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Home My WebLink AboutBUSINESS PLANu~.. ~ .- .....-".^,._r -ti. ,.u -_.k~.,,-.,_. ~.~ -.- .. f...rnf,~~-. -, ,. ~,,.v~v.~.. i~.~,n..:..-... -....~„f_.;.c*..,,.~...~.-,... «r~,2,,,...~ ~,f,. ~~.....~ .-..sv~-•~,;,,~ -. ~.vR:,,. - .,. v .....,r. F~ ~.~^c.,,.~~ ...............w.,.....F, INSPECTION RECORD - Bakersfield Fire Dept. . ;;:... _ ,: , 1715 Chester Ave. ~ THIS IS N®`~' ~ SILL ~ Bakersfield, CA 93301 _~n~J~ CUSTOMER I.D. # ENTERED `~ ~ v DATE: // FAC\ILITYrA~DDRESS/:~ F ~ ZIP: F~E/E~ O COUNTY FACILITY NAME: ~~ -~~ 1 ~-( r~ trl~ ~ I~rn~ -C~_C' ~ ~ 1 1 ~1 ~'C ~i ~l C_ ; __-_ MANAGER NAME: d~f f)(1 ~ ~ _,, ~ ~~ ~ _ -FACILITY PHONE _~ ~ __I ~'7 ~ BUSINESS OWNER NAME, ADDRESS, ZIP CODE _ -_- _____-- BILL TO: (IF DIFFERENT FROM ABOVE)-NAME, ADDRESS, ZIP CODE, PHONE No. OCC TYPE ~~ OGC LOAD ~~ No. OF FLOORS ~ ~ HI RISE BLDG. YES O NO ®, EQ YES O NO ~ RISER DATE UV~~~ VIOLA~1'ION NOTICE CORRECTION: DATE OF REINSPECTION 1. _ 3. - - - ------ 5. ~~ ` ----- ------ 7. - - - - NOTES ~ r~ ~, CUSTOMER ~ ~ /,''I ,~~' d7 .~ L%/ ~:~i( /,L~'6~1!^~' FIRE SAFETY SERVICES INSPECTOR: ~~ /~~~~1-- AP No. ~~ - (661) 326-3979 WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE FD1952 .. • FIRE PREVENTION INSPECTION = >I EF/RE ` L D ~RrM r ~_-_- ~~ BAKERSFIELD FIRE DEPT. "„ Prevention Services ~ 7 J0 900 Truxtun Ave., Ste. 210 ~ I 1 Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661 852-2171 !~ DISTRICT BLOCK NO. DATE _ ~~'} , ~ `f EE !~ l vl.. J r FACILITY ADDRESS /\ Cj ~~ ~ 0.~ / Y v /1 CITY, STATE, ZIP ~ ^7 ~ ( ' ! t./ ~ FACILITY NAME FACILITY PHONE NO. MANAGER'S NAME BUSINESS OWNER'S NAME AND ADDRESS f CITY, STATE, ZIP OWNER'S PHONE NO. BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO. A OCC~Ty_PE C OCC LQAD // NO. OF FLOORS HIGH RISE B DG ARIS~ER DA ^ YES ~~NO !\J ~ ~~ CORRECT ALL VIOLATIONS VIOLATION CHECKED BELOW No. REQUIREMENTS COMBUSTIBLE WASTE I DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its safe disposal. (U.F.C.) COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse boxlfire door (N.E.C.) (U.F.C.) 4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10) EXTINGUISHERS 5 Provide and install (amount) _____ approved (type 8 size) _____ __ portable fire extinguisher to be immediately accessible for use in (area) _____________________________ (U.F.C.) g Re-charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year, and/or after each use, by a persori having a valid license or certificate. (U.F.C.) SIGNS 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to fire escape. (U.F.C.) g Provide and maintain appropriate numbers contrasting background and visible from the street to indicate the correct address of the building. (B. M.C.) FIRE DOORS/ FIRE PARA I N g Repair all (crackslholeslopenings) in plaster in (-Iota i __~_ _ _________________________. Plastering shall return the surface to its original fire resistive condition. (~B(~ SE T O S 10 Remove/repair (item & location) _ _______________. Self-closing ----------------------------------------- doors shall be designed to close by gravity, or by the action of a mechanical device, or by an approved smoke and heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the closing device. {U.F.C.) Exlrs 11 Remove all obstruction from hallways. 'Maintain all means of egress free of any storage. (U.F.C.) 12 Provide a contrasting colored and permanently installed electric light over or near required exit (location) ______________________________ to clearly indicate it as an exit (U.F.C.) STORAGE 13 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire escapes/stair shafts are to be maintained free from obstructions at all times.) (U.F.C.) ELECTRICAL APPLIANCES 14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets where needed. (N.E.C.) (U.F.C.) 15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N. E.C.) (U.F.C.) oUTDOORBURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C. FIREWORKS 17 Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 1g /' ~ CUSTOMER: ~G c•t ',~ " ~, l t 2.T ~._~-~„ r ~ ~ r,• 1 ~ ~v 7 L I , , (, (Signa)ture) (Please Print Name Legib ,Title) ~} ~ INSPECTOR: -s~~~P/.4`k' .=(d~7TL°''~_._ AP NO.: ~ (SlgnatUre LEGEND: C.F.C. CALIFORNIA FIRE CODE U.B.C. UNIFORM BUILDING CODE B.M.C. BAKERSFIELD MUNICIPAL CODE N.F.P.A. .NATIONAL FIRE PROTECTION ASSOCIATION " N.E.C. NATIONAL ELECTRIC CODE White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05) ~ A i~ ~~ r~~ ~ ; ' i ~ ~~. ~~ M~' i~ h ~~ ~ ~t~_ f ~t s -0~. t ~ ~~ ~ ~ ti~ -_.. ._ kk'~ 77 ~_ ~11'- 5,, ;~ ~~ ; ~--~. . ~ ~, o,, :~ . ~ ~; 4 a' ~ ~ ~ ~, K -- ~~~ ~v ~ D ~/ c~ ~~~~ v # 4 `~^' I~ :~ T t~l \ ~ ~ ° 1 ~~~ ~ ~ Y ~~ `J °- ~ 1 ' ~ s o .+~,~~~ ~ -- -- M~ 3~cs ~' -: i~, ~ ~ ~. y s. ~ ~ .~ ~ ~ ~, ' ._ ~ 3 Y ~~~~ ~ ~' ~ ~~~~~ ~ ~ ~ " ~ )pro ~ A,+ ~ ~ ~~,`.~; ~, • ~ ~ ~. , _. ._ e ~ L ~ ~ ~ (~ ' ~ ~' ~ ~, ~ ~. v ~~ _~~.~ l-t V v ,4 ~~~~ ______ i ':. ~ ~~ + ~ ~~~ d ~ ~ .~ + ~ ~ ~ 3A r.~ ~, 7 ~, :~! ~ STATE OF CAII FORNIA FIRE SAFETY INSPECTION REQUEST STD. 850 (REV.'10-94) (REVERSE) INSTRUCTION S This form is designed for use with a window envelope Licensing or Requesting Agencies--Complete the following 19 sections on this form before submitting it to the fire authority havingjurisdiction. 1. AGENCY CONTACT, 2. TELEPHONE NUMBER, 5. EVALUATOR. Enter the name and telephone number of agency contact person. 10. FACILITY NAME. Insert the name of the facility as it will appear on the license. List identifying sub name ifknown (i.e., Hacienda Corp/Medina Lodge). 3. PROGRAM. Licensing agency use. 4. REQUEST DATE. Enter date request was prepared. 1 L LICENSE CATEGORY. Insert the category of license being sought as it will appear on the license certificate. G. REQUESTING AGENCY FACILITY NUMBER. This 12. ADDRESS. Insert street address and city only. A post office box is not acceptable as only location. is the file number assigned by the licensing agency. 7. REQUEST CODE. Use the seven codes shown and insert the appropriate number in the box following "Request Code". If NAME CHANGE, please list previous name. Insert date of original request is other than an original 8. AGENCY NAME AND ADDRESS. Enter the name and address of the licensing facility requesting the inspection. 9. AMBULATORY--NONAMBULATORY--BEDRID- DEN. Capacity: Insert in the appropriate section; the capacity of licensed ambulatory or nonambulatory oc- cupants covered by this request. 13. NUMBER OF BUILDINGS. Insert the total number of buildings to be used for housing of the occupants covered by the license. - 1.4. RESTRAINT. Indicate if physical restraint (locked in a room or the building) is to be used in the housing of the occupants. 15. FACILITY CONTACT PERSON--TELEPHONE NUMBER. Indicate the name and telephone number of the responsible individual at the facility to be contacted by the fire authority. . 16. HOURS. Indicate the number of hours the occupants are housed at the facility (less than 24 or 24+). Previous If request is for renewal or capacity change, 17. SPECIAL CONDITIONS. Indicate any conditions Capacity: insert capacity of previous clearance. unique to this request.. As an example, if the inspection Total Show total licensed capacity. If the facility is request is for one building in amulti-building facility. Capacity: intended to house part ambulatory, nonambu- latory, and part bedridden, show the total of the three t}pes of occupants. FIRE AUTHORITY CONDUCTING THE INSPECTION--COMPLETE THE FOLLOWING: 18. FIRE AUTHORITY, NAME AND ADDRESS. Insert 22. OCCUPANCY CLASSIFICATION. Use California the name and address of the fire authority where the facility is Building Code occupancy classifications and insert the located. occupancy determined by the inspector. 1.9. CLEARANCE/DENIAL CODE. Use the two codes: 1 23. INSPECTION DATE. Enter the actual date of the for clearance granted, and 2 for clearance denied. If denied, inspection. also include the appropriate letter code. As an example, Denial 24. INSPECTOR'S SIGNATURE. To be signed by the based upon exiting would be coded 2A. inspector conducting the inspection. 20. INSPECTOR'S NAME. Print the initial of the inspector's first name and full last name; insert the telephone number where the inspector may be contacted. 21. CFIRS LD. NUMBER. Insert the fire department's num- ber assigned by California Fire Incident Reporting System. 25. EXPLAIN DENIAL OR SPECIAL CONDITIONS. If clearance code #2 is used, briefly explain reason. This space is also to be used to specify any additional limitations placed by the fire authority, such as the use of certain floors or sleeping rooms approved for nonambulatory clients. :~3,~. ~ ,. -. INSPECTION RECORD ~ THIS IS IoT~T ~ ~3ILL Bakersfield Fire Dept. 1715 Chester Ave. Bakersfield, CA 93301 CUSTOMER I.D. # ENTERED DATE: t 1 _f~~_(\~ `°~' lJ FACILITY ADDRESS: ~ ~ ~y~ v ZIP: ~ pr, ~ FEE: CITY COUNTY FACILITY NAME: ~s'1 ~ C. ~ MANAGER NAME: _~~ f'ot1 W ~ 11~~-_ - FACILI BUSINESS OWNER NAME, ADDRESS, ZIP CODE _ __ ____ Y PHONE __~~- I_~J~ ___-__- BILL TO: (IF DIFFERENT FROM ABOVE)-NAME, ADDRESS, ZIP CODE, PHONE No. OC YPE a OCC LOAD No. OF FLOORS HI RISE BLDG. YES ^ NO EQ YES ^ NO RISER D TE VIOLA ION NOTICE CORRECTION: 1 DATE OF REINSPECTION - . 4. - --- - 5. ---- --- --- 6. - 7. - - - - - -- - - - NOTES .- CUSTOMER: =C ~~~ FIRE SAFETY SERVICES -- INSPECTOR: r~l-----~ _ AP No. _ - (661) 326-3979 WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE FD1952 N ~,'~Q y ~ a <~ ~~ / ~ESID~/ w. _~_~L~~./~ STATE OF CALI~u'RNIA -HEALTH AND WELFARE AGENCY DEPARTMENT OF SOCIAL SERVICES LOCAL FIRE INSPECTION AUTHORITY INFORMATION DATE: ' / REQUIRED BY THE DEPARTMENT OF APPLIC NT AME: ~lY/I ~y~o-~ l~1ill;u.ms "SOCIAL SERVICES, COMMUNITY CARE LICENSING FACILITY NA DIVISION CGtv~nL~,ron ~(ou,~~n Nom2 ~ac.+ ~~~ies~ 1~~. FACILITY DR 5: jQ Gt GUS. ' As part of the application process, the licensing agency is responsible for obtaining a fire safety inspection from the local fire inspection authority having jurisdiction in the area where your facility is located. To help us expedite this process, we are requiring that you identify the local fire inspection authority that is responsible to inspect your facility and issue a fire clearance. LOCAL FIRE IN CTION A THORITY: ~~ 1 ,` rre_. ~ .r ADDRESS: ~(f ~O "~\ { V ~~ \) ~ V ~ ~ CITY AND ZIP COQ: PLEASE RETURN TH-S FORM WITH YOUR COMPLETED APPLICATION LIC 9054 (8/92) STATE OF CALIFORNIA -HEALTH AND WELFARE AGENCY DEPARTMENT OF SOCIAL SERVICES LOCAL FIRE INSPECTION AUTHORITY INFORMATION ""'°~ ~~ ;~~ - o REQUIRED BY THE DEPARTMENT OF SOCIAL SERVICES, COMMUNITY CARE LICENSING DIVISION AP LIC NT NAME: G~mp~'OYL 7vu~- f~~~P ~a~t-~CTi(s, lnG ~~ As part of the application process, the licensing agency is responsible for obtaining a fire safety inspection from the local fire inspection authority having jurisdiction in the area where your facility is located. To help us expedite this process, we are requiring that you identify the local fire inspection authority that is responsible to inspect your facility and issue a fire clearance. 3~ PLEASE RETU,P~ii 3ra;S FORM W/TH YOUR COMPLETED APPLICATION LIC ,r'- .Fi n~. , `. -- r - ..~ ~'C F2F~"~l