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Home My WebLink About06-5809 CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT 5809 Permit Number: 5809 Permit Type: COMMERCIAL Class of Work: ADD/AL T COMMERCIAL Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 6440 12TH STREET ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 02-26-21-0060-00COO-001O 1,600.00 5/18/2006 50.00 50.00 5/18/2006 Phone: BUILDOUT - STORAGE AREA W/DRYWALL-STE 3 , , Name: LIBERTY PROFESSIONAL INC Address: 12603 LAKE HILLS DR RIVERVIEW, FL C,J I' \~0\0lP Lz \ 19 LUM DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED LINTEL PRE-METER WATER SHEATHING FRAME MISC SEWER MISC INSULATION WALL MISC MISC. MISC. INSULATION CEILING MISC. MISC. MISC. DRIVEWAY MISC. MISC. REINSPEcnON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement. n NO OCCUPANCY BEFORE C.O. ~. CONTRACTOR SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER CITY OF ZEPHYRHILLS 5335 - 8TH STREET (813)780-0020 BUILDING PERMIT Permit Number: 5809 Permit Type: COMMERCIAL Class of Work: ADD/AL T COMMERCIAL Proposed Use: COMMERCIAL Square Feet: Est. Value: Improv. Cost: Date Issued: Total Fees: Amount Paid: Date Paid: Work Desc: Address: 38522 COUNTY ROAD 54 STE 3 ZEPHYRHILLS, FL. Township: Range: Book: Lot(s): Block: Section: Subdivision: CITY OF ZEPHYRHILLS Parcel Number: 02-26-21-0060-00COO-0010 1,600.00 5/18/2006 50.00 50.00 5/18/2006 Phone: BUILDOUT - STORAGE AREA W/DRYWALL-STE 3 Name: LIBERTY PROFESSIONAL INC Address: 12603 LAKE HILLS DR RIVERVIEW, FL ~4.'J ~:.If 5~/9-kJ;w~ 1 DUCTS INSTALLED PRE-SLAB CONSTRUCTION POLE 2ND ROUGH PLUMB DUCTS INSULATED LINTEL PRE-METER WATER SHEATHING FRAME MISC SEWER MISC INSULATION WALL MISC MISC. MISC. INSULATION CEILING MISC. MISC. MISC. DRIVEWAY MISC. MISC. REINSPEcnON FEES: Reinspection fees will comply with Florida Statute 553.80 (2)( c) when extra inspection trips are necessary due to anyone of the following reasons: a) wrong address b) condemned work resulting from faulty construction c) repairs or corrections not made when inspections 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same "Warning to owner: Your failure to record a notice of commencement may result in your paying twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." NO OCCUPANCY BEFORE C.O. ~. SIGNATURE PERMIT OFFI CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Building Department t-aX-!ll j-I !lV-UUL 'I Date Received ff\J(,' Owner phone Number ~, ?\II~er phone Number I I Owner Phone Nu~b~r I P~fE5 loNA-t.-5 Owner's Address 112 &,0"3' LAK e... Fee Simple Titleholder NamJ L I~~ Owner's Name ff , LL 5 P tz,. . p ~ Fc55 51 tJl\J/t7..S. lW3 GfL.54- /., F f..., ., 'Y5 C, 1 Su I 1"1::.- ~ 3 LOT# I I 'PARCELlD#la'2.- 2(,:.-2.1 - OObO";' ooC Od -~al 01 (OBTAINED FROM PROPERTY TAX NOTICE) if SIGN D MOVE 0 ADD/All REPAIR COMM FRAME DEMOLIsH JOB ADDRESS I B' o D DESCRIPTION OF WORK ~ \J (n.;.. -+ 0- sro (0 \) ~\. ~~~~~'~?, ~:~~. , , , !, . ~, ~e<? , ~., , , . . " . ,! , , ' . ~~~~,~ ~~~.. , . . " , ' , '" , " " , , , ". , , , ,,~~,'~~~ , !, ,/, ~ .', , " . , , , . .. , , , !. . , , , , . . ., '" ' , . , , , , '" Ig] BUILDING 1$ I ~ LX) ()O VALUATION OF TOTAL CONSTRUCTION D ELECTRICAL 1$ D PLUMBING 1$ D MECHANICAL 1$ D GAS D FINISHED FLOOR ELEVATIONS I SUBDIVISION PROPOSED USE TYPE OF CONSTRUCTION B o D NEW CONSTR INSTALL SFR BLOCK o D OTHER I STEEL D WORK PROPOSED I I' OTHER I AMP SERVICE t::::J PROGRESS ENERGY D W.R.E.C. VALUATION OF MECHANICAL INSTALLATION ROOFING o I SPECIALTY D FLOOD ZONE AREA OTHER DYES DNO BUILDER SIGNA TU ~\lfi- COMPANY REGISTERED IAztZ-- CoN S~ Vc..-n oJ Co ., IN(,. I I '""i!Jl. N' I FEE CURRENT I ~ N , License # l <:::: Be- a 5' 77 fJ7 I I Y/N I I Y/N I I Y/N I I Y/N I Address ELECTRICIAN I ' SIGNATURE Address I PLUMBER I SIGNATURE Address I Y/N FEE CURRENT License # Y/ N FEE CURRENT License # Y/ N FEE CURRENT License # Y/N FEE CURRENT License # COMPANY REGISTERED I COMPANY REGISTERED I COMPANY REGISTERED MECHANICAL SIGNATURE Address OTHER SIGNATURE Address 1111111' III'" I 11111 '1111111.1' 11I11111111 '11111111,1111111111111111111' 11111111111111' 1111111111111111111111111111111 i 11111111111111 i 1111111111111 RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster COMMERCIAL Attach (3) sets of Building Plans; (1) liet of Energy Forms. Minimum ten (10) working days after submittal date. Required onslle. Construction Plans, Sanitary Facilities & 1 dumpster All commercial requirements must meet compliance. SIGN PERMIT Attach (2) sets of Engineered Plans. ....PROPERTY SURVEY required for alj NEW construction. 111111111111111111111111111111111.111111111,1111111111l'II"III,lllllllllllllllllllllillliiiillllillillllili1IIIIilillllillllillliliiiliiiiiliiliii Directions: Fill out application completely. Owner & Contractor sign back of application. notarized If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) Agent (for the contractor) orPower of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades Ale Driveways Fences (Plot/Survey/Footage) NOTICE OF ,DEED RESTRICTIONS: The underslgn~d understands that this 'permit may be subJect to "deedil restrictions" , which may be more restrictive than County regulations. The undersigned assumes tesponslbllity for 'compliahce with any applicable deed r~strlctlons. ' '. ' , ',' UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBiLITIES:' If the owner has hired, a contractor or cl;mtractors to und.ertake work, they may be required to be licensed In aCcordance wlttl state and local regulations. If the contractor Is not licensed as required by law, both the owner and con~ractor may be cited fQr a misdemeanor Violation under state law. If the ~wner or Intended contractor are uncertain as to what lIf?enslng requirements may apply for the' IntEmded work, th~y are advised ,to contact the P~sco County Building Insp~ctlon Divlslori-lIcensl~g Section at ri.1-84"'- 800~., Furthermore, If the owner has hired a cont~actor or contractors, he Is advised to havEdhe contraptor(s) sign , portions of the .contractor Block" of this QPpllcatlon for which they Will be responsible. If you, as the oWner sign as the, , contractor, that:rriay be an Indication that he Is not properly licensed and Is not entitled .to permitting prlvllegel;lln Pasco , County. , ,', . . ", " TRANSPO~TATION I",PACT/UTILlTIES IMPACT AND RESOUROE REOOVERY FEES: The underslgnedUhderstahds' that Transportation Impact F:ees ~nd Recourse Recovery Fees may apply to the construction of heW buildings, chahge of 'use In, existing buildings; or expansion of existing buildings, as specified In Pasco County Ordinance humber 89-07 and '. 90-07, as amended. The undersigned also understands; that such fees, as may be due; will be Identified al the Ume bf permitting. 'It is further ~nderstood th'at Transpo~atlon Impact Fees and Resource Recovery Fees must be paid pi"ior to . receiving a .certlficate of occupancy" or final power rt:tlease. If the project does hot Involve a certificate of occupancy or filial power, release, the fees must be paid prior to permit Issuance., FurtherrilOte; if Pasco CountY. Water/Sewer Impact , fees are due, they Iilust be paid prior to permit Issuance In accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW (Chapter,713. Florida statu~es. as amended): 'If valuation of work, Is $2,500.00 or more, I certify that I, the applicant, have been, provided wIth a copy of the "Florida Construction Lien Law-Homeowner's Protection Guide" prepared by the Florida Department of AgricUlture and Consumer Affairs. If the applicant Is someone ,other than,the "ownet", I certify thl1lt I, have obtained a copy of the above described document and promise In good faith to, . deliver It to the .owner" prior to cOl1lmencement. . . . CONTRACTOR'S/OWNER~S AFFIDAVIT: I certify that all the Information In this application Is accurate and:that all Work will be donl':t In compllanqe with all applicable laws regulating construction, zonltig and land developinen!. -Application Is . . hereby made to obtain' a permit to' do work and Installation as Indicated. I certify that ho work or Installation has commenced prior to Issuance. of a permit and that all work will be p~rformed to meet standards of all laws regulating Construction, County. and City codes, zonh1g regulations, and land development regulations In the jutlsdlctloh. I also ,certify that I understand that th~ regulations of other government agencies may apply to the Intended work, and that It Is . my responsibility to identify what actions I must take to be In compliance. Such agencies Include but are not limited to: . _ Department of Environmental Ptotection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive . Lands, Water/Wastewater Treatment. . .. . Southwest . Florida Water Management Distrlct-Weils, Cypress. i3ayheads,' Wetlahd Areas, Alterhig. Watercourses. . , ., " ' . ... Army Corps of Englneer~-Seawalls, Docks" Navigable Waterways.. . ... .' . ' Departm'ent of He~lth & Rehabilitative SerVices/Environmental H~alth Unit-Wells; Wastewater Treatment, . ' Septic Tanks.. . .. : . . . . . US Environmental Protection Agency-Asbestos abatement. . Federal Aviation Authority-Runways. I understand that the folloWing restrictions apply to the use of fill: Use of. fill Is. not allowed In'Flood Zone.Y" unless expressly permitted.' . ' . '.. 'If the fill material Is to be .used in Flood Zone "N, It Is understood that a drainage plan addressing a . "compensating volume" will be. submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. . ' .. . . If the fill material Is to be used In Flood Zone "A" In connection With a permitted building using stem wall . construction, I certify that fill will be used only to 'fill the ar~a within the stem wall. . . If fill. material Is to be used In' any area, I certify that use of such fill will not adversely affect adjacent properties. if use of fill is found to a~versely affect adjacent properties, ,the owner may be cited for ".Iolatlng the conditions of the building permit Issued under the attached permit application, for lots less than one (1) " . . acre which are elevated by fill, an engineered drainage plan Is required. ' ' .'. '. . ,If I am the AGENT' FOR THE OWNER, I promise In good faith to Inform the' owner of the permitting conditions set fo~h In this affidavit prior to commenclng.constructlon. I. understand that a sep~rate permit may be requited for electrical wor~, , . . plumbing, signs, wells, pools, air conditioning, gas,' or other installations not specifically Included In the application. A . permit Issued shall be construed t<;>> be a IIcens.e. to proceed with the work and not as authority to violate, c.ancel, alter. or set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the Building Official frQm .t~ereat:ter . . requiring a qorrectlon of errors In plans, construction or vlolatlons.of any code.s. Every permit lssu~d shall become Invalid . unless the work aulhorlzed by such permit Is commenced within six months of permit Issuance, or If.work authorized by the permit Is suspended or ab.andtmed for a period of-six (6) months after the tlm.e t~~ ~~rk Is commenced. 'An .extenslon may be requested; In writing, from the Building Official for. a period not to exce,ed ninety (90,) days.. and wllI.~emonstrate justlfiatlle cause for the extension. If work ceases for ninety (90) consecu~lve days, the job Is conSidered abandoned. . . . WARNING TO OWNER' YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAy RESULt IN YOUR. . PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. I.F YPU INTENQ TO O.BTA!N F~NANCING; OO~SUL T WITH OU LENDER OR AN ITO NEY BEFORE RECORDING YOU 0 OF C ENC ME T; , FLORIDA JURAT (F .s. 11,!-03) . OWNER OR AGENt -~,- Subscribed and sWorn (or affirmed Ie) JJjJIY~(., by rE. . . Who Is/are personally known to me or has va produced .r 1... 7) j. , as IdeoUflcaUon. , ' /-~~ . ./ {l /J ( ,.. ...:_~~ V~i,{/~PUbIlC Commission No. ' Commission No. ~~otary typ~tA1~I?Jn~mped ~i ~"A.."! ':~ ~Y COMMISSION # '00268763 .EXPIRES ,\~W . February 22, 2008 . , . ,if, ,~~.~",.. ,GOIWED THRIJ TroY FAIN INSURANCE, INC ",Ytw!! of Notary lvDed. I)rinled Qr stamped "i\"'r~ !dbbiEi ~wetlOnd . . {j'.."J;i.~ :~ MY COMMISSION # 1;>0268763 EXPIRES ....~.~g . February 22, 2008 , ',' " BONDE~ T'"l~U TROY FAIN INSURANC~ INC Preliminary Layout for: Liberty Professional Center Unit No. 3 ~&r()03t.o FI re EXit 241-8" .J j~ ~ ' rJ " \;ff Building shall comply with ~ cY{/\ \ r the applicable codes of ~ ~J, {,; Florida Fire Prevention Handbook 5"0"" NFPA & the City of Zephyrhills 51-0" APPROVED ~y Are Mar al of Zeph~i1b ~l)r,)[J6 441-0" 5'-0" 71-0" HC Toilet -f- flf /vJ (Ccr j,-/V!-c1 FE _ L2. -.t ~'>t1J ;f-!Er11...EA!.6 t9-J Jf ~4<<-~.r vrl-e; F.'C"v~~ L~t'1~J-s ~-"') k ~ ~ Main Entry 1 40'-0" 1 DraWing IS for conceptual purposes only. DraWing IS not to scale. All building measurements are approximate. Fire Chief Robert Hartwig ZEPHYRHILLS FIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Bus (813) 780-0041 Fax (813) 780-0044 (O/J~;tJ Occupancy No.: Plan No.: Business Name: BusinessAddress: Business Phone No.: Business Fax No.: Contact: PLAN REVIEW FEES ~ite Plan N/C Building Plans .04 sf evision .06 sf FIRE SERVICE USER FEES STANDPIPE SYSTEM o Per Riser $25 SPRINKLER SYSTEMS o 0 - 25 Heads $30 o 26 plus Heads $60 FIRE PUMP o Per Pump $100 FIRE ALARM SYSTEM o 0 - 25 Devices $30 026 plus Devices $60 SUPPRESSION SYSTEMS ~ Wet $35 Dry $35 C02 $35 Other $35 GREASENENTILATION o Hood/Ducts $35 OV PLANS TOTAL ~ INSPECTION FEES Annual N/C 1 st Re-inspection $25 2nd Re-inspection $50 3rd Re-inspection $125 4th Re-inspection $250 5th Re-Inspection $500 Construction $15 Commercial $25 SPRINKLER SYSTEMS Hydro Undergrounds $45 Hydrostatic System $45 Wet Acceptance $30 Dry Acceptance $45 Hydrant Flow $25 Hood / Booth $30 Grease Duct $15 FIRE ALARM SYSTEM B System Acceptance $50 Recall Acceptance $50 OTHER Fire Wall/Smoke Wall $15 LP Gas $25 Natural Gas $25 Fuel Tanks $25 Tent $15 INSPECTION TOTAt.c=J t Billing Phone No.: Billing Fax No.: Contact: 01""'3 - &> 10- 3. (., b ( PERMIT FEE FALSE ALARM FEE 1 st Alarm N/C 2nd Alarm N/C 3rd Alarm N/C 4th Alarm $25 5th Alarm $50 6th Alarm $75 7th Alarm $100 8th Alarm $150 9th Alarm $200 10th Alarm $250 Non Compliance $150 "Affidavit of Service/Repair" SPRINKLER SYSTEMS o Automatic $15 FIRE PUMP o Fire Pump $15 FIRE ALARM SYSTEM o Detection $15 OTHER ~ LP Gas Natural Gas Fire Works Fuel Tanks $45 $45 $25 $45 GREASENENTILATION o Hood/Ducts $15 o Kitchen Suppression $15 I FALSE ALARM I PERMIT TOTAL TOTAL. Comments: ~t~.. .~ ,. tk. G~TOTAL ~ 1,/0- I vt!.. R -0 ~ \J\:-L~ V ~ 5 ~ DC. / "'1 8rJl/6JT ~ F/Vt Date: Inspector: j/~ (11 j'y;(cf,j)J~.L ZEPHYRHILLSFIRE DEPARTMENT 6907 Dairy Road, Zephyrhills, FL 33542 Fire Chief Robert Hartwig Bus (813) 780-0041 Fax (813) 780-0044 FIRE SERVICE USER FEES Owner: Billing Address: Occupancy No.: Plan No.: CXo '-. OD4Y Business Name: :3 ~~J<j C. Jl-'t;L( BusinessAddress: ,~\~ ~ Business Phone No.: Business Fax No.: Contact: ;>4 He> PLAN REVIEW FEES ESite Plan N/C Building Plans .04 sf Revision .06 sf STANDPIPE SYSTEM D Per Riser $25 i SPRINKLER SYSTEMS n 0 - 25 Heads $30 D 26 plus Heads $60 FIRE PUMP D Per Pump $100 FIRE ALARM SYSTEM D 0 - 25 Devices $30 D 26 plus Devices $60 SUPPRESSION SYSTEMS ~ Wet $35 Dry $35 C02 $35 Other $35 GREASENENTILATION D Hood/Ducts $35 INSPECTION FEES Annual N/C 1 st Re-inspection $25 2nd Re-inspection $50 3rd Re-inspection $125 4th Re-inspection $250 5th Re-Inspection $500 Construction $15 Commercial $25 SPRINKLER SYSTEMS Hydro Undergrounds. $45 Hydrostatic System $45 Wet Acceptance $30 Dry Acceptance $45 Hydrant Flow $25 Hood / Booth $30 Grease Duct $15 FIRE ALARM SYSTEM D System Acceptance . $50 D Recall Acceptance $50 OTHER Fire Wall/Smoke Wall $15 LP Gas $25 Natural Gas $25 Fuel Tanks $25 Tent $15 PLANS TOTAL ~ ~ k-~ GRAND TOTAL Comments: INSPECTION TOTA~ Billing Phone No.: Billing Fax No.: Contact: PERMIT FEE FALSE ALARM FEE 1 st Alarm N/C 2nd Alarm N/C 3rd Alarm N/C 4th Alarm $25 5th Alarm $50 6th Alarm $75 7th Alarm $100 8th Alarm $150 9th Alarm $200 10th Alarm $250 Non Compliance $150 . Affidavit of Service/Repair" SPRINKLER SYSTEMS D Automatic $15 FIRE PUMP o Fire Pump $15 FIRE ALARM SYSTEM o Detection $15 qP ( ~~/~ct OTHER ~ LP Gas Natural Gas Fire Works Fuel Tanks $45 $45 $25 $45 GREASENENTILATION D Hood/Ducts $15 D Kitchen Suppression $15 I FALSE ALARM I PERMIT TOTAL TOTAL. Yo. G:,~l Dat. ~/ 6pb Inspector: g~j/" y ~V/1Jar/ - ~ OCCUPANCY NO.: CITY OF ZEPHYRHILlJS FIRE RESCUE INSPECTION DEPARTMENT 6907 DAIRY ROAD ZEPHYRHILLS, FL 33542 (813) 780-0035 Administration: (813) 780-0041 \/ ******************************************************************************************************************* City: Zip ~ SAFETY INSPECTION ) \-.J rf( a- Business Owner: Telephone: 5 c...;~..3. Building Owner: Telephone: ) 5.3~ _ Emergency Contact #1: Telephone: Emergency Contact #2: Telephone: Business Name: :s\ ~'-(5 bec--~~ ~)(~ Ce<)"y Building Name: Street Address: Suite: 2-4.- Manager: Telephone: Occupant Type: ******************************************************************************************************************* TYPE OF INSPECTION CONDUCTED Annual: Reinspection: Commercial: Code Violation: Fire Protection: Sprinkler: Gas: Suppression: __ Qtly: Other: ~ Approved: _ Conditionally Approved: _ Not Approved: ~ ,- ~'......".,~.,~ '.......-: ******************************************************************************************************************* -r-;/lcJ) Comments: " --~ \.. i/ '\) \ \...._. ,r/ ", ****************************************************************************************************************** This building had been assessed by the Zephyrhills Fire Department. Utilizing the Codes and Standards of, NFPA Minimum Standards, the State Fire Marshal Uniform Fire Safety Rules and other local fire safety codes. Code violations specified in this report, if not corrected could cause Crti.contribute to the spread of fire, or prevent safe egress during fire. Your immediate attention to the correction of these violations shall be required, failure to comply is a violation of the City of Zephyrhills Fire Prevention Code. Inspection Date: Inspector Name: (Print) Inspector Signature: Occupancy Representative Signature: Computer Entry: Inspector LD.#: Title: Pre-Fire Plan on File: Page of OCCUPANCY NO.: CITY OF ZEPHYRHILLS FIRE RESCUE INSPECTION DEPARTMENT 6907 DAIRY ROAD ZEPHYRHILLS, FL 33542 (813) 780-0035 Administration: (813) 780-0041 ******************************************************************************************************************* FIRE SAFETY INSPECTION '-r I . ~, Business Name: ,) \, -,) r;:> ':'.," Business Owner: :, \ I i V ~/ ,/ Building Name: Telephone: Street Address: '"') ! ( Building Owner: Suite: Telephone: City: Zip -~) ') '" '-/'(, Emergency Contact # 1 : Manager: Telephone: ? : // Telephone: " -' Emergency Contact #2: Occupant Type: Telephone: ******************************************************************************************************************* TYPE OF INSPECTION CONDUCTED Annual: Reinspection: Commercial: Code Violation: Qtly: Fire Protection: Sprinkler: Gas: Suppression: __ Other: / ',rL_ Approved: ~,. Conditionally Approved: _ Not Approved: _ ******************************************************************************************************************* Comments: '1/ 'J if / //( ./ /;;; ,.I// ../. / / / /' ,1-/7 , , , <~/~/<,> /'.s ? // / ;...... . ,/ <' t:"/ ~-/ ,." /" /",/ ,.." L;:;- ,'//<- ~" (- - > / /,./ /J / c- {-'I C, j ./,/~ i. -' ...",-~ . to t-":' /" ~/'/ ,:-F ...-: ,J' , r?/' ./ .r , t <.~.::.- ~ iJ ~~ / / "", ( (~... ,,"( '~'t ****************************************************************************************************************** This building had been assessed by the Zephyrhills Fire Department. Utilizing the Codes and Standards of, NFPA Minimum Standards, the State Fire Marshal Uniform Fire Safety Rules and other local fire safety codes. Code violations specified in this report, if not corrected could cause or contribute to the spread of fire, or prevent safe egress during fire. Your immediate attention to the correction of these violations shall be required, failure to comply is a violation of the City of Zephyrhills Fire Prevention Code. , I *********************jf******************************************************************************************** Inspection Date: ,,".' i'l' l 1/ Re-Inspection Date: Inspector Name: (Print) i I I <' ) J " //1 Inspector LD.#: /_,~~~..\..~,:_,.. Inspector Signature: Occupancy Representative Signature: Computer Entry: Title: Pre-Fire Plan on File: Page of Revised 04/04 --:+ :1t - dU.~ - '~~'T'-~, ~ t;i\; }til~~s.MT'~ \\'i!n Jje-~~-~.o{ f'tojf.J'iie'~.~fi1:KiiJk.'_ ~..iie-c'~.9f:~!lins .-.-t~~_ '~""-- , . -~.~"".., ~.~,,,,"'."''''~i'''':'''' ..,,,,0:1>""1" ~ ~-".'''~''.'''._, -- ...' '. !-~,Eg