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Home My WebLink About1854 MARRON RD; 104; 87-604; PermitUSE BALL POINT PEN ONLY &.PR(SS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. uT hereby affirm that I am licensed under of Chapter 9 (commencing with .I S.ctlon"!OOO)of Division 301 the Business -'Ivdand Professions Code, and my license is in L.! 'full force and effect. I 'hereby'atlirm that I am exempt from,the Contrac I - ,tor'sLicense Law fur, the following reason (Sec. 7031,5 t Business and Professions Cede: Any city or county whicr, re -- quires a peemrt to construct. atteft. improve- demolish; or-t -- repair.aoy.structure. prior to its issuance also requires he ap- 'jiitcant or such permit to tile a signed statement that he is 1ice05ed 'pursuadf to' the provisio'iis of the Contractor's - - . License Law (Chapter 9'couemencing with Section 7000 01 Division 301 the Business and Professions Code) or that is eu''.- _,j empt therefrom and the basin toe, the alleged eeemptino, Arr,f I vi01ati0050t Section 7031.5 by an-applicant.fora 'permit sub- l. the applicant na Ciuit penalty of not more than five han-n.. - - dred dollars 155001, - •'-----. ._ -'I 'n' I, as owner of the property, or my employees with wages..! .- as their _sole compensation, will do the work, and fee Struc' a etue is not intended or offered fur'sald lSeê. 7044. Business 4 and Professions Code: -The Conlralor'4 License 'Law dOes. 5 5 'net apply to an owner, of property who builds ori'drproues thereon,and whit-does such work himself 6i through his own i - r- employees. providedthat'such improvements are not infend-. , U, 't.bed orof lered for sale't!.'huwever. the building or impruve',t ,' Z hrent is sold within one'y&ar ofcompletioo. the owne-büulder - will have the burden of proving that he did.oOt build Or im- - prove. lot the-purpose of sale)..., - 11,1, asowrte! of. the property,' am exclusively centradting with licensed contractors to construct the project (Sec. 7044, Business: andi P/otessions Code: iher000tra6or's License I -Law does out apply loan owner of property who builds Or im. - £,Zproves'thereoo.'andwho contracts tOr each prujectswith -5 a 4' en - •,, . cuutracforlslrcedse pursuant'to the Contraclor'sLicense I t 1 As a homeowner I am improving my home, and the Inflow' -t cc4 ;ingconditions eoisf:r-e'_r •.i. e.;fsJ, '.' 0.. ._ . ..' f,' Theworh'is beiog peel urruired, prior to sale, ' I —'2. 1' have' lived io'_my,'hirlie lor,, twelve months-4 - . prior to completion of this work. .9 w -. . ._3,.., I. have ,,00fclairned this eoempl ion during the O last three years. ' • I lam exempt under Sec. - • B'& P.C. - " p;,-,--a , :t -'•--'•• -- - - - 0 1 hereby affirm that I have a certificate 01 consent to i 4 J(selt.insUre. or a ce,tificat&ot Workers' Compensation In'j e't valance. or a certified copy thereof ISec, 3800. Labor Codel POLICYNO f - 2 Cdy iv'liled with the ity '- -- - - 0 Certified copy is hereby tarnished £'Nl Lu 3. - '1 E1'a ,CERTIF,ICATE'OF EXEMPTION, FROM . 0 WORKERS' 'COMPENSATION INSURANCE - -n (This section need nor be completed flOe permit .j. V is tdr 'one hundred dollars 15100) or less) ' I certify that in the performance of the work for which " Ihiv permit is ivsued.'ishall not employ any person in any• - , manner so as to hec0me subjecl to the Workers' Compen. Laws of California. - - -NOTICE I'D APPLICANT: if. alter making this Certiti car e C -• aol ExemptiOniyou should become subject to the Workers' I' ,. Compensatiun'provisions,ol the Lab&.Cod. 7y' u must' . d tortfiwitfr comply with suchprovisiOnsur this permit'shaltt - .be deemed revoked.- her y, affirm (hat .there is a construction tending - agency for the performance of the wnrli Id, which' this per. O mdiv issued (Sec'3097. Civil Code) I - - - Mi Lender's Name a_Ld'nder5 Addiesd' --.'"- '-----. - -- CARLSBADBUILDING DEPARTMENT . ' .APPLICATIO' £ PERMIT2075Las Pàlnas Dr., Carlsbad, CA 92009-1915(619)438.1161 DRESS P.3 3 A ' • AV. ST.RD. THOMAS BROS NO. DATE /0F A PLICATION BUSt S LICENSE A VALUATION PERMIT NUMBER - CONTRA S PHONE s - Z E . ._ LOT BLOCK lSlON(J CONTRACTOR • • ' - [7/V 0 — 56 OWNERS NAME . . OWNERS PHONE éa,//t,S/ /,1iC,. 2 2 i'3' - . . .• . ,'" 7/'17,jL-,. CONTRACTOR'S ADDRESS p3 t ' -STATE LICENSE NO. ' BUILDING SO. FOOTAGE OWNER'SMAILING ADDRESS / '/ aV,z' 7". cci,i-c- - Q4"36f -23 - . •-.-.-. ..- - - ' -. /Z °- --2fWLI& C,4 DESIGNER DESIGNERS PHONE - . , . • . DESC RI P7( OF WORK —v- . - _ - • . -- ' • _•_.J _- • . DESIGNER'S ADDRESS • •- -- • STATE LICENSE NO. •- -"-'- -'---.-- - ' -' -- - - - ' ' fO F/P *:''' - FLRELEV. • NO . _ , STORIES CGP EDU ' • 111 . - - - Yoo _":" - • _ .., -- .L• • - • 'CENSUS TRACT - ' • PARKING SPACE ' RES UNITS • GRADING PERMIT ISSUED' EDEVELOPMENT . TYPE .' CO'NST CC LOAD FIRE SPR '' j,AREA.--'j O3'Ol/OS 1O1 QB1dPmt 15593o3 Wafld'Unless Not PZ'ach,ne Certified N 0 vO 0' YO NO - OTY PLUMBING PERMIT- ISSUE-Ll.- i' QTY - MECHANICAL PERMIT ISSUE - SUMMARY/ACCOUNT NUMBER Kzl=-] - EACH FIXTURE TRAP • .J'C nqS1'ALL URN. DUCTS UP T0100.00O BTU. BUILDING PERMIT OO1'81O-O00-8220 EACH BUILUING SEWER', ---•'-.---•.---'-• OvER 100000 BTUr "SIGN PERMIT'- '- 001-810'OO'OO'8221 - EACH WATER HEATER AND/OR-VkNT - - • BOILER/COMPRESSOR UP 103 HP - * - - PLAN CHECK 001-810-00-00-8891 • ./._, -- EACH GAS SYSTEM'l'TO 4"OUTLETS'". , .' BOILER/COMPRESSOR 3.15 HP' ' '',, TOTAL PLUMBING - 00'810'00'00'8222 - - - * - ., (7 METAL FIREPLACE - - -, • . . - - • • • -s.- . -ELECTRICAL- • ' - 001-810-00-00-8223 EACH INSTAL., ALTER, REPAIR WATER PiPE1 . . VENT FAN, SINGLE DUCT - - 3 , 4e MECl-lA - - • EACH VACUUM,8REAKER.a"J' - •-'- - - " MECH EXHAUST ' HOOD/DUCTS MOBIL%WkUr4 It CKIM225 a - WATER SOFTNER 4 ' ''"*. - - , .L.n, :RELOCATION 0F,.EA.LU,RNACE/HEATER ..'.. - -- -' ' - SOLAR,.,u* - - 001'810'00'008226 - EACH ROOF DRAIN (INSIDE) . . • , DRYER VENT • ; - • - '. STRONG MOTIE R '2 4 j519'92'33 .J '25I1,. -- . - (- - - - - - ' -' • "-- -TOTAL MECHANICAL -r - r , - - - • FIRE SPRINKLERS -' ;u 'TOIALPLUMBING - '' f QTY ELECTRICAL-PERMIT OTY Oftli POESSU4G 3CKV3PARK-IN-LIEU (A~ - - -NEW CONSI EA AMP'SWTBKR ' - ' - - ': ' r CAR PORT - '-• - - TIF - • - 312810-OO-OO-8835 - PH ZZPH.g- • "I AWNING • -f • 'A i, LA COSTA TIF 311-810-00-00-8835 EXIST BLDG EAAMP/SWT'B 5CKR. '• '' o GARAGE !'' ' '- - ' ' FMF'2_O'L-j - - ---- - .-- - - - --- •'• . - 1 PH , - * . - - 3'PH "" " -' '. "ic - - • - - c - -' LICENSE TAX 3/ IF 00181000008162 — -- * REMOT3E1 ALELR PER CIRCUIT •n t -; (ain - MFF 1J ) tJiO88o 5199257 IEMPPOLE ;200 AMPS -\r- - . ,, -- .- , -- - -'.-•---'--;--' - -- - -- - ---OVER.200 AMPS 4 - .'-'.)' •" 'f 1.~/:r r 1' '"N'?- - - v- - - - - •. '-• . LA?QCCjJ?NCY.I30OAYSL •. --,-• . - - -'- ' .' - •.- - -•'- .• -• •'--_ -- - - - 4 - - - CREDIT DEPOSIT - - - TOTALE[ELTRICAL - '.cTOTA!'.-*. - TOTAL.FEES PAYABLE I HAVE CAREFULLY EXAMINED THE COMPLETED -APPLICATION AND PERMIT" AND DO HEREBY Expir;tion. Every permit issued bythe Building Official under the provisions ofthis AN OSHA PERM:T IS REQUIRFn FOR FXCAY(ATIONS OVER - Code shall expirehbY limitation and become null and void it the building or work'authorized CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE by permit is not commenced within 180 days from the date 50" DEEP AND DEMOLITION OR CONSTRUCTION OF OfSuCh DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT is ISSUED: TO COMPLY WITH.ALL CITY. COUN1Y.AND STATE LAWS GOVERNING BUILDIN work authorized by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT permit. or 1p ild Orhe G CO'-t'abandoned at anthey lime altec t work is commenced for a period STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS COSTS APPLIS SIGNATURE * ,J NER / of 180 days. CONTRACTOR 0 APP VIED BY , DA/E/ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE (1&/1av ' BY PHONE 0 "AcLt r -L TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT SUB FRAME El FLOOR El CEIJNG SHEATHING El ROOF 0 SI4EAR FRAME ______ EXTERIOR LATH (4/r INSULATION INTERIOR LATH & DRYWALL PLUMBING El SEWER AND BL/CO U AL/CO UNDERGROUND El WASTE 01 WATER TOP OUT 0 WASTE 0 WATER TUB AND SHOWER PAN GAS JEST E)ATER HEATER El SOLAR VATER ELECTRICAL O ELECTRIC UNDERGROUND l UFFER ROUGH ELECTRIC o ELECTRIC SERVICE 0 TEMPbRARY El BONDING El POOL MECHANICAL El DUCT & PLEM., El REF. PIPiNG HEAT — AIR COND. SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN-ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. V FINAL I I V !UJ:IIe ELECTRICAL MECHANICAL _______________________- BUILDING_____________ IfiA1ItD _____________WI1 NvAnerm _ MONNOMM SPECIAL CONDITIONS _ !J f5qd FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTORS NOTES INSPECTION REQ. IF CHECKED INSPECTORS APPROVAL DATE SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI .'. PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING BOLtS ________ HIGH STRENGTH _____________ ________ .. -• •, :' SPECIAL MASONRY • PILES CAISSONS .• -. • .t. , CASHIER'S VALIDATION Qlitg nfQ1ar1bab SEWER PERMIT APPLICATION 0003 0ii0 0101 04Sr1atn 4500.00 APPLICANT TO FILL IN SHADED AREA SEWER PERMIT NUMBER SE BUILDING PLAN CHECK NUMBER PC BUILDING TYPE BUILDING ADDRESS / " i 1) NUMBEROFEDU'S: - /2 OWNER 1C74 CALCULATIONS MAILING ADDRESS 4 2, 7r, (7, , 1 r.Ti r Ii / ,i3O C141vA,J CONTRACTOR: AC t 1 IMAILING ADDRESS: / Vi •- ______________________________________________ LEGAL DESCRIPTION _________________________ CONNECTION FEE /M P 0 * 76 IE> III o(0 COST PER UNIT x NO UNITS S \ - LATERAL CHARGE: TOTAL CHARGES PREPARED BY:2? - (Y cc o1988 ASSESSORSPARCEL NUMBER:' OPc1J / \4gLsa.40 ,/ (PRINTED NAME) COMMENTS:, . WHITE: DPS GREEN-Financé CANARY: Water PINK: BuiIdin GOLD: Applicant ' -'. 'S ••' . - . * rjf • . FINAL BUILDING INSPECTION RECEIVED IZu 2 2. a PLAN CHECK NUMBER: DATE: 2.1888 • PROJECT NAME: .. : ADDRESS: 18E -al Rd '910. PROJECT NO.: UNIT NUMBER: _________________ PHASE NO.: TYPE OF UNIT: UComm NUMBER OF UNITS: - CONTACT PERSON: Tortt COnst •, . - CONTACT TELEPHONE: 7298630 : 4 . •i • bida; rndIr,ear. tknr. f) r&' I BY: NSPECTED DATE 7 INSPECTED cZ_I9 APPROVED ______ DISAPPROVED INSPECTED ' DATE BY: -• INSPECTED: ____________ APPROVED' DISAPPROVED INSPECTED DATE • , • L S BY INSPECTED ___________ APPROVED ': '' • . ..• ______ DISAPPROVED • ;0 • • ;.-: COMMENTS. •. '• '• 0 55 - .1 0' 0 ".4 : S • • - • 0 'S. • 0 , 0•• 0 • • • - • , "St., Rev. 1/86 WHITE: Suspense' - BLUE: Water District GREEN: Engineering CANARY: Utilities - .• - - .. •: . • .• r - PINK: Planning GOLD: Fire' o-• - S -• 0 • ,, - , - 50o J. ( - 'S'S 5 - 0'S. • 003' • 0 -( 'S ' • • - •0° 0'S 0 - FINAL. BUILDING INSPECTION • . 0, 0 PLAN CHECK NUMBER 87-604 DATE ~-18-RR PROJECT NAME: . 3 ADDRESS: 1854 Marron Rd 4104 PROJECT NO.: UNIT NUMBER: PHASE NO TYPE OF UNIT ti Comm NUMBER OF UNITS CONTACT PERSON Torre COnct CONTACT TELEPHONE: 729630 . 00 Wdc ennnr fir -INSPECTE / DATE 2 APPROVED - DISAPPROVED INSPECTED - - DATE,S S BY INSPECTED APPROVED DISAPPROVED INSPECTED - DATE BY: • • 4 -INSPECTEft. - APPROVED S ' DISAPPROVED 0 S .;.. • :••.• S S COMMENTS__ S S. •• Rev. 1/86 WHITE: Suspense BLUE: Water District GREEN: Engineering CANARY: Utilities PINK: Planning GOLD: -Fire FINAL BUILDING JINSPECTION 0 PLAN CHECK NUMBER: 3760' 0 DATE:• 2188 PROJECT NAME: ADDRESS: 18S Marron Rd #10.4. PROJECT NO UNIT NUMBER _________________ PHASE NO TYPEOF UNIT: U tornm NUMBER OF UNITS: CONTACT PERSON Torre COnt CONTACT TELEPHONE 728630 bdc. n1netr. fire . INSPECTED DATE - BY: 0 INSPECTED: //T/fl. APPROVED DISAPPROVED INSPECTED DATE BY INSPECTED APPROVED DISAPPROVED INSPECTED • DATE 0 0 0 BY: 0 0 0 DISAPPROVED INSPECTED: - 0 APPROVED 0 000 0 0 0 COMMENTS: 00 • 0 0 • • 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 - 0 0 -. 0 0 • 0 0 0 0 0 0 0 0 • •• 0 0 0 0 Rev. 1/86 WHITE Suspense BLUE Water District GREEN Engineering CANARY Utilities PINK Planning GOLD Fire ESGIL CORPORATION 9320 CHESAPEAKE DR, SUITE 208 .. SAN DIEGO, CA 92123 (619)560-1468 DATE c f5ICThN JURISDICTION: - •' [1IAN CHECKER * LIFILE COPY PLAN CHECK NO:. '7- O71 .' SET: 12!Z . fluPs. flDESIGNER 'PROJECT ADDRESS: #'oi..j,4' PROJECT NAME: 5dc A-5~., The plans transmitted herewith have been corrected -where WtJ necessary and substantially comply with the jurisdiction's ' building codes. '' . ' . . . •. fl The plans transmitted herewith will substantially comply • . : 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 * .". identified on the enclosed check list .and should be corrected and, resubmitted for a complete recheck. The check list transmitted herewith is.f or your information. - '. The plans are being held at Esgil Corp. .until corrected' . • • plans are submitted for 'recheck. ' ' ' The applicant's copy.-of th& check 1istis enclosed for the jurisdiction to return to the applicant contact person. The applican's copy of the cheek listhas been sent to: ' • fl] Esgil 'staff didndt advise the applicant contact person that L. plan check has been completed. '• ' • - if Esgil staff did adv1se applicant that the plan- check has • • . . * ...been öompleted. Person contacted: __C~T'j , . ' Date contacted: /—_- _ •Telephone '# /.¼'t,c.__/, -• REMARKS-- By: • . .' . . • ' 6 Enclosures ESGIL CORPORATION ' • ' -, • "&., '. ' ' -• '-I. r. ESGIL CORPORATION 9320 CHESAPEAKE DR., SUITE 208 SAN DIEGO, CA 92123 (619)560-1468 DATE: [JAPç ANT [pe'IS DI ON JURISDICTION: CV'LLSeDD rjHEcKER LIFILE COPY PLAN CHECK NO: B '1 - C,04- SET: J1 - []UPS PROJECT ADDRESS: 9) 15 4M 4RTaO4 2o LiDESIGNER PROJECT NAME: SjGSUvaf1 The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. fl The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficien- cies identified- are resolved and checked by building department staff. - Lj 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 Corp. until corrected plans are submitted for recheck. - The applicant's copy of the check list is enclosed for the jurisdiction to return to the applicant contact person. The applicant's copy of the check: list has been sent to: r EZ i'J A-iZ i ' C 40 L&) \ '2 Ict -V '— 1_ 1 YQ 0 s '. Esgil staff did not 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: ___ Enclosures:)3 ESGIL CORPORATION , , , 0 \1 Ehh vi C- L V G 'AYfl L N AYJ C -ko im r-j y C v L Cu U Afl O f ö. OuJ Cc v P L 1 i-J cc Rn -rl-!- U WI C C Hft 1'r 2) i 'Pr Zo- 14 1\J , 0 ESGIL CORPORATION 9320 CHESAPEAKE DR., SUITE 208 JD. L-i L it1o( -t SAN DIEGO, CA 92123 (619)560 14-C .• DATE: •. DAPPLIcANT ICT JURISDICTION: 2LE,BAL? N CHECKER FILE COPY PLAN CHECK NO: . •ouPs•• DDESIGNER PROJECT ADDRESS:(S 54- M aaN PROJECT NAME 'SU E; fl 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 El with the jurisdiction's building codes when minor. deficien- cies identified are 'resolved and checked bybuilding department staff. :o.The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected ' The check list transmitted herewith is for your information. The plans are being held at Esgil Corp. until corrected : plans are submitted for recheck. D The applicant's copy of the check list,-is enclosed forth, • jurisdiction to return to the applican€ contact person. • Theapp1icant's.copy of the check list has been sent-to: • ••. PrQD C#ovJ (#2 \JLUO r2-\IIN C. 2-i'ac ' • Esgil staff did not advise the applicant contact person that • : ' • plan check has been completed. • . .. • • 5. Esgil staff did advise applicant that the plan check has • S been completed. Person contacted: _• . •• ' ,,;'Date contacted: _____.Telephone# REMARKS-... • By:3TvV\ GLkt - Enclosure:)CO2t.Lcr - ESGIL CORPORATION . . •- ' .•- : • PLAN'auc' NO. 3 1 (, 64 - r RZRD VVAfl .IURISDxCrIoH: - Plan check is limited to technical requirements (.1t-i2.L_SERC) contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National — Electrical Code and state laws regulating energy TO: Bv2_N )S(2. C.. 40V) conservation, noise attenuation and access for . iA .. r vcE LL_I . the handicapped. The plan check is based on regulations enforced by the Building Inspection t. I (-JA ' ..) . Department. You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department or other departments. PoJr DATA Present California law mandates that A — construction. comply with Title 24 and the applicable model code editions adopted, .with or JIIDThG USE: ¶Z(L) 2 ' without changes, by the various state agencies authorized to propose building regulations for rypz 0YNSU0l(: enforcement at the local level. Code sections cited are based on the 1982 tTBC. .AcEtiAL1.RV: The above regulations apply to construction, )IILZA3I2 MEA: . regardless of the code editions adopted by . . ordinance at the local level. SIORI!S:____________ The circled items listed need clarification, modification or change. All items have to be . . satisfied before the plans will be in .eonforcewith_thecite&cdnand. - -' - ...........................relations. Per Sec. 303 (c) 1982 Uno OPA2I LOAD:_ Building Code, the approval of the plans does of2•0 c ' . ±)o5r'- not permit the violation of any state, county or city last. ez RDiAS: ''' I QW o sueed UD the recheck orocess note on this list (or a coov) where each correction item has :- PLAN kxfl0H been addressed, i.e.,Ian sheet. wec{ficatiort. TENANT IMPROVEMENT etc. Be sure to enclose the marked list when , you submit the revised plans. ___uu Data . plans received .byJuridiction . S . Data plans received by Esgil Corp.: {J 1161 6 9 . •• Date Date initial plan check completed: . . I— BY: .Applicant contact person: •• •. 0• • D=: PAcm mmEas An Nar .xm . sEqn2fcx.As PAGZS RAYM 110 rs ?ThC QDRxrXIO?f WERE flPI List No. 50, TENANT IMPROVEMENT WITHOUT SPECIFIC ENERGY ZONE DATA OR POLICY SUPPLEMENTS 2/10/87 In, i9itiñt tractng and submit two Type of construction of the existing cae make all corrections on the On the first sheet of the plans indicte, w sets of prints, and any original building. present and proposed occupancy an sets that may have been returned to classificationsof the remodel area u by the jurisdictions to: and the occupant load of .the.remodel areas and total bui1d1n9 area. F.s9Lt Corporation, 9320 Chesapeake 10 Specify on the plan title 5ht thDrive, Suite 203, San Diego, CA Building Code Edition used (or the P PI ease make all corrections on he Provide a fully dimensioned floor plan 92123. (619)6O-l468.design of the proposed work. iginal tracings and submit two new showing the size and.use of all rooms sets of prints, and any original plan or areas within the 5ACC 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 alt spaces adjacent to'the area being remodeled or improved. The responsible designer is required Show any existing fire rated area sep- , to sign each sheet of the plans. ? aration walls, occupancy separation I State-licensed Architect or Engineer walls, shafts or rated corridors. is required where there are structural Xdentify and provide construction de- changes to an existing building or S tails for proposed new fire rated walls. a structural addition. (Business and Specify on the plans the fire ratings professions Code), of assemblies to protect proposed open- (1 Provide the correct address and suite ings in existing or new fire walls. number of tenant space en the plans. . Section 302. Y , existing walls to remain and proposed Identify existing walls to be removed, provide a note on the plan indicating new walls. Identify bearingwalls, the previous use of the tenant space or building being remodeled. Section . non-bearing walls, and shear walls. 302. I Provide a section view of all new interior When the character of the occupancy par ions. Show: or use changes within a building, the. aType, size and spacing of studs. fl building must be made to comply with Indicate gauge for metal studs. current Building Code requirements . Specify manufacturer and approval for the new occupancy. please provide number or indicate 'to be Icao complete details to show the building a pp roved". will comply. Section 502. . Method of attaching top and )-p-bottom,plates -to,-structure,.-.-_- _UBC -. (NOTE: .Top or -partition i must--.... . Official to determine the total value . be secured to roof or floor of all construction work proposed under . : framing, unless suspended ceiling . this permit. The value shall include . .has been designed for partition ae ll sheathing material and all finish work, painting, roofing. . I t ral load). electrical, plumbing, heating, air . c) Wa conditioning, elevator, fire exting- . . details of attachment. (Size wishing systems and any o ther perma and spacing of fasteners).. Bent equipment. Please provide a signed Height of partition and suspended copy of the designer's or contractor's . . ceiling. construction cost estimate of all work . . Provide motes and/or details to show that proposed. the Zlo r and wall finish in toilet zooms Provide a plot plan showing the distances are surfaced with a smooth hard rton-absor- from the building to the property lines . bent material extending five inches up 4 and the location of tenant space (or the wall. Similar surfacing shall be pro- remodel) within the building. O'. vided on the walls from the floor.to Ov'J USI yjQ a height of 4 feet around urinals and S within water closet compartments. riV1 S - Note on the pItJ A11 interior finishes must comply with Chapter 42 of the unc. Specify*class _f)amo spread rating (minimum) for - Lateral bracing for suspended ceiling must be provided. (UDC Table 23-3) Where ccLlinglod5 are less than S pSF end not supporting interior part- ition,, ceiling bracing shalt be pro- vided by tour No. 12 gauge wires secured to the main runner within 2 inches of the cross runner Intersection and played 90 from each ether at an angle not exceeding 45 from the plane of the ceiling. These horizontal restraint points zhall be placed 12 feet o.c. in both directions with the first point within 4 feet of each wall. Attachment of restraint wires to the structure above ,hall be adequate for the lead Imposed. Draft stop any suspended ceiling in wood frame floor construction every 1,000 sq. it. and in attics of com- bustible construction every 3.000 sq. it. The maximum distance Allowed between draft stops is 60 feet. Section 2516(i). The tenant space and new and/or existing facilities serving the remodeled area must be accessible to and junctional for the physically handicapped. See the attached correction sheet. Title 24, Part 2. Show the exit sLn locations; show any required directional exit signs. - Section 3314. Booms with more than 10 occupants may .have on-2 exit through one adjoining .... Two complying exits are required from 'I))(r Exits must be, and main- tain, a distance apart of at least 1/2 the maximum diagonal dimension of the area served by-the exits. Section 3303 Assembly rooms with mere than 50 occupants shall not have a lock or latch on exit doors unless they are .equipped with panic hardware. Section 3318. /Note on the planss A11 exits are to be openable from inside without the use of a 'key or spoclal knowlcdq. In lieu of the above. In a,Group n occupancy, YOU may note *Provide a sign on or near the exit doors reading THIS DOOR TO nEMAIN un- LOCKCO DURINC' 8USXP1CSS BOUR$•• S 270 Required exit doorways shall be not less than 6 Inches In width, and not less than 6' feet - 8 Inches in height. Section 3)04(e). Exit doors shall swing, In the direction of exit travel (occupant load-exceeds 50). Sectlon 304 (bl ., -.... / 29 Show the, 1ecsti6hs of àxitIn9 exits, - from the-building and'5how the path' Q of travel from t')e' 'ràmodcl Area to the existing exits 3/ Corridors must provide Continuous pro- r tectLon to the exterior of the building. Interruptions by intervening room is not, permitted.- C'Foye'rs,..'l'obbiesl á'-' reception -roemsconstructed AS required for corridors are not consIdered' inter-vening rooms. " C Show exit corrldàrsC. as 44 Lnches wide minimum. Deadénd corridors are limited to 20 feet when' more- thanonà 'exit Is required £ro' the -corridor: -' Section- 3305. .- '• '.....'• 32 Provide ,One-hou construetjo details for all 'corridor walls aàd cei1In serving an occupant lead of 30 or more. deñtLfy all rated- corridor. Wa1ls - of reception rooma and--lobbie3Wh1h are 'included -withIn -protected corridors lust have walls-and ceilings constructed as required for corridors. 33 valls and'cei'l-i'ngs'. "Door -and Zrame"ntist'"" be 'labeled 20-minute-smoke and draft control assembly with self-closers or automatic .closers with .,smoke detectors. Section 3305(h). Glazing must, be 1/4 inch-thick wired glass installed in steel frames and cannot exceed 25 percent of the common wait area. Section 3305(h)2. Show the location of. fire dampers. Provide fire dampers at duct pene- trations of fire-rated occupancy and area separations, shafts and corridor walls and ceilings. Section 4306(j). 35 If building exceeds two stories show corridor is separated from elevator shaft.- Sections 3304(g)(h) and 1706(a)(b). (See I.C.B.O. interpretation). - : •. . . . . . . : I . . H: L--0)410 VJ 1 ' j>o rt5O k2t_U 2LA_-cii 1uC e._3cD WL __ J C 2. o s s vnq-Tr-4 11-\- f2. m.-o core z. ,00 t2O All Douu e.vi YUCa Dx,2.S -1-O • - Y2 Co - r2-.-n 0 ni S r2& no -r-ô ___ Co (2. yZ LO 0(2.C61JTtZ U cm 0 vo 0 YZ 5_1 1Z., ?aUJ\D& Pr 4 ?2..o i) O ¶rT2uCrU cat. CAZO5 s -..SUt..T1 o vi., s Pr CQJ1DO( __ OD ?12..O U' D S\Vur. C . w Ico (2o ptsrin., 1D w Zo - PtYZô i) AfJ M- OC)Z.. -12.O w\ L(1— ___ rr-Fvu C) 1424 -rt-i 24i - S 4 ao iJ 77-C 411- n fl ThLG4-Z--CttCcfl3 , S t.) LoC.-1 ô ) ô o iaii P'2o' U Z O' PZ oO3. 4 ' S ) J'5r'uT Lgn nfl) C.O v'4 QL) 1114 6'. (O ô 'j rn c, o' u & 0 O - (O'1APL4 .UiTh Th3ct 41 S f+ L&) 3 SGP 2)TLD Zo 'nil OT11i CX.0 Pvtc, :s a Thi3Lt s-B. __ k) I t- CJvv\ QLt- UJ 1Th L31r, 4 1LL) Wi a PrDJO (_ Coe tiiouS. 5POi -ro r4E s . 0 ra fl 3 110 4J L - - -. - 10,4 ec Ai IAiu' ,444 .4A1'%Jç • - AA/-S 4..0 ., r—&4 . ,4 r' 04) .s - I/AJC sf2, 1040 L) •/ iO 7" Aq AJ - ,46 o.ø S s' c C eAr ,2,S Zo, oi C '6tJ A)I1I (irn ,ô : - ol C. J,e.c L7c)( )AMdV '7- A4.4 A.V- - - - -.- L Sees .. .,•..'- ---- • 1 • - -- •- - S I -S J'IRI1PLAN CORRECTION SHYXI JMSDICnON:i #? L S V DATE_/J ' 7 VOLLIE WAN PLAN CHECK NB:' 6 7 PLAN OE: (MEN DILLON Submit complete electrical plans and )I. Provide overcurrent protection on the specifications. - secondary side of transformers. NEC 260- 21/384-16(d). Submit plan showing location of all . services. 14. Submit plan showing location of all • panels. • Submit . complete one-line diagram of . • . ., service and feeders. O.Submit'panels schedules. ,d Indicate the grounding system to be 3ft'. Specify conduit..and wiresizes. • installed for building service. . •.-- . - • y Specify aluminum or copper conductors and Indicate ampere interrupting capacities type of insulation... (AIC) of service and subservice • - equipment. . NEC 230-65/110-9. Show approximate length of feeders. Indicate sizes of fuses and/or circuit )V. Specify electrode-conductor size and type breakers. . .. wire. (aluminumor copper) . Indicate fuse symbols to. show fault Submit electrical-load calculations. - -' currents are limited to 10,000 amps on . . branch circuits. ()Indicate existing service size. If fuses are not used to limit fault ()Indicate existing building load. currents on branch circuits to 10,000 . .- -.-•••- • . - ;amps.,..specif•y. method.to. beused. 23. Indiçatenew. Submit plan showing location of all (3Indicate wiring method. r • . .. switchboards.. . . • . • • .: . . .. Show - exit signs on the electrical Indicate dimension of switchboards and - , lighting plan. Note: Power for exit control panels rated 1200 amperes or lights and emergency lighting must more. NEC 110-16(c). .. . - conform to the 1985 UBC Sections 3313 and 3314. Submit plan showing location of -all .- . . . transformers. . . . Provide receptacle(s) within 25' of the roof mounted A/C units. UMC Section 509. AI Indicate the . grounding system to be ,------.. - - : ' installed for transformers.'. NEC 250- . . '27.)Provide multiple switch lighting controls 26(c). .- , . . - per CAC, Title 24, 2-5319. Any - questions on electrical please contact the plan checker shown above, at Esgil Corporation. at (619) 560-1468. Thank you. ..-.. • .. - . - • . •• -" . - .• 08/31/87 ' • • - . . - - - - - ENGY QNSVAI1OH CORRECTIONS - LCMRISE OFFICE BUtLDThGS (SECOND cDRirIOH NONRtDEUTIAL STANDARDS - On January 1, 1987, new standards, and a new design manual, went into effect to govern the energy design for new heated or cooled lourise 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 lourise 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 (216 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 :'5'e upper left corner of the Certificate Certificate of Compliance (Form CF-1) - of Compliance (CF-1).. Pages 1 and 2, must be completed and imprinted on the must show the name of the documentation plans if HVAC or lighting is being author, who need,, not be a 'licensed,. extended to a new conditioned space. person. (Manual 1714) . .. (1-13 MaAuzâl) '' •'-"- . . .- . '..'--. (OB-)The owner of the building must sign in OB-Z ' A Certificate 'of Compliance (CF-1) is '.the appropriate place on Page 2 ;. of - required to be imprinted on the -plans Certificate of Compliance (CF-1)., •. for shell or speculative buildings where (Manual 1-16) . .. 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?- OB-3 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-1), . "A not known at the time of the original. . ' separate copy of the.' Certificate of 'building permit. The multiple CF-i ' 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.- (Manual 1-22) ciI) The Certificate of Compliance (CF-1)., - . - Page 1, ..must be signed. in the lower . . - ,• - right by the licensed person who is. attesting that the design-complies with the regulations. (Manual 1-14) 03-18 On CF-1, Line 1, show the proposed or Note on the plans, near the imprinted existing total resistance (R) for Certificate •of' Compliance (CF-1), "At exposed floors or soffits separating the time of permit issuance, the conditioned space from non-conditioned permittee will provide an approved copy space, 'using Form CF-2. Provide a Form ..,. of the Certificate of Compliance (CF-1) CF-3. (Slab-on-grade floors are not to the jurisdiction", for filing. (UBC considered to be 'floors for this item.) Section 302 (a) 7). 03-19 On CF-1, Line 8, show the minimum (1OIf a Certificate of Compliance (CF-1)' allowed total resistance (Rt) for the was previously prepared for this entire floor taken from the 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 wails,' show the proposed or existing average total resistance 03-11 The building is a mixed use building and using F-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 03-21 On CF-Line 10,. complete CF-2 if all 1,000 S.F. and are less than 10% of the . opaque walls 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 walls having different heat capacities, 03-12 On CF-1, Line 1, show the occupancy this may be left blank'. type, i.e. lowrise office. ..........' ''. - - ' - . 03-22 On CF-1, Liri4 ii, show the, min 03-13 On CF-1, Line 2, show the occupancy required total resistance (Rt) for ' • group B-i. opaque walls and doors. If multiple - walls, having different Heat Capacities 03-14 On CF-1, Line 3, show the package are proposed, show the area weighted selected, i.e. A, B, C, D, E or ' average using CF-2. Performance Approach. . OB-23 On CF-i, Line 12," show the total 03-15 On CF-1, Line 41 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 exteior wall, area should include opaque walls, doors and 08-16' On CF-1, Line 5, show the proposed or - windows between the'' floor. and the bottom existing total resistance (Rt) for the of the floor, or roof, above, that roof. If different types of roof, ' separate conditioned space from non- complete CF-2. Complete a CF-3 if only conditioned space. Provide,a CF-2. one roof type. 03-24 On CF-1, Line 13, show the total glazing OB-17 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. 03-29 &)' 4t £J4 -V #Osik/ / 'S - ' 03-25 On CF-1. Line lie, show the percent, of exterior, wall, between conditioned and non-conditioned space, that is glazed, - i.e. Line 13 divided by Line 12 tines 100. 03-26 On CF-1, Line 15, show the average shading coefficient for all glazing, supported bya CF-2. If only one type of glazing, no calculation is necessary just enter the shading coefficient for theglazing. 0327: On CF-1, Line 16, enter the allowed .. percent of glazing, for the selected .. package, based on the average shading coefficient shown on Line 15. This . entry should: be greater than the Line 14 . . entry. . . • OB-28 On CF-1, Lines 17 through 21 should be . • .• . • - left blank for lowrise office buildings. . .•, through29; enter the -• * :... -. -. ..:..* .. - • proposed area of skylights and the • - ...• allowed area per the package selected. * • If -more than 8 skylights attach a • . • . * * separate sheet.:- • . Dates \\7 Jurisdiction )rflL t-ai • S Pcpared bys o E1d De VALUATION AND PLAN CECK 0 Esg...1 PLAN C'{ECi< NO BUILDING ADDRESS i'E4 r/RQo D' APPLICANT/CONTACT . rO L-J - PHONE NO .cqk- 51 0 - , BUILDING OCCUPANCY A-3 DESIGNER PHONE___________ TY?E OF CONSTRUCTION CONTRACTOR -'ONE___________ BUILDING PORTION BUILDING AREA VALUATION ?4ULTIPLI!.R VALUE - • .1 - ________________________________________ Air Condjtioninz Ccnercja1 esiden.al Res. or Comm. - Fire Srir.k1ers - - ________________ Total Value Fee Adjus ted .To Reflect 0 Ene rgy Re9u1ati0n3 (Fee x 1.1) OHandica egulations cc x 1 - Building Pe r mit Fee S Plan Check F cc COttHCN TS. - - ENGINEERING CHECKLIST 41 LEGEND; Date: item Complete Plan Check No'. Project Address: Item Incomplete - Needs Your -Action Project Name: TT -jv ôo s 0 Field Check Date 1,2;3 Number. in circle indicates plancheck By: .. . , number tha.t deficiency was identified ' . . LEGAL REQUIREMENTS ' •' > Site Plan " 0• ' Provide a fully dimensioned site plan drawn to scale.' Show: North arrow, property' lines, easements, existing and proposed D 'existing structures, streets, street improvements; right-of-way • ' ' width and dimensioned setbacks.. 2. Show on Site 'Plan: Finish floor" elevations, elevations of finish 'adjacent grade to building, existing topographical lines, "existing [j.FD . , ' and proposed slopes, driveway and percent (%) ',grade and drainage patterns.. FT 3* .Proide legal, description of property. . El/E fl 4 Provide assessor's parcel number. • PERMITS REQUIRED Grading' El E - 5. Grading permit required. (Separate submittal to Engineering Department required for Grading Permit). • ", . . . 6. Grading pIan1n'pIan check PE '. . E( F-1 El 7. Need the following' completed prior to building,- permit issuance: E-1 D . ,. A... 'Grading plans signed. Er'E . . , • 'B. Grading permit issued. '• . . 0 . . Ii' 0 '' • C. Grading completed. . . ' . . •• '.• D. • Certification letter and compaction reports submitted. ES E E., Grading inspected and permit signed off by City Inspector. FF E ' ,. 8. Right-of-Way Permit required for ,work in, public right-of-way (e.g., • driveway approach,. sidewalk, 'connection to water main, ' etc). . ' " ,:. • . : , E. U , .. 9 Industrial Waste Permit application required. To be' filled out , - •' . . . . .- • completely and returned, to Development Processing. • . 0 * - -. - . FEES REQUIRED - 10 Park-in-Lieu fees required Quadrant: Fee Per Unit: ',-Total Fee:. 11. Traffic impact fee required: •: Fee '3OO. Per Unit: . , , Total Fee: - 12 Bridge and Thoroughfare fee required Fee Per Unit , Total Fee L1 13 Public facilities fee required 14 ee 0 15 Facilities management fee required F 5-0 Additional EDU's required - Sewer connection fee: Sewer 'permit no. El" E 16 Sewer lateral required REMARKS flit 210 ~X X 30C) - •- 4 •-. • . 4 0 K to issue* Date If you have aiy. questions about --an y of theabove items identified, on this plan check, please àall the De'velopment Processing Department at-L438-1161.,, . *-44._ - . * -c- -- ' - 4-; 4- - --*.. '_.4 -• 4' .--. 4 * - . * 4. .• 4 --' .. -- -- .,-..-: ,• * - -' • - 44 't *•' • - - -- 4 ••, '4 • ,* .4 .. •- : - -- * -, 4-I - w -. - .5 V - 'V s--- - -..'• - PLANNING CHECKLIST - - - '' - D .,-a Plan Check No. '87— .•- Addres/85p1v4,9,Q) R0 Type of Project and Use TI - )7fry 56E Osru-- Zone Use Allowed7 YES X. NO Setback Front /J/4 Side Rear Facilities Management Zone I F School District San Dieguito Encinitas Carlsbad ) Lan Marcos Discretionary Action Required YES NO Type fl 0 0- Environmental Required ' YES - NO 0 0 Landscape Plan Required YES NO X. Comments V. - E-1 fl 0 Coastal Permit Required YES NO Additional Comments I -* V - •.* - - V 'V t'• - OK TO DATE //23 87 -* -. - • * •*'V ,•.•", - . -- -.V V V , , V F . •* •• - - V V V . V - - * - V ,V • 1' V *V •*' -V. ' V • •* , •, ---- r - - • -. V V V VV V - •• • V S -- , V_F. 2560 ORION WAY CARLSBAD, CA 92008 TELEPHONE (619) 931-2121 Citp of Carlobab FIRE DEPARTMENT PLAN CHECK REPORT PAGE-11 OF APPROVED DISAPPROVED PLAN CHECK# 7L9oI PROJECT S_ .S ADDRESS / W&e/ . enilli, (, ARCH ITECT-r/-,L,/e.S. ADDRESS 066_" 6=77 cAc PHONE OWNER t-'7S ADDRESS 111a, ALP 3y.e1-, PHONE 7/4'-7s9 5c3/ OCCUPANCY R CONST. ___________ TOTAL SQ. FT. 7/ (D? STORIES o SPRINKLERED 0 TENANT IMP APPROVAL OF PLANS IS PREDICATED ON CONFORMING TO THE FOLLOWING CONDITIONS AND/OR MAKING S THE FOLLOWING CORRECTIONS: PLANS, SPECIFICATIONS, AND PERMITS Provide one copy of floor plan(s); site plan; sheets Provide two site plans showing the location of all éxi tin fire hydrants within 200 feet of the project. Provide specifications for the following:. Ck,eC,7 ti &j 7 t'flA/ Permits are required for the installation of all fire protection systems (sprinklers, stand pipes, dry chemical',halon, CO2, alarms, hydrants). Plan must be approved by the fire department prior to installation. _._. 5. Thebusiness owner shall complete a building information letter and return it to the fire department. FIRE PROTECTION SYSTEMS AND EQUIPMENT' • 2 6. The following fire protection systems are required: 0 Automatic fire sprinklers (Design Criteria: l.Dry Chemical, Halon,CO2(Location: D Stand Pipes (Type: ..:.. / ' 0 Fire Alarm (Type/Location:. Fire Extinguisher Requirements 'One'2AratedABC.extinguisher for each sq. ft.or portion thereof with a travel distance to the nearest / extinguisher not to exceed 75 feet of travel '-IbAn extinguisher.with a minimum rating of Lt() B to be located: -)OC/' O(Ec ,10. C11 0 Other: Additional fire hydrant(s) shall be, provided EXITS - .9. Exit doors shall be openable from the inside without the use of akey or any special, knowledge or effort. _io; 'A sign stating, This door to remain'u'n locked during business hours" shall be placed above the main exit and doors L11. EXIT sigrs (6" x 3/4" letters) shall be placed overall required exits and directional signs located as necessary to clearly indicate the location of exit doors. , • . • . ' GENERAL ........_12. StOrage, dispensing or use of any flammable or combustible liquids, flammable liquids, flammable gases and hazardous chemicals shall comply with Uniforrii Fire Code. __13. 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 bedone, comply with. Uniform Fire Code, Article. 81. • —14. Additional Requirements .............15. Comply with regulations on attached sheet(s). Plan Examine S Date Report mailed to architect - Met with Attach to Plans VV• --:..T;.. VV; trI t_ i'c; V•\ 1 COUNTY OF SAN DIEGO - DEPARTMENT OF HEALTH SERVICES Division of Environmental Health Protection 1700 Pacific Hwy., San Diego, CA. 92101 (619) 236-2243 PLAN CORRECTION SHEET PLAN CHECK #: PAGE / OF '1 r0r2) - OWNER: e.-/ DATE: /c ADDRESS:/..-Z /!/(JJ /., L5. iI;1 -7' PHONE: 43 40 CONTRACTOR 7c PHONE 17,/) -V - Address of Proposed or Remodeled Health Regulated Building;_/--• _£i_cYA '•'Y Y TYPE OF BUSINESS:.RECHECK REUIRED 1(L) APPROVED Y€) CHECKED BY:t(). /,./ke,'. • 1 ITEMS /k1i71 ((L 1,4J cr,1er,. LAV V DHS: EHP-886 (4/84)