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Home My WebLink About2652 JEFFERSON ST; 1 | 3; CBC2020-0367; PermitPrint Date: 10/21/2020 Permit No: CBC2020-0367 Building Permit Finaled Commercial Permit Job Address: Permit Type: Parcel #: Valuation: Occupancy Group: 2652 JEFFERSON ST, # 1/3, CARLSBAD, CA 92008-1441 BLDG-Commercial 1552712300 $0.00 Work Class: Lot #: Project #: P/M/E Status: Applied: Issued: 09/25/2020 10/20/2020 Finaled Close Out: #of Dwelling Units: Track #: Plan #: Closed - Finaled TAlva Plan Check #: Project Title: Inspector:ROW2020-0033Orig. Plan Check #:Bathrooms: Description:INSTALL 15A FUSE BOX IN NEW HANDHOLE SOUTH OF POLE P120513 TO SERVE SMALL CELL SITE (A01Q2CM) (E-REVIEW) Final Inspection:10/21/2020 Bedrooms:Construction Type: Contractor: HP COMMUNICATIONS INC 10400 TREENA ST SAN DIEGO, CA 92131-1126 (951) 572-1200 AMOUNTFEE PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT $175.00 Total Fees:$175.00 Total Payments To Date:$175.00 Balance Due:$0.00 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. 1635 Faraday Avenue, Carlsbad CA 92008-7314 ï 760-602-2700 ï 760-602-8560 f ï www.carlsbadca.gov Building Division Page 1 of 1 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov B-2 Page 1 of 2 Rev. 0/ COMMERCIAL BUILDING PERMIT APPLICATION B-2 Plan Check Est. Value PC Deposit Date Suite:Job Address APN: Tenant Name: Lot #: CT/Project #: Year Built: ___________ Occupancy: ___________ Construction Type:___________Fire Sprinklers: yes no A/C: yes no BRIEF DESCRIPTION OF WORK: This permit is to be issued in the name of the Property Owner as Owner-Builder, licensed contractor or Authorized Agent of the owner or contractor. The person listed as the Applicant below will be the main point of contact throughout the permit process. PROPERTY OWNER APPLICANT PROPERTY OWNERS AUTHORIZED AGENT APPLICANT Name: Name: Address:__________________ Address: City: State: Zip: Phone: City: State: Zip: Phone: Email: Email: ______________________________________________ DESIGN PROFESSIONAL APPLICANT CONTRACTOR BUSINESS APPLICANT Name: Address: City: State: Zip: Phone: Email: Architect State License: Name: Address: City: State: Zip:_______________ Phone: Email: State License: Bus. License: Solar: KW, Modules, Mounted, Tilt: Yes / No, RMA: Yes / No, Panel Upgrade: Yes / No Plumbing/Mechanical/ElectricalOnly:__ Other: Additional Gas or Electrical Features?Pool/Spa:SF Addition/New:New SF and Use, New SF andUse, _ Deck SF, _ Patio Cover SF (not including flatwork) Tenant Improvement: SF, Existing Use Proposed Use SF, Existing Use Proposed Use CBC2020-0367 9/25/20 2652 1/3 JEFFERSON ST, CARLSBAD, 92008 A01Q2CM AT&T CALIFORNIA 15A FUSE INSTALL PER SDGE WORKORDER TO SERVE SMALL CELL SITE ■Service for street light mounted small cell HP COMMUNICATIONS 15453 OLDE HIGHWAY 80 EL CAJON CA 92021 951-616-7125 JASON.MARTINEZ@HPCOMMINC.COM 752762 BLOS1219108 Small Cell 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov B-2 Page 2 of 2 Rev. 0/ IDENTIFY WHO WILL PERFORM THE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW: (OPTION A): LICENSED CONTRACTOR DECLARATION: I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for workers’ compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. Policy No.___________________________________________________________________________________________________ I have and will maintain worker’s compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers’ compensation insurance carrier and policy number are: Insurance Company Name: __________________________________________ Policy No_______________________________________________Expiration Date: ______________________________________ 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 $100,000.00, in addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney’s fees. CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender’s Name: Lender’s Address: CONTRACTOR PRINT/SIGN: ______DATE: (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor’s License Law for the following reason: I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor’s License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). 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). I am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: _____________________________________________________________________________________________________________________________________ “Owner Builder acknowledgement and verification form” has been filled out, signed and attached to this application. Proof of identification attached. Owners “Authorized Agent Form” has been filled out, signed and attached to this application giving the agent authority to obtain the permit on the owner’ behalf. Proof of identification attached. By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: http://www.leginfo.ca.gov/calaw.html. OWNER PRINT/SIGN: ________DATE: APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL By my signature below, I certify that: I am the property owner or State of California Licensed Contractor or authorized to act on the property owner or contractor’s behalf. I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5’0’ deep and demolition or construction of structures over 3 stories in height. APPLICANT PRINT/SIGN: ___DATE: CWG7459908 09/23/2020 09/23/2020 XL SPECIALTY07/15/21 JASON MARTINEZ Digitally signed by JASON MARTINEZ DN: cn=JASON MARTINEZ, o, ou, email=JASON.MARTINEZ@HPCOMMINC.COM, c=US Date: 2020.09.23 11:11:29 -07'00' JASON MARTINEZ Digitally signed by JASON MARTINEZ DN: cn=JASON MARTINEZ, o, ou, email=JASON.MARTINEZ@HPCOMMINC.COM, c=US Date: 2020.09.23 11:11:44 -07'00' PURPOSE This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance requirements apply to their projects. Unless none of the requirements apply, the completed checklist must be included in the building permit application. It may be necessary to supplement the completed checklist with supporting materials, calculations or certifications, to demonstrate full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach to comply with energy- related measures will need to attach to this checklist separate calculations and documentation as specified by the ordinances. \ If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance, an explanation must be provided to the satisfaction of the Building Official. \ Details on CAP ordinance requirements are available on the city’s website. Project Name/Building Permit No.: BP No.: Property Address/APN: Applicant Name/Co.: Applicant Address: Contact Phone: Contact Email: Contact information of person completing this checklist (if different than above): Name: Contact Phone: Company name/address: Contact Email: Applicant Signature: Date: B-50 Page 1 of 3 Revised 04/19 Development Services Building Division 1635 Faraday Avenue (760) 602-2719 www.carlsbadca.gov CLIMATE ACTION PLAN CONSISTENCY CHECKLIST B-50 Application Information 2652 1/3 JEFFERSON ST, CARLSBAD CA , 92008 JASON HP COMMUNICATIONS 15453 OLDE HIGHWAY 80 , EL CAJON , CA 92021 951-616-7125 JASON.MARTINEZ@HPCOMMINC.COM JASON MARTINEZ Digitally signed by JASON MARTINEZ DN: cn=JASON MARTINEZ, o, ou, email=JASON.MARTINEZ@HPCOMMINC.COM, c=US Date: 2020.09.23 11:10:57 -07'00'09/23/2020 2 Updated 4/12/2019 City of Carlsbad Climate Action Plan Consistency Checklist Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project. For residential alterations and additions to existing buildings, contact the building counter for the building permit valuation. Building Permit Valuation (BPV) $ Construction Type Complete Section(s) Notes: Residential տ New construction 1A տ Alterations:տ exempt տ %39 $60,000 տ Electrical service panel upgrade տ %39 $200,000 տ New construction տ Alterations A. Residential New construction and major alterations (or electric panel upgrade)* Please refer to Carlsbad Ordinance CS-349 when completing this section. տ One and two-family residential dwelling or townhouse with attached garage: տ One EVSE ready parking space required տ Exception : տ Multi-family residential:տ Exception : Total Parking Spaces Proposed EVSE Spaces Capable Ready Installed Total Calculations: Total EVSE spaces = .10 x Total parking (rounded up to nearest whole number) EVSE Installed = Total EVSE Spaces x .50 (rounded up to nearest whole number) EVSE other= Total EVSE spaces – EVSE Installed (EVSE other may be “Capable,” “Ready” or “Installed.”) *Major alterations are: (1) for one and two-family dwellings and townhouses with attached garages, alterations have a building permit valuation $60,000 or include an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit valuation $200,000, interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed. B. Nonresidential new construction (includes hotels/motels) տ Exception : Total Parking Spaces Proposed EVSE Spaces Capable Ready Installed Total Calculation: Refer to the table below: Total Number of Parking Spaces provided Number of required EV Spaces Number of required EVSE Installed Spaces տ 0-9 1 1 տ 10-25 2 1 տ 26-50 4 2 տ 51-75 6 3 տ 76-100 9 5 տ 101-150 12 6 տ 151-200 17 9 տ 201 and over 10 percent of total 50 percent of Required EV Spaces Nonresidential 1. Electric Vehicle Charging 2 1B and 2 Multi-family dwellings only where interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed 1A 1-2 family dwellings and townhouses with attached garages only 1A 1A Small Cell 3 Updated 4/12/2019 City of Carlsbad Climate Action Plan Consistency Checklist A. List each proposed nonresidential use and gross floor area (GFA) allocated to each use. B. Employee ADT/1,000 square feet is selected from the table below. Use GFA Employee ADT for first 1,000 S.F. Employee ADT for each subsequent 1,000 S.F. Total Employee ADT Total If total employee ADT is greater than or equal to 110 employee ADT, a TDM plan is required. TDM plan required: Yes տ No տ Employee ADT Estimation for Various Commercial Uses Use ADT for first 1,000 s.f. Emp ADT/ 1000 s.f.1 Office (all)2 20 20 Restaurant 11 11 Retail3 8 4.5 Industrial 4 3.5 Manufacturing 4 3 Warehousing 4 1 1 Unless otherwise noted, rates estimated from ITE Trip Generation Manual, 10thEdition 2 For all office uses, use SANDAG rate of 20 ADT/1,000 sf to calculate employee ADT 3 Retail uses include shopping center, variety store, supermarket, gyms, pharmacy, etc. Other commercial uses may be subject to special consideration Sample calculations: Office: 20,450 sf 1. 20,450 sf / 1000 x 20 = 409 Employee ADT Retail: 9,334 sf 1. First 1,000 sf = 8 ADT 2. 9,334 sf - 1,000 sf = 8,334 sf 3. (8,334 sf / 1,000 x 4.5) + 8 = 46 Employee ADT 2. Transportation Demand Management (TDM) HM-9171 (08/15) County of San Diego – DEH – Hazardous Materials Division SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY RECORD ID # PLAN CHECK # BP DATE / / Business Name Business Contact Telephone # Project Address City State Zip Code APN# Mailing Address City State Zip Code Plan File# Project Contact Applicant E-mail Telephone # The following questions represent the facility’s activities, NOT the specific project description. PART I: FIRE DEPARTMENT – HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not required for projects within the City of San Diego): 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. Occupancy Rating: Facility’s Square Footage (including proposed project): 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 DIVISION (HMD): If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, 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: YES NO (for new construction or remodeling projects) 1. Is your business listed on the reverse side of this form? (check all that apply). 2. Will your business dispose of Hazardous Substances or Medical Waste in any amount? 3. Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? 4. Will your business store or handle carcinogens/reproductive toxins in any quantity? 5. Will your business use an existing or install an underground storage tank? 6. Will your business store or handle Regulated Substances (CalARP)? 7. Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? 8. Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or greater than 1,320 gallons? (California’s Aboveground Petroleum Storage Act). CalARP Exempt / Date Initials CalARP Required / Date Initials CalARP Complete / Date Initials PART III: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San Diego, CA 92131 apcdcomp@sdcounty.ca.gov (858) 586-2650). [*No stamp required if Q1 Yes and Q3 Yes and Q4-Q6 No]. The following questions are intended to identify the majority of air pollution issues at the planning stage. Projects may require additional measures not identified 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 burns; residences forming part of a larger project. [+Excludes garages & small outbuildings.] YES NO 1. Will the project disturb 160 square feet or more of existing building materials? 2. Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition. 3. (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance Technician? 4. (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. Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet (www.sdapcd.org/info/facts/permits.pdf) for typical equipment requiring an APCD permit. 6. (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school boundary Briefly describe business activities: Briefly describe proposed project: I declare under penalty of perjury that to the best of my knowledge and belief the responses made herein are true and correct. / / Name of Owner or Authorized Agent Signature of Owner or Authorized Agent Date FOR OFFICAL 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 from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply. HM-9171 (08/15) County of San Diego – DEH – Hazardous Materials Division LIST OF BUSINESSES WHICH REQUIRE REVIEW AND APPROVAL FROM THE COUNTY OF SAN DIEGO DEPARTMENT OF ENVIRONMENTAL HEALTH – HAZARDOUS MATERIALS DIVISION Check all that apply: AUTOMOTIVE CHEMICAL HANDLING OTHERS AND MISCELLANEOUS Battery Manufacturing/Recycling Photographic Processing Asphalt Plant Boat Yard Pool Supplies/Maintenance Biotechnology/Research Car Wash Printing/Blue Printing Chiropractic Office Dealership Maintenance/Painting Road Coatings Co-Generation Plant Machine Shop Swimming Pool Dental Clinic/Office Painting Toxic Gas Handler Dialysis Center Radiator Shop Toxic Gas Manufacturer Emergency Generator Rental Yard Equipment METAL WORKING Anodizing Chemical Milling/Etching Finish-Coating/Painting Flame Spraying Foundry Machine Shop-Drilling/Lathes/Mills Metal Plating Metal Prepping/Chemical Coating Precious Metal Recovery Sand Blasting/Grinding Steel Fabricator Wrought Iron Manufacturing Frozen Food Processing Facility Repair/Preventive Maintenance Hazardous Waste Hauler Spray Booth Hospital/Convalescent Home Transportation Services Laboratory/Biological Lab Wrecking/Recycling Medical Clinic/Office CHEMICAL HANDLING Nitrous Oxide (NOx) Control System Pharmaceuticals Agricultural supplier/distributor Public Utility Chemical Manufacturer Refrigeration System Chemical Supplier/Distributor Rock Quarry Coatings/Adhesive Ship Repair/Construction Compressed Gas Supplier/Distributor Telecommunications Cell Site Dry Cleaning Veterinary Clinic/Hospital Fiberglass/Resin Application Wood/Furniture Manufacturing/Refinishing Gas Station AEROSPACE Aerospace Industry Aircraft Maintenance Aircraft Manufacturing ELECTRONICS Electronic Assembly/Sub-Assembly Electronic Components Manufacturing Printed Circuit Board Manufacturing Industrial Laundry Laboratory Laboratory Supplier/Distributor Oil and Fuel Bulk Supply Pesticide Operator/Distributor NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMD) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880. LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which include any of the following operations or equipment, will require clearance from the Air Pollution Control District. CHEMICAL 47 – Organic Gas Sterilizers 32 – Acid Chemical Milling 33 – Can & Coil Manufacturing 44 – Evaporators, Dryers & Stills Processing Organic Materials 24 – Dry Chemical Mixing & Detergent Spray Towers 35 – Bulk Dry Chemicals Storage 55 – Chrome Electroplating Tanks COATINGS & ORGANIC SOLVENTS 27 – Coating & Painting 37 – Plasma Arc & Ceramic Deposition Spray Booths 38 – Paint, Stain & Ink Mfg 27 – Printing 27 – Polyester Resin/Fiberglass Operations METALS 18 – Metal Melting Devices 19 – Oil Quenching & Salt Baths 32 – Hot Dip Galvanizing 39 – Precious Metals Refining ORGANIC COMPOUND MARKETING (GASOLINE, ETC) 25 – Gasoline & Alcohol Bulk Plants & Terminals 25 – Intermediate Refuelers 26 – Gasoline & Alcohol Fuel Dispensing COMBUSTION 34 – Piston Internal – Combustion Engines 13 – Boilers & Heaters (1 million BTU/hr or larger) 14 – Incinerators & Crematories 15 – Burn Out Ovens 16 – Core Ovens 20 – Gas Turbines, and Turbine Test Cells & Stands 48 – Landfill and/or Digester Gas Flares ELECTRONICS 29 – Automated Soldering 42 – Electronic Component Mfg FOOD 12 – Fish Canneries 12 – Smoke Houses 50 – Coffee Roasters 35 – Bulk Flour & Powered Sugar Storage SOLVENT USE 28 – Vapor & Cold Degreasing 30 – Solvent & Extract Driers 31 – Dry Cleaning ROCK AND MINERAL 04 – Hot Asphalt Batch Plants 05 – Rock Drills 06 – Screening Operations 07 – Sand Rock & Aggregate Plants 08 – Concrete Batch, CTB, Concrete Mixers, Mixers & Silos 10 – Brick Manufacturing OTHER 01 – Abrasive Blasting Equipment 03 – Asphalt Roofing Kettles & Tankers 46 – Reverse Osmosis Membrane Mfg 51 – Aqueous Waste Neutralization 11 – Tire Buffers 17 – Brake Debonders 23 – Bulk Grain & Dry Chemical Transfer & Storage 45 – Rubber Mixers 21 – Waste Disposal & Reclamation Units 36 – Grinding Booths & Rooms 40 – Asphalt Pavement Heaters 43 – Ceramic Slip Casting 41 – Perlite Processing 40 – Cooling Towers – Registration Only 91 – Fumigation Operations 56 – WWTP (1 million gal/day or larger) & Pump Station NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITTING AIR CONTAMINANTS MAY REQUIRE AN AIR POLLUTION CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL DISTRICT AT (858) 586-2600. Page 1 of 2 ENCINA WASTEWATER AUTHORITY INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY 6200 Avenida Encinas, Carlsbad, CA 92011 Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@encinajpa.com Date: _ Business Name: Street Address: Email Address: PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT : (ON REVERSE SIDE CHECK TYPE OF BUSINESS) Check all below that are present at your facility: New Business? Yes O No O SIC Code(s) if known:_ Date operation began/will begin: _ Tenant Improvement? Yes D NoO If yes, briefly describe im provement : _ Description of operations generating wastewater (discharged to sewer, hauled or evaporated): _ Estimated volume of industrial wastewater to be discharged (gal/ day) : List hazardous wastes generated (t ype/ volum e): _ Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? Yes O Date: No 0 Metal Powders Forming Nutritional Supplement/Vitamin Manufacturing Painting/Finishing Paint Manufacturing Personal Care Products Manufacturing Pesticide Manufacturing/ Packaging Pharmaceutical Manufacturing (including precursors) Porcelain Enameling Power Generation Print Shop Research and Development Rubber Manufacturing Semiconductor Manufacturing Soap/Detergent Manufacturing Waste Treatment/Storage o o o o o o o o Electroplating Electroless Plating Anodizing Coating (i.e. phosphating) Chemical Etching/Milling Printed Circuit Board Manufacturing Ŷ Ŷ Ŷ Ŷ Ŷ Ŷ o o o o o o o o o o o Food Processing Glass Manufacturing Industrial Laundry Ink Manufacturing Laboratory Machining/Milling Membrane manufacturing (i.e. water filter membranes) Metal Casting/Forming Metal Fabrication Metal Finishing o o o o o o o o o o Acid Cleaning Assembly Automotive Repair Battery Manufacturing Biofuel Manufacturing Biotech Laboratory Bulk Chemical Storage Car Wash Chemical Manufacturing Chemical Purification Dental Offices Ŷ Dental Schools Ŷ Dental Clinics Dry Cleaning Electrical Component Manufacturing Fertilizer Manufacturing Film/ X- ra y Processing o o o o o o o o o o o Ƒ9 09/23/2020 HP COMMUNICATIONS 15453 OLDE HIGHWAY, EL CAJON , 92021 JASON.MARTINEZ@HPCOMMINC.COM Page 2 of 2 ENCINA WASTEWATER AUTHORITY INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY 6200 Avenida Encinas, Carlsbad, CA 92011 Phone: 760-438-3941 Fax: 760-476-9852 SourceControl@encinajpa.com The commercial enterprises listed below are a partial listing of businesses that are exempt from industrial wastewater discharge permitting under normal operating condit ions. They are exempt because (a) they discharge no process wastewater (i. e., they only discharge sanit ary wastewater with no pollutants exceeding any local limi ts ), and (b) they hav e no potential to negativ ely impact the EWPCF or ot her wastewater treatment plants in the ESS. Any questions regarding exempt ions should be referred to EWA Source Control staff. o Automobile Det ailer s o Barber/Beauty Shops o Business/Sales Offices o Cleaning Services o Carpet/Upholstery o Childcare Facilities o Churches o Community Centers o Consulting Services o Contractors o Counseling Services o Educational Services (no auto repair/film developing) o Financial Institutions/Services o Fitness Centers o Gas Stations (no car wash/auto repair) o Grocery Stores (no film developing) o Residential based Businesses o Hot els/ M ot els (no laundry) o Laundromats o Libraries o Medical Off ices (no x-ray developing) o Mortuaries o Museums o Nail Salons o Nursing Homes o Office Buildings (no process flow) o Optical Services o Pest Control Services (no pesticide repackaging for sale) o Pet Boarding/Grooming Facilities o Postal Services (no car wash/auto repair) o Public Storage Facilities o Restaurants/Bars o Retail/Wholesale Stores (no auto repair/film developing) o Theaters (Movie/Live) CERTIFICATION STATEMENT I certify that the information above is true and correct to the best of my knowledge. Signature: _ Facility Contact: _ Print Nam e: _ DATE: _ Title: _ ENCINA WASTEWATER AUTHORITY 6200 AVENIDA ENCINAS, CARLSBAD, CA Phone: 760-438-3941 Fax: 760-476-9852 SourceCont rol@encinajp a.com JASON MARTINEZ Digitally signed by JASON MARTINEZ DN: cn=JASON MARTINEZ, o, ou, email=JASON.MARTINEZ@HPCOMMINC.COM, c=US Date: 2020.09.23 11:12:15 -07'00'JASON MARTINEZ 09/23/2020 JASON MARTINEZ PROJECT ADMIN DISABILITY ACCESS REQUIREMENTS AND RESOURCES (Issued 12-28-18) NOTICE TO APPLICANTS FOR BUSINESS LICENSES AND COMMERCIAL BUILDING PERMITS: Under federal and state law, compliance with disability access laws is a serious and significant responsibility that applies to all California building owners and tenants with buildings open to the public. You may obtain information about your legal obligations and how to comply with disability access laws at the following agencies: DEPARTMENT OF GENERALSERVICES, Division of the State Architect, CASp Program www.dgs.ca.gov/dsa www.dgs.ca.gov/casp DEPARTMENT OF REHABILITATION Disability Access Services www.dor.ca.gov www.rehab.cahwnet.gov/ disabilityaccessinfo DEPARTMENT OF GENERALSERVICES, California Commission on Disability Access www.ccda.ca.gov www.ccda.ca.gov/resourc es-menu/ CERTIFIED ACCESS SPECIALIST INSPECTION SERVICES Compliance with state and federal construction-related accessibility standards ensures that public places are accessible and available to individuals with disabilities. Whether your business is moving into a newly constructed facility or you are planning an alteration to your current facility, by engaging the services of a Certified Access Specialist (CASp) early in this process you will benefit from the advantages of compliance and under the Construction-Related Accessibility Standards Compliance Act (CRASCA, Civil Code 55.51- 55.545), also benefit from legal protections. Although your new facility may have already been permitted and approved by the building department, it is important to obtain CASp inspection services after your move-in because unintended access barriers and violations can be created, for example, placing your furniture and equipment in areas required to be maintained clear of obstructions. For planned alterations, a CASp can provide plan review of your improvement plans and an access compliance evaluation of the public accommodation areas of your facility that may not be part of the alteration. A CASp is a professional who has been certified by the State of California to have specialized knowledge regarding the applicability of accessibility standards. CASp inspection reports prepared according to CRASCA entitle business and facility owners to specific legal benefits, in the event that a construction-related accessibility claim is filed against them. To find a CASp, visit www.apps2.dgs.ca.gov/DSA/casp/casp_certified_list.aspx. DISABILITY ACCESS REQUIREMENTS AND RESOURCES GOVERNMENT TAX CREDITS, TAX DEDUCTIONS AND FINANCING State and federal programs to assist businesses with access compliance and access expenditures are available: DDisabled Access Credit for Eligible Small Businesses FEDERAL TAX CREDIT—Internal Revenue Code Section 44 provides a federal tax credit for small businesses that incur expenditures for the purpose of providing access to persons with disabilities. For more information, refer to Internal Revenue Service (IRS) Form 8826: Disabled Access Credit at www.irs.gov. STATE TAX CREDIT—Revenue and Taxation Code Sections 17053.42 and 23642 provide a state tax credit similar to the federal Disabled Access Credit, with exceptions. For more information, refer to Franchise Tax Board (FTB) Form 3548: Disabled Access Credit for Eligible Small Businesses at www.ftb.ca.gov. Architectural and Transportation Barrier Removal Deduction FEDERAL TAX DEDUCTION—Internal Revenue Code Section 190 allows businesses of all sizes to claim an annual deduction for qualified expenses incurred to remove physical, structural and transportation barriers for persons with disabilities. For more information, refer to IRS Publication 535: Business Expenses at www.irs.gov. California Capital Access Financing Program STATE FINANCE OPTION—The California Capital Access Program (CalCAP) Americans with Disabilities Act (CalCAP/ADA) financing program assists small businesses with financing the costs to alter or retrofit existing small business facilities to comply with the requirements of the federal ADA. Learn more at www.treasurer.ca.gov/cpcfa/calcap/. FEDERAL AND STATE LEGAL REQUIREMENTS ON ACCESSIBILITY FOR INDIVIDUALS WITH DISABILITIES AMERICANS WITH DISABILITIES ACT OF 1990 (ADA) —The ADA is a federal civil rights law that prohibits discrimination against individuals with disabilities, and requires all public accommodations and commercial facilities to be accessible to individuals with disabilities. Learn more at www.ada.gov. CALIFORNIA BUILDING CODE (CBC)—The CBC contains the construction-related accessibility provisions that are the standards for compliant construction. A facility’s compliance is based on the version of the CBC in place at the time of construction or alteration. Learn more at www.EVF.ca.gov. (Issued 12-28-18) Building Permit Inspection History Finaled PERMIT INSPECTION HISTORY for (CBC2020-0367) BLDG-Commercial 09/25/2020Application Date:Permit Type:Owner: P/M/E 10/20/2020Work Class:Issue Date:Subdivision:SUNNY SLOPE TRACT 04/19/2021Expiration Date:Status: IVR Number: 28928 Closed - Finaled 2652 JEFFERSON ST, # 1/3 CARLSBAD, CA 92008-1441 Address: Scheduled Date Inspection Type Inspection No.Inspection Status Primary Inspector Reinspection InspectionActual Start Date 10/05/2020 10/05/2020 BLDG-34 Rough Electrical 140088-2020 Failed Tony Alvarado Reinspection Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency October 5, 2020: 1. AT&T cell site 17" x 30" inground vault, with fuse (OCPD)-overcurrent protection device breaker, scope of work-not ready. No 10/21/2020 10/21/2020 BLDG-34 Rough Electrical 141516-2020 Passed Tony Alvarado Complete COMMENTS PassedChecklist Item BLDG-Building Deficiency October 21, 2020: 1. AT&T cell site 17" x 30" inground vault, with 15-amp fuse (OCPD)-and overcurrent protection device breaker, scope of work-approved. 2. INSTALL 15A FUSE BOX IN NEW HANDHOLE NEXT TO POLE, TO SERVE SMALL CELL SITE. (E-REVIEW) Yes BLDG-Building Deficiency October 5, 2020: 1. AT&T cell site 17" x 30" inground vault, with fuse (OCPD)-overcurrent protection device breaker, scope of work-not ready. No BLDG-Final Inspection 141515-2020 Passed Tony Alvarado Complete COMMENTS PassedChecklist Item BLDG-Structural Final October 21, 2020: 1. AT&T cell site 17" x 30" inground vault, with 15-amp fuse (OCPD)-and overcurrent protection device breaker, scope of work-approved. 2. INSTALL 15A FUSE BOX IN NEW HANDHOLE NEXT TO POLE, TO SERVE SMALL CELL SITE. (E-REVIEW) Yes BLDG-Electrical Final October 21, 2020: 1. AT&T cell site 17" x 30" inground vault, with 15-amp fuse (OCPD)-and overcurrent protection device breaker, scope of work-approved. 2. INSTALL 15A FUSE BOX IN NEW HANDHOLE NEXT TO POLE, TO SERVE SMALL CELL SITE. (E-REVIEW) Yes Wednesday, October 21, 2020 Page 1 of 1