100 2ND AVE SAJO nv9
FIRE PREVENTION
' Edmonds, and
Slid?kiC7SYi 1Sli CO. i Serving BYIeY,
Mountlake Terrace
FIRE`�TW-'-
12425 Meridian Ave S
Everett, WA 98208
" INSPECTION REPORT
❑ EDMONDS
❑BRIER
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Tenbg4�#4k�6ctl.org
Phone (425) 551-1200
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
i SS1-1272
Annual 17-C
FREQUENCY
STATION & SHIFT
LOCATION: Harbor Bldg
4257711755
N
v 2017
BUSINESS NAME:
PHONE:
SCHEDUL 9202
DATE DU
100 2nd Avenue S, Bldg, Edmonds, WA 98020
MAILING
UFIR ►
ADDRESS:Hassen, Rick 415 - 2.6q - Sit 3 1-0 - f,1 7
BUSINESS OWNER:gf�s,�
HOME PHONE: I �yU
1V
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
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EMAIL: A a SSA pr-op C L o t,C.,c,4
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
PERSON CONTACTED: ; L�, Airr.
INITIAL INSPECTION DATE
IRE SiYA%T PEC A 4/16 E 4/16 12:00:00 AM
Date Last Serviced: \ \ \
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
00
-.2__-_.__--_
3 _..---._..___._...._. ..
3
4
4
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION 2nd RE -INSPECTION EXTENSION FINAL RE -INSPECTION VIOLATIONS
DATE DUE: DATE DUE: GRANTED TO:
PATE DUE.. DATE DUE: i CITED:
PERSON PERSON PERSON
CONTACTED: CONTACTED: CONTACTED:
INSPECTOR: INSPECTOR: INSPECTOR: 2
DATE: DATE: DATE: _ 3
VIOLATIONS VIOLATIONS PRE -CITATION
1 5 1 5 LETTER SENT NUMBER: 4
_
CODE 5
2 6 2 r 6 DATE.._... _._ ....»,. .... SECTION. _ .. _.... » ...
RETURN RECEIPT B
3 7 3 7 RECEIVED
DISPOSITION'
4 : 6 4, ' 8 DATE:
LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO
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