HomeMy WebLinkAbout1281 CARLSBAD VILLAGE DR; ; CB112361; Permit12-27-2011
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No: CBl 12361
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
Project Title:
1281 CARLSBAD VILLAGE DR CBAD
Tl Sub Type:
1561907010 Lot#:
$196,925.00 Construction Type:
Reference #:
OSTEOARTH CLINIC- 3,915 SF
SHELL TO MEDICAL CLINIC
COMM
0
5B
Applicant:
ARC/ARTEL ARCHITECTURE
ALEX PROTASEVICH
STE 1003
4133 REDWOOD AVE 90066
310-822-6630
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
Plan Check#:
Owner:
CARLSBAD MEDICAL VILLAGE L P
C/O RUSS RIES
P O BOX 1422
LA JOLLA CA 92038
ISSUED
11/04/2011
LSM
12/27/2011
12/27/2011
Building Pemiit $1,075.86 Meter Size
Add'l Building Pennit Fee $0.00 Add'l Reel. Water Con. Fee $0.00
Plan Check $753.10 Meter Fee $0.00
Add'l Plan Check Fee $0.00 SDCWA Fee $0.00
Plan Check Discount $0.00 CFD Payoff Fee $0.00
Strong Motion Fee $41.35 PFF (3105540) $3,584.04
Park Fee $0.00 PFF (4305540) $3,308.34
LFM Fee $0.00 License Tax (3104193) $0.00
Bridge Fee $0.00 License Tax (4304193) $0.00
BTD #2 Fee $0.00 Traffic Impact Fee (3105541) $0.00
BTD #3 Fee $0.00 Traffic Impact Fee (4305541) $0.00
Renewal Fee $0.00 PLUMBING TOTAL $150.00
Add'l Renewal Fee $0.00 ELECTRICAL TOTAL $150.00
Other Building Fee $0.00 MECHANICAL TOTAL $150.00
Pot. Water Con. Fee $0.00 Master Drainage Fee $0.00
Meter Size Sewer Fee $0.00
Add'l Pot. Water Con. Fee $0.00 Redev Parking Fee $0.00
Reel. Water Con. Fee $0.00 Additional Fees $0.00
Green BIdg Stands (SB1473) Fee $4.00 HMP Fee ??
Fire Expedited Plan Review $317.50 Green BIdg Standards Plan Chk ??
TOTAL PERMIT FEES $9,534.19
Total Fees: $9,534.19 Total Payments To Date: $9,534.19 Balance Due: $0.00
Inspector:
FINAL APPROVAL
Date: Clearance:
NOTICE: Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, resen/ations, or other exactions hereafter collectively
refen-ed to as lees/exactlons." You have 90 days from the date this pemiit was issued to protest Imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth In Govemment Code Section 66020(a), and file the protest and any other required infonnation 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 sewice fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have previouslv been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv othenwise expired.
^ CITY OF
CARLSBAD
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717/2718/2719
Fax: 760-602-8558
www.ca risbadca .gov
Plan Check No. (2ft \\ SL^^^ (
Est. Value (^ C», ^
Plan Ck. Deposit -7^ 3. I O
Date n |H( I I SWPP
JOB ADDRESS SUITE#/SPACE#/UNIT# is^ - rHo -'ZQ -10
a/PROJECT # PHASE# # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE
DESCRIPTION OF WORK: /nc/ude Squara Feat of Affected Ana(s)
EXISnNG USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE
YESD # NOD
AIR CONDITIONING
YES • NOD
FIRE SPRINKLERS
YES • NOD
AKPUCANT NAMB^Pr/mary Contact) , ^ , APPLiCANUIAME (Secondaiy Contact)
ADDRESS ' . ' ADDRESS
CITY. STATE ZIP
ADDRESS
LA STATE ZIP ^'^l>^ STATE ZIP
PHONE FAX PHONE FAX
EMSiU
ADDRESS ^
ONTRACTOR BUS. N
Y _ STATE ZIP
ADDRESS
QITY '
OOC^I pr CJH
iNE PHONE FAX
CITY
PHONE
EiWAiL I : ' EMAIL
ARCH/DESIGNER NAME & ADDRESS
(Sec. 7031.5 Business and Professions Code: Any City or County whioh requires a permit to constrJpt, 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 pursuantto the provisions ofthe Contractor's License Law {Chapter 9, commenaing 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 applicantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)).
WOI7KEr?S' COMPENSATION
/
Workers' Compensatian Declaration: / heieby afUrm under penalty ofperjmy one ofthe fbllowing declarations:
I have and will maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the LaborCode, forthe perfonnance of the work for which this permit is issued.
Jp I have and will maintain w.odmrs' compensatipn, as required by Section 3700 of the Labor Code, for the perfonnanceKfjl^^Jfilt^' which thjs permit^ issued. My workers' compensatian insj/ranbe canier and policy
/ number are: Insurance Co. /C jJ/l/C4/'^ . Policy HoLUB-l^l^f Z- f &£i/ Expiration Date Lf 'l f IT.—
This section need not be completed if the perniit is for one hundred dollars ($100) or less.
G Certificate of Exemption: I certify that in the perfonnance of the work for which this pemnit is issued, I shall not employ any person in any manner so asto become subject to the Workers'Compensation Laws of
Califomia. WARNING: Falluiv to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, damages asm^deiHm' infection 3706 of the Labor code. Interest and attomey's fees. / /
ti-^ jPCIrSCUT HATE t ^^T^
CLARATION
^A AGENT DATE
/ hereby affimi (haf / am exempf from Contractor's Ucense Law for the following reason:
• I, as owner of the property or my employees with wages as their sole compensation, will do the work and the stmcture is not Intended or oflered for sale (Sec. 7044, Business and Professions Code: The Contractor's
License Law does not apply to an owner of property who buikis 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 dkJ 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 Contractor's License Law does not apply to an owner of
property who builds or improves thereon, and contracts fbr such projects with contractor(s) licensed pursuant to the Contractor's License Law).
O I am exempt under Sectkin. .Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construction of the proposed property impmvement C\ Yes • No
2.1 (have / have not) signed an application for a building permit for the proposed wori<.
3.1 have contracted with the following person (finii) to provide the pnjposed construction (include name address / phone / contractors' license number):
4.1 plan to provide portions of the work, but I have hired the fbltowing person to coordinate, supervise and provkle the major work (include name / address / phone / contractors' license number):
5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of wotk):
) PROPERTY OWNER SIGNATURE lAGENT DATE
COmPtMtB THIS SECTION FOB N O N-R E S I 0 E N TI A t BUILOING PERMITS ONtY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration forni o r risk management and prevention program under Sections 25505,25533 or 2SS34 of the
Presley-Tanner Hazardous Substance Account Act? OYes DNo
Is the applicant or future building occupant required ID obtain a pemiit fiom the air pollution control district or air quality management district? • Yes CJ No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? OYes ONo
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.
CONSTRUCTION LENDING AGENCY
I hereby aflinn that there is a construction lending agency for the perfomiance of the work this pemiit is issued (Sec. 3097 (i) Civil Code).
Lender's Name Lender's Address
PPLICANT CERTIFICATION
I certif that I have lead the applkatton and state that the aboie Infomiation is conect and that the Infbira
I hereby aulhorize repfesenlative ofthe Qty of Carisbad ID enter upon Ihe above mentioned property Ibr inspection puiposes. I ALSO AGREE TO SAVE, INDEMNII=Y AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL UABILiTIES, JUDGMENTS, COSTS A|D EXI^ENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
It SO deep and demolilion or constmctton of stmctures over 3 stories in height.
\\ under the provistons of this Code shall expire by limitatton and become nul and void if the building or woik aulhorized by such pennit is not comnienoed iMlhin
nvwik authorized by such pemiit is suspended or abandoned at any time afler the viork is commenced Ibr a period of 180 days (Section 106.4.4 Uniform Bulkting Code).
OSHA: An OSHA pemiit is required Ibr excavations
EXPIRATION: Every pemiit issued by the Building (M
180 days from Ihe dale of such pemnit or if the buUing
vg^APPLICANT'S SIGNATURE DATE
City ofCarlsbad BIdg Inspection Request
For: 02/16/2012
Permit# CB112361
Title: OSTEOARTH CLINIC-3,915 SF
Description: SHELL TO MEDICAL CLINIC
Itispector Assignment: PD
1281 CARLSBAD VILLAGE DR
Lot: 0
Type:TI Sub Type: COMM
Job Address:
Suite:
Location:
APPLICANT ARC/ARTEL ARCHITECTURE
Owner: CARLSBAD MEDICAL VILLAGE L P
Remarks:
Phone: 6193411014
Inspecti
Total Time:
CD Description
19 Final Structural
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Requested By: DAN MOORE
Entered By: CHRISTINE
Comments
Comments/Notices/Holds
Associated PCRs/CVs/SWPPPs Original PC#
Inspection Historv
Date Description
02/01/2012 39 Final Electrical
02/01/2012 84 Rougti Combo
01/18/2012 17 Interior Latti/Drywall
01/12/2012 84 Rougti Combo
01/06/2012 21 Underground/Under Floor
01/06/2012 24 Rougti/Topout
01/06/2012 31 Underground/Conduit-Wiring
Act Insp Comments
PA PD SERVICE
AP PD CEILING
AP PD
AP PD OK TO SEAL DUCTS
AP PD
AP PD
AP PD
tlHtieaiIsM
Final Biiidlig inspecdn
Dept: Building Engineering Planning CMWD St Lite Fire
Plan Check #: Date: 02/16/2012
Permit #: CB112361 Permit Type: Tl
Project Name: OSTEOARTH CLINIC- 3,91!^ SF Sub Type: COMM
SHELL TO MEDICAL CLINIC* '
Address: 1281 CARLSBAD VILLAGE DR Lot: 0
Contact Person: DAN MOORE Phone: 6193411014
Sewer Dist: CA Water Dist: CA
Inspected
By: r^/( s / i ^^^poroved: ^ Disapproved:
Inspected 0 /
Date
/
By: Inspected: Approved: Disapproved:
Inspected Date
By: Inspected: Approved: Disapproved:
Comments:
EsGil Corporation
In (Partnership with government for (BuiCding Safety
DATE: 12/20/11 • APPgCANT
^^-^JURFS."^
JURISDICTION: City of Carlsbad ^—a-PtAN-RB/IEWER
• FILE
PLAN CHECK NO.: 11-2361 SET: III
PROJECT ADDRESS: 1281 Carlsbad Village Dr
PROJECT NAME: Osteoarthritis Clinic - TI
^ The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
I I The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
I I The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
I I The applicant's copy of the check list is enclosed for the jurisdiction to fonward to the applicant
contact person.
I I The applicant's copy of the check list has been sent to:
IXI EsGil Corporation staff did not advise the applicant that the plan check has been completed.
I I EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone #:
Date contacted: (by: ) Email: Fax #:
Mail Teleptione Fax In Person
• REMARKS:
By: Doug Moody Enclosures:
EsGil Corporation
• GA • EJ • PC 12/13/11
9320 Chesapeake Drive, Suite 208 • San Diego, Califomia 92123 • (858)560-1468 • Fax (858) 560-1576
EsGil Corporation
In (Partnership with government for (BuiCtCing Safety
DATE: 12/12/11 5_APPUSANT
cd" JURE>
JURISDICTION: City of Carlsbad • PLAN REVIEWER
• FILE
PLAN CHECK NO.: 11-2361 SET: II
PROJECT ADDRESS: 1281 Carlsbad Village Dr
PROJECT NAME: Osteoarthritis Clinic - TI
I I The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
I I The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
^ The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
I I The applicant's copy of the check list is enclosed for the jurisdiction to fonward to the applicant
contact person.
XI The applicant's copy of the check list has been sent to:
Arc/Artel Architecture / Alex Protasevich
4133 Redwood Ave Suite 1003, Los Angeles, CA 90066
I I EsGil Corporation staff did not advise the applicant that the plan check has been completed.
EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Alex Protasevich Telephone #: 310-822-6630
Date contacted: (by: p|2J Email: arcartel(gyahoo.com Fax #:
C Mail Telephone Fax In Person
• REMARKS:
By: Doug Moody Enclosures:
EsGil Corporation
• GA • EJ • PC 12/5/11
9320 Chesapeake Drive, Suite 208 • San Diego, Califomia 92123 • (858) 560-1468 • Fax (858) 560-1576
City of Carlsbad 11-2361
12/12/11
Please make all corrections on the original tracings, as requested in the correction
list. Submit three sets of plans for commercial/industrial projects (two sets of plans
for residential projects). For expeditious processing, corrected sets can be
submitted in one of two ways:
1. Deliver all corrected sets of plans and calculations/reports directly to the City of
Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760)
602-2700. The City will route the plans to EsGil Corporation and the Carlsbad
Planning, Engineering and Fire Departments.
2. Bring one corrected set of plans and calculations/reports to EsGil Corporation,
9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468.
Deliver all remaining sets of plans and calculations/reports directly to the City of
Carlsbad Building Department for routing to their Planning, Engineering and Fire
Departments.
NOTE: Plans that are submitted directly to EsGil Corporation only will not be
reviewed by the City Planning, Engineering and Fire Departments until review by
EsGil Corporation is complete.
1. Each sheet of the plans must be signed by the person responsible for their
preparation, even though there are no structural changes. Business and
Professions Code. All sheets must be signed.
3. Please provide a wall legend, indicate on the plans the wall type and reference
the appropriate construction details. Please clarify the legend to reference
detail 8 on sheet A2-3.
4. Please clarify the section view of all new interior partitions. Show:
a) Method of attaching top and bottom plates to structure. (NOTE: Top of
partition must be secured to roof or floor framing, unless suspended
ceiling has been designed for partition lateral load). Please clarify detail
8 on sheet A2-3 to show the method of connection at the roof
structure.
b) Show height of partition and suspended ceiling, and height from floor to
roof framing or floor framing.
5. Provide a section view of the new soffits. Show:
c) Method of attaching top to the structure and lateral bracing. Please clarify
detail 6 on sheet A2-2 to show the method of connection at the roof
structure.
6. Glazing in the following locations should be of safety glazing material in
accordance with Section 2406.3 for the new entry
d) Fixed or operable panels adjacent to a door where the nearest exposed
edge of the glazing is within a 24-inch arc of either vertical edge of the door
in a closed position. And where the bottom exposed edge ofthe glazing is
less than 60 inches above the walking surface. Revise the window types
on sheet A2-3 to show all glazing less the 60" to be safety.
City of Carlsbad 11-2361
12/12/11
11. Please revise the plans to show the insulation per the energy design. I was
unable find to find any information.
To speed up the review process, note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If there are other changes, please briefly
describe them and where they are located in the plans.
Have changes been made to the plans not resulting from this correction list?
Please indicate:
Yes • No •
The jurisdiction has contracted with Esgil Corporation located at 9320
Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of
858/560-1468, to perform the plan review for your project. If you have any
questions regarding these plan review items, please contact Doug Moody at
Esgil Corporation. Thank you.
^ CITY OF
CARLSBAD
BUILDING PLANCHECK
CHECKLIST
QUICK-CHECK/APPROVAL
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
ENGINEERING Plan Check for CB 11-2361 Date: November 7,2011
Project Address: 1281 Carlsbad Village Drive (Building E) APN: 156-190-70-10
Project Description: Tenant improvement - Shell to medical office Valuation: $196,925.00
ENGINEERING Contact: Linda OntlverOS
Phone: 760-602-2773
Email: linda.ontiveros@carlsbadca.gov
Fax: 760-602-1052
• RESIDENTIAL Z] TENANT IMPROVEMENT
• RESIDENTIAL ADDITION MINOR
(<$20,000.00)
PLAZA CAMINO REAL
• CARLSBAD COMPANY STORES • COMPLETE OFFICE BUILDING
[Zl OTHER: Fees paid under CB06-1884
OFFICIAL USE ONLY
ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT
BY
REMARKS:
DATE: NovtmNtr 7,2011
Notification of Engineering APPROVAL has been sent to
via on
Page 1 of 1 E-36 REV 4/30/11
^ CITY OF
CARLSBAD
PLANNING DIVISION
BUILDING PLAN CHECK
APPROVAL
P-29
Develooment Services
Planning Division
1635 Faraday Avenue
(760) 602-4610
www.carlsbadca.gov
PERMIT NUMBER CBl 12361 DATE 11/4/11
ADDRESS 1281 CARLSBAD VILLAGE DR
RESIDENTIAL ADDITION-
MINOR (<17,000.00)
RETAINING WALL
POOL/SPA
TENANT IMPROVEMENT
COMPLETE OFFICE
BUILDING
VILLAGE FAIRE SOLAR PANELS
OTHER INTERIOR Tl ONLY
PLANNER GINA RUIZ DATE 11/4/11
p-29 Page 1 of 1 07/11
Carlsbad Fire Department lUILDING DEP t
COPY
Plan Review Requirements Category: TI, COMM
Date of Report: 12-13-2011 Reviewed by:
Name:
Address:
ARC/ARTEL ARCHITECTURE
ALEX PROTASEVICH
STE 1003
4133 REDWOOD AVE
LOS ANGELES 90066
Permit #: CBl 12361
Job Name: OSTEOARTH CLINIC- 3,915 SF
Job Address: 1281 CARLSBAD VILLAGE DR CBAD
X/X/XitUWXi^i/VWWWVWV
Conditions:
Cond: CON0005097
[MET]
* * CITY OF CARLSBAD FIRE DEPARTMENT - APPROVED:
THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUANCE OF
BUILDING PERMIT.
THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS HEREON,
CONDITIONS IN
CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS.
THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW.
Entry: 12/13/2011 By: GR Action: AP
CONDITIONAL RECOMMENDATION FOR APPROVAlgLJ^Q pEPJ QQP V
age:
CONDITION:
A2-3 Delete thumb-turn from Hardware Group #1. Keyed locking device is allowed on main door. Thumb-
turn devices are not allowed.
Daryl K. James & Associates, Inc. Checked by: Darvl Kit James kitfire@sbcglobal.net
205 Co//na Terrace Plan Check Date: December 5. 2011
Vista, CA 92084
APPLICANT: Alex Protasevich JURISDICTION: Carlsbad Fire Department
PROJECT NAME: Osteoarthritis Clinic PROJECT ADDRESS: 1281 Carlsbad Village Drive
PROJECT DESCRIPTION: CB112361 3,915 S.F. T.I.
This plan review has been conducted in order to verify conformance to minimum requirements of codes adopted by
the Carlsbad Fire Department.
The items below require correction, clarification or additional information before this plan check can be approved for
permit issuance.
COMMENTS
AO-1
•Provide a description of scope of work including mechanical equipment.
Sheet Index
• Revise Architectural Sheet from AO.l to A-1.0
Occupant Load
• Revise occupant load using CBC Table 1004.1.1. Occupant load is determined by the function ofthe space. An
occupant load factor of 15 is applicable to Conference Area 122 and Break Room 109.
Deferred Submittals
• Fire Sprinkler Modifications - 2010 NFPA 13 CFC Chapter 903 (add)
•Fire Alarm System Modifications - 2010 NFPA 72 CFC Sec 907 (add)
Provide an Exit Analysis Plan
Egress Analysis
•Denote occupant load determined by the function of the space and number of exits required for each area.
CBC Chapters, CFC Sections 1004.1 and 1015.
•Denote common path of egress travel CFC 1014.3
•Denote travel distance CFC 1016 where path of egress ends at an exterior exit.
•Denote total width of exits and actual width of exits provided. CFC 1005
• Provide a furniture and/or equipment layout plan.
A2.1
• Label existing door in Physical Therapy Area 118.
•Denote the location of rated assemblies and provide ICC report # or reference to Item number in 2010 CBC
Table 720 1(2) on detail labeled as rated construction. None
•If any rated assemblies will be penetrated, provide details with listing for fireproofing product. None
A2-2
• Provide a note referencing Sheet E2 for the locations of exit signs and means of egress illumination.
•Remove note pertaining to Salt Lake City Building Permit Department.
Page: 2 of 2
'A2-3
Door Schedule
• If Door 101 is the only main exterior exit, please specify so and add Note 8 under remarks column.
• 101 - Verify door is Type B (confirmed that this is a pair of single doors)
Hardware group #1 notes thumb-turn.
•List applicable door hardware note number under remarks column.
•Add existing door in Physical Therapy Area 118 to Door Schedule.
Door Hardware Schedule
Delete thumb-turn from Hardware Group #1. Keyed locking device is allowed on main door. Thumb-turn
devices are not allowed.
Room Finish Schedule
•Add a note: All finish materials shall comply with CBC Chapter 8, Table 803.9.
A6-2
•Title the sheet as Existing Building Sections
E2
• Denote means of egress illumination level of 1 foot-candle at the walking surface.
• Denote additional means of egress illumination in accordance with CBC 1006.2.
• Denote additional directional exit signs in accordance with CBC 1011.1
MECHANICAL PLANS
•If equipment is added to system on the roof, provide a roof plan and imprint Carlsbad Roof Equipment Policy
80-6 on plan. Address Intent B concerning fireman safety. No new roof mounted equipment.
mmy PHYSICS 980 N. La Patera Lane, Goleta, CA 93117
TflJFaxf CHn^ K4^_7.Q0Qf <>.inailr i-iiainhv«/S)<miflil <>mn
December 02,2011
Mr. Jared Davis
Reach Medical
12637 S. 256 West, Ste. 100
Draper, UT 84020
Dear Mr. Davis:
Enclosed are lead shielding specifications for new x-ray rooms for Osteo-Arthritis Clinic of
Carlsbad, CA. Design takes into consideration present lead shielding, if known, and lead
equivalence of existing walls. Tables cited are from the National Council on Radiation
Protection Reports 49 and Revision NCRP 147. Barrier transmission values and shielding
requirements are computed using software and data from D.J. Simpkin*'^. Tabulated values have
been reduced to conform with federally mandated limits of personnel exposure. These specify no
more than 2 mrem to the general public per week (exposure in any one hour) and no more tiian
100 mrem in any one year. For occupational exposures, the revised rule allows 10 mrem per
week or 500 mrem in any one year total dose equivalent.
Information conceming x-ray tube characteristics, weekly work-loads, occupancy, beam
orientation, room plans and other items or values were fumished by the user, the contractor, or
the architect and are assumed as correct. i^^NOlOOIf Pif1f5iC5 (RP) is not responsible for
determination of pre-existing lead in barriers. If any assumptions are in error, or if any
modifications have been made in plans, notify RP at once. Beam orientation, imless otherwise
noted, is determined by the image receptor. Shielding height is 80 inches unless otherwise
specified. Shielding should be butted or overlap Vz in. at joints. Wall holes, as for conduit,
should be suitably baffled. The area behind metal door handles requires no lead unless otherwise
noted. Specified banier thickness values are minimimi requirements. It is often economical to
substitute 2-lb lead (0.8 mm) for lesser specified thicknesses.
State law specifies "No user shall permit the operation of x-ray equipment unless the equipment
and the installation meet the applicable requirements of the regulations and are appropriate for
the procedures to be performed".
Very Truly Yours,
Helmar S. Jan^e
Medical Physicist
CA MQA 0103
' Douglas J. Simpkin,"A general solution of the shielding of medical x and gamma rays by the
NCRP49 methods". Health Physics, vol. 52 (431), 1987.
^ Douglas J. Simpkin,"Shielding requirements for constant potential diagnostic x-ray beams
determined by a Monte Carlo calculation" Health Physics, vol. 56 (151), 1989.
DIAGNOSTIC IMAGING PHYSICS • MAMMOGRAFHY MQSA • NUCLEAR MEDICINE
X-RAY AND RADIOISOTOPE SHIELDING DESIGN and EVALUATION
mrad in any one week. The controlled operator is restricted to not more than 50 mGy per year or
10 mrad (1 mGy) per week. We have retained the more conservative occupancy factors
recoinmended in NCRP 49.
Osteo-Arthritis CUnic Site Plan—Carlsbad, CA.
DIAGNOSTIC IMAGING PHYSICS • MAMMOGRAPHY MQSA • NUCLEAR MEDICINE
X-RAY AND RADIOISOTOPE SHIELDING DESIGN and EVALUATION
Explanation of Terms;
Workload (W): The degree ofuseofan x-ray or gamma-ray source. Usually expressed
in milliampere-minutes (mA-min) or roentgens at one meter from the source (R-m^). Usually
supplied by customer or obtained either from commercial data or common uses for the specified
equipment
Use Factor (U): Beam direction factor specifies the fraction of time during which the
radiation under consideration is directed at a particular barrier. For Scatter and Leakage radiation
this is taken to be 1.0.
Occupancy (T): The factor by which the workload should be multiplied to correct for
the degree of occupancy of the area in question while the source is "ON".
Shielding Design Considerations;
a. Shielding is to a height of 80 inches unless otherwise specified.
b. Lead glass should be equivalent to the lead in the wall or door in which it is installed.
c. Shielding calculations for stored film assume 1 month storage.
Common Materials Equivalents (100 kVp);
1 % in. plaster (2 side standard wall) = .26 mm Pb.
1 in. sand plaster = 0.65 in. concrete = .24 mm Pb.
1 in. light weight concrete = .75 in. normal concrete (147 Ib/ft^) = .27mmPb.
1 in. gypsum board = .33 in. concrete = .12 mm Pb.
1 in. concrete (147 Ib/ft^) = 1.5 in. plaster = .35 mm Pb.
VA in. lead glass (4.7 g/cc) = 1.4 mm Pb.
1 in. plate glass = .2 mm Pb.
OSTEO-ARTHRITIS CLINIC;
New x-ray equipment is being installed in two x-ay rooms located in a single-story building
erected on slab foundation on grade. Interior walls incorporate 5/8 in. gypsum wall-board.
Exterior walls are 2x6 wood frame.
Two x-ray rooms are planned: A radiography room with wall bucky and a fluoroscopy room
with C-arm.
Facility plans were provided by the user and architect who also fiimished information about
estimated weekly work loads and types of procedures.
Weekly work-load estimates are as follows:
Radiography; 120 exposures per week ofknees using a wall bucky. This results in an
estimated weekly work-load of 50 mA-min.
Fluoroscopy: 25 procedures per week for an estimated work load of 125 mA-min.
All personnel in the area, except the the x-ray operator, are assumed to be non-controlled (i.e. not
monitored with radiation badges) and as such are limited to not more than 100 mrad per year or 2
Osteo-Arthritis Clinic X-ray Rooms.
SfflELDING RECOMMENDATIONS
The analysis of shielding requirements for the Radiography and Fluorscopy Rooms were carried
out with the stated assumptions and with dimensions derived from submitted floor plans or
verbal communications with the user. Errors in distance estimates are not sufficiently large to
affect the general conclusions about shielding requirements. The shielding analysis results in the
specification of barrier transmission factors tiiat are required to reduce weekly exposure dose
levels to personnel to permissible levels. The amount of lead or lead equivalent material required
to achieve the desired transmission factor is based on calculations summarized in attached spread
sheets. Required shielding is listed below for each barrier and indicated on an attached floor
plan.
Note: Some states specify that the minimum specified lead thiclcness is 2 Ib/sq.ft. commercial
lead. If this is the case for your state, the impacted recommendations will have to be adjusted
accordingly.
I. RADIOGRAPHY ROOM 115
1. CONTROL: No shielding beyond that provided by wall constraction of two layers of
5/8 in. gypsum wall board is required IF the x-ray unit operator stands behind the wall as
indicated on the room drawing. The window in that barrier, however, needs to be at least double-
glazed with a minimum of nearly Vz in. (10 mm) of plate glass. If such is not available, we
recommend installation of a window wdth leaded ^ass of shielding equivalent to 1 Ib/sq.ft. lead.
Ifthe x-ray operator is monitored with a radiation badge, a window with ordinary plate glass may
be used.
2. HALLWAY-BUCKY: This barrier requires shielding with 2.5 lb/sq.ft. commercial
lead over an area that extends 12 in. beyond the outiine of the image receptor on all sides.
3. EXAM ROOM 116: The door leading to this room from the x-ray room requires
shielding equivalent to that of the wall. We recommend that a steel sheet of 1/32 inch (0.8mm)
thickness be applied to this door.
EXMII112
corrmoL
2.§UlmtM.tMAD
HALLWAY
OSTEOARTHRITIS CUNIC
X41AYRM.118
CARLSBAD, CA
Radiography Room 115 Shield Plan
DIAGNOSTIC IMAGING PHYSICS • MAMMOGRAHIY MQSA • NUCLEAR MEDiaNE
X-RAY AND RADIOISOTOPE SfflELDING DESIGN and EVALUATION
FLUOROSCOPY ROOM 111
1. LANDSCAPING—^User states that tiiis area is used for landscaping only and thus the
low occupancy assures that normal wall constraction is adequate to protect occasional personnel
in this area. No additional shielding is required.
2. EXAM ROOM 112— This barrier requires shielding with 2 Ib/sq.ft commercial lead
over the area indicated in the drawing.
3. CONTROL—ConfroUed Personnel (radiation badge monitored) attending patient
fluoroscopic procedures in the room need to wear protective clothing witii at least 0.8mm Lead
Equivalence. We strongly urge that non-controlled personnel not be permitted in this room
during fluoroscopy procedures.
I
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L4MOSC4P«WG
7
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RM. Ill
EXAM
112
HALLWAY
BREAKROOM
OSTEOARTHRTTtS CUNIC
FLUOROSCOPY RM. 111
CARLSBAD, CA
Fluoroscopy Room Shielding Plan
DISCLAIMER: ~ ~
i r'"^^Tf ^^^'''^^ '^^'•^ information provided by the client. Should the weekly
tytube work load increase significantly or should the uses of spaces adjacent to the x-rav
examination room change, the adequacy ofthe recommended shielding wil have to be revTewed
DIAGNOSTIC IMAGING PHYSICS • MAMMOGRAPHY MQSA • NUCLEAR MEDICINE
X-RAY AND RADIOISOTOPE SHIRDING DESIGN and EVALUATION
•Equitable Healthcare Accessibility fei- Caltferma'
Office of Statewide Health Planning and Development
Faculties Oevelopmcnl Division
1400 9" Street. Room 420 - Sacramento, Califomia 95814 1831 9* Street - Sacramento, CdiforrUa 9S814
700 N. Alameda Street. Suite 2-500, Los Angeles, Caitfomia 900123
www.ostipd .ca .gov/fdd
(916) 654-3362 Fax (916) 654-2973
(916)324-9090 Fox (916) 324-9145
(213)897-0166 Fax (213) 897-0168
CERTIFICATE FOR RADIATION PROTECTION
DATE: December 02,2011 OSHPD Application No.:
FACILITY NAME: OsteoArtiiritis Clinic
Address: 1281 Carlsbad Village Dr., Ste. E, Carlsbad, CA 92008
DESCRIPTION OF PROPOSED PROJECT: New Radiographic and Fluoroscopic
X-Ray Rooms
Based on my assumption and calculations, I declare under penalty of perjury that the
radiation protection specifled for the above project shall confonn to the applicable,
provisions of Chapter 31C, Califomia Building Code (Titie 24, Califomia Code of
Regulations), relating to radiation protection. I further declare that I am a certified
radiation physicist, health physicist, or (Specif)
Name; Helmar S. Janee, M.S./Ph.D.
Medical Physicist, CA MQA 0103
RADIOLOGY Pm««
980 N. La Patera Lane, Goleta, CA 93117
Tel / Fax: 805-845-2999
e-mail: radiphys@ginail.coni
Signature:.
Additional Comments; It is suggested that the enclosed report be forwarded under your
cover to the Office of Statewide Health Planning at one of the above addresses.
CARLSBAD
PLUMBING,
ELECTRICAL,
MECHANICAL
WORKSHEET
B-18
Dex/eiopment Services
Building IKvison
163S Faraday Avenue
760*02-2719
www.carisbadca.gov
Informcdioo prcvktsd below refers to luortj b&ng done oo ttie above mantioned permit only.
This form mosi be tompltwi and ratunwd te lk> BwiMfcitt DWsiwi befef tha pwwit can bt ti^tjl.
BuHcfing Dept Rnc 0^) 602-6558
Nianber of new or relocated fixtures, traps, or fkjor cbnins.
H»u iHiilding sewer line? „„
Ntanber df new roof ^insm?
Ves
traAcdU<Aer water tkne?.,
Numb«- of new water heaten?.
Number of new, relocated or repkKedi gas outlet?.
Ntsnber of new hose bibs?
No
Rashteiljcd Permite '2-<Zt A
New/«Bqxinded$«w»: hkmrrisercrfnewanrqss: _
Minor f{emodelon4« Ves No
ComnHWdaWndutWafa
Tenant improvernent: Nurnber of eidflbig amps involved ki thb /mvect:
Number of iww amps Aw^A^Aittiffonafect-
New Construdion: Amps per Panel:
Single Pfrase... X-
Three Phase— 7 ^' r
DH«el%]se480. - O
.Nun4>erof
, Number of
.Number of
amperes Z-g'^
new amperes
amperes
Numb^ of new fumaces. A/C, or h»at pumps?.
New or relocated duct woiii?— .Ves_N/_ No
Number of new fireplaces?
Number of new exhaust fans?
Rdocate/instaU went?..-........—.»—
NtBTri}»-of new exhaust hoods?.
Number of new boHers or compressors? .NumberofHP
B-18 1of 1 Rev.(BH»
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS QUESTIONNAIRE
UPFP#
HV# 2.T
BP DATE.
Business Name f\ . Business Contact Telephone* 0O 2>^
Project Address > City State Zip Code _ APN#
Mailing Address City State Zip Code Plan File#
Pm set Contact r\ Telephone #
The following questions represeiit the fecility's activities, NOT the specific project description.
PART 1: RRE DEPARTMENT - HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION; Indicate by circling Ihe item, whether your business
will use, process, or store any di the ft^own^ hazardous materials. If any of tfia items are drcted. applicant must contact tt» Fire Protection Agency with
jurisdiction prior to plan submtttal. Facility's Square Footage Pnduding proposed project): LS Occupancy Rating:
1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water ReacHves 13. Corrosives
2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards
3. Flammai>le/Combus&ble liquids 7. Pyrophorics 11. Highly Tojdc or Toxic Materials 15. NoneofThese.
4. Ranwnable Solids 8. Unstable Reactives 12. Radioadiwes
YES NO
1. •
?• •
3. •
4. •
5. •
6. •
7. •
mount?
or greater thaim^ ^^'^rif • 500
Will your business use pr install a Hazardous Waste Tanic System (Titie 22, Art cid^^
Will your business store petroleum in tanlts or containers at your fadlity v ith
or greater than 1,320 gallons? (California's Aboveground Petroleum Storage AcQ,
xinstruction or remodefinj i^^j^^pjects)
• CalARP Exempt /
Oah Initiais
PART 11: SAN DIESO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH - HAZARDOUS MATERIALS DIVISIONS fHMDte If the answer to any of the
questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overiand Ave., Suite 110, San Diego, CA 92123.
Call (858) 505-6700 prior to the issuance of a building pennit
FEES ARE REQUIRED. Proiect Compietion Date: Ol- I OI / 20 12- Eyperted Data ot Ucdipantjy. O 2, / ^ L..f4X.
(fisrnew
Is your business listed on tha reverse side of this form? (check all that apply).
Will. yQur business dispose of Hazardous Substances or MefiKcai Waste in any i
Will your business store or handle Hazanlous Sut>stances in quanUBes equal tc c
200 cubic feet, or carranogens/reproductive toxins in any quantity?
Will your business use an existing or install an underground storage tank?
Wili your business store or handle Regulated Substances (CalARP)?
unds,
• {falAfV Required
JL Oah Initials
(falARP Complete
i
Initials
PART III: SAN DIEGO COUNTY AtR POLLUTION CONTROL DISTRICT; If the answer fo any of the quesfions below s yes, applicant must contact the Air
Pollution Control District (APCD). 10124 Old Giove Road, San Oiego. CA 92131-1649. telephone (858) 586-2600 prior to the issuance of a buBding or demolition
permit Note: if the answer to quesfions 4 or 5 is yes, applicant must also submit an asbestos notiiicafion fbrm to tha APCO at least 10 working days prior to
commencing demolition or renovation, except demolition or renovation of residential structures of four units or less. Contact the APCD for nwre information.
YES NO
1- • Will the subject fecility or construction activities include operations or equipment that emit or are capable of emitting an air contaminant? (See the
APCD fectsheet at http:/Aww.sdapcd.org/lnfo/facts/permits.Ddf. and the list of typical equipment requiring an APCD pemiit on the reverse side
of this from. Contact APCD If you tiave any quesfions).
2. O • (ANSWER ONLY IF QUESTION 11S YES) WiU the subject facility be located within 1,000 feet of the outer boundary of a sdwol (K through 12)?
(Search the Califomia School Directory at http://www.cde.ca.Qov/r6/sd/ for public and private schools or conlact the appropriate school disfrict).
3. • ^ Has a survey been performed to determine the presence of Asbestos Containing Materials?
4. • ^ Will there be renovation that Involves handling of any friable asbestos materials, or disturtsing any material that contains non-friable asbestos?
5. • -cT Will there be demolifion involving the removal of a load supporting structural member?
Briefly describe business acfivifies:
OK of T-thc KUxec
Briefly describe proposed project:
'—k]^are under perjuty of perjury that to thei)est of my knowledge a1
Name of Owner or Auttiorized /^gent Date
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:.
BY:
FOR OFFICIAL USE ONLY:
DATE:
EXEMPT OR NO FURnlER INFORMATION REQUIRED RELEASED FOR BUILDING PERMrT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
APCD COUNTY-HMD APCD COUNTY-HMD APCD
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