HomeMy WebLinkAbout1145 CARLSBAD VILLAGE DR; ; CB020928; Permit06-24-2002
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No
Building Inspection Request Line (760) 602-2725
CB020928
Job Address
Permit Type
Parcel No
^Valuation
Occupancy Group
Project Title
1145 CARLSBAD VILLAGE DR CBAD
Tl Sub Type
1561802600 Lot#
$0 00 Construction Type
Reference #
TEXACO-RE-PIPE EXIST TANK
NO NEW ELECT, RE-CONNECT ONLY
INDUST
0
NEW
Applicant
JAUN SANDOVAL
207 WEST ALAMEDA AVE
I3URBANK CA
'91502
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
Owner
SHICK FAMILY TRUST B 09-09-93
P O BOX 599 " v
OCEANSIDECA 92045
ISSUED
03/27/2002
CB
06/24/2002
06/24/2002
Total Fees $15794
-" V V- • ,' s
Total Payments To Date
/ *>
$15794
) 'j ,
/
\/*
Balance Due $000
Building Permit
Add'l Building Permit Fee
Plan Check /
Add'l Plan Check Fee'
Plan Check Discount
Strong Motion Fee ' !,
Park Fee
LFMFee
Bridge Fee ' '
BTD #2 Fee
BTD #3 Fee
Renewal Fee
Add'l Renewal Fee ;
Other Building Fee •
Pot Water Con Fee \
Meter Size
Add'l Pot Water Con Fee
Reel Water Con Fee
-$000"
'' $000 " /
SO 00
$15694
• $0 00 - -
^ $1 00 "
'$000
SO 00
$0 00
$0 00 "
$0 00,
" $0'00
$000 -x
$0 00"; .,
$000 \
/ '
$0 00 .
^ $0 00 '''
Meter Size K
-Add! RechWaterCon
Meter Fee
SDCWA Fee
CFD Payoff Fee ^ *;
Fee'
• PFR(CFDFund)^
License Tax , ^ >f
License Tax (CFD Fund)'/
- Traffic Impact Fee «- -'.-.
Traffic lmpact,(CFD Fund).
PLUMBING TOTAL "'* '' '
ELECTRICAL} TOTAL. '/
', MECHANICAL TOTAL-
Master. Drainage Fee /
Sewer Fee
. .Redev Parking Fee /
'* Additional Fees
TOTAL PERMIT FEES -
'
$000
$000
$000
, $000
' $000
$000
\ $000
« $000
"! $0 00
' • $0 00; $000
i $000
' $000
" $000
$000
$000
$000
$15794
Inspector
FINAL APPROVAL
Date Clearance
NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as lees/exactions" You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
fees/exactions of which you have previously,been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave , Carlsbad, CA 92008
* ^PROJECT'INFORMATION t|14S
FOR OFFICE USE ONLY
PLAN CHECK
EST VAL
Plan Ck Deposit
Validated By £
Date
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total if of units3902 03/27/02 0002 01 02
Name £ + $ £W£>ir^Ee\2jN/& Address^p? WJ
^APPLICANT .". !| Qf Contractor «f( D Agent for Contracfor^^D'Owner uf EJfAgam for, Owner'"
Address N* O*0 £p. Telephone # 6)6
A
Name Address City State/Zip Telephone #
CONTRACTOR*- COMPANY .
(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 is licensed pursuant to the provisions of the Contractor's License Law
[Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom, 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 [S500]}
- v ~ « ^
Name
State License #
Address
License Class E^I CA,& (C* *#
City State/Zip Telephone #
City Business License # 1 *~\ $ ) VS
Designer Name Address City State/Zip Telephone
State License # ^^_
6 8'! ! WO'RKERS',COMPENSATION,!!8 !'!'!i |J ^^''.Ur'^Tl,,.'^'' %!<«^ >^rV!""'<$\[£T!Y!Ji'^JCJSC1^' !>!,„.! V ' 'P! , ! **,'<'* ~> '"XV.f » Vih
Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
Q I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued
J3l I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued My worker's compensation insurance cametand policy number are
Insurance Company *f?"T?"-T f^- "^pOjiyV^ Policy No &t\-Q\ LK/1-*" G&O 4*I 'Expiration Date I & " '
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS)
n CERTIFICATE OF EXEMPTION 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
WARNING Failure to secuj^workers compensation co^rage^s'unl awful, and sball subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100,OQ<&,Hn addition to the costp^^mpe/satiop^iSarnages^j^provided for in Section 3706 of the Labor, code injerest and attorney s fees
SIGNATURE ,8^y^^^:>~2_^==----^'^^-- d—^-——""""/ DATE
7 E ,1! OWNER^OllDEfi'DECL'ARATIolSn''"-'' h
hereby affirm that I yam exempt from the Contractr s License Law for the following reason
I, as owner ofthe 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/Contractor s License Law does not apply to an owner of property who builds or improves thereon, and who does
such work himself or through his 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 did not build or improve for the purpose of sale)
C] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Professions Code The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License I-aw)
n I am exempt under Section Business and Professions Code for this reason
1 I personally plan to provide the major labor and materials for construction of the proposed property improvement [~1 YES L^NO
2 I (have / have not) signed an app^cation for a building permit for the proposed work
3 I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number)
4 I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number / contractors license number)
5 I will provide some of the work, but 1 have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
of work) ___^
PROPERTY OWNER SIGNATURE DATE
.COMPLETE |TH1S SECTION|FOR NON-RESIDENTIAL .BUILDING PERMITS. ONLY^^'f f\ J , "J , I"1 >*&?l" * .f,' " V1 , !T£' JT' ' T™!.' ! ! V- "i -UU1 '" I* ' '.'.!>' - ''TkFj^C!
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley- Tanner Hazardous Substance Account Act? Q YES Q NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7 Q YES Q NO
Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? d YES Q NO
IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT
1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code)
LENDER'S ADDRESSLENDER'S NAME
93;°'AP>LICANT CERTIFICATION/''^ . ' ^H^Jpf^HhVf tAJ?"! -r;'if '1,U-TitlT' .."*>] ~r,"k! /V/'(Tn^ X'"8^/'^ ^,^^,1V, ,'. /"'" T 'Ms/A <",*
I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate I agree to comply with all
City ordinances and State laws relating to building construction I hereby authorize representatives of the CitV of Carlsbad to enter upon the above mentioned
property for inspection purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES
JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
OSHA An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height
EXPIRATION Every permit issued by the buMrta Official under the provisions of this Code shall expire by limitation and become null and void if the building or work
authorized by such permit is not commencedjwitt/n 180 days from the date ot such permit or if the building or work authorized by such permit is suspended or abandoned
at any time after the work is commenced to/a-period of 1 SOySays (SectiprrT^6 4 4 yorf^m Building Code)
APPLICANT'S SIGNATURE
/HITE Fiife YELLOW
DATE
PINK Finance
Carlsbad Fire Department 020928
1635 Faraday Ave
Carlsbad, CA 92008
Plan Review Requirements Category: Building Plan
Date of Report 04/01/2002 Reviewed by
Fire Prevention
(760) 602-4660
Name
Address
A& S Engineering
207 W AlamedaAve
City, State BurbankCA 91502
Plan Checker
Job Name Texaco
Job # 020928
Job Address 1145 Carlsbad Village Dr
Bldg # CB020928
Ste or Bldg No
Approved The item you have submitted for review has been approved The approval is
based on plans, information and / or specifications provided in your submittal,
therefore any changes to these items after this date, including field
modifications, must be reviewed by this office to insure continued conformance
with applicable codes and standards Please review carefully all comments
attached as failure to comply with instructions tn this report can result in
suspension of permit to construct or install improvements
D Approved
Subject to
The item you have submitted for review has been approved subject to the
attached conditions The approval is based on plans, information and/or
specifications provided in your submittal Please review carefully all comments
attached, as failure to comply with instructions in this report can result in
suspension of permit to construct or install improvements Please resubmit to
this office the necessary plans and / or specifications required to indicate
compliance with applicable codes and standards
i—iLJ Incomplete The item you have submitted for review is incomplete At this time, this office
cannot adequately conduct a review to determine compliance with the
applicable codes and / or standards Please review carefully all comments
attached Please resubmit the necessary plans and / or specifications to this
office for review and approval
Review
FDJob#
1st 2nd 3rrJ
020928 FDFile#
Other Agency ID
City of Carlsbad
Building Department
March 4, 2002
Cindy Bacon
Building Department
1635 Faraday Ave
Carlsbad, CA 92008-7314
Telephone (760) 602-2719
Juan Sandoval
Suite 203
207 West Alameda Ave
Burbank, CA9102
Dear Juan
We have received both sets of plans for the under ground gas tanks and the
delivery systems
In order to submit the plans into plan check we will need you to fill out an
application for each address or project We will also need the Hazardous
Materials form completed from the County Health Department
If a contractor is pulling the permit a current Cityof Carlsbad business license will
be required, and a current certificate of Workmans Compensation collected for
the file.
No fee will be collected at this time The fee will be assessed prior to issuance
and paid on that day
Once we have received the completed applications and Hazardous Materials
forms from you, we will rout the plans to Esgil, who are our structural plans
checkers The plans will also be routed to our Engineering Department and to
Fire
Please contact us if you have any questions
Sincerely,
1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (76O) 6O2-27OO • FAX (76O) 602-856O
£ • L-eparjreru or f_nvi, onmental f
g S;te 'MI ut w'lviioninenrai nMim - t
sment& Mitigation Division
PLAN APPROVAL
5JV change in Ihesa plans rr«y vj;d this
ct:
Li.o
UJ
LU
LL.
'"1:ONTRACT^« TO CONTACT
MNDERCRrtUNH SFRVICF AIFRT
— -t^-800-422-4133
CALL USA/SC
FOR UNDERGROUND LOCATING
/ WORKING WYS BEFORE YOU DIG
DRAWING ISSUED FOR
EQUILON ENGINEER
PLANT APPROVAL
PLANNING
PERMIT
BID CONTRACT DOCUMENT
NOT FOR CONSTRUCTION
CONSTRUCTION
DO NOT USE FOR CONST
UNLESS BOTH SIG ARE IN HAND
RECORD DRAWING
DATE APPROVED
A&S EQUILO*
V
NO.
\
DATE
12/26/01
' BY
OS
•^— ~^* *"
/'
V i
\\I11i11i
County of San Diego
Department of Environmental Health
Materials Division
S Permit # RT1804
Establishment # H12426
Date: February 12, 2002
Expiration Date: February 12,2003
Permit for Underground Storage Tank Construction/Closure
SITE NAME Texaco (Shell Oil Station)
SITE ADDRESS 1145 Carlsbad Village Drive,
OWNER NAME j^guilon Enterprises arf^**"*^" --
OWNER ADDRESS 2255 N. OntariojSglll: BurbanklM
„.
DESCRJPTION OF ipe three (3) existing underground storage tank systems
PERMIT CONDITlOIr TJ
will verify that the C^Ti«e2fffe^U|renie]ftts*ave|been met.
tf«dpe^of%orkath«rwil^be|)erfoi?me*at5tne sife^retedllove. The DEH inspector
,f t ',' , VJ;H I *****IMPORTANT«J*** r, „,-»,' ~f> 1%
1) Facility nwpt con?ply^tb the New Phase I Enhanced Vapor Recovfjy (EVR) requirements. -Please contact for the Air
PofIution&ootir&P>£fltH&*t (858) 650-4700 regarding EVR requireM ents and all current"approVed4 tent
Tanks v| Vj ^>S>-'''v
A Tanks areJJouh/e v^Hp'fRP with direct fills only - Issued Upgrade Certificate No. 04058
1} Existm®eeder-4°&t-rfink monitoring system (TLS 350)
2) Install Mjw $^fm|h external audible/ visual high level alarm
3) Install Kjjw ^ill^n^mftient boxes
4) Striker pipeSare^istMg ^/SV^'
PLEASE NO!jailed, they will also
A F-xistin^ivrodnctpipin" is double walled FRF (DEH Inspector to verify) , ', jjl' '-i^
1) Remove and^ep'a|e%U»ft'Mu¥t,:i'1(por piping S|fl sampling is reqiiiredtfor all product piping8 removed
until the sampli^SpQinj^re identift^dfyythe DEH i^pector) >i|s< « < ,
2) Install New d^e^^jggp^rtldu^&ies I ^ j v ^,, ' ^/i^ ,*^
3) Install New dou%c wai|f If vent'aQO'-yiafiQrJm^ ^ , %^ *" ''« n:" ' *£'
4) Install New dispenset^pntai)ftrient bqklesewith Continuous electronic monitoring (must shut down turbine upon J|i3fc detection )
5) Install interstitial leak %^cto^|tiiafo^iHEpro^i deposit! ve^turbine shut down upon leak detection^ ^ "^ f fS'^
6) Siphon line to be mstal le^gptehSi^kojn irqe^are required to have aCertified Integrity Test f ^
7) A Certified line integrity telftis retmiria erbr to.theVinMfinsijection' ~ ^' / ^ ( - , ''*,,' -' V «|lv'
piping must be exposed
B Tank sumps* "t||%^r^«^V^f
1) Install new watertight sumps with Liquid sensors and sealed manway lids at the turbine and fill ends of tanks
*Tank sumps must be installed in accordance with the tank manufacturers recommendations. Installation must not void the Tank Manufacturers
Listing You must provide documentation from the installer that they are certified to install collars on the specific underground storage tanlt(s) and
that it was done m accordance with the manufacturers recommendations You must submit the documentation at the Final inspection
Page 1 of 2
New SB 989 regulations require that all secondary containment be tested. The secondary containment must be tested in
accordance with manufacturers specification. Contractor shall certify the test Please be advised that all secondary
containment systems installed after January 1, 2001 must be tested at installation, six (6) months after installation, and every
36 months thereafter.
Inspection Requirements:
1) Removal and Soil Sampling of productjiping
2) Pressure Test
3) Final inspection
Required Documents at Final Inspection:
t) Certification of Secondary
2) Certified Pipe Line Int
3) New Monitoring and Emergent
4) CUPA Form C jSp' Jj?
;^& ^J %> |;^;j!\
Additional documentspn^be^reqiiirMatlthe^cliscrVtion of the DEH Inspector '' ^J^ ,4 ,-/ '.^M&, •«*&,ff&f *. Jttf ssfc.fusfc ,£*#*«» j<rx**^4£3^ B| i^gf SJ| ^»i*i^ *_-vs-^ * *«* * * -iif > l ^fcp1
Please note Any deyiatip'riFfrqm the'iabov'e scope of work mayj-ec|uire a $200100 plan re-reviewjfee.andlS300.00|ite-inspectiQn fee
This office must be||iven|ai'C|Ieast-48iVhours notice for ajBrSqGtfEd Undefgrotma Storage Tank Activity" Please'.contact the Hazardou1
Materials Division^laiTjgn^JSesfcat (619) 338-2214 tcfTcheduli or cancel msfllctions ^/ t ^ j^jj
£1 $$$$ffi$fi \ i / ./& , ^jSfi-* ^fe
'- iiV^Ofey^
Plans Reviewed/jul ^pproyedJB^ Robert Rapista
Notified
2/12/02
Page 2 of2
Sent by 00;OS/13/02 8
CERTIFICATE OF LIABILITY INSURANCE
4Commercial Lines „.—
ABD Insurance i Financial Seivices
33250 Hawthorne Blvd , Suite 600
Torrance, CA 90503-4110
K E.Xurtis Constiuction Company
1400 Old Conelo koatl
Newlxiry Park, CA 91320
D~fE IMM/00/YY]
09/28/01
THIS CERTIFICATE !S ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFcHS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND on
ALTER THE COVERAGE AFFORDED BY The POLICIES BELOW
INSURERS AFFORDING COVERAGE
S t e a d fa ot._Company __ ~~
AlI_gLaLe Insurance Compa_ny
State Compep.sat ion insurancft Fund
INS unco c
COVERAGES
THE POLICIES OF INSURANCE UST&) BELOW HAVE B££H ISStJED ~Q Tri£ JNSU3EO NA^EO ABOVE POR Th£ POLICY PERIOD'NDiCATgO NOTWITHSTANDING
ANY REQUIREMENT TERM OR CONinMON OF ANY OONlRACT OR OTHER DOCUMENT WITH fl^SP£CT TO WMlCh THIS CERTIFICATE MAY BE ISSUED Oil
MAr HfcflfAlN THE INSURANCE AFFOfiOCO QV TH£ POLICIES DESCniBCn HEREIN IS SUEJECT TO ALL THf TfHMS E<CLUS(ON5 ANO CONDITIONS OF SUClf
POLICIES ACGftEGAT', LIWiJSSHOWNWAY HAVE Elrf N HEOUCEO8Y-KAID CLAIMS
'[*fe WE OP INSURANCE IPOUCY EfFECTlVG '"VQUCY f (PIPftTlON
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License
CERTIFICATE HOLDER ADDITION Ai CANCELLATION
Contracvoii St.itc Licence
P O »ox 26000
, CA 95826
SHOULD ANY w IM
Q*t£ rwcneoF THE ISSUING wsunen wiu eNoeAwan IOMAII 30
tiOliCE TOTltt rLfmnCATE HDLLctlrt*M/tOTOT>l£Le»-"T flinfAJLunE TODQfiOSUALL
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F LIIMD CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
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LIABILITV LIMIT INCLUOINa OEFQWE CW^«-
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