HomeMy WebLinkAbout2177 SALK AVE; 165; CB072365; Permit10-16-2007
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No
Building Inspection Request Line (760) 602-2725
CB072365
Job Address
Permit Type
Parcel No
Valuation
Occupancy Group
Project Title
2177SALKAVCBADSt 165
Tl Sub Type
2120210300 Lot#
$41 265 00 Construction Type
Reference #
SPEC SUITE 1179SF
INDUST
0
NEW
Applicant
WHITE CONSTRUCTION
STE 100
5937 DARWIN CT
CARLSBAD CA 92008
760931 1130
Status ISSUED
Applied 09/13/2007
Entered By JMA
Plan Approved 09/14/2007
Issued 09/14/2007
Inspect Area
PlanCheck# O1-5S"
Owner
RIO SD PLAZA II MASTER LLC
C/O NEWPORT NATIONAL CORPORATION
1525 FARADAY AVE #100
CARLSBAD CA 92008
Building Permit
Add I Building Permit Fee
Plan Check
Add I Phn Check Fee
Plan Check Discount
Strong Motion Fee
Park Fee
LFM Fee
Bridge Fee
BTD #2 Fee
BTD #3 Fee
Renewal Fee
Add I Renewal Fee
Other Building Fee
Pot Water Con Fee
Meter Size
Add I Pot Water Con Fee
Reel Water Con Fee
$337 77
$000
$219 55
$000
$000
$867
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
Meter Size
Add I Reel Water Con Fee
Meter Fee
SDCWA Fee
CFD Payoff Fee
PFF (3105540)
PFF (4305540)
License Tax (3104193)
License Tax (4304193)
Traffic Impact Fee (3105541)
Traffic Impact Fee (4305541)
PLUMBING TOTAL
ELECTRICAL TOTAL
MECHANICAL TOTAL
Master Drainage Fee
Sewer Fee
Redev Parking Fee
Additional Fees
HMP Fee
TOTAL PERMIT FEES
$000
$000
$000
$000
$751 02
$000
$000
$000
$000
$000
$000
$51 25
$3300
$000
$000
$000
$000
7?
$1 401 26
Total Fees $1 401 26 Total Payments To Date $1 401 26 Balance Due $000
Inspector
FINAL APBROVAL
Date ll-l ( I—f Clearance
NOTICE Please take NOTICE thatapproval 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 capacity
changes nor planning zoning grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave Carlsbad CA 92008
vJS* f • *""At*
iddress (
PROJECT fNFO.
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By
Date
CA
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description
Z\ Z--6ZO-
Lot No Subdivision Name/Number Unit No Phase No 1 otal # of units
^. Proposed UseAssessor s Parcel S
Description of Work
CONTACT WESSON {rf diffewntW*^Ppl"
•go \TE_ PIS City
H Owner iSilAlen^for. Owner
Name Address City State/Zip Telephone #
CONTRACTOR fcCOMPlN¥WAME
(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 ,)lso 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 basi for the alleged
xerriptKjn 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])
fMd FAZ-I <hfrruHiv\ C) t^to toft CMOsfefrP- CA QZtfX 7feQ-73HJ3C
Name
StateLicense # ^7 52> J I O
Jj-C'^J 1S*TWT a>Y~£}
Address
License Class
City
usiness Li
State/Zip
se #
Telephone #
O
CW 7/075 3221
Designer Name U
State License #
Address I~?S City State/Zip Telephone
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
[~1 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
^B—.J have and will maintain workers compensation as required by Section 37.00 of the Labor Code for the performance of the work for whii h this permit is
issued My worker s compensation, insurance carrar and poftcy number are p" I » , _ .
Insurance Company ^-bify ( ftWlQtJi/l fohriW Jt£W»Mf TUWU No (Jl) Q ft /(,? Q ' Z66 ' Expiration Date 0 f "61 ~
thousand dollars ($100 000) in addition to the i!ostsQfV
SIGNATURE ^ \
) as pi ovided for in Section 3706 of the Labor c
DATE
irestand attorney s fees
(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 any manner so as
to become subject to the Workers Compensation Laws of California
WARNING Failure to secure workers compensation coverage\s Hinl^wfulf and sh^ll subject an employer to criminal penalties and civil fines up to one hundred
' " :ion
Vi
I hereby affirm that I am exempt from the Contractor s License Law for the following reason
0 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)
CD 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 contr sctor(s) licensed
pursuant to the Contractor s License Law)
CD 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 CD YES CD 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 / contractor 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 / ph me number / type
of work)
DATE
NO
PROPERTY OWNER SIGNATURE
COMPLET1 THIS SECTION FOR /VO^/?£^OT7MI BUILDING PERMITS ONLY _ " ^ <•-**.
Is the applicant or future building occupant required to submit a business plan acutely hazardous materials registration form or risk management and prevention
program under Sections 25505 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? O YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? f~l YES f~)
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? O YES Q 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
tC^ G)&j«TWc1flON LENDING ^ L7 -^HT" J|P^ ^ ^ '#t*T ^
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code)
LENDER S NAME _ LENDER S ADDRESS
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 TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES
JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT
OSHA An OSHA permit is required for excavations over 5 0 (deep and demolitioruaf-construction of structures over 3 stories in height
EXPIRATION Every permit issued by the building Official undbr\he pr&wsions w this Cede shall expire by limitation and become null and void if the building or work
authorized by such permit is not commenced within 180 days froei jhe datelof such permit onif the building or work authorized by such permit js suspended or abandoned
at any time after the work is commenced fofaperte^ \f 1^0 da$XSectior\)\06 4 \ Uniform (Building Code)
APPLICANT S SIGNATURE DATE
'WHITE File YELLOW Applicant PINK Finance
City of Carlsbad Bldg Inspection Request
For 12/18/2007
Permit* CB072365
Title SPEC SUITE 1179SF
Description
Inspector Assignment PY
Type Tl Sub Type INDUST
Job Address 2177 SALKAV
Suite 165 Lot 0
Location
OWNER RIO SD PLAZA II MASTER LLC
Owner RIO SD PLAZA II MASTER LLC
Remarks
Phone 7605356201
Inspector
Total Time
CD Description
19 Final Structural
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Requested By DEWIE
Entered By CHRISTINE
Act Comments
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp Comments
12/04/2007 39 Final Electrical
11/20/2007 84 Rough Combo
10/22/2007 17 Interior Lath/Drywall
10/15/2007 14 Frame/Steel/Boltmg/Weldmg
10/15/2007 34 Rough Electric
PA PY EMR
AP PY T BAR
AP PY
AP PY
AP PY
IHU uy b» flK CITY OF CARSCBftD FftX NO 760 602 8558
Community Facilities District No 1
NON-RESIDENTIAL CERTIFICATE Non Residential Land
please read this option carefully and be cure you thoroughly understand the options before
signing. The option you chow will affect your payment of the developedVSpecial Tax
assessed on your property this option is available only at the tone of the flrrt budding
permit Issuance. Property owner signature is required before a building permit will be
issued. Your signature is confirming the accuracy of all information shown
hwi- >
N«ne of Owner TelepboM /
•2.11 V
Addteu Project A4&«w
Ctty Stale Zip Coda
67^0
Zip Cod*
AiKMor I Pireel Number or APN tnd Lot Number if not ytt lobdmdM by Comity AtMiiar
plmllAt cited by OnUunce No NS-155 uid adopted by dM City of Cirbbftd, CtUfbnui, tin City i« lutfaorued
to tevy » Specid T» n Community .F^nhtiM Ditmtt No I Att Mt-tMUfetttol ptcptrty, upon (be
(Httinw of • botttof pam* duO k»v«,d» opttoo lo (1) ]My &• S> BClAt DSV*LO>M»rr TAX ONB
TIME or (2) uw» th* ANNUAL SPECIAL TAX DBVBUfrtt PRO?fil«Y ft« • period not to
exeeed rMntyfiv* (25) yeui. PtuM Indtotto your etoiM by lnM»Htt| At ippreprtatt Uw below
I «taet to p»y tbo SPECIAL T
Oae-Tiim Special Tu $
OPTION (I)
OPTION (2)
I DO HEREBY CERTIFY UNDER PENALTY OP PERJURY THAT THBt0flDEftSK)NED 19 THE
PROPERTY OWNER. OP THE SUBJECT PROPERTY AND THAT I UNDERSTAND AND WILL
lSIONS AS STATED
I elect to pay (be SPECIAL DEVELOPMENT TAX ANNUA
exceed^ twnty-Ove (25) ytm. MtJctomim
j / Co^XTiQ* Owner**InMilf
tnitbli
pcn>d not to
SpokUl T«
Till*
Dtn/
The City of Carlibtrf hu iloi Independently verified tike Intbimfttfoii (how* ttov*. Thweibre, we tccept no
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS QUESTIONNAIRE
OFFICE USE ONL>
H#
BP DATE.
SA/M
APCO
Business Name
un.3.
Contact Parson
1^5 5EFF
Telephone
7&0-GO-7-L/Z-5Z.
Mailing Address City
f/s£AbAY AV£ -SurrE.
State Zip Plan File*
Site Address
Aye
City State Zip Plan File#/Permlt#
ZI2 -020-ZS
f ART I. _FIQE DEPARTMENT HAZARDOUS MATERIALS -MANAGEMENT OIVtglQN. 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
circled applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal
1 Explosive or Blasting Agents 4 Flammable Solids 7
2 Compressed Gases 5 Organic Peroxides 8
3 Flammable or Combustible Liquids 6 Oxidizers 9
Pyrophoncs
Unstable Reactives
Water Reactives
10 Cryogenics
1 1 Highly Toxic or Toxic Materials
1 2 Radioactives _
13 Corrosives
14 Other Health Hazards
PART II. SAM DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HFAI TH. HAZARDOUS MATFP'A' s MANAGEMENT DIVISION IHMMD1.
If the enswer to any of the questions is yes applicant must contact the County of San Diego Hazardous Materials Management
Division 1265 Imperial Avenue 3rd Floor San Diego CA 92101 Telephone (6191 338 2222 prior to the issuance of a building
department permit
FEES MAY BE REQUIRED
Yes No
' 3},)s 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 ahy quantity?
Will your business use an existing or Install an underground storage tank?
Will your business store or handle Regulated Substances (CalARP)?
Will your business Use or install a Hazardous Waste Tank System IThlB 22 Article 10!
CalARP Exempt
/
Date Initials
CalARP Required
Date Initials
CalARP Complete
Date initials
P.ART III. SAN DtgGO i ry
If the answer to any of the questions is yes epplicant must contact the Air Pollution Control District 9160 Chesapeake Drive San Di< go CA 92123
Telephone (858) 650-4550 P»<" to the issuance of a building department permit
YES NO,
1 O JO- Wl)l *he 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?
(ANSWER ONLY IF QUESTION 1 IS YES ) Will the subject facility be located within 1 000 feet of the outer boundary of a chool (K through
1 21 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?
the building or structure for which this permit is requested contain any friable asbestos?
D
Briefly describe business activity and proposed project
TENAMT
Name of Owner or Authorized Agent
I declare under penalty of perjury that to the best of my knowledge and belief the responses made herein are true and1 correct
FOR OFFICIAL USE ONLY
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION
BY D8te
EXEMPT OR NO RWTHSS INFORMATION REQUIRED
COUNTY HMMO APCO
naeASeo TOR SUK.OINO PERMIT BUT NOT FOR OCCUPANCY
COUNTY-HMMO APCD
RELEASED FOR OCCUI ANCY
COUNTY-HMMO APCO
County of San Diego
Department ol Environmental Health