HomeMy WebLinkAbout94-4389
BUILDING PERMIT
Permit N~
CiTY 0 F ZEPHYRHILLS
(813) 788-6611
_ 4389/1
II} -Ir-?l(
Date
BUILDING
ELECTRICAL
PLUMBING
<~ANIC;>
Sewer Conn
-Water Conn:
::~:::,~,:02?19;rl ~ ;;pJ2
Parcell.D. # -.5 -;;Lt, -.;l/..... LJ 010 - 006 '/0 - 3 J
Water Me!er:
T.I.F.'s:
Zoning: Energy Code: _~ado~~s:
Description of Work........ ~M ~~.AI94....1 ~'V1 ~~__ ../~-+
rA-
NO OCCUPANCY BEFORE C.O.
FINAL I J - '7 - 9
DATE
C.O. / / - JY --7'/
DATE
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordarce with City Codes and Ordinances.
Inspector
Valuation or
Contract Price ,--~-::2, <,-0. t)-V
Pe,m;l Fee 6~ 0
S;gnaIU~e ~~
Comp~ _
Address
City License Registration # -3 -:.3 I
State Certified License#
Telephone#
~~ffe~
BUILDING ELECTRICAL
PLUMBING
MECHANICAL
Tp. Serv.
Rough In
Meter Can
Const. Pole
Pool
Pre-Meter
Final
Breakers
Ducts Insl.
Compressor
Final
SLB
Tub Set
Water
Sewer
Final
Ftr.
Pre SLB
Lintel
FRM.
Insul. CL
WL
Driveway
REINSPECTION FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Fifteen and 00/100 Dollars ($15.00) shall be made for each trip for each trade:
a. Wrong Address
b. Condemned work resulting from faulty construction.
c. Repairs or corrections not made when inspection called.
d. Work not ready for inspection when called.
e. Permit not posted on job site.
f. Plans not at job site.
g. Work not accessible.
The payment of inspection fees shall be made before any further permits will be issued to the person owning
same.
APPLICATION FOR PERKlT
CITY OF ZEPHYRHILLS
BUILDING DEPARTMENT
(ff.e.6 9-r27-YY
~ ~ :t:, ,F jJ )1 J11
L_ - ----------=Ii
OWNER'S NAKE~,0; <V ;.;: 1//7 N #
OWNER'S ADDRESS :5 ) 9 J S- flYt/Il/Tl3lA/ 2/
JOB ADDRESS ~") 'f I c;- ;?dO A/rAJ V 1?cI-
PHONE 71'.2 -.5 ~S-1
?1=?f'iR~/LJ
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL 1. D.'
(OBTAIN FROM PROPERTY TAX. NOTICE)
WORK PROPOSED:~ew Construction ~ddition ---.A1teration -.Jlepair ~ta1l
_Sign
----1Iove
->>eaolish
PROPOSED USE: _Single Fsaily
----1I/F _' of Units ----1I/H
_~ercial
_Indust. _Swia. Pool _Other
~~taurant & Health Departaent Approval
DESCRIPTION OF WORK: L/V.$-rnJ..L ,d/J//I/V~ ~f?~ _ (!OP?fZESS/O}l./
.sVSTc.-m
,
BUILDING SIZE:
x
Square Feet,
Height
RESIDENTIAL:
COHHERCIAL :
AtTACH (2) PLOT PLANS & (2) SETS OF BUlLDIRG PLANS & (1) SET ENERGY FORMS.
ArlACH (3) SETS OF BUlLDIRG PLANS & (1) SET ENERGY FORKS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTED
--BUlLDIRG
$
Valuation of Total Construction
_ELECTRICAL
AKP Service
Florida Power Corp.
W.R.E.C.
---lIECIWllCAL
$
Valuation of Kecbanical Installation
_PLUKBIIiG GAS ROOFING
SPECIALTY
TYPE OF mRsTRucnoN: .-Block _Fralle _Steel
Other
FlRISBBD FLOOR ELBVAfiORS:
Fl.
IS PROJECT IN FLOOD ZONE AREA?
YES NO
..........................................
CONTRACTOR SECTION
BITTT .DBR
Signature
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
RT .RCTRICL\I!I
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
SiOOAture
PLUKBBR
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
KECHANlGAL COMPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
OWB COIlP~ u~ ~< ~~
. >>~ State Cert. or R gist. . '/1//Jf.?C-ItJt)QU{')()
Signature ((,~ ~.A/l/L City License Registration' ~-'3.1
~ ............~......~.......................'
APPLICATIOR APPIIOVED BY J1 ilAu'd IIJ .vr~ PEBIIIT OFFlCEll..
..-~ ~
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
Tbe undersigned understands that this pemit lay be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
regulations. !be undersigned asSUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OlDer bas bired a contractor or contractors to undertake work, they lilY be required to be licensed in accordance with
state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lilY be
cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
requirl!leDts JaY apply for the intended work, they are advised to contact the City of Zepbyrbil1s Building Departlent, (813)
788-6611.
FurtherlOre, if the OlDer bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
'Contractor Sections' of this application for wbicb they will be responsible. If you, as the OIfIler sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that lilY be an indication that be is not properly licensed and is not entiUed to peraitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of 'Florida's COnstruction Lien Law - 8oIeoIDer's Protection
Guide" prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is sOftODe other than the
'OIfIler', I certify that I bave obtained a copy of the above described docUJent and prOllise in good faith to deliver it to the
'owner' prior to COllleDCl!IeDt.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIJation in this application is accurate and that all work will be done in cOlpliance with all
applicable laws regulating construction, loning, and land developlent.
Application is bereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
installation bas coaenced prior to issuance of a perlit and that all work will be perfoIJed to .et standards of all laws
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulatfons of other goveIDJeDtal agenCies JaY apply to the intended wort, and that it is
If responsibility to identify wbat actions I lust take to be in COJpliance. Such agencies include but are not liJited to:
I DepartJent of Bnvirolll8lltal Regulation - Cypress Baybeads, Wetland Areas and BnviroDJeDtally Sensitive Lands,
Water/Wastewater !reattent
I Soutbwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
t AIIY COIPs of Engineers - Seawalls, Docks, Havigable Waterways
I DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatleDt, Septic ranks
I US InvirODleDtal Protection Agency - Asbestos abateIPnt
I also certify that, if fill Jaterial is to be used in Flood Zone "A' or 'A, etc. N, it is understood that a drainage plan
addressing a 'COIPeD8ating volute' will be saitted .bich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed with the IOrk and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid
unless the work authoriled by such perlit is COll8llCed within sillOnths of issuance, or if work autboriled by the pemit is
suspended or abandoned for a period of sil IODtbs after the tile the IIOrk is C08!Ilced. One 90 day utension of tile, JaY be
allowed for the perlit with fee charge of '15.00. fbe utension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IODth period, or the project "ill be considered abandoned.
IIARJ1ING 'fO OIRIER: YOUR FAILURE fO RECORD A NO'I'ICB OF aIlMBICBIIBMI MAY RESULf IN YOUR PIYIHG "'ICI FOR IIIPROVIIIDIS fO YOUR
PROPBIm'. IF YOU IIft'IND 'fO 081111 FIIIAIICIHG, COHSULlWIrH YOOR LINDO OR IN AftORUY BlFORB RBCORDIHG YOUR NO'I'ICB OF
OIOIBHCBIIBIft'. lOBS UKDBR '2,500 IH VILUE DO HO'I' HOD fO RECORD AND POSf I -NO'I'ICI OF C(JfMDCBIIBMI'.
~ ~~~
SIGNA,.-: . 0 / URIl: R 0 Sb? -If I.{ - 0 'i' ~ cr
STA'l1 OF FLORI~
coum OF 'f\~D
The foregoing instrumen~ was ~~owledged
before me this ~~, 19~ by
_~"lf\~ 'K; ff\ IJA~,vM
who l.S Perril I ~own to me or who has
produced tbL. ~~
as i entification and ho did/did not
ta an oat .
STArE OF FLOR~A
coum OF It5CO
The foregoing instrument was acknowledged
before me this5tPTf'tll3t"'L;}..), 19~ by
J~ (!,. ""5ft./J/VV
who is pr!pnally kn~ to me or who has
produced ?tPc.. J ~L-- ':::;?€/.; u,fL JTJ. ri/ILD f.- ~,,-.))~
as i ification\\\\~~'I~/ho di did not
t th 'I III
e an if. . ,,\\' 1\ ~~/II,
'!<..,-' .~~:.. .'V/. '/
}.-.... p
(Name Typedj ~iDt8d. lft7 Stiujed)
NOTARY PUB~I~"" No. AA 722596,.: ff
~ X'" 'OUB\..\V.... ~~
~ .Jf')..... ,.' ~" "
'//.-7,1:..........0'-'"
//1111 0 F F\,: ,I"~"~
"1//1/ Ii 11111 \ \ \ \ \11
'-1--1)7)-
9/26/94
To:
Shian Hai Restaurant
Cor. Gall Blvd. & Hwy 54E
Zephyrhills, Fl. 33541
From:
Security Fire Equipment
18330 Lawrence Rd.
Dade City, Fl. 33525
904-567-7340
Re: Commercial Kitchen Fire Suppression System
Hood Description:
6' x 6' Galvanized steel exhaust hood with V Bank style grease filters
Duct Description:
12 in Length x 12" Diameter Galvanized Steel
Appliance Description:
Round 48" Diameter cooking surface with round 60" Diameter Drain pan (Gas)
Fire System Description:
Protex 2000 1.65 Gal. liquid fire Suppression System.
System Location:
System cylinder and control head to be mounted above suspended ceiling
within 50 Linear Ft. of Exhaust hood.
System Installation:
All Chemical discharge piping will be 3/8" Schedule 40 black iron pipe.
All Detection, Electrical Shut-Off, Fuel Shut-Off and Remote Manual
Release piping will be 1/2" EMT pipe.
Remote Manual Release will be located within the path of egress and not
more than 5' above the floor surface.
I SHT AN~-H^ 1 RESTAUR AN I
COR. GALL BLVD 3x 54E
----_._~-- ---------
I
o
I
Gus Shut
Off Vulve
SECURITY FIRE EQUIP
18330 LAwRENCE RD
DADE CITY) FL 33525
904-567-7340
Exho.ust Due t ---
-----------~~--- ~
~~
[I
I
Protex 2000
1.65 Go.!. Liquid
Suppressicm Sys terr
/
/
I
DElectriCul Shut Off
/'
/
PIe.QLJrr_J~ozzl.s /t~
He u t De t e C tOr / ~.,
Bufflecl Greuser'"
/
'"
",
'",
'"
+ '"
- Cherricul
Nozzle
Dischur'ge
o
Rel'1ote
Munucd
Releuse
~-----------
c;---=:=> _)
48" Go 5 Mongolian Griddle
with 6011 Droirl Pan
9/26/94
To:
Shian Hai Restaurant
Cor. Gall Blvd. & Hwy 54E
Zephyrhills, Fl. 33541
From:
Security Fire Equipment
18330 Lawrence Rd.
Dade City, Fl. 33525
904-567-7340
Re: Commercial Kitchen Fire Suppression System
Hood Description:
6' x 6' Galvanized steel exhaust hood with V Bank style grease filters
Duct Description:
12 in Length x 12" Diameter Galvanized Steel
Appliance Description:
Round 48" Diameter cooking surface with round 60" Diameter Drain pan (Gas)
Fire System Description:
Protex 2000 1.65 Gal. liquid fire Suppression System.
System Location:
System cylinder and control head to be mounted above suspended ceiling
within 50 Linear Ft. of Exhaust hood.
System Installation:
All Chemical discharge piping will be 3/8" Schedule 40 black iron pipe.
All Detection, Electrical Shut-Off, Fuel Shut-Off and Remote Manual
Release piping will be 1/2" EMT pipe.
Remote Manual Release will be located within the path of egress and not
more than 5' above the floor surface.
tOO ----~--------. -- -----
S!IIAN HAl REST^IIRANl
COR, GAII_ Bl_ VD 2,; 54[
o
I -
Gos Shut
Off Vcdve
SECURITY FIRE EQUIP
18330 LA\JRENCE RD
DADE CITY~ FL, 33525
'J04-~67-7340
Exhoust Duct-
Pie n u 1'1 ~~ 0 Z z I e
HeQi;TIetec~ro r-
--~.~-- - --'-"'-
Boffled Greose
F il teL2__
~)ro e>< 2000
1.65 Gol, Liquid
Suppressior, ~;yster'l
-1
CJElectricol
Shut Off
o
R e rID t e
lv1o.nuo.l,
Relpo.se
- CheMicoJ Dischor-ge
Nozzle
cc; ~)
1D= -'
f ---
,
48" Gas NongolicHI Gr'iddle
with 6011 Dr-oin PO-n
OWNER I S ADDRESS
~q- ~Ail~
31011<; -touVl. 'v\
C;:t\tA~
(~ . ./t 1~,J3-~r
<jF~ --1; V v'(<}>-
'.1~
c:::::"I/1 '
PB~NE 7B3 -Z(;;Z;q
APPLICATION FOR PERKlT
CITY OF ZEPHYRBILIS
BUILDING DEPARTKENT
OWNER I S NAME
V COld
JOB ADDRESS
LEGAL DESCRIPTION: LOT(S)
BLOCK
SUBDIVISION
PARCEL LD.'
(OBTAIN FROM PROPERTY TAX NOTICE)
WORK PROPOSED:~ew Construction -----..Addition ---..Alteration ~epair _Install
_Sign
--'love
-Deaolish
PROPOsm~E: _S~eF_ily
--'l/F _' of Units --"/H
_~ercial
_Indust. _Swia. Pool _Other
~estaurant Ii Health Departaent Approval
DESCRIPTION OF WORK:Jiij{JJ~ th-vl A'^~ ~,
BUILDING SIZE: X Square Feet, Height
RESIDEIITIAL:
COMMERCIAL
ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDIRG PLANS Ii (1) SET ERERGY FORMS.
ATTACH (3) SETS OF BUILDIRG PLANS Ii (1) SET ENERGY FORHS.
PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
PERMITS REOUESTm
~UILDIRG
$
Valuation of Total Construction
RI.RCl'RICAL
AIIP Service
Florida Power Corp.
W.R.E.C.
---.JIECIL\IIICAL
$
Valuation of tlechanica1 Installation
~UtlBIRG GAS ROOFING
TYPE OF alNSTRUcnON: -..JIloclt _Pralle _Steel
SPECIALTY
Other
F1IIISHBD FLOOR ELEVAnONS:
n.
IS PROJECT IN FLOOD ZONE AREA"
YES NO
..........................................
CONTRACTOR SECTION
RIJTTJ)ER.
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
RT .RCTRTCL\II
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
SiRnAt.ure
PLUtlBER.
COMPANY
State Cert. or Regist. .
City License Registration .
..........................................
Signature
tlECIIARI~ _ \-<. \I~ ~N ~cl ~ F 'AN cotIPANY l-l SkeJ f"rl ~ TA-L
r-,) (' C\ (,) .AP. State Cert. or Regist.' :::> 00 :z...
Signature~~~ ~. 'S\~~ City License Registration'
..........................................
omu cotIPANY
State Cert. or Regist. .
Signature City License Registration .
..........................................
APPLICAfiON APPROVED BY PERKlT OFFICER.
CONDITIONS OF PERMIT AFFIDAVIT
A. NOTICE OF DEED RESTRICTIONS
'be undersigned understands that this penit lay be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
regulations. !be undersigned asSUles responsibility for COIpliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the OIlIer has hired a contractor or contractors to undertake IIOrt, they laY be required to he llcensed in accordance with
state and local regulations. If the contractor is not licensed as required by lilli, both the OImer and contractor lilY be
cited for a liscleteallOr violation under state law. If the mmer or intended contractor are uncertain as to wllat licensing
requiruents lilY apply for the intended wort, they are advised to contact the City of Zepbyrhills Building DepartJent, (813)
788-6611.
FurtherlOre, if the OIlIer bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
'Contractor Sections.' of this application for wbich they will be responsible. If you, as the OImer sign as the contractor,
you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
as contractor that lily be an indication that be is not properly licensed and is not entitled to penitting privileges in the
City of Zepbyrbills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - lkIIeoImer's Protection
Guide' prepared by the Florida Departlent of Agriculture and ConsUl81' Affairs. If the applicant is 80180I18 other than the
'OIfI1er', I certify that I bave obtained a copy of the above described docutent and prcmse in good faith to deliver it to the
'owner' prior to co.encuent.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the infoIlation in this application is accurate and that all wort will be done in COJpliance with all
applicable laws regulating construction, loning, and land developl8llt.
Application is hereby Jade to obtain a penit to do wort and installation as indicated. I certify that no wort or
installation bas CDleDced prior to issuance of a penit and that all work will be perforJed to .et standards of all lillls
regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
certify that I understand that the regulations of other governtental agencies lilY apply to the intended wort, and that it is
IY responsibility to identify wbat actions I lust take to be in cotpliance. Such agencies include but are not 11lited to:
* Departlent of InvirOl1l8lltal Regulation - Cypress Bayheads, Wetland Areas and Bnvirontentally Sensitive Lands,
Water/Wastewater '1'reableDt
* Southwest Florida Water lIanagl!leDt District - lIells, Cypress Bayhea4s, Wetland Areas, Altering Watercourses
* Any Corps of Engineers - Seawalls, Docks, Havigable Waterways
* Departlent of Health i Rehabilitative Services, EnvirOlll8Dtal Health Unit - Wells, Wastewater '1'reatteDt, Septic '1'ws
* US InvirODlental Protection Agency - Asbestos ahatuent
I also certify that, if fill Iilterial is to be used in Flood ZOne 'A' or 'A,etc.', it is understood that a drainage plan
addressing a 'c0Jpen8ating volute' will be subaitted wbich is prepared by a professional engineer registered in the State of
Florida prior to perlit issuance.
A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
set aside any provisions of the technical codes, nor sllall issuance of a penit prevent the Building Official fIOl thereafter
requiring a correction of errors in plans, construction, or violations of any code. Ivery penit issued shall becaIe invalid
unless the IIOrt authoriled by such penit is COII8Dced within sillOntbs of issuance, or if work autboriled by the penit is
suspended or abandoned for a period of ail IODtbs after the tile the work is co.enced. ODe 90 day utenaion of tiE, IilJ be
allowed for the penit with fee charge of $15.00. 'fhe utension shall be requested in writing to the Building Official. An
approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
WARHING TO (*RBI: YOUR FAILURB 'f0 RECORD A HO'I'ICB OF aJIIIDCIIIINf lilY RESUL'f IN YOUR PAYING !IIICB FOR DIPROVIIIBI'1'S '1'0 YOUR
PROPBRfi. IF YOU IDBIID '1'0 OB'1'AIH FIIlAHCIIG, COISUL'1' WID YOUR LDDBR OR II AnORDY BBFORB RBCORDIIG YOUR JOIICB OF
COIIMEIfClHBl'1'. ODS UlfDBI $2,500 IH VALUlIlO HO'I' lIED '1'0 RECORD lID POS'1' A -HO'I'ICB OF CCIIIIIIICBIIED'.
QAN~Q~~ (~~CR~QJb)
SIGIII'1'URB: CODRAC'1'OR
SIGJIA
S'1'A'1'1 OF FLORIDA \;)
coum OF '\ f\ C; C 0
The foregoing instrument was ~~owledged
before me this ~T Zz. , 19~ by
)lll(}~ J-tLL~n h
who is p rsonall known to me or who has
produced ~
s dentification and who did/did not
t ke an oa .
STAR OF FLORIDA ~ t"'- ~
COUH'1'Y OF \)-" \""1 ...) C ()
The foregoing instrument was aC~~led9ed
before me this ~EPT ~.::::L, 19 by
Ron Rioeel/~
who is personally known to me or who has
produced
a . entification and who did/did not
a e oa
.,~&}t.~:r~, DANA M. GIELLA
:....:' 'a~ MV COMMISSION' CC301855 EXPIRES
~;" /qj July 14. 1997
......~,?r:,~~.... BONDED THRU TROY FAIN INSURAHCE.IfC.
....."..., DANA M maLA
..i~'t.!~~.. .
:....:. ':.~ MV COMMISSION' CC301855 EXPIRES
\i.. ~1 July 14. 1997
'-!.f.. ..' BONDED THRU TROY FAIN 1NSUIWfCE.1NC.
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ZEPHYRHILLS FIRE DEPT
Zephyrhills Florida 33540 (813) 782-8184
FIRE CODE INSPECTION
Business Name J/' / ...L1" /~, r
Address )'70,/,c,' /A.(.,' T/:1 -', LJ!
~ ./ . c' ~",'/(..I "......,1 ~(',.. '
Classification
j/-- , h / ,
, ,~~~. /~I - / ./
./ / ~ :/;
Business Phone 7 c;;; 7' ' 3 ~ ,j 'P'
Owner/Manager It /I/*, /;;~y A/h
Emergency Contact Phone
Occupancy Load Alarm Monitoring Co.
Phone #
TYPE OF INSPECTION CONDUCTED
o QUARTERLY
ORE-INSPECTION
o APPROVED
J> FINAL 0 ANNUAL
o OTHER
o NOT APPROVED
OBI-ANNUAL
o COMMERCIAL CHECK
Listed below are items which must be complied with before this occupancy can be approved by the Fire
Department.
o CODE VIOLATIONS
This inspection report specifies code violation(s) which if not corrected could cause a fire, contribute to the
spread of fire, or prevent safe egress during a fire. Your immediate attention to the correction of these
violations shall be required, as failure to do so is a violation of the city of Zephyrhills Fire Prevention Code.
IJ) ,j}/j
f
Inspect. Date 11/7/ t7 ~
Re-Inspect. Date
-.. Inspect. Time / fJ t:?./1
~n~~ec~ame
Fire Dept. ID # ~ - j -/
;J~ 4/2/"7 &/~
OwnerlManager Signature
Title
This building has been checked / the Zep yrhills Fire Dept. under the codes & regulations of the NFPA minimum
standards, the State Fire Marshall's Uniform Fire Safety rules and other local fire safety codes.
WhIle Copy - Fie Yellow Copy . Bid. Dept. Pink Copy - Business