HomeMy WebLinkAboutBUSINESS PLANLUZ URENA FCC
4425 STAR JASMINE COURT
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BUSINESS OWNER NAME, ADDRESS, ZIP CODE
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AP No. ~"°'°'°~- FIRE PREVENTION SERVICES
- (661) 326-3979
WHITE ORIGINAL-OWNER YELLOW-INSPECTOR'S COPY PINK-FILE
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Bakersfield Fire De,~
,1715 Chester Ave. ~ Q 4 ?O46
B~ak/Je~rs~f field~,/C~fA 933f 01 //
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STATE CF CALIFORNIA
'FIRE SAFETY INSPECTION REQUEST
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See /nstructlons on reverse.
AGENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM
COMMUNITY CARE LICENSING 559 243-4584 11-29-05 109
EVALUATOR'S NAME REQUESTING AGENCY FACILITY NUMBER REQUEST CODE
MIKE BUSSEY 153806122 3A
RESPONSE REQUIRED cones
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~ 1. ORIGINAL A. FIRE CLEARANCE
LICENSING
STATE DEPT. OF SOCIAL SERVICES 2. RENEWAL 8. LIFE SAFETY
AGENCY
NAMEANO COMMUNITY CARE LICENSING
s. cAPACITYCHANGE
ADDRESS 770 E. SHAW, SUITE 3OO 4. OWNERSHIP CHANGE
FRESNO, CA 93710 5. ADDRESS CHANGE
6. NAME CHANGE
7. OTHER
AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY
CAPAGTY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACfTY
14 8 14
FAGLRY NAME
URENA, LUZ FCC
STREET ADDRESS (Actw/ Locition)
4425 STAR JASMINE CT.
BAKERSFIELD 93304
FAGUTY CONTACT PERSONS NAME
LUZ URENA (661) 835
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FAMILY CHILD CARE
NUMBER OF BUILDINGS
1
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DAYTIME
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rCIEARANCE ULL CODE
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FlRE g00 TRUXTON AVE
#210 ~. FI ECLEARANCEGRANTED
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AUTHORfTY
NAAAEANa BAKERSFIELD, CA 93301 2. FlRECLEAAANCEOENIED
ADDRESS A. O(ITS
8. CONSTRUCTION
C. FIRE ALARM
INSPECTOR'S NAME (fjpad or PrNt«i} TELEPHONE NUMBER CRRS NUMBER OCCUPANCY CLAS6 D. SPRINKLERS
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F. SPECIAL HAZARD
WSPECTION DATE
~ INSPECTORS (T}yid aPmt~d) ~ G. OTHER
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EXPIaN OElNAL OR LIST SPECIAL