1067 5TH AVE S (3).pdf/9
FIRE PREVENTION
",;SerXing Brier, Edmonds,'
SNOHOMISli CO.
and 12425 Meridian Ave S
INS!�ECTION REPORT
FIR" Mountlake -7errcke--;-"-�:'-:
Everett, WA 98208
15514200
9-LtbMONDS
0 BRIER
Phone (425)
0 MOUNTLAKE TERRACE
[1 UNINCORPORATED
DISTIL
rf trict]. org
Fax (425) 551-1272
Anniml 17-17)
enVuYfAT2qis
I
f FREQUENCY
STATION& SHIFT
LOCATION
Gardenview Condo's
4 1
Dec
2017
BUSINESS NAME:
PHONE:
-
SCHEDUDATE DU 153
&
1067 5th Avenue S, Edmonds, WA 98020
MAILING
FR 10
ADDREssLarry Bach
BUSINESS OWNE lowell/Mcintosh
HOME PHONE: 42'
EMERGENCY-1:
HOME PHONE: 17
CURRENT r
CITY 0
KEY ACCESS-2:
HOME PHONE:
BUSINESS
ET
EMAIL:
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
FIRE SY84EFAMPPECY p 1/17
Date Last Serviced :'w�.Vf.a
r
HAZAEIDSIFOUND'VbLOCATIONS /Q0MM NICATIONS
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
1 st 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:
LETTER NEEDED F] YES El NO
LETTER NEEDED [:] YES ❑ No