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HomeMy WebLinkAbout2150 PALOMAR AIRPORT RD; 203; CB161300; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 04-19-2016 Commercial/Industrial Permit Permit No: CB161300 Building Inspection Request Line (760) 602-2725 Job Address: 2150 PALOMAR AIRPORT RD CBADSt: 203 Permit Type: TI Sub Type: IN DUST Status: ISSUED Parcel No: 7602218206 Lot #: 0 Applied: 04/05/2016 Valuation: $54,411.00 Construction Type: 2A Entered By: JMA Occupancy Group: Reference # Plan Approved: 04/19/2016 Issued: 04/19/2016 Inspect Area PlanCheck#: u,a'Oa Project Title: PREMIER JET SPEC SUITE-1,123 S OFFICE TO OFFICE Applicant: Owner: RICHARD AND RICHARD CONSTRUCTION JACKSON SARAH <LF> PALOMAR AIRPORT CENTER LLC STE 100 234 VENTURE ST 7408 AVENIDA DE PALAIS SAN MARCOS CA 92078 CARLSBAD CA 92009 760-759-2260 X325 Building Permit $427.71 Meter Size Addl Building Permit Fee $0.00 AddI Red. Water Con. Fee $0.00 Plan Check • $299.40 Meter Fee $0.00 AddI Building Permit Fee ($60.00) SDCWA Fee $0.00 Plan Check Discount $0.00 CFD Payoff Fee $0.00 Strong Motion Fee $15.24 PFF (3105540) $0.00 Park Fee $0.00 PFF (4305540) $0.00 LFM Fee $0.00 License Tax (3104193) $0.00 Bridge Fee $0.00 License Tax (4304193) $0.00 BTD#2 Fee $0.00 Traffic Impact Fee (3105541) $0.00 BID #3 Fee $0.00 Traffic Impact Fee (4305541) $0.00 Renewal Fee $0.00 PLUMBING TOTAL $51.00 AddI Renewal Fee $0.00 ELECTRICAL TOTAL $89.00 Other Building Fee $0.00 MECHANICAL TOTAL $54.54 Pot. Water Con. Fee $0.00 Master Drainage Fee $0.00 Meter Size Sewer Fee $0.00 Addi Pot. Water Con. Fee $0.00 Redev Parking Fee $0.00 Red. Water Con. Fee $0.00 Additional Fees $0.00 Green Bldg Stands (SB1473) Fee $3.00 HMP Fee ?? Fire Expedidted Plan Review $0.00 Green Bldg Standards Plan Chk ?? TOTAL PERMIT FEES $879.89 Total Fees: $879.89 Total P yments To Date: $879.89 Balance Due: $0.00 FINAL APPAOVAt Inspector: Clearance: NOTICE Reet cE w pt irthst}e "lnth cff, rw&i d1e ais Ieft cxla1iy Jappind cf rerra1 to "f/ecrs.' e ) thys ftun the date Itis nit isa to pttest irrp&n cf tlese fs/ecrs. If y teT yUJ fist fdkwtIe pest pnxiges sat in (hniB1 Code Seta, 20(a), and file ft protest aJ any other rir1 infcsnetcz, th the City ManWfor rig in axrxthte wth Calslai MAcipal Code section 3.32.0. Failure tobnyfdlcwthat pxaite WII bar any aitseqJezit legal action to attack raieA sat aside, \ud, or aiui their inpbcn You are hereby RRfl-€R NOTIFIED t yar nght to pest the SPefiOJ f/cxs IXES NOT PPftYto water and wAer caTsics1 fees and capacity dares nor plannirg, zoring, grading or oUa sirrilar aicatiai processing or service fees in connection wth tils pricJect. NR DOES ITAFRYto any ITE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: PLANNING DENGINEERING DBUILDING DFIRE 0 HEALTH OHAZMAT!APCD Building Permit Application Plan Check No. C3 (300City Est. Value çq i'/, of 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 G~rlsba.cl email: bUildingcarlsbadca.gov Plan Ck.Deposit Date 'j 5' ( , ISwPPP I www.carisbadca.gov JOB ADDRESS 2150 Palomar Airport Road - Suite 203 SUITE#/SPACE#/UNIT# - 203 rp" 213 - 020 - 18 - 00 CT/PROJECT # LOT A PHASE A A BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE 0CC. GROUP J #OFUNITS I J #BEDROOMS I IlA B DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) 1,123sf of Proposed Interior Tenant Improvements for Office I.ise. Spec suite for future leasing. EXISTING USE PROPOSED USE GA RAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING office YES# NOD YES NO I FIRESPRINKIERS YES NOD APPLICANT NAME— . .......... - Glenn Linthicum PROPERTY OWNER NAME - . Palomar Airport Center, LLC ADDRESS ADDRESS 234 Venture Street, Suite 100 2100 Paomar Airport Road CITY STATE ZIP San Marcos Ca 92078 CITY STATE ZIP Carlsbad Ca 92011 PHONE FAX PHONE - FAX 760-759-2260 760-759-2269 . . . ,. EMAIL EMAIL glennrrconstruction.com DESIGN PROFESSIONAL Gary Seward CONTRACTOR BUS. NAME Richard & Richard Construction ADDRESS ADDRESS 234 Venture Street, Suite 100 234 Venture Street, Suite 100 CITY STATE ZIP CITY STATE ZIP San Marcos Ca 92078 San Marcos Ca 92078 PHONE FAX PHONE FAX 760-759-2260 - 760-759-2269 760-759-2260 760-759-2269 EMAIL EMAIL gary(rrconstruction.com ___________________________________________ STATE tiC. # STATE LIC.# CLASS CITY BUS. LIC.# C-24178. 646033 B 1236383 (Sec. (tiul.b uUsiness 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 prOVl5lOfls 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 dollars ($500)). 9111103030 G®D12QOØI) Workers' Compensation Declaration: I hereby affirm under penally of perjury one of the following declarations: 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 ai'd will maintain workers' 6mpensation. as required by Section 3700 of the Labor Codé for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. - Oak River Insurance Policy No. 2200066059-141 ' Expiration Date 112017 This section need not be completed if the permit is for one hundred dollars ($100) or less. []Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to 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 to one hundred thousand dollars (&I00,000), in addition to the cost of compensation, damages as provi ed for in Section 3706 of the Labor code, Interest and attorney's fees. - - CONTRACTOR SIGNATURE— -- [Z]AGENT DATE /l— 2OJ7 O°0(!øi31I) Q O@() I hereby affirm that lam exempt from Contractor's License Law for the following reason: [] I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sate. 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 sate). [1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). El I am exempt under Section _____________Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement Dyes IINo I (have I have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name address! phone! contractors' license number): I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name! address! phone / contractors' license number): I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address! phone! type of work): .PROPERTY OWNER SIGNATURE . . . []AGENT DATE ODO?D ø Is the applicant or future building occupant required to submit a business pta a-vsuNly hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air uafitianagement district? - Yes No - Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes N IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNtETS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address bioGW' ouuu7a: - - .. I certify that l have read the application and state that the above Information is coned and thatthe information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories in height EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shalt expire by limitation and become nut and void tithe building or work authorized by such permit is not commenced within 180 days from the date of such permit or tithe building or work authorize y such permit is suspended or abandoned at any time after the work is commenced fora period of 180 days (Section 106.4.4 Uniform Building Code). .'APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.. ICERTIFI CA TE OF sX4CUPANCY (Comm ercia l P rojects On Fax (760) 602-8560, Email buiIdine@carIsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. 'CO#: (Office Use Only) CONTACT NAME - - OCCUPANT NAME - . ADDRESS BUILDING ADDRESS - . . -. CITY '. STATE ZIP - CITY STATE ZIP - - .Carlsbad .AL CA PHONE .' FAx EMAIL . . OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS , PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) . . CONTRACTOR (On Pg. 1) - - . ASSOCIATED CB# - - MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) . NO CHANGE IN USE / NO CONSTRUCTION - MAIL FAX TO OTHER: - . . .. - CHANGE OF USE/ NO CONSTRUCTION S - - - . - ..APPLICANT'S SIGNATURE . - - - * DATE - I ., . * 'a S . 'F 1..- .5 S S • I ,. - J S .4- $ 'I- S Inspection List PREMIER JET SPEC SUITE-1,123 S Permit#: CB161300 Type: TI INDUST OFFICE TO OFFICE Date Inspection Item Inspector Act Comments 05/23/2016 89 Final Combo - RI AM PLEASE/EMAILING CARD 05/23/2016 89 Final Combo PY • AP 05/17/2016 29 Final Plumbing - RI PM PLEASE/NRR 05/17/2016 39 Final Electrical - RI PM PLEASE/NRR 05/17/2016 39 Final Electrical PY PA 05/02/2016 85 T-Bar PY AP 04/20/2016 84 Rough Combo PY AP Wednesday May 25, 2016 Page 1 of EsGil Corporation In (Partners/lip with government for (Building Safety DATE: 04/15/2016 JURlSDlCTlONTCarlthd7 PLAN CHECK NO.: CB16-1300 SET: I U APPLICANT tJfis. U PLAN REVIEWER U FILE PROJECT ADDRESS: 2150 Palomar Airport Rd. Suite 203 PROJECT NAME: Spec Suite TI The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. LII The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. LI 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. El 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. EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacte Telephone #: Date contacted: ~erson Email: Mail Telephone Fax ciII REMARKS: By: John Le Vey Enclosures: EsGil Corporation LI GA LI EJ [1 MB LI ic 04/07/2016 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax(858)560-1576 Jurisdiction Code Icb IBY Ordinance Bldg. Permit Fee by Ordinance Plan Check Fee by Ordinance ,V Type of Review: E Complete Review El Repetitive Fee El Other Repeats El Hourly EsGil Fee I $423.25 I $275.11I El Structural Only Hr. @ * I $237.021 Carlsbad CB16-1300 04/15/2016 (DO NOT PAY— THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: CB16-1300 PREPARED BY: John Le Vey DATE: 04/15/2016 BUILDING ADDRESS: 2150 Palomar Airport Rd. Suite 203 BUILDING OCCUPANCY: B BUILDING PORTION AREA (Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) TI 54,411 Air Conditioning Fire Sprinklers TOTAL VALUE .1 54,411 / ENGINEERING... V .760-602-2750 . .. .- fl Chris Glassen 760-602-2784 5 V. Christopher.Glassen@carlsbadca.gov fl Linda Ontiveros V 760-602-2773 V Linda.Ontiveros@carIsbadca.gov ValRay Nelson 760-602-2741 VaIRy.NeIson©àarIsbadca.gov FIRE PREVENTION 4 760-602665 .V V Greg Ryan . V 760-602-4663 V V V Gregory.Ryán@carlsbadca.ov V F-1 Cindy Wong 760-602-4662 - V Cynthia.Wong@carlsbadca.gov V fl Dominic Fieri . 4 760-602-4664 - V Dominic.Fieri@carlsbadca.gov V PLAN CHECK Community & Economic X. ,Development Department 174 h) REVIEW CITY OF 1635 Faraday Avenue CARLSPWAID TRANSMITTAL Carlsbad CA 92008 - www.carlsbadca.gov DATE: 04/19/2016 PROJECT NAME: PALOMAR AIRPORT CENTER, LLC PROJECT ID:CB161300 PLAN CHECK NO: 1 SET#: 1 ADDRESS: 2150 PALOMAR AIRPORT RD STE2 APN: 2130201800 V V VALUATION: $54,411 V V V V V V V V V This plan check review is complete and has been APPROVED by: X LAND DEVELOPMENT ENGINEERING DIVISION V V V . Final Inspection by the Construction Management Division is required D Yes No This plan check review is NOT COMPLETE. Items missing or incorrect arelisted on the attached checklist. Please resubmit amended plans as required. V V V V Plan Check Comments have been sent to: GLENN@RRCONSRUCTION.COM V PLANNING 760-602-4610 [I]. Chris Sexton 4 5 V V• 760-602-4624 V . Chris.Sexton@carlsbadca.gov E Gina Ruiz 760-602-4675 Gina.Ruiz@carlsbadca.gov ILl For questions or clarifications on the attached checklist please contact the reviewer as marked above. V V V S S V Remarks: FEES PAID ON C8044152 V V V V t - V V . • V 4 • . . . V PALOMAR AIRPORT CENTER, LLC J. Please make the necessary corrections for Outstanding issues are marked with I1 compliance with applicable codes and standards and re-submit corrected plans and/or' specifications to the Building division. Items that conform to permit requirements are marked with [1711 -or- have intentionally been left blank. 1. SITE PLAN Provide a fully dimensioned site plan drawn to scale. Show: QJ North arrow LJ Existing & proposed structures EJ EZJ Property line dimensions ElI =Easements Show on site plan: EIlI Drainage patterns EJ Existing & proposed slopes Existing topography E1 Retaining Walls (location and height) LIII Indicate what will happen with soil excavated from pool area. 1123 SF SHELL TO Include on title sheet: OFFICE Ellil EZJ Site address 2 E11 17J Assessor's parcel number LJ EJ Legal description/lot number E:J LZJ For all commercial/industrial building and tenant improvements, include: total building square footage with the square footage fore each different use, showing square footage of different uses (manufacturing, storage, warehouse, office, etc.) Example: 10,900 sf of SHELL to 10,900 sf OFFICE 7,000 sf of SHELL to 7,000 sf STORAGE 3,900 sf of SHELL to 3900 sf MANUFACTURING Lot/Map No.: 0823 LOT Subdivision/Tract: Reference No(s): PALOMAR AIRPORT E-37 Page 20f4 REV 6/2012 TI A- r PALOMAR AIRPORT CENTER, LLC 2. GRADING PERMIT REQUIREMENTS The conditions that require a grading permit are found in Section 11.06.030 of the Municipal Code. N/A EJ Inadequate information available on site plan to make a determination on grading requirements. Include accurate grading quantities in cubic yards (cut, fill, import, export and remedial). This information must be included on the plans. If no grading is proposed write: "NO GRADING" Minor Grading Permit required. NOTE: The grading permit must be issued and grading approval obtained prior to issuance of a building permit. A separate grading plan prepared a registered civil engineer must be submitted together with the completed application form attached. Elill Graded Pad Certification required. All required documentation must be provided to your Construction Management & Inspection division inspector, . The inspector will then provide the Land Development Engineering counter with a release for the building permit. See attached checklist for minimum submittal requirements. 3. MISCELLANEOUS PERMITS EJ 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. 1 EIJ A separate right-of-way issued by the engineering division is required for the following: N/A Attachments: [J Engineering Application El Storm Water Form [J Right-of-Way Application/ Info 1Z1Reference Documents E-37 Page 3 of 4 REV 6/2012 THIS CALCULATION WORKSHEET IS NOT ALL-INCLUSIVE OF FEES THAT MAY BE DUE FOR THIS PROJECj*** Fee Calculation Worksheet ENGINEERING DIVISION Prepared by: Date: GEO DATA:LFMZ I B&T: Address: NO FEES PAID ON CB 04-4152 Bldg. Permit#: Fees Update by: Date: Fees Update by: Date: EDU CALCULATIONS: List types and square footages for all uses. Types of Use: Sq.Ft./Units EDU's: Types of Use: Sq.Ft./Units EDU's: Types of Use: Sq.Ft./Units EDU's: Types of Use: Sq.Ft./Units EDU's: ADT CALCULATIONS: List types and square footages for all uses. Types of Use: Sq.Ft./Units ADT's: Types of Use: . Sq.Ft./Units ADT's: Types of Use: Sq.Ft./Units . ADT's: Types of Use: Sq.Ft./Units ADT's: FEES REQUIRED: Within CFD:I71YES (no bridge & thoroughfare fee in District #1, reduces Traffic Impact Fee) UNO 1. PARK-IN-LIEU FEE: EINW QUADRANT UNE QUADRANT OSE QUADARANT EISW QUADRANT ADT'S/UNITS: X FEE/ADT: I 23RAFFIC IMPACT FEE: I ADT'S/UNITS: X FEE/ADT: BRIDGE & THOROUGHFARE FEE: LIDIST. #1 LJDIST.#2 DIST.0 ADT'S/UNITS: X FEE/ADT: I FACILITIES MANAGEMENT FEE ZONE: ADT'S/UNITS: FEE/SQ.FT./UNIT: $ 5. SEWER FEE EDU's I X FEE/EDU: I = BENEFIT AREA: EDU's X FEE/EDU: DRAINAGE FEES: PLDA: EIHIGH EJMEDIUM EILOW, ACRES: X FEE/AC: I = POTABLE WATER FEES: UNITS • I CODE I CONN. FEE I METER FEE I SDCWA FEE I TOTAL PLANNING DIVISION Development Services 41h-> BUILDING PLAN CHECK Planning Division CITY OF APPROVAL 1635 Faraday Avenue CARLSBAD P-29 (760)602-4610 www.carlsbadca.eov DATE: 4/5/16 PROJECT NAME: T.I. PROJECT ID: PLAN CHECK NO: CB161300 SET#: ADDRESS: 2150 PALOMAR AIRPORT RD #203 APN: This plan check review is complete and has been APPROVED by the PLANNING. Division. . By: GINARUIZ .. A Final Inspection by the PLANNING Division is required Yes Z No You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check APPROVAL has been sent to: GLEN N@RRCONSTRUCTION.COM; GARY@RRCONSTRUCTION.COM For questions or clarifications on the attached checklist please contact the following revieweias marked: PLANNING ENGINEERING FIRE PREVENTION 760-602-4610 . 760-602-2750 `760-602-4665 Chris Sexton Chris Glassen Greg Ryan 760-602-4624 760-602-2784 760-602-4663 Chris.Sexton@carIsbadca.gov Christopher.GIassencarIsbadca.gov Gregory.Ryan@carlsbadca.gov Gina Ruiz ValRay Marshall Cindy Won 760-602-4675 760-602-2741 760-602-4662 Gina.Ruiz@carIsbadca.gov ValRay.Marshall@carlsbadca.gov Cynthia.Wong@carlsbadca.gov Veronica moron es Linda Ontiveros DominicFieri 760-6024619 760-602-2773 760-602-4664 Veronica.Morones@carlsbadca.gov Linda.Ontiveros@carlsbadca.gov Dominic.Fieri@carlsbadca.gov - Kemarks: ATTACHED CUP 172 WHICH STATES ONLY AIRPORT RELATED USES ARE PERMITTED AT THIS LOCATION. I Shay Even From: Amber Ressmer Sent: Wednesday, April 06, 2016 1:55 PM To: GLENN@RRCONSTRUCTION.COM Cc: Building Subject: CB161300 Good afternoon Glenn, CB161300 plan does not require Carlsbad Fire Department fire plan review. Thank you, Amber c. Carlsbad Amber Ressmer Fire Prevention Office Specialist City of Carlsbad 1635 Faraday Ave 2J S!b Pc._LS'fl0s Carlsbad, CA CA 92008-7314 www.carlsbadca.ov P 760-602-4665 I F 760-602-8561 1 _5 SAN DIEGO REGIONAL I OFFICE USE ONLY HAZARDOUS MATERIALS RECORD ID # IPLAN CHECK #___________________ QUESTIONNAIRE BP DATE I I Business Name Business Contact Telephone # S'ctWCcvç ç'ir *.pPfrJ9 IPJ(-. cO -Y o - 9 - 00 Project Address 2..1c) 9cio1,- City State Zip Code 1,2-11 I APN# - 1o0 Mailing Address 210 0 I City 21 cov-is b,, State C01 Zip Code 'l241 ) I Plan File# I Project Contact Applicant E-mail Telephone # RI 4 wt- çLLS1 /oL, co 1' co- L/3 - IoO The following questions represent the facility's activities, NOT the specific project description. -Irs IJr-pr I IVII'l I - rI.pr%IJ.,,J IYuPI FIML IJiv.,I..,rd J...I..urMI'4I.. T I..LMOirIMI IJPI ,dicate by circling the item, whether your business will use, process, or store any of the following must contact the Fire Protection Agency with jurisdiction prior to plan submittal. any OT me items are Occupancy Rating: Facility's Square Footage (including proposed project): Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives Compressed Gases 6. Oxidizers 10. Cryogenics 1 ther Health Hazards Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 5. ne of These. Flammable Solids 8. Unstable Reactives 12. Radioactives questions is yes, applicant must contact tile eounty ot San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 110, S Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: YES NO (for new construction-or remodeling projects) D - Is your business listed on the reverse side of this form? (check all that apply). 0 L Will your business dispose of Hazardous Substances or Medical Waste in any amount? 0 t( Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? 0 E' Will your business store or handle carcinogens/reproductive toxins in any quantity? 0 Will your business use an existing or install an underground storage tank? 0 'wr Will your business store or handle Regulated Substances (CalARP)? 0 9 Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? 0 4r Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act). If the answer to any Diego, CA 92123. 0 CalARP Exempt Date Initials 0 CalARP Required Date Initials 0 CalARP Complete Date Initials PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San Diego, CA 92131 apcdcomp(sdcounty.ca.gov (858) 586-2650). [*No stamp required if Q1 Yes and Q3 Yes and Q4-Q6 No]. The following questions are intended to identify the majority of air pollution issues at the planning stage. Projects may require additional measures not identified by these questions. For comprehensive requirements contact APCD. Residences are typically exempt, except - those with more than one building on the property; single buildings with more than four dwelling units; townhomes; condos; mixed-commercial use; deliberate bums; residences forming part of a larger project. [*Excludes garages & small outbuildings.] YES NO 0 E1' Will the project disturb 160 square feet or more of existing building materials? 0 F' Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition. 0 0 (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance Technician? 0 0 (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification may be required 10 working days prior to commencing asbestos removal. 0 1f0'Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet (www.sdapcd.oro/infohfacts/perm its. bdf) for typical equipment requiring an APCD permit. 0 0 (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school boundary. Briefly describe business activities: Briefly describe proposed project: ovirl 16 LA 36 - SP- ctc6 cu'. Ae I declare u er penalty of perjury that to the best of my knowledge and belief tt e responses made herein are true and correct. QLSAIV (-v-TTh ct-' / / ( / 9. Nam wner or Authorized Agent Signature of Owner or Authorized Agent Date FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: FOR OFFICAL USE ONLY: BY: DATE: I / EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMD APCD COUNTY-HMD APCD COUNTY-HMD APCD A stamp in this box only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply. HM-9171 (08/15) County of San Diego - DEH - Hazardous Materials Division 401 ~k CITY OF CARLSD/-%D PLUMBING, ELECTRICAL, MECHANICAL WORKSHEET B-18 Develooment Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov Building@carlsbadca.gov Project Address: Permit No.: - Information provided below refers to work being done on the above mentioned permit only. This form must be completed and returned to the Building Division before the permit can be issued. - Building Dept. Fax: (760) 602-8558 Number of new or relocated fixtures, traps, or floor drains....................................................... New building sewer line? .........................................................................................Yes No Numberof new roof draini7 ............................................ ........................................................... Install/alter water line? ......................................................................................................................... Number of new water heaters? ......................................................................................................... 0' Number of new, relocated or replaced gas outlets? ................................................................... Numberof new hose bibs ...................................................................................................................1 Residential Permits: New/expanded service: Number of new amps: Minor Remodel only: Yes No Commercial/Industrial: Tenant Improvement: Number of existing amps in valved in this project: Number of new amps involved in this project: New Construction: Amps per Panel: SinglePhase ...............................................................Number of new amperes ThreePhase.................................................................Number of new amperes /00 Three Phase 480........................................................Number of new amperes Number ofof new furnaces, A/C, or heat pumps? ............................................................................ New or relocated duct work' .......................................................................... Yes Y No Numberof new fireplaces' ..................................................................................................................4' Numberof new exhaust fanO ................................................................................ 0 Relocate/install vent? ............................................................................................ . .................... ..........._____ Number of new exhaust hoods? ........................................................................................................ 1 Number of new boilers or compressth' ........................................................... Number of HP -- B-18 Page 1 of 1 Rev. 03/09