HomeMy WebLinkAbout2300 PANAMALN_UST MINOR MOD 1.10.10IIIIIIIIII till III 111
Permit No. Permit No.
SPRINKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No.
File Number: i ?OpsCc Address: c236C 7,gyij�4(,!/►�, Z-#,) -
Bakersfield, CA 933
Date Received: ec) --e,6 <
Business Name: "Ltd. c k re S y c3--
SYSTEM: BUILDING SQUARE FEET:
New Mod.
❑
❑
Commercial Hood System Building Sq. Feet:
❑
❑
Fire Alarm System Calculation Bldg. Sq. Ft: 1.
Permit No. Permit No.
SPRINKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No.
File Number: i ?OpsCc Address: c236C 7,gyij�4(,!/►�, Z-#,) -
Bakersfield, CA 933
Date Received: ec) --e,6 <
Business Name: "Ltd. c k re S y c3--
SYSTEM: BUILDING SQUARE FEET:
New Mod.
❑
❑
Commercial Hood System Building Sq. Feet:
❑
❑
Fire Alarm System Calculation Bldg. Sq. Ft: 1.
❑
❑
Fire Sprinkler System 2.
❑
❑
Spray Finish System 3.
❑
❑
Aboveground Storage Tank 4.
❑ ❑ Underground Storage Tank
mino
modification Underground Storage Tank
removal Underground Storage Tank
❑ ❑ Other:
Comments: _�`A .rt .? /L l�— /�
INSPECTION L ®��
Date Time
12-110110
Signature
Signature
UNDERGROUND STORAGE TANK
PERMIT APPLICATION
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD,
Permit # j
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501 Truxtun Avenue, 11 Floor
H Bakersfield, CA 93301
Piss Phone: 661-326-3979 • Fax: 661-852-2171,
ARTr �
yPage 1 of 1
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/EXISTING FACILITY
CHECK ONE ONLY )
❑ MODIFICATION OF FACILITY
MINOR MODIFICATION OF FACILITY
STARTING DATE/
FACILITY NAME
L r�
EXiSTINGFACILFIY PERMIT
FACILITY ADDRESS
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CITY
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ZIP CODE±
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TYPE OF BUSINESS
APN #
TANK OWNER
PHONE #
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ADDRESS ^ O
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CITY
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ZIP CO
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CONTRACTOR
CA, LI S
IC
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ADORESS,
CI[Y
ZIP CODE
'33
PHONE.#
BAKE FIEL[1` BUS ESS
NSE #
`WO NS COMP #
INS R
BRIEFLY DESCRIBE THE WORK TO BE DONE:
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I r)P%LJL1` � c��- �YTVl c�n_M—k A• \r 2lr-nC I
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
7E APPROVED;.,
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:
FD2086 (Rev 08/09)
IT
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
AST NEW INSTALL
DESCRIPTION DATE SIGNATURE
TIONS_MI
AST REMOVAL
DESCRIPTION DATE SIGNATURE
EVR UPGRADE
PRIOR-TO OPERATION OF- ANY SYSTEM
ALL UST AND /OR AST SYSTEMS SHALL BED
`INSTALL,- COMP-LETE_AND ACCEPTED BY
MISC. ACTIVITY (THE BAKERSFIELD CITY FIRE DEPARTMENT.
FIRE DEPARTMENT
REMARKS:
BUILDING ADDRESS: C Zt/
JOB DESCRIPTION:
OCCUPANCY TYPE:
OWNER: ' ; (� cl
PERMIT NO. 16-AZnn 3.5q
CONTRACTOR: PHONE # Z — $']
FD 1743
CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
r"AR D 1501 TRUXTUN AVENUE, 1sT FLR
BAKERSFIELD, CA 93313
T Office Phone: (661) 326 -3979
Application Number . . . . .
Property Address . . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
------------------ - - - - --
1095 TULARE CORPORATION
2300 PANAMA LN
BAKERSFIELD CA 93307
10- 10000354 Date 11/17/10
2300 PANAMA IN
372- 021- 21 -00 -6
FIRE DEPT
0
Contractor
------------------ - - - - --
OWNER
-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Permit' . . . . . UNDGRND STR TANK MINOR MODIFY
Additional desc . .
Phone Access Code . 1049618
Permit Fee . . . . 83.50 Plan Check Fee 83.50
Issue Date . . . . 11/17/10 Valuation . . . . 0
Expiration Date . . 5/16/11
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------- - - - - -- ---- - --- -- ---- - - - - -- ---- - - - - -- -- -- ---- --
Permit Fee Total 83.50 83.50 .00 .00
Plan Check Total 83.50 83.50 .00 .00
Grand Total 167.00 167.00 .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 after 180 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 Agenf 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)):
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
I certify that 1 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
BILLING & PERMIT STATEMENT
PERMIT NO.:;
D
PUi<6
ABfY f
RSFIELD. FIRE DEPT.
Prevention Services
1600 Truxtun Ave Ste 401
BakersSeld CA 93301
Te1_- (RR11 326 -3979 • Fam (661) 852 -2171
All.permits must be reviewed, stamped, and approved_ PRIOR. TO BEGINNING WORK ON THAT PROJECT.
13 Alarms - New & Modifications - (Mlntmum Charge) $280.00 :
M
SITE INFORMATION
RIM. ALAW "11"NAW-41- Ww=
Sq. Ft x.028 = Permit fee
■
■
84
98
0
Spriniders - New & Mod'if'ication - (Minimum Charge)
$280.00
■
■
84
98 1
11�•���J.. � � �
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CONTRACTOR
INFORMATION
98
O
Minor Sprinkler Modifications (< 10 heads)
$ 96.00 [Inspection Only]
84
98
❑
Commercial Hoods — New & Modifications
$ 470.00
■
98
❑
All.permits must be reviewed, stamped, and approved_ PRIOR. TO BEGINNING WORK ON THAT PROJECT.
13 Alarms - New & Modifications - (Mlntmum Charge) $280.00 :
M
Over 10,000 Sq. FL
Sq. Ft x.028 = Permit fee
■
■
84
98
0
Spriniders - New & Mod'if'ication - (Minimum Charge)
$280.00
■
■
84
98 1
O
Over 10,000 Sq. FL
Sq. FL x.028 = Permit•fee
■
■
98
O
Minor Sprinkler Modifications (< 10 heads)
$ 96.00 [Inspection Only]
84
98
❑
Commercial Hoods — New & Modifications
$ 470.00
■
98
❑
Additional Hoods
$ 58.00
■
■
84 '
98.
Cl
Spray Booths - New & Modifications
$470.00
■
■
84
98
O
Aboveground Storage Tanks (InstallatotAnsp: im Time)
$180.00
'
82
❑
Additional Tanks
$ 96.W '
;
82
❑
Aboveground Storage Tanks (Removamnspection)
$109.00
:
82
O
1 Underground Storage Tanks (InsWallonAnspection)
$878.00 (per tank)
■
82
O
Underground Storage Tanks (Modification)
$878.00 (perslte)
:
82
Underground Storage Tanks (Minor Modification)
$167.00 Z2
■
82
O
Underground Storage Tanks (Removaq
$573.00 (per tank)
■
84
•
Oilwell (Installation)
$.96.00
;
84
•
Mandated Leak Detection (Testing) / Fuel Monit.Cert/SB989.
Note. • $96.00 for each type of test /perslte (even If scheduled
at the same ame) .
$'98 9&-(per site,)
;
■
■
82
•
Tents
$ 96.00 (per tend
■
84
❑
Pyrotechnic - (Per event, Plus Insp. Fee 0 $96 per hour)
$ 96.00 + (5 hm. mim standby fee Ainweatlon)- W6..00
■
■
84
O
After hours inspection fee
$121.00
■
84
❑
RE4NSPECTION(S) /FOLL0 W -UP INSPECTIONS)
$ 96.00 (per hour)
■
84
O
Portable LPG (Propane): NO. OF CAGES?
$ 96.00
■
84
•
Explosive Storage
$266.00
■
84
•
Copying & File Research (File Research Fee $60.00 per hr)
250 per page
;
84
Q
Miscellaneous
84
FD 2021 (Rev. 06107)
1- ORIGINAL WHITE (to Treasury). 1- YELLOW (to File) 1-PINK (to Customer)
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