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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 />Business Name: <br /> <br />Itp /OU-l <br />, <br /> <br />"'T', 1_ <br />..' <br /> <br />FIRE SAFETY INSPECTION <br /> <br />Business Owner: <br /> <br />Building Name: <br />Street Address: <br /> <br />I}l. { <br /> <br />Telephone: <br />Building Owner: <br />Telephone: <br /> <br />", (;c' <br />'.'...; <br /> <br />.- <br />-~) "?'" <br /> <br />/lJ/" C. Y /1 <br />. <br /> <br />Suite: <br /> <br />.. / / <br />7'.' J-/ <br />(..... <br /> <br />---:<~. ~ \. <br />,J <br /> <br />,,) '<, c C <br /> <br />-----:0 - /, <br />Zip -, . '.. ~-~) "-. Y C Emergency Contact # I: <br />Telephone: <br /> <br />City: <br /> <br />Manager: <br />Telephone: <br />Occupant Type: <br /> <br />//' <br /> <br />(,,'c / Emergency Contact #2: <br />Telephone: <br /> <br />******************************************************************************************************************* <br /> <br />Reinspection: <br /> <br />c---'--' <br /> <br />TYPE OF INSPECTION CONDUCTED <br /> <br />Annual: <br /> <br />Commercial: <br /> <br />Fire Protection: <br /> <br />Code Violation: <br /> <br />Qtly: r' <br />,-' , i/ <br />Othe~//_'~ <br /> <br />Sprinkler: <br />Approved: ~ <br /> <br />Gas: <br /> <br />Suppression: __ <br /> <br />****************************~*~.********.~****.* *'****************~*****~}******************************************** <br />/4 1"<' 5""/t'c--j. c::.IC /"7/<-+,/ <br />Comments: ~.,? ,.. / <br />,-V Oil: <br /> <br />Conditionally Approved: _ <br /> <br />NotApproved:_ <br /> <br />;f'e/c' <br /> <br />/' ,.---."'\ <br />t <--.J <br /> <br />****************************************************************************************************************** <br /> <br />This building had been assessed by the Zephyrhills Fire Department. Utilizing the Codes and Standards 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, ifnot corrected could cause or contribute to the spread of fire, or prevent safe egress during fire. Your <br />immediate attention to the corre;!:tio of these violations shall be required, failure to comply is a violation of the City of Zephyrhills Fire <br />Prevention Code. /' <br />*****~**************(*;(** **~,,~~~*********************************~***************************************** <br /> <br />InspectIOn Date: ' ./ ... I // r,) , /Re-InspectlOn Date: <br /> <br />Inspector Name: (Print) /<:~~ j. ,yt,--"'A / ./ L( ~/ Inspector I.D.#: ,//.~ <br /> <br />''''p""..- Signatw-e, ':1:;f:-: ;/7'// " t <br /> <br />~ccupan~y Representative ~."_. './ ~. -,2: ~ <br />Signature. &_,--.:-:'-~~ r.....:---~ Title: <br /> <br />Computer Entry:. Pre-Fire Plan on File: Page of <br /> <br />D.:...nco.od RAinA <br />