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HomeMy WebLinkAbout025-290-027..ay.,... TI .,. tit ' i .}�,�} T��t �'l�ir {* t4 '! q r-..�t�� f'1 J• ' = P 1 i . �3:� �3 �� )ftrti i r k t F h.i �' tai• jtr' ': t �! HH ,t -� 1 jt�.�! i 3fi 1 r t t. �i t! j -• t 4 is t t � � 4 ! 2 • e y. - i1 o) ,i.��7 3 ' t } .: r a �,i:T.'� �� �S .-.'.!i",0. . ':i e�R - .. ..ta •�•. t StS j�tH ^..t. -r- r ti. T "~ FIRE DAMAGE REPORT OWNER: o LOCATION: CONTRACTOR: DATE: D p /oa A.P. # ZONING: DATE TO INSPECTOR: PERMIT HISTORY (X NONE ( ) AS FOLLOWS: BUILDING INSPECTOR'S REPORT Building Description: ~I Commercial/Usage: Residential # of Units: [ . Currently Occupied ( ) Yes ( No - Abandoned/Vacant Electric: Electric Currently ( --TUn ( ) Off Condition of Electric 0� Gas: Currently ( )On, ( Off Condition Sanitation: Plumbing Working ( ) Yes (-�lo Obvious Sewage Problems ( } Yes Mobile Home Condition of Utilities: ( ) Damaged - Requires Permit ( ) Undamaged — No Permit Required t Description of Damaged Area: Estimate Cost of Repairs: ( "d Condition of Foundation: ( ) Good ( •) Poor 3 Sketch building on reverse and indicate area of damage.- r a in if repairs needed:. Date?!! , -Z 3 '- c "? r SAM CDF/BUTTE COUNTY FIRE INCIDENT LOG DATE 10/2/03: REPORT TIME LOCATION 11902 VANCE AV RP INCIDENT NUMBER LOCAL FIRE NUMBER STATE FIRE NUMBER CASE NUMBER PHONE NUMBER WILDLAND FIRES ❑ ESTIMATED ACRES STRUCTURE FIRE INDUSTRIAL/MANUF1 OTHER FIRE MEDICAL AIDS PSA/OTHER --------------- HAZ MAT I COMMENTS EMD ❑ OES ❑ 11566: LOGGED BY LKD 10984:'a?sT9iv. RO MCKENZIE ...........; ...................... BI •;;;;;:;•::•.,•::,•::..,,•;::.. MEDICS ...mom ...................... PRA P6ECC El ........:cri......� REPORT METHOD 911 FIRE INFORMATION FIRE INFO SENT HOW EMAIL BY JAMC ; TO STA 73 ---------------- 7-DAY LOGGED INITIALS MB INCIDENT NAME VANCE ................................................... START DATE 10/ 2/03; START TIME 7:50: DIAMOND # 5.0 CAUSE EQUIPMENT LAND USE IFARMIRANCH ACRES Or TYPE OF ACRES DIAMOND 5 ONLY $ DAMAGE TYPE JALL OTHER DOLLAR DAMAGE 160000.00; SAVE10000.00: ...........................: ..... INJURIESIFATALITIES ❑ #CIVILIAN INJURIES 0 # CP ILIAN FATALITIES 0 # FF INJURIES 0` # FF FATALITIES 0: FC -40 INFORMATION FC -40 ❑ DATE OF FC -40 INC w AGENCY INC # ? INC P# ......................................... ... ........................................ : FC -40 COMP DATE i FC -40 COMP BY County Notifications © EARS Hard Copy Recieved ❑ EARS Checked Agenst EARS Computer ❑ A