HomeMy WebLinkAbout1915 CALLE BARCELONA; 135; CB150995; Permit05-27-2015
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No:
Building Inspection Request Line (760) 602-2725
CBI50995
Job Address;
Permit Type;
Parcel No:
Valuation;
Occupancy Group;
Project Title:
1915 CALLE BARCELONA CBADSt; 135
Tl Sub Type; COMM
2550120400 Lot#; 0
$134,812.00 Construction Type; 5B
Reference #
PAPER SOURCE: 3,112 SF RETAIL
TO SAME
Status; ISSUED
Applied; 04/02/2015
Entered By; JMA
Plan Approved; 05/27/2015
Issued; 05/27/2015
Inspect Area
Plan Check #;
Applicant:
W. THOMAS DOBBINS
STE 600
11 E ILLINOIS ST
CHICAGO IL 60611-5652
312-321-0400
Owner:
T-C FORUM AT CARLSBAD LLC
C/O TI/V\-CREF
4675 MACARTHUR CT #1100
NEWPORT BEACH CA 92660
Building Permit $749.61 Meter Size
Add1 Building Permit Fee $0.00 Add'l Red. Water Con. Fee $0.00
Plan Check $524.73 Meter Fee $0.00
Add'l Building Permit Fee $0.00 SDCWA Fee $0.00
Plan Check Discount $0.00 CFD Payoff Fee $0.00
Strong Motion Fee $37.75 PFF (3105540) $0.00
Park Fee $0.00 PFF (4305540) $0.00
LFM Fee $0.00 License Tax (3104193) $0.00
Bridge Fee $0.00 License Tax (4304193) $0.00
BTD #2 Fee $0.00 Traffic Impact Fee (3105541) $0.00
BTD #3 Fee $0.00 Traffic Impact Fee (4305541) $0.00
Renewal Fee $0.00 PLUMBING TOTAL $105.00
Add1 Renewal Fee $0.00 ELECTRICAL TOTAL $153.00
Other Building Fee $0.00 MECHANICAL TOTAL $44.59
Pot. Water Con. Fee $0.00 Master Drainage Fee $0.00
Meter Size Sewer Fee $0.00
Add1 Pot. Water Con. Fee $0.00 Redev Parking Fee $0.00
Red. Water Con, Fee $0.00 Additional Fees $0.00
Green Bldg Stands (SB1473) Fee $6.00 HMP Fee ??
Fire Expedidted Plan Review $295.00 Green Bldg Standards Plan Chk ??
TOTAL PERMIT FEES $1,915.68
Total Fees: $1,915.68 Total Payments To Date: $1,915.68 Balance Due: $0.00
Inspector:
FINAL ARPR
2M VAL
Date: Ciearance:
NOTICE: Please take/jOTl^ that approval of your project includes the "ljir!position''of fees, dedications, reservations, or other exactions hereafter collectively
refen-ed to as "fees/exirctions.'' You have 90 days from the date this pennit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Govemment Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have previously been oiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
THE FOLLOWING APPROVALS REQUIRED PRIOR 70 PERMIT ISSUANCE: nPLANNING •ENGINEERING •BUILDING QFIRE OHEALTH •HAZMAT/APCD
Ccityof
Carlsbad
Building Perniit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph; 760-602-2719 Fax; 760-602-8558
email; building(gcarlsbadca.gov
www.carlsbadca.gov
Plan Check No.
Est. Vaiue ^ /-^y^
Pian Ck. Deposit
Date SWPPP
CT/PR0JECT# L0T# PHASE # # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE occ. GROUP
Paper Source
JOB ADDRESS J^Calle Barcelona, Carlsbad, CA 92009 SUITE#/SPACE#/UNIT#
135
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
Interior remodeling of approximately 3,112 SF in a single-story, multi-tenant existing building.
EXISTING USE
Mercantile
PROPOSED USE
Mercantile
GARAGE (SF)
N/A
PATIOS (SF)
N/A
DECKS (SF)
N/A
FIREPLACE
YEsrV. NoTTI
AIRCONDITIONING
YES [71 NO I I
FIRE SPRINKLERS
YESfTlNOl I
APPLICANT NAME
Primary Contact W. Thomas Dobbins PROPERTY OWNER NAME Raj Chandani
ADDRESS
11 East Illinois, Suite 600
ADDRESS
1905 Calle Barcelona, Suite 200
CITY Chicaqo STATE
IL
ZIP
60611
CITY Carlsbad
STATE
CA ZIP 92009
PHONE
312.321.0400
FAX
312.321.0402
PHONE
760.479.0166
FAX
760.479.0170
EMAIL
tdobbins@dobbinsgroup.eom
EMAIL Raj.Chandani@am.jll.eom
DESIGN PROFESSIONAL Jimmy Powers CONTRACTOR BUS. NAME
ADDRESS
12035 Colwick Road
ADDRESS i//e^ f(Xld
STATE ZIP CITY
San Antonio
STATE
TX
ZIP
78216
CITY
PHONE FAX PHONE FAX
(pCq>- y3/' ^y^yl ^C^' 'iSl - 7</7 V EMAIL EMAIL
n " CLASS I niTV RI \^ i ii^« STATE LIC. #
C-32947 6 CITY BUS. LIC.#
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permitto construct alter, improve, demolish or repair any structure, priorto its issuan/t^also requires the applicantfor such permitto file a signed statement that he is licensed pursuant to the provisions ofthe Contractor's Ucense Law (Chapters, commending with Section 7300 of Division 3 ofthe Business and Professions Code) ortnat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)).
WORKERS' COMPENSATION
WorffS's' Compensation Declaration: / haeby affirm under penatty of perjury one ofthe following declarations:
LJ i have and will maintain a certificate of consent to self-insure for wortsers' compensation as provided by Section 3700 of the Labor Code, fbr the perfomiance of the wort( for which this pemiit Is issued,
LS I have and will maintain workers' compensation, as required bv Seclion 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy
numberare insurance Co feJOy^g^ %tf\S\XCk^r\L^ ComiAp PntoNo 3 W 2X\'^ Expiralion Dale /05< ^fig ^:2JC>I ^
This.seclion need not be completed if the permit is for one hundred dollars ($100) or less,
rSlQ Certificate of Exemption: i certify that in the perfomiance 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 lo secure wo[k«i3' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,0(X)), in
addition to the cost of compensation, damages asprovlded for in Sectioiv3706 of the Labor code, interest and attorney's fees.
CONTRACTOR SIGNATURE •AGENT DATE
OW NER-BUILDER rj EC LARATiON
/ heretiy alfirm that I am exempt from Contraita^'cense Law for the following reason:
I I I, as owner of the property or my emptoyees with wages as Iheir sole compensation, will do the work and the stmcture is not intended or offered for sate (Sec. 7044, Business and Professtons c;ode: The C^ontractor's
License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for
sale. If however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
I ^1 I, as owner of the property, am exclusively contracting with licensed contractors to constmct the project (Sec. 7044, Business and Professions Ckide: The Contractor's Ucense 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 Contrxtor's Ucense Law).
I I I am exempt under Section _ _Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement, •Yes Oo
2,1 (have / have not) signed an application for a building permit for the proposed work.
3,1 have contracted with the following person (firm) to provide the proposed construction (inciude name address / phone / contractors' license number):
4.1 plan to provide portions of the work but I have hired the following person to coordinate, supen/ise and provide the major work (include name / address / phone / contractors' license number);
5,1 will provide some ofthe work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work):
^PROPERTY OWNER SIGNATURE QAGENT DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUiLDiNG PERMITS ONLY
is the applicant or future building occupant required to submit a business plan, acutely hazardous materiais registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Act? Yes / No
Is the applicani or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes / No
Is the faciiity 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.
CONSTRUCTION LENDING AGENCY
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
APPLICANT CERTIFICATION
I certify that I have read the application and state that the above Infbmiation is conect and that the Infonnation on the plans Is accurate. I agree to comply with all City ordinances and State laws relating to building constmction.
1 hereby authorize representative of Ihe City of Carisbad to enter upon the above mentioned property for inspeclion purposes. 1 ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CfTY OF CARLSBAD
AGAINST ALL LIABILfTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA pennit is required for excavations over 5'0' deep and demolition or constnjctkin of stmctures over 3 stories in heighL
EXPIRATION: Every pemiit issued by the Building Official under the pnovisions of this Code shall expire by limitation and become null and void if the buikiing or wori( authorized by such pemiit is not commenced within
180 days from Ihe date of such pennit or if the building or wori< authorized by such pennit Is susperided or abandoned at any time after the work is commenced fbr a period of 180 days (Sedton 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
04.01.2015
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-8560, Email buildinq(S)carlsbadca.qov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califomia 92008.
C0#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE ZIP
Carlsbad CA
PHONE FAX
EIVIAIL OCCUPANT'S BUS. LIC. No.
DELIVERY OPTIONS
PICK UP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL TO: CONTACT (Usted above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL/FAX TO OTHER:
ASSOCIATED CB#
NO CHANGE IN USE / NO CONSTRUCTION
CHANGE OF USE / NO CONSTRUCTION
ASSOCIATED CB#
NO CHANGE IN USE / NO CONSTRUCTION
CHANGE OF USE / NO CONSTRUCTION
^eS'APPLICANT'S SIGNATURE DATE
Inspection List
Permit#: CB150995 Type: Tl
Date
07/22/2015
07/22/2015
07/10/2015
07/10/2015
06/12/2015
06/05/2015
05/29/2015
05/29/2015
Inspection Item
89 Final Combo
89 Final Combo
23 Gas/Test/Repairs
29 Final Plumbing
24 Rough/T opout
17 Interior Lath/Drywall
81 Underground Combo
84 Rough Combo
COMM
Inspector
PY
PB
PB
PB
PB
PB
PB
Act
Rl
AP
AP
AP
AP
AP
AP
AP
PAPER SOURCE: 3,112 SF RETAIL
TO SAME
Comments
FIRE AM// EMAIL CARD PM
Monday, July 27, 2015 Page 1 of 1
RECORD COPY CB150995 1915 CALLE BARCELONA
135
PAPER SOUR'CE 3.112 SF RETAIL
TO SAME
Tl COMM
Lctft W THCVAS DCRBINS
•1/
CARLSBAD INSPECTION RECORD
Eiiiid'ng Division
t: INSPECTION RECORD CARD WITH APPROVED
" PLANS MOST BE KEPT ON THE JOB
10 CALL BEFORE 3:30 om FOR NEXT WORK DAY INSPECTION
3 FOR BUILDING INSPECTION CALL: 760-602-2725
OR GO TO: www.Carlibadea.qov/BiiiTcfirtq AND CLICK ON '' ^ •
"Request Insppctfpn"
DATE: f/Zifn
IF "YES" IS CHECKED BELOW THAT DIVISION'S APPROVAL IS REQUIRED PRIOR TO REQUESTING A FINAL BUILDING INSPECTION.
IF YOU HAVE ANY QUESTIONS PLEASE CALL THE APPLICABLE DIVISIONS AT THE PHONE NUMBERS PROVIDED BELOW. AFTER
ALL REQUIRED APPROVALS ARE SIGNED OFF- FAX TO 760-602-8560, E:MAIL TO BLDGINSPECTIONS@CARLSBADCA.GOV OR
RING IN A COPY OF THIS CARD TO: 1635 FARADAY AVE., CARLSBAD, CA 92008. BUILDING INSPECTORS CAN BE REACHED
AT 760-602-2700 BETWEEN 7:30 AM - 8.00 AM THE DAY OF YOUR INSPECTION.
NO YES Required Prior to Requesting Building Final If Checked YES Date Inspector Notes
i
Planning/LarKlscape 760-944-8463 Allow 48 hours
i
/ CM&l {Englneeri/ig Impeetions) 760-438-3891 Call tiefore 2 pm
-il Fire Pre-verrtion 760-602-4660 Allow 48 hours
1 ^ j—
Type of Inspection
SEE BACK FOR SPECIAL NOTES
EsGil Corporation
lit (PartnersHip witH government for (BuiCcfing Safety
DATE: 5/1/15 • APPLICANT
• JURIS.
JURISDICTION: CityofCarlsbad • PLAN REVIEWER
• FILE
PLANCHECKNO.: 15-0995 SET: II
PROJECT ADDRESS: 1915 Calle Barcelona Suite 135
PROJECT NAME: Paper Source - TI
XI The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
I I The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
I I The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
I I The applicant's copy of the check list is enclosed for the jurisdiction to fonward to the applicant
contact person.
I I The applicant's copy of the check list has been sent to:
EsGil Corporation staff did not advise the applicant that the plan check has been completed.
I I EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone #:
Date contacted: (by: ) Email:
Mail Teleptione Fax In Person
• REMARKS:
By: Doug Moody Enclosures:
EsGil Corporation
• GA • EJ • MB • PC 4/27/15
9320 Cliesapealie Drive, Suite 208 • San Diego, Califomia 92123 • (858) 560-1468 • Fax (858) 560-1576
I'age 1 01 z
CORRECTION LIST BLDG. DEPJ' ( ()^ I
Daryl K. James & Associates, Inc. Checked by: ROBERT SCOTT
Date: April 20, 2015
APPLICANT: W. Thomas Dobbins JURISDICTION: Carlsbad Fire Department
PROJECT NAME: Paper Source PROJECT ADDRESS: 1915 Calle Barcelona # 135
PROJECT DESCRIPTION: CB15-0995, Tenant Improvement of existing 3,112 m space, in existing
sprinklered building. Work includes demolition work, ceiling, gas, electric, plumbing and finish work.
This plan review has been conducted in order to verify conformance to minimum requirements of codes
adopted by the Carlsbad Fire Department. The items below require correction, clarification or additional
information before this plan check can be approved for permit issuance.
INSTRUCTIONS FOR EXPEDITED PLAN REVIEW SERVICE
- CORRECTIONS OR MODIFICATIONS TO THE PLANS MUST BE CLOUDED AND
PROVIDED WITH NUMBERED DELTAS AND REVISION DATES ALONG WITH A
DESCRIPTIVE NARRATIVE OF CORRECTIONS ADDRESSING ALL COMMENTS. PLEASE BE
SURE TO PUT FIRE REVISIONS ON THE BUILDING DEPT. PLAN CHECK SET.
• PLEASE DIRECT ANY QUESTIONS REGARDING THIS REVIEW TO: ROBERT SCOTT 760-
402-3976 OR FYRWISE07@GMAIL.COM
• CORRECTED PLANS, DESCRIPTIVE NARRATIVE OF REVISIONS FOLLOWING EACH
COMMENT ON THIS FORM, AND A COPY OF BUILDING DEPARTMENT (ESGIL)
- ONE COMPLETE PLAN CHECK SET (initial or revised) MUST BE DELIVERED DIRECTLY TO
THE FOLLOWING ADDRESS TO AVOID DELAY:
ROBERT SCOTT
4906 CHAUCER AVE
SAN DIEGO, CA. 92120
COMMENTS - Additional comments made shall be generated by response on revised set and Clouded
A0.1
ADD 'Deferred Submittals' section to read as follows: Provide the following list of Deferred
Submittals
-Fire Sprinkler System - 2013 CFC 903 and 2013 NFPA 13
-Fire Alarm System - 2013 CFC 907.2 and 2013 NFPA 72
- Title Sheet
Provide a descriptive scope of demolition, construction and alteration for this project.
Fage z 012
AO.l
Add, Delete or Revise the following notes in 'General Project Info':
- Revise note #5 to read: - The type, rating and number of fire extinguishers shall comply with 2013
CFC, section 906.3. A minimum of two (or more) properly spaced fire extinguishers rated at 2A-
10BC are required for dining area, kitchen and other areas. Maximum Travel distance to fire
extinguishers shall not exceed 75 feet. All fire extinguishers shall be mounted in accessible and
visible location, not to exceed 5 feet above finished floor to top of extinguisher.
- Delete note , it is not applicable.* 6
- Add note; A C-16 licensed fire protection contractor shall perform all fire sprinkler system work. A
C-10 licensed fire alarm contractor shall perfonn all fire alarm system work. No fire protection
system work shall be performed without fire dept. approved plans.
- Add note: All doors shall be openable from the egress side without the use of a key or special
knowledge or effort
- Add note: All demolition work shall comply with 2013 CFC Chapter 33.
A1.1
Exit Doors shall swing in the direction of travel where serving an occupant load of 50 or more persons.
CBC 1008.1
A1.2
All finish materials, including wall coverings shall be in compliance with 2013 CBC Chapter 8.
A2.1
Add note to acoustical panel ceilings section that reads: -Suspended Ceiling Plan notes that read:
Suspended acoustical ceilings shall comply with -section 808.1 2013 CBC and meet flame spread and
smoke developed ratings
A4.2
Address numbers shall be mounted on building in visible location. Numbers shall be minimum 12
inches in height, with 1-1/2 inch stroke and contrast in color to background.
** Show location of proposed numeric address on building. CBD 17.04.320.
M-1.1
Add notes to 'Key Notes' section of Roof Plan as follows:
- Imprint the Carlsbad Policy 80-6 on to roof plan.
- Intent B (Fireman Safety) will be provided on roofs of buildings.
P-1.1
- Add Note that reads: All gas piping located in interior space shall be labeled every 20 feet and every
change of direction with labels that read 'Natural Gas. The gas meter shall be identified with a
permanent tag indicating address that gas meter serves suite 135.
ill
-Add Note: Exit signs shall be illuminated at all times and equipped with minimum 90-minute battery
backup. CBC 1011.5.3
-Add Note: Means of egress illumination level shall be not less than 1-foot candle at the walking surface
and equipped with minimum 90 minute battery backup where required. CBC1006.
EsGil Corporation
In (PartnersHip witfi government for (BuiCding Safety
DATE: 4/13/15 • APPLICANT
•^JURIS.
JURISDICTION: CityofCarlsbad ^PLANREVIEWER
• FILE
PLANCHECKNO.: 15-0995 SET: I
PROJECT ADDRESS: 1915 Calle Barcelona Suite 135
PROJECT NAME: Paper Source - TI
I I The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
I I The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
^ The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
I I The applicant's copy of the check list is enclosed for the jurisdiction to fonA/ard to the applicant
contact person.
I I The applicant's copy of the check list has been sent to:
I I EsGil Corporation staff did not advise the applicant that the plan check has been completed.
IXI EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contactedL W. Thomas Dobbins Telephone #:
y Date contacted:^/iS (by: /\^-Emall: tdobbilns(gdobblnsgroup.com
]^ Mail Telephone Fax In Person
• REMARKS:
By: Doug Moody Enclosures:
EsGil Corporation
• GA • EJ • MB • PC 4/6/15
9320 Chesapeake Drive. Suite 208 • San Diego, Califomia 92123 • (858) 560-1468 • Fax (858) 560-1576
CityofCarlsbad 15-0995
4/13/15
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLANCHECKNO.: 15-0995 JURISDICTION: City of Carlsbad
OCCUPANCY: M USE: Retail
TYPE OF CONSTRUCTION: VB ACTUAL AREA: 3112sf
ALLOWABLE FLOOR AREA: STORIES: 1
HEIGHT:
SPRINKLERS?: Yes OCCUPANT LOAD: 84
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 4/2/15
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 4/6/15
DATE INITIAL PLAN REVIEW
COMPLETED: 4/13/15
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 2013 CBC, which adopts the 2012 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 2012 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 vou submit the revised plans.
City of Carlsbad 15-0995
4/13/15
Please make all corrections on the original tracings, as requested In the correction
list. Submit three sets of plans for commercial/industrial projects (two sets of plans
for residential projects). For expeditious processing, corrected sets can be
submitted in one of two ways:
1. Deliver all corrected sets of plans and calculations/reports directly to the City of
Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760)
602-2700. The City will route the plans to EsGil Corporation and the Carlsbad
Planning, Engineering and Fire Departments.
2. Bring one corrected set of plans and calculations/reports to EsGil Corporation,
9320 Chesapeake Drive, Suite 208, San Dlego, CA 92123, (858) 560-1468.
Deliver all remaining sets of plans and calculations/reports directly to the City of
Carlsbad Building Department for routing to their Planning, Engineering and Fire
Departments.
NOTE: Plans that are submitted directly to EsGil Corporation only will not be
reviewed by the City Planning, Engineering and Fire Departments until review by
EsGil Corporation Is complete.
1. Please provide plans and calculations signed by the California State licensed
engineer or architect for the structural support and lateral bracing of the shelving
(both stock and sales). Include all calculations and finding on the plans. Please
Include the California license number, seal, date of license expiration and date
plans are signed. Business and Professions Code.
2. Please revise the plans to show the required emergency egress lighting per
section 1006.3 ofthe CBC.
•fse~ih'»pTl?TT¥ie>req4^^ oTTth^plans.
The disaggregation of electrical loads (separation of panelboards by branch
circuit load types) per Table 130.5-B energy standards is required. Review and
submit a revised electrical system design.
5. Providec?3TTiplete>kHTT6ing pl^nsT-rrTcludir
a) Complete drain, waste and vent plans.
b) Show water heater size, type and location on plans. UPC, Section 501.0
6. 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.
7. Please revise the plumbing plans to show the required clean-outs per section
707 and 719 ofthe UPC.
8. The drinking fountain shall be a minimum of 18 inches in depth and there shall
be clear and unobstructed knee space under the drinking fountain not less than
CityofCarlsbad 15-0995
4/13/15
27 inches in height and 8 inches In depth, the depth measurements being taken
from the front edge of the fountain. Additionally, there shall be toe clearance of 9
Inches In height above the floor and 17 Inches In height above the floor and 17
inches in depth from the front edge of the fountain. A side approach drinking
fountain is not acceptable. Section 11 B-602.
To speed up the review process, note on this list (or a copy) where each
correction Item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If there are other changes, please briefly
describe them and where they are located In the plans.
Have changes been made to the plans not resulting from this correction list?
Please indicate:
Yes • No •
The jurisdiction has contracted with Esgil Corporation located at 9320
Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of
858/560-1468, to perform the plan review for your project. Ifyou have any
questions regarding these plan review items, please contact Doug Moody at
Esgil Corporation. Thank you.
.CityofCarlsbad 15-0995
4/13/15
[DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: CityofCarlsbad PLANCHECKNO.: 15-0995
PREPARED BY: Doug Moody DATE: 4/13/15
BUILDING ADDRESS: 1915 Calle Barcelona Suite 135
BUILDING OCCUPANCY: M
BUILDING
PORTION
AREA
(Sq.Ft.)
Valuation
Multiplier
Reg.
Mod.
VALUE ($)
Tl 3112 43.32 134,812
Air Conditioning
Flre Sprinklers
TOTAL VALUE 134,812
Jurisdiction Code cb By Ordinance
Bldg.Permit Fee by Ordinanoe ^
$750.31
Plan Check Fee by Ordinance
Type of Review: 0 Complete Review
I ^Repetitive Fee
^ Repeats
• Other
|—I Hourly
EsGil Fee
• Structural Only
Hr.
$487.70
$420.17
Comments:
Sheet 1 of 1
macvalue.doc +
PLAN CHECK Community & Economic
CITY OF REVIEW Development Department
1635 Faraday Avenue
r ARI SRAn TRANSMITTAL Carlsbad CA 92008
www.carlsbadca.gov
DATE: 04/06/2015 PROJECT NAME: PAPER SOURCE Tl PROJECT ID: CB150995
PLANCHECKNO:! SET#: 1 ADDRESS: 1915 CALLE BARCELONA STE 135 APN:
VALUATION: $ 134.812
/ This plan check review is complete and has been APPROVED by the ENGINEERING
Division.
By: VALRAY NELSON
A Final Inspection by the ENGINEERING Division is required Yes /No
This plan check review is NOT COMPLETE. Items missing or incorrect are listed on
the attached checklist. Please resubmit amended plans as required.
Plan Check Comments have been sent to: TDOBBINS^DOBBINSGROUP.COM
You may also have corrections from one or more of the divisions listed below. Approval
from these divisions may be required prior to tlie 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:
PLANNING
760-602-4610
ENGINEERING
760-602-2750
FIRE PREVENTION
760-602-4665
Chris Sexton
760-602-4624
Cliris.Sexton@carlsbadca.^ov
Kathleen Lawrence
760-602-2741
Kathleen.Lawrence@carlsbadca.gov
Greg Ryan
760-602-4663
Gregorv.Rvan@carlsbadca.gov
Gina Ruiz
760-602-4675
Gina.Ruiz@carlsbadca.gov
Linda Ontiveros
760-602-2773
Linda.Ontiveros@carlsbadca.gov
Cindy Wong
760-602-4662
Cvnthia.Wong@carlsbadca.gov
/ ValRay Marshall
760-602-2773
ValRay.Marshall@carlsbaclca.gov
Dominic Fieri
760-602-4664
Dominic.Fieri@carlsbadca.gov
Remarks:
BUILDING PLANCHECK Development Services
^ CITY OF CHECKLIST Land Development Engineering
1635 Faraday Avenue
CARLSBAD QUICK-CHECK/APPROVAL 760-602-2750
www.carlsbadca.gov
ENGINEERING Plan Checic for CB150995
Project Acidress: 1915 CALLE BARCELONA STE 135
Project Description: ji RETAIL TO RETAIL
Date: 04/06/2015
APN:
Valuation: $ 134,812
ENGINEERING Contact: VALRAY NELSON
Phone: 760-602-2741
Email: VALRAY.IVIARSHALL@CARLSBADCA.GOV
Fax: 760-602-1052
RESIDENTIAL INTERIOR
RESIDENTIAL ADDITION MINOR
(<$20,000.00)
CARLSBAD PREMIER OUTLETS
OTHER: GYM
/ TENANT IMPROVEMENT
PLAZA CAMINO REAL
COMPLETE OFFICE BUILDING
OFFICIAL USE ONLY
ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT
BY: VALRAY NELSON
REMARKS: RETAIL TO RETAIL Tl
DATE: 04/06/2015
Notification of Engineering APPROVAL has been sent to TD0BBINS@D0BBINSGR0UP.COM |
viaVALRAY.MARSHALL@CARLSBADCA.GOV on 04/06/2015 j
1 of 1 REV 4/30/11 E-36
Fee Calculation Worksheet
ENGINEERING DIVISION
Prepared by: Date: 04/06/2015 GEO DATA: LFMZ: / B&T:
Address: 1915 CALLE BARCELONA STE 135 Bldg. Permit #: CB150995
Fees Update by: Date: 04/06/2015 Fees Update by: Date: 04/06/20^5
EDU CALCULATIONS: List types and square footages for all uses.
Types of Use: Sq.Ft./Units EDU's
Types of Use: Sq.Ft./Units EDU's
Types of Use: Sq, Ft./Units EDU's
Types of Use: Sq.Ft./Units EDU's
ADT CALCULATIONS: List types and square footages for all uses.
Types of Use: Sq.Ft./Units ADT's
Types of Use: Sq.Ft./Units ADT's
Types of Use: Sq.Ft./Units ADTs
Types of Use: Sq.Ft./Units ADT's
FEES REQUIRED:
Within CFD: YES (no bridge & thoroughfare fee in District #1, reduces Traffic Impact Fee) NO
1. PARK-IN-LIEU FEE: NWQUADRANT /NE QUADRANT SE QUADARANT SW QUADRANT
ADTS/UNITS: X FEE/ADT: =$ •
2,TRAFFIC IMPACT FEE:
•
ADTS/UNITS: X FEE/ADT: =$ •
3. BRIDGE & THOROUGHFARE FEE: DIST. #1 DIST.#2 DIST.#3
ADTS/UNITS: < FEE/ADT: =$ •
4. FACILITIES MANAGEMENT FEE ZONE:
•
ADTS/UNITS: X FEE/SQ.FT/UNIT: =$ •
5. SEWER FEE
•
EDU's X FEE/EDU: =$ •
BENEFIT AREA:
•
EDU's X FEE/EDU: =$ •
6. DRAINAGE FEES: PLDA: HIGH MED UM LOW
ACRES: X FEE/AC: =$ •
7. POTABLE WATER FEES:
UNITS CODE CONN. FEE METER FEE SDCWA FEE TOTAL
^ CITY OF
CARLSBAD
PLANNING DIVISION
BUILDING PLAN CHECK
APPROVAL
P-29
Development Services
Planning Division
1635 Faraday Avenue
(760) 602-4610
www.carlsbadca.eov
DATE: 4/3/15 PROJECT NAIVIE: INTERIOR Tl PROJECT ID:
PLAN CHECK NO: CB150995 SET#: ADDRESS: 1915 CALLE BARCELONA #135 APN:
This plan check review is complete and has been APPROVED by the PLANNING
Division.
By: GINA RUIZ
A Final Inspection by the PLANNING Division is required • Yes ^ No
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.
This plan check review is NOT COMPLETE. Items missing or incorrect are listed on
the attached checklist. Please resubmit amended plans as required.
Plan Check APPROVAL has been sent to: TDOBBINS@DOBBINSGROUP.COIVI
For questions or clarifications on the attached checklist please contact the following reviewer as marked:
PLANNING
760-602-4610
ENGINEERING
760-602-2750
FIRE PREVENTION
760-602-4665
Chris Sexton
760-602-4624
Chrls.Sexton@carlsbadca.gov
[ 1 Chris Glassen
760-602-2784
Christopher.Glassen@carlsbadca.gov
[J^ Greg Ryan
760-602-4663
Gregorv.Ryan@carlsbadca.gov
Gina Ruiz
760-602-4675
Gina.Ruiz@carlsbadca.gov
ValRay Marshall
760-602-2741
ValRav.Marshall@carlsbadca.gov
Q Cindy Wong
760-602-4662
Cvnthia.Wong@carlsbadca,gov
• Linda Ontiveros
760-602-2773
Linda.Ontiveros@carisbadca.gov
1 1 Dominic Fieri
760-602-4664
Dominic. Fieri@carl.sbadca^v
Remarks:
^ CITY OF
CARLSBAD
PLAN CHECK
REVIEW
TRANSMITTAL
Community & Economic
Development Department
1635 Faraday Avenue
Carlsbad CA 92008
www.carlsbadca.gov
DATE: 5/19/15 PROJECT NAME: paper source PROJECT ID:
PLAN CHECK NO: cbl50995 SET#: I ADDRESS: 1915 calle Barcelona #135 Al
n
This plan check review is complete and has been APPROVED by the flre Division.
By: cwong
A Final Inspection by the Division is required |EI Yes • No
This plan check review Is NOT COMPLETE. Items missing or Incorrect are listed on
the attached checklist. Please resubmit amended plans as required.
Plan Check Comments have been sent to
You may also have corrections from one or more of the divisions iisted beiow. Approvai
from these divisions may be required prior to the issuance of a buiiding permit.
Resubmitted plans shouid include corrections from all divisions.
For questions or clarifications on the attached checklist please contact the following reviewer as marked:
1 1 Chris Sexton
760-602-4624
Chrls.Sexton@carlsbadca.^ov
1 1 Kathleen Lawrence
760-602-2741
Kathleen.Lawrence@carlsbadca.^ov
Q Greg Ryan
760-602-4663
Gregory.Ryan®carlsbadca.^ov
1 1 Gina Ruiz
760-602-4675
Glna.Ruiz@carlsbadca.^ov
1 1 Linda Ontiveros
760-602-2773
Linda.Ontiveros@carlsbadca.£ov
^ Cindy Wong
760-602-4662
Cynthia.Wong@carlsbadca.gov
• • 1 1 Dominic Fieri
760-602-4664
Dominic.Fieri@carlsbadca.eov
Remarks:
5/19/15
**APPROVED:
Page 1 of 2
THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUEANCE
OF A BUILDING PERMIT.
THIS APPROVAL IS SUBJECT TO FIELD INSPECTIONS, ANY REQUIRED TESTS, FIRE
DEPARTMENT NOTATIONS, CONDITIONS IN CORRESPONDENCE AND COMPLIANCE WITH
ALL APPLICABLE CODES AND REGULATIONS.
THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE ANY VIOLATION OF THE
LAW.
Page 2 of2
Carlsbad Fire Department
Plan Review Requirements Category: TI, COMM
Date of Report: 05-19-2015 Reviewed by:
Name:
Address:
W. THOMAS DOBBINS
STE 600
11 E ILLINOIS ST
CHICAGO IL
60611-5652
Permit #: CBI50995
Job Name: PAPER SOURCE: 3,112 SF RETAIL
Job Address: 1915 CALLE BARCELONA CBAD St: 135
TM^r>A|py ,ff,TF^ The itenryou have submitted for review is incomplete. At this time, this office cannot
idequately conductareviewtoaet^^ Please review
carefully all comments attagbadHPIBSs^^esubmit the in 11 ii^ }lliin> jjj^m specifications, with changes "clouded",
to this office for revii^Wand approval.
Conditioiis:
Cond: CON0008281
[MET]
**APPROVED:
THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUEANCE OF A
BUILDING PERMIT.
THIS APPROVAL IS SUBJECT TO FIELD INSPECTIONS, ANY REQUIRED TESTS, FIRE DEPARTMENT
NOTATIONS,
CONDITIONS IN CORRESPONDENCE AND COMPLIANCE WITH ALL APPLICABLE CODES AND
REGULATIONS.
THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE ANY VIOLATION OF THE LAW.
Entry: 05/19/2015 By: ewong Action: AP
RECOMMENDED FOR APPROVAL BLDG. DEPT COPY
Daryl K. James & Associates, Inc. Checked by: ROBERT SCOTT
Date: Mav 4. 2015
APPLICANT: W. Thomas Dobbins JURISDICTION: Carlsbad Fire Department
PROJECT NAIVIE: Paper Source PROJECT ADDRESS: 1915 Calle Barcelona # 135
PROJECT DESCRIPTION: CB150995, Tenant Improvement of existing 3,112[ti space, in existing
sprinklered building. Work includes demolition work, ceiling, gas, electric, plumbing and finish work.
This plan review has been conducted in order to verify conformance to minimum requirements of codes
adopted by the Carlsbad Fire Department. The items below require correction, clarification or additional
information before this plan check can be approved for permit issuance.
The items below have all been corrected or clarified with additional information
provided, therefore, CB150995 is recommended for approval for permit issuance.
COMMENTS - Additional comments made shall be generated by response on revised set and Clouded
A0.1
ADD 'Deferred Submittals' section to read as follows: Provide the following list of Deferred Submittals
-Fire Sprinkler System - 2013 CFC 903 and 2013 NFPA 13
-Fire Alarm System - 2013 CFC 907.2 and 2013 NFPA 72
- Title Sheet
Provide a descriptive scope of demolition, construction and alteration for this project.
A0.1
Add, Delete or Revise the following notes in 'General Project Info':
- Revise note #5 to read: - The type, rating and number of fire extinguishers shall comply with 2013 CFC,
section 906.3. A minimum of two (or more) properly spaced fire extinguishers rated at 2A-10BC are
required for dining area, kitchen and other areas. Maximum Travel distance to fire extinguishers shall
not exceed 75 feet. All fire extinguishers shall be mounted in accessible and visible location, not to
exceed 5 feet above finished floor to top of extinguisher.
- Delete note , it is not applicable.* 6
- Add note; A C-16 licensed fire protection contractor shall perform all fire sprinkler system work. A C-10
licensed fire alarm contractor shall perform all fire alarm system work. No fire protection system work
shall be performed without fire dept. approved plans.
- Add note: All doors shall be openable from the egress side without the use of a key or special
knowledge or effort
- Add note: All demolition work shall comply with 2013 CFC Chapter 33.
A1.1
Exit Doors shall swing in the direction of travel where serving an occupant load of 50 or more persons.
CBC 1008.1
A1.2
All finish materials, including wall coverings shall be in compliance with 2013 CBC Chapter 8.
A2.1
Add note to acoustical panel ceilings section that reads: -Suspended Ceiling Plan notes that read:
Suspended acoustical ceilings shall comply with -section 808.1 2013 CBC and meet flame spread and
smoke developed ratings
A4.2
Address numbers shall be mounted on building in visible location. Numbers shall be minimum 12 inches in
height, with 1-1/2 inch stroke and contrast in color to background.
** Show location of proposed numeric address on building. CBD 17.04.320.
M-1.1
Add notes to 'Key Notes' section of Roof Plan as follows:
- Imprint the Carlsbad Policy 80-6 on to roof plan.
- Intent B (Fireman Safety) will be provided on roofs of buildings.
P-1.1
- Add Note that reads: All gas piping located in interior space shall be labeled every 20 feet and every
change of direction with labels that read 'Natural Gas. The gas meter shall be identified with a permanent
tag indicating address that gas meter serves suite 135.
E1.1
-Add Note: Exit signs shall be illuminated at all times and equipped with minimum 90-minute battery
backup. CBC 1011.5.3
-Add Note: Means of egress illumination level shall be not less than 1-foot candle at the walking surface
and equipped with minimum 90 minute battery backup where required. CBC1006.
Recommend Approval
R. Scott
fage 1 or
CORRECTION LIST BLDG. DEPT COPY
Daryl K. James & Associates, Inc. Checked by: ROBERT SCOTT
Date: April 14. 2015
APPLICANT: W. Thomas Dobbins JURISDICTION: Carlsbad Flre Department
PROJECT NAME: Paper Source PROJECT ADDRESS: 1915 Calle Barcelona # 135
PROJECT DESCRIPTION: CB15-0995, Tenant Improvement of existing 3,112 u space, in existing
sprinklered building. Work includes demolition work, ceiling, gas, electric, plumbing and finish work.
This plan review has been conducted in order to verify conformance to minimum requirements of codes
adopted by the Carlsbad Fire Department. The items below require correction, clarification or additional
Information before this plan check can be approved for permit issuance.
INSTRUCTIONS PORlXPEDrTEP PLAN RgVIEWSERVICE
• CORRECTIONS OR MODIFICATIONS TO THE PLANS MUST BE CLOUDED AND
PROVIDED WITH NUMBERED DELTAS AND REVISION DATES ALONG WiTH A
DESCRIPTIVE NARRATIVE OF CORRECTIONS ADDRESSING ALL COMMENTS. PLEASE BE
SURE TO PUT FIRE REVISIONS ON THE BUILDING DEPT. PLAN CHECK SET.
• PLEASE DIRECT ANY QUESTIONS REGARDING THIS REVIEW TO: ROBERT SCOTT 760-
402-3976 OR FYRWISE07@GMAIL.COM
- CORRECTED PLANS, DESCRIPTIVE NARRATIVE OF REVISIONS FOLLOWING EACH
COMMENT ON THIS FORM, AND A COPY OF BUILDING DEPARTMENT (ESGIL)
• ONE COMPLETE PLAN CHECK SET (initial or revised) MUST BE DELIVERED DIRECTLY TO
THE FOLLOWING ADDRESS TO AVOID DELAY:
ROBERT SCOTT
4906 CHAUCER AVE
SAN DIEGO, CA. 92120
COMMENTS - Additional comments made shall be generated by response on revised set and Clouded
AO.l
ADD 'Deferred Submittals' section to read as follows: Provide the following list of Deferred
Submittals
-Fire Sprinkler System - 2013 CFC 903 and 2013 NFPA 13
-Fire Alarm System - 2013 CFC 907.2 and 2013 NFPA 72
- Title Sheet
Provide a descriptive scope of demolition, construction and alteration for this project.
page i 01i
Add, Delete or Revise the following notes in 'General Project Info':
- Revise note #5 to read: - The type, rating and number of fire extinguishers shall comply with 2013
CFC, section 906.3. A minimum of two (or more) properly spaced fire extinguishers rated at 2A-
10SC are required for dining area, kitchen and other areas. Maximum Travel distance to fire
extlngylshers shall not exceed 7S feet. All fire extinguishers shall be mounted in accessible and
viilble location, not to exceed 5 feet above finished floor to top of extinguisher.
- Delete note , it is not applicable.i 6
" Add note; A C-16 licensed fire protection contractor shali perform all fire sprinkler system work. A
C'lO licensed fire alarm contractor shall perform all fire alarm system work. No flre protection
system work shall be performed without flre dept. approved plans.
' Add note: All doors shall be openable from the egress side without the use of a key or special
knowledge or effort
' Add note; All demolition work shall comply with 2013 CFC Chapter 33.
Exit Doors shall swing in the direction of travel where serving an occupant ioad of 50 or mom persons.
CiC 100B.1
All finish materials, Ineluding wall ooverings shall be in complianoe with 2013 CiC Chapter 8.
A2.1
Add note to acoustical panel ceilings section that reads: -Suspended Ceiling Plan notes that read:
Suspended aooustioal celllniB shall comply with -section 808.1 2013 CBC and meet flame spread and
smdke developed ratings
Address numbers shall be mounted on building In visible location. Numbers shall be minimum 12
Inehes in height, with 1-1/2 inch stroke and contrast in color to background.
**ShQwloeation of proposed numarle addr&ss on building. CBD 17.04,320.
Add notes to 'Key Notes' section of Roof Plan as follows:
- Imprint the Carlsbad Policy SO^S on to roof plan.
• Intent S (Fireman Safety) will be provided on roofs of buildings.
EdJ.
• Add Note that reads: All gas piping located in interior space shall be labeled every 20 feet and every
@henge of direction with labels that read 'Natural Gas. The gas meter shall be Identified with a
permanent tag Indieating address that gas meter serves suite 13§.
'^dd Note: iMit signs shall be illuminated at all times and equipped with minimum 90-minute battery
baekup. OiQ 1Qlt.§.3
-Add Note: Means of egress illumination levei shall be not less than 1-foot candle at the walking surface
and e(S|ylppid with minimum dO minute battery baokup where required, C@0106@.
TITLE 24 ENERGY COMPLIANCE
PAPER SOURCE
'^Proposed Alterations~
1923 CALLE BARCELONA
CARLSBAD, CALIFORNIA
PREPARED BY:
BEAUDETTE ENERGY CONSULTING
2261 MORELLO AVE, STE B
PLEASANT HILL, CA 94523
(925)351-8936
gcbeau@yahoo.com
STATE OF CALIFORNIA
ENVELOPE COMPONENT APPROACH
CEC-NRCC.ENV-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION ^ '
CERTIFICATE OF COMPLIANCE NRCC-ENV-Ol-E
Envelope Component Approach (Page 1 of 4)
rroi«.N,n„: p^p^^ Soufce - 1923 CallG Barcelona, Suite 135, Carlsba<d, CA 0«,Pr.p„.d: 04/01/15
A. GENERAL INFORMATION
1 Project Location: 1923 Calle Barcelona, Suite 135 6 Compliance IVIethod: _
Component
LljComponent • Unconditioned (file
Affidavit)
2 CA City and Zip Code: Carlsbad 92009 7 Building Front Orientation (deg or cardinal): 0 degrees (N)
3 Climate Zone: 7 S Permitted Scope of Work | DlNew Construction • Addition |/|Alteration
4 Totai Conditioned Floor
Area: 3,112sf 9 Buiiding Type(s) [7] Nonresidential • High-Rise Residential • Hotel/Motel Guest Room
5 Q Scliools (Public School) • Relocatable Public School Bldg. [/j Conditioned Spaces • Unconditioned Spaces
• SIcylight Area for Large Enclosed Space > 5000 ft' (If checked include the NRCC-ENV-04-E with submittal)
ByHNVELOPE DETAILS - Framed
2 3 4 5 6 7 8 9 10 11
.*'
fig/ID Assembly Type
Frame
Material
Frame
Depth
Frame
Spacing
Appendix JA4
Reference
Cavity
R-value
Continuous
Insulation
R-value
Proposed
U-Factor
Required U-Factor From
Tables, B, C, D Comments
No Change
1
C. ENVELOPE DETAILS - Non-framed
1 2 3 4 5 6 7 8 9 10
Tag/ID Assembly Type Assembly Materials
Thickness
(inches)
Interior or
Core
Insulation
R-value
Continuous
Insulation
R-value
Appendix JA4
Reference
Proposed
U-Factor
Required U-Factor from
Tables, B, C, D Comments
N/A
D. ENVELOPE DETAILS - Mass
1 2 3 4 5 6 7 8 9 10 11
Tag/ID
Mass
Type
Density
(Ib/ft"
Mass
Thickness
(inches)
Furring Strip
Thickness
(inches)
Interior
Insulation
R-value
Exterior
Insulation
R-value
Appendix JA4
Reference
Proposed
Insulation
U-factor
Required U-Factor from
Tables, B, C, D Comments
None
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
ENVELOPE COMPONENT APPROACH
CEC-NRCC-ENV-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION ^•"'^
CERTIFICATE OF COMPLIANCE NRCC-ENV-Ol-E
Envelope Component Approach (Page 2 of 4)
proi« N.m.: p^p^^ Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA 1 D.,.pr.p.™d: 04/01/15
E. ROOFING PRODUCTS (COOL ROOF)
1 2 3 4 5 1 6 1 7 8 1 9 1 10 11
Mass Roof
25 Ibft2
or greater Roof Pitch
CRRC Product
ID Number Product Type
Proposed Minimum Required
Comments
Mass Roof
25 Ibft2
or greater Roof Pitch
CRRC Product
ID Number Product Type
Aged Solar
Reflectance
Thermal
Emittance
SRi'
(Optional)
Aged Solar
Reflectance
Thermal
Emittance
SRI
(optional) Comments
• No Change ... NR NR ... NR NR ...
• ... — ...
a
D An aged solar reflectance less than 0.63 is allowed provided the maximum roof / ceiling U-factor in TABLE 140.3 is not exceeded
• High-rise residential buildings and Hotels and Motels with low-sloped roofs in Climate Zones 1 through 8,12 and 16 are exempted from aged Solar
Reflectance and emittance requirements.
O High-rise residential buildings and Hotels and Motels with steep-sloped roofs in Climate Zones 1 and 16 are exempt from aged Solar Reflectance and
emittance requirements.
• The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from aged Solar Reflectance
and emittance requirements
To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended
by the coatings manufacturer and meet minimum performance requirements listed in §110.8(1)4. Select the applicable coating:
D Aluminum-PiRmented Asohalt Roof Coatine • Cement-Based Roof Coating • Other
NOTES:
1. Check tfie box if ttie aged Solar reflectance was not available in the Cool Roof Rating Council's Rated Product Directory, Then use the equation in Section 110.8(1)2 where the Initial Reflectance
value from the same directory and use the equation (0.2+Blpi„i,„i - 0.2) to obtain a calculated aged value. Where p Is the Initial Solar Reflectance and B is either set to 0.6S for Field-Applied
Coatings or it is set to 0.70 for all other roofina products other than field-Applied Coating.
2. Calculate the SRI Value by using the SRI-Worksheet at (TBD) and enter the resulting value in the SRI Column above and attach a copy for the SRI-Worksheet NRCC-ENV-03-E to the to this form.
F. Air Barrier
1 2 3 4 5
Tag/ID
Air Barrier
Material Type
Air Barrier
Assembly Type
Whole Bullding
Air Leakage Testing Comments
Metal Panels Interlocking Wall Panels Not Req. •
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
ENVELOPE COMPONENT APPROACH
CEC-NRCC-ENV-01-E (Revised 06/14) m
CALIFORNIA ENERGY COMMISSION -
CERTIFICATE OF COMPLIANCE NRCC-ENV-Ol-E
Envelope Component Approach (Page 3 of 4)
Paper Source -1923 Calle Barcelona, Suite 135, Carlsbad, CA 1 D.,.Pr.p.,«,: 04/01/15
G. FENESTRATION PROPOSED AREAS AND EFFICIENCIES
1 2 3 4 5 6 7 8 9 10 11 12
Tag/ID Fenestration Type Area
Orientation
N, S, W, E
or Roof
(tof
Panes
Max
U-Factor Overhang
Max
(R)SHGC
Min
VT Label
Conditions
Status Comments
Windows (Fixed) 164.3 N &NE 2 0.47 None 0.31 0.42 NFRC New
Doors 60 N 2 0.47 None 0.31 0.17 NFRC New
H. ENVELOPE MANDATORY MEASURES
Indicate location on building plans of Mandatory Envelope Measures Note Block: _
INSTRUCTIONS TO APPLICANT ENVELOPE COMPLIANCE & WORKSHEETS (checl< box if worksheet are included)
For detailed instructions on the use of this and alt Energy Efficiency Standards compliance forms, please refer to the Nonresidential Compliance Manual.
IZI NRCC-ENV-Ol-E Certificate of Compliance. Required on plans for all submittals.
• NRCC-ENV-04-E Use when minimum skylight requirements for large enclosed spaces are required in climate zones 2 through 15. Optional on plans.
Fornn NRCC-ENV-04-E not required for buildings less than 5,000 sf
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
ENVELOPE COMPONENT APPROACH
CEC-NRCC-ENV-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-Ol-E
Envelope Component Approach (Page 4 of 4)
p™„aN.™: pgpg^ Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA O...Pr„.,.d: 04/01/15
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Greg Beaudette
Documentation Author Signature: "'I"'"'' "V ^reg beauaette
jy rtC*— ':""'^teg Beaudette, o.
Company:
Beaudette Energy Consulting Signiture Date: Jr cmail=gcbeau#yahoo.com, c=US
Address:
2261 Moreno Avenue, Ste. B
CEA/ HERS Certification Identification (if applicable):
City/State/Zip:
Pleasant Hill, CA 94523
Phone:
(925)351-8936
RESPONSIBLE PERSON'S DECLARATION STATEMENT
1 certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. lam eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible
designer).
3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance
conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The buiiding design features or system design features identifled on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,
worksheets, calculations, plans and speciflcations submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) Issued for the building, and made available to the enforcement
agency for all applicable inspections. 1 understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the
buiWing owner at occupancy.
Responsible Designer Naitie:
Tom Dobbins, Archilecl
Responsible Designer Signature: ; ; '''A . \ \ \ \ i
Company:
The Dobbins Group DateSigned: 04/01/15
Address:
11 E. Illinois Street, Ste. 600
License:
City/State/Zip;
Chicago, IL 60611 (312)321-0400
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
INDOOR LIGHTING
CEC-NRCC-LTI-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE -USER INSTRUCTIONS NRCC-LTI-Ol-E
Indoor Lighting (Page 1 Of 5)
ProJectName: Rgper SOUFCe-1923 Calle Barcelona, Suite 135, Carlsbad, CA 1 DatePrepared: 04/01/15
Climate Zone; Conditioned Floor Area : 3 112 sf
Unconditioned Floor Area : Q sf
General Information
Building Type: l/l Nonresidential • High-Rise Residential • Hotel/Motel
• Schools • Relocatable Public Schools • Conditioned Spaces • Unconditioned Spaces
Phase of Construction: • New Construction • Addition 0 Alteration
Method of Compliance: • Complete Building Area Category • Tailored
LIGHTING COMPIIANCE DOCUMENTS (select yes for each document included)
for detailed instructions on the use of this and all Energy Efficiency Standards compliance documents, refer to the Nonresidential Manual published by the California Energy Commission.
YES NO FORM TITLE
E] NRCC-LIT-Ol-E Certificate of Compliance. All Pages required on plans for all submittals.
NRCC-LIT-02-E Ughting Controls, Certificate of Compliance, and PAF Calculation. All Pages required on plans for all submittals.
E NRCC-LIT-03-E Indoor Ughting Power Allowance
NRCC-LIT-04-E Tailored Method Worksheets
/ NRCC-LIT-05-E Une Voltage Track Ughting Worksheets
Summary of Allowed Lighting Power
Conditioned and Unconditioned space Lighting must not be combined for compliance
Indoor Lighting Power for Conditioned Spaces Indoor Lighting Power for Unconditioned Spaces
1.
Installed Lighting
NRCC-LTI-Ol-E, page 4
Watts
Installed Lighting
NRCC-LTI-Ol-E, page 4
Watts
1.
Installed Lighting
NRCC-LTI-Ol-E, page 4 + 4,549 Installed Lighting
NRCC-LTI-Ol-E, page 4 + N/A
2. PORTABLE ONLY FOR OFFICES
NRCC-LTI-Ol-E, page 3 + 0
3. Minus Lighting Control Credits
NRCC-LTI-02-E, page 2 -0 Minus Lighting Control Credits
NRCC-LTI-02-E, page 2 -N/A
4. Adjusted Installed Lighting Power
(row 1 plus row 2 minus row 3) 4,549 Adjusted Installed Lighting Power
(row 1 minus row 3) N/A
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
INDOOR LIGHTING
CEC-NRCC-LTI-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE -USER INSTRUCTIONS NRCC-LTI-Ol-E
Indoor Lighting (Page 2 of 5)
Project Name: paper SOUfCe - 1923 Calle Barcelona, Suite 135, Carlsbacj, CA DatePrepared: 04/01/15
5. Complies ONLY if Installed < Allowed ; | Complies ONLY if Installed i Allowed t
6.
Allowed Lighting Power
Conditioned NRCC-LTI-03-E, page 1 4,604
Allowed Lighting Power
Unconditioned NRCC-LTI-03-E, page 1 N/A
Declaration of Required Installation Certificates - Declare by selecting yes for all Installation Certificates that will be submitted. (Retain copies and verify forms are
completed and signed.)
YE
1
S NO Form/Title YE
1 / NRCI-LTI-Ol-E - Must be submitted for all buildings • Field Inspector
/
NRCI-LTI-02-E - Must be submitted for a lighting control system, or for an Energy Management Control System (EMCS),
to be recognized for compliance.
• Field Inspector
NRCI-LTI-03-E - Must be submitted for a line-voltage track lighting integral current limiter, or for a supplementary
overcurrent protection panel used to energize only line-voltage track lighting, to be recognized for compliance.
• Field Inspector
/
NRCI-LTI-04-E - Must be submitted for two interlocked systems serving an auditorium, a convention center, a
conference room, a multipurpose room, or a theater to be recognized for compliance.
• Field Inspector
NRCI-LTI-05-E - Must be submitted for a Power Adjustment Factor (PAF) to be recognized for compliance. • Field Inspector
/
NRCI-LTI-06-E - Must be submitted for additional wattage installed in a video conferencing studio to be recognized for
compliance.
• Field Inspector
Declaration of Required Certificates of Acceptance - Declare by checking all of the Certificates of Acceptance that will be submitted. (Retain copies and verify forms are
completed and signed.)
YES NO Form/Title
/ NRCA-LTI-02-A - Must be submitted for occupancy sensors and automatic time switch controls. • Field Inspector
/ NRCA-LTI-03-A - Must be submitted for automatic daylight controls. • Field Inspector
/ NRCA-LTU04-A - Must be submitted for demand responsive lighting controls. • Field Inspector
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
INDOOR LIGHTING
CEC-NRCC-LTI-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE -USER INSTRUCTIONS NRCC-LTI-Ol-E
Indoor Lighting (Page 3 of 5)
Project Name: Paper SOUfCe - 1923 Calle Barcelona, Suite 135, Carlsbacl, CA 1 DatePrepared: 04/01/15
A separate Ughting Schedule Must Be Filled Out for Cortditiorted and Unconditioned Spaces. Installed Lighting Power listed on this Lighting Schedule is only for:
[7] CONDITIONED SPACE • UNCONDITIONED SPACE
A. INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKUST
• The actual indoor lighting power listed on this page and on the next page includes all installed permanent and planned portable lighting systems.
• When Complete Building Method is used for compliance, list each different type of luminaire on separate lines.
• When Area Category Method or Tailored Method is used for compliance, list each different type of luminaire by each different function area on separate lines
• Also include track lighting in schedule, and submit the track lighting compliance form (NRCC-LTI-05-E) when line-voltage track lighting is installed.
B. Installed Portable Luminaires in Offices - Exception to Section 140.6(a)
• This section shall be filled out ONLY for portable luminaires in offices (As defined in §100.1). All other planned portable luminaires shall be documented on next page of
this compliance form.
• This section is used to determine if greater than 0.3 watts of portable lighting is planned for any office
• Fill out a separate line for each different office. Small offices that are typical (having the same general and portable lighting) may be grouped together. This allowance
shall not be traded between offices having different lighting systems.
Office Portable Luminaire
Schedule
Office Installed Portable Luminaire Watts Per Square
Foot
1 Accountable 1
1 Watts 1
Office Location Fieid
Inspector
Office Portable Luminaire
Schedule
Office Installed Portable Luminaire Watts Per Square
Foot
Office Location Fieid
Inspector
A B C D E F G H 1 J
Complete Luminaire Description
(i.e., LED, under cabinet, furniture mounted
direct/indirect)
Watts per
Luminaire Numberof Luminaires Installed
portable
luminaire
watts in this
office
(BxC) Square feet of this office Watts
per
square
foot
(D/E)
If F < 0.3,
enter zero;
if F>0.3,
(F-0.3)
ExG
Identify Office area in which
these portable luminaires are
installed
•0 Tl
Not Applicable • •
• •
• •
• •
• •
Total installed portable luminaire watts that are greater than 0.3 watts per square foot per office: 0
Enter sum total of all pages into NRCC-
LTI-Ol-E; Page 1
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
INDOOR LIGHTING
CEC-NRCC-LTI-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION 'Wp"'
CERTIFICATE OF COMPLIANCE - USER INSTRUCTIONS NRCC-LTI-Ol-E
Indoor Ughting (Page 4 of 5)
Project Name: pgpgr Sourco - 1923 Calle Barcelona, Suite 135, Carlsbad, CA DatePrepared: 04/01/15
A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces. Installed Lighting Power listed on this Lighting Schedule is only for:
[3 CONDITIONED SPACE • UNCONDITIONED SPACE
C. INDOOR LIGHTING SCHEDULE and FIELD INSPEaiON ENERGY CHECKUST
Luminaire Schedule Installed Watts Location Field Inspector'
A B C D E F G H Name or Item Tag Complete Luminaire Description
(i.e, 3 lamp fluorescent troffer,
F32T8, one dimmable electronic ballast) Watts per Luminaire How wattage was
determined Number Luminaires Total Installed Watts in this area (CxE) Primary Function area in which
these luminaires are installed Pass Fail Name or Item Tag Complete Luminaire Description
(i.e, 3 lamp fluorescent troffer,
F32T8, one dimmable electronic ballast) Watts per Luminaire CEC Default from NAS According to 1130.0(c) Number Luminaires Total Installed Watts in this area (CxE) Primary Function area in which
these luminaires are installed Pass Fail
A Spot Track LED (Floor & Wall Display) 17 • 0 per plan *** Retail • •
B Wall Wash Track LED (Wall Display) 57 • m per plan ... Retail • •
C Penidant Downlight CFL (Floor Display) 18 • m 14 54 Retail • •
D 20" Pendant LED (Floor Display) 17 • 0 5 85 Retail • •
Fl 4 ft. Fluor. Strip 2-F32T8 (Stock) 64 • 0 3 192 Support • •
F2 2x2 Fluor. Lay-in 2-FB32T8 (Hall) 64 • m 2 128 Support • •
G1 Wall Sconce CFL 2-13w (Restroom) 26 • • 2 52 Restroom-Vanity • •
H Recessed Downlight LED (General - RR) 17 • • 2 34 Restroom-General • •
***Llne-Voltage Track from NRCC-LTI-05-E • 3,600 Retail Track Lighting • •
INSTALLED WATTS PAGE TOTAL: 4,145 Enter sum total of all pages into
NRCC-LTI-Ol-E; Page 2
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
INDOOR LIGHTING
CEC-NRCC-LTI-01-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION K^''
CERTIFICATE OF COMPLIANCE -USER INSTRUCTIONS NRCC-LTI-Ol-E
Indoor Lighting (Page 5 of 5)
Project Name: Paper Source-1923 Calle Barcelona, Suite 135, Carlsbaij, CA DatePrepared: 04/01/15
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certlflcate of Compliance documentation is accurate and complete.
DocumentationAuthorName: _ _ ...
Greg Beaudette
Documentation Author Signature: ""3>"«y ^'S"'" "v '"'^ Beauaette
1 / ^^M-" DN: cn=Greg Beaudette, o,
Beaudette Energy Consulting Signature Date: r emaifegebeaucayahoo.com.cUS
2261 Morello Ave, Ste. B CEA/ MERS Certification Identification (If applicable):
Clty/State/Zlp: pjeasant Hill, Ca 94523 (925)351-8936
RESPONSIBLE PERSON'S DECLARATION STATEMENT
1 certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certlflcate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identifled on this Certlflcate of Compliance
(responsible designer).
3. The energy features and performance speciflcations, materials, components, and manufactured devices for the building design or system design identifled on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 ofthe California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance
documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the
enforcement agency for all applicable inspections. 1 understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the
builder provides to the building owner at occupancy.
ResponsibleDesignerName: , , . . , .,
Tom Dobbins, Architect
Responsible Designer Signature: : I ......v \ ' i
Company: DOpbinS GfOUp DateSigned: < • 1 -1-- • v i , \,, ^ V
04/01/15
11 East Illinois Street, Suite 600 License:
city/state/zip: Chicago, IL 60611 (312)321-0400
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
INDOOR LIGHTING - LIGHTING CONTROLS
CEC-NRCC-LTI.02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION "
CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E
Indoor Lighting - Lighting Controls (Page 1 of 3)
Paper Source - 1923 Calle Barcelona. Suite 135. Carlsbad. CA 04/01/15
The NRCC-LTI-02-E shall be used to document all mandatory and prescriptive lighting controls that are applicable to the project.
Mandatory Lighting Control Declaration Statements (Indicate If the measure applies by checking yes or no below.)
YES NO Control Requirements
13 Lighting shall be controlled by self-contained lighting control devices which are certified to the Energy Commission according to the Title 20 Appliance
Efficiency Regulations in accordance with Section 110.9.
0 Lighting shall be controlled by a lighting control a system or energy management control system in accordance with §110.9. An Installation Certificate
shall be submitted in accordance with Section 130.4(b).
0 One or more Track Lighting Integral Current Limiters shall be installed which have been certified to the Energy Commission in accordance with §110.9 and
§130.0. Additionally, an Installation Certificate shall be submitted in accordance with Section 130.4(b).
0 A Track Lighting Supplementary Overcurrent Protection Panel shall be installed in accordance with Section 110.9 and Section 130.0. Additionally, an
Installation Certificate shall be installed in accordance with Section 130.4(b).
IZ] All lighting controls and equipment shall comply with the applicable requirements in §110.9 and shall be installed in accordance with the manufacturer's
instructions in accordance with Section 130.1.
0 All luminaires shall be functionally controlled with manually switched ON and OFF lighting controls in accordance with Section 130.1(a).
/
General lighting shall be separately controlled from all other lighting systems in an area. Floor and wall display, window display, case display, ornamental,
and special effects lighting shall each be separately controlled on circuits that are 20 amps or less. When track lighting is used, general, display,
ornamental, and special effects lighting shall each be separately controlled; in accordance with Section 130.1(a)4.
0 The general lighting of any enclosed area 100 square feet or larger, with a connected lighting load that exceeds 0.5 watts per square foot shall meet the
multi-level lighting control requirements in accordance with Seaion 130.1(b).
/ All installed indoor lighting shall be equipped with controls that meet the applicable Shut-OFF control requirements in Section 130.1(c).
0 Lighting in all Daylit Zones shall be controlled in accordance with the requirements in Section 130.1(d) and daylit zones are shown on the plans.
0 Lighting power in buildings larger than 10,000 square feet shall be capable of being automatically reduced in response to a Demand Responsive Signal in
accordance with Section 130.1(e).
0
Before an occupancy permit is granted for a newly constructed building or area, or a new lighting system serving a building, area, or site is operated for
normal use, indoor lighting controls serving the building, area, or site shall be certified as meeting the Acceptance Requirements for Code Compliance in
accordance with Section 130.4.(a). The controls required to meet the Acceptance Requirements include automatic daylight controls, automatic shut-OFF
controls, and demand responsive controls.
CA Building Energy Efficiency Standards • 2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
INDOOR LIGHTING - LIGHTING CONTROLS
CEC-NRCC-LTI-02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E
Indoor Lighting - Lighting Controls (Page 2 of 3)
ProLctN.™, pgpg^ Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA D™ Prepare: 04/01/15
A separate document must be filled out for Conditioned and Unconditioned Spaces. This page is used only for the following:
[7] CONDITIONED SPACES • UNCONDITIONED SPACES
MANDATORY AND PRESCRIPTIVE INDOOR UGHTING CONTROL SCHEDULE, PAF CALCULATION, and FIELD INSPEaiON CHECKLIST
Lighting Control Schedule
Standards Complying With '
{•^ all that apply, or enter 'E' if Exempted)
PAF Credit Calculation^ if Acceptance Test Required Field Inspector Lighting Control Schedule
Standards Complying With '
{•^ all that apply, or enter 'E' if Exempted) Watts of Controlled Lighting "a > -n Control Credit (KxL) if Acceptance Test Required Field Inspector A B C D E F G H 1 J K L M N 0
Location in Building
Type/ Description of Lighting
Control (i.e.: occupancy sensor,
automatic time switch,
dimmer, automatic daylight,
etc..)
#
of
Units §130.1(a) §130.0(b) §130.1(c) §130.1(d) §130.1(e) §140.6(a)2 §140.6(d) -D CD I/) u,
n
Retail Occ Sensor w/ 50% Retluctfon & Auto Time Switch 6 X X X X X X X No Credit -— ... • •
stockroom,Utility.Restfooms Occ.Sensor 4 • •
• •
• •
• •
• •
• •
Control Credit PAGE TOTAL (Sum of Column M): 0
IF MULTIPLE PAGES ARE USED, ENTER SUM TOTAL OF Control Credit for all pages HERE (Sum of all Column M); 0
Enter Control Credit total
into NRCC-LTI-Ol-E; Page
1.
1. §130.1(0) = Manual area controls; §130.0(b) = Multi Level; §130.1(c) = Auto Shut-Off; §130.1(d) = Mandatory Daylight; §130.1(e) = Demand Responsive; §140.6(d) =
Additional lighting controls installed to earn a PAF; §140.6(d) = Prescriptive Secondary Sidelit Daylight Controls.
2. Check Table 140.6-A for correct Factor. PAFs shall not be traded between conditioned and unconditioned spaces. As a condition to earn a PAF, an Installation Certificate is
also required to be filled out, signed, and submitted.
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
INDOOR LIGHTING - LIGHTING CONTROLS
CEC-NRCC-LTI-02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E
Indoor Lighting - Lighting Controls (Page 3 of 3)
Paper Source - 1923 Calle Barcelona, Suite 135. Carlsbad, CA 04/01/15
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
DocumentationAuthorName: Q^^^ BeBUdette Documentation Author Signature: Digitally signed by Greg Beaudette
/y -Z ON: cn-flreg Beaudette, o,
company: Boauclette EHorgy Consulting Signature Date: email-gcbeau@)yahoo.com, c-US
2261 Morello Ave, Ste. B CEA/ HERS Certification Identification (if applicable):
city/state/zip: RieasaHt Hill, CB 94523 (925)351-8936
RESPONSIBLE PERSON'S DECLARATION STATEMENT
1 certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. lam eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance
(responsible designer).
3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 ofthe California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance
documents, worksheets, calculations, plans and speciflcations submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the
enforcement agency for all applicable inspections. 1 understand that a completed signed copy of this Certlflcate of Compliance is required to be included with the documentation the
builder provides to the building owner at occupancy. ,
ResponsibleDesignerName: , ,_-
Tom Dobbins, Architect
Responsible Designer Signature: ; ! '''A \ )\ \
company: TilS DObblHS GtOUp DateSigned: 04/01/15 '
11 East Illinois Street, Suite 600 License:
City/State/Zip: ChiCaQO, IL 6061 1 (312)321-0400
CA Building Energy Efflclency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
INDOOR LIGHTING POWER ALLOWANCE
CEC-NRCO-LTI-03-E (Revised 06/14) CAUFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTI-03-E
Certificate of Compliance - Indoor Lighting Power Allowance (Page 1 of 4)
'"•'""""* Paoer Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA D.t.Pr,p.r«l: 04/01/15
ALLOWED LIGHTING POWER
A separate page must be filled out for Conditioned and Unconditioned Spaces. This page is only for;
\7} CONDITIONED spaces • UNCONDITIONED spaces
A. SUMMARY TOTALS OF UGHTING POWER ALLOWANCES
• If using Complete Building Method for compliance, use only the total in column (a) as total allowed building watts.
• If using Area Category Method, Tailored Method, or a combination of Area Category and Tailored Method for compliance, use only the total in column (b) as the total
allowed bullding watts
(a) (b)
1. Complete Building Method Allowed Watts. Documented in section B of NRCC-LTI-03-E (below on this page) 0
2. Area Category Method Allowed Watts. Documented in section C-1 of NRCC-LT1-03-E (below on this page) 4,604
3. Tailored Method Allowed Watts. Documented in section A of NRCC-LTI-04-E 0
TOTAL ALLOWED BUILDING WATTS. Enter number into correct cell on NRCC-LTI-01, Page 2, Row 1
[ 1 Check here if building contains both conditioned and unconditioned areas.
0 4,604 TOTAL ALLOWED BUILDING WATTS. Enter number into correct cell on NRCC-LTI-01, Page 2, Row 1
[ 1 Check here if building contains both conditioned and unconditioned areas.
B. COMPLETE BUILDING METHOD UGHTING POWER ALLOWANCE
A B C D
TYPE OF BUILDING (From §140.6 Table 140.6-B)
WATTS
PER (ft') X
COMPLETE
BLDG. AREA =
ALLOWED
WATTS X =
Total Area:
Total Watts. Enter Total Watts Into section A, row 1 (Above on this page) NA
C -1 AREA CATEGORY METHOD TOTAL UGHTING POWER ALLOWANCES (C-2 plus C-3) Watts
Total from section C-2 . 3,360
Total from section C-3 . 1,244
Total Watts. Enter Total Watts into section A, row 2 (Above on this page) . 4,604
CA Building Energy Efflclency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CAUFORNIA
INDOOR LIGHTING POWER ALLOWANCE
CEC-NRCC-LTI-03-E (Revised 06/14) 0
CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTI-03-E
Certificate of Compliance - Indoor Lighting Power Allowance (Page 2 of 4)
Pro,.c,~.„.: pgpg^ Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA D.t.Pr.p.r«l: 04/01/15
A separate page must be filled out for Conditioned and Unconditioned Spaces. This page is only for:
[7] CONDITIONED spaces • UNCONDITIONED spaces
C -2 AREA CATEGORY METHOD GENERAL UGHTING POWER ALLOWANCE
• Do not include portable lighting for offices. Portable lighting for offices shall be documented only in section 8 of NRCC-LTI-Ol-E.
• Separately list lighting for each primary function area as defined in §100.1 of the Standards.
A B
X
C D
AREA CATEGORY (From §140.6 Table 140.6-C) WATTS
PER (ft') X AREA (ft')
ALLOWED
WATTS Location In Building Primary Function Area per Table 140.6-C
WATTS
PER (ft') X AREA (ft')
ALLOWED
WATTS
Retail Sales 1.2
X
2,488 2,986
Restrooms,Stockroom,Hall Support 0.6
X
624 374
X X X X X X X X X X X X X X
TOTALS 3,112 3,360
Enter sum total Area Category allowed watts into section C-1 of NRCC-LTI-03-E (this compliance form) 3,360
WATTS
CA Building Energy Efflciency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
INDOOR LIGHTING POWER ALLOWANCE
CEC-NROC-LTI-03-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION ^^^i
CERTIFICATE OF COMPLIANCE NRCC-LTI-03-E
Certificate of Compliance - Indoor Lighting Power Allowance (Page 3 of 4)
Pro,»N...: p^pgj. Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA D.t.Pr.p.r.d: 04/01/15
A separate page must be filled out for Conditioned and Unconditioned Spaces. This page is only for:
[7] CONDITIONED spaces • UNCONDITIONED spaces
C-3 AREA CATEGORY METHOD Additionai Lighting Wattage Allowance (from Table 140.6-C Footnotes)
A B C^ D E F G
Primary
Function
Sq Ft or
linear ft'
Additional
Watts
Allowed
Wattage
Allowance
(BxC)
Description(s) and Quantity of Special
Luminaire Types in each Primary Function Area
Total Design
Watts'
ALLOWED
WATTS
Smaller of
DorF
Accent Lighting 2,488 0.2 498 29 - LED Spot Track x 17w 498 498
Display Lighting 2,488 0.3 746 13 - LED Wall Wash Track x 57w 746 746
TOTALS - Enter into TOTAL AREA CATEGORY METHOD ADDITIONAL ALLOWANCES - Section C-1 . 1,244
1. Use linear feet only for additional allowance for white board or chalk board. All other additional Area Category allowances shall use watts per square foot.
2 . Additional watts are available only when allowed according to the footnotes on bottom of Table 146-C, which include; Specialized task work; Ornamental lighting;
Precision commercial and industrial work; Per linear foot of white board or chalk board; Accent, display and feature lighting; and Videoconferencing Studio lighting..
3. Luminaire classification and wattage shall be determined in accordance with §130.0(c) ofthe Standards.
CA Building Energy Efflciency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
INDOOR LIGHTING POWER ALLOWANCE
CEC-NRCC-LTI-03-E (Revised 06/14) i9h
CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTI-03-E
Certificate of Compliance - Indoor Lighting Power Allowance (Page 4 of 4)
p,=,e«N,™: pQpQf Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA Date Prepare: 04/01/15
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certlflcate of Compliance documentation is accurate and complete.
Documentation Author Name: —, -., j
Greg Beaudette
Documentation Author Signature: Uigttalty signed by Greg Beaudette
yy jf<:f?^" ^^^^'^Q Beaudette, o,
Beaudette Energy Consulting Signature Date- '^v- <~y''''^''"^--*''-*'^^^ uu-"iBydud«u« CiiHiyy Cuiisullliiy, 0 emait=gcbeau@yahDo.com, c-US
2261 IVlorello Ave, Ste. B CEA/ HERS Certification Identification (if applicable):
city/state/zip: pjeasant Hill, Ca 94523 (925)351-8936
RESPONSIBLE PERSON'S DECURATION STATEMENT
1 certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certlflcate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certlflcate of Compliance
(responsible designer).
3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identifled on this Certlflcate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 ofthe California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance
documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued forthe building, and made available to the
enforcement agency for all applicable inspections. 1 understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the
builder provides to the building owner at occupancy.
Responsible Designer Name: —- r-, , i - A i -i j.
Tom Dobbins, Architect
Responsible Designer Signature': 1 "'W ' ' ) \ i \
The Dobbins Group 04/01/15'
11 East Illinois Street, Suite 600 License:
city/state/zip: Chicago, IL 60611 Phone: (312)321-0400
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
LINE-VOLTAGE TRACK LIGHTING WORKSHEET
CEC-NRCC-LTI-05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION ^^^^
CERTIFICATE OF COMPLIANCE NRCC'-LTI-05-E
Indoor Lighting - Line-Voltage Track Lighting Worksheet (Page 1 of 2)
Proiect Name: p^p^^ SouFce - 1923 Calle Barcelona, Suite 135, Carlsbad, CA DatePrepared: Q^/Qy^^
• There are four different methods available for determining how many watts of line-voltage track or line-voltage busway has
been installed. One or more methods may be used to determine how many watts of line-voltage track or line-voltage busway
has been installed. Use this worksheet to separately calculate the input wattage for each system.
• Separately enter each row of this worksheet into the Luminaire Schedule in section C of NRCC-LTI-Ol-E
• Method 1 is the only option available for determining wattage for track or busway rated for more than 20 amperes
• METHOD 1 - VOLT-AMPERE (VA) RATING OF THE BRANCH CIRCUIT(S)
A B
BRANCH CIRCUIT NAME OR ID
VOLT-AMPERE (VA) RATING OF THE
BRANCH CIRCUIT
N/A
• METHOD 2 - USE THE HIGHER OF 45 WATTS PER UNEAR FOOT OF TRACK OR TOTAL RATED WATTAGE OF ALL LUMINAIRES
A B C D E F
Track or Name # Linear Feet of
Track (W/LF) BxC
(W)
TOTAL RATED WATTAGE OF ALL
LUMINAIRES
LARGER OF
(Dor E)
N/A 45
45
45
• METHOD 3 - USE THE HIGHER OF: 12.5 WATTS / UNEAR FOOT OF TRACK - OR VA RATING OF INTEGRAL CURRENT UMITER
• Only integral current limiters which are certified to the Energy Commission shall be recognized by the Standards.
• This method shall not be recognized if an Installation Certificate is not submitted.
A B C D E F
Track or Name #
Linear Feet of
Track (W/LF)
BxC
(W)
VA Rating of Integral Current
Umiter
Larger of
(Dor E)
N/A 12.5
12.5
12.5
• METHOD 4 - DEDICATED TRACK UGHTING SUPPUMENTARY OVERCURRENT PROTECTION PANEL
• This method shall not be recognized ifan Installation Certificate is not submitted.
• This method shall be used only for line-voltage track lighting, and shall not be recognized for any other lighting systems. If any other lighting
systems or devices are installed, the supplementary overcurrent protection panel shall not be recognized for compliance with the Standards
A B C D
NAME OR ID
Voltage of the
Branch Circuit
Sum of the Ampere Rating of all
Devices installed in the Panel
Wattage = Sum of the Ampere Ratings of all of the Devices
Times The Branch Circuit Voltage (B x C)
CCT-1 Zone 1- Window Display 120v 2 Amp 240w
CCT-2, Zone 2 - Daylight Zone 120v 7 Annp 840w
CCT-3, Zone 3 - Daylight Zone 120v 10 Amp 1,200w
CCT-4, Zone 4 - Interior Sales 120v 13 Amp 1,560w
3,840w Total for Track Lighting
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
LINE-VOLTAGE TRACK LIGHTING WORKSHEET
CEC-Nf!CC-LTl-05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTI-05-E
Indoor Lighting - Une-Voltage Track Lighting Worksheet (Page 2 of 2)
ProjectNartie: pgpg^ Source - 1923 Calle Barcelona, Suite 135, Carlsbad, CA DatePrepared: Q^/Q^., 5
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Greg Beaudette
Documentation Author Signature; Oigitady signed by Greg Beaudette
/ J --r^y'^ '^"='^'•^9 Beaudette, o,
Company:
Beaudette Energy Consulting
Signature Date: ^ em3ii^gcbead@yahoo,com, c^US
Address:
2261 Morello Ave, Ste. B
CEA/ HERS Certification Identification (if applicable):
''^^"^'^'"'^ Pleasant Hill, Ca 94523 (925)351-8936
RESPONSIBLE PERSON'S DECLARATION STATEMENT
1 certify the following under penalty of perjury, under the laws ofthe State of California:
1. The information provided on this Certificate of Compiiance is true and correct.
2. 1 am eligible under Division 3 ofthe Business and Professions Code to accept responsibility forthe building design or system design
identified on this Certificate of Compliance (responsible designer).
3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system
design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 ofthe California Code of
Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for
the building, and made available to the enforcement agency for all applicable inspections. 1 understand that a completed signed copy of
this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Tom Dobbins, Architect
Responsible D^slghef-^tenature: .--^ \ )\ \
Company:
The Dobbins Group
Date Signed:
04/01/15
Address: _
11 East Illinois Street, Suite 600
Ucense:
City/State/Zip:
Chicago, IL 60611
Phone:
(312)321-0400
CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014
SAN DiEGO REGIONAL
HAZARDOUS MATERIALS QUESTIONNAIRE
OFFICE USE ONLY
RECORD ID #
HHMBP#
BP DATE / /
Business Name Paper Source Business Contact Jeff Cardosi Telephone* 312.775.6936
Project Address 1923 Calle Barcelona Carlsbad state CA ^'P^"'^^ 92009 APN#
Mailing Address City State Zip Code Plan File*
Project Contact W. Thomas Dobbins Telephone* 312.321.0400
The following questions represent the facility's activities, NOT the specific project description.
PART I: FIRE DEPARTiWENT - HAZARDOUS IMATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not reauired for proiects within the Citv of San
Dieao): Indicate by circling the Item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are circled,
applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal.
Occupancy Rating: Facility's Square Footage (Including proposed project):
1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives
2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards
3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These.
4. Flammable Solids 8. Unstable Reactives 12. Radioactives
PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONIVIENTAL HEALTH - HAZARDOUS MATERIALS DIVISION tHiWD): If the answer to anv of the
questions is yes, applicant must contact the County of San Diego Hazardous Materials Division,
Call (858) 505-6700 prior to the issuance of a building pennit.
5500 Overland Avenue, Suite 170, San Diego, CA 92123.
FEES ARE REQUIRED Project Completion Date:
Date Initials
• CalARP Required
I
Date Initials
Expected Date of Occupancy:
YES NO (for new construction or remodeling projects)
1. D His your business listed on the reverse side of this fomi? (check all that apply).
2. • Kl Will your business dispose of Hazardous Substances or Medical Waste in any amount?
3. • 18 Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500
pounds and/or 200 cubic feet?
4. • ES Will your business store or handle carcinogens/reproductive toxins in any quantity?
5. • Kj Will your business use an existing or install an underground storage tank?
6. • Kl Will your business store or handle Regulated Substances (CalARP)?
7. • Kl Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)?
8. • Kl Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to
or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act).
PART III: SAN DIEGO COUNTY AIR POLLUTiON CONTROL DISTRICT (APCD): if the answer to Question *1 below is no or the answer to any of the
Questions *2-5 is yes, applicant must contact the APCD at 10124 Old Grove Road, San Diego, CA 92131-1649 or telephone (858) 586-2600 prior to the issuance
of a building or demolition pennit. If the answer to questions *4 or #5 is yes, applicant must also submit an asbestos notification forni to the APCD at least 10
working days prior to commencing demolition or renovation. (Some residential projects may be exempt from the notification requirements. Contact the APCD for
more infonnation.)
• CalARP Exempt
I
• CalARP Complete
I
Date Initials
YES
•
•
3. •
NO
•
Kl
Has a survey been perfomied to detemiine the presence of Asbestos Containing Materials?
Will the subject facility or construction activities include operations or equipment that emit or are capable of emitting an air contaminant? (See the
APCD factsheet at http://www.sdapcd.orq/info/facts/pemiits.pdf. and the list of typical equipment requiring an APCD permit on the reverse side
of this from. Contact APCD if you have any questions).
(ANSWER ONLY IF QUESTION 1 IS YES) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)?
(Search the California School Directory at http://www.cde.ca.qov/re/sd/ for public and private schools or contact the appropriate school district).
Will there be renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non-friable asbestos?
Will there be demolition involving the removal of a load supporting structural member?
Briefly describe business activities:
Retail store
I declare under penalty of perjury that to the best of my knowledge and bel
W. Thomas Dobbins
Name of Owner or Authorized Agent
Briefly describe proposed project:
Interior renovations in existing building (tenant improv.)
i'rnn'n npndr berein fre true and correct.
04/ 01 /2015
Date
FOR OFFICAL USE ONLY:
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:.
BY: DATE:
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
COUNTY-HMD* APCD COUNTY-HMD APCD COUNTY-HMD APCD
*A stamp in this box onlv exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply.
HM-9171 (03/14) County of San Diego - DEH - Hazaidous Materials Division
INDUSTRIAL WASTEWATER DISCHARGE PERMIT
SCREENING SURVEY
Date 04.01.2015
Business Name Paper Source
Street Address 1923 Calle Barcelona, Suite 135, Carlsbad, CA 92009
Email Address
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
Assembly
Automotive Repair
Battery Manufacturing
Biofuel Manufacturing
Biotech Laboratory
Bulk Chemical Storage
Car Wash
Chemical Manufacturing
Chemical Purification
Dry Cleaning
Electrical Component
Manufacturing
Fertilizer Manufacturing
Film / X-ray Processing
Food Processing
Glass Manufacturing
Industrial Laundry
Ink Manufacturing
Laboratory
Machining / Milling
Manufacturing
Membrane Manufacturing
(i.e. water filter membranes)
Metal Casting / Forming
Metal Fabrication
Metal Finishing
Electroplating
Electroless plating
Anodizing
Coating (i.e. phosphating)
Chemical Etching / Milling
Printed Circuit Board
Manufacturing
Metal Powders Forming
Nutritional Supplement/
Vitamin Manufacturing
Painting/Finishing
Paint Manufacturing
Personal Care Products
Manufacturing
Pesticide Manufacturing /
Packaging
Pharmaceutical Manufacturing
(including precursors)
Porcelain Enameling
Power Generation
Print Shop
Research and Development
Rubber Manufacturing
Semiconductor Manufacturing
Soap / Detergent Manufacturing
Waste Treatment/Storage
SIC Code(s) (if known):
Brief description of business activities (Production / Manufacturing Operations):,
Description of operations generating wastewater (discharged to sewer, hauled or evaporated):
Estimated volume of industrial wastewater to be discharged (gal / day):
List hazardous wastes generated (type/volume):
Date operation began/or will begin at this location:
Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority?
Yes r Hoj If yes, when:
Site Contact i . R^J Chandani ^ jitle
Signature »<A.rmiW LMi|gtf^ t Phone No. 312.321.0400
ENCINA WASTeVATER AUTTORITX ^00 Avenida Encinas Carisbad, CA 92011 (760)438-3941
FAX: (760)476-9852
PLUMBING,
ELECTRICAL,
^ CITY OF MECHANICAL 1635 Faraday Avenue
760-602-2719
CARLSBAD WORKSHEET www.carlsbadca.gov
Building^carlsbadca.Rov
1923 Calle Barcelona, Suite 135
Project Address:Carlsbad, CA 92009 Permit No.:
Information provided below refers to worb being done on the aboue mentioned permit only.
This form must bc completed and returned to the Building Pivision before the permit can be issued.
Building Dept. Fax: (760) 602-8558
Number of new or relocated fixtures, traps, or floor drains 8 fixtures
New building sewer line? Ves ^No^
Number of new roof drains? N/A
Install/alter water line? YES
Number of new water heaters? J
Number of new, relocated or replaced gas outlets? J
Number of new hose bibs? N/A
Residential Permits:
New/expanded service: Number of new amps:
Minor Remodel only: Ves No
Commercial/industrial:
Tenant Improvement: Number of existing amps invohedin this project: 200 AMPS
Number of new amps ini/olvedin tiiis project: 200 AMPS
New Construction: Amps per Panel:
Single Phase Number of new amperes
Three Phase Number of new amperes
Three Phase 480 Number of new amperes
Number of new furnaces, A/C, or heat pumps? N/A
New or relocated duct worh? .^^e^^ No
Number of new fireplaces? N/A
Number of new exhaust fans? N/A
Relocate/install vent? N/A
Number of new exhaust hoods? N/A
Number of new boilers or compressors? Number of HP N/A
B-18 Page 1 of 1 Rev. 03/09