560 ELM WAY (3)SNOHOMIS11 CO.
FIRE
M1
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Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200,
www.FireDistrict].org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT.'
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY -
T" & SHIFT
LOCATION:
560 Elm Way 98020
Annual [STATION
17-A
BUSINESS NAME:
The Elmhouse
PHONE:
2067623877,
SCHEDULED
DATEDUE Ii,Dec2015
MAILING
LIFIR 1` 422
ADDRESS: 309 S Cloverdale St A#71 Seattle, WA
98108
BUSINESS OWNER: Adams, Joy
HOME PHONE:
EMERGENCY-1-
* Neckas, Christina
KEY ACCESS-2:
HOME PHONE:
2067623877
HOME PHONE:
CURRENT
CITV
YES NO
EMAIL:
BUSINESS
LICENSE
PERSON CONTACTED:
INITI ECT47TI
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NAME OF INSPECTOR:
FIRE SYSTEMS: FE12
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HAZARDS WOUND AND LOCATIONS/ COMMUNICATIONS
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2
3
3
4
5
5
6
6
7
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
PERSON
CONTAC TE E
INSPECTOR: I
2nd RE -INSPECTION
E�PUE:
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DATE DUE:
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CODE
SECTION:
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3
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RETURN RECEIPT
RECEIVED
DATE:
6
'0
LETTERNEEDED YES N
LE:WCR 'NEEDED YES .0 No'
8
FIRE PREVENTION
T
INSPEC ION REPORT.
'OHON . 11SH Co. --Serving Brier, Edmonds, and 12425 Meridian Ave S
EDMONDS
Mountlake Terrace Everett, WA 98208 BRIER
F1 E 7 Phone (425) 551-1200 0 MOUNTLAKE TERRACE
0 UNINCORPORATED
DI T Twww.Fir�Districtl.org fax (425) 551-1272
EQUE SHIFT
560 Elm Way 98020. TnnuTcy STff-Y
LOCATION:
BUSINESS NAME: The Elmhouse PHONE: 2067623877 SCHEDULED Dec 2016
DATE DUE 0
4ZZ
MAILING 309 S Cloverdale St A#7, Seattle, WA 98108 LIFIR
ADDRESS:
BUSINESS OWNER: Adams, Joy HOME PHONE:
Neckas, Christina 2067623877
EMERGENCY-1: HOME PHONE: URRENT
IT YES NO
KEY ACCESS-2: HOME PHONE: y
SI
FBN E S S
EMAIL: LICENSE
PERSON CONTACTED: L.PA/ - INITIAL INSPECTION DATE
NAME OF INSPECTOR:
SrEvs: FE
Date Last Serviced:
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2 2
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
.2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONSk
DATE DUE.
DATE DUE.
GRANTEDTO-
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE*
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
5
1 5
LETTER SENT
NUMBER
4
CODE
5
2 6
2 6
DATE
SECTION
RETURN RECEIPT
3 7
3 7
RECEIVED
DISPOSITION.
7
4 8
4 8
DATE
LETTER NEEDED YES NO
LETTER NEEDED YES;�'[:] NO
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8
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FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
OMISH CO. $EDMONDS
Mountlake Terrace Everett, WA 98208 0 BRIER
FIR Phone (425) 551-1200 0 MOUNTLAKE TERRACE
,,DISTR IT wwwFreDstriati.org Fax (425) 551-1272 0 UNINCORPORATED
FREQUENCY STATION & SHIFT-"*'
LOCATION: 560 ElmWay Q8020 Antival 1 17-0
BUSINESS NAME: I he Elathouse PHONE: 201,7E2387-, SCHEDULED Dm- 2014
DATE DUE 0
MAILING UFIR 0 4:)2
ADDRESS: 300 S Clavarda Ic SL A#7� Sea Wc, WA WIDS
BUSINESS OWNER: Adann,,MV HOME PHONE:
EMERGENCY-1: Nlud�, 'Chrisfina HOME PHONE: 2067f=77 CURRENTj/.
KEY ACCESS-2: HOME PHONE: CITY S NO
BUS NES
EMAIL: LICE I NSE S El 1:1
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR:
�-IHE SYS IEMS: FE 42:1 Z,:�Ii-
9MMUNICATIONS
HAZARDS FOUND AND LOCAT NS&
Wip Ole, linvS4 �_j
2
2
3
3
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VICLATION(S) IN THE NEXT 30 DAYS X
I st RE -INSPECTION
DATE DUE.
2nd RE -INSPECTION
DATE DUE.
EXTENSION
GRANTEDTO,
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
12
6
2
6
DATE:
CODE
SECTION:
5
i
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
DATE:
DISPOSITION:
\1 LETTER NEEDED [] YES NO
.8
LETTER NEEDED [-] YES NO
8
FIRE DEPARTMENT COPY