224 3RD AVE S (2)SNOHOMISH CO.
Z2q 3RO PU-C,
Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrict].org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
[3 BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY
STATION & SHIFF"S
LOCATION:
224 3 rd Avenue S 98020
Anr
17-C
BUSINESS NAME:
Jasper Five-Plex
PHONE:
4257784203
SCHEDULED
DATE DUE I' ADr 2016
MAILING
LIFIR 0 422202
ADDRESS:
224 3rd Avenue S #301, Edmonds, WA 98020
BUSINESS OWNER:
HOME PHONE:
Jasper, David/Evelyn
EMERGENCY-11:
HOME PHONE:
.
"CURRENT
KEY ACCESS-2:
HOME PHONE:
YES NO
CITY
BUSINESS
EMAIL:
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
AL.,,
FIRE SYSTEMS: FE 4/13
10MARM6
B�!Rto$?OCATIONS/COMMUNICA'nONS,
2
2
3
. . .... ... ..... . .. . .....
3
.......
5
5
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 allbusinesses and multi -family occupancies in e 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. Ab e Y�u
will find the item(s) that were noted during. our inspection which require attention to bring them into compliance
w ith 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 violation.
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7720; for
Mountlake Terrace or Brier, call (425) 744-6231.
Z2q i?,) P 0 Z FIRE.PREVENTION
INSPECTION REPORT
Serving Brier, Edmonds, and 124-15 Meridian Ave S
SNOHOMISH CO. Mountlake Terrace Everett�. WA 98208 0 EDMONDS
OBRIER
FIRE Phone (425) 551-1200 0 MOUNTLAKE TERRACE
0 UNINCORPORATED
DIST RfT www.FireDistrictl.org Fax (425) 551-1272
FREQUENCY STATION & SHIFT
LOCATION: 224 3 rd Avenue S 98020 Annual 17-A
BUSINESS NAME: Jasper FivePIex PHONE: 425776,3203 SCHEDULED Feb 2014
DATE DUE
MAILING UF1422 202
ADDRESS: 224 3rd Avenue S #301, Edmonds, W.A 98020
BUSINESS OWNER: Jasper, David/Evelyn HOME PHONE:
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
EMAIL:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS: FE
CURRENT
CITY YES NO
BUSINESS
LICENSE 1:1 1:1
INITIAL INSPECTION DATE
-z— I ( -� / 11
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
fv D
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
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:
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
SECTIOM
5
7
3
7
RETURN RECEIPT
RECEIVED
6.
j 4
'8
4
8
DATE:
DISPOSITION:
LETTER NEEDED [-] YES NO
LETTER NEEDED C] YES NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
LOCATION:
224 3rd Avenue
BUSINESS NAME:
Jasper Five-Plex
MAILING
224 3rd Ave S #301
-----------
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257784203
ADDRESS: Edmonds 93020
BUSINESS OWNER: Jasper, David/Evetyn HOMEPHONE: 4257734203
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
FRE'QUENCY
STATION& SHIFT
365
17 A
SCHEDULED
02/01/10
DATE DUE ll�
UFIR 1, 422
1 2202
AC-nVE
R I .
IV INITIAL INSPECTION DATE
PERSON CONTACTED: N vr"� / A c k A... I .
NAME OF INSPECTOR: 4:4:141 �0
FIRE FE
�Aj 62-F
0
SYSTEMS:
ANNUAL
R!
HAZAfS 0 NDAN4[)LQCAIIONSI/C!!M
�UNIICA I N
0 S
fo
ENTER CODE ONLY ONCE lo
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
lst RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
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
5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
6
2
6
DATE:
CODE
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
7
4
18
4
18
DATE,
DISPOSITION:
8
LETTER NEEDED E) YES NO
LETTER NEEDED [] YES NO
FIRE DEPARTMENT COPY
FIRE PREVENTION
SRO.HoATIS.H Co. Serving Brier, Edmonds,' and 12425 Meridian Ave S INS�PCTION REPORT
Q'5bMONDS
Mountlake Terrace Everett, WA 98208 BRIER
FIR Phone (425) 551-1200 0 MOUNTLAKE TERRACE
DI40111"T'll [I UNINCORPORATED
F17 A www.FireDistrictl.org Fax (425) 551-1272
FREQUENCY STATION & SHIFT
LOCATION:2243rd AvenueS 98020 Annual 17-D
BUSINESS NAME: Jasper Five-Plex PHONE: 4257784203 SCHEDULED Apr 2017
DATE DUE
MAILING LIFIR � 422 202
ADDRESS: 224 3rd Avenue S #301, Edmonds, WA 98020
BUSINESS OWNER: Jasper, David/Evelyn HOME PHONE:
EMERGENCY-1: HOME PHONE: CURRENT
KEY ACCESS-2: HOME PHONE: 17 CITY f4i�� 0
BUSINESS
EMAIL: LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
Cc
FIRE SYSTEMS: cv(m Mk)Y%.
Date Last Serviced: