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Home My WebLink About1950 CAMINO VIDA ROBLE; ; CBC2020-0098; PermitBuilding Permit Finaled {city of Carlsbad Commercial Permit Print Date: 07/27/2020 Permit No: CBC2020-0098 Job Address: Permit Type: Parcel#: Valuation: Occupancy Group: #of Dwelling Units: Bedrooms: Bathrooms: Project Title: 1950 CAMINO VIDA ROBLE, CARLSBAD, CA 92008-6599 Status: BLDG-Commercial Work Class: Tenant Improvement 2120931200 Track#: Applied: $47,031.60 Lot#: Issued: Project#: Finaled Close Out: Plan#: Construction Type: Orig. Plan Check#: Inspector: Plan Check#: Final Inspection: Closed -Finaled 03/06/2020 03/09/2020 MColl 07/13/2020 Description: ALPHATEC SPINE: 7,635 SF DEMO OF ALL RESTROOMS IN BUILDING (NO OCCUPANCY DURING OR AFTER DEMO WORK) Property Owner: RAF PACIFICA GROUP RE FUND IV LLC 6305 EL CAMINO REAL FEE BUILDING PERMIT FEE ($2000+) BUILDING PERMIT FEE ($2000+) BUILDING PLAN CHECK FEE (BLDG) BUILDING PLAN CHECK FEE (BLDG) CARLSBAD, CA 92009 ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL PLUMBING BLDG COMMERCIAL NEW/ADDITION/REMODEL PLUMBING BLDG COMMERCIAL NEW/ADDITION/REMODEL 581473 GREEN BUILDING STATE STANDARDS FEE 581473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-COMMERCIAL STRONG MOTION-COMMERCIAL Total Fees: $1,669.22 Total Payments To Date: $1,669.22 Balance Due: AMOUNT $393.20 $393.20 $275.24 $275.24 $43.00 $43.00 $45.00 $45.00 $63.00 $63.00 $2.00 $2.00 $13.17 $13.17 $0.00 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 FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Building Division Page 1 of 1 1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov (city of Carlsbad COMMERCIAL BUILDING PERMIT APPLICATION B-2 Plan Chee~ Cfi~J5 Est. Value foQ PC Deposit ,'2/iop() Date Job Address 1 DS0 Camino Vida Roblo Tenant Name: Alphatec Spine Suite: ____ APN: 212-093-05,12 CT/Project #: _________ Lot#:. ___ _ Occupancy: _B_-o...;_ff_ic_e ______ Construction Type: V-B Fire Sprinklers: Ives V no Air Conditioning: Ives V no BRIEF DESCRIPTION OF WORK: Demolition of interior non-structural walls, doors, frames, ceilings, lighting, mech.ductlng, plumbing. New trenches for new underground plumbing. 1 / "rr-1 , ___ --, , , Nt'J < JlJ....Aj r x..tr Jl A • D Addition/New: ___________ New SF and Use, ___________ New SF an ~se, ____ Deck SF, Patio Cover SF (not including flatwork) D Tenant Improvement: ______ SF, _____ SF, Existing Use _______ Proposed Use ______ _ Existing Use Proposed Use ______ _ 0 Pool/Spa: _____ SF Additional Gas or Electrical Features? _____________ _ D Solar: ___ KW, __ Modules, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No D Plumbing/Mechanical/Electrical Only: _________________________ _ ■ Other: 7,635 s.f. of demolition APPLICANT (PRIMARY) Name: Andrew Tarango, SCA Architecture Address: 13280 Evening Creek Drive, Ste. 125 City: San Diego State: CA Zip: 92128 Phone: (858) 793-4777 Email: andrewt@sca-sd.com DESIGN PROFESSIONAL Name: Cheryl D. Smith, SCA Architecture Address: 13280 Evening Creek Drive, Ste. 125 City: San Diego State: CA Zip: 92128 Phone: (858) 793-4777 Email: _________________ _ Architect State License: C11701 --~---------- PROPERTY OWNER Name: Adam Robinson, RAF Pacifica Group fu•sion Address: 315 S. Coast Hwy 101, Ste. U-12 City: Encinitas State: CA Zip: --"9""-20""'2"-4'---_ Phone: (760) 473-8838 Email: adam@RAFPacificaGroup.com CONTRACTOR BUSINESS Name: Tom Brunson, Bycor General Contractors, Inc. Address: 6490 Marindustry Place City: San Diego State: CA Zip: __ 9_2_12_1 ___ _ Phone: (858) 362-8947 Email: tbrunson@bycor.com State License: 444203 Bus. License: BLOS653400 (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant 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/she is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.S by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 1 of 2 Email: Building@carlsbadca.gov Rev. 06/18 ( OPTION A): WORKERS'COMPENSATION DECLARATION: I hearby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. ll I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Company Name: _,l..,C,.W.!.!. ___________________ _ Policy No. WSD503018004 Expiration Date: _,6"--/1'--'/,,,_20,,,2"-'0'------- D Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be come subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to $100,000.00, in addition the to the cost of compensation, damages as provided for In Section 3706 of the Labor Code, interest and attorney's fees. ~ ·_ H CONTRACTOR SIGNATURE: ~ ~ □AGENT DATE:~ -(e -d 0 ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). □ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (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 contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). □ 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. □ Yes □ No 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/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone/ contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone/ type of work): OWNER SIGNATURE: __________________ □AGENT DATE: _____ _ CONSTRUCTION LENDING AGENCY, IF ANY: 1 hereby affirm that there is a construction lending agency for the performance of the work this permit is issued {Sec. 3097 (i) Civil Code). Lender's Name: _____________________ _ Lender's Address: _____________________ _ ONLY COMPLETE THE FOLLOWING 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 25S0S, 2S533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes □ No ls the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ No ls 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. APPLICANT CERTIFICATION: I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST AU LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.OSHA: An OSHA permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. 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 authorized by such permit is not commenced within 180 days from the date of such permit 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 SIGNATURE: Andrew R. Tarango t?.Ur ________ DATE: 2/28/2020 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 ol 2 Email: Building@carlsbadca.gov Rev. 06/18 Building Permit Inspection History Finaled {city of Carlsbad PERMIT INSPECTION HISTORY for (CBC2020-0098) Permit Type: BLDG-Commercial Work Class: Tenant Improvement Application Date: 03/06/2020 Owner: RAF PACIFICA GROUP RE FUND IV LLC Issue Date: 03/09/2020 Subdivision: CARLSBAD TCT#81-46 UNIT#02 Status: Closed -Finaled Expiration Date: 03/10/2021 Address: 1950 CAMINO VIDA ROBLE CARLSBAD, CA 92008-6599 IVR Number: 25269 Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Re inspection Inspection Date Start Date Status 07/13/2020 07/13/2020 BLOG-11 132384-2020 Failed Jason Paslut Relnspectlon Incomplete Foundation/Fig/Piers (Rebar) Checklist Item COMMENTS Passed BLDG-Building Deficiency Wrong inspection called No BLDG-Final Inspection 132385-2020 Passed Jason Paslut Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency Need B-59 paperwork. No NOTES Created By TEXT Created Date Jason Pasiut Waste management docuemnts are needed 07/10/2020 prior to final. 07/20/2020 07/20/2020 BLDG-11 133308-2020 Cancelled Michael Collins Reinspectlon Incomplete F oundatlon/Ftg/Plers (Rebar) Checklist Item COMMENTS Passed BLDG-Building Deficiency Wrong inspection called No BLDG-Final Inspection 133307-2020 Failed Michael Collins Relnspectlon Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency 7/20/20, not ready. Need receipts. No 07/24/2020 07/24/2020 BLDG-Final Inspection 133764-2020 Cancelled Paul Burnette Reinspectlon Incomplete Checklist Item COMMENTS Passed BLDG-Building Deficiency 7/20/20, not ready. Need receipts. No 07/27/2020 07/27/2020 BLDG-Flnal Inspection 133897-2020 Passed Jason Paslut Complete Checklist Item COMMENTS Passed BLDG-Building Deficiency 7/20120, not ready. Need receipts. No Monday, July 27, 2020 Page 1 of 1 ECS ENVIRC>N1'11.ENTAL. INC. ~PECIALIZI1'C. I~ LE..\D -~lOLD -ASBE~TOS \ Y \ Y \ V. E CS-EN \'IRC> N:i\ 1 E 'ST.-\ LS ERYI C ES.CC>:\ 1 July8,2019 Andrew R. Tarango Senior Project Manager SCA Architecture 13280 Evening Cree Drive So uth, Suite 125 San Diego, California 92128 RErr:,, '~Q 0 ° 2020 CITY OF \..,t\h, . ,D BUILDING DIVISIUN RE: Asbestos Testing-Commercial Building 1950 Camino Vida Roble, Carlsbad, California 92008-6505 Drywall/Joint Compound, Floor Glue and Ceiling Tile Dear Mr. Tarango; This report documents the laboratory analytical results of the Asbestos PLM sampling conducted by AHERA Certified Building Inspector, Mason Riley, working under the direction of Bond L. Mccowan, Sr. CAC. The thirteen (13) samples of drywall/joint compound, floor glue a nd ceiling tile were collected on July 1, 2019, and submitted to Analytical Services in Rancho Cucamonga, California, for processing. A total of twenty (20) samples were analyzed, including all layers. The laboratory analytical results of the samples indicate IJQ.Asbestos Containing Materials (ACM) were detected. > ---0 Should you have any questions after reviewing the conclusions and recommendations contained within this report, please do not hesitate to contact the undersigned at (800) 511-6364. ECS Environmental, Inc. remains available to assist you in any way possible. Sincerely, ECS Environmental, Inc. Bond L. Mccowan, Sr. California Certified Asbestos Consultant Attachments; Table 1 Laboratory Analytical Results Chain of Custody Field Sketch Inspector Certification 4876 SANTA MONICA AVE, SUITE 172 •~ SAN DIEGO, CA 92107 (0) 1-800-Stl-6364 (F) 480-719-4-465 ·.•.·· Sample Area Tested Type o(Materlal Number(sl " , ", , Interior Drywall and Joint 001 Compound Interior Drywall and Joint 002 Comoound Interior Drywall and Joint 003 Compmmd Interior Drywall and Joint 004 Compound Interior Drywall and Joint 005 Compound Interior Drywall and Joint 006 Compound Interior Drywall and Joint 007 Compound Interior Floor Glue 008 Interior Floor Glue 009 Interior Floor Glue 010 TABLE 1 Asbestos Results 1950 Camino Vida Roble Carlsbad. California 92008-6505 July 1,2019 Sample ·. : , -,:-'' ,, ,<_, ,', ,,' " Locations .·· Quantity c. Sample Description.... . •·· Area #I NIA Joint Compound (White) Drywall (White) Area #5 NIA Joint Compound (White) Drywall (White) Area #3 NIA Joint Compound (White) Drywall (White) Area #2 NIA Joint Compound (White) Drywall (White) Arca #6 NIA Joint Compound (White) Drvwall (White) Area #4 NIA Joint Compound (White) Drvwall (White) Arca#2 NIA Joint Compound (White) Drvwall (White) Area#2 NIA Floor Glue (Yellow) Area #1 NIA Floor Glue (Yellow) Area #3 NIA Floor Glue (Yellow) ND= None Detected CH=Chrysotile CR=Crocidolit A=Amosite N/A=Not Analyzed A/P=Assume Positive ***Contractor shall follow all OSHA regulations with samples less <1% PLM Condition I• Results Percent > Good ND 0% ND 0% Good ND 0% ND 0% Good ND 0% ND 0% Good ND 0% ND 0% Good ND 0% ND 0% Good ND 0% ND 0% Good ND 0% ND 0% Good ND 0% Good ND 0% Good ND 0% . ·. ... Sllmple ·• Area Tested Type of Material N111nbh(s) ·. Interior Ceiling Tile 011 Interior Ceiling Tile 012 Interior Ceiling Tile 013 TABLE 1 Asbestos Results 1950 Camino Vida Roble Carlsbad. California 92008-6505 July I, 2019 . Sample < ·•·· .·.· . . .. . ... . .··.· .. Locations · Quantity . Samp!i: De~crippon { ; . .. .. .. ·• Area #3 NIA Ceiling Tile (White) Area #I NIA Ceiling Tile (White) Hallway NIA Ceiling Tile (White) ND= None Detected CH=Chrysotile CR=Crocidolit A=Amosite N/A=Not Analyzed A/P=Assume Positive ***Contractor shall follow all OSHA regulations with samples less <1% .·.... . . ·.·· . PLM Condition Results· Percent . Good ND 0% Good ND 0% Good ND 0% Client: Project: Client# 001 002 003 004 Analytical Services Bond Mccowan Report#: 0719028 ECS Environmental, Inc. Date of Receipt: 07/05/2019 4876 Santa Monica Avenue Report Date: 07/05/2019 San Diego Ca 92107 Date of Analysis: 07/05/2019 1950 CAMINO VIDA ROBLE, CARLSBAD CA Sample Material Location Description Detection Composition LAYER 1 None Detected Non-Fibrous Material 100% Joint Compound, Whlre, Non- homogeneous, Chalky, Non- Friable LAYER 2 None Detected Cellulose Fiber 10% Dr;wall, White, Non-Non-Fibrous Material 90% homogeneous, Chalky-Fibrous, Non-Friable LAYER 1 None Detected Cellulose Fiber 1% Joint Compound, White, Non-Non-Fibrous Material 99% homogeneous, Chalky, Non- Friable LAYER 2 None Detected Cellulose Fiber 10% Drywall, White, Non--Non-Fibrous Material 90% homogeneous, Chalky-Fibrous, Non-Friable LAYER 1 None Detected Cellulose Fiber 1% Joint Compound, White, Non-Non-Fibrous Material 99% homogeneous, Chalky, Non- Friable LAYER 2 None Detected Cellulose Fiber 10% Drywall, White, Non-Non-Fibrous Material 90% homogeneous, Chalky-Fibrous, Non-Friable LAYER 1 None Detected Cellulose Fiber 1% Joint Compound, White, Noo-Non-Fibrous Material 99% homogeneous, Chalky, Non- Friable LAYER 2 None Detected Cellulose Fiber 10% Dr;wall, White, Noo-Non-Fibrous Material 90% homogeneous, Chalky-Fibrous, Non-Friable ANALYTICAL SERVICES 10744 HILLBROOK AV~ BATON ROUG~ LOUISIANA 70810 Phone: {321) 837-9837 Fax: {225) 478-9731 Report Number 0719028 Page 1 of 3 NVLAP CODE 200670-0 Client: Project: Client# 005 006 007 008 009 Page 2 of 3 Analytical Services Bond McCowan Report#: 0719028 ECS Environmental, Inc. Date of Receipt: 07/05/2019 4876 Santa Monica Avenue Report Date: 07/05/2019 San Diego Ca 92107 Date of Analysis: 07/05/2019 1950 CAMINO VIDA ROBLE, CARLSBAD CA Sample Material Location Description Detection Composition LAYER I None Detected Non-Fibrous Material 100% Joint Compound, White, Non- homogeneous, Chalky, Non- Friable LAYER 2 None Detected Cellulose Fiber 10% Drywall, White, Non-Non-Fibrous Material 90% homogeneous, Chalky-Fibrous, Non-Friable LAYER 1 None Detected Non-Fibrous Material 100% Joint Compound, White, Non- homogeneous, Chalky, Non- Friable LAYER 2 None Detected Cellulose Fiber 10% Drywall, White, Non-Non-Fibrous Material 90% homogeneous, Chalky-Fibrous, Non-Friable LAYER 1 None Detected Non-Fibrous Material 100% Joint Compound, White, Non- homogeneous, Chalky, Non- Friable LAYER 2 None Detected Cellulose Fiber 10% Drywall, White, Noo-Non-Fibrous Material 90% homogeneous, Chalky-Fibrous, Non-Friable Floor Glue, Yellow, Non-None Detected Non-Fibrous Material 100% homogeneous, Resinous, Non· Friable Floor Glue, Yellow, Non-None Detected Non-Fibrous Material 100% homogeneous, Resinous, Non- Friable ANALYTICAL SERVICES 10744 HILLBROOK AVE; BATON ROUGE; LOUISIANA 70810 Phone: {321) 837-9837 Fax: {225) 478-9731 Report Number 0719028 NVLAP CODE 200670-0 Analytical Services Client: Bond Mccowan ECS Environmental, Inc. 4876 Santa Monica Avenue San Diego Ca 92107 Project: 1950 CAMINO VIDA ROBLE, CARLSBAD CA Sample Client# Location 010 011 012 013 ASBESTOS TYPES: Material Description Floor Glue, Yellow, Non- homogt!neous, Resinous, Non- Friable Celling TIie, White, Non- homogeneous, Fibrous, Friable Ceiling TIie, White, Non- homogeneous, Fibrous, Friable Ceiling TIie, White, Non- homogeneous, Fibrous, Friable Chrysotlle, Crocidollte, Anthophylllte, Tremollte, Amoslte, Actlnollte Report #: Date of Receipt : Report Date: Date of Analysis: Detection None Detected None Detected None Detected None Detected The samples listed above were suspect of containing asbestos. A result of "Non Delect• means e thorough search using appropriate techniques was conducted and no type of asbestos was discovered. San,ples submitted to this facility will be disposed of unless lhe client requests the samples be returned. Reports will be archived for a period of no more than 3 years. The analysis performed is in accordance with EPA 600/M4-82-020 Btld EPA 600.IR-93.1116. Test results apply o,lly lo the SBmples submitted. It Is not our policy to distribute the customer's informat,on without the written consent of u,e customer. n ,e tesl report shall not be reproduced except in fuN, wilhout the "'4itten approval of the laboratory. This report may not be used by the above client to claim product certification, approval or endorsement by NIST. National Voluntary Laboratory Accreditation Program or the Federal Government. Shawn Kearney Laboratory Director / Analyst /4 . .,...i-I Angela Keamey President ANALYTICAL SERVICES 0719028 07/05/2019 07/05/2019 07/05/2019 Composition Non-Fibrous Material Cellulose Fiber Mineral Wool Non-Fibrous Material Cellulose Fiber Mineral Wool Non-Fibrous Material Cellulose Fiber Mineral Wool 100% 30% 40% 30% 30% 40% 30% 30% 40% Non-Fibrous Material 30% 10744 HILLBROOK AVE, BATON ROUGE, LOUISIANA 70810 Phone: {321} 837-9837 Fax: {225) 478-9731 Report Number 0719028 Page 3 of 3 NVLAP CODE 200670-0 CHAIN OF CUSTODY Analytical Services. 2856 E Via Terrano Ontario CA 91764 Phone (321) 837-9837 Fax (225> 478-9731 [?)[s~M§(P@~ company Name: ECS Environmental, Inc. send Results Via: Fax 4876 Santa Monica Avenue #172 San Diego, CA 92107 contact: Bond Mccowan I Jim Begin Phone I Fax#: 800-511-6364 J 480-719-4465 Email : info@ecs-environmentalservices.com FEDEX: 295735198 /~ '--.---· ... ., ,nc·l fi 0' ·. T~around Time: _, ... '<·.:.--, ~.' 24 Hour 2 Day 3 Day 5 Day Type Of Analysis.: ~./v. · · if Ana. lysis 1nstructions: ~ .·· 4;~ ~ 1 <7. -.-;;;~~ !PLM(PolntCourrt[1000~ /'? c.~ncr::amw ~ 'M (Pol11l o,...,-pfo Pis.J) Vermiculite Attic fnsulation {EP.IVBDOIR-041004) Disposal Instructions: Retum to Client (At Clients Expense) Dispose of at GIC Special nstructions: _______________ _ PCM .,. Payment terms ere Net 30 Days 1 ~~ . n (. ~\<'c"'"\ . • r. ·, I . ◊I , ., ( Project Name: ; ' 1 ·'Q L~~'~1·r-.·O ~-.~~ ,·-'~1 -'<..t Project #: PO #': .•.. ~~----· ' . ... . GIC Sample Client Sample Lacation and Type of Material Oate & Time Samples PCM Info; Number Number -or-Sampled Accepted? TOTAL SS#, Naine, and Location !FCM) Y or N ON OFF FLOW VOL 11 \ 1 t~ ·----..... ·v ·:':} I n ,'f v~ \\ / · .o i ,v:t '· i ._'C)/i,i r \.,\..J .,.7' ·()(Q'? I ·e.)·iJ '-.f -l ,u0 1 r ----f..) D ::., i >--"' -:; ~ (( 0 ,· ·--•· .,, -·-· ·----. ••--··---··--·-·· ,,_ •·1 ,or; ~:{ ·c I o;J r ~; 1,1.~ ·'O :[]~ \ , ~,1·~ l --•·--- -~ ~ i (:;>\\~".~ t-\ \ .Q., ---.. -.. -~ .. _.______ - 4 ; '; 1 , ' ! OJl ! I 1 l I r:~ RelinquishedBy~ Date/Time: '7/"o/11- Rel/nquished By: _____________ Date/Time: ______ _ _,._, , __ ·-· --~p ~k:!':_ -.. . -,~ -. #A ·1 Received By: ...-' C...!\ Received By: ' Date/Time: Dat&.'Time: -~~---- ::> ('-!.}j.ty OUU(.0 YINIIU~I IYJ uva~·1~'9'::> 3190~ VOi /\ ONIW't':J 0561 uo1s.nJ ;JOJ ■8u1••JO uon11ow10 ~ ~ i ~ C: Kl i ~ I • 1 I ., • I ~ o J, I ,, ; ~ I I • I I w • I I .., r I L ~ l E •· II ,, l!.. ~· r: ·7 ~1 ,, , ... ':: l 1 ''j 'I "i'•:= f I II i I , i' ~~b lrl tth I 1!ltj t t~J I 1 , 1ili·J : ur := ,, t u~'~•'. ~l~l~ ilfl'~I' Ill SIi l !ff I i th ~ !'';I , dp i~ :1ijf, ,n I n1i ~ fi · U' l •11 ill~ di¼i I t111 ~ lj •Ii!! 1:e,!l . ~ii : iff ~, ~, ~ I!: -~·1r.Hu GI Af ,, .. y • • • r If' ,, ll s• • , p , ; ln1 1 1P ; t' I !i fiiHf I i~ l. ;! r1 • u •I t fH r ·r I: ,f i'i ;;t'r ·i I ; ls •••• 1 • •{ ·1r I }t iJii• fli ! I, j r .j ,tti i'r 1b•m h• ft J:•J ' ml••i I l P. itlltil!i,U!! ilhiif t1::1 . . ..p • • .. r • • if ii U~i fi :II I !::s :1 i' r• 11 ! tnj l~il ~,,. ij •I I l l!,!i I ! '( r• j ~• , ~I ,if pU : I' i ~ 11'1 ·••! ~·1 I 1 ~ ~;1, fiili I! t ! • w , r, l • !l r ~ ,hp H1;ldt 1.,,1 I ~. E !iili I ~ a'.;7~tl I !!•~ I ~ Asbestos Training Program This is to certify Mason Riley 2110 Has successfully completed 24 hours of formal training required by section 206 ofTSCA II entitled Building Inspector Presented By Environmental Compliance Training PO BOX 16555 San Diego, CA. 92176-6555 (858) 558-7465 Walter T. Amenta, , Approval Nmnber CA-029-05 Class Dates: 11-26-28-2018 Exam Date: 11-28-2018 Expiration Date: 11-28-2019 Certification Number: 1118ABCA120902 91vision of Occupational Safety and Health Certified Asbestos Consultant ,..., -:;~'i;:--\.tt'i,.•-. Bond L McC'oiNh~L•ft~ .. Namil•·;,_.--~·--I .:; tj I}.'. . ~ SmithConsu tingArchitects TRANSMITTAL To: Marianne Lamoureux Company: BYCOR General Contractors, Inc. 6490 Marindustry Place Date: 2/2712020 Project No: 18034.T03 Project: Alec Demo & UG San Diego, CA 92121 1950 Camino Vida Roble ATTACHED: Description No. Copies 4 Date 2/27/20 30x42 1st Plan Check Submittal Drawing Sets 2 2/27/20 8 1/2x 11 Asbestos Testing Report 1 2/27/20 8 1 /2x 11 Submittal Application TRANSMITTED VIA: D FAX (Sheet 1 of __ ) Fax No. D Mail 181 Messenger D Overnight Delivery D Other REMARKS: Fee due at the submittal is $275.24 DISTRIBUTION: SCA File ACTION D For your approval D For your review and comment 181 As requested D For your use / files D Reviewed as noted D No exceptions taken D Revise / Resubmit With Encl. D D D W/0 Encl. D D D BY: Milos Makaric 858.793.4777 13280 Evening Creek Drive south Suite 125 San Diego, CA 92128 P:858.793.4777 I F:858.793.4787 -SAN DIEGO REGIONAL OFFICE USE ONLY HAZARDOUS MATERIALS RECORD ID# . . PLAN CHECK# . QUESTIONNAIRE BP DATE I I Due.iness Ntsme Business Contact Telechone # RAF Pacifica Group fu•slon Jim Jacob (61 ) 995-1107 Project Address City State Zip Code APN# 1950 Camino Vida Roble Carlsbad CA 92008 212-093-05, 12 Mailing Address City State Zip Code Plan File# 315 S. Coast Hwy 101, Suite U-12 Encinitas CA 92024 Project Contact Applicant E-mail Telephone# Andrew Tarango-SCA Architecture andrewt@sca-sd.com (858) 79'.!r47TT .. . .. The following questions represent the fac1hty's act1v1ties, NOT the specific proJect descnpt10n . PART I: FIRE DEPARTMENT -HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not required for projects within the City of San Diego): Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are circled, applicant must contact the Fire Protection Agency with jurisdiction prtor to plan submittal. Occupancy Rating: Facility's Square Footage (including proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 4. Flammable Solids 8. Unstable Reactives 12. Radioactives 13. 14. 15. Corrosives Other Health Hazards None of These. PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEAL TH -HAZARDOUS MATERIALS DIVISION (HMO}: If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 11 O, San Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED Project Completion Date: 9/30/20 Expected Date of Occupancy: 9/30/20 0 CalARP Exempt YES NO (for new construction or remodeling projects) 1. D ■ Is your business listed on the reverse side of this form? (check all that apply). Date Initials 2. D ■ Will your business dispose of Hazardous Substances or Medical Waste in any amount? 3. D ■ Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 D CalARP Required pounds and/or 200 cubic feet? 4. D ■ Will your business store or handle carcinogens/reproductive toxins in any quantity? Date Initials 5. D ■ Will your business use an existing or install an underground storage tank? 6 D ■ Will your business store or handle Regulated Substances (CalARP)? D CalARP Complete 7. 0 ■ Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? 8. 0 ■ Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to Date Initials or reater than 1,320 allons? California's Above round Petroleum Stora e Act . P T Ill: S DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT APCD : Any YES' answer requires a stamp from APCD 10124 Old Grove Road, San Diego, CA 921 1 a m s n .ca. v (858) 586-2650). ['No stamp required if Q1 Yes l!ill!. Q3 Yes l!ill!. Q4-Q6 No]. The following questions are intended to identify the majority of air pollution issues at the planning stage. Projects may require additional measures not identified by these questions. For comprehensive requirements eontact APCD. Residences are typically exempt, except -those with more than one building+ on the property; single buildings with more than four Uwi::lfo 19 unit::., townhomes: condos; mixed-commercial use; deliberate burns; residences forming part of a larger project. r+Excludes garages & small outbuildings.] YES NO 1. ■ D Will the project disturb 160 square feet or more of existing building materials? 2. D ■ Will any load supporting structural members be removed? Notification may be required 1 O working days prior to commencing demolition. 3. D D (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance Technician? 4. D D (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification may be required 10 working days prior to commencing asbestos removal. 5. D ■ Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet (www.sdapcd.qrg/info/facts/permits.pdf} for typical equipmi:,nt requiring an APCD permit. 6. D D (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school bounda Briefly describe business activities: Briefly describe proposed project: Office 7,635 s.f interior tenant Improvement demolition I dedare under penalty of pe~ury that to the best of my knowledge and belief t e responses made herein are true and correct. Andrew R. Tarango-SCA Architecture _ ,lffi> _______________ _ Name of Owner or Authorized Agent signati.ire of Owner or Authorized Agent 2 / 28 / 2020 Date FIRE DEPARTMENT OCCUPANCY CLASSIFICATION· FOR OFFICAL USE ONLY: BY: DATE: I I EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FQR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMO* APCO l,.;UUNIY-HMU APCD COUNTY-HMO APCD *A stamp 1n this box only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply. HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY Date. ___ _ Business Name. __________________________ _ Street Address. ___________________________ _ Email Address --------------------------- PL EASE CHECK HERE IF YOUR BUSINESS IS EXEMPT: (ON REVERSE SIDE CHECK TYPE OF BUSINESS) □ Check all below that are present at your facility: Acid Cleaning Ink Manufacturing Nutritional Supplement/ Assembly Laboratory Vitamin Manufacturing Automotive Repair Machining I Milling Painting / Finishing Battery Manufacturing Manufacturing Paint Manufacturing Biofuel Manufacturing Membrane Manufacturing Personal Care Products Biotech Laboratory (i.e. water filter membranes) Manufacturing Bulk Chemical Storage Metal Casting I Forming Pesticide Manufacturing / Car Wash Metal Fabrication Packaging Chemical Manufacturing Metal Finishing Pharmaceutical Manufacturing Chemical Purification Electroplating (including precursors) Dry Cleaning Electroless plating Porcelain Enameling Electrical Component Anodizing Power Generation Manufacturing Coating (i.e. phosphating) Print Shop Fertilizer Manufacturing Chemical Etching / Milling Research and Development Film/ X-ray Processing Printed Circuit Board Rubber Manufacturing Food Processing Manufacturing Semiconductor Manufacturing Glass Manufacturing Metal Powders Forming Soap/ Detergent Manufacturing Industrial Laundry Waste Treatment I Storage SIC Code(s) (if known): _____________________ _ Brief description of business activities (Production I Manufacturing Operations): _____ _ Description of operations generating wastewater (discharged to sewer, hauled or evaporated): Estimated volume of industrial wastewater to be discharged (gal/ day): _______ _ List hazardous wastes generated (type/ volume): _______________ _ Date operation began/or will begin at this location: _______________ _ Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? Yes No If yes, when: ____________________ _ Site Contact ______________ Title ____________ _ Signature ______________ Phone No. ___________ _ ENCINA WASTEWATER AUTHORITY, 6200 Avenida Encinas Carlsbad, CA 92011 (760) 438-3941 FAX: (760) 476-9852