HomeMy WebLinkAbout3125 CALIFORNIA Avenue_UST FMC 1.6.11IIAIMPI
47
HOODS ALARMS SpG°3NKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
File Number: 7Z 73co
Date Received:
Address: /,24- Its.— &&_
Bakersfield, CA 933
Business Name:
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
❑ "her: 12--7w (2-
Comments:
9.
a.
3.
4.
INSPECTION L ®G
Date Time
V. y..G9 i%i. G
Signature
BAKERSFIELD CITY FIRE DEPARTMENT -- INSPECTION RECORD
Post this Card at the Job Site and DO NOT Remove for Duration of Work
Inspection Request Phone No. (661) 326 -3979
UST NEW
INSTALL
DESCRIPTION
DATE
SIGNATURE
BACKFILL
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT
SENSORS
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK -OFF
UST REMOVAL
DESCRIPTION DATE SIGNATURE
REMARKS:
EVR UPGRADE
AST NEW INSTALL
DESCRIPTION DATE SIGNATURE
I MODIFICATIONS MINOR / MAJOR
AST REMOVAL
DESCRIPTION DATE SIGNATURE
PRIOR- TO- OPERATION-OF- ANY - SYSTEM}
ALL UST_AND /_OR AST SYSTEMS -SHALL BE)
INSTALL, . COMPLETE AND ACCEPTED BY
MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT:}
(FIRE- DEPARTMENT-(FINAL)
►
�
BUILDING ADDRESS: '
JOB DESCRIPTION: z:-Wq j C OCCUPANCY TYPE:
OWNER: PERMIT NO.
CONTRACTOR: PHONE # 7--
11 FD 1743
1,4
A B L- o' T H?S5'P 0, i' IF i 0 N I S
THIS PORTION IS NOWNEGOTIARKE o THIS POR-r'ON 1-- NON-N,-:G!--)-
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NON-NEGOTIABLE THIS POR ON IS MOWN EGO�!A_03LE
THIS
NOU "BL-E
THIS PORTION IS NOWNEGOTIAB
THIS POR'
N,,145,
THIS PC;f::VT;C`N IS
NON-NEGOTIABLE'o THIS POFTTIC,,�
NON-INIEC""
NON-Nr-GO—'ABI E
THIS PORTION IS Y'J0N--NEG0TiA,,,_frL�_-,
THIS PORTiON
NOWNEGOT I A�BL�E
o THIS P01:1 1 S
A'UN-NEGOTIABLE o THIS PORTION IS
NOWNEGOTIAB
K
THIS P0RT_f'&'
DIN -NECK"T" E
HIS PORTION IS NON-NEGOTIABLE
THIS PORT10fQ _52
1.40
NON-NEGOTIABLE o THIS PORTION
H1 PORT'_�`
J� -N -NE G0 TiAl E
THIS PORTION IS, NON-NEGOTM',lJ_-_-_
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T,- 'IS POR'10mN
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THIS PORTION
NC__lN-NEGoTlMl,__
z
BILLING & PERMIT STATEMENT
PERMIT #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501 Truxtun Avenue, 1st Floor
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax7 661- 852 -2171
All
2
❑
permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK.
PERMIT TYPE FEE CALCULATION TOTAL
DUE
Alarm - New & Modification (minimum charge) $280
SITE INFORMATION
LOCATION OF PROJECT
PROPERTY OWNER
Cn
Co
STARTING DATE COMPLETION DATE
NAME
PROJECT NAME
ADDRESS
PHONE #
PROJECT ADDRESS3 LZ
a
CITY gKERS�IELD STATE CAF
ZIP CODE
I
CONTRACTOR INFORMATION
Over 10,000 sq ft
$0 .028 x sq ft
CONTRACTOR NAME CA LICENSE #
TYPE OF I ENSE EXPIRATION DATE
PHONE #
92 733
2
66J�32 3
CONTRACTOR COMPANY NAME
FAX #
Ca. - Ve, hu- r
ADDRESS
3DO GUMor� e
alms '�
ZIP CODE
All
2
❑
permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK.
PERMIT TYPE FEE CALCULATION TOTAL
DUE
Alarm - New & Modification (minimum charge) $280
'
ONLY
TREASURY
ACCT NO
❑
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
•
Aboveground Storage Tank (1 inspection per installation) AST
$180 /tank
82
❑
Additional Tank ATI
$96 /tank
82
•
Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR
$109 /tank
82
•
Underground Storage Tank (Installation /Inspection) NI
$878 /tank
82
•
Underground Storage Tank (Modification) MOD
$878 /site
82
•
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) =$192
82
❑
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
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 W ill 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 Agenq 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 1 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 I Date
CONSTRUCTION PERMIT
Application Number . . . . .
Property Address . . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
------------------------
DHILLON PARTNERS LLC
2710 E LAURA CT
VISALIA CA 93292
BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
R s P I D 1501 TRUXTUN AVENUE, 1sT FLR
FIRE BAKERSFIELD, CA 93313
�I
RrM r Office Phone: (661) 326 -3979
11- 10000008 Date 1/06/11
3125 CALIFORNIA AVE
007- 041- 30 -00 -5
FIRE DEPT
0
Contractor
------------------ - - - - --
OWNER
----------------------------------------------------------------------------
Permit . . . . . . MANDATED LEAK DETECT TEST
Additional desc . .
Phone Access Code . 1065051
Permit Fee . . . . 96.00 Plan Check Fee 96.00
Issue Date . . . . 1/06/11 Valuation . . . . 0
Expiration Date . . 7/05/11
----------------------------------------------------------------------------
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
(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 afterl 80 days of inactivity.
I have reviewed the above application, and find it to
be correct/complete.
Permittee: Date:
UNDERGROUND STORAGE TANKS
APPLICATION
H H R S P I D
R/Re
aRrM r
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS TEST
❑ LINE TESTING
X TO PERFORM FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT TESTING
❑ Cathodic Protection Testing
SITE INFORMATION
FACILITY ARCO
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 3125 California Ave. Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same
PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK#
VOLUME
CONTENTS
1
87 U/L
2
87 U/L
3
91 U/L
TANK TESTING COMPANY
NAME OF TESTING COMPANY Cal - Valley Equipment
Bruce W. Hinsley 661- 327 -9341
MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308
Bruce W. Hinsley 661- 327 -9341
CERTIFICATION #: 548333761 Rafael Martinez
DATE & TIME TEST TO BE CONDUCTED
ICC #:
SIGNATURE OF APPLICANT uu`
DATE 12128/2010
RA MS APP ICAQX, BECOMES PERMIT WHENI APP OVEG,
APPROVED BY G DATE
FD 2095 (Rev. 09/05)