111 MAIN ST STE 102 (2)_Redacted,J)rE i oZ
CITY OF EDMONDS
BUSINESS LICENSE APPLICATION — COMMERCIAL
FEE: $125.00
'4 CITY CLERKS OFFICE, BUSINESS LICENSE DIVISION
121 5" AVENUE NORTH, EDMONDS, WA 96020 PHONE 425,775.2525
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Building
17
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Police
OFFICE USE ONLY
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I Year
Class
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Date Paid
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INSTRUCTIONS: Please complete tho application in full and attach the required floor plan. Muddle 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. Now license required if
business changes location or ownership. Notification to City of Edmonds required if business closes. License expires December 31" each year. Renewal
must be submitted prior to January 31" to avoid late fees.
BUSINESSNAMEL Peoples.Bank
BUSINESS ADDRESS 111 Main Street Suite 102 F..dmonds, WA 98020
Street Suite # City, State, Z p, Code
MAILINGADDRESS 3100 Woburn Street 1�e11i�1ghitfn. WA 98226
Street or PO Box # Suite # Cify, State, lip Cade
BUSINESS PHONEI 800 58418859 WA STATE TAX ID It (1.181) 1 3 7 A I10 1 0 1 1 1 1 0 1 3
BUSI•VESS E MAIL vern.woods@peoplesbank-wa_com BUSINFSS WEBSIT'c
BUSINESS OWNER I MAIN CONTACT Vern Woods ( 4 _5, L2823 4.6--
Nama Phone Number
PROPER.' Y OWNER Tynes Properties LP _ , 425 1 9212200
Name Phone Number
EMERGENCY NOTIFICATION (For Premise Access in Emergeneyj:
Woods Vern. f425 s 7891446 _
Last Name Firs) Name MI Phone Number
Lest Name FirstNameMI Phone Number
NATURE OF BUSINESS (Provide a Detailed Description of Business Activities, Products E Services),,
Commercial. Bank
SPACE ALTERATIONS TO BE MADE: YES_NO X DESCRIPTION
PREVIOUS BUSINESS AT THIS ADDRESS
NUMBER OF EMPLOYEES -5 SOUARE FOOTAGE OF BUSINESS
TYPE OF BUSINESS —PLEASE CHECK APPROPRIATE CATEGORY:
L, CONSTRUCTION
C. FINANCE; INSURANCE, REAL ESTATE
r- LANDSCAPE, HORTICULTURAL
r MANUFACTURING
C NON-PROFIT
D RETAIL
r. SECONDHAND DEALER
rI SERVICES
* VdHOLESA--E
G OTHER
PROPOSED OPENING DATE: 612W 16 1
---------------
BUSINESS HOURS' 9-5 `
DAYS OPEN:
7 SUNDAY 5tt WEDNtSUAY
MONDAY rg ThURSDAY
•.XTUESDAY ,7u FRIDAY
i I SATURDAY
AMUSEMENT DEVICES ON PREMISES? YES NO_-LIF YES, TOTAL NUMBER LIQUOR SOLD ON PREMISES? YES NOS
GAMBL ING? YES_ NOS CIGARETTES SOLD ON PREMISES? YES NOS_
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED2YES NOS IF YES, PLEASE PROVIDE A LIST OF MATERIALS AND QUANTITIES:
PARKING SPACES ON SITE: TOTAL SPACES ACCESSIBLE SPACES FOR HANDICAP PARKING
DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSI63L12. TO PERSONS WITH DISABILITIES7 YES—X _ NO ,
APPLICANT
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Edmonds Realty
111 Main Street, Suite 101
Edmonds, WA 98020
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FIRE PREVENTION
Servin Brier, Edmonds, andAveINSPECTION
Serving.Brier, dd
12425 MidiASNffEDMONDS
REPORT
SIVOHOMTSH CO. .r
FIREMountlake Terrace
Everett, WA 98208
❑ BRIER
DISTRwww.FireDistrictl.org
Phone (425) 5514200
❑ MOUNTLAKE TERRACE
UNINCORPORATED
Fax (425) 551-1272
FREQUENCY
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LOCATION: 111 Main Street Suite 102 98020
2015
17-D
BUSINESS NAME: Vacant I ` I ; I
PHONE:
SCHEDULED Oct 2015
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1SNOHOMISH CO.
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Mountlake Terrace
DISTRT www FireDistrictl. org
LOCATION: 11.1 Mein Street Suite 102 98020
BUSINESS NAME: Dialpro NW, Inc.
MAILING
FIRE PREVENTION
12425 Meridian Ave S INSPECTION REPORT
Everett, WA 98208 0 ❑ BRIERNDS
BRIER
Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
Fax (425) 551-1272
FREQUENCY STATION & SHIFT
2 Year 13 17-B
PHONE: 206624972t SCHEDULED Oct 2013
DATE DUE
UFIR / 591
ADDRESS: 111 Main Street, Suite 102, Edmonds, WA 98020
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Knutson, Robert HOME PHONE: 2066509727 CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO ;
BUSINESS
EMAIL: LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED: I n
NAME OF INSPECTOR:
FIRE SYSTEMS: FE
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
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NUMBER:
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6
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DATE:
CODE
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RETURN RECEIPT
RECEIVED
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DATE:
DISPOSITION:
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LETTER NEEDED ❑ YES ❑ NO
• LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
FIRE PREVENTION
Serving Brier, Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO. `
`
❑ EDMONDS "
Mountlake Terrace,and
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FIRE
Everett, WA 98208
❑ BRIER
STR y T the Town of Woodway
Phone (425) 551-1200
❑ O AY
ElMOUNTNTLAKE TERRACE
wwwFireDistrictl.org
Fax (425) 551-1272
El UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION: 111 Main Street
102
1
17 D
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BUSINESS NAME: Dialpro NW, Inc-
PHONE: 2066249727
SCHEDULED
DATE DUE ► 10101111
MAILING 111 Main St #
UFIR ► 591 1(202
ADDRESS:
� Edmonds
98020
^+ BUSINESS OWNER: Knutson, Robert
HOME PHONE: 2066509727
AC11VE
V EMERGENCY-1: Tynes Properties
HOME PHONE: 2063631994
CURRENT
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INITIAL INSPECTION DATE
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DATE DUE:
EXTENSION
GRANTED TO:
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PERSON
CONTACTED:
PERSON
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INSPECTOR:
INSPECTOR:
INSPECTOR:
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DATE:
1
DATE:
DATE:
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VIOLATIONS
1 5
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PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
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RETURN RECEIPT
RECEIVED
6
4
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$
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑'•;NO;
LETTER NEEDED ❑ YES ❑ NO
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FIRE DEPARTMENT COPY