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Home My WebLink About2020 Cassia Rd; CS; CBC2018-0406; Permit(city of Carlsbad Commercial Permit Print Date: 08/16/2019 Permit No: CBC2018-0406 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: 2020 Cassia Rd, Cs BLDG-Commercial 2150210200 $22,000.00 Work Class: Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Tenant Improvement DEV140D2 Status: Applied: Issued: Permit Finaled: Inspector: Closed -Finaled 07/25/2018 12/27/2018 Plan Check#: Final Inspection: 8/16/2019 10:38:47AM Project Title: VERIZON CASSIA Description: VERIZON: REMOVE AND REPLACE 6 PANEL ANTENNAS ANO 3 RRU'S / INSTALL 6 NEW RRU COMBO UNITS AND 4 RAYCAP BOXES Applicant: Owner: DERRA DESIGN INC STEVE CRUZ MIDWEST INVESTMENT PROPERTIES LLC 49S E Rincon St, 204 CORONA, CA 95126-8161 BUILDING PERMIT FEE ($2000+) BUILDING PLAN CHECK FEE (BLDG) 2020 Cassia Rd CARLSBAD, CA ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL MECHANICAL BLOG COMMERCIAL NEW/ADDITION/REMODEL 5Bl473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-COMMERCIAL Total Fees: $463.54 Total Payments To Date: $463.54 Co-Applicant: BDR COMMUNICATIONS INC 760-804-5812 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby 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. $0.00 1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov $221.40 $154.98 $41.00 $39.00 $1.00 $6.16 • ' • THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING □BUILDING □FIRE □HEALTH 0HAZMAT/APCD Ccityof Building Permit Application Plan Check No.~fx'-OL/(/ n 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value (//J ~ ':) M') \ --. Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov i www.carlsbadca.gov Date +-!~5/('x JOB ADDRESS SUITEf/SPACEt/UNfTI I"" 215 2020 Cassia Road -021 -02 - CT/PROJECT# rOT # I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP Verizon V-B B DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Remove and replace 6 panel antennas and 3 RRU'S, Install 6 new RRU combo units and 4 raycap boxes, EXISTING USE I PROPOSED USE I GARAGE {SF) PATIOS (SF) I DECKS (SF) FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS v,so No[ZJ YES □No [Zj YES□ NO[Zj APPLICANT NAME Steve Cruz I Derra Design Inc. PROPERTY OWNER NAME Midwest Investment Properties , LLC Primary Contact ADDRESS ADDRESS 495 East Rincon Street # 204 5800 Armada Drive, Suite 200 CITY STATE ZIP CITY STATE ZIP Corona CA. 92879 Carlsbad CA. 92008 PHONE IFAX PHONE FAX 951-268-1650 951-268-1651 760-931-1134x 13 EMAIL EMAIL steve.cruz@derradesign.com DESIGN PROFESSIONAL William G. Atkins / Derra Design Inc. CJfS"j/,",f/r BUS. NAME , • "rr. AA A •• ., , , ,., A-,•"' k 'J'. 1 ,<.t c ADDRESS •1°lf "q. ti I ~.c L;"' ,-;-, A~E" # /0 / 495 East Rincon Street # 204 CITY STATE ZIP ~ STATE ~J..Oo 8 Corona CA. 92879 1<.LS Jfl. A 1'\ Got . PHONE l'AX PHONE flOC/-se , .') f, 951-268-1650 951-268-1651 760 60-Bot/-S-Rf ('~ EMAIL EMAIL ~le. <,i)AM> .. ,; el/71~,v.r. co.-u1 1 '"" "'c-34940 STATE LIC.# =t,' Cf'-fRls!;t~~o :,-c{:J I "7..;t.3.:2.0 2, (Sec, 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair anr structure, p_rior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law JChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the bas1s for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subJects the applicant to a civil penalty of not more than five hundred dollars {$500)). WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of petjury one of the following declarations: □ I have end will maintain e certificate of consent to self.Insure for workers' compensation as provk>ed by Section 3700 of the Labor Code, for the performaoce of the work for which this perm~ is issued. ~ave and will maintain workers' comi,ensatlon, as required bv Section 3700 of the Labor Code, for the pertormance of the work for which this i,ermit is issued. My workers' compensation· surance arrier and policy number are: Insurance Co.(? 'ff/!,E b.S ll/ S • (l) , · Policy Ne,. 'l.)'4 > G'B.C I ,,. Expiration Date J~,~~i,;.U2LZ.._ ~section need not be completed lithe permit is for one huridred dollars ($100) or less. i5 l) W C 'rl t.,;2. f O LJ Certificate of Exemption: I certify that in the performance of worl< for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' sa ge I nlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousa d dollars (&100,000), In addition to the cost of compensation, dam -~'.)~F;i;r f the Labor code, interest and attorney's fees. _NS CONTRACTOR SIGNATURE ~ I hereby affirm that I am exempt from Contractor's Uc □ □ D I, as owner of the property or my employees with wages as their sole compensation, will do the woo:. 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 ur.der 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. 0Yes 0No 2. 1 (have I 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 I contractors' license number): 4. 1 plan to provide portions of the woo:., but I have hired the following person to coordinate, supervise and provide the major work {include name I address I phone I 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 I address/ phone/ type of work): ~ PROPERTY OWNER SIGNATURE □AGENT DATE ' ' ! , COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY • Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account ActJ Jil Yes □ No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management dtstrict? □ Yes -' No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes ,0 No 1F ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AGENCY I hereby affirm that there 1s a construction lendmg agency for the performance of the wOO( this permit 1s issued (Sec 3097 (1) Civil Code) Lender's Name Lender's Address APPLICANT CERTIFICATION I certify that I have read the appllcatlon and state that the above lnfonnatlon Is correct and that the Information on the plans Is accurate. I agree to comply~ all City ordinances and State laws relating to building construction. I hereby a.ilhorize re~ntative of the Qty of Carlsba:l to enter u1xm the above mentioned property Klr inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOJENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required Klr excavations OV8f 5'0' deep and demolition or construction of structures over 3 stories in height EXPIRATION: Every pennlt issued by the Building Offi · I under the visions otth· sh~ expire by limitation and become null and '.Od if the building <:x w::tk authorized by such pennlt is rot oommenood within 180 days from the date of sud! permit or if the buikli ,~~!!E!i:i,a,11111is suspended or abandoned at any tirm after the work is commenced for a perk>d of 180days (Section 106.4.4 Unifonn Buikling C.ode) . .85 APPLICANT'S SIGNATURE DATE PERMIT INSPECTION HISTORY Rl:PORT (CBC2018-0406) Permit Type: Work Class: Status: Scheduled Date BLDG-Commercial Tenant Improvement Closed -Finaled Actual Start Date Inspection Type Application Date: 07/25/2018 Issue Date: 12/27/2018 Expiration Date· 02/12/2020 IVR Number: 12743 Inspection No. Inspection Status 08/05/2019 08/05/2019 BLOG-34 Rough Electrical 099691-2019 Failed 08/16/2019 08116/2019 August 16, 2019 BLOG-Flnal Inspection Checklist Item BLDG-Building Deficiency 099692-2019 Checklist Item BLDG-Building Deficiency BLDG-Plumbing Final BLDG•Mechanical Final BLDG·Structural Final BLDG·Electrical Final BLDG-34 Rough Electrical 101033·2019 BLDG-Flnal Inspection Checklist Item BLDG·Building Deficiency 101034-2019 Checklist Item BLDG•Building Deficiency BLDG·Plumbing Final BLDG•Mechanical Final BLDG-Structural Final BLDG-Electrical Final COMMENTS Not ready Failed COMMENTS Passed COMMENTS Not ready Passed COMMENTS Ownar: Subdivision: Address: Primary Inspector Chris Renfro Chris Renfro Paul York Paul York MIDWEST INVESTMENT PROPERTIES LLC • 2020 Cassia Rd, Cs Carlsbad, CA 92009-4211 Reinspection Reinspection Passed No Reinspection Passed No No No No No Passed Yes Passed Yes Yes Yes Yes Yes Complete Complete Complete Complete Complete Page 1 of 1 DATE: 8/3/2018 JURISDICTION: City of Carlsbad PLAN CHECK#.: CBC2018-0406 PROJECT ADDRESS: 2020 Cassia Rd. ✓• EsG1I A SAFEbuilt Company SET: I PROJECT NAME: Verizon "Cassia' (PCS-LTE) MTX:54 □ APPLICANT □ JURIS. ~ 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 comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. D The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. D The check list transmitted herewith is for your information. The plans are being held at EsGil until corrected plans are submitted for recheck. D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. D The applicant's copy of the check list has been sent to: ~ EsGil staff did not advise the applicant that the plan check has been completed. D EsGil staff did advise the applicant that the plan check has been completed. Person contacted: / Telephone#: Date contacted:/ (bl(@ ) Email: Mail Telephone Fax In Person 0 REMARKS: By: David Yao EsGil 7/26/18 Enclosures: 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 City of Carlsbad CBC2018-0406 8/3/2018 [DO NOT PAY -THIS IS NOT AN INVOICE} VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PREPARED BY: David Yao BUILDING ADDRESS: 2020 Cassia Rd. BUILDING OCCUPANCY: BUILDING AREA Valuation PORTION ( Sq. Ft.) Multiplier cell site revision Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code cb By Ordinance --------------- Bid . Permit Fee b Ordinance ... -~ g y -------::7 Plan Check Fee by Ordinance ~ ------------ Type of Review: Complete Review D Repetitive Fee -.;1 Repeats ~ Comments: D Other D Hourly EsGil Fee PLAN CHECK#.: CBC2018-0406 DATE: 8/3/2018 Reg. VALUE ($) Mod. per city 22,000 22,000 D Structural Only 1----_,,Hr. @ • $134,831 Sheet of 495 E Rincon St. Suite 204 Corona, CA. 92879 Ph: (951) 268-1650 Fax: (951) 268-1651 DESIGN INC. STRUCTURAL CALCULATIONS DESIGNED BY: ~ ' "i I JOB NUMBER: 0 4 4 S Z- DATE: I/ I 9 / l 1 /( A \I O • r,. ~ /> D D PROJECT: Vt;:;~12-01-' C,6 SS"l. (~ '2-c:, Z. c,,,,., '' · c..MLS (!, ./rD ., L.(;\ CONCLUSION: THE EXISTING ANTENNA'S SUPPORT STRUCTURES CAN HANDLE THE ADDITION AND ALTERATION OF ANTENNA'S RRU'S AND RAYCAPS WITHOUT ANY MODIFICATION TO THE EXISTING STRUCTURE CLIENT: 'D 6.y'( ~A BUILDING CODE: INTERNATIONAL BUILDING CODE 2015 EDITION, CALIFORNIA BUILDING CODE 2016 EDITION AND L.A.C. CODE 2017 MATERIALS: Except as otherwise specified herein: Concrete Concrete Block Brick Masonry Reinforced Steel Structural Steel Structural Pipe Plywood Sheathing Glu-Laminated Beams Lumber TYPE 'II" 2,500 PSI at 28 days. Grade N. Light Weight Units, ASTM C-90 Grade MW, 2,500 PSI Units, ASTM -62 20,000 PSI (ASTM A615, Grade 40) 24,000 PSI (Compact) (ASTM A572 Grade 50) 22,000 PSI (ASTM A-36) D.F.P.A., Structural II, INTR., P.S.1-95 2,400 PSI (D.F.-Larch Comb."A" or Comb. 24F) Grade Marked D.F.-Larch, W.C.L.B. Grading Rule 16. Soils Bearing Pressure 1500 PSF min. unless specified in soils report. (Including Charts & Tables from): Lumber & Timber Steel Concrete Concrete Block & Brick Masonry C Wood Structural Design Data (Volume1) National Lumber Manufacturers Association Manual of Steel Construction, AISC Reinforced Concrete Design Handbook, ACI: Ultimate Strength Design Handbook, ACI Masonry Design Manual, by Masonry Industry L-.-·•-( c:;, ~ ,1 "" j . :. /. -"' Shucri l. Yaghi ( 'nnsuh i n!! r 11gin1.L'I~ PROJECT : CLIENT : JOB NO.: DATE : PAGE : DESIGN BY : REVIEW BY : Wind Load, on Roof Screen I Roof Equipment, Based on ASCE 7-16 INPUT DATA & DESIGN SUMMARY BASIC WINO VELOCITY V = 110 mph EXPOSURE TYPE (B, C, 0) == > C SCREEN TOP ELEVATION H = 115 ft ~ C ~ w;"','"" .. ~ u "' .., 8 "' ----HEIGHT OF STRUCTURE ( < 60 ft) h = 80 ft. (ASCE 7-16 26.10.2) BUILDING WIDTH B = 100 n Roof :,: BUILDING LENGTH L = 200 ft SCREEN VERTICAL SIZE E = 5 ft SCREEN HORIZONTAL SIZE D = 16 ft, (ASCE 7-16 29.4.1) VERTICAL PROJECTED AREA At= 80 ft' HORIZONTAL PROJECTED AREA A, = 258 ft' Grou~d TOPOGRAPHIC FACTOR Kn= 1 Flat. (26.8 & Table 26.8-1) Out-or-plane load ror screen design p " 63.0 psf, Horizontal Fh . 5.043 kip&, Horizontal Fv " 12.74 kips, Vertical WIND ANALYSIS Out-of-plane wind rorce for screen design (ASCE 7-16, 29.4.1) Fh = P A1 = qpC,A1 = (0.00256KzKz,K.iV~)GC,A1 = ( 63 o psr) At " Where : GCr = Max{ Min[ 2 -At/ (B h), 1.9]. 1.0} = 1 90 , (ASCE 7-16 Eq. 29.4-2) he Bh Kz = = = 112.5 ft, centroid height of the screen 8000 tr, building side area (ASCE 7-16 Eq. 29.4-2) 1.26 , (ASCE 7-16 Tab. 26 10-1) 5.043 kips, Horizontal Kc! = 0.85 . (ASCE 7-16 26 6) K = 1 , (ASCE 7-16 Tab 26.9-1) F ,.= PA, =qpC,A, = (0.00256Kz K z,K.1V1)GC,A, = ( 49.8 psf)A, = 12 74 kips, Vertical Where : G Cr = Max{ Min[ 2 -A,/ (8 L), 1.5], 1.0) • 1.50 , (ASCE 7-16 Eq. 29.4-3) BL = 20000 1\2, building side area (ASCE 7-16 Eq 29.4-3) - II!/ V'eltlZON Wltl!l.e" l"ltl!V~Y ~0 TllJt-1 TO lte-lN ~0/TY'PJ II!) veRIZOH --~ -~'I' /41'~0 ..,. TltNeO'-eNT -TltATI! AA0 P'iNl!IH fl'AINTe:0 TO MATC.H T1e (eJ 1!11.C>G. TO ReMAll< UHC.HAN<SEO /T'l'PJ /l!J VERIZON l'I:~ l'IU!IIIOJSL Y N'l"llO\IEO 51'!:l"P'l!D TllJt-1 !IEL~ TO lte-lN VNG><AN5e0 /TY"J /I!/ \lfltlZON H "l!U!" l"lt~L 'f ~~"""'11>,c,W 5TL. ~ L.ADOelt IT.,.,.J (f) VEltlZON ...,~ l"ltevJQJ!ll Y ~ 5T'L.. PLATPO!att-1 TO ltl!MAJW ~O /T'f,.J II!) \ll!lllZON HIIU:L-l"RelllelllSL 'I' -PROveo !1!115 AAYG-i,ox GONGEALEO "'"" H II!) l"RP GUF'OLA TO REMAIN ~-p (TOTAL Of" U \ll!ltlZON Hlltl!L-TO lleTALl ~ !l!IIS AAYG-l!lO>Ce C:.ONGfAU!P HITl<IN /I!/ l"RP c:.uPOlA /TOTAL Of' 21 1:,·-0· PROPOSED ANTENNA PLAN 0 r If le) \leRIZOH "''~~ l"Rl!VlCVM. 'f -.av!O ~ TRANSPARENT S(.eSTRATE N.o l"INl!>H PAIHTEO TO MATc:.H T>E (eJ 1!11.D(t. TO ~H 1/NGHANeeO (T'Y,.J /eJ veRIZON H!Rel-e" l"R~ Y ~0 5Tl!PP£0 TRIM !IELOH TO AfMAIH ~H5fC, /TYPJ EXISTING ANT ENNA PLAN r ,, 1:,·-0· \ll!lt!ZON HllteLI!" 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NHH-658-R2B Top left Right Bottom \'itw rrom thr rrtlt ufthe •nfmntt (~lit<> er <0lornl bun• are no1 tru• d•flktluu or 1,-..,..., .. , General Specifications Operating Frequ"ncy Band Antenna Type Band Performance Note Mechanical Specifications RF Connector Quantity, total RF Connector Quantity, lov. band RF Connector Quantity, high band RF Connector Interface Color 1695 -2360 MHz I 698 -896 MHz Sector Mult iband Outdoor usage 6 2 4 7-16 DIN Fc malr. Light gray ~2017 CornmScop,-. Inc All right$ ,,,_,..,,ved Al lrodcmorh ,..Jen1,lied by® ot 'More regilkrtd lrodemo,ks, f•''lf)l!d1.al1, ol CommScope. All ,pecif100hora ore llJbjed lo chon!Je wilhoul nolico ~ ,_.,,_ . .:omm>'"..opo com 10< rhe 1110$1 currenl inlotmo!lon. R~,sed· April 14, 2017 page 2 ol 4 Mc,4,2017 Product Specifications COMMSCC,PE. NHH-658-R28 Grounding Type Radiator Material Radome Material Reflector Material RF Conn~ctor Location Wind Loading, frontal Wind Loading, lateral Wind Loading, rear Wind Speed, maximum Dimensions Length Width Depth Net Weight, without mounling kil RF connector body grounded to reflector and mounting bracket Low loss circuit board Fiberglass, UV resistant Aluminum Bottom 610.0 N @ 150 km/h 137.1 lbf t 150 krn/tl 19S.O N @ 150 km/h 43.8 lbf @ 150 km/h 717.0 N @ 150 km/h 161.2 lbf (I' 150 km/h 241 km/h I 150 mph 1828.0 mm I 72.0 In 301.0mm I 11.9in 180.0 mm I 7 .1 In 19.8kg 43.7 Ib Remote Electrical Tilt (RET) Information Input Voltage Internal Blas Tee Internal RET 10-30 Vdc Port l I Port 3 Power Consumption, Idle state, maximum High band ( 1) I Low band ( l ) 2.0 W Power Consumption, normal conditions, m.ixlrnum 13.0 W Protocol 3GPP/AISG 2.0 (Single RET) RET Interface 8-pln DIN Female I 8-pln DIN Male RET Interface, quantity Packed Dimensions Length Width Dept h Shipping Weight 2 female I 2 male 1952.0 mm I 76.9 In 409.0 mm I 16.1 in 299.0 mm I 11.8 In 32.3 kg 71.2 Ib Regulatory Compliance/Certifications Agency RoHS 2011/65/EU Classification Compliant by EKemption Above Maximum Concentration Value (MCV) China RoHS SJ/T 11364-2006 ISO 9001 :2008 Designed, manufoctured and/or distributed under this quality management system C20 l 7 CommScope. Inc All r19h1s re~rved. All lrodemorks tdenlified bt ®a™ ore re:i,.rored lrJOOmOfb. respcc1,..,I-,, ol CommSc:ope All &!)0Ciico1ioru ore swj<.d lo chongo "irhoul notice. See ..,_.., .•. comms:ope com I"' d-.. mosl cuucnl inlonnotion Re,;,,,.d Ap,il 14, 2017 page 3 ol 4 May4, 2017 A -'J 1 I'-/' I f-/ Cit V )...r lo ( 2-} ..-., o f<. YLu l J Q-1 I , (; ( ~ '2-r S" f I ' F l.,..J l ~ 1 f. )< I )Q 6 -~ z... ~ 4So--: ft,..1 '1...--~ 1-f XI ,t>o 2 ,f ) _, -~ ~' ~ l 5"1.,--$ --➔ ) S' l F-<--~ Mo, 1 . lo~+ 1-:)~-: '2--0....) 1 o ... "" -+-I oi, -z '2.. CJ 4. ~ 4t. 4--._ ( -::?-404 )Q ,'-+-'4-)6>v_L 1-~ JGS-8 , _-.:- 1, Yrv _, cp sob ) (£) f) ,, .. -fl ~t) (Ju ) s -,G4-lbd S{MIIC-6VM' c:Ary.b~~ ,J:-~ ?_7. __ -~ _cro~. -·------ I ('2-) ~ ~ V j v.; '-~ l t fJ r ._,.$ I fc.--:... 1-e.:ie /,Gx;;;,z,,f--/51.,.,, - I -I ,) -e' L M -:... 2-o 4-)o I '-r /5?-'>Ql 1 S">o1- -, 6(c I., - z, y,z,, --~ StfO, (f J p '1l cv (JU r~J srr,_u-cf!;V~ _ .. ~~~ C, ) /-1 I,._, Tb f A,va '3o(J, OFFICE USE ONLY • SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE RECORD ID# PLANCHECK-#""'D""E...,..,Q"'2."o,...1"'i--MHcrRrilJict-TT6-.,Pr---fo'rfo'MG~sl""TTi""1r-l -1- A, ,clnfll'lc Name JI£ P..J 'Z.O JI Project Address (lndude suite) 2020 Cassia Road MaHlng Address (Include suite) 495 E. Rincon. St Project Conl8d Raul Sanchez Business Contact Verizon Wireless City Carlsbad r, : -:c,·,c.-·e . er your business wi use, process, or store any leant must contact the Ire Protection Agency with jurisdlc:tion prior to plan submlnal. I BP DATE APN# 215-021-02 Plan FIie# Occupancy Rating: S-2/B Facltlly's Square Footage (lnduding proposed project~ 4898 SQ. FT Existing Bu6f '.;! 1. Exptoalve or Blasting Agents 5. Organic PeroJddes 9. Water Reactives 13. ·-:> 2. Compressed Gases 6. Oxidizers 10. Cryogenics 1 • or Health Hazards · 3. Flammable/Combustiblellquids 7. Pyrophorics 11. HighlyToxlcorToxlcMaterials 15. NoneofThese. 4. Ftommable Solids 8. Unstable Reactives 12. Radloactives PART 11; BAN DJEGQ COUHJY QEP~~I ~ ~~ He-~!ZAR~~RltB QM~N 'l!'f!; If the answer to any ot the questions is yes, applicant must contacri nt,/ ; egoza us laislvtsion,5 ancFvenue,uife 1~an Diego, CA 92123. can (858) 505-6700 prior to the Issuance of a building pennlt. FEES ARE REQUIRED Project Completion Date: 9/25/2018 Expected Date of Occupancy: 0 CalARP Exempt ,. 2. 3. 4. 5. 6. 7. 8. 1. 2. 3. 4. 5. 6. YES NO (for new cons1rUCllon or remodeling projects) 181 0 Is your business listed on the reverse side of this fonn? (check all that apply). 0 181 Will your business dlspoee of Hazardous SUl>stances or Medical Waste In any amount? 181 D WIii your buslness store or handle Hazardous Substances in quantlUes greater than or equal to 55 gallons, 500 pounds and/or 200 cubic-? 0 181 Will your btJSlnns store or handle carcinogens/reproductive toxins in any quantity? D t81 WII your business use an exJsting or install an underground storage tank? 0 181 Will your business slofe or handle Regulated Substances (CslARP)? 0 181 WII your business use or lnalall a Hazardous Waste Tank System (Title 22, Article 10)? D 181 WIii your business store petroleum In tanks or containers at your facility with a total laclllty storage capacity equal to or greater than 1,320 gallons? (Callfomla's Aboveground Petroleum Storage Act). Date Initials 0 CalARP Required I Date Initials 0 CalARP Complete Date lnHials Will the proiect dtsturb 100 square feet or more of existing buitdtng materials? COSD DEH • CASHIER WIii any load supporting structural members be removed? If yes, contact APCD prior to i notification may be required at least 10 working days prior to oommenclng demolition. ance of a building d!~ll«ioiition pennll A D D (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been perfonned b an Individual 1bal hu lll'"'od,lln EPA-a ved building lnspactor course? JUL i1 U l U 10 D D (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Based on the survey results, Will the proje disturb any asbestos conllllnlng material? I yes, contact APCD prior to the Issuance of a bulldng or demolltlon pennll A notification may be at least 10 wo Alays prior to commencing asbestos removal. K D 181 D D w• the project or associated construction equipment emit air contaminants? See the rev th~ for ~cal equipment req ring an APCD pennit. ff yes, conla<I APCD prior to the Issuance of a bulk!lng pennll (ANSWER ONLY IF QUESTION 5 IS YES) WIii the project or associated construction equipment be localed within 1,000 feet of a school bounda Briefly describe business activities: Unmanned Telecommunications F acilit la I dedare under penalty of parjury that to the best of my knowledge a Raul Sanchez 07 /24 /2018 Name of OWner or Authorized ent nt Dale FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: _______________________________ _ BY: DATE: RELEASED FOR 8Ull.D,NG PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY APCD COUNTY-HMO APCD COUNTY-HMO APCD xempts businesses from 6ompletlng or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply County of San Diego ~ OEH .:. Hazardous Materials Division