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Home My WebLink AboutUST Mod Permit App. 1-13-16BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661- 326 -3979 . Fax: 661 -852 -2171 Page 1 of 1 TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY CHECK ONE ONLY MODIFICATION OF FACILITY U MINUK MUUlI-1C:AIlUIU UI- I^AUILlI Y STARTING DATE/ PROPOSED COMPLETION DATE 12 -7 -15 1 -7 -16 FACILITY NAME EXISTING FACILITY PERMIT FIESTA LIQUOR FACILITY ADDRESS CITY ZIP CODE 2023 BAKER ST BAKERSFIELD 93305 TYPE OF BUSINESS APN # GASOLINE DISPENSING FACILITY TANK OWNER PHONE # ED 661- 323 -4684 ADDRESS 2023 BAKER ST CITY BAKERSFIELD ZIP CODE 93305 CONTRACTOR CA LICENSE # ICC # BSSR INC 672812 257282 ADDRESS CITY ZIP9 CODE 6630 RO EI3ALE ffWY #B BAKERSFIELD 93308 PHONE # BAKERSFIELD CI Y BUSINESS LICENSE # WORKMANS COMP # INSURE$ 661 -588 -2777 1500110762 RWCCA48120015 ACE AMERICAN BRIEFLY DESCRIBE THE WORK TO BE DONE: BRAKE CONCRETE, REPLACE 91 TURBINE AND TEST 91 LINE LEAK DETECTOR WITH FIRE DEPT. ALSO RELOCATE FUEL MONITOR FROM STORAGE ROOM TO FRONT COUNTER AND PERFORM A FUEL MONITOR SYSTEM CERTIFICATION AFTER REPAIRS WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE I MAILING ADDRESS 6630 ROSEDALE HWY #B NAME OF TESTER ICC# FIDEL CARRILLO I 5257282 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 I ICC# FIDEL CARRILLO 5257282 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY FD2086 (Rev 08/09)