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<br />Business Name:
<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 />***********************************************************************D~'::"************************************
<br />
<br />// 'f /' ',' . '. {/ FIRE SAFETY IN~PECTION';';;--:/ ;~ (/~ / J.. '7 )
<br />( /' 'I ":I,, /(1/ ( I /;.~.. Busmess Owner: / /'lIt( ~ ,( I / b c.j ,;- /<:.A.j
<br />, Telephone: 1.,~)':'/3'-' 'Ii. 7- y~ 22-_
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<br />Building Owner: .H/ \' /.5 ~ 7 I ) - ."v -')')
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<br />OCc;UPAN~Y NO.:
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<br />Building Name:
<br />
<br />Street Address:
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<br />Suite:
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<br />Zip
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<br />"3; <)1"2-
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<br />Telephone:
<br />Emergency Contact #1:
<br />Telephone:
<br />Emergency Contact #2:
<br />Telephone:
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<br />City:
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<br />Manager:
<br />Telephone:
<br />Occupant Type:
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<br />TYPE OF INSPECTION CONDUCTED
<br />
<br />Annual:
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<br />Reinspection:
<br />Sprinkler:
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<br />Commercial:
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<br />Code Violation:
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<br />Qtiy:
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<br />Fire Protection:
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<br />Gas:
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<br />Suppression: __
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<br />Other: ~-'
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<br />Approved: ~
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<br />Conditionally Approved: _
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<br />Not Approved,: _
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<br />******************************************************************************************************************
<br />
<br />Inspector Name: (Print)
<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, 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.
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<br />nspectlOn ate: /. ' ? / ~ / e- nspectlOn ate:
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<br />Inspector I.D.#:
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<br />Inspector Signature:
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<br />Occupancy Representative
<br />Signature:
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<br />Computer Entry:
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<br />'Jl. __--'----.
<br />
<br />Title:
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<br />Pre-Fire Plan on File:
<br />
<br />Page
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<br />of
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<br />Revised 04/04
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