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INSPECTION
PECTION REPORT
Brier, Edmunuy, «,ld 124.5Mertdian Ave S
FIRE
Mountlake Terrace Everett, WA 98208 ❑ BRERNDS
Phone .425) 551-1200 ❑ MOUNTLAKE TERRACE
DIIOUTL R w r www.FireDistrictl.org Fax (425) 551-1272 ❑ UNINCORPORATED
FREQ' l b 2016ENCY ST 1 /-A&SHIFT
LOCATION:
110 3 rd Avenue N Suite 202 98020 l I
ACFEA Tour Consultants 4256728644 SCHEDULED Oct 2016
BUSINESS NAME: PHONE: DATE DUE ►
MAILING PO BOX #849, Edmonds, WA 98020 UFIR ►
ADDRESS:
McLaughlin, Christine
BUSINESS OWNER: HOME PHONE:
Olson, Kenneth r 3609083348 CURRENT
EMERGENCY-1: J 1L �r� �pyL HOME PHONE: YES NO
KEY ACCESS-2: ! f/ //�� HOME PHONE: CITY
EMAIL: C fi S7/ nc`_'• 4Q If — / �-` 1 G� BUSINESS
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PERSON CONTACTED: r- � INITIAL INSPECTION DATE
NAME OF INSPECTOR:
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I AGREE TO CORRECT THEABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION 2nd RE -INSPECTION EXTENSION FINAL RE -INSPECTION VIOLATIONS
DATE DUE DATE DUE' GRANTEDTO. `DATE DUE. CITED:
PERSON PERSON € PERSON
CONTACTED: - CONTACTED: ;CONTACTED:
INSPECTOR: INSPECTOR: INSPECTOR: `2
3
DATE: DATE: DATE:
VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED
1 5 1 .5 LETTER SENT NUMBER, 4
CODE 5
2 6 2 6 DATE. SECTION.
RETURN RECEIPT
3 7 3 7 R..ECEIVED
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- DISPOSITION
4 8 4 8 DATE
LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO C:8
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V�e CITY OF EDMONDS
BUSINESS LICENSE APPLICATION- COMMERCIAL
FEE: $125.00
CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION
'nc.ta9° 121 5' AVENUE NORTH, EDMONDS, WA 98020 PHONE. 425.775.2525
OFFICE USE ONLY
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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 writing 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
if'business closes.
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NUMBER OF EMPLOYEES SQUARE FOOTAGE OF BUSINESS SPACE
TYPE OF BUSINESS - PLEASE CHECK -THE APPROPRIATE CATEGORY:
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Y /AMUUSEMENT DEVICES*ONPREMISES? .Cl YES A<NO . OYES. TOTAL NUMBER
LIQUOR SOLD ON PREMISES?: OYES. 0.. GAMBLING? O YES /�I(NO CIGARETTES SOLD -ON PREMISES? O YES V710
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YES�NO IF YES.- PLEASE PROVIDE UST OF MATERIALS AND QUANTITIES: '
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SECOND FLOG\\RYJP�LA�N VER
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FIRE PREVENTION
Serving Brier; Edmonds o
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIREMountlake Terrace
Everett, WA 98208
r ❑ BRIER S
❑ BRIERand
STR T the Town of Woodway
Phone (425) 551-1200
❑ O AY
[IMOUNTLNTLAKE TERRACE
www.FireDistrict].org
Fax (425) 551-1272
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
LOCATION: 110 3rd Ave N
202
730 1
I
BUSINESS NAME: Guild Madage Co
PHONE: 4256723599
SCHEDULED 10r
��1
DATE DUE ► ,12 .. .
MAILING 110 3rd Ave N #202
UFIR ► 591 1[202',
ADDRESS: Edmonds 98020
`
BUSINESS OWNER: McKinley, Bill
HOME PHONE: 2067967549
EMERGENCY-1: Markezinis, James
HOME PHONE: 4'256702444
CURRENT
_
KEY ACCESS 2:
HOME PHONE:
Ty YES No
7n,6D ' ///S/(`
BUSINESS ❑ ❑
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIFE
FE _f_
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
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:
;_)1_ t
2;�_.�'�'�#.�;•
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
6
4 6
LET TER NEEDED ❑ YES ❑!.,NO�r
DATE:
DISPOSITION:
LETTER NEEDED
❑ YES ❑ NO
8
FIRE -DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. • EDMONDS, WASHINGTON 98020 • (425) 771-0215
FIRE DEPARTMENT
4`St 189� i
LOCATION:
110 3rd Ave N
BUSINESS NAME: Guild Morlege Co
MAILING `I 10 3rd Ave N #202
FIRE PREVENTION
SAFETY SURVEY
FREAII�NCY STATI'BtiSiIFT'
202
PHONE: 4256723599 SCHEDULED 10/01/10
DATE DUE ►
UFIR ► 591 11202
ADDRESS: Edmonds 93020
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BUSINESS OWNER: l HOME PHONE: ✓�
moo:
EMERGENCY-1:
Msrkeziniv, HOME PHONE: James 42567024"
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KEY ACCESS-2: HOME PHONE:
,r
PERSON CONTACTED: � 1 L4^t T OWws
INITIAL INSPECTION DATE
NAME OF INSPECTOR: 4 A0V r&1. q vpt 0 9 11 Lq Sf 6 /1,
FIRE FE ?A
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
ENTER CODE ONLY ONCE ►
VIOLATION CODE
2
2
3+
3
4
4
5
5
6
6
7
7
8
8
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
7
4
6
4
B
DATE:
DISPOSITION:
-
8
LETTER NEEDED YES I] NO
LETTER NEEDED f YES NO
FIRE DEPARTMENT COPY