21810 76TH AVE W_1III I �1111` � / 0 / 0 76-01' Atf, (,,,)
SNOHOMISB CO.
Serving Brier, Edmonds, and
Mountlake Terrace
LOCATION: James A. Salmat
BUSINESS NAME:
21810 76th Aven
MAILING
ADDRESS:
BUSINESS OWNER: Salman, James
EMERGENCY-1:
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED:
RE UAitT&M9�1ECT4iF
12425 Meridian Ave S
Everett, WA 98208
Ehang_�4� 551-1200
Fa—x 7*Z) 5 5'�-W 72
HOME PHONE: 4257715912
20
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
2017 20-A
FREQUENCY STATION & SHIFT
2 N�v 2017
SCHEDU
DATE DUA3 156
UFIR 0
CURRENT
CITY YES NO
BUSINESS F-1
LICENSE I 1 0
INITIAL INSPECTION DATE
HAZARDS FOUNR,7 LOCATIONS/ COMMUNICATIONS
2
2
3
3
4
4
5
5
6
6
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.
Ove yo
You are to be congratulated on the relative good condition of your occupancy in regards to fire safety. Above yo
will find the item(s) that were noted during our inspection which require attention to bring them into compliance
'iance
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 or vi tion.
c
77 0.
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 77 -7 0; or
5
Mountlake Terrace or Brier, call (425) 744 -6231.
uJ
x
1 + Z02—
FIRE PREVENTION
INSPECTION REPORT
SNOHOMISHCO. Serving Briet; Ednionds, an.d 12425 Meridian Ave S jQE I DMONDS
FIIm Iwo Mountlake Terrace Everett, WA 98208 MRIER
XIMA f2flh&e� 7J2 OLO/ - 0 MOUNTLAKE TERRACE
CORPORATED
DIST Fax (425�5544A2 �`-20,iW 20-A
IN S f FREQUENCY STATION & SHIFT
LOCATIOME=d0-NU#4eR-T f 23 4257767333 + 2017
BUSINESS NAME: 3,156 —
E�j
PHONE: DATE DU
21810 76th Avenue W, Suite 201, Edmonds, WA 98026
MAILING LIFIR 0
ADDRESS: I(
BUSINESS OWNERMact29qjMe,1anie
EMERGENCY-1:
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED: Z)rA (624A
F RE SXA%TW%PEC-f04..5/11 FE
Date Last Serviced: Ll / 1-7
HOME PHONE: 4257753461
--2e-
HOME PHONE:
HOME PHONE:
-,, s+,, I A(
CURRENT
CITY
YES N * 0
BUSINESS
F__J,
[�_
LICENSE
—I--'
INITIAL INSPE7TION DATE
2-
HAZARpf FOUND AND LOCATIONS COMMUNICATIONS
vu(AS 1, sc, 0,�
0
It(j
2
2
3
4
4
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
S
PERSON
CONTACTED:,
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
DATE:
DATE:
DATE:
3
4
VIOLATIONS
VIOLATIONS
15
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
2
3
4
6
7
8
2 _J_
3
6
7
DATE:
CODE
SECTION:
RETURN RECEIPT
RECEIVED
4
8
DATE:
DISPOSITION:
k'��ETT.ER NEEDED 0 YES
LETTER NEEDED E] YES El NO