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HomeMy WebLinkAbout1801 BRUNDAGE LaneCONSTRUCTION eeamr - -7i11 J BAKERSFIELD FIRE DEPARTMENT _ PREVENTION SERVICES B' E R S F I D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 ARrM T Office Phone: (661) 326 -3979 Application Number . . . . 10- 10000008 Date 1/08/10 Property Address . . . 1801 E BRUNDAGE LN ATN (11 Digits): 167- 010 -06- - Application type description FIRE DEPT Subdivision Name Property Use . . . . . . . . Application valuation . . . . 0 Owner Contractor ----- ---------- --- - - - - -- -- ---- ---- OWNER Permit . . . . UNDGRND STR TANK INSTALL /INSP Additional desc . Phone Access Code 971416 Permit Fee . . . . 439.00 Plan Check Fee \' 439.00 Issue Date . . . . 1/08/10 Valuation 0 Expiration Date . . 7/07/10 ------------------------------------------------------------------=--------- Fee summary ----------- - - - - -- Charged --- - - - - - -- --- Paid Credited ----- -- ---- - Due Permit Fee Total 439.00 - - - -- ---- 439.00 .00 - - - - -- .00 \ Plan Check Total 439.00 439.00 .00 .00 Grand Total 878.00 878.00 .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 after180 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Permittee: Date: EIAZARDOUS 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 pequry 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 al. ^� Lure prior to its issuance also requires the applicant for such permit to file a I ions of the Contractors License Law (Chapter 9 commencing with Section 7000 of 1 to is exempt there from and the basis for the alleged exemption. Any violation of S4, : to a civil penalty of not more than five hundred dollars ($500)): I, as owner of the property or my employees with wag-. offered for sale (Sec. 7044 Business and Professions C or improves thereon, and who does such work himself intended or offered for sale. If, however, the building, burden of proving that he or she did not build or imprc' I, as owner of the property, am exclusively contractinj Code: The Contractors License Law does not apply tc project with a contractor(s) licensed pursuant to the G I am exempt under Sec. 5£;T�:4T @0 °5TS£4 IB. & P. C. for print... Owner Signature WORKERS COMPENSATION DECLARATION I hereby affirm that under penalty of perjury one of the foil+ I have and will maintain a certificate of consent to sell for the performance of the work for which this permit I have and will maintain workers' compensation ins for which this permit is issued. My workers' compensi MOW, .4af'•a: 44!punp U0 i207 105Ni 2£c4'3 - ou'1rl1aaa;, J@ T :.ia+teaQ a, :?dAi- .AHM8 MRS(; • �ildt35,t3Y.� �A n4 (� . ition insurance carrier and policy number are: Carrier Policy No. is not intended or if property who builds 'improvements are not r- builder will have the isiness and Professions contracts for such Date 700 of the Labor Code, 4 imance of the work 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. CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES B B R S F I Vy 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 k.. Office Phone: (661) 326 -3979 Application Number . . . . . 10- 10000008 Date 1/08/10 Property Address . . . . . . 1801 E BRUNDAGE LN ATN (11 Digits): 167 - 010 -06- - Application type description FIRE DEPT Subdivision Name . . . . . . Property.Use . . . . . . . . Application valuation . . . . 0 Owner Contractor - -- ------ --------- - - - - -- ---- - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . UNDGRND STR TANK INSTALL /INSP Additional desc . . Phone Access Code . 971416 Permit Fee . . . . 439.00 Plan Check Fee 439.00 Issue Date . . . . 1/08/10 Valuation . . . . 0 Expiration Date . ---------------------------------------------------------------------------- . 7/07/10 Fee summary ----- ------ Charged Paid Credited Due - - - - -- Permit Fee Total --- - - - - - -- ---- 439.00 - - - - -- ---- - - - - -- ---- 439.00 .00 - - - --- .00 Plan Check Total 439.00 439.00 .00 .00 Grand Total 878.00 878.00 .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 after180 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 Agent 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. OWNER-BUILDER DECLARATION Exp. Date Contractors Signature Date 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 mason - 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 MEMO= Date CONSTRUCTION PERNUT BAKE RSFIELD FIRE DEPARTMENT PREVENTION SERVICES B OR S F ID 1501 TRUXTUN AVENUE, 1sT FLR FI BAKERSFIELD, CA 93313 *ARl'r'ffNlflr Office Phone: (661) 326 -3979 Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner 10- 10000008 Date 1/08/10 1801 E BRUNDAGE LN 167- 010 -06- - FIRE DEPT 0 Contractor OWNER ---------------------------------------------------------------------------- Permit . . . . . . UNDGRND STR TANK INSTALL /INSP Additional desc . . •• • Phone Access Code 971416 Permit Fee 439.00 Plan Check Fee 439.00 Issue Date 1/08/10 Valuation . . . . 0 Expiration Date• .•• . • 7/07/10 ---------------------------------------------------------------------------- Fee summary ---- ------- - - - - -- Charged ---- - - -- -- Paid Credited "---- Due Permit Fee Total ---- 439.00 - - - - -- ---- -- - --- 439.00 .00 - - - - -- .00 Plan Check Total 439.00 439.00 .00 .00 Grand Total 878.00 878.00 .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 afterl 80 days of inactivity. I have reviewed the above application, and find it to. be correct/complete. Permittee: i 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 Agent one 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 pursriarit 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 complexion, 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 theion 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 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 Date