7500 212TH ST SW STE 118 (2)-5pgs_Redacted.ems. -. .. ..,:� --.'+ . t 'Bli:: •c��._.>_r _�_�°^. _-� -:r'•: r - -ti
S U 2 h �T —�i.p FIRE PREVENTION
INSPECTION REPORT
=sranxc�i� �sx � A Serving oriel, L.dmonds, and 124..5 Meridian Ave S
WA 98208 ❑ EDMONDS
Mountlake Terrace Everett, ❑ BRIER
�Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE ,
DISTRI-1 T www.FireDistrictl.org Fax (425) 551-1272 ❑UNINCORPORATED
LOCATION: 7500 212 th Street SW Suite 118 98026
Bae Muscular Therapy & Rehab
BUSINESS NAME: PHONE:
MAILING 7500 212th Street SW, Suite 118, Edmonds, WA 98026
ADDRESS:
Oliveto, Ryong
BUSINESS OWNER:
EMERGENCY-1: Clay, Ken
KEY ACCESS-2:
EMAIL:
PERSON CONTACTED:
NAME OF INSPECTOR:
Date Last Serviced:
HOME PHONE:
HOME PHONE:
HOME PHONE:
4257713164
4255012690
20
RETU6ENCY STATI V SHIFT
SCHEDULED Dec 2016
DATE DUE �
59.3
UFIR /
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIA INSPECTION DATE
1 5 //7-
CITY OF EDMONDS
BUSINESS LICENSE APPLICATION- COMMERCIAL
FEE: $125.00
Inc_ 189� , ti 1CITY CLERK'S OFFICE, BUSINESS -LICENSE DIVISION 21:5'w AW.ENUE NORTH, EDMONDS, WA 98020 PHONE: 425.775.2525
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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
ifbusiness closes.
BUSINESS NAME `' an (` - L Q
BUSINESS ADDRESS -7-ary t L S f ft e S
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MAILING ADDRESS .�(J� 2� Z �Rrt- �, 6 f-j~(3swpt- -( goj_�p
Street or PO Box Suite No. City, State and Zip Code
BUSINESS PHOWPUI Ue )_ N(D -(42UCQ WA STATE TAX ID NO. (UBI NO.) rLC - 19210 ICI
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PROPERTY OWNER
Name
EMERGENCY NOTIFICATION (For Premise Access in Emergency):
Phone Number
Last Name I First Name MI Phone No.
Last Name First Name Mi Phone No.
NATURE OF BUSINESS QS cam- C'J 08 ejd1A7'
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NUMBER OF EMPLOYEES 1 SQUARE FOOTAGE OF BUSINESS SPACE
TYPE OF BUSINESS - PLEASE CHECK.THE APPROPRIATE CATEGORY:
O CONSTRUCTION O FINANCE; INSURANCE, REAL ESTATE- O LANDSCAPE, HORTICULTURAL O MANUFACTURING O NON-PROFIT
O RETAIL O SECONDHAND DEALER OSERVIC,ES O WHOLESALE. O.OTHER
AMUSEMENT DEVICES•ON•PREMISES? .O YES PDNO . 1F YES, TOTAL NUMBER
LIQUOR SOLD ON PREMISES?: O YES. X11 NO. - GAMBLING? O YES ,ONO CIGARETTES SOLD ON PREMISES? O YES XJNO
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YES ji:lONO IF YES, PLEASE PROVIDE LIST OF MATERIALS AND QUANTITIES:
PROPOSED OPENING DAY -OF BUSINESS S} %� l O BUSINESS HOURS
DAYS OPEN O SUNDAY O MONDAY 1M TUESDAY )MWEDNESDAY 10THURSDAY FRIDAY �TSATURDAY
PARKING SPACES ON SITE: TOTAL ` ACCESSIBLE FOR PERSONS WITH DISABILITIES
DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE TO PERSONS WITH DISABILITIES?. DYES O NO
PREVIOUS BUSINESS USE AT THIS ADDRESS
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7500 Building Main Floor D� 10886 SF.
A,1 SCALE: 3/32'. i'-O'
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EDMONDS, WASHINGTON � �1
D
IM
Washington State Department of Health
By the authority of RCW 18.108 this person
SARAH J REMAKEL
is granted a
W
M a
Od N
4 13-K 14
Status
ACTIVE
Effective Date
Secretary 0110812010
\M
VVI(I
O'C\ kwl�c in
k 5 " Mum
Initial Issuance
08/31/2007
Credential Number
MA 00024673
Expiration Date
01105/2011
Personal Copy of Your Credential
Washington State Department of Health
By the authority of RCW 18.108 this person
SARAH J REMAKEL
is granted a
Massar &cfiOmqf.,_LJc9nse
NCR
tr6dential Number
'jk-CTIVE MA 00024673
Expiration Date
secretary 0110512011