HomeMy WebLinkAbout1293 CARLSBAD VILLAGE DR; ; CB100513; Permit05-11-2010
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No: CB100513
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
Project Title:
1293 CARLSBAD VILLAGE DR CBAD
Tl Sub Type:
1561907004 Lot#:
$85,540.00 Construction Type:
Reference #:
FALLAH: 1820SF DENTAL OFFICE
SHELL TO OFFICE
COMM
0
5B
Applicant:
RM CONSTRUCTION SERVICES
9450 MIRA MESA
#104
SAN DIEGO 92126
858-663-5707
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
Plan Check#:
Owner:
CARLSBAD MEDICAL VILLAGE L P
C/O RUSS RIES
PO BOX 1422
LAJOLLACA 92038
ISSUED
03/25/2010
JMA
05/11/2010
05/11/2010
Building Permit
Add'l Building Permit Fee
Plan Check
Add'l Plan Check Fee
Plan Check Discount
Strong Motion Fee
Park Fee
LFM Fee
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
Green Bldg Stands (SB1473) Fee
Fire Expedited Plan Review
$582.23 Meter Size
$0.00 Add'l Reel. Water Con. Fee
$378.45 Meter Fee
$0.00 SDCWA Fee
$0.00 CFD Payoff Fee
$17.96 PFF (3105540)
$0.00 PFF (4305540)
$0.00 License Tax (3104193)
$0.00 License Tax (4304193)
$0.00 Traffic Impact Fee (3105541)
$0.00 Traffic Impact Fee (4305541)
$0.00 PLUMBING TOTAL
$0.00 ELECTRICAL TOTAL
$0.00 MECHANICAL TOTAL
$0.00 Master Drainage Fee
Sewer Fee
$0.00 Redev Parking Fee
$0.00 Additional Fees
$1.00 HMPFee
$227.50
TOTAL PERMIT FE
$0.00
$0.00
$0.00
$0.00
$1,556.83
$1,437.07
$0.00
$0.00
$0.00
$0.00
$34.00
$86.50
$80.00
$0.00
$0.00
$0.00
$90.00
$4,491.54
Total Fees:$4,491.54 Total Payments To Date:$4,491.54 Balance Due:$0.00
Inspector:
FINAL APPROVAL
Date:Clearance:
NOTICE: Ptease take NOTICE thai 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 f'le 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.
*• Building Permit Application
^ 1635 Faraday Ave., Carlsbad, CA 92008
C < T Y ° F 760-602-2717/2718/2719
C* A D I C R A Pi Fax 760-602-8558
V« ./Vr\L«3D/VLx www.carlsbadca.gov
JOB ADDRESS ^ ^^^ vj||age p^
CT/PROJECTO |LOT# I PHASE * I # OF UNITS I # BEDROOMS^
^^ I ^ I I 1 I ^
Plan Check No. C"P? V (D G 51 3
Est. Value ^S. ^VO.
Plan Ck. Deposit ^375; ^^
Date
SUITE#/SPACE#/UNIT*
B/#7
M-T-2-OfO
APN /sr(p — i^c? — fe'-J'
156 - 190 - 53
((BATHROOMS TENANT BUSINESS NAME I CONSTR. TYPE
1 Fallah/ Exceptional Dentistry | Tl
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
Jw>Pi
-
OCC. GROUP
B
Tenant improvement for a medical-related (dental) office. Space is currently an empty shell (no previous use).
Interior space for Tlr4692.5 Sq Ft
EXISTING USE PROPOSED USE GARAGE (SF)
None/ New shell Medical office N/A
CONTACT NAME (If Different Fom Applicant) ^^~- '
ADDRESS -^
CITY STATE ZIP
PHONE FAX
EMAIL
PROPERTY OWNER NAME _ .......Dr. Al Fallah
ADDRESS
1200 Garden View Rd., Suite #108
CITY STATE ZIP
Encinitas CA 92024
PHONE FAX
760-942-0800 760-942-0805
EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE LIC. #
PATIOS (SF)
N/A
DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS
N/A YESQ* NoTy'l YES0NO[^] YESf^NOl |
APPLICANT NAME .. _ , , - . .. ,McFarland Construction, Inc.
ADDRESS
CITY
PHONE
EMAIL
1 1 19 S Mission Rd, #322
STATE ZIP
Fallbrook CA 92028
FAX
760-723-2278 760-451-1725
info@mcfarlandconstructioninc.com
CONTRACTOR BUS. NAME . _ .McFarland Construction. Inc.
ADDRESS
CITY
PHONE
EMAIL
STATE LIC.#
1 1 19 S Mission Rd., #322
STATE ZIP
Fallbrook CA 92028
FAX
760-723-2278 760-451-1725
info@mcfarlandconstructioninc.com
CLASS CITY BUS. LIC.tf
783111 B
(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 theapplicant 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 {$500}).
Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations:
I 11 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.
L^J 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 workers' compensation insurance carrier and policy
number are: Insurance Co BBa Policy No. 488038° Expiration Date "-»"
This section need not be completed if the permit is for one hundred dollars ($100) or less.
[ I Certificate of Exemption: I certify that in thejierformance of the worttlo?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 secure wnbtrs' compensatioircovepage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (8.100,000), in
addition to the cost of compensation, damage as provided fo/in Section 3706 of the Labor code, interest and attorney's fees.
^CONTRACTOR SIGNATURE //// QAGENT DATE M ~\\Z£>IO
/ hereby affirm that I am exempt from Contractor's License Law for the following reason:
| | I, as owner of the property or my employees with waies 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).
I I 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 Contractor1 s License Law).
I I i am exempt under Section Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. I |Yes I No
2.1 (have / have not) signed an application for a building permit for the proposed work.
3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
4.1 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 / 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 work):
^PROPERTY OWNER SIGNATURE QAGENT DATE
. •>^;;'-5i^;*S«37"-,;j¥*;\ - pff^i^r-^^^l^y,^vi*/A.:v.y A^^/Vkj^^ u»i'li^.Ay^-a^J-fe^^Ma-IA^aiSSg%>-Y:
Is the applicant or future building occupant required to submit a business ata/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? | |Yes l/UNo
Is the applicant or future building occupant required to obtain a permit from (lie air pollution control district or awmality management district? \_JYes
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? I lYes l/TNtr
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY HAY 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.
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name Lender's Address
I hereby authorize representative of the City 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' djrfp and demolition or construcJiBn'Of structures over 3 stories in height.
EXPi RATION: Every permit issued by the Building Cfficjdl UHMT the provisions of this Cqdrf?ha](«xpire by limitation and become null and void if the building or work authorized by such permit is not commenced within
180 days from the date of such permit or if the buttyfeypm. authorized by such pe/l is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
^APPLICANT'S SIGNATURE "/ // i . ./ / DATE
CITY OF
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717 / 2718 / 2719
Fax: 760-602-8558
www.carlsbadca.gov
Pla" CheCk
Est. Value
Plan Ck. Deposit
Date
JOB ADDRESS SUITE#/SPACE#/UNIT#
CT/PROJECT ## BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE
h>
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
~r-)""'~vm
xp.
EXISTING USE
New •
PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE
YESD#
AIR CONDITIONING FIRE SPRINKLERS
N0 D
CONTACT NAME (If Different Fom Applicant)
R-od
CITY
PHONE FAX PHONE FAX
EMAIL
IVJVCO <S"
PROPERTY OWNER NAME CONTRACTOR BUS. NAME
(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 7OOO 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 acivil penalty of not more than five hundred dollars ($500)).
Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations:
O 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.
[^ 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 workers' compensation insurance carrier and policy
number are: Insurance Co. Policy No. Expiration Date
This section need not be completed if the permit is for one hundred dollars ($100) or less.
M 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 secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (4100,000), in
addition to the cost of compensation, d§ma§« as provided for in Section 3706 of the Labor code, interest and attorney's fees.
JB<> CONTRACTOR SIGNATURE / (^ JL-
/ hereby affirm that I am exempt from Contractor's License Law for the following reason:
D 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 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).
d 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 Law).
n I am exempt under Section Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement, n Yes n No
2.1 (have / have not) signed an application for a building permit for the proposed work.
3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
4.1 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 / 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 work):
PROPERTY OWNER SIGNATURE I I AGENT DATE
THI,S"'.Smc'r-io W
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? D Yes a No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O Yes jSf No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? a Yes TJf No
IF ANY OF THE ANSWERS ARE YES,/
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
-coNJ?»u*TIoN is*N»jmm
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name Lender's Address
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 autaize representative of (he City 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'G" deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the Building 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 commenced within
180 days from Ihe date of such permit or if theJauWiflgjjr work authorized by such permit is suspended or abandoned at any tme after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
^APPLICANT'S SIGNATUI DATE
City of Carlsbad
Final Building Inspection
Dept: Building Engineering Planning CMWD St Lite Fire
Plan Check #:
Permit*: CB100513
Project Name: FALLAH: 1 820SF DENTAL OFFICE
SHELL TO OFFICE
Address: 1 293 CARLSBAD VILLAGE DR
Date: 06/28/2010
Permit Type: Tl
Sub Type: COMM
Lot: 0
Contact Person: JESSICA Phone: 7607232278
Sewer Dist: CA Water Dist: CA
Inspects^ / Date 'i
By: I y, A !U\\ / Inspected: / >y (
Inspected n Date
By: Inspected:
Inspected Date
By: Inspected:
,
\u> Approved: Disapproved:
Approved: Disapproved:
Approved: Disapproved:
Comments:
City of Carlsbad Bldg Inspection Request
For: 07/06/2010
Permit* CB100513
Title: FALLAH: 1820SF DENTAL OFFICE
Description: SHELL TO OFFICE
Inspector Assignment: PY
1293 CARLSBAD VILLAGE DR
Lot: 0
Type:TI Sub Type: COMM
Job Address:
Suite:
Location:
APPLICANT RM CONSTRUCTION SERVICES
Owner: CARLSBAD MEDICAL VILLAGE L P
Remarks:
Phone: 7607232278
Inspector:
Total Time:
CD Description
19 Final Structural
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Requested By: JESSICA
Entered By: CHRISTINE
Notice
Date
07/02/2010
06/28/2010
06/21/2010
06/07/2010
06/03/2010
05/25/2010
Comments/Notices/Holds
SEE WM10-35 FOR 5/8" WATER METER PURCHASED
Associated PCRs/CVs Original PC#
Inspection History
Description Act Insp Comments
89 Final Combo
89 Final Combo
84 Rough Combo
17 Interior Lath/Drywall
84 Rough Combo
21 Underground/Under Floor
PA RB TEMP OF C OF O - NOTICE ATTACHED
NR PY
PA PY T-BAR
AP PY
AP PY
AP PY
City of Carlsbad Bldg Inspection Request
For: 07/02/2010
Permit* CB100513
Title: FALLAH: 1820SF DENTAL OFFICE
Description: SHELL TO OFFICE
Inspector Assignment: PY
Type:TI Sub Type: COMM
Job Address: 1293 CARLSBAD VILLAGE DR
Suite: Lot: 0
Location:
APPLICANT RM CONSTRUCTION SERVICES
Owner: CARLSBAD MEDICAL VILLAGE L P
Remarks: P M PLEASE
Phone: 7607232278
Inspector:
Total Time:
CD Description
19 Final Structural
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Requested By: NA
Entered By: BINSPECT
Act Comments
Notice
Date
06/28/2010
06/21/2010
06/07/2010
06/03/2010
05/25/2010
Comments/Notices/Holds
SEE WM10-35 FOR 5/8" WATER METER PURCHASED
Associated PCRs/CVs Original PC#
Inspection History
Description Act Insp Comments
89 Final Combo
84 Rough Combo
17 Interior Lath/Drywall
84 Rough Combo
21 Underground/Under Floor
NR PY
PA PY T-BAR
AP PY
AP PY
AP PY
CITY OF CARLSBAD
BUILDING DEPARTMENT
DATE
NOTICE
TIME
LOCATION
(760) 602-2700
1635 FARADAY AVENUE
j) '
PERMIT NO.J
Z
FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? Lj YES
FOR FURTHER INFORMATION, CONTACT
BUILDING INSPECT
PHONE
CODE ENFORCEMENT OFFICER
EsGil Corporation
In Partnership with government for (Building Safety
DATE: 5/1O/10
JURISDICTION: City of Carlsbad U PLAN REVIEWER
a FILE
PLAN CHECK NO.: 1O-0513 SET: II
PROJECT ADDRESS: 1293 Carlsbad Village Dr B #7
PROJECT NAME: Dr Al A. Fallah DDS - TI
X3 The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
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.
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
The applicant's copy of the check list has been sent to:
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: Telephone #:
Date contacted: (by: ) Fax #:
Mail Telephone Fax In Person
REMARKS:
By: Doug Moody Enclosures:
EsGil Corporation
D GA D EJ D PC 5/4/10
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 * (858)560-1468 * Fax (858) 560-1576
EsGii Corporation
In Partnership with government for (Building Safety
DATE: 4/2O/10 OABRUQANT
JURISDICTION: City of Carlsbad a PLAN REVIEWER
a FILE
PLAN CHECK NO.: 10-0513 SET: I
PROJECT ADDRESS: 1293 Carlsbad Village Dr B #7
PROJECT NAME: Dr Al A. Fallah DDS - TI
The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
XJ The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
XI The applicant's copy of the check list has been sent to:
McFarland Construction Inc.
1119 S. Mission Rd Suite 322, Fallbrook, CA 92028
Esgil Corporation staff did not advise the applicant that the plan check has been completed.
XI Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: McFarland Construction Telephone #: 760-723-2278
Date contacted:cf/it l'° (by: k£ ) ^ Fax #: 760-451-1725
Mail Telephone is^ Fax ^ In Person
REMARKS:
By: Doug Moody Enclosures:
EsGil Corporation
D GA D EJ D PC 4/12/10
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 4 (858)560-1468 4 Fax (858) 560-1576
City of Carlsbad
4/20/10
10-0513
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO.: 1O-O513
OCCUPANCY: B
TYPE OF CONSTRUCTION: VB
ALLOWABLE FLOOR AREA:
SPRINKLERS?: YES
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 4/7/10
DATE INITIAL PLAN REVIEW
COMPLETED: 4/20/10
JURISDICTION: City of Carlsbad
USE: Dental Office
ACTUAL AREA: 1692sf
STORIES: 1
HEIGHT:
OCCUPANT LOAD: 29
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 4/12/10
PLAN REVIEWER: Doug Moody
FOREWORD (PLEASE READ):
This plan review is limited to the technical requirements contained in the International Building
Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state
laws regulating energy conservation, noise attenuation and access for the disabled. This plan
review is based on regulations enforced by the Building Department. You may have other
corrections based on laws and ordinances enforced by the Planning Department, Engineering
Department, Fire Department or other departments. Clearance from those departments may be
required prior to the issuance of a building permit.
Code sections cited are based on the 2007 CBC, which adopts the 2006 IBC.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 105.4 of
the 2006 International Building Code, the approval of the plans does not permit the violation of
any state, county or city law.
To speed up the recheck process, please note on this list (or a copy) where each
correction item has been addressed, i.e.. plan sheet number, specification section, etc.
Be sure to enclose the marked up list when you submit the revised plans.
City of Carlsbad 10-0513
4/20/10
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.
2. Provide the names, addresses and telephone numbers of the owner and the
responsible design professionals on the Title Sheet. Sec. A106.1.1.
3. Please clarify the section view of all new interior partitions. Show:
a) Method of attaching top plates to structure Detail B on sheet D-1. (NOTE:
This does not appear to be a 4 story building).
b) Please provide the listing and installation information for the glass wall
assembly.
c) Please provide the listing and installation information for the waterfall
partition.
4. Provide a section view of the new soffits detail E on D-1. Show:
a) Type, size and spacing of studs. Indicate gauge for metal studs. Specify
manufacturer and approval number or indicate "to be ICBO approved".
b) Method of attaching top to the structure and lateral bracing.
c) Wall sheathing material and details of attachment (size and spacing of
fasteners).
d) Show height of the soffit from floor, soffit to roof framing or floor framing.
5. Please provide plans and calculations signed by the California State licensed
engineer or architect for the medical gas enclosure addition. Include all
calculations and finding on the plans. Please include the California license
number, seal, date of license expiration and date plans are signed. Business and
Professions Code.
City of Carlsbad 1O-O513
4/20/1O
6. Please revise the plans to show a landing at the new exterior door complying
with section 1003.3.1.6 and 1003.3.1.7 of the UBC.
7. Glazing in the following locations should be of safety glazing material in
accordance with Section 2406.3 for the existing window at the new exterior door
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 of the glazing is
less than 60 inches above the walking surface.
8. Please revise the mechanical plans to show the outside air connection to the
new fan coils.
9. Indicate the location on the plans of the approved fixture to receive the main
condensate discharge from air conditioning units. (UMC Section 309)
10. Please provide a roof plan clearly show the exhaust discharge of the vacuum
system to comply with section 1326.2 of the UPC.
11. Please indicate on the plans the location of the air intake for the compressor
showing it to comply with section 1325.3 of the UPC.
Please revise the vacuum specification to show the piping to be hard-drawn
copper complying with ASTM B 88, ASTM B 280 or ASTM B 819 or stainless
steel per section 1316.3 of the UPC.
Please revise the plumbing plans to show the total aggregate vent area to be
equal to the required sewer size per section 904.1 of the UPC. (A minimum of
7.06 square inches).
14. Please note in the general wiring notes on the plans "AC Cable is not allowed in
A, B, E, H, F, M, S and I occupancies. NM cable is restricted (without City
approval) to one and two family dwellings. Note on plans that an equipment
ground conductor is to be installed in all flexible conduits".
15. Please revise the plans to show the insulation per the energy design.
Note : When alterations, structural repairs or modifications or additions are made to an
existing building, that building, or portion of the building affected, is required to comply
with all of the requirements for new buildings, per Section 1134B.2. These requirements
apply as follows:
a) The area of specific alteration, repair or addition must comply as "new"
construction.
b) A primary entrance to the building and the primary path of travel to the
altered area, must be shown to comply with all accessibility features.
c) Existing sanitary facilities that serve the remodeled area must be shown to
comply with all accessibility features.
City of Carlsbad 1O-0513
4/20/1O
16. Show on the site plan the complying disabled accessible path of travel from the
disabled accessible parking spaces to the primary entrance of the tenant space.
Please provide detailed plans of the path of travel, indicate slope and width, any
pedestrian ramps, curb ramps, walks, handrails, provide dimensioned parking
stall details etc.
17. Please revise the plans to show a disabled accessible transaction counter located
at a section of the main counter that is at least 36" long and no more than 28" to
34" high (flip-up or folding counters are only permitted in existing buildings when a
finding of unreasonable hardship is found by the building Official). Section
1122B.5.
18. Show a level area, or landing for door D, per Section 1133B.2.4.2:
a) >60" in the direction of door swing.
19. Please clarify the door schedule to show the new pocket door to be provided with
a stop that would prevent the door from fully recessing and that will provide the
required 32" minimum clear opening. Please indicate in the hardware schedule
the hand activated door opening hardware for the pocket door to be designed to
provide passage without requiring the ability to grasp the opening hardware.
20. Please revise the plans to show the non-commercial kitchen sink in the
employee staff room to provide the following:
a) A clear floor space at least 30"x 48" shall be provided for forward
approach.
b) The clear space shall extend a maximum of 19" underneath the sink.
c) The accessible sink shall be a maximum of 6 Yz" deep.
d) The sink shall be mounted with the counter or rim no higher than 34"
e) Knee clearance that is at least 27" high, 30" side and 19" underneath the
sink shall be provided.
f) Hot water and drain shall be insulated.
g) There shall be no sharp or abrasive surfaces under sinks.
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 Q No a
City of Carlsbad 10-0513
4/2O/1O
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 10-0513
4/20/10
[DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Carlsbad PLAN CHECK NO.: 10-0513
PREPARED BY: Doug Moody DATE: 4/20/10
BUILDING ADDRESS: 1293 Carlsbad Village Dr B #7
BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: VB
BUILDING
PORTION
Tl
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code
AREA
(Sq. Ft.)
1692
cb
RIHn Pprmifr FAP hv Drriinanrp ^
Valuation
Multiplier
34.37
By Ordinance
Reg.
Mod.
VALUE ($)
58,154
58,154
$459.38
Plan Check Fee by Ordinance
Type of Review:
I I Repetitive FeeRepeats
Complete Review
D Other
[—I Hourly
EsGil Fee
Structural Only
Hr. @
$298.60
$257.25
Comments:
Sheet 1 of 1
macvalue.doc +
City of Carlsbad
Public Works — Engineering
DATE:
BUILDING PLANCHECK CHECKLIST
V I / ^ s> PLANCHECK NO.;
BUILDING ADDRESS:
PROJECT DESCRIPTION: /f2v
ASSESSOR'S PARCEL NUMBER:%ST. VALUE: fi^WO
ENGINEERING DEPARTMENT
APPROVAL
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. Please review
carefully all comments attached, as failure to comply
with instructions in this report can result in
suspension of permit to build.
D A Right-of-Way permit is required prior to
construction of the following improvements:
DENIAL
Please seethe Attached list of outstanding issues
marked witjnO^^vlake necessary corrections to plans
or specifioafions for compliance with applicable
codes and standards. Submit corrected plans and/or
specifications to the Building Dept. for resubmittal to
the Engineering"Dept. Only the applicable sheets
have been
By:
By:
By:
Date:
Date:
Date:
By:
FOR OFFICIAL USE ONLY
ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT:
Date:
D
D
D
D
D
D
D
ATTACHMENTS
Engineering Application
Dedication Checklist
Improvement Checklist
Neighborhood Improvement Agreement
Grading Submittal Checklist
Right-of-Way Permit Application and Info
Sheet
Storm Water Applicability Checklist/Storm
Water Compliance Exemption Form
ENGINEERING DEPT. CONTACT PERSON
Name:
Address:
Phone:
KATHLEEN M. LAWRENCE
City of Carlsbad
1635 Faraday Avenue, Carlsbad, CA 92008
(760) 602-2741
NOTE: If there are retaining walls
associated with your project, please check
with the Building Department if these walls
need to be pulled by separate RETAINING
WALL PERMIT.
1635 Faraday Avenue • Carlsbad, CA 92O08-7314 • (76O) 6O2-272O • FAX (76O) 602-8562
BUILDING PLANCHECK CHECKLIST
RD3
D
D D
SITE PLAN
1. Provide a fully dimensioned site plan drawn to scale. Show:
A. North Arrow
B. Existing & Proposed Structures
C. Existing Street Improvements
D. Property Lines (show all dimensions)
E. Easements
F. Right-of-Way Width & Adj Streets
G. Driveway widths
H. Existing or proposed sewer lateral
I. Existing or proposed water service
J. Existing or proposed irrigation service
K. Submit on signed approved plans
DWG No.
2. Show on site plan:
A. Drainage Patterns
1. Building pad surface drainage must maintain a minimum slope of one
percent towards an adjoining street or an approved drainage course.
2. ADD THE FOLLOWING NOTE: "Finish grade will provide a minimum
positive drainage of 2% to swale 5' away from building."
B. Existing & Proposed Slopes and Topography
C. Size, type, location, alignment of existing or proposed sewer and water service
(s) that serves the project. Each unit requires a separate service; however,
second dwelling units and apartment complexes are an exception.
D. Sewer and water laterals should not be located within proposed driveways, per
standards.
3. Include on title sheet:
A. Site address
B. Assessor's Parcel Number
C. Legal Description/Lot Number
For commercial/industrial buildings and tenant improvement projects, include:
total building square footage with the square footage for each different use,
existing sewer permits showing square footage of different uses
(manufacturing, warehouse, office, etc.) previously approved.
EXISTING PERMIT NUMBER DESCRIPTION
Show all existing use of SF and new proposed use of SF.
Example:
Tenant Improvement for 3500 SF of warehouse to 3500 SF of office.
BUILDING PLANCHECK CHECKLIST
MISCELLANEOUS PERMITS
.. ST 2ND 3RD
D D D 8. A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or
private work adjacent to the public Right-of-Way. Types of work include, but
are not limited to: street improvements, tree trimming, driveway construction,
tying into public storm drain, sewer and water utilities.
Right-of-Way permit required for:
D D D 9. INDUSTRIAL WASTE PERMIT If your facility is located in the City of Carlsbad
sewer service area, you must complete the attached Industrial Wastewater
Discharge Permit Screening Survey. Fax or mail to Encina Wastewater
Authority, 6200 Avenida Encinas, Carlsbad, CA 92011, (760) 438-3941, Fax
(760) 476-9852.
STORM WATER COMPLIANCE
D D D 10a. D Requires Tier 1 Storm Water Pollution Prevention Plan
Please complete attached form and return (PSP/SW )
D Exempt - Please complete attached exemption form
STORM WATER APPLICABILITY CHECKLIST
D D D 10b. D Priority Project
D Not required
FEES
D D 11. ^Q-T^equired fees are attached
^ D Drainage Fee Applicable
Added Square Fee
Added Square Footage in last two years? yes no
Permit No.
Permit No.
Project Built after 1980 yes no
Impervious surface > 50% yes no
Impact unconstructed fac. yes no
D Fire Sprinklers required yes no (is addition over 150' from CL)
Upgrade yes no
D No fees required
BUILDING PLANCHECK CHECKLIST
,ST >ND ,RD
D
D
12c. Irrigation Use (where recycled water is available)
1. Recycled water meters are sized the same as the irrigation meter
above.
2. If a project fronts a street with recycled water, then they should be
connecting to this line to irrigate slopes within the development. For
subdivisions, this should have been identified, and implemented on the
improvement plans. Installing recycled water meters is a benefit for
the applicant since they are exempt from paying the San Diego County
Water Capacity fees. However, if they front a street which the recycled
water is there, but is not live (sometimes they are charged with potable
water until recycled water is available), then the applicant must pay the
San Diego Water Capacity Charge. If within three years, the recycled
water line is charged with recycled water by CMWD, then the applicant
can apply for a refund to the San Diego County Water Authority
(SDCWA) for a refund. However, let the applicant know that we cannot
guarantee the refund, and they must deal with the SDCWA for this.
13. Additional Comments:
/o
n n
D
D
D
n n
PLANNING DEPARTMENT
BUILDING PLAN CHECK REVIEW CHECKLIST
Plan Check No. CB10-0513 Address 1293 Carlsbad Village Dr
Planner Chris Sexton Phone (760) 602- 4624
APN: 156-190-70-04
Type of Project & Use: JJ Net Project Density: DU/AC
Zoning: R-P-Q General Plan: O Facilities Management Zone: 1
CFD (in/out) #_Date of participation: Remaining net dev acres:.
Circle One
(For non-residential development: Type of land used created by this permit:
Legend: [X] Item Complete D Item Incomplete - Needs your action
Environmental Review Required: YES D NO D TYPE
DATE OF COMPLETION:
Compliance with conditions of approval? If not, state conditions which require action.
Conditions of Approval:
Discretionary Action Required:
APPROVAL/RESO. NO. DATE .
PROJECT NO.
OTHER RELATED CASES:
YES PI NO D TYPE
Compliance with conditions or approval? If not, state conditions which require action.
Conditions of Approval:
Coastal Zone Assessment/Compliance
Project site located in Coastal Zone? YES Q NO Q
CA Coastal Commission Authority? YES Q NO Q
If California Coastal Commission Authority: Contact them at - 7575 Metropolitan Drive, Suite 103,
San Diego, CA 92108-4402; (619) 767-2370
Determine status (Coastal Permit Required or Exempt): Exempt
Habitat Management Plan
Data Entry Completed? YES D NO D
If property has Habitat Type identified in Table 11 of HMP, complete HMP Permit application and
assess fees in Permits Plus
(A/P/Ds, Activity Maintenance, enter CB#, toolbar, Screens, HMP Fees, Enter Acres of Habitat Type
impacted/taken, UPDATE!)
Inclusionary Housing Fee required: YES [H NO d
(Effective date of Inclusionary Housing Ordinance - May 21, 1993.)
Data Entry Completed? YES D NO D
(A/P/Ds, Activity Maintenance, enter CB#, toolbar, Screens, Housing Fees, Construct Housing Y/N,
Enter Fee, UPDATE!)
H:\ADMIN\Template\Building Plancheck Review Checklist.doc Rev 4/08
Site'Plan:
Provide a fully dimensional site plan drawn to scale. Show: North arrow, property lines, easements,
existing and proposed structures, streets, existing street improvements, right-of-way width,
dimensional setbacks and existing topographical lines (including all side and rear yard slopes).
Provide legal description of property and assessor's parcel number.
Policy 44 - Neighborhood Architectural Design Guidelines
D 1. Applicability: YES D NO D
D 2. Project complies: YES D NOQ
D
D
D n
n n
n n
Zoning:
1. Setbacks:
Front:
Interior Side:
Street Side:
Rear:
Top of slope:
Required
Required
Required
Required
Required
2. Accessory structure setbacks:
Front: Required
Interior Side: Required
Street Side: Required
Rear: Required.
Structure separation: Required
3. Lot Coverage: Required.
4. Height: Required
5. Parking:Spaces Required
Shown
Shown
Shown
Shown
Shown
Shown
Shown
Shown
Shown
Shown
Shown
Shown
Shown
X
(breakdown by uses for commercial and industrial projects j-eopred)
Residential Guest Spaces Required Shown tf^y^A^O0
Additional Comments 1) Will there be new roof-mounted equipment? If so. please show how it will
be screened. See attached handout. 2) Please put the correct APN on the site plan.
-S-l-q Sanoe comiv\*nts Qfa^c
OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTERdeJdfrPATE5''.f5"' 10
H:\ADMIN\Template\Building Plancheck Review Checklist.doc Rev 4/08
Carlsbad Fire Department
Plan Review Requirements Category: TI, COMM
Date of Report: 05-11-2010 Reviewed by.
Name:
Address:
RM CONSTRUCTION SERVICES
9450 MIRA MESA
#104
SAN DIEGO
CA 92126
Permit #:CB 100513
Job Name: FALLAH: 1820SF DENTAL OFFICE
Job Address: 1293 CARLSBAD VILLAGE DR CBAD
INCMPLETE The item ou hayj;jju|^i^ i ^jf t*"g t^rnfi ^s °ffice cannot
ill1' iiiiiiJ-.j-i^Ji^S^BBBM^Bj^pUoo^ review
carefully all commentsatta^Jjg^dWeiS^Ss^lDmit the necessary plans and/or specifications, withcn^^es "clouded",
to this office for review and approval.
Conditions:
Cond: CON0004000
[NOT MET]
APPLICANT: McFarland Construction, Inc. JURISDICTION: Carlsbad Fire Department
PROJECT NAME: Dr. Fallah DOS PROJECT ADDRESS: 1293 Carlsbad Village Drive BLDG B Unit 7
PROJECT DESCRIPTION: CB100513 Dental Office T.I.
INSTRUCTIONS
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.
" Corrections or modifications to the plans must be clouded and provided with numbered deltas
and
revision dates.
" Please direct any questions regarding this review to: Daryl K. James 760-724-7001 or
kitfire@sbcglobal.net
ONE CORRECTED PLAN SET AND DESCRIPTIVE NARRATIVE ALONG WITH THESE
COMMENTS TO BE SUBMITTED TO:
Daryl K. James
205 Colina Terrace
Vista, CA 92084
THE FOLLOWING COMMENTS HAVE BEEN CORRECTED AND PLANS ARE RECOMMENDED FOR
APPROVAL.
CP
" Add to the List of Applicable Codes (see below)
2007 California Mechanical Code (CMC) (Part 4, Title 24, CCR)
(2006 Edition IAPMO Uniform Mechanical Code with 2007 California Amendments)
Use 2007 CBC construction type - VB
" Please clarify the following statement - Medical Gas System to be by Separate Permit. Plans are
included in the set.
" Denote fire sprinkler plan submittal as a deferred item.
Notes
" Revise all notes referencing codes and code to 2007 California codes. Please revise General
Notes 11 &12.
" Revise Sheet Index so that sheet numbers and sheet titles match each sheet. Title each
individual sheet as indicated on the Sheet Index.
T-l
" CFC Section 1008.1.8.3. Only one exterior exit door, designated as the main exit, maybe
equipped with keyed locking device, when a sign stating this door to remain unlocked when building
is occupied is posted on the egress side or adjacent to the door. All other doors including
exterior exit doors, shall be operable without the use of a key, special knowledge or effort.
Clearly denote compliance with this requirement on the plan.
" Denote all rated walls with reference to details.
Page 2 of2
N/A - UNDER SEPARATE PERMIT CFC Section 3006.2 List the name and quantity of medical
gases stored
in exterior room. Areas dedicated to the storage of such gases greater than the permit amount shall
not be used for other storage or uses.
N/A - UNDER SEPARATE PERMIT CFC Section 3006.2.1 Provide reference to a detail sheet
for details
for the one-hour exterior room Detail fire barrier with fire-resistance rating of not less than 1
hour in accordance with CBC Section 706.
N/A - UNDER SEPARATE PERMIT Provide fire proofing detail for rated penetrations.
" Revise reference to Sheet MG-1. (See Sheet Index)
" Denote type and location of fire extinguisher
" Provide a hazardous materials inventory list of all hazardous materials stored and used. List
must include chemical name, hazardous materials classification, amount stored and location of
storage, amount used (open and closed use) and location used.
" Regarding note on bottom of CP under fire protection bottom center of sheet, Please specify
which hazardous substances are you referring to, and are shown in CFC Table 2703.1.1, that prohibit
materials from exceeding 55 gallons/500 lbs/200 cu. ft?
E-3
Revise general note to 2007 CEC.
P-l
Denote the location of the fire riser (See last comment under T-l. CFC 3006.2
D-l
N/A - UNDER SEPARATE PERMIT Replace ICBO # with ICC-ES number for details.
Clarifioation - Either
provide listed design number for one hour wall construction or provide CBC Table 720.1 Item #
designating one hour wall detail.
P-l
N/A - UNDER SEPARATE PERMIT Please remove med- gas outlet- station from this sheet
Cond: CON0004001 ^
THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUEANCE OF A
BUILDING PERMIT.
THIS APPROVAL IS SUBJECT TO FIELD INSPECTIONS, ANY REQUIRED TESTS, FIRE DEPARTMENT
NOTATIONS,
CONDITIONS IN CORRESPONDENCE AND COMPLIANCE WITH ALL APPLICABLE CODES AND
REGULATIONS.
THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE ANY VIOLATION OF THE LAW.
Entry: 05/11/2010 By: DKJ/c«f
UB.6 section 1129B.1
1129B.3.1and
«ments.
ic route of travel is the
;e, with the exception of
jacent to a sidewalk,
width, a minimum of
be centered on a wall at
i height of 36" from the
litional sign stating
xessibility. Maintain
ice to off-street parking
in size with lettering
g:
sible spaces not
; issued for persons
pense. Towed vehicles
aning ."
by the fire department
s building.
[ding shall comply with
C. rated extinguisher
ravel distance not to
l.Stds, 10-1 and C.C.R.
n shall comply with
:ction equipment and all
irshall for approval
Building Owner:
Carlsbad MedicalVillage, LP
9225 Dowdy Dr, Suite 106
San Diego, Ca. 92126
FEIN: 20-2940234
C3UWTY OF SAN WEGQOF ENVIRONMENTAL HEALTHRADIOLOGICAL HEALTH
RADIATION SHIELDING APPROVED
fetid on the data submitted, the proposed radiation sMett
IrmallafQn is approved for: (tpe of est
This facility will meet the structural
•Welding requirements of the California
Radiation Control Regulations
Number of employees
no more than four (4)
.Date
I am the Owner/Tenant
responsible for the Tenant
Improvement Project: I
have inspected the site/
premises and determined
that the existing
conditions are in full
compliance with current
site accessibility
requirements to the extent
required by law.
CP TITLE
CP-1
DM
T-l
T-2
M-l
P-l
TITL1
DEM'
FLO(
CEIL
MEC
PLUN
PLUJv
ELEC
ELEC
ELEC
ELEC
DETA
NOTE: Fire Sprii
1293 Carlsbad
CO
Plans submitted by: K -*1
Facility Name/ Owner's Na
Job Site Address: ^
Mailing Address, if differei
# of Rooms
5 \
)TT iv T v n IT c A TV niirr^n KIVA**: HtPS-toHU IM 1 i Ur o A 1> JLJ 1 Ji< Lr VJ ^
n. _^ .L .r,- a in I.LL PLAN CHECK**: WDepartment of Environmental Health ^
Communitv Health Division ACTIVITY**-, f^tf L.
Radiological Health Program FEEAMOUNTS: ^
-055
$1
5"? '°^
9325 Hazard Way. San Diego, CA 92123
Tel (858)694-3621 Fax (858)694-3629 PAYMENT TYPE: . _
RADIATION SHIELDING PLAN CHECK APPLICATION
A- COH STRUCT 1 OM StpvicELS Phone #:(£5?) <
Check Number
me: t>Jl. /kL. FKULActt , b-D-S- Phone#:(^5^ T76- ^"2-62
0»Hsb<tc/ V« i'^-^ (^/^iVc- zip: <-?a/0~
rt: Zip:
X-RAY MACHINE INFORMATION
Manufacturer Model/Type
+
\ r-or-yw^ £Ui^,v-w..\
OWNER/REPRESENTATIVE DECLARATION: I understand that the fee paid is based on my declaration of the radiation shielding classification.
If the declaration is incorrect, I understand that this application will not be approved until the appropriate fee is paid.
*f-f * ii
Signature: P 'S -.£££, •WfCKo • "pV" %CfOK7(T^f~^, Title: Date: / /
This space for Office Use
CLASSIFICATION
DENTAL, MEDICAL, or
INDUSTRIAL
Only:
COWfH OFSAN DfEGO^ .OlwwrwSrror EIWRONKEWTAL HEALTH
RADIATION SHIELDING APPROVED
*M<| oo the data submitted, •)• PnWf^ggSS^SBf1 ^tattaiiallon Is approved for: (type of estabusnmenvuat) \
This, facflny w!H meet the structural .jtiieldine requirements of tt» CaliforniaRadiation Comiol Regulations
^i»— . \^. \i/\j» &. \/\^"NXj» (J**~**~~~~*^^ ^""^ "~" ~" T^B» W\ ** / ^"^™^\^i^^^ ^«^ o«* ^v^lx I / ftfi^A '*"'x^ , f
OjAwea> T^^o
ROOMS 'F°E9ElS°^)
FIRST TWO ROOMS (6CRAD O) 82.00
EACH ADDT'L ROOM UP TO 6 (6CRAD — O) 44.00 EACH
MORE THAN 6 ROOMS (6CRADHR-O) ,. IN ADDITION TO $258 BASE FEE,
(f) HOURLY FEE BASED ON REVIEW
TIME
TOTAL
^&5£l££.
HM-9901 (06-09)
COUNTY OF SAN DIEGO
Department of Environmental Health
Hazardous Materials Division
Radiological Health Program
P.O. BOX 129261, SAN DIEGO, CA 92112-9261
(619) 338-2969 FAX (619) 338-2592
ravA#
PLAN CHECK #:_
ACTIVITY #:
FEE AMOUNT $:
PAYMENT TYPE:
DCASH DCHECK
Check Number
Plans submitted by: 12..
RADIATION SHIELDING PLAN CHECK APPLICATION
_ Phone #:
Facility Name/ Owner's Name: "D » .
Job Site Address:
Ccn r.
V. Ufl^e. "D...U,.
Mailing Address, if different:
# of Rooms
X-RAY MACHINE INFORMATION
Manufacturer Model/Type
J* \vnu ^t.
Phone #: (&*"* )T7o>. <*2to?.
Zip:
Zip:
OWNER/REPRESENTATIVE DECLARATION: I understand that the fee paid is based on my declaration of the radiation shielding classification.
If the declaration is incorrect, I understand that this application will not be approved until the appropriate fee is paid.
Signature: [Title:Date: \/ I
This space for Office Use Only:
CLASSIFICATION NO. OF
ROOMS
FEES FY
06-07 ($)TOTAL
DENTAL (6HXDEN-EHO)
(6HXDNC-EHO)
FIRST ROOM 70.00
EACH ADDT'L ROOM 20.00
ONS1TE INSPECTION 35.00
MEDICAL (6HXMED-EHO)
(6HXMDC-EHO)
FIRST ROOM 75.00
EACH ADDT'L ROOM 35.00
ONSITE INSPECTION 75.00
INDUSTRIAL (6HXIND-EHO)
(6HXINC-EHO)
FIRST ROOM 220.00
EACH ADDT'L ROOM 110.00
ONSITE INSPECTION 110.00
HM-9901 (06-06)
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS QUESTIONNAIRE
OFFICE USE ONLY
UPFP# 2 i|
BP DATE_
The following questions represent the facility's activities, NOT the specific project description.
PART I: FIRE DEPARTMENT - HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: Indicate by circling the item, whether your business
will use, process, or store any of the following hazardous materials. If any of the items are circled, applicant must contact the Fire Protection Agency with
jurisdiction prior to plan submittal.
1 . Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives
2. Compressed Gases 6. Oxidizers 10. Cryogenics
3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials
4. Flammable Solids 8. Unstable Reactives "CL^Radioactives
13. Corrosives
14. Other Health Hazards
15. None of These.
PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH - HAZARDOUS MATERIALS DIVISIONS (HMD): If
questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 1255 Imperial Avenue, 3
Call (619) 338-2222 prior to the issuance of a building permit.
FEES ARE REQUIRED. n> Qr^nJi'i^s, W.T.-I/I^ 9irsQ;/? Expected Date of Occupancy: V2. 1 \YES NO • ^au.CT,U,g m ,1 t-'UUj]
1. §}"* D Isyour business listed on the reverse side of this form? (check all that appjy},. ..„__
2. §3 D Will your business dispose of Hazardous Substances or Medical Waste in any amounf?^ A T j-*
3. D B$ Will your business store or handle Hazardous Substances in quantities equal to or grJBaf^M^a|i | ;!
55 gallons, 500 pounds, 200 cubic feet, or carcinogens/reproductive toxins in any quantity?
4. D H. Will your business use an existing or install an underground storage tank?
5. D 0 Will your business store or handle Regulated Substances (CalARP)? p£g \ 2010
6. D 0 Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)?
PART III: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT: If the answartttSHV of the/c*BHttin«b^
" floor, San Diec
"" "j
aw/ffsyesTipplitPollution Control District (APCD), 10124 Old Grove Road, San Diego, CA 92131-1649, tetepJw^{8K^fea^g66oWor to the issuance c
the answer to any of the
o, CA 92101.
D CalARP Exempt
/
Date Initials
D CalARP Required
Date Initials
D CalARP Complete
^ Date Initials
;ant must contact the Air
>f a building or demolition
permit. Note: if the answer to questions 3 or 4 is yes, applicant must also submit an asbestos notifica'toafeifn "to the APCD 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 more information.
YES
D
NOQ
n n
D
D
Ela
Will the subject facility or construction activities include operations or equipment that emit or are capable of emitting an air contaminant? (See the
APCD factsheet at http://www.sdapcd.org/info/facts/permits.pdf, and the list of typical equipment requiring an APCD permit on the reverse side
of this from. Contact APCD if you have any questions).
(ANSWER ONLY IF QUESTION 1 IS YES) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)?
(Public and private schools may be found after search of the California School Directory at http://www.cde.ca.qov/re/sd/; or contact the
appropriate school district).
Will there be renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non-friable asbestos?
Will there be demolition involving the removal of a load supporting structural member?
Briefly describe business activities:Briefly describe proposed project: £xt*T1'\M
CfTitt?
I declare under penalty of perjury that to the best of my knowledge and bejier the responses made h_
nfev "R.. C-"\Y£Q_£ / /
Name of owner f Authorized Agent
true and correct.
Date
FOR OFFICIAL USE ONLY:
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:,
BY:DATE:
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
APCD COUNTY-HMD APCD COUNTY-HMD APCD
HM-9171 (04/07)County of San Diego - DEH - Hazardous Materials Division
. \u_uate::33:38 AM
Department of Consumer Affairs •
Contractors State License Board
Contractor's License Detail - License # 377582
ZlA DISCLAIMER: A license status check provides information taken from the CSLB license database. Before
relying on this information, you should be aware of the following limitations.
••» CSLB complaint disclosure is restricted by law (8&P.7124 j>). If this entity is subject to public complaint disclosure, a link
for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information.
•:>> Per B&P ZQ71,1.7, only construction related civil judgments reported to the CSLB are disclosed
••» Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration.
••?> Due to workload, there may be relevant information that has not yet been entered onto the Board's license database.
License Number:
Business Information:
Entity:
Issue Date:
Expire Date:
License Status:
Classifications:
Bonding:
Workers' Compensation:
377582 Extract Date: 03/22/2010
R M CONSTRUCTION SERVICES
9450 MIRA MESA BLVD B104
SAN DIEGO, CA92126
Business Phone Number: (858) 663-5707
Sole Ownership
07/03/1979
10/31/2010
This license is current and active. All information below should be reviewed.
CLASS DESCRIPTION
B GENERAL BUILDING ..CONTRACTOR
CONTRACTOR'S BOND
This license filed Contractor's Bond number SC1038306 in the amount of $12,500 with
the bonding company
NCjO^
Effective Date: 03/02/2009
Contractor's Bonding HMoiX
This license is exempt from having workers compensation insurance; they certified that
they have no employees at this time.
Effective Date: 10/25/2001
Expire Date: None
VVorkers' Compensation H [story
Conditions of Use I Privacy Policy
https://www2.cslb.ca.gov/OnlineServices/CheckLicense/LicenseDetail.asp 3/22/2010
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