105 5TH AVE Sr _ _
° 5
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FIRE PREVENTION
Serving Brier, Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
SNOIiOMISi3 CO.
Mountlake Terrace
FIRE
.Everett, WA 98208
❑ BRIEREDMOS
❑BRIER
Phone (425) 551-1200
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
DISTRT
www FireDistrictl. org
Fax (425) 551-12 %2 .
FREQUENCY
FREQUENCY
STATION & SHIFT
LOCATION: 5 th Avenue S 98020
it
2018
17-A
BUSINESS NAME:
Cline Jewelers ,
PHONE: SCHEDULED
4256739090 DATE DUE ► May 2018
MAILING
UFIR ► 544 203
ADDRESS:105 5th Avenue S Edmonds WA 98020
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BUSINESS OWNERCIine, Jerry/
HOME PHONE:
EMERGENCY-1 Cline, A dy
KEY ACCESS-2: /
HOME PHONE: 2068717979
HOMEPHONE:
CURRENT
CITY YES NO
I 17
EMAIL: i S )'1 \ I ) C
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
l
NAME OF INSPECTOR:
FIRE SYSTEMS: FE 2/16
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LOA
oLuo
LOCATIONS / COMMUNICATIONS
2
2
3�v' `(v
4
3
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
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3 7 .-
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PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
DATE:
CODE
SECTION:
8
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3
7
RETURN RECEIPT
RECEIVED
8
4
-
18
DATE:
DISPOSITION:
7
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LETTER NEEDED ❑ YES 0 NO
LETTER NEEDED ❑ YES ❑ NO
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