264 RAILROAD AVE (2)Z&V l'or-t4lod 4a6
Serving Bria L and 12425 Mer idianAve S,
Molpitlake Terrace Everett, RA., 98208
Phone (425) 551-1200
wwwTit-eDistrictLoig Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[]UNINCORPORATED
FREQUENCY STATION & SHIFT
Lkjk,ml lulm:
26/1 Railroad A,.enue .98020
Annual
17-C
BUSINESS NAME:
UridonvaLcr Sporbs Inc.
PHONE:
42677IF-322
SCHEDULED
DATE DUE Jul 2014
MAILING
UFIR 0
ADDRESS:
2154 Ra'fIroad.1k-,,mnuc, EdITionds,04A. 08020
BUSINESS OWNER:
Ke.Fslt-r, Dan
HOME PHONE:
EMERGENCY-1:
Kmi-sler, lerry
HOME PHONE:
425, &0200
KEY ACCESS-2:
HOME PHONE:
7CURRENT
ITY YES NO
7"
BUSINESS
1:1 El
EMAIL:
PERSON CONTACTED:
LICENSE
'j-04 Iff
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
7
IZA 0 /
I HE aYS I L WS:
/
FES113
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
v
3
3
J_v L) v
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
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTEDTO:
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
3
7
RETURN RECEIPT
RECEIVED
6
4
18
4
18
DATE:
DISPOSITION:
LETTER NEEDED [] YES NO
1
LETTER NEEDED F] YES [I NO
1 . .
8
FIRE DEPARTMENT COPY
Serving Brier, Edmonds
SNOHOMISH CO.
Mountlake Terraceand
FIRE the Town of Woodway
DI S 'Tr R,1fiTwww.FireDistrict1.org
LOCATION: 264 Railroad Avenue
BUSINESS NAME: Underwater Sports Inc
MAILING
ADDRESS:*
BUSINESS OWNER:
Kessler, Terry
EMERGENCY-1: Kessler, Dan
KEY ACCESS-2:
PERSON CONTACTED: -'\ r, 14',') -N q, ') 50,J
NAME OF INSPECTOR:
FIRE
SYSTEMS:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 4257716322
HOMEPHONE: 4252488290
HOMEPHONE: 4253082613
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
rut EDMONDS
n BRIER
0 WOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY I STATION & SHIFT�
3 6 5 17 6
SCHEDULED
DATE DUE 1 07,101/13
UFIR � 552 7202
F3441AW
CURRENT
CITY YES NO
BUSINESS r7l
LICENSE 'ni 1:1
INITIAL INSPECTION DATE
FE 3 t xz_
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
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:
1
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR,
INSPECTOR:
INSPECTOR:
2
DATE: A
DATE:
DATE:
3
i In�LY,16LATIONS
15
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
L4
8
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES El NO
LETTER NEEDED [I YES NO
8
FIRE DEPARTMENT COPY
SNO
T
D
Serving Briet: Edmonds
Mountlake Terraceand
the Town of Woodway
Twww.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PR ' E ' VEN ' TION
INSPECTIONREPORT
0 EDMONDS
0 BRIER
0 WOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIFT7*�
LOCATION:
264 Railroad Avenue
365 '17
D
BUSINESS NAME:
Underwater Sports Inc
PHONE:
4257716322
SCHEDULED
DATEDUE 0 07/01/11
MAILING
10545 Aurora Av N
UFIR "' 552 7202
ADDRESS:
Seattle
98133
BUSINESS OWNER:
Keffier, GarYu
HOME PHONE:
425771�051
ACTIVE,
EMERGENCY-1:
uKeffier, Garym
HOME PHONE:
4257715051
CURREN I T
KEY ACCESS-2:
HOME PHONE:
YES
CITY
NO
BUSINESS -Ej
LICENSE
PERSON CONTACTED:
ToR�)
INITIALINS ECTION DATE
CTI,
NAME OF INSPECTOR:
V
FIRE
FE\1 f /C>
_j
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
3
3
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
2ATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
-DATE
PERSON
CONTACTED:
INSPECTOR:
PECTOR:
INSPECTOR:
2
DATE:
D E:
DATE:
.3.
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
2
6
2
6
DATE:
CODE
SECTION:
W.
3
7
3
7
RETURN RECEIPT
RECEIVED
4
8
4
8
DATE:
DISPOSITION:
LETTER NEEDED C] YES [I NO
LETTER NEEDED [] YES NO
1
8
FIRE DEPARTMENT COPY