22617 76TH AVE W STE 1012 Z 077
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FIRE PREVENTION'.
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12425 Meridian Ave S
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[3 MOUNTLAKE TERRACE
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BUSINESS NAME: A New Spirit Recovery Program
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BUSINESS OWNER: Cox, Donaldz HOME PHONE:
EMERGENCY-1: Cox, Donald HOME PHONE: 4254810177X
CURRENT
KEY ACCESS-2: HOME PHONE: CITY
EMAIL: BUSINESS
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED: DOA
NAME OF INSPECTOR: tILA kO 0 ..A 01
FIRE SYSTEMS: FE 8/111
Date Last Serviced -
HAZARDS JFUND AND LOCATIONS COMMUNICATIONS
2
2
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I AGREE To-cbFIRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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2nd RE -INS PECTION
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DATE DUE:
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CODE
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RECEIVED
MS -POSITION
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WE
FIRE PREVENTION
INSPECTION REPORT
Serving Brie'i; Edmonds, and 12425 Meridian Ave S
ll'SNOHOMISH CO. Mountlake Terrace Everett, WA 98208 OEDMONDS
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A New Spirit Recovery Program PHONE: 425771119 4 DATE DUE 0 Od 2013
MAILING LIFIR 0 593
ADDRESS: 22617 76th Avenue W, Suites 101 & 102, Edmonds, W.A 98026
BUSINESS OWNER: Cox, Donald HOME PHONE:
EMERGENCY-1: Cox, Donald HOME PHONE: 4254810177 CURRENT
KEY ACCESS-2: HOME PHONE: CITY Y�IES NO
EMAIL: BUSINESS Q.,,- E]
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EXTENSION
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DATE DUE:
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INSPECTOR:
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DATE:
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VIOLATIONS
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PRE -CITATION
CITATION ISSUED
1 15
1 5
LETTERSENT
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
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RETURN RECEIPT
3
7
3
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6
DISPOSITION:
14
8
4
18
DATE:
7
LETTER NEEDED [-] YES NO
LETTER NEEDED [) YES NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
SNOHOMISH CO.
Serving .4�rier,.E4monds
12425 Meridian Ave S
INSPECTION REPORT
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Mountlake Terrace, and
Everett, WA 98208
OEDMONDS
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the Town of Woodway
Phone (425) 551-1200
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0 MOUNTLAKE TERRACE
www.FireDistrict].org
Fax (425) 551-1272
0 UNINCORPORATED
LOCATION:
22617 76th Avenue W
1011102
FREOUENCY STATION & SHIFT'*'
730 20 C
BUSINESS NAME:
A New Spird Recovery Program
PHONE: 4257711194
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SCHEDULED
10101112
DATE DUE
MAILING
2261 f76th Ave W #102
LIFIR 593 11107
ADDRESS:
Edmonds 98026
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BUSINESS OWNER:
Cox, Donald
HOME PHONE: 4254810177
ACTIVE
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
Frank, Susan
HOME PHONE: 4254810177
CITY YES NO
BUSINESS
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INITIAL INSPECTION DATE
NAME OF INSPECTOR:
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2
3
3
4
4
5
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6
6
7
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1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE-IN8PEC I TION
DATE DUE:
L
EXTENSION
GRANTED TO:
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VIOLATIONS
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LETTER SENT
CITATION IS§U_ED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
6
13
7
3
7
RETURN RECEIPT
RECEIVED
a
8
4
8
DATE:
DISPOSITION:
7
YES NO
LETTER NEEDED F YES El NO
F
8
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FIRE DEPARTMENT
COPY
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CITY OF EDMONDS
1215- AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
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LOCATION: 22617 76th Avenue W
BUSINESS NAME: A New Spirft Recovery Program
MAILING 22617 76th Ave W #102
FIRE PREVENTION
..... SAFETY SURVEY
101/102
PHONE: 4257711194
ADDRESS: Edmonds 98026
4254810177
BUSINESS OWNER: Cox, Donald HOME PHONE:
EMERGENCY-1: HOME PHONE: 4254810177
KEY ACCESS-2: Frank, Susan HOME PHONE:
" FR%6 NCY
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SCHEDULED
DATE DUE 01
10/01/10
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2
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4
4
5
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6
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7
8
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1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
PERSON
GRANTED TO:
DATE DUE:
PERSON
CITED:
PERSON
CONTACTED:
CONTACTED:
INSPECTOR:
DATE:
VIOLATIONS
CONTACTED:
INSPECTOR:
--INSPECTOR:
PRE -CITATION CITATION ISSUED
DATE:
3
VIOLATIONS
5
LETTER SENT
NUMBER:
4
5
CODE
2
6
2
6
DATE:
SECTION:
6
RETURN RECEIPT
3
7
3
7
RECEIVED
7
DISPOSITION:
4
4 18
LETTER NEEDED F' YES Ej NO
DATE:
8
\� LETTER NEEDED D YES Ei NO
FIRE DEPARTMENT COPY