530 5TH AVE SSNOHONIISH CO.
Serving Brier, Edthonds, and
Mountlake Terrace
XPAC3 A A16JL%j A www.FireDistrict]-org
LOCATION: 530 5 th Avenue S 98020
Pancake Haus
BUSINESS NAME:
MAILING 530 5th Avenue S, Edmonds, WA 98020
ADDRESS:
BUSINESS OWNER: Meyer, Paul and Pam
EMERGENCY-1: Meyer, Brandon
KEY ACCESS-2:
EMAIL: snn� 'je-T
PERSON CONTACTED: V-'A' \1
NAME OF INSPECTOR:
It 4-4) '-A
STEMS: FE 10/15 HD 6T1-6
Date Last Serviced: to
FIRE,PREVENTION
12425 Meridian Ave S
Everett, WA.98208
INSPECTION REPORT
;E0 EDMONDS
BRIER
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
0 UNINCORPbRATED*
Fa� (425) 551-1272
4257712545
PHONE:
XnEQUE STA
nUajCY I ffy SHIF'**1
SCHEDULED Sep 2016
DATE DUE �
bb�3 I bJ
UFIR
HOME PHONE: e, 1,16
4253147005
HOME PHONE: �IUTRyR E N T YES NO
HOME PHONE:
BUSINESS
LICENSE
INITIAL INSPECTION DATE
Certification Given: RED[:] YELLOW0 WHITEEI
COMPLETE
FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD
High Pressure Hood Cleaning SYSTEM TEST REPORT
&THood and Duct Services, Inc. Fire Suppression Installation & Service CONFIDENCE TEST [Z' REPAIRSE11
Fire Extinguisher Sales & Service
6100 12th Ave. S. Phone (206) 726-0940 Range Hood and Fan Service & Repair
Seattle,WA 98108 Fax (206) 767-2607 Filter Sales & Service DATE:
OccupancyName: e�?C"Vkp- 'Aivi S — —
Occupancy Address: 0 S�-f A� . &' City, State, Zip-7i5e7yMopz!�Y6
Phone Number -
Responsible Person: -7 7
Building Owner: Phone Number:
Building Owner Address: City, State, Zip:
Testers Name (Please Print): 70 IDIJ L ;a6 SFD Certification Number: SCP- cYPI
System Alarm? Yes E] Nq� Central station monitoring? Yes Ej No El Monitoring company name:
Control Panel manufacturer: Model Number: I Location of Alarm Panel:
Extinguishing System ManufactureA,--eldri,-, stem Siz,6 ystem??sZ1No[j U.L. 300 Compliant? Yes[:] No;2r Chemical Type: Wet 2rDry El
OXI I.I.L. 300 6
Location / Height of Range hood: a� / !�F ;z
Is pressure gauge indicator in operable range? Yes�Ej Noo 12 year hydro date of cylinder.
Is there chemical inside of the cylinder? Yes-n No Were hand portable extinguishers properly serviced? NAE] Yes E15' No
Weigh CO2 or nitrogen cartridge. Were all cooking surfaces protected? If not, give owner full Yes;;;, No E]
No visible signs of a system fire or system tampering (if signs check no). Yes eT No F-1 information.
Check all piping and conduit. Are all piping and conduit immobilized with Yes Fn NoR Was operating procedure verbally given to restaurant personnel? Yes 21 No Ej
proper hangers and brackets? Was UL 300 compliance explained to owner or manager? Yes.2 No E]
Are all protective covers present on nozzles? Yes,�� No E] Gas shuts down upon system activation? NA [] Yes J�� Noo
Are all nozzles checked in the proper position? Yes E] No ?j Electric power shuts down upon system activation? NAa Yes F� No Ej
Does system have adequate volume and/or nozzle coverage? Yeq.F!f] No E] Range hood tied to building alarm panel? NAF -1 No Fj
.!j Yes F
Are all appliances inside of the hood protection area? Yes4�� No E] Range hood activation signal received at building alarm panel? NA4�9 Yes F� No F]
Have fuse links been replaced? Yegf!j Noo Class K extinguisher present? Yea��- No
Was system operational from terminal link? Yes4�� Noo Grease buildup in group:
Was system operational from manual remote? YesE No E] Light Medium— Heavyerecommend cleaniny
_S
i�
Was system and micro switch operational? NA YesFj No E] Date of last cleaning --Z �e- WW /
Is system visible and free from obstruction? Yes F!T No E] Are cleaning intervals §thk4A standards? Yes 2- No E]
Yest�j No F-� Previous Confidence Test Company & Technician
Is the inspection and service tag on the cylinder?
Y",
-1 A
'71
-A
f
L
-F
1-7 -L,
POILLL &----"d
Corrections Made: Date Corrected:
Corrected By:
has declined
SFD Certification Number:
This certifies that this fire anplfe safety system has been pro,,A inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
'i
standards. Discre cie etteWdd h te .1ding Owner/Responsible Person for corrective action.
Phone # (206) 726-0940
Signature of Test - A4 ��
Testing Agency:-! R&THb-63—andl5y;ttServlbes,rnc. MailingAddress: 6100 12th Ave. S., Seattle, WA98108
The owner is to perform and keep a written record of the following "quick check" fire system inspection to verify the following:
1 . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are found, appropriate corrective action shall be taken immediately
intended use. 9. A record of the monthly inspections is to be kept reflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the inspection and any corrections required.
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE %&d,
FIRE DEPARTMENT COPY
. V
John J. Dowling
From:
John J. Dowling
Sent:
Thursday, April 14, 2016 2:23 PM
To:
Kevin Zweber
Subject:
Pancake Haus 530 5ht Ave S
Kevin,
I swung by the Pancake Haus and spoke with the manager about the issues noted by RT Hoods on their 2-23-
216 inspection form. They will be contacting RT Hoods and will be e-mailing me or calling me when the work
is complete and the system is up to code.
J.J. Dowling
Acting Deputy Fire Marshal
idowlinaa-firedistrictl.ora
Office: 425-775-7720
Waffamsk Ca
F' E
DIRTR T
The information in this email is confidential and may be legally privileged. It is intended solely for the addressee. Access or use by any other person to
this internet email is not authorized and may be unlawful. If you are not the intended recipient, please delete or destroy this email. If you do not wish to
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Serving Briet; 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
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION: 530 5 th Avenue S 98020
Annual
17-A
PHONE:
BUSINESS NAME: Pancake Haus 4257712545
SCHEDULED
DATE DUE � Sep 2015
MAILING
UFIR 1' 563 153
ADDRESS: 530 5th Avenue S, Edmonds, WA 98020
1 -7(
BUSINESS OWNER: ?i V-1 T LA (V\e_JC-- HOME PHONE: (4LS--7q1_Z Z,
.EMERGENCY-1: �,Y�ck- HOME PHONE: L4 0 _1A
CURRENT
KEY ACCESS-2: HOME PHONE:
I & -Z,7-7 00 C)--n
CITY
BUSINESS
YES NO
EMAIL:
LICENSE
INITIAL INSP�CTIO
DATE
PERSON CONTACTED:
I
D
NAME OF INSPECTOR:
FIRE SYSTEMS: FIE��_ HD???
Date Last Serviced:
HAZARDS FOUND AND LOC77TIoNercoMMONICATIONS
. .. ..... ..
2
2
3 ... . ...
.4
5
5
6
6
7 ---- ---
7
I 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 allbusinesses 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, call (425) 775-7720; for
Mountlake Terrace or Brier, call (425) 744-6231.
COMPLETE Certification Given: RED E] YELLOWZI WHITEE]i
FIREPROTECTION CONFIDENCE TESTING RANGEHOOD
R High Pressure Hood Cleaning SYSTEM TEST REPORT
&THood and Duct Services, Inc. Fire Suppression Installation & Service [Z�E JEST REPAIRS Fj
Fire Extinguisher Sales & Service
6100 12th Ave. S. Phone (206) 726-0940 Range Hood and Fan Service & Repair
Seattle,WA 98108 Fax (206) 767-2607 Filter Sales & Service DATE:
Occupancy Name: —
Occupancy Address:
Responsible Person:
Building Owner:
Building Owner Address:
Testers Name (Please Print): r-, VkA- &�S -e
System Alarm? Yes E] No Central 4tation monitoring? Yes F1 Noz
Control Panel manufacturer: -It q I A — Model Number: —
Extinguishing System Manufacturet
Location / Height of Range hood:
City, State, Zip: 04Z:0, SnqtQv1- U �� ) L.,
Phone Number:
Phone Number:
City, State, Zip:
SFD Certification Number: scip. Al't.
Monitoring company name:
Location of Alarm Panel:
System?YeszNoE] LI.L. 300 Compliant? Yes[:] NoX Chemical Type: Weo Dry
Is Ye 12 year hydro date of cylinder.
pressure gauge indicator in operable range? s
Is there chemical inside of the cylinder? Yes No E] Were,hand portable�extinguishers propedy serviced? NA F� Yes No
NA�
WeigIn 60� or nitrogen cartridge. e �. Were all cooking surfaces protected? If not, give owner full Yes NoF
No visible signs of a system fire or system tampering (if signs check no . Yes No F-I . information. F6 Noo
Chieck,all I pip I ing. and con d I uit.Are,all pipin . g and conduit immobilized with Yeso NoF-1 Was operating_ procoqure verbally given to restaurant personnel? Yes -
prope , r hangers and brackets? Was LIL 300 compliance explained to owner or manager? Yes [6 No Ej
Are all protective covers present on nozzles? Yes No Gas shuts down upon system activation? NAO Yes [Z No'n
Electric power shuts down upon system activation? NAZ Yes El No El
Are all-nozzles,checked in the proper position? Yesit- *12),
Does system have adequate volume and/or nozzle coverage? Yes 21 No E] Range hood tied to building alarm panel?,-. NAZ Yes n Noo
Are all a pplia - n I ces I insid - a of t h e hood pr o . tectio n ar ea? Yes No'[j Range hood activation signal received at building alarm panel? NAZ Yes No F-1
Have fuse links been replaced? Yes V] No E] Class K extingu isher prese nt? Yes
Was system operational from terminal-iink? Yes No Grease built
p.Wgroup:
Was system operational from manual remote? Yes No E] Light Vedium Heavy, recorn d leaning
Was system,:and mjcro�switch operational? NAE] Yes No 13 Date of last cleaning cpte mF
/7 tAo\�
Is systerrivisible and free from obstruction? Yes No F� Are cleaning intervals wiWin NFPA standa7ds'2r YesX No E]
Is the inspection and service tag on the cylinder? s No Previous Confidence Test Company 4 Technician --Ake
A
x"L V
7T,
This certifies that this fire anq life safety system has been pWerly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
standards. DiscrepancieW 06ad1we-4yen repo,
r�u Wto the building Owner/Responsible Person for corrective action.
Signature of Tester: - 1±�i� Phone # (206)-726-0940
Testing Agency: R&T Hood @-#d Duct Services, Inc. Mailing Address: 6100 12th Ave. S., Seattle, WA 98108
The owner is to perform and keep a written record of the following "quick check" fire system inspection to verify the following:
1 . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2, The manual pull stations are unobstructed and in clear view and are labeled for 8. It any deficiencies are found, appropriate corrective action shall be taken immediately.
intended use. 9. A record of the monthly inspections is to be kept reflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing thi-olrspecio nd n, corn
4. Observe system, checking that no obvious physical damage or condition exists ac fequired.
that might prevent operation. AUTHORIZED
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE X
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Briet: Edmonds, and
�24j5 Mei-idian Ave S
INSPECTION REPORT
SNOHOMISErACO.
Mountlake Terrace
FIRE
Everett, WA 98208
'K'EDMONDS
f3 BRIER
Sm-ftifflT
Phone (425) 551-1200
[1 MOUNTLAKE TERRACE
0 UNINCORPORATED
wwwFireDistrictl.org
Fax (425) 551-1272
r' FREQUENCY
STATION & SHIFT-**'
LOCATION: 531 D .5 th A\etiva'S 98020
Annual
1-1-D
BUSINESS NAME: Panivakc I faus
PHONE: 4255771254�
SCHEDULED
DATE DUE 1' Sop 2014
MAILING
FIR 0
IU
ADDRESS: 530.5th A-,,criuc S, i=dr7mn&-, WA W021)
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
-CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
EMAIL:
LICENSE
N ONTACTED: 24"
INITIAL INSPECTION DATE
=E
0
NARMSEO FCINSPECTOR: 06 0 7
Lzw
9HE SYS IEMS: FE032
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
L)J W ALL -
'R?
2 4-L le "IY OJ� 0'_E CA)
LALN, S,�-po (-,e- EE
V V--
3 KF
2
3
4
4
5
5
6
6
7
7
X,'
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
I st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
x SION
x
G TED TO:
FINAL RE-&ECTION
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
SECTIO
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED [—] YES No
LETTER NEEDED E] YES [I NO
8
FIRE DEPARTMENT COPY
SNOIHOMI&MO�
FIRE
Serving Briet; Edmonds, and
Mountlake Terrace
JLJFJLL-"7 A JMJL%o A wwwFireDistrictl.org
LOCATION: 20903 70 th Avenue W 98020
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
BUSINESS NAME: Aurora House/Compass Health PHONE: 4256723333
MAILING
ADDRESS: 20903 70th Avenue W, Edmonds,
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Antes —,Barry R,4y,,'� 41,11 HOME PHONt'� �5
KEY ACCESS-2: HOME PHONE:
EMAIL:
PERSON CONTACTED: 'vVA
NAME OF INSPECTOR: L) AJ 07,
ills 1/15 )01 1110 1
MOE! L%V0-rC:ftA0. - Al- �A �14 A �� -1- 1 11 - �14 A
FIRE'PREVENTION
IPPECTION REPORT
VEDMONDS
El BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
" FREQUENCY I STA1FN & SHIF-"
Annual 1 6_
SCHEDULEDJUI 2015
DATE DUE
452207
UFIR I,
CURRENT
CITY YE NO
BUSINESS
LICENSE Z El
INITIAL INSPECTION DATE
-17 - 7 - / 057
a�JL§8rV18j_8.�AT'ONS 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:
E:
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 RECEIPT
RECEIVED
6.
4
18
4
.8
DATE:
DISPOSITION:
7
LETTER NEEDED (] YES NO
LETTER NEEDED E] YES F-1 NO
r
8
FIRE DEPARTMENT COPY
_7
Range Hood Systems Report
I�TA a I
ip
M
FIRE CONTROL
877-866-3473 Phone / 877-841-9293 Fax
PO Box 11369
Olympia, WA 98508
CUSTOMER
Name
Address
Ave, -5
city wi, ALS, -State ll,_)a ZIP
T.elephone If 2PS-7-71- 2SI-15 Store No.
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OF SERV
A.K
P.M.
-3
3N o o
I
I A
ANNUAL
SEMIANNUAL
RECHAROF
INSTALLATION
RENOVAT04
I A
I
LOCATION OF SYSI EM CYLINDERS
UL 30D
E]YES []No
FACTVRER
MODELNUMBER
WFT
DRY CHEMICAL
CYL=Et�aVEASTER
INDER SIZE SLAVE
CYUNOER SIZE SLAVE
FUSE LIW 3600 F.
FLISE LINKS 4SO- F
FUSE LINKS SOW F.
OTHM
FUELSHUTOFF
CLEClktC
GAS
SIZE
-/-\ I
X
I 1k
-
SERIALNUM13ER
_F LAST KYDRO TEST DATr
LAST RECHARGE DATE
["N _TURE WM IAI PREFERENCE
IA.=...7S
DIMING NUMBFIt
WE
f �, X�r \e V LA
2�kct A, �1 L KI;*V74 r
<3,r,
All appliances property covered w1correct nozzles
20. Replaced fuse links
2. Duct and plenum covered w/correct nozzles
21. Check travel of cable nuts/G-hooks
.3. Check positioning of all nozzles
22. Piping & conduit securely bracketed
�� * System installed in accordance w/MFG UL listing
23. Proper separation between fryers & flame
5. Hoodiduct penetrations sealed w1weld or UL device
24. Proper clearance - flame to filters
X
Check if seals intact, evidence of tampering
25. Exhaust fan in operating order
Y,
If system has been discharged, report same
26. All filters In place
8. Pressure gauge in proper range Cif gauged)
27, Fuel shut-off in on position
9. Check cartirdge weight (if applicable)
28, Manual & remote set/seals in place
10. Hydrostatic test date
29. Replace systems covers
K
il. -6 year maintenace date
30. System operational & seals in place
ZI
:12. Inspect cylinder and mount
31. Slave system operational
13. Operate system from terminal link
32. Clean cylinder & mount
K
14. Test for proper operation from remote
33. Fan warning slgn on hood
15. Check operation of micro switch
34. Personnel instructed In manual operation of system
16. Check operation of gas valve
35. Proper hand portable extinguishers
17. Clean nozzles
36. Portable extinguishers properly serviced
X_
18. Proper nozzle covers in place
37. Service & Certification tag on system
19. Check fuse links and clean
�L
NOTE.QLErfREP.ANLC.ES-Q&UFICIENCIES BELOW
COMMENTS: 'AyArn e.
r-
C j P_<, 0 y
On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire
�Uppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual, with the lr!�sults indicated above.
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM USTOMER's AUTHORIZED AGENT
'e'
The above service technician certifies that the system was personally inspected and found con itions to be as indicated on this report.
WHITE - CUSTOMER COPY I CANARY - DISTRIBUTOR I PINK - AUTHORITY HAVING JURISDICTION
FIRE PREVENTION
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
JCEDMONDS
FIRE'�t�e*
Mountlake Terraceand
Everett, WA 98208
0 BRIER
DISTR
,. 7 .4)�
the Town of Woodway
Phone (425) 551-1200
0 WOODWAY
0 MOUNTLAKE TERRACE
,
www.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
" FREQUENCY STATION & SHIFT
LOCATION:
530 5th Avenue
S
365 17 6
I
BUSINESS NAME:
Pancake Haus
PHONE: 4257712545
SCHEDULED 09/01/12
DATE DUE I`
MAILING
530 5th Ave S
LIFIR � 161 9152
ADDRESS:
Edmonds
98020
BUSINESS OWNER:
Meyer, Paul
HOMEPHONE: 4257452762
PREFIRE 130
EMERGENCY-1:
Meyer, Brandon
4253147005
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
PERSON CONTACTED: AMAM AA e7 y9r
INITIAL INSPECTION DATE
-
NAME OF INSPECTOR:
/0 - _J
FIRE HD8/12 10_t1_ I
FE _J/
SYSTEMS:
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
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 Snjohomish 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)
775-7-720; for Mountlake Terrace or Brier, call (425) 754-0434.
BUSINESS COPY
Range Hood Systems Report
A =f
FIRE CONTROL
877-866-3473 Phone / 877-841-9293 Fax
PO Box 11369
Olympia, WA 98508
CUSTOMER
Name
Address -5-50
State �LL ZIP
City
47 7/ -
�iephone -45 47 Store No,
I
I
Qwner or Manager
I
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OF SERVICE
Z
TIME
—3
4.
AAL
I RM.
Y,
ANNUAL --F��NUAL
RECHARGE
INS-TALLATION
I
RENOVATION
I
LOCATION OF SYSI F.M. CYLINDERS
UIL 3W
(9yes []NO
MANUFACTURER
MODELNUMBER
wrl
DRYCHEMICAL
CYLINOEk SIZE MASTER
CYUNDER S11E SLAVE
CYLINDER SrZE SLAVE
FUSE LINKS 3600 R
FUSE UNKS 4500 F.
FUSIE LWKS 5000 F.
OTHER
i
If
FUELSHUTOFF
ELECTRIC
GAS
SIZE
SERIAL NUMBER
LAST HYDRO TEST DATE
LAST RECHARGE DATE
MANUFACTLMER'S MANUAL PRErERENCE
PAGENUMaM
DPAWMNUMnER:
DATE
Lz
bur v-k%�-f 5
1. All appliances property covered w1correct nozzles
2. Duct and plenum covered w/correct nozzles
3. Check positioning of all nozzles
X
4. System installed in accordance w/MFG 0L listing
X
5. Hoodlduct�penetrations sealed w1weld or UL device
6�t- Check if se'als intact, evidence of tampering
7... If system has been discharged. report same
Y
6,10". Pressure gauge In proper range (if gauged)
X-
9.� -, Check car1jrdge weight (if applicable)
�110.�, Hydrostatic test date
X
11. 6 year maintenace date
di-2;, inspect cylinder and mount
.1-3. Operate system from terminal link
Test for proper operation from remote
15. Check operation of micro switch
16. Check operation of gas valve
'i-f. ciea nozzles
n
'1�. Proper nozzle covers in place
19. Check fuse links and clean
C OMMENTS: 'rc& v) K A )r c,
20. Replaced fuse links
X
21. Check travel of cable nuts/G-hooks
X,
T-
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flane
24. Proper clearance - flame to filters
V
25. Exhaust fan in operating order
Y,
26. All filters in place
27, Fuel shut-off in on position
28. Manual & remote set/seals in place
29. Replace systems covers
X
30. System operational & seals in place
X,
31. Slave system operational
X
32. Clean cylinder & mount
X
33. Fan warning sign on hood
Y,
34. Personnel instructed in manual operation of system
X
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
X
NOTE DISCREPANICES OR DEFICIENCIES BELOW
X
On. this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire
guppress!qn system requirements of NFPA1 7 or 17A, 96 and the manufacturer's manual, with the.results indicated above.
;-X v
.,\---8ERVICE TECHNICIAN PERMIT NO- DATE: TIME: AM PM CUSTOMER'S AUTHORIZED AGENT
Th'
above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
WHITE - CUSTOMER COPY I CANARY - DISTRIBUTOR I PINK - AUTHORITY H41NG JURISDICTION
APPLICATION FOR PERMIT
FOR MATERIALS OR PROCESSES
January 3, 2012
Please verify and correct the following information:
Name of Company (DBA):
Pancake Haus of Edmonds, Inc.
Edmonds Location :
530 5th Avenueth Avenue S
In conformity with the
terms of the I nternational
Fire�Code, application is
hereby made to store, use
Places of Assembly - Occupant Load: 130
or maintain the following
activity, storage or pro-
cesses:
Mailing Address:
530 5th Ave. S.
Edmonds, WA 98020
EFD UFIR #:
11611300913152
(for office use)
Your Signature
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
FOR OFFICE USE ONLY
Rec'd -2,
Check# 4 �4D
Range Hood Systems Report
SERVICE COMPANY '
F I R E 400 M A S T E R S
A Division of RM Services, Inc.
877-866-3473 Phone / 877-841-6293 Fax
PO Box H 369
Olympia, WA 98508
CUSTOMER
Name )C A
r-_
Address .5-_��- 1;11- L/p
a t y StateL,)e,, ZIP2LV__1Dn
Telephone I G111 6- � 71 -2495 Store No.
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFTTORIGHT
DATE OF SERVICL
TIW_
A M.
,?j III / I �a,
I
I
ANNUAL
4WATUAL
I RIZOIAROE
1111' GIAILATIUN
RENOVA11CM
LOCATIrNICF.SYSTEM CYLINDERS
UL 3W
?,0t�� i__ �I-
14YES [3140
DELNUNWER
Wlif,
DRY CI IEMICAL
vl�I t-16-
t
b
I
�"11_
CYUNDER SIZE MASTER
-
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE
b cy�
._.-
.
I
FUSE LINKA110-F.
FUW LINKS 4W R
ILISFI-TINKSWIlF,
OTI"
1-1
1
FUrLBIJUTOFF
ELECT=
SIZE
X
X
I
SERIAL NUMBER
LAST HYDM TEST DATE
ILAST kECIVJWE UATE
MANUFACTURER'S MANVALPREFEREME
PAGE NUMBEFL DRAWING NUMBERt
tIATr
el A
174, 11
f, k 1p
1. All appliances property covered w1corrict nozzles
2. Duct and plenum covered w/correct nozzles
3. Check positioning of all nozzles
4. System installed in accordance w/MFG UL listing
5. Hood/duct penetrations sealed w/weld or UL device
6. Check If seals Intact, evidence of tampering
7. If system has been discharged, report same
B. Pressure gauge in proper range (if gauged)
9. Check carlirdge weight (if applicable)
10. Hydrostatic test date
11. 6 year maIntenace date
12. Inspect cylinder and mount
13. Operate system from terminal link
14, Test for proper operation from remote
15, Check operation of micro switch
16. Check opei�ation of gas valve
17. Clean nozzles
18. Proper nozzle covers in place
19. Check fuse links and clean
COMMENTS: ",-A.- i. 4- 0 YY
20. Replaced fuse links
21. Check travel of cable nuts/G-hooks
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flane
24. Proper clearance - flame to filters y
25. Exhaust fan in operating order
26. All filters in place
27. Fuel shut-off in on position
28, Manual & remote settseals In place
29. Replace systems covers
30. System operational & seals in place
31. Slave system operational
32. Clean cylinder & mount
33. Fan warning sign on hood
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
NOTE DISCREPANICES OR DEFICIENCIES BELOW
On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire
suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual, with the results indicated above.
X
e-, A 02M I ix I 14/ZA fflmdn:
SERVICE TECHPr1CIAN PERMIT NO. b6 ME TIME: AM PM CUSTOMEWS AUTHORIZEDRAGENT
The above service technician certifies that the system was personally Inspected and found conditions to be as indicated on this report.
-DISTRIBUTOR /PINK -AUTHORITY HAVING J URI
WHITE - CUSTOMER COPY I CANARY
APPLICATION FOR PERMIT
FOR MATERIALS OR PROCESSES
March 7, 2011
Please verify and correct the following information:
1-�;m U \v/ I �c
APR 0 8 FAIDIJU
EDMONDS FIRE Dc"'T"T.
Name of Company; DBA
Pancake Haus of Edmonds, Inc.
Edmonds Location
530 5th Avenue
In conformity with the terms of
Places of Assembly - Occupant Load: 130
the International Fire Code,
application is hereby made to
store, use or maintain the
following activity, storage or -
processes:
Mailing Address:
530 5th Ave. S.
Edmonds WA 98020
EFD UFIR #:
1611300913152
(for office use)
Your Signature
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 1161-130-0913-152 December 31, 2011
Date of Issue UFIR Number Date of Expiration
I This PERMIT is issued to: I Pancake Haus of Edmonds, Inc. I
I located at: 1530 5th Avenue S I Edmonds, WA I
I To engage in the business, occupation or pr cess of: I 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: 130
I Allowed Occupant Load: 130 1
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
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
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
4�' t
LOCATION: 530 5th Avenue S
BUSINESS NAME: Pancake Haus
MAILING - 530 5th Ave S
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257712545
ADDRESS: Edmonds 98020
BUSINESS OWNER: Meyer, Paul HOMEPHONE: 4257452762
EMERGENCY-1: Meyer, Brandon HOME PHONE: 4253147005
KEY ACCESS-2: HOME PHONE:
I I PERSON CONTACTED: t? Y'j�A "C
NAME OF INSPECTOR:
FIRE 5/08 UL300
SYSTEMS:
HAZARDS FOUND AND LOCATIONS / COMMU
FREQUENCY
S1 XTION & SHIFT
365
17 D
SCHEDULED
g9jol 11g
DATE DUE 1,
)
LIFIR 0, 161
9152
PREFIRE 130
INITIAL INSPECTION DATE
FE
ANNUAL
NICATIONS
ENTER CODE,ONLY ONCE 1�
VIOLATION CODE
C. W,
----------
2
2
3
3
4
4
5
5
6
6
7
7
8
8
ist 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:
3
VIOLATIONS
1 5
-DATE:
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
v., LETTER NEEDED E3 YES E] NO
LETTER NEEDED [3 YES E] NO
FIRE DEPARTMENT COPY
R*A&Mia
&THood and Duct Services, Inc.
6100 12th Ave. S.
Seattle,WA 98108
Occupancy Name: -
Occupancy Address:
Responsible Person:
Building Owner:
Phone (206) 726-0940
Fax (206)767-2607
COMPLETE
FIRE PROTECTION
High Pressure Hood Cleaning
Fire Suppression Installation & Service
Fire Extinguisher Sales & Service
Range Hood and Fan Service & Repair
Filter Sales & Service
aws
Certification Given: RED 0 YELLOCQ) WHITE
CONFIDENCE TESTING RANGEHOOD
SYSTEM TEST REPORT
City, State, Zip:
Phone Number:
Phone Number:
CONFIDENCE TEST [A REPAIRS01
DATE: tO �% — t 6
JR.
Building Owner Address: 41--1 % I 9!=-,
City, State, Zip:
Testers Name (Please Prink. 15A1er,-
SFD Certification Number: SCP-
System Alarm? Yes F-1 No CK Central station monitoring? Yes F-1 No
Monitoring company name:
Control Panel manufacturer:
Model Number:
Location of Alarm Panel:
Extinguishing System Manufacture &4vv—
System Size
00Syst m?YesWoE] U.L.30 Compliant? Yes E] No 09 Chemical Type:
Wet 5t
Dry Ej
Location / Height of Range hood.
v
Is pressure gauge indicaitor in operable rang�e?
e
-
oo�
12 year hydro date of cylinder.
IVIS
Is there chemical inside of the cylinclerl
Yes
No
- — - --- - ----
Wereh�d portable exiinguishers prop
Arty_ serviced?___
No
VMigh CO2 or nitrogen cartridge.
-NAa
Were all cooking surfaces protected? If not, give owner full
Yes E]
No N]
No visible signs of a system fire or system tampering (if signs check no). Yes [Z
No F-1
infor - mation -
verbally restauran t
Yes_3
No
heck all piping and conduit. Are all piping and conduit immobili zed Wb.--Ye-sT;�
No
_oemrting procedure gLiven Jo- personnel?
proper hangers -and brackets?
Was UL 300 compliance explained to owner or manager?
Yes
No
Are all protective covers present on nozzles?
Yes 2
No E]
Gas shuts down upon sVstem activation?
Yes
Are all nozzles checked.in the proper position?
Yes
No
Electric power shuts down upon system activation? NAF�
Yes [A
No E]
Does system have adequate volume and/or nozzle covera Yes
No
Rwnge- hood -tied to - building al - arm pan , el . ? I N I AZ_
Yes 0
No L]-
Are all appliances inside of the hood protection area?
Yes
No [j
Range hood activation signal received at building alarm panel? NA 1A
Yes 0
No EJ
Have fuse links been replaced?
Yes E?
No E]
Class �Kxt!iirigui�reseni?
Yes tg_
No E-]
stem- perat __ _ __ mterminal link?
Was-si o 6naffr6
e _
No,[J.__,
Grease buQ&p in group:
Light Medium Heavy, recomm d
cleaning
Was system operational from manual remote?
Yes [;a
No E]
;Ms,—
Date of last cleanin
Was syste m and micro switch operational?
NAD e
Noj
Are cleaning intervals within NFPA sandar s?
Is system visible and free from obstruction?
As the -inspection anc�jqrvice tag or!_the cylinder?
Yes E�
Yes
No E]
No
_Previous Confidence Test Company & Technkician�
-- ----
Yes
-No
(if additional room is needed, please add a separate
�� I �M A
Corrections Made: Date Corrected:
I j I- I J-1 --- 1-- 1--, fl , 1-1
Corrected By:
r-11
REMEMEMEN
N1
Customer has declined
SFD Certification Number:
This certifies that th' a fi safety syst^has been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
standards. Discrep ncies e and ha bee uilding Owner/Responsible Person for corrective action.
Signature of Tester: Vt Wy� Phone # (206) 726-0940
TestingAgency: uHoRodand Ddls�ices, Inc. Mailing Address: 6100 12th Ave. S., Seattle, WA 98108
The owner is to perform and keep a written record of the following "quick check" fire system inspection to verity the following:
I . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are found, apprpisnate corrective action shall be taken immediately.
intended use. 9. A record of the monthly inspectio _ to be �ept �eflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the inspectio/ and c�r.)y eprrections required.
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUITIHORIZEFD-D� ZL
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE
FIRE DEPARTMENT COPY
COMPLETE FCertif !cation Given: RED[:] YELLOWLR WHITEE]l
FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD
R High Pressure Hood Cleaning SYSTEM TEST REPORT
&THood and Duct Services, Inc. Fire Suppression Installation & Service CONFIDENCE TEST [9 REPAIRS:Q:]
Fire Extinguisher Sales & Service
6100 12th Ave. S. Phone (206) 726-0940 Range Hood and Fan Service & Repair
Seattle,WA98108 --Fax (206)767-2607 Filter Sales & Service DATE: 4,.LL -(0
Occupancy Name: -9 %-WXLkj- I LXV 111* -��
%J
%
-
Occupancy Address:
4ve
City, State, Zip: CWISE; k
Md.
Responsible Person: Falyl
Phone Number: 4Z5
Building Owner:
Phone Number:
Building Owner Address: 1
City, State, Zip:
Testers Name (Please Prin,;C91j'AA k
MjAlb \/'P
SFD Certification Number: SCP- U
Uq
System Alarm? Yes F-1 No Central station monitoring? Yes E] No
Monitoring company name:
Control Panel manufacturer:
Model Number: I
Location of Alarm Panel:
Extinguishing System Manufacture&15;;t�
Q1 -
S stem Size W.L.
y
;o LI.L. 300 Comp�ant? Yes El No
300 Syst ? Yes.,�N
4
9�11 Chemical Type: Wet)5Qry E)
Location / Height of Range hood:
ls� pressure gauge1ndicator in ope . rab - le I rang . e?',
-Yes
12 year hydro date of cylinder.
Is there chemical inside of the cylinder?
Yes
No E]
Wwe-,hand'[p6rta`b- I-e--e-x-t-ing--u-is-he-rs--p-�,-o-pe-ri-y-s-ervi-c-ed?-_*_
N�o - Yes [A
4(;C1
Weigh CO2ornitrogeri_cartridge.
Were all cooking surfaces protected? If not, give owner full Yes E�
No [3
No visible signs of a system fire or system tampering (if
signs check no). Yes El
No El
information.
Check all pipin and c6n I duit.'A
119, I , re all piping and conduit immobilized with YesfA
NoM ____Mas
operating procedure verbally given to restaurant
personnel? Yes
No [I
-
properbangers and brackets?
Was LIL 300 compliance explained to owner or manager? Yes [Z
No E]
Are all protective cov6rs.present on nozzles?
Yes E�
Noo
Gas',shuts down upon sysi:em activation?
NAO Yesf�1-71467[n�
Are all nozzleschecked in the proper position?
Yes 21
Non
Electric power shuts down upon system activation?
NAD Yes
NoZ
Does system have adequate volume and/or nozzle coverage? Yes [?n
No F�
Range hood tied to.building alarm panel?
NA Z Yes n
_Non
Are all appliances Inside -of the, hood protection area?
Yes[y,_,_Noo
Range hood activation signal received at building alarm panel? NA 5A Yes El
No El
Have fuse links been replaced?
Yes 2
NoFj
Class - K - extinguisher present`7
Yes�
Was §y�teMoper6tional from terminal link?
Yes[Z
Noo
Grease buildup in group:
Was system operational from manual remote?
Yes 2
No F-1
Light leftm== Hepyy,
recomme 0 clealng
'7an
wa71'ysie*_m d micro switch operational?__
sM
yeL
Not3
Date of last cleaning
Ve
Is system visible and free from obstruction?
y�� E�f
Are cleaning intervals within NFPA standards?
Ye�y
No
Is' the,inspection and service tag, . o . n . . t I he - cylinde . r?
Yes 16
_No[]
No El
PreviQus Confidence Test Company Technician.
1- -7
`4
t7 J j
744 -1 4w
W-7-
T-1
cell
r 7
flo
�3u
...... .............. .. ... .. ... .. .. .
—TJ
Problems Found: (if additional room is need d leas dd 1parate sheet) VV41 VC> tie 0 V111 c4lm�: AIL DIP
)-,%-I -A�e- r-. .1 A A^ V---, w , A16-1— I err I A :L�
Customer has declined repairs X , 6. YLV
Corrections Made: Date Corrected: Corrected By: SFD Certification Number:
Thi e ie tha th arld We safety system an properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
ti' s ' is
sc ' . iscr p res a a'd h
stand rds D e a n ave b n repo ed to the building Owner/Responsible Person for corrective action.
Signature of Tester: Phone # — (206) 726-0940
Testing Agency: �U&T Hood and 0 SbpAcasl, Inc. MailingAddress: 610012thAve.S.,Seaftle,WA98108
The owner is to perform and keep a written record of the following "quick check" fire system inspection to verify the following:
1 . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. -The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are found, appropriate corrective action shall be taken immediately.
intended use. 9. A record of the monthly inspections is to be kept reflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the inspection and any corrections required.
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED
�5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE
FIRE DEPARTMENT COPY
November 6, 1989
MEMO TO: Gary L. McComas
Fire Marshal
FROM: Peter Knudson
Firefighter "A"
SUBJECT: PANCAKE HAUS - 530-5TH AVENUE SOUTH
For many years the Pancake Haus at 530-5th Avenue South has not been in
carpliance with the Life safety Code. For the last two years I have
gone back to the Pancake Haus and written up the poor means of egress.
The rear banquet room has no legal means of egress and the main dining
room has very poor exit facilities.
According to the Life Safety Code, 1985 Edition, Section 5-1, Paragraph
A-5-4.1.1, the Code in general requires all occupancies to have two
exits. More specifically in the chapter on Public Occupancies, Para-
graph 9-2.4.3., "Every Class C assembly occupancy shall have at least
two means of egress, consisting of separate exits or doors leading to a
corridor or other spaces giving access to two separate and independent
exits in different directions."
The banquet room on the west end of the restaurant has extremely poor
exit access. If there was a fire in the kitchen, anybody in the ban-
quet room would be cut off. In the 1985 Life Safety Code, Paragraph
9-2.5.2, "Means of egress shall not be permitted through kitchens,
storerooms, restrooms, closets or hazardous areas as described in
9-3.2." The primary exit path goes right by unprotected opening in the
kitchen and the rear exit goes right through the kitchen with an aisle
width varying from 31" to 40". By City of Edmonds ordinance, the mini-
mum corridor width shall be 44". This exit path is also the second
exit from the min dining room. It is also where the garbage and
refuse is stored and where supplies are delivered. There is no separa-
tion from other areas of hazard as required by Section 5-1.3. This
section requires an one -hour minimum rating for the corridor and all
appliances. It is emphasized in Paragraph 5-5.1.3 that the exits shall
be constructed remote from each other and constructed in such a way to
reduce the possibility that they might both become blocked in the event
of an emergency.
0 0
This exit hazard has been in existence for many years and
resolved soon. A suggestion for a fairly sinple solution
put a balcony and stairway in the northwest wall from the
of the banquet room. The cost of adding a remte exit in
of the restaurant is minimal conpared to the loss of a li
event of a fire.
Sincerely,
PK:be
needs to be
might be to
storage area
the west end
,e in the
CITY OF EDMONOS
CIVIC CENTER - EDMONDS. WASHINGTON 98WO (206) 775-2525
FIRE DEPARTMENT
April 21, 1978
1,�atvv
Mr. Ernest Boyd
520 - 12th Avenue North
Edmonds, WA 98020
RE:. PANCAKE HAUS, 530 - 5TH AVENUE SOUTH, EDMONDS
FILE CODE 161-000-038
Dear Mr. Boyd:
HARVE 14. HARRISON
MAYOR
The Fire Department inspected the Pancake Haus at 530 - 5th
Avenue South on February 22, 1978, after which a letter (copy
enclosed) was mailed to you. Your property was reinspected
on April 21, 1978. The reinspection indicates that the vio-
lations remain uncorrected.
Therefore, under authority of Ordinance 1779 of the City of
Edmonds, you are hereby required to comply with the follow-
ing corrections:
BANQUET ROOM
O'Ll. Provide exit doors to swing in direction of exit travel.
2. Provide enclosed exit corridor on north side of kitchen..
(a) MiniMUM fire resistive rating of one hour.
(b) Minimum width 44 inches.
(c) All doors to swing in direction of exit travel.
0)(-3. Provide self -closing fire door between kitchen and
Banquet Room.
ALTERNATIVES TO ABOVE
2
q03.
�b 4.
Exit doors must swing in direction of exit travel.
Due t * o the inadequacy of proper exits, the Fire
Prevention Bureau is empowered to limit the number
of persons in a given area. The maximum number of
occupants in the Banquet Room shall not exceed 49
persons.
44
Remove exit signs from north door and hall (Completed).
Repair east exit doors to open easily.
Mr. Ernest Boyd
April 21, 1978
Page 2
0
NORTH EXIT CORRIDOR
Separation from the kitchen is required in the north
corridor to provide a second exit from the dining
room. This should be accomplished by means of a door
between the kitchen and the corridor.
2 . The exit sign above the east exit door from the north
corridor shall remain.
3. The waste containers shall be removed from the north c
exit corridor.
The above requirements must be completed prior to May 22, 1978.
Failure to comply will subject you to a fine, not to -exceed
$250.00, or imprisonment, not to exceed 90 days, or both.
Each day of violation after May 22, 1978 may constitute a
separate offense.
Please contact this department if additional information is
desired.
Sincerely,
EDMONDS FIRE DEPARTMENT
Jack F. Cooper
Fire Chief
G y
a-r v omas
Fire Marshal
JFC/amm
Enclosure
cc:- City Attorney
Building Official
TRAL[I)EWELL
530-540,550 5- AV S
SCALE 1" 30'
UPPER LEVEL
530 540 550
t L
NCAll SHUR TRADEWELL
A U
Lj S KLEAN
GROCERY
REF
LA
L---4,lJT 115 V-af-
410
STORAGE
PEF
Po
LOADING
DOCK
Em
ACCX55 ID ROOF
Ml -AL�
TPADEWELL - SECOND FLOOR,OVER STORAGE
�m
CITY OF EDMONDS
CIVIC CENTER - EDMONDS. WASHINGTON 98020 M) 775-2525
FIRE DEPARTMENT
May 1, 1978
HARVE H. HARRISON
MAYOR
Mr. Ernie Boyd
530 Fifth Avenue South
Edmonds, WA 98020
RE: PANCAKE HAUS RESTAURANT - FILE CODE 161-000-038
Dear Mr. Boyd:
.This letter is to confirm our conversation of -May 1, 1978 in
regards to the Pancake Haus Restaurant at 530 Fifth Avenue
South.
The following items are partially carried over from our letter
of April 21, 1978. Newly agreed items are indicated by an ast-
Banquet Room
1. Modify main exit doors to swing in direction of
travel.
*2. Provide s olid core doors with heavier duty closing
devices at entry to kitchen.
*3. Provide a sign on the northwest exit door that
indicates "THIS IS NOT AN EXIT".
Dining Room
*1. Provide a sign on the northwest exit door that
indicates "THIS IS NOT AN EXIT".
North Hallway
*1. Discontinue the storage of combustibles in hallway
or provide a metal receptacle to hold these until
they can be disposed of.
Mr. Ernie Boyd
May 1,.1978
Page 2
*2. The number of trash cans is restricted to eight (8).
The only exception to.this item will be the addition
of a device to satisfy Item #1.
*3. Place an exit sign on the exit door.
Please advise this office if you have any questions on these
items. Further, we would appreciate a timetable for completion
so we will be able to schedule our reinspection.
Thank you in advance for your cooperation.
Sincerely,
Jack F. Cooper
Fire Chief
GaryQccomas
Fire Marshal
JFC/amm
L7-.
0.1
t1-000 -(038
-,. r-r
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CITY OF EDMONDS
CIVIC CENTER - EDMONDS. WASHINGTON 98020 (206) 775-2525
FIRE DEPARTMENT
April 21, 1978
Mr. Ernest Boyd
520 - 12th Avenue North
Edmonds, WA 98020
RE: PANCAKE HAUS, 530 - 5TH AVENUE SOUTH, EDMONDS
FILE CODE 161-000-038
Dear Mr. Boyd:
HARVE H. HARRISON
MAYOR
The Fire Department inspected the Pancake Haus at 530 - 5th
Avenue South on February 22, 1978, after which a letter (copy
enclosed) was mailed to you. Your property was reinspected
on April 21, 1978. The reinspection indicates that the vio-
lations remain uncorrected.
Therefore, under authority of Ordinance 1779 of the City of
Edmonds, you are hereby required to comply with the follow-
ing corrections:
BANQUET ROOM
OILl. Provide exit doors to swing in direction of exit travel.
2. Provide enclosed exit corridor on north side of kitchen.
(a) Minimum fire resistive rating of one hour.
(b) Minimum width 44 inches.
(c) All doors to swing in direction of exit travel.
0,(-3. Provide self -closing fire door between kitchen and
Banquet Room.
ALTERNATIVES TO ABOVE
ft I-
16J1. Exit doors must swing in direction of exit travel.
,AD2. Due t.o the inadequacy of proper exits, the Fire
Prevention Bureau is empowered to limit the number
of persons in a.given area. The maximum number of
occupants in the Banquet Room shall not exceed 49
persons.
3. Remove exit signs from north door and hall (Completed).
�M. Repair east exit doors to open easily.
Mr. Ernest Boyd1*
April 21, 1978
Page 2
NORTH EXIT CORRIDOR
Separation from the kitchen is required in the north
corridor to provide a second exit from the dining
room. This should be accomplished by means of a door
between the kitchen and the corridor.
2. The exit sign above the east exit door from the -north
corridor shall remain.
(,t03. The*waste containers shall be removed from the north
exit corridor.
The above requirements must be completed prior to May 22, 1978.
Failure to comply will subject you to a fine, not to exceed
$250.00, or imprisonment, not to exceed 90 days, or both.
Each day of violation after May 22, 1978 may constitute a
separate offense.
Please contact this department if additional information is
desired.
Sincerely,
EDMONDS FIRE DEPARTMENT
Jack F. Cooper
Fire Chief
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Fire Marshal
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Enclosure
cc: City Attorney
Building Official
0
CITY OF EDMONDS HARVG H. HARRISON
MAYOR
CIVIC CENTER 9 EDMONDS, WASHINGTON 98020 e. (206) 775-2525
FIRG DF-PARTMENT
February 27, 1978
Mr. Ernest Boyd
520 12th Ave. North
Edmonds, WA 98020
RE: PANCAKE HAUS, 530 5TH AVE. SOUTH, EDMONDS, WA
FILE CODE 161-000-rO38
Dear Mr. Boyd:
-On August 17, 1977 the Fire Department advised you by letter
that certain items at the above referenced address were in
violation of the Fire Code.
On September 22, 1977 a reinspection of the premises was made.
This inspection indicated that code viblations remained
uncorrected.
On September 28, 1977 members of the Fire Prevention Bureau
provided you with an in-depth study of the problems with
recommendations being forwarded to you on October 27, 1977.
On February 22, 1977 members of the Fire Prevention Bureau
reinspected your business and Pound that code violations remain
uncorrected.
The Fire Department is aware that it may be difficult at times
to correct such violation irmediatelyL. However, the Ordinances
and Fire Codes were adopted by the City of Edmonds to provide
a minimum of equal protection for all its citizens and their
property and are a matter of law. It is therefore necessary'
that you correct those items that remain uncorrected.
The Edmonds Fire Department requests the following:
1. All violation corrections be completed in forty-five
(45) days.
2. A correction timetable from you showing anticipated
completion dates of each stage of correction.-
Mr. Ernest Boyd
February.27, 1978
Page 2
Please advise by return mail your intentions or questions
regarding this matter -
Sincerely,.
Jack F. Cooper
Fire Chief
Tom Tyszko
Inspector
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CITY OF EDMONDS
CIVIC CENTER - EDMONDS, WASHINGTON 98020 - (206) 775-2525
FIRE DEPARTMENT
Dear Sir:
0
HARVE H. HARRISON
MAYOR
The Fire Deuartment wislies to thank for your assis-t-O.-lic-,
during the �ast year. Your continued awareness of fire
safety problems has a distinct impact in our community's
fire loss.
Due to the nature of your business a Fire Department
Permit is issued for the protection of your buildings,
employees and patrons.
Your present Fire Department Permit expired December 31st.
A renewal application is enclosed for your convenience to
renew by mail.
Please provide the requested information and return the
form with the $5 renewal fee within thirty days.
On receipt of your renewal application the Fire Prevention.
Bureau will schedule a safety survey within 90 days to
assist in reducing possible hazards on your premi-s-es.
Yours for a safer community, throu-gh fire prevention.
Jack F, Cooper
Fire Chief
Alan D. Simmons
Fire Prevention Inspector
ADS/asd
Enclosure
CITY OF EDIVIONDS HARVE H. HARRISON
MAYOR
CIVIC CGNT�R - EDMONDS, WASHINGTON 98020 - (206) 775-2525
FIRE DEPARTMENT
October 27, 1977
Mr. Ernest Boyd
520 - 12th Ave. North
Edmonds, WA 98020
RE: PANCAKE HAUS-, 530-5TH AVE. S., EDMONDS, WA 98020 -
FILE CODE 161-000-038
Dear Sir:
On August 17, 1977, the Fire Department advised you by letter
that certain items at the above referenced address were in
violation of the Fire Code.
On September 22, 1977, a reinspection of the premises was
made.. This inspection indicated that code violations remain
uncorrected.
On September 28, 1977, members of the Fire Prevention Bureau
visited your business for a more in-depth study of the circum-
stances. Subsequently, the following are listed as required
corrections:
BANQUET ROOM
1. Provide exit doors to swing in direction of exit travel.
2. Provide enclosed exit corridor on north side of kitchen.
(a) Minimum fire resistive rating of one hour
(b) Minimum width 44 inches.
(c) All doors to swing in direction of exit travel.
3. Provide self -closing fire door between kitchen and
banquet room.
ALTERNATIVES TO ABOVE
/,I. Exit doors must swing in direction of exit travel.
L--2*. Due to the inadequacy of proper exits the Fire
Prevention Bureau is empowered to limit the number
of persons in a given area. The maximum number of
occupants in the Banquet Room shall not exceed 49 persons.
'--S. Remove exit signs from north door and hall.
0
Mr. Ernest,Boyd
October 27, 1977
Page Two
L-*'4-. Repair east exit doors to open easily.
NORTH EXIT CORRIDOR
.1. Separation from the kitchen is required in the north
corridor to provide a second exit from the dining
room. This should be accomplished by means of a door
between the .kitchen and the corridor.
2. The exit sign above the east exit door from the north
corridor shall remain.
Z)Opj53. The waste containers provided'are Rubbermaid Model #2773.
These are not approved as fire resistive and shall be
replaced with approved types.
z,-4. The waste containers shall be removed from the north
exit corridor.
For further information please contact this office (775-2525,
Extension 247) .
Sincerely,
Jack F. Cooper
Fire Chief
c5k , PS I )A WJYI�
Skip Simmons
Commercial Inspector
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