7009 212TH ST SW STE 203700 �11113E.PREVEINITIIOINI
Serving Brier, Ldnionds, and 12425 Meridian Ave S INSPECTION. REPORT
0 EDMONDS
Mwintlake Terrace Everett, WA 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
[I UNINCORPORATED .
"L LU L JLIbJL%o JL www. FireDistrict]. org Fax (425) 551-1272
FREQUENCY STATION & SHIFT
LOCATION: 7009 212 th Street SW Suite 203 98026 2017 16-C
BUSINESS NAME: Johanson Law Group, Inc. 4257765547 SCHEDULED Jul 2017
PHONE: DATE DUE
MAILING UFIR 10 591
ADDRESS: 7009 212th Street SW 203, Edmonds, WA 98026
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Johanson, Jim HOMEPHONE: 4252103466 e CURRENT _'N
KEY ACCESS-2: HOME PHONE: 16 CITY YES NO
EMAIL: BUSINESS F_,�
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bb:4 INITIAL INSPECTION DATE
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NAME OF INSPECTOR: 04�
FIRE SYSTEMS: FE 11/13
Date Last Serviced: (9
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2nd RE -INSPECTION
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EXTENSION VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO: DATE DUE! CITED:
PERSON
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CONTACTED-
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INSPECTOR:
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DATE:
DATE:
3
DATE:
VIOLATIONS
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CITATION ISSUED
PRE -CITATION
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LETTER SENT NUMBER:
CODE 5
2 6
2 6
DATE SECTIOW
RETURN RECEIPT
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DISPOSITION
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4 8
4 8
DATE.
LETTER NEEDED YES NO
LETTER NEEDED YES C3 NO
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SNOHOMISH CC
FIRE
DIST
Serving Briei: Edmonds, and
Mountlake -Terrace A
wwwFireDistrictl.org
FIRE PREVENTION
I 2425'Meridian Ave S INSPECTION REPORT
OEDMONDS
Everett, W4 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
[I UNINCORPORATED
Fax (425) 551-1272
FREQUENCY
STATION& SHIF'*)
LOCATION:
7000 212 th Street SW Suite 203 98026
14
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16-D
BUSINESS NAME:
Jahaman Law Cirau.p. Inc.
SCHEDULED
PHONE: 42,1577ESS47 DATE DUE 1' Jul 2014
MAILING
FIR 1,
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ADDRESS:
70M 212 1h 9 Irccl. SW 203, Edamn&-, WA 0802E
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
Jahaman, Jim
HOME PHONE: 42521 0-?,IFE
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DATE DUE:
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DATE DUE:
EXTENSION
GRANTEDTO:
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FIRE DEPARTMENT. COPY
FIRE PREVENTION
kserv'ing Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
Mountlake Terrace� and'
FIRE
Everett, WA 98208 1
V'EDMONDS
"Ll BRIER
the Town of Woodway
ST R
Phone (425) 551-1200
OWOODWAY
0 MOUNTLAKE TERRACE
www.FireDiffli�,ictl.org
Fax �5 -1272
0 UNINCORPORATED
�(4,- 1)551
e FREQUENCY
STATION & SHIFT�
LOCATION: 7009 21,2th Street
SW 203
731
16 A
BUSINESS NAME:
Johanson Law Group, Inc.
PHONE
4257765547
SCHEDULED
DATE DUE 07/01,113
MAILING 7009 212th St SW #203
LIFIR 11, 591 7207
ADDRESS:
Edmonds
98026
BUSINESS OWNER: Johanson, Jim
HOME PHONE:
ACTIVE
EMERGENCY-1: Gis �1�thg
HOME PHONE:266
CURRENT
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PERSON CONTACTED:
INITIAL INSPECTION DATE
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FIRE
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SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
Yr72442F
�X
2
3
3
4
4
5
5
6
6
7
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I AGREE TO CORRECT THE ABOVE VIOLATION(S)-IIN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION�_
VIOLATIONS
DATE DUE:
DATE DUE,
GRANTED TO!
DATE DUE:
CITED:
PERSON
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CONTACTED:
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NUMBER:
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DATE:
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DISPOSITION:
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DATE:
LETTER NEEDED 0 YES U AO
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FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edinonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIRE
Mountlake Terrace,and
Everett, WA 98208
0 EDMONDS
0 BRIER
the Town of Woodway
Phone (425) 551-1200
0 WOODWAY
DIST
I
IT
0 MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
I'- FREQUENCY
STATION & SHIFT)
LOCATION:
7009 212th Street
SW 203
731
16 C
I
BUSINESS NAME:
Johanson Law Group, Inc.
PHONE: 4257765547
SCHEDULED
DATE DUE 0 07/01/11
MAILING
7009 212th St SW #203
LIFIR " 591 7207
ADDRESS:
Edmonds
98026
BUSINESS OWNER:
Johanson, Jim
HOME PHONE: 42521034 66
ACTIVE.�
EMERGENCY-1:
Ciccu, Samantha
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS F-]
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: Cr
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FIRE
FE1 I Ito
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
i 1�'! 0 oi e 1= 0 L) '0
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:
1
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONT . ACTED:
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:
�LETTER -NEEDED [I YES NO
rLETTER NEEDED E] YES F-1 NO
1 1
8
FIRE DEPARTMENT COPY
(800) 223-3473
AAAFIREXOM
AAA FIRE & SAFETY, INC.
30133RDAVENORTH
SEAME, WA 98109
EDMONDS
FIRE DEPARTMENT
"THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION"
SPRINKLER - WET SYSTEM
Status Given
(One System per Report)
RED
I YELLOW 7XF
WHITE
---Fo
CONFIDENCE TEST X I REPAIRS
Occupancy Address: 7009 212TH ST SW
Occupancy Name: BANNER BANK
Responsible Person Mckayla / Katie
First & Last Name:
(425) 248-4540
Phone Number:
Responsible Person
Address, City, State, Zip:
Responsible Party Katie.walker@bannerbank.com
E—Mail Address
Date of Inspection. 12/16/2015 03:30pm PST
Inspection Annual 1z
Frequencyrrype: Quarterly El
Testers Name Mark Hagen
(Please Print):
Nicet Certification
Number: 5331 itl 00507
Identification
Number:
Basement
System Location:
Central station monitoring? Yes 13 No 0
Monitoring
Monitoring Required? Yes r] No 17
Company Name:
System Make: Csc
System Model: Alarm valve
FIRE CODE VIOLATIONs FOUND: (If additional room is needed, please add a separate sheet)
Sprinkler piping due for internal pipe inspection
Gauge needs calibrate or replace
CORRECTIONS MADE: Date Corrected:
Corrected By:
(If additional room is needed, please add a separate sheet) Nicet Certification Number:
This certifies that this fire and life safety system has been properly inspected for reliability to cover the
Items listed in this report and is con nt with Fire Code
standards, and that
discrepancies are nolpLand h e be reported to the building Owner/M f rforrel
Signature of Tester: Pho ;aer o n
Building Representative (signature) V
A
Sprinklers - Wet
Page 1 of 2
The items on the checklists below shall be inspected and tested. This list does not constitute all of the required
inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting
and testing requirements.
I General
1. Main Drain and Inspector's Drain flow test conducted?
2. Static pressure: 105 s.i. Flow pressure: 95 P.S.i.
-=—P
3. Number of Sprinkler Heads: 19
4. 2-inch drain?
5. Flow switches, supervisory switches and alarm bells tested?
6. Pressure regulating valves tested?
7. Alarm bell operates?
8. System inspected and lubricated?
9. Valves are sealed or supervised?
10. Signs are provided on valves?
Other
N/A
N/A
N/A
11. Pumper connections and clapper valves unobstructed and turn freely?
� 12. Sprinkler coverage is acceptable?
Yes NoEl
Yes D
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No 0
NoO
No 0
No El
NoEl
No El
No 0
No El
NoEl
13.
Have the sprinkler heads been replaced or successfully sample test in the
Yes
No
last 50 years? Date of last test:
14.
Proper number of spare sprinkler heads available with appropriate wrenches
Yes
for each?
NoEl
15.
System left in service?
Yes
No
16.
System gauges replaced or calibrated within the last 5 years?
Yes El
Z
Year changed: 2010
No
17
Rnrink-lor hanrle froo rif nn"neirm nirkf r%kofr f; Al k ; I
damage? U%1 %J"Q a" %ji F ya %,Cz Yes 0 No El
18. Was debris found in the Fire Department Connection (FDC)? Yes El No El
19. Was the Fire Department Connection (FDC) back flushed within the last 5 Yes El No Z
years? Date of last back flush
20. Was an internal pipe and valve inspection performed within the last 5 years?
Date Performed Unknown Yes 0 No Z
21. Is the hydraulic nameplate installed and visible on riser. YesE] No
(Ref: NFPA 25 5.2.7)
22. Was a signal received at the Central Station monitoring N/A Yes 1:1 No El
company?
Sprinklers - Wet Page 2 of 2