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Home My WebLink About#775 Minor Mod FolderHOODS ALARMS SPRINKLER SYSTEMS SG INi A, V 80C) tip[- Permit No. Permit No. Permit No. Permit No. File Number. '35n 7 Co Date Received: '7-:2-6 - // Address: Business Name: Bakersfield, Of A 933 SYSTEM: BUILDING SQUARE FEET: New Mod. O minor modification removal Commercial Hood System Fire Alarm System Fire Sprinkler System Aboveground Storage Tank Underground Storage Tank Inderground Storage Tank Underground Storage Tank Other. Comments: X Building Sq. Feet: Calculation Bldg. Sq. Ft: 9. 2. 3. 4. AST UST Permit No. Permit No. 9P9SPE Y90Rd LOG Date Time 151- Signature Signature 0.1t..; j' ba ersfield FECEIPT *14-1OpelSURRIL.6 Data: ype: OC Drawer: eceipt Po: i P48 Des,:ri tla)i Amount r, MITs 13 U'A 00 TeMer dc-tEii FK D4rT' 1334,00Totaltenderedi324, 00Totalpaygvnt1334,N Tran, date; T)ie rELP UP '1,qf)L 74 00RUTPI-Nr10NFUTU CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner JAMIESON -HILL CO P 0 BOX 82515 BAKERSFIELD CA 93380 11- 10000264 4901 S UNION AVE 412 - 161- 01 -00 -0 FIRE DEPT 0 Date 7/28/11 Contractor OWNER Permit . . . . . . UNDGRND STR TANK MINOR MODIFY Additional desc . . Phone Access Code . 1117787 Permit Fee . . . . 83.50 Plan Check Fee 83.50 Issue Date . . . . 7/28/11 valuation . . . . 0 Expiration Date . . 1/24/12 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 after180 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Permittee: Date: BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES E x s P I ';r D 1501 TRUXTUN AVENUE, IsT FLR FIRS r BAKERSFIELD, CA 93313 r Office Phone: (661) 326 -3979 11- 10000264 4901 S UNION AVE 412 - 161- 01 -00 -0 FIRE DEPT 0 Date 7/28/11 Contractor OWNER Permit . . . . . . UNDGRND STR TANK MINOR MODIFY Additional desc . . Phone Access Code . 1117787 Permit Fee . . . . 83.50 Plan Check Fee 83.50 Issue Date . . . . 7/28/11 valuation . . . . 0 Expiration Date . . 1/24/12 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 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 of the outer boundary of a school? Yes—No Will the intended use ofthe 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 ofthe City of Bakersfield Fire Dept. regarding hazardous materials. Owner or Authorized AgentF lPhone 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) of the Division 3 ofthe 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 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 the burden of proving that he or she did not build or improve for the purpose of sale). I, as owner ofthe 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 I Date WORKERS COMPENSATION DECLARATION I hereby affirm that under penalty of perjury one ofthe following declarations: Carrier I have and will maintain a certificate of consent 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 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 ofthe 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 1 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 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 of the city to enter the above mentionedpropertyfor 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 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: S • ,may,• JOB DESCRIPTION: j I OCCUPANCY TYPE: OWNER: ,r PERMIT NO. //- CONTRACTOR: p c PHONE # 631 - 76 66C6 ?a Cf FD 1743 BILLING & PERMIT STATEME14T PERMIT # I Ii A i Ii it S 11 1I;_ -It 't, 9' ' RE _ 1) 41! BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 TruXtUn Avenue, Suite 401 Bakersfield, CA 93301 Phone: 661-326-3979 * Fax: 661-852-2171 9I-TE—IN FORMATION', LOCATION OF PROJECT VaZ'Y,x N-e— . PROPERTY OWNER T, 0 (3 C) STARTING DA GQMA6&T-j fikt9!- TJb1E A.9-to NAME PROJECT NAME ADDRESS PIIONF # jom PROJECT ADDRESS l4qo)i S, bnlov-) kuL• &kA qbWl ICITY .7,A J\'.. E IZ,f> F (EL-'r-" STATE CA ZIP CODE 7:0:7R INFORM'ATION' CO ACTOR NAME ICA LICENSE # TYPE OF LICENSE EXPIRATION DATE PHONFT_ Ucl, L0_A j ` A CON*1 RACI'OR COMIPANY NAMF FAX 9 b I ) - ' ( C 111C, C ADDRESS CITY rr ZIP CODE All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minirnurn charge) $280 84 98 Over 10,000 sq ft 0 .028 x sq ft 84 rl Sprinkler - New & Modification (minirnum charge) 280 M 84 98 Cl Over 10,000 sq ft 0 .028 x sq ft 84 98 Minor Sprinkler Modification (<10 heads) 96 (inspection only) 84 98 84CommercialHood (New & Modification) 4 70 98 Additional hood 58 84 98M Spray Booth (New & Modification) 470 84 98--_ Aboveground Storage Tank (Installation /One Inspection) 82180 Additional Tank 96 82 109 82AbovegroundStorageTank (Removal /Inspection) Underground Storage Tank ( Installation /Inspection) 82878/tank Underground Storage Tank (Modification) 878/site 82 IY Underground Storage Tank (Minot, Modification) 167 82 Oil Underground Storage Tank (Removal) 573/tank 84 well (Installation) 96 96 /site 84 Mandated Leak Detection (Lest)/Fuel Mont Cert/SB989 a 82 NOTE: $96 for each type of test/per site even if scheduled at the same time 1-1 Tent 96/tent 84 CI After-hours inspection fee 121 Pyrotechnic (per event, plus inspection fee of$96/hr) 96 + (5 lirs min standby fee/insp)=$576 e 84 I Re-inspection/Follow-up I nspection 96/hr m 84 Portable LPG (Propane): It of Cages? 96 M 84 1:1 Explosive Storage 266 84 If Copying & File Research (File Research fee $34/hr) 0.25/page 84 Miscellaneous 84 FD2021 (Rev 06/07) 1 - ORIGINAL WHITE (Treasury) 1- YELLOW (File) 1 -PINK (Customer)