HomeMy WebLinkAbout3624 CALIFORNIA Avenue_DEL TACO MOBIL UST FMC 10.9.09HOODS. ALARMS SPRINKLER- SYSTEMS - WRAY BOOTH AST UST
Permit No.
Permit No.,
i��n� 65.
File Number: /6)0 13046
Date Received: - /0 — c7p 07
S.YSTEM' I!
New Mod.
0 ❑ Commercial Hood System
Permit No. Permit No. Permit No. Permit No.
Address:. ;36-.,;U4
Bakersfield,. CA 933
Business Name:
BUILDING SQUARE FEE
Building Sq. Feet-,
❑ ❑ Fire AIAOM -Sy - ysto m CalcUlatiCalculation Bldg, Sq. Ft: .
❑ ❑ Fire Sprifinkler System
❑ 0 Spp" Flois Ih Sysb M I.;
❑ 0 Aboveground Storage Tank 4.
❑ 0_Underground Storage Tank
minor
modification Underground Storage Tank
removal Underground Storage Tank
❑ ❑ Other.
Comments: ZE�7_c__
`I,N$PV_CT16N, L0707]
DaW Time
Signature
'Signature,
Z6
IE
UNDERGROUND STORAGE TANKS BAKERSFIELD FIRE DEPARTMENT
LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT
S! FUEL MONITORING CERTIFICATION
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,)
PERMIT # 001-A90,00,932
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
Prevention Services
� 1501Truxtun Avenue St Floor
��R/ Bakersfield,, CA 93301
ARTY f phone: 661 - 326 -3979 . Fax: 661 - 852 -2171
Page 1 of 1
�. SITE INFORMATION �:
FACILITY TACO O I L.
A{ O
NAME & PHONE # OF CONTACT PERSON 03O
5-rQ AR.-r L61- 63 8 -
T /� /�� p rJoH,�
AODRES? ' 5 6 'Z L-k �_ Lj Fb fL W t "7 I I V C, -56 V-E 2 s F I E Lb CA,
OWNER NAME S-C CI'RJZT IS e T1Z.O LE-0r o.
OPERATOR NAME
JON N szo Aar
PERMIT T0. OPERATE #
# OF TANKS TO BE TESTED:
IS "PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
t
►dt000
84
2`
10,000
ql -a
3
1O 00�
DIESEL_
". TANK TESTING G,QMRAN.Y
TESTING COMPANY
'F355SZ tIJC 11F,N151-
NAME & PHONE # OF CONTACT PERSON
CF1Rtzt'L.LO 66%- 888 -Z -i�l
MAILING ADDRESS
6630 ROS5614)L15 HWy A* g QAKEZSFtELD CA, 933oB
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
DA-410 T�FICILE-r-r 66t- 20 6- 2'��
CERTIFICATION #
A3" 3L4 5
DATE & TIME TEST TO BE CONDUCTED
ICC #
526t2.g6 ..�-t
TEST METHOD
APPLICANT SIGNATURE
DATE
-oq
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED.
VED BY
DATE
FD2095 (Rev 03/08)
BILLING & PERMIT STATEMENT
PERMIT #
® q.-- / 45 1
f F D
E
Y r
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501 Truxtun"Avenue, 15I Floor
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax:. 661-852-2171
INFORMATION SITE
PCATIONOFPROJECT — TAC,O l�JOE)IL.. PROPERTY
STARTING DATE COMPLETION DATE NAME
!!
OWNER'' STvART�S 1�ET2pLEVrn
STJAjZT
PROJECT NAME „- ADDRESS
TIAIJK IMo�S� I o12 CEjzT�F�CgTIOtJ
t I E. yTi-t sTREET
PHONE
6t;►�b3� -o3O_t
PRO)ECT ADDRESS �1 /�
3 G 2 Ll CAL % FO R N I Iq A- t E CITY
g�C K ETZ S I E LD STATE CA
_
ZIP CODE
8 3 3 0
CONTRACTOR INFORMATION
CONTRACTOR NAME 7LICENSE 11
B7ZETT TACk�TT �2a12
TYPE OF LICENSE EXPIRATION DATE
C6t O40 -HA'Z b- o -ll
PHONE tt
661- 5gP,-2q�
CONTRACTOR COMPANY NAME
(3 SSZ INC.
FAX tt
X61-586 2 16 6 I
ADDRESS
6630 Ra SEDATE HW-j -#, F3
CITY
gAKE(ZsFIE�D
ZIP CODE
933U�
All
J
❑
permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK.
PERMIT TYPE FEE CALCULATION TOTAL
DUE
Alarm - New & Modification (minimum charge) $280 r
'
ACCT
- - - - -,
I ❑
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 --
❑
i
Commercial Hood (New &'Modification)"'
$470
❑
Additional hood
$58
i ___ ------- _ -._
F-0
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; 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
I ❑
Underground Storage Tank (Removal) TR
$573 /tank
84
'
i2(
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
j ❑
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 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 :: fi a��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
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
!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 Applicant or Agent L,' _, t�� �:w., � >�t,�:.�� ., „,�tri „ =...r., ��:: �.,;.��. �� ����,r�;,. °�"�,,.�w���h;� .r .�::. Date
CONSTRUCTION PERMIT
Application Number . . . . .
Property Address _ . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
GIBRALTAR 1031 RESTAURANTS
P O BOX 235169
92023
BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
R S F I 1 1501 TRUXTUN AVENUE, 1sT FLR
FIRE BAKERSFIELD, CA 93313
4RrM r Office Phone: (661) 326 -3979
09- 10000239 Date 10/14/09
3624 CALIFORNIA AVE
020 - 020- 05 -00 -7
FIRE DEPT
0
Contractor
OWNER
----------------------------------------------------------------------------
Permit . . . . .
. MANDATED LEAK DETECT TEST
Additional desc .
.
Phone Access Code
. 950964
Permit Fee . . .
. 96.00
Plan Check
Fee 96.00
Issue Date . . .
. 10/14/09
Valuation
. . . . 0
Expiration Date .
. 4/12/10
----------------------------------------------------------------------------
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 after 180 days of inactivity.
I have reviewed the above application, and find it to
be correct/complete.
Permittee: ' Date: 0 ^ZI-0