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HomeMy WebLinkAboutSpecial Inspection Fire Damage Report 1988-5-12 .~ \ ~ - ~ ~ I DO NOT WRITE IN THIS SPACE CONTROL EXP. NO. NO. ,c:.;OP iNC,-F/c (r1 YEAR I DAVOF nJ . WEEK STATE OF OREGON FIRE REPORT. STATE FIRE MARSHAL FIRE DEPT. I ALARM NO. -, LIlJ.JI~ p?J Thur o Fri o SlltUl D,p1. Responding ,<;' PRi/l)(".,f //LfrJ ALARM TIME I. ARRIVAL TIME I TIME BACK IN SERVICE 07fFS 6 7 'J../ f') 75<1 Q?Z;;?,.I 3EN3uS TRA<:f [,".3 CL\SS DOB (optional) TELEPHONE District ofIncident Co~ty D ThQ D W.. ..C ' I MO I OAY \. .:',- S. 11- 1 r. ,'2 D Soo D .. .,' Mon INCIDENT ADDRESS ol7~ SO, {j 3 OCCUPANT NAME {l...ut, Fint, MIl ....,.-;, tftHJ hA-{( Q,{lds-t<. ''',. " BUSINESS OWNER NAME (Last, F1!'lIt, Ml) .:1' '. Pd\f,~ RJ+.~r:L[JA . ,: './ 5 OWNER NAME (Last, Fll'St. MI) f . :4 ,.... sf, ~. ": ':.. 1/ ADDRESS ~ ir'I>-.j''7 DOB(optional) tU:Jti!1l... TELEPHONE 141- 6132. TELEPHONE ffl./IA (.. ;'I'd '" g_ V ~;(') ADDRESS DOB(optional) ..."",. "",,' ., "." -.~' /. 6 ~IRE REPORTED BY (Last, First, MI) l;t;l~ :, ')'f~b . ,. '~~,i'..,..~:" .,~. "",'r '-':' ~', 1 MfrH'OOOF ';\':!~~;~" .{~~ :-:~} ADDRESS DOB(optional) TELEPHONE :," ., '., ,.' '"" to .Autual Aid (ntinguisb or investigate only) o ~iv<<l. " :f..:- 0 Given \:: >,0 N/A ~ - " . . ~. " .' I' OTHER VEHICLES RESPONDED (do not include PA'I) . :;L -, ..~ ' o Salvage ,. o NotCJassified -::.,'i.... '''1 t- I EQUIPMENT INVOLVIID IN IGNITION (Co~leteLineE) I MODEL I SERIAL I UI<~ I LICENSE I I VOL~A~~.~. :.' Idt . f . . tu. tc'/G. ho ~ ~'1 , ITEM FIRST IGNITED: uX'}nrP iJaA!I1JL o BeloWgrd.level 0 o Not CJusified Oth" TOTAL /tJiJO (.!. f fI AIJ111 6u r:JlL;.J'1 I MATERIAL FIRST IGNITED WAS MADE OF 0 o 10to 19 feet l1JI.JlfO e~4~::!(Jj U Over70feet o 20 to 29 feet 0 SOto7Qfeet 0 ObjectainFlight Contents Vehicle and Contents 1Sl. .00 i!J... B 2storie3 B 5to6atories 3to4atories 7to121torie8 I BUILDING SIZE (Gmd FIr Only) 0 1000-4999 sq ft or 0.-999 sq ft 0 5000-9999 Iq ft 19 CONSTRUCTION TYPE U Heavy Timber 0 Unprotect.. Steel Bldg o Steel&Concnte.3-4hr.wo\.. 0 Protect..SteeIBIdg 0 Pn>teel.MuonryExt.&Woodlnl. EXTENT OF DAMAGE CONFINED TO: Flame Srnoke DETECTOR PERFORMANCE 1 The object of origin 1 0 1 0 0 I Inroornoforigin-oper. 2 PlIIrl of room or Ilfta of origin 2 0 2 0 0 2 Notinroornoforigin-opu. '20 3 Roornoforigin 3 IZd""" 3 ll.Y'''' 0 3 In rJIlof origin-not oper-firetooam.all .. Fire.ratedcornp.oforigin 4 0 4 0 0.. Notin nnoforigin-notoper. fire too Im.all 5 Flooroforigin 5 0 5 0 0 5 In roornof origin-not oper.power disconne<:t ,- ..,6 Structure of origin 6 0 6 0 0 6 Notinnnoforigin-notoper,powe1di8eon. ,~;;:J..'.7" .EJ.lendedbeyonchtructureoforigin ,',,- 7..0 7 0 0 7 Inroornoforigin-notoper.deadbattel)' . ,'\' 0 a. NOl'l\roomu{~-tu)tcpet.deadhattery"'" .~. 9 No damage of the type (N/A) 9 [J ~ No detector present 0 10 Vndetermined Undetennined '6 VALUE Building loon .00 .00 ..00 "~'. ~. LOSS .00 .00 .00 .. -.00 fWO lCOo . ~ 17 NUMBER OF STORIES ~latol'Y BUILDING AGE (In Yean) o 50 atories or more B 13to24aoories 25 to 49 atoriel o IO,ooo-19,999sqft 0 5O,QOO-99,999sqU o 2O,OOO'49.9991Q ft 0 loo,OOO.499,9998Q ft U Unprotect,Masonl)'~t,&Woodlnt. ~l\protectedWoodFrame o ProteetedWoodFrame 0 No'l.CbtYifledAbove- SPRINKLER PERFORMANCE . ,18 o 5OO,OOOsqft, ~,., "', ,;'1. 1 0 Equipmentoperated ~. ''c. ,- , 2 0 F..quip.shouldhaveoper.-didnot 3 0 Equip,presentfln!too.m.alltooper, 90 Notelaaaulfdabove o ~tenninedornotreported '. :Prin~::::!:~:5;;~D "~~i:j' ':?,\ I of Heads. Opened 21 en REMARKS Weather Conditionl (optional): o conl.onback Follow Up Investigation Requested Y- N_ If yes, who will investigate 23 NumberofInjuriea Fire Serviee 24 Member Makin<< &port I NumberofFate.lities Fire Serviee T"" -'-of -,; Other Other MU!!f1 (l.f1P1aiu 0... S-'''-A'k' KOlJtA.J f2. 25 Additional Information by Title 0." 814-440-10 tR-86) t"l. '.; () :z:S 0'" ",'" ..,t"' ~.~ ..,,,, -0 1lJ" "'~ .1',,;:.: ..,:.. ,~:J.t ,.-~, ,'f'r' '.;(~:;~ :fC')" ,0 :z::;:: 0", n~ ..,,,, -0 1lJ" "'~ ''''\.' .,; I,,," ~.'- . ':. (~, ~ ,_,I , -,' du? () o :;:: '" t"' ~ ~ " > t"' t"' :z:. o '" ::l [;; .., ~ '" ... .'~' '.00 -,':', .00 ,. ./::"'(' .t",{,_: " '" .., .' El () ~ 1lJ .., ~ '" o z .' t'"' "...,,'..~ . -< d~V:: "::;::' -'-:' .., '''::"1' ": ~ ~ ." ~ ~~~ '~~~ .' -'1 . ~" '-. . . ''':' . .~"