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Serving Brier, P-dfiionds, and 124-75 Meridian Ave S INSPECTION REPORT
EDMONDS
Mountlake Terrace Everett, WA 98208 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
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21616 76 th Avenue W Suite 204 98026
LOCATION:
Carlson, Roy W. DDS/PS 4257752521
BUSINESS " NAME: PHONE:
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ADDRESS: 21616 76th Avenue W, Suite 204, Edmonds, WA 98026
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NAME OF INSPECTOR:
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FIRE PREVENTION
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Serving Brieii, Edmonds 12425 MeridianAve S
SNOHOMISH CO.
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FIREMountlake Terraceand Everett, WA 98208
DISTh0) the Town of Woodway Phone (425) 551-1200
- t www.FireDistrictl.org Fax (425) 551-1272
LOCATION: 21616 76thAvenue W Suite 204 98026
BUSINESS NAME: Carlson, Roy W. IDDS/PS PHONE: 4257752521
MAILING
ADDRESS: 21616 76th Avenue W, Suite 204, Edmonds, WA 98026
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8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
3H CO.
SNOHOMISH CO.
EDMONDS
Mountlake Terraceand
FIRR
Everett, WA 98208
"OBRIER
IN 00,16 the Town'bf Woodway
DIST R T
Phone (425) 551-1200
E]WOODWAY
1 - Q MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
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FREQUENCY
STATION & SHIFF**'
LOCATION: 21616 76th Avenue W
204
730
16 A
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BUSINESS NAME: Carlson, Roy W. DDS/PS
PHONE: 4257752521
SCHEDULED
DATE DUE 0 09/01/12
MAILING 21616 76th Ave W #204
LIFIR 0 593 9156
ADDRESS: Edmonds 98026
BUSINESS OWNER: Carlson, Roy
HOMEPHONE: 2063657673
ACTIVE
EMERGENCY-1: Carlson, Roy
HOMEPHONE: 2063657673
CURRENT
KEY ACCESS-2:
HOME PHONE:
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I AGREE I CORREC r THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
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CONTACTED:
PERSON
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INSPECTOR:
INSPECTOR:
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LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
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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
F
8
FIRE DEPARTMENT COPY
MEMORANDUM
Date: November 9, 1995
To: Jeannine Graf, Building Official
From: Gary L. McComas, Fire Marshal
Subject: Stevens Behavioral Health,_2161,6 76th Ave.,W #204
After review I have the following comments:
1. The interior remodel is approved.
2. A plan for the fire alarm system must be completed prior to construction.
I
EDMONDS FIRE DEPARTMENT
OFFICE OF THE FIRE MARSHAL
CITY OF EDM'13PJD,S
CIVIC CENTER - EDMONDS. WASHINGTON 98020 (206) 77 . 5-2525
FIRE DEPARTMENT
September 2.2, 1978
Roy.Ca'rlson, D.D.S..
21616 - 76th Avenue West
Suite 204
Edmonds, : WA 98020
RE: CARLSON, ROY, D.D.S.- - FILE CODE 593-000-065
Dear Dr. Carlson:
HARVE.H. HARRISON
MAYOR
On September 5, 1978, your*office was inspected by members
of the Edmonds Fire Prevention Bureau.
We request the following corrections:
1. Replace combustible waste containers with approved
noncombustible types.. Plastic liners may be used
in approved containers.
2. Replace missing cover'over outlet box located in
reception area file shelf,
The Fire.Department will reinsp,ect yv\o r office after fifteen
days.
If we may be of further assistance, please it-ontact this office
(775-2525, Ext. 247) during business hours, 9:00 A.M. to 5:00
P.M.,
Yours for a safer community through fire prevention,
Jack F. Cooper
Fire Prevention
Gerald Eh'tee
Inspector
GE/amm
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