7533 OLYMPIC VIEW DR STE A.pdfSNOIiOMISIi CO.
FIRE
rr
III ICI III � � 32 o1' yMPxC Vzecj � � S7
FIRE PREVENTION
Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
Afountlake Terrace Everett, WA 98208 ❑ ❑ BEDMORIER BRIER S
Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE
1 ❑ UNINCORPORATED
DIL-gJ JM.av Z www.FireDistrictl.org Fax (425) 551-1272
7533 Olympic View Drive Suite A 98020.
LOCATION -
Star Mini Mart & Deli 4257783663
BUSINESS NAME: PHONE:
MAILING7533 Olympic View Drive, Suite A, Edmonds, WA 98020
ADDRESS:.
BUSINESS OWNER: HOME PHONE:
Nasif, Samir 2538808699
EMERGENCY-1: HOME PHONE: 16
KEY ACCESS-2: HOME PHONE:
EMAIL:
PERSON CONTACTED:
F PECT I
Date Last Serviced: ��� 0
FAMUENCY STATI SHIFT
Dec 2017
SCHEDULED
DATE DUE5f2
UFIR /
CURRENT
CITY YES NO
BUSINESS -
LICENSE 1:1 ff
INITIAINSPECTION DATE
HAZARD�XOLIND AND LQCATIONS/COAQMUNICATION
�i.�
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
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
E)(TENSION
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
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
6
4
$
DATE:
DISPOSITION:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8