512 5TH AVE S STE 2I t
FIRE PREVENTION
INSPECTION REPORT
Serving Brier, Edri. 12425 Meridian Ave S
I EIEDMONDS
.AfjWntlake Terrace, and Everett, WA 98jO8 0 BRIER
th� Town of Woodway Phone (425) 551-1200 E]WOODWAY
[I MOUNTLAKE TERRACE
www.-FireDistrict].org Fax (425) 551-1272 0 UNINCORPORATED
LOCATION: -,, 512 5"'Avenue S Suite 2 98020
BUSINESS NAME: Bod�works Pilates
MAILING
ADDRESS: 512 5th Avenue 55, Suite 2., Edmonds, WA 98020
BUSINESS OWNER: nelleaJ9-amerie
HOME PHONE:
Email:
EMERGENCY-1: Vvinters, Jack HOME PHONE: 4257784599 'CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
BUSINESS
LICENSE r—i R
PERSON CONTACTED: r4 1,1,p INITIAL - INSPECTION DATE
NAME OF INSPECTOR:
FIRE SYSTEMS: 49��rl
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PHONE: 4-264-@7Db109
e- FREQUENCY STATION & SHIFF�
Annual 17-A
SCHEDULED Sep
DATE DUE
UFIR 0 424
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
114 0 (Zo (0�' IU-� ln(24nff��
2
2
3
3
4
4
5
5
6
6
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7
IAGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st 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
5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIO.T
RECEIVED ",
6
4
8
4
8
DATE:
DISPOSITION:
7 J
LETTERNEEDED C] YES [I NO
LETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
I �"
SN
CIROMI Serving Briet; Ednzonds
IRMountlake Terrace, and
e Town of Woodway
)IS R T 'tw.FireDistrictLorg
LOCATION: 512 5th Avenue
BUSINESS NAME: Bodyworks Pilates
MAILING 512 5th Ave S #2'
ADDRESS: Edmonds
BUSINESS OWNER: Kellett, Sharlene
EMERGENCY-1: Winters, Jack
KEY ACCESS-2:
PERSON CONTACTED: S L Iv -
NAME OF INSPECTOR: 415 1�6
FIRE
SYSTEMS:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
I'- FREQUENCY I STATION &SHIFT"'
2 731 17 C
PHONE: 4254970609
98020
INSPECTION REPORT
0 EDMONDS
0 BRIER
0WOODWAY
[I MOUNTLAKE TERRACE
[] UNINCORPORATED
SCHEDULED
DATE DUE 1'
UFIR 1, 593 9152
HOME PHONE: 4257453325 ACTIVE
4 7- "5 "11 -7 0 �, 0 Cl
4257784599
CITY YES NO
BUSINESS
rLICENSE
HOME PHONE: CURRENT
HOME PHONE:
INITIAL INSPECTION DATE
vi I I I
FELZ:��o
ANNUAL
HAZARDS FOUND 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
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
'8
4
'8
DATE:
DISPOSITION:
LETTER NEEDED [] YES NO
LETTER NEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY