HomeMy WebLinkAboutBUSINESS PLANECTION RECORD
ENT's ~ AN 112006
DATE:
"'~ _ ..~' FACT/L~ITY ADD~Rj,ESS:
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FACILITY NAME: ~-~-~~~ ~~'~'
MANAGER NAME: '""'"" ~~~g~ - - __ __ FACILITY PHONE ~ - ~ (~
BUSINESS OWNER NAME, ADDRESS, ZIP CODE
BILL TO: (IF DIFFERENT FROM ABOVE}---NAME, ADDRESS, ZIP CODE, PHONE No.
OCC , - PE ~ ..
'. ~ ..~ OCC LOAD No. OF FLOORS HI RISE BLDG.
YES O NO ~~~,,. RIS R DATE
VIOLATION NOTICE CORRECTION:
1. DATEbFREINSPECTiOIV
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NOTES
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CUSTOMER: ~
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AP No. FIRE PREVENTION SERVICES
(661) 326-3979
WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE
Bakersfield Fire Dept.
1715 Chester Ave.
Bakersf field, CA 93301
~~-~ 3`~~.:3~7v
~~~ ~~.~ 3b~~
P: FEE: ®.
FD1952
_ -f
6TATT OP CALIFORNIA
FIRE SAFETY INSPECTION REQUEST
sTD. eso (REQ. la•9q
See lnstructlons on reverse.
AGENCY CONTACTS NAME TELEPHONE NUMBER REQUEST OATS PROGRAM
COMMUNITY CARE LICENSING 559 243-4584 12-7-05 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REWEST CODE
MIKE BUSSEY 153903205 1A
RESPONSE REQUIRED cooEs
LICENSING ~ STATE DEPT. OF SOCIAL SERVICES ~
AGENCY
NAIVIEAND COMMUNITY CARE LICENSING 1. ORK3INAL A. FIRE CLEARANCE
2. RENEWAL 8. LIFE SAFETY
s. cAPACmrcHANGE
ADDRESS 770 E. SHAW, SUITE 3OO 4. OWNERSHIP CHANGE
FRESNO, CA 93710 5. ADORESSCHANGE
S. NAME CHANGE
7. OTHER
AMBULATORY NONAMBLiLATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVpUB CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
i4 ~14
FACILITY NAME uGeNSe cArEavHY
AGUERO, PETRONA FCC FAMILY CHILD CARE
STREET ADDRESS (Attwl Locafbn) NUMSF3i OF BUILDINGS
6424 MONITOR ST. 1
CfTY RESTRNNT
BAKERSFIELD 93307
FACILRY CQNTACT PERSON'S NAME HOURS
PETRONAAGUERO (661) 397-3870 DAYTIME
sPECaL coNOrtIONs
rBAKERSFIELD FIRE DEPT.
ARE 900 TRUXTON AVE. #210
AV[HORITY
NAYEAND ggKERSFIELD, CA 93301
ADDRESS
L
CODE8
1~IRE CLEARANCE GRANTED
''22~~!! FIRE CLEARANCE DENIED
A. EXITS
6. CONSTAUCTiON
C. flRE ALARM
M16PJJECTOR'8 NAME (1)p~d a PnYM~dJ TELEPIIOHIE NUMBER CRRS NUMBER OCCUPANCY CLASS D. SFflINKLER$
C~S t~l ~ ((p6 ) ~~ I S~V ~ ~3 F. SP~ECl~HA7.ARD
MlSPECTION DATE MISPECT RE (T P-ilt~ G. OTHER
OR LIST CONDIT1ON3