105 5TH AVE SIIII�lIII
�05 S.aVz
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FIRE PREVENTION
Serving Brier, Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
SNOIiOMISi3 CO.
Mountlake Terrace
FIRE
.Everett, WA 98208
❑ BRIEREDMOS
❑BRIER
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Phone (425) 551-1200
❑ MOUNTLAKE TERRACE
❑UNINCORPORATED
DISTRT
www.FireDistrictl.org
Fax (425) 551-1272.
3
FREQUENCY
FREQUENCY
STATION & SHIFT
it LOCATION: 5 th Avenue S 98020
I
2018
17-A
BUSINESS NAME:
Cline Jewelers
PHONE: SCHEDULED
4256739090 DATE DUE ' May 2018
MAILING
UFIR ► 544 203
ADDRESS:,05 5th Avenue S Edmonds WA 2 980 0
BUSINESS OWNERCIIne, Jerry
HOME PHONE:
EMERGENCY-1 Cline A dy
KEY ACCESS-2:
HOME PHONE: 2068717979
HOME PHONE:
CURRENT YES NO
CITY
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EMAIL: i t )'1 1 ) C C}}'VL 17
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
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NAME OF INSPECTOR:
FIRE SYSTEMS: FE 2/16
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LOA
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LOCATIONNS, / COMMUNICATIONS
2
2
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:
E)(TENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON •'
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
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VIOLATIONS
1 5
2 6
VIOLATIONS
1 5
2 6
3 7 .—
4 6
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
DATE:
CODE
SECTION:
5
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3
7
RETURN RECEIPT
RECEIVED
6
4
-
6
DATE:
DISPOSITION:
7
_
LETTER NEEDED ❑ YES 0 NO
LETTER NEEDED ❑ YES ❑ NO
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