22618 HWY 99 STE 101 (3)Li
Mr(m 044 17L 4 1
FIRE PREVENTION
Serving Rrier, Edmonds, a'nd- 12425 Meridian Ave S lqppfc-TION"REPORT.
Mountlake Terrace j�veretl, WA 98208 P3 EDMONDS
0 BRIER
MOUNTLAKE TERRACE
Phone (425) 551 1200 13
www.FireDistrict].org Fax (425) 551-1272 E3 UNINCORPORATED
LOCATION r FREQUENCY I STATION& SHIFT"
22618 Highway 99 Suite 101 98026 Annual 20-B
SCHEDULED
BUSINESS NAME: Pho Than Brothers Restaurant PHONE: 4/257440212 DATE DUE i Mar2016
MAILING UFIR 0 161
ADDRESS: 22618 Highway 99, Suite 101, Edmonds, WA 98026
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THENEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION FINAL RE -INSPECTION VIOLATIONS
�TE PUE:
D�TE�DUE_'_..
GRANTEDTO: DATE DUE, CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
t
INSPECTOR, 2
,DATE:
DATE:
VibLAf1_0_NS
VIOLATIONS:,.
tDA __13
-
PRE -CITATION UEd
5
15
4
16
CODE
2 16
1 SECTION
17
3 7
RETURN RECEIPT
RECEIVED 6
-,^";
-
I ..'
18
.
- _' -1
4
4
DATE: 7
LETTER N EEDED YES NO]
LETTER NEEDED 'Y ES NO
FIRE PREVENTION
Serving Brier Edinonds,
and 12425 Meridian Ave S
INSPECTION REPORT
S4H&�SH�Cb.
IREI
I Mountlake Terrace
Everett, XA 98208
0 EDMONDS
0 BRIER
,DISTR
TwwwFireDistrictl.org
Phone (425) 551-1200
-Fax
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
(425) 551-1272
FREQUENCY
STATION & SHIF'**'
LOCATION:
22618 Highway 99 Suite 101 98026
Annual
20-A
I
BUSINESS NAME:
Pho Than Brothers Restaurant
PHONE: 4257440212
SCHEDULED Mar 2015
DATE DUE
MAILING
LIFIR 0 161
ADDRESS:
22618 Highway 99, Suite 101, Edmonds,
WA 98026
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
Vo,p�uong
HOME PHONE: 4253440688
CURRENT
KEY ACCESS-2:
_�-k
q Lad �
HOME PHONE:
c
CITY YES NO
BUSINESS
I;r 1:1
EMAIL:
q Nlo LL.
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR�
�-- i�� t-/�o
FIRE SYSTEMS:
FE 6/14 HD 6/14
/ILA
L(
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 6AYS 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
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES NO
I LETTER NEEDED [:] YES NO
1
8
FIRE DEPARTMENT COPY
MOM
Seni',ing Brier, Edmonds,* and-, 12425 Meridian Ave S
,*hntlake Terrace I Everett, WA 98208'
J Phone (425) 551-1206
RITAT www.FireDistrict]-org Fax_`�(425) 551-1272
6 LOCATION: 226 18 Highvimy M Suite 1 -D 1 QPM6
BUSINESS NAME: Pho I han Broffimi Ro*JoraftL PHONE: 425744021
MAILING
ADDRESS: 22618 1 iigh�hoy DD, Suilm 101, Edimndb, WA 38028
BUSINESS OWNER: HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
[]EDMONDS
[I BRIER
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIFT
Annual 20-13
SCHEDULED
DATE DUE 0 Mar 2014
- .1
LIFIR 046
EMERGEN ' CY-1:
'Va. phunng
HOME PHONE:
426344DE88
" CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
c7ej,!:4m :�7
Al vf
1-- 1 RE SYS I E Nis:
2 HD &I I
FE A
4714 N
HAZARDS FOUND AND LOCATIONS / COMMUNICAl IONS
Y-7
2
1--�7—y-y-)
2
3
11
3
7�'
4
4
5
5
V j IV LC N
6
6
7
yt�
41 P
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE.
DATE DUE.
GRANTED TO*
DATE DUE:
CITED:
PERSON
CONTACTED: /7,A 6/�
PERSON
CONTACTED:
PERSON
CONTACTED:
I
2
INSPECTOR:TZ) /1
INSPECTOR:
INSPECTOR:
'00 2,
3
DATE:
DATE:
DATE:
VIOLATIONS
VIC,
10 IONS
PRE -CITATION
CITATION ISSUED
4
5
1- 15
LETTER SENT
NUMBER:
27
6
6
DATE:
CODE
SECTION:
5
RETURN RECEIPT
6
3
7
3
147
RECEIVED
DISPOSITION:
7
4
18
4
8
DATE:
LETTER NEEDED X YES NO
LETTER NEEDED F] YES NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Sei;viOg Briet; Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terraceand
FIRE
Everett, WA 98208
0 EDMONDS
0 BRIER
the Town of Woodway
DIST Rli. IT
Phone (425) 551-1200
0WOODWAY
[1 MOUNTLAKE TERRACE
,www.FireDistrictl.org
Fax (425) 551-1272
[]UNINCORPORATED
01 FREQUENCY STATION & SHIFT'**'
LOCATION: 22618 Hvvy 99
101
2 20 C
BUSINESS NAME: Pho Than Brothers Restaurant
PHONE: 4257440212
SCHEDULED
DATE DUE 1' 03/01/13
MAILING 22618 Hwy 99 #101
UFIR � 161 3106
ADDRESS: Edmonds
98026
BUSINESS OWNER: Vo,Phuong
HOMEPHONE: 4253440688
65
EMERGENCY-1: Than, Quang
HOMEPHONE: 2067694762
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS F-]
C,
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
13
FIRE HD 8/11
FE � �U(-I_
SYSTEMS: t (). II I --z--
ANNUAL
I �_
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
U I
2
2
3
3
4
4
"A
A
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE-INSI� �QTIQNI'
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
r1ATE,
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
18
4
8__
DATE:
DISPOSITION:
7
LETTER NEEDED 0 YES [I NO
LETTER NEEDED [] YES NO
1 8
FIRE DEPARTM,EN.T,�COPY
FIRE PREVENTION
ying Bi
�qr let: Edinonds
124z'-15 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO. I, ; I I�011111
Mountlake Terraceand
FIRE
Everett, WA 98208
0 EDMONDS
0 BRIER
the Towh of Woodway
STR T
Phone (425) 551-1200
E]WOODWAY
0 MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION & SHIFT"
LOCATION: 22618 Hwy 99
101
365
20 B
BUSINESS NAME: ph"o Than Brothers Restaurant
PHONE: 4257440212
SCHEDULED 3/01/12
DATE DUE 0 0
MAILING 22618 Hwy 99 #101
UFIR 1, 161 3106
ADDRESS: Edmonds
98026.
1�1
BUSINESS OWNER: Vo,Phuong
HOME PHONE: 4253440'688
65
EMERGENCY-1: Than, Quang
HOME PHONE: 2067694762
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YjES��NO
BUSINESS
F
I
LICENSE
L
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: /if
FIRE HD 8/11
FE,�01/
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
L4
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:
I
2nd RE -INSPECTION
DATE DUE:
I :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
18
DATE:
DISPOSITION:
( LETTER NEEDED F] YES NO
I LETTER NEEDED F] YES NO
. .
8
FIRE DEPARTMENf'Q�,OY�
M 0094=- 10 V 11 MIN �115GTMI 0:6 11 0=1 emmm- 0- 1) 1 -M
Friday, September 30. 2011 04:38 PIVI Ed's Fire Inc. (425)877-1997 P.01
EVS FIRE INC DA TE
P.O. BOX 2685 LYNNWOOD, WA. 08036 09/03/2011
TEL;1(426)877-8826* FAX:1(426)877-1997
www.edsfireinc,com * odsfireinc@yahoo.com Invoice #: 1341
E-�d's Fir -a Certificate # SCP-M-0771S
Inc. RANGE HOOD INSPECTION REPORT Semi -Annual ER Annual El
CITY OF Edmonds Confidence Test Z Repain [:]
JOB Pho Thai Brother Type of system.* Wet Chem. 0 Dry Chem, E]
SITE 22618 Hwy 99 # 101 Amerex KP 375 - 3.75 ga
Edmonds, Wa. 98026
CUSTOMER PHONE 0 (425) 744-0212 RED E] YELLOW 0 WHITE Z
Cylinder's pressm-e giuge or weight is at 3cceptable level.
Yes Z]
No
IVA [:]
Systein has not been iiied cn been tampered with,
Yes Z]
No
AVA E]
All piping and conduit is immobilized witli pror4f hangerm and brackets.
Yej
No
AVA
All nozzlesare in propei position-i
Yes
No
NA
All nozzlei: -de covered by blow off cnpQ.
Yes
No
AYA
Systein hisadequate voltune and/or nozzle coverage,
Yes
No
AYA
Date of new h4s:
09/03/2011 7
.SyAtem opeioted properly lioni most remote Wsible link
Yes
No E]
VA
Systein olxrated poperly fiom ill inantial actuatorl.
Yes Z1
No Ej
AVA
Rpu4e hood tied to building alarm patiel.
Yes
No
ANVA
Manual actuators are mobstructed and in path of egresi.
Yes
No
/VA
hispeclion and service tig on system cylindei widlar remote pull station.
Yes
No
NA
All cooking smOce6 ore protected.
Yes
No
IVA
Date of last hydrostatic test ofcylindei:
N/A I
Alitornafic 4itdown of hiel/power/micro sMtch.
Yes
No
AVA
Systein is now fiffly operational wid fi-ee from otytructions.
Yes
No
WA
Clw;6 K extiingW�her in place find serviced,
Yes
No
WA
All lead and whe seals are ijitact
Yes
No
VA
The hood and duct are fiee ftom grease and sludge accwnulafion.
Yes
No
AVA
S�%tem I;; UL300.
Yoe
No
/VA
Date of last clewdrig:
08/29/11
Yom ffie 6uppretitiien iqutain doopi not ineat ctirrent UL300 otandaidFi and inore impoitantly
may not extingi&h a cooking fire. You need to ieplace your fire Piippre�sion sy�tem with P new
UL300 rated wet chemical Aystem.
El
Problems found.
inspection by:
Diagram
— — — — — — — — — — — — — — — — — — — — - — — — — — — — — — — — — — — — -
2 Sumer Range I bumor Kongo Range Re "as Range Range
...... FIRE PREVENTION
CITY OF -EDMONDS -SAFETY 8URVEY
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (4275) 771-0215
FIRE DEPARTMENT
r 71
LOCATION: 22618 Hwy 99
BUSINESS NAME: Pho Than Brothers Restaurant
MAILING 22618 Hwy 99 #10 1
101
PHONE: 4257440212
ADDRESS: Edmonds 98026
BUSINESS OWNER: Vo,Phuong HOME PHONE: 4253"0688
EMERGENCY-1: Than, Quang HOME PHONE: 2067694762
KEY ACCESS-2: HOME PHONE:
FRE(W5ENCY
STATjN & XIFT
3
1
SCHEDULED 03/01/11
DATE DUE 11
UFIR 1- 161
3106
65
PERSON CONTACTED: ?AQ0tj c, \/c) INITIAL INSPECTION DATE
NAME OF INSPECTOR: �IeQ o f-I -> - Lc;' - I I
FIRE HD 4/07 UL300 FE ±�V_Aj
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
C \-\I P, (zo 0 E IT f-I - Y—T k c 15
OUT-
ENTER CODE ONLY ONCE ll�
04: Vj-TC_l-+V_�4)
VIOLATION CODE
r--V
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
ATIONS
1 15
MOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
6
DATE:
CODE
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
4
8
4
.8
DATE:
DISPOSITION:
7
8
\,, LETTER NEEDED [] YES Ej NO
LETTER NEEDED El YES NO
FIRE DEPARTMENT COPY