HomeMy WebLinkAbout[Untitled]_2-3BILLING &PERMIT STATEMENT
E RMIT N
LOCATION OF PROJECT x
STARTING DATE � C MPI.ETION ATE
PROJECT NAME
PROJECT ADDRESS oov
ELtKERSFIELD, FIRE DEPT,
R S F Prevention Services
H S R S F I D
FIRE 1600 Truxtun Ave Ste 401
h.. r Bakersfield CA 93301
Tel.: (661) 326 -3979 e Fax. (661) 852 -2171
PROPERTY OWNER
NAME
PHONE NO.'
_ — STATE /�
I ZIP CODE
CITY ./) ! f i / 1
CA LICENSE NO. TYPE OF LICENSE. EXPIRATION DATE PHONE NO.
CoNT`RACrCiR NAME . �- \C t `� O� � f /f) -4 ,"A 3p 2 �'f
4 �� .5 FAX NO- p
CONTRACTOR COMPANY NAME r o
ZIP
ADDRESS
clrr t;�ut / 3.......... ..
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ADDRESS 5LO C-
d stain ed, and approved PRIOR TO BEGINNING WOR .CON TI�fAT hRt)JECT � ' •
All vermits must be rev__�eiNe P
❑ I Alarms -
84
= (Minimum Charge) $280-00
u�00469
❑ Underground Storage Tanks (Minor Modification)
❑ Underground Storage Tanks (Removal)
❑ Oilwell (Installation)
13 Mandated Leak Detection (Testing) / Fuel Monit.Cert/S13989.
Note: $96.00 for each 4W of test /per site (even if scheduled
at the same Time).
❑ ents
❑ Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour)
❑ After hours inspection fee
13 RE- INSPECTION(S) / FOLLOW -UP INSPECTIONS)
❑ Portable LPG (Propane): NO. OF CAGES?
❑ Explosive Storage
❑ Copying & File Research (File Research Fee $50.00 per hr)
❑ Miscellaneous
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$167.00
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$573.00 (Per tank)
$ 96.00
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82
$ 96.00 (per tenf
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$ 96.00 + (5 hrs. min. standby fee /Inspection) ,$5%6..00
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$121.00
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$ 96.0o (per hour)
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$ 96.00
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$266.00.
250 per page
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FD 2021 (Rev.
06/07)
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