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Home My WebLink About6009 COFFEE ROAD (2)HOODS ALARMS SPRINKLER SYSTEMS 1` UOT Permit No. Permit No. Permit No. Permit No. File Number: 7 z6f- Date Received: /p - /Q/- Address: 60c'? c Bakersfield, CA 933 Business Name: C<< e S AST UST Permit No. Permit No. SYSTEM: BUILDING SQUARE FEET: ENSPECTION LOG New Mod. Commercial Hood System Building Sq. Feet: Date Time Calculation Bldg. Sq. Ft: Fire Alarm System Fire Sprinkler System a E= ,,raw _> , >: Aboveground Storage Tank derground Storage Tank inor ifi o nderground Storage Tank removal Underground Storage Tank a,'-'Other 44 . 3. 4. Signature Signature K c `IZY 0oComments: p ' sv M/' AN uz /z sPuc sc sc s ^ i Je32. P.DD /C2 CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner SERVICE STATION HOLDINGS LLC 1000 TRUXTUN AV BAKERSFIELD CA 93301 BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R s P i E D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 r Office Phone: (661) 326 -3979 11- 10000392 Date 11/02/11 6009 COFFEE RD 494 - 160- 20 -00 -6 FIRE DEPT 0 Contractor OWNER Permit . . . . . MANDATED LEAK DETECT TEST Additional desc . Phone Access Code 1144989 Permit Fee . . . 96.00 Plan Check Fee 96.00 Issue Date . . . 11/02/11 Valuation 0 Expiration Date . 4/30/12 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 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 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 1 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. regardinghazardousmaterials. 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) of the 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 it signed statement that he or she is licensed pursuant to the provisions ofthe 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 ofnotmorethanfivehundreddollars ($500)): 1, as owner ofthe 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 buildsorimprovesthereon, and who does such work himself or herselfthrough 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 theburdenofprovingthatheorshedidnotbuildorimproveforthepurposeofsale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See. 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). 1 am exempt under Sec. B. & 1'. C. for the reason Owner Signature Date WORKERS COMPENSATION DECLARATION I hereby affirm that under penalty of perjury one ofthe following declarations: Carrier I have and will maintain a certificate ofconsent to self- insure for workers' compensation, as provided for by Section 3700 of the 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 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 I should become subject to the workers' compensation provisionsofSection3700oftheLaborCode. 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 TOCOSTOFCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES CONSTRUCTION LENDING AGENCY I 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 stale that the information contained herein is correct. I agree to comply with all city ordinances and statelawsrelatingtobuildingconstructionandherebyauthorizerepresentativesofthecitytoentertheabovementioned - propertyfor inspection purposes. Signature of Applicant or Agent I 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 f TANK TESTING REMARKS: F AST NEW INSTALL DESCRIPTION DATE SIGNATURE 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) BUILDING ADDRESS: .P-,e Tu- JOB DESCRIPTION: L OCCUPANCY TYPE: ,a OWNER: /,q Js PERMIT NO. CONTRACTOR: ev rtl C'.owST. PHONE # - FD 1743 BILLING & PERMIT STATEMENT ii 11.1'.... i11; 11;1111iti,lilli B 1 :111• 1, jrsj 11,1, A,•II AR1AI100T BAKERSFIEiLD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 cc1 ']']L_7[]_7 C v• i.1 -ii ii" 0223L, 211'.1:1222427911: 002 000644ii' U I L,naergruunu 5corage i ana ilnscauauun/ Inspecuunj wa 10/ Ld11K Underground Storage Tank (Modification) MOD 878 /site 82 0 167 /site 82 LOCATION OF PROJECT Underground Storage Tank (Removal) TR 573 /tank PROPERTY OWN Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of te t/per site /per UST system even if scheduled at the same time 96 /hr (2 hrs minimum) _ $192 82 Oil well (Installation, Inspection, or re- inspection) X Z 82 STARTING DATE COMOLETfON ATE 84 NAME After -hours inspection fee 121 /hr (2 hrs minimum) _ $242 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 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee ins = 605 84 Re- inspection /Follow -up Inspection PROJECT NAME 84 ADDRESS 96 /hr PHONE # 84 PROJECT ADDRESS Explosive Storage 266 crry g K ER. SF-I ELD STATE CA ZIP CODE Copying & File Research (File Research fee $50 /hr) 0.25 /page e RJ FORMATWW...'. 84 CONTRACTOR Np ttSy. y CA LICENSE # TYPE OF LICENSE EXPIRA N D '(E PHONE CONTRACTOR COMPANY NAME r FAX # q ADDRESS CITY ZIP c0 J ) i.. ii" 0223L, 211'.1:1222427911: 002 000644ii' U I L,naergruunu 5corage i ana ilnscauauun/ Inspecuunj wa 10/ Ld11K Underground Storage Tank (Modification) MOD 878 /site 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of te t/per site /per UST system even if scheduled at the same time 96 /hr (2 hrs minimum) _ $192 82 Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 Tent # 96 /tent 84 After -hours inspection fee 121 /hr (2 hrs minimum) _ $242 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 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 Miscellaneous 84 BILLIING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT Prevention Services PERMIT # `'" " piRe 2101 H StreetIrAirA/ T T Bakersfield, CA 93301 Dhnno• A,r1 -l')A 'AQ7Q . Fav• rir,1 -Rri7 -7171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minimum charge) $280 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 Sprinkler - Minor Modification ( <10 heads) $ 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) $470 Additional Hood 58 hood Commercial Hood - Minor Modification (add /move nozzle) $ 96 (inspection only) 84 Spray Booth (New & Modification) LOCATION OF PROJECT PROPERTY OwNLR knl STARTING DATE COMKET11CON ATE NAME PROJECT NAME ADDRESS PHONE # PROJECT ADDRESS I CITY >A1- ERSFIELD STATE CA ZIP CODE CONTRACTOR N/1NJE _ f'^ ONTRACTOR E FORMATION EXPIRATION h PHON CONTRACTOR COMPANY NAME FAX # ADDRESS 0 CITY el ZIP CO All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minimum charge) $280 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 Sprinkler - Minor Modification ( <10 heads) $ 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) $470 Additional Hood 58 hood Commercial Hood - Minor Modification (add /move nozzle) $ 96 (inspection only) 84 Spray Booth (New & Modification) 470 98 Aboveground Storage Tank (1 inspection per installation) AST 180 /tank 82 Additional Tank ATI 96 /tank 82 Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR 109 /tank 82 Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 Underground Storage Tank (Modification) MOD 878 /site 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test/per site /per UST system even if scheduled at the same time 96 /hr (2 hrs minimum) _ $192 82 Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 Tent # 96 /tent 84 After -hours inspection fee 121 /hr (2 hrs minimum) = $242 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 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 Miscellaneous 84 UNDERGROUND STORAGE TANKS B H B 9 P I D APPLICATION Pigs ARTM T TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION Please note that these are separate individual tests and will be charged per separate type test accordingly.) PERMIT # BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 1 ENHANCED LEAK DETECTION LINE TESTING SB -989 SECONDARY CONTAINMENT TANK TIGHTNESS FUEL MONITORING CERTIFICATION SITE INFORMATION FACILITY 1 NAME & PHONE # OF CONTACT PERSON ADDRESS 6400 6 OWNER NAME OPERATOR NAME / f PERMIT TO OPERATE # OF TANKS TO BE TEST D: IS PIPING GOING TO BE TESTED? YES NO TANK # VOLUME CONTENTS TANK TESTING COMPANY TESTING COMPANY I / N i NAME ,& PHO E # O NTACT PERSON MAILING ADDRESS i NAME & PHON(_ # OF TESTER O ALI INSPEt OR J\ 0S lk lAnM CERTIFICATION # DATE & TIME TEST TO BE CONDUCTED ICC # TEST METHOD APPLICANT SIGNATURE DATE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE d FD2095 (Rev 03/08)