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2180 RUTHERFORD RD; ; CB110757; Permit
/ ( ., City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-07-2011 Commercial/Industrial Permit Permit No: CB110757 Building Inspection Request Line (760) 602-2725 Job Address: 2180 RUTHERFORD RD CBAD Permit Type: Tl Sub Type: INDUST 0 NEW Parcel No: 2120702500 Lot#: Status: Valuation: $10,537.50 Construction Type: Applied: Occupancy Group: Reference #: Entered By: Project Title: CALLAWAY: 250 SF DATA ROOM Applicant: ANDREW TARANGO SMITH CONSUL TING 12220 EL CAMINO REAL STE 200 92130 858-793-4 777 Building Permit Add'! Building Permit Fee Plan Check Add'! 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'I Pot. Water Con. Fee Reel. Water Con. Fee Green Bldg Stands (SB:!_473) Fee Fire Expedited.Plan Review $126.91 $0:00. $82.49 $0:00 $0.00 $2.21 $0.00 $0.00. $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $1.00 $0.00 Plan Approved: Issued: Inspect Area: Plan Check#: Owner: CALLAWAY GOLF CO 2180RUTHERFORO RD CARLSBAD CA 92008 Meter Size : .. ' Add'I -Recl. 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 ISSUED 04/12/2011 JMA 06/03/2011 06/03/2011 Total Fees: $344.11 Total Payments to Date:· $344.11· Balance Due: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 $85.00 $19.50 $0.00 $0.00 $0.00 $0.00 ?? $344.11 $0.00 Inspector: ~ FINAL A~fROVAL Date: "111 /;; 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 •te·estexactions." 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 vou have oreviouslv been aiven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exnired. - «t<JP; ¥' CITY OF CARLSBAD JOB ADDRESS Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax 760-602-8558 www.carlsbadca.gov SUITE#/SPACE#/UNIT~ · Plan Check No. Est. Value Plan Ck. Deposit Date ~ /"2,,{ l SWPPP APN 010 -2S 00 CT/PROJECT# L\)T# PHASE# . ·# OF UNITS # BEDROOMS #BATHROOMS T!aNi\NT B\JSINESS N_AME CONSTR. TYPE OCC. GROUP .. c;allc;1way ~olf V-B B,i=,S DESCRIPTION OF WORK: Include ·square Feet of Affected Alea(s) -Cottstruct_a 2_50 s.f. iDF (data) room arid ass.oci_ated UPS room within an existjng tilt-up concrete building. Assc;u:ia·~ed_ '1l~~ll~nic~I, plumbing and el~_ctrical ,nch,1ded. EXISTl~G 1,1$E P~OPOSl;D U!!E . GARAGE (SF) PATIOS (SF). DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS . . . ~1, t='i, $1 . . 81, F1, ~1_ . .. .. YESQ. No[ll YES[{JNoO YES[{JNoO CONTACT NAME (If Different Fom App/leant) · APPLICANT NAME Andrew Tarango-Smitll Consulting Ard,. ADDRESS ADDRESS . . 1.2220 .el Camino Re.al, Suite 200 CITY STATE ZIP CITY STATE ZIP S~n l)ieqo CA 92130 PHONE. FAX -PHONE FAX · J8S8l 79'3.,.47T1 . (~58) 793-4787 EMAIL PROPERTY OWNER.NAME ADDRESS CITY STATE ZIP . Carlsbad ·.CA. ..920 PHONE FAX (760) 931-,J771 .. .(760) 9.30 .. 53.50 EMAIL ·mi,kem_c;t@ca:liawaygo]f.com, eds@cail.awaygQlf . ARCH/DESIGNER NAME & ADDRESS ~TATE,1,IC. # :Ch~rvl D.:Smitn~12220:El.Camino'Rea. . .CU.1:01 (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to const ct, alter, improve, demolish or repair anl structure, prior to its issuance, also requires the applicant.for such permit to file a signed statement tnat he Is licensed pursuant to the provisions o e 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 exempt, y violation of Section 7031.5 by any applicant for a permit subjects the applicant to a 11 penalty of riot more than five hundred dollars ($500)). . · --------~-----------------------~ ,l ,', j' • ,c /•1, ! '>!'..', Workers' Compensation Declaration: / hereby affirm under penalty of pe,juf}' one of the following declarations: O-1 have.and will maintain a certificate of consent to self-Insure for workers' compensation as provideg by Section 3700 of the Labor Code, for the perfonnance of the work for which this pennit is issued. D I have and will maintain work , _nsat_ion as._req . ~ction 3709 of (he L!]bof Cod~, for the _pe[fonn~f ~ JP~Y>'~ for ~!J-tP,is Pr~S$ued. My wor~e~' compens:r !!~carrier and policy number are: Insurance Co --. , ·. .. ·. Polley.No. (!JJJ:Jttf,l ;>V~ '-f} /~ . · Exp1rat1on Date -f._,'/,_ _ _,,f-,_. ____ _ This section need not !Je completed if the pennit is for one hundred dollars ($1CXl) or less. 0 Certificate of Exemption: I certify thatin the perfonnance of the work for which this pennifis Issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for Ins· ·on 3706 the Labor code, Interest and attorney's fees. ' ,k$ CONTRACTOR SIGNATURE -~ila~ii~ 0AGENT DATE < ~ ' ', ;, ' I hereby affimi that I am exempt froin Contractor's Ucense Law for the following reason: D I, as·owner of the property or my employees with wages as their sole compensation,will do the work and the structu"re is notintended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors 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 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors 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 Contractors License Law). o· 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. DY es ONo 2. I (have / have not) signed an application for a building pennit for the proposed·work. 3. I have contracted with the foilowing person (firm) to provide the proposed construction (include name address I phone/ 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/ 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/ type of work): ,k$ PROPERTY OWNER SIGNATURE 0AGENT DATE Is the applicant or future building occupant required to submit a business~, 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? D Yes LJNo Is the applicant or future building occupant required to obtain a·permit from the air pollution control district or.a!Llll!ality management district? OYes D No Is the facjlity to be constructed within-1,000 feet of the outer boundary of a school site? OYes LJNo I_F 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. I hereby affirm that there is a construction lending agency for the performance of the work·this permiUs issued (Sec. 3097 (i) Civil Code). I certify that I have read the application and state that the above lnfonnatlon is correct and that the Information on the plans is accurate. I agree to comply with all Cify ordinances and State laws relatingto building construction. I hereby authorize representative of the City of Carts bad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SA VE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENS~S WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over Sfi deep and demolition or construction of stiuctures over 3 stories in height. EXP/RATION: Every permit i~ued qy the Building Official under the provi · ns 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 180-days from the date of such permit or if the building or work autho · by such permit is suspended or abandoned at anytime after the work is commenced for peri of 180 days (Section 106.4.4 Uniform Building Code). R$ APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For:. 07/06/2011 Permit# GB110757 Inspector Assignment: TP Title: CALLAWAY: 250 SF DATA ROOM Description: --- Type:TI Job Address: Sub Type: INDUST 2180 RUTHERFORD RD Phone: 8585181559? Suite: Lot: 0 Location:· APPLICANT ANDREW TARANGO Owner.: CALLAWAY GOLF CO Remarks: a m please Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Act Comments L1:f!_. Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# NEW SEISIMIC CALCULATIONS; Inspector: L Requested By: BUTCH Entered By: CHRISTINE PCR.00003 ISSUED PCR01025 ISSUED PCR07105 ISSUED CALLAWAY-REV FLOOR/CEILING; ANCHORS -SEISMIC CALLA WAY GOLF; MECHANICAL REVISIONS PCR08067 ISSUED CALLAWAY-DEFERRED SUBMITTAL; PARKING STRUCTURE ST AIRS PCR08112 ISSUED CALLAWAY-DEFERRED STAIRS; SUBMITTAL PCR09035 WITHDRAW CALLAWAY GOLF HEADQUARTERS; APPLICANT WITHDREW PCR09069 ISSUED CALLAWAY-ADD COMPOUNDING LAB; ELIMINATE DAT A CENTER & MULTIPLE 0 SWPP0712 APPROVED CALLOWAY GOLF; Inspection History Date Description Act lnsp Comments 07/Q1/2011 89 Final Combo NR TP 06/30/2011 89 Final Combo NR TP 06/23/2011 84 Rough Combo AP PD TSAR 06/13/2011 14 Frame/Steel/Bolting/Welding AP TP 06/13/2011 34 Rough Electric AP TP WALL FLEX,TAILS AT HARD CLNG Inspection List Permit#: CB110757 Date Inspection l!em 07/06/20-11 89 Final Combo 07/06/2011 89 Final Combo 07/01/2011 89 Final Combo 06/30/2011 89 Final Combo 06/30/2011 89 Final Combo 06/23/2011 84 Rough Combo Type: Tl 06/13/2011 14 Frame/Steel/Bolting/Weldin 06/13/2011 34 Rough Electric 06/13/2011 44 Rough/Ducts/Dampers 06/09/2011 17 Interior Lath/Drywall Thursday, July 07, 2011 INDUST lnspe~tor Act RI TP AP TP NR RI TP NR PO AP TP AP TP AP TP AP TP AP CALLAWAY: 250 SF DATA ROOM Comments am please PM PLEASE TBAR WALL FLEX TAILS AT HARD CLNG DUCT IN HARD CLNG Page 1 of 1 It Clb 11 Carlsbad · Flnal Bulldlna Inspection Dept: Building Engineering Planning CMWD St Lite ,Eiml Plan Check #: Permit#: CB110757 Project Name: CALLAWAY: 250 SF DATA ROOM Address: Contact Person: Sewer Dist: 2180 RUTHERFORD RD BUTCH MILLER CA Phone: 8585181559 Water Dist: CA Date: 06/30/2011 Permit Type: TI Sub Type: INDUST Lot: 0 ··················································•······························•········································································ ln~pectedA (JV'\. b By. ~# ... - Inspected · Date 1 _ /1 ,,.../i, Inspected:~ Approved: Date ~isapproved: __ By: __________ Inspected: _____ Approved: ___ Disapproved: __ Inspected Date By: Inspected: ____ .,.-Approved: __ Disapproved: __ ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• ,i,,, •••••••••••••••••••••••••••••••••••••••••••••••••••••••••• , Comments: ______________________________ _ ... EsGil Corporation In <Partner~liip witli qo11emment fo_r <Bui{ain9 Safety PATE: 5/26./11 JURISDICTION: City of Carlsbad PLAN CHECK NO.; ·11-0757 PROJECT ADDRESS: 2180 Rut~erford Rd PROJECT NAME: Callaway Golf...:. TI . . SET:111 D The plans transmitted herewit~ have been corrected where necessary and substantially comply with the jurisdiction's codes·. ~ The plans transmitted herewith. will substantially comply with the jurisdiction's building codes when minor deficiencies identified in the remarks below are resolved and checked by building department staff. D The plans transmi_tted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. D The check list trar,ismitted herewith is for your information. The plans are being held at Esgil Corporation. until corrected plans are submitted for recheck. D · ihe applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. · D The applicant's copy of the check list has been sent to: -~ Esgil Corporation staff did not.advise the applicant that the pl~n check has been completed. D Esgil Corporation staff did advise the applicant that the plan check .has bee_n co_mpleted. Person contacted: Telephone#: Date contacted: (by: ) Email: Fax#: Mail Telephone Fax In Person lZJ REMARKS: Applicant to slip sheet the revised sheets to the City sets ~nd provide a complet~ Special Inspection Agreement form to the City. By: Doug Moody EsGil Corporation D, GA D EJ D PC Enclosures: .5/20111 9320 ~hesapeake Drive, Suite 208 + San Diego, California 92123 · + (858) 560-1468· + Fax (858) 560-1576 EsGil Corpo.rati·o.n jn (Partnersliip ,witfi government for cJJui(aing Safety DATE: 5/12/11 JURISDICTION: City of Carlsbad PLAN CHECK NO.: 11-0757 PROJECr ADDRESS: 2180 Rutherford Rd PROJECT NAME: Callaway Golf -TI SET: II 1:1 APPLICANT CO:J@P 1:1 PLAN REVIEWER 1:1 FILE D The ·plans transmitted herewith h~ve been corrected where necessary and substantially comply with the juri'sdiction's codes. D The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. D The plans transmitted herewith have sigD"ificant deficiencies identified on the enclosed check list and should ·be corrected and resubmitted for a complete _recheck. ~ rhe check list transmitted here~ith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. D The applicant's copy of the check list is enclosed for the juri$diction to forward to the applicant contact person. ~ The applicant's copy of the check list has been sent to: Smith Consulting Architects/ Andrew Tarango 12220 El Camino Real Suite 200, San Diego, CA 92130 D Esgil Corporation staff did not adv,ise the applicant that the plan check has been completed. ~ Esgil Corporation st~ff did advise the applicant that the plan check has been completed. Person contacted: Andl~IP,W Taf~_go Telephone#: 858-793-4777 · Date contacted:6'/12-/( /( _ £!'7)· E~ail: ~ndrew@sca-sd.com Fax #: 858-793-4787 ~ail( Telephone Fa lh Person . . D REMARKS: By: Doug Moody EsGil Corporation D GA D EJ D PC Enclosures: 5/9/11 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576 City of Carlsbad i 1-0757 . · r .l··S/12/11 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 submitte~ in one of two ways: · 1. Oeliver 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 i:md 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 Depar:tments. 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. 2. Please provide plans and calculations signed by the California State licensed engineer or architect for the structural support of the 750# rooftop air handler unit. Include all calculations and finding on the plans. Please include the California license number, seal, date of license expiration and date plans are signed. Business and Professions Code. Please cor"rect detail 2 on sheet S-1 to show 6x4x1/4 rs between tt,e tnJ$Ses, ciarify the cover sheet to show field welding for the support of the new 15 ton HVAC unit and complete the included Special l_nspection Agreement for the City of C~rlsbad. Please provide the complete MECH-1 C energy-design for the change from a 4 ton unit serving 300$f to a 15 ton unit serving 300sf? 4. Please provide the listing and ir:istallation· information for the UPS system. Please imprint on th~ plans the manufacturer's name and model number. ~lease provide the manufacturer's installation information. 10. Please clarify the LTG-3C form to indicate why the area category for retail is used? Please correct the L TG-3C form the total area of improvement is 296sf and the space is not Qsed for retail .. To speed up the review process, note o,n this list (or a copy) where each correction item has been a_ddressed, i.e., plan sheet, note or detail number, calculation page, etc. Please indicate here if a_ny changes have been made to the plans that are not a result of corrections from this list. ·1f there are other changes, please briefly describe them and where they are located in the plans. Have changes been made to the plans not resulting from this correction list? Please ·indicate: City of Carlsbad 11-0757 .. -' 5/12/11 J"he jurisdiction has contracted with !=sgil Corporation located at 9320 Chesapeake Drive, Suite 20g, San Diego, California 9212_3; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review.items, please contact i>oug Moody at Esgil Corpor~tion. Thank you. City of Carlsbad 11-0757 5/12./11 Development Servfcec-s . Building l;)ivi~ion 16~ Faraday'Avenue: 700;-60?-2719 · wwv,-.carlstiacica.gov In accordance with. Chapt~r--17' of.tl~eiC·a·i,t~~ni~;EJull1ll1rgi€~tle•tlnit&ll ~wing<!1lllsf,be,com11'lete-tfwh 1m work-bei1~g performed · recjidr~ spe_clai lospect/~n,$ti'Uct1_11:ai_ o_bS,tl!V?itioinlmJ c;p-.ns.:tru.~t_io(l-n~.ateria1 testing. · · · · PreJectf Permit: _________ ProJeitt-Ai;!dt~ss;_,-----,----___,--------- A.. TH iS. ·sE01QN, M~ST:B~· toMi>l.EtEp .BY'THt P.~OPJ:RlY ;9WN~R[AUTHORIZE-D. A~~NT,.Ple ase check if you· are ·owner- Builder CJ. (l_f ·you cha.eked .as owne.r-builder you.must-also,comp lefe: Secfion.B-of. tnis·a greement) · Narrre:;(Pl~t!~~-P,.rli:11,_· ____ .....___. __ '----'---------------------if.i~f . (1,1.,1) {l,al~ tvfalli.t:iQ:Ar:1dres ... · __ . _______ --'-___ ~--'--------------------- Ema11·_ -----------~~-----'-------------· .P!:ione; _________ - i .am :the: tJ Rrqperty OWrf~'r ·CJP ropertt6w:t1et's Agent.10_f.R8G.O(d-CJArchitett,of R'ecorcL GJEr:ig1neer-orRee0rd Stateoft,:11ifornia:fie.gJstrati9n N'l.ilm$e ·. · · . . . Expiration o·ate:_.c,_. ___ .....,.... ___ AG'REBM~Nt: }lj;the qMe~slgt')~'d,; de'olarifl.if1der-l·p~6alt/of p'erjury-uni:ler'tHe laws--of.the· 'state of Ca!ifor,nlar. tiiat _i . nave, rea·d ,. understaf'.ld:,' at knQ'Wreage a11d; prom1s·e,:_to_ o_om p!Y,·-w1th-the City :Of Carlsbad reqwlrem ents for ·special inspections., .structural observi;ltrons.;.<eQn,str-uttion-m at'erlals-'testirifl and off0 s ite_-f.abritatlon of. bul !ding components,, as pre.scr-lbed in the statem erit of s_peclal ins pectlons0noted ,on-.-the apP.roved plans ·and, as required b'y. the California Buildln~ Code, · · Si~natµre,,.·: ____ ---'--------'-----'---------'· Date: __________ _ · B. <;:Ot:fIRACTOR'S $1'ATE; MEf!T;ofRE$i>.ON.~fBILl'.JY i(D7 .¢BC ,.:dhj'o/, section 170(3). this section must oe com J;Jlet:ed by the contractor tbul!der i owner-ouffd'er. Contr:acto(s·cornpc)nyNam_ets..-_· -'--"-----'----"'--------'P!ease ctleddfyou are Oviner-BL!ilcler c:] Na.me: (Please.print). _____ ......;..·..,,,..~'-----,-.-'--...,.....,.-"------,---,-~------~-__,,.------- Q'lrf:9 . :(IJ;I~ /,).a'~ Ma.lll.n~.-Atidr~·$s1· _ _,__.,___ ___ _._--=--------------------......;..------......;..----------- Em~it . ...,. ·_· --------,---------'-----'------··Rbo.he; _________ ~ Stat~ or:6~utornra-6on·tkaot0ls:i2it.ense-N.afrft.fefd .. , Expiration bate:-______ _ .• i a¢kriowieog&;a~a-,.qfn, aW~fe)if::speda(fotjulr:err\'~nfs-cor.itained'.ln. the. statement Of special in~pectioris noted on.tt;'ie cJPJ'.lrovetl plans.;: . , · . . ... · • 1: acknow.l¢dg~:tf:lat control wlll i;ie exercise·d,fo obtaJr,i..conform a nee wRh-the construttion-'docum erits · approve1;fby the 'buil'dil'J.9 ,official;.. . . _ . . . . • I. will have lti~place.proc.Mures·for eJ:<ercJsitJg,cot1J~01 Within our. (the contractor's)· orgarilzatlon, for the meth·od and freq1:.1ency of .r~portlng .ancj'the distrlbution di'. the .reports; and . . • I cettify .that'I will have a.qµallfled _persorci within ow((tl:le contractor's), organization to exercise such control.- SlgncJture.._: ________ _,,_ ____________ ['.:rate; __________ _ . ( . \ PLANNING/ENGINEERING APPROVALS PERMIT NUMBER re l l -1 St DATE ±{t ff LI ADDRESS_:2---_l_~_V_cfZve _____ r-ff_~ __ crc_~_--i./2: ___ 0 ____ _ RESIDENTIAL RESIDENTIAL ADDITION MINOR (<$17,000.00) ,,TENANT IMPROVEMENT ( . PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE COMPLET~ OFFICE BUILDING OTHER ______________________ _ PLANNER ., . .,. ---------- ENGINEr;;k~ DATE _________ _ DATE 4// Lf:( II · Q:\FD~ ~Vllr pland11dcingl8UI.DING PI.ANCHECK CIQJST FORM. Pl.ANNING ENGINERING APPROV ALS.docx . ,..., !8l D D ~DD 181 DD .181 DD PI..ANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST Plan Check No. CB1 t-0157 Address 2180 Rutherford Rd Planner Chris Sexton Phone ..._(7 ___ 6 ___ 0 __ ) 6'"""0=2 .... -4 ..... 6 ___ 2 ___ 4 ___ ----_ __,.. ___ _ APN: 212-070-25 Type of Project & Use: office to data room Net Project Density:N/A DU/AC Zoning: C-M General Plan: Pl Facilities Management Zone: § CFO (in/out) #~Date of participation: __ . Remaining net dev acres: __ Circle One (For non-residential development: Type of land used created by this permit: ) Legend: [8] Item Complete@ltem Incomplete -Needs your action Environmental Review Required: YES D NO D TYPE DATE OF COMPLETION: Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval: Discretionary Action Required: YES O NO D TYPE __ APPROVAL/RESO. NO. DATE PROJECT NO. OTHER RELATED CASES: Compliance with conditions or approval? If not, state conditio~s which require action. Conditions of Approval: __ . Coastal Zone Assessment/Compliance Project site located in Coastal Zone? YES O NO D CA Coastal Commission Authority? YES O NO 0 If California Coastal Commission Authority: Contact them at -7575 Metropolitan Drive, Suite 103, San Diego, CA 92108-4402; (619) 767-2370 Determine status (Coastal Permit Required or Exempt): Habitat Management Plan . Data Entry Completed? YES D NO D If property has Habitat Type identified in Table 11 of HMP, complete HMP Permit application and assess fees in Permits Plus · (A/P/Ds, Activity Maintenance, enter CB#, toolbar, Screens, HMP Fees, Enter Acres of Habitat Type impacted/taken, UPDATE!) · ln~lusionary Housing Fee required: YES D NO D (Effective date of lnclusionary Housing Ordinance -May 21, 1993.) Data Entry Completed?· YES D NO D (NP/Os, .Activity Maintenance, enter CB#, toolbar, Screens, Housing Fees, Construct Housing Y/N, Enter Fee, UPDATE!) H:\ADMIN\Template\Building Plancheck Reyiew Checklist.doc Rev 4/08 Site Plan:. t8J D D t8J D D ODD t8J DD t8J D 0 t8J D D rgJ D D 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 setpacks and existing topographical lines (including all side and rear yard slopes). Provide legal description of property and assessor's parcel number. Policy 44 -Neighborhood Architectural Design Guidelines 1. Applicability: YES D NO D 2. Project" complies: YES D NOD Zoning: 1. Setbacks: Front: Interior Side: Street ·Side: Rear: Top of slope: Required __ Shown __ Required __ Shown __ Required __ Shown __ Required __ Shown __ Required __ Shown-. _ 2. Accessory structure setbacks: Front: Required __ . _ Shown __ Interior Side: Required __ Shown __ Street Side: Required __ Shown __ Rear: Required __ Shown __ Structure separation: Required--. Shown __ 3. Lot Coverage: Required __ Shown __ 4. Height: Required ___ Shown __ ._ t8J D D 5. Parking: Spaces Required 657 Shown 661 (breakdown by uses for commercial and industrial projects required) Residential Guest Spaces Required_. _. _ Shown ___ _ ~ Additional Comments 1) Please show how new roof mounted equipment will be screened. See ~ \ attached handout. · · 5-5-11 (1) SAME COMMENTS AS ABOVE ~ OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTE~IYJ)ATEc5--3/ -11 H:\ADMIN\Template\Building Plancheck Review Checklist.doc Rev4/08 . • ~ Carlsbad Fire Department Plan Review Requirements Category: TI , INDUST Date ofReport:05-31-2011 Name: Address: Permit#: CBl 10757 ANDREW TARANGO SMITH CONSULTING 12220 EL CAMINO REAL STE200 SAN DIEGO, CA 92130 Job Name: Job Address: CALLAWAY: 250 SF DATA ROOM 2180 RUTHERFORD RD CBAD 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, with changes "clouded", to this office for review and approval. Conditions: Cond: CONOOQ4571 [NOT MET] * * *· Bubble ALL Change*** 1. Provide manufacturer's specification sheets for UPS system : specifically battery information. List numner of cells per battery, number of batteries per system and amount in GALLONS of electrolyte including suspension. Note: Electrolyte is considered an. aqueous and homogeneous solution. 2. Add the following note: The emergency generator that powers this system shall hav:e an external emergency shut off. Field Verify. Entry: 05/16/2011 By: cwong Action: CO Cond: CON0004620 [NOT MET] 1. Sheet E2.0 -1-iowmany total UPS towers are to be installed? Are these all the Symmetra PFX40KW? Specify for.existing, new ap.d future UPS towers. 2. With APC spec sheet and considering the note from 4/21/2011 stating that electrolyte is homogeneous and aquaous, sulfuric acid amount is part of the electrolyte solution, therefore from the APS spec sheet the total per tower is 15.1 gallons vs. 9.472 gallons. 3. Add information on total amount of electrolyte on plans. Entry: 05/16/2011 By: cwong Action: CO Cond: CON0004657 LMETJ :> **APPROVED: THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUEANCE OF A BUILDING PERMIT. THIS APPROVAL IS SUBJECT TO FIELD INSPECTIONS, ANY REQUIRED TESTS, FIRE DEPARTMENT NOTATIONS, CONDITIONS IN CORRESPONDENCE AND COMPLIANCE WITH ALL APPLICABLE CODES AND REGULATIONS. THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE ANY VIOLATION OF THE LAW. Entry: 05/31/2011 By: cwong Action: AP Carlsbad Fire Department Pian Review Requirements Category: TI , INDUST Date of Report: 05-16-2011 Name: Address: Permit#: CBl 10757 Job Name: Job Address: CALLAWAY: 250 SF DATA ROOM 2180 RUTHERFORD RD CBAD Reviewed by: BLDG. DEPT COPY \]NC.O_Ml.LETE} 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, with changes "clouded", to this office for review and approval. Conditions: Cond: CON0004571 [NOT MET] *** Bu.bbI-e-~II Chang&*** e--------=-=> 1. Provide manufacturer's specification sheets for UPS system : specifically battery information. List numner of cells per battery, number of batteries per system and amount in GALLONS of electrolyte including suspension. Note: Electrolyte is considered an aqueous and homogeneous solution. 2. Add the following note: The emergency generator that powers this system shall have an external emergency shut off. Field Verify. Entry: 05/16/2011 By: cwong Action: CO Cond: CON0004620 .[NOT MET] 1. Sheet E2.0 -How many total UPS towers are to be instanect? Are these all the Symmetra PFX40KW? Specify for existing, new and future UPS towers. 2. With APC spec sheet and considering the note from 4/21/2011 stating that electrolyte is homogeneous and aquious, sulfuric acid amount is part of the electrolyte solution, therefore from the APS spec sheet the total per tower is 15 .1 gallons vs. 9 .4 72 gallons. 3. Add information on total amount of electroly:!e on plans. Entry: 05/16/2011 By: cwong ~co'J w CHRJSTIAN WHEELER. ENGINEER.ING June 29, 2011 Callaway Golf 2180 Rutherford Road Carls bad, California 92008-7320 Attention: Ed Salinas Reference: Subject: New Rooftop I-iV AC -Callaway Golf Headquarters Building 2180 Rutherford Road, Carlsbad, California Building Permit #CB11-0757 Final Inspection Report Dear Mr. Salinas, C\'v'E 2110270.1 Christian Wheeler Engineering has provided special inspection of field welding and Titen anchor installation on the above refc::renced project as described in reports dated June 8, 2011 through June 16, 2011. The work reqµiring special inspection was, to the best of my lmowledge, in conformance to the approved plans and specifications and the applicable workmanship provisions of the California Building Code. If you have any questions, please do not hesitate to call me at 619-550-1700. Sincerely, CHRISTIAN WHEELER ENGINEERING !IX Charlie G. Carter Jr., R.C.E. 61968\t""" cc: (1) Callaway Golf-EdS@callawaygolf.com (2) Pacific Building Group...,Brandon@pbginc.biz; Butch@pbginc.biz (1) City of Carlsbad 3980 Home Avenue + San Diegp, CA 92105 + 619-550-1700 + FAX 619-550-1701 ' ' ,' DAILY REPORT Project Name · '' CHR.ISTiAN WHEELER ENGINEERING Project# Permit# C.B\\07S7 Plan File# Contractor Subcontractor .D Reinforced Concrete D Shop Welding Material/Equipment: Weather: r . ~ \)'P-1", Date 0 Pre-Stressed Concrete D Field Welding Architect ,-Engineer 0 Reinforced Masonry 0 Fireproofing 00 (,re, Time End: Unless noted otherwise, the work observed is, to the best of my k~o\vledge, in compliance with the a Apr ~~ ::ccc.. lob"'\"1'1\ lnspector/Technicia~oture . wL(Rll .Wk\ Inspector Technician (Print or Type) Reg.# 0 Epoxy Anchors 0 Time Billed: /::;. cifications. 3 9 8 0 lI o rn e Ave n u e ~ San D i ego, CA 9 2 1 0 5 + 6 1 9 -5 5 0 -1 7 0 0 + FA X 6 1 9 -5 5 0 -I 7 0 1 ~f-1) Date / Project Address Contractor Subcontractor 0 Reinforced Concrete D Shop Welding Material/Equipment, Weather: Date · Time Start: -s CHRJSTIAf.l-.1 WHEELER. ENCINEE;RING Prqject # , Engineer D Reinforced Masonry D Fireproofing - Unless noted otherwise, the work observed is, to the best of my knol'iledge,-in·camplic:mce with the a prove . ~w.>.. :XCl-lol,,1:'1'11 Inspector/Technician's Si?::R~~ Reg.#. Inspector Technician (Print or Type) Plan File# D Epoxy Anchors o ________ _ Date 3980 Home Avenue·-$--San Diego, CA 92105 + 619-550-1700 -~ FAX 619-550-1701 DAILY REP_OR't Contractor· Subcontractor D Reinforced Concrete D Sho~ Weldin~ Date Time Start: ,() 7 4' C, JJ CHRISTIAN WHEELER. D Pr.e-Stressed Concrete D Field, Welding I ENGINEEIUNG Time End: Project# Architect Enginee·r D Reinforced Masonry D fireproofing Plan File# Time Billed: 3980 Home Avenue ,i,-San Diego, CJ\ 92105 + 619-550-1700 -~ FAX 619-550-1701 U;r. t &Lkd.&d A PRIME STRUCTURAL ENGINEERS 13272 Jacaranda Blossom Dr. Valley Center, CA 92082 Tel (760)751-3300 STRUCTURAL CALCULATIONS Callaway Golf HQ -Tl Support for one roof top mounted mechanical unit. 2K11-160 Sheets 1 thru 4 POOR QUALITY - ORIGINAL S ~ \ '\ j ,1 ' I I I 1 '' ! • I I I ii ;j d '~ "' ! 11 :, ,l ., :t ii d ,! d 'I jj L ' ,, ,, ! i :- I, Pa9 ! I I ! ': : ' ri i ',i / . ' f ' i : .. ! ; I ' l I '! i l ! : l .l ;It '! ! i I I :i 1 '•t ,. ~ {' ;' ' t-~ . ,, ' I ¢;;, , . ' i I ,l I ,,. L '. r l; i I S.QOft2 8:.9.9 -9,;99 -9.,g9 .,.,j ' r--,--~· f : ;--+'1--.... · -t-"!'----;---- ' ; i . ..,_, ,..l.-.-.,.... ' ' i I I i--.,.--,.---1_,___r_.,._......., i ' ----·---1···-.,..1·-..---,---...--...... } ' t ( z ~ ' I i .. 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I: I. r ,1 ~' .,.,, . , I .I ·, ib1e_11.sip~,d Pata; . . ' ' . l 1r~~1~\sl~ §t~~d~;fi+.giefiQ,X·Q~ifs.~<~:!~li~~-f:~~1,,ate11t~~~); . __ . ~---r .... ,.·-· .. ,! I I: j. j. ~ ,;!I. I, j' I• !: ' --·~ 1 -. ~,' ' ... _ .. ~ .-1 n i ' ' ·I ·' ·! ' -! 1 ' ·' c~Oaway--_fl;'.fF Ro.am. 21'!80, :~utherferd Road Qatlsbad,. :CA. :92o:_oa '.F!,r0.ject :os.sig_ner:, $mith_ C-Ortsu.ltin'.~J: Arcniteots- 12·22:tJ.: E·I ·Ca.rnino-Re·a,1,.: Suite 200.· s~n 1,resP.), ·oa ;92.rs.0-- 8. 5-o-Y7g--·-o· _.,.,7·· :7· -" " ~ I ,JiJ'!""{#.·' • ,j,;J~--~., • A.l..M. ·o:oas:gttb,1g .i:)1:g]!;)~$r~-Inc·. 63:3(;).'.J:unip_er·l~te.ek Lane· s:a.h bie,~ie,,. o~ut 92:,:2e,- -85S/.192~t100' .J~ob' Numbe.rll 1f00'9 Date:"' -,···. 4l29/2tl-1 ·1 . . . -'" ; ~=J~tiit~?~i:~~r:1:ii:~;il:~:~~J1:ea~~ltt~fl!:!f~t~::i~:,t~ri~:1af:1fltiii.r&Sfl£&!~~c;~~:::9r::f~rl(1~~f~ Ttifs-prpgram;i:level0,ped byil:oerW,Sdlltt.LC'·---\Wi,\V,,!:ln~rQY.Soft:q,Qm, ,,, ,, -, ·oove:r-'Pa9.:e Table .. of''Contents TABLE. OF· C:ONTENtS: ' '1 ,,, •" .-,;, • ,1 '-:,.-. • • _--'• •, " , I•.,, ', Forrrl Ml:¢H-f-C Oedificate. of .Oomp:1.iance; Ft1rm.MECH~2~0 Air:& Wetter System Re.q~Yfterfr$.n.t~· :F,otro 'fvlSCH"'.3-G Mechao1cal Venti.latic>"n, Fo.rm MEQH-4·,·:0 HVA.C Mrsc',; Pr~$~iiptive Reqijtrem:etits P'.cmn :MJ~CH~MM: Mechanical· Mandfitory 'Mea:sures, .. Jotf;Nuintier: '.io:;;11009: 1 .2 a ,8 9 1·0 i't ,, CERTIFICATE. OF C'OMP.LIAl'i,CS-:a.rid_· - -f(Elll lNSP~CT.ION 1$NE.AGV :CHECKLIST' !?,r.oJect~!lin~ _ ,lJ~!fa,wix lf>c'F1Jgqrp G:ENEBAL.JNF-0.RMAJION: ----, BOlldlnii 'tvne: . . ~ -----. . . . . .,, -" ' MECH-tO · Date 4/291?.ll11 I To\at:eon?: -~oor ,Area Addition Floor Area ·JQfl '_ rJ/? :H_oteiiMc,,t~J,Guest,.Rooni c, S.cnools-{PtiblicrSchool) ti }~elot:atab]e Publlc S:cbQof Bld~_ .. , . 121: C.onclitio~ed Sppces 0 · Unconditioned' Spaces -· .Caffidavin Phase~cii-c:Onsfrucifoni' -ti. tilew donstructibn· -. . 'Ct -Addition C Alteratipn . H.VAt{SYSJEMJ)ETAILS Eaulbmenf _ . . _ · ltem:-or;$ystem Tags, n:e:.Ac:t· RIU~1. HP~:u .. Niimbercol'Svsterns MltilmumJfle,atlna Efficiencv1 .. .tJl.a; r., ... :.11•1·-· ··-· 11· .. ~-:.-.iv·· --1 · · · t?,4.2~:-1.1.uc .... oc:a 0,,11 n .. a ue _ ,_ . . .. _.. _ ........ .. thermostat: _ : lfenvoriS,ystem T~gs , · li:e; AC-;'t,,.RJ:.l:1~1. HP-'11 . . -.. , . .. . -. ~ . ~- Nilmbet.,of 'SVslems --.-- Dlitf::Lbcatiot'i/'RNaliJe :Economlzet Tfieimostat Fan,.Qontro1 C,onstant Yolum.e, __ • : FIELD' INSPEC:TION.ENERGYJ~HECKLIST . . .. MeetS.,.Crlierla or Reautrements·._ _ .P.ass Fall"") t>escrlbe Reason2 ,CJ .o " " , -_, ~-. Cl .Ct __ _ p .CJ .J:;J' 'CJ .tt . FIELDJNSl?,ECTION ENERGY.'CHECKUST .P..ass> :CJ, Cl .o: :a o: [J ·tj -. ·-- CJ a .,CJ er CJ' [J i:I CJ CJ ·'1,;-itt11e,l\ctu~lnstailed:eq_uipme'nt:pe'rfom1anee.1effic!enc_yialictcapacittls:ie-s1Hliatillhi;iProp·oseo·Qrom·the·ene~gy-complfance,submlitai•o(from J(l~ QQ11gl_ng·p!iln$). (he,(eSP.Qll§it>Je, P.~!'IY !i.n~!"i'!3~ti~o'lit:tii.~i'gy,~!Tiplf~~ · · 9,l~c{e·;t!:Je;rf~W .cMrfge$~ · 21 r.or·add~lon~fc1~1~11~d jli~Qp~rtcy use-Pt1ge,2~ottfie.tnspectlon .©he'ckllst-; ·· tcompllane-e·taits-'ita:<Fa1i-bo,ds,checked; -~: >r.o.dtc.dte;'.l;quip,mpril'i}'.f)!?;:,Gas '(.Pk1ror; ~piit), ViW,Jtp {f>l.q)io.r't plij},; 1:{yQIQQ1i;, '.PTA9, Pr-Qtfier.., . ' ---~ EnsmVPro!M b"liEnsmvSoft UserNLimbsrt7628 ·· . 'RtinCode:,2D.1f#U~29T10:41:35, · • ,JD: '11.009. · Paae.3:of1;1 10E"RTlFICATE-en= COM.PLIANCt' and ,...,, . . ~ ' . . . . --' -· ,. . ' ' ~ _, --... ' ·FIE-LD' JNSPEOT.ION EN_E:8GY '.QH&~KLl$l ''.PJo)~ct:Nam~: lJ~f!a,,W.~Y-IC[f r{q;p!J1 :Discreoancies,: . Oser Numbei'Hl528' .(Part 2 of5) /D;f1,10D"!J: . Ml:CH-1-C· l·oate 4129(2011_ Paiie.4.of.1,rt , 'QEFltl'l=itATE :OF 'COMPLIANCE :and ~F}ELt>: 'INSPECtloN: EAEBG~tGHECKLIST ,. '.~-~-'--'< ... •,,_,--_, , .. .,:,_~'_ __ _.:___: ______ •-,,_ .. !... .·•. a• _,._, __ '.,,_,:.:.....:..:....,-.:!~.-c' •. ,_:._, __ c ______ ~_'. __ ~ ______ ._,:_,: ___ • __ , .-"-..!...'_.~_-,, ______ ,_, " ~ __ ;'.':,~_..:_'.: ..... '. ...... ~'. .. >< -< -, .,.,. • -'~ • --,., '" -, •• ,,,_," • " '· •" ,''•-. , __ :,: ____ ! __ ±,>_, ____ ,_ ~·· {F>,arta :otsJ Mt;QH~1 Q' P-roJ~.'<;t:N!¥il!!· · ·;Qaltaw_ay-JpF Rqe;m I Date' · ... 4J~_9'!.2Qf1' __ . f3(:)qµired;A:ccepiance· Tests . . D.esigoer.:: . .. ·• Thiii Jqfrn J$Jg §e,o~~t;t'b>r1h:e;d~ijJgi:lt:!fijn~ ~ttti¢fle.4 to,tl'tE! _pt~p~; ·fJst~'J:>~Jj:')1t~f~'.;;tlJJl'ie:.ac.~~p,ta~iH~~Ul:1~t m~haJil¢al syst~fns.m.1ij·.cle~lgnet is··;r~t;,ltecf'.to ci)i:ii;~:lne:-appllc;mle ·1 boxes by-·all ac-cept'ance iests:thahpplyiand;lfsledafl:equlpmeril:that.regoires:-an.acteprant:e'test;)f.aii:.e:golpment:ot a,cEtrtain:;type req1,1ir.eJ?,:a,te.st,.iist:tbe,~qµlpm~.nti:ie~pjipl{pri:and; ; Jqe,ntiiJtllet9f,~isJ~n)s:;:1:J1e:N~ l)Ump~r··~e_sJ,,gn.~tes .t!JecS~~pn l~:~hlil~~P.P~Ml~'qn~i ~on.t,e~1c:l~i,tlaj ij~fet~f{C~,:~,i?e/'ldtcijs MaJtUa! ,~ij~,#escp~~ 'ih~:te~M~in,c~:thi~, Jo)'.01 Wl!I ~8' part·of:the:;plan·s·,"compJetion of:thls-sectlon,-wlll,allowthe·,respPr;is1ble:party'to,b.uc:(~et·:fodhe.'-SCQpe,,l)fW!:!& ~pprpp.r.fat~IY,:; .eu_ii~b1g bepartrn,nt•.; · , · . Systems Acceptance::Befor.e .o'Ceupancy,,permitls,gramed:tor·a·in:ewly,c.onstructed buildlng,t>rspacQ, ·or a new spac.e-«1nditio.nfog: system\s.erv.l11g~:bµlfqlng::j]r-space:1s Qpe~te<;I: fot' •· ''r).Q;tn~tyi;~ •. ~l(·Cb,p_tr9J1i;f![!V}~e~1se.rvJhg]b~il:)tjlJd[ogt>r~na~:~l')~q·~J:'~ftJfl~Ltlfm~~tbig_the:}\ccEjptaf.l(f.~:~$:(Oif~'ti'ietit;;'fO(-'Gci,de.:compll,anpe~ . :Sy.stetns:,Acceptance:'Be.for,1:3,o.ccup.aocy:pennil,fa~ranied.,:All,newty,installeid-HVAC~~urpmenlm.ust(be.itest~d:t,1slo.gJhe·,A'cc~p(®cQ'·,RequirE!m~nts. 7 ~ • • theJ'MECB-lGHorm Is notcoosfcfe.recla"compieted·form:and·ls-nofto beia®.epledi.by-lb.eJ1LiildJog~depai:to:i.er.it,uoX~ss·1lu~ cofrpctl:n:~x~s are,¢becl<~~ Th_e·e;qµJ~tn:ej'lt0.rt:!g,:i'lnii_t1,:tesJii1Q,. p,!;!fs_t>n:;p~n~fir.ilog.:1fle"t~jtJ~gtJ.f.!Jil.e~ HYAGJq$t~ll~r1 j:AB,~t?r.i~ap,to.!• c,l:>~!fol~.:coflt~!'tot,J~~;{~~qh:~f~,·pt~!'.<?J~.c.~):,tt,rd·.wn~V\~~P!~!'!~tt'.\~st·n;tQst1b.e,pon~i:lctecJ.: !Ji~'!6l_lo~~9 . . chec~~~ff.forms;·~re;;r:!:!qUlr:®,fQtALL.neY.1.1.y installed eq~.uppent.Jti a.4dit1,1m~:Gei11fic;at~~t.Aci::,~ptancE! (orri;is,,!:ltial!'tie.~OUro~!,W,;to~th~~.!iU~1ogJ{~.P?,11m~ntJlt~t.c~ffiU!:!s1P..l~J1$,. Spt;l01.fi.~~i;>1isi ·Jn,st~n~tlg,n; t::$r.tlf[cate~,,;'!¥rft;t.:p~~t1n:1tand1rri~lnf~n·~~?Jtifti®~tlor,fJ.T1:~~!·thft~1:J!i'.~m.~.nts·oJ:§to:.1:o~(l)) an~'Title~24 Part:S~The:bulldli'IJflnspeetor. must;r.e'celv.e the· properly·Jllled ()Ut and)si,Q,0.e.d·fom,s1before!Jbe_ buildtag,·c;:ll!'He,.eelyei:fih_at,n~Q~pancY, •. ,' • ' -"& --• ' ~. )JE$T b~sciji!ttiPN MECl'f•2A, J. KAEJ~B~a;«,J MECH3_~ ~1 ~MECR?sA r 'MEGl:!·13.lVT ~ec"J:if.iA l:MECM-sA :! 'MECl;f~§A .. r MEG)!t~f<>A· l MEC:1:1~'1-fA . .. l;!'i~Jiim·entRegi:liiing·.Test1n1J:br-YenP§illion. l .Qty., . ,i!,c.4:rra.n~·,.ti~J1}11j, _ _ Id' .Outdoot Ventlfatri'in, F.or :. VAV&,'GAV,,' '.Cf .l:i ti .. q ti CJ t:i: Ei 0 Cl tJ c;r D D EneroYB.rtJ'ti;i:byEnernvScifl; User'Number:·1528.' k,Jr. , :oisttlhution· : =~~~~:Ducts1 'gt .I ,ta. """ •I'm ,· .. I .·. ,l-11, ·L..:.11, 'i:~' J ti .o I J:i. ti ·I o .-" -__ : -~~ LJ JJ. I -o J:r I ·1;1 P: . I :b. ·o· I ·o "cl I' D o· ti D ·:o ti D Id .Cl Oemancf . ' i3on_troi' • Ei:!>l'lifm'!ter-· I' Y.e'!ltl\atltm: Cohttots . , :oev , . . :ff~f!mlc, ,. _ . . " . . . . .§'Qpply. ~~y~t,n.t .~utom~fl(?, ,S!JRP!t ., Va,!~13· I Water' Y.~al;ifie. P.~manQ f.;f!l :le,~a"Qe; q;,et,np. ,Flow . _.shed· VAV' _"I.Elst •Reset' ;contror. conrtol :tt J p· J:;r. I _o· J P :i t:r 1 ~ ~ -----. ----- :.E1 I tf-t~ii-1 a ~ 'a· l a· ·1 a f · :ti . . . ti . tr: o : i::i · d-ci ' .. . . ,' ~-' ,, , ,. ' o, .:1 er I -.rr I-ti .I tr I :i;r I o · 'O l q I tf: -r ·a ,I fi . I .o -' I IJ tJ I ti .I tt I. b I .. tt :I CJ J ti ·o I b f d -I' ·o I er I ,o: I o tr I ti . I d -r ·o --I' . CJ· l :o. I o tJ. I o :I o 1·· ti ·1 ·d. l . :tJ'. I a D I D I a I ti I ,a· I n I D ti I et .I o I tJ I -n I tl I o n I D I D I D I Ci r tl I D ,CJ, I tJ ·1 :er I . o I ;o, I o I CJ ti I ~JJ I 0. I o I o: I a I. · CJ Rut,CQ..r:f.tt::2011.:04-2.!Tf0:47:35 .lf1: 1!I ()09, Page,5'c,f'(1 .. · C .;> -,<lEFiJIFi'.OATE:aF· ··:oM:Pti:i&ce: a11d°FiELD lNSPECTION l:NERBY CflECKLlst •'' ''-·-'•""·~'.•·,,,,-., ___ ~--••·• 9 .. • ,_.,_,.,,._,, •, ,)_, ,_,,.,,,,,,, >, __ • ___ ,·, ... C. "----''"-"'-"-' ,-,. ___ ,_,,_.-v,-, ___ .. ~ ,,,,,., .. ,' •,, '' .(P~,r:t' 4,_p[5J Ji~i.'EPH~ tC: :[ :1?.roJe:¢.f.Name - ,c~il.~w.~ji:'JDFJ1<'iem: Tl:ST'DESCRli>.110 .. ; ,Egolpment".R~g:'resflno -~q;,f'[re~.f'f;QD1Bct :;EnergyF'_;;;,-·54 byEnergySoft ' -c -'ME6H~1@; .. · 1 -~g~l!f~1aA i:--.ME.Ql-1-1~A Qty., :Faylt . .Au~omatic.FE!Plt : ,, Distlib~ed ,pelecJlopl& ,_petecli,on~~ · :E11e1:0Y:~to.rar,e: DlegqQ~tl!;s .o,~_g_nos_tlcs·for 1~X-Aq, for'D>.Wnits: ,Alr.:&Zone: '.S~fom-S'. :1 t:i' · I ·a_ I -,,p - o. .1 tt· I q El ·o· I ti Cl tf, D tJ'. tl ·o tr :j;j: 'd ,,... o. ;-1:j: b D :J:j, ·o Cl ;a a· tJ tl tJ o: t:i:-d Cl-t:r: ti cl :a: ti ti: tf D --CJ: .. r .I ·Cl -- t:f,. "J:f' !;I' a D; ;O, i;:L 0 ·cl 0 l;J tJ' p 0 D' J:I p p p p :CJ CJ q ti, I:! Ci tJ' b -0 -CJ :a D .0 b tJ D' q -0 p iJ p ·o tl, ,, -MEbi:M's:a. -. Utem:iai':Epl!f_gy· :sJ~~QeifTES) :_systems 'd ~ .ta ·CJ ti 'Cl ··o CJ ;a ]j -;CJ a· :CJ '.ltl ti CJ - 0 _J~ 'O a 0 JJ :er. 'Q :D tl ;d t:J ti tJ Yse,:Number: W2B: Ruri_c;i>cff]{:2011~0.,t;,29T10:41.:35' / _I :oate, - l ftl_lg9120s1'1' 'T..!!~tPetformed-By:: ' :· -, • • '' -• •• r ~'.' • : ·; • ,~ • • , '. ' • ' ,> '' ... J • • -'""' ris' ' -,-.,, 'B':( L. ~.J4(;:q.. 6.J2~g__. 10:-,f11109 Page:6i,M1 C ~ . ., . a ·, ¢~-~y)EJF.B®m. . ., . ~ : iJ>Oet.tfnentaQog.AutJHJrs ·De.aamlon .. Sta~nt · ·· ,lfiat.fia:deriilcahtof-Oo · · :~;i:Js,Bl'.x#Jt.me and a;rn ·-· ~ 'Thcf Ptlnci' · arMecha'ntcal :0es1 nef;sJ>eclatatlon Stiiteme:nt: ., . , .. _ . , • lp . , . • . -. , , ». , •, , , , .SJ . , • ,. . . .• , , • ... • .-a· ,, .. -. arf5ol5-. . OEAI ,CEfE,I ne '"' :=igibkt]Q:kt.~,:Pltt.i.til~;~;~-~flJl:iB,~,Ui:~~po~-.,Y-ror:~]1~$i~ -• 'ilus~Oertificale,of-Oo~--llediies ffie-~'fesbes ·ard perfi:umame:specificatiorno: -rea ion:ompiame-citffflft.•2';P~ j·.iiJd {t°':liilf P~ ~Df·fle9~R~~-. ' . mqw .. :·~ · ;CifJSt.alp(lip. a·riii..w. -~ w.tta · · · ··-••.• ,., ·-..• ,~~.t.-~;. :~'!,o, . . Al.A SYSTf:,if REQUlReNl:ENTS: MECH-20 : ·Project:Name. ~r;,il~·WeY'1Pf-Rp.qm 'itertu:,r: System tags,· . <te>AC-1, aru:_i,,He~11 . . .MN~.ID~TOFllV ,ME~§l;I RJ:,S: Hea_t!o_g £;ti4i_ptr)~ni Eff Jclency Goo,lloQ t;qLliP-meot'Efflcleti~Y f,IY,.A,p·,t,te~t::P4rt.ip. 'fh~ijr,iosl~t: fµl'f.la,c.e t;.i:mirols!Ttier.mo$Jjii, Naturat1V-enutat19n M~!J!!(ilqaj':\'~ntllaiiQn: . 'VAV'M(hlmbm·P(i~Jtiii_n Con.trPl- Ci§ipaj'Jg l;;gi:,\rQJ Ye11t1rauh11· 'l'fme,.eontror §e.ibjg'k al;i(f.$gl,µpi~9[igqj G.utdoot'.Clamper. Conlrol lsfil~t19j'fZ9.r\~ ffilprtlo~ulation Pii9',J0:~ijta,1on. PREStRIP1'1\'1E)1'E~S0.R~$. l';ralr;1-1ta1~c11P~~o;i::le.ating'toad P.roposed,HeatlfiQ 9iipa1:1ty, Qijl~y_laf11gJ'.!esJgl1:CQ.ollh1#:.oaii Rroposed GE!olli)'g C'1pliclty' fi,\,n ¢gn(i!l! DP Sens·ot-1:.ocatidri: '.§i!PP.!i Rr~sµr@,ijeset:(PbQ.-qaiy)' ·,siml.iltaneousJieatldoof . 1:cp~§.rn1~r \·iJieat·-Afr·SUpfiit Beser ;Q,oo.1.,Ak;$u.i':iP..&.ae~~r ':1:1ec1iiciBesistance;Hermn1i:1 t~fr,~_9.gl~p. Pti\!(,r.Mmitat!o,n: .'.P..J.J~t£~~ag~rSeali0,g .. 1f"(cj!s, -~-,MEQH;+Aimus.t,be1submltted I Date · .I 4/2.f}/2.()1,1. _ . .. . . . . . . . . , . ~ tndicate:Afr ,s.vs.temsi Tvne:'.<Centtalj ·Sfn·a1e. Zone, P.ackal ·e; VA v, or .etc ••• J ., ·. . . -::: :~P.1·_ -t . ln.d'icate:P.aaeJRef~tenctf<irtPtans .or·_Schedule andJndlcate:the;annlicabte,exceotton(~l . . . :1'f2tar . 1:.1.2/a) · 1:2:0,EER:' 11'2lbl, :t1-2lc1 1:21(1:l} .12Hc) .. -N.6. No. -. ' - :--122,el: ftqg,fi!romij?Jt,fS.~llro, · . ;ni.a ·124 '. t!~5::S..f{j/lj( ·f44tas'& b1 . ;O.Bttilhf· , • > • .>·, • c:'~.,• I , . 1'44(Ei:S..b1. . GbnitantVoiume., , .1Mlc) .. · 544tc) Yes; :1lP.l{dl . ,1#lff. ·. · 1, toi~tJntliii\!~ capactty:(M.Biut,tir).-~f :alf,ei11.ctri~oeatoo·-i&1s;_prciJ,e:¢texciosi1ie:of·eieo1r11tai'.lxiJtaJY,:1heatifor'heat·pomps, ·lf·electnc,ffeat,ls·usecf 'explalnwtilch;exceptlon(s} ur,1)114(Q),'Eipply. -. ·· ,r,,t~Qtf.Artll~~J:. 'VENTIL,AtlQN; AND ·S.ISHeAr :l\liECHii3(f ,Pi:QJei.l,N~~, ··:ca_1taway'i/I>P'-Rt1.ati,;. .eate . ")i~fil20':t1 A Zbni:!l_Svsiem ~_,MEOHAt!i¢Al_\l._ENTil.AtiQffi(§121{bJ2}; "AFIEA BASIS B _(:;Q(J.~lif O!l' Krea (fi3) c: ·;i· :o Min.'PFM By,Ar~~ .B:X(C . ~_\OC_.gueANCY,BA'SIS: E Nu@t~r :Reopte· .'F CFM tier. . ~ersoil' G "MlrH~FM: ~:·: __ , ,,.JI~ ·_ E'A:'F· H BEQ.'D.: v .. ~. : M~:oJ · b-or,'G aEt:iElj;U,..ltAtloN:(§;f 4.4td)l ·~AVMINIMOM t I .J K'. OMlgri 50%-'61' • V.eqll!attort · · ,pes!gfi;Zone: lt -_ ~~~f.t J JF~,:ri2 L I M ' :Md-. art. Design · . -~~lum~ ' Minimum-. ~AJ~, Air. ~300··-GFM' setpolnt . 'iOF;iJopm· i~ .Q:Jf;, '46 4~ '4~[ Ac:.,1 f.i;,lat ,,t, 4[i: ·•i -- ., :l;olii.1.s ___ _._ _________ _. cofumn·i1:otal ll>es1~nv~mliat1on Air c· •• 1Mintml:ii'n.ye~lll'3ilon.rai~'Section 1§'1·Zl~'.I'.able.12t,A. e· ·easel! on:flxed-sealor·1ftti _gr:eate'r,ofihe;expecled'.ntimber of;.6ccilr,anrs@1d·so%·onhe,CBS:octiuparitload for-·egtess__1!_L1tposes.'fotfili~®~''°'1tlio_ut:fii<ed.settihg .. :A • .Reqt.ilred'Ve'nillalion'Alr (REri~[l~\l:Ai)Js the:Jarg~H:ifthe Vehlilatiortratescialci.Jlated'llri:an ABE'A:BASIS;;or·oc-eupANCY'.(lASIS:(C~ltJmrl ,D-Ot"G)., Must~~greaterthan~or egilali1o,H,,or use,Jransfei:'Alr: (coforri_n_·NJ·to:mtl.lie -1.1t!'1hetfiffei'enc!l~c .;J :t>esi\'.ln fan,?Syflpt•{CFM (FarWFMtic:50%;.oi'-'tlie. design zone oiitdoimatfflow, rata·,jjer-,§121'.- K: Cbndftlon'.area (ft2bc'O;<t:CFM:ttf2;,«1t (, Maximum bf corumns';lfuJJ<:,or'30()~tlF.M 'M Tn1s;mJist'bifless:tfiari:or'· uaJlo,ColtlmriJ.:. and: ·re.atetllian':or.e · ualto.tlie,sum,of'Colurru;s,1:r tus·N. . _ J,,I. Transfer. .. Ale N· Tr~n.sfer;/M1::m1;1~rbe,pmvldeq wh.e~:t!le,fleq1,1Ir~ "'entjllllli~!i,Alrj_C:ol!mm f!>:!li'.Q.~~t~~tl:i~!JJh,~ .9~1g1t,~nJ(tlli!)\Al.t (CQl~rti)f~. -yvtr~r~~regµ1r~i1.· traij_sfer:alp:nust b'e· gre1'\ter than qr --'.-eaual to·the-dlfference :betWeemthe .Regulred'VentUatlon.Alr (Column H);and:the Design ·Mfnlmum'.Alr"(Column M), Column Hmlnus· M, . "EHefijyl?ib5d by.Eiiii[ilfSoft: -tJserNumbar:'-7528 _ Runco1:1e:.201.1.,0;1.29.T10::47:35 IDs 1.1009 Page 9 ou1 "' Pi'oJtrct: Name·. :ti:iilawa ·Jb,= Ro.em " ·--, . .,, . )' , ,. . .. "•. .. . . I Date: 4/2:9/2.01'1 'N,OT~;;~):ovide:one _COJ1Y .~!'.ltlis'WOrl<sh~J',_fqt ea~h,;fa_n ·s~Jfep, Wl~.,~(,Qtal·f~!:!"S}'Sl~m; ho(~eP.'i5wer gr.eatfl_f Jlian 2SJ1plor'Gons\an!,Alr VoJuin¢'. (CAV) Ean~Svstems1orV.arlable,AlrYolurtl'e iVA\ifSvstems:wheitusin!l0the,Prescriotive·~ooi'oactkSeezPower-Consumritlon-0Uan.§1'14Cc1, · A .. -B C· D. E: . ·Effl.cleil,CV. ·Pe$lgr,t Brak~: __ ...;.....:.....;...,;;...~--Nu_!Tit,,-er of . . HP . . M.o.tor 'DrJi.te Fans . ?§0.QQ ]t;f%. 1(}!)10:~ . tJJ 'TOTA'LS~AND-ADJUS:tMENTS .. .Al !l!Ji!ii,i\'.pr~ii.ure1«:1rqp. (~PiH~ greatifr'!lifirt J.'Jfi!;,!tW~ . .Q, 9'i: , .sf t0TALFANisv.itreM.:t:>0WeFi;1NOEX <Bow ;1 J. Bow;2) F _Pes1k: )Vatts, B :XE·X746 I . ((f)( D.) '1,263 t,J9~Q W/CFM ~~.fi~~l:ih1m tillf.Eirsfi •. 90 lin~ -t.)J:.!'!t~r''tiitalF~i:i. p1"eSSure,di-op,1teross:thdan,(SP;):on i::imi'5, :...,~_,_O·_. __ s ___ P,;,-~'------------------------1-------1 s} .sJ~1, . . Bt ealcuiate,Fan·Ad!Oslfnentand :entefon,line-,6 •. . Gl: ... i=an,Aa!iJslfTient.,.., 1.-c.sF1.d}PSP1 .. j? TOl!iWf~N':S'(Srt'.EM;PqWER INQEXjir J;QiJU.STT'EI;) P:liN fO\NER:-lt'.OE.X'inU!lt,~Q.!,'8~~\'!fQJ~,W/CF.t.1 ~q(Coil~\ant VQl~01~,~ystems,or 1,~5 WICFtikfpr'VAV"~Y~.lem~~ . . . . . . . . ',EnetrivPro:5.,1~bv. Eneravsoff :User'NLimbet:·,7528; · · ·· · RuiiCode:..20..1-1~04~2s.t10:;11:3 !l!):,11009. Page:1Dot11· ~T -MECHANICAL MANOATO'FlY :M,EASURES:, NtlNA'ESlrlENTIAL ' . -... _ ~- ~1-"'i'· Any,,appllance for-which there.iii Q_allfq_mia{st~nd~r:cf e_sfaolished lrHhe Appliance ,Efficie'ii:t:_y Fl~glllatlons:-will pQmply, ::1, " • ·: Wjth::fnf~flPll~,~1~ ~t~n~,~r.r;f .;. . _ -· --, :ptp1ngfe~~E!P,l thatCOQVeying fjuids atternpi;iri3,l~(e$ b~1;Wee9, i:lQ,·~nd i QS :~e:grees:Fahrenheif,, Orwiililn HVAC :~uipro.e.iit; sb.all ~,,Jnsiilatetl'ln f®QfgM_c~-Wittii~\ijfi¢fijf.d$'PettioJi 1'~$. _ ___ _ _ _ _ _ _ __ _ __ '~1'24· ;~jr h~gdlin.g p1,1ct~isJeros:~_hai!;f;i~::lo$l:IUl~'.i:!'od;ip~µl~{ed)n:_.c;efmp!i~ii9Etwill:l-$eqtjQQS'6Qt, pQ~~ 6,Q$,-~Q4:,.:iliJq'(!jQ§·:Pf !:I ' , ,•, :th~--CM.G-Sta!l~~-l'QS. --• -. . 'CQn-1r<>li tA._ 'Each;space-conaJtlbning'sy~fei];l,ser:viriQ-l;>Uilj:ll~g,!}'p~s,~.uph, as, q'fficp$":8[!d\riia,9.i:jfacttli:l~~-fa_Qllit!es (afi~:al[;o\h~fu· iiot: r~~Pliclflt~*eiTIIJtJr,Qm \nt-t~µ,Jr~m~nt$ipf.§.egJr~~o,' 11,2-@) ~h~I p-~:ln.s.t~l!~tf Wi~I:! tin'~utom~tiMime,§witc;n:wJth 9-fr :ap~$Slbl~m~?UBI 0,varrlcte.1ib,~t:alJ9W$.-opetati0,I) qftf,ie,~y_stem:-autlrig pff-l'tqiirs:::for_;upJQ•~fh,oUrs; Tnlil tirpe-,switp[l :~b\11,i~Ef:Cfip~bJt ofprQgt~.inlllil'.f!fdift:~r~nt'scli,~ule,~-{or~~~k,d?Y~::i:!ti,t':1-W~ekem:J~iiang Mv~,pr9gram bc1ckup'-.caoabllities'-ibat orevenr:itte::10-ss ot::thitaeyice's r,_rottrartr' aad-time-settina lor'af:teast· to tio:urs '.if oower_'is ihterruofecVot 1il -A:l:i1~11drmer thatcaii:he manuaf!y ,operaieciitti conlr0Hhe'..operat1rig period.iitile.:system~ -Each,space condltlonlng,system-sbatl_:~1nsfaiied 'wlth;controls thafle{l1poradly,·restarf anc;!:.temporariJY. -oRera:te the :2; _ :§~t~m: a~· ~ctYJtff9J9 roij1fit~o,~;r~t~lPlth~~Jrog:i~ftd!9ti<ii~.~tiJ1tPP..RU!'.ll!i't_ge)mil~t~t-1?~Jgg[nt; -· t:a¢!J'$Pa~ ®nc;t1ttQ'.oing:sy$t~'.m:~f!wln§: mu1t!Pli;£:tqri~s.,wittha:~PmP!i'i~q :C9nt;1U10.n~~1,Mr ~r~~ mPteJt:ta.tt·aQtPQQ - $glfare:f~~V$h~ii'be pi'ovide(J:Wiih isolation,zoneS'.-:each-tone:, sh'all notexceed',25,POO:-squareAeet; shall be;provided :wttfi'ii?,o!l.\tfgnid~,v.1q~_$;,$V¢h:'~j)i~IV.Ei.$·qt·1:JFimR~rfJnat~J!pWJn~-:~fiPP!Y-i;if'l1~at1ng·-Qi"pcto11ng.fo ~-e''~e~a-cisor.-~ngtoff' -lndeoend&ntiv-of\other•isolation,are-as::and;sna:ll be·:confrrilled bv..a'.tline·control';device-asrdescribecfabove. , -VeJnif-non ----a; ·--_____ .,, -----' -, ''.l§122(f}~ ' '' ,C,'oritrols:s~all'.be, provicl~~ fo ,'ai{Qvi'obt~Idj!ilt-darnp,e.rsJO/)Qevlc,e_irto, peJoperate.tf,,at;,tne\rEinlitatipn-i-atE!sas S.P,f:!CJfi~,d I9o~l_se'pt1w~~ · _ -_ 1AIJ,gtavlty(v~o,i)jaJtng,,~ysJ!3m1t$Ha]l''lie'.pf<>~ldecj-W1\fr'.a!li9!1ta~~:nr;rea#i!y,~c:ce#ible-manuatiy-operated,.dampendh-aii -op~nJngstt9,'ih.e·9,u1~1~;.ex~~ptf9f,®01liU~Uiln.,~1f#ii~n1oii'a: : -_ _ ~ __ _ _ _ __ _ _ _ __ ·Ventllatloli':System,Aec~ptallce~_-B,efor~-:an1occupa~,~~;¢onmisJ1,raoted for a-newly c.onstrueted;bti_ildllJQ _of.sp~i::e, bt,a M,W '/entJlatlng-~y~em'$Efl1'i_oQ M~Qlldirrs'qrlP,~®J,Sf P.~rijtfitj_:f(>tTiJ~rr.n,$)·P.t!3;ialfve~til~t~on\systemsc.;s~rvlng-th~ bulldlna;orsoace·sball be:cer:tlffed,as:-meeUna--the!Acceotance,Reaulremerits for'C6dd::i:imollance -~, -,Olrca\atJr,19'$tiv!9~:~r~r::iff!~Jlti'g sysJ&ms·tha.tl M~e,if_@f.itta1.¢~P~b1~,qfa_µt~mJ1t\ca1ry.J11,tpJt1g,tjff.-tn¢;qlrpul!:itlng·pgmR· 'Vi~~rth~t~tEJr Js~!Ji;>} ·requited. ·· _ -EberovPi'O-MotIEnerovSotr -.--User1Number:.7528' · :R.unCotle: 201-1~,~29,r,10:~1:s.s ID:11'009 Paa~ t?t'.ofi,1.1 CJ 1L ol.f~ 202. 7 SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE Business Contact OFFICE UtE ONLY UPFP# \ 0 OL l '7 HV# 2 1 -1 geo 2.. BP DATE IS I QI ID i --mt APN# Plan File# 7 e following questions represent the facility's activities, NOT the specific project description. PART I: FIRE DEPARTMENT-HAZARDOUS MATERIALS IJIVISION: 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 a~led, _)~}cant must contact the Fire Protection Agenc wit jurisdiction prior-to plan submittal. Facility's Square Footage (including proposed project): ~-;,. 4Q~ Occupancy Rating: --1 ... 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactiv~s 13. Corrosives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None ofThese. · 4. 'Flammable-Solids 8. Unstable Reactives 12. Radioactives PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH.., HAZARDOUS MATERIALS DIVISIONS {HMD): If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Ave., Suite 110, San Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED. Project Completion Date: Ltfl_t_jl_ Expected Date of Occupancy: 1-.1J.1.J-1L YES NO -(for new construction or remodeling__pro.J2,cts) 0 CalARP Exempt I 1. ~ D Is your business listed on the reverse side of this form? (check all that apply),Per~; \. ~01-IJC? l-\ '-t" 2. ~ _ D Will your business dispose of Hazardous Substances or Medical Waste in any amount? Date Initials · 3. i0" D Will your business store or handle Hazardous Substances in quantities ~qual tq or great~r}1ha,Q ooi gallons, 500 pounds 200 cubic feet, or carcinogens/reproductive toxins in any quantity? Z 509-lt! 'tr, I o-Date 0 CalARP Required I Initials 4. 5; 6. 7. D [j [j tJ @" Will your business use an existing or install an underground storage tank? < 5 c::. 0 _ o ~ Q I Ot> ~ Will your business store-or handle Regulated Substances (CalARP)? "'<JW D 0': Will your business use or install a Hazardous Waste Tank System (Title 22, Article 1 O)? r.'.) J\ T g Will your business store petroleum in tanks or containers at yo~r facility with a total torage capagny I"\~ or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act). PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT: If the answer to any of the q estions bem~ yest!1f1Pl;lliPilllt must cont ct the Air Pollution Control District (APCD), 10124 Old Grove Road, San Diego, CA 92131-1649, telephone (858) 58 -26'00 prior~alttte issuane'elbtla building ofr demolition permit. Note: if the .answer to questions 4 or 5 is ye~. applicant must also submit an asbestps notificatio form to the APCD at least 1 0 working d . s prior to commencing demolition or renovation, except demolition or renovation of residential structures of four units r less. ~!ff h~ --, , , ~ormati n. YE§ NO 1. 0 D Will the subject facility or construction activities include operations or equipment that emit· CASH E 2. 3, 4. 5. D D D D APCD factsheetat http://www.sdapcd.org/info/facts/permits.pdf, and the list of typical equipment requiring an permit on the reverse side .-:-../ bf this from. ContactAPCD ifyou.-have any questions). ~ (ANSWER ONLY IF QUESTION 1 IS YES) Will the subjectfacility be located within 1,000 feet of the outer boundary of a school (K through 12)? .,.,,, (Search the California School Directory at http://www.cde.ca.gov/re/sd/ for public and private schools or contact the appropriate school tlistrict). ~ . Has a survey been performed to determine the presence of Asbestos Containing Materials? ~ Will there be renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non-friable asbestos? ~ Will there be demolition involving the removal of a load supporting structural member? U 'PS ba,-/iwui.o __ / 1 Qf f., ( ed U Briefly describe business activities: · I R~n oCE:(._~ 4 (.A0tre......._0Lt.s~ Briefly describe proposed project: ~llt\WllCN l-f I II Date FOR OFFICIAL USE ONLY: FIR!;: DEPARTMENT OCQUPANCY CLASSIFJCATION:. _____________________________ _ BY: ____________________________ _ DATE: __ :..../ __ _,_/ __ RELEASED FOR BUiLDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMO APCO COUNTY-HMO APCO *A stamp in thi~ box only exem(3,ip~~~~~e~,~~~le\ing or updating a Hc1zardous Materials Business Plan. Other permitting requirements may still apply. HM-9171 (02/11) I:"/-~ f I ~l-) County of San Diego -DEH-Hazardous Materials Division . . INDUSTRIAL WASTEWATER DISCHARGE PERMIT ,a /,. /., . . . • .. . -~ . SCREENING SURVEY . . Date~ B~siness N_arhe ~R( ~ $1ree.tAddres&. z~ ~ ;=· ~kMC:i Q,. q7J%ll Ernai1Addres$ _J9C:~~=90~ PLEASE CHl=CK HERE IF YOUR !3USINl;SS 1$ EXEMPT: (ON R!=-V~RSE SIDE CHECK TYPE OF BUSINESS) D GJwck all qef ow that ?tre present at ypur facility: .. . . .. Acid Cleaning Ink fv1a"!'lUfacturirig Nutritional Supplement/ Ass~ml;>ly v{aboratory J/famin M_anu.facturing· Autprnotiv~ R~pair Machining I Milling _ ainting / Finishing ~~tf1:1ry Manufacturing Manufacturing Paint Mam;tacturing Bipfciel Manµfacturirtg Membrane .Man1Jfac~1,1ri_ng Personal Care Products Bio_~ech !,.,aborat9ry (Le: water filter membranes) M~nufacturfng [?,lllk Chemical Stor~ge Metal Casting/ Fonn1ng Pe~ticid~ Manufacturing/ CarWash Metai Fabrication-Packaging Chemical .Manufaotwing M~tal Finishing _ Pharmaoeµtical Manufacturing Chemical Purification · Eiectroplating (including precursors) Dry ·cieanirtg Electroies$ plating Porcela_iri Enameling ~l~'otifoal C6rnponent Anodizing Power Generation Manufacturing Coating (i.e. phosphating) Print Shop Ferttiizer Mariufact1,1ring Chemfcal Etchirg / Milling vResea,rch and Development Film I X-ray Proc~ssing Printed Circuit Board ~ubber Manufacturing Food Processing Manufacturing Semiconductor Manufacturing Glass M?m~fat:turinQ Metal Powders Forming Soap I Detergent Manuf~9turing ln<;fustri?I_I Li;ttJntjry Waste Treatment/ Storage SIC Code(s} (if known): _3___,q.__l/.._C/_,__ __ ---'--____________ _ Have you applied for a Wastewat~r Discharge P~rmit from the ncina W stewater Authority? @ No If yes, when: 'Der-~ \1 ~ ~ .:2;). 0 q q $iteContact'Uo Ca.s-e.. -Title fi1.c,V\C4~f'", £.4tS Signature.'Jb,,,,~:---~,--,---~---'--,---,-Phone No. L 7~D) q 3 o-t;z.:z.. ?- ENCINA TEW ATER AUtHORITY,. 6200 Aveni<:{~ Encfnas Carlsbad, CA 92011 (760) 438 .. 3941 FAX: (760) 476-9852 «,t ~ CITY OF CARLSBAD SPECIAL INSPECTION AGREEMENT B-45 Development Services · Bufldlng Division 1635 Faraday Avenue 760-602-2719 www.carlsbadq.gov In aceordance with Chapter 17 of the California Building Code the following-must be completed when work being performed requires special Inspection, structural observation and construotlof'!. material testing. Project/Permit: Cb /I.() 1 ~1 Project Address: :2 I~ !<Jlft/{?/llll/4() /lP;J-f} A, THIS SECTION MUST BE COMPLETED BY THE PROPERTY OWNER/AUTHORIZED AGENT, Please check If you are Owner- Builder Cl. (If you checked as owner-builder you must also complete Section B of this agreement.) Name: (Please prfnt)__/)p[_/ /Uf"W /( ~ (Firal) . ~ 1 (lnlj Malling Address: /'J'ffl) -l'v ttltY;M ~ ,• 5'1¥. /)1/ivfJ) C'A-... :-</Y/~P Email· llf'/(/( (Ill/ f Left,,.. JI(. ·~d{;J? PhonetJ.,._g}_ JfJ ..-~ 171 I am: OProperty owner OProperty OWn~r·s Agent of Record ~hitect of Record IJEngineer of Record /Jll7Af 1/(A/J// State of California Registration Numbe=r---=-C..:~1t/~ ,_v~-------Expiration Date:, ____ ,,...., ~ .... ;,,. __ v_1 __ AGREEMENT: I, the undersigned, declare under penalty of perjury under the laws of the State of California, that I have read, understand, acknowledge and promise to comply with the City_ of Carlsbad requirements for special inspections, s tural observations, construction materials testing and off-site fabrication of bulldlng components, as prescribed I th statement of s eoi I ,inspections oted on the approved plans and, as required by the Californla Building c e. G /at/. Signatur<J..-,,4-A4,4,i~~~~~~+--~------,--Date: ~_j._l ___ _ B, CONTRACTOR'S STATEMENT OF RESPONSIBILITY (07 CBC, Ch 17, Section 1106). This section must be completed by the contractor/ builder/ owner•bUllder. Contractor's Company Name: 'P-'r'Ll h <:... IS« I (...0/ iJ?,. · " ~ Please eheck if you are owner-Builder o Name: (Pleas~ print) g'~-,./ --~ ..... VV\ ____ . --------~---...;;._ ______ _ (Fitll) (M.I.} (l.asl) Mailing Address: 11):L. .4:J~ ~ c:r~ ;, S!t~ b1,6Ie_, ~ SZJ_'t::(,.,,_ ~mail: bva.,,.,4.tlVl €pl:Je ,~b(c-,_· ___ ..,..__ Phone: ITt: IT'Z.. O(pfJO State of Callfornla,contraetor's License Number: ,-O "1.. SIC, Expiration Date: / 2) 31 ) rz__ • I acknowledge and, am aware, of special requirements contained in the statement of special inspections noted on the approved plans; • I acknowledge that control will be exercised to o btarn conformance with the construction documents approved by the building officlal; • ·1 will have !n-place procedures tor exercising control within our (the contractor's) organization, for the method and frequency of re orting and the distribution of the reports; and • I cert· · ea quallfied person within-our (the contractor's)·organization to exercise such control. "'-+-.....-i.c--1-'------------,--Date: r/ :r1/4 r 1 Page 1 of1 Rev. 02/10 , CB110757 2180 RUTHERFORD RD CALLAWAY: 250 SF DATA ROOM lf/!z/11 -Tl> f(/!Jv/fNf/ 6~·t. <>f-nJ,e.€, c..f./ (~II LJ!NI\\ ~-f:v~ ~@_~ 5/Lt/1\ fJy-/j :;1l%H~4C s-/10/ 11 -Our-s ~ n, F/mc / /c,&:f tJlv.5c 5 //F.-£r.:; 7lJ fhrJ. ~ (},Ans ~~ ·5j.1i11\-tfr/JJ (UM c; I ic/!( pL~ ® (o (Lvv---_ I F (_ . f\) e e.. cl ~/ Q c. -T ~ >? ~li~B ( pl~~-A-~P C( ( ( It - (p~-//, plfrlVs~ !JCV Approved -Date By BUILDING (_ / LC.,/ t t MP PLANNING I t ENGINEERING Lf/14/ II Yi:'--~ FIRE Expedite? y (N) - HazMat .'i/-:;;J / 11 Jn,rt-- APCD Health Forms/Fees Sent Rec'd Due? By Encina 'l•t 2-.,1 y ,N Fire --y N HazHealthAPCD lf•l"Z-·II .sf 1t)/11 y N PE&M 4. IZ-•JI y N School y N Sewer y N Stormwater 1./-. f -z... JI y N Special ln~pection s-12~11 C../' // y N CFO: y (I) LandUse: ,;>ensity: lmpArea: FY: Annex: Factor: PFF: y {N) Comments Date Date Date Date Building '::;" {J../f (c,, ~ Planning L/-/1'1-/ II ,5-~fe) Engineering . Fire 4-/>t I II f//6---1( --.,_:; l-H Need? /' -COJ2-~'-cl "l?lr-6P (('~c>l',\Cv,.-. ~Done ......, ~ c~ R Ul -< .e,,+ , /'-I -)(Done ~ '----l DDone DDone DDone SW D Issued