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FIRE PREVENTION,
SNOHOMISH CO. Serving Brier, Edmonds, and 12425 Meridian Ave S IWAECTION REPORT
Mountlake Terrace Everett, WA 98208 4!J EDMONDS
FIRE D BRIER '
Phone (425) 551-1200 EI MOUNTLAKE TERRACE
DISTR' T www.FireDistricti.org Fax (425) 551-1272 0 UNINCORPORATED
r' FREQUENCY STATION I, SHIFT-I's
LOCATION: 110 Main Street Suite 101 98020 2015 17-D
BUSINESS NAME: Center for Structural Medicine PHONE: 4257742804 SCHEDULED
DATE DUE ►Nov20115
MAILING UFIR o 593 202
ADDRESS: 110 Main Street, Suite 101, Edmonds, WA 98020
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: Davis, Bruce HOME PHONE: 4257742804 "7CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES No
EMAIL: (.fo' r\ 1 0 paT N lbw V Kft'L_ BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
-T'Ar < 11 A -
NAME OF INSPECTOR:
_j
FIRE SYSTEMS: FE 2/13
Date Last Serviced:
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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4
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5
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J AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE: 15
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
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PERSON
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LETTER SENT
NUMBER:
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CODE
SECTION:
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DATE:
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RETURN RECEIPT
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RECEIVED
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DISPOSITION:
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DATE:
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LETTER NEEDED ❑ YES 0 NO
LETTER NEEDED 0 YES [I NO
8
CITY OF EDMONDS
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BUSINESS LICENSE APPLICATION- COMMERCJaL"`'"
FEE: $125.00 OCT 07 2013
CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION
one, i89� 121 5TH AVENUE NORTH, EDMONDS, WA 98020 PHONE: 425.775.2525 1
EDMONDS CITY CLERK i
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INSTRUCTIONS: Please complete the application in full and attach the required floor plan. Middle Initial or name required of all
parties concerned. If no middle name, please Indicate by writing NMN. Sign and return application with fee. Please advise of
any -change In status. New license required If business changes location or ownership. Notification to City of Edmonds required
If business closes.
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BUSINESS ADDRESS r� !/(Q • .'ICI
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NATURE OF BUSINESS
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NUMBER OF EMPLOYEES / SQUARE FOOTAGE OF BUSINESS SPACE 't9r— /. p e e _ LS. F • I I n al t'1
TYPE OF BUSINESS - PLEASE CHECK THE APPROPRIATE CATEGORY: ' �..11
O CONSTRUCTION FINANCE, INSURANCE, REAL ESTATE O LANDSCAPE,,HORTICULTURAL O MANUFACTURING O NON-P i
O RETAIL O SECONDHAND DEALER O SERVICES O WHOLESALE O OTHER
AMUSEMENT DEVICES ON PREMISES? Cl YES IF YES, TOTAL NUMBER 'L
LIQUOR SOLD ON PREMISES?: O YES IWLIO GAMBLING? O YES WNO CIGARETTES SOLD ON PREMISES? O YES
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YESWO IF YES, PLEASE PROVIDE LIST OF MATERIALS AND QUANTITIES:
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PROPOSED OPENING DAY OF BUSINESS 1 Oi (_ (1 BUSINESS HOURS Z] --co �S •� 1 ��f
DAYS.OPEN SUNDAY XJMONDAY )CTUESQAY �WEDNESDAY (THURSDAY XFRIDAY *SAT:URQAY' 1�
PARKING SPACES ON SITE: TOTAL. ACCESSIBLEtFOR PERSONS WITH DISABILITIES -
DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE TO PERSONS WITH DISABILF ES? YES. O NO
PREVIOUS BUSINESS USE AT THIS ADDRESSV+('1fL'
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Revised 14 Aug 2013
New Office for.
Edmonds Realty
Planning by:
Everett Office Fumiture
15-Aug-13 Scale 1/8"=V-0"
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Edmonds Realty
111 Main Street, Suite #101
Edmonds WA 98020
October 2, 2013
Ms. Huda Olsen
Business License Clerk
City of Edmonds
12151h Avenue N.
Edmonds WA 98020
Re: Transfer of Business License — Edmonds Realty
Dear Ms. Olsen:
Enclosed are the following:
• Business License Application — Commercial
• Our Check in the Amount of $125.00 to cover transfer fee
• Copy of floor plan
Please note that Edmonds Realty has, effective October 1, 2013, vacated the space that it
occupied at:
1233 Olympic View Drive
Edmonds WA 98020
Any questions, please do not hesitate to contact me at #425-921-2200.
Very truly yours,
Edmonds Realty
By: Lucille: Noel
Its: Vice President
Enc.
SNOHOMISH CO.
Serving Brier; Edmonds, and
- Mountlake Terrace
FIRE
DISTR T www.FireDistrictl.org
FIRE PREVENTION
12425 Meridian Ave S
INSPECTION REPORT
Everett, WA 98208
EDMONDS
BRIER
Phone (425) 551-1200
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
Fax (425) 551-1272
LOCATION: 110 Mait) Strut Suite 101 DW20
BUSINESS NAME: Ccnlcr lar Slrudural Mcdir inc PHONE: 426�42804
MAILING
ADDRESS: 110 Main 51rCCL Sui1C 1fl1, Ed man&, )NA 0,4020
BUSINESS OWNER: HOME PHONE:
FREQUENCY I STATION & SHIFT
2 Year 13 17-B
SCHEDULED
DATE DUE ►Nav2013
UFIR RBS
V EMERGENCY-1: DjWS. RrU(;c HOME PHONE: 4,)5774:,)804 CURRENT
u KEY ACCESS-2: L HOME PHONE: CITY YES NO
{� EMAIL: .E f c"h 1 D ► LZU1. �64M I . C0%'1 LICENSEBUSINESS
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PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR:
a` FIRE SYSTEMS: FE Z! 13
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:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
F>
2
F)
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
g
FIRE DEPARTMENT COPY
+.E CITY OF EDMOND'S
121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
�St. 1890
LOCATION: 110 Main Street 101
BUSINESS NAME: Center for Structural Medicine Inc, PHONE: 4257742804
MAILING 110 Main St #101
ADDRESS: Edmonds 98020
BUSINESS OWNER: Davis, BruCe HOME PHONE: 4257742804
EMERGENCY-1: Davis, Monika HOME PHONE: 4253150555
KEY ACCESS-2: HOME PHONE:
0
! FIRE PREVENTION
SAFETY SURVEY
' FREQUENCY
STATION & SHIFT
730
17 C
SCHEDULDATE ►
11/01/10
DUES
UFIR ► 593
1202
ACTIVE
PERSON CONTACTED: /�
e t1 f e, INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE FE IfL
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATI NS
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/le/Oi�CeCU ULtgii 0
Re
ENTER CODE ONLY ONCE to
D/cJ
VIOLATION CODE
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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:
1
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
7
4
8
4
8
*
DATE:
DISPOSITION:
g
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED [—I YES NO
FIRE DEPARTMENT COPY