233 5TH AVE NServing Briet: E and
SNOHOMISH CO.
Flimplow Mountlake Terrace
V00,
DISTRT www.FireDistrict].org
5-1-k -,A 0 r— A)
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
\RfEDMONDS
10 BRIER
El MOUNTLAKE TERRACE
[I UNINCORPORATED
" FREQUENCY
STATION & SHIF-*)
LOCATION:
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2335 th Awme N 23rQ0
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BUSINESS NAME:
azaldirc Brighl. LLM '76,0 -7
S7b PHONE: 421;-1712EM
SCHEDULED
DATE DUE 4r 2014,
MAILING
UFlg�.3 20j
ADDRESS:
233 13h.kunum N, EdmondF, WA 080W
BUSINESS OWNER:
",,,,HOME PHONE:
q'Z.E— -7610-7
EMERGENCY-1-
SchuILZCbri�ilJrm
HOME PHONE:
42L3 M-7=1
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CURRENT
CITY YES NO
KEY ACCESS-2:
EMAIL:
HOME PHONE:
BUSINESS
LICENSE
PERSON CONTACTED: F (Z A L
FNIT�SPECTION DATE
4-�_NAME OF INSPECTOR:
5-s- N
KtZVSIENS:
FIES,
77- H
HAZARDS FOUND AND -LOCATIONS / COMMUNICATIONS
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2
2
3 A/k 14,
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3
4
4
5
5
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I AGREE TO CORRECT THE A%lR0VE
VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
4
1 5
1 5
LETTER SENT
NUMBER:
12
6
2
6
DATE:
CODE
SECTION:
5
RETURN RECEIPT
6
3
7
3
7
RECEIVED
DISPOSITION:
7
4
18
4
8
E:
LETTERNEEDED [-] YES NO
LETTER NEEDED [:] YES NO
1
8
FIRE DEPARTMENT COPY
iv
,Kevin Zweber
From: Kevin Zweber
Sent: Monday, October 13, 2014 7:02 AM
To: 'cschuetzOO@yahoo.com'
Subject: Fire Extinguisher
Ms. Bright,
I stopped by a week or so ago to follow up on a fire inspection that was conducted on 7/14/14. It was noted that your
fire extinguisher needed it annual service.
Could you please tell me the status of this?
Thanks,
Kevin Zweber, CFI
Captain/Deputy Fire Marshal
Fire Prevention Services
Snohomish County Fire District #1/
City of Edmonds
Office 425-775-7720
C/ )6L2
M\"Omoz If
BUMME33 UCEMBE APPUCAYM- CC NX [EWAL
FE[E. MOM
CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION
11h)e. 1%9 121 5' AVENUE NORTH, EDMONDS, WA98020 PHONE: 425.775.2525
I OFFICE USE ONLY
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Customer#
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Class
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�MSTRUCTOGNS: POOM00 counPiete the MPOICS91on In fulO and attach the roqulmd !Rocw plan. Nidd5e Initiag or narna) vaquired oq all
p@Tdea =ncomod. 99 no middle nmo, plomzo Indicate by writing MMM. Sign and vetuvn appilwtion with fto. PlGmoo advice og
any change On staquo. Mew ftonzo voquOmd 59 buzinozo chenoeo Oocalon or ownevuhip. Mollflcaftn to City og Ed=ndz required
Iq bu0noes c0ozos.
BUSINESS NAME
BUSINESS ADDRESS
MAILING ADDRESS
BUSINESS PHONE
in
BUSINESS E-MAIL)4j
PROPERTY OWNER
Street or PO Box
Name
Suite No. Zip Code
Ave- J�dxmzk- olk 'fsozo
ICY NOTIFICATION (For Premise Access in Emergency):
First Name
Suite No. City, State and Zip Code
(c�
rATE ID NO. (U I NO)
ESS WEBSITE
4W I'vo 11:�p o-� rv'
No.
. 7f
Last Ham First Name Mi Phone No.
NATURE OF BUSINESS
NUMBER OF EMPLOYEES
FOOTAGE OF BUSINESS SPACE YOD '�
TYPE OF BUSINESS - PLEASE CHECK THE APPROPRIATE CATEGORY:
I v U
13 CONSTRUCTION G FINANCE, INSURANCE, REAL ESTATE 0 LANDSCAPE, HORTICULTURAL 0 MANUFACTURING 0 NON-P1%0'fjT
0 RETAIL 0 SECONDHAND DEALER &.$ERVICES 13 WHOLESALE 0 OTHER ff
- z
AMUSEMENT DEVICES ON PREMISES? 0 YES [NO IF YES, TOTAL NUMBER Ov
LIQUOR SOLD ON PREMISES?: 0 YES G�NO GAMBLING? 0 YES 01 NO CIGARETTES SOLD ON PREMISES? 0 YES �JNO
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: 0 YES 0;�(LIF YES, PLEASE PROVIDE LIST OF MATERIALS AND QUANTITIES:
PROPOSED OPENING DAY OF 13USINESS �, - ?, ff- - / f"' BUSINESS HOURS 2 - 7
DAYS OPEN 0 SUNDAY GIMONDAY AVILIESDAY 6*EDNESDAY 0 THURSDAY 0 FRIDAY G SATURDAY
% �-& 404ces
PARKING SPACES ON SITE: TOTAL 6-�6� CESSIBLE FOR PERSONS WITH DISABILITIES 6&d*)
DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE 0 PER ONS WIT� DISABILITIES? O-YES 0 NO
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PREVIOUS BUSINESS USE AT THIS ADDRESS 41fi4 �< A44S 6641Ae?, ho.
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NAME Ge- 1
Last V First Ml
ADDRESS 19541-7 t" apo -� y-
Street Apt. No., Unit No. City. State and Zip Code
DOL NO, (DRIVERS LICENSE NO.) OR OTHER ID NO (CO' 'zjj�.)
HOMEPHONENO.(7(4) F;2 (P 9 9(9 S
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DATE OF BIRTH_2:1- 12'T&_CITY AND STATE OF BIRTH_0g%jeJ/ Of" i 4b& ____jCOUNTRY OF BIRTH - CQ�40-
-PARTNERI
NAME
Last R rSt MI
ADDRESS
Street Apt. No.. Unit No. City, State and Zip Code
HOMEPHONENOi I DOL NO. (DRIVERS LICENSE NO.) OR OTHER ID NO,
DATE OF BIRTH _CITY AND STATE OF BIRTH ____�COUNTRY OF BIRTH
PARTNERSHIP -PARTNER 2
NAME
Last First Mi
ADDRESS
Street Apt. No.. Unit No. City. State and Zip Code
HOME PHONE NO.( DOL NO. (DRIVERS LICENSE NO.) OR OTHER 10 NO.
DATE OF BIRTH CITY AND STATE OF BIRTH COUNTRY OF BIRTH
CORPORATION
NAME OF CORPORATION FEDERAL TAX ID NO.
CORP.ADDRESS street Suite, Apt., Unit No. City, State and Zip Code PHONE NOJ
CORPORATE OFFICERS:
Last Name First Name MI Title Date of Birth DOL No. (Drivers License No.) or Other ID No.
LOCAL CONTACT ( I
Last Name First Name MI Tille Phone No DOL No. (Drivers Lic. No.) or Other ID No,
APPLICANT.���(J/'k4- &rlZkf- Ia. - M57 J�e-- j 9, 2414
. Name - Printed I Signature Title Date
PLANNING DEPT.
0 APPROVE
13 DISAPPROVE
DATE
---51GNATURE
ZONING CODE
CONDITIONAL USE PERMIT
COMMENTS.
BUILDING DEPT.
0 APPROVE
0 DISAPPROVE
DATE
SIGNATURE
OCCUPANTLOAD
BUILDING PERMIT
-OCCUPANCY GROUP
COMMENTS.
FIRE DEPT.
0 APPROVE
(3 DISAPPROVE
DATE
SIGNATURE_
I.I.F.I.R.
COMMEN
POLICE DEPT.
(5 APPROVE
0 DISAPPROVE
DATE
SIGNATURE
COMMEN
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P, f�' A, �J , �-� c)- J-4-
Washington State'Departm" ent of Health
By the authority of RCW 18.108"this person
Geraldine Pearl Bright
is granted a
#Ma (age. Practitioner License
WaAington State Department t�
;Health
Status Credential Number
ACTIVE MA 602931:00
Effective Date Initial Issuance Expiration Date
Secretary 08/08/2013 06/15/2012 09101/2014