21911 76TH AVE W STE 208_2104tlC IJ ST�E'z b FIRE PREVENTION
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S�rvin� H�ier, Edmonds,
and 12425 Meridian Ave S
INSPECTION REPORT
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Mountlake Terrace
Everett, WA 98208
DEDMONDS
0 BRIER
Rk
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
OUNINCORIORATED
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www.FireDistrict]-org
Fax (425) 551-1272
21911 76 th Avenue W Suite 208 98026
LOCATION:
BUSINESS NAME: TGB/Hammer Works PHONE: 4257781539
MAILING
ADDRESS: 21911 76th Avenue W, Suite 210, Edmonds, WA 98026
FREOUENCY: S TAT 16
2017 1 1 �y SHIFT's
SCHEDULED. Feb 2017
DATE DUE �
591 157
UFIR 0
11
BUSINESS OWNER: HOME PHONE:
Gregory, Kent 2068501176
EMERGENCY-1: HOME PHONE: CURRENT YES NO
KEY ACCESS-2: HOME PHONE: CITY
EMAIL: BUSINESS
LICENSE
INITIAL NSPECTION 9ATE
PERSON CONTACTED:
NAME OF INSPECTOR:y0AJe-,,/v-V,. �egc2 -�t
PIRF 9Y.I;TFMq- F:;:
SNOHOMISH CC
"FIRE
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,','DIST
5 FIRE PREVENTION
Serving Briei; Edmonds, a . nd.. 12425 Meridian Ave S INSPECTION REPORT
0 EDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER
Phone (425) 551-1200 [1 MOUNTLAKE TERRACE
[I UNINCORPORATED
www.FireDistrictl.org Fax (425) 551-1272
r FREQUENCY STATION & SHIFT-*"
LOCATION: 21911 76 th Avenue W Suite 208 98026 2 Year 14 16-C
BUSINESS NAME: Pacland - Edmonds PC PHONE: 425275960S SCHEDULED Feb 2014
DATE DUE �
MAILING UFIR491 157
ADDRESS: 21911 76th Avenue W, Suite 208, Edmonds, VVA 98026
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Parsons, Thomas HOME PHONE: 425774G415 CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: Dovi I Aj OZOO-
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
D E DUE:
. EXTENSION
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
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PERSON
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PERSON
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2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
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1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
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RETURNRECEIPT
RECEIVED
6
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8
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18
DATE:
DISPOSITION:
To,
LETTER NEEDED E] YES El NO
LETTER NEEDED F YES NO
-
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FIRE DEPARTMENT COPY.
' f Serving Brier, Edmonds
SNOHOMI �CO.
FIREIM
3104"Swi)), Mountlake Terraceand
DISTR'
the Town o Woodway
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www.FireDistrictl.org
LOCATION: 21911 76th Ave W
13USINESS NAME:
Pacland - Edmonds PC
MAILING
21911 76th Ave W #208
ADDRESS:
Edmonds
BUSINESS OWNER:
Parsons, Thomas
EMERGENCY-1:
KEY ACCESS-2:
Parsons, Susan
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
k,12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
208
PHONE: 4252759808
98026
HOME PHONE: 4257740415
HOME PHONE:
HOME PHONE: 4252523693
FIRE PREVENTION
INSPECTION REPORT
[]EDMONDS
0 BRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIFT-)
730 16 A
SCHEDULED
DATE DUE 0 02/01/12
LIFIR o 591 2157
1�1 —1-1
CURRENT
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HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
2
2
3
3
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
2DATE DUE:
E)(TENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
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1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
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1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
4
18
4
18
DATE:j
DISPOSITION:
7-
LETTER NEEDED C] YES [:1 NO
LETTER NEEDED F] YES NO
8
FIRE DEPARTMENT COPY
SNO110MIS" Co.
FIRE
_D1 A
Serving Brier, Edmonds, and
Mountlake Terrace
LOCATION: 21911 76 th Avenue
BUSINESS NAME: Pacland - EdmonXI
MAILING 21911
ADDRESS:
�p6trictl. org
Suite 210 98026
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE:
W, Suite 208, Edmonds, WA 98026
4252759808
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
r- F�6?fNCY STAJI8_Jf SHIFT
SCHEDULED Fel)-20—f-7—
DATE DUE 0
b9l lb(
UFIR 0
BUSINESS OWNER:
HOME PHONE:
Parsons, Thomas
4257740415
EMERGENCY-1:
HOME PHONE: URRENT
KEY ACCESS-2:
HOME PHONE:
ITY YES NO
FLICENSE
BUSINESS
0
El
EMAIL:
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
Date Last Serviced:
HAZARDS FOUND AND LOCATIONS C MMUNICATIONS
2.
3 3
4 4
5 5
<7 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 complianN
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
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-
Mountlake Terrace or Brier, call (425) 744-6231.
FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
SNOHO;ilSg CO; " " 0 EDMONDS
-ace ,
Mountlake Teri Everett, WA 98208 0 BRIER
FI 0 MOUNTLAKE TERRACE
DI Phone (425) 551-1200 OUNINCORPO A
T www.Fi�p'is"trict].org Fax (425) 551-1272
LOCATION: 21911 76 th Avenue W Suite 210 98026 ffff ENCY STjyg)h& SHIFT
Pacland - Edmonds PC 4252759808 SCHEDULED Fe
BUSINESS NAME: PHONE: DATE DUE I`
MAILING LIFIR ll� b9l lbf
21911 76thAvenue W, Suite 208),Edmonds, WA 98026
BUSINESS OWNER:
EMERGENCY-1: Parsons, Thomas
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED:
NAME OF INSPECTOR:
Z) I LIV!11�0: FE 8/13
Date Last Serviced:
HAZARDS FOUND AND LOCATIONS POTUNICATIONS
2
3
4
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HOME PHONE:
4257740415
HOME PHONE:
HOME,PHONE:
'7 .... ........
CURRENT .011
CITY YES NO
BUSINESS V_ __j
_F
LICENSE I 1 1:1
INITIAL INSPECTION DATE
I
2
3
4
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5
6 6
7 7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION 2nd RE -INSPECTION FINAL RE -INSPECTION
EXTENSION i VIOLATIONS
DATE DUE: GRANTEDTO
DATE DUE. DATE DUE. CITED:
PERSON PERSON
ERSON
CONTACTED CONTACTED.
CONTACTED:
2
INSPECTOR: INSPECTOR: INSPECTOR:
DATE: DATE: 3
DATE
CITATION ISSUED
VIOLATIONS VIOLATIONS PRE -CITATION
4
1 5 1 5 LETTER SENT NUMBER
2 6 2 6 DATE. CODE 5
SECTION.
"_, _ S
RETURN RECEIPT 6
3 7 3 7 RECEIVED
DISPOSITION
4 8 4 8 YATE
LETTER NEEDED (3 YES El NO LETTER NEEDED 0 YES [:1 NO 8
I
Rut,
FIRE PREVENTION
REPORT
Serving Briei; Edmonds, and
425-MeridianAveS.
[]EDMONDS
Mountlake Terrace Evie're.tt.,. WA. 9820 0 BRIER
MEN ��f Phone (425) 551-1200 [1 MOUNTLAKE TERRACE
CTwwwFireDistrictl. org Fax (425) 551-1272 [1 UNINCORPORATED
" FREQUENCY STATION & SHIFT-"*,
LOCATION: 21911 76 th Avenue W Suite 210 98026 2 Year 14 16-C
1 -
BUSINESS NAME: TGS/HammerWorks PHONE: 4257781530 SCHEDULED Feb 2014
DATE DUE I`
MAILING UFIR591 157
ADDRESS:
21911 76th Avenue W, Suite 210,
Edmonds, W.1% 98026
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
Greqorv, Kent
HOME PHONE:
2068501176 CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
YES NO
BUSINESS
ff
1:1
EMAIL:
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
Do Vj I- 1 /0
02-02-
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2
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3
3
4
4
5
5
6
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7
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE;
GRANTEDTO,
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
IINSPECTOR:
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INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
'$
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
6
3
7
3
7
RECEIVED
DISPOSITION:
4
8
4
8
DATE,
7
LETTERNEEDED E] YES [I NO
LETTERNEEDED E] YES F-1 NO
8
FIRE DEPARTMENT COPY
'8NOHOMISH CO. Serving Brier, Edinonds
1p Mountlake Terraceand
I ')
I')
1111ITairrio rp the Town of Woodway
www.FireDistrictl.org
LOCATION: 21911 76th Ave W
BUSINESS NAME: TGf3/Lt&l-M0IlMl=M-
MAILING 21911 76th Ave W #210
ADDRESS: Edmonds
BUSINESS OWNER: Gregory, Kent
EMERGENCY-1: Grainger, Dennis
KEY ACCESS-2:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
210
PHONE: 4257781530
98026
HOME PHONE: 2068501176
4258768813
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
OBRIER —
0 WOODWAY
[I MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUENCY I STATION &�HIFTN
730 16
SCHEDULED 02101112
DATE DUE I`
UFIR 11. 591 2157
CURRENT
CITY , YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED: 1JI)ID
NAME OF INSPECTOR: _�3?2W( M0f1AJf40J-
FIRE FF= —I—
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
1
1
Ale
2
2
3
3
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
D TE DUE:
1
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
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED C] YES F_] NO
LETTER NEEDED [] YES NO
1
8
FIRE DEPARTMENT COPY
I
CITY OF. EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
glow FIRE DEPARTMENT
t
LOCATION: 21911 76th Ave W
BUSINESS NAME: TGB/Hammer Works
MAILING 21911 76th Ave W #210
FIRE PREVENTION
SAFETY SURVEY
210
PHONE: 4257781530
ADDRESS: Edmonds 98026
BUSINESS OWNER: Gregory, Kent HOMEPHONE: 2068501176
EMERGENCY- 1: Grainger, Dennis HOME PHONE: 4258768818
KEY ACCESS-2: HOME PHONE:
"" FREQUENCY STATION& SHIFT '
1 16 C
SCHEDULED
DATE DUE 01 02/01/10
LIFIR o. 591 2157
01 INITIAL INSPECTION DATE
PERSON CONTACTED: 0 cf�' -rk ("j
NAME OF INSPECTOR:
FIRE FEY��
SYSTEMS:
ANIMUAL
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DATE DUE,
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EXTENSION
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VIOLATIONS
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PERSON
CONTACTED:
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INSPECTOR:
INSPECTOR,
INSPECTOR:
2
DATE: Ca
DATE:
DATE:
3
L IONS
15
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE '
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
7
4
8
4
18
DATE:
DISPOSITION:
8
� LETTER NEEDED E] YES 0 NO
LETTER NEEDED F] YES NO
1
:�FIRE DEPARTMENT COPY