Loading...
HomeMy WebLinkAbout071-440-003 CF ArchiveSIRE SAFETY INSPECTION REPO Butte County Fire Department -- CaGfomia Departrnent of Forestry and Fire Protection Oroviff e, ifornia 95965 • (530 538-7888 Acres: Ctly: ,�,.lrtspection Date: /� Name: / Business Phone: iProperty Manageme G� AP#: NO. CORRECTIONS REQUR® NOL LOCATION I REIIIIAi�Is CLEWD El 1411) t.�OC�►TK�1 i'nauide aiddness n . , ............. . 1 I.D. visible from street. 1 1 2 Remove obstructions at extis, doors, aisles, , etc. 3 East door to open without a key or any sped knowledge/ effort. 4 R 'r eadt door hardware. I 1 5 Remove obstructions from door to be dosed. 6 Remove lock Uches from doors with panic hardware. I I 7 Provide sign over main exit door - "This door to remain unlocked during business hours". I I 8 Remove storage from under u tected 9 ProvkWmaintain eadt em EXTS+t'' SIMS. 1 10 Have fire s sendoedand bgged. ES INSPECTOR 11 Providelmount fire extinguisher as indicated. 12 Post a sign irdcating fire extinguisher location. 1st / 1 13 Provide dear access to fire offnguisher. ISEP'Ri71'EC110N. EQU�PI hiT. 2nd / I 4. ... 14 Maintain, r+eW, Punt, inspect, =Vor tee spn1H% r ipe system ftdranVFDC/PIV. Refer to FPB / 1 15 Maintain 3 feet minimum clearance €or accessluse of fire appllonces/ec�iipment. District Attorney I / 16 Replace damage#ainted1missing sprinkler hea&JMC caps. Final Charanoe 1 1 17 Pwide ear certification test for 'nkter em. Class ❑ Check Pre-Fine Plan for accuracy. 18 Provide spare WMler heads min. ardor=pftle wrench BY ORDER OF THE FIRE C H 1 E F 19 IV Hoodlduct extinguishing tem to be serviced/ to every 6 mo. 20 Remove rease from hood, duct, and filters. EEP C You are hereby notified to correct all violations immediately or show cause kLARft! SYSiS ' , why you should not be requrred to do so. A reinspection will be conducted on . Wilful faflure to comply with this notice is a 21 Aintain, , impect, armor test fire alarm system. misdemeanor. Viotafiors that are not coirected Immediately and/or remain FpsSEP/ R141i HS after the reinspection may be processed as a criminal offense. Thank you 22 Repair holes in required fire resistive construction. for your assistance and cooperation in minimizing the fire and fife loss in 23 Provide! it self or automatic closing fire rated assemblies. your community. 24 Keep attic access and scuttle openings closed. E1ECTICAL = Signatiure of R 25 Discontinue use of extension cords. 26 Install permanent wiring for foxed and stationary appliances. 0 Owner 0 E ❑ Other 27 Provide cover plates for all 'unction boxes. InspectiMtRicer. 0 VWZ��� 28 Remove sposed wiring or tett in approved conduit 29 Provide a 304nch clear to and in front of electrical el. Engine Com 30 Maintain wrifing in good cord ion and pmW from damage. I WN6 VIOLATIONS NOTED THIS DATE toll LJ # .G 'S Y4U FOR BEINGFIRE SAFE 31 Provide a flammable lkpid storage cabinet or reduce storage to 10 gakm or Addtttorraf Comments: less. 32 Remove all flammable rqJds not used for maintenance purposes.15 33 Store flammable 14iids away from exits, stairs, or corridors. �\ 34 Secure com inders. / /V 01 35 Arrange storage in an orderly manner to aocessl , 1 36 Remove combuIe storage from water heater and electrical room. 37 Remove storage to 24 inch below ceiling or 18 inches below spinkler herds. 38 Remove linftbris from behind washers and dryers. 39 Remove wastat bbish ma+aiials from the premises. 40 Keep dumpsteis 5 feet away from combustble wafts, eaves, or openings. MtSC 41 Other violations and/or comments. Page of ,.. rsutte County Fire Department California Department of Forestry and Fire Protection Fire Prevention Bureau 176 Nelson Avenue, Oroville, CA 95965 530-538-7888/530-538-2105(fax) Fire Safety Inspection usiness Address: -F& -le rt Business Name:64t!J /111Gc / -/%L caner/Manager: Bus: 3d -'5 Other: ther Contact: Bus: Other: uilding Owner: Bus: Other: ddress: Fire alarms stem defective Occ. Class: e� • . • •I�1 TyT•�1O N M.IXTIlM_1112191119: 1:87•l4111111111Ti7110 1. Fire extinguishers: required, service due 10. Exit(s): obstructed, inadequate 2. Extension cords: Excessive use, defective 11. Exit sign s : require , illumination, hoto luminescent 3. Excessive rubbish, trash, debris 12. Exit sign lights: obstructed, defective 4. Fire alarms stem defective 13. Exit lighting: required, defective 5. Sprinkler system: service required, defective 14. Heating system: defective appliance, flue combustibles 6. Kitchen hood ext. system: service due 15. Wiring: exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops :_ ti 16. Address posted and visible from road 8. Smoke detectors: required, defective 17. Other 9. Fire drill log checked Yes u No ❑ 18. Other type of inspection - State below DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: <f 4t C r O T- F iC6 10.v-0 U---# 7 a!5S /S Date: / / Discussed with: Signe (Print) i Battalion 1 2 3 4 5/ 6 7 Station: By order of the Fire Ch f: You are hereby notified to correct all vi ns immediately or show cause why you should not be required to do so. A re -inspection will be conducted on Willful failure to comply with this notice is a misdemeanor. Violations that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and life loss in our community. (H & S sec. 13112) White Copy — Station File Yellow Copy — Re-inspect/business Pink Copy — Business 0 Check when sent to prevention Y' -Z- 04/28/11 THU 13:13 FAX 530 531. 5759 BUTTE CO OFFICE OF EDUCA 14002 Liar L f 5u l l p; ac-nl nr Lnomm.PQ I r nn r • Butte County Fire Department California Department of Forestry and Fire Protection Fire Prevention Bureau i° 176 Nelson Avenue, Oroville, CA 95965 `8/530-538-2105 fax ,. 530-538-788 ( ) ,nay Fire Safety Inspection Business Address �, p� ��tC y Business Name: [ /J floe Owner/Manager. Bus: 5'3.P 1 �3 Other. Other Contact Bus: Other: Building Owner: Bus: Other: Address: Occ. Class: AN INSPECTION OF YOUR FACILITY REVEALED THE FOLLOWING: 1. Fire extinguishers: required, service due 10. Exft s : obstructed. Inadequate 2. Extension cords: V!xGe581Ve use, defective 11, Exit sf n s : required, illumination, photo luminescent 3. Excessive rubbish trash, debris 12. Exit sign lights: obstructed. detective 4. Fire alarm system detective 13. Exit lighting: re ulred defective 5. Sprinkler system: service re uired, defective 14. Heating system, defective appliance, flue combustibles ti. Kitchen hood ext. s stem: service due 15. Wiring: exposed, damaged connectors etc. 7. f=ire walls ceilings. fire doors, draft stops__ 16. Address polsted and visible from road S. Smoke detectors: required, defective 17. Other 9. Fire drill log checked Yes 0 No 0 18, Other type of inspection — State below DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: S oe/c�i'Goiv d r D F F tCj; fI.JJ�'U55 /S . * pate w VISVUDaou "m I. lJ (Print) I in a� Battalion 1 2 3 4 6 7 Station: PS 13y order of the Fire ChWI: You are hereby notlfled to correct all v' s immediately or show cause why you should not required to do so. A re -inspection will be conducted on willful fallure to comply with this notice Is a misdemeanor. Violatlons that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation In minimizing the fire and life loss in our community. (H & S sec. 13112) •'a - - V to .- 10�_ /0_0� 04/28/11 THU 13:13 FAX 530 53z 5759 BUTTE CO OFFICE OF EDUCA 14001 plies[' 1 i Cu 1 1 a; CL[11•I nr L_A5r_R%IC. 1 r nf% N *--41P W. + /•.� •fan an.frf•...0f �... .•a.• �.��...T.��. �w•w.w��—��f�. fill.. P. r i.. ... � 1 bdf.Pkbd r i • wf. •f.r • I • r FIREPREVENTION BUREAU BUTTE COUNTY FIRE RESCUE CALIFORNIA DEPARTMENT OF FORESTRY AND SIRE PROTECTION Also suNng Gridley and Biggs FAX TRANSMITTAL 176 Nelson Avenue Oroville, CA 95965 Office (530) 536-7888 Fax (830) 638-2105 ❑ Confidentialon-Confidential ro: Faxx: )eoarnnent_ 4!5 Co br rom 0 Phone#. �u ect.r/y rIlle r, a� D Urgent or your review 0 -Reply ASAP D Pledse Comment v ,r .err,reyer�f,:- rr:w�e�rr>ti reyrtt MESSAGEO r elf, ' yr 91 tMa'tMtyettst»s�'iC�Rt�rlet9Mr�tllYt�lr�tlhekkt"Itlrcilts#leflkleRk 1Y��r�M'raR�������R1pr��Mt1*!It t 'he document b6ing faxed is intended oniy for the use of the individual or entity to which it is addressed, and contain(s) information that is -privileged, confidential, .and exempt from disclosure Mer state and federal law. If the reader of this message is Rat the intended recipient, or the . mployee or recipient, you are hereby notMed that any dissemination, distribution'. or copying of the ommuhication is -stfictlY prohibited. If -you have received this o6mmunicatian in error; please notify s immediately by telephone and return the original message to us at the address above via the In ted States Postal Service. tsutte County Fire Department Ky Com, California Department of Forestry and Fire Protection Fire Prevention Bureau �'� �•y 176 Nelson Avenue, Oroville, CA 95965 FIRE 530-538-7888/530-538-2105(fax) . Fire Safety Inspection usiness Address: 216 Business Name: 01 It w n e r/ M a n a g e r: Bus: `3-30 — S '$� Other: Other Contact: Bus: Other: uilding Owner: Bus: Other: ddress: Occ. Class: AN INSPECTION OF YOUR FACILITY REVEALED THE FOLLOWING: 1. Fire extinguishers: required, service due 10. Exit(s): obstructed, inadequate 2. Extension cords: Excessive use, defective 11. Exit sign(s): required, illumination, photo luminescent 3. Excessive rubbish, trash, debris 12. Exit sign lights: obstructed, defective 4. Fire alarms stem defective 13. Exit lighting: required, defective 5. Sprinkler system: service required, defective 14. Heating system: defective appliance, flue combustibles 6. Kitchen hood ext. system: service due 15. Wiring: exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Address posted and visible from road 8. Smoke detectors: required, defective 17. Other 9. Fire drill log checked Yes ❑ No ❑ 18. Other type of inspection - State below DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: i Date: Discussed with: 5- _ Sign d: c7 /(/ (Print)r-� 1-j1/1 Wylt-)P I nAWII✓J —�� r ,. A y mspectlrj unimr: k Battalion 1 2 3 4 6 6 7 Station: d_ �'DwIvow-1 By order of the Fire Ch f: You are hereby notified to correct all violations immediately or show cause why you should not be required to do so. A re -inspection will be conducted on . Willful failure to comply with this notice is a misdemeanor. Violations that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and life loss in our community. (H & S sec. 13112) White Copy — Station File Yellow Copy — Re-inspect/business Pink Copy — Business Check when sent to prevention Business Address: Business Name: owner/Property Managemer FIRE SAFETY INSPECTION REPO' Butte County Fire Department California Department of Forestry and Fire Protection Oroville, Cafffomia 95965 * (530) 538-7888 city. - Inspection Date: Business Phone: AP#: NO. CORRECTIONS REQUIRED NOL LOCATION I REMARKS CLEMED LOCATION . I -,r I Provide addiess numbersbAdN I.D. visible from streete- EXITING 2 Remove obstructions at exits, dm, aisles, stairways, etc. 3 Exit door to open without a key or any special kmW* effort. 4 Repair non-operable exit door hNdware. 5 Remove obstructions from door wWred to be dosed. 6 Remove lockstlatches from doors with panic hardware. 7 Provide sign over main exit door - 'This door to remain unlocked during business hours". 8 Remove stoiage from under unprotected staimay. 9 Rovidetmaintain exit sUVemffgency lighting. FIRE EI(TINGLISHERS 10 Have fire alingusher(s) serviced and tag*. RE -INSPECTION DATES INSPECTOR 11 Provide/mount fire Extinguisher as indicated. 1st 12 Post a sign indicating fire extinguisher location. 13 Provide clear access to fire e(fiMuisher. 2nd FIRE PROTECTION ECAMMENT 14 Maintain, repair, paint inspect, ardor test spnnkIerMar*ipe systemftdranVFDC/PfV. Refer to FPI3 15 Maintain 3 feet minimum clearance for acoess/use of fire appliances/equipment. District Attorney 1 16 Replace damage#aintedlimissing sprinkler hea&.IFW caps. Final Clearance / 17 1 Provide 5 -year certification test for spiinklerktanclpipe s;ystem. Occupawclm ❑ Check Re -Fire Plan for accuracy. 18 Providespare sprinkler heads (min. 6) ardor compatible wrench- BY ORDER OF THE FIRE CHIEF You are hereby notified to correct all violations immediately or show cause why you should not be required to do so. A reinspection will be conducted on . Willful failure to comply with this notice is a misdemeanor. Violations that are not corrected immediately and/or remain after the re 4nspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimi ft the fire and life loss in your community. 19 duCt edinnt jQhinn cantpm in ry 6 mo. 20 rease from hood, duct, and filters. KEEP CLEAN) FIRE ALARM SYSTEMS 21 Maintain, repair, inspect, anchor test fire alarm system. FIRE SEPARATIONS 22 Repair holes in required fire resistive construction. 23 ProvWrepair self or automatic closing fire rated assemblies. 24 Keep attic aoDess and scuttle openings closed. ELECTRICAL Signature of Recipient 25 Discontinue use of edension cords 26 Install permanent wiring for fixed and stationary appliances. 0 Owner 0 Ma El Employee 13 Other 27 Provide cover plates for all junction boxes. Inspecting Officer 28 Remove exposed wiring or protect in approved conduit 29 Provide a 304nch clear space to and in front of electrical panel. FPB: ..Engine Company: 30 Maintain wiring in good cordfion and protect from dam p NfJ VIOLATIONS NOTED THIS DATE THAW YOU FOR BEING FIRE SAFE] FLAMMABLE LKUDS* COMPRESSED GASES 31 Provide a flammable IqA storage cabinet or reduce storage to 10 gallons or less. Addhonal Comments: z � '4 7 — Page of 32 Remove all flammable I*ids not used for maintenance purposes. 33 Store flammable lquids away from exits, staffs, or corridors.-- 34 Secure compressed gas cylinders. STORAGE a HOUSEKEEPING 35 Ariange s in an orderly manner to pyvida acceslress. 36 Remove combustible storage from water heater and electrical mom. 37 Remove storage to 24 inches below oeilirg or 18 inches below spiinkler heads. 38 Remove lintUoixis from behind washers and dryars. 39 Remove waste/rubbish mal -rials from the premises. 40 Keep clumpsters 5 feet away from combustible walls, eaves, or openings. MISC - ELLANEOUS. 41 Other violations andlor comments. ess Address: Name: /Property Managen "-**'cIRE SAFETY INSPECTION REPO" Butte County Fre Department California Department of Forestry and Fre Protection Oroville, Califomia 95965 • (530) 538 -7888 r -4r-", City: Inspection Date: 1-.1-7-6-7 Business Phone: AP#: NO. CORRECTIONS REQUIRED ND. LOCATION I REMARKS CLEWW LOCATION - 1 Provide address numbersbAding I.D. visible from street EXITING 2 Remove obstructions at exits, doors, aisles, stairways, etc. 3 Eat door to open without a key or any special knowledge) effort - 4 Repair noncperable adt door hardware. 5 Remove obstructions from door requwed to be dosed. 6 Remove locks/latches from doors with panic hardware. 7 Provide sign over main exit door - "This door to remain unlocked during business hours'. 8 Remove storage from under urptetd staff 9 ProvkWmaintain W signVemergency lKpbng. FIRE EUNGUISHERS 10 Have fire edi s s serviced and tagged. RE -INSPECTION DATES INSPECTOR 11 Provide/mount fire edinguisher as indicated. 1st 12 Post a sign inciicati fire extinguisher location. 13 Provide dear access to fire extinguisher. I 2nd FIRE PRCREC110N EQUIPMENT 14 Maintain, repair, paint, inspect, anchor test sprinkledstandpipe system/hydranVFDC/PIV. Refer to FPB 15 Maintain 3 feet minimum clearance for access/use of fire appliances/equipment. Di trictAttomey 1 1 16 Replace damaged/painted/missing sprinkler heatdFDC caps. Final Clearance 174 Provide 5- ear certification test for nkler/sta em. Class El Check Pre -Fire Plan for accuracy. 18 Provide spare inkler heads min. ardorcorn wrench. BY ORDER OF THE FIRE CHIEF You are hereby notified to correct all violations immediately or show cause why you should not be required to do so. A reinspection will be conducted on . Wilful failure to comply with this notice is a misdemeanor. Violations that are not corrected immediately and/or remain after the re4nspec ion may be processed as a criminal offense. Thank you for your assistance and cooperation in minim¢ing the fire and life loss in your community. 19 Hoodtduct extinguishing tem to be serviced/ to eve 6 mo. 20 Remove rease from hood, duct, and filters. KEEP CLEAN FIREALARM SYSTEMS 21 Maintain, repair, irspect, and/ortest fire alarm system. FIRE SEPARATIONS 22 Repair holes in required fire resistive constriction. 23 Provide/ it self or automatic closing fire rated assemblies. 24 Keep attic access and scuttle openings closed. ELECTRICAL Signature of Recipient: 25 Discontinue use of edension cords. 26 Install permanentwiri for fixed and stationary appliances. ❑Owner ❑.Ma ,' ❑Employee ❑Other 27 Provide cover plates for all junction boxes. Inspecting Officer: 28 Remove exposed wiring or protect in approved conduit. 29 Provide a 30- nch dear space to and in front of electrical panel. FPB: Engine Can 30 Maintain wiring in good caxition and protect from damage. 0 --NO VIOLATIONS NOTED THIS DATE THANK YOU FOR BEING FIRE SAFE' FLAMMABLE L - COMPRESSED GASES. ; 31 Provide a flammable liquid staage cabinet or reduce storage to 10 gallons or less. Addbord Comments: Page 0fL 32 Remove all flammable liquids not used for maintenance purposes. 33 Store flammable liquids from exits, stairs, or corridors. 34 Secure compressed gas cylinders. STORAGE •HOUS 35 storage in an orderV manner to provide access/egress. 36 Remove combustible storage from water Treater and electrical room. 37 Remove storage to 24 indvs below ceiling or 18 inches below spdnkler heads. 38 Remove Iint1debris from behind washers and dryers - 39 Remove wasteh bbish ma'wials from the premises. 40 Keep dumpsters 5 feet away from combustible walls, eaves, or openings. MISCELLANEOUS 41 Other violations and/or comments. r E I V U 1 lu: obc "ur-norizea user oJU-o yC-ots Ls.-` P• i Fire Prevention Bureau Jutte County Fire Rescue a /bite Copy - Business 176 Nelson Avenue California Department of Forestry Yellow Copy - Occupancy File O oville, CA 95965 and Fire Protection Pink Copy-(Sation File Telephone 530-538-7888 Facility Inspection Report Occ, Class. F x 530-538-2105 Address: , ,Business Nauic: 4L e.n ner/Maiager:___ -� CC��+5' C '� l ,c{ Bus: ;�- kZ Hin: (53, �� Fax: sistant Manager: 0.c G .sc� d r Bus: 1#m: B ilding Owner04C(a, , Biis:, 3d. - 7 l03 1lnr�: �Gj ss: - AN INSPECTION OF YOUR FACILITY REVEALED THE FOLLOWING: 1, Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate - 2. Extcnsion 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, cic. _F7. Fire walls, ceilings, fire doors, draft stops 16, heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible frons road 9_ Fire Drill Witnessed _ Yes Ll No I 1 18. Offier- IDETA,ILED EXPLANATION AND CORRECTIONS: CORRECTED: iiv ,!t' i -- S nYe e: Discussed with: / Sine : C� Z - Z %-� `i - Print � .9/tiv�C--,�� ti' Ip �� _ '. fl d1,�.,�._? �J I r'" Inspe i er: talion 1 2 3 4 { 5%6 7 Station: _ FPB _ X PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOVERATION WITH RRECTI.NG THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: ST TE OF CALIFORNIA F RE SAFETY INSPECTION REwUEST STD. 850 (REV. 10-94) See instructions on reverse. AG NCY CONTACTS NAME SS/COMMUNITY CARE LICENSING EV LUATOR'S NAME 104/LISA MCKAY TELEPHONE NUMBER ( 530 ) 895-5033 REQUESTING AGENCY FACILITY NUMBER 045403380 REQUEST DATE PROGRAM 02/13/02 REQUESTCODE 1A CODES LENSING NONAMBULATORY CODES 1. ORIGINAL A. FIRE CLEARANCE kGENCY DEPARTMENT OF SOCIAL SERVICES PREVIOUS CAPACITY 2. RENEWAL B. LIFE SAFETY WE AND COMMUNITY CARE LICENSING B. CONSTRUCTION 3. CAPACITY CHANGE ,DDRESS 520 COHASSET ROAD, SUITE 6 CHICO, CA 95926 4. OWNERSHIP CHANGE 5. ADDRESS CHANGE I_ 6. NAME CHANGE 24 FAC LITY NAME ' 7. OTHER AMBULATORY NONAMBULATORY CODES BEDRIDDEN TOTAL CAPACITY CA CITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY B. CONSTRUCTION PREVIOUS CAPACITY C. FIRE ALARM 24 0 0 24 FAC LITY NAME LICENSE CATEGORY B D ROCK CHILDREN'S CENTER 850 CCC STR ETADDRESS (AcivalLocadon) NUMBER OF BUILDINGS Z 6 ROCKEFELLER ROAD CITY RESTRAINT B RRY CREEK NONE FAC 1TY CONTACT PERSON'S NAME HOURS H ATHER SENSKE OR DIANA DROBNY (530) 532-5763 M - F 8AM-3PM Steven J. Fowler Fire Captain Life Safety Officer Office (530) 53 8-3 859 Pgr. (530) 871-8381 Iso Servin 3r the Cell (530) 521-8768 ities of: Butte County Fire Department/CDF Fire iggs and ridley 176 Nelson Ave., Oroville, CA 95965 MPLETED BY':INSPECTING..AUTHORITY INSPECTOR'S NAME (Typed orPrinted) TELEPHONE NUMBER CFIRS NUMBER OCCUPANCY CLASS D • SPRINKLERS E. HOUSEKEEPING • �- l�'�0 O o'- F. SPE HAZARD 573 INSPECTIONDATE INSPECTOR'S SIGNAT RE yped orPrinted) G. OTHER EXP IN DENIAL OR LIST SPECIAL C NDITIO S 1 CLEARANCE/DENIAL CODE CODES 1. IRE CLEARANCE GRANTED 2. FIRE CLEARANCE DENIED A. EXITS B. CONSTRUCTION C. FIRE ALARM INSPECTOR'S NAME (Typed orPrinted) TELEPHONE NUMBER CFIRS NUMBER OCCUPANCY CLASS D • SPRINKLERS E. HOUSEKEEPING • �- l�'�0 O o'- F. SPE HAZARD 573 INSPECTIONDATE INSPECTOR'S SIGNAT RE yped orPrinted) G. OTHER EXP IN DENIAL OR LIST SPECIAL C NDITIO S 1