HomeMy WebLinkAbout2222 F Street_UST 2010HOODS ALARMS SPRINKLER SYSTEMS _,►- spa_.. BOOT'' AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
File Number:
qz ?S/
Of a
Address: ZZZZ F
st
Bakersfield, CA 933
Date Received:
// —,g c<— i0
Business Name: �,�,,p
t2/�•wti Gc'
J`.�2.5 S
INSPECTION LOG
SYSTEM:
BUILDING SQUARE FEET:
New Mod.
❑ ❑
Commercial Hood System
Building Sq. Feet: _
Date Time
— i✓v5�e
❑ ❑
Fire Alarm System
Calculation Bldg. Sq. Ft:
1.
J2,12-2-110
-�
❑ ❑
Fire Sprinkler System
2.
❑ ❑
Spray Finish System
3.
❑ ❑
Aboveground Storage Tank
4.
❑ ❑
Underground Storage Tank
minor
tignature
modification
Underground Storage Tank
r
removal
Underground Storage Tank
❑ 01- Other: yyl C�—
Comments:
Signature
DO #F IDF4D
N V.
hCES `t1
"COMPLIANCE WITH CONFIDENCE"
November 24, 2010
CITY-OF BAKERSFIELD
Attn: David Weirather.
Office of Environmental Services
Fire Department /UST Program
2101 H Street
Bakersfield, CA 9330.1
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 Application and permit fee
receipt to our office at 661- 587 -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.
7C
Karli Karns, Dispatch Coordinator
16250 Meacham Road • Bakersfield, CA 93314
(661) 631 -3870 or (800) 339 -9930
FAX (661) 587 -9758
City of Bakersfield ' "Y
Ramco Express (12/8110 MC) 10164
�,�,� 11/2412410
Citibank Checking . permit
Ahn
192.00
CONSTRUCTION PERMIT
Application Number . . . . .
Property Address . . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
------------------------
CATALINA BARBER CORP
PO BOX 45001
BAKERSFIELD CA 93384
BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
R s F I D 1501 TRUXTUN AVENUE, 1sT FLR
FIRE BAKERSFIELD, CA 93313
1 RTM 'T Office Phone: (661) 326 -3979
10- 10000381 Date 12/02/10
2222 F ST
003- 131- 11 -00 -8
FIRE DEPT
0
Contractor
------------------ - - - - --
OWNER
----------------------------------------------------------------------------
Permit . . . . .
. MANDATED LEAK DETECT TEST
Additional desc .
.
Phone Access Code
. 1053289
Permit Fee . . .
. 96.00
Plan Check
Fee
X96.00
Issue Date . . .
. 12/02/10
Valuation
0
Expiration Date
5/31/11
- ----------------------------
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.
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 _ 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.
4 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 Phone 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
EVR UPGRADE
MISC. ACTIVITY
REMARKS:
0
AST NEW INSTALL
DESCRIPTION DATE SIGNATURE
MODIFICATIONS MINOR / MAJOR
AST REMOVAL
DESCRIPTION DATE SIGNATURE
PRIOR TO OPERATION OF ANY SYSTEM,
ALL UST AND /OR AST SYSTEMS SHALL BE
INSTALL, COMPLETE AND ACCEPTED BY
THE BAKERSFIELD CITY FIRE DEPARTMENT.
FIRE DEPARTMENT (FINAL)
BUILDING ADDRESS: a Z?� y` - 71 6-r
JOB DESCRIPTION: C—
OCCUPANCY TYPE:
I
OWNER:
PERMIT NO. 10 -/p (no C)
CONTRACTOR: PHONE # 631-
FD 1743
UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD /LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING /TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
PERMIT
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
B— B R 9 P I'H P
Tae
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1600 Truxtun Ave., Suite 401
Bakersfield, CA 93301
Phone: 661 - 326 -3979 o Fax: 661 - 852 -2171
Page 1 of 1
❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT
L FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACI ITY
NAME & PHONE # OF CONTACT PERSON
Yti(JL IYL 1 �D
1I ^
�S
ADDRESS �22'� 5,c QQom+ T :,Af —' ERSFI EL-D, CA
OWNER NAME
OPER TOR NAME
hCN
PERMIT TO OPERATE 11
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
TANK-TESTIN,G;COMPANY. _ „•
TESTING COMPANY
[lo . C' nee US S;�r �1'�C.
NAME & PHONE # OF CONTACT PERSON '
rl rl�s CtAI..�) tr,31- '�47Qa .
MAILING ADDRESS
1 L0 25 O t A -Lac cn R � , ti ;-S �� e• C.i=\ i 3 _
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR CERTIFICATION 11
IA - sA-n►>ha 1 i�axYAS (W) t"3?) 1 ae
DATE & TIME TE T TO BE CONDUCTED
12 R l0 ak olJn -►
ICC #
TEST METHOD
APPLICANT SIGNATURE J ^ r^ J DATE
���
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
AP ED BY
e ,
DATE
FD2095(Rev 06/07)
BILLING & PERMIT STATEMENT
PERMIT #
i
it A i I: R S 1' I 1. 1)
�
FIRE i
D, fARTMi IalT
BAKERS.FIELD FIRE DEPARTMENT
Prevention Services
1600 Truxtun Avenue, Suite 401
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661- 852 -2171
FD2021(Rev 06/07)
1 - ORIGINAL WHITE (Treasury) 1!- YELLOW (File) 1 -PINK (Customer) /
s
O
SITE •
•
L-CATION OF PROJECT I+
-%_Z
PROPERTY OWNER
STARTING DATE
NAME
l 10 Q.V
(A
PRqJECT NAME
ADDRESS
PHONE 44
YP S
PROJECT ADDRESS 1 '
2 Sit QA T kf 'J 1 I
/�
STATE
CITY gA- iC E1�S F I EL✓� CIA
ZIP CODE
• • R INFORMATION
CONTRACTOR'NAME CA LICENSE 41
TYPE OF LICENSE EXPIRATION DATE
'PHONE-44
?�r15 Vi6..v nS �S0�4
LS.
Lto(c,t 1r.31 �`sIu
CONTRACTOR CO PANY NAME I
LDi' 1��_ c.. �i.. ��'1C:- C_1..i�T��...r_v►c.e.5 -, � �l_C,
FAX #
�ln- t,��_���51 -01� J�_
ADDRESS CITY
ZIP CODE
t�
�J U M I' C \Ch r� 111 124)CC c.l
All mast be reviewed, stamped, and approved PRIOR TO BEGINNING WORK.
•
permits
❑ Alarm -New &Modification (minimum charge) $280 ■
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) i
$96 (inspection only)
a
84
98
■
❑
Commercial Hood (New & Modification)
$470
■
84
98
❑
Additional hood i
$58
■
:
84
98
•
Spray Booth (New & Modification) i
$470
■
84
98
•
Aboveground Storage Tank (Installation /One Inspection) (
$180
■
°
82
❑
Additional Tank I
$96
■
82 ,
❑
Aboveground Storage Tank (Removal /Inspection)
$109
82
❑
Underground Storage Tank (Installation /Inspection) {
$878 /tank
;
82
❑
Underground Storage Tank (Modification)
$878 /site
.
82
•
Underground Storage Tank (Minor Modification)
$167
i
■
82
•
Underground Storage Tank (Removal) t
$573 /tank
■
■
84
❑
Oil well (Installation)
$96
84
Mandated Leak Detection (test) /Fuel Mont Cert /SB989
$96 /site
82
NOTE: $96 for each type of test /per site even if
■
scheduled at the same time
■
❑
Tent i
$96 /tent
■
■
84
❑
After -hours inspection fee
$121
■
a
❑
Pyrotechnic (per event, plus inspection fee of $96 /hr)
$96 -1- (5 hrs min standby fee /insp) =$576
s
84
❑
Re- inspection /Follow -up Inspection
$96 /hr
n
84
❑
Portable LPG (Propane): # of Cages? _
$96
.
84
❑
Explosive Storage i
$266
t
■
84
❑
Copying & File Research (File Research. fee $34 /hr)
$0.25 /page
■
84
❑
Miscellaneous
84
FD2021(Rev 06/07)
1 - ORIGINAL WHITE (Treasury) 1!- YELLOW (File) 1 -PINK (Customer) /
s
O