21600 HWY 99 STE 200FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
Mountlake Terrace Everett, WA 98208 0 EDMONDS
0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
www.FireDistrictl.org Fax (425) 551-1272 0 UNINCORPORATED
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2016
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4257742601
DATE DUE 0 Jan
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21600 Highway 99, Suite 200, Edmonds, WA 98026
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"CURRENT
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HOME PHONE:'
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Serving Brier, Edmonds
Mountlake Terraceand
Tthe Town of Woodway
www.FireDistrictl.org
LOCATION: 21600 Highway 99
BUSINESS NAME: Vacant
MAILING 21600 Highway 99 4200
ADDRESS: Edmonds
BUSINESS OWNER:
EMERGENCY-1:
KEY ACCESS-2:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
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12425 Meridian Ave' S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
200
PHONE: 4257742601
98026
HOME PHONE:
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
EIEDMONDS
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FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
ATION: 21600 Highway 99
Kauffman's Pharmacy
BUSINESS NAME:
MAILING 21600 Highway 99 #200
FIRE PREVENTION
SAFETY SURVEY
200
PHONE: 4,257742601
ADDRESS: Edmonds 98026
BUSINESS OWNE�N Kauffman's Pharmacy, Inc" HOMEPHONE: 4257734768
EMERGENCY-11: Kauffman, J. HOME PHONE: 4253451185
KEY ACCESS-2: HOME PHONE:
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DATE DUE 01
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VIOLATIONS
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PERSON
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PERSON
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INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
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1 5
PRE-CMATION
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CITATION ISSUED
4
2
6
2
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-SENT
DATE:
-NUMBER:
CODE
SECTION:
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7
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RETURN RECEIPT
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6
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4
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DATE:
DISPOSITION:
1,, LETTER NEEDED iD YES NO
LETTER NEEDED [] YES NO
FIRE DEPARTMENT COPY