512 5TH AVE S STE 3SNOHOMISH CO. Serving Brier, .__s� 12425 Meridian Ave S
tE ANWIfft - Mountlake Terraceand &erett, WA 98208
the Town of Woodway Phone (425) 551-1200
JLLMJ Klim, www.FireDistrictl.org Fax (425) 551-1272
FREQUENCY STATION & SHIFT
LOCATION: � 512 5"'.Avenue S Suite 3 98020 2 Year 113 17-A
BUSINESS NAME: Nancy's Nails 42-56728262 SCHEDULED Sep
PHONE: DATE DUE
MAILING LIFIR 0 559
ADDRESS: 512 5th Avenue S, Suite 3, Edmonds, WA 98020
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
El BRIER
[1WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
BUSINESS OWNER:
Nguyen, Hoang
HOME PHONE:
Email:
EMERGENCY-1:
Nguyen, Phong
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE: 1/o?
CITY YES
NO
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
A /0L,
FIRE SYSTEMS:
FE '/ / 11r'
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
zo
2
2
3
4
3
4
4
5
F_
5
v
6
6
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 Td'.
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DAT
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
UED
TATION ISSUED
E
NUMBE
.4
4
2
6
2
6
DATE:
CODE,
SECTIO
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4 '8
4
8
DATE:
DISPOS'T'
'1
7'
\,LETTER NEEDED [-] YES NO
LETTER NEEDED [] YES NO
FIRE DEPARTMENT COPY
Serving Brier, Edmonds
SNOHOMI'H CO.
IREMountlake
Terraceand
the Town of Woodway
DISTRIt4�IT
www.FireDistrictl.org
LOCATION:
512 51h Avenue
BUSINESS NAME:
Nancy's Nails
MAILING
512 5th Ave S #3
ADDRESS:
Edmonds
BUSINESS OWNER:
Nguyen, Hoang
EMERGENCY-1:
Nguyen,Phong
KEY ACCESS-2:
/'A
PERSON CONTACTED: f—tk U
NAME OF INSPECTOR:
FIRE
SYSTEMS:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-12010
Fax (425) 551-1272
S 3
PHONE: 4256728262
98020
HOME PHONE: 4257714280
HOME PHONE: 4252632377
HOME PHONE:
r D _-ii 1D 'I ;?-
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
El BRIER
OWOODWAY
[I MOUNTLAKE TERRACE
El UNINCORPORATED
FREQUENCY I STATION & SHIFF"�
731 17 C
SCHEDULED
DATE DUE 0' 09/01/11
LIFIR 1, 559 9152
ACTIVE
01 CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
5EP C;2
FE Of j/
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVEvibLATION(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
14
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTER NEEDED F] YES NO
8
FIRE DEPARTMENT COPY
PAWNBROKER / SECONDHAND DEALER LICENSE
Ordinance 2431
Chapter 4.75 Edmonds City Code
Nam e2) evk
Business Name-T)-,t,- —T 1,� re e
Fee: $20 (1-3 emDlo.yers)
�'122 (4-9 emolo ' yee.-)
S75 (10 or more en.nloyees)
Date/Pl ace of Birth --�- PSI� F+. M, Le,4,
Business Phone -7-7&- ;a i��
Nature of Business: Pawnbroker or Secondhand Dealer (Circle one)
Individual Partnership-x— Corporation_ (Check one)
Washington State Tax Number &C �e
Business Address C-,+'- Land Use Zone
Home Address of Principal 100C( f0jk) -�-7 /-�Jft, cjQ11-7 (BC, CG, ON, —CW
Home Telephone of Principal *-)
Other persons having proprietary, financial , or other interest in this business:
Name R-I'e- " C' L Address
Date/Place of Birth Business Phone
Home Phone
Name r, V'X Address JL40t Q 1 -3-7 4�qtw
Date/Place of Birth o-cl-L.C. -19-ed C�?C'V— Business Phone
Home Phone Su--2-- ?'S'7�
Emergency Notification:
Name L—C'n 6��d-c Phone
Sfqnature of Applicant
----------------------------- ------ 77 ---------- -------------------------------------
Date Forwarded to Police Department �;2—
Police Department Investigation
Remarks
Approved L-1" Disapproved
License Issued
(Date)
RENEWAL
License Renewed
Police Lhie
License Number
City Clerk
License Number
City Clerk