21615 78TH AVE Wf V Ammor-
ZJUI)� 78+A (10- LJ
Serving Brier,- P-amonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrict].org Fax (425) 551-1272
LOCATION: 21615 78 th Avenue W 98026
Stevens Park Townhomes
BUSINESS NAME:
MAILING
ADDRESS: 21615 78th Avenue W, Edmonds, WA 98026
BUSINESS OWNER: Knaphus, Roger
PHONE:
HOME PHONE:
2063999510
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUEN STATION & SHIFT
Annual CY 20-C
SCHEDULED Aug 2017
DATE DUE �
424156
LIFIR
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EMERGENCY-1: Purfeerst, Daryl
2063999510
HOME PHONE: CURRENT
Vf1 tt"O"'k
KEY ACCESS-2:
HOME PHONE: 20
CITY
YES NO
BUSINESS
F_� F]
EMAIL:
LICENSE
I I
I,-
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE SYSTEMS: FE 3/14
Date Last Serviced:
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
..3
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.
NA
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or olati6n.
7 - for
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-77���
Mountlake Terrace or Brier, call (425) 744-6231.
Co 1
78 +A /9 L) er. Uj)
FIRE PREVENTION
Serving Briet: Edmonds, and
124-65 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
0 EDMONDS
FIRE
Molintlake Terrace
Everett, WA 98208
0 BRIER
DISTRI
IT
Phone (425) 551-1200
[1 MOUNTLAKE TERRACE
[I UNINCORPORATED
www.FireDistricti.o'rg
Fax (425) 551-1272
I'- FREQUENCY
STATION & SHIFT**�
LOCATION:
21615 78 th Avatme W 9=6
Annual
20-0
I
BUSINESS NAME:
SLeverm P11,1
PHONE: 2003-CID5
SCHEDULED
DATE DUE 0 Aixg 2014
MAILING
LIFIR 1, 424 1.%
ADDRESS:
21fjl5 78Lh Avmriuc W, Ednmndti. WA 98026
BUSINESS OWNER:
Knanlum, Rraimr
HOME PHONE:
EMERGENCY-1:
Purfccnd, Daryl
HOME PHONE: 20EMM-6) 10
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS
1:1
El
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
OC) A) Z 0
I -IRE SYS ILMS:
FE 3114
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2 A) 0
2
3
3
-u
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
E:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION'
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
13
7
3
7
RETURN RECEIPT
RECEIVED
6
,8
4
8
DATE:
DISPOSITION:
D [I YES No
LETTERNEEDED E] YES NO
FIRE DEPARTMENT COPY
11
FIRE,'�PREVENTIOW�
INSPECTION'REPORT.
'0 EDMONDS
t] BRIER
0WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
0' FREQUENCY I STATION & SHIF`�
LOCATION: 21615 76th Ave W, Edmonds 20-A
SCHEDULED
BUSINESS NAME: Stevens Park Townhornes PHONE: 2063999510 DATE DUE II' AU9
MAILING UFIR 424
ADDRESS: 21615 tthAvenue W, Edmonds, WA
BUSINESS OWNER: Knaphus, Roger HOME PHONE:
Email:
jnAq
EMERGENQ�-1: p"rfmin f nmrkil aoarMn CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
BUSINESS
LICENSE
'INITIAL INSPECTION DATE
PERSON CONTACTED:
NAM E OF INSPECTOR:
FIRESYSTEMS: FE_�)_/_Lz_&
Serving Brier, Edmonds'"
Moimtlake Terrace�pnd'
Town of Woodway
.oTthe
www.FireDistrictl.org
12425 M�ridian Ave S
Everett, WA 98208 � il.
Phone (425) 551-1200
Fax (425) 551-1272
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
3
3
4
4
5
.5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(�) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
t'2nd'RE-INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON.,
PERSON
CONTACTED:
CONTACTED:?
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
3
DATE:
DATE:
DATE:
VIOLATIONS
, 11 1 VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 15' A
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
3
7
RECEIVED
6
DISPOSITION:
4
8
8
DATE:
7
LETTER NEEDED (] YES NO
-4
LETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
Serving Brier, Edmonds
SNOHOMI
FIRMountlake Terraceand
the Town of Woodway
s T www.FireDistrictl.org
21615 78th Avenue
LOCATION:
qfpxfpne Pswk Tnwnhnmpcz
BUSINESS NAME:
MAILING
ADDRESS:
BUSINESS OWNER:
Purfeerst, Daryl
Knaphus,Roger
EMERGENCY-1:
KEY ACCESS-2:
PERSON CONTACTED:e
NAME OF INSPECTOR�
CIR () 0 vi I —
SYSTEMS: \
lult
FIRE PREVENTION
12425 Meridian Ave S INSPECTION REPORT
0 EDMONDS
Everett, WA 98208 0 BRIER
Phone (425) 551-1200 E]WOODWAY
El MOUNTLAKE TERRACE
Fax (425) 551-1272 [1 UNINCORPORATED
2063999510
PHONE:
2063999510
HOME PHONE:
3607940458
HOME PHONE:
HOME PHONE:
0,� 6
FRE
,%SNCY I STAT% & 6;TT"'
SCHEDULED ngmim-)
%JW)W NJ lr_
DATE DUE �
UFIR 10 424 8156
AiCTIVE
CURRENT
CITY
YES NO
BUSINESS
1:1 1:1
LICENSE
INITIAL INSPECTION DATE
-
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FE f
A�NLIZI
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2 IV I -,r)
2
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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:
1
2nd RE -INSPECTION
D E DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
'PATE:
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
4
18
14
18
DATE:
.DISPOSITION:
7
LETTER NEEDED E] YES [_I NO
LETTER NEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 51H AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
41
LOCATION: 21615 78th Avenue w
BUSINESS NAME: Stevens Park Tomhomes
MAILING
ADDIRESS:
FIRE PREVENTION
SAFETY SURVEY
PHONE: 2063999510
FREQUENCY STATION & SHIFT
-365 16 B
SCHEDULED
DATE DUE �
UFIR j� 424 8156
BUSINESS OWNER: Purfeerst, Daryl HOME PHO'N.720I5399951 0 ACTIVE
EMERGENCY- 1: Knaphus,Roger HOME PHONE: 3607940458
KEY ACCESS-2: HOME PHONE:
INITIAL INSPE �;T]O�N DATE
PERSON CONTACTED:
NAME OF INSPECTOR: zahi�� ��L
FIRE FE I
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS-,
ENTER CODE ONLY ONCE 1�
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
1st RE -INSPECT -ION--
DATE DUE:
2nd RE -INSPECTION
1DATBD.Ugn'-'
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
�ATE 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
71
6
2
6
DATE:
CODE
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
4
18
4
18
DATE:
DISPOSITION:
7
8
LETTERNEEDED [] YES [3NO,
LETTER NEEDED 0 YES I-] NO
FIRE DEPARTMENT COPY