22315 HWY 99 STE F (2)SNOHOMISH CC
FIRE
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Servhq, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
LOCATION: 223 15 Highway 90 Suite F USCL26
BUSINESS NAME: leumcn Mah & R-ma-ding CnLr PHONE:
MAILING
ADDRESS: 22315 1 lighway 09, Sui Lc F, EdrTwinds., W A 38026
BUSINESS OWNER: HOME PHONE:
EMERGENCY-11: j\t, 11g;
KEY ACCESS-2:
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PERSON CONTACTED:
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FIRE PREVENTION
INSPECTION REPORT
MEDMONDS
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SCHEDULED
4257716055 DATEDUE �Nav2!0113
UFIR 1233
AW631 01 fJ CURRENT
CITY YES NO
BUSINESS
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INITIAL INSPECTION DATE
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HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
I
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
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS'
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
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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
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7
3
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RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED E] YES F-1 N01',
LETTER NEEDED E] YES El NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
4er'ving 'Brier, EdWonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountla-ke Terraceand
jFIRE
Everett, WA 98208
OEDMONDS
0 BRIER
e Town of Woodway
DIST11ftlT
Phone(425) - 551-1200
E]WOODWAY
[I MOUNTLAKE TERRACE
w"`ww.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION & SHIFF"�
LOCATION: 22315 Highway 99
F
365
20 C
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BUSINESS NAME: Kumen Math & Reading Cntr
PHONE: 4257710905
SCHEDULED 11/01/11
DATE DUE II'
MAILING 22315 Highway 99 #F
UFIR � 233 1107
ADDRESS:
Edmonds
98026
BUSINESS OWNER: At, Inc
HOME PHONE: 2063831018
ACTIVE
EMERGENCY-1: Hudson,Kanna
HOME PHONE: 2062271012
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
1:1
LICENSE Z
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE
FE _Lly�Z
SYSTEMS:
ANNUAL
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HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
4
4
5
5
6
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7
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1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
DATE DUE:
;� RE-INSPECTIO N
,�n
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
ONTACTED:
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
14
18
4
8
JONO
DATE:
DISPOSITION:
LETTERNEEDED [] YES NO
LETTER NEEDED []_YES
8
FIRE DEPARTMENT COPY