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HomeMy WebLinkAbout3221 TAFT Hwy_UST SB989 7.15.10�aiuuu� „ HOODS ALARMS SpRNKL ER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. lD— /d000aa File Number: Address: Date Received: Business Name: Bakersfield, CA 933 SYSTEM: BUILDING SQUARE FEET: New Mod. ❑ ❑ Commercial Hood System ❑ ❑ Fire Alarm System ❑ ❑ Fire Sprinkler System ❑ ❑ Spray Finish Syst em ❑ ❑ Aboveground Storage Tank ❑ ❑ Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank ❑ W, Other: Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: G;,eJy4,1 `q ia�eosej buf-t6- z. �n�Y ���`��Y - r�•e,boo�-s 3. 4. Date Time Signature I�IIAN N 78 j 0 BILLING & PERMIT STATEMENT PERMIT NO.: BAKERSFIELD FIRE DEPT. B 8 R S F lz_iD Prevention Services FIRE ARTY T xt 1600 Truun Ave Ste 401 Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax: (661) 852 -2171 SITE INFORMATION LOCATION OF PROJECT PROPERTY OWNER STARTING DATE COMP ION DATE NAME PROJECT NAME ^ ADDRESS PHONE NO. PROJECT ADDRESS CITY STATE ZIP CO E ' • •• INFORMATION CONTRACTOR NAME LICENSE NO. JP e rY1�S��ctt $O�l �C� TYPE OF LICENSE. EXPIRATION DATE fi�4Ofd/!A 3o r� PHONE NO. g2 -8(pai CONTRACTOR COMPANY NAME J C_tA- v FAX NO. 3r?2 - o coa- t ADDRESS � moo CITY /\ ZIPCODE 9�� or All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. ■ ° ■ ❑ Alarms - New & Modifications - (Minimum Charge) $280.00 , ■ 84 • ❑, Over 10,000 Sq. Ft Sq. Ft. x.028 = Permit fee 8 ❑ Sprinklers - New & Modifications - (Minimum Charge) $280.00 ■ ■ 84 98 Over 10,000 Sq. Ft. Sq. Ft 3c.028 = Permit fee ■ ■ 84 98 • Minor Sprinkler Modifications (< 10 heads) $ 96.00 [Inspection Only] ■ ■ 84 98 • Commercial Hoods —New &Modifications $ 470.00 ■ , ■ 84 98 ❑ Additional Hoods $ 58.00 ■ ■ sa 98 ❑ Spray Booths - New & Modifications .$470.00 84 98 ❑ Aboveground Storage Tanks (Instal /atioNlnsp. -i" Time) $180.00 ; 82 ❑ Additional Tanks $ 96.00 ; 82 ❑ Aboveground Storage Tanks (RemovaUlnspection) $109.00 . 82 ❑ Underground Storage Tanks (Installation./Inspection) $878.00 (per tank) ■ 82 ❑ Underground Storage Tanks (Modification) $878.00'(persite) ■ 82 ❑ Underground Storage Tanks (Minor Modification) $167.00 ■ 82 ❑ Underground Storage Tanks (Removo $573.00 (per tank) ' 84 ❑ Oilwell (Installation) $ 96.00 ; 84 Mandated Leak Detection (Testing) / Fuel Monit.0 rt/S13989. Note: $96.00 for each type of test 1 per site (even if sc at the same time) $'96 6t3 (flersite! / 9 ,o U - N : ■ 82 ,❑ Tents $ 96.00 (per tend ' 84 • Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) $ 96.00 + (5 hrs. min. standby fee /Inspection)-_$576_00 84 ❑ After hours inspection fee $121.00 : 84 • RE- INSPECTIONS) /FOLLOW -UP INSPEC710N(S) $ 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) 250 per page ; 84 ❑ Miscellaneous 84 FD 2021 (Rev. 06/07) 1 -ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION (Please note that these are separate individual tests and will be charged per separate type test accordingly.) ❑ ENHANCED LEAK DETECTION ❑ TANK TIGHTNESS BAKERSFIELD FIRE DEPARTMENT Prevention Services s a 1501Truxtun Avenue 1st Floor Bakersfield, CA 93301 Aaf/I f Phone:, 661- 326 -3979 a Fax: 661 - 852 -2171 Pagel of 1 ❑ LINE TESTING c�S6 -989 SECONDARY CONTAINMENT ❑ FUEL MONITORING CERTIFICATION SITE INF07tMATION .. . FACILITY NAM & PHONE # OF CONTACT PERSON ' ADDRESS ak 9:5-51 OWNER NAME \w OPERATOR NAME PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS UA ate ;TA .. NK TESTING C ©MPANY:, " TESTING COMPANY AME & PHONE # OF CONTACT PERSON MAILING ADDRESS 5ta (3 (bccCk -S T NAME & PHONE,.JjOF TESTER OIL SPECIAL INSPECTO CERTIFICATION # DATE & TIME TEST Tf BE CONDUCTED ICC # TEST METHOD APPLICANT SIGNATURE DATE //v T IS APPLICATION BECOMES A PERMIT WHEN APPROVED OVED BY DATE - .26 - /O FD2095 (Rev 03/08) CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner ------------------------ BUDIYAN VIKRAM S & AMITA S 3221 TAFT HY BAKERSFIELD CA 93313 10- 10000209 Date 7/27/10 3221 TAFT HWY 184 - 170- 26 -00 -7 FIRE DEPT 0 Contractor ------------------ - - ---- OWNER ---------------------------------------------------------------------------- Permit . . . . . . MANDATED LEAK DETECT TEST Additional desc \ Phone Access Code 1020759 Permit Fee . . . . 96.00 Plan Check Fee 96.00 Issue Date . . . . 7/27/10 Valuation . . . . 0 Expiration Date . . 1/23/11 ---------------------------------------------------------------------------- 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 after180 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Permittee: Date: BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES 1501 TRUXTUN AVENUE, 1sT FLR JFIRE BAKERSFIELD, CA 93313 Office Phone: (661) 326 -3979 10- 10000209 Date 7/27/10 3221 TAFT HWY 184 - 170- 26 -00 -7 FIRE DEPT 0 Contractor ------------------ - - ---- OWNER ---------------------------------------------------------------------------- Permit . . . . . . MANDATED LEAK DETECT TEST Additional desc \ Phone Access Code 1020759 Permit Fee . . . . 96.00 Plan Check Fee 96.00 Issue Date . . . . 7/27/10 Valuation . . . . 0 Expiration Date . . 1/23/11 ---------------------------------------------------------------------------- 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 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 }?: w= 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. 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). 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 comractor(s) licensed pursuant to the Contractor License Law). I am exempt under Sec. B. & P. C. for the reason :may �,:r �- Owner Signature � t� - �3•- _ - H �:. �� �" �3•..�.-�� -:: ;�= _ ->;�a. �x,z 7�- - _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 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 Applican t 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 DESCRIPTION BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT AUTHORIZATION FOR FUEL ELECTRICAL SEAK-OFF TING--, MODIFICATIONS MINOR/ MAJOR DESCRIPTION A Cah AL DESCRIPTION DATE SIGNATURE PRIOR TU-OPERATION OF ANY SYSTEM,' A_L"u T AND /OR -kV-r- SYSTEMS SHALL BE INSTALLED -WMPL&E AND ACCEPTED BY,', TAE—B—AK—E-R- S­FIE L-D----C-lT---Y--F-IR E- DEPARTMENT! Fl) 1743