HomeMy WebLinkAbout5401 STOCKDALE Hwy_UST FMC 7.22.10HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
/D - /GOOOZz
File Number: -416579 Address: Tqd ! -.%-T-0 C- « d k.Q--
Bakersfield, CA 933
Date Received: 7
Business Name: :24Zd -AL L
SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG
New Mod.
❑ ❑ Commercial Hood System Building Sq. Feet: �� Date -Mme
❑ ❑ Fire Alarm System Calculation Bldg. Sq. Ft: 1. ;/e PL
❑ ❑ Fire Sprinkler System �i����5 2. /ia-��c_
❑ ❑ Spray Finish System :l� l 3.
,\
❑ ❑ Aboveground Storage Tank N� - �� 4.
❑ ❑ Underground Storage Tank1'
9 9
minor Signature
modification Underground Storage Tank
removal Underground Storage Tank
Signature
❑ Other: �/yt C,
Comments:
iu�suN�
1E
UNDERGROUND STORAGE TANKS
APPLICATION
FIRE
ARTM, T
TO PERFORM ELD /LINE TESTING/
S8989 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 #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501Truxtun Avenue 1s* Floor
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1 of 1
FD2095 (Rev 03/08)
BILLING & PERMIT STATEMENT BAKERSFIELD FM DEPT.
B B R S P I D Prevention Services
F1 T r
�Rrr 1600 Truxtun Ave Ste 401
PERMIT NO.:
Bakersfield CA 93301
Tel.: (661) 326 -3979 • Fax: (661) 852 -2171
LOCATION OF PROJECT
PROPERTY OWNE
STARTING DATE COMPLETION DATE
NAME
PROJECT NAME
ADDRESS
PHO N .`� '
PROTECT ADDRESS
CITY STA
ZJP CODE
CONTRACTOR
CONTRACTOR NAME 1 CA LICENSE NO.
J+�m�S�tC� p sC�
INFORMATION
TYPE OF LICENSE. EXPIRATION DATE
fa4c�.4HA 3o icy
PHONE NO. i
�2 -S(p87
CONTRACTOR COMPANY NAME 1
t� E/ V
FAX NCO.
t� /.Z- OioOti�
ADDRESS � �
CITY ^^
ZIP CODE
All permits must be reviewed; stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. ■
■
J PERNI IT TYPE FEE CALCULATION TOTAL
DUE
❑ Alarms - New & Modifications - (Minimum Charge) $280.00 ■
•
ONLY
•
84
❑
Over 10,000 Sq. Ft
Sq. Ft. x.028 = Permit fee
a
98
❑
Sprinklers - New & Modifications - (Minimum Charge)
$280.00
■
■
84
98 .
❑
Over 10,000 Sq. Ft,
Sq. Ft x.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
■
■
84
98
.❑
Spray Booths - New & Modifications
$470.00
•
■
84
98
❑
Aboveground Storage Tanks (Installatioallnsp. -t" Time)
$180.00
•
82
❑
Additional Tanks
$ 96.00
;
82
❑
Aboveground Storage Tanks (RemovaUlnspection)
$109.00
;
82
❑
Underground Storage Tanks (Installation.11nspection)
$878.00 (per tank)
■
82
U.,,,
Underground Storage Tanks (Modification) .
$878.00`(persite)
■
82
, ❑
Underground Storage Tanks (Minor Modification)
$167.00
■
82
•
Underground Storage Tanks (RemovM
$573.00 (per tank)
■
84
•
Oilwell (Installation)
$ 96.00
84
❑ -
Mandated Leak Detection (Testin / Fuel Moni CerUS6989.
Note. $96.00 for each type of test /p ifscheduled
at the same time)
G% n
-
`
:
■
■
82
❑
Tents
$ 96.00 (per tens
■
84
❑
Pyrotechnic - (Per event, Plus Insp. Fee 0 $96 per hour)
$ 96.00 + (5 hrs. min. standby fee 1Ins)ection)= $576..00
;
84
❑
After hours inspection fee
$121.00
;
84
❑
RE- INSPECTIONS) /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)
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 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 I 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. 1 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 I Date
CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
B E R S F I D 1501 TRUXTUN AVENUE, 1sT FLR
FIRE BAKERSFIELD, CA 93313
ARtAI T Office Phone: (661) 326 -3979
Application Number
. . .
10- 10000226
Date 8/12/10
Property Address .
. . . . .
5401 STOCKDALE HWY
ATN (11 Digits):
194- 031- 03 -00 -9
,Application type description
FIRE DEPT
Subdivision Name
. . .
Property Use . . .
. . . . .
Application valuation
. . . .
0
Owner
Contractor
----------------
-- - - - - -=
------------------ -
CHAU FONG K
- - - --
OWNER
13702 TABLE ROCK AV
BAKERSFIELD
CA 93314
( 66) 301 -6617
------------------------------------------------------------_---------------
Permit . . . . . .
MANDATED LEAK DETECT TEST
Additional desc . .
Phone Access Code .
1024488
Permit Fee . . . .
96.00
Plan Check
Fee 96.00
Issue Date . . . .
8/12/10
Valuation
0
Expiration Date
2/08/11
----------------------------------------------------------------------------
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 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
UST NQUJ&UM
DESCRIPTION DATE SIGNATURE
BACKFILL
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT
SENSORS
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK -OFF
1
DATE
TANK TESTING MODIFICATIONS MINOR/ MAJOR
DESCRIPTION DATE SIGNATURE
AST REM AL
DESCRIPTION DATE SIGNATURE
PRIOR TO OPERATION OF ANY SYSTEM,A
ALL UST.AND /OR AST SYSTEMS SHALL BE
INSTALLED, COMPLETE AND ACCEPTED BY'
THE BAKERS, FIELD CITY FIRE DEPARTMENT.
Iii DING ADDRESS %57c) c. k de. C
IRt
JOB DESCRIPTION l-t4 Cr
OCCUPANCY TYPE
OWNER 6 �
PERMIT NO. 10-16 6 <9 <3 2 Z Co
CONTRACTORi c. r PHONE # 2 -- $
FD 1743
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