7500 212TH ST SW STE 115 (2) - 5pgs_Redacted-;rt?++.r: i� .�'� .'�l• '7,: •.^xR-'.wnivm?tr., i, ,......r..nryn„r c- - .c,-'n P.•i. '� 'hr �.,% _ i_ ?+`fir"., -s .Ys.1"v `T'rm;"„�N>:-'S'":7yN`.. S'I1w:W ,.x �.,--r�;aq„fie
J 0b ,S'T� FIRE PREVENTION
Serving Brier, Gamonds, and 12425 Meridian Ave S INSPECTION REPORT
SNOFIOR9ISIi CO. � ,� ❑ EDMONDS
FIRE'S �,� Mountlake Terrace Everett, WA 98208 ❑BRIER
DISTRI Phone (425) 551-1200 ❑ UNINCORPORATED
AKE TERRACE
www.FireDistrict].org Fax (425) 551-1272 ❑UNINCORPORATED
LOCATION: EENCY STfe&SHIFT
7500 212 th Street SW Suite 115 98026
Touchstone Manual Therapy, Inc 4257754778 SCHEDULED Dec 2016
BUSINESS NAME: PHONE: DATE DUE
MAILING 7500 212th Street SW, Suite 115, Edmonds, WA 98026 I
FIR /
ADDRESS:
BUSINESS OWNER: Clay, Diana HOME PHONE:
Clay, Ken 4257761.234 �""
EMERGENCY-1: HOME PHONE: CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
PERSON CONTACTED:
EMAIL: BUSINESS El❑
LICENSE
INITIAL INSPECTION DATE
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NAME OF INSPECTOR: �✓� /°(? %�G- (�%Vi �/ UcTFIAS:
._
Date Last Serviced:
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2 C 62 M✓ 7 X 7_1( VIV Cv/ S! d�1� L "Z
3
4
5
6
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION 2nd RE -INSPECTION
DATE DUE- DATE DUE* _
PERSON PERSON
CONTACTED: CONTACTED:
INSPECTOR: INSPECTOR
DATE: DATE.
2
3
4
.____ . ._ . _ 1.5
6
7
EXTENSION i FINAL RE -INSPECTION VIOLATIONS,
GRANTED TO: DATE DUE- _ CITED:
VIOLATIONS
VIOLATIONS
-
PRE -CITATION
1 5
1 5
LETTER SENT
2 6
2 6
DATE.
'
RETURN RECEIPT
3 .7
3 7
RECEIVED
4 8
4 8
DATE
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
PERSON
CONTACTED
2
€ INSPECTOR: -
°3
DATE:
CITATION ISSUED
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4
NUMBER.
CODE
5
SECTION
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DISPOSITION
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Brier: Edmonds
12425 Meridian Ave S
srroxomiCO.Serving
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FIRE- Mountlake Terrace, and
Everett, WA 98208
the Town of Woodway
DIS�� T
Phone (425) SSI -1200
www.FireDistrictl.org
Fax (425) 551-1272
LOCATION: 7500 212th Street
SW 115
BUSINESS NAME: �` ,� ��—^ '�.ry,
r�� PHONE: 4257787277
MAILING 7500 212th St S'Ifi3 #115
ADDRESS: Edmonds
Wn A 67 Kr
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95026 7 / 5"- 43g 7
BUSINESS OWNER:
HOME PHONE:-a@t4�'9'
EMERGENCY-1: ,-�'
KEY-ACCESS-2:
HOME PHONE: s�4ppr�r1
HOME PHONE: � `�O''%0Z
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FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ WOODWAY
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
730 16 D
SCHEDULE
DATE DUE D 12/0 /11
UFIR ► 591 1i157
ACTIVE
CURRENT
CITY
BUSINESS
LICENSE
INITIAL INSP Cl
PERSON CONTACTED: l�lCi 1 `�I •"+�IG+j"dJ
NAME OF INSPECTOR: v1
FIRE FE -_ !
SYSTEMS:, ANNUAL
YES NO
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
2
2
I
3
3
i
a4
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:
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
e
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
CITY OF EDMONDS
BUSINESS LICENSE APPLICATION- COMMERCIAL
FEE: $125.00
CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION
121 5TM AVENUE NORTH, EDMONDS, WA 9 020 PHONE: 425.775.2525
_ OFFICE USE ONLY
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Cus
SIC
Year
Gass
SHD
Date Paid
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Fee lb
Mailed
Delete
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.
BUSINESS NAME 1 OLICrT6TU(X- IY 1at)UCLL IT\Q
BUSINESS ADDRESS +SOO a l Cam ���� � UJ � ! � S � ��VJ
Street , ^ Suite No. Zip Code
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MAILING ADDRESS f • 6. dO� �Y� �drnonC6' Wft q8ow
Street or PO Box Suite No. City, State and Zip Code
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BUSINESS PHONE NO. ( S y �� SnLi�1% 8 WA STATE TAX ID NO. (UBI NO.) d C Owl 4 / l5Sa_
BUSINESS E-MAIL t-kCt jSkj �1Q (d'PC�1 -Cn C.Un BUSINESS WEBSITE /VON 6
PROPERTYOWNER _ Ma.t, `PnbLr --WS (L%aS ) �'�j' 12aH
Nahie Phone Number
EMERGENCY NOTIFICATION (For Premise Access in Emergency):
�►ana, I K.fn
Last Name First Na a M1
Phone No.
Last Name First Name Mi
Phone No.
NATURE OF BUSINESS
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NUMBER OF EMPLOYEES {� SQUARE FOOTAGE OF BUSINESS SPACE J2-j
22
Tcl
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TYPE OF BUSINESS - PLEASE CHECK THE APPROPRIATE CATEGORY:
O CONSTRUCTION O FINANCE, INSURANCE, REAL ESTATE O LANDSCAPE, HORTICULTURAL
O MANUFACTURING
O NON-PROFIT
i
O RETAIL O SECONDHAND DEALER 34 SERVICES O WHOLESALE O OTHER
AMUSEMENT DEVICES ON PREMISES? O YES $ NO IF YES, TOTAL NUMBER
LIQUOR SOLD ON PREMISES?: O YES "0 GAMBLING? O YES 1 LN0 CIGARETTES SOLD ON PREMISES?
OYES .II' NO
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YES QMO IF YES, PLEASE PROVIDE LIST OF MATERIALS AND QUANTITIES:
PROPOSED OPENING DAY OF BUSINESSkafif4 f.( tOC( Qf) BUSINESS HOURS ! ,�
DAYS OPEN OSUNDAY CTMONDAY -ETUESDAY-9-WEDNESDAY-A'THURSDAY $fRIDAY $SATURDAY
PARKING SPACES ON SITE: TOTAL (6I ACCESSIBLE FOR PERSONS WITH DISABILITIES _
DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE TO PERSONS WITH DISABILITIES? MYES O NO
PREVIOUS BUSINESS USE AT THIS ADDRESS (Aniff jxAX1
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--------------
1r-- -4-
5UITE 115
523 S.F.
Suite 115
7500 Building
LYNNWOOD, WASHINGTON
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Partners
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ArchitecturalDesignGroup, Inc.
WAOMMM
PROJECT: 1600 BUILDING
LOCATION: EDMONDS, WASHINGTON
DATE: AUGUST 15, 2014