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HomeMy WebLinkAbout05-2304 (3) STATE OF CALIFORNIA 278196 DEPARTMENT OF FORESTRY AND FIRE PROTECTION NOTICE OF DEFENSIBLE SPACE INSPECTION LE-100 (NEW-5/2006) NOTICE OF DEFENSIBLE SPACE INSPECTION THIS IS A LEGAL NOTICE OF FIRE HAZARD VIOLATIONS (IF NOTED IN BLOCK 32) SHADED BOXES MANDATORY-ALL OTHERS OPTIONAL TT-INSPECTOR'S FULL NAME(FIRST.M L.LAST) ' 2. INSPE TOR'S TITLE 3.BADGE NUMBER 4. IINNSPECTOR'S AGENCY- 5. INSPECTION DATE 7 ` _ •'-�""' ! ( ! 3499 ‘0, 1]" SAD-hof-©gr- 6. 17UNIT ID 8. BATTALION NUMBER 9.STATION NUMBER PROTECTION RESPONSIBILITY SRA LRA FRA I .157- Z Q ‘-? z (? -7 B1A ❑ ❑ ❑ 10 AP BOOK 11.AP PAGE 1 AP PARCEL# BLM [9d 7 �/� CAL FIRE ❑ &LA11TUDE VContract County ❑ ❑ (Datum=WGS84) 114. LONGITUDE (Datum=WGS84) USFS ❑ O 0 1 (Decimal Degrees;ex:38.5761) (Decimal Degrees:ex: 121.4969) Other ❑ ❑ 0 I 15. If mailing address for notices is other than inspection location,check here: 0 and write complete address in comments section. 16. N7E 4LAS FIRST) w LA' U _19-Y y /`l 17.ADDRS/ 03 PeA f7 F.A 18.CITY /r 119.STATE 20.ZIP 7 -e : CA Z 21. PHONE NUMBER #1 22. PHONE NUMBER #2 23. E-MAIL ADDRESS - 24.COMMENTS: IF YOU HAVE QUESTIONS CONCERNING THIS INSPECTION NOTICE, CALL THIS PHONE NUMBER: 25. I 26. INSPECTION# ( 27. CITATION# ! 28. FOLLOW-UP INSPECTION DATE: VIOLATION REI PECTION? I LI ❑ ❑ ❑ ❑ I ,� ❑YES NO I ✓1 -2 3 1 2 3 (MM/DD/YYYY) _ jQ int/A I 31. f� 29. No violations observed. 1 30. 0 Alternative practices approved having same practical ACTIONS TAKEN (check if applicable) I effect. See comments section above(14 CCR 1299(c) (check if applicable) Left information material ❑ Discussed clearance with resident 32. . /Left copy of this inspection notice 0 Violations were observed. Additional clearance is needed for the following areas: I '❑\Citation issued (check applicable sections) ❑ Recommend citation to prevention ❑ 30 foot zone, PRC 4291(a): 14CCR 1299(a)(1) ❑Grass ❑ Brush ❑ Trees ❑ Shrubs 33. GENERAL BUILDING ❑ Reduced Fuel Zone(30'-100')PRC 4291(b); 14CCR1299(a)(2) ❑Grass ❑ Brush ❑Trees❑Shrubs CONSTRUCTION TYPE ❑ Remove specific hazardous fuel identified by inspector-14CCR 1299(b) ❑ Wood Siding ❑ Dead and dying woody surface fuels- 14CCR1299(d) EI Wood Roof X,Non-combustible siding ❑ Remove portion of any tree that extends within 10 feet of the outlet of a chimney or stovepipe PRC 4291(c) ❑ Manufactured(Mobile)Home ❑ Metal ❑ Maintain any tree adjacent to or overhanging a building free of dead or dying wood-PRC 4291(d) ❑ Concrete/Block ❑ Maintain the roof of a structure free of leaves,needles,other dead vegetation-PRC 4291(e) ❑ Other ❑ Provide and maintain at all times a screen over the outlet of every chimney or stovepipe that is attached to a fireplace,stove,or other device that burns any solid or liquid fuel. The screen shall be constructed of Deck Present❑ YES NO nonflammable material with openings of not more than one-half inch in size. PRC 4291(f) l \ I 34. FOR ADDITIONAL INFORMATION ON HOW TO COMPLY WITH DEFENSIBLE SPACE CLEARA I'EQUIREMENTS. P n WWW.FIRE.CA.GOV