HomeMy WebLinkAbout215 21ST Street_ust 2010HOODS ALARMS SPRINKLER SYSTEMS SPRAY (BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
/d-
7
File Number: 14Mwz.- Address: a/6 :E' . �=?/ ::ST"
Bakersfield GA,: 933
Date Received: C� - 7 -
Business Name: ems
SYSTEM: I J BUILDING SQUARE FEET: INSPECTION LOG
New Mod.
❑ ❑ Commercial Hood System Bung Sq. Feet: WE9—:P�
❑ ❑ Fire Alarm System Calculation Bldg. Sq. Ft: 1.
❑ ❑ Fire Sprinkler System 2.
❑ ❑ Spray Finish System 3.
❑ ❑ Aboveground Storage Tank 4.
❑ ❑ Underground Storage Tank
minor Signature
modification Underground Storage Tank
removal Underground.Storage Tank
❑ Ca' Other:
Comments:
•' G�•J,P /e's � n
Signature
03
HOODS ALARMS SPRINKLER SYSTEMS SPRAY (BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
/d-
7
File Number: 14Mwz.- Address: a/6 :E' . �=?/ ::ST"
Bakersfield GA,: 933
Date Received: C� - 7 -
Business Name: ems
SYSTEM: I J BUILDING SQUARE FEET: INSPECTION LOG
New Mod.
❑ ❑ Commercial Hood System Bung Sq. Feet: WE9—:P�
❑ ❑ Fire Alarm System Calculation Bldg. Sq. Ft: 1.
❑ ❑ Fire Sprinkler System 2.
❑ ❑ Spray Finish System 3.
❑ ❑ Aboveground Storage Tank 4.
❑ ❑ Underground Storage Tank
minor Signature
modification Underground Storage Tank
removal Underground.Storage Tank
❑ Ca' Other:
Comments:
•' G�•J,P /e's � n
Signature
UNDERGROUND STORAGE TANKS
IAMUd'
BAKERSFIELD FIRE DEPT.
R8FI D
'
Prevention Services
FIRR
ARTN T
1501 Truxtun Ave., First Floor
APPLICATION
NAME OF TEST ING COMPANY Tanknolo Inc.
gy,
Bakersfield, CA 93301 i
TO PERFORM ELD % LINE TESTING
Tel.: (661) 326 -3979 ;
/ SB989 SECONDARY CONTAINMENT TESTING
800- 666 -1130
Fax: (661) 852 -2171
/TANK TIGHTNESS TEST AND TO PERFORM
MAILING ADDRESS 41785 Enterprise Cir
le S. Suite D- Temecula, CA 92590
FUEL MONITORING CERTIFICATION
Page 1 Oil
CERTIFICATION #:
PERMIT NO.
DATE & TIME CONDUCTED: TO B w :
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❑ ENHANCED LEAK DETECTION <10NE TESTING SB -989 SECONDARY CONTAINMENT TESTING
TANK TIGHTNESS TEST PERFORM FUEL MONITORING CERTIFICATION
METHOD
INF -, Xv T 'a,.G
jx D Es.'N` E EE
ORMATIONS
SIGNATURE OF APPLICANT
DATE:
1011AARIMMES
APPROVED BY
A PERMIT WHEN APPROVED
DATE
FACIL Y
i 3040 40
NAME & PHONE NUMBER OF CONTACT PERSON
JUN 2010
ADDRESS �sr
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OPJR'OF ORS AMA- ;
PERMIT TO OPERATE N0,
NU NKS TO BE TESTED
IS PIPING
GOING TO BE TESTED?
❑ YES ❑ NO
TANK# .
VOLUME
CONTENTS
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NAME OF TEST ING COMPANY Tanknolo Inc.
gy,
NAME & PHONE NUMBER OF Deanna Davenport
CONTACT PERSON p
800- 666 -1130
MAILING ADDRESS 41785 Enterprise Cir
le S. Suite D- Temecula, CA 92590
NAME & PHONE NUMBER OF
TESTER OR SPECIAL INSPECTOR:
CERTIFICATION #:
DATE & TIME CONDUCTED: TO B w :
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ICC #: �/� % —U�
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METHOD
SIGNATURE OF APPLICANT
DATE:
1011AARIMMES
APPROVED BY
A PERMIT WHEN APPROVED
DATE
FA XE D -. .
JUN 2010
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CONSTRUCTION PERMIT
Application Number . . . . .
Property Address . . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
BOTTLING GROUP LLC
1 PEPSI WY
10589
10- 10000187
215 E 21ST ST
016 - 140- 05 -00 -1
FIRE DEPT
0
Contractor
OWNER
Date 6/23/10
----------------------------------------------------------------------------
Permit MANDATED LEAK DETECT TEST
Additional desc .
Phone Access Code 1012392
Permit Fee . . 96.00 Plan Check Fee 96.00
Issue Date 6/23/10 Valuation . . . . 0
Expiration Date 12/20/10
----------------------------------------------------------------------------
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:
BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
R S P ID
1501 TRUXTUN AVENUE, 1sT FLR
FRBE
BAKERSFIELD, CA 93313
:RTM T
Office Phone: (661) 326 -3979
Date 6/23/10
----------------------------------------------------------------------------
Permit MANDATED LEAK DETECT TEST
Additional desc .
Phone Access Code 1012392
Permit Fee . . 96.00 Plan Check Fee 96.00
Issue Date 6/23/10 Valuation . . . . 0
Expiration Date 12/20/10
----------------------------------------------------------------------------
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.
,.,tea•- A _;._ s - °b'roaa�sy,- �,.,.x 'c. -- ' -•X4t
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)):
1, 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).
1, 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
- w- = .
Owner Signature `" `b • �- .. � �. k �"� .. sf 4-1. 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`foiwiNich: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. 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