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<br />OCCUPANCY NO.: <br /> <br />CITY OF ZEPHYRHILLS <br />FIRE RESCUE <br />INSPECTION DEPARTMENT <br />6907 DAIRY ROAD <br />ZEPHYRHILLS, FL 33542 <br />(813) 780-0035 <br />Administration: (813) 780-0041 <br /> <br />-- ., <br /> <br />/56tJ <br />******************************************************************************************************************* <br /> <br />Zip <br /> <br /> <br />Business Owner: <br /> <br />Business Name: <br /> <br />kl~ ~CL-\ <br /> <br />Building Name: <br />Street Address: <br />Suite: <br />City: -t--1~~\l> <br /> <br />Manager: <br />Telephone: ~\'"3 - C1 \ I --'7 b 5 <br /> <br />~<6~ q <br /> <br />CjL~,-\ <br /> <br />15! '-1 <br /> <br />uilding Owner: <br />elephone: <br />Emergency Contact # 1: <br />Telephone: <br />Emergency Contact #2: <br />Telephone: <br /> <br />Occupant Type: <br /> <br />******************************************************************************************************************* <br /> <br />TYPE OF INSPECTION CONDUCTED <br /> <br />Annual: <br /> <br />Reinspection: <br /> <br />Commercial: <br /> <br />Code Violation: <br /> <br />Sprinkler: _ ~s: V Suppression: <br />Approved: ~ Conditionally Approved: <br /> <br />Other: <br /> <br />Not Approved: _ <br /> <br />******************************************************************************************************************* <br /> <br />Comments: <br /> <br /> <br />A:.JeJ,.<.J <br /> <br />vi <br /> <br />I <br /> <br />ifo <br /> <br />p.sz; <br />I <br /> <br />(]j1 <br /> <br />Lifi G >- <br /> <br />6--1 <br /> <br />';)/7] ce <br /> <br />(J ( <br /> <br />S'or9 P J ci 5t- <br />II <br /> <br />))0 <br /> <br />l-~ A-K's. <br /> <br />/. c u Y?..IJ <br /> <br />oIL <br /> <br />T-(J <br />, <br /> <br />1/, CJ("/ ~ ciJ <br />/ <br /> <br />****************************************************************************************************************** <br /> <br />This building had been assessed by the Zephyrhills Fire Department. Utilizing the Codes ana :;~~!1dards of, NFPA Minimum Standards, the <br />State Fire Marshal Uniform Fire Safety Rules and other local fire safety codes. <br />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 <br />immediate attention to the correction of these violations shall be required, failure to comply is a violation of the City of Zephyrhills Fire <br />Prevention Code. <br /> <br />Inspection Date: <br /> <br />Inspector Name: (Print) <br /> <br />Inspector Signature: <br /> <br />Occupancy Representative <br />Signature: <br /> <br />Computer Entry: <br /> <br /> <br />*** **************************************************************************************** <br /> <br />Re-Inspection Date: <br />Inspector LD.#: <br /> <br />113 <br /> <br />Title: <br /> <br />Page <br /> <br />of <br /> <br />Revised 04/04 <br />