HomeMy WebLinkAbout2011 RESULTSHOODS ALARMS SPRINKLER SYSTEMS SPRAV 800TVl AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
6=36
File Number: '=26'T 40 Address: Go(-de-,J
Bakersfield, CA 933
Date Received: 5-077-//
Business Name:
SYSTEM: BUILDING SQUARE FEE F OR4SPEC4ION LOG
New Mod.
Commercial Hood System Building Sq. Feet:
l=ire Alarm System Calculation Bldg. Sq. Ft: 9.
Fire Sprinkler System c-b \ g,
Aboveground Storage Tank ! \ q,
Underground Storage Tank
minor
modification Underground Storage Tank
removal Underground Storage Tank
a-- 'Other.
Comments:
Dale Time
e unirl6u
Sigr-jure
CITY OF BAKERSFIELD
E,PPLICATION NUMBER:
FEE DESCRIPTION
PLAN CHECK FEES
MANDATED LEAK DETECT
TI
PROGRAM BP820L
11- 10000365 1800 GOLDEN STATE AVE
AMOUNT DUE
96.00
TEST 96.00
JTAL DUE 192.00
Please present this receipt to the cashier with full payment.
CAL - VALLEY EQUIPMENT, INC. 0064594
DATE I LOC I REF I GROSS I DISC NET I I DATE LOC REF GROSS DISC NET
09127/11 2DO03001 97261 192.00 1 0.00 192.0011 1
09/27/11 2020007 - BAKERSFIELD FIRE DEPARTMENT 192.00 0.00 192.00
CAL- VALLEY EQUIPMENT, INC. UNION BANK; 1s -a9 =s 09/27/11 0064594
3500 GILMORE FRESNO, CA 1220 DATE CHECK NUMBER
BAKERSFIELD, CA 93308
661) 327 -4628 AY EXACTLY THIS AMOUNT AMOUNT
On,'Hundred Ninety -Two Dollars "" `192.00
City of Bakersfield
CUSTOMER RECEIPT *+
Oper: SCARRILLO Type: OC Draw;,,,, i
Date: 10/11/11 01 Receipt no: 343,68
Description Quantity Amount,
2011 10000365
BP BUILDING PERMITS
1.00 s1 00
Tender detail
CK CHECK 64594 319..00
Total tendered
Total payment 319.00
Trans date: 10/11/11 Time: 11:39:18
HELP CONTROL THE PET POPULATION
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FUEL HLFRM
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CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
E E R s P 1 D 1501 TRUXTUN AVENUE, IT FLR
Y FIRE BAKERSFIELD, CA 93313
YNA r Office Phone: (661) 326 -3979
Application Number . . . . .
Property Address . . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
RJC INVESTMENTS LLC
2508 BRENTWOOD DR
LANCASTER CA 93536
11- 10000365 Date 10/12/11
1800 GOLDEN STATE AVE
332 - 210- 03 -00 -0
FIRE DEPT
0
Contractor
OWNER
Permit . . . . . . MANDATED LEAK DETECT TEST
Additional desc . .
Phone Access Code . 1139724
Permit Fee . . . . 96.00 Plan Check Fee 96.00
Issue Date . . . . 10/12/11 Valuation . . . . 0
Expiration Date . . 4/09/12
Fee summary Charged Paid Credited Due
Permit Fee Total 96.00 96.00 .00 .00
Plan Check Total 96.00 96.00 .00 .00
Grand Total 192.00 192.00 .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 after180 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 ofthe outer boundary of a 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 AgentF 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 ofChapter 9 (commencing with Section 7000) ofthe Division 3 ofthe
Business and Professions Code and my license is in full force and effect.
Lie. Class Lie. 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 of proving 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 sell' insure for workers' compensation, as provided for by Section 3700 ofthe Labor Code,
for the performance ofthe 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 of the work
for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Policy No.
I certify that in the performance ofthe work for which this permit is issued, I shall not employ any person in any manner so as to become
subject to the workers' compensation laws of California, and agree that if 1 should become subject to the workers' compensation provisions
of Section 3700 of the Labor Code. 1 shall forthwith comply with those provisions.
Applicant: Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN
EMLOYER 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 ofthe 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
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: gn Ccd lA $ `d
JOB DESCRIPTION: 2= ,L{ OCCUPANCY TYPE:
OWNER: PERMIT NO. - 36 g~ CONTRACTOR: - PHONE # 7
FD 1743
UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
SB989 SECONDARY CONTAINMENT TESTING
TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.
ENHANCED LEAK DETECTION
TANK TIGHTNESS TEST
H'Adll R 9 P I D
P 'RQ
AR1M T
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
LINE TESTING SB -989 SECONDARY CONTAINMENT TESTING
XTO PERFORM FUEL MONITORING CERTIFICATION Cathodic Protection Testing
FD 2095 (Rev. 09/05)
FACILITY Coach America NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 1800 Golden State Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? YES NO
TANK# VOLUME CONTENTS
1 Diesel
s; TANK <TESTINGCOMPANY
NAME OF TESTING COMPANY Cal - Valley Equipment Bruce W. Hinsley 661 -327 -9341
MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308
Bruce W. Hinsley 661 -327 -9341 CERTIFICATION #: 548333761
DATE & TIME TEST TO BE CONDUCTED Icc #: 5270921 -UT
SIGNATURE OF APPLICANT DATE 9/28/2011
APPROVED BY _ DATE 'e— 16— f/
FD 2095 (Rev. 09/05)
SICCING & PERMIT- STATEMENT BAKERSFIELD FIRE DEPARTMENT
Prevention Servk:es
PERMIT # F1ee 2101 H StreetART'w'
Bakersfield, CA 93301
SITE INFORMATION
Coach America Same
SrAMMG DATe amPLET" OATS
ADDRBS Ivtow s
1800 Golden State
CONTRACTOR TNFOW4ATION
MNTRAr`R1A IJAMF FA 1 TPFNCF A TVM rw 1 tt'FNCR I FVMATTAN TTATF PWTNF A
Cal- Valley Equipment 921733 A 9/30/2011 661 - 327 -9341
IccumcroR cOMCAw NAME I FAX t
Cal- Valley Equipment 661 - 325 -2529
1AEORESS I a r I nPaWE I
3500 Gilmore Ave. Bakersfield 93308
All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK.
DUE
Alarm - New & Modification (minimum charge) $280
ONLY
ACCT •.
Over 10,000 sq ft 0.028 x sq ft
96/hr 82
Sprinkler - New & Modification (minimum charge) 280
84
Over 10,000 sq ft 0.028 x sq It
0 Pyrobechnic (1 peimlt per event, plus an inspection fee of
96/hr during business hours) PY
NOTE: After hours Pyrotechnic event Inspection Is @ 121 r
0 Minor Sprinkler Modification ( <10 heads) 96 (Inspection only) 84
96/hr
Commercial Hood (NeW & Modf adon) 470
Portable LPG (Propane): * of Cages? _ 96/hr
Additional hood 58
266 84
Spray Booth (New & Modification) 470
84
13
Aboveground Storage Tank (1 Inspection per Installation) AST 180/tank
84
82
Additional Tank ATI 06/tank 82
Aboveground Storage Tank (Removal, Mod,or Inspect'n) A 109/tank 82
Underground Storage Tank (Installation/Ird;pecHon) NI 878/tank 82
D Underground Storage Tank (Modification) MOD 878/site 82
Underground Storage Tank (Minor Modification) MT14 167 /sibe 82
Underground Storage Tank (Removal) TR 573/tank 84
7
NoTEi$ `m `ar of e ems, If qg . C. . 6
0 Oil well (Installation, Inspection, or re- inspection) X 96/hr 82
O Tent # 96 /bent 84
After -hours Inspection fee 121/hr (2 hrs minimum) -.$242
0 Pyrobechnic (1 peimlt per event, plus an inspection fee of
96/hr during business hours) PY
NOTE: After hours Pyrotechnic event Inspection Is @ 121 r
96/hr + (5 hrs min standby fire nsp) =$576
5 hrs min =
84
Re4nspection/Follow -up Inspection 96/hr 84
Portable LPG (Propane): * of Cages? _ 96/hr 84
Explosive Storage 266 84
0 Copying & File Research (File Research fee $50/hr) 025 /page 84
13 Miscellaneous 84