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HomeMy WebLinkAbout5609 STINE ROAD FMC 2013HOODS I ARMS SPRINKLER SYSTEMS G°.Q 30 0 AST UST Pernik No. Permit No. Pernik No. Pernik No. Pernik No. Permit No. 3-t o a Fiie Number: a / Date Received: 2 — (3 — c 3 New Mod. Address: ' 7 Siii h, Bakersfield, CA 933 Business Name: Citi•`© SYSTEM: BUILDING SQUARE FEET: Commercial Hood System Fire Alarm System Fire Sprinkler System s Firaesf R O Aboveground Storage Tank Underground Storage Tank Underground Storage Tank removal Underground Storage Tank O Q/ Other. lit C Building Sq. Feet: Calculation Bldg. Sq. Ft: 6. a. 3. 4. INSPECTION LOG Date Time Signature Comments: SO,'ll /vcAKET Ll iESE /) ov'rl av Ol lE /:svz zr'J F' /ter./ si -s - 1, eCi%2i RLcI" 9i' IQETESr"r 7ZiL STYE f 2 .,. , _ TF_ c, M25oN cc.z S 9 785— - c T R %.3 3 spa 9 z /ry r UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION Please note that these are separate individual tests and will be charged per separate type test accordingly.) PERMIT # io- X it Sp X, FIRE Rusin it BAKERSFIELD FIRE DEPARTMENT Prevention Services aloe K S-mEET Bakerstield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 1 ENHANCED LEAK DETECTION LINE TESTING SB-989 SECONDARY CONTAINMENT 11 TANK TIGHTNESS FUEL MONITORING CE WION FD2095 (Rev 03/08) FACILITY NAME g PHONE # OF CONTACT PERSON ADDRESS Is 151 O^ y ` v` OWNER NAME OPERATOR NAME U PERMIT TO OPERATE # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES NO TANK # VOLUME CONTENTS 2 3 TANK :TESTING, .GOMPANY TESTING COMPANY ZC c' lJv \'RD tJ M, J1 L . NAME & PHONE # OF CONTACT PERSON siftm Cam- $ l0 1 MAILING ADDRESS 51aL-13 t3 ctS cT. — F3ItK RSrr E. -D C 93308 NAME & PHON OF TE5TE, R OR SPECIAL INSPECTOR r CERTIFICATION # SSC) DATE &TIME TEST YO BE C NDUCTED 3 ICC V TEST METHOD APPLICA NATURE Mc,CcX^ n BECOMES DATE THIS APPLICATION A PERMIT WHEN APPROVED APPROVED DATE FD2095 (Rev 03/08) WIZ BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPT. TFJIPR' r D Prevention Services 1600 Tnixtun Ave Ste 401PERMITNO.: r Bakersfield CA 93301 Tel -: (6611326-3979 • Fax: (6611 952 -2171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT.: a SITE INFORMATION LOCATION OF PROJEC PROPERTY OWNER STARTING DATE I i COMPLETION DATE NAME ^ PROJECT NAME DRESS \ PHONE NO. PROJECTADDRESS O CITY \< 4_ (_—\ STATE 7JPCODE Note: $96.00 for each type of test / per site duled 9988 Sprinklers - New & Modifications - (Minimum Charge) $280.00 CONTRACTOR NAME CA LICENSE NO. TYPE OF LICENSE EXPIRATION DATE PHONE NO. AR,, Vai 1 n Ann C . N _- CONTRACTOR COMPANY NAME FAX NO. Ic v 392, -o (0 01- L ADDRESS \ 6u _ CITY ZIPCODE 9 ?'3 C) All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT.: a TREASURY Alarms - New & Modifications - (Minimum Charge) $280.00 84 Mandated Leak Detection (Testing) / Fu Monit.6e SB9 89. 98 0 Over 10,000 Sq. Ft ft Ft. x.028 = Permit fee Note: $96.00 for each type of test / per site duled 9988 Sprinklers - New & Modifications - (Minimum Charge) $280.00 84 AR,, Vai 1 n Ann C . N _- RICH ENVIRONMENTAL SERVICE STATION SERVICES LIC. #809850 5643 BROOKS CT. BAKERSFIELD, CA 9330873708 661)392 -8687: PAY TOTHE , ` oan - C: 90- 7162/3222 4132 DATE 3 Nr r CHASE 1.- JP Mor en Chase Bank N.A. P Ba rsfleld, CA 93368 AUTHORIZED SIGNATUR LL .FOR 004L32u `1 :32227L627t: 308350400711' 4f 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) FD 2021 (Rev. 06/07) sr la- on $96.00 84 Mandated Leak Detection (Testing) / Fu Monit.6e SB9 89. 56 89 fperslte f G C 82 Note: $96.00 for each type of test / per site duled at the same time) Tents 96.00 (pertent) 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby tee 1Inspection)= $576..00 84 After hours inspection flee 121.00 84 RE-INSPECTION(S) /FOLLOW -UP INSPECTION(S) 96.00 (per hour) 84 Portable LPG (Propane): NO. OF CAGES? _ 96.00 84 Explosive Storage 266.00 84 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) L_ BILLING & PERMIT STATEMENT PERMIT NO.: BAKERSFIELD FIRE DEPT. R SF I D Prevention Services Fr7NB ARrr r 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 , SITE INFORMATION LOCATION OF PROJEC' PROPERTY OWNER STARTING DATE I J COMPLETION DATE NAME CNIUW res-N-1 PROJECT NAME DRESS 5 0(=>L d- ro Yc PHONE NO. PROJECT ADDRESS O CRY ^ 6— STATE ZIP CODE Over 10,000 Sq. Ft. CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE NO. TYPE OF LICENSE EXPIRATION DATE PHONE NO. Q(pCrtOSOf 4c7gNA 3o i g 2 7 CONTRACTOR COMPANY NAME G 'EIUV FAXNO. 3 z -Oiooti ADDRESS 6U 1-1 CITY ZIP CODE All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. Alarms - New & Modifications - (Minimum Charge) $280.00 , 98 Over 10,000 Sq. Ft Sq. FL x.028 = Permit fee 98 Sprinklers - New & Mod'Ifications - (Minimum Charge) 280.00 84 98 Over 10,000 Sq. Ft. 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 (Installation/Insp.-I" Tims) 180.00 82 Additional Tanks 96.00 82 Aboveground Storage Tanks (RemovaAnspection) 109.00 82 Underground Storage Tanks (/nstalladonAnspection) 878.00 (per tank) 82 Underground Storage Tanks (Modification) 878.00 (persite) 82 Underground Storage Tanks (Minor Modification) 167.00 82 Underground Storage Tanks (Removao 573.00 (per tank) 84 Oilwell (Installarion) 96.00 84 G Mandated Leak Detection (Testing) / Fu Monit.Ce SB989. Note: $96.00 for each type of test /persite addled at the same time) 11 86 (persit f n 82 Tents 96.00 (per tent) 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee /inspection)a$576..00 84 . Auer hours inspection fee 121.00 84 RE4NSPECTION(S) /FOLLOW -UP /NSPEC710N(S) 96.00 (per hour) 84 Portable LPG (Propane): NO. OF CAGES? 96.00 84 Explosive Storage 266.00 84 Copying &File Research (File Research Fee $50.00 per hr) 251E per page 84 Miscellaneous 84 FD 2021 (Rev. 06107) 1 - ORIGINAL WH(TE (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 TANK TESTING- -- -- - i UST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE PRIOR -TO OPERATION OF ANY SYSTEM, TALL-UST- AND /OR AST SYSTEMS SHALL BE CINSTAU COMPLETE AND ACCEPTED BY MISC. ACTIVITY THE- BAKERSFIELD CITY FIRE DEPARTMENT. C FIRE. DEPARTMENT.(FINAL) . /3 REMARKS: BUILDING ADDRESS: (o Q ii• JOB DESCRIPTION: OCCUPANCY TYPE: OWNER: C(,- v,j r.J PERMIT NO. / 3 -ld6 Q /6 CONTRACTOR: , c PHONE # j9z - FD 1743