HomeMy WebLinkAbout2501 Gateway Rd; ; CBC2018-0476; Permit{city of
Carlsbad
Commercial Permit
Print Date: 11/20/2018
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
2501 Gateway Rd
BLDG-Commercial
2132601100
$46,510.00
Work Class:
Lot#:
Reference #:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check #:
Description: VIASAT: ( BLDG 12) 1,000 SFT.I. REPARTITIONING
Owner:
Tenant Improvement
VIASAT INC A DELAWARE CORPORATION
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
6155 El Camino Real
CARLSBAD, CA 92009
760-476-2200
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
$B1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-COMMERCIAL
Total Fees: $760.58 Total Payments To Date: $760.58
Status:
Applied:
Issued:
Permit
Finaled:
Inspector:
Final
Inspection:
Balance Due:
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
collectively referred to as "fees/exaction." 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 limitation has previously otherwise expired.
Permit No: CBC2018-0476
Closed -Finaled
08/20/2018
11/12/2018 5:22:43PM
$0.00
$386.80
$270.76
$43.00
$45.00
$2.00
$13.02
1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
THE FOL \,OWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: •PLANNING •ENGINEERING •BUILDING •FIRE •HEALTH •HAZMAT/APCD I
C City of Bulldlng Permit Appllcatlon Plan Check No. r 1/''1018' -nLjl IA
1635 Faraday Ave., Carlsbad, CA 92008 Est. Value < • ii -. s:; I 11 ,.-ri )
Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit I
email: building@carlsbadca.gov
www.carlabadca.gov Date X J;).0/IK
JOB ADDRESS IUffU/v,u;n/lJNITt 1-213 2501 Gateway Road -261 -23 -
CT /PROJECT # ILOT# IPHASE# I# OF UNITS I# BEDROOMS #BATHROOMS I 'IDMT 9UIINDI NAIii l~A-1-~ROUP ViaSat
DESCRIPTION OF WORK: Include Squa,e Feet ol Aft'actad ArH(•J
APPROXIMATELY 1,000 S.F. OF OFFICE TENANT IMPROVEMENT ON THE FIRST FLOOR WITHIN AN EXISTING THREE STORY(+
GARAGE) CONCRETE TILT-UP COLD SHELL BUILDING WITH ASSOCIATED ELECTRICAL MODIFICATIONS. NO MECHANICAL
OR PLUMBING WORK INCLUDED. THERE IS NO CHANGE TO THE EXISTING SQUARE FOOTAGE OF THE BUILDING.
EXISIINII UIE I PROPOSED .. B I GARAGE (SF) PATIOS (SF) I DECKS (Sf) FIREPlACE ·I AIR coNomoNING I FIRE SPRINKLERS
B YESO N<{ff YES~o• YES(31<o0
_,CANT NAME Dana Tsui PROPERTY OWNER NAME Pivotal 650 California ST, LLC Prlm•rv Contact
ADDRESS ADDRESS 13280 Evenina Creek Dr. Suite 200 2201 E. Camelback Rd. Suite 650
CITY STATE ZIP CITY STATE ZIP
San Dieao CA 92010 Phoenix AZ. 85016
PHONE IFAX PHONE IFAX 858-793-4 777 602-248-8181
EMAIL EMAIL
danattiilsca-sd.com ton levinbeinvestments.com
DESl8N PROFESSIONAL Dana Tsui CONTRACl'OR BUS. NAME Whitina-Turner Construct. Comnanv
ADDRESS ADDRESS 4747 Executive Drive
CITY STATE ZIP CllY STATE ZIP
San Dieao CA 92121
PHONE IFAX PHONE l'AX 858-792-0600
EMAIL EMAIL
nick.schmidtfiilwhitina-turner.com
CITY BUS. UC.# I STATE UC.# STATE UC.# 311 l O 7 l=llB BL0!5"/ 13725'0
(Sec. 7031.5 Business and Professlons Code: Arly Clt:Y or Cou~ which requires a ~rrnlt to construct. alter, Improve, demolish or repair a~ structure, ~or to its Issuance, also r~uires the applicant for such per:mlt to file a signed statement ttiat he Is licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, commendill.l. with Sectlon 7000 of OMsion 3 of the Business and Professions Code} or that he Is exemgt therefrom, and the basis for the 81leged exemption. Any violation of Section 7031.517/ any appllcantfor a permit subjects the applicant to a clvll penalty of not more than five hundred dollars ($500)).
WORKERS' COMPENSATION
Worbrs' Complltlltlon Declarltlon: I htllby tl'IJmt underpwlfy ofptMone of Ille folowilg dedarations:
I hnl and wlll maintain I certfflcltt of consent to Nlf.lnlura for workers' companaalion as provided by Section 3700 of the Llbor Code, for the parformal a of the work for which this permit is ilal,ed,
numbef .. , ln,uranceCo. / CO V e_/rcs, -z::;,ck~ __ , PijcyNo. YTC 2JC1) /Y..BG,4[2/;j Expirationo.te0~/.20/ft
, _.., wll fflllntaln ~..U,,-as reQuilld by Sec:tloo 3700; ~ Code, for lhe performance of lhe-forwhk:h lhis pennlt le loaued. My-..S' eom~ in,nnce ,cerrier and poloy
Jlil.oecllon need nol be ... ~eled I lhe permll le for one l"<lr<lred dolllll ($100) or . ' LJ Clrtlllcltt ot Eumptlon: I certify that In the performance of the work for which this permit Is Issued, I lhall not employ any person In any rnall'III" so as to become subject to the Workers' Compensation Laws of
_, WARIING: Flilu11 lo--• .._ 11 uni-I, and lhlll ltlbjlct Ml-,.,., lo criminal pellll1ill Mid clvll ftnos U11 lo one hundred thouland dollul (1100,DIO~ In
-.1olhe_of __ ,._,_!1,11...,.IG 3 ~codl,lnllllltand_,,.,-11H1.
IS ~SIGNATURE .,,,, ~NT
I htnby ellim lhat I am exempt-Cotr/lactol's IJcense Law for lhe lollowilg .....,,, D I, as OM'III' of lhe property or my employees with wages as thair sole compensation, will do lhe work and the structure Is not Intended or offered for sale (Sec. 7044, Bulll98I and Professions Code: Tha Conlraelor's
Ucanae Law does not apply lo an owner of property who builds or inploves lherlon, and who does IUCh -hmaelf or lhrough his own omplojlea, pro,tded Iha! IUCh lmprovemenll '"' nol lnlended or offnd for
sale. W, however, lhe buldlng or lmp!Ol'lfflenl le sold wllhil one year of oompletion, lhe owner-bullder,oll haYe lhe bu""" of p,o,ing Iha! he d~ not buid or Improve for lhe purpoee of sale). D I, aa 0M'III' of the property, am exduslvely contracting with loanaed contractors to construet the projact (Sac. 7044, Business and Professions Code: The Contractor's Ucel'III Law does not apply to an owner of
property who buids or Improves u,....,,, and conlnlds for IUCh proje"8 wilh conlraclor(s) llcensed purauant lo lhe Conlraelol's License Law). D I am eX8fl1)I ooder Section --~Business and Proftuions Code for this reason:
1. I pe,sonaly plan lo provide lhe major -and -for conslrudlon of lhe fll<lf)Olad properly Improvement Oves Oo
2. I (have / have nol) signed an appl-•tion for a blilding permll for lhe propooed -·
3. I have conlraded wilh lhe /olowing pe,,on (linn) lo provide lhe fll<lf)Olad construction Qndude name add,... I phone / con1radonl' license nllllbet):
4. I plan lo provide portions of lhe -. but I haYe hnd lhe folowlng pe,,on lo coonlinala, super,ise and provide lhe major-(lndude nana / addr11& / phone / conlraclols' Ucensa numbe<):
5, I wil provide ,ame of lhe --but I haYe conlraded (hnd) lhe folowlng -· lo provide lhe -lndk:eted (ildude name / add .... / phone / lype of-):
IS PROPERlY OWNER SIGNATURE DATE
'I ~.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 Ad.? • Yes • No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? • Yes • No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? • Yes • No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUEO UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFACE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there 1s 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
APPLICANT CERTIFICATION
I ceflifythat I have read the appllcatlon and state that the aboYe Information is correct and thatthe lnfonnatlon on the plans is accurabl. I aeN bJ complywtth all Chy Ofdlnancesand State laws 191atlngto bulldtng consbuctlOft.
I heret,y aulhorize repl8S8f11ative of lhe City of Carlsbad to enter upon lhe-. menliooed property for inspedion purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL LIAEIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAD CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA,.,, OSHA pemit is requ...t forexca-. ""'s·a deep=nion orconslruclion of slrudul8s CNe13 stories n t,,;ght
EXPIRATION: Eve,y pemit isslJed by lhe lluilmg Olliaa. · ~lhe · of 1his Code shaD e,q,ire by Nnitalion and become null and ,.;d ff lhe bliklng or-,_ed by sudl pem,lt is nol amnenc.ed wi1hin
180 days from lhe date of sudl pemit orilhe buid"IJ or . · ch pemit is suspended or abandoned at anytime atlerlhe-is commeoced fore period 180 days (Sedion 1116.4.4 Uniform Buiklng Code). ' . • I
~APPUCANT'SSIGNATURE ~ :, DATE f3 /+ /6
I ( ' ,_)
PERMIT INSPECTION HISTORY REPORT (CBC2018-0476)
Permit Type: BLDG-Commercial Application Date: 08/20/2018 Owner: VIASAT INC A DELAWARE
CORPORATION
Work Class: Tenant Improvement Issue Date: Subdivision:
Status: Closed -Finaled Expiration Date: 05/07/2019 Address: 2501 Gateway Rd
Carlsbad, CA 92009-17 42
IVR Number: 13320
Scheduled Actual Inspection Status Primary Inspector Re Inspection Complete Date Start Date Inspection Type Inspection No.
11/12/2018 BLDG-Final 076821-2018 Passed Andy Krogh Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-Plumbing Final Yes
BLDG-Mechanical Final Yes
BLDG-Structural Final Yes
BLDG-Electrical Final Yes
11/08/2018 11/08/2018 BLDG-14 075602-2018 Passed Andy Krogh Complete
F rame/Steel/Boltl ng/
Welding (Decks)
November 20, 2018 Page 1 of1
DATE: 9/14/2018
JURISDICTION: Carlsbad
PLAN CHECK#.: CBC2018-0476
✓• EsG1I
A SAFEbuiltCompany
SET: II
PROJECT ADDRESS: 2501 Gateway Rd.
PROJECT NAME: ViaSat Tenant Improvement
• APPLICANT • JURIS.
~ The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
D The check list transmitted herewith is for your information. The plans are being held at EsGil
until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
~ EsGil staff did not advise the applicant that the plan check has been completed.
D EsGil staff did advise the plicant that the plan check has been completed.
Person contacted:
Date contacted:
Mail Telephone
0 REMARKS:
By: Jason Pasiut
EsGil
Telephone#:
(by ) Email:
Fax In son
Enclosures:
gn1201a
9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576
✓• EsG1I
A SAFEbuilfCompany
DATE: 9/4/2018
JURISDICTION: Carlsbad
• APPLICANT • JURIS.
PLAN CHECK#.: CBC2018-0476 SETI
PROJECT ADDRESS: 2501 Gateway Rd.
PROJECT NAME: ViaSat Tenant Improvement
•
•
•
•
•
~
•
The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
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.
The check list transmitted herewith is for your information. The plans are being held at EsGil
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:
Dana Tsui
EsGil staff did not advise the applicant that the plan check has been completed.
EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: Dana Tsuit.'.:
1
Telephone#: 858-793-4777q
Date cont~~ted~_<:j_( 4-(by:~ ) Email: danat@sca-sd.com R;:~ J Fax In Person
By: Jason Pasiut
EsGil
8/23/2018
Enclosures:
9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576
Carlsbad CBC2018-0476
9/4/2018
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK#.: CBC2018-0476
OCCUPANCY: B
TYPE OF CONSTRUCTION: II-A
ALLOWABLE FLOOR AREA: within
SPRINKLERS?: YES
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 8/20/2018
DATE INITIAL PLAN REVIEW
COMPLETED: 9/4/2018
FOREWORD (PLEASE READ):
JURISDICTION: Carlsbad
USE: Office
ACTUAL AREA: l,0OOsf
STORIES: 3
HEIGHT: unchanged
OCCUPANT LOAD: 10
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 8/23/2018
PLAN REVIEWER: Jason Pasiut
This plan review is limited to the technical requirements contained in the California version of
the International 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 2016 CBC, which adopts the 2015 IBC.
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. 105.4 of
the 2015 International 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.
Carlsbad CBC2018-0476
9/4/2018
Please make all corrections, as requested in the correction list. Submit FOUR new
complete sets of plans for commercial/industrial projects (THREE 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 and the Carlsbad Planning, Engineering and
Fire Departments.
2. Bring TWO corrected set of plans and calculations/reports to EsGil, 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 only will not be reviewed by the City
Planning, Engineering and Fire Departments until review by EsGil is complete.
• PLANS
1. Please clean up the plans by removing reference to details and sheets that are
not part of the scope of this permit application. For example, on sheet 12-A 103
there are references to sheets 12-A420, 12-A510, 12-A505 .....
2. Clearly show which building is being improved on sheet 12-AS-100.
3. Sheet 12-A426 print is very light.
• ACCESSIBILITY FOR REMODELS, ADDITIONS, AND REPAIRS
The following disabled access items are taken from the 2016 edition of California Building
Code. Per Section 1.9.1.2, all privately funded public accommodations and commercial
facilities shall be accessible to persons with disabilities.
Where existing elements or spaces are altered, each altered element or space shall
comply with applicable requirements of Division 2, including CBC section 11 B-202.4. CBC
section 11 B-202.4 states that when alterations or additions are made to existing buildings,
an accessible path of travel to the specific area of alteration shall be provided. See
exceptions to 11 B-202.4. If ii is known that the accessible path of travel has already been
improved during this or the previous code cycle, please note the permit numbers on the
plans and update the scope of work to state that the accessible path of travel meets
current standards based on work previously done.
Detail on the plans the following elements of the existing path of travel that are required
to comply with the 2016 accessibility standards:
4. Existing primary entrance to the building or facility, including path of travel
elements from the parking structure:
Carlsbad CBC2018-0476
9/4/2018
a) Show the existing ramp slope, cross-slope, 48" minimum width, 60" x 60"
landing at the top, 72" long landing at the bottom, compliant changes in
direction (60" x 72") in compliance with CBC 11 B-405.
b) Show the existing stair width, riser and tread dimensions, contrasting stipes,
handrail height, gripping surfaces and top/bottom extensions in compliance
with CBC 118-504 and 505.
c) Show the existing accessible entrance door hardware, door width, and
maneuvering clearances on either side of the door in compliance with CBC
11 B-206.4.
• FRAMING / FINISHES
5. Please add flame spread and smoke developed index information onto the finish
schedules for applicable interior floor and wall coverings being installed within this
type 11-A construction.
6. Please add fasteners proposed to details 10 and 11 on sheet 12-AF110.
• END OF REVIEW
To speed up the review process, please 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 • No
The jurisdiction has contracted with EsGil, 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 Jason Pasiut at Esgil. Thank you.
Carlsbad CBC2018-0476
9/4/2018
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad
PREPARED BY: Jason Pasiut
BUILDING ADDRESS: 2501 Gateway Rd.
BUILDING OCCUPANCY: B
BUILDING AREA Valuation
PORTION ( Sq. Ft.) Multiplier
1000 46.51
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb By Ordinance
-----------
1997 UBC Buildin Permit Fee ... 3 g
1997 UBC Plan Check Fee ·-· -~
----
Type of Review: Complete Review
D Repetitive Fee _ __3 Repeats
Comments:
D Other
D Hourly
EsGil Fee
PLAN CHECK#.: CBC2018-0476
DATE: 9/4/2018
Reg. VALUE ($)
Mod.
46,510
46,510
D Structural Only
f--------ll Hr. @ •
$236.251
Sheet 1 of 1
-SAN DIEGO REGIONAL OFFICE USE ONLY
RECORD ID# HAZARDOUS MATERIALS PLAN CHECK#
QUESTIONNAIRE BP DATE I ,
Business Name Business Contact Telephone#
ViaSat, Inc. Bob Rota 760 476.2202
Project Address City State Zip Code APN#
2501 Gateway Road Carlsbad CA 92009 213-260-10, 11, 12
Mailing Address City State Zip Code Plan File#
6155 El Camino Roal Carlsbad CA 92009
Proir,t Contact Applicant E-mail Telephone#
ob Rota 760 476.2202
Tho following questions ropruont tho faclllty'a actlvtUn, NOT tho specific project daacrlptlon.
PART : F ENT -ATERIALS DMSIO : IFIC for
: n 1cate by circling the item, er your business will use, process, or store any the rdous matenals.
app cant must contact the Fire Protaction Agency with Jurisdiction prior to plan submlttal.
Occupancy Rating: Faclllty'a Square Footage (Including proposed project):
1. Explosive or Blasting Agents 5. Organic Paroxidas 9. Watar Reactives 13. Conrosivas
2. Compressed Gasas 6. Oxidizers 10. Cryogenics 14. Other Health Hazards
3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Matarials 15. None of These.
4. Flammable Solids 8. Unstable Reaclives 12. Radloactives
quastions Is yas, app leant must contact the unty an ego Hazardous Materials lvis on,
Call (858) 50~700 prior to the Issuance of a building permit.
FEES ARE REQUIRED Project Completion Dale: Expected Date of Occupancy: 0 CalARP Exempt
YES NO (for new construction or remodeling projects)
1. D IX) Is your buslnass listed on the reverse side of this form? (check all that apply). Date Initials
2. D IX) Will your business dispose of Hazardous Substances or Medical Wasta In any amount?
3. D IX) Will your business store or handle Hazardous Substances In quantitias greater than or equal to 55 gallons, 500 0 CalARP Required
pounds and/or 200 cubic feet?
4. D IX) Will your business store or handle carcinogens/reproductive toxins In any quantity? Date Initials
5. D IX) Will your business use an existing or Install an underground storage tank?
6. D IX) Will your business store or handle Regulatad Substances (CalARP)?
7. D IX) Will your business use or Install a Hazardous Waste Tank System (Tille 22, Article 10)?
8. D IX) Will your buslnass store petroleum In tanks or containers at your facility with a total facility storage capacity equal to
0 CalARP Complate
Date Initials
or realer than 1,320 allons? Csllfomla's round Petroleum Store e Act .
~ l~S~ ~!EGO COUNTY AIR POLL~DN fiONTROL DISTRICT (APC~I; Any YES• answer requires a stamp from APCD 10124 Old Grove Road, San ego,W3 apcdcomp@sdcounty ca oov858 586-2650). rNo stamp requ red ~ Q1 Yes llllll Q3 Vas llllll Q4-Q8 No]. Tho following questions are Intended
to Identify the majority of air pollution Issues at the planning stage. Projects may require addltlonal measures not idantlfled by these questions. For comprehensive
requirements contact APCD. Residences are typically exempt, except -those with more than one building• on the property; single buildings with more than four
dwelling units; townhomes; condos; mixed-commercial use; deliberate bums; residences forming part of a larger project. rExcludes garages & small outbuildings.]
YES NO
1. D IX) WIii the project disturb 160 square feet or more of existing building materials?
2. D IX) WIii any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolltlon.
3. 0 IX) (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos SUfVIIY been perlormed by a Cartlfled Asbestos Consultant or Site Surveillance
Technician?
4. 0 IX) (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification
may be required 10 working days prior to commencing asbestos removal.
5. D IX) WIii the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheat
(www.sdapcd.org/info/facts/permits.pdl) for typical equipment requiring an APCD permit.
6. 0 IX) (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or assoclatad construction equipment be locatad within 1,000 feat of a school
boundarv
Briefly dascribe business activities: Briefly describe proposed project:
Office space ~, Modificatillli to office space design
I declare under penalty of pe~ury that to the best of my knowledge and belief ti !l'resJloUes .,,_-rein are true and correct.
Dana Tsui \ f I J / .w , L a I 14 1201s
Name of OWner or Authorized Anent Slnnature of Owner or Auth rtzed .a. .. ent Date
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION· FOR OFFICAL USE'Q!!IJ\./
BY: DATE: I I
EXEMPT OR NO FURTHER INFORMATION REQURED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RB.EASED FOR OCCUPANCY
COUNTY-HMO• APCD COUNTY-HMO APCD COUNTY-HMO APCD
.. •A stamp m this box smii exempts businesses from completing or updating a Hazardous Matenals Busmess Plan. other permitting requirements may still apply.
HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division