HomeMy WebLinkAbout3100 NILES Street_UST SB989 8.6.10VIA 35
Commercial Hood System
HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
File. Number: 466 376 Z. Address: aZpQ /yi (Q.S 67-
Bakersfield, CA 933.
Date Received:
µBusiness Name: C,tn.P.
yrd. SYSTEM: BUILDING SQUARE FEET: 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 GV Other: '5 -0 -
5;
Comments: Building Sq.
Feet: Calculation Bldg. Sq. Ft:
1. C 1r'rJ Ce . C14c zct O
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2.
3.
4. Date
Time
Signature
SITE INFORMATION
FACILITY
UNDERGROUND STORAGE TANKS
ADDRESS ;
es - `
OWNERS NAME
BAKERSFIELD FIRE DEPT.
PERMIT TO OPERATE NO. .
NUMBER OF TANKS TO BE TESTED
JA Prevention ServicesrixA'+;;fA.rWR".st.:r+.!:; Rya' gAC9: frwbrth'. t' A. n. Wts•. a^ J :tiv czTU3z;. °..ty/:edmaAY i.Ri %a, r ,Rl
ry, R ri f 900 Truxtun Ave., Ste. 210
APPLICATION Bakersfield, CA 93301
TO PERFORM ELD / LINE TESTING
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Tel.: (661) 326 -3979
I SB989 SECONDARY CONTAINMENT TESTING Fax: (661) 852 -2171TANKTIGHTNESSTESTANDTOPERFORM
TANK TESTING COMPANY
NAME AF TESTjg COMPANY
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NAME & PHONE NUMBER OF CONTACT PERSON
JVa,r-L; XC - 8(03`7
FUEL MONITORING CERTIFICATION
NAME &,PHONE NUMBER OF TEST`ERR OR SPECIAL INSPECT R CERTIFICATION #:
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Page 1 of 1
PERMIT NO.
TEST METHOD
1,K7 C-o
SIGNATURE OF APPLICAN C DATE D
APPROVED BY G DATE v._/Q
ENHANCED LEAK DETECTION LINE TESTING PF989 SECONDARY CONTAINMENT T G
TANK TIGHTNFSS TFRT El TO PFRFORM FI IFI MnNITORING CERTIFICATION
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SITE INFORMATION
FACILITY NAMk & PHONE NUMBER OF CONTACT PERSON
ADDRESS ;
es - `
OWNERS NAME
OPERATORS NAME PERMIT TO OPERATE NO. .
NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? YES NO
TANK # VOLUME CONTENTS
3 Y2vr-°t
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TANK TESTING COMPANY
NAME AF TESTjg COMPANY
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NAME & PHONE NUMBER OF CONTACT PERSON
JVa,r-L; XC - 8(03`7
MAILING ADDRESS
3(04-3 COL— 9'3-3 of
NAME &,PHONE NUMBER OF TEST`ERR OR SPECIAL INSPECT R CERTIFICATION #:
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DATE & TIME VEST TO BE CONDUCTED ICC #:
591(.e I
TEST METHOD
1,K7 C-o
SIGNATURE OF APPLICAN C DATE D
APPROVED BY G DATE v._/Q
FD 2095 (Rev. 09105)
BILLING & PERMIT STATEMENT
PERMIT NO.:
41 S', . D
4 P /BE
ARTM T
BAKERSFIELD FIRE DEPT.
Prevention Services
1600 Truxtun Ave Ste 401
Bakersfield CA 93301
Tel.: (661) 326 -3979 • Fax: (661) 852 -2171
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All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT.
Alarms - New & Modifications - (Minimum Charge) $280.00 , 84
SITE INFORMATION
LOCATION OF PROJECT PROPERTY OWNER
1 Q
STARTING DATE COMPLETION DATE NAME
Sprinklers - New & Modifications - (Minimum Charge)
2V YCS''n
PROJECT NAME ^
S9VL.J ki `
ADDRESS
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PHONE NO.
4
PROJECTPROJECT ADDRESS 3 kao N \ S +-
CITY STATE
T -k CA
ZIP CODE
INFORMATION
98
CONTRACTOR NAME CA LICENSE NO. J l,m ACS C $ 09 SCE
TYPE OF LICENSE. EXPIRATION DATE
t t)4d) A A4 g
PHONE NO.
8 i
CONTRACTOR COMPANY NAME
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FAX NO.
c92_-O(0001(
ADDRESS _ CITY ^ ZIP CODE
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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 8
Sprinklers - New & Modifications - (Minimum Charge) 280.00 84
98
0 Over 10,000 Sq. Ft. Sq. Ft x.028 = Permit fee 84
98
Minor Sprinkler Modifications (< 10 heads) 96.00 [Inspection Only] 98
Commercial Hoods — New & Modifications 470.00 84
98
Additional Hoods 58.00 84
98
Spray Booths - New & Modifications 470.00
98
Aboveground Storage Tanks ( /nsta/Won/Insp. -1s Time) 180.00 82
Additional Tanks 96.00 82
Aboveground Storage Tanks (RemovaUlnspection) 109.00 82
Underground Storage Tanks (Installation. /Inspection) 878.00 (per tank) 62
Underground Storage Tanks (Modification) 878.00'(persite) 82
Underground Storage Tanks (Minor Modification) 167.00 82
Underground Storage Tanks (RemovM 573.00 (per tank) 84
Oilwell (Installation) 96.00 84
1
v
Mandated Leak Detection (Testing) / Fuet Monit.Ce S 89.
Note: $96.00 for each type of test /per site (even ifsche
at the same time)
966 fpersit a4C, 82
Tents 96.00 (per tent) 84
Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee /Inspection)-_$576_00 84
After hours inspection fee 121.00 84
RE- INSPECTION(S) /FOLLOW -UP INSPECTION(S) 96.00 '(per hour) 84
O 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
FD 2021 (Rev. 06/07)
1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer)
CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
B E R S F I D 1.501 TRUXTUN AVENUE, I IT FLR
FIRE BAKERSFIELD, CA 93313
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T Office Phone: (661) 326 -3919
Application Number . . . . . 10- 10000261 Date 8/31/10
Property Address . . . . . . 3100 NILES ST
ATN (11 Digits): 134 - 040- 23 -00 -5
Application type description FIRE DEPT
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . . 0_
Owner Contractor
TMP CORP OWNER
5800 W MANCHESTER AV
LOS ANGELES CA 90045
Permit . . . . . . MANDATED LEAK DETECT TEST'
Additional desc . .
Phone Access Code . 1029271
Permit Fee . . . . 96.00 Plan Check Fee 96.00
Issue Date . . . . . 8/31/10 Valuation 0
Expiration Date 2/27/11
Fee summary Charged Paid Credited Due
Permit Fee Total 96.00 96.00 .00 .00
Plan Check Total 96.00 96.00 .00 .00
Grand Total 192.00 192.00 .00 .00
CALL FOR INSPECTION
661) 326 -3979
Please state the Permit Number, the Job address, and
the Type of Inspection. Requests for inspections
should be made at least 48 hours in advance.
DECLARATIONS
Permit is issued in accordance with all applicable
Federal, State and Local Ordinances. The permittee
has properly signed and dated the reverse side of this
form. This Permit expires afterl80 days of inactivity.
I have reviewed the above application, and find it to
be correct/complete.
Permittee:
r
Date:
HAZARDOUS MATERIALS STATEMENT
Yes—No Will the applicant or future occupant handle hazardous material or a mixture containing a hazardous material equal to or greater
than the amounts specified on the list of extremely hazardous substances? See checklist for guidelines.
Yes — No Will the proposed building or modified facility be within 1000 feet of the outer boundary of a school?
Yes—No Will the intended use of the building by the applicant or future building occupant require a permit for construction or modification
from the Kern County Air Pollution Control District (KCAPCD) or from the Bakersfield Fire Dept? See checklist for guidelines.
Yes—No I have read the Hazardous Material Guide and KCAPCD Permitting Checklist. I understand my requirements under the Calif.
Health and Safety Code Sec. 6.95 and Calif. Govt. Sec. 65850 and the requirements of the City of Bakersfield Fire Dept. regarding
hazardous materials.
Owner or Authorized Agen Phone No. Date
DECLARATIONS: The declarations below are mandated by the State of California under Section 19825 of the Health and Safety Code.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ofthe Division 3 of the
Business and Professions Code and my license is in full force and effect. , .
Lic. Class Lic. No. Exp. Date Contractors Signature Date
OWNER - BUILDER DECLARATION
I hereby affirm that under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5 Business
and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its
issuance also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9 commencing with Section 7000 of Division 3 or the Business and Professions Code) or that he or she is exempt there from
and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500)):
I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or
offered for sale (Sec. 7044 Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds
or improves thereon, and who does such work himself or herself through his or her own employees, provided that such improvements are not
intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the
burden of proving that he or she did not'build or improve for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon and who contracts for such
project with a contractor(s) licensed pursuant to the Contractor License Law).
I am exempt under Sec. B. & P. C. for the reason
Owner Signature I Date
WORKERS COMPENSATION DECLARATION
I hereby affirm that under penalty of perjury one of the following declarations:
Carrier
I have and will maintain a certificate of consent to self - insure for workers' compensation, as provided for by Section 3700 of the Labor Code,
for the performance of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work
for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Policy No.
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become
subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions
of Section 3700 of the Labor Code. I shall forthwith comply with those provisions.
Applicant: Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN
EMLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST AND ATTORNEY'S FEES
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 Civ. C.)
Lenders Name Lenders Address
I certify that 1 have read this application and state that the information contained herein is correct. I agree to comply with all city ordinances and state
laws relating to building construction and hereby authorize representatives ofthe city to enter the above mentioned - property for inspection purposes.
Signature of Applicant or Agent _ I Date
BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD
Post this Card at the Job Site and DO NOT Remove for Duration of Work
Inspection Reauest Phone No. (661) 326 -3979
LL
DATE
PRIOR_TO OERATION_OATEM
ALL _UST AND /OR AST_$YSTEMS SHALL BE;
INSTALLED,, COMPLETE AND ACCEPTED BYE
THE BAKERSFIELD_CIT_Y_F_IRE _ DEPARTMENT'
t FIRE. DEPARTMENT FINAL
3100 M- S
DESCRIPTION DATE SIGNATURE
BACKFILL
NTRACTOR
l
i PHONE #,3.92-7-69^;7
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT,
SENSORS
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AUTHORIZATION FOR FUEL
ELECTRICAL. SEAK -OFF
LL
DATE
PRIOR_TO OERATION_OATEM
ALL _UST AND /OR AST_$YSTEMS SHALL BE;
INSTALLED,, COMPLETE AND ACCEPTED BYE
THE BAKERSFIELD_CIT_Y_F_IRE _ DEPARTMENT'
t FIRE. DEPARTMENT FINAL
3100 M- SrRUILDINGADURESS
DESCRIPTION - OCCUPANCY TYPE
NER G c,Vrd PERMIT NO. lC rl 6
NTRACTOR
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i PHONE #,3.92-7-69^;7
FD 1743