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HomeMy WebLinkAbout1930 KELLOGG AVE; ; CB973059; Permit'· B U I L D I N G PERMIT' Permit No: CB973059. 12/01/97' 12: 50 Page 1 .of 1 Project No: A9703905·· De~-elopment No: IMPROVEMENT Suite~ Lot#: .Job Adgress: 1930 KELLOGG AV Permit ·Tyi;:ie: COMME~CIAL TENANT Parcel No: 212-170.:._01-oo Val~ation: 184,356 ·occupc:!ncy Group: Reference#: . Construction _Type: Status: 1882 12/01,:tijS~i~~~ Apr ;rs-:t;'&:M: NEW ISSUED · Descrip~ion: CTI 5121 SF, ELEC, INTER_IOR : MEDICAL LAB/OFFICE f~r~§4 .. 619 Erttered By: 486-508;1 JM Appt/Ownr : HARRIS BARBARA PO BOX 93'0 POWAY, CA 92074 **'* Fees Required *** ~-~-*-----Fee~ Collecte<f & Credits· *** ---. --------. ------------/4/ /' /:---7;:-,-----r._ -~-""· .-----. --. -----... ------- Fees: 6,409.00 , ,:,-\ ·\ ;:1\ /,')) "':-. Adjustments: /' . oo;:·~;\ ( \ .::::J{,,,-..,89t~Jj9redi{-s: . 00 Total Fees: 6',.1403. 0\0), ·.) To-caJ.~Paimenes: · 684. 00 ' ""--' "-' (\ \ ~ / ,, __ .,,._.,.,.,-;;:.; --~~,'a-~ej>{1e~· 5_,719.00 ·· Fee description / \, / .,.:,?,/1 t·tini b~ '~F~e/ i:t Ext fee Data J_ •. .._ ' / /,,-J//fl, I .~"",.,,\ .._ (Q _.,..J ---.. -ld-:-'-------:----/ -/ ,.--';...' .. -------r,, -v'\1-;\.::,,,..-----\\-'-.....s" ---· \·------------------ Bui ing Permit , r.1---.·~ ) / \."':: ~ "'-:.'.,...._1,,._"_....._,..,, .... -.;,-,....-:7 .~) . 9 37. O O 'Plan-Check _! • / ,-._: ~----~:s:~::-:-,:, ..... ____ .. /V V .", 609. 00 Stro.hg Motion Fee/ ·0 , ; ' -~~. . ... ····· n\ r;:: .. 7 \ 39. 00 . Enter 11 Y11 to Autobalc ... License T}x >·f::.Y · di} \\J 1 I .3355.00 Y Enter Traffic Impkct"-Fee\ ~'-111\f\~-,fif· 2i· ·--;·0·~ ,.__-:,,/ .. } 12 3 3. 00 * BUILDING TOTAL \ \ ,:·: "·--...(}[!\ \ · ' ( 'I> r J . 617 3, 0 0 . ·Enter. "Y •• ~or P~um~ing Is~u~"' Fe~~ . J ; / 2 o. oo Y Each Plumbing Fixt~re or Trap~': ~ F ,c-_:,;;;.--5 1 7. ~o 35. oo Each Instal)_/Repair, Water __ L'j_,pef_j . ) \ ,'4 --i/ · · 7. irn . 7. 00 * PLUMBING TOTAL \ ,.--.,....,> '-.'" lNCORP(?RATED ,./ ('..... / 62. 00 Ent:~r "Y" for Electri-y i~~-~1,;f: ~'e-... ._lJL_ .. .-~~~\\\ \~("1/7 .. · 10. 00 Y Remodel/Alter Per AMP "-., ,,,..,::_1; .) ,-1 > .. -·, ('"4·0.tf'0 \. . 2 5 1 oo·. o o * ELECTRICAL TOTAL "·, ' ( f ·' / ~:, /;:::, \ D ( \'\:;') · _110 . 0 0 ~nter 'Y' for Mechanical I~ui :F<ie> {<\.j)\>., '-· / 15. 00 Y . . ' ~-~ _Ins_tall FU:rn/Ducts/Heat Pumps'--·,-.. .. _,..> ..,............ ........... ·4 9. 00 36. 00 Each Exhaust Fan >----·-,1 6. 50 6. 50 * MECHAN:(CAL TOTAL 58. O·O ""-; ,1 Fl Na~ ... · ·pPROVAL ·. · ··oATE /tt1(_ INSP.. . -----· ~/1~, i 1, l'.(, ... CLEARANCE_,.·--........ ....,................;- . ,4~~~;_,~p:MP-~ CITY OF Ci\R!-SBAP 2075 Las Pali:nas Dr., 'Carlsbad., CA 92009 ::(619) 438-1161 Pl:RMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT CA 92009 Description of Work SQ. FT. · s r #of 6~ . t.,;Ju of Bedrooms • # of Bathrooms I~~,4a-ao~:o'~L,Z:,£.~.c-11c:.-t)-:·:'",':&()9:_3...,..0·:,:~;-7_:,.-:\-::.:.~--,,:1,-;.·-· .. ·._:·,"~;,.fi:;::-:, .. ····,:;;,·.--::-:i,~:i:-"/::"t···.-::<::.~-;":-·7·:··.·:·: ~'"'aMAfs~MA-'~7&;~~ ··p,;;µ~-ffiJJ'&· "'f.io Ba~-·-9ao' t~·~7"·c+-' ···cr~1:S7~&7~~2J.~Z~5bJ// Name· · Address ___ ,,..,..""'""_ ·City . •. ·state/Zip . Telephone # Fax # j;,Jlf ,· •• ARPJ.:l"AN.T. ·. '-1IJ-1· conlr'actdr' ., n,Anent:for'Contra,.,.or · <:·r-::t._.owrt'er : tt;A~ for· Qwn'fr'. ·: : ,· ,: ... · = :-·': v ;: '. '<. ·f',~Z ,· ':1<-~--~-?:;;:-;.:;., '.·, .. :C', ~~ ;:::,Tc'?~ ,,r,Z;t_··~-z·~::::;:J·· .. -~--·""-=;a7frtS""·:·c;~;r'3-N6i ····;:;t)·;;;/:;rz;:·c:;;p/)~-if--... z.:J2:i7cJ-"9s<?J . Name Address · City ~ · State/Zip · Telephone ·# r~c~,~~35~2£>::-y8~·-·:·.·:~.-,,.i~~~--A.·~;::· ·c!;&-,;'/Jj)j·,·~·~·:··r~:~':·:·13/y'~-7:~:-r::·:.:·,·:·::·:·:7:,.::.: .. ··;,;.,,1 Name · r Address City S,t!lte/Zip_ Telephone·# r~~Q.Qlfi8'~.Q.'t,Q.ll..t...CPM.~N):--m.1111,1~ .•. _;,,,,/ ,· »--~ , : -:;:,. -~-~~-~z:.--:.:.. .... ~::::::::·.:.; · . -. -. · . "':.::t~~~-~~:::,'f.L;;;.-:~~:;:::·{; I:::1.:-":~.:;i:tl ,(Sec. 7031.5 Business and Pr.ofessions Code: Any City or County which requires a permit'to construi;t, alter, improve, demolish or r_epair any structure; p,r.ior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed purs.uant to the provisions of the Contractor's License Law ··[Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions .Code] or that.:he is exempt. therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the ~ppli9ant to a civil penalty of not more.than. five hundred dollars [$500]). I CB · · 7tf~v TJ2:t:De ST ..ST£.A '$tP Dl~o a-9Q..f12 ... .,/ . State/Zip Designer Name State ·License # ~si,~.QR.({J:R~s:,:;:_:;QQ:;· :;M;:;;.m;;;~;;:;t,L;:;;S.:;:~;;;;l;;:::l,Q:;.!'!::;::,:;:0:::;.:;:::.:._,_:::::::c~a.=I:::;:::;;:z:.-__:;:::;-:;:::__,::~ ._, ~-==~:.,,,;..,.,.,,:,,:..,"__,,;.;,, :.,·::.:i:.c:.2:.::;... :•_-, · ,,,.::,;;,;.:::.:..!::;L,,;.,,· .. :·:i,;:, ,:t.:.s;::::;_~;,:::::::_,;:::;~-z::; Workers' Compensation Declaration: I hereby affirm under pe~alty of perjury one of the following declarations: 0 I have and will maintain a .certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the· performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company ________________ ~--Policy No •. -'-'---~----'----Expirati;m Date _______ _ (THIS SECTION·NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OiUESS} · 0. CERTIFICATE OF EXEMPTION: I certify-that in the performance of the work for which this-permit is ·issued, ·1 shall not employ any person in any manner so as to become subject ·to the Workers' Compensation Laws of California. · · · WARNING: Failure to secure workers' compensation covarage Is unlawful, ·and shall subject an employer to criminal ·penalties and civil fines up to ·one hundred thousand dollars ($100,0001, In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorn!!y's fees. SIGNATURE ______________________________ DATE _________ _ ~~:~'Q,J!Xft~.B~ lJJ!i.Q~ftQ~l;Ali~I!Plil.:.. ..:.~ -..,...:::.,;, •. ~:·:..:..,,;.,,_:.,,:,.:.~~:......:.'.,,,,,~ :-.:, ~-~ .. : .. ;;. .. 1 .. 5..:...:.::....:......:;;:;,;:},,;;;.iJ::.:...:..:G. '·',,,,ii:::c,,:~,;;;:;J;;::..:::J:,J;,;;_'~ <';. 71::·:.:,:0':.;J,:~~'-,:; I hereby-affirm that I am exempt from the Contractor's License Law for the following reason: 0 I, as owner of the property or my e_mployees with wages as their sole compensation, vvill ·do the work and the structure is not intended· or offered for sale (Sec. 7044, Business and-Professions Code: The Contractor's License Law does not apply to an owner .of property who builds or improves thereon, and who does ,such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, how1a1ver, 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). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the· project (Sec. 7044, Business arid· Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with· contractor(s) licensed pursuant to 1he Con.tractor-' s License Law). · 0 I am exempt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property.:improvement. tJ YES · ONO 2. I (have / have not) signed an application for a building permit for the proposed work, 3.--I have-·contracted, with the following person (firm) -to provide the proposed construction (include name / address / phone number / contractors license number): '4. I plan to provide portions of the w-ork, but I have hired the following person to coordinate, s~pervise and provide the major work. (include name / address / phone numb.er/ contra~tors liceose number): ___________________ ~------------------------ 5. I will provide some· of the work, but I have contracted (hire_d) the following persons to provide the work indicated (include name/ address / phone number/ type of work): ________ ~----,------------------~------------------~---- PROPERTY OWNER SIGNATURE______________________ DATE ________ _ £coup1;1:Fi"i:;·ifule> 'SCOT(0lllFOD' AtON,"'ES/@Al;rtAI :1>~111;ow,Fpc¾1TS:ON•·v::--fa• .. '.""',: ·, " ","' "'-. ,' ·:-'::·,: ... ::,A'.··!!",~>-.:.,,,,":; /l ,: ,!,./J??' ,• •\f·· ,>;;:7;,:,:-;;-:.'· ,· .. ' <,,.,,, ·; ,....,..,,,.J,.ll(J;,.,., ,~.,J.,!t-~~.!.JJ~-'>, ti',_, ~ .. ,~\f!!,.., ,•~-w~,,~~"!J.~ ~_.,.f!J!.,..~~~<O .... ,,_., ~"'<;,y, <If,;,,¥ :.....h,,. ~ ,,,,.._,,..,V.....,,.WN> v~a-'<'-"'-~ .. '-.;,,,,,.:_w-~ ._!,....«¼"'.'>•,; >.;:,:;.«',,..<-A , ....,_~?W'', ,,_,, W ;....,,A. :X ,.1;,,-«\,'w,,-, ,~ (,:;,.....',.Sh ,,.,;._h,'," _,-.,, ,,,,,o.*:-,..,J~;;/...,. 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? 0 YES ·D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control, district or air quality management district? 0 YES D NO Is the facility to be constructed within 1,000 fee_t of the outer boundary of a school site? 0 YES D 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 CONTROi. DISTRICT. - i!rii.Z,~:§P.~,llUlP..11Q1L,\;.~P!R<iA~fJ9),'' '~\.-.:.:,;,.L .. :.C~ -~7-,.: .. __;;_ :..":.-:.':.-~-:;;;;:, ::~-:llE:3:; .. ,;:·:.,_~-::::,~:.L-.:.~ :i'!:;,:i:·,_ ~:,,.::....::::,;:,,..,,:JlrJ:f-'." ·.:f'R;.::'.;-: I hereby affirm that there is a c.onstruction lending agency for the performance of the work for which this per.mit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS l~;,:~:.::~em:1c~rt1z.g,eBT:lf..lCAno...rt:..... ~ ~.....:~~ __ -:~::..;.,_._~~-:..,, :..-.•. ~ :...:~;.:,~,;:, . .:.. :!_ :...-: _,.;·t:;.~;:;,,_':..;;:,·:--::.7~:.z~:~-:;.;:;.+,;,;:.;~~:,-~; :::. ~-~c~:;, ,:;,;-::::;, ~;.;...;.·~::1.;..t:0,:;:•--;;,;; :'Ii::E ~,:"7] I certify that I have read the application and state that the above information ,is correct and that the ihtormation on the plans rs accurate: I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives ,of the· Citt of ·Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KE!:P HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGM!:NTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID.CITY lril CONSEQUENCE OF THE !;RANTING OF TRIS PERMIT. , OSHA: An OSHA permit is 'required for excavations over 5'0" ,deep and demolition or construction of strU,ctur~s ~ver 3 stories in h~ight. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code· shall expire by limitation and become null and void if the building or work authorizecl py such permit is not commenced within 365 days from the date of suqb. p(lrmit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ________________________ DATE ___________ _ WHITE: File YELlOW: Applicant . PINK: Finance \ ~\ '01/13/98 1:3:22 Page 1 of 1 BU IL D. ING Job Aqdresl:i: 1930 KELLOGG AV Permit Type: COMMERCIAL TENANT IMPROVEMENT Parcel No: 212-170.:.01-00 Valuation.:. 184,356 Suite: Lot#: Occ;:upancy Group: Reference#: D.escription: CTI 5121 SF, ELEC,INTERIOR : MEDICAL LAB/OFFICE Appl/Ownr : HARRIS BARBARA PO BOX 930 POWAY,·CA 92074 619 Permit No: CB973059 Project No: A9103905 Developrrt'ent No: Construction Typer Status: Applied: Apr/Issue: Entered By: 4e 6:-5oe.1 NE;:W · ISSUED 10/15/97 12/01/97 JM . ' ' *** Fees Required *** **-*-¥ -~-. Fee.s co·11ected & Credi t:s * * * ~...,.:-.··w•' ____ , ~---' ---------• . --' ---------' --__ , .--.--------.------------~ Fees.: 6 , 5 O 3 ;,P{f ,,. . ,,,;, , /"\ ,"' ~-""-~, · . · 2927 01/13/98 0001 01 . 02 Adjustments: / · O~ ..... \ G,, \_>. .. , lr?'\O,iCE!,1; £redJ ts: . c..:PRiiT· 00 . Total Fees: 6, J-03. 0-9~" \0 --· (, Tdt):~r,Paymeri\s: . 6, 403·. 00 / \"---.// B<:i(4nce:::::.0u~: 100. O·O Fee description / ·\ ~-,,,/':;?,...../_.,. :(l:n}.:fs(:~)§:.ee/tlnit· Ext fe.e. Data I .... , ' / ,.,. 1/..-; ~ ·"-1/. "'\ :,. . ----------------------------7-----------~----------w~--------------------.--Buildi.ng Permit / ::~~---...... --. I · .,../T!;\;xf;~-\ \:::,r.., \ -937.00 . · · Plan Check / /"": / "'Z:.~~ •:::--.:::::::;..--:::::::::::::::---~> /, :? \ ~ '\ 609. 00 Strong Motion Fee/ ~, -<: / ¾..~~p~ \ (~ 39. 00 · Enter "Y" to Autocale License x ·), b······ · ,JP·\ C' i ) 3355. 00 Y Enter Traffic Impfic~:~e~ '. ;t'V, ~ .. 4'1).J,,233_.!. 0))~-· l ~J_; 1233. o,o Enter "Y" for Plumbing !~so.,e ... 'ef/ ~~ I (/ ,,.. J . 20. oo Y Each Plumbing Fixt;ure or '!I'~p ,/./}:--!\' ;Jll! tf 7. oq 35. 00 Each Install/Repai:~ ~ater ~in~t. 'S'v? ~ _Ji~-,/ 7. 0·0 7. 00 Enter "Y" for Electric Iss~f;ee '-'> ·:--::, (...,,.-· /' / 10. 00 Y h h · :,., , / \ Uj T ree P ase Per AM.c:, ,,~:~, ,__, !N~ORPORATED 2,2. I'~ •/50 100. 00 ~emodel/Alter Per AMP\ \, '',,-, "-> 1~f2 /40~\\'v;.:> /~25 100.00 'Enter 'Y' for Mechanicr~l":::,~~p.e1 Fe'e~--·L--··-/ (~'\~J . 15~00 Y Install Furn/Ducts/Hea-e,'-Putripi:l{ (/ :"}_, /,~.0(o)\ ~ / 9. 90 36. 00 Each Exhaust Fan "'"'---Z...,,, ! / l .':> '() \. ~s \,) 1 6 . 5 0 6 . 5 0 ' "·····~ ,, ·~f \~ \) / ' -/--................ v _____ ~,_,.,.,,...,.,.,,- 100 .. 00 ·r IN':" · . ' .i ~~--·-- CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-116.1 S E W E R P E R M I T 12/01/97 12: 55 - Page 1 of 1 Job Address: 1930 KELLOGG AV Permit Type{ SEWER -OFFICE/WAREHOUSE Paroel No: 212-170-01-00 Description: CTI 6-053 SF, ELEC,INTERIOR -. : MEDICAL LAB/OFFICE Permitee: HARRIS BARBARA Po· BOX 930 POWAY, CA 92074_ . . Suite: Pe.rrrrit .No: SE970191 Bldg Planck#: CB97305.9 1882 12/01/9:i'tOOO!ti:O! I $)JUED App!lflMlf:: . 10 l~!1S1J!l; · Apr/IS$U6~ i2/01/97 619 4-'8~6-5·08i Expired·,:. 0 _Prepared By: PR FI.NAL APP·ROVAL -INS-P. ___ -DATE __ _ CLEARANCE_-'"!-___ _ , r tlia',;.t Aid ---- · CITY OF CARLSBAD . 2075 Las falnias Dr., ·Carlsbac;l;, CA 92009. (619) 438-1161 CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB973059 FOR 01/15/98 DESCRIPTION: CTI 5121 .SF, ELEC,INTERIOR MEDICAL LAB/OFFICE TYPE: CTI JOB ADDRESS: 1930 KELLOGG AV APPLICANT: HARRIS BARBARA CONTRACTOR: OWNER: REMARKS: C/BARRY/619/719-3990 SPECIAL INSTRUCT: TOTAL TIME: --RELATED PERMITS--PERMIT# TYPE AS970202 ASTI PHONE: PHONE: PHONE: STATUS ISSUED INSPECTOR AREA TP PLANCK# CB973059 OCC GRP CONSTR. TYPE NEW LOT: CD LVL DESCRIPTION ACT COMMENTS 19 .ST Final Structural 29 PL Final Plumbing 39 EL Final Electrical 49 ME Final Mechanical ~.......,...._ ____ _ E--- ----------~----------------------------· --------------------------------------- ***** INSPECTION HISTORY***** PATE 011398 011298 010998 0108,98 010798 123197 123197 123197 123097 123097 121697 121597 i21297 120997 120897 120597 120497 120497 120497 120497 120497 120297 120297 DES.CRIPTION Final Combo Final Combo Final combo Final Combo Rough/Ducts/Dampers Frame/Steel/Bolting/Welding Rough Electric Rough/Ducts/Dampers G:tout Rough Combo Footing Footing Interior Lath/Drywall Interior Lath/Drywall Interior Lath/Drywall Frame/Steel/Bolting/Welding Rough/Topout Rough Electric ·underground/Under Floor Underground/Conduit-Wiring Frame/Steel/Bolting/Welding Frame/Steel/Bolting/Welding Frame/S~eel/Bolting/Welding ACT INSP CO TP CO TP NR Ti? NR TP CO TP AP TP AP TP AP TP CO TP CO TP AP TP CO TP AP 'rP PA PD PA TP PI TP AP PS AP PS AP PS AP PS AP PS AP TP AP TP COMMENTS CORR NOT COMP SEE LIST ATTCH FIRE SIGN OFF SERVICE RECP@ ROOF EQPT T-BAR CEIL CEIL LITES DUCTS-ND A/B REV SEE JOB CARD VERT BARS REVERSED WHSE SIDE OF DMZ WALL DEMISING WALL RMS 114-124 & DMZ WALL ONE Sibi SCREW REMOVAL@ TOP TRK ASMB WALL BRCING@ EXT PNLS OPENIN REINF@ ROOF FOR BRACING City of Carlsbad 2075 Las Palmas Drive, Carlsbad Califomia 92009 IN.SPECTION RECORD INSPECTION RECORD CARD WITH APPROVED PLANS MUST BE KEPT ON THE JOB · . . . . CALL PRIOR TO 2:00 P.M. FOR NEXT WORKDAY INSPECTION .IW#~ .... DING I SPECTION: (760) 4:38-3101 JOB ADDRESS: --l.-:.I.L_:~-~~~~:,__-J.1..ll..~~----'------'-.....,.-r--::- OW.NERS NAME; --~....,,_~.,--.L..--..a._,.....--------------i~...__ ......... ~._.._--.....z...,.___...-::r:z:--7,,.,,..,,........._ U O CUPANCY TYPE CONST. PERMIT NO. CONTRACTOR : :: i ::::i::=. ' ' APPR.OVED TO COVER ,,, ,;,. ' .. TYP~ of Jnspection Date · lnsptctor ~li-+' Notes BUlLDfNG ' I ,L//l'Jt~ it • .Ah ~,.~~----~.,,. ·--.... It:,~ .. FO!)NDAT!ON ' ' '' I ~ ...... JA A-,-.i . .J .1.f,.,u, /AM! ff~ R~INFORCED STEEL I," I ' . tv,ASONRY D GRO\JT> 0 WALL DRAINS '' . ' TILT PA!"ELS ., POURSTRfPS l ,,.. . ' .. .. - CO~UMN FOOTINGS I .. /) .. ~ . SUBFRAME 0 FLOOR 0 CEILIN(i --~~ ~_,«/// /.JAlr ROOF'SHEATHING , ! . EXT. SHE~R PANELS : i. i ·-: FRAME -. ,,~4 .. 'l7 f"'f .H .,,.c, ,-_ -__;___'1 ~ ~ ~ J ~/~ ~~ lt-:,1S ULATl~N , A~'l)~, .. -: . :.,·~ /) ---l:XTSRIOR I.A rH . /'") . ' i-~ ... -L' _A_ ---D ~.JL/~~f--" . -· ..... INT~Rl9R lATH & DRYWALL /c:J;//4'-/&/? J ~ , .. FINAL r , . ' .. ' PLUMBING .. ... ,. ,, Cl SEWER • .".NO BUCO Cl Pl/CO .. . -, . . . ' --.. UNDER.OR.OU NO JLWASTF. Cl WATl:R ,1. .:...t..f ... , ? ~!Cf(./~~ TOPdl!.1: .CJ WASTE D WATf.R . ... TUB ANO SHOWER PAN • 'j_. : . ' .. ' ... ,. OGAS.JEST 0 GAS PIPING '\' I I. ; Cl WAl'.~R HEAT~R D SOlAR WATER .. '" .. : FIN~l' . ( ~·'\' '" y .. ELECTR/C1\L -.. . ji:.ELE~~IG UNDERGROUND 0 UFER 12 .... r., .. 77 l'..J!!" ..L./ : •,~,• I + ·'· ,. ROUq~ ELECTRIC WALLS l~ ... 'f ', '7. . , ~ .,,~A -~ .. , , . . , ' . ROL!,9~ ELECTRIC CEILING /~/fl)/ ~'1 .,.-. , : ,, .. ' ,. .. ·' '' .. ·-. 0 E~~C,:RIC S_ERVICE t:J TEMPORARY ,, , ·-~· .. . '-f~ ... l .. ' ... ·i.·: 0 BONDING ·.o POOL ;;_.··,.,, ,, . ffNAl-':, : . ,, ,. · MECHANICAL ; ·,· I "• '' ,,. u.~-~ERO~OUND _oµcrs & PIPIN(; I •,• . "~ l: .. : .. ·:: I -·, c::I ~\JCT· & f>~EM,O REF. PIPIN('i 1v11/~ rt"' •h,1~./ ,,/.H,'A .,,JI.A 8'#U/ . ..-,· ... ·;.. _.:;. / . .......... ·H~A~····1'1R COND. SYSTEMS •. • I ""'~ AJA.A .4.h.A . .. ~ . 1 . . . : ~· , . -'-'.'ENTILA TINC svsrEMS •AOO A..1r· ..<t,A. 1"'· A~1~··.-•' '• f!NAli. -'. , .. CALL -F.OR FINAL' INSPECTION Wl-/f.N A l.LAPPROPRIA TE ITEMS ABOVE HA VE fli(f'VAPPROVED ,., ,.,. '/' ·, FINAL:' · Sign. When Appropriate // . ·:t ; ... , ~ ... . . . Buildi~g Dep(. (l,nspectionsl 438·3101 ///011 /~ ,, ,. ,, ' _,. ...... ,_. ..... Fi_re (?epar:tment · 931·2121 1/o!W "ft. l ll.. ---rlvon,--' SH/Jtu1,-.... .,. t P!ann,ng-Departmimt 438-1161-I ., ··~ \,Engil'.!,-eering Dept_, (Inspections) 438-3891 •' 8oildirig hjspectors (7am-4pml 435,,3550 cM~D 438-2722 Ext 15 ' Wa~er ,Inspections . 438-3891 . .. REV4'96 SEE BACK FOR SPECIAL NOTES , I i 'l 'l , I I I I . I I I ! I I ' . ' i ' °' ' > ,_ I• •~ .. •;-.~: ... ,;.1-,..' • .:_ ••"",/,. _,.,,__~•,• ~.::.' J;.•. ,,-.;> •' ,.,-,,. ... ' U ,__ > ...... • • ' o ../. .. ...,_,IL .. ~ ... ~ ~ '"--.... ":., .... -l'.,_ •. SPECIAL INS~ECTION PROGRAM ADDRESS OR LEGAL DESCRIPTION; /9.31, . K-E¼>66 ,Ava PLAN CHECK NUMBER: 97 .. ?o,:t owNER's NAME: lrFe Me1)FefL I, as the owner, or agent of th~ owner (contractors may not ·employ the special inspector), certify that I, or the architect/engineer of record, will be responsible for employing the special inspector(s) as required by Uniform Building Code '(USC) Section 1701.1 for the construction project locate · listed above, UBC Section 106.3.5. I, as the engineer/architect of record,. certify that I have prepared the following special inspection program as required by DSC Section 106.3.5 for the construction project located at the site listed above. · ~-Signed~~-- 1. List of work requiring special inspection: D Soils Compliance Prior to Foundation Inspection D Structural Concrete Over 2500 PSI D Prestressed Concrete D Structural Masonry D Designer Specified D Field Welding Englnee(s/Architect's Seal & Signature Here D !:f.igh Strength Bolting ~Expansion/Epoxy Anchors D Sprayed-On Fireproofing D Other _____ _ 2. Name(s) of individual(s) or firm(s) responsible for the special inspections listed above: A. B. C. 3. Duties of tho special inspectors for the work listed above: ,. ~reLAc ~ttlMJf f21J'ft~ oe tbcPi 8. C. Special inspectors shall check in with the City and present their credentials for approval prior to beginning work on the job site. SIP 4997 I • 'J NOV-_ ,6-97 THU 12: :24 1.,1 i I "?On/Du-t '=' DATE: _,j,,,I.._.{ "'""'"""--- TIME: PAGES TRANSMITTED: (lNCLUOINC <:OVER) TO: COMPANY: . ATTENTION: FAX NUMSER: PROJECT: FROM FACSIMILE TRANSMITTAL. '·•·•• •'•n,, , -··~ •.,. '-i ·c ROSS ARCHITECTS 6Si Fifth Avenue «A San Oiego. CA 92101 Tel. 619.233.3700 Fax 619.'2.,',8619 P. 0 1 (A,{t~ hl~ ;ir ~~ ~~, A,ov:-s~ i\!u-{~ /1~ ~ P-. "" .,,.n ~ ·~ .. NOV-6-97 THU 12:25 Wi lson,Dut""' NT f'IE'.LD ~OM 'OR BE .OCKEO R..OOAPLAN. I ' ~. _________ _.._........._, WAREHOUSE um _...,.__ _____ - aaMs L Mlll!ln1mra.,..,. P.02 CoNSTRUCTION TESTING & ENGINEERING, INC. ESCONDIDO• MODESTO• CORONA• OXNARD• RENO• SEA1TLE • LAS VEGAS ENGJNEERING, INC. INSPECTION REPORT PRomcr NAME: l t Fe-m ev r Cf+. L ADDRESS: {? PO k€1,-l-06 A~; C/2.t<L-'?@6D ARCHITECT: ___________ _ ENGINEER: Ho eo W' c'TZ-v+ y U) 8. CONTRACTOR: _..._(.,_, _C.,_, .a....7, ....... t __ --'------ INSPECTION DATE:_,.(~·{_-2--'-tf_-""""C/_7 _____ _ PLAN FILE: ---,--,----------,----,----~ BLDG PERMIT:_~E-E._/t/,-P.~t~N~G~?_· ~---- OTHER=-----'---------- Material Sampling PAGE OF CTE JOB# f{!;}-').._5 7.3 REPORT# ______ _ ( ) CONCRETE ( ) MORTAR ( ) GROUT ( ) FIREPROOFING ( ) MASONRY BLOCK ( ) REBAR ( ) STRUCTURAL STEEL ( ) BOLTS ?~tf~:ff!lf-.:;;.::: ~~~p~.~~~t :~~~~Pi~~~t;~:.I:· - t(lQ/l((IOt,£1) t::eoxt: JfV~TAli/rT!DII./ OF 5/4 r:>11n-z~TIR , > -> . NAME: (PRINT) Al-C.6C-A :!? SIGNATURE: c:t2-8~__,M...-- CERTIFICATION NO.: ..... 2"-l.f-_,_·7L-..l-'(<=O _______ _ GEOTECHNICAL & CONSTRUCTION ENGINEERING TESTING & INSPECTION 2414 VINEYARD A VENUE SUITE G ESCONDIDO, CA 92029 (619) 746-4955 FAX (619) 746-9806 EsGil Corporation Professiona[ Plan !.l{.eview 'F,ngineers DATE: 11/ 17/97 JURISDICTION: Carlsbad PLAN CHECK NO.: 97-3059 PROJECT ADDRESS: 1934 Kellogg Ave. PROJECT NAME: Life Medical Labs SET: II D~CANT D JURIS. D 'REVIEWER D FILE ~ The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building_ codes. D The plans transmitted herewith will substantially c9mply with the juriscjiction's-b-uilding 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 Corporation 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 Corporation staff did not advise the applicant that the plan check has been completed. ~ Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Dave Cross Date contacted: (by: ) Mail Telephone Fax In Person Telephone#: In person recheck Fax#: ~ REMARKS: Mr. Dave Cross will carry perforated Set II plans to the City of Carlsbad . O.K. per John.~ · Note ti ,at with-the plan sets is a Special lnspeetio11 _Program document for--ff:K? ,._Blan records that ntttSt be completed by the arehitect. , 7J)lUU By: Mike Puckett l;nclosures: Esgil Corporation 0 GA O CM O EJ O PC 11 /14/97 trnsmtl.dot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (619) 560-1468 + Fax (619) 560-1576 EsGU Corporation Profusionaf Pfan !l{.evie'Jl) 'F.ngineers DATE: 10/28/97 JURISDICTION: Carlsbad PLAN CHECK NO.: 97-3059 PROJECT ADDRESS: 1934 :Kellogg Ave. PROJECt NAME:-Life Medical Labs SET:I 0 APPLICANT ~ ~EVIEWER 0 FILE D The plans trar:ismitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes.- D The plans transmitted herewith will substantially comply with the jurisdiction's building 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. cg] The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation 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. cg] The applicant's copy of the check list has been sent to: Innovative Contracting Services 7 440 Trade Street Suite "fl:' San Diego, Ca. 92121 Fax# 619-578-2486 Esgil Corporation staff did not advise the applicant, except by Fax, that the plan check has been completed. D Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: bate contacted:· (by: ) Fax#: Mail Telephone Fax In Person D REMARKS: By: Mik~ Puckett l;f1closures: Esgil Corporation D GA 0 CM 0 EJ D PC 10/20/97 trnsmtl.dot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92-123 + (619) 560-1468 + Fax (619) 560-1576 Carlsbad 97-3059 10/28/97 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO.: 97-3059 OCCUPANCY: B., Fl, S1 TYPE OF CONSTRUCTION: VN ALLOWABLE FLOOR AREA: SPRINKLERS?: Yes. REMARKS: DATE PLANS Rl=CEIVED BY JURISDICTION: 10/15/97 DATE INITIAL PLAN REVIEW COM_PLETED: 1012:8/97 FOREWORD (PLEASE READ): JURISDICTION: Carlsbad USE: Office,Lab, Warehouse ACrUALAREA: 6053sqft STORIES: 1 HEIGHT: OCCUPANT LOAD: 52 DATE PLANS RECEIVED BY ESGIL CORPORATION: 10/20/97 PLAN REVIEWER: Mike Puckett This plan review is limited to the technical requirements contained in the Uniform 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 1994 UBC. 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. 106.4.3, 1·994 Uniform 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. LIST NO. 40, TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1994UBC) tiforw.dot Carlsbad 97-3059 10/28/97 1. Please make all ·corrections on the original tracings, as requested in the correction list. S~bmit 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, 2075 Las Palmas Drive, Carlsbad, CA 92009, (619) 438- 1161. 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 Diego, CA 92123, (619) 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. 2. Each sheet of the plans must be signed .by the-person responsible for their preparation, even though there are no structural changes. Business and Professions Code. 3. Revise Occupancy Classification on sheet CS to read B, F1, S1. 4. A complete description of the activities and processes that will occur in this tenant space should be provided. A listing of all hazardous materials should be included. The materials · listing should be stated in a form that would make classification in Tables 3-D and 3-E · possible. The building official may require a technical report to identify and develop methods of protection from hazardous materials. Section 307.1.6. 5. Glazing in the following locations should be of safety glazing material in accordance with Section 2406.4 (see exceptions): • Fixed or operable panels adjacent to a door where the nearest exposed edge of the glazing is within a 24-inch arc of either vertical edge of the door in a closed position and where the bottom exposed edge of the glazing is less than 60 inches above the walking surface. There appears to be glazing ac;:ljacent to office doors. Identify glazing if any on plans. 6. The 3-5/8" 2·5ga. metal studs per ICBO Report 3403 at wall details exceed allowable heights per Cemco Tables. Provide approved size and-gauge of studs and note on plans. Show spacing of bottom track fasteners. 7. Note on plan that suspended ceilings shall comply withUBC Tables 25-A, 16-0 and 16-B. Revise note on sheet A4 to reflect current code section. 8. Note on the plans: "All exits are to be openable from inside without the use of a key or special knowledge." In lieu of the above, in a Group B, F, Mor S occupancies, you may note "Provide a sign on or near the exit door, reading THIS DOOR TO REMAIN UNLOCKED DURING BUSINESS HOURS." This signage is only allowed at the main exit. Section 1004.3. Carlsbad 97-3059 i0/28/97 9. The Lab area requires 2 exits. Exit cannot pass through secure ware house to outside. Relocate exit to satisfy separation and egress path to outside. 1 O. In areas where the occupant load exceeds 30 two exits are required. See Table 10-A. 11. The maximum number of required exits and their required separation must be maintained until egress is provided from the structure. Section 1003.1. 12. Exits shall hot pass through kitchens, store rooms, or spaces used for similar purposes. Section 1003.5. 13. Corridors must provide continuous protection to the exterior of the building. Interruptions by an intervening room is not permitted. Foyers, lobbies or reception rooms constructed as required for corridors are not considered intervening rooms. Section 1005.1. The egress from offices, lab and secured warehouse cannot pass through the assembly area or file room. There must be a corridor. 14. Corridors serving 30 or more occupants shall have walls and ceilings of one-hour construction. 15. One .. hour fire-rated corridors shall hav$ interior door openings protected by tight-fitting smoke and draft control assemblies rated 20 minutes, except openings in interior walls of exterior exit balconies. poors shall be maintained self-closing or be automatic closing by action of a smoke detector per Section 713.2. Doors shall be gasketed to provide a smoke and draft seal where the door meets the stop on sides and top. Section 1005.8.1. 16. Show rated corridors, lobbies, reception .or foyers cross-hatched on the floor plans. 17. Total area of all openings, except doors, in any portion of an interior corridor, shall not exceed 25 percent .of the area of the corridor wall of the room which it is separating from the corridor. Such openings shall be protected by fixed glazing listed and labeled for a fire-protection rating of at least 3/4-hour. Section 713.9. 18. Provide a complete ·architectural section of the corridor, or exterior exit balcony, showing all fire-resistive materials and details of construction for all floors, walls, ceiling and all penetrations .. Section 1005. 7. 19. The Redhead Self Drilling concrete anchor proposed to secure added diagonal braces from wall to roof are not approved for use in resisting seismic or wind loads per ICBO report ER- 1372. See attached sheet. Provide approved substitute anchor. Complete Special Inspector Program Sheet attached. ELECTRICAL 20. Submit plan showing location of all panels. Could not find location of new subpanel LM on E2. Carlsbad· 97-3059 10/28/97 21. Indicate wiring method, i.e. EMT, metal flex. Make note on plans that No AC cable or . Romex is allowed. 22. Show exit signs on the electrical lighting plan( s ). As per Sections 1012 and 1013 of the 1994 UBC, provide two sources of power to exit signs and exit illumination. MECHANICAL 23. Show the size, location and type of all heating and cooling appliances or systems. 24. Provide mechanical ventilation in all rooms capable of supplying outside air at a minimum rate of ·15 cubic feet per minute per occupant. UBC, Section 1202.2.1 25. Provide mechanical plans showing existing and proposed HVAC equipment, ducts and access to equipment. 26. Detail disposal of main condensate drainage from air conditioning units. (UMC Section 310) 27. Fire rated corridors are not to be used to convey air to or from rooms. UMC Section 601.1.1. 28. Smoke dampers shall be installed per Section 713, 1 0 at all ducted or unducted air openings at penetrations of: • The fire-resistive construction of corridors, or horizontal exit walls. 29. Fire dampers shall be installed per Section 713.11 at all ducted or unducted air openings at penetrations of: • The fire-resistive construction of corridors, or horizontal exit walls. 30. If Class!, II, or Ill liquids are used in the Lab area, a mechanically operated exhaust. ventilation system shall be provided sufficient to produce six air changes per hour. Such exhaust ventilation shall be taken from a point at or near the floor level. · PLUMBING 31. Provide complete plumbing plans, including: • Complete drain, waste and vent plans. • Provide .gas line plans and calculations, showing pipe lengths and gas demands. UPC Section 1217.0 • Provide complete water line sizing calculations, including the water pressure, pressure losses, water demands, and developed pipe lengths. UPC Section 610.0 • Show water heater size, type and location on plans. UPC, Section 501.0 32. Show that water heater is adequately braced to resist seismic forces. Provide two straps (one strap at top 1/3 of the tank and one strap at bottom 1/3 of the tank). UPC, Section 51-0.b -· Carlsbad 97-3059 10/28/97 33. Show P & T valve on water·heater and detail drain line route from P & T valve to the exterior. UPC Section 608.5. 34.Show 1/4" per 12" slope on drain and waste lines. UPC Section 708.0. ENERGY 35. Provide plans, calculations and worksheets to show compliance with current energy standards 36. Provide complete energy designs for the proposed changes in envelope, lighting, and mechanical systems. Provide the completed ENV-, L TG-, and MECH-forms showing energy compliance. Note: L TG is on plans. 37. 38. On the plans clearly show the wall and roof insulation locations, thickness, and R-values, as per the energy design. 39. The completed and signed ENV-1, L TG-1, and MECH-1 forms must be imprinted on the plans. Note ·L TG is on plans. DISABLED ACCESS REQUIREMENTS 40. Dimension restrooms to show a 60" circle inscribed jn space. 41. Make note on floor plan that restrooms will comply with Title 24 disabled requirements as per Cover Sheet of Plans. 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 ariy 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 pl·ans. 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 619/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Mike Puckett at Esgil Corporation. Thank you. Page 2 of 8 B-94.12-1977. The anchors must be installed in holes the same nominal size as the anchor size, with a greater depth than the length of embedment desired, but no less than the minimum embedment. The hole must be cleaned out prior to installation of the anchor. The anchor must be tapped into the hole to the embedment depth de- sired, but no less than the minimum embedment. A standard hexag- onal nut and washer must be used over the material being fastened and the nut tightened until the minimum installation torque, as indi· cated in Tables 7 and 14, is reached. 2.5 ITW Ramset/Red Head Multi-Set II Anchor 2.5.1 General: The Multi-Set anchors are designed to be installed in a predrilled hole equal to the anchor diameter. The anchor consists of a shell formed from carbon steel or stainless steel meeting the minimum requirements of AISI C-1213 or Type 304, respectively, and an expansion plug formed from carbon.steel or stainless steel meeting the minimum requirements of AISI C-1010 or Type 303, re- spectively. The expansion end is divided into four equal segments by radial slots. The expansion plug is preassembled and is cylindrical in cross section. 2.5.2 Installation: Embedment, spacing, edge distance, and con- crete requirements are shown in Tables 10, 11 and 13. Holes must be predrilled in normal-weight and lightweight concrete with car- bide-tipped masonry drill bits manufactured within the range of the maximum and minimum drill tip dimensions of ANSI Standard B-94.12-1977. The anchors must be installed in predrilled hoies, the hole depth and diameter for each anchor .size .being listed in Tables 1 o, 11 and 13. After the hole is drilled, it is cleared of all cuttings. The anchor is set by installing the expansion shell and th~n driving the cone expander with a setting tool provided with each anchor size. When the cone expander is driven down into the anchor, the legs of the shell expand. 2.6 Design: Allowable static loads are as set forth in Tables 1, 3, 5, 7, 10, 13 and 14. Allowable loads for anchors subjected to combined shear and tension forces are determined by the following equation: where: P5 = Applied tension load. Pr = Allowable tension Load. Vs = Applied shear load. Vr = Allowable shear load. The anchors cannot be subjected to vibratory loads. Sources of such loads include, for example, rec;iprocating engines, crane loads and moving loads due to vehicles. 2.7 Special Inspection: When special inspection is required, compliance with Section 1701.5.2 of the code is necessary. The special inspector must be on ER-1372 the jobsite continuously during anchor installation to verify anchor type, anchor dimensions, concrete type, concrete compressive strength, hole dimensions, anchor spacings, edge distances, slab thickness, anchor embedment and tightening torque. 2.8 Identification: The concrete anchors are identified by their dimensional character- istics, the anchor size, and by the length code stamped on the an- chor. The conical-shaped expander plugs are colored red. See Figure 1 for additional details. Length codes are in Table 12. Packages are identified. with the anchor type and size, the manufacturer's name and address, and· the name of the quality control agency, PFS Corpo- ration. 3.0 EVIDENCE SUBMITTED Data complying with the ICBO ES Acceptance Criteria for Expansion Anchors in Concrete and Masonry Elements (AC01) dated January 1993. 4.0 FINDl~GS 1 That the ITW Ramset/Red Head fasteners described in this report comply with the 1994 Uniform Building Code··, subject to the lol- lowinQ conditions: 4.1 Anchor sizes, dimensions and installation are as set forth in this report. 4.2 Allowable shear and tension loads are as set forth in Sec- tion 2.6. 4.3 Calculations justifying that the applied loads comply with this report are submitted to the building official for approv- al. 4.4 Special inspection is provided as set forth in Section 2.7. 4.5 Anchors are limited to installation in uncracked concrete, which is concrete subjected to tensile stresses not exceed- ing 170 psi (1.2 MPa) as induced by external loads, de- formations and interior exposures. 4.6 Anchors are limited to nonfire-resistive construction un- less appropriate data is submitted to demonstrate anchor performance is maintained in fire-resistive situations. 4.7 Anchors are manufactured at U.S. 12 and liberty Trail, Michigan City, Indiana, with inspections by PFS Corpora- tion, NER-QA251. 4.8 Use of electroplated or mechanically plated carbon steel anchors is limited to dry, interior locations. Use of hot- dipped galvanized carbon steel or stainless steel anchors is ermitt • · r-exposur amp environ Use of anchors in resisting earthquake or wind loads is be- yond the scope of this report. o reexaminati one ear. Carlsbad 97-3059 10/28/97 VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 97-3059 PREPARED BY: Mike Puckett DATE; 10/28/97 BUILDING ADDRESS: 1934 Kellogg Ave. · BUIL[)ING OCCUPANCY: B, Fl, S1 TYPE OF CONSTRUCTION: VN BUILDING PORTION BUILDING AREA VALUATION VALUE . (ft. 2) MULTIPLIER ($) Tenant Improvement 9,987 City Estimated Value 217,500.00 .. Air Conditioning Fire Sprinklers TOTAL VALUE 217,500.00 IZ! 1991 USC Building Permit Fee D Bldg. Permit Fee by ordinance: $ 1052.50 IZ! 1991 USC Plan Check Fee D Plan Check Fee by ordinance: $ 684.13 Type of Revi·ew: D Complete Review D Structural Only D Hourly D Repetitive Fee Applicable D Other: Esgil Plan Review Fee: $ 547.30 Comments: Sheet 1 of 1 macvalue.doc 5196 City of Carlsbad . M#iU·hh44Ahi·1•24·Shleef401 BUILDING PLANCHECK ·CHECKLIST DATE: . /0/:2';) /q, , PLANCHE;CK NO.: CB 97~ .)O)f su1LrnNG AODREs's; . 19 3L-f t<e[lo,M .. ~. PROJECT DESCRIPTION: . 'T_;c: C0I ____ ....:.:::;;;._,.._,____,a-'-"------'i---"'------'---------- ASSESSQR'S PARCEL NUMBER: 1../2. -/70 r OI. EST. VALUE: ·217 <te:/8 ENGINEERING DEPARTMENT APPROVAL DENIAL The itE;im you have submitted for .review has been approved. The approval is based on plans, information and/or specific,ations provided in your submittal; therefore any changes to these items after this date, including field modifications, must be reviewed by this· office to insure continued conformanc~ with applicable codes. Please review car~fully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to build. A Right-of~Way permit is required prior to construction of the following improvements: ' ATTACHMENTS\ Dedication Applic~tion Dedication Checkl/st i Improvement App)ication i Improvement Checklist Future Improvement Agreem~nt Grading Permit Application Grading. Submittal Checklist Right-of~Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet Sewer Fee Information Sheet . \\LASPALMAS\SYS\LIBRARYIENGIWORDIDO SI HKLST\Bulldl Planch Ckls P 1 ttached report of deficiencies e necessary corrections to plans or s cifica · for compliance with applicable codes and standards. Submit corrected plans and/or specifications to this office for review. Date: By: Date: By: Date: -------- ENGINEERING DEPT. CONTACT PERSON Name: David Rick City of Carlsbad Address:. .2075 Las Palmas Dr., Carlsbad, CA 92009 Phone: (6'19) 438-1161, ext. 4324 CFO INFORMATION Parcel Map No: Lots: Recordation: Carlsbad Tract: A-4 Rev:913'97 2075 Las Palmas Dr.• Carlsbad, CA 92009-.576 • (619) 438-;1161 • FAX (619) 438-0894 • BUILDING PLANCHECK CHECKLIST SITE PLAN 1. Provide a fully dimensioned site plan drawn to seal~. Show: . ' A North Arrow D. Property Lines B. Existing & Proposed Structures E. Easements C. Existing Street Improvements · F. Right-of-Way Width & Adjacent Streets G. Driveway widths 2. Show on site plan: A Drainage Patterns 1. Building pad surface drainage must maintain a minimum slope of one · percent towards an adjoining street or an approved drainage course. 2. ADD THE FOLLOWING NOTE: "Finish grade will provide a minimum positive drainage of 2% to swale 5' away from building." 8. Existing & Proposed Slopes and Topography 3. Include on title sheet: A Site address B. Assessor's Parcel Number C. Legal Description For commercial/industrial buildings and tenant improvement projects, include: total .building square footage with the square footage for each different use, existing sewer permits showing square footage of different uses (manufacturing, warehouse, office, etc.) previously approved. EXISTING PERMIT NUMBER DESCRIPTION DISCRETIONARY APPROVAL COMPLIANCE Q 4a. Project does not comply with the following Engineering Conditions of approval for Project No. _______________________ _ Q 4b. All conditions are in compliance. Date: __________ _ ~~:~1~AS\SYS\LIBRARY\ENG\yYORDIDOCS\CHKLST18ulldlng Plancheck Cklsl BP0001,Form DR.doc 2 1 sr.r Cl 0 0 0 0 BUILDING PLANCHECK CHECKLIST DEDICATION REQUIREMENTS 5. Dedication for all ,street Rights-of-Way adjacent to the building site and any storm drain or utility easements on the buildir-ig site is required for all new buildings and for remodels with a value at or exceeding $. , pursuant to Carlsbad Municipal Code Section 18.40,030. Dedication required as follows: __________________ _ Dedication required. Please have a registered Civil Engineer or Land Surveyor prepare the appropriate legal description tqgether with an 8 ½" x 11" plat map and submit with a title report. · All easement documents must be approved and signed by owner(s) pt-ior to issuance of Building Permit. Attached please find an application form and s1,.1bmitt~I checklist for the dedication process. Submit the completed application form with the reqaired checklist items and fees to the Engineering Department in person. Applications will not be accept by mail or fax. Dedication completed by: . ..-----------------Date: ..------ IMPROVEMENT REQUIREMENTS 6a. All needed public improvement~ 1;1pon and adjacent to the building site must be constructed at time of building construction whenever the value of the construction exceeds $ ___ "------' ,pursuant to Carlsbad Municipal Code Section '18A0:040. Public improvements required as follows: ..--------------- Attached please fine! an application form and submittal checklist for the public improvement . requirements. A registered Civil Engineer must prepare the appropriate improvement plans and submit them together with the requirements on the attached checklist to the Engineering Department through a separate plan check process. The completed application form and the requirements on the checklist must be submitted in person. Applications by mail or fax are not accepted. lmprovemer-it plans must be approved, appropriate securities posted and fees paid prior to issuance of building permit. Improvement Plans signed by: _____________ ____ Date: ----- 6b. Construction of the public ,improvements may be deferred pursuant to Carlsbad Mur-iicipa'I Code Section 18.40. Please submit a recent property title report or current grant deed on the property and processing fee of $. _______ so we may prepare the necessary Future Improvement Agreement. This agreement must be signed, notarized ,~nd approved by the City prior to issuance of a Building permit. Future public improvements required as follows: 1\LASPALMASISYSILIBRARY\ENG\WORD\DOCSICHKLST\Bulldlng Plancheck·Cklst 8P0001 •Fonn DR.doc Rev, 9/3/97 3 CJ CJ CJ CJ CJ CJ BUILDING PLANCHECK CHECKLIST 6c. Enclosed please find your Future Improvement Agreement. Please return agreement signed and notarized to the Engineering Department. Future Improvement Agreement completed by: Date: 6d. No Public Improvements required. SPECIAL NOTE: Damaged or defective improvements found adjacent to building site must be repaired to the satisfaction of the City Inspector prior to occupancy. GRADING PERMIT REQUIREMENTS The conditions that invoke the need for a grading permit are found in Section 11.06.030 of the Municipal Code. 7a. Inadequate information available on Site Plan to make a determination on grading requirements. Include accurate grading quantities (cut, fill import, export). Write "No Grading" on plot plan if none is required. 7b. Grading Permit required. A separate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form attached. NOTE: The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit. Grading Inspector sign off by: Date: 7c. Graded Pad Certification required. (Note: Pad certification may be required even if a grading permit is not required.) 7d. No Grading Permit required. 7e. If grading is not required, write "No Grading" on plot plan. MISCELLANEOUS PERMITS CJ 8. A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or private work adjacent to the public Right-of-Way. Types of work include, but are not limited to: street improvements, tree trimming, driveway construction, tieing into public storm drain, sewer and water utilities. Right-of-Way permit required for: ~~:,:~~AS\SYSILIBRARY\ENGIWORDIDOCS\CHKLST\Bulldlng Plancheck Cklsl BP0001 Fonn DR.doc 4 BUILDING PLANCHECK CHECKLIST 9. A SEWER PERMIT is required concurrent with the building permit issuance. The fee is noted in the fees section on the following page. 10. INDUSTRIAL WASTE PERMIT If your facility is located in the Gity of Carlsbad sewer service area, you need to contact the Carlsbad Municipal Water District, located at 5950 El Camino Real, Carlsbad, CA 92008. District personnel can ~~~jl( provide forms and assistance, and will check to see if your business enterprise is h'-/\: ,on the EWA Exempt List. You may tel~phone (760) 438-2722, extension 153, for V · ' assistance. Q Q ~ ""~h, Industrial Waste permit accepted by: JD Date: Q Q Q 11. NPDES PERMIT Complies with the City's requirements of the National Pollutant Discharge Elimination System (NPDES) permit. The applicant shall provide best management practices to reduce surface pollutants to an acceptable level prior to discharge to sensitive areas. Plans for such improvements shall be approved by the City Engineer prior to issuance of grading or building permit, whichever occur_yrtst. · 12. ~Required fees are attached CJ No fees required 13. Additional Comments: ~~:,~1~s\SYS\l.lBRARY\ENGIWORD\DOCS\CHKLST\Bulkllng Planchecl< C~lst BP0001 Form DR.doc 5 ENGINEERING DEPARTMENT FEE CALCULATION WORKSHEET D Estimate based on unconfirmed information from apP.licant, D Calculation. based on building planeheck plan submittal. Address:. jq34 Bid·g. Permit No. CQ 97--3CF;Cf Prepared qy: D, 1<~cl{ · Date: · I o/'2-3/'17 Checked by: ___ _ Date: ----- EDU CALCULATIONS: List type's and square footages for all uses. Types of Use: -------Sq. Ft./Units: ,~ ------EDU'·s: b / J ADT CALC.ULATIONS:. List types and square footages for .all uses. Types of Us~: ______ _ Sq. Ft./Units: ------ADT's: 26 .6~ FEES REQUIRED: PUBLIC FACILITIES FEE .f{EP,l.,IIRED: DYES D NO (See Building Department for amount) WITHIN CFO: D YES (no bridge & thoroughfare fee, reduced Traffic Impact Fee) D NO /tfrf. PARK-IN-LIEU FEE PARK AREA: ___ _ / FEE/UNIT: . ~2. TRAFFIC iMPACT FEE ADT's/UNITS; ·· 5'. oC:- tJ:1(3. 'BRIDl3E .AND THOROU~HFARE FEE X X ' . ' NO. UNITS: _____ _ FEE/ADT: _'Z._?-__ . ADT's/UNITS: ___ ___,._ · X FEE/ADT: ___ _ ~-FACILITIES MANAGEMENT FEE ZONE: ~'>' · =$ =$ =$ UNIT/SO.FT.: X FEE/SQ.FT./UNIT:. ___ _ =$ D 5. SEWER FEE PERMIT No. S £. q7,. r11 · X FEE/EDU: ,: i l.0. r . EDU's: f. l) BENEFIT AREA: pl}- 1:DU's: DRAINAGE BASIN: -----------.~-DRAINAGE FEES .. PLDA. _______ _ .X FEE/EDU.: __ _ HIGH ---{LOW __ _ ACRES: __ . ____ _ X FEE/AC:._· __ _ ~ 7. SEWER LATERAL ($2,500) • . ' .. =$ =$ =$ =$ ~ /,;)}J i gf /Z 2 009 ·if jzf, ,er TOTAL OF ABOVE FEES*:$ 3 12 4 2_., --=~,---- *NOTE: This calculation_.sbyet is NOT a complete list (?fall fees which may be due. Dedications and Improvements may also be required with Building Permits. ,· ., P: \DOCS\MISFORMS.\.BP0002. FRM REV 01/22/97 - - ()(1'' c -e_ @ S-0 0 Sf-. :::: y 2 o E Du1 Mal\ v fc_c_ t~ @ C/; l/ t 7 .£f ~ /. 9 £ Dv'; 2 ,If EDvs ---- 2.1 ED.J's 51 c./ 4 ObLJ I ";:::. + ,12.. " 3. 2 CJ {3:f)v'S A-DT 1s ( l'4' j t' ,t-- 3' 1-? -2. /)J ;cc ~ . 0-t-h~ o-e @ 1:, OLJ -:::. / 0 A DT , '; lv\b -,\) flvic7 Q 9, lf f 7 ==-'3 r A-or l/f ltDr 1.:: fl.'::;- MC.. vJev1''1t-t wc..~'io->~ @ 4'-f 7 I Y ;(a ()cl ~ M ~,ivt\c. + e 1 Yo L/ y. 4/joao '.:'. lo... h. ~.. 5 ILf X Uo<lo '.:: 0 {" ~ c --e_ G 3 -,;; C/ fl 'f-2%,o " :=. Qo2_... )b ), b 2.. 4. I I 71. 9-b --- >->-.c .c ~ "' 'Ila X X u U, ., -, .. ~ ~ . .c t.l t.l C: C: ro ro a: a: &DD PLANNIN'G DEPARiMENT BUILDING PLAN: CHECK REViEW CHECKLIST Plan Check No. CB 97-io r't:/ Planner Van Lynch • APN: 212-f 70-0/ Address / (J 3 t/ /CB'll06 G IJ I/. .Phone (619) 438-1161, extension 4325 . Type of Project and Use:_-'-------'---------· Project Density: ________ _ · Zoning: _ __,.. ___ General Plan:---'-~--Facilitjes Management Zone: ___ _ CFD liri/nntl # Date of participation: Remaining net dev acres: a~~OM --- (For rion-,residential development: Type of land used created by thfs, permit: ____ ---'--_______________ ) Legend: ·~ Item Complete Q Item Incomplete -Needs your action Environmental Review Required: YES_ NO f5:_ TYPE __ _ DATE OF COMPLETION: _______ ........... __ _ Compliance with conditions of apptovaf? If not, state conditions which require action. Conditions of Approval: ~ D D. Discretionary Action Required: Y!:S NO TYPE ~DD APPROVAL/RES.O. NO._··_ .. -.-...........----DATE ___ _ · ·PROJECT NO. '? r-<f ------------------- OTHER RELATED CASES: ..... · ----------------------------- Compliance with conditions or approval? If not, state conditions which require action. Conditions of Approval: . -'---'----'-------'----~'---------------- Coastal Zone Assessment/Cpmpliimce Project site located in Coastal Zone? YES NO -25_ cp... Coastal Commission Authority.? YES NO · If California Coastal Commission Authority: .Contact them at -3111 Camino Del Rio North, Suite 200, San Diego CA 92108-1725; (619) 521-8036 Determine status (Coastal Permit Required or !:xempt): Coastal ·Per~it o'etermination· Form ai~eady' ~ompleted? YES NO · .ff NO, complete Coastal Permit Deter:mlri~tion Form nbw. ·Coastal Permit Determination Log #:' Follow .. l:Jp Actions:·· 1) Stamp Building Plans as "Exempt" or "Coastal Permit Required" (at minimum Floor Plans). 2) Complete Coastal ,Permit Determit-lation Log as needed. ~DD lnclusionary Housing Fee required: YES __ NO~ (Effective date of lnclusionary Housing Ordinance -May 21, ·1993.J Data Entry Completed? YES __ NO __ (Enter CB#; UACT; NEXT12; Construct housing Y/N; Enter Fee Amount (See fee schedule for amount); Return) Site Plan: ~DD,. Provide a fully dimensional site plan drawn to scale. Show: North arrow, property lines, easements, existing · and proposed structures, streets, existing street improvements, right-of-way widthr dimensional setbacks and existing topographical lines. @rzj D 2. Provide legal description of property and assessor's parcel number. Ptvv1bs Nl:/JJ /c/(;fM"'!S@ oJ />44nr 2-r "t..-/70 -o I ~DD Zoning: 1 . Setbacks: Front: Interior Side: Street Side: Rear: Required -----Al'--- Required ___ __,_/ __ Required __ __,/'----- Required ___ ! __ _ ~D D 2. Accessory structure setbacks: Front: Required Shown Interior Side: Required Shown Street Side: Required Shown Rear: Req'uired Shown Structure separation: Required Shown ~ D D 3. Lot Coverage: Required VD c.HIJ~(;tr Shown ., ------ 4. Height: Required IJcJ CHAH(;g Shown . ------ 5. Parking: Spaces Required _ _,z. __ (_,__ __ _ Shown 2.s __ ::.....:;;. __ _ Guest Spaces Required _____ .;...._ Shown ------- Additional Comments fA(}.,,ll/N6 L>l@:1ANO IS hllSt;m q.,J 6 MC:C Boo&--.&Pk©, f)tt:YJSS' ·PflOVIEE" >'@/Jll.6' &,oTAblr OE f::$cH U$!:£ {1.e-. CF°RC.IS/ IM,ArJllf1iicllllW{:J_; &t.lP f!)AWM?u cs-) lu, rtt ,,J Tf--lf;CtrG11t-'bl1v&. Ptuut-1N & ~IL C?fi9r..€ I"$' 0/1/&1 e;/J~U:}" PSIL 2--ro s &udrur AJW: qc 6JM s ~£. A JU,;>A, "1-f,1.vu R«/A.;,tl{; 11 1 I ~oc !A fol r> WAl?(£,l-(tpt/St1 /J. 1/Jot:Jo f. ft-C;!!Se-J>uce-w.s 1µ~,l'/",.; ~/J 1 "?'Ha- 1 ttlf:&' >HM°: OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER V-fe!== DATE/f.-./7-?7 ·City of Carlsbad · _ 97383 . · Fire Department • Bureau of Prevention Plan Review: Requirements Category: Building. Plan Check Reviewed by:---+~~.~ ~~ Date of R~port: Wednesday, November 26, 1997 Contact Name Address City, State Barbara Harri.s PO Box 930 _ Poway CA 9207 4 Job Name Unknown . ~ . /130 ~ Planning No. Job Address _1:..,;9,c;_~~K-'--el-'-lo.....,gg...__ __ ___c __ -,--~--'--~-~-'---.7 Ste. or Bldg. No. ____ _ ~ Approved -The item you have $ubmitted for review has been approved. The approval is based on plans; information and/or specifications provided in your submittal; therefore any cha,nges to these Uem$ after this date, including field modifica- tions, must be reviewed by this office to insure continued conformance with applicable codes. Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements. D Disapproved -Please see the attached report of deficiencies. Please make corrections to . plans or specifications necessary to ·indicate compliance with applicable codes and standards. Submit corrected plans and/or specificatior:1s to this office for review. ForFite Department Use Only Review 1st._· ---'---2nd._---'-'-3rd._,_. ,----'-- Other Agency ID CFD Job# . 97383 File#---'---'--'--'-- 2560 Orion Way • Carlsbad, California 92008 • (619) 931-2121 .. HO-RO WITZ ·1;AYLOR ENGINEERING STRUCTURAL & CIVIL COt!SULTlt!G STRUCTURAL CALCULATIONS "., ~. PROJECT: _ _.i:::::L:..L, J_E_..l.,£:;...__.1M~F-1· i\..l...!l...:::::C~A-_,._L"--_-'=G4-=...c.-L. -'-',R,.-Lc=S--"'t?'-'-'A'-L-'-1-r>,c_._ _______ _ DESIGN ASSUMPTIONS: CONCRETE STRENGTH AT TWENTY EIGHT DAYS: __ tJ_,_/4-'-A-'----PSI MASONRY: fv ~ GRADE "N" CQ}fCRETE BLOCK F' M = ---'-'~~--- MORTAR: TYPE S 1800 PSI GROUT: '.2000 PSI REINFORCING STEEL: A-615 STRUCfURAL STEEL: A-36 LUMBER: DOUGrAS FIR-URCH JOISTS BEAMS AND POSTS STUDS GRAD~40: GRADE 60: #2 #2 STUD OR ~ETIER SEISMIC FORCE: 0. / 'B 3 .·~ REPORT BY: --"------------'------i;;, SOIL PRESSURE,-~~ WIND FORCE: 1 '2... · ('~ F · DESIGN LOADS: ROOF DEAD LOAD SLOPING ROOFING PLYWOOD JOISTS INSUL. & CLG. MISC. TOTAL= ROOF LIVE LOAD SLOPING FI.AT REPORT NO.: _____ _ FLOOR DEAD LOAD FLOORING PLYWOOD JOISTS INSUL. & CLG. MISC. TOTAL= FLOOR LIVE LOAD INTERIOR BALCONY EXIT WALKWAY 40 PSF 60 PSF (U.O.N.) 100 PSF WALL DEAD LOAD INTERIOR EXTERIOR 10 PSF 16 PSF These calculations are limited only to the items included herein, selected by the client and do not imply approval of any other portion of the structure by this office. These calculations are not valid if altered in any way, or not accompanied by a wet stamp and signature of the Engineer of Record. 3914 Murphy Canyon Rd. • Suite AlOO • San Diego, California 92123 • {619) 5604383 • FAX {619) 560-8842 'Sv11-1 -u;,__ 12..oor-. V If /) !'2-; _rl-YfJbP~ 2->< f:::. ~ 1·{' -rJt 96 Q __ 'o/ X ,, 6 '(P. {3t2t,. ::: ~-(~ {NSvLA.;T10,,J - S PR.JN~t~S-......... -::: 71_t ';,(/Ji:<._ ll}A±./ e LE'-. ---~-.. L~- 2, 70 I . ::f D I. I a J .ZS 2-.2§ ( .sv I .SD . l.:_'hQ ..... -"•--• --· ' ·-·-----, ----~ --· I --- ~ 1'3,DO . . ~ --~:-~-~~~-~--. z~t~ pb~') __ ! -· ~; z·~r --. 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INDUSTRIAL WASTE DISCHARGE PERMIT APPLICATION ~ CB.No. _______ _ SE No;, ______ _ · APPL NO~ ..... :·------ IND •. CLASS·". BUSINESS NAME __ l ___ : ...... :£ ___ ~ _· _~_J_.,_c_cil_ _________________ _ SITE ADDAE$S _ __,/__.Cf_1......_-D ____ t_-2.__,_{_/ ~-+=J-+1 _h._._.e...___~,...... ........,_J.....,$i_:L,__d __ ,_f_#J _ __.q_2 ...... e2 ...... o~~--r--- CONTACT PERSON (at business) ~}< WL,, ifl l PHONE NUMBER . 6bo\ 1'.z 9-ct lij. Type of Business ·(check all that apply) D Agricultural D Government D Assembly D Laboratory D Automotive D Laundry D Chemical Handling D Manufacturing D Electronics D Medical D Food D Metal Work D Office DPhoto Lab D Retail D Service Station Dwarehous~ Ja:fOth_er n /,V?~u: 7 DESCRIBE WASTE OTHE:R THAN DOMESTIC (Chemicals,. ·particulates, etc.>---..4 .... · ),_.. Q.._<-1 ........ e ______ _ , .. DESCRIBE BUSINESS ACTIVITY: ----;::,loo::. \o-a//1, 1 : e),, seJ _1.;, GENERAL .DESCRIPTION OF ONSR"E WASTEWATER PROCESSING: (chemical & physical characteristics)_ /Uan e · ~ ~ · -· . . . · · : 3):62?/2 V,Z~&z?t?&2 . Is .business presently in operation at site? D YES 3'.No · · · · Has Wastewater Discharge Permit been applied for through the Encina Water Authority? D YES~O Applicant's Na:-T?~+~ c.J'l,.IIJ Titl~ Y"y/lll.:~ · Phone (?66) 12?-71?1 Please Print Agency: ~ Signature:~------/ ... Date / -i,,;[;; ,2 Date le)---(--LJ Z EXEMPT D NOT EXEMPT Date forwarded to Encina ________ _