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<br />I I <br /> <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 />",.-- <br />It: 7.#- <br /> <br />5{ lJ 1.. <br /> <br />;;;; L/Oc-' <br /> <br />FIRE SAFETY INSPECTION <br /> <br />Business Owner: <br /> <br />Building Name: <br />Street Address: <br /> <br />City: <br /> <br />Zip 33 -s'i z- <br /> <br />Telephone: <br />Building Owner: <br />Telephone: <br />Emergency Contact # l: <br />Telephone: <br />Emergency Contact #2: <br />Telephone: <br /> <br />I (~Ji A II c.... <br /> <br />Suite: <br /> <br />Z;-I <br /> <br />Manager: <br />Telephone: <br />Occupant Type: <br /> <br />******************************************************************************************************************* <br /> <br />TYPE OF INSPECTION CONDUCTED <br /> <br />Annual: <br /> <br />Reinspection: <br />Sprinkler: <br /> <br />Approved: V <br /> <br />Commercial: <br /> <br />Code Violation: <br /> <br />Suppression: __ <br /> <br />Qtly: <br />Other: ".....--- <br /> <br />Fire Protection: <br /> <br />Gas: <br /> <br />Conditionally Approved: _ <br /> <br />Not Approved: _ <br /> <br />******************************************************************************************************************* <br /> <br /> <br />Comments: n;J <br /> <br />(J.;,ll <br />4,;?7~ <br /> <br />SI <br /> <br />'/7 /' 0'';' <br />~Y'I'f <br /> <br />R....&'t <br />S^'y/1 <br /> <br />(V-- t-57 ) <br /> <br />..... /' <br /> <br /> <br />fJo <br /> <br />7.k Or <br />...-/ <br /> <br /> <br />- // <br />5.::; v :r h <br />',,) \ O<...('A"t'(,c \ <br /> <br />~~H!iT ) <br />./ <br /> <br />()-/ <br />!r 1 /c. (, <br /> <br />5/LJC: <br /> <br />oK- <br /> <br />ok <br /> <br />~-<- <br /> <br />CD <br /> <br />r~ h C( v S <br /> <br />1:>, ~ \cl (~5 ,\\..e_ ,+ <br /> <br />****************************************************************************************************************** <br /> <br />This building had been assessed by the ZephyrhiUs 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 /> <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 />*********************~~**~************************************************************************************* <br /> <br />Inspection Date: V/'~/0 ? Re-Inspection Date: <br /> <br />In,peolo, NamqPrint) ~ d~. ~..e/~' '",p"lnd.D.", <br /> <br />Inspector Signature: ~ ~- m <br />/' <br />,-- <br /> <br />/8 <br /> <br />Occupancy Representative <br />Signature: <br /> <br />Title: <br /> <br />Computer Entry: <br /> <br />Pre-Fire Plan on File: <br /> <br />Page <br /> <br />of <br /> <br />Revised 04/04 <br />