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BUILDING PERMIT
Permit
218z-J3 ,
3-lf-9~
CITY OF ZEPHYRHILLS
(813) 788-6611
N~
Date
~ErTRICAL
~
~AL
Sewer Conn
Pmp,"yOwne, ~~?:J.~~~
Job Address: If, :::s-< .
.
Water Conn:
Water Meter:
T,I.F.'s:
Parcell.D. #
Zoning: Energy Code:
Description of Work s~~~~
3- 6 -I 7 - ?~
Radon Gas:
~~V\ ~ cf" ~~ -+ -Lr.1~
NO OCCUPANCY BEFORE C.O.
FINAL c...f-S-'7:L.
DATE
Complete Plans, Specifications and Fee Must Accompany Application, C.O.
All work shall be performed in accordance with City Codes and Ordinances.
DATE
Valuation or
Contract Price
/~;/A
Inspector
Permit F~e/ -.5': ~
SlgnadHili" n~ /'
Company -------l
Address
Telephone#
City License Registration #
State Certified License#
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~ILDING :-:s )
Ftr. Tp. Servo
Pre SLB Rough In
Lintel Meter Can
~
-----,
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.............
M~NICAL
~
SLB
Tub Set
Water
Sewer
Final
Breakers
Ducts Insl.
Compressor
Final
FRM.
Insul. CL
WL
Const. Pole
Pool
Pre-Meter
Final
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
P.O. BOX 802
6755 GALL BL YD.
ZEPHYRHILLS, FL 34248
HENRYS'
OFFICE SUPPLY
TELEPHONE:
(813) 782-3825
MARCH 3, 1992
City of Zephyrhills
Building Department
Zephyrhills, Floirda
To whom it may concern:
We have granted permission to the following individual to setup a
food concession on the property located at 6755 Gall Boulevard,
Zephyrhills, Floirda for Friday and Saturday, March 6th and 7th,
1992:
Walter L. Henry
6334 Massey Road
Zephyrhills, Floirda 33541
Thanking you, I Remain
HENRYS OFFICE SUPPLY
----,
S'iME. 0 f f Lflu 0-1
Co vl'lrY 0 f- PAS CQ
NOTARY PUBL~j I- I, -
~"VI b (VI,~
Notary Public. State of Florida at large
My Commi ss ion expires ~y Commission Expires May 3.1993
Personally appeared before me, the above signed authority, f~LENL ~ ~EN~~
who, after first being sworn by me, affixed his/her signature in the space
provided above on this 3~f) day of M~tlc.).l , 19't2.-
C f:tc-j :tl ~ ~ G, '1 (:), '1 3
h,
SALES & SERVICE
SUPPLIES · FURNITURE. MACHINES
~ 22,003 (1/91)0 3 8423
STATE "OF FLORIDA DEPARTMENT OF BUSINESS REGULATION
, DIVISION OF HOTELS AND RESTAURANTS TALLAHASSEE, FLORIDA 32399,1012
LICENSE
iSUED
TO
HENRY WALTER l
LEROY'S OAWG HOUSE
6334 HASSEY RD
ZEPHYR-HILLS
33541
FL
'AILED
TO
HENRY WALTER l
LEROY'S DAWG HOUSE
6334 MASSEY RD
lEPHYRHILLS
FL
33541
'ISPLAY IN A CONSPICUOUS PLACE SEE REVERSE SIDE
HIS LICENSE IS NOT TRANSFERABLE FROM PLACE OR INDIVIDUAL TO ANOTHER
LICENSE NUMBER
61 5029~R-4
LODGING
CLASS UNITS
FOOD SERVICE
SEATS SERVICES
o
HEP FEE $ 6.00
LICENSE FEE $ 260.00
LATE RENEWAL $
TOTAL FEE PAID $ 266.00
EXPIRATION DATE 02/01/93
LAWTON CHILES
GOVERNOR
AUDIT CONTROL NO. 8 7 8 5 7
I
j.,
State of Florida
Department of Business Regulation I Department of Health and Rehabilitative Services
Division of Hotels and Restaurants Health Program Office
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.............
HRS PASCO COUNTY PUBLIC HEALTH UNIT
FOOD SERVICE / FOOD OUTLET ESTABLISHMENT INSPECTION REPORT
OWNER
MO DAY YR
TELEPHONE
INSPECTION
DATE
\ \ 1 i I
'~C~
0 WARNING MGR.
Minor and/or major violations in the operation of your establishment must
be corrected by
~EXT ROUTINE ---
SPECTION OR Dsy MO DAY YR
REASON 1 2 3 4 5
RESULT 1 2 3 4 5
GRADE MAXIMUM SCORE 100
(A- LESS VIOLATIONS - -a
INSPECTION SCORE \0 (j
Maj / Min FOOD
0 0 .01 Source: sound condition, no spoilage 5 0
0 0 02 Original container: properly labeled 1 0
FOOD PROTECTION
o
o
o
o
o
o
o
o
o
'03 Potentially hazardous food meets temperature requireme,-,ts during 5
storage, preparation, display. ser;.vice, transportation
...
.04 Facilities to maintain product temperature 4
05 Thermometers provided and conspicuous 1
06 Potentially hazardous food properly thawed 2
'07 Unwrapped and potentially hazardous food not re'served 4
.07 Reconditioned food. cross contamination
08 Food protection during storage, preparation, display, service 2
Og Handling of food (ice) minimized . -. ~-., 2'
10 In use, food (ice) dispensing utensils properly stored 1
o
o
o
o
o
o
o
o
o
PERSONNEL
o
o
o . 11 Personnel with infections restricted
o * 12 Hands washed and clean, good hygienic practices
5
5
NOTICE OF INTENT
TO FILE
ADMINISTRATIVE
CHARGES
no
FOOD OUTLET
Maj / Min WATER
o 0 '27 Water source, safe: hot & cold under pressure
5
o
SEWAGE
o ~ Sewage and waste water d.sposal
PLUMBING
4 I
o
o
5
TOILET & HANDWASHING FACILITIES
o 0
o 0
'31 Number, convenient, accessible, designed, installed 4
Toilet rooms enclosed, self-closing doors, fixtures, good repair, clean; 2
32 hand cleanser, sanitary towels/tissues/hand-drying devices provided,
proper waste receptacles
GARBAGI; & REFUSE DISPOSAL
o
o
~~\~jr,.:~Su~~~~~~~IeS, covered: adequate number, insect/rodent 2
33
34
OutsKJe storage area enclosures properly constructed, clean: controlled
incineration 1
INSECT, RODENT, ANIMAL CONTROL
o
Presence of insects/rodents - outer openings protected, no birds,
turtles, other animals
4
o .35
FLOORS, WALLS & CEILINGS
o
o
36 Fklors contructed, drained, clean, good repair, covering installation, 1
dustless cleaning methods
37 Walls, ceiling, attached equipment: constructed, good repair, clean 1
surfaces, dustless cleaning methods
o
o
-0-
LIGHTING
o G Lightll1!tt'ft)Ylded 8S reQUired, fixtures shielded
VENTILATION
" 1
o
o 39 Rooms and equipment - vented as required
DRESSING ROOMS
o
o 40 Rooms clean, lockers provided, facilities clean, located, used