700 EDMONDS WAYSNOHOM'ISH CO.
FIR
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FIRE"PREVENTION
Serving,Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT
?19DMONDS
Mountlake Terrace Everett, WA.98208 E3 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
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www.FireDistrictl.org Fax (425) 551-1272
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LOCATION:
700 Edmonds Way 98020
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BUSINESS NAME:
PHONE:
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Westgate Vet Clinic'
4257748801
DATE DUE
MAILING
LIFIR
ADDRESS:
556
700 Edmonds Way, Edmonds, WAX8020
BUSINESS OWNER:
HOME PHONE:'y,.36 -77L_1-395_a_
Zacharia, Mark
EMERGENCY-1:
HOME PHONE -_Cgg.j.
CURRENT
KEY ACCESS-2:
HOME PHONE''
CITY YES NO
EMAIL: Z-210 +2-1r S' 4
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF.INSPECTOR:
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I AGREE TO%CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
a
GRANTEDTO:
DATE DUE:
CITED:
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LETTER SENT
DATE:
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NUMBER:
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VIOLATIONS;�
DATE:
.2 6
2 6
CODE
SECTION:
5
RETURN RECEIPT
6
.3
7
3 7
RECEIVED
DISPOSITION:
4
18
4 18
DATE:
7
LETTER NEEDED [:] YES NO
LETTER NEEDED [] YES 0 NO
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FIRE PREVENTION
'CITY'OVEDMONDS
SAFETY SURVEY
121 5� AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
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I OCATION. 700 Edmonds Wav
BUSINESS NAME:
Westgate Vet Clinic
'MAILING
.700 Edmonds Wy
ADDRESS:
Edmonds
BUSINESS OWNER:
Zacharia, Mark
EMERGENCY-1:
go", Carol DVM
KEY ACCESS-2:
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PHONE: 4257748801
FREQUENCY
STATION& SHIFT
731
20 6
SCHEDULED
DATE DUE 11�
05/01/10
UFIR 0- 556
5103
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HOME PHONE: -5+04201345%_ AC-nVE
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HOME PHONE: 4-2667023M
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HOME PHONE:
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE FE f
SYSTEMS: ANNUAL
HAZARDS FOUND AND LOCATIONS COMf4UNICATIONS
Z�
ENTER CODE ONLY ONCE 110
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
Ist RE -INSPECTION
DATE DUE,
2nd RE -INSPECTION
DATE DUE*
1
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE*
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
C NTACTED:
PERSON
CONTACTED:
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
7
4
18
4
8
DATE:
DISPOSITION:
8
�_�ER NEEDED [] YES No
LETTER NEEDED [] YES NO
FIRE DEPARTMENT COPY