7500 212TH ST SW STE 214-6pgs_Redacted`� + IIII��III %/Jd V +f rZl Z�H Sr f� .;."�'Tk .Zl FIRE PREVENTION
r` Serving Brier; Carnonds, and . 12425 Meridian Ave S INSPECTION REPORT
-SNd;<iCiI ISH CO. ❑ EDMONDS
r. �; Mountlake Terrace Everett, WA 98208 ❑ BRIER
FIRE �� ` �" Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE
�� T
g ( ) ❑UNINCORPORATED
DI
www.FireDistrictl.or Fax 425 551-1272
LOCATION: 7500 212 th Street SW Suite 214 98026
BUSINESS NAME: 1 PHONE: 4257713311
MAILING
ADDRESS: 7500 212th Street SW, Suite 214, Edmonds, WA 98026
FREQUENCY I STATION & SHIFT
.2016 16-B
SCHEDULED Dec 2016
DATE DUE ►
UFIR ► 593
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Shaltan,R09� MD A HOME PHONE: 4_ 5 ��
CURRENT
KEY ACCESS-2:M�r~l•. O •�j • Low f+-' HOME PHONE:`' 7 3 CITY YES NO
EMAIL: "l67 3 B CENSES
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FE tjk
Date Last Serviced:
SNOI
F.
D
Serving Brier-, Edrnonds
Mountlake Terrace, and
the Town of Woodway
www.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ WOODWAY
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION:
7500 212th Street
SW 214
730
I
16
D
J BUSINESS NAME:
Carlton & ACCt}C1ates, Inc.
PHONE:
4257748881
SCHEDULED 12101t11
DATE DUE
MAILING
7500 212th St SW #214
of4
UFIR / 591
1;157
ADDRESS:
Edmonds
98026
1 BUSINESS OWNER:
Carlton, Thomas
HOME PHONE:
4253377734
ACTIVE
EMERGENCY-1:
Clay, Diana
HOME PHONE:
4257701302
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
YES
NO
BUSINESS
LICENSE
'
PERSON CONTACTED:
INITIAL INSPE TIO
DATE
NAME OF INSPECTOR:
N
`
FIRE
PE
SYSTEMS:
A(i5u
L
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
2
2
3
3
fv
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:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
a
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
8
FIRE DEPARTMENT COPY
J� 3 0&01 Z, (5- ? D
CITY OF EDMONDS
BUSINESS LICENSE APPLICATION— COMMERCIALCEIV�
FEE: $125.00 D
CffY CLERK'S OFFICE, BUSINESS'LICENSE DIVISION
!n�, 18911 121 5�' AVENUE NORTH, EDMONDS, WA 98020 PHONE: 425.775.2525 JUN 21 �012
OFFICE USE ONLY y
BL#
Customer#
'
Year
Class
SHD
GD 'P ld
TR#
Fee P
.•
'
Mailed f`
1 M
INSTRUCTIONS: Please complete the application in full and attach the tequired 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.
BUSINESS NAME
BUSINESS ADORE
MAILING ADDRESS 7 SOv Ala* s i . s t ti 5& C- dworas . wk 17DSO a�.
Street or PO Box Sulte No. City, State and Zip Code
BUSINESS PHONE NO. ( 1 7 i / " 13 I 1 WA STATE TAX ID NO. (UBI NO.) n GAO tYSG I �I
BUSINESS E-MAIL ed1j07j; N1L1i11diIS L liri&.60CcwlfGS�-fW-t- BUSINESS WEBSITE e1j)ala71d5 W0;-1LeiI5u111A:. c &41
PROPERTY OWNER 7 5-0 /g /d q. 1-k C, C ke k1 L
Name
EMERGENCY NOTIFICATION (For Premise Access In Emergency):
Ila LI IA'4 hAe I _ �? N. 5c d5 I - 7'73 ^ a673 Ce it
Last Name First Name MI Phone No.
� P MIX- l�o�er /J . (BLS' 3LdD c Pl
Last Name t Name Mi Phone No.
NATURE OF BUSINESS nledi -t eD &4 ail. FI •C e-
NUMBER OF EMPLOYEES 3 SQUARE FOOTAGE OF BUSINESS SPACE -7d-
TYPE OF BUSINESS - PLEASE CHECK.THE APPROPRIATE CATEGORY:
O CONSmOTION * O FINANCE, INSURANCE. REAL ESTATE. ' O LANDSCAPE, HORTICULTURAL O MANUFACTURING O NON-PROFIT
.O RETAIL 0 SECONDHAND DEALER �LSERVIGES O WHOLESALE O.OTHER
AMUSEMENT OE:VICES'ON•PREMISES? .(j YES *NO . IF YES, TOTAL NUMBER
LIQUOR SOLD ON PREMISES?: O YES. *0.' GAMBUNG? C1YES KNO CIGARETTES SOLD•ON PREMISES? Cl YES NO
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YES *NO IFYES. PLEASE PROVIDE UST OF MATERIALS AND QUANTITIES:
PROPOSED OPENING DAY -OF BUSINESS 3-lq -/,i, BUSINESS HOURS
DAYS OPEN O SUNDAY "OND/,Y *TUESDAY AWEDNESDAY LQTHURSDAY 1AFRIDAY • O SATURDAY
PARKING SPACES ON SITE: TOTAL S>' I ACCESSIBLE FOR PERSONS WITH DISABILITIES ves
DOES THE BUSINESS CONTAIN AN ENTRANCE ACCES81BLLSE TO PERSONS WITH DISABILITIES? )kYES O NO
PREVIOUS BUSINESS USE AT THIS ADDRESS S,t2!GC( _
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