21600 HWY 99 STE 230 (2)SNOHOMISH CO.
FIRE
DIST:
ZI&OLI? Plz6"WAY Z-30
FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
0 EDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
www.FireDistrict].org Fax (425) 551-1272
FREQUENCY STATION & SHIFT
LOCATION:
21600 Highway 99 Suite 230 98026
2016 16-C
BUSINESS NAME:
PHONE:
SCHEDULED
4257742620 DATE DUE � Jan 2016
MAILING
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UFIR 1' 593
ADDRESS:
21600 Highway 99, Suite 230, Edmonds, WA 98026
BUSIN ESS OWNER:
HOME PHONE:
.EMERGENCY-1:
Takagi, Brian HOME PHONE:
2067998998 CURRENT YES NO
KEY ACCESS-2:
HOME PHONE:
CITY
BUSINESS
E
EMAIL:
LICENSE L—J
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: 1:211
FIRE SYSTEMS:
FE
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
A
2
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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 comptiance
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 0 Xviolattion.
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.
MOOS'
'o
Serving Briet: Edmonds
HOMISH Mountlake Terrace, and
FIR
DIS R T the Town of Woodway
www.FireDistrictl.org
LOCATION: 2*1601) Highway 99
BUSINESS NAME: Brian, Takagi, WID
MAILING 21600 Highway 99 #230
ADDRESS: Edmonds
BUSINESS OWNER: Takagi, Brian
EMERGENCY-1:
KEY ACCESS-2:
PERSON CONTACTED: -I H P, y /tj
NAME OF INSPECTOR: A,)
FIRE
SYSTEMS:
FIRE PREVENTION
124-25 Meridian Ave S INSPECTION REPORT
0 EDMONDS
Everett, WA 98208 0 BRIER
Phone (425) 551-1200 E]WOODWAY
[I MOUNTLAKE TERRACE
Fax (425) 551-1272 [1 UNINCORPORATED
FREQUENCY STATION & SHIFT
230 731 16 D
PHONE: 4257742620 SCHEDULED
DATE DUE 11' 01/01/13
UFIR 1, 593 1157
98026 1., j
HOMEPHONE: 2067998998
HOME PHONE:
HOME PHONE:
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE El 1:1
INITIAL INSPECTION DATE
7- 1 Z
FE 8 112
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
1
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
I st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
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PERSON
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PERSON
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INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
.1 5
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PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
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6
2
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DATE:
CODE
SECTION:
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RETURN RECEIPT
RECEIVED
6
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18
4
18
DATE,
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTER NEEDED [] YES NO
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FIRE DEPARTMENT COPY
FIRE PREVENTION
SAFETY SURVEY
CITYOF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
418, a 9 �)
LOCATION: 21600 Highway 99 230,
BUSINESSNAME: PHONE: 4257742620
MD
MAILING 21600 Highway 99 #230
ADDRESS: Edmonds 98026
FREQUENCY I STATION 1, SHIFT
731 16 6
SCHEDULED
DATE DUE 01 01/01/11
UFIR o, 593 1157
BUSINESS OWNER: HOME PHONE: ACTIVE
EMERGENCY-1: 17-0 (a) I il q �
HOMEPHONE:
KEY ACCESS-2:, Gre Kruger, LLC . 2062230525
HOME PHONE.
A
PERSON CONTACTED: A� I �.s cy" INITIAL INSPECTION DATE
NAME OF INSPECTOR: 61 r!� W er I )
FIRE FE'
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SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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ENTER CODE ONLY ONCE.,F
VIOLATION CODE
2
2
3
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4
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5
5
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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
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
8
4
18
DATE:
DISPOSITION:
8
�, LETTER NEEDED El] YES E] NO
LETTER NEEDED 0 YES NO
FIRE DEPARTMENT COPY