23416 HWY 99 STE Cmk.
SNOHOMISH CO.
FIRE
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FIRE PREVENTION
Serving Brier, Edmonds,'and 12425 Meridian Ave S INSPECTION REPORT
Mountla.ke Terrace Everett, WA 98208 0 EDMONDS
0 BRIER
[3 MOUNTLAKE TERRACE
Phone (425) 551-1200 HKIIKIflnDpr%p A'rc!r,%
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PHONE:
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DATE DUE hAnu gnis
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23416 Highway 99, SuiteX, Edmo'nds, WA 98026
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Je,Choon
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Kang,.Sung HOME PHONE:' 4257121236'�
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�l LETTER NEEDED YES El NO
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8
FIRE PREVENTION
BNOHOMISUCO.
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
Mountlake Terrace, and
Iti
Everett, WA 98208
0 EDMONDS
0 BRIER
:1
the Town of Woodway
Phone (425) 551-1200
0 WOODWAY
Tj www.FireDistrict].org
Fax (425) 551-1272
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY
STAT ION & SHIFT"
LOCATION:
23416 Highway 99
C
366
20 D
BUSINESS NAME:
Farmers! Insurance
PHONE:
4257746029
SCHEDULED
DATE DUE nstnim
MAILING
ADDRESS:
23416 Highway 99 #C
UFIR 0
591 5056
Edmonds
98026
BUSINESS OWNER:
Boyce, Kay
HOME PHONE:
2967141068
ACTIVE
EMERGENCY-1-
Kozl(yv, Alla
HOME PHONE
: 4258773270
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KEY ACCESS-2
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INITIAL INSPECTION DATE
NAME OF INSPECTOR:
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ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -I NSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
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PERSON
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INSPECTOR:
INSPECTOR:
INSPECTOR:
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DATE;
DATE:
DATE:
3
VIOLATIONS
1 5
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PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
6
2
6
DATE:
CODE
SECTION:
6
7
3
7
RETURN RECEIPT
RECEIVED
4
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4
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DATE:
DISPOSITION:
7
'D 0 YES [:1 NO
LETTERNEEDED 0 YES Ej NO
FIRE DEPARTMENT COPY
FIRE PREVENTION
''f;NOHOMISH CO. Serving Brier, Ednionds
Mountlake Terraceand
,TIRE the Town of Woodway
.DIST R T www.FireDistrictl.org
LOCATION: 23416 Highway 99
BUSINESS NAME: Farmers! Insurance
MAILING 23416 Highway 99 #C
ADDRESS: t-- t �(
BUSINESS OWNER: Boyce, Kay
EMERGENCY-1: Koz1ov, Alla
KEY ACCESS-2:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
e--
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
A
PHONE: 4257746029
98026 (4z1_1 -7-6-
HOME PHONE: i967141068
HOME PHONE: 4258773270
HOME PHONE:
INSPECTION REPORT
0 EDMONDS
0 BRIER
OWOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY I STATION & SHIFf')
366 20
SCHEDULED
DATEDUE 1` 05,101/12
UFIR � 591 5056
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE E] 1:1
INITIAL INSPECTION DATE
FE
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2 \J
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
1st RE -INSPECTION
DATE DUE'
2nd RE -INSPECTION
DATE DUE:
ExTEN91ON
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATfONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
D TE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:,
4
2
6
2
6
DATE:
CODE
SECTION:
5
%'k- ,
3
7
3
7
RETURN RECEIPT
RECEIVED
4 W"
8
4
8
DATE:
DISPOSITION:
LETTERNEEDED YES No
LETTER NEEDED [-] YES E] NO
8
FIRE DEPARTMENT COPY