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Home My WebLink About1830 FLOWER StreetHOODS ALARMS SPG°3NKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: Z,,,?3r / Address: IT, 3a 571 . Bakersfield, CA 933 Date Received: 140-1-16 Business Name: 7-A4 C... SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG New Mod. ❑ ❑ IE ❑ HOODS ALARMS SPG°3NKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: Z,,,?3r / Address: IT, 3a 571 . Bakersfield, CA 933 Date Received: 140-1-16 Business Name: 7-A4 C... 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 ❑ 11�- Other: '-'� yYl C.., Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: 11. 2. 3. 4. Date Time Signature Signature IE CONFIDENCE UST SERVICES, INC. City of Bakersfield Kern Medical Center (MC, 10/21/10) �s -- Citibank Checking Permit 9/29/2010 10133 192.00 192.00 UNDERGROUND'ST.ORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION PERMIT # ❑ ENHANCED LEAK DETECTION ❑ TANK TIGHTNESS i IAJ!R JrNr n BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 Phone: 661- 326 -3979 • Fax: 661 - 852 -2171 Page 1 of 1 ❑^ /LINE TESTING 11 SB -989 SECONDARY CONTAINMENT lid FUEL MONITORING CERTIFICATION FD2095(Rev 06/07) SITE' INFORMATION - FACILITY C0. NAME & PHONE # OF CONTACT PERSON I — 2 ADDRESS 10 d pAk-' ER�SFI E5L.D, CA- OWNER NAME OPERATOR NAME -T PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES O NO TANK # VOLUME CONTENTS TANK TES TING•COMPANY• ' TESTING COMPANY �' CL U S2r (VC , NAME & PHONE # OF CONTACT PERSON Y n 5 CLF to - e�4 . MAILING ADDRESS I. 25 0 , s �� . Cif -33 14 NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR CERTIFICATION # DATE L &`TIME TEST PTO` BE CONDUCTED OCA-0 L1 ICC # T�E�ST. METHOD APPLICANT SIGNATURE - DATE 912V\ o THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095(Rev 06/07) MLING & PERMIT STATEK AT ' Il •Aid h 'R S F 1 3 11, ll PERMIT # ARTM�Nr �j411.; QQ d gig 9'QW.ILI�Y BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Avenue, Suite 401 Bakersfield, CA 93301 Phone: 661- .326 -3979 o Fax: 661- 852 -2171 FD2021(Rev 06/07) 1 - ORIGINAL WHITE (Treasury) I!- YELLOW (File) 1 -PINK (Customer) SITE INFORMATION LOCATION OF PROJECT I i<MC 630 �LUXIr Si. cm3a> STARTING DATE -TWE i PROPERTY OWNER Kex_r� NAME - - -- — - - - – - -- PROJECT NAME K CA l \ C ADDRESS PHONE# PROJECT ADDRESS ,��ey �� k� �� 1 CITY P>AKE- R.SFIE(D STATE CA ZIP CODE CONTRACTOR CONTRACTO-RR NAME CA LICENSE Jl 1<,-I D1) 1�x }ins ��a� T INFORMATION TYPE OF LICENSE EXPIRATION DATE Ls' PHONE # �, (C, 10 CONTRACTOR CO PANY NAME ..( 't 1• ADDRESS CITY f� � C 14111''1 ploo, 8 ck FAX # ZIP CODE � r All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. ❑ Alarm - New & Modification (minimum charge) ( $280 .' mi, 84 98 ❑ . Over 10,000 sq ft i $0 .028 x sq ft ■ ■ 84 98 ❑ Sprinkler - New & Modification (minimum charge) $280 ■ ■ 98 ❑ Over 10,000 sq ft $0 .028 x sq ft ■ 84 98 ❑ Minor Sprinkler Modification ( <10 heads) $96 (inspection only) ■ 98 ■ ❑ Commercial Hood (New & Modification) i i $470 I ■ ; 84 98 ❑ Additional hood { $58 ■ ■ ■ 84 98 ❑ Spray Booth (New & Modification) $470 ■ ■ 84 98 ❑ Aboveground Storage Tank (Installation /One Inspection) I $180 r ■ 82 ❑ Additional Tank $96 ■ 82' ❑ Aboveground Storage Tank (Removal /Inspection) $109 ; 82 ❑ Underground Storage Tank (Installation /Inspection) $878 /tank ; 82 ❑ Underground Storage Tank (Modification) j $878 /site . 82 • Underground Storage Tank (Minor Modification) I $167 i ■ 82 • Underground Storage Tank (Removal) j $573 /tank ■ 84. • Oil well (Installation) $96 ■ a 84 Mandated Leak Detection (test) /Fuel Mont Cert /SB989 NOTE: $96 for each type of test /per site even if scheduled at the same time $96 /site ■ ■ ■ 82 ❑ Tent 1 $96/tent ■ F 84 ❑ After -hours inspection fee $121 ■ a ❑ Pyrotechnic (per event, plus inspection fee of $96 /hr) $96 + (5 hrs min standby fee /insp) =$576 v 84 • Re- inspection /Follow -up Inspection $96 /hr o 84 • Portable LPG (Propane): # of Cages? ! $96 ■ 84 • Explosive Storage $266 ■ 84 ❑ Copying & File Research (File Research.fee $34 /hr) $0.25 /page ■ 84 ❑ Miscellaneous I 84 FD2021(Rev 06/07) 1 - ORIGINAL WHITE (Treasury) I!- YELLOW (File) 1 -PINK (Customer) CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R S P I D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 6RTM r Office Phone: (661) 326 -3979 10- 10000316 Date 10/07/10 1830 FLOWER ST FIRE DEPT 0 Contractor OWNER ---------------------------------------------------------------------------- Permit . . . . . . MANDATED LEAK DETECT TEST Additional desc . . Phone Access Code . 1039213 Permit Fee . . . . 96.00 Plan Check Fee 96:00 Issue Date . . . 10/07/10 Valuation . . . . 0 Expiration,Date . 4/05/11 ---------------------------------------------------------------------------- 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 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 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) of the Division 3 of the Business and Professions Code and my license is in full force and effect. Lie. Class Lie. 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 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 1 certify that I have read this application and state that the information contained herein is correct. 1 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 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 DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT, SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK OFF AST REMOVAL DESCRIPTION DATE SIGNATURE PRIOR TO- OPERATION OF-ANY-SYSTEM, ALL UST AND /OR AST SYSTEMS-SHALL BE .INSTALLED, COMPLETE AND ACCEPTED BY n 'THE BAKERSFIELD CITY FIRE DEPARTMENT. • JOB DESCRIPTION t'�i/ OCCUPANCY TYPE OWNER PERMIT NO. — CONTRACTOR ;deK1e to PHONE # 6 -0S• D FD 1743 p #F IDFti v p� N0 0 V*1 V "COMPLIANCE WITH CONFIDENCE" September 28, 2010 CITY OF BAKERSFIELD Attn: David-Weirather Office of Environmental Services Fire Department /UST Program 2101 H Street . Bakersfield, CA 93301 To Whom It May Concern: Enclosed for your approval, please find Application to Perform Fuel Monitoring Certification and Billing and Permit Statement, along with.our check in the amount of $192.00. Please fax the approved Applications and- p6rmit fee receipts to our office at 661 - 58.7 - 9758. Should you-have any.questions, please feel free to contact me at 631 -3870. Thank you for your attention herein. Enclosures Yours truly, CONFIDENCE UST SERVICES, INC. Karli Karns, Dispatch Coordinator 16250 Meacham Road • Bakersfield, CA 93314 (661) 631 -3870 or (800) 339 -9930 FAX (661) 587 -9758 ��ityy �ifi`Hal��rsfieIQ "4 CtISTMER..R.ECEPT. „ 4!p2r: MR31RFORD .. Tyue,. OC ' .DraWere Dit @ �►I iieceiPt ire: ..•3 9&6 f i tiai?: ileantity Ae�a�nt. i 4•;� , .., BUILDING PERMITS j 3 0133 192:d!i� �. 1Gt31 teodel -4 T- an. .dca.t, ;'¢fir.,, POPULAT • - "�Y -`, �? fir;: F..;�; »%a ?� e:..3M�. - � . �y�� ?r.,.r r�lh=:1^.a:c:;` k'�': PtA ;Ef'NVt?R'- �lEUTER `