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HomeMy WebLinkAbout2561 EL CAMINO REAL; ; CB121111; Permit08-13-2012 Job Address: Permity Type: Parcel No: Valuation: Occupancy Group: Project Title: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No: CB121111 Building Inspection Request Line (760) 602-2725 2561 EL CAMINO REAL CBAD TI Sub Type: COMM 1563010900 Lot #: 0 $58,196.00 Construction Type: 5B Reference # SEARS - 1,029 SF TI OF WAREHOUSE TO -SHOWROOM Status: ISSUED Applied: 06/14/2012 Entered By: LSM Plan Approved: 08/13/2012 Issued: 08/13/2012 Inspect Area Plan Check #: Applicant: Owner: MILAN JELIC SEARS ROEBUCK&CO <LF> PLAZA CAMINO REAL C/O SEARS ROEBUCK & CO 22792 FORTUNA LN 3333 BEVERLY RD MISSION VIEJO CA 92691 HOFFMAN ESTATES IL 60179 949-813-7216 Building Permit $372.85 Meter Size Add1 Building Permit Fee $0.00 Add'I Red. Water Con. Fee $0.00 Plan Check $261.00 Meter Fee $0.00 Add'I Building Permit Fee $0.00 SDCWA Fee $0.00 Plan Check Discount $0.00 CFD Payoff Fee $0.00 Strong Motion Fee $8.02 PFF (3105540) $0.00 Park Fee $0.00 PFF (4305540) $0.00 LFM Fee $0.00 License Tax,(3104193) $0.00 Bridge Fee $0.00 License Tax (4304193) $0.00 BTD #2 Fee $0.00 Traffic Impact Fee (3105541) $0.00 BTD #3 Fee $0.00 Traffic Impact Fee (4305541) $0.00 Renewal Fee $0.00' PLUMBING TOTAL $0.00 Add'I Renewal Fee $0.00 ELECTRICAL TOTAL $40.00 Other Building Fee $0.00 MECHANICAL TOTAL $0.00 Pot. Water Con. Fee $0.00 Master Drainage Fee $0.00 Meter Size Sewer Fee $0.00 Add'I Pot. Water Con. Fee $0.00 Redev Parking Fee $0.00 Red. Water Con. Fee $0.00-- Additional -Fees $0.00 Green Bldg Stands (SB1473) Fee $1.00 HMP Fee ?? Fire Expedidted Plan Review $0 00 - ° - Green Bldg, Standards Plan Chk ?? ,TOTAL PERMIT FEES $682.87 Total Fees: $682.87 Total, Payments To Date:, $682.,8.7 Balance Due: $0.00 FINAL,AI'P OVAL Inspector: -s Date: 06 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 fortMn 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 imp#tion. 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 aiven a NOTICE similar to this, r as to which the statute of limitations has oreviously otherwise ex fired. Building Permit Application 760-602-2717 / 2718 / 2719 Fax 760-602-8558 www.carisbadca.gov Plan Check No.l006 I b l t i Est. value 3$11l a (p Plan Ck. Deposit oho I - p a Date &/ 1 L(-' f Z JOB ADDRESS p SUITE#/SPACE#/UNIT# APN CT/PROJECT # LOT # PHASE # # OF UNITS I # BEDROOMS J#BATHROOMS _ TENANT BUSINESS NAME I CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: I��deSquare Feet ofA�edA(s) C��� ` vGa-ke-�s-, 4 .]T 4kx� ce- kWk ( NO A ^ \6ack b V- ) "` J) `oo�\ '�c��,�-� �x�Sew0�� ".� /, , oa.9 EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES ❑t♦ NO[:] AIR CONDITIONING YES[:]NOE:] IFIRESPRINKLERS YES❑NO❑ APPLICANT NAME (Primary Contact) �. APPLI TNA (Secondar Contest) ADDRESS ADDRESS �� k a `�`��� CITY,oN STATE P�A I � `� 7�` CITY jy STATE ZIP oz© S PH� "\ ` V` r v��\ FAX/L.' - PHO/`�•YhV�- � �� F 00� r C � P� EMAIL ` ' 1 `o t l Cr �-�^\ S�G t...ftJ. EMAIL .O \`� �%lt �LiTV l� �f� Ak- PR TYOWNER NAM ^ M CONTRACTOR BUS. NAME ADDRESS ADDRESS ATE —1-L ZIP 60 CITY STATE ZIP „�` � \Y`�F✓l� FAX PHONE FAX ; EMAIw ``/ ��\"` i/ 1 M l�O� EMAIL SRQH�`+/D\S E�NAME & ADDI�►NM e • &qe S^LI � - STATE LIC.# CLASS CITY BUS. LIC.# (Sec. 7031.5 Business and Professions Code: Any City or Countfwhich requires a permit to.consVuct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permitto file a si nod statementthat he is licensed pursuantto the provisions of the Contractor's License Law {Chappter 9 commendingwith Section 7000 of Division 3 of the Business and Professions Code) or t at 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 applicantto a civil penalty of not more than five hundred dollars ($500)). s,,�§.�`'sd ,g•_ .-� ..N . � r Workers' Compensation Declaration: l hereby affirm underpenalty ofpedury one of the following declarations: Eli 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. ❑ 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 workers' compensation insurance carder and policy number are: Insurance Co. Policy No. Expiration Date This section need not be completed ifthe permit is for one hundred dollars ($100) or less. Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), 1 n addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. R5 CONTRACTOR SIGNATURE []AGENT DATE ;4., %HE,.. E:Yt�:.: »; E„„ 3: £, .•s.,e.'1.0 n•r 1 hereby affirm that I am exempt from Contractor's License Lawfor the following reason: 1, as ownerof the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does notapply to an owner of property who builds or improves thereon, and who does such work himseff 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). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and contracts'for such projects with contractor(s) licensed pursuant to the Contractors License Law). I am exempt under Section - - - Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement, Dyes [:]No 2. [(have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction.(include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address / phone I contractors' license number): 5.1 will provide some of the work, but I o provide the work indicated (include.name / address / phone /type of work): p .ESPROPERTYOWNS ' ENT DATE V 11q/9zP-%-1 l ;AE:5 .: ; •..: 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? 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 ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY"SERVICES-AND THE AIR POLLUTION CONTROL DISTRICT. y" ,�'�agx��;��+^ j (� asF. �o3 °d. bRd4 M 2 i ?•na y, . !. �`:i. ,Nl,„`,,• , j•, I hereby.affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address A ,� /k�`%6:ieF';wres�•'•m+`�:b�`iC%�dr'9Y,',, u��c;is«;�;.., I certify that I have read the application and statethatthe above information is conectand thatthe information on the plans is accurate.I agreeto eomplywdh all City ordinances and State laws relatingto buildingoonstruction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 6V deep and demolition or construclio ofstruclums over 3 stories in height s of this pire by limitation and become null and void if the building orwork authorized by such permit is not commenced within EXPIRATION: Every permit issued by the Building Officaautho6 180 days from the date ofsuch permit 'ng permit is sus gabandoned at anytime after the work is commenced fo a period 180 days (Section 106.4.4 Uniform Building Code). ,ESAPPLICANT'S SIGNATURE �� DATE I STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email www.building0carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS: LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg.1) ASSOCIATED"CEI MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg.1) NO CHANGE -IN USE/ NO CONSTRUCTION MAIL / FAX TO OTHER: CHANGE OF USE/ NO CONSTRUCTION ,ESAPPLICANTIS SIGNATURE DATE I Oct. 16, 20112 8;:'030 V ;CITY OF -CARLSBAD ''IN$PgCTION RECORD Building bMslon tit INSPECTION RECORD CARD WITH 'APPROVED - PLANS MUST BE KEPT ON TH9 JOR E[CALL-'BEPORE 3130 pm FOR -NEXT WQRK-DAY INSPECTION 0 FOR BUILDING INSPECTION CALL- 760-602-2725 OR Qo'T0: wvm.CarJsbadcx.qovAujBft AND CLJCK ON :"Request Inspection" N No,0294 Fp, 1/1 C6121'111 2561 EL CAMINO REAL SEARS - 1,029,9F TI OF WAREHOUSE TO SHOWROOM, TI Comm Lot#.' MILAN JELIC RECORD COPY ❑ CM&I (Emine - edng Inspcoions), 760439-3991 ca it Wore 2'p- Fire Pteventlon 760402-4660 A110W.48 h0U►-'_ ro type of I c2l Date ction, Ins !lion Date Ins !clot I ff MAI FOUNDATION L-l-ELICSICUNDERGROUND , OUFER REINFORCED STEEL ROUGH ELEMICWALL$ 'MASONty R OUIN ELECTRIC CEILING QQROUT 13WALLDRMNS TILT PANELS El BONDING I0 POOL aL_uml N molptcs- FIKAL SUBF"mf M'FLOOR [3 CEILING UNDERGROUNDDUCTS a PIPING ROOFSHEATHING. 0 CUCT6PIfNUM' [IREF PIPING FRAMEHWAIR COND. SYSTEM INSULATION VINTILAMNSMIMS iOrMRIOR LATH FINAL INTERIOR -LATH A DRYWALL 1A_ FINAL It* Dag-l- Inspector bum vato Inspector tOCCUPMOY U'SEWER&BL/co OPL/co W M UNDERGROUND OWASTE UWAYM suNDOGROUND0YOR0 N. WATER E2 WAY TOP OUT 13WASK OWEN UNDERGROUND FLUSH TUB,& SHOWER PAN A/$ OVWFAD VISUAL US OVERRUD HYDROSTATIC E3WATER HEATER 13SOLARWATER A/11 FINAL FIN" F/AROUGH-IN rl/AFIXAL sw,- PREcOm$TRUCnON MALTING FDOW OUINGIVISHING SYSTO ROUGH -IN FUD EKANO SYS7131 HYDROSTATIC MST 603-FOLLOW UP 605. NOTIORTO CLEU "p gjkTINQUISHINQ SYSTEM FINAL f-WRITTENWARNING MEDICAL OU PRESSURETEST M - NOTICE OFVIOLATION MEDICAL QA$FINAL 6 1O.-YERiALWARNINO FINAL FINAL _ sm BACK FOR SPECIAL NOTES Inspection List Permit#: CB121111 Type: it COMM SEARS -1,029 SF TI OF WAREHOUSE TO SHOWROOM Date Inspection Item Inspector Act Comments 02/07/2013 89 Final Combo - RI AM 10-12 PLS STORE OPENS AT 10 02/07/2013 89 ri'nal Combo MC M FOR PY 12/18/2012 66 Grout PY WC 09/13/2012 84 Rough Combo PY AP 08/31/2012 17 Interior Lath/Drywall PD AP 08/29/201214 Frame/Steel/Bolting/VVeldin PY AP Friday, February 08, 2013 Page 1 of 1 EsGil Corporation In Tantnenship with Government for Building Safety DATE: 6/25/ 12 JURISDICTION' City of Carlsbad PLAN CHECK NO,: 12-1111 SET:_I PROJECT ADDRESS: 2561 El Camino Real PROJECT NAME: Sears Footwear Stockroom - TI ICANT ❑ JURIS. ❑ PLAN REVIEWER ❑ FILE The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building 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 Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the checklist is enclosed for the jurisdiction to forward to the applicant contact person. ❑ The applicant's copy of the check list has been sent to: ® EsGil 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: Date contacted: Mail Telephone ❑ REMARKS: Telephone #: (by: ) Email: Fax In Person By: Doug Moody EsGil Corporation ❑ GA ❑ EJ ❑ PC Enclosures: 6/14/12 Fax #: 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 City of Carlsbad 12-1111 6/25/12 [DO -NOT PAY— THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PLAN CHECK NO.: 12-1111 PREPARED BY: Doug Moody DATE: 6/25/ 12 BUILDING ADDRESS: 2561 El Camino Real BUILDING OCCUPANCY: M TYPE OF CONSTRUCTION: IIIB BUILDING PORTION AREA (Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) 'TI 1-029 37.1`2 38,196, Air Conditioning Fire Sprinklers TOTAL VALUE 38,196 Jurisdiction Code Icb 113y Ordinance Bldg. Permit Fee by Ordinance Pla n Check Fee by Ordinance #' Type of Review. 0 Complete Review ❑ Other ❑Repetitive Fee Repeats Hourly EsGil Fee ❑ Structural Only H r. @ $372.85 $242.35 $208.80 Comments: Sheet 1 of 1 macvalue.doc + <t?jCITY OF CARLSD/-%D DATE: 6/14/12 PROJECT NAME: PLAN CHECK NO: CB121111 SET#: PLAN CHECK REVIEW TRANSMITTAL PROJECT ID: Community & Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carlsbadca.gov ADDRESS: 2561 EL CAMINO REAL APN: 156-301-09=00 This plan check review is complete and has been APPROVED by the PLANN'IN6 Division. By: GINA RUIZ A Final Inspection by the PLANNING Division is required ❑ Yes ® No This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check APPROVAL have been sent to: MILAN.JELIC@SEARSHC.COM You may -also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checklist please contact the following reviewer as marked: PLANNING 760-602-4610 'ENGINEERING'. 760-6024750' FIRE PREVENTION 760-602-4665 . -Chris Sexton 760-602-4624 Chris.Sexton@carisbadca.gov F-] Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carisbadca.gov Greg Ryan 760-602-4663 Gregory.Ryan@carisbadca.gov 0 Gina Ruiz 760-602-4675 Gina.Ruiz@carlsbadca.gov F] Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.gov Cindy Wong 760-602-4662 Cvnthia.Wong@carisbadca.gov Dominic Fled 760-602-4664 Dom inic.Fieri@carlsbadca. ov Remarks: PLANNING DIVISION Development Services 4 BUILDING PLAN CHECK Planning Division CITY OF APPROVAL 1635 Faraday Avenue CAR LSBAD (760, 602-4 P-29 www.carlsbadca.gov gov PERMIT NUMBER CB121111 DATE 6/14/12 ADDRESS 2561 EL CAMINO REAL RESIDENTIAL ADDITION - MINOR (<171000.00) RETAINING WALL VILLAGE FAIRE OTHER PLANNER GINA RUIZ POOL/SPA N-TIMPROVEMENTI COMPLETE OFFICE BUILDING SOLAR PANELS DATE 6114/12 P-29 Page 1 of 1 07/11 e, N V4�CIJY OF CARLSBAD PLAN CHECK REVIEW TRANSMITTAL Community & Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carisbadca.gov DATE: 6/20/2012 PROJECT NAME: WESTFIELD / SEARS PROJECT ID: PLAN CHECK N0: CB 12-1111 SET#: 1 ADDRESS: 2561 EL CAMINO REAL APN: 156-301-09-00 VALUATION: 38,196 This plan check review is complete and has been APPROVED by the ENGINEERING Division. By: A Final Inspection by the CM&I Division. is required ';Yes ✓: No This plan check review is NOT COMPLETE. Items missing or incorrect are listed on -,.— the attached checklist. Please resubmit amended plans as required. Plan Check Comments, have been sent to: You may -also have corrections from one or more of the divisions listed below. Approval from these divisions may, be required prior to the issuance of a building permit. Resubmitted plans" should include corrections from all divisions. For cluestions'0r- clarifications on the attached checklist please contact the following reviewer as marked: .PLANNING . ENGINEERING FIRE�PREVENThON,- .. ". 760-602-4610 760-602-2750 """ 760,-602-4665 Chris Sexton #Kathleen Lawrence M ; Greg Ryan -- 760-602-4624 - 760-602-2741 760-602-4663 Chris.Sexton@carlsbadca.gov Kathleen.Lawrence@carisbadca.gov Gregory.Ryan@carisbadca.gov 0 Gina Ruiz ; Linda Ontiveros Lj Cindy Wong 760-6024675 ! 760-602-2773 760-602-4662 Gina.Ruiz@carlsbadca.gov -Linda.Ontiveros@carlsbadca.gov Cynthia.Wong@carisbadca.gov ElDominic Fieri 760-602-4664 Dominic.Fieri@cafisbadca.gov Remarks: N s�r> CITY OF CARLSPAD PLAN CHECK REVIEW TRANSMITTAL DATE: 06/24/2012 PROJECT NAME: Sears PROJECT ID: CB121111 PLAN CHECK NO:1 SET#:1 ADDRESS: 2525 EL CAMINO REAL APN: Community & Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carisbadca.gov ® This plan check review is complete and, has been APPROVED by the FIRE Division. By: GR A Final Inspection -by the FIRE Division is required ® Yes ❑ No ❑ This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended, plans as required. Plan Check Comments have been sent to: You may also have corrections from one or more- of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checklist please contact the following reviewer as marked: PLANNING ENGINEERI,iVG 760�6U2-46 0' "76'0 02.2750' ` ` 76r 6'02=4665 ; Chris Sexton F1 Kathleen Lawrence ® Greg Ryan 760-602-4624 760-602-274J. 760-602-4663 Chds.Sexton@carlsbadca.gov Kathleen.Lawrence@carlsbadca.gov Gregory.Ryan@carlsbadca.gov ❑ Gina Ruiz ❑] Linda Ontiveros Cindy Wong, 760-602-4675 760-602-2773 760-602-4662 Gina:Ruiz@carlsbadca.gov Linda.0ntiveros@carlsbadca&y Cynthia.Wong@carlsbadca.gov ❑ ❑ ❑ Dominic Fieri 760-602-4664 Dominic.Fieri@carlsbadca.gov Remarks: 1 �r Carlsbad Fire Department Plan Review Requirements Category: TI , COMM Date of Report: 06-24-2012 Name: Address: -Permit #: CB 121111 MILAN JELIC 22792 FORTUNA LN MISSION VIEJO CA 92691 Job Name: SEARS - 1,029 SF TI OF Job Address: 2561 EL CAMINO REAL CBAD Conditions: Cond: CON0005509 [NOT MET] Reviewed by: * * CITY OF CARLSBAD, FIRE DEPARTMENT - APPROVED: W/NOTES BUILDING DEPT. CPlY THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUANCE OF BUILDING PERMIT. THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS HEREON, CONDITIONS IN CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS. THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW. Cond: CON0005510 [MET] Any revisions to the existing automatic fire sprinkler system shall be in accordance with NFPA 13 and Carlsbad Municipal Code. Plans for any alterations to the existing automatic fire sprinkler system shall be submitted to the Carlsbad Fire Department as a deferred submittal. Entry: 06/24/2012 By: GR Action: AP CERTIFICATE OF COMPLIANCE (Part 1 of 4) LTG-1 C Project Name Date Sears 512112012 Project Address Climate Zone Total Cond. Floor Area Unconditioned Floor Area 2561 Camino El Real Carlsbad 9 4,600 0 GENERAL INFORMATION Building Type: m Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ School ❑ Relocatable Public p Conditioned Spaces ❑ Unconditioned Spaces School 'Phase of Construction: ❑ New Construction E Addition ❑ Alteration Method of Compliance: ❑ Complete Building m Area Category ❑ Taijored Documentation Author's Declaration Statement I certify that this Certificate of Compliance documentation is accurate and complete. //k Signa r t Name Mikeal Kane Company Dat Sears Holdings 5121120 2 Address CEA # 3333 Beverly Rd CEPE # City/State/Zip Phone Hoffman Estates, Illinois 60179 847-286-1879 The Principal Lighting Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professional Code to accept responsibility for the lighting design. • This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Pages 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consiste . w' h the information provided to document this design on the other applicable compliance forms, worksheet , I ulations, plans and specifications submitted to the enforcement agency for approval with this g t application. Name Signatu Mikeal Kane Company Ph ' Sears Holdings Corporation 847- 8 -1879 Address License # 3333 Beverly Rd City/State/Zip Date Hoffman Estates, Illinois 60179 Lighting Mandatory Measures Indicate location on building plans of Mandatory Measures Note Block: LIGHTING COMPLIANCE FORMS & WORKSHEETS (check box if worksheets is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms; please refer'to the Nonresidential Manual published by the California Energy Commission. © LTG-1 C Pages 1 through 4 Certificate of Compliance. All Pages required on plans for all submittals. ❑ LTG-2C Lighting Controls Credit Worksheet LTG-3C Indoor Lighting Power Allowance ❑ LTG-4C Pages 1 through 4 Tailored Method Worksheet ❑ LTG-5C Pages 1 and 2 Line Voltage Track Lighting Worksheet EnergyPro 5.1 by EnergySoft User Number. • 7440 RunCode: 2012-05-21T1 • 2 ID: 1678 _ Page 1 of 6 (MA 1-?0* 1((( CERTIFICATE OF COMPLIANCE' (Part 2 of 4) LTG-1 C Project Name Sears Date 1 512112012 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Installation Certificate, LTG-1- INST (Retain a copy and verify form is completed and signed.) Field Inspector ❑ Certificate of Acceptance, LTG-2A and LTG-3A (Retain a copy and verify form is completed and signed.) Field Inspector ❑ A separate Lighting Schedule- Must Be Filled Out for Conditioned and Unconditioned- Spaces Installed Lighting Power listed on this Lighting Schedule is only for: ® CONDITIONED SPACE ❑ UNCONDITIONED SPACE ® The actual indoor lighting power listed below includes all installed permanent and portable lighting systems in accordance with §146(a). Only for offices: Up to the first 0.2 watts per square foot of portable lighting shall not be required to be included in the ® calculation of actual indoor lighting power density in -accordance with the Exception to §146(a). All portable lighting in excess of 0.2 watts per square foot is totaled below. Luminaire (Type, Lamps, Ballasts)- Installed Watts A B C D E F G H None or Item Ta Complete Luminaire Description' (i.e,-31amp fluorescent troffer, F32T8, one dimmable electronic ballasts)�' N a E `� � How wattage Was determined N O a) �,cz E Z L X — (fis °ecto'tr CEC Default From NA8 o �� v r 0 23) 09 ¢ ~ a - ` m u? • ' A (3) 4 ft Fluorescent T8 Rapid Start Elec 93.0 ❑ ❑ 53 4,929 B (1) 4 ft Fluorescent T8 Rapid Start 39.0 ® ❑ 40 1,560 11 El ❑ ❑ `LT' ."G7., El El 13 ID ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o:: o a ❑ 11 ID Installed Watts Page Total: 6,489' Building total number of pages: Installed Watts Building Total Sum of all pa — es) 6,489 Enter into LTG-1 C Page 4 of 4 1. Wattage shall be determined according to Section 130 (d and e). Wattage shall be rating of light fixture, riot rating of bulb. 2. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. En; r Pro 5.1 by EhergySoft. User Number. 7440 RunCode: 2012-05-21T12:43:22 1D: 1678 Page 2 of 6 CERTIFICATE OF COMPLIANCE (Part 3 of 4) LTGA C Project Name Sears Date 1 512112012 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Fill in -controls for all spaces: a) area controls, b) multi -level controls, c) manual daylighting controls for daylit areas > 250 fe, automatic daylighting controls for daylit areas > 2,500 fe, d) shut-off controls, e) display lighting controls, f) tailored lighting controls — general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls for retail stores > 50,000 ft2, in accordance with Section 131. MANDATORY LIGHTING CONTROLS — FIELD INSPECTION ENERGY CHECKLIST ? Field; T e/ Description Number of Units Location in BuildingFeatures Special ❑ ❑.warp C . 04 ❑ �C3�r�1 .i7 ❑ C.l. AF- ❑ : •cif _ � -�; :el `: . SPECIAL FEATURES INSPECTION CHECKLIST (See Page 2 of 4 of LTG-1 C) 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. 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. Field Inspector's,Notes or Discrepancies: EnergyPro 5_1 by EnergySoft User Number: 7440 RunCode: 2012-05-21T12:43:22 - ID: 1678 Page 3 of 6 CERTIFICATE OF COMPLIANCE Part 4 of 4 LTG -IC Project Name Date Sears 1 512112012 CONDITIONED AND UNCONDITIONED SPACE LIGHTING MUST NOT BE COMBINED FOR COMPLIANCE Indoor Lighting Power for Conditioned S aces Indoor Lighting Power for Unconditioned Spaces Wafts Watts Installed Lighting 6,489 Installed Lighting 0 from Conditioned LTG-1 C, Page 2 - from Unconditioned LTG-1 C, Page 2 Lighting Control Credit _ 0 Lighting Control Credit _ 0 Conditioned Spaces from LTG-2C , Unconditioned Spaces from LTG-2C Adjusted Installed = 6,489 ' Adjusted Installed = 0 Lighting Power- Lighting Power 'Complies if Installed 5 Allowed Complies if Installed 5 Allowed Allowed Lighting Power 7,360 Allowed Lighting Power 0 Conditioned Spaces from LTG-3C pr PERF-1 Unconditioned Spaces from-LTG-3C Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for the Lighting system, LTG-2A and LTG-3A. The designer is required to check the acceptance tests'and list all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. If all the lighting system or control of a certain type requires a test, list the different lighting -and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference, Appendices Manual describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Forms can be grouped by type of Luminaire controlled. Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or when ever new lighting system with controls. is installed in the building or space -shall be certified as meeting the Acceptance Requirements. The LTG-2A and LTG-3A forms are not considered complete forms and are not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Title 24 Part 6. The field inspector must receive the properly filled out and signed forms before the building can receive final occupancy. A copy of the LTG-2A and LTG-3A for each different lighting luminaire control(s) must be provided to the owner of the building for their records. LTG-2A and Luminaires Controlled LTG-3A Controls and Sensors and Number of Automatic Luminaires Daylighting Controls Equipment Requiring Testing Description controlled Location Acceptance El El El El El El 11 El El El EnergyPro5.1by_Energy,Soh User Number. 7440 RunCode: 2012-05-21T12:43:22 ID: 1678 Page 4 of 6 INDOOR LIGHTING POWER ALLOWANCE LTG-3C Project Name Sears Date 512112012 ALLOWED LIGHTING POWER Chose One Method) A Separate LTG-3C must be filled out for Conditioned and Unconditioned Spaces. Indoor Lighting Power Allowances listed on this page are only for: CONDITIONED SPACES ❑ UNCONDITIONED SPACES COMPLETE BUILDING METHOD BUILDING CATEGORY From §146 Table 146-E WATTS PER (ft2) X COMPLETE BLDG. AREA = ALLOWED WATTS TOTALS AREA WATTS AREA CATEGORY METHOD BUILDING CATEGORY From g146 Table 146-F WATTS PER (ft) X Area ft2 = ALLOWED WATTS Retail Sales, Wholesale 1.60 4,600 7,360 TOTALS 4,600 7,360 AREA WATTS TAILORED METHOD Total Allowed Watts using the Tailored Method taken .from LTG-4C (Page 1 of 4 Row 3 0 The indoor lighting power allowance using the Tailored Method of compliance shall be determined using the LTG-4C set of forms. A separate set of LTG- 4C forms shall be filled out -for CONDITIONED -and UNCONDITIONED spaces EnergyPro 5.1 by EnergySoft User Number. 7440 RunCode: 2012-05-21T12.43:22 ID: 1678 Page 5 of 6 LIGHTING MANDATORY MEASURES: NONRESIDENTIAL LTG-MM. Project Name 7512112012 ate Sears Indoor Lighting Measures: §.131(d): Shut-off Controls For every floor, all interior lighting systems shall be equipped with a separate automatic control to shut off the lighting. 1. 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. Override for Building Lighting Shut-off: The automatic building shut-off system is provided with a manual, accessible 2 override switch in sight of the lights. The area of override is not to exceed 5,000 square feet. Automatic Control Devices Certified: All automatic control devices specified are certified, all alternate equipment shall 119 h § ()" be certified and installed as directed by the manufacturer. Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for the project are certified and listed in the §111: Directory. All installed fixtures shall be certified. §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. Uniform Reduction for Individual Rooms: All rooms and areas greater than 100 square feet and more than 0.8 watts §131(b): per square foot oflightingload shall be controlled with bi-level switching for uniform reduction of lighting within the room. Daylight Area Control: All rooms with windows and skylights that are greater than 250 square feet and that allow for §131(c): 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(c): Display Lighting. Display lighting shall be separately switched -on circuits that are 20 amps or less.6. ,Outdoor Lighting Measures: §130(c)1: Mandatory lighting power determination for medium base sockets without permanently installed ballasts §132(a): All permanently installed luminaires with lamps rated over 100 Watts either have a lamp efficacy of at least 60 lumens per Watt or are controlled by a motion sensor. 132 b § ()' All Luminaires with lamps rated greater than 175 Watts in hardscape area, including parking lots, building entrances, canopies, and all outdoor sales areas meet the Cutoff Requirements. §132(c)1: All permanently installed outdoor lighting meets the control requirements listed. 132 c § ()' Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements listed. EnergyPro 5.1 by Energy5off User Number: 7440 RunCode: 2012-05-21T12:43:22, ID: 1678 Page 6 of 6 e is ry�,A�o 4 ' SAN DIEGO REGIONAL Syr° oo° °Moccc�HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY UPFP# HV# BP DATE / / Business Na • ` Business!nb_ `C '] T� e ^7�t i 1� Project 4 dre s `` t Z' 0 APN#r-a3AWb&A ailing ddress� City ` State o�- L1� M �SSI ©!1 e 0 C Zip C Plan File# Project Cortac ;` a� ' ` C Talep oEe # at 6 The following questions represent the -facility's activities, NOT the specitic project aescription. PART I: FIRE DEPARTMENT — HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are cir led a plicant must contact the Fire P otection Agen ,lJI jurisdiction prior to plan submittal. Facility's Square Footage (including proposed project): Occupancy Rating: e- 1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These. 4. Flammable Solids 8. Unstable Reactives 12.-Radioactives PART II SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH —HAZARDOUS MATERIALS DIVISIONS (HMD): If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Ave., Suite 110, San Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. FEES ARE REQUIRED. Project Completion Date: / / Expected Date of Occupancy: ❑ CaIARP Exempt YES NO - (for new construction or remodeling projects) / I. ❑ LJ Is your business listed on the reverse side of this form? (check all that apply). Date Initials 2. ❑ Will your business dispose of Hazardous Substances or Medical Waste in any amount? ❑ CaIARP Required 3. ❑ ET Will your business store or handle Hazardous Substances in quantities equal to or greater than 55 gallons, 500 pounds / 200 cubic feet, or carcinogens/reproductive toxins in any quantity? Date Initials 4. ❑ [' Will your business use an existing or install an underground storage tank? 5. ❑ Will your business store or handle Regulated Substances (CalARP)? ❑ CaIARP Complete 6. ❑ Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? 7. ❑ [Will your business store petroleum in tanks or containers at your facility with a total storage capacity equal to Date Initials or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act). PART III, SAN DIEGO COUNTY -AIR POLLUTION CONTROL DISTRICT: If the answer to any of the questions below is yes, applicant must contact the Air Pollution Control District (APCD), 10124 Old Grove Road, San Diego, CA 92131-1649, telephone (858) 586-2600 prior to the issuance of a building or demolition permit. Note: if the answer to questions 4 or 5 is yes, applicant must also submit an asbestos notification form to the APCD at least 10 working days prior to commencing demolition or renovation, except demolition or renovation of residential structures of four units or less. Contact the APCD for more information. YES N[3 O _/ 1. ❑ Will the subject facility or construction activities include operations or equipment that emit or are capable of emitting an air contaminant? (See the APCD factsheet at http:/Iwww.sdar)cd.org/info/facts/i)eemits.pdf, and the list of typical equipment requiring an APCD permit on the reverse side of this from. Contact APCD if you have any questions). 2. ❑ Q` (ANSWER ONLY IF QUESTION 1 IS YES) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)? (Search the California School Directory at http://www.cde.ca.gov/re/sd/ for public and private schools or contact the appropriate school district). 3. ❑ [ir Has a survey been performed to determine "the presence of Asbestos Containing Materials? 4. ❑ F Will there be renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non -friable asbestos? 5. ❑ [ ,� Will there be demolition involving the removal of a load supporting structural member? B ' escrriib�busine `4ctivitie Briefly describe propose ect: � bA VeC,Iarekur!der1ppeenalty of perjury that:to the best of my, knowledge and b 'eit a res et less e e it rg true and co ect. r^ / r� �, r r� Name of Owner or Authorized Agent Signat Ant `C J Date / ��1 FOR OFFICIAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: BY: DATE: EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY-HMD* APCD COUNTY-HMD APCD COUNTY-HMD APCD *A stamp in this box only exempts businesses Trom completing or upaating a Mazaraous materials business rlan. Omer perrmmng iequuemumb umy sun apply. HM-9171 (02/11) County of San Diego — DEH— Hazardous Materials Division Erman INDUSTRIAL WASTEWATER. DISCHARGE. PERMIT W AMORITY SCREENING SURVEY Date I Business Name Street Address Email Address M Aon - x ta--, \, C— 41L S e-0-5` SC- M, PLEASE CHECK.HERE IF YOUR.BUSINESS 1SEXEIVIPT. (00:I:tEVEF2SE SIDE CHECK TYPE OF BUSINESS) Check all below that are- present at -your facility: Acid Cleaning 'Ink, Manufacturing_ Nutritional Supplement Assembly Laboratory 'Vitamin Manufacturing Automotive Repair Machining I Milling Painting I Finishing Battery Manufacturing Manufacturing Paiin't Manufacturing BiofUel Manufacturing Membrane Manufacturing Personal Care Products Biotech Laboratory (i.e. water filter filt6r membranes) MahLifoctudrig Bulk Chemical Storage Metal Castingj "Forming Pesticide Manufacturing I Car Wash Metal Fabrication Packaging Chemical Manufacturing Metal Firiishihg -Pharmaceutical Manufacturing Chemical Purification Electroplating (including precursors) Dry Cleaning Eleciroles5 plating Porcelain Enameling Electridal.-Comporient Anodizing Power Generation Manufacturing Coating (Le.,phosphatin'g) Print Shop Fertilizer, Manufacturing Chemical Etchin,g / Milling, Research and Development Film IX -ray Processing Printed Circuit Bobed Rubber Manufacturing Food Proce$sibg Manufacturing Semiconductor Manufacturing Glass Manufacturing 'Metal Powders Forming 'Soap / Detergent Manufacturing Industrial'Laundry- Waste Treatment/ Storage SIC.-Code(s) (if -known).-. Brief description of business activities- (Production,/ Manufacturing Operaflons): OL IN Description of operations generating Wastewater- (discharged. to sewer, 'hauled or evaporated): Estirriated -volume of industrial wastewater to be discharged (gal 1-dayl, List:hazar,dous wastes generated (type /volume): Date operation began/or will begin at this location: Have .you a0phe1j' for a Wastewater Discharge. Permit frOffi the Encina Wastewater Authority? Yes N2 If yes,, When: . Site Contact Titlet- M sf Sig Phone No.-- enjda E noines ENCINA WAS Carlsbad, CA 92011 (760)438-3941 PAX: . (760) 476 9852