100 2ND AVE S STE 200i IIII��III
,` vU ZN,9 AvF F -oo FIRE PREVENTION
Serving Brier, 1,
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
'FIRFIRE
Mountlake Terrace,and
Everett, WA 98208
❑ EDMONDS
El BRIER
e Town of Woodway
thww.FireDistrictl.
Phone (425) SSl -1200
AY
❑ M O MOUNT
❑ MOUNTLAKE TERRACE
org
Fax (425) 551-1272
❑ UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION:
100 2nd Avenue S
200
731
17 B
BUSINESS NAME:
Law Offices of John Budlon
PHONE: 42567319U
SCHEDULED 11!®1/12
DATE DUE
MAILING
100 2nd Ave S ##200
UFIR ► 591 1202
ADDRESS:
Edmonds
98020
~ BUSINESS OWNER:
Eudlong, John
HOME PHONE: 2065423146
ACTIVE
EMERGENCY-1:
HohbeCh, Slarla
HOME PHONE: 206$181168
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE El 1:1
PERSON CONTACTED: JA. 1/� k INITIAL INSPECTION DATE
NAME OF INSPECTOR: ( i le,
r FE �I
SYSTEM; /i ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
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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:
DATE DUE:
CITED:
PERSON
PERSON
I
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
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INSPECTOR:
INSPECTOR:
INSPECTOR:
2
I DATE:
DATE:
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3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
4
1 5
1 5
LETTER SENT
NUMBER:
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
6
3
7
3
7
RECEIVED
DISPOSITION:
4
6
4
6
DATE:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
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FIRE DEPARTMENT COPY
--pc-
CITY OF EDMONDS
I
121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 • (425) 771-0215
FIRE DEPARTMENT
LOCATION: 100 2nd Avenue S
BUSINESS NAME: Lew Offices of John Budiang
MAILING 100 2nd Ave S #200
FIRE PREVENTION
SAFETY SURVEY
200
PHONE: 4256731944
I? ADDRESS: Edmonds 98020
;BUSINESS OWNER: i3Udlong, John HOME PHONE: 2065$23146
EMERGENCY-1: Hohbach, StSPia HOME PHONE: 2068181168
KEY ACCESS-2: HOME PHONE:
FREQUENCY
STATION 8 SHIFT
731
17 D
I
SCHEDULED
11l01110
DATE DUE ►
UFIR ► 591
ACTIVE
PERSON CONTACTED: LI Lv Lw (,,— INITIAL INSPECTION DATE
NAME OF INSPECTOR: T azeZ
FIF?F Ft 1
i SYSTEMS:
ANNUAL
•HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1• N� � I � UL�OW/ �uw�
ENTER CODE ONLY ONCE ►
VIOLATION CODE
1
2
2
3
3
4
4
5
5
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
8
DATE:
CODE
5SECTION:
3
7
3
7
RETURN RECEIPT
RECEIVED
8
7
4
8
4
B
DATE:
DISPOSITION:
-
1 8
LETTER NEEDED ❑ YES NO
LETTER NEEDED ❑ YES Ej NO
1
FIRE DEPARTMENT COPY