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CITY OF ZEPHYRHILLS FIRE RESCUE INSPECTION DEPARTMENT 6907 DAIRY ROAD ZEPHYRHILLS, FL 33542 (813) 780-0035 Administration: (813) 780-0041 /. I I if K-'~ <1# lf6 ~ '& ***********************************************************************************************'******************* OCCUPANCY NO.: FIRE SAFETY INSPECTION Business Name: v ACfJM Business Owner: Building Name: Street Address: Zip 33"Y4L Telephone: Building Owner: Telephone: Emergency Contact #1: Telephone: Emergency Contact #2: Telephone: 3<64qtj (Uls<{ Suite: City: ~~~rt-~~ ~ls Manager: Telephone: Occupant Type: ******************************************************************************************************************* TYPE OF INSPECTION CONDUCTED Annual: Reinspection: Gas: Commercial: Code Violation: Sprinkler: Suppression: Other: Approved: _ Conditionally Approved: _ Not Approved: _ Comments: ****************************************************************************************************************** This building had been assessed by the Zephyrhills Fire Department. Utilizing the Codes ana :;~:1!1dards 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. *****************~*** *~************************************************************************************* Inspection Date: .:; J 0 t5~ Re-Inspection Date: Inspector Name: (Print) Inspector LD.#: //""5 . Inspector Signature: Occupancy Representative Signature: 't. Title: Computer Entry: Pre-Fire Plan on File: Page of Revised 04/04