655 EDMONDS WAYFIRE PREVENTION
SNOHO . MISH CO. Ser'vingprier, Edmonds, and 12425 Meridian Ave S 2fECTION REPORT
MONDS
Mountlake Terrace Everett, WA 98208 TBRIER
FIRE, 1;
D*4 — Phone (425) 551-1200;�' El MOUNTLAKE TERRACE
ISTJKT -www-.FireDistrictl,.org �'Fax (425) 551-1272 E3 UNINCORPORATED
LOCATION: FREQUENCY STATION& SHIFT
655 Edmonds Way 98020 29461
BUSINESS NAME: PHONE: SCHEDULED
Chermak Construction 4257761367 DATE DUE 9016
MAILING UFIR 0
ADDRESS: 591.
655 Edmonds Way, Edmonds, WA 98020
BUSINESS OWNER: HOME PHONE:
Chermak, Howard -77 1--�
EMERGENCY-1:
HOME PHONE: CURRENT
KEY ACCESS-2: Chermak, Dana HOME PHONE: 2064849517 CITY YES NO
T BUSINESS
EMAIL: LICENSE El
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR: kt)IN"
FIRE SYSTEMS:. FE 6/13
D9lakaE;tc9aDAnedOCArIONS COMMUNICATIONS
2
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I AGREE To.cbRRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
DATED E:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
INSPECTOR:
DATE:
PERSON
CONTACTED-
INSPECTOR:
DATE:
. .
PERSON
C ONTACTED:
. ...... . ...... ....
INSPEC R:
2
3
DATE:
VIOLATIONS
PRE -CITATION
_LETTELR �IENT
DATE:
CITATION ISSUED
NUMBER:.
4
2
6
2
6
CODE
SECTION:
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES NO
LETTER NEEDED [3 YES NO
8
M '4r
FIRE PREVENTIOk
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Set-ving Briei-,, g4inonds
12425 Meildian Ave S
INSPECTION REPORT*
SNOHOMI I . %
M6zlhtldke'Te�race, and
FIR
Everett, WA 98208
Ul EDMONDS
0 BRIER
the Town of Woodw ay
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Phone (425) 551-1200
0WOODWAY
0 MOUNTLAKE TERRACE
-DIS www.FireDistrictl. arg
Fax (425) 551-1272
0 UNINCORPORATED
FIR EQUENCY
STATION&SHIF)
LOCATION:
655 Edmonds Way
I 20 A
BUSINESS NAME:
Chermak Construction, Inc.
PHONE:
4257761367
SCHEDULED
DATE DUE
MAILING
ADDRESS: 655 Edmonds Wy
UFIR II,
591 5103
Edmonds
98020
BUSINESS OWNER: Chermak, Howard
HOME PHONE: 4257719"2
ACTIVE
EMERGENCY-1:
Chermak, Dana
HOME PHONE: 2064849517
CURRENT
YES NO
KEY ACCESS-2:
HOME PHONE:
CITY
BUSINESS
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LICENSE
PERSON CONTACTED: eoy c (L �qwo L I, T-� -lo
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
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FIRE
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qvq7l=mq.
ANNUAL,
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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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
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR.
2
DATE: -22
DATE:
DATE:
3
VIOLATIONS
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
14
18
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES No
I LETTERNEEDED E] YES [:1 NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
INSPECTION REPORT
�e ing Brier Edmonds 12425 Meridian Ave S
SNOHOA4ISH CO. , ry , 0 EDMONDS
Mountlake Terraceand Everett, WA 98208 0-bAIER
FIRE I E]WOODWAY
the Town of Woodway' Phone (425) 551-1200 0 MOUNTLAKE TERRACE
D�-ISTh,kTwww.FireDist.rictl.org, Fax (425) 551-1272 0 UNINCORPORATED
LOCATION: FREQUENCY I STATION & SHIFT"'
655 Edmonds Way 731 20 C_
BUSINESS NAME: Chermak Construction, Inc. PHONE: 4257761367 SCHEDULED 05,101111
DATE DUE
MAILING LIFIR
655 Edmonds Wy 591 5103
1
ADDRESS: TLJ
Edmonds 98020
BUSINESS OWNER: HOME PHONE: 4257719442 ACTIVE
Chermak, Howard / /
EMERGENCY-1: HOME PHONE: 4
KEY ACCESS-2: -Mestem",dueft ' / Z%9&A2 "'CURRENT YES NO
HOME PHONE: CITY
c, K f wN 7 BUSINESS
LICENSE
PERSON CONTACTED: y INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE FE—) 1? 0 1
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
�j 0 /'j
2
2
3
4
4
5
5
6
6
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
p
bATE:
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
RECEIVff'
4
8
4
8
DATE:
DISPOSITION:
LETTER NEEDED E] YES [I NO
LETTER NEEDED C] YES F-1 NO
8
FIREPEPARTMENT COPY