HomeMy WebLinkAbout5700 AUBURN Street_UST FMC 10.26.091-j
-VOODS ALARMS SPRINKLER SYSTEMS SPRAYBO07H AST UST
Permit No.
File Number:
Date Received:
Permit No.
a
ire mki
1E
New Mod.
❑ ❑ Commercial Hood System
❑ ❑ Firfe"AlarimSy m
❑ 0 Fire Sprinkler System
0 ❑ Above-ground Storage Tank
❑ Gy
MOO
modifi.cation
removal
0111111111111111AW
Comments:
Underground Storage Tank
Underground Storage Tank
Underground Storage Tank
Other:
73
Permit No.
Address:
Business Name:
Permit No.
, CA
BUILDING SQUARE FEET:
Building Sq. Feet:
Calculation Bid'. Sq.
Permit No.
;>L
2,
I
4.,
Permit No.
Date Time
12-11011)9
ld�
I " Signature
-Signature
74
1E
UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
!TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.
FIRM
ARTS T
BAKERSFIELD FIRE DEPT.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Pagel of 1.
❑ ENHANCED LEAK DETECTION `�— ❑ SB-989 SECONDARY CONTAINMENT TESTING
❑ TANK TIGHTNESS TEST ` O PERFORM FUEL MONITORING CERTIFICATION
FD 2095 (Rev. 09/05)
FACILITY
NAME 8 PH NUMBER OF CONTACT PER N
ADDRESS
�5-, oo �. co'-
OWNERS NAME
OPERATORS NAME
PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
TANK.TESTING COMPANY
NAME OF TESTI g COMPANY
C_Vk 1v V 120 A /V TEL
NAME & PHONE NUMBER OF CONTACT PERSON
J rnf-: \C—"
MAILING ADDRESS
ou 3 r , -'3 k� AQL
NAME & PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR
CERTIFICATION #:
g"09�S a
DATE &TIME TEST TO BE CONDUCTED
ICC _
TESL CET�O�
SIGNATURE OF APPLICANT
DATE
APPROVED BY . DATE // C'99
FD 2095 (Rev. 09/05)
BILLING & PERMIT STATEMENT
PERMIT NO.:
E E R S F I1. D
FIRE
ANTM �r
BAKERSFIELD FIRE DEPT.
Prevention Services
1600 Truxtun Ave Ste 401
Bakersfield CA 93301
Tel.: (661) 326 -3979 • Fax: (661) 852 -2171
V± vsi 5a r� °veet'rad, starrfped, and approved PRIOR TO BBGIM!'VING y6rORK Oill THAT PROJECT, or
■
S PERMIT TYPE FEE CALCULATION •
DUE
❑ Alarms - New & Modifications - (Minimum Charge) $280.00 ■
■
•
ONLY
ACCT NO
84
SITE INFORMATION
❑
LOCATION OF PROJECT
PROPERTY OWNER
Poo 0 c)
STARTING DATE COMPLETION DATE
NAME
Sprinklers - New & Modifications - (Minimum Charge)'
$280.00
■
■
84
PROJECT NAME
Cn
ADDRESS
PHONE NO.
PROJECT ADDRESS
CITY STATE
ZIP COD[
CONTRACTOR
INFORMATION
Minor Sprinkler Modifications (< 10 heads)
CONTRACTOR NAME ^ s CA LICENSE N
Go
LICENSE. EXPIRATION &
_Q4/2
PHONE
,C
K I , Op(
H- e13!1
Commercial Hoods — New !& Modifications
CONTRACTOR COMPANY NAME
FAX NO.
t�V
59z- 0(00_Lc
[AD DRESS
CITY �
ZIP CODE 9 3 -3!:�
V± vsi 5a r� °veet'rad, starrfped, and approved PRIOR TO BBGIM!'VING y6rORK Oill THAT PROJECT, or
■
S PERMIT TYPE FEE CALCULATION •
DUE
❑ Alarms - New & Modifications - (Minimum Charge) $280.00 ■
■
•
ONLY
ACCT NO
84
98
❑
Over 10,000 Sq. Ft.
Sq. Ft. x.028 = Permit fee
88
•
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 (InstallafionAnsp. -16' Time)
$180.00
;
82
❑
Additional Tanks
$ 96.00
;
82
❑
Aboveground Storage Tanks (RemovaNnspection)
$109.00
:
82
❑
Underground Storage Tanks (Instal /ationAnspection) .
$878.00 (per tank)
■
82
❑
Underground Storage Tanks (Modification)
$878.00 (per site)
■
82
❑
Underground Storage Tanks (Minor Modification)
$167.00
■
82
❑
Underground Storage Tanks (RemovaQ
$573.00 (per tank)
■
84
❑
Oilwell (Installation)
$ 96.00
;
84
Mandated Leak Detection (Testing) Fuel Moni Cert/SB989.
Note: $96.00 for each type of test / per ven ' scheduled
at the same time)
$'9S�E {sit 1 _
--
■
■
■
82
•
Tents
$ 96.00 (per tent)
a
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- 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)