23830 HWY 99 STE 202U
0, SrL zoz—
'2383..' y
FIRE PREVENTION
Serving Brier* Edmonds,: and 12425 Meridian. Ave S MISPECTION REPORT
0 EDMONDS
Mountlake Terrace Everett, WA 98208 DBRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
wW1W.FireDistrictl.org Fax (425) 551-1272 []UNINCORPORATED -
FREQUENCY
STATION & SHIFT"S
LOCATION:
23830 Highway 99 Suite 202 98026
26%
29A
BUSINESSNAME:
PHONE:
SCHEDULED
DATE DUE
0-7 1,
Auig 2016
MAILING
:
LIFIR 0
ADDRESS:
0
23830 Highway 99, Suite 202, Edmonds, WA 98026
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
"CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS
El
r
LICENSE ;0
PERSON CONTACTED: V�)
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
j//
FIRE SYSTCMS:. FE
DMRasgMi4pAtgpd0CATIONS COM ATIONS
57
2�'
. ........ . .........
2
�3
...... ...... .............
5
6
4
5
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
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
LONTACTED.
PERSON
CONTACTED:
PERSON
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS:-
1
6
3 7
PRE -CITATION
SqN:L_.
dIfA_TF0i4 ISSUED
BE�:
4
5
7
2 _�6
3
7
___LETTER
DATE:
CODE
__��CTIC�N:
RETURN RECEIPT
RECEIVED
4
8
DATE:
LETTER NEEDED [:] YES NO
LETTER NEEDED [] YES NO
8
SNOHOMISH CO.
FIRE
T"
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
LOCATION: I'- FREQUENCY I STATION& SHIF""
23830 0 202, Edmonds 2 year 20-8
SCHEDULED
BUSINESS NAME: New Cad Construction PHONE: 201BO120815 DATE DUE 0 Aug
MAILING UFIR 0 593
ADDRESS: 23830
�jW'99 202. ,
BUSINESS OWNER: HOME PHONE:
Email:
EMERGENCY-1 : Torres, Loz HUME-IPJR L:: 206CI24982 CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
NAME\?F i INSPEC'TO','R:
FIRE!§YSTEk4,,.- 'FE'
Serving Briet: Edmonds
Mountlake Terraceand�
the Town of Woodway
www.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
_7
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
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:
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
18
4
18
DATE:
1
DISPOSITION:
7
\1 LETTER NEEDED [] YES NO
LETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
rs
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
t Sq
LOCATION: 23830 Highway 99
BUSINESS NAME: New Cad Construction
MAILING 23830 Highway 99 #202
FIRE PREVENTION
SAFETY SURVEY
202
PHONE: 2066120815
FREQUENCY
STATION 1, SHIFT
20 C
�
SCHEDULED
01
08/01/10
DATE DUE
LIFIR Ill * 59 1
8006
ADDRESS: Edmonds 98026
BUSINESS OWNER: Torres, Loz HOME PHONE: 2066124982 ACTIVE
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
INITIAL INSPECTION DATE
PERSON CONTACTED: . /
NAME OF INSPECTOR: h4gl -4�/YO/h
FIRE
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE 0
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
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:
1
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
7
RETURN RECEIPT
RECEIVED
6
7
4
18
4
18
DATE:
DISPOSITION:
8
�, LETTER NEEDED E] YES NO
LETTER NEEDED E] YES E] NO
FIRE DEPARTMENT COPY