22618 HWY 99 STE 102_103 (3)7`7 .7
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3 Serving B�ier, LA,ttvrtua, and 12425 Meridian Ave S /OZ
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LOCATION: 22618 Highway 99 Suite 102/103 98026 nUajCY
BUSINESS NAME: Sushi Moto PHONE: 4256735477 SCHEDULED Mar 2017
DATE DUE 0
MAILING 22618 Highway 99, Suite 102, Edmonds,'WA 98026 UFIR
ADDRESS:
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BUSINESS OWNER: HOME PHONE:
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EMERGENCY-1: HOME PHONE: "CURRENT YES NO
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DATE DUE: DA�E DUE: GRANTEDTO. i DATE DUE: CITED:
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FIRE PREVENTION
Serving Brier, Ednionds, and
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J Serving Edmonds, and 12425 Meridian Ave S
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BUSINESS NAME:
Sushi Moto PHONE: 4256735477
MAILING
ADDRESS:
22618 Highway 99, Suite 102, Edmonds, WA 98026
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
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4
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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DATE DUE:
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DATE:
DISPOSITION:
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LETTER NEEDED 0 YES NO
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FIRE DEPARTMENT COPY
FIRE PREVENTION
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Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terraceand
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Everett, WA 98208
OEDMCNDS
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the Town of Woodway
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LOCATION: 22618 Hwy 99
102
365
20 C
BUSINESS NAME: Sushi Moto
PHONE: 4256735477
SCHEDULED
DATE DUE � 03,1111/13
MAILING 22618 Hwy 99 #102
LIFIR � 161 3106
ADDRESS: Edmonds
93026
BUSINESS OWNER: Sushi Moto, Inc
HOMEPHONE: 42,56735477
EMERGENCY-1: Oh, Chi
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE: 1%:;qV
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INITIAL INSPECTION DATE
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SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
4
4
5
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DATE DUE:
2nd RE -INSPECTION
DATE DUE:
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EXTEN SION
GRANTED TO:
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NUMBER:
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DISPOSITION:
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FIRE DEPARTMENT COPY
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FIRE PREVENTION
Serving Brier; �8dtnonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terraceand
FIRE
Everett, WA 98208
EIEDMONDS
0 BRIER
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DISTR T twhwwFireDistrial.org
Phone (425) 551-1200
0 WOODWAY
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LOCATION: 22618 �hw 99
102
365
20 B
BUSINESS NAME: Sushi Moto
PHONE: 4256735477
SCHEDULED
DATE DUE � 03/01112
MAILING 22618 1" 99 #102
LIFIR � 161 3106
ADDRESS: Edmonds
98026
BUSINESS OWNER: Sushi Moto, Inc
HOME PHONE: 4256735477
EMERGE"NCY-1: Oh, Chi
HOME PHONE. 4253853U3
"'CURRENT
KEY ACCESS-2:
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HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
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4
5
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6
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 15
VIOLATIONS
1 15
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
—SECTION:
5
3
7
3
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RETURN RECEIPT
RECEIVED
6
4.
8
4
8
DATE:
DISPOSITION:
%, LETTER NEEDED F] YES El NO
I LETTER NEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY