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Home My WebLink AboutFAI15-0065 Fire Annual Inspection Archive"00*4VIRE SAFETY INSPECTION REPO'^m' Butte County Fire Department California Department of Forestry and Fire Protection Oroville, California 95965 • (530) 538-7888 Business Address: �i1% � I t/f � 7 City. Inspection Date: Business Name: Business Phone: Owner/Property Management: = ;'Nt ; .. v; AP#: NO. ,, CORRECTIONS REQURED NQ LOCATION I REMARKS CLEWED LOCATION 1 Provide address numbersibuilding I.D. visible from street EXMNG I / 2 Remove obstructions at exits, doors, aisles, stairways, etc. 3 Bat door to open without a key or arry special krrowledgel effort. 4 Repair exit door hardware. 5 Remove obstructions from door mqxW to be dosed. 6 Remove lod&Wc>es from doors with panic hardware. 7 Provide sign over main exit door - "This door to remain unlocked during business hoes". 8 Remove storaW from under unprotected 9 Providelmaintain exit sgrVemergency lighfing. FIRES 10 Have fire s serviced and tagged. RE41NISPECTION DATES INSPECTOR 11 Provide/mount fire extinguisher as indicated. 1st / J 12 1 Post a s n indicatiN fire ad usher location. 13 Provide clear access to fire extinguisher. 2nd J / FIRE PROTECTION EQUIPMENT 14 Maintain, repair, paint, inspect, ardor test spnnklerM anci ipe system/hydanVFDC/PIV. Refer to FPB I 1 15 Maintain 3 feet minimum clearance for access/use of fire appliances/equipment. DstrictAttomey 16 Replace damagedrpaintedrmssing sprinkler head,1FW lops. FInal Cteararrce / / 17 Provide 5 -year certification test for sprinklerklancIpipe system. I OccupapWC/as ❑ Check Re -Fire Plan for accu 18 Provide spare Wirilder heads min. 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 re -inspection will be conducted on . WKU failure to comply with this notice is a misdemeanor. Violations that are not corrected immediately and/or remain after the reinspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and rife loss in your community. 19 Hoodvduct edinguishing system to be servicedl tagged every 6 mo. 20 Remove grease from hood, dud, and filters.(KEEP CLEAN) FIRE ALARM SYSTEM 21 Maintain, repair, inspect, ardor test fire alarm system. FIRE SEPARATIONS 22 Repair holes in required fire resistive constructor. 23 ProvkWrepair self or automatic closing fire rated assemblies. 24 Keep attic access and scuttle openings closed. ELECTRICAL Signature of Recipient: 25 Discontinue use of extension lords. 26 Install permanentwiri for fixed and stationary iances. 11 Owner 0 Wnager ❑Employee ❑Other 27 Provide cover plates for all junction braces. Inspecting Officer, - 28 Remove exposed wiring or prated in approved conduit 28 29 Provide a 304nch clear space to and in front of electrical panel. FPB: " Engine Com 30 Maintain wring in good corrdbon and protect from damage. ET' NO VIOLATIONS NOTED THIS DATE THANK YOU FOR BEING FIRE SAFEI FLAMMABLE LIQUIDS • COMPRESSED GASES 31 Provide a flammable liquid storage cabinet or reduce storage to 10 gallons or less. Additional Comments: �� `F /(� �i �!% � (/Z -- ! / <�< 5le"I 77—S _ PVC1of ,c 32 Remove all flammable liquids not used for maintenance purposes.f 33 Store flammable liquids from exits, stairs, or corridors.,/ 34 Secure compressed gas cyinders. STORAGE • HOUSING 35 1 Arrange storage in an orderty manner to provide access/egress.�?�� 36 Remove combustible storage from water heater and electrical room. 37 Remove storage to 24 inches below ceilirg or 18 inches below sprinkler heads. 38 Remove lint/debris from behind washers and dryers. 39 Remove wasteuk ubbish ma' -rials from the premises. 40 Keep dumpsters 5 feet away from combustible walls, eaves, or openings. MISCELLANEOUS 41 Other violations ardor comments. 06/30/2008 09:20 FAX 530 895 5dd4 COMMUNITY CARE LICENSING lih0021002 TE F HFl;ZA7F ,104.7 INSPECTION REDDEST Sae instructions on rover". NCV CONTAOrS NAME TELLPHONE NUt"A Requ66T MATE mmaRAY DSS/COMMUNITY CARE LICENSING 530 695-5033 05/30/08 ADULT RESIDENTIAL ALUom" NAYS MOUER'M(k AOENCY FACILITY NUMBQA REOUE&I" 0000 J3181DONNA GURRIERE 045001065 3A CODES i. On1Y1N 14. A. FIRECLEA7MNOE CENTS Nc DEPARTMENT OF SOCIAL SERVICES AGENCY 2. RENEWAL B, UFESAFETY MEAND COMMUNITY CARE LICENSING 3. CAPACITY CHANGE ADDRESS 520 COHASSET ROAD, SUITE 6 A, OWNERSHIPCHANOE CHICO, CA 95926 S. ADDRESS CHANGE L B, NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY C.kPACIYY FREMME CAAALITT CAPACITY FRHYICUS CAPAp1V CAPACITY FREVWS CIIPw" 4 2 0 5 F�CIUTY NAYS UCVNBE CATMCAr ADE CARE HOME 84735/ARF ADDRESS (AOuN Ln raV NUYBEA DF BUILDINGS 7 RIVERVIEW TERRACE 1 REBTAAINY ROVILLE, CA 95965 NO F lftY CONTACT PERISMS NAME NCURB YNETTE WADE 530 533-4630 24 F—SUTTE COUNTY CDF FIRE 176 NELSON AVENUE INORfTY ME AND OROVILLE, CA 95965 L_ (ATE INBP6CTCRR 6g 01) < AL OR URT wl=AL CONar TELEPHONE MICR (53V) 538-7 (F)pWar� 7 CJ SARAMW M"AL CODE �8u� Al s57WI 2s 1.S 1/9-7- X4P' 1-1 /A EZ 1. FIRE CLEARANCE GRANTED 2 FIRE CLEARANCE DENIED A. EXITS B. CONSTRUCTION C. FIRE ALARM D. BPRINO.ER9 E. HOUSEKEEPING CFm MUMMA CCr4WAk4V Casa ! F. SPECIAL HAZARD G. OTHER �8u� Al s57WI 2s 1.S 1/9-7- X4P' 1-1 /A EZ 06/30/2008 09:19 FAX 530 893 5'oo4 COMMUNITY CARE LICENSING ka 2 001 /002 STATE OF CALIFORNIA -HEALTH AND HUMAN SERVICES AGENCY ARNOLD SCHWARZENEGGER, Govemor DEPARTMENT OF SOCIAL SERVICES Community Care Licensing 520 Cohasset Road, Suite 170 Chico, Cq 95926 (530) 895-5033 (530) 695-5934 (FARC) FAX TRANSMITTAL DATE: Lo- 30- O Q' TO: FAX NUMBER: �3T• a.105 FROM: O � MESSAGE: TOTAL NUMBER OF PAGES INCLUDING COVER SHEET: al_~ IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL COMMUNITY CARE LICENSING Ilii CHICO AT (530) 895-5033 AS SOON AS POSSIBLE. The information contained in this facsimile transmittal is privileged and confidential by law. It is intended only for the use of the addressee above. If the reader of this message is not the above named addressee, you are b treby notified that any dissemination, distribution, or copying of this transmittal is strictly prohibited. If you have received this transmittal in error, please notify us immediately by telephone (collect) and return this transmittal to the above address. Thank you. nLADT ir \1 —InT zo / Z z— From � Date lk7 AD Maeyom Pc TEL. 0-54 rh a �e Lt C1Fax 0-34 IV_ FD VOLUNTEER IECOMPANIES BANGOR BIGGS BUTTE CREEK CANYON BUTTE MEADOWS CHEROKEE CLIPPER MILLS RHAM kTHER FALLS GEST RANCH LDEN FEATHER EATER GRIDLEY .LY RIDGE GALIA RTH CHICO .ER MO JTZ VALLEY N MILL CITY BCD FULL-TIME FIR STATIONS RHAM IDLEY ILLY RIDGE RD RTH CHICO ,UTH CHICO PER RIDGE :IRE STATIONS TTE MEADOWS IHASSET ATHER FALLS REST RANCH RTS MILL RBO GAP OVILLE HO RADISE BINSON MILL IRLING CITY E FIRE CENTER REFC RESTATION NUR ERY D VIS M GALIA AIR A TTACK BASE co FIRE OOS I LD MOUNTAIN BL OMER HILL PL kTTE MOUNTAIN SA NMILL PEAK SUNSET HILL ALSO PROUDLY SERVING C11 Y OF BIGGS CM OF GRIDLEY February 26, 200 Ms. Lynette Wade, Owner Wade Care Home 67 Riverview Terrace Oroville, CA 95965 Dear Ms. Wade. 1;utte Count BUTTE COUNTY FIRE DEPARTMENT CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION "Sixty-seven Years of Cooperative Emergency Services" 176 NELSON AVENUE • OROVILLE, CALIFORNIA 95965-3495 TELEPHONE: (530) 538-7111 FAX: (530) 538-7401 CppY RE. Deadboits Due to recent criminal activity at your home you have my permission to install thumb -latch (no key -locks) deadbolts on the basement doors leading to the exterior of your home. It is understood that your senior guests have no access to this area and they have sufficient exits upstairs to meet code. No deadbolts upstairs unless they are interconnected with the primary opening mechanism (door handle or latch). Tease call me at 530-538-6837, Ext. 166, if you have any questicns. Henri Brachais Fire Chief i By: Steven J`. Epvler Captain/Fire Marshal AL Fire Prevention Bureau 176 Nelson Avenue Oroville, CA 95965 Telephone 530-538-7888 Fax 530-538-2105 Address: Owner/Manager: Assistant Manager: Building Owner. Address: Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report Vc1.rr v ems. , Business Name: , s Bus: Bus: Bus: M White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. Fax: . XT n►TV !"rrnl►T 9"11V vnrTu Ti A Cn .7TV 12 V V -F A IND TAF. Fnl .l ,nWINCt- 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 ElNo ❑ 18. Other T lYTfTT _ DETAILED EXPLANATION AND UOKKEU llUn�0: < V nV 1L` L• ate: Discussed with: (Print) , Signed: Inspecting Officer: attalion 1 2 3 4 5' 6 7 Station: r FPB PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION WITH ORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: ', Ank S ATE CP CALI-FCAN1A RE SAFETY INSPECTION REQUEST . 850 (REV. 70-941 See Instructions on reverse. CONTACTS NAME I TELEPHONE NUMBER REQUEST DATE PROGRAM SS/COMMUNITY CARE LICENSING 530 895-5033 03/07/01 ALUATORS NAME REQUESTING AGENCY FACILITY NUMBER RECUEST CCCE 201 045001065 5A. CODES i. ORIGINAL A. FIRECLEARANCE CENSING DEPARTMENT OF SOCIAL SERVICES 2. RENEWAL B. LIFE SAFETY AGENCY COMMUNITY CARE LICENSING 3. CAPACITY CHANGE AMEAND GRANTED 1. ECLEARANCEDENIED ADDRESS 520 COHASSET ROAD, SUITE 6 4. OWNERSHIPCHANGE CHICO, CA 95928 S. ADDRESS CHANGE I L— 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY �lTi�� its 1 c 4 F UT NAME LICENSE CATEGORY ADE CARE HOME ARF ADDRESS (Admi Lo=fbn) NUMBER OF BUILDINGS 7 RIVERVIEW TERRACE 1 C TY RESTRAINT ROVILLE, CA 95965 NO CUTY CONTACT PERSON'S NAME — 24 YNETTE WADE (530)533-4630 'ECTAL CONDITIONS ;NAGE OF LOCATION :.m pm ., .. _ CLEARANCE /DENIAL CODE F—STEVE FOWLER CODES FIRE BUTTE COUNTY FIRE DEPARTMENT GRANTED 1. ECLEARANCEDENIED UTHORITY E AND 176 NELSON AVENUE 2. FIRE CLEARANCE DENIED ADDRESS OROVILLE, CA 95965 A. EXITS S B. CONSTRUCTION C. FlRE ALARM NAME m TELEPHONE NUMBER CFIRS NUMBER OCCUPANCY CLASS (Typed or Pri D. SPRINKLERS E. HOUSEKEEPING l C� '�t� l/�i F. SPECIALHAZARD DATE WSPECTORS SKMTURE (T ' ft'0 G. OTHER /-�L!) % I xarAIN Dp4AL OR LIST SPECIAL CONATIONS �lTi�� its c BUTTE COUNTY FIRE DEPARTMENT/CDF FIRE TITLE 19/24 FACILITY INSPECTION INSPECTION NO. 1 2 3 REINSPECT: F<�.YES F'NO Facility l�/d_ Occupancy Address / �'l= �_ L_'%f Inspector Phone — VZW Station . = r; Contact Station Phone compliance: Yes =%r 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) i _-Fire protection equipment visible/accessible (T19-3.14) NO= U NOT applicable = IV/A ELECTRICAL --All inspections Extension cords do not replace permanent wiring (CEC-400-8(1)) 4 Extension cords do not pass through doors/walls (CEC-400-8 9,3)) 30 inch clearance around all electrical panels (CEC-110-16A) All panels and breakers are marked (CEC-110-17C) Repair holes in fire -resistive construction CEC (300-21,22) Multi -plug power strips have circuit breaker (CEC 400-13) 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 (T19-563.2) Extinguishers mounted on wall/or in cabinet, visible and signed (r19-563.8) EXITS --All Inspections Exits not obstructed (T19-3.11) Exit signs in place (CBC 1003.2.9.1) Doors operate without key or special knowledge (CFC 1207.3) Rooms with Occupant Load of 50 Persons or More Exit illumination and Signs In'place (CBc,10032:a:2) Maximum occupancy sign in place (T19-3.30) 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) 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 (r -19-3.19c) Flammable liquids stoled properly (T-19-3.15) I Corrections and Corr The above deficiencies must be corrected within 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) Maintain extinguishing, systems (T19-3:24) l Provide spare sprinkler heads (6 min.) and/or sprinkler wrench (T19 -9o4.5) Replace darjiaged, corroded, or painted sprinkler heads (T19-904.5) Identify sprinkler valves 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 (r19-904) MECHANICAL EQUIPMENT -- All Inspections Vents and chimneys -- No obvious hazards (CMC -Ch. 8) SMOKE DETECTORS -- Day Care Sr. Res., Hospitals, Apts. 1- Properly installed and tested (T19-749,754) SCHOOLS, JAILS AND HOSPITALS Decorations `and curtains fire retardant (T19-3.08) LPG-tanks'fenced with locked gates (r19-3.22) FIRE DRILLS -- School and Day Care (Title 19-3.13) All systems operable/hooked to office..- Held monthly (elementar)! schools) Held semi-annually'. emi-annually (high schools) Evacuation plans posted in all rooms ,Emergency procedures posted in office Teachers take roll books c'O days Inspection Date: 2-1*;? Owner/Manager AP # A BUTTE COUNTY FIRE DEPARTMENT/CDF FIRE TITLE 19/24 INSPECTION NO FACILITY INSPECTION REiNSPECT: 1 a) 3 YES VNO Facility fes% f �� Wcupancy Address W1— Inspector Phone 3 Station _ Contact Station Phone Compliance: Yes = It ACCE -All inspections Address correct/posted and visible from road (Butte co. Code 32-9) mess to public street or 20 ft. wide lane (T19-3.05) mates wide enough to admit fire apparatus (T19-3.16) protection equipment visible/accessible (T19-3.14) No = 0 Not applicable = N/A PORTABLE FIRE EXTINGUISHERS -- All Inspections �xtinguishers have current annual service tag (T19 -575.1A) L -h akimum travel 75 ft. (r19-567) Lf'i v�de_clear access to fire extinguisher (r19-563.2) `Extinguishers mounted on wall/or in cabinet, visible and signed (r19-563.8) EXITS- All Inspections `Exits not obstructed (T19-3.11) xit signs in place (CBC 1003.2.9.1) _ .rl36ors operate without key or special knowledge (CFC 1207.3) Rooms with Occupant Load of 50 sons or More Exit illumination and signs place (CBC 1003.2.8.2) Maximum occupa nPKgn in place (T19-3.30) Two exit door anic hardware swing in direction of travel (CFC 2501.8.2) HOUSEKEEPING -- All Inspections ^--No waste or rubbish accumulation inside or outside T19-3.14) Reduce storage to at least below ceiling/ sprinklers (T19-3.14) '--'Remove combus. storage from heater, meth., elect. room CM -3.19f) Zammable a approved metal container for oily rag storage Cr -19-3.19c) liquids stored properly (T-19-3.15) ELECTRICAL --All inspections Extension cords do not replace permanent wiring (CEC-400-8(1)) -- txrension cords do not pass through doors/walls (CEC-400-8 9,3)) --;;, -,-50 inch clearance around 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/ a every 6 mo. b tech. (-19-904) Clean filters, hoo , a rea oy ooking appliances (CFC 1006.2.8) Maintain extin ishin ste (r1s3 24) Provide spare spri eads (6 min.) and/or sprinkler wrench (r19-904.5) Replace dam d, corroded, or painted sprinkler heads (r19-904.5) Identi rinkler valves and secure in open position (T19-904.5) lace missing caps on fire department connection (r19-904.3) Provide 5 -yr. certification test for sprinkler/standpipe (T19-904) MECHANICAL EQUIPMENT --All Inspections v CHVents and chimneys --No obvious hazards (CMC -Ch. 8) SMOKE DETECTORS -- Day Care Sr. Res., Hospitals, Apts. —L-el`roperly installed and tested (r19-749, 754) SCHOOLS, JAILSAND HO ITALS Decoration an cu fire retardant (T19-3.08) LPG tanks fent wi h I cked gates (T19-3.22) FIRE DRILL --School any( Day Care (Title 19-3.13) All sy/ans able ked to office Held nt schools) Held Ily hi schools) Evacposted in all rooms Emerdures posted in office Teacll books The above deficiencies must be corrected within Inspection Date: -3_12-ZoeJ Owner/Manager AP # A-", Office of the State Fire Marshal Fire Safety Correction Notice I � CALIFORNIA STATE FIRE MARSHAL File No: O -0t1- --�-7 a/ 0(- - av ()- 03S - C) Name: Address: The. California Healthand Safety deficiencies be corrected. Code and the State fire Marshal's regulations require the following fire safety - 0 r 0 IX;z cl)�r /7� 647 The above deficiencies are to be corrected within days. When ALL deficiencies have been corrected, sign and return the certificatiovn the opposite side of this form. If you have any questions, contact the Office of the State Fire Marshal at ( ) PL/ ISSUED BY iDepuly Slat6 Fire Mars alY /� RECEIVED BY DATE I I iRe, - Nhi 1 1) 88/61 DItiTRIRUIION. GREE—Fa, &It WHITE- ReGion ) F[ [ 01A—,udrl Office of the State Fire Marshal .F: Fire Safety Correction Notice I I CALIFORNIA STATE FIRE MARSHAL File No: v^ v- 0 L - -Z Name: wr �n2 f �k_f /nt-fC /� t_I.i,-L Address: The California Health and deficiencies be corrected. Safety Code and the State Fire Marshal's regulations require the following fire safetyr r tf r 27 The above deficiencies are to be corrected within days. When ALL deficiencies have been corrected, sign and return the certificatioa.on the opposite side of this form. If you have any questions, contact the Office of the State Fire Marshal at(-) ISSUED BY (DeputySmCf 7I`lre Marshal) RECEIVED BY DATE SE SF CALIFORNIA RE SAFETY INSPECTION Rio"" ;ST 850 (REV. 10-94) See instructions on reverse. A NCY CONTACTS NAME TELEPHONE NUMBER ' REQUEST DATE PROGRAM DOSS/CO1NQ4TTNIrT CARE LICENSING 530 895-5033 05/13/99 EV LUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE 0207/DONNA GURRIERE 041373612 7A CODES 1. ORIGINAL A. EIRECLEARANCE FIRE ORITY L CENSING DEPARTPIENT :OF SOCIAL SERVICES t • 2.' RENEWAL B. LIFE SAFETY GENCY COMMUNITYCARE LICENSING CIiICO CA 95926 • ME:AND 3. CAPACITY CHANGE 520 COHASSET ROAD, SUITE 6 A. EXITS ADDRESS -CHICO, CA .95926 4. OWNERSHIP CHANGE . B. CONSTRUCTION 5. ADDRESS CHANGE atr 6. NAMECHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAP CITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPAGTY Z E. HOUSEKEEPING 2 `"1. l ��(� �� ' II ' l a4" F. SPECIAL HAZARD G. OTHER INSPEC ON D�Q INSPECTOR'¢ S US ATrE Or,ype dor2 b"ted) UcENSE'CATEGORY .....z ADE CARE HOME 84735/ARF STR ET ADDRESS (Actual Location) NUMBER OE_BUILDINGS 079 GRAND -AVENUE 1=. CITY RESTRAINT ROVILLE, CA 95965 NO FACT TY CONTACT PERSON'S NAME HOURS ,ETTE WADE (530) 533-4630 24 SPEC AL CONDITIONS VEST FOR UPDATE. LAST ~IRE SkFET`f INSPECTION `BIAS 07/91. TO BE COMPLETED BY INSPECTING AUTHORI CLEARANCE/DENIAL CODE STATE FIRE MARSHAL CODES FIRE ORITY 44 WILL F AiMSSURG LANE, SUI' 7 1. FIRE CLEARANCE GRANTED AUT NAME AND CIiICO CA 95926 • 2. FIRE CLEARANCE DENIED ADDRESS A. EXITS L B. CONSTRUCTION C. FIRE ALARM D. SPRINKLERS INSPE OR'S.NAME.(TJP 4r &jIlfBd), __� - _ _ . _. _ _-T€LEf-B0N _,NUMBER _ . , CFIRS NUMBEQ .. , _ .,OCCUPANCY. CLASS CJ/lam 7�j, �� 7' E. HOUSEKEEPING `"1. l ��(� �� ' II ' l a4" F. SPECIAL HAZARD G. OTHER INSPEC ON D�Q INSPECTOR'¢ S US ATrE Or,ype dor2 b"ted) ,y+ EXPLAIP DENIAL OR UST_SPECIAL CONDITIONS r I V 7 "` r2 r= j r-r�. /i�e off_ (• 12,-A 1 i