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21420 HWY 99_212-ILIZO Ak&4vlq� FIRE PREVENTION INSPECTION REPORT Serving Brier, P-dinonds, and 12425 Meridian Ave S SNOI�ONIISH Co. OEDMONDS Mmintlake Terrace Eve*rett,:WA 98208 0 BRIER FIRE Phone (425) 551-1200 0 MOUNTLAKE TERRACE 101111M T www.FireDistrict]. I org Fax (425) 551-1272 0 UNINCORPORATED D1,;7 jL R ZnEOUE 21420 Highway99 98026 nua7CY Slyele SHIFT LOCATION: McDonald's #214 4256708467 SCHEDULED Sep 7M BUSINESS NAME: PHONE: DATE DUE IbI MAILING 21420 Highway 99, Edmonds, WA 9 1 8026 UFIR 0 ADDRESS: BUSINESS OWNER: HOME PHONE: G & G Restaurants EMERGENCY-1: KEY.ACCESS-2: EMAIL: PERSON CONTACTED: C;1 'IV Co. -Y. NAME OF INSPECTOR: (;i�% V C, 4 Vj Date Last Serviced: o., 2063216842 HOME PHONE: HOME PHONE: CURRENT CITY YES NO BUSINESS LICENSE INITIAL INSPECTION DATE SNOHOMISH CO. FIRE DIST] Serving Brier, Edmonds, and Mountlake Terrace www.FireDistrictl.org 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 FIRERIIEVENTON INSPECTION REPORT 0 EDMONDS [I BRIER 0 MOUNTLAKE TERRACE []UNINCORPORATED - 0' FREQUENCY STATION & SHIFT LOCATION: 21420 Highway.99 98026 Annual 16-C BUSINESS NAME: McDonald's #214 PHONE: 4256708467 SCHEDULED DATE DUE Sep 2015 MAILING LIFIR 161 ADDRESS: 21420 Highway 99, Edmonds, WA 98026 BUSINESS OWNER: HOME PHONE: EMERGENCY-1: G & G Restaurants HOME PHONE: 20'63216842 CURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO EMAIL: BUSINESS LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: FIRE SYSTEMS: FE 3/15 UL300 ?? n.qtp I q-qt.RPr\/irP(1- A- I C- Q� - K HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 2 ... .............. 2 3 3 4 6 4 5 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 GRANTEDTO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: E: DATE: 3 VIOLATIONS 1 6 VIOLATIONS;- 1 2 3 4 15 6 17 8 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: CODE SECTIO�N: STO�� 4 5 6 DATE: RETUR� RECEIPT RECEIVED DATE 3 7 4 8 8 LETTER NEEDED [] YES NO LETTER NEEDED [] YES NO OMISH CC FIRE DIST Serving Bril?�t; kdtnonds,�� and Mountlake Terrace wwwFireDistrictl. ore LOCATION: d I 120 mqmoray QQ 08026 BUSINESS NAME: Mc;Dariakf s 4214 MAILING ADDRESS: 21420 1 lighway 00, Edamrids, 'JVA 0802E 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 PHONE: FIRE PREVENTION INSPECTION REPORT 0 EDMONDS! 0 BRIER i 0 MOUNTLAKE TERRACE [I UNINCORPORATED FREQUENCY I STATION I, SHIFT"`� Annual 16-B SCHEDULED Sop2014 DATE DUE II' UFIR ll� 119s BUSINESS OWNER: HOME PHONE: EMERGENCY-1: (3 G limitauranl.s HOME PHONE: r�" CURRENT KEY ACCESS-2: HOMEPHONE: CITY -YES NO EMAIL: BUSINESS PQ111 LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: -"!> - Z7 -- Zol S�- �_Ifilm SYS IEMS: FE 3i 0!:' HAZARDS F�UND AND LOCATIONS / COMMUNICATIONS 1 A - 1 1 A��Ike_lo 3 p 01T� 2 3 3 4 4 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEX43/0 DAYS X lst RE -INSPECTION DATE DUE. 2nd RE -INSPECTION DATE DUE. EXTENSION GRANTEDTO, FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED. PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: DATE: INSPECTOR: INSPECTOR: 2 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 .8 4 .8 DATE: DISPOSITION: LETTER NEEDED [] YES Cl NO LETTER NEEDED E] YES NO 8 FIRE DEPARTMENT COPY FRIECEIVED 12.1ANSUL.1 - � 'i " W' 16 2012 A �Ko C.MA§.y DEVELOPMENT SERVICES McDonald's Restaurant: COUNTER Store No. 2,0 Licensee Mccopco Store Manager city "ss- Zip �ode Phone (V) FIRE SUPPRESSION SYSTEM CHECKLIST Date Authorized AtLSUL Dilribulor: Company OXACP_Ckv,� C�)�FtL Address 2_600. AirJ),,CJWQ_,i I City, S1a1e_6eqffR_1L�:!6t 0. Zip Code q gi�-3 , � o1ne. 0 _3!L0- - _300 Inspected By eory 1 - v , % NMSIA Insp. 6 12 Year I nSo. D Recharge COOKING STATION/FIRE SYSTEM INFORMATION I HOOD 1 1 HOOD 2 HOOD 3 HOOD 4 Cooking Equipment Identification (e.g. I G, 2G, 2V, 3V, 4V, Combo, Other) ....... . - - I — R-102 System Size (e.g. 3 gal., 6 gal,, Other) ....... — ...... .. ............ . . 4r2 Last Tank(s) Hydro Date(s) ..... ................................. I . ................ _119 Note: Follow all current requirements in McDonald's Store Checklist ln*uctions (r-2011201) and R-102 Design, Installation and Maintenance manual (Part No. 418087). A. Prt-Inspeclion 1 . Has system discharged/tam Dared with ......................... ...................... 2. Inspection seals have teen removed/replaced ......... . ..... ...... i .. I ...... a ....... 3. Has equipment changed (if yes, explain below) ..................... ............. . ... 4. Hood not experiencing excessive vibration: Cooking equipment/ventilator properly cleaned 5. Distribution piping secured, unobstructed, sealed ..... ......... ....... ............. 6. Correct nozzles, properly located and aimed, clean and unobstructed 7. Detector/Pull Station/Gas Valve cable, conduit, pulley wheels secured, undamaged, unobstructed . . B. Interlock. Shutoff, Fan, Accessories operate properly .... ......................... 9. System meets ANSUUUL300/NFPA design crlterla ............. . ....... .............. B. Operation Tesling I . Cock release mechanism and install IoCk bar; Remove cartridge, install safety shipping cap, and safely set aside. Remolve agent tank(s) I ...... ..... . ... ....... 2. Manual Pull Station Operation ............................... ................. a. ALITOMAN regulated release operates properly .............. ........................ b. Switches operate shutoft, fan, accessories . . : ............. . ....................... c. Install break rod and service tag; Cock release, install lock bar ............. ............. 3. Automatic Operation - Cut terminal detector link; Verify steps 2a and 2b � .................... 4. Gas Valve Operates and so indicates ........... I ........................... I ....... a. Mechanical - Manually operate air cylinder; If valve closes properly, recock valve; Re-insiall cover, screws, and seals .................... ........ b, Electrical - Valve automatically closes (Reset relay - RED) wit Steps 2 and 3 above; To open valve (Res?t relay - GREEN) depress reset button . . . ...... c Gas valve and gas line properly supported ............... .. ...... C. Component Check and/or Replacement 1 . Replace f usible links (Refer to Temperature selection chart). . . . . .............. 2. Check wire rope condition .Replace it frayed ............. ............................. 3. Check clearance between trip hammer and cable lever ........................ - . . 4. Check o-ringsiflat gaskets/bursi discs; Replace if necessary . . . . . . - . ........... ...... . 6. Check tank condition, agent quality and till level ....................... ............... 6. Check nozzles/piping for residue; Clean/teplace, Verify nozzle aiming: Replace cap§ annually ..... 7. Re -install tank recock release ' and install lock bar ............................... . .... 8. Inspect cartridge and i9al, and verify weight; Then install : ........... ............... 9. Sign/date chart on AUTOMAN cover, install, and seal if applicable .. ....... I .............. 10. Reset pressure switches, it applicable ............ ......... ...................... 11. Verify proper portable extinguishers (K-Class / Dry Chemical): inform - System back in operation . 12. 12-year Inspection completed, if applicable (Red tanks replaced) .... .. . ... Note: Based on local code requ�lrements, other.tests or services may �ead to be pqr1ormed. mam I 0 COMMENTS: -ULAR r'01' 64CEII Q 0 n 12 11 - Z> P rT_n�� Quotation for additional re �'a noted in comments above: $1 00�v� Store WrIagerSignaturo: &'e". Service Technician Sgnalurea.A4 ORIGINAL - TYCO FIRE PROTECTION PRODUCTS, CANARY- MCDONALD'S MANAGER. PINK -DI BUTOR tqco Fire Protection Products One Stanton Street Marinette, WI 54143-2542 +1-715-735-7411 www.ansul.com right 0 2011 T cc Are Prolecuon Products Alt rIgnI8 reserved, rM No. F-2011200 Au,g. 8, 2012 11:10AM 'No. 1851 P. 1/1 MM 6; RECEIVED 10 N�SUL . Al"r; 16 2012 'A 7WO iftffl.v�w compa.), DEVELOPMENT SERVICES McDonald's Restaurant: COUNTER StoreNo. 2-o-7t,3 Licensee MCCOPCO "o" Mang A 6 re$5 C ty Sta a phone (r Zp �od e:�7 I FIRE SUPPRESSION SYSTEM CHECKLIST Authorized APUL company —&.21 Address 216C City, Staie_4e� 'Zip Code_iau Inspected By 'MS/A insp. Date )t'awgy / 1k 12 Year I nsp. 0 Recharge COOKING STATIONIFIRE SYSTEM INFORMATION HOOD 1 � HOOD 2 1 HOOD 3 HOOD 4 Cooking Equipment Identification (e.g. 1 G, 2G. 2V, 3V, 4V, Combo, Other) .... ... ...... ........ I _V I 7—ev 14 R-102 System Size (e g� 3 gal,, 6 gal., Other) ... . .............. .... I 26n 1 13 gi I %5!5.a I Last Tank(s) Hydro Date(s) .......... ............ ...... ... .. ........ _1 19 1 59 1 179 1 Note: Follow all current requirements in McDonalds Store Checklist Instructions (F-2011201) and R-102 Design, Installatlon and Maintenance manual (Part No. 418087). A. Pro -Inspection 1. Has system disc h arged/tam pared with ......... .............................. 2. Inspection seals have teen rem oved/rep I aced ........... .... ; '' * " * ..... 3. Has equipment changed (if yes, explain below) ....... ............. ............ 4 Hood not experiencing excessive vibration: Cooking equipment/ventilator properly cleaned 5. Distribution piping secured, unobstructed, sealed ................................. 6. Correct nozzles, properly located and aimed, clean and unobstructed .......... . 7. Detector/Pull Station/Gas Valve cable, conduit, pulley wheels secured, undamaged, unobstructed . . 8. Interlock, Shutoff, Fan, Accessories operate properly, . � ........ ......................... 9. System meets ANSUUUL300/NFPA design criteria , ...................... ............... B. Operation Tesfing 1., Cock release mechanism and install lock bar; Remove cartridge, install safety shipping cap, and safely set aside: RemAe agent tank(s) .............. i ........... 2. Manual Pull Station Operation ............... ............ . ............ ....... a. ALITOMAN regulated release operates properly . .......... ........ ...... b. Switches operate shutoff, fan, accessories � � . : .......... . ..................... .. c. Install break rod and service tag; Cock release, install look bar. 3. Automatic Operation - Cut terminal detector link; Verify steps 2a and 2b ..................... 4. Gas Valve Operates and so indicates ............ ............. ...................... a. Mechanical - Manually operate air cylinder; If valve closes properly, recock valve; Re-insiall -cover, screws, and seals ..................... b, Electrical - Valve automatically closes (Reset relay - RED) with Steps 2 and 3 above� To open valve (Resdt relay - GREEN) depress reset button ... . . I ... I ... ... 11 ..... ... c. Gas valve and gas line properly supported. . . ............ ....... C. Component Check and/or Replacement 1 . Replace fusible links (Refer to temperature selection chart) ............................... 2. Check Wre rope condition; Replace it frayed ................... ....... ....... ...... 3. Check clearance between trip hammer and cable lever ............ ............. 4. Check o-ringsiflat gaskets/burst discs; Replace if necessary . � .................. 6. Check tank condition, agent quality and fill level .............. _ _ .................... 6. Check nozzlestpiping for residue; Cloan/replace; Verify nozzle aiming; Replace oap� annually ..... 7. Rie-install tank, recock release. and install lock bar ................................ .. . 8. Inspect cartridge and ?9al, and verify weight: Then install . . � ................... 11 ....... 9. Sign/date chart on AUTOMAN cover, install, and seal if applicable, � ........................ 10. Reset pressure switches, it applicable ..... ........ ......... ................ . . . 11. Verity proper portable extinguishers (K-Class Dry Chemical); Inform - System back in operation . 12. 12-year Inspection completed, if applicable (Red tanks replaced� ......... __ ... . ..... Note. Based on'local oode requirements, other tests or services may need to be performed. COMMENTS: orrAr MEMNE 0 MINVIN 1100 .ANN ME MM No Quotation for additional re noted in comments above: $S ZJ ,�A Store Manager Signature: 111�*�, e�&_ Service Technician Signature.& V ORIGINAL — TYCO FIRE PROTEOTtON PRODUCTS, CANARY— MCDONALD'S MANAGER, PINK— tqco Fire Protection One Stanton Sueet Products Marinette, WI 54143-2542 0 yrlgh�,I? 2 ection Products +1-715-735-7411 40 Wwy No. F-2011200 T Y.ansul.00m .0 a 0 0 0 0 0 i 0 APPLICATION FOR PERMIT FOR MATERIALS OR PROCESSES January 3, 2012 Please verify and correct the following information: Name of Company (DBA): McDonalds #20783 Edmonds Location : 21420 Highway 99 In conformity with the terms of the International 'Fiff-C6ft 6pplib6tibn-it hereby made to store, use Places of Assembly - Occupant Load: 84 or maintain the following activity, storage or pro- cesses: c/o G&G Restaurants Mailing Address: 9700 Harbour PI #219 Mukilteo, WA 98275 EFD UFIR #: (for office use) 16108498157 Your Signature aAA-0, &&OA) Your Name (print) Anya Dlsivt Your Title OT� be H a-.naA 8 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 2-16 Check# teo44 Serving Brier, Edmonds Mountlake Terraceand the Town of Roodway www.FireDistrictl.org LOCATION: 21420 Highway 99 BUSINESS NAME: McDonalcrs #214 MAILING 3201 Shore Ave ADDRESS: Everett BUSINESS OWNER: G & G Restaurants EMERGENCY-1: Gomez, Alefa KEY ACCESS-2: Gomez, Ramon PERSON CONTACTED: NAME OF INSPECTOR: FIRE HD 2/11 SYSTEMS: 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 PHONE: 4256708467 98203 HOME PHONE: 4253499714 P1, -�) -� 0 HOME PHONE: 4252392897 HOME PHONE: 4253101315 FIRE PREVENTION INSPECTION REPORT 0 EDMONDS 0 BRIER E]WOODWAY [I MOUNTLAKE TERRACE 0 UNINCORPORATED FREQUENCY I STATION 1, SHIFT"I 366 16 C SCHEDULED DATE DUE 1` 09/01/11 UFIR � 161 9157 ACTIVE CURRENT CITY YES NO BUSINESS F-I LICENSE INITIAL INSPECTION DATE FE / ANNUAL HAZARDS FOUND AND LOCATIONS COMMUNICATIONS C23!=, 40 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 In our continuning 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 standrads 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 or the Town of Woodway, call (425) 775-7720; for Mountlake Terrace or Brier, call (425) 754-0434. BUSINESS COPY A, APPLICATION FOR PERMIT FOR MATERIALS OR PROCESSES March 7, 2011 Please verify and correct the following information: H D PAID MAR �- ' ill L -- -PA D EDMONDS FIRE DEPT. Name of Company; DBA McDonalds #20783 Edmonds Location 21420 Highway 99 In conformity with the terms of Places of Assembly - Occupant Load: 84 the International Fire Code, application is hereby made to store, use or maintain the following activity, storage or processes: Mailing Address: G&G Restaurants 9700 Harbour PI #219 Mukilteo WA 98275 EFID UFIR #: 161084098157 (for office use) Your Signature Your Name (print) Arma D150y) Your Title Please make corrections, attach $40 payable to the City of Edmonds, and mail to: Fire Marshal Department of Fire Prevention 121 _5th Avenue North Edmonds, WA 98020 CITY OF EDMONDS DEPARTMENT OF FIRE PREVENTION PERMIT January 1, 2011 161-084-098-157 December 31, 2011 Date of Issue LIFIR Number Date of Expiration I This PERMIT is issued to: I McDonalds #20783 I located at: 121420 Highway 99 1 Edmonds, WA = I To engage in the business, occupation or process of: I I And shall constitute permission to maintain, store, use or handle materials or to conduct process which produce conditions hazardous to life or property or to install equipment used in connection with such activities as follows: Places of Assembly - Occupant Load: 84 I Allowed Occupant Load: 1 84 1 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. Fird Marshal Dedartment of Fire Pr6ention This Permit Must Be Posted At All Times in The Premises Identified Above City of Edmonds Community Development Code 19.25.020 John J. Wesffall From: John J. Westfall Sent: Tuesday, April 12, 2011 1:37 PM To: 'fbecker@riley-group.com' Cc: Steve Sherman; Marsha Moore Subject: RE: Public Records Request Mr. Becker: I have searched the City of Edmonds Development Services database to 1958 and find no indication of permits taken for installations or removal of UST/ASTs. My address file indicates a 250g exterior AST at Alan BMW SAAB Inc in 1984 that was used to fuel two floor stoves in the service area of mixed use automobile retail/shop. No records exist for its removal. The Alan structure was demolished in 1998. The current structure for McDonalds was constructed in 1998. I do not keep spill response records filed by location, however, if you have a date, I am able to search for spill incidents at any location. 3ohn 3. Westfall Fire Marshal Fire Prevention Services 425-771-0213 Desk 425-775-7721 Fax 425-231-3644 Mobile ^'0)4V.%vJ:01 LA) Ak D1STR'J,""'Uwff___T From: Steve Sherman Sent: Tuesday, April 12, 2011 11:54 AM To: Marsha Moore Cc: John J. Westfall Subject: FW: Public Records Request Marsha, This is an Edmonds address. I have cc'd John for follow-up. From: Marsha Moore Sent: Tuesday, April 12, 2011 11:32 AM To: Steve Sherman Subject: FW: Public Records Request �teve, Is this us or Edmonds? I am not sure on the exact boundaries of Esperance. Thanks! Marsha 1 From: Fred Becker rmailto:FBecker(&riley-group.com Sent: Tuesday, April 12, 2011 11:31 AM To: Marsha Moore Subject: Public Records Request Ms. Moore: Do you have any records of underground or above ground storage tanks or spill response records for the former Allan BMW/Saab dealer at 21420 Highway 99, Edmonds? Frederick H. Becker, LG, LEG,— Sn'yar cn�:A_6n fberker,,&riley -group. com The Riley Group, Inc. (425) 415-055110iork (425)415-03llFax 17522 Bothell'Way NE Bothell,,�iA 93,311 rkv -couD con-, Environmental - Geotechnical - Wetland �eb.28- 2011 9:08AM No. 8532 P. I jal AN! 7�1k. FIRE SUPPRESSION SYSTEM CHECKLIST Py Date McDonald's Restaurant Address FIRL Me W. HWV 3 —Licensee City, State ,,c 15 , a., Store Manager Zip Code 9 2 41 Phone (q Regional Office Ansull Distributor: Company _—_>0Lv1Jfi('50r� City, State 5-t- 6�_ ti 1,�_ Wo f Zip Coder-, 6 13 Ll Ph'?n Inspected By L_e_rY UJ System Size (1.5 gal., 3 gal., 4.5 gal., 6 gal., e.1c.) . . . . . . . . A. Pre -inspection 1. Has the system been discharged . . . . . . . . . . . . . . 2. Are all inspection seals attached . . . . . . . . . . . . . . 3. Has the appliance line up been changed . . . . . . . . . . 4. System meets Ansul / NFPA design criteria . . . . . . . . 5. Systems are UL 300 Listed . . . . . . . . . . . . . . . . . 6. K-Class Extinguishers Verified . . . . . . . . . . . ... . . 7. Is hood condition clean . . . . . . . . . . . . . . . . . . . B. Gperations Test And Parts Replacement I . Remove all gas cartridges and agent tanks in the system. a. Check weight �nd sea[ In each cartridge . . . . . . . . b. Check agent level and color in each tank . . . . . . . 2. Place test link in terminal detector and trip the system . a. Release mechanism trip, pin extends, indicates "fired". b. Micro switches trip, fuel shut off, exhaust fan on . . . . c. Check wire rope condition . . . . . . . . . . . . . . . . d. Supply air shut off . . . . . . . . . . . . . . . . . . . . 9. Replace fusible links with correct degree rating . . . . . f. Re -cock the release mechanism . . . . . . . . . . . . 3. Operate Manual Pull Station(s) . . . . . . . . . . . . . . . a. Check to insure manual pull tripped the system . . . . b. Re -install break rod in manual pull . . . . . . . . . . . c. Re -cock the release mechanism . . . . . . . . . . . . 4. Simulate gas valve closes . . . . . . . . . . . . . . . . . a. Mechanical gas valve, push down on the gas piston . . b. Electrical gas valve, shut off power to valve . . . . . . c. Check gas valve for correct operation . . . . . . . . . d. Check gas lines properly supported . . . . . . . . . . . 9. It mechanical gas valve, re -cock gas valve . . . . . . . f. If electrical gas valve, reset manual reset relay . . . . . 5. Distribution piping and nozzles . . . . . . . . . . . . . . . a. Distribution piping properly supported . . . . . . . . . . b. Quick Seals in place . . . . . . . . . . . . . . . . . . . c. Nozzles are correct for the hazard they are protecting . d. Nozzles have a small amount of Dow Corning 111 . . . e. Rubber blow off caps on nozzles, replaced annually . .. COOKING ARFA HAZARD ANALYSIS HOOD ONE HOODTWO HOOD'THREE HOOD FOUR Appliance Line Up Appliance Line Up Appliance Line Up Appllanca Line Up �rv-ev, A14 �r",vfr Tank(s) Hydr6 Date Date Tenk(s) Hydm Dare Tank(s) Hydro Date I f Z NWJMM�1� MW COMMENTS: A // A iIi et n )A 10 h2 Wt///r7) J I b ire be lt-,� Quotation f ir additional requi d rvice as noted in comments above: Store Manager Dislri%� �ns 0491nai-Dietributor, Cangry-McOonsIdWMan"r, Pirk-AMIM&I'InOne ANSUL. AUTOM". and R-102 Grelne0ernaftol'An3ul Incorporated oriteaffilistez. Part No, 7e413-04 =05 Ansul Incorporstw CITY OF EDMONDS 121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215 FIRE DEPARTMENT LOCATION: 21420 Highway 99 BUSINESS NAME: McDonalcrs #214 MAILING 3201 Shore Ave FIRE PREVENTION SAFETY SURVEY PHONE: 4256708467 ADDRESS: Everett 98203 BUSINESS OWNER: G & G Restaurants HOME PHONE: 4253499714 EMERGENCY- 1: Gomez, Alefa HOME PHONE: 4252392897 4253101315 KEY ACCESS-2: Gomez, Ramon HOME PHONE: FRECILIENCY STATION& SHIFT 366 16 6 SCHEDULED ()9"01/1() DATE DUE 1- LIFIR ll� 161 9157 ACTIVE r INITIAL INSPECTION DATE PERSON CONTACTED: /-4 NAME OF INSPECTOR: 0 It 51" C, FIRE HD 2/08 UL300 FE!�e- ��O SYSTEMS: < r-/ /_/ — ANNUAL HAZARDS FOUND AND LOCATIONS COMMUNICATIONS ENTER CODE ONLY ONCE ll� VIOLATION CODE 2 Ll C, 2 3 3 4 4 5 5 6 6 7 7 8 8 lst 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 MOLATIONS 1 5 ACLATIONS 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 8 �, LETTER NEEDED Ej YES NO LETTER NEEDED Ej_ YES NO FIRE DEPARTMENT COPY Date: To: From: Subject: W MEMORANDUM 5/18/99 Jeannine Graf, Building Official Mike Smith, Fire Inspector Plan Check 99-113/McDonalds Hood, 21420 Highway 99 The Fire Department has the following comments: 1) The ductwork in drawing 3/Al0 is acceptable. The ductwork shown in drawing 2/A 10 with the 2 ninety degree elbows is not acceptable. 2) Our office for final approval must witness a trip test consisting of an automatic and a manual operation of the hood suppression system. City of Edmonds Fire Department Date: To: From: Subject: MEMORANDUM 4/29/99 Jeannine Graf, Building Official Mike Smith, Fire Inspector Hood & Fire Suppression @ McDonalds, 21420 Hwy 99 RE: Plan Review #99-89 The Fire Department has the following comments: 1) The fire suppression system in the hood shall be in compliance with UL300 2) A Class K portable fire extinguisher located within 30 feet of the cooking appliances shall protect the hood system. City of Edmonds Fire Department 9-05-1997 5:33PM FROM FREIHEIT�HO ARCHITEC 2068286899 P.1 FQEINEIT & 110 11 AQCHITECT8., INC., ID-6. [] EvergreenOne, 10940NE 33rd Place, Suite-202 Bellevue, WA 98004 (425)827-2100 FA: September 5, 1997 TO: John Westfall Edmonds Fire Department FAX: (425) 771-0208 ATTN: John RE: McDonald's Preliminary Site Investigation PROJECT NO. 97426 WE ARE SENDING YOU: (1) Fire Code Information (Existing) (2) Fire Code Information (Pending) (3) Preliminary Site Plan THESE ARE TRANSMITTED: FOR YOUR USE AND INFORMATION XX FOR YOUR REVIEW AND COMMENT REMARKS: NUMBER OF PAGES- 4 (INCLUDING COVER) X. On the first sheet are the responses gathered from you last year by another architectural firm (your original responses.) The second sheet are the questions we need answered for McDonald's Corporation. We know that there are some questions you cannot answer (like whether or not something is adequate for M'cDonald's use or not.) The third sheet is our proposed site plan. If you have any more questions that would help you in answering any of the questions, please feel free to call us here at (425) 827-2100 or fax us at (425) 828-6899. Thank you kindly for your cooperation. Sincerely, I IT & HO ARCHITECTS, INC., P.S. Franklin Ng Encl. cc: Project File f"tmnr.20.doc \9-05-1997 5:34PM FROM FREIHEIT"HO ARCHITEC 20GS28GS99 P.2 SEMON V .. FME CODE INFORMATION Ls site located in a fire zone? Yes _ No ir yes, explain: 2. Sphnklm required? Yes_ No Location: r1L A, -FYement Kitchen NA' Dirung Other 7X-P _Pr_o_XT-07$j'____ Sep�rate line No Yes A Size required- 3. Is d%ere an eyisting oj!s�itere s rvice? LV�0 PAI? VqD FDC? VIO is the hydrant on the b g occup7ie'cllby McDoriald's? Yes No — if so, what is the water'llow to the hydrant? ZZo4tll GPNI 4. Additional fire hydrant required? _ AO V&ere? who instalfs? t',+ A VAiat is the approxjrnateco�ts to bring in a hydrant? ' NtA 3, Does a new hydrant have to be active prior to building perlWts? Y;D-�A NC_ 0. Does anew hydrant have to be active prior to framing? Yes I+A No 7. ArLsul system" Yes A_ No In what areas -T-LA 0A :r 40'24-.'� Are remote pulls required? Yes � (a., V-ew � AA4 ffX Are working drawings required 6ransuTos �em�ly:_� No — Are electronic sensors required for ansul system? Yes A No Will make-up air be required? Yes A No i. Any special fire department requirements necessary in addition to standard plans - (list) i.e., fire stops in a - ttic; fire -rated walls (interior or exterior); qmoke and/or firo alaW-, fire lai;ies in parking lot. A"41*v 10. If basement, is a second means of egress necessary? Yes _ -No — N/A Is emergency lighting package required? Yes '4- No L) U !�emarks: C_A�-n ?NA 0'rg94�-� bc*, It- ta Contact- Phone. Title:— Date:. 944, ELECTRICAL VAVLT ELELTRIGAL EA5EMENT BELOA GRADE BELOA GRADE EXISTI% 5LOG PROPOSED ACCESS PROP05ED PROPERTY TO/FROM SERVICE TO 5E 12EMOLISPED LIKE TO BE LEASED 4(4 ---------- 0261.25- :24'-0,:-- 77 - %o 2 5L P(7 5E:T 1 4 ALCESS EA5EMENT (n 130,00, vV SITE PLAN SCALE. V = 40' McDonald's Restaurant - Edmonds, WA Hwy. 99 & 214th Ave. 2 1 // b -1 ,'(--STORM 5ENER Nt C* 1# N - STORM SEkR 1 APPROX. LOCATI /— Ar- I I rho M� 5 ba'4455" E 112.81' PROJECT VATA LOT AREA: 33,055 S.F. 131-06. AREA-. 3.(a,90 5.F. PRK'G REOV: 1/200 S.F. 6FA = Iq PRK'D PRVV; 33 5TALL5 4OF SANITARY A --,5EAER LINE Z/O05EV CUT rVERM a Ho tQCHNECAS, INC., PA. bft—s ftA M" a so'd rk.. am WL Dam. VA M" MIQ ev�. 97426SP2 09/04/97 1750 (0 U1 U1 U1 WU K City of Edmonds 121 5th Ave. No., Edmonds, WA 98020 FAX I To:' PS& H&71 49 Phone: —Fax phone: CC: Date: !E�l z.,,/ q 7 Number of pages including cover sheet: 71 From: TI-P-DW el— A-j,-Om F�-D� Phone: Fax phone: (425) 771-0266 RENLkRKS: Urgent E] For your review Reply ASAP E] Please comment 9-05-1997 5:34PM FROM FREIHEIT�HO ARCHITEC 2068286899 P. 3 Fire Code Information I Sprinklers required? Yes No Location *NQte: g& �� is - T" 4000 "Approx. Cost Kitchen Basement Dining Other Separate line required: Yes _ No Size — 401 cw%c I; Wyo 5q!'TS^#1 No In what areas Uti- I ;TTDjc, 2. Ansul system? Yes Are remote pulls required? Yes -91 No 61*ATC- WAA iT' Are working drawings required of ansul system? Yes 91, Are electronic sensors required for ansul system? Yes No dard plans: (list) i.e., 3. Any special fire department requirements necessary in addition to stan fire stops in attic; fire -rated walls (interior or exterior); smoke and/or fire alarms; fire lanes in parking lot. 20AAWIft Cm-f--l's6- 26L VR— 'DOG 4, If basement, is second means of egress necessary, Yes No N/A 5. Is emergency lighting package required: Yes 2�-' No 6. Fire flow required: Fire flow available: 7. Location of nearest hydrant: pao±L'P� WI&-ju Verified: Phone: Verified: Phone: 0 L. ': c . - : A� C� 5 ', S )A-'6��& :5 /11 A 7 7- /17 7 ; mo t,)-() Pj," FOP, FUCj- - 0 1.rAS-#JT 1-*-'C 7 V-16T AftL1 -7 -7 6_7 -7 -712-co IAIIL� UN5(5i5:VY.,4 TRANSMISSION VERIFICATION REPORT TIME: 09/12/1997 08:38 NAME: CITY CLERK FAX 2067710266 TEL 2067710245 DATEJIME 09/12 08:37 FAX NO./NAME 82068286899 DURATION 90:00:49 PAGE(S) 02 RESULT OK MODE STANDARD ECM I C9 9 0 1 9 C5 TO 71 q -7-0 1-14-U -( 1� ? CITY OF EDMONDS BARBARA FAHEY MAYOR 250 5TH AVENUE NORTH - EDMONDS, WA 98020 - (206) 771-0200 - FAX (206) 771-0208 POLICE DEPARTMENT * A STATE ACCREDITED LAW ENFORCEMENT AGENCY 00-L'L�6--� Recipient's Fax Number FROM FACSIMILE TRANSMITTAL SHEET 0A0-(-- -7 4 6 6 8 -3 (� DATETRANSMITTED 610.1,76 NUMBER OF PAGES If there are any problems during transmission, please call: Police Department 771-0200, extension Fire Department 771-0215, extension -32-o-j Municipal Court 771-0210, extension RE: by F-&e A-4-n --u— 2-14 Z<-) H wY -7 — A4A-P PA<,-& (0q0kWT-5 -= bjAC-k- 141+7,q —,.jo +, q - 7 q A 57A-rc- - I ot /izi-:�,,' qr3; tt I L4 - Z-?,l /, a ( -v:o H I q - 2- 1 A.,-o i v r-o f4,q - 7-1- STY�-r, C_ - I 0o Z6 1; 76 J,,; C, t L) AA C- C- L-,"r I L- I 6FAA A --Alt- 6 zojof;: Z(,41 6wfA AVAAt- (2 U (5:; ,,q 31 � (,g?;;) CONFIDENTIALITY NOTICE: The documents accompanying this facsimile transmission contain information belonging to the City of Edmonds. This info ' rmation may be confidential and/or legally privileged and is intended only for the use of the individual or entity named on this transmittal sheet. If you are not the intended recipient, you are hereby notified that disclosure, copying, distribution, or the use of the contents of this transmitted information is strictly prohibited. If you have received this facsimile in error, please notify us immediately by phone at the above listed number. EPD310, 1/96 9 Incorporated August 11, 1890 0 Sister Cities International — Hekinan, Japan DA Zone G N.W. 1/4, SEC. 29 —T.27N., RA E.W.M. 157 ,00,0 00 % zoqog 2410 0 V000 Z4 1, a rlO22 Hq P 14, 210W 15 7 Q,,' plachaft 2103 /0 %L 41t 21011 -1110 ZV 21101 Lill* Vb 'c wm$&L 2/109 JAM 1,w 4. 112, I n *— 2113 -- SIT 7j 4i IQ * & S. 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