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Home My WebLink About1854 MARRON RD; 102; CB121510; PermitCity ofCarlsbad 1635 Faraday Av Carlsbad, CA 92008 090ç52012 - Commercial/Industrial Permit Permit No C6121510, Building Inspection Request Line (760) 602-2725 4 1 I'. - - -• t• ,. -Job Address 1854 MARRON RD CBADSt 102 Permity Type TI Sub Type COMM Status ISSUED Parcel No: - -1563011600 ,Lot#: "0 '-Applied: 08/09/2012 ,- 'Valuation: Valuation $77,009.00 Construction Type 5B Entered By. JMA Occupancy Group Reference # Plan Approved 09/05/2012 Issued 09/05/2012 Inspect Area - Plan Check # Project Title DOMINO S PIZZA 1531 SF RETAIL--. TO RESTAURANT !Applicant:Owner SPACE CONCEPTS/ART BABAYAN P K I NORTH COUNTY PLAZA L P .• .T CIO KIMCO REALTY-CORP . .. 2922 W TEMPLE ST (3333 NEW HYDEkPARK RD #100 LOS ANGELES CA 90026 7' I NEW HYDE PARK NY 11042 2133848131 JVh /J BuiIding Permit. •.V587.82 Meter Siie \ Add'l Building Permit Fee / . /' $0.00 Add'l Red. Water Con. Fee " \ $0.00 - Plan Check / / $411'.47-, Meter Fee \ - $0 00 Add 'I Building Permit Fee /.. $0 O0.r SDCWA Fee \ $0.00 Plan Check Discount / / $0.00 / CFD Payoff Fee .-.\ \ $0.00 Strong Motion Fee $1617 PFF (3105540) \ $140156 Park Fee / .$0 00i-4PFF (4305540) \ \ $V293.75 75 LFM Fee / / $0O0LicenseTax (3104193) $000 Bridge Fee / $6.00 4 L e, x 304193) \ $0.00 BTD #2 Fee ( $000 Traffic Impact Fee (3105541) \ $0.00 BTD #3 Fee - I •. $0.00 Tràffid Impact Fee (4305541) $0.00 Renewal Fee I • - - - $O.00 PLUMBING TOTAL . .- $86.00 AddI Renewal Fees . $6.00 ELECTRICAL TOTAL-.K . j $90.00 '.'other Building Fees $000 MECHANICALTOTAL J'- jf. J $52.00. Pot Water Con Fee $0 Ma 00 steDi inagFe\\ . 7 / / $0.00 Meter Size '\ SewerFee '7 IJ i / / $0.00,1_ Add I Pot Water Con Fee \ $0 00 Red Parking Fee / $0 00 Red- Water Con. Fee4 \ $0.00 * !AdditionàlFees / /,;. $0.00. - Green Bldg Stands (5B1473) Fee \ $1 00 HMPdFee " Fire Expedidted Plan Review \ $0.00d 0 Rqrter Bldg Standards Plan Chk I \ N iTOTAL PERMIT FEES1 I $3,939.77 Total Feels:' ees $3 939 77-.Total Paynts TôDate $3 939 77BaIan'Du ' $0 00 Inspector:.'"-Date 09ji( 1- __-6arane NOTICE Please take NOTICE that approval of your project includes the imposition of fees dedications reservations or other exactions hereafter collectively ' referred to as fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must follow the protest procedures set forth in Government Code Section 66020(a) and file the protest and ary other required information with the City Manager for processing in accordance with Casbad Municipal Code Section 332 030 Failure to timely follow that procedure will bar any subsequent legal action to attack review, set aside void or annul their imposition . r ç - _ You are hereby FURTHER NOTIFIED that your'night 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 tees/exactions of which you have previously been given a-NOTICE similar to this, óra to iAihich the statte of limitations has previousl otherwise expired. • .s -. -. •. --•.- -' -.r--.•--- -•- -.,.. ,•. - -* .-.-, • ..S'' ..--1 f- - - - 4 4* .4 •.-'- -.4 4 V 4 4 - - - - 4 -- -- - . . - 4-. - ,_. _•5 4 .- '. --'I -;............- - . . •• . _.•.r - •.. .-*'. - . - •a -. e - . 1THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE LPLANNING OENGINEERING ZILDING Efl 'F1 RE Plan Check No Building Permit Application - .. 1635 Faraday Ave., Carlsbad, CA 92008. Est. Value -. \" CITY OF . 760-602-2717/2718/2719 • CAR LSB/\D ww Fax 760-602-8558 . tan Ck . - eposut ,carIsbadcagov Dategf D c /2. LTH El HAZMATIAPCD z 42 JOB ADDRESS ' I) a - fMacr Oe' V- SUITE#/PAE#/UNIT# :. 1 6 APN . - - - - CT/PROJECT B LOT # . PHASE B B OF UNITS. B BEDROOMS B BATHROOMS TENANT BUSINESS NAME . D 'c Piz g ,no CONSTR. TYPE 0CC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area (a) (J toi41 (-E) Q*4'( 4? Qoi"°'i )°!2fc &1fr)I 7+.( area C *'iieaif :.: . :.:. : ,• \ I EXISTING USE . • PROPOSED USE . . GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING F FIRE SPRINKLERS tc) - 'tNOD YESD# ' YESDNOE YESElNOE APPLICANT NAME (Primary Contact) .1 , . APPLICANT NAME (Secondary Contact) - • 1e°,4ki t1t'3I5,1 .. . • ADDRESS '-reF,PLe - ADDRESS CITY /jekJ STATEC>.. ZIP 90 , o CITY - - 'STATE i. ZIP, PHONE FAX PHONE FAX EMAIL Voho EMAIL - 4 PROPERLY OWNER NAME r k o m (iur t P ' Oft CONTRACTOR BUS. NAME - c 'S7& 770A1, ADDRESS . . - - L )D-, ADDRESS -. 2Z& ;'. CITY ..' . ftj) Rd ôk -' STATE - , ZIP ." 0 . ((p CITY . - STATE . ZIP AMtW,1- ?'3Z/-2107. PHONE ,IJ . . a. •.. FAX • - PHONE EMAIL EMAIL - ARCH/DESIGNER NAME & ADDRESS C . ja,,- . STATE LIC. B . - STATE UC.# . . . 4666 7 12191 CLASS -. CITY S. LIC.# I , (Sec. (041.b Musifless and Proressions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any Structure, prior to its issuanci, allO 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 7fllOOf 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 ($50011. ZX3U1OO Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: - • • : . . -, - - El I have and will maintain a certificate of conent 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. IiiIIJ I have and will maintain workers' compensation, as required by Section 37000) 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. 5 ?Vc -537Exp6tion Date This section need not be completed it the permit is for one hundred dollrs ($100) or less. - El 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' copensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in, addition to the cost of compensation, damages as v, for in Section 3706 of the Labor code, interest and attorney's fees. - - CONTRACTOR SIGNATURE AGENT • DATE eowo&c oecz (hereby affirm that! am exempt from Contractor's License Law for the following reason: [J 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). [1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contraclor'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). I ;in exempt under Section - Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. , ElYes ElNo - 2. I (have / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone / contractors' license number): I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address /phone / contractor'license number): -. I 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): - - - '• . . - --. - , . .t ..PROPERTY OWNER SIGNATURE JAGENT DATE 'I. - - -I CERTIFICATE OF OCCUPANCY lCommerciall Projects OZ1I'J . Fax (760) 602-8560, Email www.buiIdinp(carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO# (office Use Only) - CONTACT NAME • - . - OCCUPANT NAME BUILDING ADDRESS - - - STATE '- ' -, ZIP Cl-.; - - Cl •.,. STATE ZIP Carlsbad CA PHONE - FAX • .• * - -v - EMAIL .- - . .•- .• . 0 • OCCUPANT'S BUS. LIC. No - • DELIVERY OPTiONS . 4 PICK LIP: •' CONTACT (Listed above) "OCCUPANT (Listed above) ' . . • - CONTRACTOR (On P. 1) '- : I . • • --- .. ' , . MAIL TO: CONTACT (Listed above), OCCUPANT (Listed above) - ASSOCIATED CB# CONTRACTOR (On Pg. 1). --; . . NO CHANGE USE/ NOCONSTRUCTION - 0•4 MAIL/ FAX TO OTHER: - . . . . . •. - - - - -- • , - CHANGEOFUSE/NOCONSTRUCTION • . '' - . - APPLICANTSSIGNATURE DATE 1635 Faraday Ave Carlsbad, CA 92008 a0mmmumoo, aaOwom Goo ~ MM000000MM16 000amme POOJO1O ®aJ Is the applicant or future building occupant required to submit a business plah,..autely hazardous materials registration form or risk management and prevention proram under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? L.Yes . r-'Is the applicant or future building occupant required to obtain a permit from the air pollution control district or airgif1ity management district? i.,. Yes No V Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? ,Yes No . IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF - . EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. - •. OP003U0G3 :o)oUjg 30GS1 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 l have read the application and state that the above information iscornectand that the infomiationon the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. - 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 114 ANYWAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories in height. - EXPIRATION: Every permit issued by the Buikling e provisions of lhis Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within in from the date of such permit or if the bu g or onzed by such permd is suspended or abandoned at any time alter the work is commenced fora period of 180 days (Section 10644 Uniform Building Code) ,.APPLICANT S SIGNATURE _. DATE 0 9/'D -1/ Ii - . - : - - -. . . ' r I - • ' - I •' •- - - t * - -. • ;' .- .. I , - . .'. . ' .. , •-.. - ,- - STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. •• - - Complete the following ONLY if äCertificate of Occupancy will be requested at final inspection. •'. a •' - ' . .4 , Inspection List - - Permit#: CB121510 Type: TI DOMINOS PIZZA: 1531 SF RETAIL COMM , TO RESTAURANT' Date Inspection Item , Inspector 'Act Comments 09/26/2012 89 'Final Combo ' , MC Fl 09/26/2012 89 Final'Combo ' . , - ' RI ' 09/25/2012 89 Final Combo ' , '- ' RI 44 ,,• ' 4 09/25/2012 89 Final Combo , MC ' 'CO SEE CARD 09/20/2012 84 Rough Combo RI 09/20/2012 84 Rough Combo , , MC .. AP T-GRlD .' 09/14/2012 14 Frame/Steel/Bolting/Weidin ' - '. RI 09/14/2012 14 Frame/Steel/Bolting/Weldin PY , PA '09/14/2012 17 Interior Lath/Drywall , p9/14/2012 17 Interior Lath/Drywall . PY .. AP , ,• . . .09/12/2012 84 Rough Combo ' MC ' CO SOFFITS 09/10/2012 31 Underground/Conduit-Wirin MC ' ,., AP ' CONDUIT ONLY 09/10/2012 31 Underground/Conduit-.Wirin MC . AP WALLS ONLY SEE CARD , 09/10/2012 84 Rough Combo ' ' MC , PA ' WALLS ONLY SEE CARD 09/10/2012 84 Rough Combo ' - MC PA - I • ' WALLS ONLY ,' 09/06/2012 21 'Underground/Under Floor 4- . ' •- • ' . MC CO - NOT PER PLAN- ' 09/06/2012 21 Underground/Under Floor - MC . CO ' 4. NOT PER PLAN . • '- ' -. ' 09/06/2012 84 Rough Combo',.MC CO '09/0612012 84 Rough Combo MC ' CO NOT PER PLAN . 4 • . . - ,. •''. .-''.,.•-'. .4 4 - - . - 4. ' '4 - ' ' • .4 ' - - 4.4 44 • ' 4 4 , - '- 4 .. . .4 '•., •,;. 4 . , • , ' 4. ' 4. '4. 4 4 .- .4 4 - 4. ' • , - . • I I - ) .4 . . ' ' • -, ' 4 '- 44 74 1 •'- ,.' --4' '4' 4 - . 4 -4' 4 -. 4 ', . 4 . 4 .4 4 •' .4, 4 '4 4 4 .444 • - 44 4' . 4,'. - . -. . I :' -: - ' - " 4 - - 4 •• - 1. - Thursday; September 27, 2012 , . - .'-. . - . . a Page 1 of 1' 4 - - ' . 4 . * ' , 14•,44 .. T PIZZA: 1531 SF RETAIL CB121510 1854 MARRONRD 102 CARLSBAD INSPECTION Building Division IN RECORD DOMINOS TO RESTAURANT II INSPECTION RECORD CARD WITH APPROVED TI COMM PLANS MUST BE KEPT ON THE JOB Lot#: SPACE CONCEPTS/ART BABAYAN (I CALL BEFORE 3:30 pm FOR NEXT WORK DAY INSPECTION (Z FOR BUILDING INSPECTION CALL: 760-602-2725 OR GO TO: www.Carisbadca.gov/Buil 'RECORD AND CLICK ON COPY' -Request Insp6ction" DATE: /5')i Z, Carlsbad, T.q3Isl Building Inspectors can .*i reached TWLWI Y ILI1ILiIYi!II] VIUII1i.I Ihi•RIlItATD1IFIiltII.LSitLI1I Required for Final if Checked Date Inspector Notes U Planning/ Landscape 760-944-8463 MOW 48 hours U CM&I (Engineering Inspections) 760-438-3891 Call before 2 pm 19 Fire Prevention 760-602-4660 Allow 48 hours 3 Apfvf I U? LI Type of Inspection FOUNDATION Date Inspector Type of Inspection Date Inspector 9([ECTRIC UNDERGROUND 0 LIFER "I 10, &1 REINFORCED STEEL ROUGH ELECTRIC WALLS MASONRY ROUGH ELECTRIC CEILING GROUT 0 WALL DRAINS 0 ELECTRIC SERVICE 0 TEMPORARY T1LTPANELS OBONDING [3 POOL POUR STRIPS - PHOTOVOLTAIC COLUMN FOOTINGS FINAL SUBFRAMi DFLOOR DCEILING ROOFSHEATRINO UNDEJROUND DUCTS &PIPING EXT. SHEAR PANELS -- SØ6iJCT&PLENUM DREF.PIPING b'74(Z# MCI FRAME Cl/Ii&/Z_ f - HEAT-AIR CON D. SYSTEMS INSULATION . VENTILATION SYSTEMS EXTERIOR LATH FINAL INTERIOR LATH & DRYWALL SEWER & BL/CO 0 PL/CO Date Inspector FINAL OCCUPANCY Irl Date Inspector A/S UNDERGROUND VISUAL UNDERGROU!LD,.Y1ASTE OWATER kA , . A/S UNDERGROUND HYDRO TOPOUT4WASTE OWATER A/S UNDERGROUND FLUSH TUB & SHOWER PAN A/S OVERHEAD VISUAL GAS TEST 0 GAS PIPING A/S OVERHEAD HYDROSTATIC WATER HEATER 0 SOLAR WATER A/S FINAL FINAL F/A ROUGH-IN of F/AFJNAL 600- PRE-CONSTRUCTION MEETING FIXED EXTINGUISHING SYSTEM ROUGH-IN 603-FOLLOW UP FIXED EXT1NG SYSTEM HYDROSTATIC TEST 605- NOTICE TO CLEAN FIXED EXTINGUISHING SYSTEM FINAL frfj. teii't__. 7al- 607 -WRITTEN WARNING MEDICAL GAS PRESSURE TEST NOTICE OFVIOLATION MEDICAL GAS FINAL VERBAL WARNING FINAL FINAL REV 6/2012 ., SEE BACK FOR SPECIAL NOTES .1 Section 5416. Health and Safety Co, State of California There shall be not less than one water closet for each 20 employees or fractional part thereof working at a construction job site. The water closet shall consist of zi patented chemical type toilet. For the purpose of this section the term construction site shall mean the location on which actual construction of a building is in progress. A violation of this section shall constitute a misdemeanor. . All construction or work for which a permit is required shall be subject to inspection and all ch construction or work shall remain accessible and exposed for inspection purposes until approved by the inspector. Work shall not be done beyond the point indicated in each successive inspection without first obtaining the apprc..: the inspector. nATF ADDITIONAL NOTES ,/ - - Min- - 4,M"! -r 1. 4 4. 4 •4 - . . . - EsGil Corporation In Partners flip with Government for Building Safety DATE: 9/5/12 . . APPLICANT LI JURIS. JURISDICTION: City of Carlsbad . U' PLAN REVIEWER L) FILE . PLAN CHECK NO 12-1510 SET II PROJECT ADDRESS 1854 Marron Rd Suite 102 PROJECT NAME Domino's Pizza - TI FT-The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes -The plans transmitted herewith will substantially comply with-the jurisdiction's building codes when minor deficiencies identified in the remarks 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 LII 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 ) Email Fax # Mail Telephone Fax in Person REMARKS: Applicant to hand carry the plans directly to the City of Carlsbad and slip sheet pages A-2.0, A-3.0, K-I, K-1.1, K-2, E-2 and P-I to the City held sets. Applicant to add notes in red on sheet P-2 for the mop sink on the City set II This does not assure a permit will be issued the city may have other corrections 4 L By Doug Moody Enclosures EsGil Corporation rl GA El EJ El PC 8/27/12 9320 Chesapeake Drive, Suite 208 • San Diego California 92123 • (858) 560-1468 • Fax (858) 560 1576 EsGil Corporation In cPartnerIlip with Government for Building Safety. DATE: 8/21/12 . 0 APPLICANT JURISDICTION: City of Carlsbad U PtcTc1EVIEWER U FILE PLAN CHECK NO.: 12-1510 SET: •I PROJECT ADDRESS: 1854 Marron Rd Suite 102 PROJECT NAME Domino's Pizza - TI The plans transmitted herewith have been corrected where necessary and substantially comply With the jurisdiction's codes LII The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. .. The plans transmitted herewith have significant deficiencies identified on the enclosed checklist 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: Space Concepts & Design 2922 W. Temple Street, Los Angeles, CA 9002 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: Space Concepts & Design Telephone #: 213-384-8131 Date contacted: 71 2.Z1 ,_(by:l ) Email: •scdesiqnIayahoo.com Fax #: Mail " Teiephone-. Fax In Person . . LII REMARKS By: Doug Moody Enclosures: EsGil Corporation El GA El EJ LI PC . 8/9/12 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468• Fax (858) 560-1576 City of Carlsbad 12-1510 8/21/12 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS IPLAN CHECK NO.: 12-1510 OCCUPANCY: B TYPE OF CONSTRUCTION: VB ALLOWABLE FLOOR AREA: ISPRINKLERS?: Unknown IREMARKS: DATE PLANS RECEIVED BY JURISDICTION: 8/9/12 DATE INITIAL PLAN REVIEW COMPLETED; 8/21/12 JURISDICTION: City of Carlsbad USE: Restaurant ACTUAL AREA: 1537sf STORIES: 1 HEIGHT: OCCUPANT LOAD: 39 DATE PLANS RECEIVED BY ESGIL CORPORATION: 8/9/12 PLAN REVIEWER: Doug Moody FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the California version of 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 2010 CBC, which adopts the 2009 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 2009 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 pIans - City of Carlsbad 12-1510 8/21/12 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: 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. 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. 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. Provide evidence of Health Department approval (for restaurants), where regulated by the local Health Department. 3; Please provide a statement on the Title Sheet of the plans to show compliance with the current Codes. The following are the correct current Codes: The 2010 edition of the California Building Code (CBC) adopts the 2009 International Building Code (IBC) and the 2010 California Amendments. The 2010 edition of the California Electrical Code (CEC) adopts the 2008 National Electrical Code (NEC) and the 2008 California Amendments. The 2010 edition of the California Mechanical Code (CIVIC) adopts the 2009 Uniform Mechanical Code (UMC) and the 2009 California Amendments. The 2010 edition of the California Plumbing Code (CPC) adopts the 2009 Uniform Plumbing Code (UPC) and the 2009 California Amendments. The-2010 edition of the California Fire Code (CFC) adopts the 2009 Uniform Fire Code (UFC) and the 2007 California Amendments. The 2008 edition of the California Energy Efficiency Standards. 4. Please have the document author and the principle designer of the LTG-1 C form sign the imprinted document. - 5. Provide automatic shut-off controls for lighting as per Title 24, Part 6, Section 131(d). City of Carlsbad 12-1510 8/21/12 6. Please complete the LTG-1-C part 3 of 4 mandatory automatic controls portion of the LTG-1-C forms. 7. Please have the principle designer check the appropriate box(s) and complete the Statement of Compliance System Acceptance section of the LTG-1 -C part 4 of 4 documents. 8. Occupancy sensors are required for the following room types: Offices 250 square feet and smaller, multipurpose rooms less than 1,000 square feet, and classrooms and conference rooms of any size. Please add where appropriate. Section 131. 9. Provide dryer vent to outside. The maximum length is 14 feet with two 90-degree elbows. UMC, Section 504.3.2. 10. Please revise the plans to show the restroom to be equipped with an environmental air exhaust fan sized to provide the minimum exhaust rate per Table 4-4 of the UMC. 11. Please provide evidence from the serving waste authority that a grease interceptor is not required. 12. Hot water supplied to a public use lavatory is limited to a maximum temperature potential of 120 degrees by a device that conforms to ASSE 1070 or CSA B125.3; please provide the manufacturer's listing showing compliance. Detail how this temperature limitation is achieved. The water heater thermostat may not - be used for compliance with this Code section. UPC 413.1 & UPC 414. 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: The area of specific alteration, repair or addition must comply as 'new" construction. 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. 13. 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. City of Carlsbad 12-1510 8/21/12 14: Show that the water closet is located in a space, per Section 1115 B. 3.2.3, which provides: d) A minimum side clearance of either: i) ~!28" from a fixture. This clearance shall extend all the way to the rear wall. Section 1115 B.4.1 .1. This will generally require the toilet room to be 7' wide (along the rear wall) by 6' 6" in the other direction. ~!32" from a wall on one side. This clearance shall extend all the way to the rear wall. A clear space at the water closet in compliance with Section 111513.4. 1, Item 2 (this prohibits any fixtures from encroaching into the clear space at the rear wall). A clear space in front of the water closet measuring 60" wide by 48" in front. Section 1115B.4.1.2. Seethe following figures: : ' . . .. ••_____________ . CENTERLINE CENTERLINE OF OF FIXTURE. FIXTURE . 16'18 • :]j j2&MIN.[T] TG EDGE FLUSH if \\orwATcR' - ACTIVATOR /LcLO3ET ON WIDE Uj co 18"'32MIN . -MIN. CLEAR • 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. . . . City of Carlsbad 12-1510 8/21/12 Please indicate here if any changes have been made to the plans that are not a result of corrections from this list. If there are other changes, please briefly describe them and where they are located in the plans. Have changes been made to the plans not resulting from this correction list? Please indicate Yes No U 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 12-1510 8/21/12 [DO NOT PAY— THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PLAN CHECK NO.: 12-1510 PREPARED BY: Doug Moody DATE: 8/21/12 BUILDING ADDRESS: 1854 Marron Rd Suite 102 BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: VB BUILDING PORTION AREA - ( Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) TI 1531 50.30 77,009 Air Conditioning Fire Sprinklers TOTAL VALUE 77,009 Jurisdiction Code cb jBy Ordinance -- Bldg. Perm Fee by Ordinance v • I $587.821 - Plan Check Fee by Ordinance V • I - $382.081 Type 6f Review: Complete Review Structural Only • _______ Repetibve Fee Other ., Repeats El Hourly • Hr. @.• ________________ EsGil Fee I . $329.181 Comments: - •• - . . . Sheet of 1 • • • rnacvalue.doc + a- .4 - I •, • 4 -I . - - . .- I • I I -DATE:,08/21/12 PROJECT NAME DOMINO'S PIZZA ' PROJECT ID CB12 1510,, T (I r * 1PLAN CHECK NO 1 SET# 1 ADDRESS 441854 MARRON RD APN 4 - 4. 4•• -.-, I • VALUATION $77,462 .4 4 J/ This plan check review IS complete and has been APPROVED by theENGINEERING - Division ' - By KATHLEEN LAWRENCE 08/21/12 I_f . . - - - - . -I I - • • A Final Inspection by the 'Division is required E1Yes No , This plan check review is NOT COMPLETE Items missing or incorrect are listed on ' ' the attached checklist Please resubmit amended plans as required 41) ' Plan Check Comments have been sent to: SCDESIGNLA@YAHOO.COM . - •. 4 •k- V4 You may also have corrections from one or more of the divisions listed below Approval from these divisions may be required prior to the issuance of a building permit Resubmitted plans should include corrections from all ditisions 4 For questions or clarifications on the attached checklist please contact the following reviewer as marked:' I - aPLANNING ,' .- ENGINEERING FIRE PREVENTION '76O'6O2 4610 760-6022750 '760 602-4665'r 'S .1_.,.S •..4•4,4. :--'- LIII Chris Sexton ' Kathleen Lawrence Greg Ryan 760-602-4624 760-602-2741 760-602-4663 Qhris.Sexton@carlsbadca.gov Kathleen Lawrence@carlsbadca gov Gregory Ryan@carisbadca gov LII Gina Ruiz Linda Ontiveros El 'Cindy Wong 760-602-4675 760-602-27A73 - . 760-602-4662 Gina.R,uiz@carisbadca.gov Linda Ontiveros@carlsbadca gov Cynthia WonE@carlsbadca gov Dominic Fieri -. 760-602-4664 41 - Dominic Fieri@carlsbadcp gov _f_•4_',_ i',--- . ,• - . . -- - - --- Remarks:'4 4 4, • I (4 -J •• 4, ,. .• I. - . . . I_I . - . . 4. ••- ,. I ..,4, t 4 4-4 - •'l' I 4 - S 444414 1 - -I . . ' 4.44 .' 44 45 ••. •-_- .4 4 L - 4. . 4 1 - -. - - • ' 4 41 - -r --. ,• :- 8.S 4 5• S -, - ,. •-. '- -- • . - DING- - -- - - - -- .._. -- . fløllDlflhlvflDflt ct,riiir,c BUILDINi PLANCHECK Land Development Engineering. C IV 0 F CHECKLIST 1635 Faraday Avenue CARLSBAD QUICK-CHECK/APPROVAL . 760-602-2750 www.carlsbadca.gov 8. TIENGINEERING Plan Check for CB 12-1510. - Date: 08121112 ! - 5_! 5 'S S S .. . ... -- I 4 8 Project Address: Address 1854 MARRON APN I -. ' • . H. Project Description CHANGE OF USE FROM RETAIL TO DOMINO S Valuation $77,462 V. . • PIZZA . . 5 .. '. . - . . . . . 5._5 . ' 8'' • - - . -. k. • '''. . . .' - ....4 ' -P-' . - 5- S . •, S . . S 5_s__ - - 5. . •,L. ., .---... . .,, ENGINEERING Contact: -Kathleen Lawrence Email: kathIeen.IawrencecarIsbadca.gov. Phone ' 760-602-2741 Fax 760-602-1052 S - . S 4_ . .- . F - •55 S_ e . 8,- - -_ . • - •-• '._. • -. EIREsIDENTIAL IE7J TENANT IMPROVEMENT I S5 ___,5 1" -5' •5!5, E RESIDENTIAL ADDITION MINOR fl PLAZA CAMINO REAL (<$20,000.00) - CARL SBAD PREMIER OUTLETS LII COMPLETE OFFICE BUILDING .LIiIOTHER CELLANTENNAS 5. '-.3.8 45•' • . .5 . . 5 5 ,• - S .. . .5 5 "4 .• . 8 . - •. • • . S _ .,S - - -. S - S . — - - - OFFCALUSEONLY T k ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT -L I :-- :,- :- ;.s . .,"5- ,.•-.,-.:4-"-_.' I--.. ... BY KATHLEEN LAWRENCE:"'DATE 08l21l12 REMARKS SHOPPING CENTER AT 100% FOR TRAFFIC IMPACT I .__'-'.i'5 .•--- - '5 5 ••8. .'r.,, -: .•-- •. ...........8'•_5S •,. -5 4 -4 4 NO NEW FEES COLLECTED IT : L " - .S • 41 11 8. 8 I/s - -sNotuficatuonof Engineering APPROVAL5 has been sent to . I I via -4. - on - ____- •5 - --5. — - _.__5 ____i --_•.-_-__-_-._-------- E 36 V Page 1 of I REV 4/30/11 'F k ,• * J 4 PLAN CHECK CITY 01F REVIEW TRANSMITTAL :1CARLSBAD; Community & Economic Development Department 1635 Faraday Avenue. Carlsbad CA 92008 www.carlsbadca.gov , DATE August 13, 2012 PROJECT NAME PROJECT ID PLAN CHECK NO CB 12-1510 SET# I ADDRESS 1854 Marron Road APN 156-301-16-00 A 4 This plan check review is complete and has been APPROVED by the Planning Division .4 4 By Chris Sexton • 4- 54 5 . 0 '. f.•04 - A Final -inspection by the Planning Division is required FIYes •No -. 445 S44 4 This plan check review is NOT COMPLETE Items missing or incorrect are listed on the attached checklist Please resubmit amended plans as required . 1' 14 4 ' Plan Check Comments have been sent to .4 .5 You may also have corrections from one or more of the divisions listed below Approval fro -n these divisions may be required prior to the issuance of a building permit 1 Resubmstted plans should include corrections from all divisions 5._ 4 For questions or clarifications on the attached checklist please contact the following reviewer as marked PLANNING 54' . ENGINEERING FIRE PREVENTION 760 602-4610 '760-602 2750 760-6024665 Chris Sexton , Kathleen Lawrence Greg Ryan 76O6O2-4624 760-602-2741. 760-602-4663 4- Chris.Sexton@carlsbadca.gov . Kathleen.Lawrence@carisbadcagov . Gregory.Ryan@caIsbadca.gov Gina Ruiz .: .El LiridaOntiveros . - Cindy Wong 760-602-4675--: . . 760-602-2773 ,. - -760-602-4662 Gina.Ruiz@carlsbadca.gov . Linda.ontiveros@carlsbadca.gov Cynthia.Won@carIsbadca.ov - - : Lii Dominic Fieri 1 760-602-4664 Ov 4. Dominic Fueri@carlsbadca ov * Remarks 4¼ ' • •,_.t•' ; .,• * -: .--.. ... --4 '-4 •••7 •. . ,... i'-- . 4-' 4 4. p . 4 4i 5, 14 .4 - - . . '4) - - A - - . - . 4. - .' S • . -.5. -. 5. - . s . • 5 '-, • ,4 .-.. '. 4.. 4' -. A) - .4 I A ' .. I PLANNING DIVISION Development Services BUILDING PLAN CHECK Planning Division 1635 Faraday Avenue C I T Y 0 F APPROVAL (760) 602-4610 CARLSBAD P-29 wwwcarlsbadcagov & 0 PERMIT NUMBER CB 12-1510 DATE August 13, 2012 ADDRESS 1854 Marron Road RESIDENTIAL ADDITION- POOL/SPA * MINOR (<17,000.00) TENANT IMPROVEMENT RETAINING WALL 4 COMPLETE OFFICE BUILDING VILLAGE FAIRE SOLAR PANELS 4., A OTHER 4. PLANNER Chris Sexton r DATE August 13, 2012 4 4 A * 4- 4. / 4 £ I .4 9- - . . 0 4 44 0 P-29 ' Page 1 of 1 07/11 4 1 4 - PLAN CHECRLDG TEPT dty& Economic RE II Development Department CITY -0 F4 VIEW ., 1635 Faraday Avenue ,,C A fl I CD A TRANSMITTAL . Carlsbad CA 92008 frii\ L)D/ I www.carlsbadca.gov DATE: 8-21-12 PROJECT NAME: Domino's Pizza Ti. PROJECT ID: cb121510 . PLAN CHECK NO 0121510 SET# I ADDRESS 1854 Marron Rd Ste 102 APN This plan check review is complete and has been APPROVED by the Fire Prevention Division By D Fled 1 • I A Final Inspection by the Fire Division is required Z Yes No This n pla check review is NOT COMPLETE Items missing or incorrect are listed on the attached checklist Please resubmit amended plans as required * . _ • . PlanCheck Comments have been sent to .. You may also have corrections from one or more of the divisions listed below. Approval - from these divisions may, be required prior to the issuance of a building permit Resubmitted plans should include corrections from all divisions For questions or clarifications on the attached checklist please contact the following reviewer as marked 1 4 4 'Ar Remarks cThKifchin fire Iod system is not pirt of this aiiprO'ál . :: . . - . •. . .- ---.. ,deferred submittal is required- 44 :4 4 4 4 . 4 .. PLANNING ENGINEERING FIRE PREVENTION 760-602-4610 -. 760-602-2750 760-602-4665 Chris Sexton . Kathleen Lawrence . Greg Ryan 760-602-4624 760-602-2741 / 760-602-4663 o Chris.Sexton@carisbadca.g v . Kathieen.Lawrence@carisbadca.gov Gregorv.Ryan@carIsbadéa.ov Gina Ruiz - Linda Ontiveros Cindy Wong 4 760-602-4675 . 760-602-2773- ..' 760-602-4662 • - -. Gina. Ruiz@carisbadca.gov ' Linda.Ontiveros@carisbadca.gov Cynthia.Wong@carisbadca.gov Dominic Fieri • I V .4 760-602-4664 Dominic.Fieri@carisbadca.gov VV V, V V V •VVV - BLDG Carlsbad Fire Department DFPT COPY Plan Review ' Reuirements Category: TI , COMM V. Date ofRepo 08-21-2012 Reviewed by Name: :SPACE CONCEPTS/ART BABAYAN. • V V Address: • V V V - V• V .' . 2922 W. TEMPLE ST. V V . • LOS ANGELES CA V . 90026 V •V - V Permit # CB121510 Job Name: V DOMINO'S PIZZA: 1540 SF RETAIL Job Address: 1854 MARRON RI) CBAD St: 102 V V • ''V •, V •V•• ,V V. V VV V V V - V -INCOMPLETE The item you have- submitted for review, ic in6omplete. At thLo time, thl3 office cannot - - adequately .uiidu.,t-a -re-view tud miiiic-compliance with the applicable codes- and/or standards. Please review---' a.earefu11y all eomms attached. Please-resubmit the necessary plans and/or -specifications, with Aiaiis "elouded',... to this office for review and approvaI V V4 V 'VV V VV V V I * V I 4 .—eR4-GONOOO5-6-2fr V V V V V V V '• V V V V - - V V V V • V V V V V • V V V VVV V V V dfferdsiibttal is ie,Ttnrediof the hthëñ fire extinguishmg hood system Not artöfthiC' (~~PRqVED~- V THIS PROJECT HAS BEEN REVIEWED AND APPRO VED FOR THE PURPOSES OF ISSUANCE OF V V V :Buh1LDlNG PERMIT. V V V V V V V THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS H E R E O N , ' V CONDITIONS IN CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS. *: V V THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW. V - - VVV V V VVV •V ' V :V V VV•V V Entry: 08/21/2012 By: df Action: AP V V V V V V V V V V V V V * VI - -V V V VVV V V V V V V, V VV •. V . Vt V V .jV V V V V . VVV V V V V V V V V - • I 4 . V V •V V V V V V V V V V V V V V V V 4* Aj 5500 Overland Ave #110 15! E.CARMEL'i SAN DIEGO, CA 92123 SAN MARCOS, CA 92078 PART I I iFACILITY aiiuji AND CONTACT IIi]tlIl[I' - NEW DREMODEL J []CONVERSION (D1OBILE r0ONSULTATION 1LIREVISLON OTHER Facility Name b 0,qiM5 fb/2 z4 Assessor's Parcel No. Facility Address 1(6,54 ,i',i0AJ ki) /02. City &2_5B). Zip BUSINESS OWNER: Name 'bc&J Ho çe E iJ J— Company _ CA-1- 'DO/I) I IVO lb S (fl C - Mailing Address j5 35 (oRSUiJ 15O City 4eM)aA OA44<> State C Zip V1O3 Phone (1 )_.3 'O' qg 1 (Fax ( )_______________ E-Mail__________________________________ DESIGNER/CONTRACTOR: Namefllf)U4() K frKOtAj Company gk,5c CM c(Pf5 'fE(6 - Mailing Address £9Z2 W- 4C$f city 4A State Zip5I2Z E-Mail Address _ bE S (641 . 4 f 51kO, CL"7 State Contractor's License if applicable___________________ Contact Person Mb / Contact Phone (2/3 )_351- 8/3 / Contact Fax ( ) - Contact E-Mail Address____________________________________ FACILITY INFORNIATION IUnpackaged Food Prep J E1 100% Prepackaged [Warehouse DUinited (Mobile/Satellite Food) 0Whoiesaie Processing (FDB) FoPèith'annt Food'Faéilities . '-• .- - .- Total Square Feet of Facility: 4 5 O c-f Projected Date for Completion: /0 - -42-- Total # Staff: Max. Number of Food Employees per Shift:'1-10 011-25026-1000100+ Seating: Do Dl-202l-50 051-100 0101+ Anticipated Max # Meals to be Served: Breakfast V Lunch _A/ Dinner J Customer Utensils: oSingle Service [ii]Multi-service Is there outdoor diving, O outdoor bar, barbecue, wood oven etc. associated with the food facility? 'Yës No If yes, explain: Ot/ti)oa,Q )M(,1 ( OF /2 04&- Is this facility within a Food Court []Yes (No-If so is the facility enclosed Dyes DNo Explain Are sneeze guards required? es DNo-If yes plans must indicate details of the sneeze guard and location Grease Trap/Interceptor required: Dyes [No; If yes indicate location # Employees Restrooms ; Public Access? jQyes 0 No Will alcohol be served and consumed on site? Dyes Wo SEWER: Public-DSeptic/ Private WATER: flPublic-Dwell/ Private (If private contact Land Use at (858) 565-5173) Identify the municipal water and wastewater district(s)______________________________________________________________________ - p-i FHD-PC-177 (02/11) FOOD & HOUSING DIVISION-PLAN CHECK 0 RTII 4 j LJBMIT THE FOLLOWING DOtuMENTwI I I I YouR.APPL!çT9. Applications will not be processed until all required documents are received and all fees are paid. " 1) Plans must be submitted to a stated s,ale (i e ¼ per ft) and donea professional manner. The mrnnqin size is 11 x 17 A total of three (3) sets are required An Environmental Health No seon it bin p1ans 2) Proposed menu (Including seasonal, Qff-site and catering meu). ' . Finish schedule of interior finishes Plumbing layout showing type anl locàion oequipment\vith drains floor si1ks nd p1urpbing'chedule Equipment schedule showing type, manufacturer, and model numbers.. .. Floor plan layout. All equipment shailbe clearly labeled on the plan with its common name. Manufacturer specification sheets "cut sheets" for equipment shown on the plan. Complete exhaust ventilation plans (HVAC), including restroOm ventilation and kitchen exhaust system plans. All existing equipment and. finishes must be defined. Site plan showing the location of restrooms, mop. basin,alleys, streets, vacant lots, adjacent businesses, and outside. equipment (dumpsters, well, septic system, etc.). Written legal agreement for shared restrooms or common restrooms not located within the establishment. If there are open or continuous doors, then the food prep areas must be shown as completely enclosed. For unenclosed (non-occupied) Mobile Food Facilities (MFF), operational procedures for food handling and the cleaning and sanitizing of food-contact surfaces, food equipment and utensils. MFF commissary agreement letter, if available at that time, shall accompany the plans (otherwise to be submitted upon application for the operational health permit.) jJ Kitchen (Hood Ventilation) TYPE I]Z OPERATION (check 1lthat LI Kitchen (No hood) 1 Lii Buffet or salad bar LiVentless cooking-2 exempt max 1 L] Institution - Li] Tableside / display cooking []Cafeteria . []Take out only [II] Hospital/Licensed care facility LI Fast food i Li Catering 1 L] Lodging facility LI Bar Li Mobile vendor I Li Galley Li Deli [1 School II] CommissaiyfVending HQ Grôér Related . . ... . . [:1 Market [[IProduce proc [1 Shellfish storage []Raw Meat 1 []Smoked fish []Wholesale food distribution warehouse [].Seafood / fish j [IBakery 1 [j] Commissary LiDeli . Li Sushi prep Li Ice production / packaging Li Produce [LI_Self-service bulk items Li Self-service baked goods OTHER AGENCIES: ci BLDG DEPARTMENT CI FIRE DEPARTMENT ci ZONING CI WATER/WASTEWATER DISTRICTS Cl APCD ci DEH-LWQ (NOTE: If you are the business owner and an honorably discharged veteran you may be eligible for a fee exemption.) I declare under penalty of perjury that to the best of my knowledge and belief, the description of use and information contained on this application and plans are correct and true: j hereby consent to all necessary inspections made pursuant to law and incidental to the issuance of this review and the operation of this business. I also agree to conform to all conditions, orders, and directions, issued pursuant to the California Health and Safety Code, and all applicable County and City Ordinances. I understand that.if the plans are incomplete due to a lack of any of the required information, the plans. will be rejected and upon resubmission, a plan recheck fee will be charged. I am aware that plan check fees are not fully refundable and that plans, once reviewed, will be picked up within 60 days or they will be discarded. Plans are valid for one year after stamp. Any changes to the released documents will be submitted and filed with the County of San iego, Department of Environment Health. Authored Signature . . Date______________ Print Name and Title Here (1-6i27 For office use only) PLAN CHECK #/TYPE: • . . PERMIT.NUMBERJTYPE: . . . CENSUS TRACT: ASSIGNED TO: . . ____. __. ___. _.. ___..• ROUTE CODE: PLAN ST ATUSL]APPROVEDThAPPROVED[] BLUE TAG PC INIT1ALØkEVIEW DATE_____________ RECHECK TPCINf}iAtS RECHECKDATE _£i/,//z_ "_7-_c_)'_______________DATE APPROVED________ V 46' FOOD & HOUSING DIVISION-PLAN CHECK . . P-Z FHD-PC-177 (02/11) INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY Date o9(/f BusihessName t11Y70.j r'2z Street Add res5 Email Addres PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT (ON REVERSE SIDE CHECK TYPE OF BUSINESS) Check all below, that are present at your facility Acid Cleaning Ink Manufacturing Nutritional Supplement! Assembly Laboratory Vitamin Manufacturing Automotive Repair M achining / Milling Painting I Finishing Battery Manufacturing Manufacturing Paint Manufacturing Biofuel Manufacturing Membrane Manufacturing Personal Care Products Biotech Laboratory (i e water filter membranes) Manufacturing Bulk Chemical Storage Metal Casting I Forming Pesticide Manufacturing / Car Wash Metal Fabrication Packaging Chemical Manufacturing Metal Finishing Pharmaceutical Manufacturing Chemical Purification Electroplating (including precursors) Dry Cleaning Electroless plating Porcelain Enameling Electrical Component Anodizing Power Generation Manufacturing Coating (i.e. phosphating) Print Shop Fertilizer Manufacturing Chemical Etching./. Milling Research and Development Film / X-ray Processing Printed Circuit Board Rubber Manufacturing Food Processing Manufacturing Semiconductor Manufacturing Glass Manufacturing Metal Powders Forming Soap! Detergent Manufacturing Industrial Laundry Waste Treatment / Storage SlCCádé() (if knbwn): Brief description of business activities (Production /Man ufactuirinc Operations) bcripon of bYonsgpneraing wasfewater (distharged to sew r, haUied or, yapprte1) Estimated volume of industrial wastewater to be discharged (ga(/ day) ListJazardous ?stes generated (type! volume); Date operation begn/orwiil begin-at- this: IQçatiqn:.___________________________________ Have you applied for a Wastewater, ch Disarge Permit from. the Encina Wastewater Authority7 Yes No If yes, when Site Contact /'iOQtetd 4/q /5i 4V'i Title :Sn.tue phoneNo. ((3) __9T9I( ENCINA WASTEWA R AUTHORITY 6200 Avenida Encinas Carlsbad CA 92011 (760) 430,-3941 EA) (ThO) 476-9852 - CR121510 1854 MARRONRD 102 DOMINOS PIZZA: 1540 SF RETAIL . . .. TC ITAI IDA MT L3 Cv - f(, 6 //3/i- 9u4A 74i(z. /q/j L 77—/ /1-pprV , I i151J' -- - t Final Insp. Approved . Date By BUILDING ?f,c/i z-- ________ PLANNING ENGINEERING z. FIRE Expedite? Y() • . AFS Checked by: HazMat AP.CD. Health Forms/Fees Sent Reed Due? By Encina Fire HazHealthAPCD . — V N PE&M V N School - - V N Sewer . - - Y N Stormwater —Y N Special Inspection V N LandUse: Density :YN ImpArea: FY: Annex: Factor: PFF V N Comk6nts • Date Date Date Date Building Planning Engineering Fire Need? . . $eone f,d( one - / • Done .13 Done -. ODone SW .: • :-. - -. ..- • .• ,:.. U Issued - ._.-- .---,--•-.-•----- -;-.......••----. -- ---k ....-r------ ----------- 4 -•, I. 'S - . S ' - -. - . • - &