23014 EDMONDS WAY (2)WAY FIRE PREVENTION'
170mo6J0J INSPECTION REPORT
Serving Brier, Eumurtua, and 12425 Meridian Ave S DEDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
www.FireDistrictl.org Fax (425) 551-1272 [1 UNINCORPORATED
LOCATION: 23014 Edmonds Way 98020
BUSINESS NAME: Compass Apartments
4256731300
PHONE:
MAILING 23014 Edmonds Way, Edmond . s, WA 98020
ADDRESS:
BUSINESS OWNER: Marzett, Desmond HOME PHONE:
e' FREQUENCY STATION & SHIFT
Annual I 20-C
SCHEDULED Jul 2017
DATE DUE �
42455
UFIR 0
t-,ompass apts 4ZOO(J-1.5
EMERGENCY-11: HOME PHONE-
* 20
"'CURRENT . Vf�
KEY ACCESS-2: HOME PHONE:
CITY YES No
EMAIL:
BUSINESS F__1
LICENSE L_J
PERSON CONTACTED: ID P-111�
INITIAL INSPECTION DATE
NAME OF INSPECTOR: 0 3
�;11RE SYSTEMS: AS 4/161FA
_J
4/16 FE 4/16 12-00:00 AM
Date Last Serviced: s-//
HAZARDS FOUND AND LOCATIONS COMMUNItATIONS
VIQ
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
In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the 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. Above you
will find the item(s) that were noted during our inspection which require attention to bring them into compliance
with 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 i lati
olali
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-77 ; or
0
Mountlake Terrace or Brier, call (425) 744-6231.
;� - - a
SNOHOMISH CO.
Serving Brier, Edmonds, and
Mountlake Prrace
www.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PREVENTION
IN!���ION REPORT
_MDMONDS
DBRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY
STATION & SHIF`�
LOCATION:
23014 Edmonds Way 98020
BUSINESS NAME:
PHONE:
SCM;;1=
DATE DUE �
Compass Apartments
4256731300
duffi2016
MAILING
UFIR 0
ADDRESS:
42455.
23014 Edmonds Way, Edmonds, WA 98020
BUSINESS OWNER:
HOME PHONE:
Marzeft, Desmond
.EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
Compass apts
HOME PHONE:
4256731300
CITY YES
NO
BUSINESS
EMAIL:
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: t7n, kK\10,f_4
1411,& zV1
t
FIRESYSTEMS: AS3715FA4/16 E015 FDLkBox/
1381M Mat ZdJoCATIONS /COMMUNICATIONS
011,
2
2
3
4
— — --------
3
4
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 all.businesses and multi -family occupancies in the 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. Above you
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.
V1,
FIRE PREVENTION
Serving:Brier Edin0i'ids-and 1242A)6AfliW,.4ve S-JA INSPECTION REPORT
O'EDMONDS
Everett, WA 98208 0 6�11ER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
MA"imitil www.FireDistrictl.'org Fax (425) 551-1272
FREQUENCY
STATION & SHIF*`�
LOCATION:
23014 Edmonds Way. 98020
Annual
20-A
I
BUSINESS NAME:
Compass Apartments
4256731300
PHONE:
SCHEDULECLJUI 2015
DATE DUE I`
MAILING
UFIR 1,424 55
ADDRESS:
23014 Edmonds Way, Edmonds, WA 98020
BUSINESS OWNER:
Marzett, Desmond
HOME PHONE:
EIVIERGENCY-1:
Compass apts
HOME PHONE: 4256731300 'CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
YES NO
BUSINESS
El 1:1
EMAIL�
LICENSE
PERSON CONTACTED: 4A e rA />-v,,o t
INITIAL INSPECTION DATE
NAME OF I NSPECTOR:
1 1)
e—
A5 f F
PIPP qV.qTPhA.q-
A4Z q11A CA '2/1A C:C A11A( CrI, . I L1, 0 �--
=4
S� DrAND LFATIONS COMMUNICATIONS
'bifeF
"ea �e VICe
Ll
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
1 st RE -INSPECTION
2nd RE -INSPECTION
L/-'FINAL
RE -INSPECTION
EXTENSI�N
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
E:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
3
7
RECEIVED
DISPOSITION:
7
.4
18
I
4
18
1
DATE7
LETTERNEEDED [-] YES NO
I LETTERNEEDED E] YES El NO
8
FIRE DEPARTMENT COPY
Fire Protection, Inc.
CONTRACTOR OFIREPI*021ML
Fire and Security Alarm Installations
24 Hour Local UL Monitoring
Date: _qhz)_&
Acct #: W-2-? 7
Work Order #- 7 _5
(425) 290-960100 (800) 681-1125
ll;;�: (426) 353-4546
FIREALARM SYSTEM
(One System per Report)
Certification Given
YELLOW
WHITE
_�LCONFIDENCE TEST
I C3 REPAIRS
11
Lcupancy Address: 230 4 F� & o Al 5 �U�
Testers Name: M f,&y V)
Timeln:, Time Out: &"n
Central station monitoring? IF_Yes Q No
System Make: S K
System Location: -1 C, r
Occupancy Name: 60mp'a SS AAI.-
*.S ' -4, b '
Phone Number: Gq4
Responsible Party
E-mail Address: Drew
Inspection FrequencytType: Ll Monthly
El Quarterly
Q Semi -Annual
Annual
Certification Number: V-02373
Monitoring Company Name. Fire Protection, Inc.
System Model:
CORRECTIONs NEEDED:
AJ L5
UA A
-Se
— Neel
Q trbl-ev-15 44�5-tjal
CORRECTIONS MADE: Date Corrected:
Corrected BY:
b
,W -�pc,\R. �
This certifies that this fire and life safety system has been inspected. Discrepancies are noted and
have been reported to the building representative, along with a copy of this report for corrective action.
Signature of Tester: Tech # Phone # 425-290-9600
Building Representative: (sign) X (print) VAIUe_u�c
Fire Alarm Systems Page I of 2
Fire Protection, Inc. Acct.#:
c Dil�
n - . 4�)Lf jr- I
The items on this checklist have been inspected and tested. This list does not constitute all of the
required inspecting and testing of the fire and life safety system. Refer to Fire Department Fire Codes
for inspecting and testing requirements.
Alarm System Functionality
1:
'Trouble signal with AC power off?
Yes
-3 No
L
-yst m_op a,'�es ppeqy on battery backup?
__ _ _e( _�I�r _ - - - � - - - -- - -
Yes
L) No
3.
I
_Battery voltage (no loadL I volts
_141
-- --- -
-- -A
4,
-
Battery voltagefull load� 71 C f U volts (signals o
5.
_pmfing)
Charge circuit voltage volts
6.
System operktes�- properly on standby power?
Yes
Cl No
7.
All signals operate on AC power'?
Yes
-0 No
8.
Number of initating circuits
9. -
, Number of signal circuits
10.
Does alarm syatern meet audibility standards as acce ted?
-- pi
Yes
'I No
11.
All circuits_ checked for electrical supervision?
Yes
0 No
12.
Allauxiliary ento erates (elevators, fans, dampers)?
_eq _!71_ _ -P
Q N/A
Yes
Ll No
13.
Ventilation controls operate?
PLN/A
a Yes-
0 No
14 .
Key to panel dvailable?
Yes
Lj No
15.
Operating instructions at panel?
Yes
Q No
16.
Trouble indicajors function properly?
- -- - -
I Yes
U No
17.
Remote Annunciator Panels function properly?
- - - -- I—. -- - 11 - .
* N/A
C3 Yes
0 No
18.
Elevator Call Down functions properly?
N/A
T4 Ye s
No
19.
Test record posted at - pan - el?
XYes-
0 No
20.
General alarm, automatic time delay (minutes),
N/A
21. --Was
a signal received at the Central Station monitoring compa
- ----- ---- --
r7l N/A
4 Yes
0 No.
22.
Other Devices, (specify) S)(Si-1574 IPA- 6/-i4
Yes
:3 No
System Devices
To(al Number of
Total Number
I
Units in Building
Units Tested
Test
Results Acceptable
23.
I -
Bells, Horns, Chimes
-1 1 - - , --- ----
n N/A
14 Yes
0 No
24.
Voice Speakers (Voice Clarity)
PL N/A
0 Yes
- -
0 No
25.
Smoke Detectors
0 N/A
Yes
0 No
26-.�
Heat -Detectors
0 N/A
Yes
El No
27.
--
Duct Detectors
- - -
N/A
C) Yes
U No
28.
.29.
- -
Sprinkler - Flow Switches
Sprinkler Supervisory Switches
_A
El N/A
ZI N/A
Yes
-
es
0 No
Ll No
Visual Alarm Devices
El N/A
Yes
3 No
31.
-
Manual Pull Stations
L
Q N/A
Yes
0 No-
32.
-
Annunciator(s)
N/A
0 Yes
0 No
33.
Beam Detectofs
N/A
7 Q
0 No
34.
Automatic Door -Unlocks
N/A
-Yes---
.0 Yes
No
35.
Automatic DooT Release
N/A
D Yes
_0
No
36.
Fire Dampers
N/A
El Yes
C], No
Communicatiobs Equipment
Total Number of
Total Number
Units in Building
Units Tested
Test
Results Acceptable
37.
Phone Sets
Ll N/A
Yes
J No
38.
Phone Jacks
- - -
I
a N/A
Q Yes
0 No
39.
Call -in Signal
------------ li-
-----------
C3 N/A
Ye s
0 No
1-1re Alarm Systems Page 2 of 2
I
AMA AN
0(0 AFP;
574261
Fire Protection, Inc.
CONTRACTOR #FIREPI*021ML
Fire and Security Alarm Installations
24 Hour Local UL Monitoring
Date: qlja(a
Acct. #:0-2— c? 7 9
Work Order #: gZ21-3
(425) 290-9600 e (800) 681-1125
Fax: (425) 3634546
FIRE ALARM SYSTEM
(One System per Report)
Certification Given
YELLOW
I O(WHITE_
ILCONFIDENCE TESTF_Q
REPAIRS
Occupancy Address: -7 014 EJmod-5 LUL
Flv-Nor),8, WA,
TA6s-iers Name: __f11^A. W01 VOLt.0 k r%
sk&r'lre,
Time. In: .0 CL 0;— Time Out: Z-',
Central station monitoring? `1�k Yes LJ No
System Make,:
System Location: er �0-0 V-�
OccupancyName:
hr
Phone Number: b
Responsible, Party
E-mail Address: Lpf'&Ll
Inspection Frequencyftype: Q Monthly
Quarterly
Semi -Annual
AAnnual
Certification Number: V__ 0?K7 3
Monitoring Company Name: Fire Protection, Inc.
System Model: 5700
CORRECTIONs NEEDIEW
CORRECTIONS MADE: Date Corrected:
Corrected By:
This certifies that this fire and life safety system has been inspected. Discrepancie& are noted and.
have been reported to the building representative, along with a copy, of this report for corrective action.
Signature of Tester: Te& # Phone # 425-290-9600
Building Representative: (sign.) X (print)
Fire Alarm Systems
Page 1 of 2
F AMA N
P;
Fire Protection, Inc.
AC
IV
The items on this checklist have been inspected and tested. This list does not constitute all of the
required inspecting and testing of the fire and life safety system. Refer to Fire Department Fire Codes
for inspecting and testing requirements.
Alarm System Functionality
1 .
Trouble signal with AC power off?
Yes
0 No
2.
S stem operates properly on battery backup?
Wyes
:3 No
Battery voltage (no load) volts
_1_
4._
- __
load
Battery voltage ti volts (signals operating.)
5.
Charge circuit voltage volts
6.
System operates roperly on standby Power?
Yes
U No
7.
All signals operate on AC power?
Yes
0 No
8.
Number of initiatiqq circuits
9.
Number of signal circuits
10 .
Does alarm sVstem meet audibility standards as accepted?
:J1 No
11.
All circuits. checked for electrical supervision?
A -Ye S
0 No
12.
All auxiliary equipment operates (elevators, fans, dampers)?
N/A
El Yes
-
0 No
13.
Ventilation controls operate?
N/A'
Q Yes
C3 No
14.
Key to panel available?
Yes-,
:3 No
15.
Operating instructions at panel?
Yes
0 No
1 6.
Trouble ind icators functi on proper ly?
Yes
:3 No
17.
Remote Annunciator Panels function properly?
N/A
0 Yes
0 No
18 .
Elevator Call Down functions properly?
NIA
F1 Ye s
_3 No
19.
Test record posted at panel?
Yes
0 No
20.
General alarm, a utomatic time delay mi nutes)
N/A
21.
Was a signal received at the Central Station monitoring company?
0 N/A
WYes
0 No
22.
Other Devices (specify)
U Yes
K_No
Total Number of
Total Number
System
Devices
Units in Building
Units Tested
Test
Results Acceptable
23.
Bells, Horns, Chimes
NIA
Yes
U No
24.
Voice Speakers (Voice Clarity)
f& N/A
Q Yes
0 No
25.
Smoke Detectors
J N/A
kYes
0 No
26.
kea�t Detec tors
f9L N/A_
El Yes
El No-
27.
-
Duct Detectors
10 N/A
0 Yes '
EI No
28.
Sprinkler Flow Switches
0 N/A
Yes
Q No
- -
29.
Sprinkler Supervisory Switches
:1 N/A
Yes
0, No
30.
Visual Alarm Devices
Q N/A
Yes
0 No
31.
Manual Pull Stations
C3 N/A
Yes
El No
32.
Annunciator(s)
N/A
0 Yes
0 No
33.
Bear n Detectors
N/A
J Yes
Cl No
34.
Automatic Door Unlocks
NIA
El Yes
0 No
35.
Automatic Door Release
N/A
:1 Yes
Q No
36.
Fire Dampers
N/A
0 Yes
El No
Total Number of
Tbtal,Number
Communications Equipment
Units in, Building-
-Units Tested
Test
Results Acceptable
37.
Phone Sets
N/A
Yes
El No
38.
Phone Jacks
-0
N/A
Yes
0 No
39.
Call -in Signal
0 N/A
A.Yes
0 No
Fire Alarm Systems Page 2 of 2
All Events Report
Report for period. 1112612015 12:00:OOAM to 1112612015 11:59:OOPM
Compass Apts - North Bldg
23014 Edmonds Way
Edmonds
Snohomish
Washington
98020
Daft and 77me, Zone and ftstore nme
11/26/2015 1:08:21AM
88,2978
Phone: 425-673-1300
Event,Actions Taken, Completion Tine and Operator
Trans Test O'clue (1) N1 11/2612015 6:38:46AM
11/26/2015 1:08:21AM Trans Test O'due (1) T: I A: 1
11/26/2015
6:37:55AM
Action Started N1 Fire Protection, Inc.
KSC
11/26/2015
6:37:56AM
Actioned N1 (Done)
KSC
11/26/2015
6:38:43AM
Test Overdue Resolved
KSC
11/26/2015
6:38:46AM
EFM - Emailed Fire Marshall
KSC
11/26/2015
6:38:46AM
Operator Closed (Opr)
KSC
11126/2015
6:38:01AM
Details Opened for Editing (Opr)
KSC
Thu 11/26/2015 11:45:15PM 199 Timer Test
Actions Legend: P = Police, K = Keyholder Group, S = Site, A = Special Action, F = Fim, G = Gen Agency, I = Installer, M = Medical
Alarm Center Inc. 1-800-752-2490
All Events Report
Report for period. 1112612015 12:00:OOAM to 1112612015 11:59:OOPM
Compass Apts - North Bldg 88,2978
23014 Edmonds Way Phone: 425-673-1300
Edmonds
Snohomish
Washington
98020
Date and Tim, Zone and Restore Tfme
Event,Actions Taken, Compledon Tine and Operaftr
11/2612015
1:08:21AM
Trans Test O'clue (1)
NI 11/26/2015 6:38:46AM
11/26/2015
1:08:21AM
Trans Test O'due (1) T: 1 A: 1
11/26/2015
6:37:55AM
Action Started N1 Fire Protection, Inc.
KSC
11/26/2015
6:37:56AM
Actioned N1 (Done)
KSC
11/26/2015
6:38:43AM
Test Overdue Resolved
KSC
11/26/2015
6:38:46AM
EFM - Emailed Fire Marshall
KSC
11/26/2015
6:38:46AM
Operator Closed (Opr)
KSC
11/26/2015
6:38:01AM
Details Opened for Editing (Opr)
KSC
Actfons Legend: P = Police, K = Keyholder Group, S = Site, A = Special Action, F = Fire, G = Gen Agency, I = Installer, M = Medical
Alarm Center Inc. 1-800-752-2490
All Events Report
Report for period: 711512015 12:00:OOAM to 7/15/2015 11:59:OOPM
Compass Apts - North Bldg 88,2978
23014 Edmonds Way Phone: 425-673-1300
Edmonds
Snohomish
Washington
98020
Date and 77me, Zone and Restore 77m
Event,Actions Taken, Compleffon Tine and Operator
7/1512015
1:06:08AM
Trans Test O'due (1)
N1 7/15/2015 1:13:45AM
7/15/2015
1:06:08AM
Trans Test O'due (1) T: 1 A: 1
7/15/2015
1: 1 1:46AM
Action Started N1 Fire Protection, Inc.
JPM
7/15/2015
1: 1 1:47AM
Actioned N1 (Done)
JPM
7/15/2015
1: 1 3:34AM
FTF - Faxed Ticket to Fire Marshal
JPM
7/15/2015
1: 1 3:45AM
Test Overdue Resolved
JPM
7/15/2015
1: 1 3:46AM
FTF - Faxed Ticket to Fire Marshal
JPM
7/15/2015
1: 1 3:47AM
Operator Closed (Opr)
JPM
7/15/2015
1:11:55AM
Details Opened for Editing (Opr)
JPM
Actions Legend: P = Police, K = Keyholder Group, S = Site, A = Special Action, F = Fire, G = Gen Agency, I = Installer, M = Medical
Alarm Center Inc. 1-800-752-2490
Emerald Pire
Fire Sprinkler Specialists
11021 Cramer Rd. KPN Gig Harbor, WA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS,�
(One System per Report)
X3 0 Ili Edw-ml-ofa
Occupancy Aciclress:_&4��-T 64/o k0aQ Occ pancy Name: Ck_%��
Responsible Person: lVot,+k
- /Phone Number:
Building Owner:
Phone Number:
Date of Inspection: :R -_goA�_ Type of Inspection: Quarterly Ej Annual E] Other F�
Testers Name (Please Print): 3.6 aqmj WAStateFSCC#
%J I
DRY SYSTEM/PRE-ACTION SYSTEM:
1 Trip test (dry trip or full flow) conducted: .................................................. Yes F� No F]
System tripped in seconds. I,-
2. All flow switches, supervisory switches and armbellstested: ..................... YesEl Noo N/AE]
3. Alarm bell operates-......,. . .... * .... .. ..... Yes 0 No E] N/A E]
4. Flow tests conducted: Yes [] No E]
7
-V
7
...........
Flow pressure: ps. A h drain? ....................................... Yes E] Noo
2-in
5. Systems inspected and lubric ed: .................................................. Yes E] No E] N/A E]
0 in t
tv . e
6. Air compressor refills syst rn in 30 inu 5: .............................................. Yes El No El
7. System drained and r tored to normal operation: ..................................... Yes Ej Non
8. Were the heat actuafion devices tested on pre -action and deluge system? ..... Yes 11 No El N/A EJ
WET SYSTEM/ANTI-FREEZE SYSTEM: Tested at
1 Trip test conducted: .............................................................................. Yes Y No D
Staticpressure: 2_�;— psi Flow pressure: 70 psi I inch drain? ....... Yes 2� No E] N/A F�
2. Flow switches, supervisory switches and alarm bells tested: ..................... Yes e No Fj N/A E]
3. Alarm bell operates: ............................................................................. Yesy Non N/An
4. Systems inspected and lubricated: .......................................................... Yes E01" No F�
5. Pressure regulatin-g valves tested: ........................................................... YesE] NoR N/Ad
.AUTOMATIC SPRINKLER SYSTEMS (continued)
General:
1 Central Station Monitoring? .......................................................................... Yes Ep�' No R
Monitoring company name rp—r-
2. Location of Sprinklers
100% ......... Parking ......... Basement ......... E] Hallways ......... E] Other ........ F]
3. Pumper connections and clapper valves unobstructed ....................................... Yes V No F]
4. Sprinkler heads less than 50 years old ............................................................. Yes 00", No F-�
5. Sprinkler coverage is acceptable .................................................................... Yes G/ No F-1
6. Spare sprinkler heads are available ................................................................. Yes V No F-1
7. Systems left in service .................................................................................. Yes No[-]
8. Valves are sealed or supervised ...................................................................... Yes No F]
9. Signs are provided on valves ......................................................................... Yes No F-1
10. City static water pressure psi.
Problems Found:
� I
fY--C E4 5SIA) 4 55
- LA&4-T ylo� 01��
Corrections Made: Date Corrected: Corrected By:
SIGNATURE OF TESTER:
AGENCY: Ernera-ld Fire PHONE: 253-857-2056
MAILING ADDRESS: 11021 Crainer Road KPN, Gig Harbor, WA 98329
Emerald 'I' ire
Fire Sprinkler Specialists
11021 Cramer Rd. KPN - Gig Harbor, WA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(One Svstern Der ReDort)
X3 0 1 �4 EOKO'to V'Cfa VJ6.1
Occupancy Address: F_Q&jdaw& IA-6- qRc2aa Occupancy Name: — I w)&.Rs I C
Responsible Person: AZoA,, Rldr,. Phone Number:
V
Building Owner: Phone Number:
Date of Inspection: Type of Inspection: Quarterly E] Annual [;e Other [-]
Testers Name (Please Print): 'Rn(Q WA State FSCC# 0 6 3 3 - Iff - u'_) 55 1, C'_�
V I
DRY SYSTEM/PRE-ACTION SYSTEM:
1. Trip test (drytrip o ullflow onducted: ..................................................
<qE�x
Yes [y No 0
System tripped in Aq seconds.
2. All flow switches, supervisory switches and alarm bells tested: .....................
Yes 52( No El N/A E]
3. Alarm bell operates: ............................................................................ .
Yes [Y( No E] N/A n
4. Flow tests conducted: ...........................................................................
Yes [5?' No n
Flow pressure: .70 —psi $,inch drain? .......................................
YesW Non
5. Systems inspected and lubricated: ..........................................................
Yes N( No E] N/A E]
6. Air compressor refills system in 30 minutes: ..............................................
Yes V No E]
7. System drained and restored to normal operation: .....................................
Yes Cy No E]
8. Were the heat actuation devices tested on pre -action and deluge system?.....
Yes n No E] N/A Y
WET SYSTEM/ANTI-FREEZE SYSTEM: Tested at
1 Trip test conducted: .................. .. .......... .... ........................................ Yes El No El
Static pressure: psi Flo pr ssure): psi 2 inch drain? ....... Yes E-] No N`/A r-1
5s
rm
2. Flow switches, supervisory switches \ad rm b�ls tested: ..................... Yes E] No E] N/A E]
3. Alarm bell operates: ........................ ...... ... .................................... Yes E-] No F-1 N/A E]
4. Systems inspected and lubricated: ... / ..................................................... Yes E] No E]
5. Pressure regulating valves tested:. If ......................................................... Yes F No E] N/A E]
AUTOMATIC SPRINKLER SYSTEMS (continued)
General:
I
Central Station Monitoring? ..........................................................................
Yes [jr
Non
Monitoring company name EP5,
2.
Location of Sprinklers
100% ......... g Parking ......... n Basement ......... n Hallways ......... El Other .........
El
3.
Pumper connections and clapper valves unobstructed .......................................
Yes [Z
No EJ
4.
Sprinkler heads less than 50 years old .............................................................
Yes Ej
No E]
5.
Sprinkler coverage is acceptable ....................................................................
Yes[!(
No El
6.
Spare sprinkler heads are available .................................................................
Yes [!�
Non
7. Systems left in service .................................................................................. Yes V Non
8. Valves are sealed or supervised ...................................................................... Yes Yr No E]
9. Signs are provided on valves ......................................................................... Yes G2( No E]
10. City static water pressure Z 0 psi.
Problems Found:
A,- /S�n� QQ !j54-,/ T4e*,o
Corrections Made: Date Corrected:,
SIGNATURE OF TESTER:
Corrected By;
AGENCY: Emerald Fire PHONE: 253-857-2056
MAILING ADDRESS: 11021 Cramer Road KPN, Gia Harbor, WA 98329
FIRE PREVENTION
Serving Briei: Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
SNO�&I
EDMONDS
9BRIER
FIRE
Mountlake Terrace
Everett, WA 98208
DISTRT
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
[1 UNINCORPORATED
mvwFireDistrictl.org
Fax (425) 551-1272
FREQUENCY
STATION& SHIF'**�
LOCATION:
23314 Edrivotbis Way 2802D
20-D
NAME:
Campatit; AparLimnLi
PHONE: 42EE731300
SCHEDULED Jul 2014
DATE DUE
MAILING
424
ADDRESS:
2'3014.Edrnort&-'VVay,'�dmi2ridb,'�d'JA 0,9020
BUSINESS OWNER:
MAr-7fttt, C),-F.mTmrI
HOME PHONE:
EMERGENCY-1:,
campalm apts
HOME OHOE: 42.65F.731-100
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES tLo
BUSINESS F__j
EMAIL:
LICENSE
PERSON CONTACTED:
0) :5 AA 0 4) 0
INITIAL INSPECTION DAfE_
NAME OF INSPECTOR:
C) LA) I- ) A-)
FIRESYSILMS: AS3114FA,6113FE21113 FDLkBo-x
b)),i OL'i 0 1z,
HAZARDS FOUND AND LOCATIONS/ bOMMUNICATIONS
A-,
L
2 A) DA)
2
3
3
4
-4
15
6
6
7
7
I AGRE E TO CORRECT THE ABOVE VIOLATION(S) I NTHE NEXT30 DAYS X
11
IstRE-IN E TION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON 14
PERSON
PERSON
CbNTACTED:1
CONTACTED:
CONTACTED:
IINSPECTOR:
INSPECTOR:
-
INSPECTOR:
DATE:
2
3
I
DATE:
DATE:
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1, 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
3
7
RECEIVED
6
DISPOSITION:
4
18
4
18
DATE
7
LETTER NEEDED El YES [I No
LETTER NEEDED E] YES [:1 NO
8
FIRE DEPARTMENT COPY,
Emerald Pir
Fire Sprinkler Specialists
11021 Cramer Rd. KPN - Gig HarborWA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(One System per Report)
a3olci JFdw,,,7,-,ots Vyo�',
Occupancy Address: E�0441111S "o" !?Rio-,i_o — Occupancy Name���
Responsible Person: Aloc4 k zk,& Phone Number:—
V
Building Owner:
Phone Number:
Date of Inspection: '3 -1 Z-1 Type of Inspection: Quarterly E] 5� nnual EK Other
Testers Name (Please Print): WA State FStC# 0633-IT-051 8,
DRY SYSTEM/PRE-ACTION SYSTEM:
1. Trip test (dry trip or full flow) conducted: ......................... ........ 4 �/
................. Yes[:] No
System tripped in seconds.
2. All flow switches, supervisory swi ches d alarm b s tested: . ......... ......... Yes 0 Noo N/A El
3. Alarm bell operates: ............... .... ... ........... ........................................ Yes E] No f-� N/A
n
co
d
n
i c
c
d
h
s
e
te
s
d
d
7 'a
r
m
..b ... s
t
e
s
t
e
d
4. Flow tests conducted: .......... i ................. .......... ................................... Yes E] No
Flow pressure: psi 2-in drain? .. . .................................. Yes No
El El
.. . .............. . ..........
5. Systems inspected and lubricated: . ................. .. ................................... Yes No E] N/A E]
..........
............
6. Air compressor refills system in minutes: ...... ....................... Yes E] Noo
7. System drained and rest/ore to normal operation: ..................................... YesE] NoEl
8. Were the heat actuation devices tested on pre -action and deluge system? ..... YesE] No[] WAD
WET SYSTEM/ANTI -FREEZE SYSTEM: Tested at
1. Trip test conducted: .............................................................................. Yes W No F-1
Static pressure: '7,'5- psi Flow pressure: G_>' psi t inch drain? ....... Yes Eg"" No E] N/A E]
2. Flow switches, supervisory switches and alarm bells tested: ..................... Yes EV No F-1 N/A Ej
3. Alarm bell operates: ............................................................................. Yes IV No F] N/A E]
4. Systems inspected and lubricated: .......................................................... Yes Q/ No E]
5. Pressure regulating valves tested: ........................................................... Yes[:] No 0 N/Aa/
AUTOMATIC SPRINKLER SYSTEMS (continued)
General: I
I . Central Station Monitoring? .......................................................................... Yes [P/ No[]
Monitoring company name F P- � L-
2. - Location of Sprinklers
100% ......... E],/ Parking ......... El Basement ......... E] Hallways ......... E] Other ........
3. Pumper connections and clapper valves unobstructed ....................................... Yes V No E]
4. Sprinkler heads less than 50 years old ............................................................. YesLX NoE]
5. Sprinkler coverage is acceptable .................................................................... Yes 2" No []
6. Spare sprinkler heads are available ................................................................. Yes V No E]
7. Systems left in service .................................................................................. Yes W No El
8. Valves are sealed or supervised ........... YesE;� NoE)
9. Signs are provided on valves ......................................................................... Yes E;/ No[]
10. City static watbr pressure 7S"-- Psi.
Problems Found:
A ,J A FZ-111
IS
Corrections Made: Date Corrected: Corrected By:
SIGNATURE OF TESTER:
AGENCY:
PHONE: 253-857-2056
MAILINGADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
Emerald Tire
Fire sphnkler Specialists
11021 Cramer Rd. KPN - Gig HarborWA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(Onp qvctpm npr Rpnort)
R-0.2p — Occupancy Nam
Occupancy Address: AJn, e:
Responsible Person: ZVO. 136kg Phone Number:
Building Owner: Phone Number:
Date of Inspection: Type of Inspection: Quarterly E] Annual G/ Other E]
Testers Name (Please Print):
WAStateFSCC#' Ub-5-j-H-U518
DRY SYSTEM/PRE-ACTION SYSTEM:
1 Trip testeEDor full flow) conducted: .................................................. Yes No F]
System tripped in D&:t -rc�je seconds.
1 1
2. All flow switches, supervisory switches and alarm bells tested: ..................... Yes No E] N/A Ej
3. Alarm bell operates: ............................................................................. Yes VNo E] N/A
4. Flow tests conducted: ........................................................................... Yes D/No E]
Flow pressure: psi *,inch drain? ....................................... Yes VNo E]
1114 5. Systems inspected and lubricated: .......................................................... Yes[yNoE] N/A[]
6. Air compressor refills system in 30 minutes: .............................................. Yes QK No Ej
7. System drained and restored to normal operation: ..................................... Yes QX No F]
8. Were the heat actuation devices tested on pre -action and deluge system? ..... Yeso NoEj N/AE;/
WET SYSTEM/ANTI-FREEZE SYSTEM: Tested at
1. Trip test conducted: ........................ ............... ..................................... Yes El No El
Static pressure: psi Flo pr sure: psi 2 inch drain? ....... Yes F No El N/A
r s
u
r
e
0 P/ 'I *,' ' "
2. Flow switches, supervisory swi ch and al m bells tested: ..................... Yes No 0 N/A
3. Alarm bell operates: ................. ....... ..... . ......... Yes r_1 No E] N/A F1
.. .............................. ..........
4. Systems inspected and lubricated: . .... ... .... ............................... Yes E] No E]
5. Pressure regulating valves teste�K ........................................................... Yes E] No Ej N/A E]
AU TOMATIC SPRINKLER SYSTEMS (continued)
General:
I Central Station Monitoring? .......................................................................... Yes lz-"� No
Monitoring company name
2. Location of Sprinklers
100% ......... E] Parking ......... Ei� Basement ......... E] Hallways ......... E] Other ........ El
3. Pumper connections and clapper valves unobstructed ....................................... Yes Y No E]
4. Sprinkler heads less than 50 years old ............................................................. Yes [!J/ No E]
5. Sprinkler coverage is acceptable .................................................................... Yes Eg/ No F]
6. Spare sprinkler heads are available ................................................................. Yes Y No[j
7. Systems left in service .................................................................................. Yes IV/ No E]
8. Valvesa"re sealed or supervised ...................................................................... Yes [2/ No F-1
9. Signs are provided on valves ......................................................................... Yes R/ No 0
10. City static water pressure 7-:5�' psi.
Problems Found:
/. n dll— . . � - --� '�CJ�101%-'J P77,11'cY- ., , %:�,-�
Corrections Made: Date Corrected: Corrected By:
SIGNATURE OF TESTER:
AGENCY: Emerald Fire PHONE: 253-857-2056
MAILINGADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
John J. Westfall
From: John J. Westfall
Sent: Thursday, May 23, 2013 1:14 PM
To: Iverna@venvironmental.com'
Subject: RE: 23014, 23020 and 23110 Edmonds Way - Compass Apartments
Attachments: 20130523130653.pdf
Ms. Curry:
Attached you'll find the records in the city permitting database that satisfies your requested information.
John I Westfall
Fire Marshal
Fire Prevention Services
425-771-0213 Desk
425-775-7721 Fax
425-231-3644 Mobile
DISTRIA-C"T
From: verna(cbvenvironmental.com [mailto:verna@venvironmental.com]
Sent: Monday, May 06, 2013 3:31 PM
To: John 3. Westfall
Subject: 23014, 23020 and 23110 Edmonds Way - Compass Apartments
Good afternoon,
Several single-family residential homes were demolished during site preparation activities for this multifamily residential complex. Were there any heating oil
tanks that were removed and do you have records of them?
Thanks in advance!
Verna Lee Curry, MS Environmental Science
Environmental Scientist
253-939-9369 phone
Aft
Inspection Comments
BLD20070873 70 - Tanks/Fuel
PERM ITT Fu,-,,,
Applied: 08/23/2007 Issued: 08/23/2007 Expires: 02/19/2008
Address: 23014 EDMONDS WAY, EDMONDS
IINSP�6TION DATE INSPECTOR ACTION
1960 - F-Tank Inspection 09/12/2007 SMITHM CMP
Comment: TANK REMOVE D/LEAKER, BOTTOM OF TANK HAD PRODUCT AND ODOR/SOIL SAMPLES
OBTAINED
5/23/2013 1:11:57 PM Page 1 of 1
a
Inspection Comments
BLD20120051 70 - Tanks/Fuel
PERM ITT�-7.^.,-'
Applied: 01/24/2012 Issued: 01/24/2012 Expires: 07/24/2012
Address: 23020 EDMONDS WAY, EDMONDS
iNS—PECTION DATE INSPECTOR ACTION
1960 - F-Tank Inspection 07/12/2012 SMITHM CIVIP
Comment: Tank Location Approved and Removed
5/23/2013 1:12:36 PM
Page 1 of 1
i I i
Emerald Tire
Fire Spfinkler Specialists
11021 Cramer Rd. KPN - Gig HarborWA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(One System per Report)
-�, q%e2l IS
2.0 Y�7p�� /4y�s
Occupancqym� wqx Occupa Na7
Responsible Person: Phone NtPbe
Building Owner:. Phone Number:
Date of Inspection: Type of Inspection: Quarterly Annual,.��Other E]
Testers Name (Please Print): WA State FSCC#
DRY SYSTEM/PRE-ACTION SYSTEM:
est (dry trip offull flow) conducted: ...... : ...................................... es E] No E]
Syste�� ippeclin seconds.
Id ................. Yes E] No E] N/A E]
2. All flow switch upervisory switches and alarm bellsteste
3. Alarm bell operates: ....... ..................... .............................................. Yes E] No E] N/A F]
4. Flow tests conducted: .............. ..... Yes E] No E]
Flow pressure: : '. . ... Yes E] No E]
5. Systems inspeq�,�ncl lubricated: ... ... Yes 0 No 0 N/A E]
6. =or refills system in 30 minutes: .............. Yes No E]
7. ed and restored to normal operation: ................... .............. Yes Ej No 0
Were the heat actuation devices tested on pre -action and deluge system'%-�.. Yes F] No E] N/A [-]
WET SYSTEM/ANTI-FREEZE SYSTEM -Tested at
Trip test conducted ................................................................................ Yq&f�t' No El
Static pressure: psi Flow pressure: psi 2 inch drain? ....... Yes� No E] N/A
2. Flow switches, supervisory switches and alarm bells tested: ..................... Ye?ff--No E] N/A 0
3. Alarm bell operates: ............................................................................. Y6_5 NoR N/AE]
4. Systems inspected and lubricated: ........................................................... YQ�-� 0 El
5. Pressure regulating valves tested: ........................ ................................... Yes E] No E] N/&_ET'o'
6 4
AUTOMATIC SPRINKLER SYSTEMS (continued)
t
General: we
1 Central Station Monitoring? .......................................................................... Yoyr-'_ No El
Monitoring company name
2. Location of Sprinklers yo Y-�!\
100% ....... Parking ......... E] Basement ......... Hallways ......... E] Other ........ E]
3. Pum per connections and clapper valves -unobstructed ....................................... Yq&f!:r No El
4. Sprinkler heads less than 50 years -old ........................................ Ye
N o
5. Sprinkler coverage is acceptable .................................................................... Yesin' No E]
6. Spare sprinkler heads are available ................................................................. Ye
,�J2 No E]
7. Systems left in service .................................................................................. YeetT No
8. Valves are sealed or supervised ...................................................................... Yec�� No
9. Signs are provided on valves ........................................................................... Yq,� No El
10. City static water pressure 71 -psi.
Problems Found:
Corrections Made:
SIGNATURE OF TESTER:
-5 li� Iz-
Date Corrected:
s *),n Nw,
Corrected By:
AGENCY: Emerald Fire PHONE: 253-857-2056
MAILING ADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
Emerald'Pire
Fire Sprinkler Specialists
11021 Cramer Rd. KPN - Gig Harbor, WA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
AUTOMATIC SPRINKLER SYSTEMS
(One System per Report)
1�02
04 7fy
ccupancy a JT, V
pt n cy� �Avld d) roe s 11: J W(7�1 7 0h I .
Occu 73- 1 3W
Responsible Person: P h o n e N&2e:
Building Owner- Phone Number:
Date of Inspection: Type of Inspection: Quarterly E] Annuk��Other
Testers Name (Please Print): WA State FSCC# 12,10
DRY SYSTEM/PRE-ACTION SYSTEM:
1
Trip test (dry trip or full flow) conducted: ..................................................
Yorl
No E]
System tripped in seconds.
2.
All flow switches, supervisory switches and alarm bells tested: ......................
Ye),P�'
No Ej
N/A E]
3.
Alarm bell operates: ..............................................................................
Yerff
No Ej
N/A F�
4.
Flow tests conclucPc� ...........................................................................
2-inch drain?
Yq.*15
Yes-�
No 0
No E]
Flow pressure: 10 !t . psi .......................................
5.
Systems inspected and lubricated: ..........................................................
Yqs.E�t-
No E]
N/A
6.
Air compressor refills system in 30 minutes: ...............................................
Ye,-.,�
No El
7.
System drained and restored to normal operation: ......................................
Ye ��No E]
8.
Were the heat actuation devices tested on pre -action and deluge system? .....
Yes E]
No E]
NlAa'
WIET
SYSTEM/ANTI-FREEZE SYSTEM: Tested at
ITO
st conducted: ...........................................................................
0 El
Static pre psi Flow pressure: psi ain? .......
Yes E]
No F�
N/A E]
2.
Flow switches, super switche m bells tested: .....................
Yes [-]
No E]
N/A
3.
Alarm bell o ...................... ...................................................
Yes Ej
No [-]
N/A E]
4
ems inspected and lubricated: ...................... .................................
Yes []
No E]
5.
Pressure regulating valves tested: ......................................... .................
Yes E]
Noo
N/A E]
AUTOMATIC SPRINKLER SYSTEMS (continued)
15 U, f- 0 �'?y
General:
1. Central Station Monitoring? ............................................................ ......
Yeg�-�No El
Monitoring company name
2. Location of Sprinklers
100% ......... Parking ......... Basement ......... E] Hallways ......... E] Other ......... E]
3. Pumper connections and clapper valves unobstructed ....................................... Yes
0 E]
4. Sprinkler heads less than 50 years old .................................. : ........................... Ye,�No E]
5. Sprinkler coverage is acceptable .................................................................... Y4kT- No El
6'. Spare sprinkler heads are available ................................................................. YeA-ff t' No El
7. Systems left in service ................................................................................... Ye's� 0 F]
8. Valves ar . e sealed or supervised ...................................................................... Yekf 5N 0 El
9. Signs are provided on valves .......................................................................... Ye.!50- No El
10. City static water pressure 75 —psi.
Problems Found: V J� (3 )��y - 00
Fly
Corrections Made: Date Corrected:,
SIGNATURE OF TESTER:
Corrected By:
AGENCY: Emerald Fire - PHONE: 253-857-2056
MAILINGADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
Emerald Pire
Fire sprinkler Specialists
11021 Cramer Rd. KPN - Gig Harbor, WA 98329
Office (253) 857-2056 - Fax (253) 857-2312 - Local 699 Contractor
S0,11
AUTOMATIC SPRINKLER SYSTEMS (A At 0
(One System per Report)
s
OccuiliaEnc,yWe��.S.: W11) &TWiS WA q Q20 Occupa�g�Vai�m"IP451'
Responsible Person: Phone ��W.G23--13(Z
Building Owner: Phone Number:
Date of Ins I pection: Type of Inspection: Quarterly E-] Annuak-11" Other El
Testers Name (Please Print):— sllay)Q OV WA State FSCC# �ZJ 6C)
(_DR'�_S�YST /PRE -ACTION SYSTEM:
1.— �np test QE�or full flow) conducted: .................................................. Yes No 0
System tripped in seconds.
2. All flow switches, supervisory switches and alarm bells tested: ....................... Y*<5_`No Ej N/A E]
3. Alarm bell operates: ............................................................................. Ya&fT-N o El N /A E]
................................... Yese' No E]
4. Flow tests conduct �O
Flow pressure: psi 2-inch drain7 ?
. ................. t ..................... Ye,-,,� No E]
5.. Sy�tems inspected and lubricated: ............................................................... Ye5.g4.-'NoF� N/AE]
6. Air compressor refills system in 30 minutes: .................................. I ............ Ye��No El
7. System drained and restored to normal operation: ..................................... Ye,$k�r No E]
8. Were the heat actuation devices tested on pre -action and deluge system? ..... Yes[] No Ej N/.�.
Q�ia/ANTI-FREEZE SYSTEM: Tested at
1 Trip test conducted: .............................................................................. YeA-E�r— No
Static pressure: psi Flow pressure: psi 2 inch drain? ....... Yes
,;?"ON o E] N/A E]
2. Flow switches, supervisory switches and alarm bells tested: ..................... YeserNo E] N/A Ej
3. Alarm bell oper ates: ............................................................................ e Yels�. No E] N/A E-]
4. Systems inspected and lubricated: .......................................................... Ye,&� No E]
5. Pressure regulating valves tested: ............................................................ YesE] NoE] N/.&�
AUTOMATIC SPRINKLER SYSTEMS (continued)
General:
I Central Station Monitoring? ........................................................................... Ywr7-- 'No El
Monitoring company name
2. Location of Sprinklers
100% ......... [:�-- Parking ......... E] Basement ......... E] Hallways ......... E] Other ........ F�
3. Pumper connections and clapper valves unobstructed ....................................... Y�,� No F]
4. Sprinkler heads less than 50 years old ............................................................. Yq&ETII'�No E]
5. Sprinkler coverage is acceptable .................................................................... Ye&f J� No 0
6. Spare sprinkler heads are available ................................................................. Yes -Er No E]
7. Systems left in service .................................................................................. Yes� No El
8. Valves are sealed or supervised ....................................................................... Ye&�Klo El
9. Signs are provided on valves ................... ............. : .................. Ye&-E� 0 El
10. . City static water pressure psi.
Problems Found: IV
Corrections Made: Date Corrected: Corrected By:.
SIGNATURE OF TESTER:
AGENCY: Emerald Fire PHONE: 253-857-2056
MAILING ADDRESS: 11021 Cramer Road KPN, Gig Harbor, WA 98329
_S%W�
Serving Briet; Edinonds 12425 Mei:id�gn Ave, S
SNOHOMISH CO.
Mountlake Terrace, and Everett, WA 426�
�,imo
ire Town of Woodway Phone (425)1t- Y03
I T FireDistrictl.org Fax (425) 551-1272
DIL TR, wWW.
LOCATION:
23014 Edmonds Wy
BUSINESS NAME:
Compass Apailments
PHONE:
4256731300
MAILING
ADDRESS:
23014 Edmonds Wy
Edmonds
98026
BUSIN . ES S,QWNER:
Compas's . apts I
HOME PHONE: 4256731300
EIVERGENCY-1:
KEYACC.ESS-2�
0 W, 0
5
HOME PHONE:
HOME PHONE: (9,0 10� Lt a 0 -
0 2- 'g- L9
PERSON CONTACTED: 14-10, 0/7� �7/7
0[
/P,- e in
NAME OF INSPECTO R:
t V,_
f 7w
'k
F A!��4/1?10I L
, IRE kE3x
SYSTEMS:
71yi,
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 WOODWO
[I MOUN�T,[!AKE TERRACE
0 UNINCORPORATED
FREQUENC Y
STATION & SHIF`�
365
20 C
SCHEDULED
DATE DUE 1` 07101113
LIFIR 0 424 7055
CURRENT
CITY YES
NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
jZ-1 P 3
FE
ANNUAL
�.7 /i" 2>
HAZARDS FOUND AND LOCATIONS COMMUKICATIONS
gx,,,1-,afdQ�
d6�:'g-1
hL,
2
2
3
3
4
4
5
5
6
6
X
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE:
TE DUE:
GRANTEQTO:
DATE DUE:
CITED:
PERSON
PERSON ;
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
11 5
1 5
LETTER SENT
NUMBER:
4
CODE
2
6
2
6
DATE:
SECTION:
5
RETURN RECEIPT
3
7
3
7
RECEIVED
6
DISPOSITION:
4
18
4
18
DATE:
7
LETTER NEEDED [] YES NO
LETTER NEEDED F] YES NO
8
FIRE DEPARTMENT COPY
J.