300 ADMIRAL WAY STE 2073 00 i9bMj-ieq1— WPY J*ri,,?07
Servirig 2, —, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
[I MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION: 300 Admiral Way Suite 207 98020
2017
17-A
BUSINESS NAME: Anthony Eusanio, PhD. PHONE:
4252315248
SCHEDULED Jan 2017
DATE DUE �
MAILING
UFIR 1, 593
ADDRESS: 300 Admiral Way, Suite 207, Edmonds, WA 98020
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Eusanio, Anthony HOME PHONE:
4252315248 CURRENT
KEY ACCESS-2: HOME PHONE:
17
CITY
YES NO
BUSINESS
11
11
EMAIL:
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE SYSTEMS: FE
Date Last Serviced:
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
3
3
4
4
5
5
.6
6
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities
covered by Snohomish County Fire District 1.
You are to be congratulated on the relative good condition of your occupancy in regards to fire safety. Above you
will find the item(s) that were noted during our inspection which require attention to bring them into compliance
with the minimum standards adopted by the above jurisdictions.
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation.
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7720; for
Mountlake Terrace or Brier, call (425) 744-6231.
T'�
FIRE PREVENTION
S6-ving Briet: E�i�641'ds.
Ave 07 INSPECTION REPORT
,SNOHOMISH CO.
EDMONDS
FIRE
Mountlake Terrace
Everett, WA 98208
0 BRIER
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
T
0 UNINCORPORATED
�DISTRI
www.FireDistricti-org
Fax (425) 551-1272
dD
'�ex A-,
FREQUENCY
STATION 1, SHIF'**)
VACCATION:
-300 Admiral Way Suite 207 98020
2
14 17-B
I
BUSI ESS NAME:
AnUiany Emiania. PhO.
PHONE: 42,521-15
124E
SCHEDULED
DATE DUE Jan 2014
MAILING
LIFIR
ADDRESS:
300 Admiral Way, SuiLc 207, Edmonds-,
WA SM20
__j
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
CURRENT
FUSnniLi, )Vithuny
HOME PHONE: 4,)5',)315,)4t
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS
LICENSE
=PER N CONTACTED:
INITIAL INSPECTION DATE
NA E0 I N SPECTOR:
M O�
F I R E S"ys T E 9S); FE
HAZARDS F LIND AND LOCATIONS / COMMUNICATIONS
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
E DUE:
1
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
8
4
8
DATE:
DISPOSITION:
7
\. LETTER NEEDED E] YES I—] NO
LETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY