The URL can be used to link to this page

Home My WebLink About1616 NILES STREETHOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTHOOT1H AST UST Permit No. Permit No. Permit No. Permit No. Permit No. 9— Permit No. File Number: a) '3 Address: /;:, /,. S 37— Bakersfield, CA 933 Date Received: Business Name: INSPECTION LOGSYSTEM: I F BUILDING SQUARE FEET: New Mod. Commercial Hood System Building Sq. Feet: Date Time Fire Alarm System Calculation Bldg. Sq. Ft: 1. Fire Sprinkler System 2. Spray Finish System 3. C Aboveground Storage Tank 4. Underground Storage Tank minor Signature modification Underground Storage Tank removal Underground Storage Tank Signature Other: 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 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) BUILDING ADDRESS: /914 A)t (-e 57- JOB DESCRIPTION: --r, OCCUPANCY TYPE: OWNER: = PERMIT NO. laEr- CONTRACTOR: .,d,u,Q.f• t'G &, g_!!! PHONE# —Zr3;?- -5331 I-U 1/43 a BILLING & PERMIT STATEMENT tliillUlll;i' BAKERSFIELD FIRE DEPARTMENT R 9 F I 11L D Prevention Services PERMIT # FIRE W 2101 H StreetARrM ! Bakersfield, CA 93301 Dhnnn•f. f._Z7f._ZQ7Q Fav• 6,:.1 -RS7 -7171 Please make checks payable to CITY OF BAKERSFIELD. Thank you. 1 Alarm - New & Modification (minimum charge) 1$280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - New & Modification (minimum charge) $280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - Minor Modification ( <10 heads) $ 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) $470 Additional Hood 58 hood Commercial Hood - Minor Modification (add /move nozzle) $ 96 (inspection only) 84 Spray Booth (New & Modification) 470 98 Aboveground Storage Tank (1 inspection per installation) AST SITE INFORMATION 82 LOCATION OF PR JECT n , V UCOMPLETION 96 /tank PROPERTY OWNER 82 STARTING DATE 6 DATE 4 aDloZ NAME PROJECT NAME mF w;- ADDRESS 1 PHONE # PROJECT ADDRESS NAL cm gAKE1ZSFIELD STATE CA ZIP CODE 82 Underground Storage Tank (Minor Modification) MTM 167 /site C(?NTRACr R A A , 5W '(/ n / ' (' J n4 LiC N I TYPE QF ENS EX ^RATION DATE IJ n7C lJ PHONE # , J FAX # CONTRACTOR COMPANY NAME ADDRESS 96 /hr (2 hrs minimum) _ $192 cITY n „ / - / 7 ZIP CODE i w 96 /hr 82 Please make checks payable to CITY OF BAKERSFIELD. Thank you. 1 Alarm - New & Modification (minimum charge) 1$280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - New & Modification (minimum charge) $280 Over 10,000 sq ft $0 .028 x sq ft Sprinkler - Minor Modification ( <10 heads) $ 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) $470 Additional Hood 58 hood Commercial Hood - Minor Modification (add /move nozzle) $ 96 (inspection only) 84 Spray Booth (New & Modification) 470 98 Aboveground Storage Tank (1 inspection per installation) AST 180 /tank 82 Additional Tank ATI 96 /tank 82 Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR 109 /tank 82 Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 Underground Storage Tank (Modification) MOD 878 /site 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test/per site /per UST system even if scheduled at the same time 96 /hr (2 hrs minimum) _ $192 82 i Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 p Tent # 96 /tent 84 P. _ After -hours Inspection fee 121 /hr (2 hrs minimum) _ $242 p, Pyrotech.nic,(1 permit per event, plus an inspection fee of 6 /hr during business hours) Py TE: After hourss Pyrotechnic event inspection is @ $121 /hr 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee ins = 605 84 Re- inspection /Follow -up Inspection 96 /hr 84 Portable LPG (Propane): # of Cages? 96 /hr v$ i Z Lu' 00.7 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 84 AmenGas Americas Pmpeae Company . DOLLAR_- GEfVERAL NEW INSTALLATION ACKNOWLEDGEMENT & SITE PLAN FORM DISTRICT TO FILL OUT INSTALLATION REQUIREMENTS & FAX OR EMAIL BACK TO: SURVEY DUE DATE: Email: ACENewlnstallsTeam (aaamerigas.com GRAND OPENING: 4/1/2012 Fax: 623- 931 -2400 OBTAINING THE PERMIT AND /OR LICENSE INFORMATION IS THE RESPONSIBILITY OF AMERIGAS DISTRICT - all authorities must be notified immediately to determine if they will approve installation prior to store opening. FAX A COPY OF STATE AND /OR LOCAL LICENSE AND /OR PERMIT TO THE CYLINDER EXCHANGE OFFICE UPON RECEIPT. The AmeriGas District will pay for the initial license and /or permit. Renewals are the responsibility, of the customer. All Dollar General Application's for permit and/or licenses must use the Dollar General Corporate address below for the renewals. Dollar General Tax/License Department 100 Mission Ridge, Goodlettsville, TN 37072 STATE license required: Y or(V 1218/860 Customer Name & Date application submitted: AG Mkt/Dist: BAKERSFIELD CA Store Number: DOLLAR GENERAL 13344 By: d! - 8.?1 -533 f Address, City, State, 1616 NILES ROAD Dist Phone /Fax: 64, , -B39 - 05,16' fix Zip: BAKERSFIELD, CA 93306 Account #: To be assigned by the ACE Office Store Phone /Contact: TBA OBTAINING THE PERMIT AND /OR LICENSE INFORMATION IS THE RESPONSIBILITY OF AMERIGAS DISTRICT - all authorities must be notified immediately to determine if they will approve installation prior to store opening. FAX A COPY OF STATE AND /OR LOCAL LICENSE AND /OR PERMIT TO THE CYLINDER EXCHANGE OFFICE UPON RECEIPT. The AmeriGas District will pay for the initial license and /or permit. Renewals are the responsibility, of the customer. All Dollar General Application's for permit and/or licenses must use the Dollar General Corporate address below for the renewals. Dollar General Tax/License Department 100 Mission Ridge, Goodlettsville, TN 37072 STATE license required: Y or(V LOCAL permit required: nr N Date application submitted: Date application submitted: Month_Day Year Month Day Year Account Specifications - only if meets jurisdiction requirements. On the following page draw a Diagram of cage (s) at store location, MUST comply with jurisdiction requirements. 'Identify required location of vehicle protection, handicap. ramp; :,all entrances, exits & list measurements on drawing. An' 18 pound Dry Chemical BC rated extinguisher will be supplied by AmeriGas if two or more cages are set and /or the Authority Ho/ding,Jurisdiction.requires. District Consent Information: Week of ONE 18 CAPACITY CAGE WILL BE THE STANDARD UNLESS AHJ Cage Size & Qty: REQUIRES LESS CAPACITY AND /OR ADDITIONAL CAPACITY NEEDED DUE TO DISTANCE FROM SERVICE LOCATION. Form Completed IN FRONT OF BLDG AT LEAST 20' FROM THE DOOR IF POSSIBLE AND By: BALANCED WITH OTHER OUTDOOR FIXTURES. THE STORE MGR CAN Cage Location: REQUEST ALTERNATE LOCATION AS LONG AS IT IS WITHIN CODE COMPLIANCE. On the following page draw a Diagram of cage (s) at store location, MUST comply with jurisdiction requirements. 'Identify required location of vehicle protection, handicap. ramp; :,all entrances, exits & list measurements on drawing. An' 18 pound Dry Chemical BC rated extinguisher will be supplied by AmeriGas if two or more cages are set and /or the Authority Ho/ding,Jurisdiction.requires. District Consent Information: Week of TO BE SET BY THE ACE OFFICE. DISTRICT WILL- BE'NOTIFIED OF Install Date: SCHEDULE IN ORDER TO INSTALL OR TO FOLLOW INSTALL TEAM WITH, CYLINDERS AND TRAINING. Form Completed Today's Date: J P 7 SBy: N ry o &J O 1— 3- a7-1A To request a Certificate of Insurance if required, contact the ACE Customer Office a@ 1- 800 -434 -2323 or email ACELicenseandPermittingTeam D-amerigas.com. z: America's Propane Company DQLLAR' GENERAL`': AnvoGas NEW INSTALLATION ACKNOWLEDGEMENT & SITE PLAN FORM Any questions with completing the survey, contact the ACE-Office-at 1- 800 - 434.2323 STORE FRONT opc OO 4 plPr ai,` RNs- 4uF. TZ) /3v D NCT w ry INSTALL FOUNDATION: Concrete _Asphalt 1218/860 Customer Name & AG Mkt/Dist: BAKERSFIELD CA Store Number: DOLLAR GENERAL 13344 6c,(- 'a 3.) —533/ Address, City, State, 1616 NILES ROAD Dist Phone /Fax: 6W —9 3)- -06,6- Fi4y- Zip: BAKERSFIELD CA 93306 all Bollard orders must go through the ACE O is To be assigned by Store Phone /Contact: NOTE: 36" minimum required for handicap access Account #: the ACE Office I I TBA Any questions with completing the survey, contact the ACE-Office-at 1- 800 - 434.2323 STORE FRONT opc OO 4 plPr ai,` RNs- 4uF. TZ) /3v D NCT w ry INSTALL FOUNDATION: Concrete _Asphalt CAGES BOLTED DOWN: X YES NO EXISTING VEHICLE PROTECTION: Sidewalk Curb Height: --k Existing Curb Stop: Y AUTHORITY HOLDING JURISDICTION REQUIREMENTS ONLY: Other Doors into Building: 5' 10' 20' COMPLETE ONLY IF ADDITIONAL PROTECTION REQUIRED Source of Ignition: 5' 10' 20' BY AH11J: Qty 2 Bollards: circle one Bolt Down ore ore Drille Other: all Bollard orders must go through the ACE O is Other Protection: NOTE: 36" minimum required for handicap access CAGE CAPACITY & QTY: 12CT 18CT FIRE EXTINGUISHER —18 lb B,C REQUIRED: NO YES DISTANCE FROM CAGE: O FT An 18 pound ry Chemical BC rated extinguisher will be SURVEY DATE: supplied by AmeriGas if two or more cages are set and/or the Authority Holding Jurisdiction requires. STORE MANAGER AMERIGAS EMPLOYEE SIGNATURE: SIGNATURE: 1 e 1 . - 1 .. , i t 1 . - 1 .. , i i" 1 1 . Y