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HomeMy WebLinkAbout1801 BRUNDAGE Lane (2)I T rn� M000.3 ALARM 3 SPRUKLER SYSTE VMS SPMY BOOTH AST UST Permit No. - IV�IN�V� 69 --IE File Number: Date Rece-Mad: Permit No. Permit No. Permit No. Permit No. Permit No. Aa WdCM%* J 3-T Z.9 Address: can Bakersfield, CA 933.---- 'NOW Mod. 0 ❑ Commercial Hood System ❑ ❑ FIV-6-Algr I M Sy$t. 'MI ❑ ❑ Fire Sprinkler Systom 0 systs M... ❑ ❑ Aboveground Swage 'Tank 0 Underground Storage Tank minor modification Und,ergrd,und,Slorage Tank removal Underground .Storage Tank Other: Business Name: .. A wc-o - 4G I OULPAI SQUARE FEET: - .. B Scj: FeetA., Calculation Bidd.41Sq-. Ft.' I, ,2. I 4. MIjjEAM§J)LWT I NO 1� Comments: -4/— i Aj&C=- �60 —i 70 IE UNDERGROUND STORAGE TANK B B R S F i Cr PERMIT APPLICATION FIRE TO OPERATE AN UST Au PERMIT # TYPE OF APPLICATION (CHECK) OPERATE NEW FACILITY BAKERSFIELD FIRE D41PARTMENT Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 ❑ TRANSFER OF OWNERSHIP ❑ OPERATE AN EXISTING FACILITY ",F.' ^r _�. .`'rc ¥• - r;'T=Y`r'y -�,`'. ��5'ny 3 y �`•Y'.IR'. �✓ � t ^ .r'1` T�,'�pe '«`�'"r. `y``^",�r _.'�.a- 'f" °"„ `^^^^J „ -, NAME,',, PHONE-# r1 - ADDRESS ,'+ CITY' ZIP CODE•" ti3' 4' � r 't'•5, y�". ,is -..PFD- '<. f;A -.s.,x +FJ- if� ""'wii3 =�' -:. y. '�i� r�f .u't ��"�•`� tea. �„ .„,'�Mr "Y... , ',3: '=;?�, -� `.s`v 'sru� _ '.3:i, «, . ,r �y ^rmy. r..o/r,s• .'�r� ^," ;..�.,- .,ta,,,"# r :�.,/:�Rnt, Tom?/ v:.,, a4 :.SrYK.l;..,.,1. <.,.5.....:`ftFY w='+' 3i... i,. S.-,J s� ,r2,.,./t.:s'O.IJ:`���'." -°-41d �S. 1' N�'� «J.g{[{t%'�}sxa�%A.rr:4a5'1 �'" <io1':� -'i r, Ff-; �y" Sp: i..«r t3.`. �' w�.- ll: �r', �3e�' J". G. �, f.. �. i;„ H. s...✓.. xi; 3':.:: x��{' .`<:^ r.f' S�Gi'".;, sL< �1- .<.- l #.��.«.�,.�!�'c.`��31.,. .f�AF%i,..h�'�iC.r!'lJt? .NAME -- PHONE # Have you filled out a HAZARDOUS MATERIAL BUSINESS PLAN? ❑ YES ❑ ADDRESS /- - r CITY =, t - i .,. - '' ,'. •;,.i': ZIP CODE BILLING ADDRESS '` i �PERATO CITY -' •^ '` ZIP, CODE " 'd °.= =, =r.^ r ;^•r-y'a•.<'?r �r~w z r +.+%� �z �. , S1r,'.'✓r.��'�.v: =,' ^�k� r n'�::..v�. �,n... TANK'= 'f =" i r ai`.. ".;'is;;.'r�� ^r;+r• ..;,.,e `, ..n, z�. - �; °O R:� i d ffe`r'entf om ^OWN )T. - �'rr�.�',t:. ^ry`„ C`k:,4E,N't M. L..:�s� =•,. a.n`w •, ,. i.� '�ry, x . "ne5,= «�• ",,. w,,. #•r' ". /r'.' r. , .�"vJ? _ �� ,>a - - - � ::age- , e - :,,7�..7F`" .. _ _ •.,:'rR°" "fig rr,:' ] . .: �v{'K- °: ..'�Y'r � %` -'<' - .,:. %, -r 3' � �; , ,''.,"ua•_ ._,�._. ..}r „, .u9rr�r,F't��.. L,�t •- .,.�'i,.. ,:cf "<'. �,�r�.,�`'vr�rr „J,�;�';, itm,_`r ,n, i�n�^rii'�-,�,7+ ?. .t ,�7��:- b.�.;�i;=. ,.._- iran,<. ,,:n., ,�•::.;� _;i�,,?�� , n a�. � � ro + -,. i r «.r.,'s:: r .;k,,y: �'r.� -„r� n.'7..�v, .Xr�z�a,:F�'�§ NAME PHONE# ' ADDRESS CITY IP CODE ;�uY- ;...✓•�. �, '=`-1' i'r ^S: v�.p.: .�:;i,�'w" ',,+„ .N >�J;+: ,r. ..d °•. r; k1;~W;,, p,7,. ,5:'��,z:.4.4 "`r'.4"4;•4'; ,r. t +i�, ;r .k "kK -, {T' ifti3 =FSif�d�fferent ��`",§'�.�$,r�•��i : r.�^��� ;..:,,.�.;•^ '.,? � ".,r , ,�,.. ,e. F^ .tea., � .rAPPLI_GANT�NAME from�OWNER -'- >�k:'k� . , � ;:x'�- mm,3.._.,M,�i ttilri_., e "i�ira,. �� w�M: aaPi - »r• ..Lr:r .>s.,. ia;r -�#"._ w_t "_,. P,n�.:.. a, ^(�:, v'3. ,�!�'.a,, n ^i�?,,..sz, .. =a�.,.'�... `%` o.�s'�.fi�,k.._._,a,,_. ":_b+°+f: ' NAME ebriaa � j,( PHONE # �T C _ ADDRE4O CITY A-Vcacj ZIP CODE S r ,..r...,. +:,nom z.�t• - - - -. ff.y .5i 4 � .%5. f - , .W'£�"izlt= '3iF��ery', kR3uL�;yh2 =Sir�Ty,'~3yi �qu�Fz 3Plss7.�K. E�� FACILITY NAME OPPERATOR NAME PHONE # - 33 ADDRESS l Cam, E �" � 1 E 1 T ZIP CODE DEC I\ I��'rn t l Y ct" - �J� •(_ _�}r ' f. +'.x„ ±y�Sp� -: +a, Eh1�ERGENCY "CON�TACTv.��i 't•,� ,y �F�r�= ��:r�'s�''' t y{,�*>rili�' }.�,. -- J t,�• �,k, _ „_�rxn: �?„ }S. a•`.'. .ra•_ , r: >�., -�.0 u`� «. ,tom''. NAME PHONE # (�qv 57-> ADDRESS �bq6 V-el ulow pNe- 0..- V' CITY � %- ZIP CODE 33© J •rt•' ^mow., . _ ....r,a= ,. ,_.w 0 • ...- u., .,:\"..Ei y y .. �S..e rFwa, `, dv'Y - - ''Yrfi� Z'•a „„�;+ .zip r `'7`^., ..i � ` -i A ,.I , fi %^ .'t:;fr`� " -•� .y t i .�.: c� dr'v -, •rY. fl}= 'fli:.J�t?ny `tar ,R mi . ,k ./ -;iii: `.•xS?,i "ri � 'r'(. itf i;- i ..,!__ :':,'.(`• 44 '' .. xf':,w •.?:a ^ „�` ,G .�' u� t. Y � 'ITT!- _ rte.. _, TANK^ INFORMATION-- ��a�rti �r :,rJf_,r,.r_.,�:R.�r,:�' ➢a = "-it Era:.= �r.c__ YAa,,b�'k�s+�c,xi^�,v•Ir�:.a�:4 •: t'r %TANK'. #r. ,;,.; .'', `,, VOLUME',r '- -' DATE INSTALLED .'•;SUBSTANCE STORED '' PREVIOUS�SUBSTANCE —il Li Do you have a HAZARDOUS MATERIAL RESPONSE PLAN? ❑ YES ❑ NO Do you have an OWNER /OPERATOR AGREEMENT? ❑ YES ❑ NO Have you filled out a HAZARDOUS MATERIAL BUSINESS PLAN? ❑ YES ❑ NO FOR OFFICIAL USE ONLY The applicant has received, understands, and will comply with the attached conditions of the permit and any other state, local and federal regulations. This form has been completed under penalty of perjury, and to the best of my knowledge,-%. --:tom nd caFrpct. RE 'APPLICANT NAME (PRINT) // APPROVED BY THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FD2087 (Rev 06107) ,,, „- • `.� t .,:.: BILLING & PERMIT STATEMENT i0"O"A",11�- 1 B_ R R S F 1' D PERMIT # ��+,1 i O 1 ARTM IT BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, lSt Floor Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. OFFICE US nNl V 121 ❑ PERMIT TYPE Alarm - New & Modification (minimum charge) FEE CALCULATION $280 TOTAL DUE ACCT NO 0 Over 10,000 sq ft $0.028 x sq ft SITE INFORMATION Sprinkler - New & Modification (minimum charge) $280 LOCATION OF PROJECT r u ujcaoc( ❑ PROPERTY OWNER M3 $0 .028 x sq ft i W_ l v1C- STARTING DATE COMPLETION DATE Minor Sprinkler Modification (<10 heads) NAME( Y�1 marw 84 PROJECT NAME ptwo M $470 ADDRESS M+ yew- o fie- PHONE # U -3 3 PROJECT ADDRESS $58 CITY P7/ CICF(�J�I�i( -D STATE C� ZIP CODE i Spray Booth (New & Modification) CONTRACTOR INFORMATION 98 ❑ Aboveground Storage Tank (1 inspection per installation) AST CONTRACTOR NAME CA LICENSE # 82 TYPE OF LICENSE EXPIRATION DATE PHONE # CONTRACTOR COMPANY NAME 82 1 Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR $109 /tank FAX # ADDRESS • Underground Storage Tank (Installation /Inspection) NI CITY IZ 82 ZIP CODE All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. OFFICE US nNl V 121 ❑ PERMIT TYPE Alarm - New & Modification (minimum charge) FEE CALCULATION $280 TOTAL DUE ACCT NO 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 heads) $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,or Inspect'n) ATR $109 /tank 82 • Underground Storage Tank (Installation /Inspection) NI $878 /tank 3 3 IZ 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 NOTE: $96 /hr for each type of test/per site even if scheduled at the same time TT $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 BAKERSFIELD CITY, FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work InsDection Reauest Phone No. (661) 326 -3979 DESCRIPTION I DATE I SIGNATURE OVERFILL PROTECTION ELECTRICAL SEAL -OFF SECONDARY CONTAINMENT 7-1m, MODIFICATIONS MINOR/ MAJOR UST REMQvAl DESCRIPTION DATE SIGNATURE DESCRIPTION DATE SIGNATURE PRIOR TO OPERATION OF ANY SYSTEM, ALL UST AND /OR AST SYSTEMS SHALL BE .INSTALLED, COMPLETE AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT. i DESCRIPTION DATE SIGNATURE BACKFILL CONTRACTOR PHONE # PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAL -OFF DESCRIPTION I DATE I SIGNATURE OVERFILL PROTECTION ELECTRICAL SEAL -OFF SECONDARY CONTAINMENT 7-1m, MODIFICATIONS MINOR/ MAJOR UST REMQvAl DESCRIPTION DATE SIGNATURE DESCRIPTION DATE SIGNATURE PRIOR TO OPERATION OF ANY SYSTEM, ALL UST AND /OR AST SYSTEMS SHALL BE .INSTALLED, COMPLETE AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT. i JOB DESCRIPTION ,,U ;4X ( OCCUPANCY TYPE OWNER Aeco PERMIT NO. CONTRACTOR PHONE # FD 1743