627 DAYTON STSNOHOMIS11 CO.
FIRE
DIST:
6Z7 NYTOAP'' S-r
-Serving Brier, Edmonds, and 12425 Meridi&7 Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
)94ff EDMONDS
OBRIER
[3 MOUN.TLAKE TERRACE
[3 UNINCORPORATED
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LOCATION:
627 Dayton Street 98020 2946
BUSINESS NAME: PHONE: SCHEDULED
Pacific Int. Underwriters Inc 4257718988 DATE DUE A 9036
MAILING FIR 0
ADDRESS: 591
627 Dayton Street, Edmonds, WA 98020
BUSINESS OWNER: HOME PHONE:
Blanchard, Ran
-EMERGENCY-1:
HOME PHONE: CURFiENT
KEY ACCESS-2: Pacific Intl Underwriters Inc HOME PHONE: 4257718988 CITY YES NO
EMAIL: eq BUSINESS
LICENSE
PERSON CONTACTED: 4, V'j I U I V_x'_ INITIAL INSPECTION DATE
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FIRESYSTEMS: FE4-/10
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I AGREE TO cbRRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
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2nd RE -INSPECTION
FINAL RE
EXTENSION
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DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:,
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PERSON
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LETTER SENT
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FIRE PREVENTION
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIRE
Mountlake Terraceand
Everett, WA 98208
0 EDMONDS
0 BRIER
DISr"R
the Town of Woodway
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Phone (425) 551-1200
0WOODWAY
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www.FireDistrictl.org
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[1 UNINCORPORATED
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LOCATION:
627 Dayton Street
730 17 A
I
BUSINESS NAME:
Pacific Int. UndenqMers Inc
PHONE: 4257716988
SCHEDULED
DATE DUE � 06/01/13
MAILING
P06 #2007
UFIR 11, 591 6 2 03
ADDRESS:
Edmonds
98020
BUSINESS OWNER:
Pacific Intl Underwriters Inc
HOME PHONE: 42577-18988
ACTIVE
EMERGENCY-1:
Slanchard,Randy
HOME PHONE: 4253377467
"'CURRENT
KEY ACCESS-2:
Wood, Ann
HOME PHONE: 4257451079
CITY YES NO
BUSINESS
LICENSE
PERSON CONTACTED: ICA [� a C 0 A th CA A,,\
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
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2
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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
DATE DUE:
1
EXTENSION
GRANTED TO:
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DATE DUE:
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PERSON
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DATE:
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NUMBER:
4
2
6
2
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DATE:
CODE
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3
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3
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RETURN RECEIPT
RECEIVED
6
4
18
1
18
DATE:
DISPOSITION:
7
LETTER NEEDED E] YES [I NO
I LETTER NEEDED [:1 YES NO
8
Q� FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edmonds
.12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIRE Mountlake Terraceand
W*VM0:1
Everett, WA 98208.
bWrDMONDS
6BRIER
DISTR
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Phone (425) 551-1200
0 WOODWAY
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LOCATION: 627 Dayton Street
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BUSINESS NAME: Pacific Int. Underwriters Inc
PHONE: 4257718988
SCHEDULED
DATE DUE � 06/01/11
MAILING 13013 #2007
UFIRO 591 6203
ADDRESS:
Edmonds
98020
BUSINESS OWNER: Pacific Intl Underwriters Inc
HOME PHONE: 4257718988
ACTIVE
EMERGENCY-1: Blanchard,Randy
HOME PHONE: 4253377467
e—CURRENT.
KEY ACCESS-2: Wood, Ann
HOMEPHONE: 4257451079
CITY YES NO
BUSINESS 0 El
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
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FIRE
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ANNUAL'
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2
2
Lj
3
3
4
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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:
1
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
IDATE:
DISPOSITION:
7
\� LETTER NEEDED C] YES NO
LETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY