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Home My WebLink About033-320-026ire Prevention Bureau 176 Nelson Avenue roville, CA 95965 Telephone 530-538-7888 ��v szn_SZQ_�in5 A-,, Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report ,r. White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. -- 1 Address: y 7), U - v w ; Business Name: �, (:- ,�, �e_1� , A Owner/Manager: 3y, , ^I¢ f G cc , ; Bus: Hm: Fax: Assistant Manager: Bus: Hm: Building Owner. Bus: Hn: Address: AN INSPECTION OF YOUR FACILITY REVEALED THE FOLLOWING: 1. Fire Extinguishers: Required, service due 0. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 1. fl Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes ❑ No ❑ 18. Other DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: Date: / Discussed. with: (Print)J�+ rai; SS Signed: Battalion 1 2 3 4 5 6 '`7 Station: FPB Inspecting Officer: FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATIONWITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: Fire Prevention Bureau 176 Nelson Avenue Oroville, CA 95965 Telephone 530-538-7888 Fax 530-538-2105 Address: 7.2 A 4-- OwnertManager: Assistant IV mger: Building Owner. Address: Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report 0 =&W Jk1AJC_% Business Name: Bus: Bus:- Bus: us:Bus: Hm: Hm: Hm: "te Copy - Business Yellow Copy - Occupancy File Pink Copy - Station File Occ. Class. /e -.1 . m2.4 Fax: AN INC -PIP PTInN nF VnlTR F A VU .TTV 1tF.VF. A T .FD THF FOI J .OWYNi 1. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate 12. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 13. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 14. Fire alarm system defective 13. Exit lighting: Required; defective 15. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 16. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 17. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 18. Knox Box keys 17. Address posted and visible from road 19. Fire Drill Witnessed Yes ❑ No ❑ 18. Other DETAILED EXPLANATION AND CORREC110IN S: DUMC UI ZU: 77J Date: Discussed with: Signed: �� g — �(_ ZdGr-j (Print) ing Oft Battalion 1 2 3 4 5 & 7 Station: FIRE PREVENTION SAVES LIVES, PROPERTY9AND BUSINESS. VdbR, COOPER- ATIONITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: zlye � AMBULATORY NONAMBULATORY TATE OF CALIFORNIA BEDRIDDEN IRE SAFETY INSPECTION RL*4UEST CAPACITY PREVIOUS CAPACITY See Instructions on reverse. 850 (REV. 10-94) CAPACITY rD. GENCY CONTACTS NAME TELEPHONE NUMBER REQUESTDATE PROGRAM Nadalie Martin 916 445-7771 -- 2-4-04 A/DRF EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUESTCODE Nadalie Martin LICENSE CATEGORY 4A ALC/DRUG FACILITY CODES 1. ORIGINAL A. FIRE CLEARANCE NUMBER OF BUILDINGS 2472 A and B Oro -Quincy Highway LICENSING Department of Alcohol and Drug Programs 2 2. RENEWAL B. LIFE SAFETY AGENCY Licensing and Certification Branch RESTRAINT 3. CAPACITY CHANGE NAME AND 1700 "K" Street None ADDRESS Sacramento, CA 95814-4037 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE L I 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY 6 each building -- -- -- -- -- 6 each building (total 12) FACT UTY NAME LICENSE CATEGORY Tri -County Treatment ALC/DRUG FACILITY STREETADDRESS (Acu91LOCR00n) NUMBER OF BUILDINGS 2472 A and B Oro -Quincy Highway 2 CITY RESTRAINT Oroville, CA 95966 None FACILITY CONTACT PERSON'S NAME ~%ow"' Renee Jones 24+ - SPECIAL CONDITIONS Fsteve Fowler, Fie Captain FIRE Life Safety Officer AUTHORITY CDF Fire/Butte County Fire Department NAME AND 176 Nelson Avenue ADDRESS Oroville, CA 95965 L I INSPECTOR'SNAME; lypedarPdrrted) TELEPHONENUMBER CFIRS NUMBER OCCUPANCYCLASS < �—'V /Z,--53 0 53 8-3 859 04035 R -6.2A INSPECTION DATE INSPECTOR'SSIG NATURE/Typed Pri t / 2-9-04 Y EXPLAIN DENIAL OR LIST SPECIAL CONDITIONS Facility approved for 6 ambulatory occupants in each building 2472 A and 2472 B, Oro -Quincy Highway. CLEARANCEIDENIAL CODE 1 CODES 1. FIRE CLEARANCE GRANTED 2. FIRE CLEARANCE DENIED A. EXITS B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS E. HOUSEKEEPING F. SPECIAL HAZARD G. OTHER FI _ E� SAFETY- INSPECTION: RE EST STD. a sotsw: 0-94):- AGEN YCONTACTS NAME EVAN : TQR'S NAME til- ::Sommers See instrc- ons on reverse. TELEPHONE NUMBER REQUEST DATE PROGRAM 916 3222911. ;CDU . REQUESTING AGENCY FACILITY NUMBER REQUESTCODE 3A LICENSING 5oppament:of A1cohQ1 and Doug Programs A ENCY Wqpsmg: an. CeRiiicaton _ N E AND 17f10 K:Stseet A DRESS 5acraniento, CA. 95814:-4037 L CODES 1. ORIGINAL A. FIRE CLEARANCE 2. RENEWAL B. LIFE SAFETY 3. CAPACITY CHANGE 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY ;pP et'y::: PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY F. . ... 'FY�IAM�: .. ..� A � 1 ::: LICENSE CATEGORY _ Or. wll.e :Recovery : Center: ALCLL�r,ig:�ra�cila�t: - :: STIP ET AbbFiESS'(Adua1Locadon) NUMBER OF BUILDINGS .............................. .......... .... ............. RESTRAINT C*.vi11e.,.CA.,:9-5966-.... ... FAC ITYCONTACTPERSON'S:NAME-' ,`••••," Re gee.. SPEd1ALdONDftNS:::: Steve Fowler FIRE �lre Ma.'shal A THORtTY Butte County dire Department. N ME AND :.,.. 176 Nesan Avenue ............................................... . DRESS ()rovi11e CA X95965 INS ECFOR'SNAI�IIE{1"ypedorPrinted) TELEPHONE NUMBER CFIRS NUMBER OCCUPANCYCLASS 530 538-3859:.:.104555-i,: INSRECTION DATE.::: INSPECTOR'S SIGNATURE(TypedorPrrnted) 3f 4/03 - AtNDENIALORCISTSPECIALGOIVDti'IONS CLEARANCE/DENIAL CODE I CODES 1. FIRE CLEARANCE GRANTED 2. FIRE CLEARANCE DENIED A. EXITS B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS E. HOUSEKEEPING F. SPECIAL HAZARD G. OTHER ,,. 6;z ... �-e-D 5.,...._�L LPli✓c`1� //lJ /��Z i/ t-�.�Od<2-� Z .0, 0 Te)7�L f„^ FAX TRANSMITTAL °" FIRE PREVENTION BUREAU "��"'� BUTTE COUNTY FIRE RESCUE CALIFORNIA DEPARTMENT OF FORESTRY A NO FIRE PROTECTION Also serving Gridley and Biggs Department: 176 Nelson Avenue Orovillef CA 95965 Office (530) 538-7888 Fax (530)538-2105 S�av//l/I��ZS From: S�05. Subject: MESSAGE: � C O� J`S FIRE FAX* SIG — 3co?;?.�24rs) Phone#:530 538-3�'S - Z� 4::p7- 7 19- I)Ilet/�S 400( ,e0000000r 00000e4t*mJ j JAA)e 1 1111 PAGE / OF 7,,,0)_ Aw ire Prevention Bureau Butte County Fire Rescue White Copy - Business 76 Nelson Avenue California Department of Forestry Yellow Copy - Occupancy File roville, CA 95965 and Fire Protection Pink Copy - Station File elephone 530-538-7888 Facility Inspection Report Occ. Class. ax 530-538-2105 Address: Business Name: fi'v~s er/Manager: Bus: Hm: Fax: sistant Manager: Bus: Hm: uildine Owner: Bus: Hm: A1v nvc1D-Vdr7nTv nr Vn7T12 Ti Ar-n.TTV RF.VFA1.Fn TRF, FOLLOWING: 1. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8.Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes ❑ No ❑ 18. Other DETAILED EXPLANATION AND CORi EUHUAS: I.VICKEt - IEL: Date:�� I Discussed with: I Signed: Z /G' (Print) , l7 �IAI Inspecting Officer:: /' Battalion 1 2 3 4 5 '6 7 Station: FPB FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION WITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: January 6, 2003 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX This is to confirm the requirements which were discussed with Mr. Ed Dolder. This conversation occurred this morning at the Development Services Department. 1. Drug and alcohol recovery center in a residential zone is limited by planning use to 6 occupants unless a use permit is obtained. Use of the structure for drug and alcohol recovery center is limited by the UBC to six or fewer occupants -with the structure meeting residential requirements of a single family residence. There are two residences on this property and planning has given the ok to use both residences for drug and alcohol recovery centers with 6 or fewer occupants. 2. We will require a letter of intent from the owner of the business stating how the buildings will be used and the number of people to be housed in each facility. Each separate house on the property is allowed by planning to house 6 occupants as each house is a self contained living unit. 3. Owner must restore kitchen in the rear unit. Kitchen must contain a sink, a stove and a refrigerator. 4. A permit is required to correct an illegal laundry and hot water heating facility located in the rear bedroom. Provide three sets of plans which are to indicate how this will be resolved. 5. After the permit has been approved, issued and corrections made and approved by our inspector and letter of intent has been reviewed and approved by building, planning and fire departments then licensing agency can be notified that buildings are in compliance. Sincerely, Martha Christy Plans Examiner F1 E SAFETY INSPECTION RE EST IV r-Ift BEDRIDDEN See instn on re verse. sTD. (REV. 10-94) CAPACfiy .ins AGE CY C.ONTACTS NAME TELEPHONE NUMBER REQUESTDATE PROGRAM Eil xn Sommers 916 322-2911 0 4 A/DU EVAL ATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE Eileen Sommers STRE ETADDRESS (AdtualLowf n) 3A 24 72B pro -Quincy Highway 1 - CRv CODES 1. ORIGINAL A. FIRE CLEARANCE F—Department 0 of Alcohol and DruLI ENSINGg Pro HOURS 2. RENEWAL B. LIFE SAFETY A ENCY Licensing and Certification N ME AND 1700 "K" Street 3. CAPACITY CHANGE ADDRESS Sacramento, CA 95814-4037 4. OWNERSHIP CHANGE S. ADDRESS CHANGE L I 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAP CRY PREVIOUS CAPACITY CAPACfiy PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY 4 0 0 0 0 0 4 FACT ITY NAME LICENSE CATEGORY Or ville Recovery Center ALC/Drug Facility STRE ETADDRESS (AdtualLowf n) NUMBER OF BUILDINGS 24 72B pro -Quincy Highway 1 - CRv RESTRAINT Or ville, CA 95966 0 FACT M CONTACT PERSON'S NAME HOURS Ej Dolder 24+ CONDITIONS TO BE COMPLETED BY INSPECTING AUTHORITY CLEARANCE/DENIAL CODE 1 [—Steven J. Fowler CODES FIRE Life Safety Officer, Fire Prevention Bureau 1. FIRE CLEARANCE GRANTED ATHORITY Butte County Fie Department N ME AND 176 Nelson Ave. 2. FIRE CLEARANCE DENIED A DRESS Oroville, CA 95965 A. EXITS B. CONSTRUCTION C. FIRE ALARM INS CTOR'S NAME (r"wdorPdnted) TELEPHONE NUMBER CFIRS NUMBER OCCUPANCYCLASS D. SPRINKLERS E. HOUSEKEEPING Y A- 1 530 538-3859 04555 R6.1A F. SPECIAL HAZARD INSF ECTION DATE INSPECTOR'S SIGNATUR orPdnted) G. OTHER 12-30-02 1 !fin Da , . , 10 A EAll XP N OENIALOR LIST SPECIAL CONDITIONS 4 beds must be placed in the living room of residence. Once the Butte County Development Services --Building Division has approved the remodeling necessary to enclose the wager he in r in fire resistant construction --separating it from the rear bedroom, then 2 additional beds may be approved for the home. No beds are to be placed in the kitchen. i �' Californt t Department of Forestry anu Fire Protection F4.0 4s Butte County Fire Department Before requesting the Fire Department's final Fire and Life Safety Inspection for California state licensed facilities (e.g. Community Care Licensing, Alcohol and Drug Programs) the following requirement must be completed: To ensure that the building(s) which will house the new occupancy complies with the laws, codes, standards, regulations and ordinances of the Butte County Development Services Department — Building Division and Planning Division, approval of each division prior to the final fire department inspection is required A wet stamp and signature is required at the bottom of this form once the requirements of each Division have been met NOTE: The Fire Department will continue to do Fire and Life Safety Pre -inspections prior to Development Services' sign -offs. Assessor's Parcel #: ✓ 3 Facility Name: Facility Address: Facility Contact: Facility Phone #: Planning Official: Building Official: l= New Building Occupancy Classification: Planning Division Wet stamp and signature Return form to: (Please print name) (Please print name) Steve Fowler, Life Safety Officer Butte County Fire Department 176 Nelson Ave Oroville, CA 95965 (530) 538-3859 Building Division Wet stamp and signature V Z� 1 Inter -Departmental Memorandum To: BuildingDepartment PlanninDepartment From: Subject Date: Steve Fowler, Fire Department a — /I' -- '/_� 2 -6.a.-I- The attached STD 850 form from Community Care Licensing has been received for our approval. Prior to the Butte County Fire Department making a fire clearance inspection it is requested that your department check for compliance with Butte County ordinances (use permit and zoning) and building requirements and occupancy based on the requested category. Please forward your requirements to this office and we will forward them to the applicant. Planning requirements: Current Building Department Occupancy classification: Building Requirements: Other: CC: U. Moms Chrono File Copy LETTERHEAD STATE OF CALIFORNIA - HEALTH AND WELFARE AGENCY DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS 1700 K Street Sacramento, CA 95814-4037 TDD (916) 445-1942 (916) 322-9897 ADP BULLETIN Page 1 of 7 PETE WILSON, Governor YW4 Title: Issue Date: Issue No. Spring Updates and Reminders for Residential April 1, 1998 98-13 Alcoholism or Drug Abuse Recovery or Treatment Facilities Expiration Date: Deputy Director Approval Function Supersedes Bulletin/ADP Letter No. [ ] Information Management Robert L. Jackson, PC] Quality Assurance [ ] Service Delivery R.Ph. [ ] Fiscal Quality Assurance [ ] Administration Division PURPOSE The purpose of this bulletin is to share new information and comment on some of the problems encountered regarding licensing residential alcoholism or drug abuse recovery or treatment facilities. It is our intent to facilitate better communication and rapport with providers during licensing reviews and complaint investigations, and to reduce deficiencies. DISCUSSION License Format The format of the license is being modified to identify facilities that provide detoxification services, admit both male and female residents, house residents and their dependent children, or have been granted a waiver to serve adolescents. Therefore, it is essential to notify the Department of Alcohol and Drug Programs (ADP), Licensing and Certification Branch, prior to adding or deleting any of these services. Noting the Department of Changes http://www.adp.cahwnet.gov/ADPLTRS/98-13.html 12/18/2002 !�ETT DREAD Page 2 of 7 3OMW The California Code of Regulations (CCR), Title 9, Section 10513, states that the licensee shall not a operate facility beyond the conditions and limitations specified on the license. Licensees are reminded P tY Y to notify the Licensing and Certification Branch prior to changing their legal name (including corporate mergers, dissolutions of partnerships, etc.), moving to another location, increasing the total occupancy or treatment/recovery capacity ca aci of the facility, or changing any of the special conditions identified on the license. Fire Clearance Each licensed facilitymust have an approved Fire Safety Inspection Request Form (STD. 850 form) that PP identifies all of the following: the total occupancy, the treatment/recovery capacity, and the number and e range of adependent children that may be housed at the facility. The portion of the STD. 850 � any y "capacity" c form that specifies ca acity should be completed to indicate the total occupancy. Total occupancy is defined as the maximum number of people who live at the facility and includes residents receiving recovery,treatment or detoxification services; children of residents; and staff (volunteers that receive ' in kind services such as room and board are considered staff. The treatment/recovery capacity �aci refers to the maximum number of residents who receive recovery, treatment, or detoxification services at any one time. The number of dependent children refers to the maximum number of children who spend one more nights at the facility with a parent or guardian, and includes children that stay temporarily at the or g tY facility such as on weekends. Itis important that the licensee maintain a valid and accurate fire clearance for the facility. If the target population of the facility changes to include the dependent children of residents, this needs to be reflected on an approved fire clearance. Should the fire clearance be withdrawn or denied by the local fire authority, CCR, Title 9, Section 10529(c) specifies that the license automatically expires. Legislation The Business and Professions Code Section 719 was changed pursuant to Senate Bill 685, Chapter 444, Statutes of 1995. The Section details the penalties (imprisonment up to three years and fines up to $1017 000) any holding himself or herself out to be an alcohol and drug abuse counselor who YPerson g engages in acts of sexual intercourse, sodomy, oral copulation, or sexual contacts with a client. This also extends to former clients when there was a counsel or/client relationship and the counsel or/client relationshipwas terminated to engage in the relationship (unless the client was referred to another counselor recommended by a third party). Denial of Entry to Licensed Facilities ThisYast ear, some licensees or their star were unaware of ADP's authority to conduct unannounced P licensingreviews and complaint investigations. As a result, department employees were refused access P to the facilityremises. Please be advised that Health and Safety Code Section 11834.35 provides P . authorityfor employees or ents of ADP, upon presentation of proper identification, to enter and � an inspect building, premises and records with or without (i.e., unannounced) notice to secure P Y g information regarding compliance with the licensing regulations. The Department has taken legal action g g to gain entry via an inspection warrant when the licensed provider did not comply. The cost of obtaining such a warrant is borne by the licensee. In order to avoid such a situation, please train your staff regarding ardin these requirements. Please be sure that someone is designated in charge during the absence of the regular administrative personnel pursuant to CCR, Title 9, Section 10564(a)(2). http://www.adp.cahwnet.gov/ADPLTRS/98-13.htm1 12/18/2002 B FD VOLUNTEER FI IECOMPANIES BANGOR BIGGS BUTTE CREEK CANYON BUTTE MEADOWS CHEROKEE CLIPPER MILLS COHASSET DeSABLA DURHAM FEATHER FALLS FOREST RANCH GOLDEN FEATHER GREATER GRIDLEY KELLY RIDGE MAGALIA NORTH CHICO PALERMO PENTZ VALLEY )BINSON MILL -IRLING CITY iERMALITO ) FULL-TIME STATIONS RHAM IDLEY -LY RIDGE RD RTH CHICO DVILLE OUTH CHICO PPER RIDGE CDF FIRE STATIONS UTTE MEADOWS O HASS ET FATHER FALLS OREST RANCH ARTS MILL ARBO GAP ROVILLE HO ARADISE OBINSON MILL TIRLING CITY BU'IjTE FE CENTER AGALIIRA REFTRESTATION NU SERV AVIS butte Coun LAND OF NATURAL WEALTH AND =. U BUTTE COUNTY FIRE DEPARTMENT CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION "Sixty-seven Years of Cooperative Einergency Services - 176 NELSON AVENUE • OROVILLE, CALIFORNIA 95965-3495 TELEPHONE: (530) 538-7111 FAX: (530)538-7401 December 11, 2002 Mr. Jim Adams C/o Oroville-Recovery Centers 2472 Oro -Quincy Highway Oroville, CA 95966 Ref: 2472 A and B, 2479 Oro -Quincy Highway Dear Jim, I have been in contact with the Butte County Development Services Planning and Building Divisions, and Eileen Sommers (your new contact with the California Department of Alcohol and Drug Programs -- Licensing and Certification Branch.) Ms. Sommers has informed me that I now have the authority to complete the Fire Safety Inspection Request form from start to finish. I have attached copies of a Standard Form 850 for each of your three rehabilitation sites. AIR CHICO TTACK BASE Note that the capacity for the home at 2472 A, Oro -Quincy Highway has FIRE LOOKOUTS been reduced to 6 ambulatory residents. Mr. Carl Durling of the County B BLOOMER P LD MOUNTAIN HILL TTE MOUNTAIN Planning Division informed me that you have never applied for a Use S S NWMIUL PEAK occupancy NSET HILL Permit to increase the occuP Y over six . From the Fire ( 6 ) ALSM PROUDLY SERVING Department's point of view the home maintains a reasonable degree of fire C C TY OF BIGGS TY OF GRIDLEY and life safety—even for the 9 residents you now house. However, until you complete the Planning Division's Use Permit process the fire AM vp clearance is granted for only 6 occupants. Mr. Durling said that there is no provision for a "temporary permit." At In addition, the cottage behind 2472 A (known as 2472 B) does not meet any building code definitions to allow it to be used in the manner it is presently being used. The closest it comes to be used as a livable space is as an "efficiency dwelling unit." I have enclosed the code requirements that it would have to meet in order for you to house up to two residents in it. The building department files have no record of the recent remodeling of the structure. In their mind it is an illegal building. Therefore, I cannot allow it to be used by any of your clients until these matters are cleared up with the County Development Services Building Division. In the future, you must complete all Butte County Development Services requirements before you ask for a fire department inspection. If I can be of further assistance, or you desire additional information or clarification, please contact me at the CDF Fire/Butte County Fire Department Fire Prevention Bureau (530) 538-3859. Sincerely, William R. Sager Fire Chief By: Steven 7. wler Life Safety Officer Attachments (3) Cc: Chief Sager Chief Carter Chief Morris Carl Durling Mike Vieira Martha Christie File r . r • r. v• yr •r.• v... ... . F1 E SAFETY INSPECTION RE UEST STD. 850 (REV. 10-94) AGENCY CONTACTS NAME Eileen Sommers EVA UATOR'S NAME E' een Sommers See instr' onsonreverse. TELEPHONE NUMBER ( 916 ) 322-2911 REQUESTING AGENCY FACILITY NUMBER LI ENSING Department of Alcohol and Drug Pro ep g grams G ENCY Licensing and Certification N ME AND 1700 "K" St. A DRESS Sacramento, CA 95814-4037 L J REQUEST DATE PROGRAM AfDRF REQUESTCODE 3A CODES 1. ORIGINAL A. FIRE CLEARANCE 2. RENEWAL B. LIFE SAFETY 3. CAPACITY CHANGE 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUSCAPACITY CAPACITY PREVIOUS CAPACITY 6 9 0 �0 0 0 6 FAC ITYNAME LICENSECATEGORY Ville Recovery Center ALC/Drug Facility STR ETADDRESS (AduafLoca!lon) NUMBER OF BUILDINGS 24'72 A Oro-Qunicy Highway - 1 CITY RESTRAINT Ville, CA 95966 None FACT ITY CONTACT PERSON'S NAME HOURS J' Adams 24+ % Jlvvl 1 RJNQ -TO BE : MP � IN CQ LET�Q SY .. SPECTING -� AUTH ..:: CLEARANCE/DENIAL CODE 1 Steven J. Fowler FIRE Life Safety Officer, Fire Prevention Bureau AU HORITY Butte County Fire Department N E AND 176 Nelson Avenue A DRESS Oroville, CA 95965 L J CODES 1. FIRE CLEARANCE GRANTED 2. FIRE CLEARANCE DENIED A. EXITS B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS INSP CTOR'SNAME (TypedorPhnled) TELEPHONENUMBER CFIRS NUMBER OCCUPANCYCLASS E. HOUSEKEEPING O 530 l 538-3859 04555 R 6.2.A F. SPECIAL HAZARD INSPE CTION DATE INSPECTOR'S SIGNATURE(T)ped Printed) G. OTHER 12-3-02 EXPU JN DENIAL ORLIST SPECIAL CONDITIONS Cap city reduced until facility contact person applies receives a "Use Permit" from the Butte County Developmental Services --Planning (1Div sion for increasing resident capacity over six. Thi should have done prior to the fire department inspection. No use permit is required for up to 6 residents. Name JEDWARDS JOSEPH C' ETAL Asmt # 033.320-026-000 FE 1033-320-026-000 _._____. Status ,ACTIVE Status Dake Ad r1 PO BOX 1343 —_ Tax 000 N0RPr1AL O'vrNERSHIP TRA 1091-018 Ad r2 BERRY CREEL: CA 95916 Situs 2472 ORO QUINCY HWY OROVILLE Ad Jr31.Base Dt M01/2000 101 12000 Ad r4 Land 20,400 Timber Preserve Structure 96,900 AgPres Co Fixtures' 0 ments 3332002600 CONVERTED 09/08188 r Etal CreE - —._ Growing 0 king Doc# 1981 R2599472 Date ry Notes Total L&Ij 117,300 Cur f Bonds ent Doc# 2001IR13049971 Date 1212012000 Fix. R 0 Multi Situs Killi g Doc# Date ! F Flag1 MH PP 0 Asmt Desc 12472 ORO QUINCY 1 -1%. -VY SuplCnt 2' F Flagg PP 0 Zoning R1Dwe11 0 F 910 MH Exempt 0 A res1S Ft 1.u1 N/0033 f Asmt PP Pen Net 117.300 q — -Tax 17 PP Pen iRIC#I Appeal Pending T1R Dtf Split Pending R1C Stat— HY OWN EXP TAX HON ATT SIT APR. PCL I - ► ►� Find L1 - 2002 sa 00712312002 6:02:00 PM _ ��ry'j 1:�+ rership H. 22 S -lei T , C3 .3 6� 0 ,03 a-%. Oda : �l f y n O n r E a F .� J E PH � ; : E:T L -- [ f. y M 1 K Y ' t '.D n rF/ - S • v. x r.: K O - r Ow •- _ _ ev - f l: a' .b yi �-f - - -rima S � a �C� -r�� j!R_� is 1 - rti aL ! D�� DA N EY VEDA AR LE N E ESTATE OF _ .... . ; .. ,N 50.000000% i 199319 00713 _ ' 199419 35306.- '11/06/1991 LED ER NANCY JANE N 50.000000% 19938 00713 19941935306 11/06/1991 T H M PS O N J E S S I E MAY E S TATE O F � 100.000000 � 19921 D 112690 19931900713 E 01/07/1993 DAB EY LESLIE N 25.000000% 1994R 35306 19971942235 111/12/1997 LED R AR LI N W & NAN CY J ! N 50.000000%11994R35306 1997R42235 11/12/1997 r DAB EY STEVEN N 25.000000% 119948 35306 1997R42236 111 /12/1997 LED R AR LI N W & NANCY J N 75.000000%11 997R 42235 19971942236 11112/1997 H U ERT LE S T E R L& D E NA L Y 100.000000% i 1997R 42236 1998190055393 112/28/1998 H U ERT D E NA L Y 100.000000% 1998R 0055393 2000190042258111101/2000 E D ARDS JOSEPH C _ Y --._.. j 100.000000% 1 20008 0042258 --------.--- 1200OR0042260 _.._- - - - 1:11101/2000 ED ARDS JOSEPH Cx - - Y 0.000000% E 2000R 0042260 20008 0049971 '12120/2000 CAB E WILLIAM ZACHARY N 0.000000% 1 20008 0042260 : 2000R 0049971 12/20/2000 c L - -7 r _ r o - 7-7.77. I •.Vii - - + - 'o I -! ..1 s. _ I, s - 1 •}5 A a � 1' 09. TO 9 5 �� .. PSI l" i C ra Kiri elea irti mere r ` r k9 s s :C 1 .. AS0200INQ: PC Physical Characteristics (All Documents] Dec 05.1 2002 01:52 pm Asmt R9733-320-026-000 Fee Parcel 1 033.320.026.000 Owner IEDWARDS JOSEPH C x ETAL Land Description Acres 1. 07 Land Sq Ft 0 Land UseF FTIPLE RES, NOT MATCHINGDqvr ree- I j E New] 4' Save Q) Cancel Property TypeI :qV1 Residential Residential Land DesCiription H msites 0 #Bld Sewer Src V Prop Cond�� Utilities�� Water Src Subdivision N �s0 #Unitsj 2 View F1 V Pool0�� Access -- U nsec Bldg r Description A Description A Comment 0Leleke �. Delete All 0 iy,.Nm Fired 0 D Name EDWARDS JOSEPH C 11 ETAL Addrl 1PO BOX 1343 Addr2 IBERRY CREEK CA 95916 Addr31 Addr4 Comments 3332442604 CONVERTED 0910$188 J Creating D oc#198182599472 Date Current Doc# 1200OR0049971 Date 112/20/2000 Killing Doc# Dake I Asmt D esc2472 ORO Q U I N CY J Zoning R 1 DwelI10 Acres/Sq Ft1.701 .4, 1 N/C1033 PHY I OWN I EXP re -1- i ee SuplCnt 1 2 TAX Asmt # 10733-320-026-000 Fee #1 033-320-026-000 Status ACTIVE Status Dake Tax 1000 NORMAL OWNERSHIP TRA 091.018 --- Situs 12472 ORO QUINCY HWY OROVILLE Base D t 111 r Timber Preserve r AgPres ry E t a I r7o Notes r Bonds r Multi Situs r Fla 1 r Flag2 r 910 MH r Asmt PP Pen r Tax PP Pen r Appeal Pending r Split Pending Land S ructure Fixtures Growing Total L&I Fix. R MH PP P Pp 20,400 96,9 00 0 0 117,300 0 0 0 Exempt) 0 Net 1 117,300 R/C#j T/R Dt I RIC Statl HON I ATT SIT APR, PCL 0 � V.... - V. -49 V*.1*as . =F1 E SAFETY INSPECTION REQUEST STD. (REV. 10-94) See instrc ins on reverse. .,,GEt ICY CONTACTS NAME TELEPHONE NUMBER Eileen Sommers 916 322-2911 EVAOR'S NAME REQUESTING AGENCY FACILITY NUMBER T:n Sommers LI ENSING F—Department. of Alcohol and Drug Programs A ENCY Licensing and Certification NAME AND 1700 "K" Street A DRESS S,acramento, CA 95814-4037 J REQUEST DATE PROGRAM AMRF REQUESTCODE 3A CODES 1. ORIGINAL A. FIRE CLEARANCE 2. RENEWAL B. LIFE SAFETY 3. CAPACITY CHANGE 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE 6. NAME CHANGE 7. OTHER AMBULATORY NON%MBULATORY BEDRIDDEN TOTAL CAPACITY CAP CRY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY 0 0 0 =0 0 0 0 FACI RY NAME LICENSE CATEGORY Qr vide Recovery Center ALODrug Facility STR ADDRESS (AclualLocaffon) NUMBER OF BUILDINGS 24 2 B aro-Quincy Highway 1 CITY RESTRAINT ar ville, CA 95W 0 FACII 17Y CONTACT PERSON'S NAME HOURS J4 Adams 24+ CONDRIONS 12-B-02 =-XPUdNDENIALORLWSPECIALCONWIONS Me al occupancy --no specific occupancy See attached letter. for this structure. May have been remodeled without building permits. V . I • � y• VI ...I• VI •• •.. F1 E SAFETY INSPECTION REQUEST s-ro 850 (REV. 10-94) See instrons on reverse. "AGE Y CONTACTS NAME TELEPHONE NUMBER een Sommers 916 322-2911 EVA UATOR'S NAME REQUESTING AGENCY FACILITY NUMBER een Sommers _i ENSING F—Department of Alcohol and Drug Programs GENCY Licensing and Certification 4 1 E AND 1700 "K" Street A DRESS Sacramento, CA 95814-4037 L REQUESTDATE PROGRAM AlDRF REQUESTCODE 3A CODES 1. ORIGINAL A. FIRE CLEARANCE 2. RENEWAL B. LIFE SAFETY 3. CAPACITY CHANGE 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY 6 6 0 -0 0 0 6 FAC BYNAME LICENSECATEGORY Oioville Recovery Center ALC/Drug Facility STR ADDRESS (Ad WLocabon) NUMBER OF BUILDINGS 2479 Oro -Quincy Highway 1 CITY RESTRAINT 01 Ville, CA 95966 0 FACT M CONTACT PERSON'S NAME HOURS J'Adamis T - 24+ CONDITIONS TO BE COMPLETED BY INSPECTING AUTHORITY CLEARANCE f DENIAL CO DE 1 Steven J. Fowler �I CODES FIRE Life Safety Officer, Fite Prevention Bureau 1. FIRE CLEARANCE GRANTED AU HORITY Butte County Fire Department N E AND 176 Nelson Avenue 2. FIRE CLEARANCE DENIED A DRESS Oroville, CA 95965 A. EXITS I B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS INSP CTOR'S NAME (T"wdorPdnted) TELEPHONE NUMBER CFIRS NUMBER OCCUPANCYCLASS E. HOUSEKEEPING f - 0 w t, — 530 ) 3859 04555 R6.2.A F. SPECIAL HAZARD INSP EECTIONDATE INSPECTOR'S SIGNAT RF„ (j3WorP'Vnted) G. OTHER 12103-02-- EXPLOJNDENIALORLWSPECIALCONOMNS Facility had requested infant (non-ambulatory) city change. This would have required a Use Permit and Butte County Development Se ices --Planning and Building approval. Facility contact withdrew request. 0 A s0900: Mara Development Services Department Dec t13, 2Q02 7Q:73 am Lmt 1933-320-026-000 Status A TRA 091.018 Building Num 1 1 Building Class DF65FDM Effect Year1963 Cooling CN Land Type [R77 Garage SqFt 0 Year Built 1963 Heating [C7N Num Pools �- Unik Mum 1 .� S q Footage 3213 Num Bedrooms 6 Num Baths F��5 Num Fireplaces Values Improvement Lard H 0 E xempkion Comments FP, -06001 7-365BX B.C.F.D.(SRA) OROVILLE #5 General Additional k.Ph_y Char & Comments r. --m I ore I ps- j_" nit Save N | Ad ----- ��---'-- �---- - `|EDW ARDS JOS ErH C^E|, � ----------- Asmt # Fe '-''-''-'-' ' ---- __ Status r�v�-----'' - Status - |pO8��1343 '- / / Tax I-0-0-0-- ERS H|p- TRA ' ERRYCREEKC�853 G ' ,---------------�- ' �m S 2472 ORO QU|NCfH\vY OROVLLE �[��-�----------- � -----' ' IF Timber Preserve Structure�— F- AgPreo | 961,900 �� 3332OO2GOOCONVERTED OS/O80O � 'F �F� E�� | ---|-------� Growing, 0 gDou#111S0R2588472 Date Fv- Notes Total�� I 117,300 ---'' ---�- ' �Doc#2OUURUO43S7 Do� 12/2U/2OOO � - — [- Bonds �[- Multi Situs ' Fix. RP _ _ Doc# Uate [- Flagl mn PP 0 ritDesc|2472OROQU|NCYHWSuplCnt2 [- Flag2 PP 0 --- 6�-' Zoning R1 D*o ° [- S18�H � ^°'t ��qRU�N N/C|033 [-AomtPPPon m�L /|/�u» F Tax PpPen '""� � |F- Appeal Pending T/R[u| - | | ----- /[- Split Pending Ig _IR/CS ati N | ATT^ | SIT | APR-'� _12002 isa, 07/23�2002 6:02:00 PM '� rand 00MQ: OwnershiHist Ownership History Dec 03, 2002 ?0:06 am A MT '033-320.026.000 Fee # ;033 320 L J00 Owner'EDWARDS JOSEPH C' ETAL Document Own r HW Primary Ownership % Granting Releasing Rel. Date TH0 PSON JESSIE M SS Y 100.000000%1 19KID112890 01:01!1900 �� r ��rr�� _ -�r PM-OrAZINOW LED 719 NANCYJANE N 50.000000% 1993800713 19941935306 11106}1991 THC APSON JESSIE MAY ESTATE OF `r 100.000000% 19921D112890 1993800713 01/07/1993 DAB 4EY LESLIE N 25.000000% 19941935306 19971942235 11/12/1997 LED R ARLIN W & NANCY J N 50.000000% 19941935306 1997842235 11112/1997 DABI 4EY STEVEN N 25.000000% 19941935306 1997842236 11/1211997 LEDER ARLIN W & NANCY J N 75.000000% 19971942235 1997842236 1111211997 HUB RT LESTER L & DENA L Y 100.000000% 19971942236 199880055393 1212811998 HUB RT DENA L Y 100.000000% 199880055393 2000190042258 1110112000 _ ED RDS JOSEPH C Y 100.000000% 200080042250 1200OR0042260 1110112000 EDVv ARDS JOSEPH C' Y 0.000000% 200OR0042260 200080049971 1212012000 f A.B E WILLIAM ZACHARY N 0.000000% 200080042260 200080049971 1212W2000 775% '. IJ ► ►t - B IJ [Doub a click on Granting/Releasing document number to see history ,2002 FNV019,101061199912:35:09 PM EDWARDSJOSEPH "ETAL GABLE CHARLOTTE FPO BOX 1343 BERRY CREEK CA 9591 AM, gents 13333100500 CONVERTED 09108/88 ------------ ng D oc#1 1 98OR 0692100 Date, - - — :ntDoc#',2001R0001G36 Date 0111612001 Dac# Date' _..-_..__ :mt Desc 2479 ORO QUINCY HWY SuplCnt 2 Zoning R1 Dwell 1 slSq Ft 10.21N1C 033 ;Asmt # I I Fe 1033-331-005-000 s: Status ACTIVE O Status Date l Tax j000 NORMAL OWNERSHIP TRA 091.019 Situs 2479 ORO QUINCY HWY OROVILLE Base D 11211812000 ' Land 20,400 r- Timber Preserve Structure 42,840 J- AgPres Fixtures 0 F- Etal Growing 0 W Notes r Bonds Total L&I 63,240 F Multi Situs Fix. RP 0 F Flag1 MH PP_ 0 F Flagg PP 0 F 910 MH Exempt 0 F Asmt PP Pen Net 63,240 F Tax PP Pen R/C#; -- r Appeal Pending T1R Dt'.-- F- Split Pending WC Stat HON I ATT I SIT APR PCL 2002sa, 07123/2002 6:02:00 PM Find 001NQ: OwnershrpHist Ownership History Dec 03, 2002 a0:0s am� MT 033-331-005.000 Fee # 1033-331-L J00 Owner JEDWARDS JOSEPH - ETAL _ Docum_en_t :r I HW j Primary] Ownership %I Granting Releasing Rel, Date BLAE ER STEFFAN EDWARD BLAE ER STEFFAN EDWARD__ MOREQUITY INC ED RDS JOSEPH Y 100.000000% 1990802074 199BR35995 08/24/1998 Y 100.000000% 1998835995 200080009350 03116/2000 Y 100.000000% 200080009350 200080049624 12118/2000 Y 100.000000% 200080049624 200180001636 0111612001 500% 0 a click on Granting/Releasing document number to see history F20-0-2-- rCNV019,10/06}199912:35:09 PM 71 I Na e EDWARDS JOSEPH C . ETAL i Adc r1 PO —BOX -1 --- 343 Ad r2 (BERRY CREEK CA 55316 Asmt # 19111011=Fe J33 320 026 000 Status ACTIVE Status Dater Tax ;000 NORMAL OWNERSHIP TRA 091.018 Situs ,2472 ORO QUINCY HWY OROVILLE Base D 11110112000 - Preserve r Timber Pres Land 20,400 r AgPres Structure 96,900 n s 332 r Etal Fixtures 0 _ _ - _ Doc# 198182599472 Date g _ R- Not r N otes Growing 0 _ _ it Doc# 200080049971 Date 1212012000 r Bonds Total L&I Fix. 8P 117,300 0 - ----- Doc# Date F Multi Situs r Flag1 MH PP 0 7t Desc 12472 ORO QUINCY HWY SuplCntr2 r FIag2 PP 0 ZoninglR1 Dwell r 910 MH Exempt 0 31Sq Ft 1.01 N1C 033 F Asn�k PP Pen Net 117,300 F Tax PP Pen R1C#F— r Appeal Pending; T1R Dt�– r Split Per-�dir-� 9 R1C �kdtr ------ c - IY OWN , EXP I TAX HON I ATT SIT � Find 002 �sa, 0712312002 6:02:00 PM as0 oofAP: OmershpH st Ownership History Dec 03, 2002 90:06 am A MT 033-320-026-000 Fee # 033-320-L. X00 Owner JEDWARDS JOSEPH C . ETAL Document Own r I HW I Primary] Ownership %I Granting Releasing Rel. Date THO PSON JESSIE M SS Y 100.000000'; 1992 1112890 01101!1900 MOWN 11R.M.2111111111111 LEDI R NANCYJANE N 50.000000' 1993800713 1994835306 11/0611991 THO IPSON JESSIE MAY ESTATE OF Y 1100.000000% 1992ID112890 11993ROO713 01/0711993 DAB EY LESLIE N 25.000000' 1994835306 1997842235 11/1211997 LED R ARLIN W & NANCY J N 50.000000' 1994835306 1997842235 11/1211997 DAB 4EY STEVEN N 25.000000' 1994835306 1997842236 11/1211997 LED R ARLIN W & NANCY J N 75.000000% 1997842235 1997842236 1111211997 HUB RT LESTER L & DENA L Y 100.000000% 1997842236 199880055393 12128/1998 HUB 7RT DENA L Y 100.000000' 199880055393 200080042258 11/0112000 EDWARDS JOSEPH C Y_ 100.000000' 200080042258 200080042260 1110112000 ED RDS JOSEPH Cx Y 0.000000' 200080042260 200080049971 1212012000 CAB LE WILLIAM ZACHARY N 0.000000' 200080042260 200080049971 12/20/2000 775' click on Granting/Releasing document number to see history 2002 CNV019,101061199912:35:09 PM W EDWARDS JOSEPH . ETAL Asmt # Fe, 333-331.005-000 GABLE CHARLOTTE Status ACTIV ' i Status Date -_ _ _--- Tax 000 [N—ORMAL OWNERSHIP TRA k91-0�---19 PO BOX 1343— - --- - ... -- Situs x2479 0 R 0 QUINCY HWY 0ROVILLE BERRY CREEK CA 95916Base Dt X12/18/2000 ' -- Land 20,400 r Timber Preserve Structure; 42,840 F AgPres Fixtures 0 mts 13333100500 CONVERTED 09/08188 r Etal 9 - G rowin 0 g Doc# 1 9888 0692100 Date � Notes i__ ___ - _ r__— _-___- r Bands Total L&I 63,240 ras01<OQINQ: nwnershr Hist Ownership History Dec 03, 2002?0:03 am ASMT 033.331.005-000 Fee # 033-331-L J00 Owner [EDWARDS JOSEPH x ETAL Document - - Owner HW Primary! Ownership %I Granting Releasing Rel. Date BL4 ER STEFFAN EDWARD Y 100.000000% 1990R02074 119981935995 08/24/1998 BLA ER STEFFAN EDWARD Y 1100.000000'/.11990R35995 12000R0009350 03/16/2000 MOF EQUITY INC Y 100.000000% 200080009350 1200080049624 12/18/2000 EDV ARDS JOSEPH Y 100.000000: 200080049624 2001 80001636 01 /16/2001 500% il_ t fat Doube click on Granting/Releasing document number to see history 2002 !CNV019,10-/06/199912:35:09 PM 7e.ree-C% State of California "'I - 64 __4,L Department of Alcohol and Drug Programs CERTIFICATION is hereby granted to the following alcohol and/or other drug program, pursuant to Health and Safety Code, Sections 11831.5 and 11994: OROVILLE RECOVERY CENTER WOMEN'S HOUSE 2472 A&B ORO QUINCY HIGHWAY OROVILLE, CALIFORNIA 95966 Services Certified. RESIDENTIAL ALCOHOL AND/OR OTHER DRUG SERVICES Effective Date: 06114101 Expiration Date: 01131103 Certification Number. 040009AN This Certificate establishes that the program listed above Meets or exceeds the minimum standards set by the Department for the services listed in this Certificate. This Certificate is not transferable. Department of Alcohol and Drug Programs y Authorized Representative of Certifying Agency r � s •tia tte oun tq ms's PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE * OROVILLE. CALIFORNIA 95965-3397 TELEPHONE: (530) 538.7501 FAX: (530) 538-7785 April 19, 2001 Jim Adams Oroville Recovery Center 2472 Oroville Quincy Highway Oroville, CA 95966 Re: Zoning Approval for a Residential Care Facility, as defined. in Section. 2.4-120(b)(6.) of the- Butte heButte County Code, located at 2472 Oroville Quincy Highway, Oroville, APN 033-320-025 and 026 Dear Mr. Adams: The Qmdllc Recovery en, ter- Women's Facility (Name of program) ❑ this document indicates location approval for building use Wis not required to obtain a use permit to operate Wa residential or ❑ an outpatient alcohol and/or drug treatment program at: (Address of program) (Name, title, and telephone number of individual confirming compliance [typed or printed]) (Signature of local planning department representative) q // -7/0 t (Date signed) so fames j ad MS From: Betts, Steve <SBetts@ButteCounty.net> To: 'james j adams' <jadams2@jps. net> Sent: Monday, October 23, 2000 8:48 AM Subject: Group homes for six or fewer persons Jim, Wage 1 of l This e-mail is to confirm our phone conversations regarding having more than one group home per parcel if there are two separate dwelling units on the parcel. If the two dwelling units were legally placed on the parcel the County cannot preclude the use of each dwelling for a group home of six or fewer persons. State law is very clear that local agencies cannot treat a group home of six or fewer persons any differently then a family residential use. If two separate families can live on the same property in two separate dwellings, then two group homes for six or fewer persons can also be placed in those dwellings. This would also apply if there is a two story duplex on a parcel. If you have any further questions please don't hesitate to call. ;rt.� :U Stephen Betts Senior Planner Butte County Planning Division (530) 538-7153 1/26/01 ST TE OF CALIFORNIA FIRE SAFETY INSPECTION REUdEST STT. 650 (REV. 10.94) See instructions on reverse. :NCY CONTACTS NAME TELEPHONE NUMBER CHUCK BROWNING 91Y 322-2911 LUATOR'S NAME CHUCK BROWNING REQUEN8fGW4p6$VVff SING F Department of Alcohol & Drug Programs I ICY Licensing and Certification Branch AND 1700 "K" Street Ess Sacramento, CA 95814-4037 INAME C�r_ ADDRESS (Actual 41 i 7� 4^nUII 1 t�uu� TORY NONAMBULATORY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPA I i I I FIRE AUTHORITY �� s-_-s/,��J �Fi-1G�•� NAME AND ADDRESS INSPECTOR'S NAME (Typed or Printed) TELEPHONE NUMBER INSPECTION DATE INSPECTOR'S SIGN RE (Typed or Printed) , GLS EXPLAIN DENIAL OR LIST SPECIAL CONDITIONS REQUEST DATE PROGRAM A/DRF REQUIX CODE PPII CODES 1. ORIGINAL A. FIRE CLEARANCE B. CONSTRUCTION 2. RENEWAL B. LIFE SAFETY 3. CAPACITY CHANGE CFIRS NUMBER 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE 6. NAME CHANGE C/ C� 7. OTHER BEDRIDDEN I TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY e Y' LICENSE CATEGORY A LCII)R 1 . F NUMBER OF BUILDINGS RESTRAINT NONE HOURS 24+ CLEARANCE /DENIAL CODE CODES 1. FIRE CLEARANCE GRANTED 2. FIRE CLEARANCE DENIED A. EXITS B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS CFIRS NUMBER OCCUPANCY CLASS E. HOUSEKEEPING C/ C� F. SPECIAL HAZARD G. OTHER Sl ATE OF CALIFORNIA IRE SAFETY INSPECTION RE JEST S7 D. 850 (REV. 10.94) See instructions on reverse. AC ENCY CONTACTS NAME CHUCK BROWNING TELEPHONE NUMBER 91 322-2911 REQUEST DATE, Pq F J XATOR'S NAME CHUCK BROWNING REOUESI7�AGF�1G`GEACIIITKNUIdgER 1V lJ 1 AJJ1li1V L� L Y r.1 u5g REO lAT CODE CODES 1. ORIGINAL A. FIRE CLEARANCE 10ENSING Department ofAlcohol &Drug Programs AGENCY Licensing and Certification Branch 2. RENEWAL B. LIFE SAFETY AME AND 1700 "K" Street 3. CAPACITYCHANGE ADDRESS Sacramento, CA 95814-4037 4. OWNERSHIP CHANGE S. ADDRESS CHANGE L 6. NAME CHANGE T OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY FACILITY NAME Orgy; ' LICENSE CATEGORY � r E r ALC/DRUG FACILITY STI IEET ADDRESS (Adual Location) NUMBER OF BUILDINGS t fl 1 LA i+ ki G CI ii RESTRAINT O V t I 1 NONE FACILITY CONTACT PERSONS NA4E HOURS 24+ :IAL CONDITIONS �t1 Q (t�SP GIN WITTY WN CLEARANCE /DENIAL CODE CODES AUTHORITY FIRE 1. FIRE CLEARANCE GRANTED N ;; �� ,/� ME AND///L- F�/=1 — /G��`�— ADDRESS 2. FIRE CLEARANCE DENIED A. EXITS h�7zlf B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS INSI IECTOR'S NAME (Typed or Printed) TELEPHONE NUMBER CARS NUMBER OCCUPANCY CLASS 1 c } ��L �� (` t�73�� %y (5-3e� �1 e e!5 �LW 3 E. HOUSEKEEPING �1� J�j s: S� F. SPECIAL HAZARD G. OTHER INSRECTION DATE INSPECTOR'S SIGNATURE (Typed or Printed) % — Zi OD LGZ L- K� 1 EXP IN DENIAL OR LIST SPECIAL CON ONS S L /'f/� r�1�'T v r ----------- 2 Z.4ove Orville Recovery Center Plot Plan 2472 Oroville Quincy Highway 53r53,4 7321 °o tj "I k i. ON 19.W v � � ----------- 2 Z.4ove Orville Recovery Center Plot Plan 2472 Oroville Quincy Highway 53r53,4 7321 0 Oroville Recovery Center Women's Facility BC..J .B 2472 Oro Quincy Hwy Oroville, CA 95966 s t � I ZOO 14 C Of -4 If x Z q' 6gr� re � `�du•vo.cr- 1, -c a ,� Po,�T �j �• / i> Lv l4 L K w•q Y M 3 C4 ! ! ,,One ~ — i ._.._...._...___..._�...�.........._. SWIanBob �' 1 t � 310 t� ti 112 Odh aff Q` Bedroom t � e.dnxw, Bedroar, v c RoanFoully { ; m 2G.V 4 Kktm ok*V eedroo�n eadh edh SO � # �.� "Ar ;i I, r L! f I Ooville Recovery Center Plot Plan 2472 Oroville Quincy Highway 5 05347321 crf CP f 1 T n dRIVAIM r J • rr r s �1 ZIP X E�lC is o c got Q � � � X � N N � � N T n r J �1 b I r � � z E�lC is o c got Q � � � X � N N � � N �Gve ��-1Alf c CA�ACir1' O Oroville Recovery Center Women's Facility BLO B 2472 Oro Quincy Hwy Oroviile, CA 95966 A— STATE OF CALIFORNIA- HEALTH AND HUMAN. SERVICES AGENCY Governor Gray Davis DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS 1700 K STREET SACRAMENTO, CA 95814.4037 TDD (916) 445-1942 (916)322-2911 ' January 10, 2001 Mr. James J. Adams, Executive Director Oroville Recovery Center 19 Glen Circle Oroville, California 95966 Dear Mr. Adams Notice of a Complete Licensing Application Facility Identification Number 040009AN Your application for licensure of an alcoholism or drug abuse recovery or treatment facility for Oroville Recovery Center Women's House, located at 2472 Oro Quincy Highway, Oroville, California 95966 has been reviewed and determined to be complete. In the future, the Department will schedule an on site review of your facility to determine your compliance with Title 9, Chapter 5, Subchapter 2, Section 10522(d)(2), of the California Code of Regulations. If you should have any questions please contact me at (916) 323-2000. Sincerely, JERRY D. VAUGHN Licensing and Certification Analyst Licensing and Certification Branch cc: Administrator, Butte County Alcohol and Drug Programs Licensing File • r 1 * _ .. .N • • .Y —r• .r..... r r._.r .... ♦.,_,. ...�.T, .. ..-a+• ». -� . . r ... .... ... j �l�y[ 1 r •' } ' - .�.«ww•A•+. �_.... .. (, .. ._•-M, ... a•••ww .. ,.,�..a•••- r. .••r•r w-. • • ,� ..• ... _ ..•- .rllr•. -. .•.�. ... e.. -.. ! - .• ..._ r .. • 1p jj -• • r •.♦. r• y • ....... ti .... ; i � j ; .... ... ti ... .. ••/•- •tea. .....,._.r_ ... ' F • • 1 -01 .�• r ••M.•• r�•••.j , ►wwM ..� • r•,•.... . y .....I„• _.. • .I.... r.•. N— •• r .♦. ..� ,., • r - 1 1 w � r-.�,y• .—. • +• .w. Y.- •. ..r• rte_ • _� rr•• .rte'_•--•� r•r .. j••• w....� M� ' • �. t Mw.. .. ♦ 1 � - ,..- 4- , _. .. 4h,.•...... �_ .. ••a -j-..... •-t .. r . _. •. i • r.t. ..... 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I • •a • • •. w ck «. - _...•. .�. ....«..�. .•.. -r..� � _.tea *.r.....».y « ..... ..... • ..w-..,.. ... .. �•n.. - .-�-.•_.... r �� .. ..sem ...• � _ .a . .. - + �•••y.cM-.. • j Ir •+, � ,rte ..»�. _. i BUTTE COUNTY FIRE DEPARTMENT/CDF FIRE TITLE 19/24 FACILITY INSPECTION INSPECTION NO. 1 2 3 REINSPECT: [ 1 YES NO Facility Occupancy Address :G r ;�. �" ,(, Inspector } ,� ✓F �gGc1L`� Phone Station Contact -', s F 4'r Station Phone `� �,; -- :3 F A -::-D,5 Compliance: Yes =-f No = 0 Not applicable = NIA ACCESS --All inspections Address correct/posted and visible from road (Butte Co. Code 32-9) Access to public street or 20 ft. wide lane (T19-3.05) Gates wide enough to admit fire apparatus (T19-3.16) Fire protection equipment visible/accessible (T19-3.14) PORTABLE FIRE EXTINGUISHERS --All Inspections Extinguishers have current annual service tag (T19 -575.1A) Maximum travel 75 ft. (r19-567) Provide clear access to fire extinguisher (r19-563.2) 'Extinguishers mounted on wall/or in cabinet, visible and signed EXITS -- All Inspections t Exits not obstructed (r19-3.11) . Exit signs in place (CBC 1003.2.9.1) Doors operate without key or special knowledge (CFC 1207.3) ELECTRICAL --All inspections Extension cords do not replace permanent wiring (CEC-400-8(1)) Extension cordsAo not pass-through doors/walls (CEC-400-8 9,3)) 30 inch clearance i round all electrical panels (CEC-110-16A) ____All panels'and breakers are marked (CEC-110-17 C) Repair holes in fire -resistive construction CEC (300-21,22) Multi -plug power strips have circuit breaker (CEC 400-13) FIRE PROTECTION EQUIPMENT --All Inspections Hood system serviced/tagged every 6 mo. by cert. tech. (T19-904) Clean filters, hood, and duct area over cooking appliances (CFC 1006.2.8) (r19-563.8) ! : ' Maintain extinguishing syst (T1s 3 zap Provide spare 9 1r kl efad5,(.6 min.) and/or sprinkler wrench (T10-904.5) Replace damaged, c eroded or painted sprinkler heads (T19-904.5) Identify sprinkler 4alves and secure in open position (T19-904.5) Replace, -missing caps on fire department connection (T19-904.3) , Provide 5 -yr. certification test for sprinkler/standpipe (T19-904) Rooms with Occupant Load of 50 Persons or More Exit illumination and sig in place (CBC 1003.2.8.2) Maximum occupancy .Ign in place (r19-3.30) Two exit doors/pan hardware swing in direction of travel (CFC 2501.8.2) HOUSEKEEPING --All Inspections ?. No waste or rubbish accumulation inside or outside T19-3.14) i- Reduce storage to at least "below ceiling/ sprinklers (r19-3.14) Remove combus. storage from heater, mech., elect. room (r19 -3.1m Provide approved metal container for oily rag storage (r -19-3.19c) Flammable liquids stored properly (T-19-3.15) MECHANICAL EQUIPMENT --All Inspections Vents and chimneys -- No obvious hazards (CMC -Ch. 8) SMOKE,DETECTORS -- Day Care Sr. Res., Hospitals, Apts. -•' Properly installed and tested (T19-749, 754) SCHOOLS, JAILS AND HOSPITALS Decorationsaqd ourt ns ft)e retardant (r19-3.08) LPG tan ksfenced with locked gates (r19-3.22) FIRE DRILLS -- School and Day Care (TittivA94.13) -All systems opera' ooked to -office ~ Held month) ,�'leQhentat'y schools) Held semi-annually (high schools) Evacuation plans posted in all rooms Erpergency procedures posted in office Teachers take roll books Corrections and Comments The above deficiencies must be corrected within days. Inspection Date: Owner/Manager AP # x II �� -�7 �,r- ��, - � � -, - - L BUTTE COUNTY FIRE DEPARTMENT/CDF FIRE TITLE 19/24 FACILITY INSPECTION AW �Lr INSPECTION NO�- "1 2 3 REINSPECT: YES NO Facility ' l ' = � - ' ' ccupancy A- CX Address-2�/7- - Inspector 5 Phone 2 l0 Station Contacti`Gi', Station Phone Compliance: Yes =.4f No = 0 Not applicable = N/A ACCESS --All inspections Address correct/posted and visible from road (Butte Co. Code 32-9) _k,:�` Access to public street or 20 ft. wide lane (r19-3.05) &/.c Gates wide enough to admit fire apparatus (T19-3.16) _Fire protection equipment visible/accessible (T19-3.14) PORTABLE FIRE EXTINGUISHERS --All Inspections / _- 1Z Extinguisher have current A ictal s2rvicertag (T19 -575.1A) ti Maximum travel 75 ft. (T19-567) —L-:: Provide clear access to fire extinguisher (r19-563.2) -Extinguishers mounted on wall/or in cabinet, visible and signed EXITS --All Inspections /Exits not obstructed (r19-3.11) „� Exit signs in place (CBC 1003.2.9.1) _ iL. Doors operate without key or special knowledge (CFC 1207.3) ELECTRICAL --All inspections � A Extensi4 fiords do riot replace permanent wiring (CEc400-8(1)) Extension cords do not pass through doorstwalls (CEc400-8 (2,31) 1�4�130 inch clearance around all electrical panels (CEC-110-16A) /_AII panels and breakers are marked (CEC-110-17 C) 1,::�fRepair holes in fire -resistive construction CEC (300-21,22) ug power strips have circuit breaker (CEC 400-13) FIRE PROTECTION EQUIPMENT --All Inspections Hood system *erviced/tagged every. mo. by cert. tech. (T19-904) Clean filters, hood, and duct are4bver cooking appliances (CFC 1006.2.8) (r19-563.8) Maintain extinguishing systems`' (r19-3.24) 1 Provide spare sprinkler heads (6 min.) and/or sprinkler wrench Cri9-904.5) i Replace damaged, cork�o'ded, or painted sprinkler heads Cr19-904.5) Identify sprinkler valves and secure in open position (r19-904.5) Rooms with Occupant Load of 50 Persons or More Exit illumination and signs in.place (CBC 1003.2.8.2) Maximum occupancy serf in place (r19-3.30) Two exit doors/panic hardware swing in direction of travel (CFC 2501.8.2) HOUSEKEEPING --All Inspections No waste or rubbish accumulation inside or outside T19-3.14) i.' Reduce storage to at least "below ceiling! sprinklers (T19 -3.14) Remove combus. storage from heater, mech., elect. room (T19 -3.19f) Provide approved metal container for oily rag storage Cr -19-3.19c) Flammable liquids stor properly (r-19-3.15) it Replace missing caps on fire department connection (r19-904.3) Provide 5 -yr. certification test fo sprinkler/standpipe (r19-904) MECHANICAL EQUIPMENT --All Inspections Vents and chimneys --No obvious hazards (CMC -Ch. 8) SMOKE DETECTORS -- Day Care Sr. Res., Hospitals, Apts. -�Properly installed and tested (T19-749.754) SCHOOLS, JAILS AND HOSPITALS Decorations and cagains fire retardant (r19-3.08) LPG tanks fenced 0XIocked gates (T19-3.22) FIRE DRILLS -- School and Day Care (Title 19-3.13) ___All systems operable/hooked to office Held monthly (elementary schools) Held semi-arynually (high schools) Evacuation(ilaps posted in all rooms Emergency procedures posted in office The above deficiencies must be corrected within days. Owner/Manager Z,'2 Inspection Date: AP # ?i / F CALIFORNIA SAFETY INSPECTION REQW� ST STD. 8 0 (REV. 10-94) See instructions on reverse. v AGENCY CONTACTS NAME * TELEPHONE NUMBER 2 a `a EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER 1741 LIC NSING ��- . . _ ... A ENCY FF] ti >. . 1 •ISif i _.! .�Si ..: =� �Y� ; •• .i1T\ NA E AND AD RESS , . •. L J REQUEST DATE PROGRAM REQUEST CODE A CODES 1. ORIGINAL A. FIRE CLEARANCE 2. RENEWAL B. LIFE SAFETY 3. CAPACITY CHANGE 4. OWNERSHIP CHANGE S. ADDRESS CHANGE 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPA ITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CODES FIRE CLEARANCE GRANTED IRE "� r `..� .P� :;►�-"1 (.- AU HORITY_ FACILF rY NAME LICENSE CATEGORY STREET ADDRESS (Actual Location) E 1",; NUMBER OF BUILDINGS 2. FIRE CLEARANCE DENIED AD RESS CITY ~ ` A. EXITS RESTRAINT , Ll FACILITY CONTACT PERSON'S NAME G HOURS . r CONDITIONS CLEARANCE /DENIAL CODE CODES FIRE CLEARANCE GRANTED IRE "� r `..� .P� :;►�-"1 (.- AU HORITY_ NA E AID. i-� 1",; 2. FIRE CLEARANCE DENIED AD RESS A. EXITS , Ll B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS INSPE TOR'S NAME (Typed or Printed) TELEPHONE NUMBER CFIRS NUMBER OCCUPANCY CLASS E. HOUSEKEEPING � �( C f F. SPECIAL HAZARD ' j - G. OTHER INSPE TION DATE INSPECTOR'S SIGNATURE (Typed or Printed) - do EkPLAINbEklALOR UST SPECIAL CONDITIONS' 1 f r s 1 STATE OF CALIFORNIA KRE SAFETY INSPECT.10N REQUEST 871D. 85011EV-10-94) (REVERSE) INSTRUCTIONS. Thisform is designed for use with a window envelope Licensing or Requesting Agencies--Compjo.te the.. following 19 sections on thts,form before submitting It to the fire a.uthonity havin'g jurisdidtom AGENCY CONTACT, 2. TELEPHONE NUMBER, 5. EVALUATOR. Enter the name and telephone number of agency con tact person. 3. PROGRAK. Licensing agency use. 4., REQUEST DATE. Enter date reques't was.prepared. 6. REQUESTING- AGENCY FACILITY NUMBERO. Thisi -the file number assigned, by the licensing agency. Capacity: Insertin the appropriate section, the,capaclity. of licensed ambulatory or nonambulatory oc- cupants, covered by this -request. Previous -if request is.for renewal or capacity change,. Capacity-. in s*ert capacity of previous clearance. Total Show total licensed capadity. If -the facility is Capacity. intended -*to house,part ambulatory, nonambu latory, and- part bedridden, show'the total of the. three types of occupants. FIRE AUTHORITY CONDUCTING THE SPECT PLEA THE FOLLOWING. 18. FIRE AUTHORITY9 -NAM.E.AND ADDRESS.- Insertthe name and address of the fire autho -r-ity where the facility is located. 19. CLEARANCE/DENIAL CODE. - Use the two codes: 1 .22.00CUPANCY CLASSIFICATION. g Use. -California is fldh' Code occupancy classifications and insert the ut I occupancy determined by the -inspector. 23. INSPECTION DATE, Enter -the actual date -of the. I -A Capacity: Insertin the appropriate section, the,capaclity. of licensed ambulatory or nonambulatory oc- cupants, covered by this -request. Previous -if request is.for renewal or capacity change,. Capacity-. in s*ert capacity of previous clearance. Total Show total licensed capadity. If -the facility is Capacity. intended -*to house,part ambulatory, nonambu latory, and- part bedridden, show'the total of the. three types of occupants. FIRE AUTHORITY CONDUCTING THE SPECT PLEA THE FOLLOWING. 18. FIRE AUTHORITY9 -NAM.E.AND ADDRESS.- Insertthe name and address of the fire autho -r-ity where the facility is located. 19. CLEARANCE/DENIAL CODE. - Use the two codes: 1 .22.00CUPANCY CLASSIFICATION. g Use. -California is fldh' Code occupancy classifications and insert the ut I occupancy determined by the -inspector. 23. INSPECTION DATE, Enter -the actual date -of the. STATE OF CALIFORNIA NONAMBULATORY BEDRIDDEN TOTAL CAPACITY FI E SArETY INSPECTION REQU-dST PREVIOUS CAPACITY C ACI � PREVIOUS CAPACITY CAPACITY See instructions on STD. 0 (REV. 10-94) DDRESS .reverse. A. EXITS AGEN Y CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAY$M- A _1K 1 -1- t 4 IN�a/ L C. FIRE ALARM /• • j qpi R EVALUATOR'S NAME ss g•� q 1 i E REQUESgT,rhyNG AG NCY FOCI NUMBER TELEPHONE NUMBER REQ T CODE - i - - ! • � �� CODES t ,'�.:z_'i.f%=7'� FACII JTY NAME • " ;!� 1. ORIGINAL A. FIRE CLEARANCE cr•r..:_:�r��...._s... `+ .;.�•._ 2L' s Eii,: LI ENSING F. SPECIAL HAZARD INS • ECTION DATE 2. RENEWAL B. LIFE SAFETY A ENCY �, ;.;::t.:x •�f.�:. ;: E-:.�£�{.:`� - I v� _;i. i 'ji STREET ADDRESS (Actual Location) NA E AND NUMBER OF BUILDINGS 17 ` 3. CAPACITY CHANGE A DRESS 4. OWNERSHIP CHANGE CITY RESTRAINT 5. ADDRESS CHANGE r FACT CONTACT PERSON'S NAIVE 6. NAME CHANGE HOURS 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY '00.— PREVIOUS CAPACITY C ACI � PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY Z DDRESS rw A. EXITS or� ,� J B. CONSTRUCTION C. FIRE ALARM OCCUPANCY CLASS D. SPRINKLERS INS ECTOR'S NAME (Typed or Printed) TELEPHONE NUMBER - - ! • � �� ..ear•- ! i FACII JTY NAME • " ;!� LICENSE CATEGORY ! F. SPECIAL HAZARD INS • ECTION DATE )rov I e. e, c �/e r i/ - I v� _;i. i 'ji STREET ADDRESS (Actual Location) NUMBER OF BUILDINGS 17 ` EX IND NIAL OR LIST SPECIAL CONDlYi6NS CITY RESTRAINT rTY r FACT CONTACT PERSON'S NAIVE HOURS CONDITIONS ;h CLEARANCE /DENIAL CODE CODES FIRE _ - ATHORITY - 1. FIRE CLEARANCE GRANTED N ME AND :` f,. - ,��= = • ,��.,/�i F ' 2.' FIRE CLEARANCE DENIED DDRESS A. EXITS or� ,� J B. CONSTRUCTION C. FIRE ALARM OCCUPANCY CLASS D. SPRINKLERS INS ECTOR'S NAME (Typed or Printed) TELEPHONE NUMBER CFIRS NUMBER - ! • � �� `� E. HOUSEKEEPING .• �_ ,mow.++ t ;. - • " ;!� ! F. SPECIAL HAZARD INS • ECTION DATE INSPECTOR'S SIGNATURE (Typed or Printed) j G. OTHER EX IND NIAL OR LIST SPECIAL CONDlYi6NS STATE OF CALIFORNIA a M - i a r�` ! � `� �wi �• � �� 's �+ � 1 i ��` � � x �., r.„,. ..� !,�' 1• � � r .:ter. ;� � �Iµ we +a �It It+y 1t *.: M � '� �M • k � ': c • !. '.!, £ 4..E # >�2 ':� � :..._ �h � F � a ''. F Y... : '�i R• t d 7 Y 3....,. i � i- i A i }x f t t 2 , y , r t r— f s . � ;�c :A►: M aR. yl,.2 M; � s F � �.,. ? 1 s � :iK - i° a I►, M �� + S^ E 2 ; ��!. wx ?� �.'•, � i � Ali: :�. -� � iAt llt: ♦. � i. � � � ' '� i 3 �' i F i �..� { s i..:: 3 S i Y. L ...�.. �... 2 h' � 1 E F. -. L....� ,.,i'r ��.# i N r..,• _ ,S t o _ �C ti i �. �. :�f:. �. :Ilk. s .�►. .' : yk , .. low IMF t { i llE 3 [S f r - S - M-34PEC"Muo"'I r TE THE 3 FOLLOWING: s _ NONAMBULATORY BEDRIDDEN TOTAL CAPACITY STATE OF CALIFd -,-` PREVIOUS CAPACITY CAPACITY IRE AU HORITY FIRE SAFETY INSPECTION REQUEST CAPACITY PREVIOUS CAPACITY 1. �r See instructions on reverse. STD. 8 0 (REV. 10-94) AGEN Y CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM LICENSE CATEGORY Ci EVALUATOR'S NAME REQUES{T�I;NGA�GEN�yyCYY! FACILITY NUMBER ��r �►' 6 f,- - REQUEST CODE B. CONSTRUCTION - y CODES � �.�� CITY C. FIRE ALARM 1. ORIGINAL A. FIRE CLEARANCE -;- �,�°r: sf;.-.� .•t' J.,LIC NSING �z�3=., = :�,,�.=�-.jz:�_, 2. RENEWAL B. LIFE SAFETY D. SPRINKLERS INSP TOR'S NAME (Typed or Printed) TELEPHONE NUMBER NA E AND :,� - _;, �:,-: FACI J TYCONTACT PERSON'S NAME 3. CAPACITY CHANGE A RESS = ' 4. OWNERSHIPCHANGE 5. ADDRESS CHANGE L 6. NAME CHANGE _- 7. OTHER; AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPA ITY ` '' PREVIOUS CAPACITY CAPACITY IRE AU HORITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY 1. �r NA d� r E AND �= f� �`{:- P: •-. yr ' C" FIRE CLEARANCE DENIED FACILJ TY NAME ��rr�� DRESS' ff��/,^ f f �.�'". LICENSE CATEGORY - S I - • � M I Z • O � . 2 STREET ADDRESS (Actual Location) ��r �►' 6 f,- - NUMBER OF BUILDINGS B. CONSTRUCTION y CITY C. FIRE ALARM • -RESTRAINT D. SPRINKLERS INSP TOR'S NAME (Typed or Printed) TELEPHONE NUMBER CFIRS NUMBER FACI J TYCONTACT PERSON'S NAME f HOURS _ SPECIAL CONDITIONS • CLEARANCE /DENIAL CODE CODES IRE AU HORITY . j 1. FIRE CLEARANCE GRANTED _ NA d� r E AND �= f� �`{:- P: •-. yr ' C" FIRE CLEARANCE DENIED A DRESS' ff��/,^ f f �.�'". A. EXITS ��r �►' 6 f,- - B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS INSP TOR'S NAME (Typed or Printed) TELEPHONE NUMBER CFIRS NUMBER OCCUPANCY CLASS E. HOUSEKEEPING tet. t 10 F. SPECIAL HAZARD G. OTHER INSPECTION DATE INSPECTOR'S SIGNATURE (Typed or Printed) r - -27 J • f, - -EXP " IN ENIAL OR LIST•SPECIAL CONDITIONS C j .. J STAT E OF CAWFORNIA FIRE SAFETY INSPECTION RE(dUEST STD. 850 .(REV. 10-94) (REVERSE) INSTRUCTIONS This form is designed for use with a window envelope Requesting Agencies— omplet the following 19 sections on this form Llcenslhg or C before submitting It to the fire authority having Jurisdiction. Capacity: Insert in. the appropriate section, the capaccity of licensed ambulatory or nonambulatory oc- cupa.- t8 c re . n ov6i d by this request. Previo.us If request -is for- renewal or capacity change, Capacity.- insert capacity of.previous clearance, Total Show total: Iicensed capacity.facility, is Capacity:' intended to house part ambulatory,'nonam�u- La'tory, - a . nd part bedridden, show the total of the three types of occupants, the fire authority. FME AUTHORITY CONDUCTING THE- THE FOLLOWING: