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Home My WebLink About6009 COFFEE ROADHOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: ; 2, 405 Address: add ' U.Q 'P-- 7C . Bakersfield, CA 933 Date Received: Business Name: ;3, ^J SYSTEM: BUILDING SQUARE FEET: MPECTOON LOG New Mod. Commercial Hood System Fire Alarm System Fire Sprinkler System Spray Finish System Aboveground Storage Tank Underground Storage Tank minor modcation nderground Storage Tank removal Underground Storage Tank Other: Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: '97r 3. 4. Date Time Signature Signature 1619 I V I IN 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 INSTMLL, COMPLETE AND ACCEPTED BYMISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL) REMARKS: BUILDING ADDRESS: JOB DESCRIPTION: OWNER: CONTRACTOR: c OCCUPANCY TYPE: PERMIT NO. PHONE # FD 1743 UNDERGROUND STORAGE TANK PERMIT APPLICATION TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD IPermit # TYPE OF APPLICATION: CHECK ONE ONLY) NEW TANK INSTALL/NEW FACILITY MODIFICATION OF FACILITY NEW TANK INSTALL/EXISTING FACILITY Mr MINOR MODIFICATION OF FACILITY STARTING DATE/ _ Tee / O/ BAKERSFIELD FIRE DEPARTMENT FACILITY NAM G .vE Prevention Services FACILITY ADDRESS / 2101 H Street ZIP CODE Bakersfield, CA 93301 APN # Phone: 661 - 326 -3979 e Fax: 661 - 852 -217141,1N.14, ADDRESS C Page 1 of 1 NEW TANK INSTALL/NEW FACILITY MODIFICATION OF FACILITY NEW TANK INSTALL/EXISTING FACILITY Mr MINOR MODIFICATION OF FACILITY STARTING DATE/ _ Tee / O/ PROPOSED COMPLETION DATE ] FACILITY NAM G .vE EXISTING FACILITY PERMIT # FACILITY ADDRESS / 7C ZIP CODE TYPE OF B ESS APN # TANK OWNE PHONE # ADDRESS C ZIP DE CON OR CA LICENSE # ICC # ADDRESS / — C _ ZIODE PHONE # BAK FIELD CITY BUSINESS LICENSE # WORKMANS COMP # INSURER BRIEFLY DESCRIBE THE WORK TO BE DONE: WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? 10 YES NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER Tank Testing Company NAME OF TESTING COMPANY PHONE HUMBER MAILING ADDRESS NAME OFTESTER 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 BY FD2086 (Rev 08/09) BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT D Prevention Services PERMIT # FIRE T 2101 H Street Bakersfield, CA 93301 I_. — nom^ n- SITE All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. n Alarm - New & Modification (minimum charge) 1$280 Over 10,000 sq ft INFORMATION LOCATION OF PROJECT PROPER OWNER STARTING DATE COMPLETION DATE NAME PROJE ME ADDRESS PHONE # 0 .028 x sq ft PROJECT AD RESS CITY U.4KER.SFIELD STATE CA ZIP co_ 96 (inspection only) CO OR NAME LICENSE LICENSE EXPIRAgON DATE PHONE # Q CONPAGrOR COMPANY NAME 84 ADDR S \ CITY ZIP CODE 4dn 98 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. n Alarm - New & Modification (minimum charge) 1$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 headsP ( ) 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) Additional Hood 470 58 hood Commercial Hood - Minor Modification ( <10 nozzels) 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 0 (y - {(c-i 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 CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner SERVICE STATION HOLDINGS LLC 6009 COFFEE RD BAKERSFIELD CA 93308 BAKERSHELD FIRE DEPARTMENT PREVENTION SERVICES 8 R S F I D 1501 TRUXTUN AVENUE, 1sT FLR F'RB BAKERSFIELD CA 93313ARTMrOfficePhone: (661) 326 -3979 11- 10000208 Date 6/17/11 6009 COFFEE RD 494 - 160- 20 -00 -6 FIRE DEPT 0 Contractor OWNER Permit . . . . . UNDGRND STR TANK MINOR MODIFY Additional desc . Phone Access Code 1106442 Permit Fee . . . 83.50 Plan Check Fee 83.50 Issue Date . . . 6/17/11 Valuation 0 Expiration Date . 12/14/11 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 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. 1 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 Agent[ hone 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 ofperjury 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 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 ofnotmorethanfivehundreddollars ($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 I 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 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 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 ofCalifornia, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I 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 I 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 1 have read this application and state that the information contained herein is correct. 1 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