HomeMy WebLinkAbout059-083-011059-083-011 PE
RMIT#96-11
WALTON, Michael & Cheryl
17114 Skyway, Stirling Cites
Cont; Mathew D. Thompson „J ll
Add Garage & Fnd Under/SF fil
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059-083-011 PERMIT#96-1147
WALTON, Michael &Cheryl
17114 Skyway, Stirling City
Cont; Mathew D. Thompson
Add Garage & Fnd Under/SF 5-30- 97
FlCE COPY
jAddress
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GAS .'
Meter By ¢ ate
ELECTRIC
i Meter By Datef/& -
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JOB FINALED (D e) —
Signature
V=OK
O = Not OK
ble
NottR dy
`= MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements - Setbacks - Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location-Test0rap; / P12ft.
/ /Nat. or/ /°L'ft./ /LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector'
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date ECKS, OVERS, CARPORTS, GARAGES Pla OK except #'s
ni g Requirements -Setbacks -Easement
tings; SoilsSize-Depfh-Spacing-Co rs- t
3. Decks; Girders and/or Joists-Deckin - acing -Stairs -Rails
4. Wood A , osts-Bea%�'� onnectors
.
Sh -Rf .-Braeiff
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
'J OK
O = Not OK
Not Applicable
Rea
Not Ready RESIDENTIAL (Single & Duplex) 5
' =
Date UNDERFLOOR (Plans) OK except ft's
1. Zoning Setbacks Easements -Flood -Slope
2. Ftg., Main;'Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage;. Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth)
.. Ft.ig., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel=Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Bfockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test.
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date _ PLUMBING (Permit),OK except a's
16. Water Htr.: Vent -Access -Combustion Air -Baffle
-
-------------- ---------------
17. Water Pipe: Test & Anchor -Nail Protection
------ - --------------------
18. D.W.V : Test -Fittings & Anchor -Nail Protection
19. Shower Pan: Test. First Floor -Tub Access
20. Test Tub & Shower. Second Floor -Tub Access
-------------------- --------------------------------------------
- 21. Gas Pipe: Size & Anchors
-------------- ------------------------------------------------------------------
Date Card B-1 Date Card B-1
----------------------------------------------------------- -------- ---- ------
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except a's
22. Fixture & Transformer Clearance -Ins. Protection
--------- - -------- ---- •- -- ---------------------
23. Elec. Receptacles Spacing -Lights & Switches at Doors
24. Size Boxes & No. of Conductors -Stapled
------------------------------------------------------------- -------- --- - - --
25. Romex Installed Close to Edge of Studs & C.J.
-------------
------ --...-------------------------------................
26. Equip. Ground made up wrMech. Fastners-Bond Gas & Water
----------------------------------------------------- ---- --- - -- - - -- - - - ------- - -----
27 2 Appliance Circuts in Kitchen & Conductor Size,GFI
------------------------------------------..........-
28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size • ga.
Cu or At
------------- - - ----- ------------------------ ---------- -
29. Range Circ. r ga. Cu or AI -Oven Circ. r r ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
------- --------------------------- _ -----._..._. ..
30. Service -Riser Conductors & Ground -Main Disconnect
- ---------------------------------------_.. . --.... ....... ....
31. Equip. Clear --- - ------- ---------- .... ._....
. . ....... ..
32. Clothes Closet Light -Shower Light -Spa Light
--------------------- ----- -- ------
33. Smoke Detector
---------------..------- ....... ... ...-_...------....-_................... ..
Date Card B-1 Date Card B-1
---------------- -- --- . . . - -- ----- ----......... ... ...I... ... ... -
Date Card B-1 Date Card B-1
Date MECHANICAL(Permit)OK except n's
34. A.C. Ducts Insulation & Support
----------------------------------------------------------- ---- _ .. ... .. _..
35. Vent Fan: Exhaust above insulation
. ........... .. ... ..
36. Condensate Drain & Overflow: Size & Grade
---- - - - ............... ...............-- ---.. ....... .
37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet
38 Attic Access & Platform if Furnance in Attic
------------- --- - ---------- .. .. .. ......... ..
Date Card.13-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except a's
39. Sils. Proper Material & Anchors
_.._.. . - -. ... ..._.. ........._. ... ... .
40. Walls Studs -Nailing. Spacing & Bracing - Plates -Sound
...... ... ''' .. .... ............... ...... ..
41. Bearing Walls over Girders & Floor Nailing
.......... ... ........... ................. ... ... ..
42. Draft Stop in Walls (rat proof)
43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub
------------ ....... . -- .. _ .
44. Headers & Beam -Size & Bearing
Date FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
-----------------
51. Property Line Firewall & Openings _
52. Ext. Doors -One 3=Check Garage -3rd Story, 2 Exits
53. -Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54 plywood on Roof Overhang -Attic Vents -Rafter Outriggers
------------ - -
55. Siding -Nailing Veneer
-------------------------------------- - -
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
____________ 57. -Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls: Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
--------------------
---------
----------------------------------------
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except a's
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
-- -I ----------------------------- - -
63. Furnace: Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor -Ducts -Meeh. Protection
--- - -----------------------
64. Bedroom Exiting
-------------------------
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Sub anel: Breaker Sizes & Labels
------ ---------------------------
67. Stairs & Rails
- - - - - -----------------------
68. Fireplace or Stove: Clearances -Hearth
---- -------------------------- ----
69 Elec. Outlets at Wood Panel: Int. & Ext.
----------------------------- - ----------
70. Kit.Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance
- - - - - . _ . .... ----------------------------------- --
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door: Swing -Landing -Closer
�... - ------ ..---------------------------------- - -
73. A.C. Duct in Garage -Damper
...........------------------- --------
----- ----
74. Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor -Meth. Protection
----------------------------------------------- ---
75. Plb.. Elec. & Mech. Equip. Listed for Location
-
--------------------
76.
- ----------------76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
--------------------------------------------
7,. Insulation -Foam -Looked in Attic ❑ Yes
------ ---- -- ---------------------------------------------------
78. Guard Rails & Deck Construction -Post Caps
. .... ..-.. -------------------------------- --
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
.. ... ._. .. - - - -- - - ---------------------
80. Following instld.: Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No:
Planters ❑ Yes ❑ No
-------------------------------------------------
81. Stucco: Brown -Finish
__._._.-...-- - --------------------------------------
82. A C Unit: Disconnect. Electrical. Plumbing
.. ... ... ... ... .....------ -------------------------- --- -----
83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to
Openings
--------------------------------------- -----
84 Water Well: Disconnect. Electrical. Plumbing
------------------------ --------- -----
85 Exterior Elec. Trim: G.F.I. Receptacle -Underground
- --------------------------------
86
------------------------------86 Ventilation Throughout House
87 Glass Protection
88. Corrections from Previous Inspections
-- - -- - ----------------
89 Gas Test -Meters Tagged: Gas -Electric
...__...--------------------------------------
90. Water & Sewer Connected -C/0 to Grade -HD Approval
- - ----------------------------
91. Energy Compliance Certificate -Other Certificates
--- -------------------------------
Date Card B -t Date Card B-1
.._...- --------------------------------------
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
t COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
q6-1
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need.additional explanation,
please contact this office immediately.
— . . 11 n 1 —
Pal
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - OroviUe, California 95965 - Telephone (916) 538-754yy,, PERMIT NO.
APPLICATION AND PERMIT `? L /q'%
ASSESSOR PARCEL NUMBER
059-083-011
ZONING
U
BUILDING PERMIT
OWNER
MICHAEL & CHERYL WALTON
TELEPHONE
873-0292
SQ. FT. OCC. BUILDING VALUATION
576 U 10368.
OWNERS MAILING ADDRESS
PO BOX 74 STIRLING CITY CA 95978
CONT 8900.
CONTRACTOR'S NAME
MATHEW D. TH01,TSON
TELEPHONE
872-1441
CONTRACTORS MAILING ADDRESS
PO BOX 905, PARADISE CA 95967
Fireplace
CONSTRUCTION LENDER
UNIOVOWN
Total Valuation $ 19263:
Filing Fee $ 20.00
LENDER'S MAILING ADDRESS
Permit Fee $ 207 0
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $ 134.55
Energy Plan Checking Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty $
BUILDING ADDRESS
17114 SKYWAY, STIRLING CITY
PERMITFEE $ 361.55
PLUMBING PERMIT Filing Fee 20.00
Each Trap 1 7.00 7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater 23.00
USE OF STRUCTURE
SF [XXDuplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping 15.00 5.00
Each gas water heater or vent 15.00
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
TYPE OF WORK
New ❑ AdditionA Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: ATTGA,R.AGE, !NSTALI, NEW PITA UNDER EX
DWELLING & NEW ESE SER
Mobile Home I S I GI W 1 @20.00
PERMITFEE g 42.00
Contractor
ELECTRICAL PERMIT Filina Fee 20:00
Main Service aOOV OR LESS
( 200A OR LESS ) 23.00
Main Service ( 200A TO 1000A ) 46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in fu orce and effect.! �Z
License Class Lic. No. 6
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUP. SO.
OR ACDNS. ( & ACC. ) 3.Sa FT.go_ 16
NEW CONST. MULTI-OUTLEUTLE T
NON-RESID. ( BRANCH CIRCUITS ) @7.50
( POWER APPARATUS )
8 SINGLE OUTLET S
Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00
BAL .50
Ex. Occup. ( OUFIXED TLETS(RESID.)EA) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMITFEE $ 63.16
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT Filing Fee 20.00
9
Heating
Cooling
Hood 6.50
Ventilation
PERMITFEE $
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
d"', certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith complwith t ose provisions.
01
X Date J " G� 7�
NwkA��--
O ner &-Contractor ❑ Agent
Signa ure of ApplicFired
An OSHA permit is rer excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
I
TOTAL FEE $ 466.71
H!EJD.FEES
IMP
FLOOD
CDVl
PARCEL PD H
ISSU
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
Date
By Z111 J—Y�
PERMITEXPIRESON
(Date)
Receipt No. 201646
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
..-.:.rhe!}.wr,.r..+"'r-1.':1�"!%+^fV'r,.r"".yV1'iY�'..2.,«i'7Vcr"i'..^•wodti"'+r^'eQ'9"...gyPc'`i''��!r.'t..a:Y.Yi'tfY`'"""YK'��•=,�,K7.✓-'`vY�'�.rrfy'r+r. `, T• -:...Y . ,
i ..COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
� {y
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE (916) 538-7541
t
PERMITAPPLIG'ATION DATASHEET
OWNER Nk Ad--/ e4 C� fi
Proposed Building Use Nea<-) goat
&)a /fib,"
ng Inspector
P. ,No' , ,j 7 D'3 3 - o /r
A40! Date 5-d3 `96
At time ofpermit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
v/ DATE RECENED BY
1, All items have been submitted . ....................................... .
2. Plot plans, 3/4 sets, signed by preparer of plans . ......................... .
3. Complete plans, 3/4 sets, signed by preparer of plans . ......................
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans. .... z ........
5. Hazardous Material Form . .............................
6. Energy Design Compliance and supporting documentation. .......... �''"^�•._ _.
7. Statement of Intent for Non -Heated and A/C Buildings . ................I
8. Engineered truss details and layout in duplicate (required prior to plan check). .... 24_
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ..........
10. Fees of $�.
1. Impact�fees as shown on attached schedule.
12. California,Department of Forestry plan approval fees. RC1/6.�p ....
.....
.
13. Flood elevation letter (100 year flood) by Califor ' gineer. ................
14. Sanitation and plot,plan approval Health Department .
15. City of Chico plumbing permit . ........................................ .
16. Plot plan and business license approval from City of Biggs/Gridley. ........ . .
17. Planning approval for (A) Use: (B) Parking:
18. Contact Land Development.about (A) Improvements (B) Drainage. ...........
19. Driveway permit (construction approval required prior to occupancy). .. .. ...
20. Pre -inspection for required. .. o Build 9 nsp� (Date)
21. Contractor's license information. (No., Name Style, Classification). ..............
22. Certificate of Workmans Compensation Insurance . ......................... ?n ��
23. Owner -Builder Verification (Given to owner , Mail to owner ............ w'
24. Recorded copy of Agricultural Acknowledgement Statement . ..................I -a
25. Letter of signature authorization . ....................................... .
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use ......................................... .
28. Mobilehome utility clearance . .......................................... .
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements. ...........
31. Existing violations/expired permits . ..................................... .
32. Plan check list. ................................ '
�
0 .,ice R1a e G.� uJ A kL �lan►� s
34.
When ou issue the rmit .g ocess as follows: Mail IQ owners Mail to contractor.
Telephone f 10 f and hold for pickup at vt�_49 U office. Deliver with inspector.
Other`
Parcel CreationM4 � 11
Acreage Applicant Date of
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air PollutW Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No. C
2. Additional items required:
Pws- MAtla ,
ntractor designer, owner, was advised of above required data by -.K phone _ mail Counter by j Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by G k 5 6 Date Plans approved by (< ( 6iSs d5 Date S, _3o. n
Sets of plans on hold in ,3 File cabinet AP folder
Copy - Department of Public Works .�
r E—.H. USE ONLY
Plot Plan Attached ! C"a
Rwr Plan Amschel iF
Sect to B.D.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Locatio
Plan Annroved for: Sewage Disnosal Water Simniv- PAU(-
,51C -Io 03 -o(�
AP#
PrtvatP WPII
Hold final for:
Final clearance O.K. for:
NOTE: , tai i
Environmental
COUNTY OF BUTTE'
BUILDING DIVISION
DEPARTMENT OF DEVELOPMEN r SERVICES
ani
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
?:a
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•.Y
4
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VI
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Date Inspector
REV 10/92
166M,
DATE — 1114/2006
REPORT TIME 7i48�
050-083-011
INCIDENT NUMBER 492
EVENT NUMBE 545+ LOGGED B TMJ
LOCAL FIRE NUMBE 11R}1� F��, RO NEEDLES
STATE FIRE NUMBER 10� IAA} C}p}q FirA ' �nri�, e'r' BI J
CASE NUMBER 3j ; AR}CARNS MEDICS I
LOCATION u17114 SKYWAY
RP(JASON WAL�TON j PHONE NUMBER 873-
WILDLAND FIRES ❑ ESTIMATED ACRES
STRUCTURE FIRE RESIDENTIAL
OTHER FIRE
MEDICAL AIDS
PSA/OTHER
HAZ MAT
Billable Incident ❑
COMMENTS
BURN
I PRA F6 _ j ECC ❑
REPORT METHO 911 }
_ 01 FIRE INFORMATION.
LFIRE INFO SENT HO EMAIL I BYDAY LOGGED INITIALS MB
J
EMD ❑ OES ❑ Interesting Event d❑
TO IFS13
INCIDENT NAM SKYW_A_Y _. II
START DATE 1/14/20061 START TIME 7:38
DIAMOND # [2.0
CAUSE UNDETERMINE D_��
LAND USEJD�OMES�Tl
ACRES 1'r-0;1 TYPE OF ACRE
DIAMOND 5 ONLY $ DAMAGE TYPE
DOLLAR DAMAGE _ 150000.001 SAVE _ 2500.001
INJURIES/FATALITIES ❑
# CIVILIAN INJURIES #CIVILIAN FATALITIES 0�
# FF INJURIE # FF FATALITIES 0j
FC -40 INFORMATION
♦
11 New Incident, FC40 ❑ DATE OF FC -40 INC
AGENCY INC # I INC P#
FC -40 COMP DATE FC -40 COMP BY
County Notifications RI EARS Hard Copy Recieved ❑ EARS Checked Agenst EARS Computer ❑