22019 HWY 99 STE B (2)99 S-rcs,
7 FIRE PREVENTIO N
INSPECTION REPORT
Serving Brier, Edmonds, and 12425 Meridian Ave S
0 EDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
www.FjreDistrictl.org Fax (425) 551-1272
FREQUENCY
sTATIO N & SHIFT
LOCATION
22019 Highway 99 Suite A/C 98026
2016'
20-C
BUSINESS NAME:
Olympic Spine & Sports Therapy
PHONE: 4257742411
SCHEDULED
DATE DUE iI. Mar 2016
MAILING
FIR o 593
ADDRESS:
22019 Highway 99 #A, Edmonds, WA 98026
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BUSINESS OWNER:
Shelley, Mark
HOME PHONE:
EMERGENCY-1:
Shelley, LeeAnne
HOME PHONE: 4256817280
"CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
NO
EMAIL:
P1 Aj, 1_
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INITIAL INSPECTION DATE
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HAZAFIDS�FOUND AND LOCATIONS COMMUNICATIONS
2
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5
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I AGREE TO cbRRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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2nd RE -INSPECTION
FINAL RE
EXTENSION
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VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
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CITED:
PERSON
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VIOLAT ONS
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PRE-C TATION
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2
6
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RETURN RECEIPT
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7
\',LETTER NEEDED [:] YES NO
F LETTER NEEDED 0 YES� NO
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SNOHOMI Servink Brier, Edmonds 12425 Meridian Ave,'
Mountlake Terraceand Everett, WA 98208
'DISTTIRE he Town of Woodway Phone (425) 551-120
R T iyww.FireDistrict1.org Faic (425) 551-1272
LOCATION: 2264 Highway 99 B
BUSINESS NAME: "log@ L�!0,11epWl (I VIIHONIE.
4256409789
MAILI�L —=�-�way , 99 #8
ADDRESS:
f Edmonds 98026
BUSINESS OWNER: Lowell, Randall HOME PHONE: 2062002517
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
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PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY I STATION & 8HIF",
730 20
SCHEDULED n3fol/12
DATE DUE
UFIR � 591 3 101'
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
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HAZARDSFOUNDAN LOCATIONS/ COMMUNICATIONS
2
2
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
DATE DUE:
2nd I RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
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INSPECTOR:
INSPECTOR:
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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:
LETTER NEEDED 0 YES NO
LETTER NEEDED [-] YES El NO
8
I
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
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LOCATION: 22019 Hightsuray 99
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BUSINESS NAME: -A+IkreUTT5&tffltS_M
MAILING 22019 Highway 99 #B
ADDRESS: Edmonds
BUSINESS OWNER: 4-ftbner-
,Mark ?,o,�j04,LL_ (,4DW4EL4_
EMERGENCY-1:
KEY ACCESS-2:
FIRE PREVENTION.
SAFETY SURVEY
')( (,f 24-)�909-7811
PHONE: _424W_3?.50
FREQUENCY 1. STATION& SHIFT
730 20 A
SCHEDULED
DATE DUE I�
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98026 FI . R 0 591
HOME PHONE: ACTIVE
HOME PHONE: CEO- 2S I -I
HOME PHONE:
PERSON CONTACTED: SA -A CIAI-L INITIAL INSPECTION DATE
NAME OF INSPECTOR: J 5-ne�l pek q-010
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DATE DUE:
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DATE DUE:
VIOLATIONS
CITED:
PERSON
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PERSON
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1
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DATE:
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VIOLATIONS
1 5
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1 15
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CITATION ISSUED
NUMBER:
4
2 Ok
6
2
6
DATE:
CODE
SECTION:
5
,
1
3
7
3
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RETURN RECEIPT
RECEIVED
6
4
18
18
IDATE:
DISPOSITION:
7
8
LETTER NEEDED [] YES N
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FIRE DEPARTMENT COPY '