following will effect all apartments and condominums with
two or more doors that open on a common area/corridor.
I
2. Self -closures on all living unit/corridor doors.
Life Safety Code 19-3.6.2
3. Fire rating on living unit/corridor door:
a. Minimum 20 minute door (label on hinge side of
the door)
b. 1 3/411 solid bonded woodcore door. Life Safetv
Code 19-3.6,.3
We request that the above items be checked by you for compliance
and noted on the attached form. Your reply ver-ifving compliance
or current status is to be received by this office within thirty
(30) days.
If we may be of any assistance, Dleas6 contact this office at
775-2525, Ext. 231, between the hours of 8 a.m. and 5 p.m.,
Monday through Friday.
Sin cerely,
Stan A. Olsen
Senior Inspector
VERIFICATION OF CUMPLIANCE FORM
# 422-004-039
This form must be completed and returned to the Edmonds Fire
Department within thirty days.
1. Smoke detector installed .............. Yes , No
2. Self -closures installed ............... Yes— NoX
3. Fire rating on doors:
a. 20 minute label .................. Yes No X
b. 1 3/4" solid core ................ Yes— No X
In addition, it has been noted that stated item(s) need to
be corrected to be in compliance with current City Ordiances
or Fire Codes:
Service fire extinguishers - to be done annually.
Correction made ......................... Yes— No
Apartment Name Oaher's Signature
706 - DILU-�wood Lane 776-2710
Address Edmondz, Oa. 98020 Phone Number
We wish to thank you for your time and attention in completing
this form.
Have no haUwayz in guigding
7hiz condo i.6 '.' known az Wigeowdate III - 21107 - 80-th Ave. 4).
7h,e ajacen,'- condo iz. known az Niggowdate 11. 21105 - 80th Id.