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Home My WebLink About2075 CORTE DEL NOGAL; F; CB920385; Permit05/05/92 12 Page 1 of Job Address Permit Type Parcel No" Valuation BUILDING PE -41 1 2075 CORTE DEL NOGAL INDUSTRIAL TENANT IMPROVEMENT 213-061-07-00 18,312 VN R M I T Str- ** Fl Permit No Project No. Development No x ^ A >k S^"G ^7503'05/05/92 OOOi 01 C-PRMT CB920385 A9 201070 02 1838.00 C. tc ^Ilijti uu UJL.UII •"- y t^ v " ccupancy Group B2 Reference* sscription 872 SF/521 OFF/351 WHSE . AUTOMATED COMMUNICATION Appl/Ownr WHITE CONSTRUCTION 6305 CORTE DEL ABETO #100 CARLSBAD CA 92009 A- A* Fees Required *** *** Fees 3 ,920 00 Ad 3 us tmen t s . 0 o Total Fees 1,920.00 T Fee description Building Permit Plan Check Strong Motion Fee Enter 'Number of EDU's > Enter "Y" to Autocalc License Tax > C . P . D . (T1F Fund) , '•..',;. (CFD Fund) Enter Bridge Fee * BUILDING TOTAL Enter "Y" for Plumbing Issue Fee/;>. . • ; Each Plumbing Fixture or Trap > * PLUMBING TOTAL Enter "Y" for Electric Issue Fee > Three Phase Per AMP > * ELECTRICAL TOTAL Enter 'Y' for Mechanical Issue Fee> Install Furn/Ducts > Each Install/Reloc Appliance Vent > * MECHANICAL TOTAL t Status- ISSUED Applied 04/20/92 Apr/Issue 05/05/92 Validated By MDP 619 931-1130 Fees Collected S Credits *** Total Credits: 00 otal Payments: 82 00 Balance Due: 1,838 00 Units Fee/Unit Ext fee Data 198 00 1 0 o c\ n. 2 9 0 0 4 00 .19 418,00 333 00 Y 308 00 129 00 31900 176.00, 176 00 1814 00 •-./••'.•' 7 50 Y 2 2 50 5 00 1300 100 0 Y 100 .50 50 00 60 00 15 00 Y 1 9 00 9 00 2 4.50 9.00 3 3 0 0 FlftydpPROWU. INSpHA-\ MTF^T^- 1 CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr.. Carlsbad. CA 92009 (619) 438-1161 I PliRMll A - LJ Commercial U New Building D Tenant Improvement B - 6il Industrial D New Building ^Tenant Improvement C - D Residential D Apartment D Condo Q Single Family Dwelling O Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home D Electrical D Plumbing D Mechanical D Pool D Spa D Retaining Wall D Solar D Other 2. PROJECT INFORMATION ^ trfc^ ^cTF^j' PLAN CHECK NO. //] <5?2Z£ /EST VAL / 1/ r S_S PLAN CK DEPOSIT &-^- VALID BY /£><r~ DATE ™, M/r£*?/•**? S^y "^ C-PRMT =^02 82-00 FOR OFFICE USE ONLY ute No Nearest Cross Street LEGAL DL'SCklM'loN Unit No Phase No CHECK BLLOW It SUUM11 ILL) Energy Calcs D 2 Structural Gales D 2 Soils Report ^ 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ FT Tl I *J &-"*- I # OF STORIES / 3 CONTACT NAME CITY from applicant; ^^o^b^W ADDRESS STATE C/jft- ZIP CODE V//PXX 4 APPLICANT Q CONTKACTOR U AGENT FOR CON 1 HAL, 1 UK LJOWNLR tj AGENT FOR OWNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE 5 PROPER IT OWNERNAME ADDRESS STATE DAY TELEPHONE 6 CONTRAC1OR NAME toHTTTL- CITY STATE STATE UC # ADDRESS^ SO5 ZIP CODE LICENSE CLASS DAY TELEPHONE ^ 3/ \\~1>O CITY BUSINESS LIC # Workers Compensation Declaration I hereby amrm that 1 have a certificate of consent to self-insure issued by tne Director ol Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab C) INSURANCE COMPANY POLICY NO EXPIRATION DATE Certificate of Exemption I certify that in the performance ol the work lor 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 SIGNATURE DATE 8 OWNEK-BUILDER DECLARATION Owner-Builder Declaration I hereby affirm that I am exempt from the Contractors License Law Tor the ToIIowmg reason D 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) D 1, 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) D 1 am exempt under Section Business and Professions Code for this reason (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, commencing 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 dollars [$500]) SIGNATURE 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 Act7 O YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7 D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO IF AN Y OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS TI IE APPLICANT HAS MET OR IS MEETING HIE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT uoNsinuirnoN U'LNIJINI; AUENCY 1 hcreDy attirm that there is a construction lending agency tor the performance ot the work tor which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME 10 APPLICANT LENDER'S ADDRESS I certify tnat I nave read me application and state that the aoove information is correct I agree to comply with all City ordinances and State laws relating to building construction I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes I ALSO AGRFJ. TO SAVE INDEMNIFY AND KEEP HARMLESS THE OTY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA. An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stones in height Expiration Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code) DATE ^T WHITE File YELLOW Applicant PINK: Finance F l FINAL BUILDING INSPECTION ^CQVEJJ Jjjjy g . ^ \*Of DEPT: BUILDING ENGINEERING \ FIRE '] PLANNING U/M WATER PLAN CHECK*: CB920385 DATE: 05/27/92 PERMIT*: CB920385 PERMIT TYPE: ITI PROJECT NAME: 872 SF/521 OFF/351 WHSE AUTOMATED COMMUNICATION ADDRESS: '2075 CORTE DEL NOGAL SUITE* F CONTACT PERSON/PHONE*: MH/TRAVIS/931-1130 SEWER DIST: CA WATER DIST: CA INSPECTED^ DATE , I BY: C\ . IP cJLcJU_s INSPECTED: ^/"gp^- APPROVED V^ DISAPPROVED _ INSPECTED DATE BY: INSPECTED: APPROVED DISAPPROVED INSPECTED DATE BY: INSPECTED: APPROVED DISAPPROVED COMMENTS: CITY OF CARLSBAD 1 ' INSPECTION REQUEST PERMIT* CB920385 FOR 05/27/92 DESCRIPTION: 872 SF/521 OFF/351 WHSE AUTOMATED COMMUNICATION TYPE: ITI JOB ADDRESS: 2075 CORTE DEL NOGAL APPLICANT: WHITE CONSTRUCTION PHONE: CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: MH/TRAVIS/931-1130 SPECIAL INSTRUCT: STR:** FL:**** 619 931-1130 INSPECTOR AREA MC PLANCK* CB920385 OCC GRP CONSTR. TYPE NEW STE: F INSPECTOR TOTAL TIME: —RELATED PERMITS—PERMIT* TYPE SE920033 SWOW STATUS ISSUED CD 19 29 39 49 LVL DESCRIPTION ST Final Structural PL Final Plumbing EL Final Electrical ME Final Mechanical COMMENTS ***** INSPECTION HISTORY ***** DATE DESCRIPTION 051992 Frame/Steel/Bolting/Welding 051992 Rough/Topout 051992 Rough Electric 051992 Rough Electric 051992 Rough/Ducts/Dampers 051392 Interior Lath/Drywall 050892 Interior Lath/Drywall 050892 Underground/Under Floor 050892 Rough/Topout 050892 Interior Lath/Drywall 050792 Frame/Steel/Bolting/Welding 050792 Rough Electric 050692 Underground/Under Floor ACT AP CO AP CO PA AP PA AP AP PA AP AP NR INSP MPC MPC MPC MPC MPC MPC MPC MPC MPC MPC MP MP MP COMMENTS CEILING GRID COND. DRN.NDS ADQT SUPPRT LIGHT FIXTURES SEE INSP NOTES SEE INSP NOTES REST OF DRYWALL PARTITIONS & PARTIAL DEM WALL SOIL LN WASTE & VENTS LNS SEE INSP NOTES WALLS, SEE CARD ^?H^ NOTICE_ _ _CITY OF CARLSBAD ~ ™ "^^ ~ ~ "^^ ^^~ 438-3550 BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE DATE >?>/? PERMIT NO Co^pk FOR INSPECTION CALL 438-3101 RE-INSPECTION FEE DUE? | | YES FOR FURTHER INFORMATION CONTACT C\ ^Y 1 ( (s ( fr H <-( fe C>_ PHONE BUILDING INSPECTOR CODE ENFORCEMENT OFFICER 2 "I***-DATE JW 6 I / «/ ^- INSPECTOR UNSCHE.PVLEP INSPECTION PERMIT # _ __ PLANCK # JOB ADDRESS f TIME ARRIVE: TIME LEAVE: CD LVL DESCRIPTION ACT COMMENTS PERMITS 6/15/89 CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB920385 FOR 05/19/92 DESCRIPTION: 872 SF/521 OFF/351 WHSE AUTOMATED COMMUNICATION TYPE: ITI JOB ADDRESS' 2075 CORTE DEL NOGAL APPLICANT: WHITE CONSTRUCTION PHONE: CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: MH/TRAVIS/931-1130 SPECIAL INSTRUCT: TOTAL TIME: —RELATED PERMITS—PERMIT# TYPE SE920033 SWOW INSPECTOR AREA MC PLANCK# CB920385 OCC GRP CONSTR. TYPE NEW STR:** FL:**** STE: F 619 931-1130 INSPECTOR STATUS ISSUED CD 14 24 34 44 LVL DESCRIPTION ST Frame/Steel/Bolting/Welding PL Rough/Topout EL Rough Electric ME Rough/ Ducts/ Dampers ACT COMMENTS ***** INSPECTION HISTORY ***** DATE DESCRIPTION 051392 Interior Lath/Drywall 050892 Interior Lath/Drywall 050892 Underground/Under Floor 050892 Rough/Topout 050892 Interior Lath/Drywall 050792 Frame/Steel/Bolting/Welding 050792 Rough Electric 050692 Underground/Under Floor ACT INSP AP MFC MFC MPC MFC MPC MP MP MP PA AP AP PA AP AP NR COMMENTS REST OF DRYWALL PARTITIONS & PARTIAL DEM WALL SOIL LN WASTE & VENTS LNS SEE INSP NOTES WALLS, SEE CARD CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB920385 FOR 05/11/92 DESCRIPTION: 872 SF/521 OFF/351 WHSE AUTOMATED COMMUNICATION TYPE: ITI JOB ADDRESS:2075 CORTE DEL NOGAL APPLICANT: CONTRACTOR: OWNER: WHITE CONSTRUCTION REMARKS: MH/TRAVIS/931-1130 SPECIAL INSTRUCT: PHONE: PHONE: PHONE: INSPECTOR AREA MC PLANCK* CB920385 OCC GRP CONSTR. TYPE NEW STR:** FL.**** STE: F 619 931-1130 INSPECTOR TOTAL TIME: —RELATED PERMITS—PERMIT* SE920033 TYPE STATUS CD 17 LVL DESCRIPTION ST Interior Lath/Drywall SWOW ISSUED ACT COMMENTS #- ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 050792 Frame/Steel/Bolting/Welding AP MP 050792 Rough Electric AP MP 050692 Underground/Under Floor NR MP COMMENTS WALLS, SEE CARD ESGIL CORPORATION 9320 CHESAPEAKE DR , SUITE 208 SAN DIEGO, CA 92123 (619) 56O-1468 DATE JURISDICTION _ PLAN CHECK NO: PROJECT ADDRESS PROJECT NAME SET- T 'Z.o 7 g* Co v&rg X>g APPLICANT LJPLAN CHECKER QFILE COPY QUPS QDESIGNER D 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 codecs when minor deficien- cies identified *B>irLouQare resolved and D D 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 Corp. until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to return to the applicant contact person The applicant's copy of the check list has been sent to Esgil staff did not advise the applicant contact person that plan check has been completed. "| Esgil staff did advise applicant that the plank c ~" been completed. Person contacted- Date contacted- REMARKS (T)(sicm=- OKI A-C To Telephone/ft " £LQQSF JM z By •o S~ '•> •> (\v\ Cr?H-<S.HiRM Enclosures • ESGIL CORPORATION DGA LJCM Date:Jurisdiction Prepared byt yj ItM VALUATION AND PLAN CHECK FEE Q Bldg. Dept. D Esgil PLAN CHECK NO. BUILDING ADDRESS APPLICANT/CONTACT _< BUILDING OCCUPANCY H-L, til lri2-S£W PHONE NO.. DESIGNER PHONE TYPE OF CONSTRUCTION V/-W CONTRACTOR PHONE BUILDING PORTION OPP^ UJVKH5Ht)/JS,Gr Air Conditioning Commercial Residential Res. or Comm Fire Snrinklers Total Value BUILDING AREA <52 \ 6^ *-^-^-^ a^^ c VALUATION MULTIPLIER ^ ^(.(^0 (§ (a @ VALUE = \ 2> ^ I'Z-/ '5,312 Building Permit Fee $ 1 •> <^' u ^ Plan Check Fee $ 1 ^ O '"JO COM MENTS V~mi5" ^ ^N"hLlHHr'>JS.(5 VH^K */ru6TT2> *. LidLH^r^ 5c; r in s $ » UOT&, OC <SUsoTT2.lC.ftt- ;^Ljosn (V ui Y!l. L SHEET OF 12/87 1s T C H E C K 2 N D C H E C /* 3 R D C H E C K an an ana nan BUILDING PLANCHECK ENGINEERING CHECKLIST BZf PLANCHECK NO . Cfg? ITEM COMPLETE i ITEM INCOMPLETE NEEDS YOUR ACTION ITEM SELECTED 52A T PROJECT ID: LEGAL REQUIREMENTS Site Plan 1. Provide a fully dimensioned site plan drawn to scale Show: north arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, right-of-way width and dimension setbacks. 2. Show on site plan: Finish floor elevations, pad elevations, elevations of finish grade adjacent to building, existing topographical lines, existing and proposed slopes, driveway with percent (%) grade and drainage patterns. 3. Provide legal description and Assessors Parcel Number. Discretionary Approval Compliance 4. No Discretionary approvals were required. 5. Project complies with all Engineering Conditions of Approval for Project No. _ . Project does not comply with the following Engineering Conditions of Approval for Project No. _ Date:Conditions complied with by: Field Review I—I 7. Field review completed. No issues raised. '—''—'I—' 8. Field review completed. The following issues or discrepancies with the site plan were found: '—I'—I'—I A. Site lacks adequate public improvements '—I'—I'—I B. Existing drainage improvements not shown conflict with site plan. '—II—'I—I C. Site is served by overhead power lines. or in P \DOCS\MISFORMS\FRM0010 OH REV 02/27/91 I—I I—I I—'D. Grading is required to access site, create pad or provide for ultimate street improvement. '—' '—'I—'E. Site access visibility problems exist. Provide onsite turnaround or engineered solution to problem. F. Other: Dedication Requirements D l—I1—'9. No dedication required, 1—' '—I '—' 10. Dedication required. Please have a registered civil Engineer or Land Surveyor prepare the appropriate legal description together with an 8V x 11" plat map and submit with a title report and the required processing fee. All easement documents must be approved and signed by owner(s) prior to issuance of Building Permit. The description of the dedication is as follows: Dedication completed, Date By:. Improvement Requirements '—' '—' 11. No public improvements required. SPECIAL NOTE; Damaged or defective improvements found adlacent to building site must be repaired to the satisfaction of the Citv inspector prior to yccupancy. '—''—''—'12. Public improvements required. This project requires construction of public improvements pursuant to Section 18.40 of the City Code. Please have a registered Civil Engineer prepare appropriate improvement plans and submit for separate plancheck process through the Engineering Department. Improvement plans must be approved, appropriate securities posted and fees paid prior to issuance of permit. The required improvements are: Improvement plans signed, Date:___ by:. P \OOCS\MISFORMS\FRM0010 ON «V 02/27/91 '—' 13. Improvements are required. Construction of the public improvements may be deferred in accordance with Section 18.40 of the City Code. Please submit a letter requesting deferral of the required improvements together with a recent title report on the property and the appropriate processing fee so we may prepare the necessary Future Improvement Agreement. The Future Improvement Agreement must be signed, notarized and approved by the City prior to issuance of a Building Permit. Future Improvement Agreement completed, Date: By: 7 I—II—I-i—11—i 13a> inadequate information available on site plan to make a determination on grading requirements. Please provide more detailed proposed and existing elevations and contours Include accurate estimates of the grading quantities (cut, fill, import, export). '—''—' 14. No grading required as determined by the information provided on the site plan. '—' '—' '—' 15 Grading Permit required. A separate grading plan prepared by a registered Civil Engineer must be submitted for separate plan check and approval through the Engineering Department. NOTE; The Grading Permit must be issued and grading substantially complete and found acceptable to the Citv Inspector prior to issuance of Building Permits. Grading Inspector sign off. Date: by: Miscellaneous Permits Right-of-Way Permit not required. Right-of-Way Permit required. A separate Right-of-way Permit issued by the Engineering Department is required for the following: 1—' '—' '-—' 18. Sewer Permit is not required.an 19. Sewer Permit is required. A sewer Permit is required concurrent with Building Permit issuance. The fee required is noted below in the fees section. LJ LJ LJ 20. Industrial Waste Permit is not required. P \OOCS\H1 SFOWt$\F«*0010 ON KV 02/27/91 ' ' I !I. ! 1 J 21. Industrial Waste Permit is required. Applicant must complete Industrial Waste Permit Application Form and submit for City approval prior to issuance of a Building Permits. Permits must be issued prior to occupancy Industrial Waster Permit accepted - Date: By: " D D a a Fees Required 27. 23, 24, 25, 26. 27, Park-in-Lieu Fee Quadrant: Fee per Unit:. Total Fees: Traffic Impact Fee Fee Per Unit:* Pi _ Total Fee- dp24-r) » Bridge and Thorough fare Fee Fee Per Unit:Total Fee: Public Facilities Fee required. 2JDC^ /3 Facilities Management Fee Zone:. Sewer Fees Permit. No. Fee EDU's Benefit Area;Fee:; 320-44 28. Sewer Lateral Required:. Fee: 1444 29. REMARKS: ENOINEERINQ AUTHORIZATION TO I88UB PERMIT BY i DATE J: 4 P \DOCS\MISFORMS\FRM0010 OH REV 02/27/91 PLANNING CHECKLIST Plan Check No 92~3%f Address .2 °7^ Cor**- Del Planner Xxa/.^ t<i c^ Phone 438-1161 ext (Name) APN Type of Project and Use a a ao o o *- ry ro * * *-X Jt Jrf 4) 00 4) .C .C .C»U (J U C C Co o a Zone (/-VM Facilities Management Zone J Legend LLJ Item Complete Item Incomplete - Needs your action 1, 2, 3 Number in circle indicates plancheck number where deficiency was identified Environmental Review Required YES NO XTYPE DATE OF COMPLETION Compliance with conditions of approval7 If not, state conditions which require action Conditions of Approval D D Discretionary Action Required YES NO APPROVAL/RESO NO DATE PROJECT NO OTHER RELATED CASES Compliance with conditions of approval7 If not, state conditions which require action Conditions of Approval D D California Coastal Commission Permit Required YES NO J DATE OF APPROVAL San Diego Coast District, 3111 Camino Del Rio North, Suite 200, San Diego, CA 92108-1725 (619) 521-8036 Compliance with conditions of approval7 If not, state conditions which require action Conditions of Approval D Landscape Plan Required YES NO See attached submittal requirements for landscape plans Site Plan Zoning nan a a npfr 3 4 Provide a fully dimensioned site plan drawn to scale Show North arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, nght-of-way width and dimensioned setbacks Show on Site Plan Finish floor elevations, elevations of finish grade adjacent to building, existing topographical lines, existing and proposed slopes and driveway Provide legal description of property Provide assessor's parcel number Setbacks Front Int Side Street Side Rear ^ 2 Lot coverage /|~ 3 Height 4 Parking Additional Comments Required Required Required Required Required Required Spaces Required Guest Spaces Required Shown Shown Shown Shown Shown Shown , / 1^ >/// Shown /7J/ Shown OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTE DATE PLNCK FRM City of Carlsbad 92099 Fire Department • Bureau of Prevention Plan Review: Requirements Category Building Plan Check Date of Report Tuesday, April 21,1992 Reviewed by Contact Name Robert Plant Address 2385 Camino Vida Roble City, State Carlsbad CA 92009 Bldg Dept No 92-0023 Planning No Job Name Automated Commumcat Job Address 2075 Corte Del Nogal 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 modifica- tions, must be reviewed by this office to insure continued conformance with applicable codes Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to construct or install improvements Disapproved - Please see the attached report of deficiencies Please make corrections to plans or specifications necessary to indicate compliance with applicable codes and standards Submit corrected plans and/or specifications to this office for review For Fire Department Use Only Review 1st 2nd 3rd Other Agency ID CFD Job# 92099 File# 2560 Orion Way • Carlsbad, California 92008 • (619) 931-2121 HAZARDOUS MATERIALS QUESTIONNAIRE Business Name txirtD M Contact Person <ZsrtHMLWflCA4>T2rt}J Telephone PART I. FIRE DEPARTMENT HAZARDOUS MATERIALS MANAGEMENT DIVISION. OCCUPANCY CLASSIFICATION Indicate by circling the item whether your business will use process or store any of the following hazardous materials If any of the items are checked off applicant must contact the Fire Department Hazardous Matenals Management Division 525 8 Street Suite 705 San Diego CA 92101 Telephone (619) 533 4400 prior to plan submittal 5 Organic Peroxides 10 Cryogenics 6 Oxidizers 11 7 Pyrophoncs 8 Unstable (Reactive) Matenals 9 Water Reactwes 1 Explosive or Blasting Agents 2 Compressed Gases 3 Flammable or Combustible Liquids 4 Flammable Solids Highly Toxic or Toxic Matenals 12 Radioacbves 13 Corrosives 14 Other Health Hazards HAZARDOUS MATERIALS MANAGEMENT DIVISION.PART II. COUNTY OF SAN DIEGO HEALTH DEPARTMENT CONTINGENCY PLAN REVIEW If the answer to any of the questions is yes applicant must contact the County of San Diego Hazardous Matenals Management Division 1255 Imperial Avenue 3rd floor San Diego CA 92138 Telephone (619) 338-2222 prior to the Issuance of a building permit YES NO (FEE MAY BE REQUIRED) 1 I *L^ Is y°ur business type listed on the reverse side of this form' 2 I _-^\ Will your business dispose of Hazardous Substances or Medical Wastes in any amount' 3 I I \^^ Will your business store or handle Hazardous Substances in quantities equal to or greater than 55 gallons 500 pounds or 200 cubic feet ^^ of compressed gas' 4 I I U^H Will your business use an existing or install an underground storage tank? 5 I I L^J Will your business store use or handle carcinogens reproductive toxins or Acutely Hazardous Matenals' 6 I I L^J Will your business be located within 1 000 feet from the outer boundary of a school and handle Acutely Hazardous Matenals' PART III. SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT If the answer to any of the questions is yes applicant must contact the Air Pollution Control Distnct 9150 Chesapeake Dnve San Diego CA 92123 Telephone (619) 694 3307 prior to the Issuance of a building permit YES NO Will the intended occupant install or use any of the equipment listed on the Listing of Air Pollution Control Distnct Permit Categones on the reverse side of this form' (ANSWER ONLY IF THE ANSWER TO QUESTION 1 IS YES ) Will the subject facility be located within 1 000 feet of the outer boundary of a school (K thru 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 Pnvate School Directory compiled in accordance with provisions of Education Code Section 33190' Briefly describe nature of the intended business activity Name of Owner or Authonzed Agent / Signature of Owner or Authorized Agent I declare under penaltv of penury that to the be«t of my knowledge and belief the responses made herein are true and correct , Date DO NOT WRITE BELOW THIS LINE / // ( FIRE DEPARTMENT OCCUPANCY CLASSIFICATION BY Date EXEMPT FROM PERMIT REQUIREMENTS COUNTY HMMD APCD APPROVED FOR BUILDING PERMT BUT NOT FOR OCCUPANCY COUNTY HMMD APCD APPROVED FOR OCCUPANCY COUNTY HMMD APCD APCD (10 90) COMMERCIAL/INDUSTRIAL APPLICATION FORM FOR INDUSTRIAL HASTE DISCHARGE PERMIT CITY OF CARLSBAD APPLICATION: NEW (CHECK ONE) REVISED BUILDING P C. NO. APPLICATION NO. BY; SignaturB-W City Representative INDUSTRIAL CLASS. 5< / DATE; APPLICATION FOR INDUSTRIAL WASTE DISCHARGE PERMIT A. GENERAL. APPLICANT; SITE TYPE OF BUSINESS;I I APPLICANT'S ADDRESS '.WbrJllVO &FVn^ g /? ' B. HASTES AND PROCESSING. (Check where applicable) Domeatic Haate Only |~| Industrial Haate \~\ Induatrial Waste NOT Discharged to Sewer Discharged to Sewer GENERAL DESCRIPTION OF HASTE (Chemical and Physical Characteristics of proposed waste). _ ' GENERAL DESCRIPTION OF PROCESS (If Applicable) 6 <*-*, UA^nft Hcnt^fr / -?f C. HASTES TO"6E DISCHARGED TO SEHER. TREATED.WASTE. (Check One)UNTREATEDT QUANTITY (Daily) / 4-71 *, f AVERAGE MAXIMUM GPD GPD (Gallons Per Day) APPLICANT OR REPRESENTATIVE OF FIRM- T ITLE • SIGNATURE; (Print) DATE-