514 5TH AVE S STE B1Z ^Ad h
q/
6--fh 19 06 j S-r FIRE PREVENTION
Serving Brier,
12425 Meridian Ave S
INSPECTION REPORT,
SNOHOMISHAW..
FIR
Mountlake Terra'6eand
&erett, WA 98208
0 EDMONDS
0 BRIER
DIS R, T
th e Town of Woodway
Phone (425) 551-1200
[1WOODWAY
[1 MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION
LOCATION: - 514 5thAvenue S Suite BI 98020
2 Year
13 17-A
BUSINESS NAME: Vacant
PHONE: 4257722931
4
SCHEDULED Sep
DATE DUE
MAILING
UFIR 0 559
ADDRESS: 514 5th Avenue S, Suite Ell, Edmonds, WA
98020
BUSINESS OWNER: Winters,
John
HOME PHONE:
Email:
EMERGENCY-1:
HOME PHONE:
'CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECWON DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS: FE
HA76ASS FRUND AND LqCATIONS
9MM NIPATIONS
(fsl:�
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:
I
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:
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:
1
DISPOSITION:
7
LETTER NEEDED [-] YES El No
LETTER NEEDED C] YES [I NO
8
FIRE DEPARTMENT COPY
/A
FIRE PREVENTION
'7 CITY OF EDMONDS SAFETY SURVEY
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
LOCATION: 514 5th Avenue S 131
BUSINESS NAME: Winters DesignfOOB PHONE: 4257722931
MAILING 514 5th Ave S #13
ADDRESS: Edmonds, 98020
FREOUENCY
STATION & SHIFT
1 17 6
SCHEDULED
0,
09/01/10
DATE DUE
LIFIR i� 591
9152
BUSINESS OWNER: Winters, Gwen HOMEPHONE: 4257720916 AC-nVE
EMERGENCY-1: Winters, John HOME PHONE: 4257748171
KEY ACCESS-2: HOME PHONE:
r- INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
SYSTEMS:
HAZARDS FOUND AND. LOC
r r_ — I
ANNUAL
ATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE 10
VIOLATION CODE
2
'2
3
3
4
4
5
5
6
6
7
7
8
8
1st 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
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
7
4
18
4
18
DATE:
DISPOSITION:
8
LETTER NEED D [F] YES ED N
] YES El N
fLEiTER NEEDED E] YES NO
FIRE DEPARTMENT COPY