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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 />/- <br /> <br />(\.\ - <br /> <br />. . ( <br />....~_...\. ,,- <br />J (....... \ ,~(w, if,....'''~_. <br /> <br />FIRE SAFETY INSPECTION <br /> <br />Business Owner: <br /> <br />Building Name: <br />Street Address: <br /> <br />City: <br /> <br />. .~..,-) I <br />-C h <br /> <br />~''''-::'' '-II, <br />Zip ,:) "'::>,' ,I ~. <br /> <br />Telephone: <br />Building Owner: <br />Telephone: <br />Emergency Contact # I: <br />Telephone: <br />Emergency Contact #2: <br />Telephone: <br /> <br />17' ::; -; ""? '~A ,,\ <br />~..Jj / <br /> <br />Suite: <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 />Commercial: <br /> <br />Code Violation: <br />-- <br /> <br />Suppression: ~~ <br /> <br />Qtly: <br />Other: <br /> <br />Fire Protection: <br /> <br />Gas: <br /> <br />Approved: ~. <br /> <br />Conditionally Approved: _ <br /> <br />Not Approved: _ <br /> <br />****************************************************7************************************************************** <br />/ / ' <br />Comments: ~) /;),;{, 1"1/<' /l;;/~ ~c/~l. 11t"~e-.../ r,c./"v' <br />, <br />, <br /> <br />AJU <br /> <br />I <br />/~:: /f,i~ <: <br /> <br />,,0\"//:7' l~ <br />.> .b t:'-- ,c1 <br />/ <br /> <br />/of <br />~ <br /> <br />/ <br />~/., " ' , <br />,,',.../,1";..../ ,; S. <br />// (.,f/ ~'.-'Z--./ /~//7 <br /> <br />, 0"1 ~,. <br />C / '~'--' <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 /> <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 />Inspector Name: (Print) <br />Inspector Signature: <br /> <br />*************************************************************************************** <br /> <br /> <br />r n -<),bZ I L- <br />/' I 1,/ / _ <br /> <br />1{~:~ !L_~I ;i~,!:-: -, <br />"__ .7 f ,7 / /L. <br /> <br />y <br /> <br />Re-Inspection Date: <br /> <br />Inspector I.D.#: <br /> <br />//' .-;> <br />,//~ <br /> <br />Occupancy Representative ::::: (( .,,-:-:~. I <br />Signature: Ui./..~_- <br /> <br />-- <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 />