1048 WALNUT STSNO11OMISH CO. Serving Brier, Edmonds, and
Mountlake Terrace
FIRE
DISTRT www FireDistrictl. org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION1048 Walnut Street
98020
2018
17-C
BUSINESS NAMEGTE Exchange Bldg
PHONE:
4257784600
DATE DUEED► Jun 2018
MAILING
UFIR 1, 634
ADDRESS1048 Walnut Street, Edmonds, WA 98020
BUSINESS OWNERpodgorny, Kit
HOME PHONE:
EMERGENCY -'GTE Everett Office
HOME PHONE:
4257784600 CURRENT
KEY ACCESS4
HOME PHONE:
17
CITY YES NO
BUSINESS ❑
EMAIL:
LICENSE
b
PERSON CONTACTED:
INITIAL IONSC2 N DATE
NAME OF INSPECTOR:
FIRE SYSTEMS
D
FE 6/13
HAZARL1S FOUND AND LOCATIONS / C,/O�M,MUNICATIONS
2
2
3
3
4
4
5
5
6
6
7
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:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE: -
DATE:
DATE:
3
VIOLATIONS
1 5
2 6
VIOLATIONS
1 5
2 6
3 _ 7
4 8
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
DATE:
CODE
SECTION:
5
3
7
RETURN RECEIPT
RECEIVED
6
4
8
DATE
DISPOSITION:
e
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES �❑ NO
G _ .