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Home My WebLink About3711 MT. VERNON Avenue_UST FMC 6.7.101111113 75 Address: -32/1 IAT, VPrOQG AO A�►2___ HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: 10636 (o 6 Address: -32/1 IAT, VPrOQG AO A�►2___ Bakersfield, CA 933 Date Received: 7-16 Business Name: AA 0 ,0!!i ,^fir? I-e- INSPECTION LO� SYSTEM: BUILDING SQUARE FEET: New Mod. ❑ ❑ Commercial Hood System Building Sq. Feet: _ Date Time ❑ ❑ Fire Alarm System Calculation Bldg. Sq. Ft: 9201 ❑ ❑ Fire Sprinkler System 2. ❑ ❑ Spray Finish Systems 3. ❑ ❑ Aboveground Storage Tank 4. ❑ ❑ Underground Storage Tank IV- 9�;� minor Signature modification Underground Storage Tank removal Underground Storage Tank Signature ❑ M Other: 7 Pt't C, Comments: /NO7P : iyo �oSI-�� ✓� 5!� vT Downi 2�� % sv l��ti� 76 UNDERGROUND STORAGE TANKS BAKERSFIELD FIRE DEPARTMENT Prevention Services sE - I it j s r MCI 1501Truxtun Avenue 1st Floor APPLICATION plet Bakersfield, CA 93301 I. TO PERFORM ELD /LINE TESTING/ *,WjrrAFAWT Phone: 661- 326 -3979 . Fax: 661- 852 -2171 SB989 SECONDARY CONTAINMENT Page 1 of 1 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 # ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT ❑ TANK TIGHTNESS FUEL MONITORING CERTIFICATIO FACILITY CA ax NAME & PHONE # OF CONTACT PERSON a -3 ADDRESS OWNER NAME OPERATOR NAME PERMIT TO OPERATE #. # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK #. VOLUME CONTENTS 3 t e e- TANK TESTING COMPANY TESTING COMPAN NAME & PHONE # OF CONTACT PERSON cCo'kan MAILING ADDRESS 5U- L4,3 CC) NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #— —'— DATE & TIME TEST TO BE CONDUCTED ICC # TEST METHOD APPLICANT SIGNAPJCE DATE ZZTHIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY /• G►� �(//CC // DATE FD2095 (Rev 03/08) BILLING & PERMIT STATEMENT PERMIT NO.: BAKERSFIELD FIRE DEPT. B - 8 R S F 1 D Prevention Services FIRE I 1600 Truxtun Ave Ste 401 ART MT Ir� Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax: (661) 852 -2171 FD 2021 (Rev. 06/07) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) SITE INFORMATION LOCATION OF PROJECT MC x' PROPERTY OWNER 2 u3a�S STARTING DATE �- - 1 COMP ION DATE U NAME PROJECT NAME rn� n -� 0 ADDRESS 5 1 ear PHONE NO. - PROJECT ADDRESS 1 n ^ L , r CITY �^ \� STATE ZIP CODE G'7'•��2��Jc • • • ' •`i' CONTRACTOR NAME CA LICENSE NO. TYPE OF LICENSE. EXPIRATION DATE J IF�m�S tc t't $09 50 f 7Q40A)-/,4 30 PHONE NO. CONTRACTOR COMPANY NAME tG�vvz-OiooLl FAX NO. ADDRESS J�lp �i CITY d I C-Py ZIP CODE All permits must be reviewed, stamped, and approved PRIOR TO BEG INNING WORK ON THAT PROJECT. ■ M R] PERMIT TYPE FEE CALCULATION TOTAL DUE ❑ Alarms - New & Modifications - (Minimum Charge) $280.00 ■ • ONLY TREASURY ACCT 84 • ❑ Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee ■ ■ 84 . 98 ❑ Sprinklers - New & Modifications - (Minimum Charge) $280.00 ■ ■ 84 98 . 4 Over 10, 000 Sq. Ft. Sq. Ft x.028 = Permit fee sa 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 .0 Spray Booths - New & Modifications $470.00 84 98 ❑ Aboveground Storage Tanks (Installadonllnsp. -1" Time) $180.00 ; 82 ❑ Additional Tanks $ 96.00 ; 82 ❑ Aboveground Storage Tanks (RemovaUlnspection) $109.00 . 82 ❑ Underground Storage Tanks (Instel1ationJlns0ecti6n) $878.00 (per tank) ■ 82 P . Underground Storage Tanks, (Modification)' ., ..:.: ,: �: '$878.001persite) 82 . ❑ Underground Storage Tanks (Minor Modification')` $167.00 ■ 82 ❑ Underground Storage Tanks (RemOYal) $573.00 (per tank) ' 84 ❑ Oilwell (Installation) $ 96.00 ; 84 Mandated Leak Detection (Testing /Fuel Monit.Cert/ 989. Note: $96.00 for each type of test /per c eduled at the same time). `� ,� - ° : ■ ■ 82 • Tents $ 96.00 (per teno ; 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- INSPECT/ON(S) /FOLLOW -UP INSPECTION(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) BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Reauest Phone No. (661) 326 -3979 DESCRIPTION PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF ( TANK TFCTitir _ MODIFICATIONS MINOR/ MAJOR I DESCRIPTION I DATE I SIGNATURE 1 DESCRIPTION DATE SIGNATURE CPRIOR T_O_O_PERATION_OF -ANY SYSTEM, ALL UST ANDIOR AST - SYSTEMS- SHALL_BE INSTALLED, COMPLET €AND ACCEPTED BY. THE_BAKERSFIELD -CCI'Y FIRE_DEP_ARTMENT. G t-7 ESCRIPTIO N "'lr� C. OCCUPANCY TYPE rJOB R PERMIT NO. D — ACTOR PHONE #,-?Y.2 - FD 1743 1 CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner ------------------------ KARRIS PROPERTIES 42263 W 50TH ST STE 101 LANCASTER CA 93536 10- 10000174 Date 6/16/10 3711 MT VERNON AVE 382- 020- 01 -00 -4 FIRE DEPT . 0 Contractor ------------------ - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . MANDATED LEAK DETECT TEST Additional desc . . Phone Access Code . 1010198 Permit Fee . . . . 96.00 Plan Check Fee 96.00 Issue Date . . . . 6/16/10 Valuation 0 Expiration Date 12/13/10 -------------------------------------------------------- -- ------ --- --- - - - - -- 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 after180 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Permittee: Date: BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES E R S P I D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 'ARTM T Office Phone: (661) 326 -3979 10- 10000174 Date 6/16/10 3711 MT VERNON AVE 382- 020- 01 -00 -4 FIRE DEPT . 0 Contractor ------------------ - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . MANDATED LEAK DETECT TEST Additional desc . . Phone Access Code . 1010198 Permit Fee . . . . 96.00 Plan Check Fee 96.00 Issue Date . . . . 6/16/10 Valuation 0 Expiration Date 12/13/10 -------------------------------------------------------- -- ------ --- --- - - - - -- 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 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 ., . a �: x 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 ' : ,-. `:: g .., } g`:s E a _ - I .a _ ` 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 constniction and hereby authorize representatives of the city to enter the above mentioned - property for inspection purposes. Signature of Applican t or Agent 5 R)'`5 .g' X1, V °°mot 77 3,4 N^ _ , =� 71 Date