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HomeMy WebLinkAbout2231 RUTHERFORD RD; 100 | 200; PC2019-0006; Permit(City of Carlsbad Print Date: 02/04/2020 Permit No: PC2019-0006 2231 Rutherford Rd BLDG-Plan Check 2120701900 $ 0.00 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: Work Class: Commercial Lot #: Reference #: Construction Type Bathrooms: Orig. Plan Check #: Plan Check #: Status: Closed - Finaled Applied: 03/04/2019 Issued: 03/26/2019 Permit 01/27/2020 Inspector: Final Inspection: Description: BECKMAN PROPERTIES: 8,910 SF OFFICE TO OFFICE T.I. OF SUITES 100 & 200 Applicant: Owner: Contractor: TIM SEAMAN BECKMAN CARLSBAD I LLC S P WHITE CONSTRUCTION INC 14428 Springvale St POWAY, CA 92064-5147 2231 Rutherford Rd 2524 Gateway Rd 619-993-8846 CARLSBAD, CA Carlsbad, CA 92009-1742 760-931-1130 FEE AMOUNT MANUAL BUILDING PLAN CHECK FEE - $1,220.98 Total Fees: $ 1,220.98 Total Payments To Date : $ 1,220.98 - Balance Due: $0.00 Building Division 1635 Faraday Avenue, Carlsbad CA 92008-7314 1 760-602-2700 1 760-602-8560 f I www.carlsbadca.gov (City of Carlsbad COMMERCIAL BUILDING PERMIT APPLICATION B-2 Plan Check Est. Value PC Deposit Date Job Address .7131 904 a44 iJ. Suite: 106 $240 APN: 2J.2. 070 01 00 Tenant Name: 19 CT/Project #: Lot #:________ Occupancy: Construction Type: 7.1. Fire Sprinklers: yes / no Air Conditioning: yes / no BRIEF DESCRIPTION OF WORK: St!C*[ &e#'i 1.1. 4f fWQ Sif, &It ot, C, P.4!.,1 (/,tnr Of LI Addition/New: New SF and Use, ___New SF and Use, Deck SF, _________ Patio Cover SF (not including flatwork) -Tenant Improvement: I i &_ SF, Existing Use Cfc / CC— Proposed Use ccfIc-_- ./eD(2- 41 /I OR SF, Existing Use Proposed Use 0Pei-iCe.- Pool/Spa: SF Additional Gas or Electrical Features? LI Solar: KW, Modules, Mounted, Tilt: Yes / No, RMA: Yes / No, Panel Upgrade: Yes / No LI Plumbing/Mechanical/Electrical Only: LI Other: APPLICANT (PRIMARY) PROPERTY OWNER 4O/4L1(5 a4 I Name: tl0&ce,4— Name:I3eCkww., I'3o.eg'4Iej,. IA/cC. Address: P0 &, C Address: 505 LotiuI P i,- Ict, City: CLJ,i. V/c4-r,.. State:ILA- Zip: 914 12- City: So/",.I)€a.e..&. -State: Ch Zip: 7S Phone: 614' 1cf Phone: 'S 71 0/00 Email:T1 Email:__________________________ DESIGN PROFESSIONAL Name: Address: City: Phone: State: Zip: CONTRACTOR BUSINESS Name: \AfI* Coe" Address: 29.2e( 41wy Roa4 City: C-Icb,A State: Zip:00 ef Phone: 760 131 1I3() Email: Email: Architect State License: State License: __S2.. 5'I3 Bus. License:1 2..02.80 (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she 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/she 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}). 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: BuiIdingcarIsbadca.gov B-2 Page 1 of 2 Rev. 06/18 (OPTION A): WORKERS'COMPENSATION DECLARATION: I hearby affirm under penalty of perjury one of the following declarations: 13 li have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. 13 I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Company Name: 3faJ__(m.jn.eviy aAt?.at ZnCdaisf.e Fq.4 Policy No. .l'I 30 36 Expiration Date: I / I / 72& O 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 be come 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 $100,000.00, in addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. CONTRACTOR SIGNATURE: rJ1'b1L46 E3V'AGENT DATE: 3)41/) ' (OPTION 13 ): OWNER-BUILDER DECLARATION: I hereby affirm that! am exempt from 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). El 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). ci 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. ci Yes ci No I (have / 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): S. 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): OWNER SIGNATURE: LJAGENT DATE: CONSTRUCTION LENDING AGENCY, IF ANY: 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: ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 Yes 0 No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? ci Yes ci No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? ci Yes ci 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. APPLICANT CERTIFICATION: 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 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 ANY WAYACCRUE AGAINSTSAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.OSHA: An OSHA permit is required for excavations over 5'O' 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 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 authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT SIGNATURE: DATE: 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Build ingcarlsbadca.gov B-2 Page 2 Of 2 Rev. 06118 V EsGil A SAFEbuilt Company DATE: 3/15/2019 U APPLICANT U JURIS. JURISDICTION: City of Carlsbad PLAN CHECK #.: pc2019--0006 SET: I PROJECT ADDRESS: 2231 Rutherford Rd. PROJECT NAME: Carlsbad Courtyard Suites 100 and 200 T.I. The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. El 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. El The check list transmitted herewith is for your information. The plans are being held at EsGil until corrected plans are submitted for recheck. LII The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: EsGil staff did not advise the applicant that the plan check has been completed. El EsGil staff did advise the applicant that the plan check has been completed. Person contacted: /(b Telephone #: Date contacted: y Email: Mail Telephone Fax In Person El REMARKS: By: David Yao Enclosures: EsGil 3/7/19 9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576 (DO NOT PAY— THIS IS NOT AN INVOICE) VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PLAN CHECK #.: pc2019--0006 PREPARED BY: David Yao DATE: 3/15/2019 BUILDING ADDRESS: 2231 Rutherford Rd. BUILDING OCCUPANCY: B BUILDING AREA Valuation PORTION (Sq. Ft.) Multiplier Reg. Mod. VALUE ($) OFFICE 4681 46.51 217,713 Air Conditioning Fire Sprinklers TOTAL VALUE 217,713 Jurisdiction Code cb By Ordinance 77- I Plan Check Fee by Ordinance I Type of Review: E Repetitive Fee Repeats 121 Complete Review 121 Other El Hourly EsGil Fee El Structural Only Hr. © * $637.43 Comments: Sheet of PLANNING DIVISION B Development Services BUILDING PLAN CHECK Planning Division CITY OF REVIEW CHECKLIST 1635 Faraday Avenue CARLSBAD P-28 (760) 602-4610 www.carIsbdca.ov MAR 25 2019 DATE: 3/20/19 PROJECT NAME: Ti PROJECT ID: CITY OF CARLSBAD BUILDING DIVISiflN PLAN CHECK NO: PC20I9-0006 SET#: I ADDRESS: 2231 RUTHERFORD RD APII: This plan check review is complete and has been APPROVED by the Division. By: HECTOR SALGADO A Final Inspection by the PLANNING Division is required fl Yes 0 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 Comments have been sent to: TIM@CHAMPIONPERMITS.COM For questions or clarifications on the attached checklist please contact the following reviewer as marked: Hector Salgado 760-6024624 Hector.Salgado@carlsbadca.Eov Remarks: Plan Check No. PC2019-0006 Address 2131 RUTHERFORD Date 3/20/19 Review #1 Planner HECTOR SALGADO Phone (760) 602- 4624 APN: Type of Project & Use: Net Project Density: DU/AC Zoning: _____ General Plan: Facilities Management Zone: CFD (in/out) #_Date of participation: Remaining net dev acres:_____ (For non-residential development: Type of land use created by this permit: 1 Y4 I Ak'C 1 2 3 Legend: Z Item Complete LI Item Incomplete - Needs your action LI LI Environmental Review Required: YES El NO El TYPE DATE OF COMPLETION: Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval: Z LI fl Discretionary Action Required: YES LI NO LI TYPE APPROVALJRESO. NO. DATE PROJECT NO. OTHER RELATED CASES: Compliance with conditions or approval? If not, state conditions which require action. Conditions of Approval: Z LI LI Coastal Zone Assessment/Compliance Project site located in Coastal Zone? YES Q NO 0 CA Coastal Commission Authority? YES 0 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): 0 LI Habitat Management Plan Data Entry Completed? YES LI NO LI If property has Habitat Type identified in Table 11 of HMP, complete HMP Permit application and assess fees in Energov LI LI Inclusionary Housing Fee required: YES LI NO LI (Effective date of Inclusionary Housing Ordinance - May 21, 1993.) Data Entry Completed? YES LI NO LI For construction of inclusionary units, email notification provided to HNS?: YES El NO LI (Email Susan Steinkemp in HNS with project number and contact info) LI El Housing Tracking Form (form P.20) completed: YES LI NO LI N/A LI P-28 Page 2 of 3 07/11 alm Zoning: 1. Setbacks: Front: Interior Side: Street Side: Rear: Top of slope: Required Shown Required Shown Required Shown Required Shown Required Shown Site Plan: El Provide a fully dimensional site plan drawn to scale. Show: North arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, right-of- way width, dimensional setbacks and existing topographical lines (including all side and rear yard slopes). Provide legal description of property and assessor's parcel number. City Council Policy 44— Neighborhood Architectural Design Guidelines IZI El El 1. Applicability: YES El NO El 0 0 2. Project complies: YES El NOD N E-111 2. Accessory structure setbacks: Front: Required Shown Interior Side: Required Shown Street Side: Required Shown Rear: Required Shown Structure separation: Required Shown El El 3. Lot Coverage: Required Shown El El 4. Height: Required Shown El El 5. Parking: Spaces Required Shown (breakdown by uses for commercial and industrial projects required) Residential Guest Spaces Required Shown El El El Additional Comments PLAN CHECK #1 #1. PLEASE REVISE PLANS TO SHOW SCREENING OF ROOFTOP EQUIPMENT. SEE ATTACHED OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER DATE P-28 Page 3 of 3 07/11 A BNVE STRUCTURAL • CIVIL .SURVEY • LAND PLANNING 9449 Balboa Avenue, Suite 270 .San Diego, CA 92123 Phone (619) 299-5550 • Fax (619) 299-9934 www.bwesd.com ENGINEER: Dane Hansen DATE: February 28, 2019 PROJECr NUMBER: 13328A.1.00 *2 STRUCTURAL CALCULATION S' FOR Carlsbad Courtyard 2231 Rutherford Rd Carlsbad, CA Table of Contents: ProjectLoads.......................................................................................................................1 C.) Mechanical Unit Support Design ........................................................................................4 Exterior Opening Anchorage Design...................................................................................8 cFESS,o Prepared for DATE SIGNED: 02/28/2019 idStudios 236 S Sierra Avenue, Suite 110 Solana Beach, CA 92075 2/25/2019 U.S. Seismic Design Maps 1 * OSHPD cAwomtn Carlsbad Courtyard 2231 Rutherford Rd, Carlsbad, CA 92008, USA Latitude, Longitude: 33.1312881, -117.2787715 I Callaway Golf0 9 Rd - = vku*d 1 .1 9 Crestone Group Google L-3 Communications 'Photonics"O Map data 02019 Google Date 2/25/2019, 8:46:34 AM Design Code Reference Document ASCE7-10 Risk Category II Site Class D - Stiff Soil Type Value Description Ss 1.068 MCER ground motion. (for 0.2 second period) S1 0.413 MCER ground motion. (for 1.0s period) SMS 1.146 Site-modified spectral acceleration value 5M1 0.655 Site-modified spectral acceleration value SDS 0.764 Numeric seismic design value at:0.2 second SA 5D1 0.437 Numeric seismic design value at. 1.0 second SA Type Value Description SDC D Seismic design category Fa 1.073 Site amplification factor at 0.2 second Fv 1.587 Site amplification factor at 1.0 second PGA 0.413 MCEG peak ground acceleration FPGA 1.087 Site amplification factor at PGA PGAM 0.449 Site modified peak ground acceleration TL 8 Long-period transition period in seconds SsRT 1.068 Probabilistic risk-targeted ground motion. (0.2 second) SsUH 1.099 Factored uniform-hazard (2% probability of exceedance in 50 years) spectral acceleration SO 1.5 Factored deterministic acceleration value. (0.2 second) SIRT 0.413 Probabilistic risk-targeted ground motion. (1.0 second) SI UH 0.403 Factored uniform-hazard (2% probability of exceedance in 50 years) spectral acceleration. S1 1D 0.6 Factored deterministic acceleration value. (1.0 second) PGAd 0.504 Factored deterministic acceleration value. (Peak Ground Acceleration) CRS 0.972 Mapped value of the risk coefficient at shorl periods https://seismicmaps.org/ 1/3 2/25/2019 U.S. Seismic Design Maps Type Value Description CRI 1.025 Mapped value of the risk coefficient at a period of I s https://seismicmaps.org/ 2/3 2/25/2019 U.S. Seismic Design Maps 3 2.5 5.0 7.5 Period, T(sec) - Sa(g) 2.5 5.0 7.5 Period, T (sec) - Sa(g) DISCLAIMER While the information presented on this website is believed to be correct, SEAO /Q JIfJ and its sponsors and contributors assume no responsibility or liability for its accuracy. The material presented in this web application should not be used or relied upon for any specific application without competent examination and verification of its accuracy, suitability and applicability by engineers or other licensed professionals. SEAOC I OSHPD do not intend that the use of this information replace the sound judgment of such competent professionals, having experience and knowledge in the field of practice, nor to substitute for the standard of care required of such professionals in interpreting and applying the results of the seismic data provided by this website. Users of the information from this website assume all liability arising from such use. Use of the output of this website does not imply approval by the governing building code bodies responsible for building code approval and interpretation for the building site described by latitude/longitude location in the search results of this webstie. https://seismicmaps.org/ 3/3 MCER Response Spectrum 1.5 1.0 (5 CO 0.5 0.0 0.0 Design Response Spectrum 0.8 0.6 COZM 0.4 CO 0.2 0.0 0.0 I I I DATE _____________ Pw.r SHEET I 3 1 - ENGINEERED TO INCUO EXPRCTATIOrdS • • - . ENGR 1. • -4 1- JOB NO CV4 PROJECT- #A/L7 I Oct - —t— + ((4WAJC c!co lt 9'O" -&fe'4 - '•___i_•.-•' -t • • • 1.1 I' 'AitAl- j44 - LJ- -c 4 ?c 73 lip - ill + [Ii4. :.L ._ •, .1 • - + I -- • .'- -t L 1 +ti3Op1, 3 I - !-- r Tfl tc 17 1 • - I I - •7 3 I I. ••,, 1-.- •. t-- r — ç(7,$7 -) ,,. t,•(-" 7, 11 J 1I J I!' II .1.11 f . ••II -' fT ± 1 4 4 I I ' SHE ________ ________ r3%, DATE - . : ET ENGINEERED TO IXCUD INflCTATJO(5 JOB NO, : PROJECT -- t&J(644-r 75( ey , ' V 2) __ TACKIS IC - -- -r- -ILI T r AIDkOGO'X6 0 1 thy (a) HT #4CDçP) I 1 II 1a- - P '7!Lfr I4 4 4 -. -. 1 r1&,L ( P-"et !H& -4 -4 r - - Fle f 70.( ~ 1o) , I •:-.- 1 3 i 4 I I 1 1 fr:::IT TT1 A- T-1 * 1 c •- _!_ 4 j _I . .1 - • . . 7 13NVE I . I I - SHEET DATE ___________ - E1MgNU010 TO EXCEED EXPECT.4TIOMS 1 ENGR - J06 NO 1 c PROJECT CA&134O — I - !f) 1 utf C4(P4.1 sec) H •1 rof -€' — . - ((,1I VM i L 've •• - --• -, 1 - -- •- - 1.. oz 1 r1 r - i7T I (pJ - - Ill L L :- 1c V,i&r0t1 T Ij II - 1 11 t J •1 IDATE _________________13" VE SHEET r NGU4EUED TO EXCIED EXPECTATON5 - I ENGR: t - - ' -JOB NO PROJECT (AIl4.BO 4O :76J W A -DeC7&k) - . . \(:: t 1 Oi.pL• . cl 1 Q '- m&& I Cos rrt , I -j -I II I I I II tll J'-(eIAJ c to I I , Al (L0 IP6 ' - i . u.i5Ce I - Lo t,UoO gjt.) p I-" I I - . - , 1 c I - 4 Al Q6c_J 0 _t._vL I 1 I_I- I I - I! • - .. K 9 I . I I = Profis Anchor 2.7.6 Page: 1 Project: Carlsbad Courtyard Sub-Project I Pos. No.: Date: 2/26/2019 KWlK HUS-EZ (KH-EZ) 318 (2 1I2) hef = 1.860 in., hnom 2.500 in. Carbon Steel ESR-3027 211/2016112/1/2017 Design method ACI 318 / AC193 - (Recommended plate thickness: not calculated) no profile cracked concrete, 2500, f = 2,500 psi; h = 420.000 in. tension: condition B, shear: condition B; no supplemental splitting reinforcement present edge reinforcement: none or < No.4 bar no www.hilti.us Company: Specifier: Address: Phone I Fax: E-Mail: Specifier's comments: linput data Anchor type and diameter: Effective embedment depth: Material: Evaluation Service Report: Issued I Valid: Proof- Stand-off installation: Profile: Base material: Reinforcement: Seismic loads (cat. C, D, E, or F) Geometry [In.] & Loading [lb in.lb] Input Input data and results must be checked for agreement with the existing conditions and for plausibility! PROMS Anchor (c) 2003-2009 Huh AG, FL-9494 5chsan Hilti is a registered Trademark of Hilti AG. Schaan www.hllti.us Prof is Anchor 2.7.6 Company: Page: 2 Specifier: Project: Carlsbad Courtyard Address: Sub-Project I Pos. No.: Phone I Fax: I Date: 2/26/2019 E-Mail: 2 Proof I Utilization (Governing Cases) Design values [Ib] Utilization Loading Proof Load Capacity DN' PV lYe] Status Tension - - - -I- - Shear Concrete edge failure in direction x- 360 380 -/95 OK Loading PN Pv Utilization PN,V ('I.] Status Combined tension and shear loads - - - - - 3 Warnings Please consider all details and hints/warnings given in the detailed report! Fastening meets the design criteria! 4 Remarks; Your Cooperation Duties Any and all information and data contained in the Software concern solely the use of Hilti products and are based on the principles, formulas and security regulations in accordance with Hilti's technical directions and operating, mounting and assembly instructions, etc., that must be strictly complied with by the user. All figures contained therein are average figures, and therefore use-specific tests are to be conducted prior to using the relevant Hilti product. The results of the calculations carried out by means of the Software are based essentially on the data you put in. Therefore, you bear the sole responsibility for the absence of errors, the completeness and the relevance of the data to be put in by you. Moreover, you bear sole responsibility for having the results of the calculation checked and cleared by an expert, particularly with regard to compliance with applicable norms and permits, prior to using them for your specific facility. The Software serves only as an aid to interpret norms and permits without any guarantee as to the absence of errors, the correctness and the relevance of the results or suitability for a specific application. You must take all necessary and reasonable steps to prevent or limit damage caused by the Software. In particular, you must arrange for the regular backup of programs and data and, if applicable, carry out the updates of the Software offered by Hilti on a regular basis. If you do not use the AutoUpdate function of the Software, you must ensure that you are using the current and thus up-to-date version of the Software in each case by carrying out manual updates via the Hilti Website. Hilti will not be liable for consequences, such as the recovery of lost or damaged data or programs, arising from a culpable breach of duty by you. re Input data and results must be checked for agreement with the exIstIng conditions and for plausibllityt PROFIS Anchor ( c ) 2003-2009 Hilti AG, FL-9494 Schaan Huh Is registered Trademark of HIS AG. Schaan SAN DIEGO REGIONAL I OFFICE USE OP HAZARDOUS MATERIALS IREC0RDIO. PLAN CHECKS_______________ QUESTIONNAIRE I NIP Busirs Contact Telephone S t I&Vcid%d\ c- ic- 000 ide sulte state aPCde API '\ L i Sk de suite) qG state I : lndkate i ryous races or ne* L fl o1Iterns are OEM icant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. Occupancy Rating: Facility. Square Foctig. (including proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives 2. Compressed Oases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards 3. FlammablelContbustlble Liquids 7. Pyrophorlcs 11. Highly Toxic or Toxic MaterIals 15. None of These. 4. Flammable Solids 8. Unstable Reactives 12, Radloactives PART II: SAN DIEGO COUNTY DEPMTMENT OF EALTh HAZARDOUS MATERIALS DIVtON ft): If the answer to any of the questions is yes, applicant must contact the otrity of iiateriai DMslon, 5500 overland Avenue, Suite 170, San Diego CA 92123. Call (858) 505.6700 prior to the issuance of a building peiTnit. FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy 0 CaIARP Exempt YES (for new construction or remodeling projects) 0 Is your business listed on the reverse side of this form? (check all that apply). Date Initials 0 I Will your business dispose of Hazardous Substances or Medical Waste in any amount? 0 Will your business stare or handle Hazardous Substances In quantities greater than or equal to 55 gallons, 500 0 CSIARP Required pounds and/or 200 cubic feet? I 0 Will your business store or handle carclnogenslreproductive toxins In any quantity? 05te InitIals 5 . 0 Will your business use an existing or install an underground storage tank? 0 Will your business store or handle Regulated Substances (CalARP)? 0 CaIARP Complete 0 WIN your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? I 0 Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to Date Initials or greater than 1,320 gallons? (California's Aboveground Petmleian Storage Act). PART ill: SAN DIGO COUNTY AIR POLLUTION CO!4fltOL DISTRICT IAPçDj The following questions are Intended to identify the majority of air pollution Issues at the planning stage. Your project may require additional measures not identified by these questions. Some residential projects may be exempt from APCD requirements. if yes is answered for either questions 1,2 or :5 or for more comprehensive requirements, please contact APCD at secdcombsdcoontvcaaov (858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131. YES NO 0 Will the project disturb 100 square feet or more of existing building materials? Will any load supporting structural members be removed? 0 (ANSWER ONLY IF QUESTION I or 2 IS YES) Has an asbestos survey been performed by an Individual that has passed an EPA-approved building inspector course? J 0 (ANSWER ONLY IF QUESTION lot 2 I YES) Based on the survey results, will the project disturb any asbestos containing material? If yes, a' notification may be required at least 10 working days prior to commencing asbestos removal Additionally, a notification may be required prior to the removal of a load supporting structural, member(s) regardless of the presence of asbestos. S. 0 0 Will the projector associated construction equipment emit air contaminants? See the reverse side of this form for typical equipment requiring an APCD permit if yes, contact APCD prior to the issuance of a building permit 6. 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 Briefly descdbe business activities: Briefly describe proposed proj I declare under Aer0y of pelts that to the best of my knowledge and belief the responade1,er&n , 6, 010V% FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: FOR OFFICAL USE ONLY: BY: DATE: 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 P In this box 211!! exemPwsinessesfea'n completing or.upoaung a MazarOOus Materials Business Plan. Other permitting requirements may Sill apply of W HM-9171 (9I18) County of San Diego - OEM - Hazardous Materials Division Scanned with CamScanner ENCM INDUSTRIAL WASTEWATER DISCHARGE PERMIT WMMAM Date 3Jz///g SCREENING SURVEY Business Name Street Address L2( PA-LAt r2A i-- cc!4 c..4- Email PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT: (ON REVERSE SIDE CHECK TYPE OF BUSINESS) Check all below that are present at your facility: Acid Cleaning Ink Manufacturing Nutritional Supplement! Assembly Laboratory Vitamin Manufacturing Automotive Repair Machining I Milling Painting I Finishing Battery Manufacturing Manufacturing Paint Manufacturing Biofuel Manufacturing Membrane Manufacturing Personal Care Products Biotech Laboratory (i.e. water filter membranes) Manufacturing Bulk Chemical Storage Metal Casting / Forming Pesticide Manufacturing! Car Wash Metal Fabrication Packaging Chemical Manufacturing Metal Finishing Pharmaceutical Manufacturing Chemical Purification Electroplating (including precursors) Dry Cleaning Electroless plating Porcelain Enameling Electrical Component Anodizing Power Generation Manufacturing Coating (i.e. phosphating) Print Shop Fertilizer Manufacturing Chemical Etching / Milling Research and Development Film /X-ray Processing Printed Circuit Board Rubber Manufacturing Food Processing Manufacturing Semiconductor Manufacturing Glass Manufacturing Metal Powders Forming Soap! Detergent Manufacturing Industrial Laundry Waste Treatment! Storage SIC Code(s) (if known): Brief description of business activities (Production! Manufacturing Operations):______________ Description of operations generating wastewater (discharged to sewer, hauled or evaporated): Estimated volume of industrial wastewater to be discharged (gal/ day): List hazardous wastes generated (type / volume): Date operation began/or will begin at this location: Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? Yes No If yes, when: Site Contact W( (' m 1? - Title Ow c Signature... Z-_-__ Phone No. t4 17 ?65 ENCINA WASTEWATER AUTHORITY, 6200 Avenida Encinas Carlsbad, CA 92011 (760) 438-3941 FAX: (760) 476-9852