HomeMy WebLinkAbout2616 EL CAMINO REAL; ; CB100130; PermitCity of Carlsbad
1635 Faraday Ay Carlsbad, CA 9008
02-17-2010 .' Commercial/Industrial Permit Permit No: CB100130
- Building Inspection Request Line (760) 602-2725
- Job Address: 2616 EL CAMINO REAL CBAD Permit Type: TI . Sub Type: COMM •. ' . '..
Parcel No: 0000000000 Lot #: 0 - Status: ISSUED .
Valuation: $4,480.00 Construction Type: NEW Applied: 01/21/2010
Occupancy Group: Reference #: Entered By: . JMA . •. ..
Project Title: HUGHES INVESTMENTS- ADD 2 ADA . Plan Approved: .. 02/17/2010
BATHROOMS TO THE BLDG. : Issued: 02/17/2010..
Inspect Area: . , . .• '
0 • Plan Check#:
Applicant: Owner: --- . . -. .•
,
'
CAMBRIDGE COMMERCIAL & DEV. . -- •, ,, . . . .'
24619 WASHINGTON AVE
SUITE 201
951-698-0222
. :-
MURRIETA 92562
Building Permit / .
. $72.31 Meter Size . Add 'I Building Permit Fee $0 Add I Red Water Con Fee,'
1~0 $0 00
Plan Check . / $47.00 /MeterFee \ • $0.00
AddI Plan Check Fee/ I / $0.00 SDCWA Fee \ "- \' ' $0.00 .
Plan Check Discounts $0.00_ CFD Fayoff Fee '\ L, T $0.00 •. '.
Strong Motion Fee i / '- $100----- PFF (3105540)/ . ). / $0.00
Park Fee '- $0.00 --./PFE(4305540) j' . \ (.' : $0.00 -. ...
LFM Fee 1 $0.00 License Tax (3104193) 1 'T " I $0.00
Bridge Fee , $0.00 •Liise Tax (304193) 2? $0.00,'.
, BTD#2 Fee . • -'i $0.00. _TraffclmptFee(310541)1 $0.00 •
;. BTD #3 Fee I ('$0.00 - Tifflc iñipactFe(4305541)j $0.00 -
Renewal Fee $0.00 PLUMBING TOTAL\ 1 $48.00 • ; /.,
AddI Renewal Fee, J$0.00 ELECTRICALtTOTAL .1 / . $20.00 • - •0 .' Other Building-Fee \. : '\ $0.00'11 .% MECHANlCAL'TOTL,- 7 0 [ $28.00
Pot. Water Con. Fee \ s'-.. • $0.00 Mstr Drainage Fee ' / • / . $0.00 • , .'.'
Meter Size 5ewer Fee._.' / f' $0.00 . .
AddI Pot. Water Con. Fee / $0.00 Rèdev Parking.Fee / / . . $0.00 . ..
Red. Water Con. Fee • - .. $0.00 4C(tAdditionaI Fees / • $0.00 '
,. Green Bldg Stands (5B1473) Fee.' / ,$1.00 HMP. Fee - • . 7 .. ??. .,,.
0 \ \7 7 -5_TOTAL PERMIT EES . •
• $217.31-
\ -
Total Fees: $217.31 TotaIPaymeitsToDáte: $21731 Balanc •. . $0.00 ••: '.
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Building Permit Application Plan Check No CS QO (3O
441,1:11.4k 1635 Faraday Ave.,Carlsbad CA 92008 Est Value Cf
CITY. -0 F 760-602-2717 [2718/27•19; .'.. /-
Fax 760 602 8558 Plan Ck Deposit CARLSBAU.., www carlsbadca ov
" Date
JOB ADDRESS , SUITES/SPACES/UNITS AP
—
Rea
CT/PROJECT # ' LOT S PHASES ROE UNITS S BEDROOMS S BATHROOMS T NANT BUSINESS NAME .. cONSTR. TYPE 0CC. GROUP
L(f //f744 ç
DESCRIPTION OF WORK: include Square Feet of Affected Area(s)
11-Pf}
EXISTING USE PROPOSED USE ]GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS
....S ' . . . - YES 0 #. NO 0. YES 0 NO 0 YES 0 NO 0
CONTACT NAME (if Dlffere t Fern Applicant) . .' APPLICANT NAME
Jtç/
ADDItESS ADDRESS
. ., CITY STATE ZIP CITY STATE .- ZIP
p1 1 2-
PHONE ,,:. FAX . . PHONE.__________I_FAX /-3J (o3 0, F4/
EMAIL. •. EMAIL
co j;+1 ______•:• . __. ____________._.:-•. _______.______.:
PROPERTYO E NAM CONTRACTO BUS:N ME . . .' . ......... .....6cetèL_ llkt
ADDRESS ADDRESS
..•. . —7 LIC14 was 4Ld~~i CITY ' •-.•- STATE . ZIP CITY . . , . . -STATE , ZIP •. . ...
PHONE FAX PHO E FAX
&/-7-oZ
,EMAIL EMAIL. '. . . ' . .' . . .•. . .
ARCH/DESIGNER NAME & ADDRESS STATE LIC a STATE LIC B CLAS CITY US LIC Ii
_____________•I._23.____J.#p.i--
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to con4truct, alter, improve, demolish or repair any structureprior to its issuanbe/'also requires the applicant for such permit to tile a signed-statement that he is licensed pursuant to theprovisions 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)). ., .
. . . .
Workers Compensation Declaration (hereby affirm under penally of perjury one of the following declarations
'iave and will maintain a certificate of consent to self insure for worfters compensation as provided by Section 3700 of the Labor Code for the performance of the work for which this permIt IS Issued
t1 I have and will maintain workers' compensation-as required by Section 3700 of the Labor Code, for the performance of the work forwhicli this permit is issued. My workers compensation insurance carrier and policy -
num rare Insurance Co Policy No Expiralion Dale
- Thi cf on need not be completed if the permit is fbi 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 10 become subjecl to the Workers Compensation Laws of
California. WARNING: Failure to secure Work e ' ompensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines ip to one hundred thousand dollars (9100,000), in
addition to the cost of compensatton,jRma , rovidéd form S'ection 3706 of the Labor code, interest and attorney's fees. . .. '
CONTRACTOR SIGNAT R€ - D'AGENT.,-DATE
I hereby affirm that lam exempt from Contractors License Law for the following reason
1a5 owner of the property or my employees with wages as their sole compensation will do the work and the struclure 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 himelf or through his own employees, provided that such improvements are not intended or offered for
sate 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)
0 - las 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 loan owner of . .
property who builds or improves thereon and contracts for such projects with contractor(s) licensed pursuant to the Conlractor's License Law)
0 I am exempt under Section Business and Professions Code for this reason I
1 I personally plan to provide the maior labor and materials for construction of the proposed properly improvement 0 Yes 0 No
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 / contractors license number)
4 I plan to provide portions of the work but I have hired the following person to coordinate supervise and provide the major work (include name/address/phone! contractors license number)
5 101 provide some of the work bull have contracted (hired) the following persons to provide the work indicated (include name/address/phone! type of work)
.PROPERTY OWNER SIGNATURE El AGENT DATE
-.5 •...' • .-. ' - .1 ,,.•. '-. • -: .5,',-.. ..ii . , •. 5
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Is the applicant or future büildingoccupant 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 Prestey Tanner Hazardous Substance Account Act?Z 0 Yes '1(o
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality maiagement district? 0 Yes 0 No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site2 0 Yes 0 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 POLLUTIONCONTROL DISTRICT. ' , .4' •- ',.................... .. . . .
LJC .'
I he rt-by offirmthat there is a construction lend i t tn r the performance of the work this permit is issued (Sec 3097 (i) Livil Code)
4. •41- ., ,. . . Lic r s Name Lender'sAddress
I certrtythat I have read the application and state that the above information is conactand that the information on the plans us accurate I agree to compfywrth all City ordinances and State laws mlatjngto burldingconstructron
I hereby, aultionze representative of the City of Carlsbad to enter upon the above mentioned property, for inspeon purposes.) ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY.IN CONSEQUENCE OF. THE GRANTING OF THIS PERMIT:' '.
OSHA An OSHA permit is required for excavations over 50 deep and demolition or construction of structures over 3 stones in height
EXPIRATION Every permit issued by the Building Otftuual der the provisions of thus Code shall expire by Imitation and become null and void if the building orworic authored by such permit is not commenced within
180 days from the date of such permit or if the build' rk authorized by sudi permit is suspended orabandoned at any time after the work is commenced fora period of 180 days (Section 106.4.4 Uniform Building Code)
...APPLtCANT S SIGNATURE ,. DATE
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City ofCarlsbad Bldg Insp ection Request .,
V For: 03/25/2010 V VV V
Permit# CBI00I30 Inspector Assignment: RB V
- Title: HUGHES INVESTMENTS- ADD 2 ADA
V
Description: BATHROOMS TO THE BLDG. V V V V
Type: TI Sub Type: COMM
V V Phone: 9513166050 V V
V
Job Address: 2616 EL CAMINO REAL
V Suite: V Lot: 0 V V V V V
Location: V inspector:
V
V APPLICANT CAMBRIDGE COMMERCIAL & DEV.
Owner:
V
V
V V V V
V
Remarks: V
V
V V
V
V V V Total Time: V
V
V Requested By: RON
V
V
Entered By: CHRISTINE V V V
VV
V
CD Description Act Comments V V
V
V 19:,
V
Final Structural VVV
V
V
1. V V
V
V
V
29 V Final Plumbing-
39 V V Final Electrical V V V V
V V V
V
V
49 Final Mechanical
VV
V
V
V
V
V
V
V
V
V Comments/Notices/Holds V
V V
VV
V
V
V
V
V V V Associated PCRs/CVs Original PC#
CV030149 CLOSED Z- BANNER:
V
V V V VV V V V V
CV060559 CLOSED Z- BANNER,
V V CV070567 CLOSED V 0- SIGNS IN R.O.W. OUTDOOR BIZ: V
V V
V V V V V V
V
CV090362 CLOSED 0-BUSINESS LICENSE; B.L. 1227381 V
V V V
PCR03232 V ISSUED V FITNESS ELITE-REVISE USE OF I; ROOM FROM OFFICE TO EXERCISE/ EQUIPMENT
V V
V V
V V V V
V V
V Inspection History V
V V
V
Date V V Description V
V Act Insp Comments V V V V
V
03/23/2010 89 Final Combo CO MC SEE NOTICE ATTACHED V V
V V V V
03/11/2010 17 Interior Lath/Drywall V AP RB
03/10/2010 14 Frame/Steel/Bolting/Welding WC RB
V 03/10/2010 16 Insulation V
V AP RB V V V
V
03/10/2010 84 Rough Combo AP RB ON CORRECTIONS V
V
03/09/2010 14 Frame/Steel/Bolting/Welding CO RB SEE LIST
V03/09/2010 24 Rough/Topout V , CO RB V V
• V V V • ,
03/09/2010 34 Rough Electric AP RB
V .03/01/2010, 21 Underground/Under Floor V AP RB
City. of Carlsbad Bldg Inspection Request .
For: 03/23/2010. . . ..
Permit# CBI00I30 . . . Inspector Assignment: RB
Title: HUGHES INVESTMENTS- ADD 2 ADA
Description: BATHROOMS TO THE BLDG.
Type: TI Sub Type: COMM .
Phone: 9613166050.-
Job Address: 2616 EL CAMINO REAL S ,•. . .
Suite: Lot: 0 . .
Location: .
. .
.
. Inspector:
APPLICANT CAMBRIDGE COMMERCIAL & DEV. . . .
Owner: .
Remarks: .
. .
Total Time:
•
Requested By: NA .
) Entered By: CHRISTINE ..
CD Description . Act Comments . . ..
.19 Final Structural . . . .
29 Final Plumbing . •. . : .
. . 39 Final Electrical
49
.
Final Mechanical
Comments/Notices/Holds . . . . . . .
Associated .PCRs/CVs Original PC# .
. CV030149 CLOSED Z- BANNER;
CV060559 CLOSED ZBANNER; .. •.
CV070567 CLOSED 0-SIGNS IN R.O.W. OUTDOOR BIZ;
CV090362 CLOSED 0- BUSINESS LICENSE; B.L. 1227381 .
PCR03232 ISSUED FITNESS ELITE-REVISE USE OF 1; ROOM FROM OFFICE TO EXERCISE/ EQUIPMENT
Inspection History . . . .
Date Description Act Insp Comments ..
03/11/430 17 Interior Lath/Drywall • AP RB
03/10010 14 Frame/Steel/Bolting/Welding WC RB • . . • . . . •
03/10/2010. 16 Insulation . AP. RB
03/10/2010 84 Rough Combo AP RB ON CORRECTIONS
03/09/2010 14 Frame/Steel/Bolting/Welding CO RB SEE LIST .
03/09/2010 24 Rough/Topout CO RB • . . . . .•
03/09/2010 34 Rough Electric AP RB . •
03/01/2010 21 Underground/Under Floor AP RB .
02/19/2010 22 Sewer/Water Service CA TP . • . • .:
V
Es(., ii corporation .
- In cPartnersfiip with covernment for(Building. Safety
DATE: 1/29/10 , .. CANT..
JuRis:
JURISDICTION: city of Carlsbad U PLAN REVIEWER
EI'FILE,
PLAN CHECK NO.: 10-0130 SET: I
PROJECT ADDRESS: 2616 El Camino Real
'.•
PROJECT NAME: Gray Shell Reètroom Addition - TI '
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 bruil din g 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 cópy'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:
Cambridge Contracting Group / Ron Huska'
24619 Washington Ave Suite 201, Murrieta,'CA 9.2562 .
El 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: on Huska . ' Telephone #: 951-316-6050
'.
Date contacted: (b ;/A : Fa .. #: 51-698-0299' V.
Mail/ Telephone Fax in Person
LI REMARKS
By: Doug Moody . . Enclosures:
.
,
.
. EsGil Corporation . . .. , . .
E GA E EJ i:i PC 1/22/10
9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468, • Fax (858) 560-1576
':4
City of Carlsbad 10-0130 = 0
1/29/10 -
- - PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO 10-0130 JURISDICTION City of Carlsbad
OCCUPANCY M USE Retail
TYPE OF CONSTRUCTION VB ACTUAL AREA 128sf
ALLOWABLE FLOOR AREA STORIES 1
HEIGHT
SPRINKLERS?: YES OCCUPANT LOAD N/A
REMARKS
DATE PLANS RECEIVED BY DATE PLANS RECEIVED BY
JURISDICTION 1/21/10 ESGIL CORPORATION 1/22/10
DATE INITIAL PLAN REVIEW PLAN REVIEWER Doug Moody
COMPLETED 1/29/10 (
FOREWORD (PLEASE READ)
This plan review is limited to the technical requirements contained in 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 maybe
required prior to the issuance of a building permit
Code sections cited are based on the 2007 CBC, which adopts the 2006 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 2006 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
00 •0
14
City of Carlsbad 10,0130
1/29/10
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 I
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 note in the general wiring notes on the plans "AC Cable is not allowed in
A, B, E, H, F, M, S 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"
2 Please indicate in the fixture schedule the specification for the new restroom
fans Show the minimum CFM per Table 4-4 of the UMC
3 Hot water supplied to 'a public use lavatory or any bathtub is limited to a
maximum temperature potential of 120 degrees Detail how this temperature
limitation is achieved Note The water heater thermostat may not be used for 7.
compliance with this Code section.'UF?C 413 1 & UPC 414
4 Please revise the plumbing plans tol show the total aggregate vent area to be
equal to the required sewer size per section 904 1 of the UPC (A minimum of
7 06 square inches)
5 Show that the water closet is located in a space, per Section 1115B.3.2.3, which
provides
a) A clear space in front of the water closet measuring 60" wide by 48" in front
Section 1115B.4.1.2.
I I- -
-I •1 •
I 4 1,
City of Carlsbad 10-0130
1/29/10
.
EtEE Ri$E
Fix" WC
18 ; .18
; vplzi J R. t QFrWMF< r
ACTIVATOR CLOSET '
ON WiDE JA
The reqiured dear
fhJurkspac
. 3,. jn.front'6O .
w,de'
SINGLCCOMMODflQN
' .
6. . Doors in the room shall not swing into the clear floor space required for any fixture.
Maintain the required clearances at the lavatory/water closet without the entry door
swinging into those areas. Section 1115B.3.2.2. . . . .
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 . No L3
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.
•
0
•,•
•
I -
City, bf CarLsbad 10-0130
1/29/10
[DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION City of Carlsbad PLAN CHECK NO 10-0130
1
PREPAREDBY DougMoody DATE 1/29/10
BUILDING ADDRESS: 2616 El Camino Real
BUILDING OCCUPANCY M TYPE OF CONSTRUCTION VB
Bldg Permit Fee by Ordinance V
Plan check Fee by Ordinance V
Type of Review: LIJ Complete Review.
LI Repetitive Fee LI •Other
Repeats LI Hourly
• EsGH Fee
:Cdmments:
-•
f j
OFFICE USE ONLY
- UPFP# SAN DIEGO REGIONAL HV#__________
HAZARDOUS MATERIALS QUESTIONNAIRE BP DATE I
Business Na
'dme Business Contact
AW' h s ,nnex L 4/ Ron /1VSfrY<.L
Telephone #
(Qf) ) 3/c7?
Project Address City State
c- rZ€.. L c,
Zip Code
92o'
I APN#
Mailing Address ,57 City State
/ q t'J4 1k.' cE.JO1 Z'vi c ; je• C-.6ZZSZ
Zip Code 2 I Plan File#
Project Cont Telephone #
V<Drl , . S ( 3/C
I he following questions represent the facility's activities, NOT the specific project description.
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 circled, applicant must contact the Fire Protection Agency with
jurisdiction prior to plan submittal.
Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives
Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards
Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These.
Flammable Solids 8. Unstable Reactives 12. Radioactives
PART If: 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, 1255 Imperial Avenue, 3'° floor, San. Diego, CA 92101. Call (619) 338-2222 prior to the issuance of a building permit.
FEES ARE REQUIRED. Expected Date of Occupancy: - / /-
YES NO
//6 IARP Exe.-
0 'Is your business listed on the reverse side of this form? (check all that apply). . Date niis
0 0?-Will your business dispose of Hazardous Substances or Medical Waste in any amount? . 0 CaIARP Required 0 ''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
. El E" Will your business use an existing or install an underground storage tank? 0 "Will your business store or handle Regulated Substances (CalARP)? , . 0 CaIARP Complete 0 F"WiII your business use or install a Hazardous Waste Tank System (Title 22, Article 10)?
.
Date Initials
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 3 or 4 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 NO,,,.- 0 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 htt://www.sdacd.org/info/facts/permits.df, and the list of typical equipment requiring an APCD permit on the reverse side of this from. Contact APCD if you have any questions). 0 0 (ANSWER ONLY IF QUESTION 1 I YES) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)?
(Public and private schools may be found after search of the California School Directory at htto://www.cde.ca.gov/re/sd/; or contact the appropriate school district). 0 "Will there be renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non-friable asbestos? 0 I "Will there be demolition involving the removal of a load supporting structural member?
Briefly describe business activities: Briefly describe proposed project:
t7 /5 L /d4 7't.vo cJZ-T i;. ?C,e?l1f
I declare u!3erp 1 of perjury to the best of my knowledge and belief the res sJade herein are true and correct.
-W" lquff C'
Authorized Agent SigJIulrner or Authorized Agent Date
FOR OFFICIAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:
BY: DATE: I /
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
HM-9171 (04/07) . . County of San Diego - DEH - Hazardous Materials Division
Approved Date - -
BUILDING i t /to
PLANNING .
ENGINEERING
FIRE
HazMat
APCD
Health
Forms/Fees Sent . Rec'd Due?
Encina /• zi. / /. V. ,'O- Y N
Fire i ..Y N
HazHeaIthAPCD ,24. 10 Y N
PE&M f. 2.,. ib (2.i. 10 Y N
School . y N
Sewer 5 Y N
Stormwater /. 2/- /. / -/ ./ V N
CFD V LandUse: impArea: Pr': F:ctc
PFF: V - -.
Comments . Date -
Date Date
Building
Planning
Engineering
Fire -
Need?
CB100130 2616 EL CAMINO REAL
HUGHES INVESThENTS- ADD 2 ADA
- BATHROOMS TO THE BLDG: . ri. - rr,,..n_..._....._.........____...__,....._____._____._._....A, r. --------- ----•------- - ......._.
- U