520 MAPLE STSNO11OM1SH CO.
FIRE
ST
-Z 0 MID 1- 7
0
Serving Brier, 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
;M EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY STATION & SHIFT"�
LOCATION:
520 MapleStreet 98020 Al I[ Iucll i?_D
BUSINESS NAME: PHONE: SCHEDULED
The Maples DATE DUE 0 Atig 26%
MAILING LIFIR 0
ADDRESS: 422
4902 Doon Wy, Anacortes, WA 98221
BUSINESS OWNER: HOME PHONE:
Waltari, Marga
.EMERGENCY-1: HOME PHONE: rCURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS M
LICENSE PL-11
INITIAL INSPECTION DATE
PERSON CONTACTED: 1vo L-JutT
NAME OF INSPECTOR: -I' as& t . --g ,-1, ;3 1 1L
FIRE SYSTEMS: FL 10/12(
EkkaimatcrueDAcedOCATIONS
COMVVNWA_ft6NS
2
2
3
3
4
5
4
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
k,
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.
ol
Any overlooked hazards or violations. of the fire regulations does not imply approval of such conditions orON I n.
for
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-777) for
Mountlake Terrace or Brier, call (425) 744-6231.
SNOHOMISH CO.
I bill
Serving Brier, Edmonds
Mountlake Terraceand
the Town of Woodway
,www.FireDistrictl.org
LOCATION: 520�.ST Edmonds 98020
BUSINESS NAME: The Maples
MAILING
ADDRESS: 4902 Doon Wy, Anacortes, WA
BUSINESS OWNER: Waltari, Marga
Email:
EMERGENCY-1:
KEY ACCESS-2:
PERSON CONTACTED: A.10,QC—_
NAME OF INSPECTOR: A - si, , A-1- 115:71t tf
FIRE SYSTEMS: 1Ww5M1r&FE J0/JC9,*14Z=Q4W
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE:'
HOME PHONE:
HOME PHONE:
eA e 41-e
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY I STATION & SHIFT
Annual 17-A
SCHEDULED
DATE DUE 0 AJJ9
LIFIR 131
CURRENT
CITY
YES NO
BUSINESS
1:1 1:1
LICENSE
INITIAL INSPECTION DATE
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
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 or the Town of Woodway, call (425)
775-7720; for Mountlake Terrace or Brier, call (425) 754-0434.
BUSINESS COPY
5z U,
le
FIRE�PREVENTION
INSPECTION REPORT
SNOHOMISH CO.
rl,�VIng Bl-iet; Edmonds
�
5'M' eridian S
0 'PD4,0 , NDS
FIRE.
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Mountlake Terraceand
Everett, WA 98208
1
BRIER
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DISTRI 'I
the Town of Woodway
- wwW.FireDistrictl org.
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Phone (425) 551-1200
.. 1,
Fax (425),,551-1272
wo6DWAY
11 MOUNTLAKE TERRACE
O'UNINCORPORATED
LOCATION:
520 Maple Strept
F-STATION & SHIFT_'�
17 D
FREQUENCY
366
BUSINESS NAME:
The Maples
PHONE:
SCHEDULED
DATE DUE 08101112
MAILI NG
4902 Doon Wy.
LIFIR 1, 423 8203
'
ADDRESS:'
Anacortes
98221
BUSINESS OWNER:
"Waltari, A.R."
HOME PHONE: 3602934926
ACTIVE
EMERGENCY-f:
"Waftari, Margaret"
HOME PHONE: . 4257757014
KEY ACCESS-2:
HOME PHONE: -
FURRENT
Ty YES NO
US, E S
0 0
K_ INITiAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: 06 a
FIRE F E
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
4epI;�
.
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
GRANTED TO-
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
18
18
DATE
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTERNEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY
SNOHOMISH CO. Serving Brier, Edmonds
TIREMountlake Terrace, and
Nowk*6 the Town of Woodway
DISTRI Twww.FireDistrict]. org
LOCATION: 520 Maple Street
BUSINESS NAME: The Maples
MAILING 4902 Doon Wy
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE:
ADDRESS: Anacorles ----98221
BUSINESS OWNER: uWallari. A.R.- HOMEPHONE: 3602934926
J EMERGENCY-1: "Wallari, Margaretu 4257757014
HOME PFCONE:
KEY ACCESS-2: 90ME PHONE:
�.n I
/7
PERSON CONTACTED:
NAME OFINSPEC T OR:
FIRE
SYSTEMS:
FIRE PREVENTION
INSPECTION REPORT
_;211�Q'MONDS
0 BRIER
0 WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY I STATION & SHIFF")
366 17 C
SCHEDULED
DATE DUE � [)8101/"
UFIR � 423 8203
ACTIVE
e'CURRENT
CITY YES NO
BUSINESS
LICENSE El 1:1
INITIAL INSPECTION DATE
-.O\ _'7,1, /I
FE�t /10
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2 .
2
...........
3
3
A
4
4
5
6
,7'
7
I AUHLL., I -0 CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION,
2nd RE -INSPECTION
FINAL RE
EXTENSION
-INSPECTION
VIOLATIONS
DATE DUE.
DATE DUE.
GRANTED TO,
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:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
7
3
7
RECEIVED _
6
DISPOSITION:
7
4
18
4
18
DATE:
LETTERNEEDED F] YES No
LETTERNEEDED [] YES NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5� AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
4's 9z
LOCATION:
520 Maple Street
BUSINESS NAME:
The Maples
MAILING
4902 Doon Wy
I
ADDRESS:
Anacortes
BUSINESS OWNER:
'Waffari, A.R.'
EMERGENCY-1:
"Waltari, Margaret'
KEY ACCESS-2:,
FIRE PREVENTION
SAFETY SURVEY
PHONE:
98221
HOME PHONE: 3fiG2934T-?6
4257757014
HOME PHONE:
HOME PHONE:
FREQUENCY
STATION 1, SHIFT
2
17 B
SCHEDULED
10
DATE DUE
UFIR Io 423
8203
ACTIVE
PERSON CONTACT ED: INITIA INSPE5TIONJDATE
NAME OF INSPECTOR:
FIRE FE
SYSTEMS:
ANNUAL
HAZARD,SF UND AND LOCATIONS/ COMMUNICATIONS
ENTER CODE ONLY ONCE 10
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
�7ovv
c &
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
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED 0 YES NO
LETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY