176 SUNSET AVE (2)/7 (o J&4&)fi,r Rai --
Serving Brier, Edmonds, and 12425 Meridian Ave S
Mountlake Terrace. Everett, WA 98208
Phone (425) 551-1200
www.FireDistrict].org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
LOCATION: 176 Sunset Avenue S 98020 2016 17-C
SCHEDULED
BuslNEss NAME: Goodies Mini Mart PHONE: 4256975141 DATE DUE Mar 2016
MAILING UFIR / 512
ADDRESS:. 176 Sunset Avenue S, Edmonds, WA 98020
BUSINESS OWNER: HOME PHONE:
. EMERGENCY 1: Mog, Inc. HOME PHONE: tB� CURRENT YES NO
KEY ACCESS-2: HOME PHONE: CITY
EMAIL: lam' '^ / ''yam �v, =t. �13 5 7 "
5,, L.
n B SIN ESS ❑
PERSON CONTACTED: • " 1 1 vt L.Q� INITIAL INSP TION D
NAME OF INSPECTOR: Y v \U
Lek
FIRE SYSTEMS: FE 8/13 (tj
DatA I ASt SP_rviCA(t'
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
2
2
3
a,
3
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities
covered by Snohomish County Fire District 1.
You are to be congratulated on the relative good condition of your occupancy in regards to fire safet ve you
will find the item(s) that were noted during. our inspection which require attention to bring them into pliance
with the minimum standards adopted by the above jurisdictions.
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation.
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7720; for
Mountlake Terrace or Brier, call (425) 744-6231.
% Je,
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 42615D?Si4
FIRE PREVENTION
INSPECTION REPORT
❑EDMONDS
❑ BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
,' ntlua l 1 17-.A
SCHEDULED
DATE DUE ► N.4a' 2014
UFIF
ADDRESS: -17E Sumct Awn= N. I-drmrmds.. {dVA 08020 \11 J
BUSINESS OWNER: HOME PHONE:
EMERGENCY 1: mag- Irl{. HOME PHONE: 2VIE-'334; 6,,25, CURRENT
KEY ACCESS-2: HOME PHONE: CITY
EMAIL: `- �` �'17 G° �" ` I ` C"`�' BUSINESS
LICENSE
INITIAL INSPECT
SNOHOMISH CO.
Serving Brier Edmonds, and
Mountlake Terrace
www.FireDistrict].org
LOCATION: 176 Sunset ? %etiu8 N 2W2D
BUSINESS NAME: dim Mini Marl.
MAILING
YES NO
PERSON CONTACTED: DATE
�1 )Cnjsj r
NAME OF INSPECTOR: �jl
HAZARDS FOUND AND LOCATIONS / COM UNICATIONS
_3
4 4
5 5
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7 7
I 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: _ DATE DUE: GRANTED TO: DATE DUE: [ CITED:
- PERSON PERSON PERSON
CONTACTED: CONTACTED: CONTACTED:
INSPECTOR: INSPECTOR: INSPECTOR: 2
DATE: DATE: DATE: i 3
VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED
4
1 5 1 5 LETTER SENT NUMBER:
._...._...�.-.,. „.... �. CODE ..,. 5 ....-...�.d.._...,..
2 6 2 6 DATE: SECTION:
RETURN RECEIPT
3 7 3 7 RECEIVED 6
DISPOSITION:
4 8 4 8 DATE: i
❑ YES ❑ NO LETTER NEEDED,..6.a.,�.....,.�_...._�.._...�..._.
LETTER NEEDED ❑ YES ❑ NO e
FIRE DEPARTMENT COPY
SNOHOMISH CO.
Serving Brier, Edmonds 12425 Meridian Ave S
Mountlake Terrace, and Everett, WA 98208
the Town of Woodway Phone (425) 551-1200
www.FireDistrictl.org Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ WOODWAY
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY STATION & SHIFT
LOCATION:
176 Sunset Avenue
365 17 C
I
BUSINESS NAME:
Goodies Mini Melt
PHONE:
4256975141 SCHEDULED
DATE DUE ► 03/01t12
MAILING
176 Sunset Ave
UFIR ► 512 3202
ADDRESS:
Edmonds
98020
y�s-� 6 )
BUSINESS OWNER:
Mog, Inc.HOME
PHONE:
-28633476§Ri— ACTIVE
EMERGENCY-1:
Lee, Sunyouncg
HOME PHONE:
4257738377 CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
-
BUSINESS
LICENSE
INITIAL INSPECTION ATE
PERSON CONTACTED:
NAME OF INSPECTOR:
FIRE
FE �o I LZ
SYSTEMS:
_.
ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1
1
2 D
---
2
,444)
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:
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
g
4
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑. YES ❑ NO
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FIRE DEPARTMENT COPY-.1, .