HomeMy WebLinkAbout3620 WILSON ROAD FMC 2013HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTHH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
File Number: 7(%- z z-- Address:
Bakersfield, CA 933
Date Received: - i 3 — 3
Business Name: I v L L
SYSTEM: BUILDING SQUARE FE F INSPECTION LOG
New Mod.
Commercial Hood System
Fire Alarm System
Fire Sprinkler System
Spray Finish System
Aboveground Storage Tank
Underground Storage Tank
minor
modification Underground Storage Tank
removal Underground Storage Tank
Other. .0 1"" c-,
Building Sq. Feet:
Calculation Bldg. Sq. Ft:
a.
3.
4.
Date Time
Signature
Signature
Comments: -a c/„ ; Spur -/v o sn
aolz11y
4/4/ /3
UNDERGROUND STORAGE TANKS;
FACILITY ^ NAME 8 PHONE a OF CONTACT N
F\
ADDRESS
k
APPLICATION FIRM
OPERATOR NAME
ARrAF, ! TO PERFORM ELD /LINE TESTING /
IS PIPING GOING TO BE TESTED? YES NO
SB989 SECONDARY CONTAINMENT T
TESTINGITANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
Please note that these are separate
Individual tests and will be charged per
3
separate type test accordingly.)
PERMIT #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
6210 t l-t S -Mee —T
Bakerstield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661- 852 -2171
Page 1 of 1
ENHANCED LEAK DETECTION SB-989 SECONDARY CONTAINMENT
TANK TIGHTNESS FUEL MONITORING CERTIFI ON
SITE.INFO"
FACILITY ^ NAME 8 PHONE a OF CONTACT N
F\
ADDRESS
OWNER NAME
OPERATOR NAME PERMIT TO OPERATE t
OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES NO
TANK # VOLUME CONTENTS
O-
3
TANK;TESTINGCOMPANY
TESTING COMPANY
tJV \'R t 1.Y\t -
NAME & PHONE A OF CONTACT PERSON
Off- $ to I
MAILING ADDRESS
5LQL 73 t C{oo c.S C T. — F3P KE+RSF lE - C °13308
NAME & PHONE a Of TESTER OR SPECIAL INSPECTOR
O
CERTIFICATION #
GSUlJ
DATE S TIME TEST TO BE CON UCTE
X 3 • `
ICC # TEST METHOD
APPLICANT SIGN RE DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY DATE
FD2095 (Rev 03/08)
Y
BILLING & PERMIT STATEMENT
PERMITIT NO.: I
Qan-R-s -
P1*
i.,-.D
FIRK -
ARrm r
46*
MYCLIP't.-I P-Mi 11"
A1
l"i
Prevention Services
1600 T uxttm Ave Ste 401
Bakersfield CA 93301
TPI - (AA I 1 129-1979 • Fqx- (AR I I RR9 -2171
All permits must be reviewed. stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT.
PERMIT TYPE FEE CALCULATION TOTAI TREASURY
DUE ACCTNO
Alarms - Now & Modifications - (Minimum Charge) 280.00
SITE INFORMATION
Tents
98
0 Over 10,000 Sq. Ft.
LOCATION OF PROJECT
Pyrotechnic - (Per event, Pius Insp. Fee @ $96 per hour)
I 1
98
PROPERTYOWNE975rA
4131
After hours inspection fee
STARTING OATE MPLETI!Z
Sprinklers - New & Modifications - (Minimum Charge) 280.00
NAME - \
V by\
84
98
PROJECT NAME
oMn ftc
Portable LPG (Propane): NO. OF CAGES?
a
PDRESS
to
DATE
ONE NO.
US6—
PROJECT ADDRESS
84
94
CITY P)k STATE 71P CODE c)
84
CONTRACTOR
AYTO THEPORDER
INFORMATION
84
CONTRACTOR NAME CALICENSE NO, OF LICENSE. EXPIRATION DATE PHONE NO.
12ICVM;.S tC ti A 21- Q 3CI /01J sq
CONTRACTOR COMPANYNAME
E
FAX NO.
B I C- 0y Q I VQ n A) M F 59 2- - 0 (0 GL I
ADDRESS
5u C4 14:) CITY ZIP CODE
All permits must be reviewed. stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT.
CHASE
JP Morgan Chase Bank, N.A.
Baorsfie!d, CA 93308
fP FOR
1190041,31,111 i:32227&627i:
pi
AUTHORIZED SIGNATURE
308 3 SO 400 711•
24,9050 tf BTunwediInirWlan
PERMIT TYPE FEE CALCULATION TOTAI TREASURY
DUE ACCTNO
Alarms - Now & Modifications - (Minimum Charge) 280.00
WP
Tents
98
0 Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee
Pyrotechnic - (Per event, Pius Insp. Fee @ $96 per hour)
84
98
90- . 7162/32 22 4131
After hours inspection fee
LIC.#809850
Sprinklers - New & Modifications - (Minimum Charge) 280.00 84
98
2, 3//-3
Portable LPG (Propane): NO. OF CAGES?
DATE
Explosive Storage
84
CHASE
JP Morgan Chase Bank, N.A.
Baorsfie!d, CA 93308
fP FOR
1190041,31,111 i:32227&627i:
pi
AUTHORIZED SIGNATURE
308 3 SO 400 711•
24,9050 tf BTunwediInirWlan
Mandated Leak Detection ffesfing)/F "elMonit.0 SB989..
Note., $96-00 for each OW of test 1per site uled
at the same time)
0 C:I, 19
M
82
WP
Tents
RICH ENVIRONMENTAL
84
Pyrotechnic - (Per event, Pius Insp. Fee @ $96 per hour)
SERVICE STATION SERVICES 90- . 7162/32 22 4131
After hours inspection fee
LIC.#809850
01 84
RE4NSPECTION(S) / FOL L 0 W-UP INSPECTION(S)
5643 BROOKS. CT. 2, 3//-3
Portable LPG (Propane): NO. OF CAGES?
BAKERSFIELD, CA 93308-3708 DATE
Explosive Storage
6611.392 -8687
94
Copying & File Research (File Research Fee $50.00 per hr) 84
AYTO THEPORDER di
84
OF
5
CHASE
JP Morgan Chase Bank, N.A.
Baorsfie!d, CA 93308
fP FOR
1190041,31,111 i:32227&627i:
pi
AUTHORIZED SIGNATURE
308 3 SO 400 711•
24,9050 tf BTunwediInirWlan
Mandated Leak Detection ffesfing)/F "elMonit.0 SB989..
Note., $96-00 for each OW of test 1per site uled
at the same time)
0 C:I, 19
M
82
Tents 96.00 (per tent) 84
Pyrotechnic - (Per event, Pius Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby tee nnspadon)=$576-00 84
After hours inspection fee 121.00 01 84
RE4NSPECTION(S) / FOL L 0 W-UP INSPECTION(S) 96.00 (per hour) 84
Portable LPG (Propane): NO. OF CAGES? 96.00 84
Explosive Storage 266.00 94
Copying & File Research (File Research Fee $50.00 per hr) 250 per page 84
Miscellaneous 84
1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1-PINK (to Customer)
FD 2021 (Rev. 06/07)
ME
BILLING'& PERMIT STATEMENT
FPERM NO.:
41.111104fth. -
S F D
4 P/RB
ARrm r
BAKERSFIELD FIRE DEPT.
Prevention Services
1600 Truxtun Ave Ste 401
Bakersfield CA 93301
Tel.: (661) 326 -3979 • Fax: (661) 852 -2171
All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT.
Alarms - New & Modifications - (Minimum Charge) $280.00 , 84
Over 10,000 Sq. FL Sq. Ft, x .028 = Permit fee
LOCATION OF PROJECT
SITE INFORMATION
I 1 PROPERTY OWNE
Spdnlders - New & Modifications - (Minimum Charge) 280.00
STARTING DATE MPLETI A
84
98
NAME
Over 10,000 Sq. FL Sq. Ft. x.028 = Permit fee
PROJECT NAME / /
O ^
98
RESS
C O l
ONE NO.
O
PROJECT ADDRESS
b
84
98
CITY STATE
Commercial Hoods — New & Modifications
ZJPCODE
CONTRACTOR NAME
14YY1 ES _ ti
CA LICENSE N.
O so
98
TYPEOF LICENSE. EXPIRATION DATE
f R Nei o icy
PHONE NO.
g 2 -8 i
CONTRACTOR COMPANYNAME
tc
84
98
FAX NO.
2 -O(ocl
ADDRESS
470.00
CITY
98
ZIPCODE
9 ?3
All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT.
Alarms - New & Modifications - (Minimum Charge) $280.00 , 84
Over 10,000 Sq. FL Sq. Ft, x .028 = Permit fee
Spdnlders - New & Modifications - (Minimum Charge) 280.00 84
98
Over 10,000 Sq. FL Sq. Ft. x.028 = Permit fee 84
98
Minor Sprinkler Modifications (< 10 heads) 96.00 [Inspection Only] 84
98
Commercial Hoods — New & Modifications 470.00 84
98
Additional Hoods 58.00 84
98
Spray Booths - New & Modifications 470.00 84
98
Aboveground Storage Tanks (Installatiodinsp. -1 °Time) 180.00 82
Additional Tanks 96.00 82
Aboveground Storage Tanks (Removal/Inspection) 109.00 82
Underground Storage Tanks (InstalladonAnspection) 878.00 (per tank) 82
Underground Storage Tanks (Modification) 878.00 (per site) 82
Underground Storage Tanks (Minor Modification) 167.00 82
Underground Storage Tanks (RemovaQ 573.00 (per tank) 84
Oilwell (Installation) 96.00 B4
Mandated Leak Detection (Testing) / F el Monit.0 SB989.
Note: $96.00 foreach" oftest1persite uled
at the same time)
ets. ` , n 82
Tents 96.00 (per tent) 84
Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee Anspection)=$576..00 84
After hours inspection fee 121.00 84
RE4NSPECTION(S) 1FOLLOW -UP INSPECTIONS) 96.00 (per hour) 84
Portable LPG (Propane): NO. OF CAGES? _ 96.00 84
Explosive Storage 266.00 84
Copying &File Research (Rle Research Fee $50.00 per hr) 250 per page 84
Miscellaneous 84
FD 2021 (Rev. 06/07)
1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer)
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
111111\ 16.1111.6
UST REMOVAL
DESCRIPTION DATE SIGNATURE
AST NEW INSTALL
DESCRIPTION DATE SIGNATURE
MODIFICATIONS MINOR / MAJOR
AST REMOVAL
DESCRIPTION DATE SIGNATURE
EVR UPGRADE
PRIOR TO- OPERATION OF ANY SYSTEM, b
ALL"USTAND/OR AST SYSTEMS SHALL BE ,
INSTALL,_COMPLETE AND ACCEPTED BY ,
MISC. ACTIVITY THEU KERSFIELD- CITY-FIRE -DEPARTMENT.
CFIRE-DEPARTMENT (FINAL)- _
REMARKS: av 1/I AlegM cl_i41w'6 L/ /Sual ) dtg l A,9 64St c &Y1162v ZFs
BUILDING ADDRESS: p t
JOB DESCRIPTION: FtAA C___ OCCUPANCY TYPE:
OWNER: -kA PERMIT NO. 13 - 16aCO /O Z
CONTRACTOR: . LC' PHONE # 3 Z -.
FD 1743