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Home My WebLink About3150 PANAMA LANEPerm1 t # ~ -/Z~'TC~_. z aC", ~,, ~_ .~,,,~ ..... ~_z~,-.de,. ~-z.-'~_..~ ( INSR LO~ TI~3E D ~Fire Sprinkler Sys. D Calculation '~ - HAZARDOUS, MATERIALS STATEMENT - ' rn Yes Cl No Wiil the applicant or future occupant handle ~rd~.4'materi~For a mi:~tu~nlai~ng ~ haZaM0us material equal to or hq'eater than ~he amounts specified on the list of extremely hazardous substances? Sec checff~ffs~ fo[~.'~idelinr, s. :,' ':' "'i O Ye~~ O No WiHthe proposed building or modified facility be within 1000 ti:ct of thc outer boundary ora school? C3 Yes CI No ' Will the intended use of the building by the ai~piicant"0t; fixture building occupant require a permit for construction or modificanon from the Kem County Air Pollution Control District (KCAPCD) or from the Cit~ of Bak. Fire Dept? See checklist for guidelines. Q yes rn 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 CalifGovt. Sec. 65850 and the requirements or'the City of Bakersfield Fire Dept. regarding hazardous materials. OWner or Authorized Agent Phone No ~-~ Date DECLARATIONS: The deeluralions below are mandated by the SI~,te of California under Section 1982S of the Heulth and Safety 'Code. UCENSE CONTRACTOR'S ECL^RA ION I h~eby affirm under p~alty of ~u~ that I am licensl~ under provisions ot'C~{er 9 (co.d~ci~g wi~jSc:tion 7000) of the qi~isi?. 3 or the nusi.css Lic. C,~s Lic. No. E~p.lDa,e / Cont~cto~SirLt~~ '' ~' OWNER-BUILDER DECLARATION I. h~eby affirm that und~ ~alty of p~ju~ that I am exempt t?om the Contractor's License ~w t~r ~e tbllowing reason (S~. 7031.5 Busings and ProlL~sions Code: Any ci~ or couhty which r~uir~ a ~mit to construct, alter, improve, demolish, or repair any structure p~or to its issuance also requi~ the applican~ {bt such ~it to file a si~ statement ~at he or she is licens~ pu~nt to the provisions of the Contractor's Licmse Law (Chapter 9 commencing with Section 7000 of D{vision 3 or th~ Busings and Professions C~c) or that he or she is ex.pt thief?om add the ~is ibr the alleged exemption. Any violation of Section 7031.5 by any'applicant lbr a ~rmit subjects the applic~t to a civil ~alty of not more than five hundred dollam ~ I. as owner of the property, or my employe~ with wages as their sole com~sation, will do the work and the structure is not intended or altered Ibr sale (Sec. 7044 Busings and ~ofmsions C~e: ~e Contractor's License Law do~ not apply to an owner ofprope~ who builds or improves thereon, and who does such work himself or henelf through his or her own employees, provided that such improvem~ts are not int~ded or oflL~ed Ibr sale. IL however, the building or improve- merit is sold within one year of completion, the own~-builder will have the burden of proving that he or she did not build or improve lbr th~ put,sc of sale). ~ I, as own~ of the prop~y, am exclusiyely contracting with licens~ contractors to construct the project (Sec. 7044 Business and Professions Code: The Conm~ctor:s License ~w do~ not apply to an owner ofprope~ who builds or imp~v~ therc~n and who contmc~ {bt such proj<t with a contractods) licensed pu~uant to the Contractor Lic~se ~w). __ I am exempt under Sec. B.& P.e. lbr ~is reason ' Owner Signature Date WORKER'S COMPENSATION DECLARATION I hereby afl~rm thal under penalty of perjury one of the tbllowing_.d/:clarations: I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided tbr by section 3700 of the L~lbor Code, I~r Ihe pcrfi.)nnance of the work tbr which this permit is issued. ~. I have and will maintain workers' compensation insurance, as rc'quired by Section 3700 of t~e LabOr Code. for the perfi~rmance of the work lbr which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy No. I certil~, that in the performance of the work tbr 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 o£Section 3700 at'thc Latx~r Code. I shall tbcthwith comply with those provisions. Applicant: Date. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUl.. AND sHAI.I. SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED THOUSAN[} DOLt,ARS ($100,00Ol IN ADDITION TO THE COST OF'COMPENSATION~ DAMAGES AS PROVID~'.D FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AN[} ATTORNEY'S FEES. CONSTRUC'FIONLENDINGAGENCY :. : · · . . .... ' . . i'. : · [ hereby affirm that there is a construction lending ag6ncy lbr the perlbrmance of the work liar which this permit is issued {Scc. 3097 Civ. C.). Lender's Name I cert~t~' that thaae read this application and state that the it!]brmatio, ca.tai.ed hereia is ~on'ecL I agree to compb' ss,ith all ciO' Ordittances a~d irate laws relating to building co.structio.'a.d~ hereby authorize repre~entative~ DJ'the citr to enter the above-rae, tia.ed propern' /bt $nspectiott purposes. SignatureofApplicantorAgent ':' " Date ..... !'":: ' APPROVED BUILDING DIRECTOR Bv CONSTRUCTION !:;:!~:.?~.~.~.~. s:~' ~:~ ~evenUon Se~ces ....... 7~~ ....:. ',,~¢{:.~I~E. ~am' ~'.' '17.15' CheSter Ave.. ..... , - ~ .~ "~. BakerSfield, CA 93301 Application Number ..... 04-10000230 Date. 11/04/04 Pin number ......... 027880 Property Address . . . ; .. . 3150 PANAMA LN · ..... ATN (11 Digits): 372-021-34-00-4 Application description . FIRE DEPT Subdivision Name ... . .... · Property Use ........ Application valuation .... 0 Owner Contractor MEYER IVAN & ELSIE TR RLH FIRE PROTECTION 2808 LA CRESENTA 310 30TH ST BAKERSFIELD CA 93312 . BAKERSFIELD; cA . BAKERSFIELD CA 93301 ' (661)322-9344' permit ...... FIRE SUPPRESSION ADD/ALT Additional desc . . . Phone Access Code .. 292359 .. ~ . Permit Fee ..... 150.00 Plan Check Fee . .. 60.00 Issue Date ..... 11/04/04.. , .. Valuation ...... Expiration Date . . 5/04/05 Fee summary Charged Paid Credited Due Permit Fee Total 150.00 150.00 ' .00. " ;00 Plan Check Total 60.00 60.00 .00 .00 Grand Total 210.00 210.00 .00 .00 DECLARATIONS CALL FOR INSPECTION .... : . ..., . (661) 326-3979 Permit is issued in accordance withall applicable Federal, Sate and Local Odnanc~s., The permitee has propedy signed and dated the reverse side Please state the Permit Number, the JOb Address, and the .. of this form Type of Ispection. Requests for inspections should be /~This permit expires after 180 days of inactivity. made at least 24 (twenty-four) hours in advance. ..... '1 haf/e re~iewed th~.a/~.e ap'l~,ati°n and find it to be correqt/comp' ::etc.' Inspect°rs °ffice h°Urs are: ~. ~ff~Ol.~,~/~/~ ~ l/~/~r~,)~ 7 am to 5 pm Monday thru Friday Pe;mi~ O - Dat~ ] BAKERSFIELD FIRE DEPARTMENT -.- INSPECTION .RECORD CHECK LIST TO BE COMPLETED BEFORE FINAL OCCUPANCY For Inspection Request Call Phone No. 326-3979 :BUILDING ADDRESS: ~.[,l~"~...~ '(-T,"/MI~)..~I'~.%.4~,,.i~,, ~ GROUP TYPE: ~ ~OCCUP~CY N~E: ~~~~ ~~~ OCCUP~T LOAD: GENE~L CONT~CTOR: PHONE ~ SPRINKLER CONT~CTOR: PHONE ~ FIRE A~ CONT~CTOR: PHONE ~ CO~ERCIAL HOOD CONT~CTOR: PHONE ~ SP~Y FINISH CONT~CTOR PHONE ~ FIRE SUPPRESSION SYSTEM DESCRIPTION DATE SIGNATURE UNDERGROUND DEPTH, PIPE SIZE & THRUST BLOCKS FDC, PIV, WITH ATTACHMENT SIGNS UNDERGROUND HYDRO TEST UNDERGROUND SYSTEM FLUSH OVERHEAD PIPE & HANGER INSPECTION FIRE PUMP TEST RISER, FIVE YEAR START DATE SPRINKLER CALCULATION SIGN AT RISER LOCATION FIRE ALARM SYSTEM & ASSOCIATED EQUIPMENT DESCRIPTION DATE sIGNATURE FIRE ALARM INSTALLATION PER PLANS SMOKE DETECTOR TEST H~T DETECTOR TEST D~PERS, FIRE DOORS ELECTRICAL & A~ TEST FIRE PUMP RUN & A~ ~NUNCIATION TEST EMERGENCY GENE~TOR RUN & LOAD TEST CO~ERCIAL HOOD INSTAL~TION & TEST EMERGENCY LIGHTS EXIT LIGHTS LOW LEVEL EXIT LIGHTS, (A,E,I & Al) OCCUP~CIES SP~Y BOOTH TEST DATE SIGI~TU~ 'FINAL INSPECTION COMPLETED ON ~,/~.21('~/~J//~~4~.