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Home My WebLink About2317 L Street_CHEVRON_UST LINE TESTING 7.30.10HOODS ALARMS SPRINKLER SYST MS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: w• ac(36� Address:.3/ Bakersfield, CA 933 Date Received: � — �3p --�� Business Name: `�.�`�� r• SYSTEM: BUILDING SQUARE FEET: F 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 minor modification Underground Storage Tank removal Underground Storage Tank Date Time Signature Signature ❑ W Other: Comments: BILLING WPERMIT STATEMENT PERMIT # FIRE BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun AvenL►e, SL►ite 401 Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 F0202 I ('Rev Ub/U'/) I - ORIGINAL WHITE (Treasury) 1- YELLOW (File) 1 -PINK (Customer) LOCATION ON OF PROJECT PROPERTY OWNER STARTING DATE COMPLETION DATE t NAME ADDRESS PHONE 0 PROJECT NAME J k� jk- .2A2 (G t- 0 3') = -7— 5 PROJECT ADDRESS CITY 'Ak C _ STATE IIPCODE A 7 z '0 ff CONTRACTOR NAME CA LICENSE A TYPE OF LICENSE EXPIRATION DATE PHONE ff CONTR ACTOIT COMPANY NAME FAX ff Lk%-le-c UST `.SQ_VVI'QeS' Inc. ADDRESS CITY ZIP CODE Permits must he vevievved, stamped, and approved PRIOR' 13 O ""'f'i7.t.;' ❑ ❑ Warm - New & Modification (minimum charge) It Over 10,000 sq ft 1$280 f 1 $0 .028 x sq ft — — I U ■ ---------- 98 - -- 84 98 1— ❑ Sprinkler - New ,& Modification (minimum charge) $280 13, 13, 84 98 ❑ Over 10,000 sq ft $0 .028 x sq ft 84 96, ❑ Minor Sprinkler Modification (<10 heads) $96 (inspection only) ^ 13 13 84 98 0 ❑ Commercial Hood (New & Modification) Additional hood $470 $58 D �1 13 —84 98 84 ❑ ❑ Spray Booth (New & Modification) Aboveground Storage Tank (Installation/One Inspection) $470 13 13 98 84 82 $180 0 Additional Tank $96 82 ❑ Aboveground Storage Tank (Removal/Inspection) ^ $109 T 82 ❑ Underground Storage Tank (Installation/Inspection) $878/tank 82 ❑ Underground Storage Tank (Modification) $878/site 82 ❑ underground Storage Tank (Minor Modification) $167 $573/tank $96 ■ or ■ ■ 82, 84 84 ❑ Underground Storage Tank -(Removal) Oil well 'Installation) ❑ 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 $96/tent 84 ❑ After-hours inspection fee $121 ❑ Pyrotechnic (per event, plus inspection fee of $96/hr) $96 + (5 hrs min standby fee/insp)=$576 84 ❑ Re-inspection/Follow-up Inspection $96/hr 84 ❑ Portable LPG (Propane): # of Cages? $96 r 84 0 Explosive Storage $266 ■ 84 Cl Copying & File. Research (File Research fee $34/hr) g25/page Miscellaneous $0 84 84 ❑ F0202 I ('Rev Ub/U'/) I - ORIGINAL WHITE (Treasury) 1- YELLOW (File) 1 -PINK (Customer) BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work InSDection Reauest Phone No. (661) 326 -3979 DESCRIPTION DATE SIGNATURE `PRIOR TO OPERATION OF ANY SYSTEM; ALL UST AND /OR AST SYSTEMS SHALL BE,, INSTALLED,= COMPLETE _AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT; .FIRE DEPARTMENT (FINAL _ _ . r ESCRIPTION tnJ i OCCUPANCY TYPE R .J PERMIT NO. D ` C' ACTOR C C PHONE # 63/— FD 1743 DESCRIPTION DATE SIGNATURE BACKFILL . PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT, SENSORS AUTHORlZA710N FOR FUEL ELECTRICAL SEAK OFF i DESCRIPTION DATE SIGNATURE `PRIOR TO OPERATION OF ANY SYSTEM; ALL UST AND /OR AST SYSTEMS SHALL BE,, INSTALLED,= COMPLETE _AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT; .FIRE DEPARTMENT (FINAL _ _ . r ESCRIPTION tnJ i OCCUPANCY TYPE R .J PERMIT NO. D ` C' ACTOR C C PHONE # 63/— FD 1743 V0 f D��cF UST r TIZIESY "COMPLIANCE WIM CONFIDENCE" - CITY OF BAKERSFIELD Attn: David Weirather Office of Environmental Services Fire Department /UST Program 1501 Truxtun Avenue, First Floor g Bakersfield, CA 93301 To.Whom It May Concern: July 23, 24010 Enclosed for your approval, please find Application to Perform Product Line'Testing and Billing and Permit Statement, along with our check in the amount of Please return the approved Application, permit fee receipt and job card to our office in the self- addressed envelope provided. 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. A�ac& e�.tkdl/ Karli Karns, Dispatch Coordinator 16250 Meacham Road • Bakersfield, CA 93314 (661) 631 -3870 or (800) 339 -9930 FAX (661) 587 -9758 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 a FIRE ARrM r 10/L INE TESTING 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 ❑ FUEL MONITORING CERTIFICATION ❑ SB -989 SECONDARY CONTAINMENT SITE -INFORMATION FACILITY -mow NAME & PHONE # OF CONTACT PERSON S_LkWV_6t0 06160 ADDRESS 2. )J-j �_ bAKJER�SFIELD, CA OWNER NAME SLL.i1 I Van OPERATOR NAME PERMIT TO OPERATE 4 # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS - TANK ''T ES T ING'.COMPANY _ TESTING COMPANY NAME & PHONE # OF CONTACT PERSON a V_ ' a,+-n 1 r 8 -70 MAILING ADDRESS l0 25b ,rn 96 O-A -kA. CA 64 1 NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR DOLAn ks Limwo 1 21 - (p CERTIFICATION # - O IL DATE & T4ME TEST TO BE CONDUCTED) 22 Q 2 2010 P U b ICC # 6-8,7 9 u46 UST TEST METHOD APPLICANT SIGNATURE DATE `7/23/10 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095(Rev 06/07) BILLING & PERMIT STATEMENT � ,Il FIRE niqr PERMIT .# oeARTMnir i BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Avenue, Suite 401 Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661- 852 -2171 r All permits eviusQ be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. • SITE INFORMATrON, LOCATION OF PROJECT PROPERTY OWNER STARTING DATE COMPLETION DATE '71:206 NAME k- Sv_W Z o '!�_i-O'n r) PROJECT NAME a wn+nwr,_ C _Q y a-yn ADDRESS J571 2 L� +h PHONE # PROJECT ADDRESS CITY bfA K.1✓1� 5�(EC D srarE GA ZIP CODE 2 98 ' ■ _ ❑ CONTRACTOR NAM[ CA LICENSE it TYPE OF LICENSE EXPIRATION DATE PHONE 11 CONTRACT COMPANY NAME - �,()i1�_i_r✓r1CC <�� r_v FAX # ADDRESS ( CITY ZIP CODE r All permits eviusQ be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. • ❑ Alarm - New & Modification (minimum charge) $280 ■ 84 98 ■ ❑ Over 10,000 sq ft $0 .028 x sq ft ° 84 98 ■ _ ❑ Sprinkler - New & Modification (minimum charge) ! $280 ■ 84 98 _ — ■ F ❑ Over 10,000 sq ft $0 .028 x sq ft ■ 84 98 ❑ Minor Sprinkler Modification ( <10 heads ) $96 (inspection onl y) 84 98 M ❑ Commercial Hood (New & Modification) ! $470 ° 84 .98 r ❑ Additional hood $58 ° � 84 98 ❑ Spray Booth (New & Modification) $470 ■ 84 98 ■ ❑ Aboveground Storage Tank (Installation /One Inspection) ; $180 ■ 82 _ ❑ Additional Tank i $96 ' 82 _ • Aboveground Storage Tank (Removal /Inspection) $109 v 82 • Underground Storage Tank (Installation /Inspection) $878 /tank ; 82 • Underground Storage Tank (Modification) $878 /site ■ ■ 82 ❑ Underground Storage Tank (Minor Modification) $167 ■ 82 • Underground Storage Tank (Removal) $573 /tank r ■ 84 • Oil well (Installation) j $96 _ 84 LL� 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 $96 /tent ■ ■ 84 ■ ❑ After -hours inspection fee $121 ■ m. • Pyrotechnic (per event, plus inspection fee of $96 /hr) $96 -1- (5 hrs min standby fee /insp) =$576 v 84 • Re- inspection /Follow -up Inspection $96 /hr c 84 ❑ Portable LPG (Propane): # of Cages? — $96 ■ t 84 ❑ Explosive Storage $266 ■ 84 • Copying & File Research (File Research. fee $34 /hr) $0.25 /page ° 84 • Miscellaneous 84 FD2021 (Rev 06/07) 1 - ORIGINAL WHITE (Treasury) IL YELLOW (File) 1 -PINK (Customer) UNDERGROUND STORAGE TANKS APPLICATION Fffffg TO PERFORM ELD /LINE TESTING/ �sS SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION PERMIT 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 ❑ ENHANCED LEAK DETECTION 93 LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT ❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION SITE INFORMATION FACILITY r • 11 NAME & PHONE # OF CONTACT PERSON \ • ~YLc,I`l � S ii/.�1 �iCe'p�`\� i�r i• � J -� L 1/ L1/i fr, c ADDRESS 2.� 1 i� �/-\ I\.l� I W � I_l� l..A� CA OWNER NAME' 1 OPERATOR NAME PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS j TANK TESTING COMPANY TESTING COMPANY NAME & PHONE R OF CONTACT PERSON \ nt' � !`��•.�_s'..� t •i,.��V' CE`_.� i r: Ci,Y" O..0 i \ �S.�t?SLt_LC(t.,;� � � if✓ MAILING ADff.`,DRES�S�( V _NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR t Dou 6, - A DATE & T- ME TEST TO BE CONDUCTED1 CERTIFICATION # C ((_ —L021n ICC # TEST METHOD APPLICANT SIGNATURE DATE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APP VED BY -2,e )-V-� DATE FD2095 (Rev 06/07) c j �` -; � � '`-1 . . r CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES B E R S F I D 1501 TRUXTUN AVENUE, 1 ST FLR F/RE BAKERSFIELD, CA 93313 ARTM T . Office Phone: (661) 326 -3979 Application Number Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner ------------------ - - - - -- SERVICE STATION HOLDINGS LLC 1508 18TH ST STE 222 BAKERSFIELD CA 93301 10- 10000272 Date 9/02/10 2317 L ST 005- 382- 07 -00 -1 FIRE DEPT 0 Contractor ------------------------ OWNER ---------------------------------------------------------------------------- Permit . . . . . . MANDATED LEAK DETECT TEST Additional desc . Phone Access Code 1030188 Permit Fee . . . . 96.00 Plan Check Fee 96.00 Issue Date . . . . 9/02/10 Valuation 0 Expiration Date- 3/01/11 ----------------------------------------------7----------------------------- 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 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 therequirements 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 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 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 CONFIDENCE UST SERVICES, INC. City of Bakersfield R L' Product Line Testing (7/22 & 23, 2010) (BALANCE DUE) 7/30/2010 10091 •m Citibank Checking Sullivan Petrol /Downtown Chevron (Balance Due 96.00