600 MAIN STST
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
INFECTION REPORT
JZtDMONDS
OBRIER
[3 MOUNTLAKE TERRACE
[3 UNINCORPORATED
LOCATION:
600 Main Street Bldg 98020 Al 11 Mai 117-12)
BUSINESS NAME: PHONE: SCHEDULED
DATE DUE
Centennial Bldg 42!57
MAILING ,�Il 814 LIFIR 0 dun 28%
ADDRESS: m, � I
BUSIN . ESS OWNER: 600 Main Street, Bldg, Edmonds, WA 98020 HOME PHONE:
EMERGENCY- . 1: Campbell, Scott HOME PHONE: CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
BUSINESS
EMAIL: LICENSE oo�
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: A,7�,O 9�06
FIRE SYSTEMS: FE 5/14 ,n ky 11cv,11
De,baks9tcfi)9D\AsedocATiONS
COMMUNICATIONS
2
2
3
4
5
3
4
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 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 vio�l f n.
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-77 f
Mountlake Terrace or Brier, call (425) 744-6231.
Serving Briei; Edmonds, and 12425 Meridian Ave S
SNOHOM-ISH CO. \
Mountlake Terrace Everett, WA 98208
FIRIE . " w Phone (425) 551-1200
DIST W,4wfmo-,Twwii�FireDistrictl.org I Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
EDMONDS
BRIER
MOUNTLAKE TERRACE
UNINCORPORATED
FREQUENCY
STATION & SHIFT"'
LOCATION:
600 Witi Streat F.Id.q 93028
'aulflual
17-B
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BUSINESS NAME:
Ccrknnial B'dil
PHONE:
426T18181 .4
SCHEDULED
DATE DUE I` JUI-4 4_01-4
MAILING
LIFIR 0 bO9 203
ADDRESS:
LOD Mairi Sl.rcc� Skig, Ldrrmndzi, VIJA 3302f)
BUSINESS OWNER:
r-milphl-11, SI-witt
HOME PHONE-
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EMERGENCY-1:
HOME PHONE:
"CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS D
EMAIL:
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
clo�s
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114
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FE 5113 Q
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
3
3
4
4
5
5
6 j 411,10
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
1
CONTACTED:
CONTACTED:
CONTACTED:
"
2
INSPECTOR��t)h;?/
INSPECTOR:
INSPECTOR:
3
DATE:
DATE:
DATE:
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
4
1 5
1 5
LETTER SENT
NUMBER:
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
6
3
7
3
7
RECEIVED
DISPOSITION:
7
4
8
4
8
DATE:
LETTER NEEDED A YES NO
LETTER NEEDED C] YES I-] NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION'
INSPECTION REPORT
SerNng Brier, Edmonds
12425 Meridian Ave S
SNOHOMISH CO.
Mo un i�ke Terraceand
Everett, WA 98208
0 EDMONDS
0 BRIER
FIRK
DISTVIRIt
the Town of Woodway
Phone (425) 551-1200
OWOODWAY
0 MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
it I
" FREQUENCY
STATION & SHIFF"I
LOCATION: 600
Main Street
365
17 A
BUSINESS NAME: Centennial Bldg
PHONE: 4257781814,
SCHEDULED
DATE DUE 06/01/13
MAILING
UFIR 0 509 6203
ADDRESS: Edmonds
98026
BUSINESS OWNER: Campbell,
Scott
HOME PHONE: 2067793597
ACTIVE
EMERGENCY-1:
HOME PHONE:
KEY ACCESS-2:
HOME PHONE:
CITY �ES NO
BUSINESS
LICENSE
PERSON CONTACTED: A ��Iattr.,
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INITIAL INSPECTION DATE
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NAME OF INSPECTOR:
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2
2
3
3
4
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:
2nd RE -INSPECTION
D TE 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
4
18
4
8
DATE:
DISPOSITION:
7
11 LETTER NEEDED [j YES El No
LETTER NEEDED 0 YES [1 NO
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edinonds
J2425MeridianAve,S-
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terrace, and
FIRE 1*W1:I1
Everett,' WA 98208
OEDMONDS
El BRIER
PE - e Town of Woodway
STRT
Phone (425) 551-1200
[3 WOODWAY
[]MOUNTLAKE TERRACE
w"ww.FireDistrict1.org
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION& SHIFF�
LOCATION: 600 Main Street
365
17 C
I
BUSINESS NAME: Centennial Bldg
PHONE:
SCHEDULED
DATE DUE 1` ()6/01/11
MAILING
UFIR " 509 6203
ADDRESS: Edmonds
98026
BUSINESS OWNER: Campbell, IL-3coff
HOME PHONE: 2067793597
AC*nVE
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
A
NAME OF INSPECTOR:
FIRE
FE -45—f 1
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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2
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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:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INS PECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
IONS
1 15
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
1.8
DATE:
DISPOSITION:
LETTER NEEDED E] YES El NO
LETTERNEEDED [] YES NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edmonds.*
12425 Meridian Ave S
'INSPECTION REPORT
SNOHOMISH CO.
'FIRE
Mountlake Terraceand
4.
Everett, WA 98208
CIEDMONDS
0 BRIER
DIST R1
the Town of Woodway
T
Phone (425) 551-1200
E]WOODWAY
0 MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
[1 UNINCORPORATED
FREQUENCY STATION & SHIFF`�
LOCATION:
600 Main Street
365 17 D
I
BUSINESS NAME:
Centennial Bldg
PHONE: 4257781814
SCHEDULED
DATE DUE 1` 06/01/12
MAILING
LIFIR 0 509 6203
ADDRESS:
Edmonds 98026
BUSINESS OWNER:
Campbell, Scott
HOMEPHONE: 2067793597
ACTIVE
!c)
EMERGENCY-1:
HOME PHONE:
7_
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
PERS ON CONTACTED:.
INITIAL INSPECTION DATE
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NAME OF INSPECTOR: (0 cn,
FIRE
FE
SYSTEMS:
ANNUAL
HAZARDS FOUNIJAND LOCATIONS/ 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
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
,4
8
r4
8
DATE:
DISPOSITION:
7
LETTERNEEDED [] YES El NO
LE;ER IE:EDE:D El YES [I NO
.4
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
t
LOCATION: 600 Main Street
BUSINESS NAME: Centennial Bldg
i
MAILING
FIRE PREVENTION
SAFETY SURVEY
PHONE: 4257781814
ADDRESS:
Edmonds 98026
BUSINESS OWNER: Campbell, Scoff HOMEPHONE: 2067793597
%
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: HOME PHONE:
PERSON CONTACTED: -::- MWAII& 41SPA
NAME OF INSPECTOR:
FIRE
S STE
y
FREQUENCY
STATION 11 SHIFT
365
17 6
SCHEDULED
DATE DUE 11'
06/01110
UFIR 11- 509
- 6203
AC.-nVE .
INITIAL INSPECTION DATE
--IAt "A I k -.
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
ENTER CODE ONLY ONCE 0
VIOLATION CODE
2
2
3
4
3
4
5
6
5
6
7
7
8
8
'Ist RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
�ATE DUE:
EXTENSION
GRANTED TO:
....... ... ........ . . . ..
PRE -CITATION
LETTER SENT
DATE:
FINAL RE -INSPECTION
DATE DUE:
PERSON
CONTACTED:
INSPECTOR
DATE.
CITATION ISSUED
NUMBER:
CODE
SECTION:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
DATE.
I
INSPECTOR:
2
DATE�
VIOLATIONS
1 5
3
VIOLATIONS
1
3
5
6
7
4
2
6
5
3
7
RETURN RECEIPT
RECEIVED
DISPOSITION:
DATE: . . ..... - - ------
6
7
4
18
4
8
8
LETTER NEEDED E] YES NO
LETTER NEEDED [] YES NO
FIRE DEPARTMENT COPY