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7500 212TH ST SW STE 218 (2)-9pgs_Redactedr, ' illl��lll RECEIVED 7 5-oo 2'Z4-' J''' f,,j CITY OF EDMONDS AUG 2{l17BUSINESS LICENSE APPLICATION —COMMERCIAL FEE: $125.00CITY CLERK'S _ t5®11' ONDS v ITYClI H A ENUE14ORTOHF EIDMONDSI?� H , WA 980ONE 1SION 4255.775.2525 —07 Z18 ❑ gineering /Pi, anning lice OFFICE USE ONLY BL# Customer # Tc SIC I Year Cias I SHD I Date Paid -3-/ TR# QD�(v0�-oas i�,r Mailed Deleted INSTRUCTIONS: Please complete the appllcatton In full and attach the required floor plan. Middle Initial or name required of all partles concerned. If no middle name, please Indicate by writing NMN. Sign and return applicaflon with fee. Please advise of any change In status. New license required If =b I ess changes location or ownership. Notification 10 City of Edmonds required if business closes. License expires December 31" each year. Renewal must be submitted prior to January 31" to avoid late foes. BUSINESS NAME IRQI n C ,\�U BUSINESS Street IdAILING AbDRtSS City, Slato, Zip [] ` (�/j aStreet or PO Box g Sultry # �( ,, j j City, State, Zip Code BUSINESS PHONE( i ��/J� 1 1`i 1• I t l� WA STATE TAX ID #((UUBII)) I� O l i^!_ t I I 1 1,\ I X I Z 13 1,37 c BUSINESS E-MAIL I `ii �arlm M i��EA l/° i1U�1 BUSINESS WEBSIT fa 021i�11()p_.l�_..JJ(SCUVI_I �1 ra IndhA_ aw BUSINESS OWNER/MAIN CONTACT 7 I ► 'Y(�Dl (�2� 1 Ci`•-i•"! . / / LZS Name Phone Number PROPERTY - Name EMERGENCY NOTIFICATION (For Premise Access in Phone Number Last Name First Name MI `,, Phone Number NATURE OF BUSINESS (Provide a Detailed Description of Business Activities, Products & Services): 1 V(1 Y 1t�� V'1n � /` \n1�..i /'1.J :._ .,. I n e t n ►_�... .1 r'i7',-1'�'11t� \ `/ SPACE ALTERATIONS TO BE MADE: YES_NO DESCRIPTION PREVIOUS BUSINESS AT THIS ADDRESS_ NUMBER OF EMPLOYEES I SQUARE FOOTAGE OF BUSINESS TYPE OF BUSINESS - PLEASE CHECK APPROPRIATE CATEGORY: ❑ CONSTRUCTION ❑ FINANCE, INSURANCE, REAL ESTATE ❑ LANDSCAPE, HORTICULTURAL ❑ MANUFACTURING ❑ NON-PROFIT ❑ RETAIL 0 SECONDHAND DEALER J1 SERVICES ❑ WHOLESALE ❑ OTHER PROPOSED OPENING DATE:_n / 11114 1 1 BUSINESS HOURS: Ivy) - (,Q QT Y(1 DAYS OPEN: SUNDAY EDNESDAY MONDAY HURSDAY ERIDAY ))(TUESDAY X SATURDAY AMUSEMENT DEVICES ON PR MISES? YES NO& —IF YES, TOTAL NUMBER LIQUOR SOLD ON PREMISES? YES NO, z GAMBLING? YES_ NOCIGARETTES SOLD ON PREMISES? YES No FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED? YES NO IF YES, PLEASE PROVIDE A LIST OF MATERIALS AND QUANTITIES: PARKING SPACES ON SITE: TOTAL SPACESACCESSIBLE SPACES FOR HANDICAP PARKING I Al .S_ DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE TO PERSONS WITH DISABILITIES? YES- NO DATE � + Z u ien a N NAME Qa-?Lm � IL&na (I MAST RR 1 '� fiT MIDDLE INITIAL .NIARPR6 ?In l4 IR2�a �1 R!CM A 011 U 19 q M' l 2 PARTNERSHIP- PARTNER 7 NAME IA6 I EMT MIDDLE INRIAL ADDRE68 STREET 6UITEIPPTNNITtl CRYRTATE2PCOOE HOME PHONE I 1 NEED LICENSE OR ID R 6 STATE DATE OF BIRTH CDYISTATE OF DIRT COUNTRY OF OWN P P-PARTNER2 NAME LAST Raw MIDDLE INTIAL ADDRESS STiEFf SOR£/MrNNITp CRY/$TATERIPCODE HOME PHONE( WVERSLICENWOROX&STATE DATEOFWRTH CRYIWATE OF BIRTH CWNRIY OF MRTLE I NAME OFCORPOPATI COIPMDRESS CORPORATIONI LLC or PLLC ERALTAXOR Strael CORPORATE OPFICENB: IeN Noma Pom NeaN . ,Apl."A City. SIMa and➢aCode Plrone Number The OeNNBHA Drivers Lkema or Dow DN/Sbb LOGLCOMACT Iadhan" Far Name MI Ttla DgorNM � I Odmfs Lkbm m ODb W /SWf Plans Numbb CRY lum ONLY: BUILDINGDE T. O APPROVE O DISWPRDVE MTE SIGNATURE OCGIPAM LOAD aUIDWO PERMT OCCUPANCY GROUP COMMENTS . ENWIEERING Q APPROVE O DISPPROVE DATE SIGNATURE FIRE DEVT. APPROVE d DISWPROVE MTE SGNATURE PLANNNG DIRT, Q APPROVE El DISAPPROVE ZONING CODE CWDDN]NALUSEPER POLICE DEPT. d WPROVE O DISAPPROVE �jOtt�nreom i n �X-hn CJt��S�n�r �I lv�a,�.{ STATE OF WASH I NGTON DEPARTMENT OF LICENSING — BUSINESS AND PROFESSIONS DIVISION . THIS CERTIFIES THAT THE PERSON OR BUSINESS NAMED BELOW IS AUTHORIZED AS A LICENSED ARTIST OPERATOR PERMANENT COSMETICS JOANNA CAROLYN MARZA 5199 License Number 'L-630-159(RM1 Al 03/03/2017 03/03/2018 Issued Daze Expiation Date Pat Kohler. Director a CITY OF EDMONDS BUSINESS LICENSE APPLICATION - COMMERCIAL FEE: $125.00 r.,.: CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION 121 5T" AVENUE NORTH, EDMONDS, WA 98020 PHONE 425.775.2525 OFFICE USE ONLY Or BL# Customer # CIA SIC Year,., ?�is Class SHD Date Paid �I �11 TR# mss 6-GOO1 Fee Mailed Deleted 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 it business closes. License expires December 31" each year. Renewal must be submitted Rrlor to January 31" to avoid late fees. BUSINESS BUSINESS MAILING ADDRESS_... MCI Stre�elll or PO Box # Suite # �' ��j�'Citty. State. Zip Code BUSINESS PHONE( Lv' Z� t 2 0 S 'b SDt-' WA STATE TAX ID # (US)) I / ., I / 7 I (1 I I ► I `2, 1 � )�'' LSCL1 v � �J LJ_Ly1_I •) 1 BUSINESS E-MAIL i r Vl �l V �J �� BUSINESS WEBSITE �� 1A mat torn 1cn �� 12ca c _S Phone BUSINESS OWNER / MAI CONTACT Name ,^ Phone Number PROPERTY OWNER Ds-ob `31 -n(_-r LA- Name I Phone Number 7 NOTIFICATION (For Premise Access In last rneme First Name NATURE OF BUSINESS (Provide a Detailed Description of Business Activities, Products S SPACE ALTERATIONS TO BE PREVIOUS BUSINESS AT THIS ADDRESS �) l 1(L P lQ W I' \ NUMBER OF EMPLOYEES SQUARE FOOTAGE OF BUSINESS TYPE OF BUSINESS - PLEASE CHECK APPROPRIATE CATEGORY: O CONSTRUCTION ❑ FINANCE, INSURANCE, REAL ESTATE ❑ LANDSCAPE, HORTICULTURAL In MANUFACTURING D NON-PROFIT ❑ RETAIL ❑ SECONDHAND DEALER SERVICES ❑ WHOLESALE ❑ OTHER Phone Number PROPOSED OPENING BUSINESS HOUc>h L' r �JA � otlG� v, DAYS OPEN: R-SUNDAY 1N I-WEDNESDAY it-MONDAY 'ETHURSDAY ,CTUESDAY t>✓FRIDAY yl'SATURDAY AMUSEMENT DEVICES ON PRE V ISES? YES NO IF YES. TOTAL NUMBER- _ -�--LIQUOR SOLD ON PREMISES? YES NO GAMBLING? YES_ NO CIGARETTES SOLD ON PREMISES? YES No FLAMMABLE OR HAZARDOUS MAT RIALS USED OR STORED? YES NO IF YES, PLEASE PROVIDE A LIST OF MATERIALS AND QUANTITIES: PARKING SPACES ON SITE: TOTAL SPACES�l N �� 4fCESSIBLE SPACES FOR HANDICAP PA ING DOES THE BUSINESS CONTAIN AN ENTRANCE ACCE SIB E O PERSONS.WITH DISABILITIES? YES= NO SOLE PROPRIETORSHIP NAM IPST FIRST NICOLE INITIAL ADDRESS STM.ET SUITEIAPTIUNITF C"WATE/lWCOE HOME PHONEI_.I CRIVERSLICEN8ECANDO&OTATE DATE OF BSTH C"WATE OF aBON CIXRRRYCF BOtTX PARTNERSHIP— PARTNER B NAE IAB'r FIRST AYOOLEINDML oDRe53 MEET SVrtFJAPTNNRp CRYSTATE?IDCOOE HOME P40NE1 f ORNERB LICENSE OR IO e S STATE DATE OF BIRTH CITOSTATE OF BIRTH COUNTRY OF PIRTH PARTNERSHP — PARTNER 2 N ME u9r Fwsr LvonE INRML POONE59 STREET SUITE/ApTNNITq CT'STATGJLP CODE HOME PHOME wnrflYS LCENSE OR ID 38 STATE CATEOFBMM CRTASTATE OF@tl MINTRYMOVETHI CORP RATIO LC or PLLCL L NAME OFCORPOMTpN S4'M ItA"APSC �I�Iy1 Rf��h �EEHALT/YRS TI.�'�IGTI�I corF OORE83 g,I �i0q5j IN fLA try{IiC WA 91 oqp r4zST 7T'c xboy SAWN 8ub.AM.UBE CIy.81aMaMLpCaM Phone Numw CORPCMTE OFFICERS: UFO;�mtrlC FMNena MI TNf qM MN� Oi. �r� 41nf� MfmhfP ��y_f19g0 LOCAL CONTACT 2'1C hrn CCl , nCA �)nYl �I�I II411" GG10 MI Tlb D BiN kSu� Dinar. Mwa.. a 1425 T 705 Pha. xamMH CFFYINGEONLY: BI imm DEPT. IM APPROVE O DISA PIDVE OCCUFANrLDAD BULDwOPERMIT OCCUPANCY DRaur COMMENTS ENGINEERING APPEOVE DISAPPROVE WTE EEiNTEE FIRE DEPT. APPROVE DISAPPROVE DATE SIGNATI1RE PIANNINGEPE. Q RFFROVE O MUPPRDVE MTP SN3NATURE WNINGCODE CO MONLLVSEPERMR CONNBRS POLICE BE".. ED ADRIOVE Q DISAPPR0VE DATE saspo IRE FIRE PREVENTION ng Brier, Edmonds, and 124N Meridian Ave S INSPECTION REPORT SNOHONIISH CO. Se"' 0 EDMONDS Mountlake Terrace:;' i Everett, WA 98208 0 BRIER FIRE A Phone (425) 551-1200 [1 MOUNTLAKE TERRACE "T El UNINCORPORATED A XV a www.FireDistrictl.org LOCATION: 7500 212 th Street SW Suite 218 98026 BUSINESS NAME: Infoman Inc. Fax (425) 551-1272 PHONE: 4256739299 MAILING ADDRESS: 7500 212th Street SW, Suite 218, Edmonds, WA 98026 BUSINESS OWNER: HOME PHONE: FREQUENCY T—STATION & SHIFT 2016 1 16-B SCHEDULED Dec 2016 DATE DUE I` 591 UFIR Burgess, John 2069549865 r EMERGEN&-l: HOME PHONE: CURRENT KEY ACCESS-2': HOME PHONE: CITY YES NO BUSINESS EMAIL: LICENSE INITIAL INSPECTION DATE PERSON CONTACTED: NAME OF INSPECTOR: Lr-x/I ) K '01--d q 13112 FIRE SYSTEMS: FEQ IK Date Last Serviced: SNOHOMISH CC FIRE DIST Sei-ving Brief;- Edmonds Mountlatie Tef•race,and the Town of Woodway www.FireDistrictl.org LOCATION: 7500 212th Street BUSINESS NAME: Infdiman Inc. MAILING 7500 212th St SW #218 ADDRESS: Edmonds BUSINESS OWNER: Burgess, John EMERGENCY-1:r+.` sunders, Rota KEY ACCESS-2: PERSON CONTACTED: NAME OF INSPECTOR: 'J FIRE SYSTEMS: 12425 Mef•idian Ave S Everett, WA 98 208 Phone (425) 551-1200 Fax (425) 551-1272 SW 218 PHONE: 4256739299 98026 HOME PHONE: 2069549865 HOME PHONE: 4257438897 HOME PHONE: FIRE PREVENTION INSPECTION REPORT ❑ EDMONDS ❑ BRIER ❑ WOODWAY ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED FREQUENCY I STATION & SHIFT 730 16 D SCHEDULED DATE DUE ► 12/01/11 UFIR ► 691 1a-l57 ACTIVE CURRENT CITY YES NO BUSINESS (j LICENSE INITIAL INSP ;IO;;ATE UAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 1 U 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 X 1sf 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 4 8 4 8 DATE: DISPOSITION: LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 FIRE DEPARTMENT COPY