HomeMy WebLinkAbout2601 WHITE Lane_UST MINOR 2.19.10HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH
Pgrmit No. Permit No. Permit No. Permit No.
File Number:
Date Received: - .-1 !k - �a
Permit No.
Address: ti Lp.a -e. ,
Bakersfield, CA 933
Business Name: t4A r -L c -,r MkAw-l4ve--t"'
Permit No.
a - i0000e�
UILDING SQUARE FEET; INSPECTION BOG
New Mod.
❑ 0 Commercial Hood System Building Sq. Feet: _ Pate Time
❑ ❑ Fire Alamo. sy rn Calculation Bid'. Sm Ft
0 O Fire Sprinkler System
❑ ❑ Spray Finish System
0 ❑ Aboveground Storage tank
❑ Gd Underground Storage Tank
minor - Signature
Modifcati Underground Storage Tank
removal Underground ;Storage Tank
Si,g00t are
1 ❑ Other-:
Comments:
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UNDERGROUND STORAGE TANK
PERMIT APPLICATION
TO CONSTRUCT414STALL NEW TANK (NEW FACILITY)
NEW TANK INSTALLATION (EXISTING FACILITY) /
MODIFICATION & MINOR MODIFICATION - FACILITY
00
D
AREA/ #1r
PERMIT NO.
TYPE OF APPLICATION: ❑ NEW TANK INSTALL / NEW FACILITY
IfIl—L, n.. !*am nnl.% . n UnnIF:If1ATInM OF PArIl ITV
BAKERSFIELD FIRE DEPT.
Prevention Services
501 Tnixtun Ave., 18t Floor
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661).852-2171
Page -I of 1 .
❑ NEW TANK INSTALLATION I EXISTING FACILITY
ri mimnR mnniFICATinm nF FACILITY
3TARTING DATE
............... . .. .
:ACILITY NAME
-ACILITY ADDRESS
ITY
P CODE
'2-6 0/
TYPE OF BUSINESS
iu 5
C7—AIL e5AJ
AN Or;ER
PHONE NO
0 S-4
ADDRESS
31ITY
COPE
col Z
923 0
!I �A ACTOR
. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . .
al" �o
... ..........
Eul
4-
9
W IR' N
. . . ..... ...
BRIEFLY DESCRIBE THE WORK To BED NE
F7 t--,v�iZA22r EL--F 1,--X-7- Jt-
n� I—AgQ,!52 ZAA,,gg 4/.t- I- d" .4A zQ A.,o
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
NO. OF TANKS TO HE INSTALLED
ARE THEY FOR MOTOR FUEL
SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE
❑ YES ❑ NO
❑ YES ❑ NO
T&ilQ -Qgt--nnu IQ rnp unTnia ci im
N
Jkk
............... . .. .
I
... ..........
. . . ..... ...
Twi-q-qpr,nntji-qs:nRmnmur%vnociICI
The applicant has recetyeg understands, and will comply with the attached con&nons of the permit and arty other state, local and fideral
regulations, This form has been completed under penalty of perjury, and to the best of my kwwledge, is ow and correct.
APPROVED BY: APPLICANT NAME (PRINT)
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPLICANT SIGNATURE
FO 2086 (Rev. 09106)
... ..........
The applicant has recetyeg understands, and will comply with the attached con&nons of the permit and arty other state, local and fideral
regulations, This form has been completed under penalty of perjury, and to the best of my kwwledge, is ow and correct.
APPROVED BY: APPLICANT NAME (PRINT)
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPLICANT SIGNATURE
FO 2086 (Rev. 09106)
BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD
Post this Card at the Job Site and DO NOT Remove for Duration of Work
InsDection Reouest Phone No. (661) 326 -3979
DATE I SIGNA
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK -OFF
AST N S ALL
DESCRIPTION DATE SIGNATURE
TANK TF7RTINC: I I MODIFICATIONS MINOR/ MAJOR
ST REM()VAl
DESCRIPTION DATE SIGNATURE
1
DESCRIPTION
PRIOR TO OPERATION OF ANY SYSTEM,
ALL UST AND /OR.AST- SYSTEMS SHALL BED
, INSTALLED ,_COMPLETE- ANDACCEPTED BY
\THE BAKERSFIELD CITY FIRE -DEPARTMENT.
BUILDING ADDRESS aGO MA; r.P =
JOB DESCRIPTION A_=V /Z
OCCUPANCY TYPE
OWNER 61" ' !
PERMIT NO. 6J
CONTRACTOR .' i✓'c� . PHONE #--:?%Z — S7
FD 1743
CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
B ER`s P i D 1501 TRUXTUN AVENUE, 1ST FLR
FIRE BAKERSFIELD, CA 93313
ARTM T Office Phone: (661) 326 -3979
CALL FOR INSPECTION DECLARATIONS
Permit is. issued in accordance with all applicable
(661) 326-3979,- 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.
Please state the Permit Number, the Job address, and I have reviewed the above application, and find it to
the Type of Inspection. Request's for inspections be correct/complete..
should be made at least 48 hours in advance.
Permittee: Date:
Application Number
. . . . .
10- 10000065
Date 2/25/10
Property Address
. . . .
2601 WHITE IN
ATN (11 Digits):
405- 230- 20 -00 -6
Application type description
FIRE DEPT
Subdivision Name
Property Use
. . . . .
Application valuation . . . .
0
Owner
Contractor
SOLANKI YOGENDRA
OWNER
2601 WHITE LN
BAKERSFIELD
CA 93309
--------------------------------------------=------------------------.-------
Permit . . . . .
. UNDGRND STR TANK MINOR MODIFY
Additional desc
.
Phone Access Code
981365
v
Permit Fee
83.50
Plan Check Fee
83.50.
Issue Date
2/25/10`,
Valuation . .
. .. 0
Expiration Date
8'/24/10
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 DECLARATIONS
Permit is. issued in accordance with all applicable
(661) 326-3979,- 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.
Please state the Permit Number, the Job address, and I have reviewed the above application, and find it to
the Type of Inspection. Request's for inspections be correct/complete..
should be made at least 48 hours in advance.
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 one 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).
1, 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 :_ - °p._ Date
WORKERS COMPENSATION DECLARATION
I hereby affirm that under penalty of perjury one of the following declarations:
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 6y, 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:
Carrier 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. 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_
Date
BILLING & PERMIT STATEMENT
PERMIT NO.:
pal BAKERSFIELD. FIRE DEPT.
.4 It S P 1IRZ-D Prevention Services
FIRE
RY 1600 Truxtm Ave Ste 401
"Y' t
Bakersfield CA 93301
Tel.: (661) 326 -3979 • Fam. (661) 852 -2171
All.permits must be reviewed, stamped, and approved PRIOR T.0 BEGINNING WORK ON THAT PROJECT.
1 N Alarms - New & Modifications - (Minimum Charge) $280.00
"':98
SITE INFORMATION
❑
LOCATION OF PROJECT
PROPERTY OWNER
STARTING DATE COMPLETION DATE
NAME
Spridders - New & Modifications - (Minimum Charge)
O
PROJECT NAME J
�
A CT"
ADDRESS
PHONE NO.
s -7 -539
PROJECT ADDRESS �
CITY STATE : '
ZIP CODE � n�
CONTRACTOR
INFORMATION
98
CONTRACTOR NAME CA UCENSE NO.
—cS IR
ITYPEOFLICENSE. EXPIRATION DATE
PHONE NO.
�rYY13
98
CONTRACTOR COMPANY NAME
FAX NO. _
1$470.00
O
ADDRESS
'611
CITY
ZIP CODE
9:6,8 �
All.permits must be reviewed, stamped, and approved PRIOR T.0 BEGINNING WORK ON THAT PROJECT.
1 N Alarms - New & Modifications - (Minimum Charge) $280.00
"':98
❑
Over 10,000 Sq. Ft
Sq. Ft x.028 = Permit fee
98
•
Spridders - New & Modifications - (Minimum Charge)
$280.00
■
■
84
98
❑
Over 10,000 Sq. Ft.
Sq. Ft x. 028 = Permit fee
84
98
•
Minor Sprinkler Modifications (< 10 heads)
$ 96.00 [Inspection Only]
98
❑
Commercial Hoods — New & Modifications
1$470.00
`
64
98
❑
Additional Hoods
$ 58.00
■
■
84
98.
❑
Spray Booths - New & Modifications
$470.00
■
■
84
98
❑
Aboveground Storage Tanks (InstallatlotAnsp: to Time)
$180.00
'
82
❑
Additional Tanks
$ 96.00
;
82
❑
Aboveground Storage Tanks (Removal/Inspection)
$109.00
r
82
❑
Underground Storage Tanks (Installatlon./Inspection)
$878.00 (per tank)
r
82
❑
Underground Storage Tanks ( Modificatlon)
$878.00 (perSft9)
•
82
W
Underground Storage Tanks (Minor Modification)
$167.00
■
82
❑
Underground Storage Tanks (Removal)
$573.00 (per tank)
84
❑
Oilwell (Installation)
$.96.00
84
❑
Mandated Leak Detection .(Testing) / Fuel Monit.CerVSB989.
Note: $96.00 for each ON of test /per site (even If scheduled
at the same time), -
$16:9& fpeF6de ,-
■
■
82
❑
Tents
$96.00 (per tenQ
■
84
❑
Pyrotechnic - (Per event, Plus Insp. Fee 0 $96 per hour)
$ 96.00 + (5 hrs. min. standby fee hnspect6)4576.00
84
❑
After hours inspection fee
$121.00
■
84
0
RE4NSPEC710N(S) /FOLLOW -UP INSPEC77ON(S)
$ 96.00 (per hour)
■
84
❑
Portable LPG (Propane): NO. OF CAGES? _
$ 96.00
■
84
•
Explosive Storage
$266.00
'
84
•
Copying & File Research (17119 Research Fee $50.00 per hr)
250 per page
;
84
❑
Miscellaneous
84
FD 2021 (Rev. 06/07
1- ORIGINAL WHITE (to Treasury). 1- YELLOW (to File) 1 -1PINK (to customer)
K ,.
Cityy of Bakersfield
CUS'iDMER- RECEIPT. * '
Dper:: SCARRE I.D 'Type:' DC . Draper: '1 �
Date: .2/25110 01 Receipt'no: 73920
Description .Quantity Awount.
22510 .1000 765
bN BUILDIN13 PERMITS
1..00 *167.00.
1 Tender.detai+
E Total tendered 8167.0e,
Total payoent X167 >00
trans. late 2125/10.. Tiger 14:37:35.
�` ..
NEtP CONTROL THE PET PDPULATIDN
PLEASE. SPAY. OR NEUTER '