21600 HWY 99 STE 260% - 11
SNOHOMISH CO.
FIRE
DI
FIRE PREVENTION
ServingBrier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
DEDMONDS
Mountlake Terrace Everett, WA 98208 OBRIER '
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
[]UNINCORPORATED
www.FireDistrictl.org Fax (425) 551-1272
LOCATION: hway 99 Suite 255 98026
BUSINESS NAM : Vacant PHONE:
MAILINi
ADDRESS: 21600 Highway 99, Suite 255, Edmonds, WA 98026
BUSINESS OWNER: HOME PHONE:
4257742628
FREQUENCY I STATION & SHIFT
201 16-C
SCHEDULED
DATE DUE � Jan 2016
FIR � 593
EMER.GENCY-1: HOME PHONE: o CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
BUSINESS
EMAIL: LICENSE 1:1 1:1
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS: FE
n f I + CZ i4
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
5
4
5
6
6
7
7
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 violatio ns. of the fire regulations does not imply approval of such conditions or>io<l� on.
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.
SNOHOMISH CO.
FIRE
DIST:
Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
LOCATION- 99 Suite 245 98026
i
BUSINESS N E: Part of 260 PHONE:
MAIL
ADDRESS: 21600 Highway 99, Suite 245, Edmonds, WA 98026
BUSIN ESS OWNER: Wirtala HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
[3 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY I STATION& SHIFT
201 16-C
SCHEDULED
DATE DUE � Jan 2016
LIFIR 0 593
.EMERGENCY-1: HOME PHONE:
CURRENT
KEY ACCESS-2: HOME PHONE:
CITY YES NO
BUSINESS F__1
EMAIL:
LICENSE L—J
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: 04�
FIRE SYSTEMS: FE
HAZARDS FOUND AND LOCATIONS I COMMUNICATIONS
2
2
3
4__
--- -------- .........
3
_4_
5
5
6
6
7
7
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. ><
10
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions violatio
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 77;-7720; for
Mountlake Terrace or Brier, call (425 )744-6231. J
_%c
FIRE PREVENTION
CITY OF EDMONDS SAFETY SURVEY
121 5TH AVENUE N. . EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
0
rk
LOCATION: a goo
Z,
BUSINESS NAME: p o Co 3eulf�0 PHONE:
7?
MAILING
'ADDRESS:
r, L)II-4,01VIV &V t-l- -1
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
FREQUENCY STATION& SHIFT
_ 0
73
SCHEDULED
DATEDUE
UFIR I�
PERSON CONTACTED: c i-�� L/ t— INITIAL INSPECTION DATE
NAME OF INSPECTOR: r
SAT / 7/4
t-1 _/0
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE Ilo
VIOLATION CODE
PO T4��O
2
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:
1
PERSON
CONTACTED:
PERSON
CONTACTED:
rPE FWS 0
CONTACTED:
CO,
INSPECTOR:
2
INSPECTOR:
INSPECTOR:
DATE:
3
DATE,
DATE,
PRE -CITATION
LETTER SENT
_d1_TAfl6_Ni9S_U_E6___
NUMBER:
4
VIOLATIONS
5
1
\AOLATIONS
5
DATE:
CODE
SECTION:
5
2 6
2 6
RETURN RECEIPT
RECEIVED
3 7
6
4 18
k4
DATE...
--l=
DISPOSITION.
LETTER NEEDED (j YES NOI
L ET�ER NEEDED
0 YES n NO
1 .4
8
FIRE DEPARTMENT COPY
R
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
4t' t
LOCATION: 21600 Highway 99
BUSINESS NAME: Digestive Disease Cntr
MAILING 21600 Highway 99 #260
FIRE PREVENTION
SAFETY SURVEY
260 FREQUENCY STATION & SHIFT
731 16 6
PHONE: 4257742650 SCHEDULED 01/01/11
DATE DUE 01
LIFIR P, 593 1157
ADDRESS: Edmonds 98026
4257713443
BUSINESS OWNER: Chaffee,Robed HOME PHONE:
EMERGENCY-1: HOME PHONE: 2064198045
KEY ACCESS-2: ROL114cl (X*A se HOME PHONE:
Suites
PERSON CONTACTED: ftl�r Jc_ Yxe--fy-'4A INITIAL INSPECTION DATE
NAME OF INSPECTOR: e e,� 1- 11
FIRE FE _LI_LD
SYSTEMS: ANNUAL
HAZARIDS FOUND AND LOCATIONS / COMMUNICATIONS
.5isy, 4!�f ';O"�—\' odelce- A 07 'r
ENTER CODE ONLY ONCE 11
VIOLATION CODE
1
\60 )
r
2
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2
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5
6
6
7
7
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ViO�0�rj(t,', Yl C�("j
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
IAM__g
DATE:
DATE:
3
\AOLATIONS
1 5 C9 CZ
MOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2 C�_
6
2
6
—
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
7
4
18
4
8
DATE:
DISPOSITION:
8
LETTERNEEDED E] YES [] NOI
LETTER NEEDED E] YES El NO
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
t
LOCATION: 21600 Highway 99
BUSINESS NAME: Digestive Disease Cntr(part of)
MAILING 21600 Highway 99 #220
ADDRESS: Edmonds
BUSINESS OWNER: Degan, Thomas
EMERGENCY-1- nhallick Deanna
KEY ACCESS-2:
FIRE PREVENT'ION
SAFETY SURVEY
220
PHONE: 4257742686
1
98026
HOMEPHONE: 2065463826
2065408594
HOME PHONE:
HOME PHONE:
FREQUENCY
731
STATION & SHIFT
1 1 6 13
SCHEDULED 01,101/11
DATE DUE 0
UFIR 1� 593
1 157
Suites
01 INITIAL INSPECTION DATE
PERSON CONTACTED: Rcj i 5&->, f II
NAME OF INSPECTOR: ki
FIRE FE
-LI-D
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
0 V (o Q"!�t
ENTER CODE ONLY ONCE 10
VIOLATION CODE
2
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:
3
VIOLATIONS
1 5
VIOLATIONS
5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
-1
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED 17] YES NT
LETTER NEEDED F-1 YES F_j NO
FIRE DEPARTMENT COPY