HomeMy WebLinkAboutUST-PERMIT COVERSHEET 8/31/2011HOODS ALARMS SPRINKLER SYSTEMS S P R „ V LO C, AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
0000 3 3 3
1 011
File Number: Address: 0?3/ 7,L S —r -
Bakersfield, CA 933
Date Received: <?7 -3 / - //
Business Name:
SYSTEM: BUILDING SQUARE FEET: MSPECTPON LOG
New Mod.
Commercial Hood System
Fire Alarm System
Fire Sprinkler System
IFpi'aa F msh System
Aboveground Storage Tank
Underground Storage Tank
minor
modification nderground Storage Tank
Val Underground Storage Tank
Other.
Building Sq. Feet:
Calculation Bldg. Sq. Ft: ;;r I.
a.
3.
4.
Date Time
Signature
Signature
Comments- l J V`-efp,a.. -S 1 i /I/ &V /AcT7 VVV FVrL w"' --nx DLWC- L^)'0 -r,4f s
SUNSET MECHANICAL & CONSTRUCTION INC
City of Bakersfield Fire Department
Date Type Reference
8/31/2011 Bill
8/31/2011
Original Amt. Balance Due Discount
334.00 334.00
Check Amount
2105
Payment
334.00
334.00
Wells Fargo 001 334.00
UNDERGROUND STORAGE TANK
PERMIT APPLICATION FIRSTOCONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW RrTANKINSTALL (EXISTING FACILITY) /MOD -MINOR MOD w r
IPermit #
TYPE OF APPLICATION: NEW TANK INSTALL/NEW FACILITY NEW TANK INSTALL/EXISTING FACILITY
MINOR MODIFICATION OF FACILITY
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171
Page 1ofI
CHECK ONE ONLY) MODIFICATION OF FACILITY
STARTING DATE / PROPOSED COMPLETION DATE
FACILITY NAME
G .Souk EXISTING FACILITY PERMIT #
r
FACILITY AD RESS I CITY ZIP-CODE,
2 17 i 1 '13:30H
TYPE OF BUSINES APN #
TANK OWNER PHONE #
ADDRESS
C
CITY
le
ZI CODE
11
CONTRACO
011.5 7LY- f/ U
CA CENSE # Iya,
ADDRESS CITY
v ZIP CODE
0
PHON -
66061
BAKERSFIELD CITY BUSINESS LICENSE # WORKMANS COMP # INSURER /
BRIEFLY DESCRIBE THE WORK TO BE DONE: i+ 1.
1
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER 7 SOIL TYPE EXPECTED AT SITF
a y
OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL?
YES NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
A YES NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
Tank Testing Company
NAME OF TESTING COMPANY PHONE NUMBER
MAILING ADDRESS
NAME OF TESTER ICC#
THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS.OF THIS
PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER
PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF TESTER ICC#
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED APPROVED 'L
FD2086 (Rev 08/09)
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BILLING & PERMIT STATEMENT
PERMIT #
@_ _.L _1t 9 P k L_ D
FIRE
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BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501 Truxtun Avenue, 1s FLR
Bakersfield, CA 93301
Phone: 661 -326 -3979 • FaY• F,F1 -RS7 -')171
SITE INFORMATION
LOCATION OF PROJECT
h 4 C_ A e roo
STARTING DATE COMPLETION DATEAsAp
PROP OWNER
NAME
PROJECT NAME ADDRESS PHONE i
PROJECT ADDRESS I Cm. S gA KEPSF l E l_D STATE CA ZIP CODE
CONTRACTOR NAM
v Coils,
INFORMATION
CA LICENSE • TYPE OF LICENSE EXPIRATION DATE PHONE d
CONTRACTOR COMPANY NAME
ADDRESS - - CITY— — -
FAX i
ZIP CODE —
1400 permits must be reviewed, stamped, and approved PRUOR T® GiIIEGIR9f ENG WORCt.
G •
Alarm - New & Modification (minimum charge) $280
e
Over 10,000 sq ft 0 .028 x sq ft
Sprinkler - New & Modification (minimum charge) 280
Over 10,000 sq ft 0 .028 x sq ft
Minor Sprinkler Modification ( <10 heads) 96 (inspection only) 84
Commercial Hood (New & Modification)
Additional hood
470
58
Spray Booth (New & Modification)
boveground Storage Tank (1 inspection per installation) AST
470
180 /tank 82
Additional Tank ATI 96 /tank 82
Aboveground Storage Tank (Removal /Inspection) ATR 109 /tank 82
Underground Storage Tank Installation Ins99 ( / pection) NI 878 /tank 82
Underground Storage Tank (Modification) MOD 878 /site
6 /site o le A
82
Underground Storage Tank (Minor Modification) M 82
Underground Storage Tank (Removal) TR 573 /tank 84
Mandated Leak Detection (test) /Fuel Mont Cert/SB989
NOTE: $96 /hr for each type of test/per site even if
scheduled at the same time TT
96 /hr (2 hrs minimum) = $192 84
Oil well (Installation, Inspection, or re- inspection) X 96 /hr
96 /tent - -
82
84Tent
After -hours inspection fee
Pyrotechnic (1 permit per event, plus an Inspection fee of
96 /hr during business hours) PY
NOTE: After hours Pyrotechnic event inspection Is @ 121 /hr
121 /hr (2 hrs minimum) =$242
96 /hr + (5 hrs min standby fee /insp)= $576
5 hrs min standby fee ins = 605
84
Re- inspection /Follow -up Inspection 96 /hr 84
Portable LPG (Propane): * of Cages? — 96 /hr 84
Explosive Storage 266 84
Copying & File Research (File Research fee $50 /hr) 0.25 /page 84
11 Miscellaneous 84
UNDERGROUND STORAGE TANK Prevention Services
2101 H Street
PERMIT APPLICATION 2AAR Bakersfield, CA 93301
TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD r
Page 1 of 1
IPermit #
TYPE OF APPLICATION: NEW TANK INSTALL/NEW FACILITY NEW TANK INSTALL/EXISTING FACILITY
CHECK ONE ONLY MODIFICATION OF FACILITY MINOR MODIFICATION OF FACILITY
STARTING DATE/ PROPOSED COMPLETION DATE
FACILITY NAME
d
EXISTING FACILITY PERMIT
1
G /Vora
FACILITY ADDRESS / I CITY ZICODE
i
TYPE OF BUSINES APN #
TANK OWNER I
f
PHONE
ADDRESS
d
CITY ZICIIE
1 i
CONTRACrO
U
CA CENSE # ICC #
ADDRESS CITY /
1
ZIP CODE'S
O
PHON
3 - 4660
BAKERSFIELD CITY BUSINESS LICENSE #
o r I
WORKMANS COMP #
o
INSURER
i
BRIEFLY DESCRIBE THE WORK TO BE DONE: e /U / y
el
WATER TO FACILITY PROVIDED BY CCJ
DEPTH TO GROUNDWATER ^ /J
r
SOIL TYPE EXPECTED AT SrrF
J%i1
OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL?
YES NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
A YES NO
THEE SIECTRON RS FOR ST09UGIE TARN II1DIEH77FIICATII0N
TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
Tank Testing Company
NAME OF TESTING COMPANY PHONE NUMBER
MAILING ADDRESS
NAME OF TESTER ICC
THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS
PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER
PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF TESTER ICC#
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ON
DATE APPROVED
7--5 '- It
APPROVE BY
FD2066 (Rev 08/09)