HomeMy WebLinkAbout2524 OSWELL Street_UST MINOR MOD 7.27.1010111111 17
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HOODS ALARMS SPRNl LER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
�o-�cama2 a
File Number: �i/7 7!o 7
Date Received: '? --;2 7 — /6
Address:
6
Bakersfield, CA 933:
Business Name:e��
❑ ❑ Other:
INSPECTION L ®G�
Date Time
Signature'
Dill ia
IE
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
minor
modification
nderground Storage Tank
removal
Underground Storage Tank
❑ ❑ Other:
INSPECTION L ®G�
Date Time
Signature'
Dill ia
IE
BILLING & PERMIT STATEMENT
PERMIT NO.:
AIRS
ARM '#
RSFIELD• FIRE DEPT.
Prevention Services
1600 T uxtun Ave Ste 401
Bakerafleld CA 93301
TeL: (661) 326 -3979 ■ Fa= (661) 852 -2171
SITF •-
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Lo &-A-6 e--HA0
UrARTM D
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0 M�E
NAME EA 4-,
PROJECTNAME ! �LGJ o L
Z 4 . oJI�eLL %
3',,,T=
PROJECTADDRESS
p J�fZL -.1
SME
/s%fID G4
ZPCW
3 0
CONTRACTOR
CONTRACTOR NAME "WENSE N0.
•
TrPeaF uc6dsE o ATroN oaTE
PrrONE Na
CONTRACTOR COMPM"VA
FAXNO.
3921-0(094
ADDRESS crnr aPCaoe 1; P.
All.permits mustbe roviewv4 sbn pod, and approved_PRIOR.TO.BEGINNING PIORKON T .HAT PROJECT.
❑ Alarms - New & Modific edons - WWrm in Charge) $280.00 ■
0
Over 10,W0 Sq. FL
S¢ FL x.028 m Plemrit fee
■
■
84
88
❑
SpdMers - New & ModiflMons - (Urcimum Charge)
$280.00
. • }- . _
■
■
84
98
❑
Over 10,000 Sq. FL
84
98
' ❑
Minor Sprinkler Modit atfone (< 10 heads)
IS 96A0 pnspedbrr OnW
98
'O
Commerdal Hoods — New & Modificalons
$ 470.00
■
84
❑
Additional Hoods
$Saw
■
■
�
88.
O
Spray Booths - New & Modifications %
$470.00
■
■
84
08
O
Aboyeground Stomp Tanks (gyp. -t° lime)
$180.OQ
82
O
Addidonal Tanks
$96.00
;
82
❑
Aboveground MOM Tanks (RoWm lrrspec6on)
$109.00
;
82
❑
Underground Storage Tanks ( )
$878.00 (per Ilow
82
O
Underground Storage Tanks (Modiecalari)*
$878.00 (Waft)
'82
6L
Underground Storage Tanks Mm LUNcalon)
1-10 S
■
82
❑
Underground Storage Tanks (Removal)
$MOO (per tonk)
■
84
❑
Oiiweu (IrrstsWm) '
$ ss oo
;
-.84
C
Mandated Leak Detec don (roofing) / Fuel MonitCeN56989.
NoW MW lbreac+ Mm cf lmt /perslte (emffsdmdufed
at fire sstrre GhTe).
MW W &OF4 t41. -
■
■
82
❑
Tents
$98.00 (peram"
■
84
❑
PWOWft - (Per event. Plus Insp. Fee 0 $96 per hour)
$ 960 + (s hm mtL SWWby be
84
❑
Aftarhom Inspection fee
$121.00
■
84
O
RE4NSPECWAf(S) /FOLLOW- UP /NSPEC710N(5)
$ 96.00 (per hour)
■
84
❑
Portable LPG (Propane): NO. OF CAGES? _
$ 96.00.
■
84
❑
Explosive Storage
$266.00
■
84
❑
Copying & File Research (File Research Fee $50.00 per hr)
23¢ per page
;
84
❑
Macetlaneous
84
FO 202, (Ftev. 0697)
1- ONG WA1. WHFrE (to Troaafry). 1 -YELLOW (to File). 1-PINK (to Custmor)
!Permit #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501 Truxtun Avenue, 11 Floor
Bakersfield, CA 93301
Phone: 661- 326 -3979 • Fax: 661- 852 -2171
Page 1 Of 1
TYPE OF APPLICATION: 0 NEW TANK INSTALL/NEW FACILITY 0 NEW TANK INSTALVEMSTING FACILM
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BRIEFLY DESCRIBE THE WORK TO BE DONE:
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECIED AT SITE
i OF TANKS TO BE INSTALLED
TA E THEY FOR MO1DR FUEL?
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
YES a NO
G YES O No
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
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Tank TeWng Company
NAME oT= Tesr>Tw cAN,►`� �i� ., -,,►L ETA L
TAE T.RmER
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MATasNeaNORTrss �d y ,��o�J
NAME OF TENTER
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THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS
PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER
PENALTY OF PERIURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME Or- TESIM
=0
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
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BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK Prevention Services
1501 Truxtun Avenue, 11 Floor
PERMIT APPLICATION t� phone 661-326-3979 •Fax: 661- 852 -2171
TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW 4VAACTra— mw
TANK INSTALL (E)ISTING FACILITY) /MOD -MINOR MOD
Page lofi
,Permit #
TYPE OF APPLICATION: 0 NEW TANK INSTALL/NEW FACILITY 0 NEW TANK INSTALL/EXISTING FACILITY
(CHFCK ONF ONLY) ❑ MODTFICATTON OF FACILITY JW MINOR MODTFTCATTON OF FACTLTTY
STARTING DATEI j /ta
N'DI►.'n11: . °.
FACARY NAME �`T.FIGC>?ITY
PERMIT F
FAQLr" ADDRESS
2- O.Sti -e7�
CITY
ZIP COD
TYPE OF BUSINESS
APN #
1
TANK OWNER/
PHONE #
o e,
ADDRESS 2 � � J
C17Y� -
ZIP /� 0
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BRIEFLY DESCRIBE THE WORK TO Be DONE:
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
i OF TANKS TO BE INSTALLED
ARE THEY FOR MOTOR FUEL?
SPILL PREVENTION CONTROL AND CDUNiERMEASURES PLAN ON FILET
O YES G NO
O YES O NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
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Tank Testing Company
NAME OF TESTING COMPANY �I/t`� �) �n L
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PHONE NUMBER 3.X.4,_ ee b �1
MAILTaI® AD<iRE58
y ��° , f Y o
NAME of TESTER
'
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THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS
PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER
PENALTY OF PERIURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF YEW=
mw
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
.DATE APPROVIED:- - - :t, :tom .; :. ,r)xr .. ?,: x:
`H
:f 4 �,.
! _
rue.u60 (Kev UiflUy)
,L
4 Mkty �of 'aakersf ield
eye C115T1 R RECEIPT ** !
Leer: 5Ci1RRILLU TYpe: M 'Drawer: 1
Date: gt13t10 01 ; ;Receipt no: X1542
DescriPPtio,+ Quantify Aeount
2Q110 1031 : '
BUILDING PE[D41T5 1
1. 99 . $167A .
I T der d fait S157A
1 : ,
1167;W
Total Tendered '. Si7.00
4 Total payment,
Trans date: 8!13110 Tise: 14:12:45
-HELP CONIRDL THE r�T ppp1�ATIC I
pLEME SPRY•LR NEATER - `
n
CONSTRUCTION PERMIT
BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
R S F I D 1501 TRUXTUN AVENUE, 1sT FLR
FIRE BAKERSFIELD, CA 93313
61._ r Office Phone: (661) 326 -3979
Application Number . . . . . 10- 10000231 Date 8/13/10
Property Address . . . . . . 2524 OSWELL ST
ATN (11 Digits): 130 - 162- 12 -00 -4
Application type description • FIRE-DEPT
Subdivision Name
Property Use . . . . . . . .
Application valuation . . . . 0
Owner
Contractor
----- ---- ----- ---- ---- --
CHAO LOUNG K & MELISSA Y
------------------------
OWNER
5609 $TINE, RD
BAKERSFIELD
CA 93313
( 66) 345 -6208
------------------------=---------------------------------------------------
Permit . . . .
UNDGRND STR
TANK MINOR MODIFY
Additional desc .
.
Phone Access Code
1024967
Permit Fee
83.50
Plan Check Fee
83.50
Issue Date-
8/13/10•
valuation . . .
. 0.
Expiration Date
2/09/11
----------------------------------------------------------------------------
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 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 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 Date