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HomeMy WebLinkAboutMINOR MOD BILLING APP 9-17-18..LING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT 8 � R 5 f t D Prevention Services PERMIT # PINK 2101 H Street Bakersfield, CA 93301 rilease maKe cnecKS payaDiie to CITY OF BAKERSFIELD. NO CASH Please. Thank you. ' IIN G: BUSINESS, jN �'� .� # `w 9 y' 90-4279/1 22 r' N . 11911 t'R�kGKSIDE CIRIVE k. ; 2 4` 19 BAKE RSFIELD,tA-93312 . PAY TO THE ORDER OF LL FOR C/1 - W-"A Ni IS ..i3.... 1330 Truxtun Avenue Bakersfield, CA 93,3611 16'00241911' 1:12224, 2 ?9 W: ©1 �DTE Featums noLLARS owfu"d. back } C 00'L' 03.0$0816• ❑ 1 Aboveground Storage Tank (Removal, Mod, or Inspection) ATR 1 $ 112 /tank ❑ Underground Storage Tank (Installation /Inspection) NI $ 900 /tank '.r Underground Storage Tank (Modification) MOD $ 900 /site W-- Underground Storage Tank (Minor Modification) MTM 171 /site ❑ Underground Storage Tank (Removal) TR $ ank J ❑ Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. $ 98 /hr (2 hrs minimu = $196 NOTE: $98 /hr for each .ty, e of tes SPF��JPpO .l'F�G9F iE�9�,�CGH,vO y�`JP SITE INFORMATION LOCATION OF PROJECT 32..20 fA.JG A.v e- PRO TY r OWNER ,P» STANG D COMPLETION DATE � / % o NAM PROJECT NAME ADDRESS " PHONE # Mob S:Z f -ri' 900/ SZo /A 177 PROJECT ADDRESS CITY L�!"Cf�.ER,S�I�i_I� STATE CA ZIP CODE: CONTRACTOR IN• • CONTRACTOR � �' �� CA LICENSE #� TYPE OF LICENSE �PI TIO AT�� PHONE #61,� 7�� s� CONTRACTOR COMPANY NAME FAX # 4 2;z 5313 ADDRESS (� ��(} �A\ ZIP CODE rilease maKe cnecKS payaDiie to CITY OF BAKERSFIELD. NO CASH Please. Thank you. ' IIN G: BUSINESS, jN �'� .� # `w 9 y' 90-4279/1 22 r' N . 11911 t'R�kGKSIDE CIRIVE k. ; 2 4` 19 BAKE RSFIELD,tA-93312 . PAY TO THE ORDER OF LL FOR C/1 - W-"A Ni IS ..i3.... 1330 Truxtun Avenue Bakersfield, CA 93,3611 16'00241911' 1:12224, 2 ?9 W: ©1 �DTE Featums noLLARS owfu"d. back } C 00'L' 03.0$0816• ❑ 1 Aboveground Storage Tank (Removal, Mod, or Inspection) ATR 1 $ 112 /tank ❑ Underground Storage Tank (Installation /Inspection) NI $ 900 /tank '.r Underground Storage Tank (Modification) MOD $ 900 /site W-- Underground Storage Tank (Minor Modification) MTM 171 /site ❑ Underground Storage Tank (Removal) TR $ ank J ❑ Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. $ 98 /hr (2 hrs minimu = $196 NOTE: $98 /hr for each .ty, e of tes SPF��JPpO .l'F�G9F iE�9�,�CGH,vO y�`JP