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HomeMy WebLinkAbout3001 SILLECT Avenue _UST MINOR 9.30.09HOODS ALARMS SPRINKLER SYSTEMS WMV BOOTH AT UST Permit No. Permit No. IIIIIIIIVIIIIIIIiII 19 -i ............... IE File Number: /do 836-3 Date Received: 30 = C5:7 Permit No. Address: Business Name: Permit No-. Bakersfield, CA 933 4_Tt"1q10"1r1 J �j—c SYSTEM BUILDING SQUARE FEET: New Mod. ❑ ❑ Commercial Hood System 13uliding Sq. Feet: ❑ ❑ Fir'. Al 6WOZY06 M Calculation Bldg, Sq. Ft: ❑ ❑ Fire Sprinkler System 2. ❑ ❑ Sprig �Fhlsh 5 tam 3. ❑ ❑ Aboveground Storage Tank 4. ❑ ❑ Underground Storage Tank minor modificatio Underground Storage Tank removal Underground Storage Tank ❑ ❑ - Other! Comments: Permit No. ECTION LOG Time Signature Signature 20 1E UNDERGROUND STORAGE TANK PERMIT APPLICATION TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD IPermit # TYPE OF APPLICATION (CHECK ONE ONLY) S H 8 F I D FIRQ AR CAI T ❑ NEW TANK INSTALL /NEW FACILITY ❑ MODIFICATION OF FACILITY BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue Bakersfield, CA 93301 Phone: 661- 326 -3979 a Fax: 661-852-2171 Page 1 of 1 ❑ NEW TANK INSTALL /EXISTING FACILITY 10 MINOR MODIFICATION OF FACILITY STARTING DATE /.; _: _ _ PROPOSED COMPLETION DATE- -.. ; - ' FACILITY NAME �^ I� EXISTING FACILITY PERMIT FACILITY ADDRESS ^OO �, �` C T AVE JS t N CTfY 1 JI"1 L t `� ZIP CODE TYPE OF BUSINESS APN # TANK OWNER 13A �RSF�ELI� (�(LT (- 'C�S�ITAL PHONE # &/ 52^ 64-4 1 ADDRESS .! Q` ' ©© S1 L L*E C ` AV E . Qn 1, _o CI7Y A kE es-' 7% C l.i] ZIP CODE 1530$ .., -> - CONTRACLOR_ r. J - CA INCENSE`# � - - ICC: #_ <`. :,_: SE-1 -/ BRIEFLY DESCRIBE THE WORK TO BE DONE: ST IS c" O� 1 J V 'P tJ c Su t,A� r WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE # OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? ❑ YES ❑ NO ❑ YES ❑ NO THIS SECTION IS FOR MOTOR FUEL STORAGE TANKS UNLEADED REGULAR:;:; 'k' PREMIUM ' DIESEL`'ij.,:`_' "- ' ";;'AVIATION r , ^/ . THIS SECTION IS FOR NON -MOTOR FUEL STORAGE TANKS VOLUME : =`c ".: ;: `', UNLEADED. r REGULAR j,- PREMIUM`., aL; ^. DIESEL AVIATION "`-?`_`.` -" =- - - - - FOR OFFICIAL USE ONLY APPLICATION;DATE` "'`. =i :; ° :. ° : +_- .'•. :_._; FACILITY;# -. " #:OF:TANKS:," =..' -; -:` ; .FEES 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 PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. PR VED BY APPLICANT NAME (PRINT) APPLICANT SIGNATURE T'tOEL- CAQ9-%LL® THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FD2086 (Rev 08/07) CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT -, PREVENTION SERVICES B E R s F I D 1501 TRUXTUN AVENUE, l ST FLR, FIRE BAKERSFIELD, CA. 93313 ARTM T Office Phone: (661) 326 -3979 Application Number . . . . . 09- 10000222 Date 10/09/09 Property Address . . . . . . 3001 SILLECT AVE ATN (11 Digits): 332 - 580- 27 -00 -8 Application type description FIRE DEPT Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . 0 Owner Contractor ----- -------- ----- --- - -- ------------------ - - - - -- HEART HOSPITAL OF BK LLC OWNER 14400 METCALF AV OVERLAND PARK KS 66223 ------------------------------------------------------------------=--------- Permit . . . . . UNDGRND STR TANK MINOR MODIFY Additional, desc .., .. 'M.._.. .. _, ......... Phone•iAccess ;Code, 94985;9 Permit--Fee­­-k= 167.00 Plan Check Fee 010 Issue Date . . . . 10/09/09 Valuation 0 r ' Expiration Date 4/07/10 ------------------ ------------- ---------- - - - - -- ------=---=----------------- c, � y u. . Fee summary Charged Paid Credited ­­.,' Due " ---------- ---------- -- --------- --s------- Permit Fee Total 167.00 167.00 .00 .00 Plan Check Total .00 .00 .00 .00 :....,.. "Gi -and Total' ... 167.'00. .167.00 .00 00 , ,.,n..... is 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 Agent - Phone 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 1 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 ($100,000) IN ADDITION TO COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES CONSTRUCTION LENDING AGENCY I,hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 Civ. C.) Lenders Name Lenders Address I certify that 1 have read this application and state that the information contained herein is correct. 1 agree to comply with all city ordinances and state laws relating to building construction and hereby authorize representatives of the city to enter the above mentioned - property for inspection purposes. Signature of Applicant or Agent Date --- Prevention Services ' :I PERMIT # FIRE r 1501 Truxtun Avenue, 1s` FLR Bake_rsfield, CA 93301 Phone: 661-326-3979 . Fax: 661-852-2171 LOCATION OF PRO)ECT 8 OSR4 PROPERTY OW EJHE NAME �` TomA. S ("AL%tsjDO STARTING DATE COMPLETION DATE lo- 5 -oq 10 -2y -oq PRD)FfT NAME - - - i aSTA�L s�n�Sor,Z " t N 'f2RlJ5MO►J Sump ADDRESS �0;� St LLE�'t IAVE PHONE r 66• -8 52 -b`I r, PROJECT ADDRESS 160 l S L LlFC'C FN E, crrr F::,A ICE1'LS F I E (_D STATE CA TYPE OF LICENSE EXPIRATION DATE C6; yo WAZ 6• o -tl ZIP CODE �{ 3.3 0 g PHONE r 8 --213-7 661 - 58F0 CONTRACTOR NAME CA LICENSE r CONTRACTOR COMPANY NAME �35SCZ itivC. FAX t 6k-5g$ -286 ADDRESS u I ' b6-3o -Q©SUbRLF J,wy -+ 5 CITY LJAVEICS�IELb t2� n ZIP CODE 3308 All permits must be reviewed,, stamped, and approved PRIOR TO BEGINNING WORK, J • • INS ❑ Alarm - New & Modification (minimum charge) $280 • , 0 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 ❑- boveground Storage Tank (1 inspection per installation) AST $180 /tank 82 ❑ Additional Tank ATI $96 /tank 82 • Aboveground Storage Tank (Removal /Inspection) ATR $109 /tank 82 . • Underground Storage Tank (Installation /Inspection) NI $878 1tank 82 • Underground Storage Tank (Modification) MOD $878 /site 82 MI Underground Storage Tank (Minor Modification) MTM $167 /site 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 minimum) =1$192 84 ❑ 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