The URL can be used to link to this page

105 5TH AVE S (2)_RedactedIIII��III I o s 4-11 rgoE Serving Brier, Edmonds, and 12425 Meridian Ave S Mountlake Terrace Everett, WA 98208 Phone (425) 551-1200 www.FireDistrictl.org Fax (425) 551-1272 FIRE PREVENTION INSPECTION REPORT ]EDMONDS BRIER ❑ MOUNTLAKE TERRAGE;;.�' ❑ UNINCORPORATED` FREQUENCY STATION & SHIFT LOCATION: 105 5 th Avenue S 98020 BUSINESS NAME: PHONE: SCHEDULED Cline Jewelers 4256739090 DATE DUE ► MAILING UFIR ► ADDRESS: 544 203 105 5th Avenue S, Edmonds, WA 98020 BUSINESS OWNER: HOME PHONE: Cline, Jerry EMERGENCY-1: HOME PHONE: CURRENT KEY ACCESS-2: Cline, Andy HOME PHONE: 2068717979 CITY YES NO EMAIL: BUSINESS '�i j LICENSE /L]J El "PERSON CONTACTED: INITIAL INSPECTION DATE :NAME OF INSPECTOR: FIRE SYSTEMS: FE 2/14 �1 z UIAMk%StGbQMAQ0(IJ0CATIONS / COMMUNICATIONS 2 2 ,y 3 ;3: 4 4 5 5 6 6 7 7 I I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X DATE DUE: PERSON CONTACTED: INSPECTOR: DATE: W�� VIOLATIONS 1 I5 2 6 3 7 LETTER NEEDED ❑ YES ❑ NO DATE DUE: PERSON CONTACTED: INSPECTOR: DATE: _..___..- _ VIOLATIONS 1 5 . 2 - ---- . 6.. 3_._._. 3 7._..... 4-,_®...._..... .... . LETTER NEEDED ❑ YES ❑ NO EXTENSION FINAL RE -INSPECTION VIOLATIONS GRANTED T0: DATE DUE:. CITED - PERSON CONTACTED: 6 INSPECTOR: - [I Z ... DATE: 3 .. _ .._ _ ^ PRE -CITATION 6F TATIONISSUE15 _ ^" LETTER SENT NUMBER: 4 ____._.T_._ _.._ ._ - CODE - 5 DATE: SECTION: RETURN RECEIPT RECEIVED e �- _ _.. _...... _....._. ..__-.__ _.. . DISPOSITION: T DATE: Y FIRE PREVENTION �A'�' Serving Brle1; Edmonds, and - tN25 Meridian Ave S INSPECTION REPORT . - CO. Mountlake Terrace FIRE Everett, WA 98208 El ❑ BRIEREDMOS ❑BRIER DISTR T Phone ?425) 551-1200 Fax AKE TERRACE ❑ UNINCOMOUNTRPORATED ❑UNINCORPORATED wwwFireDistrictl.org (4..5) 551-1272 LOCATION: FREQUENCY I STATION & SHIFT 105 5.th Avenue S 0,6020 Annual 17-.A BUSINESS NAME: Cline Jewelers PHONE: 4258739090 SCHEDULE DU�' May 2014 _ MAILING UFIR E44 203 ADDRESS: 105 51[h AVenUe S, Edmonds, WA 98020 BUSINESS OWNER: Cline, Jerre HOME PHONE: EMERGENCY-1: Cline, Andy HOME PHONE: 2068717979 CURRENT, --- KEY ACCESS-2: HOME PHONE: CITY Y S NO 1 I Q BCENSES EMAIL: 1 PERSON CONTACTED: INITIAL INSPECTION DATE / NAME OF INSPECTOR: I � 2- FIRE SYSTEMS: FED_ HAZARDS FOUND AND LOCATIONS / COMMUNICATION 1 1 2 2 3 3 4 4 5 5 6 6 7 7 1 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: INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 I 12 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 4 $ 4 $ DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO g FIRE DEPARTMENT COPY FIRE PREVENTION SNOHOMISH CO. Serving Brier; Edmonds 12425 Meridian Ave S IN PECTION REPORT t � UIVAJOILjo Mountlake Terrace,and Everett, WA 98208 BRIER ❑BRIER URI. the Town of Woodway Phone (425) 551-1200 ❑ MOUNT AY �_ ❑ MOUNTLAKE TERRACE www FireDistrictl.org Fax (425) 551-1272 ❑ UNINCORPORATED FREQUENCY STATION & SHIFT LOCATION: 105 5th Avenue S 365 17 B BUSINESS NAME: Cline Jewelers PHONE: 4256739090 DATE DUE SCHEDULED► 05/01/11 MAILING 105 15#h Ave S UFIR ► 544 5203 ADDRESS: Edmonds 98020 BUSINESS OWNER: `line, Andy HOME PHONE: 2068717979 ACTIVE EMERGENCY-1: Cline, Jerry HOME PHONE: 2068199734 eCURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO BUSINESS LICENSE PERSON CONTACTED: k 11 U1144 INITIALDATE ILL L�A NAME OF INSPECTOR: C-b S v FIRE FE 01! rl SYSTEMS: ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 0 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: 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 , s, 3 7 RETURN RECEIPT RECEIVED 6 4 8 4 8 DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO I ' 8 i FIRE DEPARTMENT COPY 11 `z--c) CITY OF EDMONDS BUSINESS LICENSE APPLICATION— COMMERCIAL FEE: $125.00 C� CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION 121 5T" AVENUE NORTH, EDMONDS, WA 98020 PHONE: 425.775.2525 OFFICE USE ONLY BL# Customer# SIC Year Class SHD I Date Paid I TR# Fee Paid Mailed Delete t9 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. BUSINESS NAME BUSINESS ADDRE MAILING ADDRESS 105 �� Ave S • Street orPO�1Box Suite No. City, State and Zip Code p BUSINESS PHONE NO.( L0b / 5) J- 9o9v WA STATE TAX ID NO. (UBI NO.) 3 6 BUSINESS E-MAIL Qh Gl GD C Ih'I6 t biAy-.lei & BUSINESS WEBSITE r- It'ne ,I C 1. ejjeYS • c om PROPERTY OWNER ( ) Name Phone Number 'Y NOTIFICATION (For Premise Acres n Emergency): Ell (� tJ� >�2eA. TR740-.,p Last NATURE OF BUSINESS (�6) BQ-79 MI Phone No. ( Za ) �30-177 Mi .Phone No. )r�� NUMBER OF EMPLOYEES SQUARE FOOTAGE OF BUSINESS SPACE I ZS V TYPE OF BUSINESS - PLEASE CHECK THE.APPROPRIATE CATEGORY: O CONSTRUCTION O FINANCE, INSURANCE, REAL ESTATE. O LANDSCAPE, HORTICULTURAL O MANUFACTURING O NON-PROFIT DETAIL O SECONDHAND DEALER O SERVICES O WHOLESALE O OTHER AMUSEMENT DEVICES ON PREMISES? O YES 9>qO IF YES, TOTAL NUMBER LIQUOR SOLD ON PREMISES?: O YES . •�40 GAMBLING? O YES O NO CIGARETTES SOLD -ON PREMISES? O YES dq<O FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YES -)�NO IF YES, PLEASE PROVIDE LIST OF MATERIALS AND QUANTITIES: PROPOSED OPENING DAY OF BUSINESS r:0i0 15T BUSINESS HOURS DAYS OPEN O SUNDAY ONDAYi UESDAY \iO WEDNESDAY /I THURSDAY RIDAY XSATURDAY PARKING SPACES ON SITE: TOTAL ff ll'' ACCESSIBLE FOR PERSONS WITH DISABILITIES DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIB E TO PER ONS �TH DIS IABILITII.E}S.? V©YES O NO. PREVIOUS BUSINESS USE AT THIS ADDRESS (I e �I l I I a 1� SOLE PROPRIETORSHIP a NAME Last First MI ADDRESS Street Apt No., Unit No. City, State and Zlp Code HOME PHONE NO. ( ) DOL NO. (DRIVERS LICENSE NO.) OR OTHER 10 NO. DATE OF BIRTH CITY AND STATE OF BIRTH COUNTRY OF BIRTH PARTNERSHIP-PARTNERI NAME Last First MI ADDRESS Street Apt. No., Unit No. City. State and Zip Code HOME PHONE NO.() DOL NO. (DRIVERS LICENSE NO.) OR OTHER ID NO. DATE OF BIRTH CITY AND STATE OF BIRTH COUNTRY OF BIRTH PARTNERSHIP -PARTNER 2 NAME Last First MI ADDRESS Street Apt. No., Unit No. City, State and Zip Code HOME PHONE NO.() DOL NO. (DRIVERS LICENSE NO.) OR OTHER ID NO. DATE OF BIRTH CITY AND STATE OF BIRTH COUNTRY OF BIRTH NAME OF CORPORATION ]�/� CORPORATION l(A6 J )G�J) GIC rim q_ �Wf/�$EDERALTAX ID NO. CORP. ADDRESS V W Fl Uo U PHONE� / NO.e73 �o y Street Suite, Apt., Unit No. City, State and Zipt Code CORPORATE OFFICERS: Last N e t First Narne MI Title Date of Bi DOL No. (Drivers Liwnsc No.) or Other 0No. _.w-- LOCAL CONTACT Last ame First Name MI Title Phone No D o- rs rive APPLICANT�NJY��I�Q r. ' Name - Printed Signature Title Oats. CITY USE ONLY: --- - - ------ PLANNING DEPT. O APPROVF O DISAPPROVE DATE SIGNATURE ZONING CODE CONDITIONAL USE PERMIT COMMENTS BUILDING DEPT. O APPROVE O DISAPPROVE DATE SIGNATURE OCCUPANT LOAD____.__ BUILDING PERMIT OCCUPANCY GROUP COMMENTS FIRE DEPT. O APPROVE O DISAPPROVE DATE SIGNATURE U.F.I.R. COMMENTS ____ POLICE DEPT. O APPROVE O DISAPPROVE DATE SIGNATURE COMMENTS r� C � iKe, 0 1 rdow IN-4 f ldha)