100 2ND AVE S STE 180IIII�lIII
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Serving Brier, Edn
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIREMountlake
Terrace,and
Everett, WA 98208
❑ EDMONDS
❑ BRIER
DI I TR
Town of Woodway
Phone (425) 551-1200
AY
❑ M O MOUNT
[3the
OULAKE TERRACE
www.FireDistrictl.org org
Fax (425) 551-1272
❑ UNINCORPORATED
S 1 /
FREQUENCY
STATION & SHIFT
LOCATION:
100 2nd Avenue S � A I
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(J4257743537
730
17 B
BUSINESS NAME:
Planned Giving Today �� r `' '
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SCHEDULED
DATE DUE 1 11,101/12
MAILING
100 2nd Ave S #180 �/`�
UFIR ► 591 1202
ADDRESS:
F_dmends 98020
BUSINESS OWNER:
SChoenhals, G. Roger
HOME PHONE: 4256729979
ACTIVE
EMERGENCY-1: HOME PHONE: CURRENT
KEY ACCESS-2: Kelly, Lenihan HOME PHONE: 4257120943 CITY YES NO
BUSINESS
LICENSE El 0
PERSON CONTACTED: ( (T— 1+- INITIAL INSPECTION DATE
1 NAME OF INSPECTOR:
FIRE FE �f___
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS //^COMMUNICATIONS
111A
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE.
2nd RE -INSPECTION
DATE DUE. 1t
EXTENSION
GRANTED TO,
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
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CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
4 VIOLATIONS
5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
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DATE:
DISPOSITION:
7
i LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TH AVENUE N. • EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
4'st 181 �
LOCATION:
100 2nd Avenue S
BUSINESS NAME:
Planned GMng Today
MAILING
100 2nd Ave S #180 ,
Iy
FIRE PREVENTION
SAFETY SURVEY
180
PHONE: 4257743837
ADDRESS: Edmunds 98020
BUSINESS OWNER: SChoenhels, C. Roger HOME PHONE: 4256729979
EMERGENCY-1: HOME PHONE:
KEY ACCESS-2: Kelly, Lenlhan HOME PHONE: 4257120943
FREQUENCY
STATION & SHIFT
730
17 D
DATE DUES ►
11"01110
UFIR ► 591
1'202
ACT1VE
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR:
91! w.Aa�Z-LV r 17 - 6- ) 0
FIRE
SYSTEMS:
FE
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
NON
ENTER CODE ONLY ONCE ►
VIOLATION CODE
4
2
2
3
3
4
4
5
5
6
6
7
7
8
8
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:
1
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
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
8
LETTER NEEDED ❑ YES NO
LETTER NEEDED I] YES ❑ NO
FIRE DEPARTMENT COPY
CITY OF EDMONDS
121 5TM AVENUE N. • EDMONDS, WASHINGTON 9W20 • (425) 771-0215
FIRE DEPARTMENT 6 C
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LOCATION: 100 2nd Avenue S
BUSINESS NAME:
MAILING 100 2nd Ave S #300
FIRE PREVENTION
SAFETY SURVEY
190
PHONE: 4259544055
ADDRESS. Edmonds 93020
BUSINESS OWNER: Dyer, Grace HOME PHONE: 4254781795
EMERGENCY-1: Schaefer, Donna HOME PHONE: 4253393638
KEY ACCESS-2: HOME PHONE:
01 FREQUENCY
STATION 8 SHIFT
730
17 D
I
SCHEDULED
DATE DUE ►
11/01/10
UFIR ►
ACTIVE
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR: l , v✓J A f9-9 -P- O
FIRE FE 7 /10
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS ENTER CODE ONLY ONCE ►
VIOLATION CODE
2
2
3
3
4
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5
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In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the City of
Edmonds.
You are to be congratulated on the relative good condition of your occupancy in regards to fire safety. Above you
will find the item(s) that were noted during our inspection which require attention to bring them into compliance
with the minimum standards adopted by the City of Edmonds.
Please call (425) 775-7720 within 30 days to schedule a reinspection.
Any overlooked hazards or violations of the fire regulations does not imply approval of such condition or violation.
If you require additional information or assistance, please contact this office by calling (425) 775-7720 between
the hours of 8 a.m. and 5 p.m., Monday through Friday.
BUSINESS COPY