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Home My WebLink About5401 STOCKDALE Hwy_UST MINOR MOD 10.7.1MOODS ALARMS SPRNKLER SYSTEMS SPLAY BOOTH . AST UST- . Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. /a- /fbafl3/� File Number: Vt.-S22 Address: --;-g Q ( s o CAGC C3A.-e-- A&j!re Bakersfield, CA 933.. Date Received: /d _ ? .- /6 Business Name:�� i L. SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG New Mod. ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ minor modification removal Commercial Hood System Fire Alarm System Fire Sprinkler System Spray Finish System Aboveground Storage Tank Underground Storage Tank i nderground Storage Tank Underground Storage Tank ❑ ❑ Other: Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: ald! 1. a. 3. 4. Date Time 5ignature Signature I�OII 54 IE J UNDERGROUND STORAGE TANK PERMIT APPLICATION TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW TANK INSTALL (EXISTING FACILITTY) /MOD -MINOR MOD ,Permit # j TYPE OF APPLICATION: (CHECK ONE ONLY) Oft JUNE Alf/ BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, 1st Floor Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of i 0 NEW TANK INSTALL/NEW FACILITY 0 NEW TANK INSTALL/EXISTING FACILITY ❑ MODIFICATION OF FACILITY Ar,1 MINOR MODIFICATION OF FACILITY STARTING DATE/ - - — - - - - PROPOSI D OPI 0 4'FE FACILITY NAME , A C7057ING�Fi4CffiF1f PERMLT.'S^ FACILITY ADDRESS CITY ZIP COD TYPE OF BUSINESS APR t TANK OWNER T770Y� C PHONES ADDRESS S-Ly 6 LLq3�c1c6& eLUA CITY ZIP C09 'DDNiRA1C1aRt'.' :,c` „' ;'!r".... : i'� _ %', :. •:�`= .CA'.,'. 6' u ..rbcn.... _ - ,'t:'._• .CF[•Yu_. �ADDRESStt- ,:� ,T r9 � k - ZIP CODE' e 'A. } . i PFIOIVE:iC` '' °" ' " 9AICERSkZEU) -CiTYF `$ % *: a'; r P: (k' ' ^• ' R'_ lit BRIEFLY DESCRIBE THE WORK TO BE DONE: i Y — l✓ VIL- WATER TO FACILITY PROVIDED BY DEPT TO GROUND WATER SOIL TYPE EXPECTED AT SITE S OF TANKS TO BE INSTALLED TARE THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? YES 0 NO O YES 0 NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION :�Y• �Y�s. 'RTANK'i,' G' .-I :YOI;UIO:•= • ''y..i �ifEAD ,•4. ..'T•yFd •N R56UtA1C y,ri•!; s'a -',n PL�11': <'< 't. .5t. !)IESEI:'. "� � OTHER F'. r.. :y7• e Tank Testing Company NAME OF TESRNG COMPANY l PHONE NUMBER MAILING ADDRESS C+ . . NAME OF TESTER 1 _ ICCt , OT 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 PERIURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. NAME OF TESTER ICCa THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY :l>I1TE:'/1PPROVID� '`r:`. {'I""s:,5,- °s; .-r. >. .py ;r• -••r .. r• ti. . i.1 FD2086 (Rev 08/09) T Gib'y f Raltersfield. i tUiD . Type. ; DG = .Drawer. • � •��1..��' 'kecgipt- no::�:; °•r36841:�.�' :.':::'• � . . ' , • ;�." :' •'• •''::: • ••':ter ' . � . r: • •.e`�' ,. ; llescriotOrk 'Uuanti.i r ` 1:R@;; :1192.x' •t'utal�:ter�dere;t�:�:..�:::.; .t :' � •'':'539 ':.,: at payment it": 0 If 11. Giie.r;f4':07:17 ' MER• :'i - '•ef;' .• .•::_ :.,fir:. �:t,e :'• ::...,•�.: '!•:.c.' 1 • CONSTRUCTION PERMIT. BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R S P I D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 I RTM r Office Phone: (661) 326 -3979 Application Number . . . . . 10- 10000318 Date 10 /11 /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 . 1040146 Permit Fee . . . . 96.00 Plan Check-Fee 96.00 Issue Date . . . . 10 /11 /10 Valuation 0 Expiration Date . . 4/09/11 ---------------------------------------------------------------------------- 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: 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 Agenf 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. 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 I Date WORKERS COMPENSATION DECLARATION I hereby affirm that under penalty of perjury one of the following declarations: 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 thejLabor Code, for the performance of the work for which this permit.is issued. My workers' compensation insurance carrier and policy numbi r are: Carrier ;s' Policy No. ' I certify that in the performance of the work`fdf which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' com, pensation, aws'of Wifornia, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the La6or.Cod'e.-,:I 'shall forthwith comply with those provisions. Applicant: Date WARNING: FAILURE TO SECUREMORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES i CONSTRUCTION LENDING AGENCY I { I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 Civ. C.) i Lenders Name Lenders Address 1 I certify that 1 have read this application and state that the information contained herein is correct. I agree to comply with all city ordinances and state laws relating to building construction and hereby authorize representatives of the city to enter the above mentioned property for inspection purposes. Signature of Applicant or Agent I I Date BAKERSFIELD CITY FIRE DEPARTMENT -- INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Request Phone No. (661) 326 -3979 I. UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF TANK TESTING UST REMOVAL DESCRIPTION I DATE SIGNATURE AST NEW INSTALL DESCRIPTION I DATE I SIGNATURE AST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE PRIOR TO- OPERATION -OF -ANY - SYSTEM? BALL UST AND /OR-AST SYSTEMS SHALL BE 1 ' 'INSTALLED, COMPLETE AND ACCEPTED BY MISC. ACTIVITY THE;BAKERSFIELD CITY FIRE DEPARTMENT, FIRE DEPARTMENT-(FINAL) REMARKS: BUILDING ADDRESS: JOB DESCRIPTION: OCCUPANCY TYPE: OWNER: ," PERMIT NO. /D CONTRACTOR: WIL6v . PHONE # z— &'507 FD 1743 BILLING & PERMIT STATEMENT BAKER$FIELD• FIRE DEPT. . Prevention Services f/R6 16001Yu dam Ave Ste 401 PERMIT NO.: BakersSeld GA 83301 Toil - (RRll 42FI -4979 . F� f6B11 R52 -2171 Am permits must be reviewed, ,stamped, and approved- PRIOR-70-BEGINNING WORK ON T .HAT PROJECT. ❑ Alarms - New & Modifications - (Hrimum Charge) $280.00 84 i 98 0 Over 10,000 Sq Fai: Sq. Ft x.028- Permit fee ea 98 ❑ Sprinklers - New & ModficaMmis - Wmum Charge) $280.00 ■ 84 ■ 98 ❑ Over 10,000 Sq. Ft. SITE INFORMATION I 76—mm M, I k _6 84 88' ❑ Minor Sprinkler Modifications (< 10 heads) $ 96.00 (Inspection Only] x 84 98 CONTRACTOR INFORMATION . $ 470.00 r � - � . u ■ems � . . ryl �. Addidonal Hoods Am permits must be reviewed, ,stamped, and approved- PRIOR-70-BEGINNING WORK ON T .HAT PROJECT. ❑ Alarms - New & Modifications - (Hrimum Charge) $280.00 84 i 98 0 Over 10,000 Sq Fai: Sq. Ft x.028- Permit fee ea 98 ❑ Sprinklers - New & ModficaMmis - Wmum Charge) $280.00 ■ 84 ■ 98 ❑ Over 10,000 Sq. Ft. ft a x.028 =Parm&lbe • ■ 84 88' ❑ Minor Sprinkler Modifications (< 10 heads) $ 96.00 (Inspection Only] x 84 98 O Commercial Hoods — New & Modifications $ 470.00 ■ 98 ❑ Addidonal Hoods $ S8A0 ■ ■ 84 98. 0 Spray Booths - New & Modifications $470.00 ■ ❑ Aboveground Store a Tanks (Instalaffad1nsp:10 Time) $180.00 ■' •. 82 ❑ Additional Tanks $96.00 ; 82 • ._ ❑ Aboyeground Si ora a Tanks (Rem mllnspec6on) $109.00 : 82 • Underground Storage Tanks (/rrsO9laBonJlnspectlon) $878.00 (per tank) 82 • Underground Storage Tanks (Modtticatloo)' $878.00 (per) : 82 Underground Storage Tanks (Minor Mod ficat on) $167.00 ( E b ° ■ 82 ❑ Underground Storage Tanks (Remmo $573.00 (per tank) ■ 84 ❑ OlNmll (Instsiladon) $ 96.00 64 ❑ Mandated Leak Detection (Testing) / Fuel MonlWorUSB989. Note: MW at the same time). $18:9@ fjaer-eltg6 ; ■ • 82 ❑ Tents $ 9600 (per ten* ■ 84 ❑ Pyrotechnic - (Per event. Plus Insp. Fee 0 $98 per hour) $ 96.00 +ohm. mh dmW by fee A mpecdm)- W6..00 84 ❑ ARerhours Inspection lee $121.00 ■ 84 ❑ RE4NSPECTI0N(S) 1F0LLOW -UP INSPECTION(S) $ 96.00 (per hour) ■ 84 ❑ Portable LPG (Propane): NO. OF CAGES? _ $ 9600- ■ 84 • Fxploslw Storage $266.00 ■ 84 • Copying & File Research (Flo Research Fee $50.00 per h* 250 per page ; 84 O Miscellaneous 84 FD 20M MW. 060711 1- ORM3WALWNriE (to Ttessmy) 1- YELLOW (to-Fib). 1-PINK (to Customer)