HomeMy WebLinkAbout2270 CAMINO VIDA ROBLE; I; CB044574; PermitJob Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Grouj:
Project-Title:
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial/Industrial Permit Permit No: CB044574
Building Inspection Request Line (760) 602-2725
1557 GRAND
SAN MAR
2^6677
2270 CAMINO VIDA ROBLE CBAD St: I
Tl Sub Type:
2130504700 Lot #:
$31,372.00 Construction Type:
Reference #:
1023 SF TENANT IMPROVEMENT
COMM
0
NEW
CA 92069
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
Plan Check*:
Owner:
2270 CAMINO VIDA ROBLE LLC
685 TURQUOISE ST
LAJOLLACA 92037
ISSUED
12/20/2004
KG
02/18/2005
02/18/2005
Building Permit
Add'l Building Permit Fee
Plan Check
Add'l 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'l Pot. Water Con. Fee
Reel. Water Con. Fee
$254.11 Meter Size
$0.00 Add'l Reel. Water Con. Fee
$165.17 Meter Fee
$0.00 SDCWA Fee
$0.00 CFD Payoff Fee
$6.59 PFF
$0.00 PFF (CFD Fund)
$0.00 License Tax
$0.00 License Tax (CFD Fund)
$0.00 Traffic Impact Fee
$0.00 Traffic Impact (CFD Fund)
$0.00 PLUMBING TOTAL
$0.00 ELECTRICAL TOTAL
$0.00 MECHANICAL TOTAL /I A,
$0.00 Master Drainage FeeBUiLDlNCj t LAI
Sewer Fee / 1N STORAGE
$0.00 Redev Parking Fee —-
$0.00 Additional Fees _
TOTAL PERMIT FEES
.ATTACHED
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$55.00
$35.00
).50
1.00
$0.00
$0.00
$0.00
$546.37
Total Fees:$546.37 Total Payments To Date:$165.17 Balance Due:$381.20
2242 02/18/05 0002 01 02
CGF" " 381-20iE.04.S30
Inspector:
FINAL APPROVAL
Date: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 "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
PERMIT
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
ATION
FOR OFFICE USE ONLY
PLAN CHECK
EST. VAL.
Plan Ck. Deposit
Validated B
Date
*T6 - X y. ^ >n -t f\ j.-\
re**)1 Q/Q4 QQQ2 01Address (include Bldg/Suite #)Business Name (at this add Q XaLX i~
&6F VL7Legal Description Lot No.Subdivision Name/Number Unit No.Phase No."Total # of unrts'
Assessor's Parcel #
O b W
Existing Use Proposed Use
4.0 \ 1_
# of Bedrooms
D
Description of Work
p. CONTACT PERSON (if different from applicant)
SQ. FT.#of Stories # of Bathrooms
Name
3. APPLICANT
C-.j-J- Q
/Contractor
Address
Q Agent for Contractor f~| Owner
City
| Agent for Owner
State/Zip Telephone #Fax #
Name **
4. PROPERTY OWNER
Address City State/Zip Telephone #
e/c
Address City State/Zip Telephone #Name
5. CONTRACTOR - COMPANY NAME
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
[Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]).
C-<U^L a^,^J , W. I Sit (,#*,*? **>$/* S*/> *MHo.f C* «T£o4? Cl^ ^i-flBB
Name
State License #
Address
License Class
City State/Zip
City Business License tt
-^i Teep
ffi B \Q /
Telehone #
Designer Name Address City State/Zip Telephone
State License # .S"VUnb4
6. WORKERS'COMPENSATION -:!'.;. ,, ' K IH'IR >;•-,.;.., V. ;: ::.' • ^fl-"'- :(::= ••:!::, II
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
C] I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
0^ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company (fJ"Tfr'T& f-ir*Q 11>> A-'&VCB' Policy No. C/C/*^ ltsf\J Expiration Date °9'&l 'O £
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)
Q CERTIFICATE OF EXEMPTION: I certify that inthe performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers'fiompefisation Lwvs of California.
WARNING: Failure to secure-workers' compensnroh coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100,OOpfTja addition withe cpsjfpf compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
SIGNATURE / 'V/.^^i^K~A/n DATE
7. OWNER-BUILDER DE
I hereby affirm that I am exehjaxitgfKthe Contractor's License Law for the following reason:
O I, as owner of the prduprty 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).
(~l I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
n 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, fj YES l~lNO
2. I (have / have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / 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
number / contractors license number):
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
of work):
PROPERTY OWNER SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? [H YES ^8^NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES J2^ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES /S? 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.
8. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
9. 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 representatives 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 WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excava
EXPIRATION: Every permit issued
authorized by such permit is not comm
at any time after the work is commeni
APPLICANT'S SIGNATURE
p and demolition or construction of structures over 3 stories in height.
ie provisions of this Code shall expire by limitation and become null and void if the building or work
:he date of such permit or if the building or work authorized by such permit is suspended or abandoned
Section 106.4.4 Uniform Building Code).
DATE / L- 2-0 ~ 8X4
WHITE: File YELLOW: Applicant PINK: Finance
List 1 - Permit-Type
From the following list, determine the permit-type that best describes the work you propose to do. Please put the code of that
permit-type in the blank at the top of die page on the front of this application. Residential permits (only) also require the
identification of the structure-type to be associated with the permit. Choose a structure-type from "List 2 - Structure-Types" and put
its code in the appropriate blank on the front of this application.
Code
APT
CONDO
CVNNR
CVNRN
CVNRR
DEMO
DUP
MOHO
MOHON
RAD
RREISSUE
RREPAIR
RREPLACE
SFA
SFD
Code
COM
CREISSUE
CREPAIR
CREPLACE
CTI
DEMO
ELEC
HOTEL
HOTELR
INDUST
m
MECH
MISC
PATIO
PLUM
POOL
RETAIN
SIGN
SOLAR
SPA
Residential Permits
Description
Apartments - new construction.
Condominiums - new construction.
Conversion. Convert all or a portion of a non-residential building to residential use, creating one or more new
residential units.
Conversion. Convert one or more residences in a building to non-residential usage.
Conversion. Increase or reduce the number of dwelling units in a residential structure through interior modifications
(i.e.: a four bedroom house converted to a duplex, with 2 bedrooms each).
Demolition permit. (Also specify type of structure from List 2).
Duplex - new construction.
Mobile home, renovation, repair, or addition of accessory structure not yielding a new living unit.
Mobile home, pre-fabricated house, or trailer installed (plumbed, wired) in a mobile home park (see distinction from
single-family residence, below).
Residential addition/alteration, creating no new dwelling unit(s).
Residential permit re-issue.
Residential building repair. Damage, fire, etc.
Residential building replacement (no additional units).
Single-family, attached - new construction. A one-family house attached to one or more other houses, with one or
more common walls extending from foundation to roof at, or forming, a lot line. Has own plumbing and heating
system (e.g.: townhouse, row house, half-plex)
Single-family, detached - new construction: A one-family house with open area on all four sides. May have an
attached or detached garage, or a business. May be a detached "granny flat". May be a mobile home or trailer on an
individual lot, but not in a mobile home park.
Non-Residential/Accessory Permits
Description
Commercial structure, new construction.
Commercial permit re-issue.
Commercial building - repair. Damage, fire, etc.
Commercial building - replacement.
Commercial tenant improvement.
Demolition permit.
Electrical permit, for electrical work only.
Hotel or motel (including Managed Living Unit hotel) - new construction.
Hotel renovation.
Industrial structure, new construction.
Industrial tenant improvement.
Mechanical permit, for mechanical work only.
Miscellaneous. Use only if proposed work doesn't fit another activity type.
Patio and/or deck.
Plumbing permit, for plumbing work only.
Gunite pools and spas.
Retaining wall permit.
Sign construction/installation permit.
Solar energy system installation permit (specify structure type to be served).
Factory-made or Gunite.
List 2 - Structure-Type (Use with Residential Permit Only)
From the following list, determine the type of residential structure that best describes the structure on which you will be working.
Please put the code of that structure- type in the appropriate blank at the top of the page on the front of this application.
Code
SFA
SFD
MF2-4
MF5 +
MOHO
Description
Single-family, attached. A one-family house attached to one or more other houses, with one or more common walls
extending from foundation to roof at, or forming, a lot line. Has own plumbing and heating system (e.g.: townhouse,
row house, half-plex).
Single-family detached: A one-family house with open area on all four sides. May have an attached or detached
garage, or a business. May be a detached "granny flat". May be a mobile home or trailer on an individual lot, but not
in a mobile home park.
Multi-family, 2 to 4 units. A residential structure on a single lot, containing two, three, or four dwelling units. Units
may share master heating, plumbing, or electrical service (e.g.: duplex, triplex, quad-plex).
Multi-family, 5 or more units. Same as MF2-4, except the building has a t least five attached units on the same lot.
Mobile home, pre-fabricated house, or trailer installed (plumbed, wired) in a mobile home park (see distinction from
single-family residence, above).
City of Carlsbad
August 10, 2005
C S I GENERAL, INC.
1529 GRAND AV #A
SAN MARCOS CA 92069
RE: BUILDING PERMIT EXPIRATION
PERMIT TYPE: TI
Building Department
Permit Number: CB044574
Issue Date: 2/18/05
ADDRESS: 2270 CAMINO VIDA ROBLE #1
PLEASE CALL FOR AN INSPECTION IF WORK IS
COMPLETE
Our records indicate that your building permit will expire by limitation of time on 9/3/05.
The provisions of UBC, Section 106.4.4 as amended by the Carlsbad Municipal Code state: "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 (unless issued prior to 7/1/99 which is one year from date of permit), or if the building or
work authorized by such permit is stopped at any time after the work is commenced for a period of 180 days or if
the building or work authorized by such permit exceeds three calendar years from the issuance date of permit.
Work shall be presumed to have commenced if the permittee has obtained a required inspection approval of work
authorized by the permit by the Building Official within 180 days of the date of permit issuance. Work shall be
presumed to be stopped if the permittee has not obtained a required inspection approval of work by the Building
Official within each 180 day period upon the initial commencement of work authorized by such permit.
Before such work can be recommenced, a new permit shall be obtained to do so, and the fee, therefore, shall be
one-half the amount required for a new permit for such work, and provided that no changes have been made or
will be made in the original plans and specifications for such work, and provided further that such suspension or
abandonment has not exceeded one year. In order to renew action on a permit after expiration, the permittee shall
pay a new permit fee.
Any person holding an unexpired permit may apply for an extension of the time within which work may
commence under that permit when the permittee is unable to commence work within the time period required by
this section for good and satisfactory reasons. The Building Official may extend the time for action by the
permittee for a period not exceeding 180 days on written request by the permittee showing that circumstances
beyond the control of the permittee have prevented action from being taken. No permit shall be extended more
than once.
Please check below indicating your intentions and return this letter to us.
Project abandoned. A new permit will be obtained prior to commencing work.
No fee extension requested for 180 days, (attach a letter of explanation)
Renewal permit requested.
If the project has been completed and only a final inspection is needed, please call the inspection request line at
(760) 602-2725.
If you have any questions, please contact the Building Inspection Department at (760) 602-2700.
Christine Wauschek
Office Specialist
1635 Faraday Avenue • Carlsbad, CA 92OO8-7314 • (760) 602-27OO • FAX (760) 6O2-856O
City of Carlsbad
Final Building Inspection
Dept: Building Engineering Planning CMWD St Lite
Plan Check #:
Permit #: CB044574
Project Name: 1023 SF TENANT IMPROVEMENT
Date: 08/07/2006
Permit Type: Tl
Sub Type: COMM
Address: 2270 CAMINO VIDA ROBLE #l
Contact Person: PHILLIP Phone: 7606440043
Sewer Dist: CA Water Dist: CA
Lot:
Inspected jj / /° ;
Bv: ///- VyL1
Inspected
Bv:
Inspected
Bv:
Comments:
1 Date /'
^8^23 Inspected: fl/A
Date
Inspected:
Date
Inspected:
*) 6 L? Approved:
Approved:
Approved:
Disapproved:
Disapproved:
Disapproved:
City of Carlsbad Bldg Inspection Request
For: 12/23/2009
Permit# CB044574
Title: 1023 SF TENANT IMPROVEMENT
Description:
Inspector Assignment: PD
2270 CAMINO VIDA ROBLE
I Lot 0
Type:TI Sub Type: COMM
Job Address:
Suite:
Location:
OWNER 2270 CAMINO VIDA ROBLE LLC
Owner: 2270 CAMINO VIDA ROBLE LLC
Remarks: EXPIRE? REFER TO CODE?
Phone:
Inspector:
Total Time:Requested By:
Entered By: CHRISTINE
CD Description
92 Compliance Investigation
Act Comments
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
CV020086 CLOSED ZONING VIOLATION; RETAIL SALES IN INDUST LOCATION
Inspection History
Act Insp
CO RB
NR TP
CA RB
CA RB
AP PD
AP PD
AP PD
AP PD
Date Description
08/15/2006 89 Final Combo
08/11/2006 89 Final Combo
08/08/2006 89 Final Combo
08/07/2006 89 Final Combo
03/07/2005 84 Rough Combo
02/24/2005 17 Interior Lath/Drywall
02/23/2005 14 Frame/Steel/Bolting/Welding
02/23/2005 34 Rough Electric
Comments
SEE NOTICE
BLDG LOCKED
@1:30
@ 12:50PM BY PHILLIP
CEILING
WALLS
City of Carlsbad Bldg Inspection Request
For: 08/15/2006
Permit* CB044574
Title: 1023 SF TENANT IMPROVEMENT
Description:
Inspector Assignment: PD
Type:TI Sub Type: COMM
Job Address: 2270 CAMINO VIDA ROBLE
Suite: I Lot 0
Location:
APPLICANT C.S.I. GENERAL INC.
Owner: 2270 CAMINO VIDA ROBLE LLC
Remarks:
Phone: 7606440043
Inspector:
Total Time:
CD Description
19 Final Structural
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Requested By: PHILLIP
Entered By: CHRISTINE
Act Comment
CfO
Comments/Notices/Hold
Associated PCRs/CVs Original PC#
CV020086 CLOSED ZONING VIOLATION; RETAIL SALES IN INDUST LOCATION
Inspection History
Act Insp Comments
NR TP
CA
CA
AP
AP PD
AP PD WALLS
AP PD
Date Description
08/11/2006 89 Final Combo
08/08/2006 89 Final Combo
08/07/2006 89 Final Combo
03/07/2005 84 Rough Combo
02/24/2005 17 Interior Lath/Drywall
02/23/2005 14 Frame/Steel/Bolting/Welding
,., 02/23/2005 34 Rough Electric
BLDG LOCKED
RB @1:30
RB @ 12:50PM BY PHILLIP
PD CEILING
CITY OF CARLSBAD
BUILDING DEPARTMENT
DATE
NOTICE
(760) 602-2700
1635 FARADAY AVENUE
FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? I J YES
FOR FURTHER INFORMATION, CONTACT
PHONE
BUILDING INSPECTOR CODE ENFORCEMENT OFFICER
EsGil Corporation
In Partners/lip with government for <Buifafing Safety
DATE: 2/14/05 a APPLICANT
JURISDICTION: City of Carlsbad a PLAN REVIEWER -a FILE
PLAN CHECK NO.: 04-4574 SET: III
PROJECT ADDRESS: 2270 Camino Vida Roble Suite I
PROJECT NAME: Spec Suite - TI
[ I The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
A] The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
I | The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
The applicant's copy of the check list has been sent to:
XI Esgil Corporation staff did not advise the applicant that the plan check has been completed.
Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone #:
Date contacted: (by: ) , „ Fax #:
Mail Telephone Fax In Person
EXJ REMARKS: City to verify unreasonable h^roship application.
By: Doug Moody Enclosures:
Esgil Corporation
D GA D MB D EJ D PC 2/7/05 tmsmtl.dot
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858)560-1468 *• Fax (858) 560-1576
EsGil Corporation
In Partnership witH government for (Building Safety
DATE: 1/26/05
JURISDICTION: City of Carlsbad Q PLAN REVIEWER
a FILE
PLAN CHECK NO.: 04-4574 SET: II
PROJECT ADDRESS: 2270 Camino Vida Roble Suite I
PROJECT NAME: Spec Suite - TI
I | The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
I I The plans transmitted herewith will substantially comply with the jurisdiction's building 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.
XI The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
XI The applicant's copy of the check list has been sent to:
CSI
1529 Grand Ave Suite A, San Marcos, CA 92069
Esgil Corporation staff did not advise the applicant that the plan check has been completed.
Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: CSI Telephone*: 760-471-9388
Date contacted: ifa/cr (by:(% ) Fax #: 760-471-0149
Maii^relephone Fax -/^In Person
REMARKS:
By: Doug Moody Enclosures:
Esgil Corporation
D GA D MB D EJ D PC 1/21/05 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 * San Diego, California 92123 + (858)560-1468 + Fax (858) 560-1576
City of Carlsbad O4-4574
1/26/05
RECHECK PLAN CORRECTION LIST
JURISDICTION: City of Carlsbad PLAN CHECK NO.: O4-4574
PROJECT ADDRESS: 2270 Camino Vida Roble Suite I SET: II
DATE PLAN RECEIVED BY
ESGIL CORPORATION: 1/21/05
REVIEWED BY: Doug Moody
DATE RECHECK COMPLETED:
1/26/05
FOREWORD (PLEASE READ):
This plan review is limited to the technical requirements contained in the Uniform Building Code,
Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws
regulating energy conservation, noise attenuation and disabled access. This plan review is
based on regulations enforced by the Building Department. You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department
or other departments.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3,
1997 Uniform Building Code, the approval of the plans does not permit the violation of any
state, county or city law.
A. Please make all corrections on the original tracings and submit two new complete sets of
prints to: ESGIL CORPORATION.
B. To facilitate rechecking, please identify, next to each item, the sheet of the plans upon
which each correction on this sheet has been made and return this sheet with the
revised plans.
C. The following items have not been resolved from the previous plan reviews. The original
correction number has been given for your reference. In case you did not keep a copy of
the prior correction list, we have enclosed those pages containing the outstanding
corrections. Please contact me if you have any questions regarding these items.
D. Please indicate here if any changes have been made to the plans that are not a result of
corrections from this list. If there are other changes, please briefly describe them and where
they are located on the plans. Have changes been made not resulting from this list?
QYes QNo
City of Carlsbad 04-4574
1/26/05
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
submitted in one of two ways:
1. Deliver 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 and 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
Departments.
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 note on the plans "AC Cable is not allowed in A, B, E, H, and I
occupancies. NM cable is restricted (without City approval) to one and two
family dwellings. Note on plans that an equipment ground conductor is to be
installed in all flexible conduits". The plans still show AC cable to be installed.
Per the California Building Code the restrooms serving the tenant
improvement must be accessible. The law allows in existing buildings an
application for unreasonable hardship exemption from providing full
compliance. Upon completion of the application, it and the supporting
documents must be submitted to the Building Official of the City of
Carlsbad for approval. Then the plans must show in detail the work to be
done for the exemption.
3. When alterations, structural repairs or modifications or additions are made to an
existing building, that building, or portion of the building affected, is required to
comply with all of the requirements for new buildings, per Section 1134B.2. These
requirements apply as follows: See comment above.
a) A primary entrance to the building and the primary path of travel to the
altered area, must be shown to comply with all accessibility features.
b) Existing sanitary facilities that serve the remodeled area must be shown to
comply with all accessibility features.
4. Show on the site plan the complying disabled accessible path of travel from the
disabled accessible parking spaces to the primary entrance of the tenant space.
Please provide detailed plans of the path of travel, indicate slope and width, any
pedestrian ramps, curb ramps, walks, handrails, provide dimensioned parking
stall details etc. See comment above.
City of Carlsbad 04-4574
1/26/O5
5. It is unclear from the plans if the restrooms servicing the tenant improvement are
disabled accessible, please provide a dimensioned restroom plans showing the
restroom to be accessible compliant. See comment above.
The jurisdiction has contracted with Esgil Corporation located at 9320
Chesapeake Drive, Suite 208, San Diego, California 92123; 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 Doug Moody at
Esgil Corporation. Thank you.
EsGil Corporation
In <PartnersHip with government for Qiuififing Safety
DATE: 1/4/05 a APRUCANT
JURISDICTION: City of Carlsbad a PLAN REVIEWER
a FILE
PLAN CHECK NO.: 04-4574 SET: I
PROJECT ADDRESS: 227O Camino Vida Roble Suite I
PROJECT NAME: Spec Suite - TI
I I The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
I | The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
2<J The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
XI The applicant's copy of the check list has been sent to:
CSI
1529 Grand Ave Suite A, San Marcos, CA 92069
Esgil Corporation staff did not advise the applicant that the plan check has been completed.
[X] Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: CSI ("DAUJ,O) Telephone*: 760-471-9388
Date contacted: / A//o5" (by: (c^} Fax #:. 760-471-0149
Mail t__^Ielephone i_-^~ Fax. In Person
D REMARKS:
By: Doug Moody Enclosures:
Esgil Corporation
D GA D MB D EJ D PC 12/21/04 tmsmldot
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 4 (858)560-1468 * Fax (858) 560-1576
City of Carlsbad 04-4574
1/4/O5
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO.: 04-4574
OCCUPANCY: B/S1
TYPE OF CONSTRUCTION: VN
ALLOWABLE FLOOR AREA:
SPRINKLERS?: YES
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 12/20/04
DATE INITIAL PLAN REVIEW
COMPLETED: 1/4/05
JURISDICTION: City of Carlsbad
USE: Office /Warehouse
ACTUAL AREA: 4150sf
STORIES: 1
HEIGHT:
OCCUPANT LOAD: 15
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 12/21/04
PLAN REVIEWER: Doug Moody
FOREWORD (PLEASE READ):
This plan review is limited to the technical requirements contained in the Uniform Building Code,
Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws
regulating energy conservation, noise attenuation and access for the disabled. This plan review
is based on regulations enforced by the Building Department. You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department,
Fire Department or other departments. Clearance from those departments may be required
prior to the issuance of a building permit.
Code sections cited are based on the 1997 UBC.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3,
1997 Uniform Building Code, the approval of the plans does not permit the violation of any
state, county or city law.
To speed up the recheck process, please note on this list (or a copy) where each
correction item has been addressed, i.e.. plan sheet number, specification section, etc.
Be sure to enclose the marked UP list when you submit the revised plans.
TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC)tiforw.dot
City of Carlsbad O4-4574
1/4/05
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
submitted in one of two ways:
1. Deliver 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 and 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
Departments.
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.
1. Please revise the section view of all new interior partitions. Show:
a) Method of attaching top plates to structure. (Please revise the spacing of
the studs used for lateral bracing to 4' or provide calculations to show the
8' adequate).
2. Please note on the plans "AC Cable is not allowed in A, B, E, H, and I
occupancies. NM cable is restricted (without City approval) to one and two
family dwellings. Note on plans that an equipment ground conductor is to be
installed in all flexible conduits".
3. Please provide a roof plan showing the new roof mounted equipment and a
service receptacle located less than 25' from the new equipment and GFCI
protected.
4. Please indicate the location of the ladder access to roof mounted HVAC
equipment.
5. Indicate the location on the plans of the approved fixture to receive the main
condensate discharge from air conditioning units. (UMC Section 309)
6. Please imprint on the plans the City of Carlsbad Policies and Procedures for
Roof Mounted Equipment to the plans.
7. Provide complete plumbing plans, including:
a) Complete drain, waste and vent plans.
8. The completed and signed ENV-1, LTG-1, and MECH-1 forms must be imprinted
on the plans.
a) Show water heater size, type and location on plans. UPC, Section 501.0
City of Carlsbad O4-4574
1/4/O5
9. On the.plans clearly show the wall insulation locations, thickness, and R-values,
as per the energy design.
When alterations, structural repairs or modifications or additions are made to an existing
building, that building, or portion of the building affected, is required to comply with all of
the requirements for new buildings, per Section 1134B.2. These requirements apply as
follows:
a) A primary entrance to the building and the primary path of travel to the
altered area, must be shown to comply with all accessibility features.
b) Existing sanitary facilities that serve the remodeled area must be shown to
comply with all accessibility features.
10. Show on the site plan the complying disabled accessible path of travel from the
disabled accessible parking spaces to the primary entrance of the tenant space.
Please provide detailed plans of the path of travel, indicate slope and width, any
pedestrian ramps, curb ramps, walks, handrails, provide dimensioned parking
stall details etc.
11. It is unclear from the plans if the restrooms servicing the tenant improvement are
disabled accessible, please provide a dimensioned restroom plans showing the
restroom to be accessible compliant.
To speed up the review process, note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If 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:
Yes Q No a
The jurisdiction has contracted with Esgil Corporation located at 9320
Chesapeake Drive, Suite 208, San Diego, California 92123; 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 Doug Moody at
Esgil Corporation. Thank you.
BEST COPY
CITY OF CARLSBAD
POLICIES AND PROCEDURE
•JUMBER; 80-6
EFFECTIVE: 5/1/92
SUPERSEDES: .80-6(9/10/80)
80-6(5/01/81)
SU3JECT: ROOF MOUNTED EQUIPMENT
SECTION: BUILDING DEPARTMENT
PURPOSE:
INTENT:
PROVIDE INSTALLATION STANDARDS FOR ALL ROOF MOUNTED EQUIPMENT -K
PENETRATIONS ON COMMERCIAL AND INDUSTRIAL BUILDINGS. '
POLICY;
A.
B.
C.
1.
2.
3.'
Maintain roof Integrity.
Prevent'hszardous condition to firemen who mus\ fighi fire on the roof.
Provide an installation that is aesthetically sensitive to the building End 'the
adjoining properties/ '
All equipment shall ba concealed from view end the design * shall msec
approval of the Planning Department.
All equipment shall be specifically designed and approved for exterior u«a end
shall ba approved by the City of Carlsbad Building Department.
All roof mounted equipment shall be on E platform which shall be sn integrel
part of the roof-flashed and waterproofed. Whsn a screen Is spproved, it shall
have as few roof connections as possible and be structurally adequate.
4. AH electrical^ plumbing, mechanical duct work and related piping shell ba inside
the building and not on tha roof. AH connections related to equipment shall be "
made In the sama roof opening on the platform or have the prior epproval from
the building official.
5. Sewer verus shall be brought TO one main vent bslow tha roof and heve ons
penetration where restrooms or other plumbing fixtures are back to bsck or in
the general proximity.
Air exhaust fans and other equipment shall be within the building and use the
same roof opening whare restrooms and other equipment are back to back or In
- „ general proximity.
'6. Existing buildings and equipment, remodel or replacement, shall meet the above
regulations or shall have the prior.apprpval fr.qm The building official.
"' ' . 7. • . Where new equipment is Installed; unused'or abandoned equipment including .
all roof mounted piping, electrroal, mechanical, duct, qr\d other' r'elated
appurtenances shall be removed from roof and Unused ripening's properly sealed
-to maintain roof Integrity. . • • •'
i ' " •
•The architect should, through design, conceal tha heating/AC unit and other, equipment whether
they are pn the roof or elsewhere. • .
initiated By:Approved B
TQTflL P.04
City of Carlsbad 04-4574
1/4/05
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Carlsbad PLAN CHECK NO.: 04-4574
PREPARED BY: Doug Moody DATE: 1/4/O5
BUILDING ADDRESS: 2270 Camino Vida Roble Suite I
BUILDING OCCUPANCY: B/S1 TYPE OF CONSTRUCTION: VN
BUILDING
PORTION
Tl
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code
AREA
(Sq.Ft.)
4150
cb
Valuation
Multiplier
City Valuation
By Ordinance
Reg.
Mod.
VALUE ($)
31,372
31,372
1994 UBC Building Permit Fee
1994 UBC Plan Check Fee
Type of Review:
D Repetitive Fee
Repeats
Complete Review
D Other
r—I Hourly
Q Structural Only
Hour*
Esgil Plan Review Fee
$254.11
$165.17
$142.30
Comments:
Sheet 1 of 1
macvalue.doc
PLANNING/ENGINEERING APPROVALS
PERMIT NUMBER CB
ADDRESS
DATE
RESIDENTIAL
RESIDENTIAL ADDITION MINOR
« $10,000.00)
IMPROVEMENT
INO REAL
CARLSBAD COMPANY STORES
VILLAGE FAIRE
COMPLETE OFFICE BUILDING
OTHER
PLANNER DATE
ENGINEER DATE
/ '
Docs/MUforms/Plannina Engineering Approvals
Carlsbad Fire Department 044574
1635 Faraday Ave.
Carlsbad, CA 92008
Plan Review Requirements Category:
Date of Report: 12/27/2004
Fire Prevention
(760) 602-4660
Building Plan
Reviewed by:
Name:
Address:
C.S.I. General, Inc.
1529 Grand Ave. #A
City, State: San Marcos CA 92069
Plan Checker:
Job Name: Spec Suite
Job #: 044574
Job Address: 2270 Camino Vida Roble
Bldg #: CB044574
Ste. or Bldg. No.
Approved The item you have submitted for review has been approved. The approval is
based on plans, information and / or specifications provided in your submittal;
therefore any changes to these items after this date, including field
modifications, must be reviewed by this office to insure continued conformance
with applicable codes and standards. Please review carefully all comments
attached as failure to comply with instructions in this report can result in
suspension of permit to construct or install improvements.
Approved The item you have submitted for review has been approved subject to the
Subject to attached conditions. The approval is based on plans, information and/or
specifications provided in your submittal. Please review carefully all comments
attached, as failure to comply with instructions in this report can result in
suspension of permit to construct or install improvements. Please resubmit to
this office the necessary plans and / or specifications required to indicate
compliance with applicable codes and standards.
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 to this
office for review and approval.
Review
FD Job #
1st 2nd 3rd
044574 FD File #
Othfir Agenry in
6'-11 ENWOMENTAL
EXHAUST FAN
o
ENLARGED RESTROOM DETAIL
NOT TO SCALE
TITLE 24 REPORT
Title 24 Report for:
2270 Camino Vida Roble
Ste1
Carlsbad, CA 92009
Project Designer:
Report Prepared By:
Steve Balderrama
Stueven Engineering Consultants
326 Kalmia Street
Escondido, CA 92025
(760) 735-8577
Job Number-
Date:
12/17/04
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is
authorized by the California Energy Commission for use with both the Residential and Nonresidential 2001 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC (415) 897-6400.
EnergyPro 3.1 By EnergySoft Job Number User Number: 3429
TABLE OF CONTENTS
Cover Page 1
Table of Contents 2
Nonresidential Performance Title 24 Forms 3
Form ENV-MM Envelope Mandatory Measures 13
Form LTG-MM Lighting Mandatory Measures 14
Form MECH-MM Mechanical Mandatory Measures 15
EnergyPro 3.1 By EnergySoft Job Number: User Number: 3429
IPERFORMANCE CERTIFICATE OF COMPLIANCE Part 1 of 3 PERF-I|
PROJECT NAME
2270 Camino Vida Roble
PROJECT ADDRESS
Ste 1 Carlsbad
PRINCIPAL DESIGNER - ENVELOPE
DOCUMENTATION AUTHOR
Stueven Engineering Consultants
TELEPHONE
TELEPHONE
(760) 735-8577
DATE
12/17/04
Building Permit #
Checked by/Date
Enforcement Agency Use
GENERAL INFORMATION
DATE OF PLANS
BUILDING TYPE g
PHASE OF CONSTRUCTION g
BUILDING CONDITIONED FLOOR AREA
1,012Sq.Ft.
[] NONRESIDENTIAL Q HIGH RISE RESIDENTIAL QJ
[] NEW CONSTRUCTION Q ADDITION Q] ALTERATION
CLIMATE ZONE
7
HOTEL/MOTEL GUEST ROOM
EXISTING + ADDITION
STATEMENT OF COMPLIANCE
This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and
6, of the State Building Code. This certificate applies only to a Building using tb^qerformance compliance approach.
DOCUMENTATION AUTHOR
Steve Balderrama
SIG DATE
The Principal Designers hereby certify that the proposed building design represented in the construction documents and modelled
for this permit application are consistent with all other forms and worksheets, specifications, and other calculations submitted with this
permit application. The proposed building as designed meets the energy efficiency requirements of the State Building Code, Title
24, Part 6.
ENV. LTG. MECH.
| | Q | | 1.1 hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to
sign this document as the person responsible for its preparation; and that I am licensed as a civil engineer,
mechanical engineer, electrical engineer or architect.
r~\ r~] r~~\ 2.\ affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code Section
5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed
contractor preparing documents for work that I have contracted to perform.
| | Q Q 3.1 affirm that I am eligible under Division 3 of the Business and Professions Code to sign this document
because it pertains to a structure or type of work described as exempt pusuant to Business and Professions
Code Sections 5537, 5538, and 6737.1. (These sections of the Business and Professions Code ae printed in
full in the Npnresidential Manual.)
ENVELOPE COMPLIANCE
Indicate location on plans of Note Block for Mandatory Measures
Required
'RINCIPAL ENVELOPE DESIGNER - NAME
' > "~~L~ eZ,l'.^*^&l> .1 M t
SIGNA'LIC. NO.DATE
LIGHTING COMPLIANCE
Indicate location on plans of Note Block for Mandatory Measures
Required Fprnis LTG-1
PRINCIPAL LIGHTING DESIGNER - NAME SIGNATURE
/
LIC. NO.DATE
MECHANICAL COMPLIANCE T
Indicate location on plans of Note Block for Mandatory Measures
Required MECH-1.MECH-2. MECH-3
PRINCIPAL MECHANICAL DESIGNER - NAME
J./ft -
SIG>»AT LIC. NO.DATE
Run Initiation Time: 12/17/04 12
EnergyPro 3.1 By EnergySoft User Number: 3429
21:57 Run Code: 1103314917
Job Number:Page:3 of 16
PERFORMANCE CERTIFICATE OF COMPLIANCE Part 2 of 3 PERF-1
2270 Camino Vida Roble
DATE
12/17/04
ANNUAL SOURCE ENERGY USE SUMMARY (kBtu/sqft-vr)
Standard
ENERGY COMPONENT Design
<
I
I
[
[
L
F
Space Heating 0.89
Space Cooling 27.57
ndoor Fans 18.97
Heat Rejection 0.00
3umps & Misc. 0.00
Domestic Hot Water 0.00
.ighting 44.17
Receptacle 16.90
Process o.oo
TOTALS: 108.50
Percent better than Standard:
Proposed Compliance
Design Margin Q Standard | Proposed
0.30 0.59
21.94 5.63
21.05 -2.08
0.00 0.00
0.00 0.00
0.00 0.00
26.98 17.19
16.90 0.00
0.00 0.00
87.15 21.34
Space Heating
Space Cooling
Y -i
fc^r-™ j^j^^^t
Heat Rejection
pumpsaMiac
OHW
Lighting
Receptacle
Process
^^^^^^^^
0 10 20 30 40
kBtu/sqft-yr
;
19.7% ( 19.7% excluding process)
BUILDING COMPLIES
GENERAL INFORMATION
Building Orientation (Nor
Number of Stories
Number of Systems
Number of Zones
th)0deg Conditioned Floor Area
1 Unconditioned Floor Area
1 Conditioned Footprint Area
2
1,01 2 sqft.
2,500 sqft.
1,01 2 sqft.
Orientation Gross Area Glazing Area Glazing Ratio
Front Elevation (t
Left Elevation (
Rear Elevation (E
Right Elevation (\
Total
Roof
Jorth) 185 sqft.
East) 0 sqft.
OUth) 0 sqft.
Vest) 0 sqft.
185 sqft.
1,012 sqft.
0
0
0
0
0
0
sqft. 0.0%
sqft 0.0%
sqft. 0.0%
sqft. 0.0%
sqft. 0.0%
sqft. 0.0%
Standard
Lighting Power Density 1.5C
Prescriptive Env. Heat Loss 1C
Prescriptive Env. Heat Gain 9,65
Proposed
0 W/sqft. 0.919 W/sqft
9 Btu/h 47 Btu/h
4 Btu/h-F 3,595 Btu/h-F
LEED Energy & Atmosphere Credit
Savings vs. Title 241 23.30%
Energy Performance Credit 4 Points
1. excludes process and receptacle 2. see LEED table 8-c or 8-d
Remarks:
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PERFORMANCE CERTIFICATE OF COMPLIANCE Part 3 of 3 PERF-1
PROJECT NAME DATE
2270 Camino Vida Roble 1 2/1 7/04
IZONE INFORMATION
\ ,
System Name
HP-2.5
Zone Name
Manufacturing
Warehouse
Occupancy Type
Precision Industrial
Unconditioned
Floor
Area
(sqft.)
1,012
2,500
Inst.
LPD
(W/sf)1
0.919
0.000
Port.
LPD
(W/sf)1
0.000
0.000
Notes: 1 . See LTG-1 (items marked with asterisk, see LTG-2 by others) 2. See LTG-3 3. See LTG-4
Ctrl.
Credits
(W/sf)2
Tailored
LPD
(W/sf)3
Proc.Loads
(W/sf)
Items above require specialdocumentation
(EXCEPTIONAL CONDITIONS COMPLIANCE CHECKLIST
The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written
justification and documentation, and special verification to be used with the performance approach. The local enforcement agency determines
the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification
and documentation submitted. I Plan I Field
The exceptional features listed in this performance approach application have specifically been reviewed. Adequate written justification and
documentation for their use have been provided by the applicant.
Authorized Signature or Stamp
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[EnergyPro 3.1 By EnergySofl User Number: 3429 Job Number:Page:5of16
ENVELOPE COMPLIANCE SUMMARY Performance ENV-1
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
IOPAQUE SURFACES I
#
1
2
3
Surface
Type
Demising
Roof
Wall
Framing
Type
Metal
Wood
Wood
Area
725
1.012
185
U-Fac.
0.189
0.031
0.088
Act.
Azm.
0
0
0
Solar
Gains
Tilt Y/N Form 3 Reference
90
0
90
X
X.
X R-11 Metal Stud Wall
R-30 Roof(R.30.2x4.24)
R-13Wall (W.13.2x4.16)
Location / Comments
Manufacturing (faces Warehouse)
Manufacturing
Manufacturing
FENESTRATION SURFACES
Site Assembled Glazing Check box if Building is >= 100,000 sqft of CFA and >= 10,000 sqft vertical glazing then NFRC Certification is required.
Follow NFRC 100-SB Procedures and submit NFRC Label Certificate Form.
#Type Area U-Fac.Act. Azm.SHGC Glazing Type Location / Comments
EXTERIOR SHADING
#Exterior Shade Type SHGC
Window
Hgt. Wd.
Overhang
Len. Hgt. LExt.RExt.
Left Fin
Dist. Len. Hgt.
Right Fin
Dist. Len. Hgt.
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LIGHTING COMPLIANCE SUMMARY Part 1 of 2 LTG-1
PROJECT NAME
2270 Camino Vida Roble
(INSTALLED LIGHTING SCHEDULE
DATE
12/17/04
Code
LUMINAIRE
DESCRIPTION
(3) 4 ft Fluorescent T8 (Tandem) Elec
LAMPS
TYPE
DESCRIPTION
F32T8
Lighting Schedule on Plans Shows Exterior Lighting
Meets
I I Efficacy and Control Requirement of §130(c)
I I Control Requirements of§131(f)
#
3
WattsPerLamp
32
BALLASTS
DESCRIPTION
Electronic
#
1,5
Luminaire
(Lamp + Ballast
#
10
Watts
93.0
Subtotal from this Page
Total
Portable Lighting (From LTG-1)
Less Control Credit Watts (From LTG-3)
Adjusted Actual Watts
Total
Watts
930
930
930
0
0
930
[MANDATORY AUTOMATIC CONTROLS
CONTROL LOCATION(Room #)CONTROL
IDENTIFICATION
CONTROL TYPE
(Auto Time Switch, Exterior, etc.)SPACE CONTROLLED
NOTE TO
FIELD
[CONTROLS FOR CREDIT
CONTROL LOCATION(Room # or Dwg. #)CONTROL
IDENTIFICATION
CONTROL TYPE
(Occupant, Daylight, Dimming, etc.)LUMINAIRES CONTROLLEDTYPE# OF LUMINAIRES
NOTE TO
FIELD
NOTES TO FIELD - For Buildina Department Use Onlv
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LIGHTING COMPLIANCE SUMMARY Part 2 of 2 LTG-l|
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
ITABLE 1A - PORTABLE LIGHTING NOT SHOWN ON PLANS FOR OFFICE AREAS >250 SQUARE FEET I
A B C D
ROOM*
OR ZONE ID
DEFAULT
(W/sqft)
TOTAL
AREA
(SF)
0
TOTAL WATTS
(BXC)
0
ITABLE IB - PORTABLE LIGHTING SHOWN ON PLANS FOR OFFICE AREAS >2so SQUARE FEET
R
OR
A B C D E
LUMIN. TASK
OOM# PORTABLE LIGHTING #OF WATTS PER AREA
ZONE ID Description FIXT. FIXTURE (SF)
Manufacturing 1,012
F
#OF
TASK
AREAS
1
TOTAL
G
TOTAL TOTAL
AREA(SF) WATTS
(D x E) (C x E)
1,012
1.012 0
ITABLE 1C - PLANS SHOW PORTABLE LIGHTING IS NOT REQUIRED FOR OFFICE AREAS > 250 SQUARE FEET I
ROOM*
OR ZONE ID
TOTAL
TOTAL AREA
(SF)Designer needs to provide detailed documentation that the lighting
level provided by the overhead lighting meets the needs of the
space. The details include luminaire types, CU, and mounting
locations relative to work areas.
IBUILDING SUMMARY - PORTABLE LIGHTING I
BUILDING SUMMARY
BUILDING TOTAL
TOTAL AREA (SF)
(FROM TABLES 1A+1B+1C)
1,012
TOTAL WATTS
(FROM TABLES 1A+1B)
0
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CERTIFICATE OF COMPLIANCE Performance MECH-1
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
ISYSTEM FEATURES
SYSTEM NAME
TIME CONTROL
SETBACK CONTROL
ISOLATION ZONES
HEAT PUMP THERMOSTAT?
ELECTRIC HEAT?
FAN CONTROL
VAV MINIMUM POSITION CONTROL?
SIMULTANEOUS HEAT/COOL?
HEATING SUPPLY RESET
COOLING SUPPLY RESET
HEAT REJECTION CONTROL
VENTILATION
OUTDOOR DAMPER CONTROL
ECONOMIZER TYPE
DESIGN O.A. CFM (MECH-3, COLUMN 1)
HEATING EQUIPMENT TYPE
HEATING EQUIPMENT EFFICIENCY
COOLING EQUIPMENT TYPE
COOLING EQUIPMENT EFFICIENCY
MAKE AND MODEL NUMBER
PIPE INSULATION REQUIRED?
PIPE/DUCT INSULATION PROTECTED?
HEATING DUCT LOCATION R-VALUE
COOLING DUCT LOCATIOr. R-VALUE
VERIFIED SEALED DUCTS INCEILING/ROOF SPACE
MECHANICAL SYSTEMS
HP-2.5
Programmable Switch
No Setback Required
n/a
Yes
0.0 kW
Constant Volume
No
No
Constant Temp
Constant Temp
n/a
Air Balance
Auto
No Economizer
152 cfm
Heat Pump
6.80 HSPF
Packaged DX
10.0 SEER/ 9.1 EER
RHEEM RQKA-A030JK
Yes
Yes
Ducts in Attic 4.2
Ducts in Attic 4.2
No
NOTE TO
FIELD
CODE TABLES: Enter code from table below into columns above.
HEAT PUMP THERMOSTAT?
ELECTRIC HEAT?
VAV MINIMUM POSITION CONTROL?
SIMULTANEOUS HEAT / COOL?
HEAT AND COOL SUPPLY RESET?
HIGH EFFICIENCY?
PIPE INSULATION REQUIRED?
PIPE/DUCT INSULATION PROTECTED?
SEALED DUCTS IN CEILING/ROOF SPACE
Y:Yes
N:No
?
TIME CONTROL
S: Prog. Switch
O: Occupancy
Sensor
M: Manual Timer
VENTILATION
B: Air Balance
C: Outside Air Cert.
M: Out. Air Measure
D: Demand Control
N: Natural
SETBACK CTRL.
H: Heating
C: Cooling
B: Both
OUTDOOR DAMPER
A: Auto
G: Gravity
ISOLATION ZONES
Enter Number of
Isolation Zones.
ECONOMIZER
A: Air
W: Water
M: Not Required
EC: Economizer
Control See Section
144(e)3
FAN CONTROL
I: Inlet Vanes
P: Variable Pitch
V: VFD
O: Other C: Curve
O.A. CFM
Enter Outdoor Air
CFM.
Note: This shall be no
less than Col. H on
MECH-3.
NOTES TO FIELD - For Building Department Use Only
Run Initiation Time: 12/17/0412:21:57 Run Code: 1103314917
EnergyPro3.1 By EnergySoft User Number: 3429 Job Number: Page:9of16
MECHANICAL EQUIPMENT SUMMARY Parti of2 MECH-2
PROJECT NAME
2270 Camino Vida Roble DATE 12/17/04
CHILLER AND TOWER SUMMARY
Equipment Name Equipment Type Qty.Efficiency Tons
PUMPS
Tot.
Qty GPM BMP
Motor
Eff.
Drive
Eff.
Pump
Control
DHW / BOILER SUMMARY
System Name System Type Distribution Type Qty
Rated
Input
Vol.
(Gals.)
Energy Factor
or Recovery
Efficiency
Standby
Loss or
Pilot
TANK INSUL.
Ext.
R-Val.
CENTRAL SYSTEM RATINGS
HEATING COOLING
System Name System Type Qty.Output
Aux.
kW Eff.Output Sensible Efficiency Economizer Type
RHEEM RQKA-A030JK Packaged DX 29,600 0.0 6.80 HSPF 30,000 21,00010.0 SEER/9.1 EER No Economizer
CENTRAL SYSTEM FAN SUMMARY
System Name
RHEEM RQKA-A030JK
Fan Type
Constant Volume
SUPPL1
Motor Location
Blow-Through
CFM
1,050
KFAN
BMP
0.50
Motor
Eff.
77.0%
Drive
Eff.
100.0%
RETURN FAN
CFM
none
BMP
Motor
Eff.
Drive
Eff.
Run Initiation Time: 12/17/0412
EnergyPro 3.1 By EnergySoft User Number: 3429
21:57 Run Code: 1103314917
Job Number:Page: 10 of 16
MECHANICAL EQUIPMENT SUMMARY Part 2 of 2 MECH-2
PROJECT NAME
2270 Camino Vida Roble DATE 12/1 7/04
ZONE TERMINAL SUMMARY
Zone Name
VAV TERMINAL BOX
System Type Qty.
Min. CFM
Ratio
Reheat Coil
Type DeltaT
TERMIh
CFM BHP
ALFAN
Motor
Eff.
Drive
Eff.
BASEBOARD
Type Output
EXHAUST FAN SUMMARY
EXHAUST FAN
Room Name Qty.CFM BMP
Motor
Eff.
Drive
Eff.
Run Initiation Time: 12/17/04
EnergyPro3.1 By EnergySoft
EXHAUST FAN
Room Name Qty CFM BHP
Moto
Eff.
r Drive
Eff.
12:21:57 Run Code: 1103314917
User Number: 3429 Job Number:PEge:11 of 16
MECHANICAL VENTILATION MECH-3
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
IMECHANICAL VENTILATION
ZONE/SYSTEM
Manufacturing
HP-2.5
_C_
E
I
1<~
AREA BASIS
COND.
AREA
(SF)
1,012
CFM
PERSF
0.15
WIN.
CFM
(BxC)
152
OCCUPANCY BASIS
NO.
OF
PEOPLE
CFM
PER
PERSON
MIN.
CFM
(ExF)
Total
REQ'D
O.A.
(MAX OF
DORG)
152
152
DESIGN
OUTDOOR
AIR
CFM
152
152
VAV
MIN.
RATIO
TRANS-
FER
AIR
Minimum Ventilation Rate per Section 121, Table 1-F.
Based on Expected Number of Occupants or at least 50% of Chapter 10 1997 UBC Occupant Density.
Must be greater than or equal to H, or use Transfer Air. Design Outdoor Air includes ventilation from Supply Air System & Room Exhaust Fans.
Must be greater than or equal to (H minus I), and, for VAV, greater than or equal to (H-J).
EnergyPro3.1 By EnergySoft User Number: 3429 Job Number: Page:12of16
ENVELOPE MANDATORY MEASURES ENV-MM
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
DESCRIPTION
Ex]
[x]
D
[x]
§ 118(a) Installed Insulating Material shall have been certified by the manufacturer to comply
with the California Quality Standards for insulating material, Title 20, Chapter 4, Article
3.
§ 118(c) All Insulating Materials shall be installed in compliance with the flame spread rating
and smoke density requirements of Sections 2602 and 707 of Title 24, Part 2.
§ 117(a) All Exterior Joints and openings in the building that are observable sources of air
leakage shall be caulked, gasketed, weatherstripped or otherwise sealed.
§ 116(b) Site Constructed Doors, Windows and Skylights shall be caulked between the unit
and the building, and shall be weatherstripped (except for unframed glass doors and
fire doors).
§ 116(a)1 Manufactured Doors and Windows installed shall have air infiltration rates not
exceeding those shown in Table Number 1-E. of the Standards. Manufactured
fenestration products must be labeled for U-value according to NFRC procedures.
§ 1 1 8(e) Demising Walls in Nonresidential Buildings:
The opaque portions of framed demising walls in nonresidential buildings shall have
insulation with an installed R-value of no less than R-11 between framing members.
Designer Enforcement
EnergyPro 3.1 By EnergySoft User Number: 3429 Job Number: Page:13of16
LIGHTING MANDATORY MEASURES LTG-MM
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
DESCRIPTION
|X| § 131(d)1 For every floor, all interior lighting systems shall be equipped with a separate automatic
control to shut off the lighting. This automatic control shall meet the requirements of
Section 119 and may be an occupancy sensor, automatic time switch, or other device
capable of automatically shutting off the lighting.
( | § 1 31 (d)2 Override for Building Lighting Shut-off: The automatic building shut-off system is
provided with a manual, accessible override switch in sight of the lights. The area of
override is not to exceed 5,000 square feet.
I I § 119(h) Automatic Control Devices Certified: All automatic control devices specified are
certified, all alternate equipment shall be certified and installed as directed by the
manufacturer.
|X| § 1 1 1 Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for the
project are certified and listed in the Directory. All installed fixtures shall be certified.
|X| §132 Tandem Wiring for One and Three Lamp Fluorescent Fixtures: All one and three lamp
fluorescent fixtures are tandem wired with two lamp ballasts where required by
Standards Section 132; or all one and three lamp fluorescent fixtures are specified
with electronic high-frequency ballasts and are exempt from tandem wiring
requirements.
|X| § 131 (a) Individual Room/Area Controls: Each room and area in this building is equipped with
a separate switch or occupancy sensor device for each area with floor-to-ceiling
walls.
| | § 131(b) Uniform Reduction for Individual Rooms: All rooms and areas greater than 100
square feet and more than 0.8 watts per square foot of lighting load shall be
controlled with bi-level switching for uniform reduction of lighting within the room.
I I §131(c) Daylight Area Control: All rooms with windows and skylights that are greater than
250 square feet and that allow for the effective use of daylight in the area shall have
50% of the lamps in each daylit area controlled by a separate switch; or the effective
use of daylight cannot be accomplished because the windows are continuously
shaded by a building on the adjacent lot. Diagram of shading during different times
of the year is included on plans.
| ] § 131(f) Control of Exterior Lights: Exterior mounted fixtures served from the electrical panel
inside the building are controlled with a directional photo cell control on the roof and
a corresponding relay in the electrical panel, or uses an astronomical time clock.
{ | §131(e) Display Lighting. Display lighting shall be separately switched on circuits that are
20 amps or less.
[ | § 130(c) Efficacy of Exterior Lights: Exterior mounted fixtures with lamps over 100 Watts
served from the electrical panel inside the building have a source efficacy of at
least 60 lumens per Watt, or are controlled by a motion sensor.
Designer Enforcement
EnergyPro 3.1 By EnergySoft User Number: 3429 Job Number: Page:14of16
MECHANICAL MANDATORY MEASURES Parti of2 MECH-MM
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
DESCRIPTION
Equipment and Systems Efficiencies
JX] §111 Any appliance for which there is a California standard established in the
Appliance Efficiency Regulations will comply with the applicable standard.
|XJ § 115(a) Fan type central furnaces shall not have a pilot light.
| | § 123 Piping, except that conveying fluids at temperatures between 60 and 105 degrees
Fahrenheit, or within HVAC equipment, shall be insulated in accordance with
Standards Section 123.
|X| § 124 Air handling duct systems shall be installed and insulated in compliance with
Sections 601, 603 and 604 of the Uniform Mechanical Code.
Controls
§ 122(e) Each space conditioning system shall be installed with one of the following:
| | § 122(e)1A Each space conditioning system serving building types such as offices and
manufacturing facilities (and all others not explicitly exempt from the
requirements of Section 112 (d» shall be installed with an automatic time switch
with an accessible manual override that allows operation of the system during
off-hours for up to 4 hours. The time switch shall be capable of programming
different schedules for weekdays and weekends and have program backup
capabilities that prevent the loss of the device's program and time setting for at
least 10 hours if power is interrupted; or
| | § 122(e)1B An occupancy sensor to control the operating period of the system; or
| I § l22(e)1C A 4-hour timer that can be manually operated to control the operating period of
the system.
IX I § 122(e)2 Each space conditioning system shall be installed with controls that temporarily
restart and temporarily operate the system as required to maintain a setback
heating and/or a setup cooling thermostat setpoint.
| | § 122(g) Each space conditioning system serving multiple zones with a combined
conditioned floor area more than 25,000 square feet shall be provided with
isolation zones. Each zone: shall not exceed 25,000 square feet; shall be
provided with isolation devices, such as valves or dampers, that allow the supply
of heating or cooling to be setback or shut off independently of other isolation
areas; and shall be controlled by a time control device as described above.
(XJ § 122(a&b) Each space conditioning system shall be controlled by an individual thermostat
that responds to temperature within the zone. Where used to control heating, the
control shall be adjustable down to 55 degrees F or lower. For cooling, the
control shall be adjustable up to 85 degrees F or higher. Where used for both
heating and cooling, the control shall be capable of providing a deadband of at
least 5 degrees F within which the supply of heating and cooling is shut off or
reduced to a minimum.
(Xl § I22(c) Thermostats shall have numeric setpoints in degrees Fahrenheit (F) and
adjustable setpoint stops accessible only to authorized personnel.
I { § 112(b) Heat pumps shall be installed with controls to prevent electric resistance
supplementary heater operation when the heating load can be met by the heat
pump alone.
Designer Enforcement
EnergyPro3.1 By EnergySoft User Number: 3429 Job Number: Page: 15 of 16
MECHANICAL MANDATORY MEASURES Part 2 of 2 MECH-MM
PROJECT NAME
2270 Camino Vida Roble
DATE
12/17/04
Description
Ventilation
[ | § 121(e) Controls shall be provided to allow outside air dampers or devices to be operated at
the ventilation rates as specified on these plans.
| | § I22(f) Gravity or automatic dampers interlocked and closed on fan shutdown shall be
provided on the outside air intakes and discharges of all space conditioning and
exhaust systems.
| | § I22(f) All gravity ventilating systems shall be provided with automatic or readily accessible
manually operated dampers in all openings to the outside, except for combustion air
openings.
[j(] § I21(f)1 Air Balancing: The system shall be balanced in accordance with the National
Environmental Balancing Bureau (NEBB) Procedural Standards (1983), or
Associated Air Balance Council (AABC) National Standards (1989); or
| | § I21(f)2 Outside Air Certification: The system shall provide the minimum outside air as
shown on the mechanical drawings, and shall be measured and certified by the
installing licensed C-20 mechanical contractor and certified by (1) the design
mechanical engineer, (2) the installing licenced C-20 mechanical contractor, or (3) the
person with overall responsibility for the design of the ventilation system; or
| | § t21(f)3 Outside Air Measurement: The system shall be equipped with a calibrated local or
remote device capable of measuring the quantity of outside air on a continuous
basis and displaying that quantity on a readily accessible display divice; or
| | §i21(f)4 Another method approved by the Commission.
Service Water Heating Systems
| | § 113(b)2 If a circulating hot water system is installed, it shall have a control capable of
automatically turning off the circulating pump(s) when hot water is not required.
| | § 113(b)3B Lavatories in restrooms of public facilities shall be equipped with controls to limit the
outlet temperature to 110 degrees F.
[ | § 1 13(b)3C Lavatories in restrooms of public facilities shall be equipped with one of the
following:
Outlet devices that limit the flow of hot water to a maximum of 0.5 gallons per
minute.
Foot actuated control valves, and outlet devices that limit the flow of hot water to a
maximum of 0.75 gallons per minute.
Proximity sensor actuated control valves, and outlet devices that limit the flow of hot
water to a maximum of 0.75 gallons per minute.
Self-closing valves, and outlet devices that limit the flow of hot water to a maximum
of 2.5 gallons per minute, and 0.25 gallons/cycle (circulating system).
Self-closing valves, and outlet devices that limit the flow of hot water to a maximum
of 2.5 gallons per minute, and 0.50 gallons/cycle (non-circulating system).
Self-closing valves, and outlet devices that limit the flow of hot water to a maximum
of 2.5 gallons per minute, and 0.75 gallons/cycle (foot switches and proximity sensor
controls).
Designer Enforcement
EnergyPro 3.1 By EnergySoft User Number: 3429 Job Number: Page: 16 of 16
City of Carlsbad
Building Department
APPLICATION FOR UNREASONABLE HARDSHIP EXCEPTION TO
STATE OF CALIFORNIA
DISABLED ACCESS REQUIREMENTS
(EXISTING BUILDINGS; CHAPTER 31, DIVISION III, Sec. 3112A.(a) ex. 1.)
When existing buildings are remodeled and, when the valuation of the modifications is less than approximately
93,000 dollars, the California State Building Code allows relief from some accessibility requirements when the
cost of compliance with those regulations is disproportionate. Disproportionate cost is defined as when the cost of
all compliance requirements except mandatory measures exceeds 20% of the cost of the project. Where the cost
of alterations necessary to fully comply is disproportionate, access shall be provided to the extent that it can
without incurring disproportionate costs. In other words, accessible elements must be provided or upgraded to a
maximum cost of 20% of the project valuation. Priority for providing access should be given in the following
oidei;
A. An accessible entrance,
B. An accessible route to the altered area,
C. At least one accessible restroom for each sex,
D. Accessible telephones,
E. Accessi^lf drinVin? fountain1;. and
F. When possible, additional accessible elements such as parking storage and alarms.
NOTE: SEE CHAPTER 31, DIVISION III, CALIFORNIA BUILDING CODE FOR MANDATORY
REQUIREMENTS AND THE COMPLETE TEXT OF THE REGULATIONS FOR ACCESS COMPLIANCE
IN EXISTING BUILDINGS.
DOCUMENTATION OF UNREASONABLE HARDSHIP:
PLEASE PRINT
Project Address: 22 "7Q cfi^gto ^i0A Plan Check #:
P-°0(.& ST6- T
Proposed Use: Cfpic-t /uQA£adQQj>'ig _
Owner: __ Telephone:
Applicant: Telephone:_
Signature: :
Rev 3-20-01
1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-27OO • FAX (760) 6O2-8560
Please print Name_
WORKSHEET FOR DISPORPORTIONATE COSTS
i
1 .PROJECT VALUATION <f /£,
2.VALUATION OF OTHER AREAS WITH SAME PATH OF TRAVEL
(Total valuation dating back to January 26, 1992)
3.TOTAL OF LINE 1 &2
IF LINE 3 EXCEEDS THRESHOLD AMOUNT ($93,132 FULL COMPLIANCE IS REQUIRED
IF LINE THREE IS LESS THAN THRESHOLD AMOUNT, COMPLETE WORKSHEET.
4.ESTIMATED COST OF UPGRADING ENTIRE PATH OF TRAVEL
5. PROPORTION ATE COMPLIANCE COST
(Divide line 4 by line 3)
6.ENTER TWENTY PERCENT OF PROJECT VALUATION
7.MINIMUM COMPLIANCE COST OBLIGATION 4 2,
(Lesser of lines 5&6)
INDICATE BELOW HOW COST OF COMPLIANCE OBLIGATION WELL BE SPENT
ITEM ESTIMATED COST
'
see
SIGNATURE OF APPROVING AUTHORITY:
TITLE: fev^ f C& A £
PLEASE ATTACH THIS DOCUMENT TO THE APPROVED PLANS FOR THE USE
OF THE BUILDING INSPECTOR AND THE CONTRACTOR. THANK YOU
Rev 3-20-01
Jan 18 05 02:50p Office 619 287 8400 p.2
Allied Grading & Paving, Inc.
6914 Mission Gorge Rd
San Diego, CA 92120
Voice: (619)583-4881
Fax: (619) 287-8400
Estimate
DATE
1/14/2005
ESTIMATE
8131
ESTIMATE TO
CSI General
Manny Lopez
1529 Grand Ave Suite A
San Marcos CA 92069
Location
2270 Camino Vida Ro Big Carlsb
Project
Tenant Improvement
Rep Job Telephone Fax Attention
HSG 8131 760-471-9388 760-471-0149 Manny Lopez
DESCRIPTION QTY UNITS TOTAL
1. Overlay two stalls @ +/-4" using 3/8"fine hotmix asphalt.
Overlay to meet no more than 2% ADA slope requirements.
2. stripe two stall plus access aisle and signage to meet ADA
requirements.
* Payment is due upon completion of job.
S ignatur e
494 SqFt
LpSm 2,630.00
TOTAL $2,630.00
•PAYMENT IS DUE UPON COMPLETION OF JOB.
SD
POLICYHOLDER COPY
COMPENSATION
I N S U R A N CE
FUND
P.O. BOX 807, SAN FRANCISCO,CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 08-01-2004
CITY OF SAN DIEGO
BUILDING AND SAFETY
1222 FIRST AVE MAILSTATION 301
SAN DIEGO CA 92101
SD
GROUP: 000046
POLICY NUMBER: 0014720-2004
CERTIFICATE ID: 24
CERTIFICATE EXPIRES: 08-01-2005
; 08-01-20O4/08-01-2005
'• ': ' "... JOB:,. : < ',-
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer.
We will also give you 16 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document
with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditipns' of such policies. ; j
AUTHORIZED REPRESENTATIVE PRESIDENT ""-."•,
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS; $1,000,000.00 PER OCCURRENCE.
EMPLOYER LEGAL NAME
CSI GENERAL INC
1529 GRAND AVE STE A
SAN MARCOS CA 920?8
CSI GENERAL INS
.(REV.3-03)
1023 SF TENANT IMPROVEMENT
Tl COMM
Lot#: C.S.I. GENERAL INC.
nWECORR<CT/AI
,
/