23607 HWY 99 STE 1DF
9!
SNOHOMISH CO.
FIREI
DISTIN
231,e07 Mr6
FIRE PREVENTION
INSPECTION REPORT
Serving Brier, Edmonds, and 12425 Meridian Ave -S
Mountlake Terrace Everett, WA 98208 DEDIVIONDS
[3 BRIER
Phone (425) 551-1200 E3 MOUNTLAKE TERRACE
APT www.FireDistrictl.org Fax (425) 551-1272 0 UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION:
:90-A
23607 Highway 99 Suite 1 D 98026
BUSINESS NAME:
PHONE:
SCHEDULED
0
Zachor & Thomas, Inc 4257782429
DATE DUE
h in
9016
MAILING
FIR
ADDRESS:
�U 591
23607 Highway 99, Suite I D, Edmonds, WA 98026
BUSINESS OWNER:
HOME PHONE:
:
Zachor H. James
lb
EMERGENCY- 1:
. HOME PHONE�j t 11
01 CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
BUSINESS
YES '114<0
EMAIL:
r-111 4' rl) ?-/,! —
LICENSE
LZ
PERSON CONTACTED: 4p :0,U(alife dam-p_
NAME OF INSPECTOR:
Uw
INITIAL INSPECTION DATE
FIRE SYS/TL�S. FE'_T__�
Loam W�4aecbCATIONS COMMUNIC NS
2
2
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
Z�z
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
-FINACRE-INSPECTION
--VlOtATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED-f
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
VIOLATF014'S �-
5
DATE:
NUMBER:
4
VIO IQNS
PRE-CITATION
LETTERSENT__
2
6
2 6
DATE:
CODE
SECTION:
5
RETURN RECEIPT
3
17
7
RECEIVED
6
.3
DISPOSITION:
4
8
4
-8
DATE:
7
LETTERNEEDED [:] YES NO
LETTER NEEDED 0 YES [I NO
I r
FIRE PREVENTION
INSPECTION REPORT
Serving Brier, Edmonds .12425 Meridian Ave S,.,-, 0 EDMONDS
Mountlake Terraceand Everett, WA 98208 0 BRIER
OWOODWAY
the Town of Woodway Phone (425) 551-1200. 0 MOUNTLAKE TERRACE
www.FireDistrictl.org Fax (425) 551-1272 0 UNINCORPORATED
FREQUENCY STATIONA..SHIFf�
LOCATION: 23607 Hwy 99 1 D 1.1,11 zu 0
SCHEDULED
BUSINESSNAME: Zachor&Tho as Inc. PHONE: 4257782429 MA�C M"C � 06/01/13
MAILING
23607 Highway 99 #1 D
UFIR 11, 591
6006
ADDRESS:
Edmonds
98026
HOME PHONE:
42W2.1906
BUSINESS OWNER:
iachor, H. James
ACTIVE
EMERGENCY-1:
Flugstad, Beverly
HOME PHONE:
2065501724
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
YEY NO
BUSINESS
LICENSE
INITIAL INSPEC 6�DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
y
FIRE
FE
_L/
SYSTEMS:
ANPILIAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
1
2
2
3 A
3
Y,
4
4
\J�
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:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
I
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 E] YES I-] N�
LETTERNEEDED [] YES NO
8
FIRE DEPARTMENT COPY