610 GLEN STsr -
MISH Co.
FIRE
DIST]
Serving Brier, Edn ""89 "' id 12425 Meridian Ave S
Mountlake Terrace kverett, WA 98208
Phone (425) 551-1200
T wwwFireDistrictl.org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
OBRIER
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY
STATION & SHIF')
LOCATION:
6 10 Gleri Street 0801D
Annual
I
17-D
BUSINESS NAME:
E10 (31cri 81.=L Cafidbs
PHONE:
SCHEDULED
DATE DUE I, ALm 2014
MAILING
LIFIR
ADDRESS:
fj10 Glcri SIrcc� F-dmDrKL-. WA 38020
BUSINESS OWNER:
Etwit-wh-r, Raliard
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
EMAIL:
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE j'-'ys I EMS:
FE
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
tA (s)
Aj L/�, P�
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:
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
RE.TURN RECEIPT
RECEIVED
6
4
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED E] YES [I NO
LETTER NEEDED [-] YES NO
8
2 1
FIRE DEPARTMENT COPY
Serving Brier, Edmonds
I
SNOHOMISH CO.
�'FIRE
191T
Mountlake Terraceand'
DISTh
the Town of Woodway
www.FireDistrictl.org
LOCATION:
610 Glen Street
BUSINESS NAME:
610 Glen St Condos
MAILING
ADDRESS:
BUSINESS OWNER:
EMERGENCY-1:
Surgender, Richard
KEY ACCESS-2:
PERSON CONTACTED: _1�19 Al it;
NAME OF INSPECTOR: AV P&I.Sa^]i
FIRE
SYSTEMS:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE:
HOME PHONE:
HOMEPHONE: 4257121441
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
,QeDMONDS
0 BRIER
E]WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIF'*�
365' 17 B
SCHEDULED
DATE DUE 1' 08/01/12
LIFIR � 422 8253
ACTIVE
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
/0 /_? 0/2 0 1 _L
FE f
A r4 _NU � _L
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
Aj10
2
2
3
3
4
4
5
51
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:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
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
14
18
4
18
DATE:
DISPOSITION:
7
LETTERNEEDED E] YES El NO
rLETTER NEEDED [__1 YES 0 NO
F
8
FIRE DEPARTMENT COPY