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Home My WebLink About6009 COFFEE Road_UST 8.26.10VIIIIII 67 SYSTEM: HOODS ALARMS SPRN KLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: 7,R Date Received: c' —a Address: Bakersfield, CA 933 Business Name: 5v ❑ Other: � yYJc. Comments: 1. 2. 3. 4. INSPECTION LOG Signature i�imanN Date Time IE SYSTEM: BUILDING SQUARE FEET: New Mod. ❑ ❑ Commercial Blood System Building Sq. Feet: ❑ ❑ Fire Alarm System Calculation Bldg. Sq. Ft:_ ❑ ❑ Fire Sprinkler System ❑ ❑ Spray Finish Systern ❑ ❑ Aboveground Storage Tank ❑ ❑ Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank ❑ Other: � yYJc. Comments: 1. 2. 3. 4. INSPECTION LOG Signature i�imanN Date Time IE BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work InSDection Reauest Phone No. (661) 326 -3979 PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT, SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF UST REMOVAL DESCRIPTION DATE SIGNATURE DESCRIPTION DATE SIGNATURE PRIOR TO OPERATION _OF -ANY SYSTEM, ALL UST AND_ /OR_AST SYSTEMS SHALL BE INSTALLED, COMPLETE AND ACCEPTED BY n THE_BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL)- -- e JOB DESCRIPTION ;=>til C.. OCCUPANCY TYPE _ OWNER S✓ CC �'� A� �`.� PERMIT NO. 16 7 / CONTRACTOR PHONE #,792 -S-6W7 FD 1743 BILLING & PERMIT STATEMENT PERMIT NO.: V S F I D RE r�r r BAKERSFIELD FIRE DEPT. Prevention Services 1600 Truxtun Ave Ste 401 . Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax: (661) 852 -2171 SITE INFORMATION LOCATION OF PROJECT ^ PROPERTY OWNER Y0_4 S STARTING DATE o � 1 O COMPLET` IYON DATE l i NAME � �� PROTECT NAME ^ ^ �� J ADDRESS � , /g UBG Y PHONE NO. PROTECT ADDRESS � O O V-8 CITY < '_A STATE C ZIP CODE CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE NO. TYPE OF LICENSE. EXPIRATION DATE J X1'1 rc S PHONE NO. 3q 2 -8 (V 167 CONTRACTOR COMPANY NAME ►G -/UU FAX NO. 59z- -o r ADDRESS � CITY ZIPCODE Mr All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. ■ • J • • ❑ Alarms - New & Modifications - (Minimum Charge) $280.00 ■ 84 ■ 9e, „ . ❑ Over 10,000 Sq. Ft. Sq. Ft. x .028 = Permit fee 0 8 ❑ Sprinklers - New & Modifications - (Minimum Charge) $280.00 ■ ■ 64 98 . Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee ■ • 84 98 • Minor Sprinkler Modifications (< 10 heads) $ 96.00 [Inspection Only]' 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 (Installationfinsp. -t "Time) $180.00 ; 82 ❑ Additional Tanks $ 96.00 ; 82 ❑ Aboveground Storage Tanks (RemovaUinspection) $109.00 : 82 ❑ Underground Storage Tanks (Installation. /Inspection) $878.00 (per tank) ■ 82 ❑ Underground Storage Tanks (Modification) $878.001persite) ■ 82 . ❑ Underground Storage Tanks (Minor Modification) $167.00 ■ 82 ❑ Underground Storage Tanks (Removal) $573.00 (per tank) ■ 84 ❑ Oilwell (Installation) $ 96.00 84 Mandated Leak Detection (Testing / Fuel Monit. rt/SB989. Note. $96.00 for each type of test 1 pe a scheduled at the same time) $'St366 (persite� 9 ,� ; ■ ■ 82 ❑ Tents $ 96.00 (per tent) ' 84 ❑ Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) $ 96.00 + (5 hrs. min. standby fee /Inspection) - X576..00 ; 84 ❑ After hours inspection fee $121.00 ; 84 • RE- INSPECTION(S) /FOLLOW -UP /NSPECRON(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 0 pe r page ; 84 11 Miscellaneous 7�� 84 FD 2021 (Rev. 06 /07) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 7 -PINK (to Customer) UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD / LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. R /Rl ARM T BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 ❑ ENHANCED LEAK DETECTION ❑ L ❑ SB-989 SECONDARY CONTAINMENT TESTING ❑ TANK TIGHTNESS TEST PERFORM FUEL MONITORING CERTIFICATION— SITE INFORMATION FACILITY l NUMBER OF CONTACT PERSON ADDRESS � O� OWNERS NAME lam] \ OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS P .TANK TESTING COMPANY NAME.OF TESTjg COMPANY I 1E N3 V 19-C) Q NAME & PHONE NUMBER OF CONTACT PERSON MAILING ADDRESS oco clo__ 913-3 of NAME & PHA E NUMBER OF TESTER OR SPECIAL INSPECTOR $ CERTIFICATION #: a ICC #: TEST METHOD 69. 948 -c�'T nco►� DATE & TIME TES TO Bg COND CTED O o =a _ SIGNATURE OF APPLICA T DATE ��- APPROVED BY DATE - Z -- 16 r FD 2095 (Rev. 09/05) CONSTRUCTION PERMIT Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner ------------------ - -- - -- SERVICE STATION HOLDINGS LLC 6009 COFFEE RD BAKERSFIELD CA 93308. BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R s F I n 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 AR� r Office Phone: (661) 326 -3979 10- 10000271 Date 9/02/10 6009 COFFEE RD 494 - 160- 20 -00 -6 FIRE DEPT 0 Contractor ------------------ - - - - -- OWNER ----------------------------------------------------------- Permit . . . . . . MANDATED LEAK DETECT TEST - ---------------- Additional desc . .' Phone Access Code . 1030162 Permit Fee . . . . 96.00 Plan Check Fee 96.00 Issue Date . . . . 9/02/10 Valuation . . . . 0 Expiration Date . . 3/01/11 ---------------------------------------------------------------------------- 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 afterl80 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Permittee: Date: 1�1 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. 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 F 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 1 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