10016 EDMONDS WAY STE DIII I�� III 1601(p FD1)')0ti0�f W /ly J 7-f-
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F
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Serving Brier, Edmonds, and
Mountlake Terrace
I
www.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
PrEDMONDS
BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATIONA0016 Edmonds Way Suite D 98
2018
20-B
BUSINESS NAM Subwa�228011 .� 1��r. PHONE: (425478185$'ATEDUEED
Feb 2018
MAILING
UFIR / 513 54
ADDRESS:10016 Edmonds Way, Suite D, Edmonds, WA 98020
BUSINESS OWNER: E PHONE:
/
EMERGENCY-lHollek, Mathew HOME PHONE: 2532A82,543
CURRENT
YES
KEY ACCESS-2: HOME PHONE:
CITY `NO
BUSINESS
EMAIL:
LICENSE
PERSON CONTACTED: D.- p+
INITIAL INSPECTION DATE
% 1
NAME OF INSPECTOR:����
�(4/15
FIRE SYSTEMS: J
Date Last Serviced:
HAZARDS FOUND FOUND AND LOCATIONS / COMMUNICATIONS
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2
3 _.. �— W.-- ---
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3
5—
5
—_ _
7
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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:
PERSON
CONTACTED:
INSPECTOR:
EXTENSION
GRANTED TO:_
FINAL RE -INSPECTION
k DATE DUE:
-~PERSON
�, CONTACTED:
I� INSPECTOR:
VIOLATIONS
CITED: .. .
`
2
PERSON
CONTACTED:
INSPECTOR:
DATE:
DATE:
'
DATE:
3
VIOLATIONS
1 5
2 -_ - 6
3 `7
- -
LETTER NEEDED ❑ YES ❑ NO
VIOLATIONS
1 5
PRE -CITATION --CITATION ISSUED
LETTER SENT NUMBER:
CODE
DATE: SECTION:
RETURN RECEIPT
RECEIVED
DISPOSITION:
4
5
5
8
2 6
!
3 7
- --
LETTER NEEDED ❑ -YES ❑ NO