604 GLEN STAS!
Serving Briet
and
12425 MeiJidian Ave 's''
SNOHOMISH CO.
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FIRE
)5i;�rett, WA 98208
DISTicillftu*!T
Phone (425) 551-1200
Fax 551-1272
www.FireDistrictl.org
(425)
LOCATION: 6611-Gilen Street 2802D
BUSINE§S NAME: 1504 (31cri Slccl. Apbi
PHONE:
MAILING
,ADDRESS: E04 C31crk StrccL, Ldman&, WA 98020
bL)bINtbS OWNER: Ani-ti Mrinit Itir.
HOME PHONE:
EM'IERGENCY-1: i0imm, ShalAn
-37
HOME PHONE: 200FS 784
KEY'ACCESS-2:
HOME PHONE:
EMAIL:
PERSON CONTACTED: -
NAME OF INSPECTOR:
FEII.
FIRE PRE VENTION
INSPECTION REPORT
EIEDMONDS
El BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUENCY
STATION & SHIFT
Annual
17-D
I
SCHEDULED
Aug 2014
DATE DUE I'
LIFIR I, 42b
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
/Jo a 5 Zia z=,
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
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
D E:
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 E] YES El N
rLETTER NEEDED E] YES El NO
8
FIREDEPARTMENT COPY
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SNOHOMISH CO. /A "Ni 'a Serving Brier Edmonds
'IRE 'f
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Mountlake Terraceand
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the Town of Woodway
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www.FireDistrictl.org
LOCATION: 604
Glen Street
BUSINESS NAME: 604 Glen St. Apts
MAILING
ADDRESS:
BUSINESS OWNER: Olesen, Shawn
EMERGENCY-1:
KEY ACCESS-2:
PERSON CONTACTED: " 0 -*_A�
NAME OF INSPECTOR:
FIRE
SYSTEMS:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 2063637784
HOMEPHONE: 2063637784
HOME PHONE:
HOME PHONE:
FIRE PREVENTION'
INSPECTION REPORT
,WEDMONDS
0 BRIER
0 WOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIFT"I
366 17 6
SCHEDULED
DATE DUE 1` 08/01,112
LIFIR � 422 8253
ACTIVE
CURRENT
CITY, - YES NO
BUSINESS
LICENSE El 1:1
INITIAL INSPECTION 5,ATE
I
/0/3(D/z_Q I _z_
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ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
3
3
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4
4",
5
6 z
6
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7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE.
2nd RE -INSPECTION
D E DUE.
EXTENSION
GRANTED TO-
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
D E:
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
4
8
DATE,
DISPOSITION:
LET -TER NEEDED [:] YES NO
LETTER NEEDED E] YES C3 NO
8
FIRE DEPARTMENT COPY
e�' O��L
Serving Brier Edmonds
SNOHOMISH CO. /(
Mountlake Terraceand
IRE
the Town of Woodway
DISTR T www.FireDistrictl.org
LOCATION: 604 Glen Street
BUSINESS NAME: 604 Glen St. Apts
MAILING
ADDRESS:
BUSINESS OWNER: Olessen, Shawn
EMERGENCY-1:
KEY ACCESS-2:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
SYSTEMS:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE. 2063637784
HOME PHONE: 2063637784
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
OBRIER
0 WOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY I STATION & SHIFF"�
366 17 A
SCHEDULED
DATE DUE �
LIFIR � 422 8253
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
FE
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
y
2 V,
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
4
8
-
DATE.
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTER NEEDED C] YES C:1 NO]
I
____ - — —
— 8
FIRE DEPARTMENT COPY