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Home My WebLink About1824 MARRON RD; 112; 87-358; Permit.. :... - - - 2 - aj'i hereby affirm that am ilcensed under Uk proViai0n5'0t Chapter 9(commencing with 'I Siction-7000) of Division 3 of the Business :Ifld Professions Code, and my license is in I L h1 force and effect. - .'-' i hereby at firm that i am exempt trom the Corr ac :r tor s ;license Law for the ,following reason (Sec, 7031.5 4Busness and Professions Cnde: Any city or county whicr. re j - * quiresa permit, to. construct, alter, improve, demolish; or- -- repair any structure, prior to its issuance also requires he ap- 1 plicant for such permit to fife a signed statement that he is I -'lrcensedpursuanrto 'fheprnvisions 0llhe4 Centraclbr's'- - . Licanse law (Chapter 9 commencing with Section 7000 of Division-3 of the Business and Prutessinns'Code) or that is ex— empt therefrom and the basis for the altegee exemption. 'Any' violation ul,Section 7031.5 by an applicant lord jfermil sup- • edo Ihe applicant to,a civil penalty of out more thanlive hun- .dred.dollars.($500).. CK --'- ' - lii, as owner ol_lhQprnperty, or my employees with wages J Uj -as their sole compensation, -ill do the work. and the struc- (turd is bet intended or ottehed for sale 'Sic. 7044. Business ---and Professions-Code: The Contractor's license Law' dees'i' -not apply to anuwnêrut property ,whn atTilds or improves, i - - - the, and who does such work himself 'at through his own - - employees, provided thal,such improvements are not intend tat ed or uttered for 'safe. ll,however, the building oi improve-- j -z - ment is sold-within one year 01 copfetioo'théow'ber,,builder will have fee burden Of proving that,,,he;did net 'build or ins- I 0 ,,prove for the purpose of sold... .---,- -..----• I - -a I, as owner at the properly, am exclusively contracting, I ,with licensed contractors to construct the project (Sec. 7044. I 'Btisiness and' Professions Code:. ThesContractor's License - - law does not apply loan owner ot'preperly who builds or im- I, . proves thereon, and,whn contracts Or each projects with-a U) L, contractor(g) license puroant- to the Cootraclor's 'License - - Z -lawi:'.'- - - 2 I 'y ;o I- - - Ii Asa homeowner I am Improving my home, and the follow- •. - ing cunditions exist:.- A r-a • \ - cc • . t ,. The work is being pertormed -prior to sale,--'' - __ - 2--1 have lived - in,- my:home for twelve menths prior to completion of this work!-J n W ._ 3,,. I. have not- claimed this .enemplien during the - - last-three years. -, 0 lane exempt under Sec:,_- - ' -11 I- for '1 this reason '4"'n' -01-4 - . ' -" aa 'k' r. a5 - ; 'l hereby affirm that-I have a certificate 01 consent to - -. I ')r.sett.i5ure or a certiiicale'et'klorkers' Compensation In-)11, surance,'or a certified copy thereot iSec, 3800, Labor Cedel I -- 4j PôCtc,v,eo • 'C9MPANV :cos tiled with the City,'..'._. - 0 Certitied cop is kereby'lurniOfsed,r (LI Q- - --•- s-.---.---.- -- oC1 CERTIFICATE OF-EXEMPTION FROM - 0 WORKERS' COMPENSATION INSURANCE - 51) TiThi sectiorl need not be completed lithe permit 'C $- is lorone hundred dollars 101001 or less) uJ - -,D t certit;r i the performance of the work or which• -' 'this-permit iT idsurld. l'shall not employ any person in any: I C' - manner so as to become sJbject 101kv Workers' Compev. I -- " - sution Laws of California. NOTICE TO APPLICANT: If. alter making this Certificate, -of Exemption. you should becorrie subject to the WorkeA' - - Compensatior yrovidiens of the,, Labor Code. 'yeu rbout - - - Qorthwith comply with such provisions or this permit shall be deemed revoked,— 40 I hereby itiGn that lheie,is a construction lending L - agency for the pertormance 01 the work for which this per 01 ' rr,it is-issued Sec. 3097, Civil Code) zi_ - - - - -•. - - -- WI lender's Name -1 - -- , Lender's Address - , - •. USE BALL POINT PEN ONLY &'PRESS HARD -. - APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ' - - -. - - - •-...•--•--•-__ - -* --.. -,- - - - -DEPARTMENT - - - -CARLSBAD BUILDING DEPARTMENT t APPLATION & PERMIT - 2075 Las Palmas Dr.,Carlsbad CA 92009-1915 (619) 438 1161 JOB ADDRESS AV. ST. RD. THOMAS BROS NO. DATE OF APPLICATION BUSINESS LICENSE at - - ALUAT19P PERMIT NUMBER /( - - - LOT I BLOCK Or VISION ASSESSOR PARCEL NO, CONTRACTOR - / ZONE..(7..._- 3 jf9. r6NTRACTORS511ONE# OWNER SNAME - OWNE R'S PHONE - -- - - -BUILDING SO FOOTAGE , - Gz1rf ,4•':z:. d74 71c,53j CONTRACTOR'S ADDRESS STATE LICENSE NO. WNE AS MAILING ADDRESS - DESIGNER - DESIGNER'S PHONE • ,-• - -- T,VO (efi P42kD INita"zA0,- — 01 DESCRIPTION OF WORK • - - ieo rr 7tUJ7 JØ444flJ7 DESIGNER'S RS STATE LICENSE NO. -- - - -- - • .- . - w- - -' tal2dl '— I %V IWJ-'tCM./ L.tS7L_ 0003 08/1? 0101 O2B1dptht -497.3 NO F/P FLR ELEV. - OC G EDU - ' STORIES - - YO NC) -4_-•6--- - - -- - - -• CENSUSTRACT-' -PARKING SPACE RES UNITS -GRADING PERMIT ISSUED REDEVELOPMENT YPE 0CC LOAD FIRE SPA I J AREA -- S oD N ND Not ;ah;un/o Machine cerrthed QTY. t PLUMBING' PERMIT - ISSU,E 7 £- OTY. MECHANICAL PERMIT :ISSUE •• - SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP - - : - - INSTALL FURN. DUCTS UP TO100.000 BTUi - - BUILDING PERMIT 001-810-00-00-8220 EACH BUILDING SEWER - , ,-• - - - . • - - -. -OVER 100,000 BTU - -' - -- - -- - SIGN PERMIT- - ------ 001-810-00-00-8221- -- - - ---- - - - - EACH WATER HEA'TER A'JDiOR VENT , . BOILER/COMPRESSOR UP 103 HP - - - PLAN CHECK 001-810-00-00-8891 - EACH GAS SYSTEM -i 104 OUTLETS —: - - BOILER/COMPRESSOR 3-15 HP • TOTAL PLUMBING 001-810-00-00-8222 ' EACH GAS SYSTEM'S OR MORE- - , - , - • .-- METAL FIREPLACE _. ____• - .---;-- '-ELECTRICAL • _'001-810-00-00-223- - EACH INSTAL.ALT-tR, REPAIR WATER-PIPE __- -_-. - VENT FAN SINGLE DUCT MECHANICAL -•001-810-00-00.8224 - _— - . - -. 2.— - EACHVACUUMBREAKER - -., MECHEXHAUSTHO0D!OUCTS - __- .- MOBILEHOME--001-810-00-00-8225 - WATERSOFTNER -'-- _--• RE LOCATION OF_EAFURNACE,HEAJERr __-CL.- - __------ -SOLAR EACH ROOF DRAIN (INSIDE) - - - - .- r. DRYER STRONGMOTION'880-519-92-33 -_/_f --_- _-_-•-'. . - 'J I. - - -- -- --_101AL-PLUMBINI,i"-•--_-- -_-_' PUBLICFACILITIES FEE 320-810-00-00-8740. - ______ -- OTY. - ELECTRICAL PERMIT. ISSUE • OTY. - • -• • BRIDGE FEE 360-810-00-00-8740 - - ,-------- - - MOBILE HOME SETUP _- •• . '--- - 3 — ',- - - -_IE_• - - NEW CONSILA BKIL— - - - CARPORT --:L. - . T _-2__00008835 - - I 'PH - 3 PH — AWNING LA COSTA TIF -•_311-810-00-00-8835 EXISF BLDG EAAMPISWT'B _ - - - ,I- GARAGE •----_o ---r •-' - - - ' --FMFU-I2b'1(-'' i 1•PH—\\r,.-".,'3PH___- . _- F ,----_- . TOTAL MECHANICAL - ------FIRESPRINKLERS 00181000-008227 ?7_LJ-JP - 'RtMODEL"ALTi'R 'PE'R'CIRC'UIT LICENSE TAX _'i—_-oot'81'0'00'0O-8162 cityofCARLSB19-92-57 TEMP PDI-E,-?00AMS ------ __' '--'-- ------_-•-. - *---_ ---- -- - -- OVER_200AMPS ' __,._,.'s.-. - - - - '' _.-•• - '' - - - '- TEMP OCCUPANCY 130 DAYS) - - . 4 . - - . - . ' - - - - - - - - *.- - ' '' EVELOPMENTPROCESSIN-cFPvc-- ' ' - - ' ' - CREDIT DEPOSIT - / ••_•,-,7 I - - - TFALEL!LL -- r -blAt - - TOTAL FEES PAYABLE - - - 7---' I HAVE CAREFULLY EXAMINED THE COMPLETED '-APPLICATION AND PERMIT" AND DO HEREBY Expiration. Enerypermit issued by the Building Official under the provisions oIthis INCLUDING THE Code shall expire by limitation and become null and void If the building 01 work * AN OSHA PERMlT IS REQUIRED FOR EXCAVs IGN OF authCERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON ed by such permit is not commenced within 180 days from the date of such 50" DEEP AND DEMOLITION O CONSTRT' 't DECLARATIONS ARE TRUE AND CORRECT AND FURTHER CERTIFY AND AGREE IF A PERMIT IS prmi °r buildu, or work CITY, COUN1Y AND STATE LAWS GOVERNING BUILDING CON OVER 3 STORIES IN NEIGH. ISSUED: TO COMPLY WITH ALL aba fled at any Iirn aen Ihe work'is commenced ton a perIod WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANU HARMLESS TI-fE CITY OF CARLSBAD AGAINST ALL LIABIUTTES. JUDGMENTS. COSTS P1 AN 'S SIp/UAE OWNER 0 01180 dayo KEEP ASTRUCTION. CONTRACTOR 0 ftT77TURES ' EXPENSES WHICH MAY IN ANY WAYACCRUE AGAINST SAID CITY IN CONSEQUENCEOF THE - A1/ BY PHONE 0 GRANTING OF TI-uS PERMIT. -' • - - -C to- - 0)' 0 C 'to C IL- 0' Ci 0)- - 0)- 0'- 4- I TYPE I DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY .. - GUNITEORGROUT- SUB FRAME 0. FLOOR- CEILING SHEATHING .0 ROOF. 0 SHEAR, FRAME EXTERIOR LATH INSULATION ' 1 INTERIOR LATH &-DRYWALL •.: . . - PLUMBING -- LI. SEWER AND BL/CO Li P.JCO • .. UNDERGROUND 0 WASTE UJIWATER' :-- ---" -- TOP OUT- 0 WASTE 0 \&ATER' — TUB AND SHOWER PAN - GAS TEST. O WATER HEATER 0 SOLAR WATER., -ELECTRICAL. --- - 0 ELECTRIC UNDERGROUND d UFF,ER - ROUGH ELECTRIC - O ELECTRIC SERVICE 0 TEMPORARY 0 BONDING 0 POOL . . MECHANICAL Li DUCT.4&PLEM. TDREFPIPING . t' HEAT,-'AIR-COND. SYSTEMS VENTILATING SYSTEMS I . •- ,, "S.-', . ., 'S - - 4 - ' - — '- '-4. - --, - - .-._.: - - - FIELD INSPECTION RECORD / - - REQUIRED SPECIAL INSPECTIONS * INSPECTOR :S NOTES -. -* --- INSPECTION-s REQ. IF INSPECTOR'S ATE CHECKEDAROVALP :'- _" -.-. .-..I . ... _SOILS COMPLIANCE - .PRIORTO ,,.. - .-..-- --' --• - -----'-- ' ' -- FOUNDATION INSP - - — - - - - - - - - - 'V STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED .CONCRETE---- -POST TENSIONEP - '-- -. ----4.-__-...-.•-•-.• ..-'-..-.-- FIELD WELDING HIGH STRENGTH 1 — — - — BOLTS._- SPECIAL M1. 1 ASONRYJ -, - - PILES CAISSONS — — — -- -- - • .,.-- ------S. — ..- ---- -S.- SS.*_•S._•SV=S '_'-_-S.--.- ...,\--. \-.:,, - • '-k -. --+ - - - - — - -,- - - 'I '.- '-• ' - -. J- ' '-- r - - - - - - - - \i " — L(' Q(4Q (,,,yt '-- -' r' - 4 CALLFORFIIJALINSPEC1!IONWHENALLAPPROFRIATE',.'-. ITEMS ABOVE HAVE BEEN5 APPROVED Lt \ \ I 4, 5 !. FINAL- .. .-... ..:- Jk ELECTRICAL, MECHANICAL eas BUILDING- SPECIAL CONDITIONS.....- '' "•••---• •' •-' I -' . - c-" -s': .. • 1 — •1 4,I•_.,__ . -. . -.. - - —. . ----V .....- --4- - — - -5--- - - - --V ___ - - - - ---S.--.- - -S. •. -- '.#._ - - - - — S.- - - S. _' - - S — - - - - - - V •; 1' j';'. •I1'.z.U.j.4.i •.:'--'.'..L — -. '•. c' .- . '.. V: V a DEVELOPMENT PROCESSING-SERVICES DIVISION 1 2075 LAS PALMAS DRIVE Y , CARLSBAD, CA 920094859 $ * (619) 438-1161' MISCELLANEOUS FEE RECEIPT Applicant Please Print And Fill In Shaded Area Only JOB ADDRESS '&24 /McIJ O gii2 'PAN:ID NO /SVIO7, PARCEL NO. -j - 000797/06 0101 Misc. 36270 J/iiJ MX1 vuy ,4c OWNER OWNER'S -• To, MZZ5OV MAILING ADDRESS ,q6A1 c4 Z'.dO CFTYJS17j4 ZIP 7V&O— TELq.c5, VALIDATION AREA CONTRACTOR ESTMATED VALUATION CONTRACTOR'S MAILING ADDRESS .• . PLANCHECKEEE 001-810-00-00-8821 IF.THE,APPLICANT TAKES NO ACTION 7 WITHIN-180 DAYS, PLAN CHECK FEES CITY; ZIP TEL. V WILLBEFORFEiTED: ,a - V - V V STATE BUSINESS . LICENSE NO. LICENSE NO. \ -'a ' . . .. • ' . SUBDIVISION LOT(S) LEGAL DESCRIPTION CHECK IF SUBMITTED 24Wi9Krwrz c ..2ENERGYCALCSa . O i#Av r4q 7&-1P PI5f9 2 1987 ENERGY . FOR NON RESIDENTIAL BLDGS . DESCRIPTION OF WORK El ?,STRUCTURAL CALCS -Ia rr• -'1jJ1 '2 SOILS RORTs ..:-: ftfl/E(47j5 2 SELF -A.DDRESS~D, ENVELOPES DATE GIVEN! DATE ,. . . . SENT TO APPLICANT CONTACT PERSON V.47 d q 4. e LA COSTA LETTER ADDRESS jftj7i. SCHOOL FEE FORM CITY PJO// 9ZIP TEL 17*'.O/31 a.- ,, * ' P&ECORRECTIONS LIST ( - JJ( /7 ' -' 'a - çERTIFICATEO 9CCUPANCY ' APPLICANT'S SIGNATURE - ,. DAtE: '. •'' . . - . . -. a. - -- . •"a V -' V. V. -. - -• . - V. . V I • -. . a, a - V.. • • . • * - - ---V. .' S ', - .. ' 'V ••_ - 'V • - V.. V.' * •' • . V - . .•• •' - - V , - * . .- V. •...........V.. V * - V.- I • - - -' White - File ., YeIIow - Applicant • -. , Pink Finance. - . , Gold - Assessor - . V , - ,. • V, - V - 4 ' V • FINAL BUILDING INSPECTION 87-358 October 23, 1987 PLAN CHECK NUMBER: ________________________________________ DATE: • HUGHES. NORTH COUNTY ASSOC . o PROJECT NAME: S 1824 MARRON ROAD, SUITE 112 ADDRESS: - .• PROJECT NO UNIT NUMBER PHASE NO • 1.1. . •: TYPE OF UNIT: ______________________________ NUMBER OFUNITS: 0 { JOHN QMEZA.T ço.LUNS • : : •. CONTACT PERSON: 0 ..• 276-3380 CONTACT TELEPHONE: • . '. BUILDING, ENGINEERING,'' PLANNING AND FIRE DEPT. INSPEC DATE INSPECTED: APPROVED ______ DISAPPROVED I INSPECTED • DATE • • . . BY: •_• INSPECTED: ___________ APPROVED • DISAPPROVED . INSPECTED • - DATE • •• BY: •_• INSPECTED:. , APPROVED • DISAPPROVED COMMENTS . S • S 5 • • -••.'Ifi' S • 0; 5 1., 5 5 .5 . • S • ••••! I}. • • Rev. 1186 WHITE: Suspense BLUE: Water District: GREEN: Engineering CANARY: Utilities PINK:'Planning GOLD: Fire S ........ .• :$ . 0 0 • • . • .2 . • 0• FINAL BUILDING INSPECTION • 87-35 October 23, 1987 PLAN CHECK NUMBER: DATE: HUGHES NORTH COUNTY ASSOC. PROJECT NAME: 18214. MARRON ROAD, surrE 112 ADDRESS: PROJECT NO.: UNIT NUMBER: _________________ PHASE NO.: T. 1 . TYPE OF UNIT: . NUMBER OF UNITS: JOHN GOMEZ AT COLLINS . CONTACT PERSON:_____________________________________________________________ 216-3380 CONTACT TELEPHONE:_____________________________________________________________________ BUILDING, CINEERIUC, PLANNING AND FIRE DEPT. = INSPECTED . DATE BY: INSPECTED: __________ APPROVED _____ DISAPPROVED INSPECTED DATE • • BY: • • INSPECTED: • APPROVED • DISAPPROVED INSPECTED . DATE BY: • . INSPECTED: APPROVED DISAPPROVED • COMMENTS: . ra Rev. 1/86 WHITE: Suspense BLUE: Water District GREEN: Engineering CANARY: Utilities PINK: Planning GOLD: Fire FINAL BUILDING INSPECTION RECEIVED fY 2 7 17 • '87-358 October 23, 1901 PLAN CHECK NUMBER: DATE: HUGHES NORTH COUNTY ASSOC. PROJECT NAME: - 18218 MARRON ROAD, SUITE 112 ADDRESS: '- PROJECT NO.: UNIT NUMBER:' _________________ PHASE -NO.: 1 I TYPE OF UNIT: _____________________________ NUMBER OF UNITS: JOHN GOMEZ AT COLLINS CONTACT PERSON:________________________________________________________________________ ' 76-3380 . 'CONTACT TELEPHONE:_____________________________________________________________________ UIU)ING, NC'EUNG, PLANNING AND FIRE DEPT. DATE INSPECTED/) BY: IN SPECTED /0717 APPROVED DISAPPROVED INSPECTED " DATE BY: ' INSPECTED: 'APPROVED ______ DISAPPROVED ______ ,• - --,'INSPECTED DATE. • •,• BY: 'INSPECTED: ___________ APPROVED DISAPPROVED COMMENTS Rev. 1186 WHITE: Suspense BLUE: Water District GREEN: Engineering CANARY: Utilities PINK: Planning GOLD: Fire DATE: 13' S'7 :DAPPLICA411T 7UThDIC)bN JURISDICTION: (.4 i'2- A 0 -pLN-enEcKER DFILE COPY PLAN CHECK NO: i- ')'5 QUPS ODESIGNER PROJECT ADDRESS PROJECT NAME: CE \ \rz b1L 'T S The, plans transmitted herewith have been corrected where tVZ2 necessary and substantially comply-with the jurisdiction's building codes. The plans transmitted herewith will substantially comply El with the jurisdiction's building codes when minor deficien- cies identified are resolved and checked by building department staff . The plans transmitted herewith have significant deficiencies D identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. S Ej The check list transmitted herewith is for your information. The plans are being held at Esgil Corp. until corrected S plans are submitted for recheck. S fl The applicant's-copy of the check list is enclosed for the jurisdiction to return to the applicant contact person. : Li The applicant's copy of the check list has bean sent to Ea Esgil staff didnot advise the applicant contact person.that plan check has been completed.. fl Esgil staff did advise applicant that the plan. check has been completed Person contacted Date contacted: Telephone #_________________ REMARKS: By: 3,\_LS4v'.L S Enclosures:'LqN1S ESGIL CORPORATION t .. V •' ' - ESGIL CORPORATION V '•, ':". 9320 CHESAPEAKE DR., SUITE 208 R'o '•5.I L : •.. V SAN DIEGO, CA 92123 (619)560-1468 DATE::':'' . ' - 1'(io . ' V ' , APPLICANT V , JURISDIC JURISDICTION: 'V •, ' JPLA'N'CHECKER" []FILE COPY . ' V PLAN .CHECK,NO:. ' 81—.—I •' ' CUPS ODESIGNER PROJECT' ADDRESS: 82-4- •'/-\ ltO ' ' PROJECT. NAME:_V,V j _____\'2 fl"TheplanStransmitted herewith have been corrected.where, necessary and substantially comply ,with the jurisdiction's building codes. The plans transmitted herewith will' substantially comply, V with the jurisdiction's building codes when minor deficien-. cies identified ' are resolved and che,cked 'by building, department staff. , ' V V , ' ' , • V D Theplans transmitted herewith have significant deficiencies identified n the enclosed check list and should be. ,cor'r'ected and resubmitted for a complete recheck. ,, ' ' • 'V The check list transmitted herewith is for your information. The plans are being held at Esgil Corp.' until corrected,. plans are submitted for recheck. V , D The applicant's copy of the check list is enclosed for, the 'V jurisdiction to return to the applicant contact person. The applicant's copy of the check list has been sent to: A• $'-itu. Co c -r 2L s-- 1t10C 'io Esgil staff did' not advise the applicant contact person that plan check has been completed. V • . - V Esgil staff did advise applicant that the plan check has been' completed. Person contacted: . ' . . - • ' Date contacted: ' . • Telephone # • - REMARKS: By:TV\A S4KJ V'', Czlz,z.. ESGIL CORPORATION . V -' , • V ' ' V V.V*V FLAX aia io. - c p) pg READ-,._ 3URISDIC7rIOH: • Plan check is limited to technical requirements contained in the Uniform Building Code, Uniform S _____________________________________________ Plumbing Code, UnIform Mechanical Code, National - S • 2't r TO: - PrTfl".) .aUtT Electrical Code and state laws regulating energy •, conservation, noise attenuation and access for the handicapped. The plan check is based on %5?5 OTL C1aC..L.t r# - xegulations enforced by the Duilding-Inspection. Department. Youmay have other corrections DlE-D CA-. p.-) 0 based on laws and ordinances enforced-by the Planning Department, Engineering Department or - other departments. PROJECT DATA Present California law mandates that oc:___1 construction comply with Title 24 and the I. applicable model code editions adopted, with or JTLDThC USE: __ --. / without changes, by the various State agencies , / / ,/) authorized to propose building regulations for YPE OF cxDNSUCTION:V - II / enforcement at the local level. Codesections 7 cited are based on the 1982 UBC Vj / /• The above regulations apply to construction, LtZABI.E AREA:________________________________ . regardless of, the code editions adopted by \1 ) ordinance at the local level. SIORfl:______________ • The circled items listed need clarification, -' • -.• modification or change. All items have to be N I satisfied before the plans will be ir SPRfl(L: _-1 conformance with the cited codes and . I regulations. Per Sec. 303 (c), 1982 Uniform 0PA2tC LOAD: _I Building Code, the approval of the plans. does • not permit the violation of any state, county or I city law. the recheck orocess, note on this coov) where e.ach correction item has MARKS: Fthe PLAN CORRECflO)(sed, IP*'ROVEl'EUT i.e., 1an sheet, wecifjcation. TENANT etc. Be sure to enclose the marked list when Mu revplans.uo Data plans received by Jurisdiction:1J( B'?' • • Date plans received by Esgil Corp.:. l • • • - Date initial plan check completed: .• S Applicant contact person: S - • • S S D%Z. Pr rl 013 i : • lO': PACE NUKES A PAGE.wiw No lints MMX24C CORFX=1ON WERE DYI PT. List No. 50, TENANT IMPROVEMENT WITHOUT SPECIFIC ENERGY ZONE DATA OR POLICY SUPPLEMENTS -• -• - 2/10/87 • S •• •: - -• - please make all cocrecttons on the two / I On the first sheet of the plans indicat* Type of construction Of the existing originAl tCeCLfl9A and submit - 4 ' newsets -of print5.'and any original "' building, present and proposed occupancy I plan'setS that may have been returned to '.- classificatLon.of the remodel, area I you by the 'jurisdictions, to: . .' -• -' . end the occupant load of the remodel areas and total building area. rsgil Corporation, 9320 Chesapeake Specify,oh the-Plan title sheet the'.' Drive-*, Suite 203,: San Dlego...CA Building Code Edition used for the 92123,. (619)560-1468 . / design of the proposed work. . pleaseinake all corrections on. the 1/.. -,Provide' a fully dimensioned floor plan showing tho,size and use of all rooms original tracings and submit two new / • sets of prints, and any original plan or areas within the space being improved sets that may have been returned to •'- :' or altered. Draw the plan to scale you by the jurisdiction, to: / and indicate the scale on the plan. / The jurisdiction's building department'. Indicate the use of all spaces OJacent to'-the area being remodeled . r I • The responsible designer is required. 1. Show any existing fire rated area sep- to'sign each sheet Of the plans. A aration walls, occupancy separation / State-licensed Architect-or Engineer - - walls, shafts or rated corridors. is required where there are structural Identify and provide construction de- changes to an existing building or ' tails for prop osed new fire rated-walls. -, a (Business and ,.Specify on the plans the fire ratings / Pro e5S OnS 0 e)• •. / of assemblies to protect proposed open- Provide the correct address and suite ings in existing or.. new fire walls. number of tenant space on the plans. Section 302. . V 15. Identify existing'walls to be removed, Provide a 'noteon the plan indicating - V / existing walls, to remain and proposed new walls. Identify bearing walls, 7 the previous use. ofthe tenant space or building being remodeled. Section.V . . .' non-bearing walls, and shear walls. 1 302; V •• 16 Provide a section view of all new interior I. partitions. Show- .occupancy en the character of the occupancy V Ca) Type, size' and spacing of studs. f or use changes within a building, the V .' building must be made to. comply with , V •, .. Indicate gauge for metal studs. current Building Code requirements V Specify manufacturer and approval wmber or indicate to be xcao for the new.occupancy. please provide complete details to show the building (b),}ethod of attaching top and 1. V . will comply. Section 502. ' UBC Section 304 requires the Building ' V V V ' bottom plates to structure. Top or partition must ' be I Official to determine the total value . , secured to roofor floor , . of all construction work proposed under - V ' frang, unless. suspended 'ceiling • 'this permit. The value shall include .: V V has been designed for partition V all finish work, painting, roofing. '• ' lateral load). V electrical, plumbing, heating, air , ' ' CO Wall sheathing material and V conditioning, elevator, fire exting , . . . V details of attachment. (Size . V wishing systems and any-other pe=a- . V and spacing of fasteners). ztent equipment. Please provide a signed . ' Cd) Height of partition and suspended V V copy of the designer's or contractor's ' . V I ceiling. ) construction cost estimate of all WOk , . Provide notes and/or details to show that proposed. the floor and wall, finish in toilet rooms . Provide a plot plan showing the distances . ' are surfaced with a smooth hard non-absor- / from the building to the .property lines . ' bent material extending five inches up and the location of tenant space for • . -: V the wall. Similar surfacing shall be pro- remodel) within the building. ' 'V . vsded on the walls from the floor to a height of 4 feet around urinals and within water closet compartments. - ., : - -.:' • •... . •.. .,. • , • V H o te on the an U interior fjLshoa %,ithC)8pter 42 of the / Note on the plans A11 exits are to be openable from inside without the must comply Use of a key or specialkn0w1cd0e . UDC. Specify c1a3s flsme In lieu of the above. In a Croup -u spread rating (minimum) for 0 ,..OuphnY, you may flOtO 'Provide sign on or near the exit doors Lateral bracing for suspended ceiling must be provided. (UDC Table 23-3) - I 2 . reading TIlLS DOOR TO flD1AIN WI. LOCXCO DURIUC BUSINESS flOURS% ' Where ceiling loads are less than Required exit doorways shall be not PSr and not supporting interior part- less than 36 inches In width and not .Ition,, ceiling bracing shall be pro- lea, than 6 feet- 8 inches In height. : vided by tour No. 12 9AU9C wires secured Section 3304(e).-' to the main runner within 2 inches intersection and • Exit doors shall swing in the direction of the cross runner splayed 90 from each other at an angle of exit travel (occupant load exceeds not cxcceding.45 from the plane of 2 • -50). Section 3)04(-b). the ceiling. These horizontal restraint / Show the locations'of existing exits points shall be placed 12 feet O.C. from the building and show the path in both directions with the first point of travel from the remodel area to within 4 feet of each -wall. Attachment the existing exits. of restraint wires to the structure . above shall be adequate for the load Corridors must provide continuous pro- imposed. tection to the exterior of the building. Interruptions by intervening room is Draft stop any suspended ceiling in not permitted. Foyers, lobbies or wood frame floor construction every reception rooms constructed as required 41 1,000 sq. it. and in attics of corn- for corridors are not Considered inter- bustible construction every 3,000 sq. vexing rooms. it. The maximum distance allowed between feet. Section 2516(f). • Show exit corridors as 44 inches wide draft stops is 60 minimum. Deadend corridors are limited 2. The tenant space and new. and/ar existing to 20 feet when more than one exit is required from the corridor. Section " facilities serving the remodeled area must be accessible to and functional 3305. . for the physically handicapped. See provideone-hour construct on. details the attached correction sheet. Title for all corridor walls and cejljn - 24, Part 2. serving an occupant load of 30 or more.. 2. Show the exit sLx% locations; show Identify all rated corridors. Walls any required directional exit signs. . of reception rooms and lobbies which Section 3314. . . are included within protected corridors 2j. Rooms with more than 10 occupants may just have walls and ceilings constructed as required for corridors. . .have ons exit through one adjoining . room. Revise exits to comply. Section 3 .. Protect all interior openings in corridor 330(e) walls and ceilings. Door and frame TWO complyl ng exits are required from . be labeled 20-minute smoke and draft control assembly with selfclosers Exits must -be, and rnain- tam, a distince apart of at least or automatic closers with smoke detectors. 1/2 the maximum diagonal dimension Section 3305(h). Glaring must be 1/4 inch-thick wired glass installed i at the area served by the exits. steel frames and cannot exceed 25 Section 3303 . S percent of the common wall area. Section Assembly rooms with more than 50 3305(h)2. occupants shall not have a lock or latch on exit doors unless they are .equipped with panic hardware. SectLe Show the location of fire dampers. 3318. provide fire dampers at duct pene- trations of fire-rated occupancy and area separations, shafts and corridor walls and ceilings. Section 4306(j). If building exceeds two stories show • corridor is separated from elevator shaft. Sections 3304(g)(h) and 1706(a)(b). (See 1.C.B.O. interpretation). e.J i tcw uj H) Co O(i c V \JT1 La-rio 4 CO A P '-1 S .AJ m4 CO 5 . '-i o I. Ou Yr(Z..E C.&nfliX - - C kQ (2 OP)J 1ThZU 11+ '(\ .t • Ui -t L -r -r èic 1ô I Q ç72U C11J12. C+ Lc.. 5 - VCT'4-1 çj_,,)355 -- - - ' LOu34( E • . N (2_-tC 6 IZ.- IZ ,• s7-3s-r ,4&Q C4,1 L 41- S 2#r éc ENERGY CONSVAflOM CORRECTIONS wiiirn': (SECOND CENERAflON HOMMIDENTIAL STANDARDS On January 1, 1981, new standards, and a new design manual, went into effect to govern the energy design for new heated or cooled 1QWXise office buildings, (i.e. 3 stories or less). The new standards and' design also apply to alterations or additions involving heated or cooled space in' existing lowrise office buildings or existing shell or speculative buildings wherein heated or cooled office space is being proposed or lighting is being extended to new 'conditioned space. •• - • The new standards (214 pages) and the new "Designing for Compliance" manual (400+ pages) - contain forms and design instructions that are essential to developing a complying design To order the standards and manual you, can contact the California Energy Commission, Accounting Office, 1516 North Street, MS #2, Sacramento, California 95814 (Telephone (916) 324-3014) Please address the circled items and, when resubmitting, provide a copy of this showing .. the page, detail, etc where each circled item has been addressed In new or existing buildings a The upper left corner of the Certificate Certificate of Compliance(Form CF-i). of Compliance (CF-i), Pages 1 and 2, must be completed and imprinted on the must show the name of the documentation plans if NVAC or lighting is being author, who need not be a licensed extended to a new conditioned.' space. person. (Manual 1-14) (1-13 Manual). The owner of the building muse sign in A 'Certificate of Compliance (CF-1) is the appropriate place on ,Page I of ., required to be imprinted on the plans ' , " Certificate of Compliance (CF-1). .' .' • ' ' . for shell or speculative buildings where . (Manual 1-14) . lighting, HVAC or other improvements. .' will' be made by the tenants. . The design entities (electrical, etc.), -. (Manual 1-13) ' must sign in the appropriate space on Page 2 of Certificate of Compliance (C?- Multiple Certificates of Compliance (C?- . . , 1). (Manual 5-4) 1) are required to be imprinted on the plans . for speculative pr 'shell , OB-8 Note 'on the plans, near the imprinted buildings, where the final Occupancy is ' Certificate of Compliance (CF-i), "A not known at the time of the original separate copy of the Certificate of building permit. The multiple CF-1 . . Compliance (CF-1) has been retained by -, documents should address the potential • the owner, and will be made available to uses, i.e. office, retail sales, etc., • . • future owners or future tenants.'.' • and should apply the appropriate , (Manual -5-4) standards to the specific occupancies. . • - •- : • S (Manual 1-22) The Certificate of Compliance (CF-1),-':, - - - •. - S • -5-., Page 1, must be signed in the lower • . • - right by the licensed person who is • • attesting that the design complies-with the regulations. (Manual 1-1.4) - - . - - - - 1 - -- . o48 On CF-1. Line 1, show the proposed or Note on the plans, near the imprinted - existing total resistance' ..(Rt) ., for Certificate of Compliance (CF-1), "At exposed floors or: soffits separating the time of permit issuance, the conditioned space from noncondtioned perinittee will provide an approved copy. .. space, using Form CF-2. Provide a Form of the Certificate of Compliance (CF-i) CF-3. (Slab-on-grade floors, are not to the jurisdiction", for filing. (UBc considered to,bé floors for this, item.) Section 302 (a) 7). . . . . 7/9 . On CFi,. Line 8, show the minimum ' If a Certificate of Compliance (CF-1) ' allowed total., resistance (Re) for the was previously prepared for this entire floor taken from th'è package you building, or for improvements or selected. alterations in this building, provide a . . .. . copy of the approved Certificate of .. OB-20 On CF-1, Line 9, if.there.are different Compliance (CF-1).- (Manual 5-4) types of' walls,, show the proposed or existing average total resistance The building is ,a mixed use building and using CF-2. If only one wall type, only. a Certificate of Compliance (CF-1) must . CF-3 need be completed. be prepared for each use unless the subordinate occupancies total less than 0B-21 On CF-1, Line 10, complete CF-2 if all 10000 S.F.,and are less than 10% of the ' , opaque wails and, doors have the same ' total conditioned floor area.. , ' heat capacity, generally, a Heat, Capacity (Manual 1-22) . . ;. . . , . less than four. 'If there 'are multiple wails - having different heat capacities, 03-12 On CF-1,' Line 1, show the occupancy . this may, be left blank'. 'type, i.e. effiee. A rAt4_ 0B},Z2 On CF-1, Line 11, show the minimum .- On CF-i, Line 2, show' the occupancy .e' required total resistance (Rd for ' group B-2. ' . ' . . . , opaque walls and doors. If multiple walls, having different HeatCapacities 03-14 On . CF-i, Line -3, show the package are proposed, show . the area weighted ' selected, i.e. . A, B, C, D, B or ' average using-CF-2. Performance Approach. -1, On CFLine .12, show the total On CF-1, Line 4, show the conditioned . exterior wall area for the entire floor area being addressed by the building or that portion covered by the documentation. . . ' . ' - new standards. The exterior wall area 03-16 On CF-11 Line 5, show the proposed- or should include opaque walls, doors and windows between the floor and the bottom existing total resistance (Re) for the of the"floor,' or roof, above, that roof. ''If "different types of roof, separate -conditiOned' spacet from. non- complete CF-2. Complete a CF-3 if only. . conditioned space. ' Provide .a CF-2. , one.roof'type. On CF-1, Line'13,'show the total glazing ,41'i On, ' CF-1, Line 6, show the . minimum . ' . . in walls separating conditioned space allowed total resistance (Re) for the . . , from non-conditioned space. Provide a 'roof taken from - 'the package you , '. CF-2. .. '. ' - - selected'. .... . .,- -.', . '.'• -' -..-..,-'-. ,.',.•-',. .' .'-. .- - ., .. ., - ':r, On CF-1, Line 14, show the percent of exterior wall, between conditioned. and non-conditioned space, that is glazed, . i.e. Line 13 divided by Line 12 times . . 100. On CF-1, Line 15, show the average shading coefficient for all glazing, . supported. by aCF-2. if only one type of glazing, no calculation is necessary just enter the shading coefficient for the glazing. . • . ,9B7 On CF-1.1 Line. 16, enter- the allowed percent of glazing, for the selected .. . • .. package, based on the average shading . - . coefficient shown on Line 15. . This . .• . . • . S - entry should be greater than the Line '14 ' entry. On CF-i, Lines 17 through 21 should be .. •. '. . left blank for lowrise office buildings.. On CF-1, Lines 22 through 29, enter the proposed • area of skylights and the • . allowed area per the package selected. • . S S • If more than 8 skylights attach- it • • S - . - S • • separate sheet. . . . • S • . S S /,,,.r,,- /, . - - . .V •• • S • 4,(:j ij Sn'oj S S • S • w . A 4/-I ,,C / S . • : -. Pr •pJ °J • )Z(Li C'i14 -• V •_• • - c;Lc)- V -• ô nj 6Co-;-.4.-c; -rô1j S S 5 .5 5 O• LCor??. C-.LL S • V. V V V • • S .- . . • . - - 5- ... - • - • • V S S •__ - S • _ •. 5 _ • - V. S S V - • S - V S V S - V V - V - • - .•,•. S_ ..ELECTRICAL PLAN CO1UECTION SHEET JURISDICTION:' tiI2 DATE:,;., 'PIJN CHECK NUMBER: 1,-8I PLAN CHECKER i,34 44,14 o ,3 Submit complete electrical plans and. specifications. Submit plot plan showing location of all services;' switchboards; transformers; and 'panels. . •'. . '; /. Submit' complete one-line-diagram of service and 'feeders; show, ....... conduit and wire sizes; specify aluminum or copper conductors,., - 'and type of insulation. Indicate' 'sizes of fuses and/or circuit, breakers; approximate' length of feeders. Indicate ampere'- interrupting.capacities (AIC) of service and. ., 'subservice equipment. . NEC 230-98/110-9. . . ., 'A. Indicate the grounding system to be-installed-for (a) 'building ' service (b)'transformers.. Indicate dimensions of switchboards and. control panels rated ' 1200 amperes or more. NEC 110-16(c). ' Prbvidè overcurrent protection on.'thè secondary side of trans- formers. 'NEC 240-21/384-16(d). ( Submit electrical load calculàtions• and/ panels shedules. Indicate (a) existing building load, (b). added building load and size of existing service. ' • - '$ ' . Indicate wiring'method. Show exit.signs on the electrical lighting p1an. Note:' Power for-exit lights and emergency lighting must conform to the,'''' 1982 UBC Sections 3313 and 3314. crcviae 'receptacle(s) within 25' of the roof mounted A/c units. ' UMC Section 509. - " Provide multiple switch lighting controls per CAC,.Title 24, 11/5/86 S Date I1fl01 JurisdictionCtLS&O Prepared byt • 0 Bldg. Dept. VALUATION AND PI.N.CHECK.FEE •• Esgil PLAN CHECK NO. BUILDING ADDRS \Z4 vorezo L) APPLICANT/CONTACT. Cut PHONE NO. S17 .O 3 i• BUILDING OCCUPANCY B DESIGNER PHONE 0 TYPE OF CONSTRUCTION _SL- CONTRACTOR PHONE •• ; Fee Adjusted To Reflect .0 Energy Regulations (Fee x 1.1) . DHandiáapped Regulations (Fee x 1.065) •• - ,-. -. - S • Building Permit Fee. $ _I L)L' Plan Check Fee $ 1 0 COMMENTS 0 S . • • •• •,.. . . 0 - ,••• . . . .5. - S - •- - S., 5- S••.,S-- - 5 . . •: • . ., . • 8/4 /82 • ENGINEERING CHECKLIST * - Date: _' - " LEGEND ' * . Item Complete Plan CheckNo. 87-358 .; •. Project Address: _,S2'i1' ,, Iten Incomplete - Needs You~ Action Project Name: _•/&D Xr Field Check Date: .1,2,3 Number in circle • . . •. 4 .. indicates ' plancheck By: . - . number that deficiency' was identified.: •. LEGAL REQUIREMENTS I > 4) > 4) ,> .4). Site. Plan ) • - .,. : • i Provide a fully dimensioned ,site plan drawn to scale. Show: 'North arrow, property lines,, easements, . existing ' and , proposed structures, streets; existing street improvements, rightofway width and dimensioned setbacks Show on Site Plan': Finish floOr elevations;: elevations •of.'finish ,' . grade adjacent to building,- existing topographical lines, existing 'j fl F-1 ' , '' -and proposed slopes, driveway and percent (%) grade and drainage patterns fi fl ' . 3. Provide' legl decrition of op.rty fi fi 4 Provide assessor's parcel,,number. PERMITS REQUIRED - Grading '. M- fi - fi -. 5. Grading permit . required. " (Separate submittal to Engineering '' ' , ' Department' required ford Grading . Permit). /J 6 Grading plans in plan check PE___________ fi fi 7 Need the following completed prior to building permit issuance LI LI A Grading plans signed 71 LI Grading permit issued." ',• ' ' " ' LI: fl ' Grading completed. ••' '' ._-T' V -• D.- Certification letter and comaction reports submitted - - E. Grading inspected and' 'permit. signedl off by City Inspector'. FT - 8. ' Right-of--Way Permit required- for work in public right-of-way - '(e.g., driveway approach,, sidewalk; connection to water , main, - etc). . '• •- ' '. - I -. ' * . . ' -, . 4' .-' . -' • . t• - /F ' 9. Industrial 'Waste Permit application required. To.' be . filled out completely and returned to Development Processing ' .. . . . . . .. .. S FEES REQUIRED 10 Park-in-Lieu fees required .55/ ' . •. Quadrant: -_----------,Fee Per.Unit:., , Total Fee: 11:-Traffic impact fee required. . .5 ..•' Fee Per Unit Total Fee - fj fl • S 12.. Bridge andThorough'fare fee required. S . . • Fee Per IJnit: -- ,TotalFee: .. S L1 fi 13 Public Jacilities fee required fi fl Facilities management fee.required. Fee: __________ S • ' I El '9to Additional EDU's required: S 5 Sewer connection fee: ____-," SewerOpermit no. 16.1 Sewer lateral required R'EMARKS:. 0-A. to issu Date • If you have any questions about any, of 'the above items identified' on this plan check, please call the Development Processing Department at 438-1161 • ( a) - 'a)•'W j - 4-I .. - - • -.. ( • ( • . ,• _%..__% .•. ,•. ,,,• - •• ,-.. •• ft - •• • *1 co CO -CO It t • V • PLANNING - - - .• - CHECKLIST . Plan Check No 7-3J Address /8221 )91A RROAJ RD Type of Project and Use 77 - iJoc Ir 0,2 Zone Use Allowed?' YES.*____ NO Setback Front Side Rear. School District San Dieguito Encinitas ,CrIsbad 1 SanMarcos.____ O D fl Discretionry Action Required YES >2 'NO Type S' )c97 0 ,_•'•_ 0 - -. E - -. • -. . Environmental Required . - ....... YES NO 0 0 Landscape Plan Required YES NO,K Comments 'T. . . •........ 0 fl fl Coastal Permit Required YES NO >C 0 U Additional Comments - -. -.• - ; . •1 4. -. . ,• •, I .•,•. . •. .4__• .t . • 1 -4, . . - . - a. • - I . .. ,.. •- - .• . •.• • • .. .• - - -. . .. • - ' : - -•.- - --- -: ,- . • • • - 17 ' • - . - - .4 ' - • - -, . 4 - . - . '_ • .. . OK I DATE 2560 ORION WAY: :. ItP at .arIbab ... S CARLSBAD, CA 92008 FIRE DEPARTMENT PAGE 1 OF L TELEPHONE PROJECT ADDRESS flAlôdJ ga,iô ARCHITECT ' ' ADDRESS /O. OfO,'A1 /Aa,PHONE .5 'OWNER' A4 cf AM. Co..jrV 4cOc.ADRESS •S' Aa,7PHbNE 9'2co.0 OCCUPANCY 1 CONS T TOTAL SQ. FT Yoo TORIES DSPRINKLERED r(TENANTIMP 100 dI i 75oo' APPROVAL OF PLANS IS PREDICATED ON CONFORMING TO THE FOLLOWING CON bITIONS 'AND/OR MAKING , , , , ':. THE FOLLOWING CORRECTIONS: PLANS, SPECIFICATIONS, AND PERMITS 1 Provide one copy of floor plan(s) site plan;.,sheets - 2 Provide two site plans showing the location of all existing fire hydrants within 200 feet of the project' 3 Provide specifications for the following 4 Permits are required for the installation of all fire protection systms (sprinklers stand pipes dry chemical halon CO2 alarms, hydrants) Plan must be approved by the fire department prior to installation 5 The business owner shall complete a building information letter and return it to the fire department FIRE PROTECTION SYSTEMS AND EQUIPMENT 6 The following fire protection systems are required Automatic fire sprinklers (Design Criteria:' 0 Dry Chemical, Halon, CO2.(Loáation: ' . ' ' . . ... ' • '. ' ' -) ." . ' ' ' ' . ' -' . • ' . -' :0 Stand Piped (Type: :'" . 0 Fire Alarñi (Type/Location: 7 Fire Extinguisher Requirements 1 One 2A,rat,ed ABC extinguisher for each (,000 sq. ft. or portion thereof with a travel distance to the nearest : , ' extinguisher-not to exceed 75 feet of 'travel. : ' .' ' . ' ' ' An extinguisher with a minimum rating of to be located D Other:' 'Additional fire' hydrant(s) shall be piovided EXITS .9.. Exit doors shall be openable from the inside without the use of a key or any special knowledge or effort , ._io. A sign statin5g" This door to remain unlocked during business hours" shall belaced above the main exit and 'DAf)O/' doors.: t7 ,i,'AAI //(71#./ _ii. EXIT signs (6" x 3/4 ".letters),shall be placed over all'requftedexis and'directional signs located, as neOéssaryto clearly indicate the location of exit doors GENERAL _12.. Storage, dispensing or use of any flammable or, combustible .liquids,'flammable liquids, flammable gase& and hazardous chemicals shall comply with Uniform Fire Code X13 Building(s) not approved for high piled combustible stock Storage in closely packed piles shall not exceed 15 feet in height, 12 feet on pallets or in racks and 6 feet for tires plastics and some flammable liquids If high stock pil- ing is to be done comply with Uniform Fire Code Article 81 :14. Additional Requirements.: . '• S 5 . . . ' -S o'rr: cGPé CCt.yr r2AKE) -ço .,'v'o.?./ 'e,ksi-..' " ' -••. SAI'J i9"e'o, 9zio 15 Comply with-regulation-Pon attached heet s) • - S PIanExaminer " S .Date 'Report mailed to'architect. ' ', ' Met with • ' S , - Attach to Plans COMMERCIAL/INDUSTRIAL APPLICATION FORM FOR INDUSTRIAL WASTE DISCHARGE PERMIT - CITY OF CARLSBAD APPLICATION NEW BUILDING P.C. NO 87-3 5S (CHECK ONE) REVISED APPLICATION NO.: INDU — By DATE: 5T$Lj,fl1 ignature of City Representative th117,-: Cr 2 7-. 0/3 / APPLICATION FOR INDUSTRIAL WASTE DISCHARGE PERMIT GENERAL: •• * rnm7,&rør I6Z4 MA( POO SITE APPLICANT:Jk_h(,trl, ADDRE SS. 4thIto " It TYPE OF BUSINESS:1A1t. ?kt6 av, 00'1MNt , APPLICANT'S ADDRESS: ji /VWE1 e1 )OTh 'h) QS?4 (AIO6 B. WASTES-AND-PROCESSING: (Check where applicable) Domestic Waste Only Industrial Waste fl Industrial Waste NOT Discharged to Sewer ,Discharged to Sewer GENERAL DESCRIPTION OF WASTE (Chemical and: Physical Characteristics of proposed waste): GENERAL DESCRIPTION OF PROCESS (If Applicable);_________________________ C WASTES TO-BE DISCHARGED TO SEWER WASTE: TREATED: • QUANTITY: AVERAGE • GPO (Check One) UNTREATED. (Daily) MAXIMUM jf) GPD (Gallors er Day) APPLICANT OR REPRESENTATIVE OF FIRM: CLQ5 SIGNAT j __... DATE