110 W DAYTON ST STE 204SNOHOMISIf CO.
FIRE
DISTR
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BUSINESS NAME:
MAILING
ADDRESS:
BUSINESS OWNER:
Email:
EMERGENCY-1:
KEY ACCESS-2:
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Serving Brier, Edrr, _ . - ___. - 12425 Meridian Ave S
Mountlake Terrace,and Everett, WA 98208 E BR ERNDS
the Town of Woodway Phone (425) 551-1200 ❑ WOODWAY
❑ MOUNTLAKE TERRACE
wwwFireDistrictl.org Fax (425) 551-1272 ❑UNINCORPORATED
FREQUENCY STATION & SHIFT
110 West Dayton Street Suite 204 98020 2 Year 13 17-B
Wbu-Systems USA 4257756900 SCHEDULED Sep
PHONE: 11,
110 West Dayton Street, Suite 204, Edmonds, WA 98020
HOME PHONE:
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE SYSTEMS: FE /
HOME PHONE:
V4C,pc�j ��HOOME PHONE:
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DATE DUE
UFIR 1 591
CURRENT CITY YES No
BUSINESS
LICENSE
INITIAL INSPECTION DATE
101U (L)
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
2
2
3
3
4
4
5
5
'6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
1
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
-
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ ;YES [INO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
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FIRE PREVENTION
CITY OF EDMONDS µ v SAFETY SURVEY
121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 • (425) 771-0215
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FIRE DEPARTMENT
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-. LOCATION:
110 W. Dayton Street
204
BUSINESS NAME:
NBU-SYSTEMS USA Inc.
PHONE:
4257756900
MAILING
110 W. Dayton St #204
" ADDRESS:
Edmonds
95020
-
1
BUSINESS OWNER:
Buchhett, MarGBllus
HOME PHONE:
2063553930
EMERGENCY-1:
Port Of Edmonds
HOME PHONE:
4257741511
KEY ACCESS-2:
Buchhalt-Ekdahl I_ISa
HOME PHONE:
2065464891
FREQUENCY STATION & SHIFT
730 17 C
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SCHEDULED O9lD1f1D
DATE DUE 1,
UFIR ► 591 9202
ACTIVE
lo
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: I
FIRE 5 FE
` SYSTEMS: } • ANNUAL
HAZARDS FOUND.AND LOCATIONS / COMMUNICATIONS
ENTER CODE ONLY ONCE ►
VIOLATION CODE
1Ki i. N6,1
N
1
3
3
5
5
6
6
7
7
8
8
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
PERSON
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
CONTACTED:
CONTACTED:
INSPECTOR:
DATE:
VIOLATIONS - -r_
CONTACTED: -
INSPECTOR:
1
INSPECTOR:
2
DATE:
DATE:
PRE -CITATION CITATION ISSUED
3
VIOLATIONS
1 5
1 5
LETTER SENT
NUMBER:
4
5
CODE
2
6
2 6
DATE:
SECTION:
_ RETURN RECEIPT
6
3
7
3 7
RECEIVED
DISPOSITION:
7
4
8
4 8
LETTER NEEDED YES []NO
DATE:
8
LETTER NEEDED ❑ YES E] NO
FIRE DEPARTMENT COPY
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