HomeMy WebLinkAbout430 CALIFORNIA AVENUE (2)HOODS ALARMS SPRNKLER SYSTEMS AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
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File Number: Viggo j Address: --136 'V- (/, Ape
Bakersfield, CA 933
Date Received:
Business Name:
SYSTEM: BUILDING SQUARE FEET: HSPECiiM L ®G
New Mod.
Commercial hood System
Fire Alarm System
Fire Sprinkler System
Aboveground Storage Tank
Underground Storage Tank
minor
modification Underground Storage Tank
removal Underground Storage Tank
Other:
Building Sq. Feet:
Calculation Bldg. Sq. Ft: 9.
PA
3.
4.
Date Time
Signature
Signature
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Ai TWO NEUTE?
CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
B Ai E R s F-1 D 1501 TRUXTUN AVENUE, 1sT FLR
4FIRE BAKERSFIELD, CA 93313ARTN'IfT Office Phone: (661) 326 -3979
Application Number . . . . .
Property Address . . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
REYNA AGUSTIN & IRENE
10055 SAN EMIDIO ST
LAMONT CA 93241
11- 10000120 Date 4/08/11
430 E CALIFORNIA AVE
016 - 480- 10 -00 -4
FIRE DEPT
0
Contractor
OWNER
Permit . . . . . . UNDGRND STR TANK MINOR MODIFY
Additional desc . .
Phone Access Code . 1086412
Permit Fee . . . . 83.50 Plan Check Fee 83.50
Issue Date . . . . 4/08/11 Valuation . . . . 0
Expiration Date . . 10/05/11
Fee summary Charged Paid Credited Due
Permit Fee Total 83.50 83.50 .00 .00
Plan Check Total 83.50 83.50 .00 .00
Grand Total 167.00 167.00 .00 .00
CALL FOR INSPECTION
661) 326 -3979
Please state the Permit Number, the Job address, and
the Type of Inspection. Requests for inspections
should be made at least 48 hours in advance.
DECLARATIONS
Permit is issued in accordance with all applicable
Federal, State and Local Ordinances. The permittee
has properly signed and dated the reverse side of this
form. This Permit expires afterl80 days of inactivity.
I have reviewed the above application, and find it to
be correct/complete.
Permittee: Date:
HAZARDOUS MATERIALS STATEMENT
Yes—No Will the applicant or future occupant handle hazardous material or a mixture containing a hazardous material equal to or greater
than the amounts specified on the list of extremely hazardous substances? See checklist for guidelines.
Yes — No Will the proposed building or modified facility be within 1000 feet of the outer boundary ofa school?
Yes—No Will the intended use of the building by the applicant or future building occupant require a permit for construction or modification
from the Kern County Air Pollution Control District ( KCAPCD) or from the Bakersfield Fire Dept? See checklist for guidelines.
Yes _ No I have read the Hazardous Material Guide and KCAPCD Permitting Checklist. I understand my requirements under the Calif.
Health and Safety Code Sec. 6.95 and Calif. Govt. Sec. 65850 and the requirements of the City of Bakersfield Fire Dept. regarding
hazardous materials.
Owner or Authorized Agen -Phone No. Date
DECLARATIONS: The declarations below are mandated by the State of California under Section 19825 of the Health and Safety Code.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ofthe Division 3 of the
Business and Professions Code and my license is in full force and effect.
Lic. Class Lic. No. Exp. Date Contractors Signature Date
OWNER- BUILDER DECLARATION
I hereby affirm that under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5 Business
and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its
issuance also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9 commencing with Section 7000 of Division 3 or the Business and Professions Code) or that he or she is exempt there from
and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500)):
I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or
offered for sale (Sec. 7044 Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds
or improves thereon, and who does such work himself or herself through his or her own employees, provided that such improvements are not
intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the
burden ofproving that he or she did not build or improve for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon and who contracts for such
project with a contractor(s) licensed pursuant to the Contractor License Law).
I am exempt under Sec. B. & P. C. for the reason
Owner Signature Date
WORKERS COMPENSATION DECLARATION
1 hereby affirm that under penalty of perjury one of the following declarations:
Carrier
I have and will maintain a certificate of consent to self - insure for workers' compensation, as provided for by Section 3700 ofthe Labor Code,
for the performance of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance ofthe work
for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Policy No.
I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become
subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions
of Section 3700 ofthe Labor Code. I shall forthwith comply with those provisions.
Applicant: Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN
EMLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST AND ATTORNEY'S FEES
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 Civ. C.)
Lenders Name Lenders Address
I certify that I have read this application and state that the information contained herein is correct. I agree to comply with all city ordinances and state
laws relating to building construction and hereby authorize representatives ofthe city to enter the above mentioned - propertyfor inspection purposes.
Signature of Applicant or Agent Date
BAKERSFIELD CITY FIRE DEPARTMENT -- INSPECTION RECORD
Post this Card at the Job Site and DO NOT Remove for Duration of Work
Inspection Request Phone No. (661) 326 -3979
UST NEW INSTALL
DESCRIPTION DATE SIGNATURE
BACKFILL
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT
SENSORS
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK -OFF
TANK TESTING
UST REMOVAL
DESCRIPTION DATE SIGNATURE
AST NEW INSTALL
DESCRIPTION DATE SIGNATURE
F- MODIFICATIONS MINOR / MAJOR
AST REMOVAL
DESCRIPTION DATE SIGNATURE
EVR UPGRADE
PRIOR'TO OPERATION OF ANY SYSTEM,
ALL UST AND /OR AST SYSTEMS SHALL BE
INSTALL, COMPLETE AND ACCEPTED BY
MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT.
FIRE DEPARTMENT (FINAL)
REMARKS:
BUILDING ADDRESS:
JOB DESCRIPTION: 17,11.;VQY" -- -lip cc , OCCUPANCY TYPE:
OWNER: 4P e='. gg PERMIT NO. !.R v
CONTRACTOR: PHONE #
FD 1743
BILLING & PERMIT STATEMENT
PERMIT #
dtl'6t9:9g:n;e
Q' . , FIRE
PAN rW T
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1600 Truxtun Avenue, Suite 401
Bakersfield, CA 93301
PhnnA' 661 - 126 -'q7q • FAY- A61 - R57 -71 71
FD2021(Rev 06/07)
1 - ORIGINAL WHITE (Treasury) 1- YELLOW (File) 1 -PINK (Customer)
SItE'INFOkMATION
LOCATION OF PROJECT
LO GU
PRO RTY OWNER 1P0..r11Lq 1io11
STARTING DATE COMPLETION DATE -j0.V4 OC Q ,Qa NAME
PROJECT NAME ADDRESS PHONE #
W _ _ 35 u
PROJECT ADDRESS
CITY I>A K GT\.SFI EL -D STATE CA ZIP CODE
CONTRACTOR INFORMATION
ONTRACTQR NAME CA LICENSE 11 TYPE OF LICENSE EXPIRATION DATE PHONE H
lt = =l IG S _t' l li_li l' - x`51 u
CONTRA CO N MEMPANY FAX h
ADDRESS I CITY ZIP CODE
C
All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. • •
Alarm - New & Modification (minimum charge) $280 84
98
Over 10,000 s ftq 0 .028 x sq ft 84
98
Sprinkler - New & Modification (minirnum charge) 280 84
98
Over 10,000 sq ft 0 .028 x sq ft 84
98
Minor Sprinkler Modification <10 headsp ( ) 96 (inspection only) 84
98
Commercial Hood (New & Modification) 470 84
98
Additional hood 58
98
Spray Booth (New & Modification) 470
Iw- 84
98
Aboveground Storage Tank (Installation /One Inspection) 82180
Additional Tank 96 i 82
Aboveground Storage Tank (Removal /Inspection) 109 82
Underground Storage Tank (Installation /Inspection) 878 /tank 82
I Underground Storage Tank (Modification) 878 /site 82
I Underground Storage Tank (Minor Modification) 167 eK W243 111-7 It t C 82
I Underground Storage Tank (Removal) 573 /tank 84
I Oil well (Installation) 96 84
Mandated Leak Detection (test) /Fuel Mont Cert /SB989 96 /site 82
NOTE: $96 for each type of test /per site even if
scheduled at the same time
l Tent 96 /tent - -- - -- 84
I After -hours inspection fee 121
r
I Pyrotechnic (per event, plus inspection fee of $96 /hr) 96 -1- (5 hrs min standby fee /insp) =$576 84
Re- inspection /Follow -up Inspection 96 /hr a 84
Portable LPG (Propane): # of Cages? _ 96 84
Explosive Storage 266 84
Copying & File Research (File Research fee $34 /hr) 0.25 /page 84
0jMiscellaneous 84
FD2021(Rev 06/07)
1 - ORIGINAL WHITE (Treasury) 1- YELLOW (File) 1 -PINK (Customer)