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Home My WebLink About5201 STOCKDALE Hwy_UST REMOVAL 12.22.09pll! Permit No. File Number, Date Received: Permit No. I�IIYYW 1-5 111111q� New Mod. 0 ❑ Commercial Hood System ❑ ❑ Fire' - AlArM S y0t6it ❑ ❑ Fire Sprinkler System jzas�!�I i 1111111111111� qI;pZ1111 �,:..�, 0 Aboveground Storage Tank ❑ 0 Underground Storage Tank minor mod ification Underground Storage Tank removal Underground Storage Tank ❑ ❑ Other: Permit No. Permit No. Address: tr-2-6 / 'Bakertfield, CA 933 Business Name: 8W.L01 FEET: Building ing Sq. Feet:. Calculation Bldd'.;S-4, Ftr AST Permit No. Permit No. Date Time 20 3. 4. I. g-h 'at u r e Comments: 3 16 IE CONSTRUCTION PERMIT Application Number . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . . Application valuation . . . . Owner NNN CA AUTO SVC LLC 450 S ORANGE AV STE 900 ORLANDO FL 32801 10- 10000004 Date 1/05/10 5201 STOCKDALE HWY 194 - 450- 03 -00 -4 FIRE DEPT 0 Contractor OWNER ---------------------------------------------------------------------------- Permit . . . . . BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R S F ID 1501 T.R. UXTUN AVENUE, IT FLR FIRE BAKERSFIELD, CA 93313 4__,,, T Office Phone: (661) 326 -3979 10- 10000004 Date 1/05/10 5201 STOCKDALE HWY 194 - 450- 03 -00 -4 FIRE DEPT 0 Contractor OWNER ---------------------------------------------------------------------------- Permit . . . . . . UNDGRND STR TANK REMOVAL Additional desc.. . Phone Access Code 970277 Permit Fee . . . 286.50 Plan Check Fee 286.50 Issue Date 1/05/10 Valuation . . . . 0 Expiration Date 7/04/10 ---------------------------------------------------------------------------- Fee summary ----------- - - - - -- Charged --- - - - -- ---- Paid Credited Due Permit Fee Total - - 286.50 - - ---- -- -- -- - - -- ---- 286.50 .00 - - - - -- .00 Plan Check Total 286.50 286.50 .00 .00 Grand Total 573.00 573.00 .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 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 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 r+ 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 th e 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;'epresentatives of the city to enter the above mentioned property for inspection purposes. Signature of Applicant or Agent '' f '' p Date CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property use . . . . . . . . Application valuation . . . . Owner ------------------------ NNN CA AUTO SVC LLC 450 S ORANGE AV STE 900 ORLANDO FL 32801 10- 10000004 Date 1/05/10 5201 STOCKDALE HWY 194 - 450- 03 -00 -4 FIRE DEPT 0 Contractor ------------------ - -- - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R S F ID 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 4RTN r Office Phone: (661) 326 -3979 10- 10000004 Date 1/05/10 5201 STOCKDALE HWY 194 - 450- 03 -00 -4 FIRE DEPT 0 Contractor ------------------ - -- - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . UNDGRND STR TANK REMOVAL Additional desc . Phone Access Code 970277 Permit Fee . . . . 286.50 Plan Check Fee 286.50 Issue Date . . . . 1/05/10 Valuation . . . . 0 Expiration Date . . 7/04/10 ---------------------------------------------------------------------------- Fee summary --------- - - - - -- Charged ---- - - -- - Paid Credited - - ---- Due - - - - -- -- Permit Fee Total -- 286.50 --- --- - -- ---- - - 286.50 -- .00 .00 Plan Check Total 286.50 286.50 .00 .00 Grand Total 573.00 573.00 .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 iischool? 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 Agent w . m d .. �: 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 ' ,. .� ..�. � �.� .y k�� _ �_ .mss .��,� _. ,� >.: . ,_ �- 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 Applicant or Agent _ Date F,.- ..,A ,a, In.. m..., q�n. w CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R S F I n 1501 TRUXTUN AVENUE, 1sT FLR FlRB BAKERSFIELD, CA 93313 �IIPTM T Office Phone: (661) 326 -3979 Application Number . . . . . 10- 10000004 Date 1/05/10 Property Address . . . . . . 5201 STOCKDALE HWY ATN (11 Digits): 194 - 450- 03 -00 -4 Application type description FIRE DEPT Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . 0 Owner Contractor - ------ ----------- - NNN CA AUTO SVC LLC -- - -- ------------------------ OWNER 450 S ORANGE AV STE 900 ORLANDO FL 32801 ---------------------------------------------------------------------------- Permit . . . . . . UNDGRND STR TANK REMOVAL Additional desc . Phone Access Code 970269 Permit Fee . . . . 286.50 Plan Check Fee 286.50 Issue Date . . . . 1/05/10 Valuation . . . . 0 Expiration Date . . 7/04/10 ---------------------------------------------------------------------------- Fee summary ----------- - - - - -- Charged ---- - - - - -- ---- Paid Credited - - - - -- -- -- - - - - -- ---- Due - - - - -- Permit Fee Total 286.50. 286.50 .00 .00 Plan Check Total 286.50 286.50 .00 .00 Grand Total 573.00 573.00 .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 Agent hone No. Date _ � a 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 contractor(s) licensed pursuant to the Contractor License Law). I am exempt under Sec. B. & P. C. for the reason Owner Signature 11 r` �:�.; 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 Cade, 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 Applicant or Agent �,h.- � � �, ' :� :� �a SWA, Date 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 BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAL -OFF uw�.rvr i ivry - - ur+i � JNIW11 URC CRASH POSTS OVERFILL PROTECTION ELECTRICAL SEAL -OFF SECONDARY CONTAINMENT TAAIV TGeTlKI(_' I I MODIFICATIONS MINOR/ MAJOR UST REM()vAl DESCRIPTION DATE SIGNATURE link DESCRIPTION DATE SIGNATURE PRIOR TO OPERATION OF ANY SYSTEM, ALL UST AND /OR AST SYSTEMS SHALL BE INSTALLED, COMPLETE AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT. FD 1743 JOB DESCRIPTION OCCUPA CY TYPE OWNER ; "' zj T r PERMIT NO. / - CONTRACTOR ct K..) c-C.6m 1 PHONE # 3r S- goV& Z FD 1743 Cat' of Qa'eFSfleld �� gSTOMER RECEIPT arm Doer: TVAFOSSE1.1 Type: 0C Drawer: I. Date; 1I05/10 01 Receipt no: 54105 Description, Quantity Amount . 100010004 . RP BUILDING PERMITS i. 00 31715.00 Tender detail CY, CHECK '?74 $1719.00 s`otal tendered $1715.00 Total payment 41719. Wi Trans .date:` 'li05110 Time: 13:57:IE 114APPY P.GLIDi1YT' BILLING & PERMIT STATEMENT y _ BAKERSFIELD FIRE DEPARTMENT E R S F I - L D Prevention Services PERMIT # FIRE i 1501 Truxtun Avenue, 1 Floor aR'NTr. Bakersfield, CA 93301 Dhnnc• Ar,1 _11r,_Z070 s Fav• ��1 _Rr.7_'�1 71 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. ❑ Alarm - New & Modification (minimum charge) $280 , ❑ Over 10,000 sq ft SITE INFORMATION LOCATION � 7� OF PROJECT / .'� AI + PROPERTY OW E STAR NG DATE COMPLETION DATE ' Q ( �5, NAME /f jo/z JI 4 PROJECT NAME /z- G►9�2 fl ADDRESS . O PHONE# - �-'� PROJECT ADDRESS+ CITY g.410E125�(ELD STATE C.4 ZIP CODE �� 1 CONTRACTOR NAME D 14#j 1Z- ' ;�So,J CONTRACTOR,, INFORMATION CA LICENSE # aS 279 TYPE OF LICENSE >�� EXRIRATON� „l 10 PHONE # 2S—L4,? 0 T CONTRACTOR COMPANY NAME �Q 2. 5a�- -� •' FAX # to J s -siz ADDRESS $470 ' / " / ZIP CODE O All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. ❑ Alarm - New & Modification (minimum charge) $280 , ❑ Over 10,000 sq ft $0 .028 x sq,ft ❑ Sprinkler - New & Modification (minimum charge) $280.,' ❑. Over 10,000 sq ft $0 .02 &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 1tank 82 ❑ Additional Tank ATI $96 /tank. 82 • Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR $109 /tank. 82 • Underground Storage.Tank (Installation /Inspection) NE $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 -Y 3 7/9 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 firs. min standby fee /insp) =$576 5 hrs-min standby fee ins = 605 84 ❑ Re- inspectionjFollow -up Inspection $96 /hr 84 ❑ Portable LPG (Propane): # of Cages? — $96 /hr 84 0 Explosive Storage ."; . $266 84 ❑ Copying & File�Research (Rle`Research fee $50 /hr) $0.25 /page 84 ❑ Miscellaneous 84 UNDERGROUND STORAGE TANK r,T-7- Tr� ff QP �: 2 ffiN� PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK :Permit # rPARBAKERSFIELD FIRE DEPARTMENT Prevention Services B E R S P D 1501 Truxtun Avenue - — s FIR16F Bakersfield, CA 93301 jr ►FIV, T THI -852-2171 RT Phone: 661-326-3979 e Fax: 661 Page 1 of 1 SITE INFORMATION SITE^ J 94 rt)OA-70 al#- AAM ADDRESS 52O/ FACILITY NAME CROSS Wk:kl TANKOWNE OP TO PHONE # fba.5 71)- -Val* 'Sys Atjoaaq 00-1(*A %J APIN # -0 7 MAI'4,#ERE��6 CITY oo-l- ZIP CODE CONTRACTOR INFORMATION COMPAN)T PHONE # z- LICENSE # 2--7f ADDRESS 7-0 j7- CITY ZIP INSURANCE CARRIER WORKMENS COMP # PRELIMINARY ASSESSMENT INFORMATION cgpz\/, 141- .5. P" e4 -5;e5 PHONE # 3A:F-- Lie- -3 ENSE # io Z- Z--Ap AJ8!S Z. CITY -&LC1> ZIP CODE9 INSURAi CAR . 2. _RVj W8 ztz 5, 12RKMENS jp P # TANK CLEANING INFORMATION COMPANY • PHONE #' # ADDRESS d? ZIP COQ;ka INSUR %t��E (CE 4 'q&1zy1 car -7 WORKMENS C qb IL S --bl j 7 1A FACILITY ID # WASTE TRANSPORTER ID rq NAME OFA&SATE DISPOSAL POSAL FACILITY ADDRESS CITY ZIP CODE TANK TRANSPORTER INFORMATION COMPANY VA eL; U H PV ONE , 40or o c LICENSE # a (.a2.S4 2.-0'7 ADDRESS3,.z. ZIP C E 4 b TANK DESTINATIO :51er=lm r1R:6yCLjN6 U�k%fo- Apzd 50-z-, TANK INFORMATION TANK # AGE VOLUME CHEMICAL STORED DATES STORED CHEMICAL PREVIOUSLY STORED ,a 0-0 6w— LO CIO z FOR OFFICIAL USE ONLY APPLICATION DATE FACILITY # # OF TANKS FEE $ 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. AU ROVED BY APPLICANT NAME (PRINT) APPLICANT I N , RE THIS APPLICATION WILL BECOME A PERMIT � H N APPROVED FD2088 (Rev 03/08) BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT B E R S F R2SL D Prevention - Services PERMIT # FIRE 1501 Truxtun Avenue, 1St Floor � rla iras g Bakersfield, CA 93301 Dhnna• F,F.1- 'A7F -"AQ7Q a Fax• F,Fi1 -R9;7-7171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minimum charge) $280 ❑ Over' 10,000 sq ft $0.028 x sq ft SITE INFORMATION ❑ Sprinkler - New & Modification (minimum charge) $280 LOCATION IRO]ECT � / Y' ❑ PROPERTY PONE lg� STAR NG DATE COMPLETION DATE 1 o v � .,;W0 NAMME ❑ Minor Sprinkler Modification (<10 heads) PROJECT NAME 14, 84 ADDRESS OWWA46 r PHONE # 5 t3 - SA-p PROJECT ADDRESSe- Z 0 / � I' ^^ ^ CITY g/ C E -S F I E L.� STATE CIA ZIP CODES 3_Z O OJ CONTRACTOR NAME 014jj i��OrJ CONTRACTOR CA INCENSE #' tS 2.77 •• • TYPE OF LICENSE --� EX IRATION DATE 11 20:1 PHONE # &6P/ CONTRACTOR COMPANY NAME 98 ❑ Aboveground-Storage Tank (1 inspection per installation) AST FAX # V 1' ADDRESS 2_®/ z ^� ' ST ' i ❑ Additional Tank ATI $96 /tank h G� ,. ' ZIP CODE O, All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. Alarm - New & Modification (minimum charge) $280 ❑ Over' 10,000 sq ft $0.028 x sq ft ❑ Sprinkler - New & Modification (minimum charge) $280 ❑ Over 10,000 sq ft .. i $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 1711 . 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 0 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) IPX NOTE: After hours Pyrotechnic event inspection is @ 121 hr $96 /hr + (5 hrs min standby fee /insp) =$576. 5 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) $0,25 /page 84 ❑ Miscellaneous. 84 F$i,:.,'�r -`� ��••s,�,7�,,,�ic �me�t .r,.,,is,, s�+y,^4'rikt'+' c'.3� t '�Y 7aa' `� Kxt s f —. UNDERGROUND STORAGE TANK L.. 4a-$:• e:.: �... wv"' ��'+..'. Gt�i:.: 3F... .' ..3:se:...:..,ra.eh"�,:.£...� � ..�..k'.P!? r1....n.. i`.e. :ch .+. :�.. ,. w,..(:;: PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK ..:._._.__..._.___.__._...- -- �......__.._.._.....- °- - - - -.. is - •. , Permit # BAKERSFIELD FIRE DEPARTMENT Prevention Services B_ E R S r _D 1501 Truxtun -Avenue PBRR Bakersfield, CA 93301 1RrX f Phone: 661- 326 -3979 a Fax 661 - 852 -2171 Pagel of 1 SITE INFORMATION SITE ^ Avre o- 2 ADDRESS 2 0/ .S'i 2cx r04 ZIP C DE FACILITY NAME /J _ (�%/�• CROSS SIRE TANKOWNE OPE TO PHONE # ie>o APN # MAI N DDRE CITY ZIP CODE CONTRACTOR XNFORMA71ON COMPAN O ►� i �Se�� PHONE # - S- y -f `i LICENSE # ' A 2.R ADDRESS Z E� CITY S�I ZIP DE INSURANCE CARRIER T 1 ERBIf WORKMENS COMP # C 243-L t21 PRELIMINARY ASSESSMENT INFORMATION CF �OpMP jpNN�Y V /I Mpk , -K_ _ "ce se5 PHONE # $- y�` Z CENSE�# Z. • . A JRES! Z �� S J CITY /1L —l(A ZIP CODEy, *,. 7 INSURANCE CARRIER or WORKMENS COMP # Iw lsRilJ'�S 2O8Z�2.5'237 G� Z�Z �1 S / TANK CLEANING INFORMATION COMPANY Iy PHONE # / - Z S' - X18 tp z. LICENSE # 4 Z ADDRESS _o/2 J s7. o �i ZIP COD INSURANCE CARRIER W iW e�c Zo8Z 8 z WORKMENS COMP # ' 4b IL WASTE TRANSPORTER ID # FACILITY ID # Lay a? o o/ 3 3 5-1, NAME OF NSATE DISPOSAL FACILITY N�- ADDRESS CITY ZIP CODE TANK TRANSPORTER INFORMATION COMPANY PONE # o LICENSE # cD��.c jJ64 7 ADDRES 41" 09— , ZIP C E TANK DESTINATIO 'y I ZO E. TANK INFORMATION TANK #' AGE VOLUME CHEMICAL STORED DATES STORED , CHEMICAL PREVIOUSLY STORED FOR OFFICIAL USE ONLY' APPLICATION DATE fACILITY # # OF TANKS FEE $ 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. APPROVED BY - APPLICANT NAME (PRINT) �l�O APPLICANT N RE THIS APPLICATION WILL BECOME A-PERMIT �N APPROVED FD2088 (Rev 03/08) BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK � Prevention Sertve�es +bh a.N a ry 1600 Truxtun Ave., Suite 401 FINN Bakersfield, CA 93301 INSPECTION FORM u, ��1rM Phone: ,661- 326 -3979 ® Fax: 661- 852 -2171 FOR TANK REMOVAL Page 1 of 1 CONDITION OF TANK CONDITION OF PIPING (� ^ —Se� CONDITION OF SOIL / COMMENTS "�^-� �i v � -ems. C L. d►15�� -ns dr DATE INSPECTOR NAME SIGNATURE Kern County Online Mapping This map is a user generated static output from an Internet mapping site and is for general reference only. Data layers that appear on this map may or may not be accurate, current, or otherwise reliable. THIS MAP IS NOT TO BE USED FOR NAVIGATION. �ILL. d t.t IL I Legend /' .�iterinl r/J %of cftr Unpaved t: County of Kern Assessment Parcels High Res Aerial Photo 300 2 n { Scale: 9:559