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HomeMy WebLinkAbout6601 MING AVENUE MOD 2013 (2)HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. 3- t 9c7 40`' File Number. Address: -VtA C Bakersfield, CA 933 Date Received: Business Name: t" `J vrc!-'C SYSTEM: BUILDING SQUARE FEET: New Mod. Commercial Hood System Building Sq. Feet: Fire Alarm System Calculation Bldg. Sq. Ft: 1. Fire Sprinkler System 2. Spray Finish System 3. Aboveground Storage Tank 4. Underground Storage Tank mi r modification Underground Storage Tank removal Underground Storage Tank Other. INSPECTION LOG Date Time 1, e'. 4 -, . Signature Signature Comments: i cL S-I C) 5--) y-3 ova. 3/i r/i3 FLSrrs - 1 7 Foo - ib BILLING & PERMIT STATEMENT P PERMIT # 'F A T BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 FD2021 (Rev 05/10) SITE INFORMATION LOCH_ TION OF PROJECT + T/ PROPE TY OWNER . ST TING DATE tOMPLETION DATE NAME PROJECT M ADDRESS PHONE # PROD ADDRESS L CITY :>A1 —' RS IFiLD STATE C'4 ZIP CODE O CONTRACTOR CONT CTOR NAME ,L yt t,S CA LICENSE # INFORMATION TYPE OF LICENSE EXPIRATION D TE PHONE # G CONTRALTO CoAPANY ME FAX # ADDRESS M-50 [411166c ea / ZIP COPE a All per its must be reviewed, stamped, and approved PRIOR TO B GINNING WORK. J • • Alarm - New & Modification (minimum charge) $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 Minor Sprinkler Modification <10 headsp ( ) 96 (inspection only) 84 Commercial Hood (New & Modification) 470 Additional hood 58- 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 /Inspect) 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 Leak Detection (test) /Fuel Mont Cert/SB989 TT NOTE: $96 /hr for ea type of test/per site even if scheduled at he same time 96 /hr (2 hrs minimum) =$192 82 Cl Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 Tent # 96 /tent 84 After -hours inspection fee 121 /hr (2 hrs minimum) =$242 Pyrotechnic (1 permit per event, plus an inspection fee of $96 /hr during business hours) PY NOTE: After hours 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 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 84 FD2021 (Rev 05/10) w BILLING & PERMIT STATEMENT BAIT # A"R' Rff T'N# BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661- 326 -3979 • Fax: 661 - 852 -2171 wulling-uti Service Technologies, Inc. 7050 Village Dr, Suite D Buena Park, CA 90621 714) 523 -0194 DATE a ` 15-1-3 2502 16- 4280/1220 PAY TO THE ORDER OF features AMERICAN B U S[ N E DOLLARS Q,snty S S BAN 6 Details on back. 523 West 61h Street • Suite 900LosAngeles, CA 90014 -1223 MEMO... It'00 2 50 21I' is 1 n22042807: 0 2 1008 4 3 . 3 4 4 4 10) SITE INFORMATION LOCATION OF PROJECT F l PROPE TY OWNER ib ST TING DATE LOMPLETION DATE Wb e.ir--D NAME PROJECT NAMt ADDRESS PHONE* PRO] CT ADDRESS ,. V n r - "All CITY F CK FiRS (Fi LD STATE C ZIP CODE U CO•NT CTOR NAME dL q yS ' CA LICENSE # TYPE OF LICENSE EXPIRATION D TE PHONE # CONTRACTOV cofaPANY ME i FAX # ADDRESS pCl l ZIP COPE All per its must be reviewed, stamped, and approved PRIOR TO B J Alarm - New & Modification (minimum charge) $280 GINNING WORK. ionsff-9 • 0 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 Minor Sprinkler Modification <10 headsp ( ) 96 (inspection only) 84 Commercial Hood (New & Modification) 470 Additional hood 58 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 /Inspect) ATR 109 /tank 82 Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 Underground Storage Tank (Modification) MOD 878 /site 82 1h**' l.lnderaround Stnrana Tank (Minor Modification) MTM 167 /site 82 wulling-uti Service Technologies, Inc. 7050 Village Dr, Suite D Buena Park, CA 90621 714) 523 -0194 DATE a ` 15-1-3 2502 16- 4280/1220 PAY TO THE ORDER OF features AMERICAN B U S[ N E DOLLARS Q,snty S S BAN 6 Details on back. 523 West 61h Street • Suite 900LosAngeles, CA 90014 -1223 MEMO... It'00 2 50 21I' is 1 n22042807: 0 2 1008 4 3 . 3 4 4 4 10) P , rC ACbR °® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 10i31 202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. IfSUBROGATION IS WAIVED, subject to the termsand conditions ofthe policy, certain policies mayrequire an endorsement. A statement on this certificate does notconfer rights to the certificate .holder in .lieu of such endorsement(s). PRODUCER CONTACT ' Willis of Seattle, Inc. c/o 26 Century Blvd: P. O. Box 305191 PHONE FAX877- 945 -7378 888 - 467 -2378 E-MAIL certificates@willie.com Nashville, TN 37230 -5191 INSURER(S)AFFORDINGCOVERAGE. NAIC# INSURERA:Evanston Insurance Company 35378 -000 200 000 INSURED , Fueling and Service.Technologies, Inc. 7090 Village Drive INSURERB:Philadelphia Iademnity Iaeuraace Company' 18058 -001 INSURERC:RSUl.Indemnity Company 223Y4 -000 Suite D Buena Park, CA 90621 INSURER D: Alaska National Insurance Company 38733 -001 INSURER E: PRODUCTS - COMP/OP AGG 2,000,000 INSURER R B COVERAGES CERTIFICATE NUMBER: inais7o3 REVISION NUMBER_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE DD' SUB POLICY NUMBER POLICYEFF POLICY EXP LIMITS A GENERAL LIABILITY X COMMERCIALGENERAL LIABILITY CLAIMS -MADEa OCCUR Sacramento, CA 95827 12PKGO2604 11/1/2012 11/1/2013 EACH OCCURRENCE 1,000,000 PREMISES( aocruEence 200 000 MED EXP (Any one person) 5,000 PERSONAL B ADV INJURY 11000,000 GENERALAGGREGATE 11000,000 GENI AGGREGATE LIMITAPPLIES PER: POLICY X PRO• LOC PRODUCTS - COMP/OP AGG 2,000,000 B AUTOMOBILE LIABILITY X ANYAUTO ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PHPK941629 11/1/2012 11/1/2013 CEO. MeBI I LELIMIT 1,000,000 BODILY INJURY(Per person) BODILY INJURY(Per accident) PROPERTY DAMAGE Per accident) C A UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE NRA231652 12EFX00277 11/1/2012 11/1/2012 11/1/2013 11/1/2013 EACH OCCURRENCE 11000,000 X AGGREGATE 1,000,000 DED I X RETENTION $ 10,000 D WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YINANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Mandatory in NH) fyyes, describe under DESCRIPTIONOF OPERATIONS betow N/A 12DWS08336 1/2012 4/1/2013 X TORY IM. E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 11000,000 DESCRIPTION OFOPERATIONS I LOCATIONSIVEHICLES (Attach Acord 101, Additonal RemarksSchedule, If more space Is required) Proof /Evidence of Insurance for License #794519 Policy #12EFX00277 is excess over General Liability & Employers Liability. Policy #NHA231652 is excess over Auto Liability. CERTIFICATE HOLDER CANCELLATION Coll:3908220 Tpl:1547503 Cert:18815703 © 1988- 2010ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Contractors State License Board 9821 Business Park Drive Sacramento, CA 95827 Coll:3908220 Tpl:1547503 Cert:18815703 © 1988- 2010ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD State Of Calilomia CONTRACTORS STATE LICENSE 130ARO a ACTIVE LICENSE ARa,n (0 794519 CORP FUELING ANO SERVICE TECHNOLOGIES fNC w.. A HA2 C21 C IOC a. 05/31/20111 cslb ca goy- 7050 VILLAGE DRIVE, SUITE D 8635 COMMERCE BUENA PARK, CA 90621 SAN DIEGO, CA 92121 OFFICE: (714) 523 -0194 FAX: (714)523 -4235 24/7 AFTER HOURS: (800) 788 -8815 WWW.FASTECHUS.COM CA CONTRACTOR LIC. #794519 -A HAZ, C10, C21 Certificate Of Completion Code: oyo00zbaQ3 4 Franklin Fueling Systems This is to certify that Benito Tapia FASTECH, Inc. has been certified in: ite EVR Phase I Systems - VR -101 -M Training Date: September 28, 2012 Certification # 9980613702 Expiration Date: September 28, 2014 The person named on this certificate of completion has demonstrated knowledge of the listed products and installation procedures by completing an exam, provided by Franklin Fueling Systems techLAB. This certification is valid, for two years from the training date listed. Mall a W t Q maex war UZ UrnuomwuaNooumF WILLFR %ERXES TINI6 l» UGKr s HEALYC IR- SEPARATOR TAN wsz sox e \ * Nk%l— _ GAS MEMR-\_ o I 1) 1 - O w' R= MAW QI I a° Mt' N EWERRMY U gglf F I (71'P OF SVlipl Z U , ht ft.* SW pLyOp i"' I o Z. Z. LUBE CENTER owosmA00REWE 7 PLANTER PRXE SW comoRm so-" CONCOEM &MMA 1 ODNQB,E W MING AVENUE _ P DIRECTIONAL ARROW S W(l) E 0 10 N 20 30 GRAPHIC SCALE 1"=10'-U' VICINITY MAP SMOMA L NW 4t[ SITE SCOPE OF WORK: 1) REPLACED " NEW MODFI, SAME AS OLD AIODEI,' PH11, - TITE 35100 SPIi.L FILL BUCKET :3.5 GAl- IN THE 89 MIA, SLTNIP- 17 7 ^ e ° •g b uo9a SITE PLAN IOClh@W[F@H CHEVRON # 98119 7368 N. FIGUEROA LOS ANGELES CA 90041 PLANS PREPARED BY: FASTECH FUELING & SERVICE TECHNOLOGY INC. 7050 VILLAGE DR. BUENA PARK, CA TELEPHONE (714) 523 -0194 FAX - 1 -800 - 980 -5777 LICENSE # 794519, CLASS A, HAZ, C21 EXPIRATION: 5 / 31 /13 SHEET 1 OF 2 ur Q PPLANTER z0U 2U U AAC PMOID aa Mi"' I o Z. Z. LUBE CENTER owosmA00REWE 7 PLANTER PRXE SW comoRm so-" CONCOEM &MMA 1 ODNQB,E W MING AVENUE _ P DIRECTIONAL ARROW S W(l) E 0 10 N 20 30 GRAPHIC SCALE 1"=10'-U' VICINITY MAP SMOMA L NW 4t[ SITE SCOPE OF WORK: 1) REPLACED " NEW MODFI, SAME AS OLD AIODEI,' PH11, - TITE 35100 SPIi.L FILL BUCKET :3.5 GAl- IN THE 89 MIA, SLTNIP- 17 7 ^ e ° •g b uo9a SITE PLAN IOClh@W[F@H CHEVRON # 98119 7368 N. FIGUEROA LOS ANGELES CA 90041 PLANS PREPARED BY: FASTECH FUELING & SERVICE TECHNOLOGY INC. 7050 VILLAGE DR. BUENA PARK, CA TELEPHONE (714) 523 -0194 FAX - 1 -800 - 980 -5777 LICENSE # 794519, CLASS A, HAZ, C21 EXPIRATION: 5 / 31 /13 SHEET 1 OF 2SHEET1OF2 r DIRECTIONAL ARROW S W(l) E 0 10 N 20 30 c,uaric scaE r= o• A ° ° aa Q . a o• VICINITY MAP a e . sToamae NW FILL SUMP (REF.) VENT RISER (REF.) W Not FILL RISER (REF.) SITE W. SCOPE OF WORK: I) R.EPLaCED " NEW MODEL SAME AS OLD NIODEL" PHIL - THE 85100 SPILL FILL BUCKET :3.5 GAL. IN THE 89 FILL. SUAIP- VENT LINE VAPOR LINE UST (REF) SEE SCOPE OF WORK FOR SUMP(S) AFFECTED TYPICAL FILL SUMP DETAILS N.T.S. rrye g., C SITE PLAN 4 CHEVRON # 98119 7368 N. FIGUEROA SPILL FILL BUCKET 3.5 GAL LOS ANGELES CA 90041 PHIL - TITE 85100 PLANS PREPARED BY: FASTECH FUELING & SERVICE TECHNOLOGY INC. 7050 VILLAGE DR. BUENA PARK, CA TELEPHONE (714) 523-0194 FAX - 1 -800 - 980 -5777 LICENSE # 794519, CLASS A, HAZ, C21 EXPIRATION: 5 / 31 /13 SHEET 2 OF 2