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2075 CORTE DEL NOGAL; L; CB010232; Permit
•k 03/08/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No Building Inspection Request Line (760) 602-2725 CB010232 Job Address Permit Type Parcel No Valuation Occupancy Group Project Title 03/08/2001 2075 CORTE DEL NOGAL CBAD St Tl Sub Type 2130610700 Lot# $15,78000 Construction Type Reference # QUOREX - 526 SF STORAGE TO RESEARCH & DEVELOPMENT INDUST 0 NEW Applicant MANSOUR ARCH 111 5897 OBERLIN DRIVE SAN DIEGO CA 92121 858-558-1509 Owner SAN-GAL TRUST 550 WCST #1820 SAN DIEGO CA 92101 Status Applied Entered By Issued Inspect Area ISSUED 01/22/2001 JM Plan Approved 03/08/2001 3425 03/08/01 0002 01 CGP 02 477=15 Total Fees $772 35 Total Payments To Date $295 20 Balance Due $47715 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot Water Con Fee Meter Size Add'l Pot Water Con Fee Reel Water Con Fee $145 89 Meter Size $0 00 Add'l Reel Water Con Fee $94 83 Meter Fee $0 00 SDCWA Fee $0 00 CFD Payoff Fee $331 PFF $0 00 PFF (CFD Fund) $0 00 License Tax $0 00 License Tax (CFD Fund) $0 00 Traffic Impact Fee $0 00 Traffic Impact (CFD Fund) $0 00 LFMZ Transportation Fee $0 00 PLUMBING TOTAL $0 00 ELECTRICAL TOTAL $0 00 M EC HAN ICAL TOTAL Master Drainage Fee $0 00 Sewer Fee $0 00 Redev Parking Fee TOTAL PERMIT FEES $000 $000 $000 $000 $000 $000 $287 20 $000 $7200 $000 $000 $4800 $2000 $3950 $000 $61 62 $000 $772 35 Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" 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 capactiy 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 limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1" PROJECT INFORMATION FOR OFFICE USE OIML PLAN CHECK NO EST VAL Plan Ck Deposit^ Validated By Date ;m L Address (include Bldg/Suite #)Business Nameiatafffs addre:••" XK Legal Description Tctal # of units Assessor s Parcel #Existing Use Proposed Use Description of Work~SQ FT 2 CONTACT PERSON (if different from applicant) : i ft»ffS"tonesST #o( Bedrooms # of Bathroorns ¥^ '* 953Q 01/22/Q1 QQQ2 Q1 0: Name 3 APPLICANT D Contractor1 Address | Agent for Contractor fcO Owner City •gentjor Owner State/Zip Telephone!]*5 Name 4W PROPERTY OWNER Address City State/Zip Telephone # Name Address City State/Zip Telephone tt 1 ^CONTRACTOR - COMPANY NAME • "^Ife T. ' Ti"-, '"":'":: X" - ,; (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 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 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 dollais [$500J) Name State License #7. S~<3~f Address License Class f~J Ar. City State/Zip City Business License # Telephone Designer Name / Address City State/Zip Telephone State License # _ 6' ..... WORKERS' COMPENSATION "': •-, ..: ... ' : '% 'i&- .. "•' ..... ::"::'":' Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q I have and will maintain a certificate of consent to self-insure for workers compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My worker's compensation insurance carrier and policy number are Insurance Company Jrfo-pP ffJKlO _ Policy No3?Jc5£> n^OoJ frj" Expiration Date frjr-Qf'-f)/ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~l 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 an/ manner so as to become 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 10 one hundred thousand dollars ($100 000) in adojjionto the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE _ (J&A- J&Z- -- _ DATE 3 ~ O^-^l 7 S: OWNER-BUILDER DECLARATION -- ", illL : , "",,:' « I hereby affirm that I am exempt from the Contractor's License Law for the following reason n 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) l~l 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 contractors) licensed pursuant to the Contractor s License Law) n 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 fj YES I~|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 number / 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 number / 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 number / type of work) _ _ PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY ,'„:„ r - 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? F1 YES l~l NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district' C] YES [U NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site' l~1 YES l~l 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 •8 CONSTRUCTION LENDING AGENCY "": '.' S'T||. <-g|: ""° •" :-;«; ^- "' -:*v I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER S NAME LENDER S ADDRESS 9 APPLICANT- CERTIFICATION •£;! - f : 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 representatives of the CitV of Carlsbad to enter upon the above mentioned property for inspection purposes I ALSO AGREE TOSAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS COSTS AND EXPENSES WHICH MA>ltfAN> WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required for excavations overJFQ deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issued by the/tfuilding 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 1 aef 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 commence6\[ora tferioxfof 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE ^ DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Final Building Inspection Dept: Building Engineering Planning CMWD Plan Check # Permit* Project Name Address Contact Person Sewer Dist Inspected Inspected Bv Inspected By CB010232 "QUOREX - 526 SF STORAGE TO RESEARCH & DEVELOPMENT 2075 CORTE DEL JP JONES CA (7^ NOGAL #L Phone 6197193630 Water Dist CA Date ,// /^•/"? //•» tInspected /^/OJ Date Inspected Date Inspected St Lite (Tire, Date Permit Type Sub Type Lot 0 Approved (— ^ Approved Approved 04/12/2001 Tl INDUST Disapproved Disapproved Disapproved Comments City of Carlsbad Bldg Inspection Request For 04/24/2001 Permit* CB010232 Title QUOREX - 526 SF STORAGE TO Description RESEARCH & DEVELOPMENT Inspector Assignment TP 2075 CORTE DEL NOGAL L Lot 0 Type Tl Sub Type INDUST Job Address Suite Location APPLICANT MANSOURARCH Owner PLETA TRUST Remarks ROLLED OVER FROM MONDAY Total Time Phone 0000000000 Inspector Requested By NA Entered By CHRISTINE CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Act Comments Associated PCRs Inspection History Date 04/12/2001 04/04/2001 04/04/2001 04/04/2001 04/04/2001 04/04/2001 04/03/2001 03/19/2001 03/15/2001 03/15/2001 03/15/2001 03/12/2001 03/12/2001 03/12/2001 03/12/2001 Description 89 Final Combo 14 Frame/Steel/Bolting/Welding 14 Frame/Steel/Bolting/Welding 24 Rough/Topout 34 Rough Electric 44 Rough/Ducts/Dampers 84 Rough Combo 17 Interior Lath/Drywall 14 Frame/Steel/Bolting/Welding 16 Insulation 34 Rough Electric 14 Frame/Steel/Bolting/Welding 24 Rough/Topout 34 Rough Electric 44 Rough/Ducts/Dampers Act CO AP AP we AP AP CO AP AP AP AP AP AP NR we Insp TP TP TP TP TP TP TP TP TP TP TP TP TP TP TP Comments RTU ROOF REINF T-BAR CEIL CEIL LITES DUCTS, PLMNS TEAR CEIL WALLS DOOR OPENING City of Carlsbad Bldg Inspection Request For 04/02/2001 Permit# CB010232 Title QUOREX - 526 SF STORAGE TO Description RESEARCH & DEVELOPMENT Inspector Assignment TP 2075 CORTE DEL NOGAL L Lot 0 Type Tl Job Address Suite Location APPLICANT MANSOURARCH Owner PLETA TRUST Remarks Sub Type INDUST Phone 6197193630 Inspector Total Time CD Description 14 Frame/Steel/Boltmg/Weldmg 24 Rough/Topout 34 Rough Electric 44 Rough/Ducts/Dampers Requested By J P JONES Entered By CHRISTINE Act Comments Associated PCRs Inspection History Date Description 03/19/2001 17 Interior Lath/Drywall 03/15/2001 14 Frame/Steel/Bolting/Welding 03/15/2001 16 Insulation 03/15/2001 34 Rough Electric 03/12/2001 14 Frame/Steel/Boltmg/Welding 03/12/2001 24 Rough/Topout 03/12/2001 34 Rough Electric 03/12/2001 44 Rough/Ducts/Dampers Act Insp Comments AP TP AP TP WALLS AP TP AP TP AP TP DOOR OPENING AP TP NR TP WC TP EsGii Corporation In Partnership with Government for Building Safety DATE 2/28/O1 JURISDICTION City of Carlsbad a PLAN REVIEWER a FILE PLAN CHECK NO 01-232 SET II ^PROJECT ADDRESS 2075 Corte Del Nogal SuiteUJ &K PROJECT NAME Quorex Pharmaceuticals - TI ^^ The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person The applicant's copy of the check list has been sent to Esgil Corporation staff did not advise the applicant that the plan check has been completed I I Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted Telephone # Date contacted (by ) Fax # Mail Telephone Fax In Person REMARKS By Doug Moody Enclosures Esgil Corporation D GA D MB D EJ D PC 2/22/01 trnsmtldot 9320 Chesapeake Drive, Suite 208 ^ San Diego, California 92123 ^ (858)560-1468 ^ Fax (858) 560-1576 EsGil Corporation In Partnership with Government for Building Safety DATE 2/1/O1 g>APPyQANT _ JURIS. JURISDICTION City of Carlsbad "CTPCANREVIEWER a FILE PLAN CHECK NO O1-232 SET I PROJECT ADDRESS 2075 Corte Del Nogal Suite J & K PROJECT NAME Quorex Pharmaceuticals - TI I | The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes I I The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person The applicant's copy of the check list has been sent to Mansour Architecture 5897 Oberlm Dr Suite 111, San Diego Ca92121 _] Esgil Corporation staff did not advise the applicant that the plan check has been completed Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted Telephone # Date contacted /0\f^- (by~t^ ) Fax # Mail ^Telephone Fax In Person REMARKS By Doug Moody Enclosures Esgil Corporation D GA D MB D EJ D PC 1/25/01 trnsmtldot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576 City of Carlsbad 01-232 2/1/01 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO 01-232 OCCUPANCY B TYPE OF CONSTRUCTION VN ALLOWABLE FLOOR AREA SPRINKLERS'? YES REMARKS DATE PLANS RECEIVED BY JURISDICTION 1/22/01 DATE INITIAL PLAN REVIEW COMPLETED 2/1/01 JURISDICTION City of Carlsbad USE Office / Laboratory ACTUAL AREA 2522 STORIES 1 HEIGHT OCCUPANT LOAD 31 DATE PLANS RECEIVED BY ESGIL CORPORATION 1/25/01 PLAN REVIEWER Doug Moody FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and access for the disabled This plan review is based on regulations enforced by the Building Department You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department, Fire Department or other departments Clearance from those departments may be required prior to the issuance of a building permit Code sections cited are based on the 1997 UBC The following items listed need clarification, modification or change All items must be satisfied before the plans will be in conformance with the cited codes and regulations Per Sec 106 4 3, 1997 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e.. plan sheet number, specification section, etc. Be sure to enclose the marked up list when you submit the revised plans. TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC)tiforw dot "City of Carlsbad 01-232 2/1/01 Please make all corrections on the original tracings, as requested in the correction list Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects) For expeditious processing, corrected sets can be submitted in one of two ways 1 Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave , Carlsbad, CA 92008, (760) 602-2700 The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments 2 Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468 Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments NOTE Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete 1 Revise plans to show that the minimum strike edge distances are provided at the level area on the side to which a door (or a gate) swings, per Section 1133B 243 a) >24" at exterior conditions b) >18" at interior conditions c) >12" on the push side, if the door has both a latch and a closer 2 In Groups B, F, M, and S Occupancies, or portions thereof, where Class I, II, or III-A liquids are used (in any amount), mechanical exhaust shall be provided sufficient to produce six air changes per hour Such mechanical exhaust shall be taken from a point at or near the floor UBC, Section 1202 2 2 Please clarify if the exhaust fans labeled EF-1 and EF-2 shown on the mechanical sheets are intended to provide the required six air changes per hour'? The technical report lists all use of Class I, II, or III-A liquids shall be performed within fumes hoods Please revise the plans to show the exhaust fans to comply or please provide the Manufacturers listing for the fume hoods Please provide plans to show the construction of the ducting system for the chemical hoods 3 Please indicate on the plans the type of exhaust produced form the BIO hood? Is this hood also intended to vent hazardous fumes'? Please provide listing information 4 Show exit signs on the electrical lighting plan(s) As per Section 1003 2 8, provide two sources of power to exit signs and exit illumination To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i e , plan sheet, note or detail number, calculation page, etc City of Carlsbad O1-232 2/1/01 Please indicate here if any changes have been made to the plans that are not a result of corrections from this list If there are other changes, please briefly describe them and where they are located in the plans Have changes been made to the plans not resulting from this correction list? Please indicate Yes Q No a The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123, telephone number of 858/560-1468, to perform the plan review for your project If you have any questions regarding these plan review items, please contact Doug Moody at Esgil Corporation Thank you City of Carlsbad 01-232 2^1/01 VALUATION AND PLAN CHECK FEE JURISDICTION City of Carlsbad PLAN CHECK NO O1-232 PREPARED BY Doug Moody DATE 2/1/O1 BUILDING ADDRESS 2075 Corte Del Nogal Suite J & K BUILDING OCCUPANCY B TYPE OF CONSTRUCTION VN BUILDING PORTION Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code AREA ( Sq Ft ) 2522 cb Valuation Multiplier 3000 By Ordinance 1994 UBC Building Permit Fee ^ Reg Mod VALUE ($) 75,660 75,660 $51608 1994 UBC Plan Check Fee Type of Review 0 Repetitive Fee Repeats Complete Review D Other D Hourly Structural Only Hour(s) * $ 335 45 Esgil Plan Review Fee $268 36 Comments Sheet 1 of 1 macvalue doc DATE BUILDING PLANCHECK CHECKLIST PLANCHECK NO PROJECT DESCRIPTION ASSESSOR'S PARCEL NUMBER Qg.JL /)*rt-f c) EST VALUE ENGINEERING DEPARTMENT APPROVAL The item you have submitted for review has been approved The approval is based on plans, information and/or specifications provided in your submittal, therefore any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to build A Right-of-Way permit is required prior to construction of the following improvements DENIAL Please sea thtj^-attached report of deficiencies marked withxETMake necessary corrections to plans or specifications for compliance with applicable codes and standards Submit corrected plans and/or specifications to this office for review Date Date Date 1C By FOR OFFICIAL USE ONLY ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT Date Y^rFTACHB/IE \^^' /IENTS Dedication Application Dedication Checklist Improvement Application Improvement Checklist Future Improvement Agreement Grading Permit Application Grading Submittal Checklist Right-of-Way Permit Application Right-of-Way Permit Submittal Checklist and Information Sheet Sewer Fee Information Sheet ENGINEERING DEPT CONTACT PERSON Name JOANNE JUCHNIEWICZ City of Carlsbad Address 1635 Faraday Avenue, Carlsbad, CA 92008 Phone (760) 602-2775 CFD INFORMATION Parcel Map No Lots Recordation Carlsbad Tract A-4 H \WORD\DOCS\CHKLST\Building Plancheck Cklsl Form (Generic) doc BUILDING PLANCHECK CHECKLIST jRD SITE PLAN 1 Provide a fully dimensioned site plan drawn to scale Show F Right-of-Way Width & Adjacent Streets G Driveway widths H Existing or proposed sewer laleral I Existing or proposed water service J Existing or proposed irrigation service A North Arrow B Existing & Proposed Structures C Existing Street Improvements D Property Lines E Easements 2 Show on site plan A Drainage Patterns 1 Building pad surface drainage must maintain a minimum slope of one percent towards an adjoining street or an approved drainage course 2 ADD THE FOLLOWING NOTE "Finish grade will provide a minimum positive drainage of 2% to swale 5' away from building " B Existing & Proposed Slopes and Topography C Size, type, location, alignment of existing or proposed sewer and water service (s) that serves the project Each unit requires a separate service, however, second dwelling units and apartment complexes are an exception D Sewer and water laterals should not be located within proposed driveways, per standards 3 Include on title sheet A Site address B Assessor's Parcel Number C Legal Description For commercial/industrial buildings and tenant improvement projects;, include total building square footage with the sguare footagp for each different use, existing sewer permits showing square footage of different uses (manufacturing, warehouse, office, etc) previously approved EXISTING PERMIT NUMBER DESCRIPTION H \WORD\DOCS\CHKLST\Building Plancheck Cklst Form (Generic) doc BUILDING PLANCHECK CHECKLIST 1ST 2ND 3rd DISCRETIONARY APPROVAL COMPLIANCE CH D Q 4a Project does not comply with the following Engineering Conditions of approval for Project No CD O [H 4b All conditions are in compliance Date DEDICATION REQUIREMENTS 5 Dedication for all street Rights-of-Way adjacent to the building site and any storm dram or utility easements on the building site is required for all new buildings and for remodels with a value at or exceeding $15.000. pursuant to Carlsbad Municipal Code Section 18 40 030 Dedication required as follows Dedication required Please have a registered Civil Engineer or Land Surveyor prepare the appropriate legal description together with an 8 Yz" x 11" plat map and submit with a title report All easement documents must be approved and signed by owner(s) prior to issuance of Building Permit Attached please find an application form and submittal checklist for the dedication process Submit the completed application form with the required checklist items and fees to the Engineering Department in person Applications will not be accept by mail or fax Dedication completed by Date IMPROVEMENT REQUIREMENTS L~H D CH 6a All needed public improvements upon and adjacent to the building site must be constructed at time of building construction whenever the value of the construction exceeds $75.000. pursuant to Carlsbad Municipal Code Section 1840040 Public improvements required as follows Attached please find an application form and submittal checklist for Ihe public improvement requirements A registered Civil Engineer must prepare the appropriate improvement plans and submit them together with the requirements on the attached checklist to the Engineering Department through a separate plan check process The completed application form and the requirements on the H \WORDlDOCS\CHKLST\Building Plancheck Cklsl Form (RIDDLE HARVEY 7 12 00) doc BUILDING PLANCHECK CHECKLIST ST 2ND 3rd checklist must be submitted in person Applications by mail or fax are not accepted Improvement plans must be approved, appropriate securities posted and fees paid prior to issuance of building permit Improvement Plans signed by Date CH D D 6b Construction of the public improvements may be deferred pursuant to Carlsbad Municipal Code Section 1840 Please submit a recent property title report or current grant deed on the property and processing fee of $280 so we may prepare the necessary Neighborhood Improvement Agreement This agreement must be signed, notarized and approved by the City prior to issuance of a Building permit Neighborhood Improvement Agreement will include the following 6c Enclosed please find your Neighborhood Improvement Agreement Please return agreement signed and notarized to the Engineering Department Neighborhood Improvement Agreement completed by Date D D 6d No Public Improvements required SPECIAL NOTE Damaged or defective improvements found adjacent to building site must be repaired to the satisfaction of the City Inspector prior to occupancy GRADING PERMIT REQUIREMENTS The conditions that invoke the need for a grading permit are found in Section 11 06 030 of the Municipal Code CH D D 7a Inadequate information available on Site Plan to make a determination on grading requirements Include accurate grading quantities (cut, fill import, export) C] O D 7b Grading Permit required A separate grading plan prepared by a registered Civil Engineer must be submitted together with the completed application form attached NOTE The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit Grading Inspector sign off by Date EH 7c Graded Pad Certification required (Note Pad certification may be required even if a grading permit is not required ) H \WORD\DOCS\CHKLST\Building Plancheck Cklst Form (RIDDLE HARVEY 7 12 00) doc 1ST D D D oRDO D D D D D D D D D D BUILDING PLANCHECK CHECKLIST 7d No Grading Permit required 7e If grading is not required, write "No Grading" on plot plan MISCELLANEOUS PERMITS 8 A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or private work adjacent to the public Right-of-Way Types of work include, but are not limited to street improvements, tree trimming, driveway construction, tying into public storm dram, sewer and water utilities Right-of-Way permit required for INDUSTRIAL WASTE PERMIT If your facility is located in the City of Carlsbad sewer service area, you need to contact the Carlsbad Municipal Water District, located at 5950 El Cammo Real, Carlsbad, CA 92008 District personnel can provide forms and assistance, and will check to see if your business enterprise is on the EWA Exempt List You may telephone (760) 438-2722, extension 7153, for assistance Industrial Waste permit accepted by Date 10 NPDES PERMIT Complies with the City's requirements of the National Pollutant Discharge Elimination System (NPDES) permit The applicant shall provide best management practices to reduce surface pollutants to an acceptable level prior to discharge to sensitive areas Plans for such improvements shall be approved by the City Engineer prior to issuance of grading or building permit, whichever occurs first 11 QfRequired fees are attached Q No fees required WATER METER REVIEW 12a Domestic (potable) Use Ensure that the meter proposed by the owner/developer is not oversized Oversized meters are inaccurate during low-flow conditions If it is oversized, for the life of the meter, the City will not accurately bill the owner for the waler used • All single family dwelling units received "standard" 1" service with 5/8" service H \WORD\DOCS\CHKLST\Buikling Planchec* Cklst Form (Generic) doc 1ST •>ND 3RD D 12b BUILDING PLANCHECK CHECKLIST • If owner/developer proposes a size other than the "standard", then owner/developer must provide potable water demand calculations, which include total fixture counts and maximum water demand in gallons per minute (gpm) A typical fixture count and water demand worksheet is attached Once the gpm is provided, check against the "meter sizing schedule" to verify the anticipated meter size for the unit • Maximum service and meter size is a 2" service with a 2" meter • If a developer is proposing a meter greater than 2", suggest the installation of multiple 2" services as needed to provide the anticipated demand (manifolds are considered on case by case basis to limit multiple trenching into the street) Irrigation Use (where recycled water is not available) All irrigation meters must be sized via irrigation calculations (ir gpm) prior to approval The developer must provide these calculations Please follow these guidelines 1 If the project is a newer development (newer than 1998), check the recent improvement plans and observe if the new irrigation service is reflected on the improvement sheets If so, at the water meter station, the demand in gpm may be listed there Irrigation services are listed with a circled "I", and potable water is typically a circled "W" The irrigation service should look like STA 1+00 Install 2" service and 5 meter (estimated 100 gpm) If the improvement plans do not list the irrigation meter and the service/meter will be installed via another instrument such as the building plans or grading plans (w/ a right of way permit of course), then the applicant must provide irrigation calculations for estimated worst-case irrigation demand (largest zone with the farthest reach) Typically, Larry Black has already reviewed this if landscape plans have been prepared, but the applicant must provide the calculations to you for your use Once you have received a good example of irrigation calculations, keep a set for your reference In general the calculations will include • Hydraulic grade line • Elevation at point of connection (POC) • Pressure at POC in pounds per square inch (PSI) • Worse case zone (largest, farthest away from valve • Total Sprinkler heads listed (with gpm use per head) • Include a 10% residual pressure at point of connection In general, all major sloped areas of a subdivision/project are to be irrigated via separate irrigation meters (unless the project is only SFD with no HOA) As long as the project is located within the City recycled water H \WORD\OOCS\CHKLST\Buikljng Plancheck Cklst Form (Generic) doc 1ST oND gRD BUILDING PLANCHECK CHECKLIST service boundary, the City intends on switching these irrigation services/meters to a new recycled water line in the future D D D 12c Irrigation Use (where recycled water is available) D 1 Recycled water meters are sized the same as the irrigation meler above 2 If a project fronts a street with recycled water, then they should be connecting to this line to irrigate slopes within the development For subdivisions, this should have been identified, and implemented on the improvement plans Installing recycled water meters is a benefit for the applicant since they are exempt from paying the San Diego County Water Capacity fees However, if they front a street which the recycled water is there, but is not live (sometimes they are charged with potable water until recycled water is available), then the applicant must pay the San Diego Water Capacity Charge If within three years, the recycled water line is charged with recycled water by CMWD, then the applicant can apply for a refund to the San Diego County Water Authority (SDCWA) for a refund However, let the applicant know that we cannot guarantee the lefund, and they must deal with the SDCWA for this 13 Additional Comments H \WORDOOCS\CHKLST\BuiMing Plancheck Cklst Form (Generic) doc ENGINEERING DEPARTMENT FEE CALCULATION WORKSHEET D Estimate based on unconfirmed information from applicant Q^^^Calculation based on building plancheck plan submittal Address r2p^ Gxk(L 'QoJ? A/Srk^L.B\dg Permit No ^fe C/OtPiSe3 Prepared by ^\\ EDU CALCULATIONS Typesxif Use Types of Use APT CALCULATIONS Types~of Use Types of Use FEES REQUIRED Date %/n/O/ Checked by List types-and square.,footages for^all uses (zjB s^Si-^rS \isv- CsJtc^ )u Sq Ft /Units ' Sq Ft /Units List types and square Jootages for aJJ uses ^^ Sq Ft /Units Sq Ft /Units Da EDU's EDU's ADT's ADT's 3 WITHIN CFD B'YES (no bridge & thoroughfare fee in District #1, reduced Traffic Impact Fee) D MO D 1 PARK-IIM-LIEU FEE -EE/UNIT PARK AREA & # X NO UNITS = S 2 TRAFFIC IMPACT FEE ADT's/UNITS 3 X FEE/ADT = $ D 3 BRIDGE AND THOROUGHFARE FEE (DIST #1 ADT's/UNITS X FEE/ADT DIST #2 DIST #3 * D 4 FACILITIES MANAGEMENT FEE UNIT/SO. FT 5 SEWER FEE EDU's BENEFIT AREA EDU's ZONE X FEE/SQ FT /UNIT = $ FEE/EDU X FEE/EDU D 6 SEWER LATERAL ($2,500) D 7 DRAINAGE FEES PLDA_ ACRES = $_ = $ HIGH /LOW FEE/AC = $ 8 POTABLE WATER FEES UNITS CODE CONNECTION FEE METER FEE SDCWA FEE IRRIGATION Word\Docs\Misforms\Fee Calculation Worksheet Iof2 Rev II14/00 ENGINEERING DEPARTMENT FEE CALCULATION WORKSHEET D 9 RECLAIMED WATER FEES UNITS CODE CONNECTION FEE METER FEE TOTAL OF ABOVE FEES* $ *NOTE This calculation sheet is NOT a complete list of all fees which may be due Dedications and Improvements may also be required with Building Permits. 2 of 2 Word\Docs\Mlsforms\Fee Calculation Worksheet Rev 7/14/00 I I Inclusionary Housing Fee required: YES NO \ V (Effective date of Inclusionary Housing Ordinance - May 21, 1993 Data Entry Completed? YES NO , • (A/P/Ds, "Activity Maintenance, enter CBtf, toolbar, Screens, .Housing Fees, Construct Housing Y/N, Enter Fee UPDATE1! Site Plan: , ; \~ - ^ ' ,.: [ ' I | 1 Provide a fully dimensional site plan drawn to scale Show North arrow, property lines, easements, .existing and proposed, structures, streets, existing street improvements, right-of-way width, dimensional setbacks and existing topographical lines | | 2 Provide legal description of property and assessor's parcel number Zoning: D D D 1 Setbacks- Front:Required Interior Side. Required Street Side. Required Rear. | I [ | | | 2 Accessory Front: Interior Sic Street Side Rear: Structure s I I | I I I 3 Lot Covera EH CH CD 4 Height: tO LS CH 5 Parking-vU T G Required structure setbacks. Required le- Required ;. Required Required separation: Required ge: Required Required Spaces Required uest Spaces Required Shown Shown Shown Shown Shown Shown Shown Shown Shown Shown Shown Shown Shown\ \ L^ ni r"l Additional Comments CDPUosc 5 kouj BarlU^ Calci 60 i i**1 E \ rvoto KOUJ ftrofioieJ fOO^-mou^4ccf <?^oiift/V\oi^ I* * V/ * i/-/* \\ ID (- SC'/Ctf'^Ccx . / OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER H \ADMlN\COUNTER\BldgPlnchkRevChklst PLANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST 9r<n Cl Plan Check No Address Q.O75 c\ Planner Paul Godwin Phone (760) 602-4625 a APN a\7>-061-07-00 Io aO 0a- Type of Project & Use: Zoning: 9rOt General Plan Net Project Density Facilities Management Zone DU/AC CFD fin/nut) #_ Circle One _Date of participation Remaining net dev acres •gOJ6 £ CN=ttI o £a •g0)6 (For non-residential development Type of land used created by this permit- ) Legend-Xs Item Complete | I Environmental Review Required: DATE OF COMPLETION- _ YES Item Incomplete - Needs your action NO TYPE Compliance with conditions of approval? If not, state conditions which require action Conditions of Approval. Discretionary Action Required: APPROVAL/RESO NO PROJECT NO. YES NO _X_ TYPE DATE OTHER RELATED CASES' Compliance with conditions or approval7 If not, state conditions which require action Conditions of Approval- I | I | Coastal Zone Assessment/Compliance Project site located in Coastal Zone' YES NO X CA Coastal Commission Authority? YES NO If California Coastal Commission Authority Contact them at - 3111 Camino Del Rio North, Suite 200, San Diego CA 92108-1725, (619) 521-8036 Determine status (Coastal Permit Required or Exempt) ^ Coastal Permit Determination Form already completed? jlf NO,i complete Coastal Permit Determination Form "now Coastal Permit Determination Log #: YES.NO Follow-Up Actions: : : - 1) Stamp Building Plans as "Exempt" or "Coastal Permit Required" (at minimum Floor Plans) 2) Complete Coastal Permit Determination Log as needed H \ADMIN\COUNTER\BldgPlnchkRevChklst Carlsbad partment 010232 1635 Faraday Ave Carlsbad, CA 9200 Plan Review Date of Report FILE COPY Fire Prevention (760) 602-4660 uirements Category '8/2001 Building Plan Reviewed by 0 Name Address City, State MANSOUR ARCH 5897 OBERLIN DR SAN DIEGO CA92121 Plan Checker Job Name Job Address job* 010232 Quorex 2075 Corte Del Nogal Bldg # CB010232 Ste or Bldg No Approved The item you have submitted for review has been approved The approval is based on plans, information and / or specifications provided in your subrnittal, therefore any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes and standards Please review carefully all comments attached as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements Approved The item you have submitted for review has been approved subject to the Subject to attached conditions The approval is based on plans, information and/or specifications provided in your subrnittal Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements Please resubmit to this-office the necessary plans and / or specifications required to indicate compliance with applicable codes and standards fj] Incomplete The item you have submitted for review is incomplete At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and / or standards Please review carefully all comments attached Please resubmit the necessary plans and / or specifications to this office for review and approval Review FD Job # 1st 2nd 3rd 010232 FDFile# Other Agency ID Carlsbad Fire Department 010232 1635 Faraday Ave Carlsbad, CA 92008 Plan Review Requirements Category Date of Report 03/08/2001 Building Plan Reviewed by Fire Prevention (760) 602-4660 (L Name Address MANSOUR ARCH 5897 OBERLIN DR City, State SAN DIEGO CA 92121 Plan Checker Job Name Quorex Job# 010232 Job Address 2075 Corte Del Nogal Bldg # CB010232 Ste or Bldg No Approved The item you have submitted for review has been approved The approval is based on plans, information and / or specifications provided in your submittal, therefore any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes and standards Please review carefully all comments attached as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements Approved The item you have submitted for review has been approved subject to the Subject to attached conditions The approval is based on plans, information and/or specifications provided in your submittal Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements Please resubmit to this office the necessary plans and / or specifications required to indicate compliance with applicable codes and standards Incomplete The item you have submitted for review is incomplete At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and / or standards Please review carefully all comments attached Please resubmit the necessary plans and / or specifications to this office for review and approval Review FD Job # 1st 2nd 3rd 010232 FDFile# Other Agency ID Carlsbad Fire Department 010232 1635 Faraday Ave Carlsbad, CA 92008 Plan Review Requirements Category Date of Report 02/06/2001 Fire Prevention (760) 602-4650 Building Plan Reviewed by Name Address MANSOUR ARCH 5897 OBERLIN DR City, State SAN DIEGO CA 92121 Plan Checker Job Name Quorex Job# 010232 Job Address 2075 Corte Del Nogal Bldg # CB010232 Ste or Bldg No D Approved The item you have submitted for review has been approved The approval is based on plans, information and / or specifications provided in your submittal, therefore any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes and standards Please review carefully all comments attached as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements Approved The item you have submitted for review has been approved subject to the Subject to attached conditions The approval is based on plans, information and/or specifications provided in your submittal Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements Please resubmit to this office the necessary plans and / or specifications required to indicate compliance with applicable codes and standards Incomplete The item you have submitted for review is incomplete At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and / or standards Please review carefully all comments attached Please resubmit the necessary plans and / or specifications to this office for review and approval Review FD Job# 1st 2nd 3rd 010232 FDFile# Other Agency ID Requirements Category Building Plan Requirement Pending 0514 Provide Technical Report To determine the acceptability of technologies, processes, products, facilities, materials and uses attending the design, operation or use of a building or premises subject to the inspection of the department, the Chief is authorized to require the owner or the person in possession or control of the building or premises to provide, without charge to the jurisdiction, a technical opinion and report The opinion and report shall be prepared by a qualified engineer, specialist, laboratory or fire-safety specialty organization acceptable to the Chief and the owner and shall analyze the fire-safety properties of the design, operation or use of the building or premises and the facilities and appurtances situated thereon, to recommend necessary changes Page 1 02/06/01 Mar 08 01 09:00a Mansour Rrchitectura1 (858) 558-9221 p.4 Plan Check Response March 8,2001 Mansour Architectural Corporation 5897 Oberlin Drive, Suite 111 San Diego, California, 92121 Ph (858) 558-1509 Fax (858) 558-9221 Project: Quorex Pharmaceuticals 2075 Corte Del Nogal, Suites L and M Carlsbad, California, 92009 Permit No. CB010232 Attention: Raenette Abbey The square footage breakdown at the proposed Quorex Pharmaceuticals tenant improvement space is as follows Suite L Total area of improvement = 1,255 sq ft Area converted from Warehouse to Research and Development = 526 sq ft Suite M Total area of improvement = 1,267 sq ft Area converted from Warehouse to Research and Development = 606 sq ft Area converted from Warehouse to Office = 661 sq ft Tony Mansour Principal Architect Jeff Keyser Project Manager CERTIFICATE OF COMPLIANCE (Parti of 2)ENV-1 = O3ECT NAME DATE PROJECT ADDRESS PRINCIPAL DES.G^JEP ENVELOPE \4/A C/- DOCUMENTATION AUTHOR TELEPHONE TELEPHONE E1- i -5 Parrx s rec<eJ c//Da:e eTea: Ajency GENERAL INFORMATION DATE OF PLANS BUILDING CONDITIONED FLOOR ,CLIMATE ZONE BUILDING TYPE NONRESIDENTIAL D HIGH RISE RESIDENTIAL D HOTEL/MOTEL GUEST ROOi* PHASE OF CONSTRUCTION D NEW CONSTRUCTION D ADDITION IS ALTERATION D UNCONDITIONED (file affidavit) METHOD OF ENVELOPE COMPLIANCE D COMPONENT D OVERALL ENVELOPE D PERFORMANCE STATEMENT OF COMPLIANCE This Certificate of compliance lists the building features and performance specifications need to comply with Title 24, Parts and 6 of the California Code of Regulations This certificate applies only to building envelope requirements The documentation preparer hereby certifies tnat the documentation is accurate and complete OOCUf ISNTATION AU THOR SIGNATURE DATE \-V-Qt The Principal Envelope Designer hereby certifies that the proposed building design represented in tnis set of construction documents is consistent with tne otner compliance forms and worksheets, with the specifications, ?nd with any other calculations submitted with this permit application The proposed building has been designed to meet tne envelope reouiremens-s contained in sections 110 115 t-iro'.icih 113 and 1^0 1^2 143 or 149 of TiMe ?4 Pa* 6 Please check one [H I hereby affirm thaf I an eligible i^de1" tne provis'ons of Division 3 of the Business an.d Profess'ons Code to sian tn'5 document as tne person responsiole for its preparation, and that I am licensed in tne State of California as a civ.l engineer or mechanical engineer, or I am ^ licensed architect D I affirm tnat I am eligiole under tne provisions of Division 3 of the Business and Professions Code by section 5537 2 or 6737 3 to sign tnis document as tne person responsible for its preparation, and tnat I am a licensed contractor performing this work D I afnrm tnat I am eligible under D,;,sion 3 of the Business and Professions Ccc'e to sign this document because ('• pertains to a structure or type of work described as exempt pursuant to Business and Professions Code Sections 5537, 5538 and 6737 1 (These sections of the Business eno Prc'essions Code are printed in full in the Nonresidentia' Manual 1 PRINCIPAL ENVELOPE DESIGNER NAME SIGNATURE ENVELOPE MANDATORY MEASURES Indica'e location on plans of Note Looi-1 TO' Mandatory Measures INSTRUCTIONS TO APPL 1C; J For Detailed instructions on tne use o. d ••> eric' all Energy Efficiency Standards compliance Nonrssidenfial Manua1 publisnecl by f- r ?r.'f Energ/ Commission ENV-1 Req i*red on plir.sf"'<. Cl. > i1-' f rrcy oe incoroorated in schedules or - ENV-2 Used for all subm L *ls i ' 0' t .' \.?rsion depending on metnod of ei-i«:' ENV-3 Options' Us. if defau' U' - „ - ' C^oo~9 expropriate version f' <s; / a C, '0 t' TO CERTIFICATE OF COMPLIANCE (Part 1 of 2)MECH-1 P-OJECT N^M = .-/7-a/F = 0'JECT ADDRESS ESS A*?. F3 NCIPAL OESiGNE3, MECHANICAL OOCL'i IcNTATlO.S AUTHOR TELEPHONE TELEPHONE B-i di.-g Pe ~,r C-ec-.ed by 0= = Er D.CS-SI! Age-..;/ GENERAL INFORMATION TS Or PLANS BUILDING CONDITIONED FLOOR AREA EUILDING TYPE D3 NONRESIDENTIAL D HIGH RISE RESIDENTIAL D HOTEL/MOTEL GUEST ROO, \ PHASE OF CONSTRUCTION D NEW CONSTRUCTION D ADDITION (3 ALTERATION D UNCONDITIONED (file afr'aa/;; METHOD OF MECHANICAL COMPLIANCE PRESCRIPTIVE D PERFORMANCE PROOF OF ENVELOPE COMPLIANCE PREVIOUS ENVELOPE PERMIT ENVELOPE COMPLIANCE ATTACHED STATEMENT OF COMPLIANCE This Certificate of Compliance lists the building features and performance specifications need to comply wth Title 24 Part; 1 and 6 of the California Code of Regulations This certificate applies only to building mechanical requirements The documentation preparer hereby certifies tnat the documentor) is accurate and complete DOCUMENTATION AUTHOR R.AVJDV <ioK>2>oLAc.»&ki SIGNATURE DATE 7-o) Tne Principal Mechanical Designer hereby certifies tnav. tie proposed building design represented in this set of constructs documents is consistent with tne other compliance forms and worksheets, with the specifications, j>nd with any othe ca'culations submitted with tnis permit app'ication The proposed bu'ldmg has been designed to rm-et tne mechanic; requirements contained in the applicable parts of Sections 110 tnrough 115, 120 through 124, 140 through 142, 144 and 145 Please check one IS I hereby a,,lrm tnat I am eligible unaer tne provisions of Division 3 or" tne Business and Professions Code to sign tnis document 23 the person responsiole for if's prep-?ra';on, and tnaf I am licensed in tne Sta^e of C?'ifornia as a civil engineer o- mechanical engineer, or I am a licensed architect D I affirm tnat I am eligible under tne exemption to Division 3 of tne Business and Pro.essions Code by Section 5537 2 o 67373 to sign this document as tne person responsible for i's preparation, and tnat I am a i censed conn-act a performing tnis work D I affirm that I am eligible under the exemption to Division 3 of tne Business and Professions Code to sign this documer because it pertains to a structure or ty 5538, and 6737 1 (These sections of the Business and Profd pursuant to Business and Professions Code sections 553/ priced in full in tne Nonresidential Manual) P = liVCIPAL MECHAN'CAL DESIGNER NAME SIG DATE LIC * MECHANICAL MANDATORY ME Indicate location on plans of Note Biock for Mandatory Measures M*./ INSTRUCTIONS TO APPLICANT For Detai/ed instructions on the use of this and all Energy Envc/ency Standards compliance forms, please refer t > ' rionresrfentia! Manual published by the California Energy Commission MECH-1 Required on plans for all submtttals Part 2 n?./ ce incorporated in schedules on plans i 'ECH-2 Requ red for a't su^n.i'tals, bu'r may t& mcuifjo.'ti 50 in schedules on plans /' 'ECH-3 Required for all submrtals unless reqnirc-J i c-n-iiition rates and airflows are sno,;ri on p/ar/s Sec •'. ;' 'ECH-4 Reqnired for all prescriptive submitted i' :i '^i'dantia/ Corn; /ancfl Form CERTIFICATE OF COMPLIANCE (Part 2 of 2)MECH-1 PROJECT NAME I-S-&1 SYSTEM FEATURES SYSTEM NAME TIME CONTROL SEiBACKCONiROL I3OLATION ZONES ELECTRIC HEAT? FAN CONTROL VAV MINIMUM POSITION CONTROL? S'MULTANEOUS HEAT/COOL? HEAT AND COOL SUPPLY RESET? VENTILATION OUTDOOR DAMPER CONTROL? ECONOMIZER TYPE DESIGN O A CFM (MECH-3 COLUMN H) HEATING EQUIPMENT TYPE HIGH EFFICIENCY? IF YES ENTER EFF # M-iKE AND MODEL NUM3ER COOLING EQUIPMENT TYPE - C^E-,- :^~? i- VES E-:,^ £-- - MAKE AND MODEL NUMBER Pi°E INSULATION REQUIRED? =I=E TYPE (SU°?LY, RETURN, ETC ) -.EATING DUCT LOCATION R-VALUE COOLING DUCT LOCATION R VALUE DJCT TAPE ALLOWED? HP- ,2,3 s Q & V vO C? VO \^ V •& A Vs) £&^ Ml.) >/ Vi —c^6-/£.»vJC; 2.. I <2-fflLl*~JC\ 2-. 1 Vsi MECHANICAL SYSTEMS i NOTE TO FIELD Bldg Dept Use CODE TABLES Enter code from table below into columns aoove LJCAT miR/m TLJCDB/IOCTATO TIME CONTROL SETBACK ISOLATIONHEAT PUMP THERMOSTAT? CTRL ?ONFS ELECTRIC HEAT? ^ VAV MINIMUM POSITION CONTROL? Y Yes SIMULTANEOUS HFAT/OOOI ? N Nn :Drog Sv/itcn H Hea'ing Enter number of Occupancy C Cooling Isolation Zones Sensor B Bo>h Manual Timer HEAT AND COOL SUPPLY RESET? VENTILATION O^DOOR ECONOMIZER HIGH EFFICIENCY? ^ ' DUCT TAPE ALLOWED? M PIPE INSULATION REQUIRED? p \if Uaiance A Auto A Air Outside Air Cert G Gravity W Water Outside Air N Not Required Meas'j'e FAN CONTROL Inlet Vanes P Variable P,t:n V VFD O Otnar C Cur/= DESIGN O A CFM Enter Design Outdoor Air CFM Note This snail be no kss t'na- Cr _r ;• H • f!c.' 2 MECHANICAL EQUIPMENT SUMMARY (Part 1 of 2) P6OJECT NAME MECH-2 DATE $ -S-C) CHILLER AND TOWER SUMMARY Equipment Name Equipment Type Qty Efficiency Tons PUMPS Total Qty GPM BHP Motor Eff DHW / BOILER SUMMARY Drive Eff Energy Factor System Name System Type Distribution Type Qty Rated Input Vol or Recovery (Gals) Efficiency Pump Control Standby Loss or Pilot TANKINSU External R-Val CENTRAL SYSTEM RATINGS HEATING System Name System Type Qty Output HP-I Jyr PUMP \ nq.o HP-& I 32 0 HP-3 i ' n,<8> CENTRAL FAN SUMMARY Aux kW — » __ Efficiency 35 3.2- 2.9 COOLING Output <47,S 3S* 3 /?.£? Sensible 35; ^S 6 13. K SUPPLY FAN System Name Fan Type Ir i i |r Motor Location CFV — - i BHP — Motor Drive Eff Eff i , Efficiency 1-2 12 .& & *O.C> ^•^m RETURN CFM BHP •n Economizei Type _- -- ••••naim in FAN P/lotor Drive Eff tff " Wo1/ MECHANICAL EQUIPMENT SUMMARY (Part 2 of 2) MECH-; PROJECT NAME C"E t-S-Ol VAV SUMMARY Zone Name vj/A VAV System Type Qty Mm CFM Ratio Reheat' Type AT FAN Flow Ratio CFM BHP Motor Eff Drive Eff BASEBOARD Type Outpu EXHAUST FAN SUMMARY EXHAUST FAN Room Name £F~f &F-2- £f-3 Qty I I \ CFM )Bo 2&O loO BHP O.DZ Q(^ — Motor Eff 4o% Hcfl* - Drive Eff 100% IfiO^o Ioo9p EXHAUST FAN Room Name &'** Qty \ CFM l&OD BHP O.J3 Motor Dnv Eff Eff fe*/% Tfl MECHANICAL VENTILATION MECH-3 PROJECT NAME QUO REX DATE l-5-o J MECHANICAL VENTILATION ZONE/ SYSTEM HP-/ •HP-2 f/P-3 AREA BASIS COiNO AREA (SF) e-?^ 4kc? ^5"0 CFM PER SF .15 •\/ MIN CFM (SXC) I3J ^^3& Totals (For MECH-4) OCCUPANCY BASIS NO OF PEOPLE 9 ^10 CFM P = ?PE°3O,v /5 ^ ' M,M C = " (= ' F) 135 leV 150 REQ'D OA (M-\X 0"D O^C) |3,^ fc*» ISO DESIGN OUTDOOR AIR CF.V 5*40 420 ISO VAV WIN CFM TRANSFEt A13 C = ,,' E Min.murn vent:lalion rate per Section § 121 Table 1 F Eased c,i ejected number of occupants or af least 50% of Chapter 10 1?}7 UBC occupant densit/ Musi tegrea'er tnan or equal to H or use Transfer Air Des.gn outdoor a r '-clu^-: vent-la! en from supply a system & exhaust fans which Opera!e ?t das on cordiiions f-lus! be grea!er then or equal to (H -1) a-d for VW grsa'e, tian or equd' (T (H - J) a,' Ccrnp/iance Form MECHANICAL SIZING AND FAN POWER MECH-4 PROJECT NAME (*\ \ i r** O C f ^^ L-/ AS? k.Ji A /""' C ' 1 T~J^* £ / ^*^^ \x U r^« C~ ?•*- V *• *^ ^ ^A r\'h— JS w * * ^JT. ^ ^ SYSTEM ,'UME HP-i DATE /-s-o/ FLOOR A = =.A NOTE Provide one copy of this form for each mechanical system when using the Prescriptive Approach SIZING and EQUIPMENT SELECTION 1 DESIGN CONDITIONS - OUTDOOR DRY BULB TEMPERATURE - OUTDOOR. WET BULB TEMPERATURE - INDOOR. DRY BULB TEMPERATURE 2 SIZING -DESIGN OUTDOOR AIR sjj - ENVELOPE LOAD -LIGHTING |. - PEOPLE - MISCELLANEOUS EQUIPMENT - OTHER 1) 2) 3) (APPENDIX C) (APPENDIX C) (See Chap 8, ASHRAE handbook. 1993) tf 0 CFM (MECH 3, COLUMN I) Btu/Hr (ENV-2 Part 2 of 5 Column E) 5 W / SF (Adjusted Actual Watts-LTG-2) CJ # OF PEOPLE (MECH 3, COLUMN E) g WATTS / SF COOLING §5 10 7,R HEATING 3& -?& 5.q 7.4 H.6 2*3 I4lct TOTALS OTHER LOADS/SAFETY FACTOR (1 21 for cooling 1 43 for heating) MAXIMUM ADJUSTED LOAD (TOTALS FROM ABOVE x OTHER LOAD SAFETY FACTOR) 3 SELECTION INSTALLED EQUIPMENT CAPACITY IF INSTALLED CAPACITY EXCEEDS MAXIMUM ADJUSTED LOAD, EXPLAIN 3^.5 /•a; ^/. 7 \VA 135. e KBtu / Hr 4-KBtu / Hr I FAN POWER CONSUMPTION FAN DESCRIPTION V)/A DESIGN BRAKE HP <as _ y^ NOTE Include only fan systems exceeding 25 HP (see § 144 Total Fan S>s'em Power Demand may not exceed 0 ° '/Vatts/CFM for constant volume systems or 1 25 V.'a iS/CFM MV s/s'ems EFFICIENCY MOTOR 1 or | DRIVE NUMBER OF FANS TOTALS PEAK WATTS B x E x 746 / (C x D) CFM (Supply Fans) 1 TOTAL 1 Af, bYSTcf. j PO/,Lr HEM AN: L W^.residential Compliance Form Mover:',, MECHANICAL SIZING AND FAN POWER MECH-4 PROJECT h«M= SYSTEM fUV= HP-* KS-0/ ^o .SB. Pr MOTE P ovcia one copy of tnis forrr for each mechanical s/sien when us r,g tne Prescriptive Asoroacn SIZING and EQUIPMENT SELECTION (A°?ENOIX C) (-^PEN'D'X C) (See Chap 8, ASHRAE handoook. 1S93 CFM (MECH 3. COLUMN I) Btu/Hr (ENV-2 Part 2 of 5 Column E) W/ SF (Adjusted Actual Watts LTG 2) £ OF PEOPLE (MECH 3. COLUMN' E) WATTS/SF 1 DESIGN CONDITIONS - OUTDOOR, DRY BULB TEMPERATURE - OUTDOO^ WET BULB TE,'- '=ERATURE - INDOOR DRY BULB TEMPERATURE 2 SIZING - DESIGN OUTDOOR AIR - ENVELOPE LOAD - LIGHTING - PEOPLE - MISCELLANEOUS EQUIPMENT - OTHER _1) J2) _3) TOTALS OTHER LOADS/SAFETY FACTOR (1 21 for cooling 1 43 for heating) MAXIMUM ADJUSTED LOAD (TOTALS FROM ABOVE x OTHER LOAD SAFETY FACTOR) 3 SELECTION INSTALLED EQUIPMENT CAPACITY IF INSTALLED CAPACITY EXCEEDS MAXIMUM ADJUSTED LOAD, EXPLAIN KB'u /Hr KBtu/H- FAN POWER CONSUMPTION E LH FAN DESCRIPTION WA DESIGN BRAKE HP <3S _. [c] 0 (D E (D EFFICIENCY MOTOR NOTE Inoude crl/ fan s>s!em5 e.<ceed,ng 25 H3 (553 § 14-',; Tc!a' Fan S'/s'eTi Pc,,e' Denurd nay rot e<cee j C £ ,Va''5,'CFM f:r ccrtsiar,: vc'urre s ^'ems cr 1 25 V. .'CF' ' f. /AVsys'ems DRIVE NUMBER OF FANS TOTALS PEAK WATTS B x E x 745 / (C x D) L_ TOT ' ' .s', r'J5 I/ CFM (Snoply Fc~.i \ rtr r " \Ur L. MECHANICAL SIZING AND FAN POWER MECH-4 PROJECT tu-' IE HP-/* Cr- 1 = l-S-Qi \ NOTc P.'ov de one cooy o. tms form for ea;h mecnamcal system './hen usina tr.e Prescrict ve Aaoroacn — [SIZING and EQUIPMENT SELECTION 1 DESIGN CONDITIONS - OUTDOOR, DRY BULB TEMPERATURE (±° O'J : 'ZOO- V,ET BULB TE' '^cR- i UR - INDOOR DRY BULB TEMPERATURE 2 SIZING - DESIGN OUTDOOR AIR - ENVELOPE LOAD - LIGHTING - PEOPLE - MISCELLANEOUS EQUIPMENT - OTHER 1) 2) 3) i ~~"=E' D Y C) (See Chap 8 ASHR^E handooo'< 151-:, ISO — 1.5 ID 0,6 CFM (MECH 3, COLUMN 1) Btu/Hr (ENV-2 Part 2 of 5 Column E) W/ SF (Adjusted Actual Watts LTG 2) # OF PEOPLE (MECH 3, COLUMN E) WATTS / SF TOTALS OTHER LOADS/SAFETY FACTOR (1 21 for cooling 1 43 for heating) MAXIMUM ADJUSTED LOAD (TOTALS FROM ABOVE x OTHER LOAD SAFETY FACTOP) 3 SELECTION INSTALLED EQUIPMENT CADACITY COOLING 3.2 70 7,a HEATIN3 3 3 -7- 1.5 •?.** /. i 0.^ 13.) ' / 'ft / (5,9 Vi/A i | /3-S ,/ KBt'.i/h' IF INSTALLED CAPACITY EXCEEDS MAXIMUM ADJUSTED LOAD. EXPLAIN KBtu / Hr [FAN POWER CONSUMPTION FAN DESCRIPTION V)/A DESIGN BRAKE HP <as EFFICIENCY MOTOR DRIVE NUMBER OF FANS PEAK WATTS B x E x 745 / (C> D) CFM CS'i'K-y F-r-iS1 E lio-.ds cr'; faa s'/s'em^ exce;i -,g 25 h3 (se-3 § 1',-',; ' FCT S;5'e~] Pc'..5' De~i?"d ray ro' exceed 0 S /CFM forcons'art voln.r 5 5/5' -n^ <• i 25 V.a'.i'Cf." f: s/s'ams TOTAL S IT/1. I r j d?n'i3l Cc/7p f 1C.: r S~ Mar 13 01 10:45a Mansour Rrohitectural (858) 558-9221 p.2 EXISTING CONCRETE WALL ATTACH 20 <3A. METAL TRACK TO TO CONCRETE SLAB WITH ,017" DIA, RAMS2T No «33 AT 4S» OC MIN, 1-1/4" MIN. IMREDMENT PER 1C&0 No. 1147 ATTACH WITH 5 #8 TYPE "S' BUBLE HEAD SCREWS AT 14" O.C. MIN. SUSPENDED CEILING PER REFLECTED CEILING PLAN R-11 INSULATION 5/8" GYPSUM BOARD ON 5-5/8" X 25 ©A. METAL STUDS AT 24" O.C. PER ICBO No 9403-P. .ATTACH' TO WALL AT MID-HE19HT ATTACH METAL SILL TO CONCRETE SLAB WITH .017" DIA. RAMSET No. MM AT 24" OC., 1-1/4" MIN WBEDMENT PER ICBO No. 1147 BASE PES SCHEDULE FINISH FLOOR TYPICAL FURRED WALL SECTION NTS. REVISED PER BUILDING INSPECTORS REQUEST 3/13/01 8V NTS O'JCKSX Tl. R-1 J W 1 »«•!• Quorex Pharmaceuticals, Inc. TECHNICAL REPORT HAZARDOUS MATERIALS SUMMARY For 2075 Corte del Nogal, Suites L and M Carlsbad, CA 92009 December 18, 2000 Revision 1 \OCCVPA11ONAL 'SERVICES, INC Quorex Pharmaceuticals, Inc December 18, 2000 Technical Report / Hazardous Materials Summary Revision I Page 1 Quorex Pharmaceuticals, Inc will occupy 2075 Corte del Nogal, Suites L and M, Carlsbad, CA 92009 This is a research and development facility performing bench scale science using typical laboratory quantities of hazardous materials Based upon the proposed volume and usage of hazardous materials, the proper occupancy classification for 2075 Corte del Nogal, Suites L and M, is "B" There will be 1 one-hour occupancy separation control area For detailed information concerning both the physical and health hazards at 2075 Corte del Nogal, Suites L and M, please refer to the enclosed two chemical classification reports based on 1997 UBC Tables 3D and 3E The building is equipped with an approved automatic sprinkler system None of the hazardous materials exceed the exempt amounts for physical or health hazards for storage or use CONTROLS The following controls will be installed at 2075 Corte del Nogal, Suites L and M, Carlsbad, CA 1 Automatic Fire Extinguishing Systems [1997 UFC 1003 2 2] The building will be equipped with an approved automatic fire extinguishing system 2 Shelving and Lips/Guards [1997 UBC 307 1 3 (3) and 1997 UFC 8001 11 9] The laboratories will be equipped with adequately braced and anchored shelving of substantial noncombustible construction with a chemical resistant coating Shelves will be provided with a lip or guards Shelf storage of hazardous materials will be maintained in an orderly manner 3 Seismic Bracing Shelves greater than six feet high will be braced 4 Separation of Incompatible Materials [1997 UFC 8001 11 8] Incompatible materials will be separated from each other on shelving, in storage cabinets, and in waste collection containers Incompatible materials will be separated by one or more of the following methods Storage in separate storage cabinets Separation by a distance of more than twenty feet Isolation using noncombustible partitions greater than 18" high Chemists and biologists will receive chemical safety instruction on the separation of mcompeatible materials Furthermore, scientists will be trained not to exhaust mcompatibles into the ventilation systems 5 Empty Containers [1997 UFC 7902 5 3] The storage of empty containers and containers previously used for the storage of flammable or combustible liquids, unless free from explosive vapors, will be stored as required for filled containers and tanks Tank and containers, when emptied will have the covers or plugs immediately replaced in openings Quorex Pharmaceuticals, Inc Technical Report / Hazardous Materials Summary Revision I December 18, 2000 Page 2 Security [1997 UFC 8001 11 2] The suite will be equipped with lock(s) to prevent unauthorized entry Fire Extinguishers [7997 UFC 7902 5121] The facility will be equipped with portable dry chemical fire extinguishers Flammable Liquid and Hazardous Materials Storage Cabinets [1997 UFC 7901 421 & [1997 UFC 8001 10 6] Flammable and combustible liquids will be stored in approved flammable liquid storage cabinets Doors will be well fitted, self-closing, and equipped with a latch The flammable liquid cabinets will meet the construction standards in 7997 UFC 7901 421 Hazardous materials including Highly Toxic Solids and Liquids, Oxidizer, Reactive, and Water Reactive materials will be stored in hazardous materials storage cabinets Doors will be well fitted, self-closing, and equipped with a latch The hazardous materials storage cabinets will meet the construction standards in 7997 UFC 8001 10 6 Laboratory Fume Hoods and Building Ventilation a Flammable Gases and Vapors in the Exhaust Systems The storage and use of flammable and combustible liquids and gases in hoods and exhaust ducts will be limited to the smallest amounts needed each day Concentrations of gases and vapors will be diluted to less than 10% of the lower explosive limit (L E L ) for each compound Therefore, no automatic fire protection systems will be required in the fume hoods or exhaust ducts Mechanical exhaust will be provided where Class I, II, or III-A liquids are used (in any amount) in Groups B, F, M, and S occupancies, or portions thereof The rate of exchange will far exceed the minimum of six air changes per hour Under normal operating conditions explosive vapor-air mixtures will not develop at QUOREX PHARMACEUTICALS The majority of the work involving Class I, II, or III-A liquids will be performed in chemical fume hoods, not in the open laboratories The exhaust ventilation will be sufficient to maintain nonflammable and nonexplosive vapor concentrations throughout the entire exhaust duct system Quorex's activities will not require elevated temperatures Table 1 is a listing of the LEL for commonly used flammable liquids and gases Flammable Liquids and Gases Acetone Acetonitnle Cyclohexane Ethanol Ethyl Acetate Ethyl Ether Hexane Hydrogen Isopropanol LEL (%) 26 44 1 3 33 22 19 1 2 40 25 10%ofLEL(%)* 026 044 013 033 022 019 0 12 04 025 Quore* Pharmaceuticals, Inc Technical Report / Hazardous Materials Summary Revision I December 18, 2000 Page3 Flammable Liquids and Gases Methanol Pyndme Tetrahydrofuran Toluene LEL (%) 60 1 8 1 8 1 2 10%ofLEL(%)* 06 0 18 0 18 0 12 *Ducts conveying flammable vapors at concentrations greater than 10% of the LEL are required to be equipped with automatic fire protection systems Face Velocities Face velocities for laboratory fume hoods will not be less than the following Type General Use Use with Carcinogens Average Face Velocity 100lfpm 150lfpm Minimum Face Velocity 70 Ifpm 125lfpm 10. Water Reactive Materials [1997 UFC 8001 15234] Materials that react with water or other liquids to produce a hazard will not be stored in the same room with flammable or combustible liquids 11 Sources of Ignition [1997 UFC 7901 10] In locations where flammable vapors could be present, precautions will be taken to prevent ignition by eliminating or controlling sources of ignition Adequate grounding and bonding will be provided to prevent the accumulation of static electricity wherever Class I or II liquids are transferred or dispensed 12 Compressed Gases [1997 UFC 4904 2] Compressed gases in service and in storage will be adequately secured to prevent falling or being knocked over Cylinders, including empty ones, will have their caps in place and valves tightly closed If you have any questions regarding the contents of this report, please contact me at (619) 316-4955 Thank you Prepared for Quorex Pharmaceuticals, Inc by Occupational Services, Inc Brad Stanard, Health and Safety Specialist SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY H# BP DATE. SA/M_ APCD_ Business Name Quorex Pharmaceuticals, Inc Mailing Address 2075 Corte del Nogal, Suite J Site Address 2075 Corte del Nogal, Suite L and M City Carlsbad City Carlsbad Contact Person Robert Robb State CA State CA Telephone 760-602-1910 Zip 92009 Zip 92009 Plan File# Plan File#/Permit# 'ART I FIRE DEPARTMENT - HAZARDOUS MATERIALS MANAGEMENT DIVISION OCCUPANCY CLASSIFICATION idicate by circling the item, whether your business will use, process, or store any of the following hazardous materials If any of the items are ircled, applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal Explosive or Blasting Agents Compressed Gases Flammable or Combustible Liquids I Flammable Solids Organic Peroxides I Oxidizers I Pyrophorics Unstable Reactives I Water Reactives I ] Cryogenics J Highly Toxic or Toxic Materials JRadioactives Corrosives Other Health Hazards 'ART II SAN niERO COUNTY DEPARTMENT DF ENVIRONMENTAL HEALTH - HA7ARDOUS MATERIALS MANAFJEMFNT DIVISION (HMMm. Date Initials I I CalARP Required Date Initials CH CalARP Complete the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Management iivision, 1255 Imperial Avenue, 3rd Floor, San Diego, CA 92101 Telephone (619) 338-2222 prior to the issuance of a building I I CalARP Exempt epartment permit L EES MAY BE REQUIRED Yes _Np Is your business listed on the reverse side of this form? Will your business dispose of Hazardous Substances or Medical Waste in any amount? Will your business store or handle Hazardous Substances in quantities equal to or greater than 55 gallons, 500 pounds, 200 cubic feet or 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)? Date Initials Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10) >ART III SAN niFflO COUNTY AIR POLLUTIONS CONTROL DISTRICT the answer to any of the questions is yes, applicant must contact the Air Pollution Control District, 9150 Chesapeake Drive, San Diego, CA 92123 Telephone 319) 694-3307 prior to the issuance of a building department permit YES NO LJ K! Will the intended occupant install or use any of the equipment listed on the Listing of Air Pollution Control District Permit Categories, on the reverse side of this form? LJ LJ (ANSWER ONLY IF QUESTION 1 IS YES ) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12) as listed in the current Directory of School and Community College Districts, published by the San Diego County Office of Education and the current California Private School Directory, compiled in accordance with provisions of Education Code Section 33190? i the buildma or structure for which this oermit is reauested contain anv friable asbestos? iriefly describe business activity and proposed project "o focus on the development of an entirely new class of broad-spectrum anti-infective drug that disables disease-causing mechanisms in >athogemc bactena Jame of Owner or Authorized Agent Robert Rnhh Signaty»-^f Ownerof Aujbowzed /gent Date 12/18/on declare under penalty of perjury that to the best of my knowledge and belief the responses made herein are true and correct OR OFFICIAL USE ONLY IRE DEPARTMENT OCCUPANCY CLASSIFICATION JY EXEMPT OR NO FURTHER INFORMATION REQUIRED COUNTY-HMMD APCD RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY COUNTY-HMMD APCD RELEASED FOR OCCUPANCY COUNTY-HMMD APCD )EH HM-9171 (10/98) County of San Diego Department of Environmental Health Quorex Pharmaceuticals Physical Hazard Report Summary CLASS Location LABORATORY COMBUSTIBLE LIQUID CLASS II COMBUSTIBLE LIQUID CLASS III-A COMBUSTIBLE LIQUID CLASS III-B COMBUSTIBLE FIBER CRYOGENIC, FLAMMABLE OR OXIDIZING EXPLOSIVES FLAMMABLE SOLID FLAMMABLE, GAS FLAMMABLE LIQUID CLASS I-A FLAMMABLE LIQUID CLASS I-B FLAMMABLE LIQUID CLASS I-C ORGANIC PEROXIDE, DETONATABLE ORGANIC PEROXIDES CLASS I ORGANIC PEROXIDES CLASS II ORGANIC PEROXIDES CLASS III ORGANIC PEROXIDES CLASS IV ORGANIC PEROXIDES CLASS V OXIDIZER CLASS 1 OXIDIZER C[ASS 2 OXIDIZER CLASS 3 OXIDIZER CLASS 4 OXIDIZER - GAS OXIDIZER, GASEOUS OR LIQUIFIED PYROPHORIC UNSTABLE (REACTIVE) CLASS 1 UNSTABLE (REACTIVE) CLASS 2 UNSTABLE (REACTIVE) CLASS 3 Lbs. 0000 0000 0000 0000 0000 0000 1 123 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0066 0000 0000 0000 0000 0000 0000 0000 0000 0242 Storage Gallons 0531 0053 0451 0000 0000 0000 0000 0000 0000 3905 0139 0000 0000 0000 0000 0000 0000 0032 0000 0000 0000 0000 0000 0000 1 585 0000 0000 Closed System Cu.Ft 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Lbs. 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Gallons 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Cu. Ft. 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Open System Lbs. 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Gallons 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Thursday, December 14, 2000 Page 1 of2 Quorex Pharmaceuticals Physical Hazard Report Summary Storage Closed System Open System CLASS Lbs. Gallons Cu Ft UNSTABLE (REACTIVE) CLASS 4 RADIOACTIVES WATER REACTIVE CLASS 1 WATER REACTIVE CLASS 2 WATER REACTIVE CLASS 3 NON HAZARDOUS 0000 0000 2203 0441 0000 10213 0000 0000 0013 0013 0000 0264 0000 0000 0000 0000 0000 0000 Lbs. Gallons Cu. Ft 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Lbs. Gallons 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 0000 Thursday, December 14,2000 Page 2 of2 Quorex Pharmaceuticals Health Hazard Report Summary Location LABORATORY Storage CLASS CORROSIVES HIGHLY TOXICS IRRITANTS SENS1T1ZERS OTHER HEALTH HAZARDS TOXICS Lbs. 3601 0220 46411 0 177 17503 3700 Gallons 0897 0000 5579 0000 4069 0 185 Cu. Ft. 0000 0000 0000 0000 0000 0000 Closed System Lbs. 0000 0000 0000 0000 0000 0000 Gallons 0000 0000 0000 0000 0000 0000 Cu.Ft 0000 0000 0000 0000 0000 0000 Open System Lbs 0000 0000 0000 0000 0000 0000 Gallons 0000 0000 0000 0000 0000 0000 Thursday, December 14, 2000 Page 1 of 1 Inventory Report for Quorex Pharmaceutical Location LABORATORY Class COMBUSTIBLE LIQUID CLASS II (LIQUIDS) Cname CAS# Unit Quantity Quantity in Gallons Acetic Acid, Glacial 64-19-7 L 2 0528 Methyl-2,4-Pentancthone 815-57-6 T 5 0001 Methyltetrahydrofuran-3-one 3188-00-9 T 5 0001 Summary for Gallons (3 detail records) Sum 0531 Class COMBUSTIBLE LIQUID CLASS III-A (LIQUIDS) Cname CAS# Unit Quantity Quantity in Gallons Decyl Aldehyde Dicthyl Pyrocarbonate Hydroxytetrahydrofuran Hydroxytetrahydrofuran Methoxy-3-buten-2-one Phenol Rose Oxide 112-31-2 1609-47-8 453-20-3 453-20-3 4652-27-1 108-95-2 16409-43-1 T T T T T T T 25 50 5 5 10 100 5 0007 0013 0001 0001 0003 0026 0001 Summary for Gallons (7 detail records) Sum 0 053 Class COMBUSTIBLE LIQUID CLASS III-B (LIQUIDS) Cname CAS# Unit Quantity Quantity in Gallons DITHIOTHEITOL DMSO EGTA FORMAMIDE - DEION1ZED Hexanoic Acid Twcen 20 27565-41-9 67-68-5 67-42-5 75-12-7 142-62-1 9005-64-5 T T T T T L 5 500 100 100 2 1 0001 0 132 0026 0026 0001 0264 Thursday, December 14, 2000 Page 1 of 13 Summary for Gallons (6 detail records) Class CORROSIVES (LIQUIDS) Cname CAS# Sum 0451 Unit Quantity Quantity in Gallons Acetic Acid, Glacial Butyryl Chloride Dichloromethane Hexanoic Acid Hydrochloric Acid Hydrogen Peroxide Isobutyl Chloroformatc Phenol Triethylammc 64-19-7 141-75-3 75-09-2 142-62-1 7647-01-0 7722-84-1 543-27-1 108-95-2 121-44-8 Summary for Gallons (9 detail records) Class CORROSIVES (SOLID ) Cname CAS# Crystal Violet Hexadccyltrimethylammomum Bromide IM1DAZOLE Iodine Iron III Chloride, Anhydrous Iron III Chloride, Hexahydrate Levulmic Acid Lithium Chloride PHENYL-METHYL SULFONYL FLUORIDE Potassium Hydroxide Sodium Hydroxide Tnchloroacetic Acid Summary for Lbs (12 detail records) Thursday, December 14, 2000 548-62-9 57-09-0 288-32-4 7553-56-2 7705-08-0 7705-08-0 123-76-2 7447-41-8 329-98-6 1310-58-3 1310-73-2 76-03-9 L T T T T T T T T Unit M M M M M M M M M M M M 2 50 500 2 500 120 25 100 100 Quantity 25 25 100 30 100 100 50 100 5 100 500 500 0528 0013 0 132 0001 0132 0032 0007 0026 0026 Sum 0 897 Quantity in Lbs. 0055 0055 0220 0066 0220 0220 0110 0220 0011 0220 1 101 1 101 Sum 3 601 Page 2 of 13 Class FLAMMABLE LIQUID CLASS I-B (LIQUIDS) Cname Acetonitnle UV Alcohol, Reagent Butyryl Chloride Chloro-2,4-pentanedione Ethanol, 200 proof Ethyl Acetate Isopropanol Methanol Pentancdione Pyridme Tnethylamme CAS# 75-05-8 64-17-5 141-75-3 1694-29-7 64-17-5 141-78-6 67-63-0 67-56-1 600-14-6 110-86-1 121-44-8 Unit Quantity Quantity in Gallons L L T T L L T L T T T 4 4 50 5 1 1 500 4 25 100 100 1 057 1 057 0013 0001 0264 0264 0132 1 057 0007 0026 0026 Summary for Gallons (11 detail records) Sum Class FLAMMABLE LIQUID CLASS I-C (LIQUIDS) Cname CAS# Unit Quantity Quantity in Gallons Summary for Gallons (2 detail records) Sum Class FLAMMABLE SOLID (SOLID) Cname CAS# Unit Quantity Quantity in Lbs. Charcoal 7440-44-0 Dmitrophenylhydrazine 119-26-6 Summary for Lbs (2 detail records) Class HIGHLY TOXICS (SOLID) M M 500 10 1 101 0022 Sum Cname Thursday, December 14,2000 CAS#Unit Quantity Quantity in Lbs. 3905 Isobutanol Isobutyl Chloroformate 78-83-1 543-27-1 T T 500 25 0132 0007 0 139 1 123 Page 3 of 13 Muscimol Sodium Azide 2763-96-4 26628-22-8 Summary for Lbs (2 detail records) Class IRRITANTS (LIQUIDS ) Cname CAS# Acetic Acid, Glacial Acetomtnle UV Alcohol, Reagent Amyl Alcohol Butyryl Chloride Chloro-2,4-pentanedione Chloroform Decyl Aldehyde Dichloromethane Diethyl Pyrocarbonatc DITHIOTHEITOL DMSO EDTA EGTA Ethanol, 200 proof Ethidium Bromide Ethyl Acetate FORMAMIDE - DEIONIZED Hexanoic Acid Hydrochloric Acid Hydroxytetrahydrofuran Hydroxytetrahydrofuran Isobutanol Isopropanol 64-19-7 75-05-8 64-17-5 75-85-4 141-75-3 1694-29-7 67-66-3 112-31-2 75-09-2 1609-47-8 27565-41-9 67-68-5 6381-92-6 67-42-5 64-17-5 1239-45-8 141-78-6 75-12-7 142-62-1 7647-01-0 453-20-3 453-20-3 78-83-1 67-63-0 I M Unit L L L T T T T T T T T T T T L T L T T T T T T T 1 100 Quantity 2 4 4 500 50 5 500 25 500 50 5 500 500 100 1 500 1 100 2 500 5 5 500 500 0000 0220 Sum 0 220 Quantity in Gallons 0528 1057 1057 0 132 0013 0001 0132 0007 0132 0013 0001 0 132 0132 0026 0264 0132 0264 0026 0001 0 132 0001 0001 0 132 0132 Thursday, December 14, 2000 Page 4 of 13 Methanol Methoxy-3-buten-2-one Methyl- 1 ,3-Cyclopentanedione Methyl-l,3-Cyclopentanedione Methyl-2,4-Pentanedionc Methyl-2-CyclOpenten- 1 -one MethyI-2-Cyclopenten-l-one Methyltetrahydrofuran-3-one Pentanedione Pyndme Rose Oxide Triton X-100 67-56-1 4652-27-1 765-69-5 765-69-5 815-57-6 1120-73-6 1120-73-6 3188-00-9 600-14-6 110-86-1 16409-43-1 9002-93-1 Summary for Gallons (36 detail records) Class. IRRITANTS (SOLID ) Cname CAS# ACES Acetylcyclopentanone Adenmc Adomtol Agar, Skim Milk Agar, TSA Blood Base Agarose, General Purpose Agarose, Low Meltmg Poml Agarose, Small Fragments Ammonium Acetate Ammonium Chloride Ammonium Sulfate Ampicillm Bone Acid 7365-82-4 1670-46-8 73-24-5 10058-44-3 1120-73-6 1121-05-7 39346-81-1 39346-81-1 1128-23-0 631-61-8 12125-02-9 7783-20-2 69-52-3 10043-35-3 L T T T T T T T T T T T Unit M M M M M M M M M K M K. M K 4 10 5 10 5 1 5 5 25 100 5 100 Sum Quantity Quantity 25 5 1 1 500 500 100 25 100 1 500 1 25 1 1 057 0003 0001 0003 0001 0000 0001 0001 0007 0026 0001 0026 in Lbs. 0055 0011 0002 0002 1 101 1 101 0220 0055 0220 2203 1 101 2203 0055 2203 5579 Thursday, December 14, 2000 Page 5 of 13 Bromophenol Blue Broth, LB Miller Broth, Phenol Red Base Calcium Chloride, Dihydrate Cmoxacm Coomassie Brilliant Blue R-250 Dihydro-2-Methylfuran Dihydrouracil Dimtrophenylhydrazine Ethyl-2,4-Pentanedione Ethyl-2-Hydroxy-2-Cyclopenten-l-one Ficoll Glucose, Anhydrous HEPES Hydantom Hygromycm B Iodine IPTG IPTG Iron III Chloride, Anhydrous Iron III Chloride, Hcxahydrate Kmetm Riboside Laurie Acid Lithium Chloride Lithium Dodecyl Sulfate Lysozymc, Egg White Magnesium Chloride, Hexahydrate Magnesium Sulfate, Heptahydrate Manganese Chloride MES MOPS 115-39-9 130-40-5 13436-46-9 10035-04-8 28657-80-9 6104-59-2 25564-22-1 504-07-4 119-26-6 3859-41-4 4338-47-0 26873-85-8 488-86-8 7365-45-9 461-72-3 31282-04-9 7553-56-2 367-93-1 367-93-1 7705-08-0 7705-08-0 4338-47-0 143-07-7 7447-41-8 2044-56-6 12650-88-3 7786-30-3 10034-99-8 13446-34-9 4432-31-9 1132-61-2 M M M M M M M M M M M M K M M I M M M M M I M M M M M M M K K 5 500 500 500 1 25 5 1 10 5 25 10 1 100 25 50 30 5 1 100 100 100 2 100 25 5 500 500 125 1 1 0011 1 101 1 101 1 101 0002 0055 0011 0002 0022 0011 0055 0022 2203 0220 0055 0000 0066 0011 0002 0220 0220 0000 0004 0220 0055 0011 1 101 1 101 0275 2203 2203 Thursday, December 14, 2000 Page 6 of 13 NADPH Phenol Red Piperacillm POLYETHYLENE GLYCOL - (8,000 MW) Potassium Acetate Potassium Phosphate, Dibasic Potassium Phosphate, Monobasic Potassium Sulfate Potassium Tetraborate Tetrahydrate Ribose Ribose Ribulose Roxithromycin Sodium Acetate, Anhydrous Sodium Bisulfite Sodium Citrate Sodium Hydroxide Sodium Phosphate, Dibasic Anydrous Sodium Phosphate, Monobasic Monohydrate Sorbose Sorbose Sulfisoxazole SULFOSALICYCLIC ACID Tetracyclme Thiamme Hydrochlonde Tobramycin Tnchloroacetic Acid Tns Tns-HCl Trypan Blue Tryptophan 765-69-5 143-74-8 59703-84-3 25322-68-3 127-08-2 7758-11-4 7558-80-7 7778-80-5 12045-78-2 979-92-0 979-92-0 979-92-0 80214-83-1 127-09-3 7631-90-5 613204-3 1310-73-2 7758-29-4 7758-29-4 87-79-6 87-79-6 127-69-5 5965-83-3 60-54-8 67-03-8 32986-56-4 76-03-9 77-86-1 77-86-1 72-57-1 73-22-3 I M M K M M M M M I M I M M M M M M M I M M M M M M M K M M M 25 5 1 1 500 500 500 500 500 250 10 25 1 500 500 100 500 500 500 100 1 25 125 25 100 5 500 1 500 25 25 0000 0011 0002 2203 1 101 1 101 1 101 1 101 1 101 0001 0022 0000 0002 1 101 1 101 0220 1 101 1 101 1 101 0000 0002 0055 0275 0055 0220 0011 1 101 2203 1 101 0055 0055 Thursday, December 14, 2000 Page 7 of 13 Urea Vancomycm XYLENE CYANOL PF Xyhtol Yeast Extract Zinc Chloride Zingerone 57-13-6 1404-93-9 4463-44-9 87-99-0 8013-01-2 7646-85-7 122-48-5 Summary for Lbs (83 detail records) Class NON HAZARDOUS (LIQUIDS ) Cname CAS# Glycerol 56-81-5 Summary for Gallons (1 detail record) Class NON HAZARDOUS (SOLID ) Cname CAS# Agar ALBUMIN Arabmose Deuterium Oxide Enoxacm Fructose Gelatin, Nutrient Homoscnne Jasmone Potassium Chloride Sodium Bicarbonate Sodium Chloride Sucrose Summary for Lbs (1 3 detail records) Thursday, December 14, 2000 9002-18-0 9048-46-8 5328-37-0 7789-20-0 84294-96-2 57-48-7 488-10-8 672-15-1 672-15-1 7447-40-7 144-55-8 7647-14-5 57-50-1 K I M M M M M Unit L Unit M M M M I M M I M M M K M 1 2203 250 0001 25 0055 5 0011 500 1 101 100 0220 5 0011 Sum 46411 Quantity Quantity in Gallons 1 0264 Sum 0 264 Quantity Quantity in Lbs. 500 1 101 25 0055 100 0220 5 0011 500 0001 1 0002 500 1 101 250 0001 5 0011 500 1 101 500 1 101 2 4405 500 1 101 Sum 10213 Page 8 of 13 Class OXIDIZER CLASS 1 (LIQUIDS) Cname CAS# Unit Quantity Quantity in Gallons Hydrogen Peroxide Summary for Gallons (1 detail record) Class OXIDIZER CLASS Cname Iodine 7722-84-1 T 1 (SOLID) CAS# Unit 7553-56-2 Summary for Lbs (1 detail record) Class OTHER HEALTH HAZARDS Cname CAS# Acetic Acid, Glacial Alcohol, Reagent Chloroform Dichloromethane DMSO EDTA Ethanol, 200 proof Ethidium Bromide FORMAMIDE - DE1ON1ZED Hexanoic Acid Hydrochloric Acid Isobutanol Isopropanol Methanol Phenol Tnethylamme Triton X- 100 64-19-7 64-17-5 67-66-3 75-09-2 67-68-5 6381-92-6 64-17-5 1239-45-8 75-12-7 142-62-1 7647-01-0 78-83-1 67-63-0 67-56-1 108-95-2 121-44-8 9002-93-1 M 120 Quantity 30 (LIQUIDS) Unit Quantity L L T T T T L T T T T T T L T T T 2 4 500 500 500 500 1 500 100 2 500 500 500 4 100 100 100 0032 Sum 0 032 Quantity in Lbs. 0066 Sum 0 066 Quantity in Gallons 0528 1057 0132 0 132 0132 0132 0264 0 132 0026 0001 0 132 0 132 0 132 1 057 0026 0026 0026 Thursday, December 14, 2000 Page 9 of 13 Summary for Gallons (17 detail records) Sum 4069 Class OTHER HEALTH HAZARDS (SOLID) Cname Ammonium Chloride Ammonium Sulfate Ampicillin Biotin Broth, LB Miller Chloramphemcol Crystal Violet Erythromycin Glutathione IPTG 1PTG Kanamycin Sulfate Lithium Chloride Magnesium Sulfate, Heptahydrate Manganese Chloride MOPS Muscimol Nitnlotnacetic Acid Phenol-Red Broth Base PHENYL-METHYL SULFONYL FLUORIDE Potassium Tetraborate Tetrahydratc Riboflavin Sodium Bisulfite Streptomycin Sulfate SULFOSALICYCLIC ACID Tetracyclmc CAS# 12125-02-9 7783-20-2 69-52-3 58-85-5 130-40-5 56-75-7 548-62-9 1 14-07-8 70-18-8 367-93-1 367-93-1 25389-94-0 7447-41-8 10034-99-8 13446-34-9 1132-61-2 2763-96-4 139-13-9 83-88-5 329-98-6 12045-78-2 83-88-5 7631-90-5 3810-74-0 5965-83-3 60-54-8 Unit M K M I M M M M M M M M M M M K I M M M M M M M M M Quantity Quantity in 1 500 1 25 500 500 100 25 50 10 1 5 10 100 500 125 1 1 100 500 5 500 10 500 100 125 25 Jos. 1 101 2203 0055 0001 1 101 0220 0055 0110 0022 0002 0011 0022 0220 1 101 0275 2203 0000 0220 1 101 0011 1 101 0022 1 101 0220 0275 0055 Thursday, December 14, 2000 Page 10 of 13 Tobramycm Tns Trypan Blue Urea Zinc Chloride 32986-56^ 77-86-1 72-57-1 57-13-6 7646-85-7 M K M K M 5 1 25 1 100 0011 2203 0055 2203 0220 Summary for Lbs (31 detail records) Sum Class UNSTABLE (REACTIVE) CLASS 1 (LIQUIDS) Cname CAS# Unit Quantity Quantity in Gallons Summary for Gallons (2 detail records) Sum Class UNSTABLE (REACTIVE) CLASS 3 (SOLID) Cname CAS#Unit Quantity Quantity in Lbs. Dmitrophenylhydrazme 119-26-6 M 10 0022 Sodium Azide 26628-22-8 M 100 0220 Summary for Lbs (2 detail records) Class SENSITIZERS (SOLID) Cname CAS# Sum Unit Quantity Quantity in Lbs. Summary for Lbs (4 detail records) Class TOXICS (LIQUIDS) Cname CAS# Sum Unit Quantity Quantity in Gallons 17503 Acetic Acid, Glacial Acetonitnle UV 64-19-7 75-05-8 L L 2 4 0528 1 057 1 585 0242 Iodine Lithium Dodecyl Sulfate Tnmethoprim Vancomycin 7553-56-2 2044-56-6 738-70-5 1404-93-9 M M M I 30 25 25 250 0066 0055 0055 0001 0 177 Thursday, December 14,2000 Page 11 of 13 Ethidium Bromide 1239-45-8 Phenol 108-95-2 Tnethylamine 121-44-8 Summary for Gallons (3 detail records) Class TOXICS (SOLID ) Cname CAS# Bromophenol Blue 11 5-39-9 Chloramphemcol 56-75-7 Crystal Violet 548-62-9 Hexadecyltnmethylammonmm Bromide 57-09-0 IM1DAZOLE 288-32-4 Lithium Chloride 7447-41-8 Potassium Hydroxide 1310-58-3 Sodium Bisulfite 7631-90-5 Streptomycin Sulfate 3810-74-0 Tnchloroacetic Acid 76-03-9 Trimethopnm 738-70-5 Zinc Chloride 7646-85-7 Summary for Lbs (12 detail records) Class WATER REACTIVE CLASS 1 Cname CAS# Diethyl Pyrocarbonate 1609-47-8 Summary for Gallons (1 detail record) Class WATER REACTIVE CLASS 1 Cname CAS# Potassium Acetate 127-08-2 Sodium Hydroxide 1310-73-2 T T T Unit M M M M M M M M M M M M 500 0 132 100 0026 100 0026 Sum 0185 Quantity Quantity in Lbs. 5 0011 100 0220 25 0 055 25 0055 100 0220 100 0220 100 0 220 500 1 101 100 0220 500 1 101 25 0055 100 0220 Sum 3 700 (LIQUIDS) Unit Quantity Quantity in Gallons T (SOLID) Unit M M 50 0013 Sum 0013 Quantity Quantity in Lbs. 500 1 101 500 1 101 Thursday, December 14, 2000 Page 12 of 13 Summary for Lbs (2 detail records) Sum 2 203 Class WATER REACTIVE CLASS 2 (LIQUIDS) Cname CAS# Unit Quantity Quantity in Gallons Butyryl Chloride 141-75-3 T 50 0013 Summary for Gallons (1 detail record) Sum 0013 Class WATER REACTIVE CLASS 2 (SOLID) Cname CAS# Unit Quantity Quantity in Lbs. Potassium Hydroxide 1310-58-3 M 100 0220 Sodium Azide 26628-22-8 M 100 0220 Summary for Lbs (2 detail records) Sum 0441 Thursday, December 14,2000 Page 13 of 13 PO BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSU RANGE PU N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE NOVEMBER 2, 2000 POLICY NUMBER CERTIFICATE EXPIRES 333-00 UNIT 0000345 10-1-01 rCITY OF CARLSBAD ATTHi PURCHASING DEPT 2075 LAS PALMAS DRIVE CARLSBAD CA 92009 JOB: ALL OPERATIONS L This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the Califoi nia Insurance Commissioner to the employer named below for the policyjperiod indicatedjQ This policy is not subject to cancellation by the Fund except upon teYi&ays' advance written notice to the employer 30 We will also give you TES days' advance notice should this policy be cancelled prior to its normal expiration This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein Notwithstanding any requirement, term, or condition of any contract or other document v/ith respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies AUTHORIZED REPRESENTATIVE PRESIDENT SMDLOY£R'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,600 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 11/32'00 IS ATTACHED TO AND FORMS A FART OF THIS POLICY, EMPLOYER r GOOD & ROBERTS, INC 2320 COUSTEAU COURT VISTA CA 92083 RB THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCflF 10262 (REV. 3-95) ^I p*c $r~' ^x ^^D \i Q , \P "^VO ^ ^ S Q^i (^ ^.^ £ r ^' \ r\^ ^ & « [ V 1 -\t - •». k\s•~. >H 3° 0•>5 ^3 1S CD -ooeo! Ssooffl^i^;w osSO 3D a || S 3qa i~ H ^3 D Oa ~ m c 5tt w n 2 IT1 Tn o>m^?l*»-1- 01P go ro "-05 SOUO Dm m en o -n !3D rn S > Dm CD m HHg >|— O D W