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110 W DAYTON ST STE 1031/0 W Oq y row �'; s 103 FIRE PREVENTION CITY' OF EDMONDS SAFETY SURVEY 121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 • (425) 771-0215 FIRE DEPARTMENT 4'St. 1890 i FREQUENCY STATION &SHIFT LOCATION: 110 W. Dayton Street 103 730 17 C =y {�x BUSINESS NAME: Tile Maplewood Foundation PHONE: 4253273802 09101110 DATEEDUEE ► MAILING 110 W Dayton #103 UFIR ► 591 9202 ADDRESS: Edmonds 93020 BUSINESS OWNER: Hustler. Andy/Libby HOME PHONE: 4253273814 I EMERGENCY-1: HOME PHONE: KEY ACCESS-2: HOME PHONE: y PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: _5+<-A w FIRE FE 1 110 SYSTEMS. ANNUAL � HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS ENTER CODE ONLY ONCE ► VIOLATION CODE 1 1 2 2 3 3 4 ---m ... ..,.,.W .v... ... 4 5 . w.. p". 6 ..... ___. g 4 E ....... .... ,,......__,.e w ..d e... �.............�..�.m... �»,..,��w.,....A..e.--,..»-.........,.,,...,,...................w.....,...... .......,.,......,... ,..., ......m. _,.w...,.,,..._, .,......, ... .. .,...,. _...,.. _...,, ,....... ,. ,.. ......_ ... .,._... , _ .-... _ 7 .... 7 . ..,.�_.--........ ..w..... ,_..W.. w. .... _. ....,n�.wW� .�m� .�..a. _.... .W_..... ..... 8 8 1st RE -INSPECTION 12nd RE -INSPECTION EXTENSION FINAL RE -INSPECTION VIOLATIONS - DATE DUE: I DATE DUE: € b GRANTED TO: DATE DUE: CITED: PERSON IPERSON PERSON ' CONTACTED CONTACTED: [ CONTACTED 1 INSPECTOR * INSPECTOR: L INSPECTOR 2 t DATE DATE: �....... ._ DATE ...._m..._ 3__.. VIOLATIONS VIOLATIONS 3 PRE —ORATION LETTER SENT CITATION ISSUED 4.....__,,, 1 5 1 5 NUMBER CODE 2 8 2 8 DATE: SECTION:5 3 RETURN RECEIPT 3 ;7 t 3 17 RECEIVED 6 .,..e. ._... .,, »..,..»a.�..»�,.�... DISPOSITION t 4 i g 4 8 �' �yLETTER DATE• 7 ...�.. . _..__.�.a LETTER NEEDED YES ! ,; NO I NEEDED w. YES i 8 A FIRE DEPARTMENT COPY ;g