21508 HWY 99 (2)111111111:415L
A1:r&j441#y q1
FIRE PREVENTION
Serving Bri,�,r, E_.. and
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
0EDMONDS
-FJJTLL-.JILLm E
Mountlake Terrace
Everett, WA 98208
0 BRIER
DI I
STu
-
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
El UNINCORPORATED
www.FireDistrict].org
Fax (425) 551-1272
FREQUENCY
STATION& SHIFT_'*�
LOCATION:
2 1 MS Hi.qhArAy 311 08026
Atinual
16-6
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BUSINESS NAME:
CartupV Warld
42,577G4E41
PHONE:
SCHEDULED Sep 2014
DATE DUE
MAILING
LIFIR 11'
ADDRESS:
2*1509 1 fint-mov 00, bdnmn&,vVA 0802E
BUSINESS OWNER:
Fmd&rn, Milo -
HOME PHONE:
EMERGENCY-1:
Schac1crr, Hav - awmar
HOME PHONE: 3f_,1037721S8
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KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
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EMAIL:
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
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NAME OF INSPECTOR:
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
I
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:
D�TE:
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
18
4
8
1DATE�
DISPOSITION:
7
"I LETTER NEEDED [] YES El No
I LETTER NEEDED [-] YES NO
1
8
FIRE DEPARTMENT COPY
W,
SNOHOMISH CO.
FIRE
ST
Serving Brier, Edmonds
Mountlake Terraceand----
the Town of Woodway
www.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
LOCATION: 21508 Highway 99 98026
BUSINESS NAME: CanopyNorld PHONE:
MAILING
ADDRESS: 21508 Highway 99, Edmonds, WA 98026
BUSINESS OWNER: HOME PHONE:
Email:
EMERGENCY-1: Schaeferr, Roy HOME PHONE:
KEY ACCESS-2: HOME PHONE:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS:
42577-54641
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
/U BRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
[I UNINCORPORATED
e FREQUENCY STATION & S
Annual I 16-A
SCHEDULED S e p
DATE DUE
LIFIR 11, 593
CURRENT -1
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
9/4// 3
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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: f'
1
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
D ATE: �
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
14
18
4
18
DATE:
DISPOSITION:
7
LETTERNEEDED [:] YES El NO
LETTERNEEDED F] YES [:1 NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terrace, and
FIRE
Everett, WA 98308
OEDMONDS
0 BRIER
the Town of Woodway
DISTIM T
Phone (425) 551-1200
OWOODWAY
0 MOUNTLAKE TERRACE
www.FireDistrict].org
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY STATION & SHIFT�
LOCATION: 21508 Highway 99
366 16 C
BUSINESS NAME: Canopy World
PHONE: 4257754641
SCHEDULED
DATE DUE � 09/01/11
MAILING 16053 Aurora Av N M3
LIFIR 1, 575 9157
ADDRESS: Seattle
98133
BUSINESS OWNER: Schaeferr, Roy
HOME PHONE: 3603772158
ACTIVE
EMERGENCY-1: Feddem, Mike
HOME PHONE: 2536303580
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
1:1 1:1
LICENSE
el PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE
FE I
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
-1441 L"L C.I?
2
2
3
z�
3
4
4
5
5
6
Z
6
7
7
I 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
4E PREVENTION
CITY OF EDMONDS SAFETY SURVEY
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
t 13
LOCATION: 21508 Highway 99
�j BUSINESS NAME: Canopy World PHONE: 4257754641
MAILING 16053 Aurora Av N #B
ADDRESS: Seaftle 98133
1j
FREQUENCY
STATION & SHIFT
366
16 6,,-
SCHEDULED
DATE DUE I�
09/01/10
LIFIR I� 575
9157
BUSINESS OWNER: Schaeferr, Roy HOME PHONE: 3603772158 ACTIVE
EMERGENCY-1: Feddem, Mike HOME PHONE: 253,6303580
KEY ACCESS-2: HOME PHONE:
INITIAL INSPECTION DATE
PERSON CONTACTED:
r — 1-5— 1 :fS
NAME OF INSPECTOR:
clor- r:t= I
SYSTEMS:
HAZARDS FOUND AN
A14NUZ
D LOCATIONS / COMMUNICATIONS
ENTER CODE ONLY ONCE 10
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
.7
8
8
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
E DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CON`rACTED-
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:
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
7
4
4
8
DATE:
DISPOSITION:
8
�, LETTER NEED D E] YES F] No
[I"ITTER NEEDED []' YES NO
FIRE DEPARTMENT COPY