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David Everett rl 6— r. EVERE. .-D _.A.. '2443=72B �
Rd & Lassen Ave. _ TT-'
NW Corner Cohasset � � �#'ftl
Chico
,
(FIRE DAMAGE REPORT - 9/17/80 I� p
1270 E. Lassen Ave., Chico
(reroof)
u
Owner:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
Address:
Tenant:
Building Location:-/
Type of Inspection requested:
.m
A.
/fG ,
Date of Inspect -
Inspector
1. dousing Z2 2. Financing 3. Change of Occupancy to
4. Other (specify) %/�E �i�"�tiJ�}C745%
Present use of building:
A. Sanitation (Housing)
1. Water closet:
2. Lavatory:
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating'facilities:
7. Natural light and ventilation:
8. Room and space requirements:
9. Bedroom window or door for second exit:
10. Infestation* of insects, vermin, or rodents:
11. Connecti.oni to sewage disposal:
12. Connection to water -supply:
13. Rubbish and garbage facilities:
14. Comments:
B. Structural
1. Piers and footings:
2. Floor construction:
3. Wall construction:
4. Ceiling and roof construction:
5. Fireplaces:
6. Comments:
C. Electrical
1. Service and ground:
2. Receptacles:
3. Fusing:
4. Comments:
r
D. Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4. Comments:
(continued on hack)
t
1
E. Other
1. sMAintenances and repair: -
2. Fire hazards:
3. Safety hazards:
4. Weather protection: �
~S. tndc:rfroor and attic ventilation:
6. Comments•
F. Commercial Buildings .
1. Roof covering:
2. Distance to property lines:
3. Physically handicapped:
4. Rest-oom floors and walls:
5. Exits:
6. Improvements:
7. Zoning:_
8. Comments° -
G. Field ProbLmis or Violations
1. Problem or -violation (give complete description):
'2. What action taken (give complete description)
3.
What action recommended:
77A. infonuation only -- file.
/ / B. Hold for ten. (10) days, then write letter.
/ / r Write letter.
/% D. Other:
C-18 (1180)
1 ORDER NUMBN
REG' R.U. INCIDENT NO.
J
FIRE NUMBER,
REG.1 R.U. I NO.
START MO. DATE YEAR COUNTY
FIRE NAME:
thru
2 ORIGIN LOCATION
SEC. TOWNSHIq-,N RANGE MILES DIRECTIO. psi h BfROM IN
T
INCIDENT TYPE
IR ❑FALSE ALARM
❑ 00P
GO TO 10
4A RESPONSISILITY.(AT ORIGIN)
46
Z�WDIRE PROT. RESP.c'D.P.R•) STATUTORY
Ref- ✓ STATE ZONE
RESPONSIBILITY
0 ❑ WILDLAND BURNED OR THREATENED
❑ LIGHTNING
SCHEDULE A D.P.R.
��
❑STATE
�O❑
t,3) ❑ UNPROTECTED
X40❑
DISTRICT
• OTHER AGENCY D.P.R.
❑ DOMESTIC
CITY
LOCAL ZONE
aOTHER INDUSTRY- COMRCL.
❑COUNTY .
O® SCHEDULE A D.P.R.
❑ ROAD
❑ U.S.F.S.
80❑ OTHER AGENCY O.P.R. (Unincorp)
[]OTHER
❑ B.L.M.
FEDERAL ZONE
❑ B.I.A.
0 ❑ FEDERAL(except Mill,ary) D.P.R.
❑ N.P.S.
On SCHEDULE A D.P.H.
OTHER FEDERAL
® ❑ MISC./OTHER ('ZONE•)OTHER
s
D7DAMAGE ( 2
. 6 ORvONLY)
Number$ DAMA
❑ NO DAMAGE IN of (Nearest
1000RO Veh/Dwlg 1 2 8/or
TIMBER b/OR
YOUNG GROWTH
WILDLAND VEGETATION
(Other than TS Y G)
AGRICULTURAL PROD
(Other than T8YG)
DWELLINGS
8/OR CONTENTS
OTHER STRUCTURES
8/OR CONTENTS
VEHICLES 8 CONTENTS
OTHER
TOTAL
NATIONAL FOREST, FIRE DIST., CITY 8 STREET NO.,
ETC. /
,r
aON ARRIVAL
❑ 1 VEGETATION FIRE
SIZE
a
.l
❑ OTHER, GO TO 10
DISTANCE (Origin to head) r" F "
Z.41,
ACRES
�!
ACRES =4 _ !*F -ET"' {.
WEATHER (ESTIMATE AT SCENE)
WIND DIRECTION FROM TEMPERATURE.
M.P.H.
4 l�G
1 p �.
+ !u
+ OVER PLEASEIfet
.b•: - � � Ytpty�jY •++�
• 1.
+•- • r••.„ : i ;•.+`,.. CDF 76407.130-0118
CAUSE (STARTS IN
100 OR0 ONLY)
5
Did Trot start In 12
5 or 80❑ SMOKING ❑ EQUIPMENT
❑ LIGHTNING
❑ DEBRIS ❑ PLAY W/FIRE
❑ CAMPFIRE
XARSON L OTHER/MISC.
O:NLAND USE(STARTS IN 0 2 OROONLY)
6
❑ Did not start trF0 2 6 OrO ❑ FOREST -INDUSTRY
❑ DOMESTIC
❑RECREATION
❑ RANCH -FARM
aOTHER INDUSTRY- COMRCL.
❑ DUMP
❑WILDLAND
❑ ROAD
❑NON•-WILDLAND
❑ UTILITY, RAILROAD
[]OTHER
❑ UTILITY, ELECTRIC
D7DAMAGE ( 2
. 6 ORvONLY)
Number$ DAMA
❑ NO DAMAGE IN of (Nearest
1000RO Veh/Dwlg 1 2 8/or
TIMBER b/OR
YOUNG GROWTH
WILDLAND VEGETATION
(Other than TS Y G)
AGRICULTURAL PROD
(Other than T8YG)
DWELLINGS
8/OR CONTENTS
OTHER STRUCTURES
8/OR CONTENTS
VEHICLES 8 CONTENTS
OTHER
TOTAL
NATIONAL FOREST, FIRE DIST., CITY 8 STREET NO.,
ETC. /
,r
aON ARRIVAL
❑ 1 VEGETATION FIRE
SIZE
a
.l
❑ OTHER, GO TO 10
DISTANCE (Origin to head) r" F "
Z.41,
ACRES
�!
ACRES =4 _ !*F -ET"' {.
WEATHER (ESTIMATE AT SCENE)
WIND DIRECTION FROM TEMPERATURE.
M.P.H.
4 l�G
1 p �.
+ !u
+ OVER PLEASEIfet
.b•: - � � Ytpty�jY •++�
• 1.
+•- • r••.„ : i ;•.+`,.. CDF 76407.130-0118