HomeMy WebLinkAbout5600 AUBURN Street_UST MINOR MOD 3.2.11Willi
43
HOODS ALARMS SPRNKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
File Number: 3 3g'y
Date Received:
Address:
Bakersfield, CA 933 _
Business Name: G ; HC (,.p K
SYSTEM: BUILDING SQUARE FEET:
New Mod.
O ❑
❑ ❑
❑ ❑
O ❑
❑ ❑
❑ ❑
minor
modificati
removal
Commercial Hood System
Fire Alarm System
Fire Sprinkler System
Spray Finish Systern
Aboveground Storage Tank
Underground Storage Tank
Underground Storage Tank
Underground Storage Tank
❑ ❑ Other:
Comments:
Building Sq. Feet:
Calculation Bldg. Sq. Ft:
1.
2.
3.
4.
INSPECTION
Signature
IE
CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT
PREVENTION SERVICES
B E R S P I D 1501 TRUXTUN AVENUE, 1 ST FLR
FIRE BAKERSFIELD, CA 93313
ARTM T Office Phone: (661) 326 -3979
Application Number . . . . .
Property Address . . . . . .
ATN (11 Digits):
Application type description
Subdivision Name . . . . . .
Property Use . . . . . . . .
Application valuation . . . .
Owner
------------------------
NIELSEN ENTERPRISES
5416 CASTILLO DE ROSAS
CAMARILLO CA 93012
11- 10000086 Date 3/08/11
5600 AUBURN ST
438 - 110- 03 -00 -2
FIRE DEPT
0
Contractor
------------------ - - - - --
OWNER
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Permit . . . . . . UNDGRND STR TANK MINOR MODIFY
Additional desc .
Phone Access Code 1078443
Permit Fee . . . . 83.50 Plan Check Fee 83.50
Issue Date . . . . 3/08/11 Valuation . . . . 0
Expiration Date . . 9/04/11
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Fee summary Charged Paid Credited Due
----------- - - - - -- ---- - - - - -- ---- - - -- -- ---- - - - - -- ---- - - - - --
Permit Fee Total 83.50 83.50 .00 .00
Plan Check Total 83.50 83.50 .00 .00 .
Grand Total 167.00 167.00 .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 afterl80 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 _ Phone 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 1 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 ($100,000) IN ADDITION TO
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST AND ATTORNEY'S FEES
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 Civ. C.)
Lenders Name
Lenders Address
I certify that I have read this application and state that the information contained herein is correct. I agree to comply with all city ordinances and state
laws relating to building construction and hereby authorize representatives of the city to enter the above mentioned property for inspection purposes.
Signature of Applicant or Agent Date
ISLAND PETROLEUM BUILDERS, INC.
Bakersfield Fire Dept.
r-
l _
3/2/2011
21573
167.00
1 Primary Checking 3 Circle K 5600 Auburn St Bakersfield 167.00
COB
3/1/2011 8 :21:02 AM PAGE 2/002 Fax Server
BILLING �ERMa� STATEMENT BAKERSFIELD FIRE DEPA�ti MENT
B A B A s F t E\ Prevention Services
PERMIT # o;� ARTIEU T 2101 H Street s7
Bakersfield, CA 93301
-Phone: 661-326-3979 o Fax: 661-852-2171
FD2021 (Rev 04/08)
IN'FORMATION
LOCATION OF PROJECT
15(00 Avbv rr� Sf
PROPERTY OWNER
STAR NG DATE COMPLETION DATE
_3 15h
NAME
circle 1'i 5+ores In
PROJECT NAME
S 1"489 2 1"i r`S
ADDRESS
255 E- R.Y,ccD► -i St "Icy
PHONE #
PROJECT ADDRESS
S(pC) fJtubvrn 5 "�
/' _ j r
CITY ►�rc3i'��1: STATE C/4
ZIP CODE
728
• .•
CONTRACTOR NAME_ _ CA LICENSE #
Char (p
.-
TYPE OF LICENSE EXPIRATION DATE
[3clo oho HAS ? 3; iz
PHONE #
qo9 423 9373
CONTRACTOR COMPANY NAME
is 1 Pe- troleQvn (3vi l8er-5 Inc.
FAX #
q04? 4z3 93 -7z
ADDRESS 6 A 3 �W\ o 5 INV �
'T
� � \ �
ZIP CODE
�f 17(,
A09 89ePB999$S 61iIIHAS$ bid �evleel ed,_stampes9, and approved PRIOR TO BEGINNING WORK.
a•. PER61T TYPi FEE CALCULATION TOTAL
DUE
11 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 .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
j 82
❑
Additional Tank ATI
$96 /tank
82
•
Aboveground Storage Tank (Removal /Mod /Inspect) ATR
$109 /tank
82
•
Underground Storage Tank (Installation /Inspection) NI
$878 /tank
82
❑
Underground Storage Tank (Modification) MOD
$878 1site
82
Underground Storage Tank (Minor Modification) MT
$167 /slte
7
82
❑
Underground storage Tank (Removal) TR
nk
84
❑
Mandated Leak Detection (test) /Fuel Mont Cert/SB989 TT
NOTE: $96 /hr for ea type of test /per site even if scheduled at
he same time
$96 /hr (2 hrs minimum) =$192
84
•
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) Pv
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
❑
Copying & File Research (File Research fee $50 /hr)
$0.25 /page
84
❑
Miscellaneous
84
FD2021 (Rev 04/08)