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Home My WebLink AboutUST-PLAN COVERSHEET 3/9/2011HOODS ALARMSS SPRNKLER SYSTEMS AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: 3'5 X00 Date Received: 3 5 — /l Address: y Z c- -,t-4- 7 Z. Z Bakersfield, CA 933 Business Name: Xe O / /,isr;r ?.jfdvt -e C,7 Other: G .ti ,P /e s i'!l G. Comments: 1. 2. 3. 4. NSPECTIOH LOG Date Time S :ZT // Ei Signature Signature SYSTEM: BUILDING SQUARE FEET: New Mod. Commercial hood System Building Sq. Feet: 0, Fire Alarm System Calculation Bldg. Sq. Ft: Fire Sprinkler System O Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank C,7 Other: G .ti ,P /e s i'!l G. Comments: 1. 2. 3. 4. NSPECTIOH LOG Date Time S :ZT // Ei Signature Signature CONSTRUCTION PERMIT BAKERSHELD FIRE DEPARTMENT PREVENTION SERVICES B B R S F I D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313AT " T Office Phone: (661) 326 -3979 Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner USF REDDAWAY INC 10990 ROE AV OVERLAND PARK KS 66211 11- 10000089 Date 3/15/11 4901 LISA MARIE CT 499 - 080- 07 -00 -1 FIRE DEPT 0 Contractor OWNER Permit . . . . . . MANDATED LEAK DETECT TEST Additional desc . . Phone Access Code . 1079938 Permit Fee . . . . 192.00 Plan Check Fee 96.00 Issue Date . . . . 3/15/11 Valuation . . . . 0 Expiration Date . . 9/11/11 Fee summary Charged Paid Credited Due Permit Fee Total 192.00 192.00 .00 .00 Plan Check Total 96.00 96.00 .00 .00 Grand Total 288.00 288.00 .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 ofthe 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 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 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 1 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 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 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 ofproving 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 1 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 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 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 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 state that the information contained herein is correct. I agree to comply with all city ordinances andstatelawsrelatingtobuildingconstructionandherebyauthorizerepresentativesofthecitytoentertheabovementioned- property for 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 I UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF TANK TESTING e UST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE MISC. ACTIVITY REMARKS: AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE PRIOR TO OPERATION OF ANY SYSTEM, ALL UST AND /OR AST SYSTEMS SHALL BE INSTALL, COMPLETE AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL) BUILDING ADDRESS: JOB DESCRIPTION: —' r OCCUPANCY TYPE: OWNER: ec 9lin PERMIT NO. CONTRACTOR: - [Q PHONE Ss-/I A79; -1 &,qfl FD 1743 Cats of 5ahersfield UISTWR RCMPT **Tr uppr., MR ';! JRD Type: LIC Drawer: I Kneipt ro. M6 Guant i tv Amount BUILDING REMITS 111 r0 4288, N TE, r,, i L. -,, , i , ,, ai 1 Cil 1:0 IV, 5108 $192.@@ Ch C*ul 5119 $96, W Total tp-11;iwer Q86. 00 f(ital navuot 3288.01 iran5 bite: 3/15/11 Tin: 16:09:54 i' ll- P LJN,,--QL TW PET PPIATION PLEAU 5PAY AND MUTER 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 14 x Flvr. AFR" R'ff TM f BAKERSFIELD FIRE DEPT. Prevention Services 1501 Truxtun Ave., First Floor Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 o(1 LINE TESTING SB -989 SECONDARY CONTAINMENT TESTING D TO PERFORM FUEL MONITORING CERTIFICATION SI•;0NEORMAT ON FACILITY 8a 2- NAM & PHONE NUMBER O ONT CT PERSO a - 33- X95 _ ADDRESS4^OI Li so, mQY'le OWNERS NAAAR eddaw QM OPERATORS NAME J PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? YES NO TANK# VOLUME CONTENTS i I i TANK TESTING COMPANY NAME OF TESTING COMPANY Tanknolo , Inc. NAME & PHONE NUMBER OF Michelle Cleghorn -YounggYCONTACTPERSON800- 666 -1130 MAILING ADDRESS 41785 Enterprise Circle S. Suite D Temecula, CA 92590 j NAME 8 PHONE NUMBER OF QI -ICIC FYOLn CERTIFICATION #: --f TESTER OR SPECIAL INSPECTOR: %oZ $' 8 - 0 DATE & TIME TEST To B /,, CONDUCTED: N 0`13 i v gam ICC #: / y- Sas9 U 1 TEST ,1METHODTtb- I SIGNAT RE OF 4PPLICANT DATE: APPROVED BY DATE