556 ALDER ST-NTION
'FIRE PREVE
INSPECTION
SH CO.
Serving, Brier, Edr, 2,�2q5LMt&diaAjS REPORT
SNOHOMI 0 EDMONDS
A 98208
Mountlake Terrace, and Everett, W 0 BRIER
TIR the Town of Woodway Phone (425) 551-1200 E]WOODWAY
IS rr- [I MOUNTLAKE TERRACE
T A www.FireDistrictl.org Fax (425) 551-1272 0 UNINCORPORATED
FREQUENCY STATION & SHIFr"I
LOCATION: '5 t3
55 ST Edmonds 98020 2 Year 13 1 7-A.
SCHEDULED
BUSINESS NAME: Keile_Vs Mderhouse Apts PHONE: 4257740164 DATE DUE � L Aug
MAILING
ADDRESS: 556 Alder Street, Edmonds, VVA 98020
[UFIR 503
BUSINESS OWNER: Johnson, Jim HOME PHONE:
Email:
01
EMERGENCY-1 : Kei14y, LloAtSan,dra J. #A HOME_P_HORE� 425774'G164 CURRENT
YES NO
KEY ACCESS-2: HOME PHONE: CITY
BUSINESS Ej
LICENSE
PERSON CONTACTED: AJ4 pi e INITIAL INSPECTION DATE
NAME OF INSPECTOR:
7y'
FIRE SYSTEMS: FE
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
4
4
5
5
6
6
7
7
11. rj
C' M' �E ABG\k Vl'[!�TION(S) IN THE NEXT 30 DAYS X
I AGREE TO ORRE T 0
1st RE -INSPECTION
2n,d RE -INSPECTION
EXTENSION
FINAL RE -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
8
4
8
DATE:
LETTER NEEDED C] YES NO
LETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY
I 'I.
21
\S rier, Edmonds,�.:�..,
SNOHOMISH CO. I k I �1.
FIREMountlake Terrac�, and
the Town of Woodway
DISTR T www.FireDistrictl.or-a
LOCATION: 556 Alder Street
BUSINESS NAME: Keileys Alderhouse Apts
MAILING 556 Alder St #A
12425 Meridian Ave S
i�e.rett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 4257740164
ADDRESS: Edmonds 98020
BUSINESS OWNER: "Keiley, Lloyd/Sandra J. #Au HOMEPHONE: 4257740164
EMERGENCY-1: "Johnson, Jim' HOME PHONE: 4257712211
KEY ACCESS-2: HOME PHONE: -
PERSON CONTACTED: 111,91x—
NAME OF INSPECTOR: 14ZWh17 $?�
FIRE
SYSTEMS:
-FORIE-PREVENTION
INSPECTION REPORT
0 EDMONDS
El BRIER
0 WOODWAY
[I MOUNTLAKE TERRACE
El UNINCORPORATED
FREQUENCY I STATION & SHIFT_*1
366 17 D
SCHEDULED
DATE DUE 11' 08/01/12
LIFIR 1, 428 8203
ACTIVE,
el CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
FE j_fj7
ANNUAL
HAZARDS FOUND AND.LOCATIONS /COMMUNICATIONS
I
/yW
_T r___c_77
2
r,
-3.
3
4
5
5
6
—4-
6
—4
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
"A
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-CITAT_ION-
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:
7
LETTER NEEDED YES NO
LETTER NEEDED C] YES NO
8
FIRE DEPARTMENT COPY
Serving Brier, Edmonds
FSNOHOMISH CO.' 'iT Mountlake Terraceand
IRE the Town of Woodway
DISTR' www.FireDistrictl.org
L 'ATION: 556 Alder Street
OC
BUSINESS NAME: Keileys Alderhouse Apts
MAILING 556 Alder St #A
ADDRESS: Edmonds
BUSINESS OWNER: "Keiley, Lloycl/Sandra J. #A'
"Johnson, Jim"
EMERGEN�CY-1:
v
KEY ACCESS-2:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
FIRE PREVENTION
1.21425 Meridian Ave S INSPECTION REPORT
Everett, WA 98208 0eDMONDS
0 BRIER
Phone (425) 551-1200 E]WOODWAY
[I MOUNTLAKErERRACE
Fax (425) 551-1272 0 UNINCORP6RATED
PHONE: 4257740164
98020
HOME PHONE: 4257740164
HOME PHONE: 4257712211
HOME PHONE: -
e' FREQUENCY I STATION & SHIFF*�
366 17 C
SCHEDULED oni/i i
DATE DUE
IUFIR � 428 8203
L
ACTIVE
e'CURRENT, 7.)
CITY YES NO
BUSINESS
LICENSE E] 1:1
INITIAL INSPECTION DATE
I -A - ILI � ( t
FE -Z—f I I
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
O!pb k 0
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
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
IC
VIOLAT ONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
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 [:1 NO
8
FIRE DEPARTMENT COPY
CITY Of EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
4S' t 1 S9 z
LOCATION: 556 Alder Street
BUSINESS NAME: Keiley's Alderhouse Apts
MAILING 556 Alder St #A
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257740164
ADDRESS: Edmonds 98020
BUSINESS OWNER: ftKeiley, Lloyd/Sandra J. mix HOMEPHONE: 4257740164
11
EMERGENCY-1: ajohnson, Jim" HOME PHONE: 4257712211
KEY ACCESS-2: HOME PHONE: t
FREQUENCY
STATION & SHIFT
366
17 6
SCHEDULED
08/01/10
DATE DUE 1�
LIFIR io 428
ACTIVE
e INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: AA ,-A,<,.<
FIRP z / FF" I
SYSTEMS:
A�NUZ
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE I�
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
E 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:
2
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
7-
4
18
4
8
DATE:
DISPOSITION:
8
k, LETTER NEEDED 0 YES E3 NO
LETTER NEEDED 0 YES NO
FIRE DEPARTMENT COPY