HomeMy WebLinkAbout2698 OSWELL Street_UST FMC 7.30.10II'IIII �IIII III IIII 01
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HOODS ALARMS SPRNKLER SYSTEMS SPRAY BOOTS`! AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
/-,n 1'an-0Oa'2
File Number: 3pZp
Date Received:
Address: 9 ? 65we u/ 5y-
Bakersfield, CA 933
Business Name: 64z- r�
Comments:
1.
2.
3.
4.
iNsPEcrioN Lo�
Signature
l�uu�ui�
02
SYSTEM:
BUILDING SQUARE FEET:
New
Mod.
❑
❑
Commercial Hood System Building Sq. Feet:
❑
❑
Fire Alarm System Calculation Bldg. Sq. Ft:
❑
❑
Fire Sprinkler System
❑
❑
spray Finish System
❑
❑
Aboveground Storage Tank
❑
❑
Underground Storage Tank
minor
modification
Underground Storage Tank
removal
Underground Storage Tank
❑
011 Other:
Comments:
1.
2.
3.
4.
iNsPEcrioN Lo�
Signature
l�uu�ui�
02
IE
CONSTRUCTION PERMIT
BAKERSFIELD FIRE DEPARTMENT
JNY,^eA PREVENTION SERVICES
1501 TRUXTUN AVENUE, 1sT FLR
BAKERSFIELD, CA 93313
Office Phone: (661) 326 -3979 .
Application Number . . . . . 10- 10000240 Date 8/16/10
Property Address . . . . . . 2698 OSWELL ST
ATN (11 Digits): 130 - 161- 13 -00 -0
Application type description FIRE DEPT
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . . 0
Owner Contractor
JACO -HILL CO OWNER_
P O BOX 82515.
BAKERSFIELD CA 93380
"Permit . . . MANDATED .LEAK DETECT TEST"
Additional desc .
Phone Access Code 1025386
Permit Fee 96.00. Plan Check Fee.. 96.00
Issue Date 8/16/10.2 Valuation 0•.
Expiration Date 2/12/11
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 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 after180 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. Requests 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 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
1 certify that 1 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 Date
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
DATE
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK OFF
TANK TFSTIN[; MODIFICATIONS MINOR/ MAJOR
DESCRIPTION DATE SIGNATURE
RE
AST UMQ'AL
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.
BUILDING ADDRESS- =2 —Q&47We-U 67 _
B DESCRIPTION G.
r
OCCUPANCY TYPE
WNER S ! i
PERMIT NO.
ONTRACTOR 'G(CKJcs�, PHONE # 63/ —.3 7d w
FD 1743
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
B_ { B R S P I D
T�• P /Rd ; °
aJRF r
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
11 LINE TESTING El SB -989 SECONDARY CONTAINMENT
LM/ FUEL MONITORING CERTIFICATION
•
• .
`'•` SITE:INFORMATION
- - --
FACILITY
STC 1 F
NAME & PHONE # OF CONTACT PERSON
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ADDRESS
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FAf`l. T'�.�SFIELI�,
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CA
OWNER NAME
OPERATOR NAME
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES
❑ NO
TANK #
VOLUME
CONTENTS
:TANK TESTING'COMQANY .,
TESTING COMPANY
a
T SA,U
1
NAME & PHONE # OF CONTACT PERSON
1► n 5. Cu(po ot -
8'
MAILING ADDRESS
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1
NAME & PHONE # OF TESTER OR SPECIAL INSP CTOR
r C 3- 66-25,
CERTTF.ICATION_
ICC #
ur
TEST METHOD
DATE & TIME TEST TO BE CONDUCTED
APPLICANT SIGNATURE
r
DATE
7 2-Ld
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
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DATE
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FD2095 (Rev 06/07)
BILLING & PERMIT STATEMENT
PERMIT #
i8,9�0�E�91Rn'.
II A„ L' K S h I I, 1) " FIRE it
DfARTM T
.aiC:a•„ �,,eIG e : "
BAKERSFIELD FIRE,DEPARTMENT
Prevention Services
1600 Truxtun Avenue, Suite 401
Bakersfield, CA 93301
Phone: 661-326-3979-a Fax: 661-852-2171
FD2021 (Rev 06/07)
1 - ORIGINAL WHITE (Treasury) i_ YELLOW (File) 1 -PINK (Customer)
INFORM
•
LOCATION OF PROJECT
�ylvq_� Del I Sf_, _ c_8kf 1d
PROPERTY OWNER
Saco
STARTING DATE 7-1416-
NAME
PROJECT rS`TY I ��
ADDRESS � 6 . �OX d
P l 1011 ��� -1 3 - %GDd
PROJECT ADDRESS
CITY �A ICE1:.lSFl >✓ LD STATE CA-
ZIP CODE
CONTRACTOR
INFORMATION
CONTT ACTOR NAME CA LICENSE J!
_ L? c+ �-I c�e, i U ��cLIZ
TYPE OF L[C[NSE EXPIRATION DATE
�' S �.
PHONE It
Cl lc_I� 1L-3 ► 6% '1 L)
CONTR�R COMPANY NAME
C-u ok-i_c.�i ►1C;C l t- �T�`:�e r_v_t Ce �_ — �_11 -C! I
FAX #
—_Wu lJ%_
ADDRESS CITY
ZIP CODE
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All permits must 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
■
r
❑
Over 10,000 sq ft
$0 .028 x sq ft
■
84
98
°
0
Minor Sprinkler Modification ( <10 heads) j
$96 (inspection only)
°
84
98
0
❑
Commercial Hood (New & Modification) i
$470
°
84
_
98
-�
❑
-
Additional hood '
$58
°
0
84
98
■
•
Spray Booth (New & Modification)
$470
■
84
98
■
—
•
Aboveground Storage Tank (Installation /One Inspection) i
$180
■
82
❑
Additional Tank
$96
'
82
•
Aboveground Storage Tank (Removal /Inspection)
$109
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
■
84
•
Oil well (Installation) i
$96
°
84
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
e
■
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
o
84
❑
Portable LPG (Propane): # of Cages?
$96
■
84
— �
t
❑
y
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) i_ YELLOW (File) 1 -PINK (Customer)