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HomeMy WebLinkAbout3620 WILSON Road_UST 5.11.11FOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH OTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. i / - /oo ©417 File Number: ZZ Address: 3 &2- d 1_-t Bakersfield, CA 933 Date Received: - //- i/ _ Business Name: - `C"P `yKC'S(0L' SYSTEM: L BUILDING SQUARE FEET: INSPECTION LOG New Mod. ❑ 11111111 Jill 71 ❑ Fire Alarm System ❑ ❑ FOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH OTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. i / - /oo ©417 File Number: ZZ Address: 3 &2- d 1_-t Bakersfield, CA 933 Date Received: - //- i/ _ Business Name: - `C"P `yKC'S(0L' SYSTEM: L BUILDING SQUARE FEET: INSPECTION LOG New Mod. ❑ ❑ Commercial Hood System ❑ ❑ Fire Alarm System ❑ ❑ Fire Sprinkler System ❑ ❑ Spray Finish System ❑ ❑ Aboveground Storage Tank ❑ ❑ Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank ❑ ❑ Other: Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: 1. 2. 3. 4. Date Time Signature Signature BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK Prevention Services 2101 H Street PERMIT APPLICATION e I Bakersfield, CA 93301 TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY ) /NEW Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD wATA/ 1 Page 1 of 1 Permit # TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY r❑ /NEW TANK INSTALL/EXISTING FACILITY WHFCIC ONF r)N1 Y) dd MODTFTCATTON OF FACT] TTY \R MTNOR MODTFTCATTON OF FACTLTTY STARTING DATE/ �� PROPOSED COMP. ETION DATE r es. FACILITY NAME /Y ' 'EXISTING FACILITY PERMIT # FACILITY ADDRESS Z / �i/, CITY ZIP CO rJ�� J TYPE OF BUSINESS 1_ „ kD !lam/ /VLY �i APN # TANK OWNER r7 PHONE # V ) 3 6 07 ADDRESS 36 �7 _ 5 n CITY ZIP CODE CONTRACTOR •..T. CA.LICENSE # ICC # ADDRESS " CITY , • ZIP C E� ) , 7 PHONE #6 A� BAKERSFIELD CITY BUSINESS LICENSE # .r WORKMANS COMP'# . "' INSURER BRIEFLY DESCRIBY THE WORK TO BE TNE, 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? ❑ YES ❑ NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? ❑ YES ❑ NO ' THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED.,.. j- Pr,�ir°.; "° ; •REGULAR','- ,,y,} "`;�. PREMIUM'v. r, ' _ r w DIESEL OTHER_, y. 'F 7 Tank Testing Company NAME OF TESTING COMPANY PHONE NUMBER MAILING ADDRESS NAME OF TESTER ICC# 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. NAME OF TESTER ICC# THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE O DATE APPROVED G - APPROV BY I. rULUOU (KCV Uif /U9) 'U . v`STOD3ER atie i ,Dati� ;,5 /:a6lii= 10x933. =:'.; t � � �P.SCY'.1 �i0ii� ". ^' %�':u��ti• i��l�', .:�, ^:.:;r� >;i,`?? - . €i BUIDINk+ AE.ht #Iii': .a. ",4:fY' %�.'•f,1�'.l+}�'..' 'L• Q l -a,?` — �:'r'�ii�tY,i� "YtY.!:•r1:�`. t��!`'t�OP1JO� '�=�.'T��k ,:t' ' • ,f!C�F'ka7 AT:It1'1' ,. PF�,O[wL''-�PAY.= A'i�11 iJr 11TFN'. •' fir:, ,,:ly r` ,: ';"i'` ,.f;::; x,4: