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HomeMy WebLinkAbout2301 F StreetUST MINOR MOD 12.2.10inn IE 07 t- ��•�J;,�, �,�<<1� ?�-�` sF��iNK�_E� sYSTEr��s �,� -;a�r- F��� ►1��� Permit No. Permit No. AST UST Permit No. Permit No. Permit No. Permit No. /611' File Number: 7-57/9 Address: p r S Bakersfield, CA 933 Date Received: Business Name: rep SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG 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 i modification Underground Storage Tank removal Underground Storage Tank ❑ ❑ Other: Date Time Signature loinsignature IE BILLING & PERMIT STATEMENT k0o. BAKERSFIELD FIRE DEPARTMENT F Prevention Services PERMIT # FR � 1501 Truxtun Avenue, 1St Floor Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 LOCATION OF PROJ PROPERTY OWNER Ir 1313 • /11 D N E Z STARTING DATE COMPLETION DATE NAME PROJECT NAME ADDRESS PHONE # co Am Z40,o Ooqw-rg RD 35. PR03ECT ADDRESS ZIP CODE 2• G�6 cm gfkIGERS�IEI_D STATE CA p� s o• •• TIO CONTRACTOR NAME CA LICENSE # TYPE OF LICENSE EXPIRATION DATE . PH6NE'# urz 3 - 30-1 to ra I . 34. In 99L7 C NTRACfOR COMPANY NAME FAX # P, A es�n. ADDRESS I my I ZIP CODE /-- All permits'must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. BankofAmerica. 1316 5 REDWINE TESTING SERVICES, INC. SakweAdCA P.O. BOX 1567 (661) 834 -6993 esIAS& aeo BAKERSFIELD, CA 93302 16 -66 -1220 PAY TO THE ` $ `% ?. rJ� ORDER OF G"A--g QA �1� Ste, C&•eI'iwt S Z/00-- DOLLARS r. 0 s AUTHORIZED SIGNATURE ME MOPACO - ..,. , "_...r,�......... •..... � .,.. .....,..,. .... ...,-- .._�..... _...,....,._ eu. .....,.........s.- ....,_....... o.•...... u..,,.:- w::. �: �.: r...., s,.......,...,... a.-_..•.. c........:.:.. �... �w.....-.........,.....:. aa..... �..:..... a::.•..a,......- �.�....,,..,.�. ,r..- .._.... 1120131i650 41,22000'660: 09065111047560 �^ Underground Storage Tank (Minor Modification) MTM $167 /site ' Z ' Z -1p C W 13 t tPC 82 ❑ Underground Storage Tank (Removal) TR $573 /tank 84 82 ❑ Mandated Leak Detection (test) /Fuel Mont Cert/56989 NOTE: $96 /hr for each type of test/per site even if scheduled at the same time TT $96 /hr (2 hrs minimu =$192 p Oil well (Installation, Inspection, or re- inspection) X $96 /hr 82 ❑ Tent •# $96 /tent 84 ❑ After -hours inspection fee $121 /hr (2 hrs minimum) =$242 , i ❑ Pyrotechnic (1 permit per event, plus an inspection fee of $96 1hr during business hours) PY NOTE: After hours Pyrotechnic event inspection is @ $121 /hr $96 /hr + (5 hrs min standby fee /insp)= $576 5 hrs min standby fee ins = 605 84 ❑ Re- inspection /Follow -up Inspection $96 /hr 84 ❑ Portable LPG (Propane): # of Cages? _ $96 /hr 84 ' ❑ Explosive Storage $266 1. 84 ❑ Copying & File Research (File Research fee $50 /hr) $0.25 /page 84 ❑ Miscellaneous i 84 BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT Prevention Services PERMIT # /nts 1501 Truxtun Avenue, in Floor r . Bakersfield, CA 93301 Phone: 661 - 326 -3.979 o_Fax: 661- 852 -2171 SITE INFORMATION LOCATIOro OF PROD PROPERTY 'n . OWNER AqL0,VD9fi E z STARTING DATE COMPLETION DATE NAME PROJECT NAME ADDRESS co a mA RD PHONE # 35. PROJECT ADDRESS • i 2301,, CITY • i CO NTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE # fZ 3 n U�ICERS�IEI_D STATE CA TYPE OF LICENSE EXPIRATION DATE - 30- ZIP CODE {� PF10& # , TRACTOR COMPANY NAME FAX # ADDRESS 0 6 ZIP CODE 3 0p— All permitsi roust be reviewed., stamped, and approved PRIOR TO BEGINNING WORK. 6: PERMIT TYPE FEE CALCULATION. TOTAL DUE ❑ Alarm - New & Modification (minimum charge) $280 • ONLY 7 TREASURY I ACCT NOj ❑ Over 10,000 sq ft $0 .028 x sq ft ❑ Sprinkler - New & Modification (minimum charge) $280 ❑ Over 10,000 sq ft $0 .028 x sq ft ❑ Minor Sprinkler Modification (<10 heads) $96 (inspection only) 84 ❑ Commercial Hood (New & Modification) $470 ❑ Additional hood $58 • Spray Booth (New & Modification) $470 98 • Aboveground Storage Tank (1 inspection per installation) AST $180 /tank 82 ❑ Additional Tank ATI $96 /tank 82 ❑ Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR $109 /tank 82 ❑ Underground Storage Tank (Installation /Inspection) NI $878 /tank 82 ❑ Underground Storage Tank (Modification) MOD $878 /site 82 Underground Storage Tank (Minor Modification) MTM $167 /site I'l 7- " 10 EV 13 Los 82 ❑ Underground Storage Tank (Removal) TR $573 /tank 84 ❑ Mandated Leak Detection (test) /Fuel Mont Cert/SB989 NOTE: $96 /hr for each type of test/per site even if scheduled at the same time TT $96 /hr (2 hrs minimu =$192 82 ❑ Oil well (Installation, Inspection, or re- inspection) X $96 /hr 82 • Tent # $96 /tent 84 • After -hours inspection fee $121 /hr (2 hrs minimum) =$242 • Pyrotechnic (1 permit per event, plus an inspection fee of $96 /hr during business hours) PY NOTE: After hours Pyrotechnic event inspection is @ 121 /hr $96 /hr + (5 hrs min standby fee /insp)= $576 5 hrs min standby fee ins = 605 84 • Re- inspection /Follow -up Inspection $96 /hr 84 ❑ Portable LPG (Propane): # of Cages? — $96 /hr 84 • Explosive Storage $266 84 • Copying & File Research (File Research fee $50 /hr) $0.25 /page 84 ❑ Miscellaneous 84 CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES B B R S A I D 1501 TRUXTUN AVENUE, 1ST FLR FIRE BAKERSFIELD, CA 93313 A R TA/ T Office Phone: (661) 326 -3979 Application Number . . . 10- 10000384 Date 12/08/10 Property Address . . . . . 2301 F ST ATN (11 Digits): 003 - 112- 05 -00 -2 Application type description FIRE DEPT Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . 0 Owner Contractor SAM SAMBEE ENTERPRISES INC OWNER 2400 CARLITA RD BAKERSFIELD CA,93304 -------------------------------- -------------------------------------------- Permit . . . . . UNDGRND STR TANK MINOR MODIFY Additional desc . Phone Access Code 1055540 Permit Fee. 83.50 Plan Check Fee 83.50• Issue Date . . . . 12/08/10 Valuation 0 Expiration Date . . 6/06/11 ---------------------- 7 --------- =------------------------------------------- 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 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 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 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 certi)� 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 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: AST NEW INSTALL DESCRIPTION DATE SIGNATURE 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: 3 C7 / 019 ST. JOB DESCRIPTION: ,n —r.4A) I< WjcC , OCCUPANCY TYPE: OWNER: PERMIT NO. /O - /ClZtn© -W CONTRACTO Q PHONE # •.»� FD 1743 C(1 OMER'.RE1IAT' ,' •M, "' Oper.S`•;TAANF(LS5EN Typ ?, :� Oc, Wiwim. 1 :, Datee" 1El89If0 81 ' • Recei 'no:,:. 53224::, Desc'r' b J Duantityy, -A iauht' • 218' 1@080384. •. •.. .. • . ,... .• • BF :..:_ . ,: .;RJiLDII. AEIn41T5.. = A 4167.88 Tender detail... Cf('tiECli `13165. ': ' `:.. #.167.8�b Total terdered -. #167.08 Trana:datc: !2'/08 19