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° IDA"Q OCCUPANCY ACTIVITY REPORT
s GLENDALE FIRE DEPARTMENT
2 T 6835 NORTH 57th DRIVE
GLENDALE, AZ 85301 MONTH. DAY YEAR PAGE
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ADDRESS NO. DIR. STREET NAME TYPE SUITE OR UNIT k ZIP CODE
17.51y s� ►� f z:✓� 3
OCCUPAN YNAME L PHONE BUSINESS OWNER'S NAME LAST FIRST MI HOME PHONE
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BUILD/PROPERTY OWNER'S NAME HOME PHONE 4BC LAS TYPE 3 ION
C���PE ��{,G JSPOF❑ACTCONST CMPT❑ OTHER❑
S0.FT.OF OGG.INSP. STORIES STANDPIPE SYSTEM HOUSE LINES FIRE PUMPS HOOD SYS LOCK BOX FIRE LANES
WET❑ DRY❑ NONE W YES❑ NO I YES❑ NO,9 YES❑ NO I YES❑ NO❑ YES❑ NO
AUTO SPKLR SUPERVISED FIRE ALARM SUPERVISED
FULL a PART❑ NONE❑ YES R1 NO ❑ YES I? NO � YES NO
HAZARDOUS MATERIALS BUILD PLACARDED COMPLETION DATE
YES ❑ NO �2 YES ❑ NO H:_ .F: _ R: S:
ITEM CODE REMARKS RECHECK CORRECTED
NO. SECTION C DATE DATE
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The items noted above are in violation of the Glendale Fire Code. This is an ofpcial notice of violation and order to comply REQUIRING
IMMEDIATE CORRECTION. A follow-up inspection will be conducted on by 4:00 to insure compliance. Failure to
comply with this NOTICE AND ORDER will result in a CIVIL or CRIMINAL Complaint. For information regarding this inspection please
contact the inspector at /�3 e
COP E.�EN'I1,Fp / (NAME) IN$PE TOR.
DATE I�/ Ida
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#3320-027A(11-94)