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9715 FIRDALE AVE (3)DAL� '01 0 FIRE PREVENTION Serving Brier, Edmwws, and4 12425 Meridian Ave S INSPECTION REPORT SNOH6*f%IISH CO-',— DEDMONDS Mountlake Terrace Everett, WA 98208 ❑0 BRIER FIRE Phone (425) 551-1200 0 MOUNTLAKE TERRACE DISTR T www.FireDistrictl.org Fax (425) 551-1272 :- 0 UNINCORPORATED LOCATION: 9715 Edmonds Way 98020 BUSINESS NAME: Kwick NXIeen Carwash MAILING ADDRESS: 9715 Edmonds Way, Ednionds, WA 98020 BUSINESS OWNER: Roberts, Mikael —EMF.RQ9h[CY-1: Castro,.Bill (Mgr) KEY ACCESS,"'-2. . . ---, EMAIL:3�~ PERSON CONTACTErl&\ NAME OF INSPECTOR: PHONE: 4257749715 HOME PHONE: HOME PHONE: HOME PHONE: 20 FIRE SYSTEMS:. FE1/14 %111 �Aj � Date Last Serviced: FREQUENCY STATION & SHIFT 2015 20-D SCHEDULED DATE DUE ► Jan 2017 (UFIR I` 571,- CURRENT CITY �zs NO BUSINESS Ar] LICENSE E] NITAL INSPECTION DATE \ I-Z, 3 I r-1 SNOHOM18H CO. FIRE DIST: LOCATION: i BUSINESS NAME: ' MAILING I ADDRESS: FIRE PREVENTION Sewing B•raer;,E-dinoiids, and 12425 Meridian Ave S INSPECTION REPORT � gEDMONDS Mountlake Terrace Everett, WA-98208 0 BRIER Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE T,,www.FireDistrictl.org Fax (425) 551-1272 ❑ UNINCORPORATED FREQUENCY I STATION & SHIFT 0715 Firdale Avianue, of3 :.., Annuill 20-A C•{]{:oon ChilC1i:arc PHONE: �D i�'D I �� DATE DUE �01 !l, `ir'` UFIR / `'`)3 0715 Firdaic Avcnuc, Edrpond-, WA 08021D BUSINESS OWNER: HOME PHONE: EMERGENCY-1: Mcf-addcfe• Briana HOME PHONE: 21064121318 CURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO BUSINESS n ❑ >� EMAIL: r., LICENSE `~ PERSON CONTACTED: i. A �/ t f r p f) cie Nt INITIAL INSPECTION DATE 1_ ��j�.�•� � � f �[),� 14- NAME OF INSPECTOR: tL V A h� Lr�tJ ��L,l �N i2 � 1-1RE= GIB iENis: FE 3111 I `z -% �-- HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 2 2 3 3 4 4 5 5 6 6 I 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 18 4 18 DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO B FIRE DEPARTMENT COPY SNOHOMISH CO. FIRE DIST] Serving Brier; Edmonds, and Mountlake Terrace p e TwwwFireDistrictl.org 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 LOCATION: 9715 Flydale Avenue 98020 BUSINESS NAME: Cocoon Childcare PHONE: 2068017704 MAILING ADDRESS: 9715 Firdale Avenue, Edmonds, WL� 98020 BUSINESS OWNER Email: EMERGENCY-1: McFadden, Briana KEY ACCESS-2: EMAIL: I PERSON CONTACTED: G ►� I NAME OF INSPECTOR: FIRE SYSTEMS: FE J HOME PHONE FIRE PREVENTION INSPECTION REPORT ❑ EDMONDS ❑ BRIER ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED FREQUENCY STATION & SHIFT Annual 20-B SCHEDULED Dec 2013 DATE DUE UFIR / 253 HOME PHONE: 2064/21818 CURRENT HOME PHONE: CITY YES NO BUSINESS LICENSE INITIAL INSPECTION ) � '# DATE / 3 HAZARDS FOUND AND LO�CBATIONSS// COMMUNICATIONS �7J c?, 2 2 4 de- / 4 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X t , 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: 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 DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO g FIRE DEPARTMENT COPY SNOxOMISH CO.tin Serving Brier, Edmonds 1 ���Mountlake Terrace, and Woodway'' )IS)f TR LOCATION: 9715 Firdale Avenue BUSINESS NAME: Cocoon Childcare 12425 Meridian_Ave'S Everett, WA 98208 Phone (425) 5514200 Fax (425) 551-1272 PHONE: 2068017704 MAILING 9715 Firdale Ave ' ' ADDRESS: Edmonds 98020 BUSINESS OWNER: McFadden, Briana HOME PHONE: 2064121818 Y EMERGENCY-1: McFadden, Judy HOME PHONE: 2064124558 KEY ACCESS-2: HOME PHONE:, PERSON CONTACTED: NAME OF INSPECTOR: FIRE SYSTEMS: FIRE PREVENTION IN REPORT EDMONDS 'ff BRIER ❑ WOODWAY ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED FREQUENCY STATION & SHIFT 365 20 D SCHEDULED DATE DUE ► 12/01/12 UFIR ► 253 1 e4 ACTIVE CURRENT CITY YES NO BUSINESS ', ❑ 0 LICENSE INITIAL INSPECTION DATE FE _} ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 P0VA10 �- e- �LV' 6 O;= ;--I R_� ' / .. G�T7 �c� () C ,S t C7 1Ff j 22 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 CONTACTED: INSPECTOR: INSPECTOR:' INSPECTOR: 2 DATE: ,�% DATE: DATE: 3 IOLATI 1 NS 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 6 i DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ N0 LETTER NEEDED ❑ YES ❑ NO 8 FIRE DEPARTMENT COPY CITY OF EDMONDS BUSINESS LICENSE APPLICATION- COMMERCIAL FEE: $125.00 ' CITY CLERK'S OFFICE, BUSINESS•LICENSE DIVISION 121 5 ' AVENUE NORTH, EDMONDS, WA 98020 PHONE: 425.775.2525 2S3 0�� z-er 00Y • OFFICE USE ONLY BL# Customeril I SIC 15, 1 Year A Cr I SHD I Date Paid 6 _r T A E<< Fee Pa / 0' W'ed Delete INSTRUCTIONS: Please complete the application in full and attach the required floor plan. Middle initial or name required of all parties concerned. If no middle name, please indicate by witting NMN. Sign and return application with fee. Please advise of - any change in status. New license required If business changes location or ownership. Notification to City of Edmonds required Hbuslness doses. BUSINESS NAME BUSINESS ADDRE MAILING ADDRESS SANJ E 6S _"�A Street or PO Box Suite No. City. State and Zip (Cood(ei �� i2 BUSINESS PHONE NO. ( 00 G') 8 d C - 7704 WA STATE TAX Iq NO. (um No.) 1��� 7 D ) Z BUSINESS E-MAIL Cocoot) C%1 / dcg joP i ll l/C. C&r—sus NESS WEBSITE (7 n2or_?n j - "A,l,_/i,,:0'17iti e212 T PROPERTY OWNER. SH/Aa- )k/l1, LOU cQ06, I.�4"1 q 9.4, Name Phone Number EMERGENCY NOTIFICATION (For Premise Acoess in Emergency): a 3 S - q, 5 7 Last Name First Name MI Phone No. ? i -nnl. � -.I A'x- NUMBER OF-EM'PLOYEES SQUARE FOOTAGE OF BUSINESS SPACE .2 L400 .S-(!../t- TYPE OF BUSINESS - PLEASE CHECK THE APPROPRIATE; CATEGORY: O CONSTRUCTION a FINANCE; INSURANCE.AEAL ESl`ATE• ' O LAhOS,CAPE, HORTICULTURAL O MANUFACTURING - O NON-PROFIT .O RETAIL :O1 SECONDHAND Q&LER O smirES O WHOLESALE OTHER AMUSEMENT DEVICEB-ORPREMISES? .d YRS NO . 1F YES, TOTAL NUMBER UQUOR SOLD ON PREMISES?: DYES IO 6A(1ABlJ(VG? OYES ,b:9O CIGARETTES SOU}ON PREMISES? OYES >v0 FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YES NO IF YES; PLEASE PROVIDE UST OF MATERIALS AND QUAN'i'f 1TES: PROPOSED OPENING DAXOF BUSINESS DAYS OPEN O SUNDAY �iIONDP�Y BUSINESS HOURS % '0n �om - " AWEDINESDAY 6 ] HURPAY A(FRIDAY --_ • iiiO SATURDAY PARKING SPACES ON SITE: TOTAL ACCESSIBLE FOR PERSONS WITH DISABILITIES -� ' DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE TO PERSONS WITH DISABILfC(ES? . YES O NO PREVIOUS BUSINESS USE AT THIS ADDRESS SOLE NAME - Lasd First MI ADDRESS StteM Apt. No., Unit No. CIty, State and ZJp Cade HOME PHONE NO. ( / —OM NO. DRIVERS LICENSE NO.) OR OTHER ID NO DATE OF BIRTH CITY AND STATE OF BIRTH ' COUNTRY OF BIRTH -PARTNER I Ll HOME PHONE No.(a2ttt b 1 4/ � — I /1 I••L� OOL NO. (DPJV+E�R.S LICENSE Nq.) OR OTHER IDNO.�- EZ60A/ & // 13P DATE OF BIRTH l JJ_ jCITY AND STATE OF BIRTH� 7C �J✓ . /�%� .. COUNTRY OF BIRTH PARTNERSHIP - PARTNER 2- NAME_.. / `�fC,�Y i�/�L7E �GCI� • C, Lastt. -.Fhg MI: HOME PF DATE OF . LJA NO. (DRIVERS LICENSE NO:) OR OTI4ER1U NO: efW L51,� RI� TY AND STATE OF BIRTH ag / CAA©, �� • COUNTRY bF BiRTK Usti NAME OF CORPORATION FEDERAL TAX ID NO. CORP. ADDRESS PHONE NO.( 1 Street Su IW ApC Unit No. City. State and Z(p Code CORPORATE OFFICERS: Last Name First Name MI TiQe Daub of Girth OOL No. (Drivers Lioense No.) or Odwar'ID No. Lad Nama First Name MI . Title Phone No. DOL No. (Drivars Um No.j or Odw ID,No. Nye —P - T&Is Date ,USE•CENLY:^ .. _ - _ < •rm;•• :..;.:.:: •'r.Y;' ='t8 - .. PLANNiN(i' Ti ROvFq'.00isAt�PaOv 'O�►iE.. ,,,.„. Ltd°+ i`•.. ":: �coDE: ••COI P T1ONAI.USEPERIIAIT.-':.'r'. �• CQ'AittN�i I S.... BURONG•CEPTa, O'APPROVE O DISAPPROVE DATE SIGNATURE OCCURM(T LOAD' ' BUILDING PERMIT OCCUPANCY GROUP FIRE DEFT. ' •O APPROVE O DISAPPROVE OATS SIGNATURE POLICE DISPT. 0-APPROVE • 0 DISAPPROVE DATE SIGNATURE ' :TN P9Nf RDo/y 3201. 00t' li c � c\1nPN C1myo , 3(0" U) 9-Evp�- �bo✓�1n�'Qs�n�n�\c\ -TN FA I,]-f- koc)M �2 pRe - c-- - !Roo (,AN 595 REeeptio DGS-11� `{ CITY OF EDMONDS 121 5- AVENUE'N. • EDMONDS, WASHINGTON 98020 • (425) 771-0215 FIRE DEPARTMENT 4S' 1 Sg13 LOCATION: 9715 Firdele Avenue ' BUSINESS NAME: Little Learners Academy Daycare MAILING 9715 Firdale Ave IN 14 FIRE PREVENTION SAFETY SURVEY PHONE: 2065425097 ADDRESS: Edmonds 93020 BUSINESS OWNER: IJI V➢Yi7 HOME PHONE: 4252395664 EMERGENCY-1: Brown, ISidraM HOME PHONE: 2069318367 KEY ACCESS-2: HOME PHONE: FREQ6UENCY STATfN 8 SHIFT SCHEDULED ► 12/01I10 DATE DUE UFIR ► 253 1 t4 ACTIVE PERSON CONTACTED: % D A I J O �' ✓ INITIAL INSPECTION DATE NAME OF INSPECTOR: D D vJ a l U FIRE FE _! SYSTEMS: /' ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 ENTER CODE ONLY ONCE ► VIOLATION CODE 1 2 _ 2 3 3 4 4 5 5 6 6 7 7 8 8 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: ` '' 2:1 :r..: 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 7 4 8 4 8 DATE: DISPOSITION: 8 LETTER NEEDED ] YES i l NO LETTER NEEDED ❑ YES NO FIRE DEPARTMENT COPY