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Home My WebLink About2011 sb989 FILEIE Fite. Number� z 3 KAddress: _ .. Bakersfield, CA 933 ate Received:',.._ i ' m "B ' es us n s'`tVa e:" '. SYSTEM: BUILDING SQUARE FEET-j-, 4: " INSPECTION LOG. 6 .. } meriaU O i Hood S ste m:, , Buildin S Feet- Date` Time' =��m Fir 1` C]' e A arm';S stem : = _ Calculation Btd Sq.-Ft--. 1: i a= 'O. a Sbdrikldr S �steih?,:- • y.,x, ," .- -.;2 - n e .3. !•� _ 'L Y �� ;.� o ve round StoMae 'Ati "� :Farek' .� I' r T ❑� U e ound Stiora"e ank' nii erg _.9 _9 - � Y 's /'Cif _`'• _ , Y - :. minor_ -•� . ignature . Under round -Story a Tank:. - :modification _ 9 _ . 9 " -+ - I4•, :$ " round Sto ank'ra a ' - ' - Hp _ - -na ur ®: t Other.: _ / Comments ^a .. 1. r' Z� NC; DG - =5." �y.s" "� -.. - � T�N� DtXa/i11c�Y -�' US y.• _ - :.r �. ° - •- /5/Lf)IJC� %, )5 `LC� �' C.:IJ�M� I� -AJ �,C' .. ,�•C.0 .. lT.- ��, 7 L��- • G" � ��% 3. _ - CLDS.tr, I wPi2oi"oo ;P fief12 ,' IIIIIII �1� ,e CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES B B R S F I D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 A R TM T Office Phone: (661) 326 -3979 Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use Application valuation . . . . Owner ------------------ - - - - -- CHEVRON USA INC P 0 BOX 1392 BAKERSFIELD CA 93302 11- 10000153 Date 5/02/11 1125 COFFEE RD 501- 010- 06 -01 -2 FIRE DEPT 0 Contractor ------------------ -- - - -- OWNER ---------------------------------------------------------------------------- Permit. .. . . . . . MANDATED LEAK DETECT TEST Additional desc . . Phone Access Code 1093087 Permit Fee 96.00 Plan Check Fee 96.00 Issue Date 5/02/11 Valuation . . . . 0 Expiration Date 10/29/11 ---------------------------------------------------------------------------- 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: 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 hone 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) of the 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 I 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 of the city to enter the above mentioned - property for inspection purposes. Signature of Applicant or Agent I I Date BAKERSFIELD CITY FIRE DEPARTMENT -- INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Request P"tone 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 UST REMOVAL DESCRIPTION DATE SIGNATURE MISC. ACTIVITY REMARKS: AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE {PRIOR TO OPERATION-OF ANY SYSTEM,l ALL UST AND /OR AST SYSTEMS SHALL BE INSTALL, COMPLETE AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL) BUILDING ADDRESS: JOB DESCRIPTION: OCCUPANCY TYPE: OWNER: PERMIT NO. //— t" CONTRACTOR: Ao) PHONE 7/ —03 b' FD 1743 131LL11VU Ck VCKM1 1 ,1 A 1 CM PERMIT # B H R 9 F] n FIRE ARTM r Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661 - 852 -2171 FD2021(Rev 05/10) SITE INFORMATION LOCATION OF PROJECT � ' /'+ PROPERTY OWNER l STARTING DAT / COMPLETION DA ZU 11 —� NAME jl' , (O ^ P NAME lJ ADDRESS vw TH NE — PR ADDR s �OIC CITY _B A ICERSFI ELD STATE t✓' f� ZIP '✓{ CONTRACTOR CONTRACTOR NAME CA LICENSE # INFORMATION TYPE OF LICEN EXPIRATION DATE PHONE # CON RA C MPANY F # ADDRES CITY 0 ZIP CODE �/ _ ^ /Vyw/�C•� /• All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK, 7Ei 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 heads) . $96 (inspection only) 84 ❑ Commercial Hood (New & Modification) $470 ❑ Additional hood $58 • Spray Booth (New & Modification) $470 98 • boveground 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 $M/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/ 989 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 ❑ 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) A 40 .. 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 # ;� ® BAKERSFIELD FIRE DEPARTMENT Prevention Services B Bxsrl n 2101HStreet FIRE Bakersfield, CA 93301 ARrN, T Phone: 661- 326 -3979 • Fax: 661 - 852 -2171 OWNER Page 1 of 1 ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING �SB 989 SECONDARY CONTAINMENT ❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION i -. - - - _ - - s,- ',.,,.;, n':•' i , - - - ,.SITE:iINFORMATION;' FACILITY ADDRESS Cc3�� N4I 4E &.PHONE Yt OF CONTACT PERS0�6,._ O1 ` l/Ln/ /u/, �ZcQ e. 33v� OWNER OPERATOR N A ` PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES ' ❑ NO . TANK # VOLUME CONTENTS OOD onv i j�;Yi';'i -.1 - ", -/' :L._•.,.., .,.::n.lr. y`: r '- - _ - - - -_ = r ?i::•�) - 'Ih4•L:nl ail:._• - -_ TANK'.TESTING'COMPANY TE T COMPANY c NA E & PHONE # OF CONTACT PERSO iy v S XuAl, �L R) pri NE & PHO E # OF TE TER OR SPECIAL INSP �i �� 0 �I CERTIFICATION # DATE & TIME TEST Tjq BE CONDUCTED L' I °5 ICC # „� �v1 ��03V I' TEST MET OD rte V� dl APP ICA SIG ATURE ._.._ DATE gp LICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE _2 —�� FD2095 (Rev 03/08) h,e f-• C. t� WAY{dE pERRY INCORPORATED O g 3 9 9 7. J VENDOR ID VENDOR NAME 1 PAYMENT NUMBER CHECK DATE �BAKERSFI BAKERSFIELD FIRE-DEPARTMENT 115697 4/27/2011 / VOUCHER NUMBER INVOICE NUMBER INV. DATE INVOICE AMOUNT AMOUNT PAID JOB # /DESC.\\ NET AMOUNT 1200980 9 3997C 4/27/2011 $192.00 $192.00 11123 $192.00 I \ $192.00 $192.00 L �'' $192:00 1 I ` J 3_�13VIIO03 NdON — NOEIHO V ION — 3-19VI-LO9,3N ION A3_-lH' 0 V ION — 3-10VII11093N ION NOT A CHECK — NOT NEGOTIABLE — NOT A� CHECK'— NOT NEGOTIABLE — NOT A CHECK- 3_l3VIiO93N 10� — NO3HO V iON —,,, 3_19VI I O!D3N I ON — �10311-10 V ION — 3-19VII003N I ON NOT A CHECK —NOT NEGOTIA, BLE —,NOT A CHECK —NOT NEGOTIABLE —NOT A CH�,CK 3_1!9VIlO!DDNiON—N33H0V_LON/ D-19VI-LO03N ION —)<D3H0 V ION — 3-10VI 1093 , 'N ION NOT- A CHECK — NOT NEGOTIABLE — NOT A CHECK — NOT NEGOTIABLE — NOT A CHEECK 3_19VUO93 N ION — )II03HO V ION — E119VII093N ION NO3HO V ION 1319VII00AN ION NOT A C"�ECK — NOT N EG'0Ti"A-BLE':ll'-, .,NOT ECK`�'-N'bT',N�-'b'bf'r A- C H B'LLE,"..c �FISIVIIO!D�31\1 ION — N,,' 0_31HO V, ION i-.-371SIVIIOD�3NION —ADDHO VION — D-19VII0 :]NiON NOT A CHECK NOT NEGOTIABLE NOT'A CHECK NOT NEGOTIABLE NOT A'- 'CHECK :;I-iovi.ibC��]N ION. NODH5 V ION —:l�!dvIIo!D_qN IOW— Nb3HO V ION lSVIIOQ:_lN7_LON NOT A CHECK — NOT NEGOTIABLE —,-NOT A CHECK — NOT NEGOTIABLE NOT A CHECK 3_12IVIIO!D�314 ION —,NO:3HO V ION.— ION — NODHO V I ON — D-10V/1 I O!D-A.N,ION