402 5TH AVE S STE B4.62-
ServingBrier P-amonds, and
SNOHO'NIISII t1o. Mountlake Terrace
FI
D-1 T T www.FireDistrictl.org
LOCATION:4025th AvenueS 98020
BUSINESS NAME: Hendricks -Bennett, PLLC
MAILING
ADDRESS:402 5th Avenue S, Edmonds, WA 98020
TE
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 42577527511�
BUSINESS OWNER: HOME PHONE:
EMERGENCY- 1: Hendricks, Al
R53084683
KEY ACCESS-2: HOME PHONE:
EMAIL: A I 6b, 4 -Zj b IQ Co,�,
PERSON CONTACTED: L�1!�Pr sz..'Ack
NAME OF INSPECTOR: T7
FIRE SYSTEMS: FE
Date Last Serviced:
�FIRE PREVENTION
INSPECTION -REPORT
)6EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUE NCY I STATION&SHIFT
2017- 17-B
SCHEDULED Apr 2017
DATE DUE �
591 202
UFIR
CURRENT -
CITY I YES NO
BUSINESS NA [:]
LICENSE 4'
INITIAL INSPECTION DATE
%-:5- ri
Serving Brier, Edmonds
SNOHOMISH CO.
YIRE
Mountlake Terraceand
DIST
e Town of Woodway
I t'
www.FireDistrictl.org
LOCATION:
402 5th Avenue
BUSINESS NAME:
Hendricks - Bennett, PLLC
MAILING
402 5th Ave S
ADDRESS:
Edmonds
BUSINESS OWNER:
Hendricks, Al
EMERGENCY-1:
Hendricks, Matt
KEY ACCESS-2:
I "!
PERSON CONTACTED:
NAME OF INSPECTOR:
SYSTEMS:
S
7 . 1
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 4257752751
98020
HOME PHONE: 4253084683
4257711283
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
0WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATI�N %HIFT"
731 1 1
SCHEDULED 04/01/12
DATE DUE �
LIFIR 0 C'91 4202
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
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
lst RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE:
D TE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
D E:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
3
7
RECEIVED
6
DISPOSITION:
7
4
8
4
8
DATE:
\� LETTER NEEDED [] YES NO
LETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5� AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
41:'
LOCATION: 402 5th Avenue S
BUSINESS NAME: Hendricks - Benneff, PLLC
MAILING 402 5th Ave S
&MM0000
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257752751
Edmonds 98020
BUSINESS OWNER: Hendricks, Al HOMEPHONE: 4253084683
EMERGENCY-1: Hendricks, Maft HOMEPHONE: 4257711283
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION & SHIFT
17 C
SCHEDULED
DATE DUE 11-
04/01/10
UFIR 0 591
4202
ACTIVE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: t '60
FIRE 1-/(_j FE 1 10
SYSTEMS: LX ,
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNI ATIONS
ENTER CODE ONLY ONCE ll�
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
PERSON
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
CONTACTED:
CONTACTED:
INSPECTOR:
DATE,
VIOLATIORS_
CONTACTED:
... . .... ......
INSPECTOR:
2
INSPECTOR:
DATE,
DATE,
PRE -CITATION CITATION ISSUED
3
VIOLATIONS
1 5
1
15
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
6
7
RECEIVED
7
DISPOSITION:
4
18
4
LETTER NEEDED
8
[3 YES NO
DATE:
8
I,'UETTERNEEDED 0 YES NO
FIRE DEPARTMENT COPY
57t�)
FIRE PREVENTION
Serving Brie�,
A and
'j'`
2.4-"15 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
'FIRE
Mountlake Terrace
,
�llerett, WA 98208
0 EDMONDS
El 13RIER
Pfi one r425) 551-1200
0 MOUNTLAKE TERRACE
DIST
T
[I UNINCORPORATED
ivivitTireDistrictLorg
Fax (425) 551-1272
FREQUENCY
STATION & SHIFT"
LOCATION:
/Irj5 5 th A,�enua S 08020
Annual
17-13
BUSINESS NAME:
Bcf;k's �-uricral I lamc
PHONE: 4257711234
SCHEDULED
DATE DUE I` Aup 2014
MAILING
FIR I, 4,mi 2o.3
lu
ADDRESS:
4M-,'.-)Lh Avcriuc S, �-dmnds, \il/A 0.0,020
BUSINESS OWNER:
"Al Prefi-rr.-d Fum-rAl Setr\Ane.
HOME PHONE:
EMERGENCY-1:
NlJV Prclured 1-uncral Scr.
HOME PHONE: 42684e&I122
"' CURRENT
KEY ACCESS-2:
HOME PHONE: 4-LS 6-7o 2_�5,j
CITY YES NO
EMAIL:
BUSINESS
E]
1:1
LICENSE
PERSON CONTACTE6
r,.&
INITIAL INSPECTI.ON DATE
NAME OF INSPECTOR:
i-IRE SYS I Ems: ' ,F,�El \17
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
In rg.. ic
2
2
3
3
4
4
5
5
!�2
7Q
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
CODE
4
5
2
6
2 6
DATE:
SECTION.,
RETURN RECEIPT
3
7
3
7
RECEIVED
6
DISPOSITION:
4
8
4"'
8
DATE:
LETTER NEEDED C] YES NO
LETTER NEEDED C] YES F-1 NO
8
FIRE DEPARTMENT COPY
APPLICATION FOR PERMIT
FOR MATERIALS OR PROCESSES
January 3, 2012
Please verify and correct the following information:
Name of Company (DBA):
Beck's Funeral Home
Edmonds Location :
405 5th Avenueth Avenue S
In conformity with the
terms of the International
Fire Code, application is
hereby made to store, use
Places of Assembly - Occupant Load: 345
or maintain the following
activity, storage or pro-
cesses:
c/o NW Preferred Funeral Services, Inc
Mailing Address:
405 5th Ave S
Edmonds, WA 98020
EFD UFIR #:
1343450813203
(for office use)
j
Your Signatur��
Your Name (print)
Your Title
7t
Please make corrections, attach $40 payable to the City of Edmonds and mail to:
Fire"Marshal
Department of Fire Prevention
121-5 th Avenue North
Edmonds, WA 98020
FOR OFFICE USE ONLY
Rec'd
Check#
-7084
.i.
APPLICATION FOR PERMIT
FOR MATERIALS OR PROCESSE
March 7, 2011
Please verify and correct the following information:
Name of Company; DBA
Beck's Funeral Home
Edmonds Location
405 5th Avenue
In conformity with the terms of
Places of Assembly - Occupant Load: 345
the International Fire Code,
application is hereby made to
store, use or maintain the
following activity, storage or
processes:
Mailing Address:
NIN Preferred Funeral Services, Inc
405 5th Ave S
Edmonds WA 98020
EFID UFIR #:
13434508B203
(for office use)
Your Signa turt
Your Name (print)
Your Title
Please make corrections, attach $40 payable to the City of Edmonds, and mail to:
Fire Marshal
Department of Fire Prevention
121-5 th Avenue North
Edmonds, WA 98020
CITY OF EDMONDS
DEPARTMENT OF FIRE PREVENTION
PERMIT
January 1, 2011 134-345-0813-203 December 31, 2011
Date of Issue UFIR Number Date of Expiration
I This PERMIT is issued to: I Beck's Funeral Home
I located at: 1405 5th Avenue S I Edmonds, WA
I To engage in the business, occupation or process of: T— I
And shall constitute permission to maintain, store, use or handle materials or to conduct
process which produce conditions hazardous to life or property or to install equipment used in
connection with such activities as follows:
Places of Assembly - Occupant Load: 345
Allowed Occupant Load: 345��]
Pursuant to the provisions of the International Fire Code, any violation of the Code may be
grounds for the revocation of this PERMIT.
This permit does not take the place of any
license required by law and is not
transferable. Any change in the use or
occupancy of premises shall require a new
permit.
Firq)Marshal,4 k
Debbrtment of Fire Prevention
This Permit Must Be Posted At All Times in The Premises Identified Above
City of Edmonds Community Development Code 19.25.020