The URL can be used to link to this page

Home My WebLink About1925 Calle Barcelona; 162; CBC2018-0178; Permit( City of Carlsbad Commercial Permit Print Date: 08/03/2018 Permit No: CBC2018-0178 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 1925 Calle Barcelona, 162 BLDG-Commercial 2550120400 $138,413.76 Work Class: Tenant Improvement Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Description: SOMA: 2976 SF T.I. -FITIING ROOM AND MERCANTILE SPACE (NO P/M/E) Applicant: MARY RYAN Po Box 3749 MISSION VIEJO, CA 92690 949-582-3735 BUILDING PERMIT FEE ($2000+) BUILDING PLAN CHECK FEE (BLDG) SB1473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-COMMERCIAL Total Fees: $1,344.33 Owner: T-C FORUM ATCARLSBAD LLC 4675 Macarthur Ct Tiaa-Cref, 110 NEWPORT BEACH, CA 92660. Total Payments To Date: $1,344.33 Status: Applied: Issued: Permit Finaled: Inspector: Final Inspection: Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and 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 FURT~ER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Closed -Finaled 04/02/2018 06/26/2018 8/3/2018 1:45:00PM $0.00 $764.45 $535.12 $6.00 $38.76 1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov City of Carlsbad 1635 Faraday Ave., Garlsbad. CA 92008 760-602-2717 J 2718 I 2719 / 2121 0/18 ~~\1).:::±:~~~~,t/J'J. ~ Fax: 760-602-8558 Bulldlnv Permit AppHcatlon JOBADDRt!SS 192J'Calle Barcelona " "' BEDROOMS f MTHROO "" . 162 Date OONSTR TYPE OCC. GRO V M T.I of the minor remodel of a fitting room to provide accessibility and a fefresh of an existing mercantile space In an existing exterior center .Space is combined with adjacent retail space Chicas .Existing Electrical ,Mechanical ,Plumbing systems are to remain. SQUARE FOOTAGE 2,976 S.F M CONTACT NAMI PERMIT RESOURCES ADDRESS P.O BOX 3749 CflY MISSION VEIJO STATE CA PHONE 9495823735 "" EMAIL MARY@PERMITRESOURCES .COM PROPDTY OWNIR NAME JLL -RETAIL ADDRESS 1125 SANCTUARY PARKWAY cflY ALPHARETI A STATE GA PHONE 6782265301 '"' ,.., RAJ.CHANDONl@AM.JLL.COM ARCll/Of.SKlNE,:t NAME & ADDAESS GERALD S. SHREMSHOCK WORKERS COMPENSATION ZIP 92690 ZIP 30009 STATE UC.I C-27005 AREPlACE YES #. NO AflPUCM1' NAME MARY RYAN ADDRESS PO BOX 3749 ""' MISSION VEIJO PNDNE 9495823735 ™"' STATE CA FAX Worbr9' Campenakn Dldltd1111: I hetebyatrilm !.VldlJrpen,/lyolpetjlll)"me of!lte ~ declan!tioo&; ZIP 92690 I lllw Md lffll lllllntaln • Oltllflcalil of-I ID ..... _,. for WO!t.eni' COlnpl!M8llon aa pllMded by Sedlon 3700 rJ Iha labor Code, for the per1om,""'8 rJ the \Wit for l'ltliotl !his permit ia iaaued. )IC 1111.1111:1 villlllllni.lft ---~~s 19CJ,lired~ section 3700rJthel.aborCode. rorllleperform.vioe rJtfll:lwork for~~f i\jeeued· Mywork!,rs' ~n insunn::ecailllr and p,:Alcy oont,er1we:l11&Uranc:.eeo 4~V-/\3~ PdlcyNo. fqoi:t:".30~ ~ El!pntklno.te kf-o)-Zo(C:, Thia aectloo need not be~ ff Ill& perml ill for OIIB hood!ed ~ (5100) or less. C9fllflcm d ExlfflPllon: I certify that I the peiformanoe ol lhe lflOlk for "Mlich thia permit ts issued, I sh .. not e!1llloy 111ry person In 91)' mannef llO "" to become altljm lo the Worl(ers" C<Jr!l)ens!!lion L..-al Calfomia WARtlNG: f111Uf9 ID ---.plllllllOll -.11 Lt, 1nd lhml llabttdall ~ Ill crlmlllll pilllltlll 111111 dvll 11-uptD -hundnd lhouund ...... (l100,GOD). Ill Mldltlonlll lhledd~ •pnr,kkidfll\ln Stc:lon fflli d Labarcocl9, lllllr9llalld .UO""'Y•'- ..S CONTRACTORSIGNAT\ME I hereby elltm lh.tl tam exempt /ll'Jlll Gonfllld(rr'r 1.Jcen68 Law for the follolllng -t:Vl; I, aa awnerofthep~ or myeflllloyees with wages s thelrtole~, wll dothe"Mlrt anclthealructure is not intendedoroffe!lldfor Sille (Se,;. 70M, Buatr.s and Prclossona Code: Th, Contrlldo,'1 l.icenaB Law does not ffl to an -d property 'MIO b\llds or Improves t11"'90fl, aid who does such work hlmaeff orllvough hill O'MI ~ l)lf)Yid!ld thlll such imp1t1Y91!19r11& se not lnlencied or dfered for Ne. It, ix-er, the b\lldilg or improwml!lrt 18 9l)kl Nthin on11 yea-al~. the owner4>t*lerwl llavethe b\liden of proo,ing Iha! he !id not buid or Improve for Ille pulp)M al &ae). L, aa t"'Mlllroflhe property, 1111 exdwnly conlrdngwjti llollllaed conlnlclonlto oonall\lcltheproject (sec. 7044, Business and Profll88loflsCode: The Coolra:tor's l..lceMe l.Ndoes not ll!)fjy lo an CMnBrof proplft)' ..tio buld1 or illJWIS thereon, and ronba'u for IUCh proled.l; with ccnrador{1) lloen&ed pursu.-,t to the Coolractcr'11.Jcense law). I am exempt undl!r section .Bualresa and Professions Code for ttls 1NIIOf1: 1.1 peraonaly plan to l)IOYi::111 the major ll!IOOI" an:l lnlMIWI for oonetnK:tlon al Iha proposed property ~merit Ya 2. I (119ni I h....., not) signed .., IM)ticalion for a buiding perm~ for the proposed wolic. 3.1 haw rontracted with the k6;iwing JICflOl'I (firm) to prlMde lhe prOfll)'ed CO'l9tllldlon {ndOOII nane addresa I phooe I oontraclorl' bnse nurrm): 4.1 plan to pn,llida pOl!ioros al Iha --1<. but I hlMI hired the folol,,jng person to ooordilate, IIUJll'l'Yise and pr-avid& the major wort (l!'ldooa name I address I phone I ~..n" lb,nse number)· 5. I .,... proYlde some al the \Wllk, but I have GOl'ltrilQecl (hired) !he lobNing pemlllB lo prov~ !he work Indicated Ondude osne I addms I pll,:me / lypll fll 'Mllk~ JI! PROPERTY OWNER SIQNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 11 lhe ~lean! or Mure buldlng OClCllp8li ~ to 81.tJmit a bulirlesll pis!, actHty hazardous mlllariela •ralim form or risk man,gement ~ p.-rtlon program under SectioM 25605, 25533 or 25534 al Ille Pfllll,,,--Tamerlilurdoua&malanceAooo111tAd1 Yes No I• !he •leant or future bt.ldlng ~ mquinld to obtain a pe,ml lrom the air polution oonlrd dilllr1ct or tllr qulillity managemen! diltrict? Ys No la thefriity to bitconatn.declwllhln 1,000fealdtheouterbound.y ol ,scllO<ll .ite? Y88 No IF NfY Of TitE ANSWERS ARE Yl:8, A FINAL CERTIFICATE Of OCCL.PANCY MAY NOT BE Issue:> UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUREIIENTS OF THE OFRCE OF EMEROENCY SSMCES AND THE MR POLUJ1IOH CONTROL DISTlllCT. lml!P/tlllt.lllMnlldtheeppblionllldllltBM111eabMWolnllllonllCIIIIIICtllldtllatthelnflllffllllononthepln15acant&llf'NtGCGIIIPlrVllll•CIIJ..._.._.Sballwlllllllllt:tDbullllllCOllll!Udlalt. 1 hnby dmze~ rlllll City rlenbldto --~ hi atlCMI IIWl"llonlld ~ftt blplldlon pupD11t11L I ALSO AGREE TO SA\£, INDBNFY AND KE8' HARM..ESS THE CITY OF CARLSBAD AGHNST ,6U UABILITlES. JUDGM:NTS, COSTS ~D EXPENSES VffCH MAY lN ANfWAY K:.cRUE AGAINST SM! CITY IN CONSEaJENCE Cf TIE GAANTING OF TIIS PBUT. OSHA: kl OSHA permil lare(Ji'ed b m:arttons !Mr"Sfl' dNp 11111 demollDn or oorMt\ldlOn d lru:lnsO!llr 3 m1el ~-,.. EXPIRATIQ,I: e..y permiliau!d by !he aB1!1 Oldal lnllrhl pr1M1i1m dlil Code ahlll .. by~ IJld becXllle rd nl wit lfhtding a-work duiZ8CI by ax:tJ permills rdcontraad 1111111 180 day& tom Iha dal rltudl ~orlfh tdlng orlllOlk IINIZ9d by WI permillaupencled or aan,d allff/ tne IDl!ew:rk Is CCll'l"l*1Clld b" a period d 180 ch,Ja(Sdon 106.4.4 lnmn Bukq Codei ,65 APPUCAHrS IIGNATURE 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 materials 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 lhe applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the atx,.<e information is oorrectand that the lnfonnation on the plans Is accurate. I agree to comply with all City ordinances and State lav.s relating to bultding construction. I hereby authorize rei:resentative of the City of Ca~sbad to enter up::m the above mentioned property klr inspectbn pulJX)SeS. I ALSO AGREE TO SAVE, INDEMNIFY N,JD KEEP HARMLESS THE CITY OF CARLSB-6.D AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CllY IN COOSEOJENCE OF THE GRANTING OF THIS PERMIT. OSHA: /:v1 OSHA pennlt is required for excavatons over 5'0' deep and demolition or c.onstruction of structures over 3 stories in height. EXPIRATION: Every pennlt issued by the \ding Offidal under the provisKlns of this Ccxle shall expire by limitation and berome null and vok:I ~ the buik:ling or 'Mltk authorized by sudl pennit is not rommenced Vvtthin 100 days from the date of sudl pennlt or if buik:!ing oroork authorized by sudl perm rt is uspended or abandoned at any ~me after the v.ork is rommenced klr a peood of 100 days (Section 100.4.4 Unifonn Building Ccxle}. ,w5 APPLICANT'S SIGNATURE DATE • 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 bui1dinq@carlsbadca.gov or Mail the completed form to City of Cartsbad, Building Division 1635 Faraday Avenue, Cartsbad, California 92008. CONTACT NAME ADDRESS CITY STATE PHONE EMAIL DELIVERY OPTIONS PICKUP: MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. 1) CONTACT (Listed above) CONTRACTOR (On Pg. 1) ZIP FAX OCCUPANT (Listed above) OCCUPANT (Listed above) MAIL/ FAX TO OTHER:----------------- A$ APPLICANT'S SIGNATURE CO#: (Office Use Only) OCCUPANT NAME BUILDING ADDRESS CITY STATE ZIP Carlsbad CA OCCUPANT'S BUS. UC. No. ASSOCIATED CB#,------------- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ' PERMIT INSPECTION H(STORY REPORT (CBC2018-0178) Permit Type: BLDG-Commercial Application Date: 04/02/2018 Owner: T-C FORUM AT CARLSBAD LLC Work Class: Tenant Improvement Issue Date: 06/26/2018 Subdivision: CARLSBAD TCT#92-08 GREEN VALLEY Status: Closed -Finaled Expiration Date: 01/29/2019 Address: 1925 Calle Barcelona , 162 Carlsbad, CA 92009-8461 IVR Number: 10476 Scheduled Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete 07/13/2018 07/13/2018 BLDG-84 Rough 063931-2018 Failed Paul Burnette Reinspection Complete Combo(14,24,34,44) Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-14 No Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout No BLDG-34 Rough Electrical No BLDG-44 No Rough-Ducts-Dampers 07/1612018 07/16/2018 BLDG-84 Rough 064125-2018 Passed Paul Burnette Complete Combo(14,24,34,44) Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical Yes BLDG-44 Yes Rough-Ducts-Dampers 08/02/2018 08/02/2018 BLDG-Final 065753-2018 Partlal Pass Michael Collins Re inspection Incomplete Inspection Checklist lte,n COMMENTS Passed BLDG-Building Deficiency See card for minor pick up No BLOG-Plumbing Final No 08/03/2018 08/03/2018 BLDG-Final 065927-2018 Passed Michael Colllns Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-Building Deficiency See card for minor pick up No BLOG-Plumbing Final No August 03, 2018 Page 1 of 1 City of Carlsbad CBC2018-0l 78 5/8/2018 DATE: 5/8/2018 JURISDICTION: City of Carlsbad PLAN CHECK#.: CBC2018-0l 78 ~ EsG1I A SAFEbullf Cornpany SET II PROJECT ADDRESS: 1925 Calle Barcelona PROJECT NAME: Soma & Chico's -Retail space -TI D APPLICANT D JURIS. [SJ The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. D 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. D The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. D The check list transmitted herewith is for your information. The plans are being held at EsGil until corrected plans are submitted for recheck. D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. D The applicant's copy of the check list has been sent to: [SJ EsGil staff did not advise the applicant that the plan check has been completed. D EsGil staff did advise the applicant that the plan check has been completed. Person contacted: / Telephone#: Date contacted: / (b~ ) Email: Mail Telephone Fax In Person D REMARKS: By: Morteza Beheshti EsGil 4/30 Enclosures: ' DATE: 4/11/2018 JURISDICTION: City of Carlsbad PLAN CHECK#.: CBC2018-0l 78 EsG1I SETI PROJECT ADDRESS: 1925 Calle Barcelona PROJECT NAME: Soma & Chico's -Retail space -TI D APPLICANT fl JURIS D The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. D 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. D 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 until corrected plans are submitted for recheck. D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. D The applicant's copy of the check list has been sent to: D EsGil staff did not advise the applicant that the plan check has been completed. ~ EsGil staff did advise the applicant that the plan check has been completed. Person contacted: Permit resources Telephone#: 949.582.3735 Date con17ctedA [JI//~ (b?\,Q) Email: mary@permitresources.com /f:Mail _fe1ephone\/M Fax l~son D REMARKS By: Morteza Beheshti EsGil Enclosures: 4/4 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576 City of Carlsbad CBC2018-0l 78 4/11/2018 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK#.: CBC2018-0178 OCCUPANCY: M TYPE OF CONSTRUCTION: VN ALLOWABLE FLOOR AREA: SPRINKLERS?: YES REMARKS DATE PLANS RECEIVED BY JURISDICTION: 1/16/18 DATE INITIAL PLAN REVIEW COMPLETED: 4/11/2018 FOREWORD (PLEASE READ): JURISDICTION: City of Carlsbad USE: Merchantile ACTUAL AREA: 6574 STORIES: 1 HEIGHT: OCCUPANT LOAD: DATE PLANS RECEIVED BY ESGIL CORPORATION: 4/4 PLAN REVIEWER: Morteza Beheshti 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 2016 CBC, which adopts the 2015 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 2015 International Building Code, the approval of the plans does not permit the violation of any state, county or city law. To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet number, specification section, etc. Be sure to enclose the marked up list when you submit the revised plans. City of Carlsbad CBC2018-0178 4/11/2018 Please make all corrections on the original tracings, as requested in the correction list. Submit four sets of plans for commercial/industrial projects (three 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 two corrected sets of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. 1. Please print all contents on sheet A14.2 loose non printed attachments are present. 2. Please provide dimensions to the bench(s) provided at the filling rooms to comply with CBC 2016 11 B-903 3. Please dimension the accessible bathroom to demonstrate compliance with CBC 2016118-603 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 D No D The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Morteza Beheshti at Esgil Corporation. Thank you. City of Carlsbad CBC2018-0178 4/11/2018 [DO NOT PAY -THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PLAN CHECK#.: CBC2018-0178 PREPARED BY: Morteza Beheshti DATE: 4/11/2018 BUILDING ADDRESS: 1925 Calle Barcelona BUILDING OCCUPANCY: M BUILDING AREA Valuation PORTION ( Sq. Ft.) Multiplier Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdil-i1on ! 'r.1dl cb By Ordinance 1997 UBC Building Permit Fee 1997 UBC Plan Check Fee Type of Review: 0 Complete Review D Repetitive Fee ..,. Repeats Comments: D Other D Hourly EsGil Fee Reg. VALUE ($) Mod. D Structural Only 1---------<I Hr. @ • 138,414 138,414 $764.51 I $496.931 $435.77\ Sheet 1 of 1 «~~', ~ CITY OF PLUMBING, ELECTRICAL, MECHANICAL WORKSHEET Development Services Building Division 1635 Faraday Avenue 760-602-2719 www .carlsbadca.gov Building@carlsbadca.gov CARLSBAD B-18 Project Address:\~2,.~_ (q\l e fuy-c,elol\.O. Permit No.: Inf~~'°"~ refen to wom being done on the above mentioned permit only. This form must be completed and returned to the Building Division before the permit can be issued. Building Dept. Fax: (760) 602-8558 Number of new or relocated fixtures, traps, or floor drains ....................................................... __ New building sewer line? ......................................................................................... Yes __ No __ Number of new roof dralm? ............................................................................................................. .. lmtall/alter water line? .......................................................... &!/!::::: ............................................... __ Number of new water heaters? ....................................................................................................... .. Number of new, relocated or replaced gas outlets? .................................................................... __ Number of new hose bibs' ................................................................................................................ .. Residential Permits, New/expanded service: Number of new amps: ------- Minor R I only: Yes__ No erc~rt,ndustrlah enant Improvement: Number of exlstln9 amps l11Yolved in this proJed: Number of new amps Involved In this proied: New Construction: Amps per Panel: Single Phase .................... bi./t:::: ............................ 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? ............................................................................ __ New or relocated duct worh? .......................................................................... Yes No __ _ Number of new fireplaces? ..................................... W//¥2,. ......................................................... __ Number of new exhaust fam? ........................................................................................................... . Relocate/Install vent? .......................................................................................................................... .. Number of new exhaust hoods? ...................................................................................................... .. Number of new boilers or compressors? ........................................................... Number of HP 8-18 Page 1 of 1 Rev. 03/09 ':'.l ... ,. g·--, l '/ ~'-1'~--'-.'+,.'.;,.'cc"•s.;,...,_---,,-====-==c----------, , , ' ,J :, ••• OFFICE USE ONLY ., .,,_,., .;. ... p -• SAN DIEGO REGIONAL HAZARDOUS MATERIALS JUN f~is~!. __________ 1 QUESTIONNAIRE c1 i: c); BP DATE Zip Code Plan File# 5. Organic Peroxides 13. Corrosives Explosive or Blasting Agents Compressed Gases Flammable/Combustible Liquids Flammable Solids 6. Oxidizers 7. Pyrophorics 8. Unstable Reactives Water Reactives Cryogenics Highly Toxic or Toxic Materials Radio actives _1ti.. Other Health Hazards C,:JNone of These. PART H: ljiAN DIEC;~ COUNJY QEP~NT OF ~tMRONMENTAL H~L!!;I -~W!3~US c¥,°'!B1~S QIYl~IQN 1~11!~1: If the answer to any of the questions IS yes, app cant must contaci e Ounty of an Diego Hazardous aienals1vis1on,SOoveandVenue, Uite 1 0, 8n Diego, CA 92123. Call (858) 50~700 prior to the issuance of a building pennlt. FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: 0 CalARP Exempt 1. 2. 3. 4. 5. 6. 7. 8. YES N {for new construction or remod~ing projects) D Is your business listed on the reverse side of this form? (check all that apply). O Will your business dispose of Hazardous Substances or Medical Waste in any amount? O Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? D D D D D Will your business store or handle carcinogens/reproductive toxins in any quantity? Will your business use an existing or install an underground storage tank? Will your business store or handle Regulated Substances (CalARP)? Will your business use or install a Hazardous Waste Tank System (litle 22, Article 1 O)? Win your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or rester than 1,320 aUons? California's Above round Petroleum Stora e Act . Date Initials 0 CalARP Required I Date Initials 0 CalARP Complete I Date Initials P;f:~~~ij~~~~i~~[&:~~11~1~~,~J;D~I~~~\!,!~~: Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San ~ iego, 9213 a c com c un .ca. ov (8 8 58 2650). o stamp required if Q1 Yes amt 03 Yes W Q.4-06 No]. The followin9 questions are intended to identify the majortty of air pollution issues at the planning stage. Projects may require additionafmeasures not identified by these questions. For comprehensive requirements contact APCD. Residences are typicalty exempt, except -those with more than one building+ on the property; single buildings with more than four dwelling units; townhomes; condos; mixed-commercial use; deliberate bums; residences forming part of a larger project. rExdudes garages & small outbuildings.] 1. Wiff the project disturb 160 square feet or more of existing building materials? YBES i 2. WiU any load supporting structural members be removed? Notification may be required 1 O working days prior to commencing demolition. 3. O O (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been perfonned by a Certified Asbestos Consultant or Site Surveillance Technician? 4. 0 O (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification may be required 1 O working days prior to commencing asbestos removal. 5. D }l!( Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet (www.sdapcd.org/info/facts/permits.pdf) for typical equipment requiring an APCD pennit. 6. O O (ANSWER ONLY IF QUESTION 515 YES) Will the project or associated construction equipment be located within 1,000 feet of a school bound a Briefly describe business activities: FIRE DEPARTMENT OCCUP BY· EXEMPT OR NO FURTHER INFORMATION REQUIRED COUNTY-HMO* APCD Briefly describe proposed project: DATE· I RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY COUNTY-HMO APCO Date I RELEASED FOR OCCUPANCY COUNTY-HMO APCO . A stamp 1n this box mill exempts businesses from completing or updating a Hazardous Matenals Business Plan. Other pennittlng requirements may still apply . HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division , UST OF BUSINESSES WHICH REQUIRE REVIEW AND APPROVAL FROM THE COUNTY OF SAN DIEGO , DEPARTMENT OF ENVIRONMENTAL HEALTH-HAZARDOUS MATERIALS DIVISION Check all that apply: AUTOMOTIVE D Battery Manufacturing/Recycling D Boat Yard D Car Wash D Dealership Maintenance/Painting D Machine Shop 0 Painting 0 Radiator Shop D Rental Yard Equipment 0 Repair/Preventive Maintenance D Spray Booth D Transportation Services D Wrecking/Recycling CHEMICAL HANDLING D Agricultural supplier/distributor 0 Chemical Manufacturer D Chemical Supplier/Distributor D Coatings/Adhesive D Compressed Gas Supplier!Distributor D Dry Cleaning D Fiberglass/Resin Application 0 Gas Station D Industrial Laundry D Laboratory 0 Laboratory Supplier/Distributor 0 Oil and Fuel Bulk Supply 0 Pesticide Operator/Distributor CHEMICAL HANDLING D Photographic Processing 0 Pool Supplies/Maintenance D Printing/Blue Pnnting D Road Coatings D Swimming Pool 0 Toxic Gas Handler D Toxic Gas Manufacturer METAL WORKING D Anodizing D Chemical Milling/Etching D Finish-Coating/Painting D Flame Spraying D Foundry 0 Machine Shop-Drilling/Lathes/Mills D Metal Plating D Metal Prepping/Chemical Coating D Precious Metal Recovery D Sand Blasting/Grinding D Steel Fabricator D Wrought Iron Manufacturing AEROSPACE D Aerospace Industry 0 Aircraft Maintenance D Aircraft Manufacturing OTHERS AND MISCELLANEOUS D Asphalt Plant D Biotechnology/Research D Chiropractic Office D Co-Generation Plant D Dental Clinic/Office D Dialysis Center D Emergency Generator 0 Frozen Food Processing Facility D Hazardous Waste Hauler D Hospital/Convalescent Home D Laboratory/Biological Lab D Medical Clinic/Office D Nitrous Oxide (NO,) Control System D Phannaceuticals 0 Public Utility D Refrigeration System D Rock Quarry D Ship Repair/Construction 0 Telecommunications Cell Site D Veterinary Clini<:/Hospltal D Wood/Furniture Manufacturing/Refinishing ELECTRONICS D Electronic Assembly/Sub-Assembly D E~ctronic Components Manufacturing D Printed Circuit Board Manufacturing NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH lYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880. LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which indude any of the following operations or equipment, will require dearance from the Air Pollution Control District. CHEMICAL 47 -Organic Gas Sterilizers 32 -Acid Chemical Milling 33 -Can & Coil Manufacturing 44 -Evaporators, Dryers & Stills Processing Organic Materials 24 -Dry Chemical Mixing & Detergent Spray Towers 35 -Bulk Dry Chemicals Storage 55 -Chrome Electroplating Tanks COATINGS & ORGANIC SOL)(ENTS 27 -Coating & Painting 37 -Plasma Arc & Ceramic Deposition Spray Booths 38 -Paint, Stain & Ink Mfg 27 -Printing 27 -Polyester Resin/Fiberglass Operations METALS 18 -Metal Melting Devices 19 -Oil Quenching & Salt Baths 32 -Hot Dip Galvanizing 39 -Precious Metals Refining ORGANIC COMPOUND MARKETING !GASOLINE, ETCI 25 -Gasoline & Alcohol Bulk Plants & Terminals 25 -Intermediate Refuelers 26 -Gasoline & Alcohol Fuel Dispensing COMBUSTION 34 -Piston Internal -Combustion Engines 13-Boilers & Healen; (1 million BTU/hr or larger) 14 -Incinerators & Crematories 15 -Bum Out Ovens 16 -Core Ovens 20 -Gas Turbines, and Turbine Test Cells & Stands 48 -Landfill and/or Digester Gas Flares ELECTRONICS 29 -Automated Soldering 42 -Electronic Component Mfg FOOD 12 -Fish Canneries 12 -Smoke Houses 50 -Coffee Roasters 35 -Bulk Flour & Pov.Jered Sugar Storage SOLVENT USE 28 -Vapor & Cold Degreasing 30 -Solvent & Extract Orien; 31 -Dry Cleaning ROCK AND MINERAL 04 -Hot Asphalt Batch Plants 05 -Rock Drills 06 -Screening Operations 07 -Sand Rock & Aggregate Plants 08 -Concrete Batch, CTB, Concrete Mixers, Mixers &Silos 10 -Brick Manufacturing OTHER 01 -Abrasive Blasting Equipment 03 -Asphalt Roofing Kettles & Tankers 46 -Reverse Osmosis Membrane Mfg 51 -Aqueous Waste Neutralization 11 -Tire Buffers 17 -Brake Debonden; 23 -Bulk Grain & Dry Chemical Transfer & Storage 45 -Rubber Mixers 21 -Waste Disposal & Redamation Units 36 -Grinding Booths & Rooms 40 -Asphalt Pavement Heaters 43 -Ceramic Slip Casting 41 -Perlite Processing 40 -Cooling Towers -Registration Only 91 -Fumigation Operations 56 -WWTP (1 million gaVday or larger) & Pump Station NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITTING AIR CONTAMINANTS MAY REQUIRE AN AIR POLLUTION CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL DISTRICT AT (858) 586-2600. HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division