HomeMy WebLinkAboutBUSINESS PLANI l
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ii ~ ii SHELLEY MMES
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'Y`''~~ - ~i ~ BAKERSFIELD FIRE DEPT.
Prevention Services /~/~~
SIRE PREVENTION INSPECTION a ~P~RiE I D 900 Truxtun Ave., ste. 210 - ~V
ARTM T Bakersfield CA 93301
Tel.: (661) 326-3979 ^ Fax: (61~ -2171
DISTRICT BLOCK NO. DATE fir, ! _ ,/ `
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FACILITY ADDRESS 8~
CJ CITY, STATE, ZIP
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FACILITY NAME
' MA GE 'S NAME FACILITY PHONE,~NOS.
BUSINESS OWNER'S NAME AND ADDRESS CITY, SrTATE, ZlP OWNER'S PHONE NO.
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO.
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~~ OCC DADS NO. OF FLOORS HIGH RISE BLDG /A R,ISE,R q/~TE
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CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS
CHECKED BELOW No.
BUS
ASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
TIBLE W
COM
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 & size) __________________ portable fire extinguisher to be
immediately accessible for use in (area) _________ _ ___________ (U.F.C.)
g Re-charge all fire extinguishe~lE~ e~i s h serviced at least once each year, and/or after each use,
by a person having a valid lic c r i%ate. (U.F.C.)
7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to
SIGNS fire escape. (U.F.C.)
g Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the
correct address of the building. (B.M.C.) (U.F.C.)
g Repair all (cracks/holes/openings) in plaster in (location) ______________________________________. Plastering
FIRE DOORS/
FIRE SEPARATIONS Shall return the surface to its original fire resistive condition. (U.B.C.)
10 Remove/repair (item 8 location) _ ____. Self-closing
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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.)
EXITS 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
escapeslstair shafts are to be maintained free from obstructions at all times.) (U.F.C.)
14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets
ELECTRICAL APPLIANCES 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.)
OUTDOOR BURNING 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 Ba ersfield Munici a Code B.M.C. re ardin fireworks.
OTHER 1g ~
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CUSTOMER: ~ ~ ~ LEGEND:
($I ~ ature) (Please Print Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
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~ B.M.C. BAKERSFIELD MUNICIPAL CODE
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INSPECTOR: , ! I
~ ~cT N~ [~{ AP NO.: ~ N.F.P.A. NATIONAL FIRE PROTECTION
~h(Signature') ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)
STATEbF C~ ~JRNIA
FIRE SAFETY INSPECTION REGIUEST
sTD. eso tREV. Tae~> See lnstructlons on reverse.
~(iENCY CONTACTS NAME TELEPHONE NUMBER REOUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243- 8090 August 2, 2007 109
EVALUATCdi'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
Lori N. Beck ~~ ~ 157204037 4A
RESPONSE REQUIRED coDEs
LICENSING STATE DEPT. OF SOCIAL SERVICES ~ 1. ORIGINAL A. FIRE CLEARANCE
2. RENEWAL B. LIFE SAFETY
AGENCY
NAME AND . COMMUNITY CARE LICENSING 3. CAPACITY CHANGE
ADDRESS 770 E. SHAW, SUITE 3OO 4. OWNERSHIP CHANGE
FRESNO, CA 93710-778 5. ADDRESS CHANGE
6. NAME CHANGE
T. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY
0 0 4 4 0 0 4
FAGLITY NAME uGENSE GATEQaRY
AIMES Shelley ADULT DAY PROGRAM
STREET ADDRESS (Actual Location) NUMBER OF BUILDINGS
2808 Shelley Lane One
cmr RESTRaNT
Bakersfield, CA 93306 None
FACILITY CONTACT PERSON'S NAME HOURS
Stephen Killebrew 661-327-3332
sPEaAL coNDlnoNs
This is a change in ownership from Partnership to Corporation with the same owners and same home.
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AUTHORRY Bakersfield Fire Department/Esther Duran ~?l4 ('7
NlWEAND 900 Truxtun Ave., Suite 210 r
ADDRESS Bakersfield, CA 93301
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MSPECTOR'S (TypadorP TELEPHONE NUMBER
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INSPECTION DATE INSPECTOR'S TUR or Prhted)
O 07 -' ~
EXPWN DENIAL OFi UST SPEGAL DITIONS
CRRS NUMBER OCCUPANCY CLASS
~ ~o ~a2,
~RE CLEARANCE GRANTED
2. FIRE CLEARANCE DENIED
a ExITs
B. CONSTRUCTION
C. FlRE ALARM
D. SPRINKLERS
E. HOUSEKEEPING
F. SPECIAL HAZARD
G. OTHER