21225 76TH AVE W (2)SNO,
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Serving Brier, Eamonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
"ALOAAAAMiA www-FireDistrictl-org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
)�EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION: 21225 76 th Avenue W 98026
Annual
16-A
BUSINESS NAME: Pheasant Run Condos (21227,21229)"
PHONE: 4252805253
SCHEDULED Oct 2016
DATE DUE 0
MAILING
UFIR � 425157
ADDRESS: 21225 76th Avenue W, Edmonds, WA 98026
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1: TLC Management
HOME PHONE: 4252805253
"CURRENT
-'s
KEY ACCESS-2:
HOME PHONE:
CITY
YES NO
BUSINESS
EMAIL:
LICENSE
r-
PERSON CONTACTED:
INITIAL INSPECTI
NAME OF INSPECTOR: I_F�-.
-ice, e-C C,5
FIRE SYSTEMS: FE 5/15
Date Last Serviced:S//6
HAZARDS FOUND D OC TIONS /COMMUNICATIONS
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2
2
3
3
4
5
5
6
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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.
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SNOHOMISH66 Serving Brier, Edmonds, and 12425 Meridian Ave S
FE Mountlake Terrace Everett, WA .98208
IR Phone (425) 551-1200
'DI www.FireDistrictl.org Fax (425) 551-1272
T*-
F T FTAT 10
REOUENCY N & SHIFT
L ATION: 21225 76 th'Avenue W 98026 Annual 16-D
SCHEDULED
BUSINESS NAME: Pheasant Run Condos (21227,21229)" PHONE: 4252805253 DATE DUE II' Oct 2015
MAILING LIFIR � 425 157
ADDRESS: 21225 76th Avenue W, Edmonds, WA 98026
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1 HOME PHONE: 4252805253
: TLC Management,, "'CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS M
LICENSE I El
INITIAL INSPECTION DATE
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FIRE SYSTEMS: FE 5/1
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[3 BRIER
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HAZARDS FOUND AND LOCATIONS
OOMMUNICATIONS.
2
5
2
3
3
4
4
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE
EXTENSION
-INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
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3
VIOLATIO
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CITATION ISSUE6__
PRE -CITATION
4
1- 5
LETTER ENT
NUMBER:
CODE '
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2
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DATE:
SECTION:
RETURN RECEIPT
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DISPOSITION:
4
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4
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7
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LETTERNEEDED YES NO
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04 Serving Briei: Edmonds, and
Mountlake Terrace
FT, www'.FireDistrictl.org.
2122.5 76 th Avetwe'W 03026
Pht,a6anI, Rurk Candas (21227..212�or
FIRE PREVENTION
12425, Meridian Ave S, INSPECTION REPORT
0 EDMONDS
Everett, WA 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
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Fax (425) 551-1272
PHONE: 42528M,26
0 FR611UENCY
STATION & SHIFT-'**'
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SCHEDULED Ocl, 2,014
DATE DUE 0
21226 Mh Awriuc'W, EdIrmIndti, WA OSIL125 FIR � 42b 1,�7
HOME PHONE:
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HOME PHONE: CITY
BUSINESS
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
WA R-A 1�7
FIRE SYS R-ms: FE-511.3
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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3
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4
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5
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6
7
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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
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
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INSPECTOR:
INSPECTOR:
2
DATE:
D E:
DATE:
3
VIOLATIONS
1 5
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1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
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RETURN RECEIPT
RECEIVED
6
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18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED ED] YES [01 N
rLETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Briei; Edmonds, and
1'7425'Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
0 EDMONDS
FIRE
Mountlake Terrace
Everett, WA 98208
0 BRIER
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
DISTRT
www.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION 1, SHIFTJ
LOCATION:
21225 7Cth Avenue W 98026
r
Annuall
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BUSINESS NAME: Pheasant Run Condos (21227,21229)" PHONE:
MAILING
ADDRESS: 21225 76th Avenue W, Edmonds, INA 98026
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: TLC Management HOME PHONE:
KEY ACCESS-2: HOME PHONE:
EMAIL:
PERSON CONTACTED:
NAME OF INSPECTOR: ovi I -
FIRE SYSTEMS: FE
4252805253 SCHEDULED Oct 20-1.3
DATE DUE I`
LIFIR ll� 425
4
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2 IZ 0 L
A`1
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
lst RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
D E DUE:
EXTENSION
GRANTEDTO:
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
13
7
3
7
RETURN RECEIPT
RECEIVED
6
6LE
'8
4
8
DATE:
DISPOSITION:
E=RNEEDED [] YES No
LETTER NEEDED E] YES F-1 NO
8
FIRE DEPARTMENT COPY
01 �11 ftEk,
FIRE PREVENTION
'01 Serving Brier, Edmonds
12425 Meridian Ave S
IN$PECTION REPORT
SNOHOMISH CO.
'ffE6MONDS
Mountlake Terraceand
FIRE
Everett, WA 98208
El INER
STI th Town of Woodway
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Phone (425) 551-1200
0 W�ODWAY
0 MOUNTLAKE TERRACE
www.FireDistrictl.org
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0 UNINCORPORATED
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STATION & SHIFT
LOCATION: 21225 76th Avenue
w
365
16 A
BUSINESS NAME: Pheasant Run Condos (21227,21229)"
PHONE: 4252805253
SCHEDULED 1(,1,101142
DATE DUE
MAILING PO Box 25
LIFIR � 425 1(157
ADDRESS: Edmonds
98020
BUSINESS OWNER: TLC Management
HOMEPHONE: 4252805253
ACTIVE
EMERGENCY-1: White, David Condo Pres.'
HOMEPHONE: 4256734212
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE
FE 1
"'S TEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
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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:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE-C'ITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
-3
7
3
7
RETURN RECEIPT
RECEIVED
6
.8
FLE;ER
8
DATE:
DISPOSITION:
L=ETTER =NEEIED [-] YES N]
0
NEEDED I-] YES NO
8
FIRE DEPARTMENT COPY
SNOHOMISH CO.
Serving Brier Edmonds
FIREMountlake
-Terrace, and
DISTT
th—eTbwn of Woodway
www.FireDistrictl.org
L OCATION:
21225 76th Avenue
BUSINESS NAME:
Pheasant Run Condos (21227,21229)-
MAILING
PO Box 25
ADDRESS:
Edmonds
BUSINESS OWNER:
TLC Management
EMERGENCY-1:
White, David Condo Pre�-
KEY ACCESS-2:
PERSON CONTACTED
NAME OF INSPECTOR:
FIRE
SYSTEMS:
w
FIRE PREVENTION
12425 Meridian Ave S INSPECTION REPORT
0 EDMONDS
Everett, WA 98208 0 BRIER
Phone (425) 551-1200 E]WOODWAY
0 MOUNTLAKE TERRACE
Fax (425) 551-1272 0 UNINCORPORATED
PHONE: 4252805253
98020
HOME PHONE: 4252805253
HOME PHONE: 4256734212
HOME PHONE:
FREQUENCY
STATION& SHIFT'*)
365
16 D
SCHEDULED
1111
DATE DUE �
LIFIR � 425 1(157
ACTIVE
CURRENT
CITY YES NO
BUSINESS
El El
LICENSE
INITIAL INSPECTION DATE
I
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HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
4
4
5
5
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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
!3RANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:-
PERSON
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1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE,
DATE-
DATE:
3
VIOLATIONS
1 5
VI OLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTER NEEDED [] YES El NO
8
DEPARTMENT COPY
CITY OF EDMONDS
12151 AVENUE N. * EDMONDS, WASHINGTON 98020 * 14251771-0215
FIRE DEPARTMENT
LOCATION: 21225 76th Avenue yy
Pheasant Run Condos (21227,21229)"
BUSINESS NAME:
MAILING PO Box 25
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4252805253
ADDRESS: Edmonds 98020
J BUSINESS OWNER: TLC Management HOMEPHONE: 4252805253
EMERGENCY-1: White, David Condo Pres. HOME PHONE: 4256734212
KEY ACCESS-2: HOME PHONE:
FR�W,�NCY
I
STAT?d & ttiIFT
I
SCHEDULED
10/01/10
DATE DUE Ill
LIFIR 1, 425
11157
ACTIVE
PERSON CONTACTED: -Jej c_;—N-%_N I INITIAL INSPECTION DATE
NAME OF INSPECTOR: S c -
FIRE FE
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Ist RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONlACTED:
PERSON
CONTACTED:
PERSON
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INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
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
7
4
4
18
DATE:
DISPOSITION:
8
�' LETTER NEEDED E] YES NO
LETTER NEEDED El YES F] NO
FIRE DEPARTMENT COPY