102 5TH AVE N STE Bn11-
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FIRE PREVENTION
SNOIiOMISH CO.
Serving Brier, Edmonds, and
Terrace
12425 Meridian Ave S
Everett, WA 98208
INSPECTION REPORT
A EDMONDS
❑BRIER
FIREMountlake
/
DISTRT
Phone (425) 551-1200
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
www.FireDistrict].org
Fax (425) 551-1272
LOCATION102 5 th Avenue N Suite B 98020
BUSINESS NAMEPelindaba Lavender Edmonds PHONE: 425
MAILING 4.25
ADDRESS902 5th Avenue N, Suite B, Edmonds, WA 98020
BUSINESS OWNERReddick, Lisa HOME PHONE:
EMERGENCY-1Atkins, Robert . o E: 4256721657
KEY ACCESS-2: ]� pp �q bF Cd M HOME PHONE: 17
EMAIL:"• \ A _
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS: FE 2/17
Date Last Serviced:
FREQUENCY I STATION & SHIFT
2018 17-B
SCHEDULED Jun 2018
DATE DUE
UFIR / 519 203
CURRENT NO
CITY
BUSINESS
LICENSE
INITIAL INSPECTION DATE
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HAZARDS FOUND AND LOCATIONS / CfMMUNICATIONS
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2
2
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X l
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
b
EXTENSION
GRANTEDTO:
FINAL FIE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
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2 6
3 7
4 8
VIOLATIONS
1 5
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2 6
3 7
4 8
PRE -CITATION
LETTER SENT
DATE:
RETURN RECEIPT
RECEIVED
CITATION ISSUED
NUMBER:
CODE
SECTION:
4
X_
6
DATE:
DISPOSITION:
•--...��._.__..._..�-
LETTER NEEDED ❑ YES ❑ NO
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LETTER NEEDED ❑ YES ❑ NO
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