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Home My WebLink About1950 CAMINO VIDA ROBLE; ; CBC2020-0253; PermitPrint Date: 10/21/2020 Permit No: CBC2020-0253 Building Permit Finaled Commercial Permit Job Address: Permit Type: Parcel #: Valuation: Occupancy Group: 1950 CAMINO VIDA ROBLE, CARLSBAD, CA 92008-6599 BLDG-Commercial 2120931200 $158,000.00 Work Class: Lot #: Project #: Cogen Status: Applied: Issued: 07/07/2020 07/28/2020 Finaled Close Out: #of Dwelling Units: Track #: Plan #: Closed - Finaled TKers Plan Check #: Project Title: Inspector:Orig. Plan Check #:Bathrooms: Description:550.235 KW ROOF MOUNT PV SYSTEM, 395 MODS (E-REVIEW) Final Inspection:10/21/2020 Bedrooms:Construction Type: Applicant: BAKER ELECTRIC INC COURTNEY CABRAL 1298 PACIFIC OAKS PL ESCONDIDO, CA 92029(760) 745-2001 x5148 Property Owner: RAF PACIFICA GROUP RE FUND IV LLC 6305 EL CAMINO REAL CARLSBAD, CA 92009 Contractor: N B BAKER ELECTRIC INC 2120 HARMONY GROVE RD ESCONDIDO, CA 92029-2053 (442) 257-0877 AMOUNTFEE BUILDING PERMIT FEE ($2000+)$831.90 BUILDING PLAN CHECK FEE (BLDG)$582.33 SB1473 GREEN BUILDING STATE STANDARDS FEE $7.00 STRONG MOTION-COMMERCIAL $44.24 Total Fees:$1,465.47 Total Payments To Date:$1,465.47 Balance Due:$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. 1635 Faraday Avenue, Carlsbad CA 92008-7314 ï 760-602-2700 ï 760-602-8560 f ï www.carlsbadca.gov Building Division Page 1 of 1 {"Cityof Carlsbad CBC2020-0253 $158,000.00 7/7/2020 Ccicyof Carlsbad COMMERCIAL BUILDING PERMIT APPLICATION B-2 Plan Check --------- Est. Value PC Deposit --------- Date --------- Job Address 1950 Camino Vida Roble, Carlsbad, CA 92008 Suite: _____ APN: 212-093-12 CT/Project#:. __________________ Lot #:_34 ___ _ Fire Sprinklers: 0 YES O NO Air Conditioning: G) YES Q NO Electrical Panel Upgrade: 0 YES G) NO BRIEF DESCRIPTION OF WORK: The ins1allation o1 a 550.235 kWDC rooftop photovoltaic system with (1,393) a.Peak Duo L-G5.2 395 modules with (6) SMA STP62-US-41 and (1) SMA STP33-UA-41 inverters. 0 Addition/New: _____ Living SF, ____ Deck SF, ____ Patio SF, ____ Garage SF Is this to create an Accessory Dwelling Unit? 0 YON New Fireplace? 0 YON, if yes how many? __ □Remodel: ____ SF of affected area Is the area a conversion or change of use ? 0 Y ON 0 Pool/Spa: ____ SF Additional Gas or Electrical Features? ____________ _ [2]Solar: 550-235 KW, 1,393 Modules, Mounted:G)RoofQGround, Tilt:0 YON, RMA:0Y0N, Battery:Ov G)N, Panel Upgrade: OY G)N D Reroof: _________________________________ _ D Plumbing/Mechanical/Electrical Only: _______________________ _ D Other: ________________________________ _ APPLICANT (PRIMARY CONTACT) Name: Courtney Cabral I Baker Electric Address: 1298 Pacific Oaks Place City: Escondido State:._C_A __ Zip: 92029 Phone: (760) 690-5027 Email: ccabral@baker-electric.com DESIGN PROFESSIONAL Name: TKJ Structural Engineering Address: 9820 Willow Creek Road, Suite 490 City: San Diego State: CA Zip: _9_2_13_1 __ _ Phone: (858) 649-1700 Email: bo@tkjse.com Architect State License: _S_4_8_45 _________ _ PROPERTY OWNER Name: RAF Pacifica Group Address: 315 S. Coast Highway, Suite U12 City: Encinitas Phone: (619) 995-1107 Email: jim@rafpacificagroup.com CONTRACTOR BUSINESS Name: Baker Electric Address: 1298 Pacific Oaks Place State.: ___ Zip: 92024 City: Escondido State:,_C_A __ Zip: 92029 Phone: (7601 745-2001 Email: dpostoian@baker-electric.com State License:._1_6_17_5_6 ____ Bus. License: BLOS1211897 (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 7031.5 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 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov B-1 Page 1 of 2 Rev. 03/20 ( OPTION A): WORKERS'COMPENSATION DECLARATION: I hearby affirm under penalty of perjury one of the following declarations: 01 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. (211 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:_"_"'_'"-'-"'-'"-"-"-" '-"-""_"°_'_c'"c.'"_ccy_,_,c ____________ _ Policy No. Mwzvs12ss420 Expiration Date: -""-"-"'-"-"-------- 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. ~ CONTRACTOR SIGNATURE: -~--------:::::::---,.,, □AGENT DATE: "'""mo ---~ ----'--'----'--------( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the foffowing reason: D1, 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 sa!e (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). DI, 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). DI 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. QYES Q 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: l 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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? I Yes/ No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes/ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes/ No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. APPLICANT CERTIFICATION: l 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 ALL UABILITJES, 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 f 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. CBC~ 105.5. APPLICANT SIGNATURE: 1635 Faraday Ave Carlsbad, CA 920~08~-~~W:Gn:,-;~LEaJ!:."::J,60-602-8558 B-1 Page 2 of 2 Email: Building@carlsbadca.gov Rev. 03/20 ("city of Carlsbad PURPOSE CLIMATE ACTION PLAN CONSISTENCY CHECKLIST B-50 Development Services Building Division 1635 Faraday Avenue (760) 602-2719 www.carlsbadca.gov This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance requirements apply to their projects. The completed checklist must be included in the building permit application. It may be necessary to supplement the completed checklist with supporting materials, calculations or certifications, to demonstrate full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach to comply with energy-related measures will need to attach to this checklist separate calculations and documentation as specified by the ordinances. NQT.E{Th~ f<jll<jwi.ii\i tf~~!PI•l>~fmitf/if~iH9i ·r~qllif~gJo:.fill putt~.is•· form.•••·.··········•·•·· .•.• ,,.,., •: ,,' ·" ',,'.,,;,,~,,,.·,e,,i·-.,, ,,,.·_,"., d:,!);.,.,_,_,;:,:,-·:" 'y '"'••"\ '., i.f<,1'·'•'·,,h/ .•. ;;_,._,,;_,\,·;,,·.,. "·" ·•,i,, -;. __ ,_. ,,, .. " ·, ·.cv ., •'!"'·\·' ·'" ,;·, ❖ Patio ❖ Decks ❖ PME (w/o panel upgrade) ❖ Pool .,. If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance, an explanation must be provided to the satisfaction of the Building Official. .,. Details on CAP ordinance requirements are available on the city's website . .,. A CAP Building Plan template (form B-55) shall be added to the title page all building plans. This template shall be completed to demonstrate project compliance with the CAP ordinances. Refer to the building application webpage and download the latest form. ----------------------- \17' ~~";~ r' '~0[-:'~lS'I j)-:;-7 -------------------------------Project Name/Building Permit No.: Alphatec Spine BP No.: ----------- Property Address/APN: 1950 Camino Vida Roble, Carlsbad, CA 92008 / 212-093-12 Applicant Name/Co.: Baker Electric ----------------------------- App Ii cant Address: 1298 Pacific Oaks Place, Escondido, CA 92029 Contact Phone: (760) 690-5027 Contact Email: ccabral@baker-electric.com Contact information of person completing this checklist (if different than above): Name: Company name/address: Contact Phone: Contact Email: Applicant Signature: _7,,.,~-"~~===::s;,~=====--i:;gi.,3tetec.,· ,;;:0:_:6::_/1::_1.:.;/,;::2~0;::2:.::0~-- ~------S::: ~ B-50 Page 1 of 6 Revised 08/19 City of Carlsbad Climate Action Plan Consistency Checklist Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project. For alterations and additions to existing buildings, attach Building Permit Valuation worksheet. Building Permit Valuation (BPV) from worksheet: $_"_,_,os_o ____ _ □ New construction □ Additions and alterations: □ BPV < $60,000 □ BPV 2' $60,000 □ Electrical service panel upgrade only □ BPV" $200,000 □ Alterations: □ BPV 2' $200,000 or additions 2' 1,000 square feet □ BPV;, $1,000,000 □ ;, 2,000 sq. ft new roof addition 2A, 3A, 4A N/A 1A,4A 1A, 4A' 1B, 5 1B, 2B, 5 2B,5 1B, 2B, 3B,4A N/A 4A 1B, 4A' All residential additions and alterations 1-2 family dwellings and townhouses with attached garages only 'Multi-family dwellings only where interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are reposed Building alterations of;, 75% existing gross floor area 1B also applies if BPV" $200,000 Please refer to Carlsbad Municipal Code (CMC) sections 18.21.155 and 18.30.190, and the California Green Building Standards Code (CALGreen) for more information when completing this section. A D Residential addition or alteration ~ $60,000 building permit valuation. □ N/A ________ _ See CMC section 18,30.190. □ Exception: Home energy score~ 7 (attach certification) Year Built Single-family Requirements Multi-family Requirements □ Before 1978 Select one: □ Duct sealinQ □Attic insulation □Cool roof □ Attic insulation □ 1978 and later Select one: □ Lighting package □ Water healing Package □ Between 1978 and 1991 Select one: □ Duct sealinQ □ Attic insulation □Cool roof Select one: □ 1992 and later □ Lighting package □ Water heating package B, D Nonresidential' new construction or alterations~ $200,000 building permit valuation, or additions~ 1,000 square feet, □ N/A Updated 8/15/2019 2 City of Carlsbad Climate Action Plan Consistency Checklist See CMC 18.21.155 and CALGreen Appendix A5, Division A5.2 -Energy Efficiency. A5.203.1.1 Choose one: □ .1 Outdoor lighting □ .2 Warehouse dock seal doors □ .3 Restaurant service water heating (comply with California Energy Code section 140.5, as amended) □ NIA _________ _ □ .4 Daylight design PAFs □ .5 Exhaust air heat recovery A5.203.1.2.1 Choose one as applicable: □ .95 Energy budget □ .90 Energy budget □ NIA A5.211.1" □ On-site renewable energy □ NIA AS.211.3" □ Green power (if offered by local utility provider, 50% minimum renewable sources) □ NIA A5.212.1 □ Elevators and escalators □ NIA A5.213.1 □ Steel framing □ NIA • Includes hotels/motels and high-rise residential buildings "For alterations~ $1,000,000 BPV and affecting> 75% existing gross floor area, or alterations that add 2,000 square feet of new roof addition: comply with CMG 18.30.130 instead. ~imqt~:.:·1t,!.~--Jl1lltlll~~I(llll,«l~i1111111rm[t~1~1til1~~~~-~,~1tr~t~Sfffl~ A. D Residential new construction (for low-rise residential building permit applications submitted after 111120). Refer to 2019 California Energy Code section 150.1(c)14 for requirements. Notes: 1) High-rise residential buildings are subject to nonresidential photovoltaic requirement (2B below) instead. 2) ff project includes installation of an electric heat pump water heater pursuanlto CMC 18.30.150(8) (high-rise residential) or 18.30.170(B) (low-rise residential), increase system size by .3kWdc if PVoffset option is selected. Floor Plan ID (use additional CFA #d.u. Calculated kWdc' sheets if necessary) Total System Size: kWdc = (CFAx.572) I 1,000 + (1.15x#d.u.) 'Formula calculation where CFA = conditional floor area, #du= number of dwellings per plan type If proposed system size is less than calculated size, please explain. Exception □ □ □ □ kWdc B. D Nonresidential new construction or alterations ~$1,000,000 BPV and affecting ~75% existing floor area, or addition that increases roof area by ~2,000 square feet. Please refer to CMC section 18.30.130 when completing this section. Note: This section also applies to high-rise residential and hotel/motel buildings. Choose one of the following methods: □ Gross Floor Area (GFA) Method GFA: □ If< 1 O,OOOs.f. Enter: 5 kWdc Min. System Size: □If;, 1 O,OOOs.f. calculate: 15 kWdc x (GFA/10,000) ** kWdc *'Round building size factor to nearest tenth, and round system size to nearest whole number. □Time-Dependent Valuation Method Updated 8/15/2019 3 City of Carlsbad Climate Action Plan Consistency Checklist Annual TDV Energy use:"* ______ x .80= Min. system size: _____ kWdc ... Attach calculation documentation using modeling software approved by the California Energy Commission. A D Residential and hotel/motel new construction Please refer to CMC sections 18.30.150 and 18.30.170 when completing this section. □For systems serving individual dwelling units choose one: D Heat pump water heater AND Compact hot water distribution AND Drain water heat recovery (low-rise residential only) D Heat pump water heater AND PV system .3 kWdc larger than required in CMG section 18.30.130 (high rise residential hotel/motel) or CA Energy Code section 150.1(c) 14 (low-rise residential) D Heat pump water heater meeting NEEA Advanced Water Heating Specification Tier 3 or higher D Solar water heating system that is either .60 solar savings fraction or 40 s.f. solar collectors D Exception: D For systems serving multiple dwelling units, install a central water-heating system with all of the following: D Gas or propane water heating system D Recirculation system per CMG 18.30.150(B) (high-rise residential, hotel/motel) or CMG 18.30.170(B) (low- rise residential) D Solar water heating system that is either: D .20 solar savings fraction D .15 solar savings fraction, plus drain water heat recovery □Exception: B. D Nonresidential new construction Please refer to Carlsbad Ordinance CMC section 18.30.150 when completing this section. D Water heating system derives at least 40% of its energy from one of the following (attach documentation): D Solar-thermal D Photovoltaics D Recovered energy □Water heating system is (choose one): D Heat pump water heater D Electric resistance water heater(s) □Solar water heating system with .40 solar savings fraction D Exception: Updated 8/15/2019 4 City of Carlsbad Climate Action Plan Consistency Checklist A O Residential New construction and major alterations* Please refer to Carlsbad Ordinance CMC section 18.21.140 when com letin this section. One and two-family residential dwelling or townhouse with attached garage: Done EVSE Ready parking space required D Exception : 0 Multi-family residential· D Exception · Total Parking Spaces EVSE Snaces Proposed Caoable I Readv Installed I Calculations: Total EVSE spaces= .10 x Total parking (rounded up to nearest whole number) EVSE Installed= Total EVSE Spaces x .50 (rounded up to nearest whole number) EVSE other= Total EVSE spaces -EVSE Installed (EVSE other may be "Capable," "Ready" or "Installed.") I Total I 'Major alterations are: (1) for one and two-family dwellings and townhouses with attached garages, alteralons have a building penntt valualon ~ $60,000 or include an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit valuation~ $200,000, interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed. B. D Nonresidential new construction (includes hotels/motels) D Exception · Total Parking Spaces EVSE Soaces Proposed Caoable I Readv I Installed l Total 10 2 I 5 I 1 I 8 Calculation· Refer to the table below· Total Number of Parkin□ S□aces □rovided Number of re□uired EV Spaces Number of re□uired EVSE Installed S□aces 0-9 1 1 10-25 2 1 26-50 4 2 51-75 6 3 □ 76-100 9 5 □ 101-150 12 6 7 151-200 17 9 I 201 and over 1 O oercent of total 50 oercent of Reauired EV Soaces Updated 8/15/2019 5 City of Carlsbad Climate Action Plan Consistency Checklist An approved Transportation Demand Management (TDM) Plan is required for all nonresidential projects that meet a threshold of employee-generated ADT. City staff v.111 use the table below based on your submitted plans to determine whether or nor your permit requires a TDM plan. If TDM is applicable to your penmit, staff will contact the applicant to develop a site-specific TDM plan based on the permit details. Acknowledgment Employee ADT Estimation for Various Commercial Uses EmpADTfor fir$_!_1,000 s_f. EmpADTI 1000s.f.J__ Office (all), 20 Restaurant 11 Retails 8 Industrial 4 Manufacturing 4 Warehousin 4 1 Unless otherwise noted, rates estimated from /TE Trip Generation Manual, 10thEdition 13 11 4.5 3.5 3 1 , For all office uses, use SANDAG rate of 20 ADT/1,000 sf to calculate employee ADT , Retail uses include shopping center, variety store, supermarket, gyms, pharmacy, etc. Other commercial uses may be subject to special consideration Sample calculations: Office: 20,450 sf 1. 20,450 sf/ 1000 x 20 = 409 Employee ADT Retail: 9,334 sf 1. First 1,000 sf= 8 ADT 2. 9,334 sf -1,000 sf= 8,334 sf 3. 8,334 sf/ 1,000 x 4.5 + 8 = 46 Em lo ee ADT I acknowledge that the plans submitted may be subject to the City of Cartsbad's Transportation Demand Management Ordinance. I agree to be contacted should my permit require a TDM plan and understand that an approved TDM plan is a condition of permit issuance. Applicant Signature: _________________ _ Date: _____ _ Person other than Applicant to be contacted for TOM compliance (if applicable): Name(Printed): _________________ _ Phone Number: ____ _ Email Address: __________________ _ Updated 8/15/2019 6 OFFICE USE ONLY SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE RECORD ID# _________________ I PLAN CHECK# __________________ , Business Name Alphatec Spine Project Address 1950 Camino Vida Roble Mailing Address 1950 Camino Vida Roble Project Contact Courtney Cabral Business Contact Telephone# Jim Jacob {619) 995-1107 City State Zip Code Carlsbad CA 92008 City State Zip Code Carlsbad CA 92008 Applicant E-mail Telephone# ccabral@baker-electric.com (760) 690-5027 BP DATE APN# 212-093-12 Plan File# The following questions represent the facility's activities, NOT the specific project description. 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 prior to plan submittal. Occupancy Rating: Facility's Square Footage (including proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These. 4. Flammable Solids 8. Unstable Reactives 12. Radioactives PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH 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 110, San Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: 0 CalARP Exempt I 1, 2. 3. 4. 5, 6. 7. 8. YES NO □ 0 0 □ □ 0 □ □ □ □ □ (for new construction or remodeling projects) Is your business listed on the reverse side of this fonn? (check all that apply). Will your business dispose of Hazardous Substances or Medical Waste in any amount? Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? Will your business store or handle carcinogens/reproductive toxins in any quantity? Will your business use an existing or install an underground storage tank? Will your business store or handle Regulated Substances (CalARP)? Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or greater than 1,320 anons? California's Aboveground Petroleum Storage Act). Date Initials □ CalARP Required I Date Initials 0 CalARP Complete I Date Initials PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San Diego, CA 92131 apcdcomp@sdcounty.ca.gov (858) 586-2650). [*No stamp required if Q1 Yes and 03 Yes and 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 contact APCD. Residences are typically exempt, except -those with more than one building+ on the property; single buildings with more than four dwelling units; townhomes; condos; mixed-commercial use; deliberate burns; residences fonning part of a larger project. rExcludes garages & small outbuildings.] YES NO 1. 2. 3. 4. 5. 6. □ 0 □ 0 □ □ □ Will the project disturb 160 square feet or more of existing building materials? Will any load supporting structural members be removed? Notification may be required 10 working days prtor to commencing demolition. (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance Technician? □ □ □ (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. 0 Will the project or associated construction equipment emit air contaminants? See the reverse side of this fom, or APCD factsheet (www.sdapcd.org/info/facts/permits.pdf) for typical equipment requiring an APCD permit. □ (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: Commercial building Rooftop photovoltaic system installation I declare under penalty of perjury that to the best of my knowledge and belief tlie re Cc"~ney Cabral es made herein ar 11 / 2020 Name of Owner or Authorized A ent at r or Authorized A en Date FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:. ______________________________ _ BY· DATE· I I EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMO* APCD COUNTY-HMO APCD COUNTY-HM□ APCD . . *A stamp 1n this box only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other penn1ttmg requirements may still apply . HM-9171 (08115) County of San Diego -DEH -Hazardous Materials Division LIST OF BUSINESSES WHICH REQUIRE REVIEW AND APPROVAL FROM THE COUNTY OF SAN DIEGO DEPARTMENT OF ENVIRONMENTAL HEALTH -HAZARDOUS MATERIALS DIVISION Check all that apply: AUTOMOTIVE D Battery Manufacturing/Recycling D Boat Yard D Car Wash D Dealership Maintenance/Painting D Machine Shop D Painting D Radiator Shop D Rental Yard Equipment D Repair/Preventive Maintenance D Spray Booth D Transportation Services D Wrecking/Recycling CHEMICAL HANDLING D Agricultural supplier/distributor D Chemical Manufacturer D Chemical Supplier/Distributor D Coatings/Adhesive D Compressed Gas Supplier/Distributor D Dry Cleaning D Fiberglass/Resin Application 0 Gas Station D Industrial Laundry D Laboratory D Laboratory Supplier/Distributor □ Oil and Fuel Bulk Supply D Pesticide Operator/Distributor CHEMICAL HANDLING D Photographic Processing D Pool Supplies/Maintenance D Printing/Blue Printing D Road Coatings D Swimming Pool D Toxic Gas Handler D Toxic Gas Manufacturer METAL WORKING D Anodizing D Chemical Milling/Etching D Finish-Coating/Painting D Flame Spraying D Foundry D Machine Shop-Drilling/Lathes/Mills D Metal Plating D Metal Prepping/Chemical Coating D Precious Metal Recovery D Sand Blasting/Grinding D Steel Fabricator D Wrought Iron Manufacturing AEROSPACE D Aerospace Industry D Aircraft Maintenance D Aircraft Manufacturing OTHERS AND MISCELLANEOUS □ Asphalt Plant D Biotechnology/Research D Chiropractic Office D Co-Generation Plant D Dental Clinic/Office D Dialysis Center D Emergency Generator D Frozen Food Processing Facility D Hazardous Waste Hauler D Hospital/Convalescent Home D Laboratory/Biological Lab D Medical Clinic/Office D Nitrous Oxide (NOx) Control System D Pharmaceuticals □ Public Utility D Refrigeration System D Rock Quarry D Ship Repair/Construction D Telecommunications Cell Site D Veterinary Clinic/Hospital D Wood/Furniture Manufacturing/Refinishing ELECTRONICS D Electronic Assembly/Sub-Assembly D Electronic Components Manufacturing D Printed Circuit Board Manufacturing NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMD) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880. LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which include any of the following operations or equipment, will require clearance from the Air Pollution Control District. CHEMICAL 47 -Organic Gas Sterilizers 32 -Acid Chemical Milling 33 -Can & Coil Manufacturing 44 -Evaporators, Dryers & Stills Processing Organic Materials 24 -Dry Chemical Mixing & Detergent Spray Towers 35 -Bulk Dry Chemicals Storage 55 -Chrome Electroplating Tanks COATINGS & ORGANIC SOLVENTS 27 -Coating & Painting 37 -Plasma Arc & Ceramic Deposition Spray Booths 38 -Paint, Stain & Ink Mfg 27 -Printing 27 -Polyester Resin/Fiberglass Operations METALS 18 -Metal Melting Devices 19-Oil Quenching & Salt Baths 32 -Hot Dip Galvanizing 39 -Precious Metals Refining ORGANIC COMPOUND MARKETING (GASOLINE. ETC) 25 -Gasoline & Alcohol Bulk Plants & Terminals 25 -Intermediate Refuelers 26 -Gasoline & Alcohol Fuel Dispensing COMBUSTION 34 -Piston Internal -Combustion Engines 13-Boilers & Heaters (1 million BTU/hr or larger) 14-Incinerators & Crematories 15 -Burn Out Ovens 16 -Core Ovens 20-Gas Turbines, and Turbine Test Cells & Stands 48 -Landfill and/or Digester Gas Flares ELECTRONICS 29 -Automated Soldering 42 -Electronic Component Mfg FOOD 12 -Fish Canneries 12 -Smoke Houses 50 -Coffee Roasters 35 -Bulk Flour & Powered Sugar Storage SOLVENT USE 28 -Vapor & Cold Degreasing 30 -Solvent & Extract Driers 31 -Dry Cleaning ROCK AND MINERAL 04 -Hot Asphalt Batch Plants 05 -Rock Drills 06 -Screening Operations 07 -Sand Rock & Aggregate Plants 08 -Concrete Batch, CTB, Concrete Mixers, Mixers &Silos 1 O -Brick Manufacturing OTHER 01 -Abrasive Blasting Equipment 03 -Asphalt Roofing Kettles & Tankers 46 -Reverse Osmosis Membrane Mfg 51 -Aqueous Waste Neutralization 11 -Tire Buffers 17 -Brake Debonders 23 -Bulk Grain & Dry Chemical Transfer & Storage 45 -Rubber Mixers 21 -Waste Disposal & Reclamation Units 36 -Grinding Booths & Rooms 40 -Asphalt Pavement Heaters 43 -Ceramic Slip Casting 41 -Perlite Processing 40 -Cooling Towers -Registration Only 91 -Fumigation Operations 56 -WWTP (1 million gal/day or larger) & Pump Station NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITTING AIR CONTAMINANTS MAY REQUIRE AN AIR POLLUTION CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL DISTRICT AT (858) 586-2600. HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division ENCINA WASTEWATER AUTHORITY INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY 6200 Avenida Encinas, Carlsbad, CA 92011 Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@encinajpa.com Date: 06/11/2020 Business Name: Alphatec Spine street Address: 1950 Camino Vida Roble, Carlsbad, CA 92008 Email Address: ccabral@baker-electric.com PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT: (ON REVERSE SIDE CHECK TYPE OF BUSINESS) Check all below that are present at your facility: □ o Acid Cleaning o Assembly o Automotive Repair o Battery Manufacturing o Blofuel Manufacturing o Blotech Laboratory o Bulk Chemical Storage o CarWash o Chemical Manufacturing o Chemical Purification o Dental Offices • Dental Schools • Dental Clinics o Dry Cleaning o Electrical Component Manufacturing o Fertilizer Manufacturing o Film/X-ray Processing o Food Processing o Glass Manufacturing o Industrial Laundry o Ink Manufacturing o Laboratory o Machining/MIiiing o Membrane manufacturing (i.e. water filter membranes) o Metal Casting/Forming o Metal Fabrication o Metal Finishing • Electroplating • Electroless Plating • Anodizing • Coating (i.e. phosphating) • Chemical Etching/Milling • Printed Circuit Board Manufacturing o Metal Powders Forming o Nutritional Supplement/Vitamin Manufacturing o Painting/Finishing o Paint Manufacturing o Personal Care Products Manufacturing o Pesticide Manufacturing/ Packaging o Pharmaceutical Manufacturing (including precursors) o Porcelain Enameling o Power Generation o Print Shop o Research and Development o Rubber Manufacturing o Semiconductor Manufacturing o Soap/Detergent Manufacturing o Waste Treatment/Storage New Business? YesONoO SIC Code(s) if known: ______ Date operation began/will begin:. ______ _ Tenant Improvement? VesONoO If yes, briefly describe improvement:. _________________ _ 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).: __________________________ _ Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? YesD Date.: _____ NoO Page 1 of2 EN CINA WASTEWATER AUTHORITY INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY 6200 Avenida Encinas, Carlsbad, CA 92011 Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@encinajpa.com The commercial enterprises listed below are a partial listing of businesses that are exempt from industrial wastewater discharge permitting under normal operating conditions, They are exempt because (a) they discharge no process wastewater (i.e., they only discharge sanitary wastewater with no pollutants exceeding any local limits), and (b) they have no potential to negatively impact the EWPCF or other wastewater treatment plants in the ESS. Any questions regarding exemptions should be referred to EWA Source Control staff. o Automobile Detailers o Hotels/Motels (no laundry) o Barber/Beauty Shops o Laundromats o Business/Sales Offices o Libraries o Cleaning Services o Medical Offices (no x-ray developing) o Carpet/Upholstery o Mortuaries o Childcare Facilities o Museums o Churches o Nail Salons o Community Centers o Nursing Homes o Consulting Services a Office Buildings (no process flow) o Contractors o Optical Services o Counseling Services o Pest Control Services (no pesticide repackaging for sale) o Educational Services (no auto repair/film developing) o Pet Boarding/Grooming Facilities o Financial Institutions/Services o Postal Services (no car wash/auto repair) o Fitness Centers o Public Storage Facilities o Gas Stations (no car wash/auto repair) o Restaurants/Bars o Grocery Stores (no film developing) o Retail/Wholesale Stores (no auto repair/film developing) o Residential based Businesses o Theaters (Movie/Live) CERTIFICATION STATEMENT I certify that the information above is true and correct to the best of my knowledge. 4--, "'" ,,me, Coortcoy Cabcal Signature: <-:.:::.._:_ DATE: 06/11/2020 Facility Contact:, __________ _ Title: Project Engineer II ENCINA WASTEWATER AUTHORITY 6200 AVENIDA ENCINAS, CARLSBAD, CA Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@encinajpa.com Page2 of2 DISABILITY ACCESS REQUIREMENTS AND RESOURCES NOTICE TO APPLICANTS FOR BUSINESS LICENSES AND COMMERCIAL BUILDING PERMITS: Under federal and state law, compliance with disability access laws is a serious and significant responsibility that applies to all California building owners and tenants with buildings open to the public. You may obtain information about your legal obligations and how to comply with disability access laws at the following agencies: DEPARTMENT OF GEN ERALSERVICES, Division of the State Architect, CASp Program www.dgs.ca.gov/dsa www.dgs.ca.gov/casp DEPARTMENT OF REHABILITATION Disability Access Services www.dor.ca.gov www.rehab.cahwnet.gov/ disabilityaccessinfo CERTIFIED ACCESS SPECIALIST INSPECTION SERVICES DEPARTMENT OF GENERALSERVICES, California Commission on Disability Access www.ccda.ca.gov www.ccda.ca.gov/resourc es-menu/ Compliance with state and federal construction-related accessibility standards ensures that public places are accessible and available to individuals with disabilities. Whether your business is moving into a newly constructed facility or you are planning an alteration to your current facility, by engaging the services of a Certified Access Specialist (CASp) early in this process you will benefit from the advantages of compliance and under the Construction-Related Accessibility Standards Compliance Act (CRASCA, Civil Code 55.51- 55.545), also benefit from legal protections. Although your new facility may have already been permitted and approved by the building department, it is important to obtain CASp inspection services after your move-in because unintended access barriers and violations can be created, for example, placing your furniture and equipment in areas required to be maintained clear of obstructions. For planned alterations, a CASp can provide plan review of your improvement plans and an access compliance evaluation of the public accommodation areas of your facility that may not be part of the alteration. A CASp is a professional who has been certified by the State of California to have specialized knowledge regarding the applicability of accessibility standards. CASp inspection reports prepared according to CRASCA entitle business and facility owners to specific legal benefits, in the event that a construction-related accessibility claim is filed against them. To find a CASp, visit www.apps2.dgs.ca.gov/OSA/casp/casp certified /ist.aspx. (Issued 12-28-18) DISABILITY ACCESS REQUIREMENTS AND RESOURCES GOVERNMENT TAX CREDITS, TAX DEDUCTIONS AND FINANCING State and federal programs to assist businesses with access compliance and access expenditures are available: Disabled Access Credit for Eligible Small Businesses FEDERAL TAX CREDIT-Internal Revenue Code Section 44 provides a federal tax credit for small businesses that incur expenditures for the purpose of providing access to persons with disabilities. For more information, refer to Internal Revenue Service (IRS) Form 8826: Disabled Access Credit at www.irs.gov. STATE TAX CREDIT-Revenue and Taxation Code Sections 17053.42 and 23642 provide a state tax credit similar to the federal Disabled Access Credit, with exceptions. For more information, refer to Franchise Tax Board (FTB) Form 3548: Disabled Access Credit for Eligible Small Businesses at www.ftb.ca.gov. Architectural and Transportation Barrier Removal Deduction FEDERAL TAX DEDUCTION-Internal Revenue Code Section 190 allows businesses of all sizes to claim an annual deduction for qualified expenses incurred to remove physical, structural and transportation barriers for persons with disabilities. For more information, refer to IRS Publication 535: Business Expenses at www.irs.gov. Galifomia Ga pita I Access Financing Program STATE FINANCE OPTION-The California Capital Access Program (CalCAP) Americans with Disabilities Act (CalCAP/ADA) financing program assists small businesses with financing the costs to alter or retrofit existing small business facilities to comply with the requirements of the federal ADA. Learn more at www.treasurer.ca.gov/cpcfa/calcap/. FEDERAL AND STATE LEGAL REQUIREMENTS ON ACCESSIBILITY FOR INDIVIDUALS WITH DISABILITIES AMERICANS WITH DISABILITIES ACT OF 1990 (ADA)-The ADA is a federal civil rights law that prohibits discrimination against individuals with disabilities, and requires all public accommodations and commercial facilities to be accessible to individuals with disabilities. Learn more at www.ada.gov. CALIFORNIA BUILDING CODE (CBC)-The CBC contains the construction-related accessibility provisions that are the standards for compliant construction. A facility's compliance is based on the version of the CBC in place at the time of construction or alteration. Learn more at www.bsc.ca.gov. (Issued 12-28-18) Building Permit Inspection History Finaled PERMIT INSPECTION HISTORY for (CBC2020-0253) BLDG-Commercial 07/07/2020Application Date:Permit Type:Owner:RAF PACIFICA GROUP RE FUND IV LLC Cogen 07/28/2020Work Class:Issue Date:Subdivision:CARLSBAD TCT#81-46 UNIT#02 04/19/2021Expiration Date:Status: IVR Number: 27311 Closed - Finaled 1950 CAMINO VIDA ROBLE CARLSBAD, CA 92008-6599 Address: Scheduled Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection InspectionActual Start Date 09/18/2020 09/18/2020 BLDG-34 Rough Electrical 138690-2020 Partial Pass Tim Kersch Reinspection Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes 09/21/2020 09/21/2020 BLDG-34 Rough Electrical 138807-2020 Partial Pass Tim Kersch Reinspection Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes 10/05/2020 10/05/2020 BLDG-34 Rough Electrical 140081-2020 Partial Pass Tim Kersch Reinspection Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes BLDG-35 Solar Panel 140080-2020 Partial Pass Tim Kersch Reinspection Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes 10/14/2020 10/14/2020 BLDG-34 Rough Electrical 140845-2020 Partial Pass Tony Alvarado Reinspection Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency October 14, 2020: 1. Rough electrical scope of work for (Disconnect/reconnect), New meter release-new transformer panel, line side tap at utility side, verified taps connections, U.L. listed connectors products verified, lugs torqued down, grounds verified, electrical cabinets anchored-approved. 2. Released electrical meter to SDG&E. 3. Rough electrical for roof mount at PV solar system at roof location – approved. Yes 10/15/2020 10/15/2020 BLDG-33 Service Change/Upgrade 141025-2020 Passed Tim Kersch Complete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes 10/21/2020 10/21/2020 BLDG-35 Solar Panel 141527-2020 Passed Tim Kersch Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes Wednesday, October 21, 2020 Page 1 of 2 {cityof Carlsbad PERMIT INSPECTION HISTORY for (CBC2020-0253) BLDG-Commercial 07/07/2020Application Date:Permit Type:Owner:RAF PACIFICA GROUP RE FUND IV LLC Cogen 07/28/2020Work Class:Issue Date:Subdivision:CARLSBAD TCT#81-46 UNIT#02 04/19/2021Expiration Date:Status: IVR Number: 27311 Closed - Finaled 1950 CAMINO VIDA ROBLE CARLSBAD, CA 92008-6599 Address: Scheduled Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection InspectionActual Start Date BLDG-Final Inspection 141528-2020 Passed Tim Kersch Complete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final Yes BLDG-Electrical Final Yes Wednesday, October 21, 2020 Page 2 of 2