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HomeMy WebLinkAbout2675 GATEWAY RD; 101; CB091983; Permit01-20-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No: CB091983 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: Project Title: 2675 GATEWAY RD CBAD St: 101 Tl Sub Type: 2131911400 Lot#: $50,995.00 Construction Type: Reference #: FROOTS RESTAURANT- 1085 SF SHELL TO RESTAURANT COMM 0 NEW Applicant: PQ DESIGN STUDIOS ATTN PHIL QUATRINO STE 207 7960 SILVERTON AV 92126 858527-0818 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Plan Check#: Owner: LNR CPI BRESSI RETAIL L L C C/0 LNR PROPERTY CORP 4350 VON KARMAN AVE #200 NEWPORT BEACH CA 92660 ISSUED 11/30/2009 RMA 01/20/2010 01/20/2010 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'l Pot. Water Con. Fee Reel. Water Con. Fee Green Bldg Stands (SB1473) Fee $422.98 Meter Size $0.00 Add'l Reel. Water Con. Fee $274.94 Meter Fee $0.00 SDCWA Fee $0.00 CFD Payoff Fee $10.71 PFF (3105540) $0.00 PFF (4305540) $0.00 License Tax (3104193) $0.00 License Tax (4304193) $0.00 Traffic Impact Fee (3105541) $0.00 Traffic Impact Fee (4305541) $0.00 PLUMBING TOTAL $0.00 ELECTRICAL TOTAL $0.00 MECHANICAL TOTAL $0.00 Master Drainage Fee Sewer Fee $0.00 Redev Parking $0.00 Additional Fees $1.00 HMPFee TOTAL PERMIT FEE! $0.00 $0.00 $0.00 $0.00 $928.11 $0.00 $0.00 $0.00 $0.00 $0.00 $119.00 $110.00 $24.00 $0.00 $0.00 $0.00 ING PLANS ?°-°° STORAGE "i ACHED 9? $1,890.74 Total Fees:$1,890.74 Total Payments To Date:$1,89074 Balance Due:$0.00 Inspector: FINAL APPROVAL Date: t Clearance: NOTICE: Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. CffM£te) Plan Check No. 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Ck. DeositCARLSBADHI if)/PI DESCRIPTION OF WORK: Include Square Feet oMffected Area(s)eet or Affected /treats) , -nrpt tenfarfr CONTACT NAME (If Different Fom Applicant) (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires theapplicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of theBusiness 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 acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one ofthe following declarations: I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this perm it is issued. , I have and will maintain workers' compensatio|i, as required by Section 37QO of the Labor.Code, for the performance ofthework for which this permit is issued^Mv workers' compensation iosujaive qanjerand oolicy number are: Insurance Co fo^W/CM ^\fl> -f CKCH iVU Policy No. ^ (PO fJQrt Q^SCT 1 Expiralion Dale This section need not be completed if the permit is for one hundred dollars ($100) or less, r ' OM > f\ Y I LJC» Cl Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100.000), in / addition to the cost of compensation, damagesa£providejUef-in-Section 3706 of the Labor code, interest and attorney's fees. ^ JS$ CONTRACTOR SIGNATURE / >f> ft f^ \>~~ ---- — DATE ( I £j(J / hereby affirm that I am exempt from Contractor's License Law for the following reason: n 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). n 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). D 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. D Yes Q No 2.1 (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 (incl ude name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): vfiTpROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a business alai)('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? O Yes gt,N° ' . Is the applicant or future building occupant required to obtain a permit frorr/the air pollution control district or a\i qua}i,ty management district? O Yes Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CD Yes =JW 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. 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 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 .1 agree to com ply 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. 180 days from the date of such permit or if the building or work autajzedbyjjuch permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ) APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 02/17/2010 Permit* CB091983 Title: FROOTS RESTAURANT-1085 SF Description: SHELL TO RESTAURANT Inspector Assignment: TP 2675 GATEWAY RD 101 Lot: 0 Type:TI Sub Type: COMM Job Address: Suite: Location: APPLICANT PQ DESIGN STUDIOS Owner: Remarks: Phone: 8584148283 Inspector: Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By: BOB Entered By: CHRISTINE Comments Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date 02/08/2010 02/08/2010 02/05/2010 02/05/2010 01/29/2010 01/27/2010 01/27/2010 01/27/2010 01/21/2010 01/21/2010 Description 14 Frame/Steel/Bolting/Welding 34 Rough Electric 14 Frame/Steel/Bolting/Welding 34 Rough Electric 17 Interior Lath/Drywall 24 Rough/Topout 24 Rough/Topout 34 Rough Electric 21 Underground/Under Floor 31 Underground/Conduit-Wiring Act AP AP NR NR AP AP PA AP AP AP Insp PD PD TP TP PD TP TP TP TP TP Comments CEILING METER RELEASE NOT COMPLETE & NEED FIRE ASO NEED MECH ENC MATERIAL CHANGE City, of Carlsbad Final Building Inspection Dept: Building Engineering Planning CMWD St Lite Fire Plan Check #: Permit #: Project Name: Address: Contact Person: Sewer Dist: Inspected By. 0 Inspected Bv: Inspected By: Comments: CB091983 FROOTS RESTAURANT- 1085 SF SHELL TO RESTAURANT 2675 GATEWAY RD #101 BOB Phone: 8584148283 CA Water Dist: CA / Date / / U>-Ji3Y\V inspected: (2\ [bl(ty 'A Date ^ Inspected: Date Inspected: Date: Permit Type: Sub Type: Lot: 0 ' Approved: Approved: Approved: 02/17/2010 Tl COMM Disapproved: Disapproved: Disapproved: EsGil Corporation In Partnership with government for (BuiCding Safety DATE: 1/14/10 a APPLICANT a JURIS. JURISDICTION: City of Carlsbad a PLAN REVIEWER a FILE PLAN CHECK NO.: 09-1983 SET: III PROJECT ADDRESS: 2675 Gateway Rd Suite 101 PROJECT NAME: Froots Restaurant - TI XI 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 building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. The applicant's copy of the check list has been sent to: XI Esgi! Corporation staff did not advise the applicant that the plan check has been completed. Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: ^ Date contacted: (by: ) Fax #: Mail Telephone Fax In Person X] REMARKS: Applicant to hand carry the plans directly to the City of Carlsbad this does not assure a permit will be issued the city may have other corrections. By: Doug Moody Enclosures: EsGil Corporation D GA D EJ D PC LOG 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858)560-1468 + Fax (858) 560-1576 EsGil Corporation In Partnership with government for (BuiCtfing Safety DATE: 12/9/O9 [^APPLICANT JURISDICTION: City of Carlsbad a PLAN REVIEWER a FILE PLAN CHECK NO.: 09-1983 SET: I PROJECT ADDRESS: 2675 Gateway Rd Suite 1O1 PROJECT NAME: Froots Restaurant - 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 building codes when minor deficiencies identified below are resolved and checked by building department staff. The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. XI The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. XI The applicant's copy of the check list has been sent to: Phil Quatrino 7960 Silverton Ave Suite 207, San Diego, CA 92126 Esgil Corporation staff did not advise the applicant that the plan check has been completed. XI Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted :,Phil Quatrino Telephone #: 858-527-0818 Date contacted/7?< °' (by>X^ Fax #: 858-527-1767 Mai^X^ Telephone Fax ^/In Person REMARKS: By: Doug Moody Enclosures: EsGil Corporation D GA D EJ D PC 12/1/09 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858)560-1468 *• Fax (858) 560-1576 City of Carlsbad O9-1983 12/9/09 PLAN REVIEW CORRECTION LIST TENANT IMPROVEMENTS PLAN CHECK NO.: O9-1983 OCCUPANCY: B TYPE OF CONSTRUCTION: VB ALLOWABLE FLOOR AREA: SPRINKLERS?: YES REMARKS: DATE PLANS RECEIVED BY JURISDICTION: 11/30/09 DATE INITIAL PLAN REVIEW COMPLETED: 12/9/09 JURISDICTION: City of Carlsbad USE: Restaurant ACTUAL AREA: 1086sf STORIES: 1 HEIGHT: OCCUPANT LOAD: 27 DATE PLANS RECEIVED BY ESGIL CORPORATION: 12/1/09 PLAN REVIEWER: Doug Moody 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 may be 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. City of Carlsbad O9-1983 12/9/O9 Please make all corrections on the original tracings, as requested in the correction list. Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: 1. Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760) 602-2700. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. 2. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. 1. Each sheet of the plans must be signed by the person responsible for their preparation, even though there are no structural changes. Business and Professions Code. 2. Provide evidence of Health Department approval (for restaurants), where regulated by the local Health Department. 3. 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". 4. 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 compliance with this Code section. UPC 413.1 & UPC 414. 5. Specify lever-type hardware for passage doors on floors accessible to the disabled. Title 24. 6. Show that the water closet is located in a space, per Section 1115B.3.2.3, which provides: a) A minimum side clearance of either: i) >28" from a fixture. This clearance shall extend all the way to the rear wall. Section 1115B.4.1.1. This will generally require the toilet room to be 7' wide (along the rear wall) by 6'-6" in the other direction. City of Carlsbad O9-1983 .12/9/O9 7. Show that dining facilities are accessible, per Section 1104B.5, as follows: a) Fixed seating, counters and/or tables shall comply with Section 1104B.5.4 as follows: i) Wheelchair access is required to all areas where each type of functional activity occurs. ii) Each dining, banquet and bar area shall have one wheelchair seating space for each 20 seats, with >1 space per functional area. b) Accessible seats are integrated with the general seating to allow a reasonable selection of seating area and to avoid having one area specifically highlighted. To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, calculation page, etc. Please indicate here if any changes have been made to the plans that are not a result of corrections from this list. If there are other changes, please briefly describe them and where they are located in the plans. Have changes been made to the plans not resulting from this correction list? Please indicate: Yes Q No Q 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. City of Carlsbad O9-1983 12/9/09 [DO NOT PAY- THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: City of Carlsbad PLAN CHECK NO.: 09-1983 PREPARED BY: Doug Moody DATE: 12/9/09 BUILDING ADDRESS: 2675 Gateway Rd Suite 1O1 BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: VB BUILDING PORTION Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code AREA ( Sq. Ft.) 1086 cb Valuation Multiplier 46.56 By Ordinance Reg. Mod. VALUE ($) 50,564 50,564 $422.98 Plan Check Fee by Ordinance Type of Review: \2 I I Repetitive FeeRepeats Complete Review D Other [—I Hourly EsGii Fee Structural Only Hr. $274.94 $236.87 Comments: Sheet 1 of 1 macvalue.doc + PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB091983 DATE 11/30/09 ADDRESS 2675 GATEWAY RD SUITE 101 RESIDENTIAL ADDITION- MINOR (< 17,000.00) RETAINING WALL VILLAGE FAIRE POOL/SPA TENANT IMPROVEMENT COMPLETE OFFICE BUILDING OTHER Tl - ALL ROOF MOUNTED EQUIPMENT IS EXISTING AS STATED ON SHEET M-2 PLANNER GINA RUIZ ENGINEER DATE 12/4/09 'A,DATE H:\ADHIN\(flUNTEK/PlANNlNG/ENGINEEIHNf1 APPROVALS Carlsbad Fire Department Plan Review Requirements Category: TI, COMM Date of Report: 01-20-2010 Reviewed by: Name: Address: PQ DESIGN STUDIOS ATTN PHIL QUATRINO STE 207 7960 SILVERTON AV SAN DIEGO CA92126 Permit #: CB091983 C Job Name: FROOTS RESTAURANT-1085 SF Job Address: 2675 GATEWAY RD CBAD St: 101 INCOMPLETE adequately conduct a re is incomplete. At this time, this office cannot*** —.-.. - „._ntn the appUcuElLi^gg^^f^gtandards. Please review carefully alTcfis^eiits^tfacrred. Please resubmit the necessary plans and/or specificaHonsTW^^feiiaiigesJ'clouded", to this office for review and approval. Conditions: Cond: CON0003799 [NOT MET] 1. Add the following note or similiar to plans: "(If required) Complete plans and specifications for fire alarm systems, fire extinguishing systems, including automatic sprinklers and wet and dry standpipes; inert/halocarbon systems and other special types of automatic fire protection systems and appurtenances thereto shall be submitted to Carlsbad Fire Department for review and approval PRIOR to installation. (CFC 901.2)" 2. Sheet TS - Reference California Fire Code, 2007 Edition, in "Codes & Govt. Agencies" section. Entry: 12/23/2009 By: cwong Action: CO Cond: CON0003832 [MET] **APPROVED: THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUEANCE OF A BUILDING PERMIT. THIS APPROVAL IS SUBJECT TO FIELD INSPECTIONS, ANY REQUIRED TESTS, FIRE DEPARTMENT NOTATIONS, CONDITIONS IN CORRESPONDENCE AND COMPLIANCE WITH ALL APPLICABLE CODES AND REGULATIONS. THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE ANY VIOLATION OF THE LAW. Entry: 01/20/2010 By: cwong Action: AP Carlsbad Fire Department Plan Review . Requirements Category: TI , COMM Date of Report: 12-23-2009 Reviewed by:) I) Name: Address: PQ DESIGN STUDIOS ATTN PHIL QUATRINO STE 207 7960 SILVKRTON AV SAN DIEGO CA 92126 Permit #: CB091983 **** B*-^£ •!-( ItV^••'^••;r I Job Name: FROOTS RESTAURANT- 1085 SF Job Address: 2675 GATEWAY RD CBAD St: 101 INCOMPLETE The item you have submitted for review is incomplete. At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and/or standards. Please review carefully all comments attached. Please resubmit the necessary plans and/or specifications, with changes "clouded", to this office for review and approval. Conditions: Cond: CON0003799 [NOT MET] 1. Add the following note or similiar to plans: "(If required) Complete plans and specifications for fire alarm systems, fire extinguishing systems, including automatic sprinklers and wet and dry standpipes; inert/halocarbon systems and other special types of automatic fire protection systems and appurtenances thereto shall be submitted to Carlsbad Fire Department for review and approval PRIOR to installation. (CFC 901.2)" 2. Sheet TS - Reference California Fire Code, 2007 Edition, in "Codes & Govt. Agencies" section. Entry: 12/23/2009 By: cwong Action: CO f • SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY UPFP# HV# BP DATE Busi Busi Telephone # Proj City Zip Code APN# Mailing Address City State Zip Code Plan File* Project Contact " 523- -off iff The 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. 5. Organic Peroxides 9. 6. Oxidizers 10. 7. Pyrophorics 11. 8. Unstable Reactives 12. 1. Explosive or Blasting Agents 2. Compressed Gases 3. Flammable/Combustible Liquids 4. Flammable Solids Water Reactives Cryogenics Highly Toxic or Toxic Materials Radioactives 13. Corrosives 14. Other Health Hazards 15. None of These. 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, 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 1. D 2. D 3. D 4. D 5. D 6. D B Is your business listed on the reverse side of this form? (check all that apply). m Will your business dispose of Hazardous Substances or Medical Waste in any amount? Lu Will your business store or handle Hazardous Substances in quantities equal to or greater than T 55 gallons, 500 pounds, 200 cubic feet, or carcinogens/reproductive toxins in any quantity? m Will your business use an existing or install an underground storage tank? CD Will your business store or handle Regulated Substances (CalARP)? Q] Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? D CalARP Exempt / Date Initials D CalARP Required / Date Initials D CalARP Complete / 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 1. D 2. D 3. D 4. D NO []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 httD://www.sdapcd.ora/info/facts/permits.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). (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)? (Public and private schools may be found after search of the California School Directory at http://www.cde.ca.oov/re/sd/: or contact the appropriate school district). Will there be renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non-friable asbestos? Will there be demolition involving the removal of a load supporting structural member? 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 OFFICIAL USE ONLY:FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:. BY:DATE: EXEMPT OR NO FURTHER INFORMATION REQUIRED COUNTY-HMD APCD RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY COUNTY-HMD APCD RELEASED FOR OCCUPANCY COUNTY-HMD APCD HM-9171 (04/07)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 D Battery Manufacturing/Recycling D Boat Yard D Car Wash D Dealership Maintenance/Painting D Machine Shop D Painting D Radiator Shop D Rental Yard Equipment D Repair/Preventive Maintenance D Spray Booth D Transportation Services O Wrecking/Recycling CHEMICAL HANDLING D Agricultural supplier/distributor D Chemical Manufacturer D Chemical Supplier/Distributor D Coatings/Adhesive D Compressed Gas Supplier/Distributor D Dry Cleaning O Fiberglass/Resin Application D Gas Station D Industrial Laundry D Laboratory D Laboratory Supplier/Distributor D Oil and Fuel Bulk Supply D Pesticide Operator/Distributor CHEMICAL HANDLING D Photographic Processing D Pool Supplies/Maintenance D Printing/Blue Printing D Road Coatings D Swimming Pool D Toxic Gas Handler D Toxic Gas Manufacturer METAL WORKING D Anodizing D Chemical Milling/Etching D Finish-Coating/Painting D Flame Spraying D Foundry D Machine Shop-Drilling/Lathes/Mills D Metal Plating D Metal Prepping/Chemical Coating D Precious Metal Recovery O Sand Blasting/Grinding O Steel Fabricator D Wrought Iron Manufacturing AEROSPACE D Aerospace Industry O Aircraft Maintenance D Aircraft Manufacturing OTHERS AND MISCELLANEOUS D Asphalt Plant D Biotechnology/Research D Chiropractic Office D Co-Generation Plant D Dental Clinic/Office O Dialysis Center D Emergency Generator D Frozen Food Processing Facility D Hazardous Waste Hauler D Hospital/Convalescent Home D Laboratory/Biological Lab O Medical Clinic/Office D Nitrous Oxide (NOX) Control System D Pharmaceuticals D Public Utility D Refrigeration System D Rock Quarry D Ship Repair/Construction D Telecommunications Cell Site D Veterinary Clinic/Hospital D Wood/Furniture Manufacturing/Refinishing ELECTRONICS O Electronic Assembly/Sub-Assembly D Electronic Components Manufacturing D Printed Circuit Board Manufacturing 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 (619) 338-2222. 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 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. HM-9171 (04/07) County of San Diego - DEH - Hazardous Materials Division 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 BOYS & GIRLS CLUB (NOT INCLUDED)COUNTY OF SAN DIEGO v DEPARTMENT OF V ENVIRONMENTAL HEALTH PLAN REVIEW PROVISIONAL APPROVAL PLANS ACCEPTED FOR CONSTRUCTION SUBJECT TO THE REQUIREMENTS OF THE STATE AND LOCAL REGULATIONS. THIS S >>\MP 13 NO ASSURANCE THAT THE PLANS OR SPECI- FICATIONS AR? CORRECT IN EVERY RESPECT. ERRORS IN DESiGH OR CONSTRUCTION MUST BE CORRECTED. COUNTY OF SAN DIEGO DATE. ANSliUsT REMAIN ON THE JOB SITE DURING CONSTRUCTION.SCALE 1"=100'-0" II-IN 1 tj|- ...-. L HEALTH CHECK ABBREVIATIONS gROMTIICD/!CONSTRUCTION BEGllM . vv-i-L~PE vQfDED ANn MFyy piT»ITT i ED hUR APPROVAI AC. ACOUSTIC ACT. ACTUAL AL. ALUMINUM ARCH. ARCHITECTURAL AVG. AVERAGE BLK. BLOCK BPL . BEARING PLATE BR . BRICK, BEDROOM CPT. CARPET r.MI I CONC MSNRY UNIT DR. DS. DWG. E. EA. ELEV. EST. E.W. EXIST. EXT. DOOR DOWN SPOUT DRAWING EXISTING EACH ELEVATIONS ESTIMATED EACH WAY EXISTING EXTERIOR INTR.DSGNR. INSUL INT. KIT. LAM. LAV. LR. LT.LIGHT MAR. MATL. INTERIOR DESIGNER INSULATION INTERIOR KITCHEN LAMINATED LAVATORY LIVING ROOM LT.LIGHT MARBLE MATERIAL PLYW POL. PSI. PSF. R. RCP. REBA REFR REF. REV. CITY OF CARLSBAD STORM WATER COMPLIANCE EXEMPTION B-24 Development Services Building Department 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov am applying to the City of Carlsbad for the following type(s) of construction permit: a Building Permit a Right-of-Way Permit Q My project is categorically EXEMPT from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it only requires issuance of one or more of the following permit types: Electrical Fire Additional Fire Alarm Fixed Systems Mechanical Mobile Home Plumbing Patio/Deck Re-Roofing Sign Spa-Factory Sprinkler Water Discharge /Project Storm Water Threat Assessment Criteria* No ThreaJMssessment Criteria t* My project qualifies as NO THREAT and is exempt from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it meets the "no threat" assessment criteria on the City's Project Threat Assessment Worksheet for Determination of Construction SWPPP Tier Level. My project does not meet any of the High, Moderate or Low Threat criteria described below. Tier 1 - Low Threat Assessment Criteria Q My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt permit type (See list above) and the project meets one or more of the following criteria: • Results in some soil disturbance; and/or • Includes outdoor construction activities (such as roofing, saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling). Tier 2 - Moderate Threat Assessment Criteria Q My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more of the following criteria: • Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code); or, • Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more of the additional following criteria: • Located within 200 feet of an environmentally sensitive area or the Pacific Ocean, and/or • Disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical, and/or • Disturbed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse, and/or • Construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). Tier 3 • Significant Threat Assessment Criteria G My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, stockpiling, pavement removal, refueling and maintenance areas: and/or l_l My project is part of a phased development plan that will cumulatively result in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, refueling and maintenance areas: or, G My project is located inside or within 200 feet of an environmentally sensitive area (see City ESA Proximity map) and has a significant potential for contributing pollutants to nearby receiving waters by way of storm water runoff or non-storm water discharge(s). / certify to the best of my knowledge that the above checked statements are true and correct. I understand and acknowledge that even though this project does not require preparation of a construction SWPP, I must still adhere to, and at all times during construction activities for the permit type(s) check above comply with the storm water best management practices pursuant to Title 15 of the Carlsbad Municipal Code and to City Standards. The City Engineer may authorize minor variances from the Storm Water Threat Assessment Criteria in special circumstances where it can be shown that a lesser or higher Construction SWPPP Tier Level is warranted. Owner/Owner's Authorized Agent Name Owner/Owner s Authorized Agent Signature B-24 Page 1 of 1 Rev.03/09 Date INDUSTRIAL WASTEWATER DISCHARGE PERMIT SCREENING SURVEY Business Name Street Address. Email Address WAlj PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT: (ON REVERSE SIDE CHECK TYPE OF BUSINESS) Check all below that are present at your facility:7 Acid Cleaning Assembly Automotive Repair Battery Manufacturing Biofuel Manufacturing Biotech Laboratory Bulk Chemical Storage Car Wash Chemical Manufacturing Chemical Purification Dry Cleaning Electrical Component Manufacturing Fertilizer Manufacturing Film /X-ray Processing Food Processing Glass Manufacturing Industrial Laundry Ink Manufacturing Laboratory Machining/Milling Manufacturing Membrane Manufacturing (i.e. water filter membranes) Metal Casting / Forming Metaf Fabrication Metal Finishing Electroplating Electroless plating Anodizing Coating (i.e. phosphating) Chemical Etching / Milling Printed Circuit Board Manufacturing 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 SIC Code(s) (if known): Brief description of business activities (Production / Manufacturing Operations): \AM\ 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 (type / volume): Date operation began/or wilt begin at this location: Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? Yes No If yes, When: Site Contact Phil QUfllDDO Signature ENCINA W, Title Phone No. , 6200 Avenida Encinas Carisbad.CA 92011 (760)438-3941 FAX: (760)476-9852 DISCHARGE PERMIT EXEMPT LIST The commercial enterprises listed below are a partial listing of businesses that are exempt from industrial wastewater discharge permitting under normal operating conditions. They are exempt because (a) they discharge no process wastewater (i.e., they only discharge sanitary wastewater with no pollutants exceeding any local limits), and (b) they have no potential to negatively impact the EWPCF or other wastewater treatment plants in the ESS. Any questions regarding exemptions should be referred to EWA Source Control staff. Automobile Detailers Barber/Beauty Shops Business/Sales Offices Carpet/Upholstery Cleaning Services Childcare Facilities Churches Community Centers Consulting Services Contractors Counseling Services Educational Services (no auto repair/film developing) Financial Institutions/Services Fitness Centers Gas Stations (no car wash/auto repair) Grocery Stores (no film developing) Home-based Businesses Hotels/Motels (no laundry) Laundromats Libraries Medical Offices (no x-ray developing) Mortuaries Museums Nail Salons Nursing Homes Office Buildings (no process flow) Optical Services Pest Control Services (no pesticide repackaging for sale) Pet Boarding/Grooming Facilities Postal Services Public Storage Facilities Restaurants/Bars Retail/Wholesale Stores (no auto repair/film developing) Theaters (Movie/Live) JAN-20-2010 WED 11:52 AM SOUZA & SOUZA FAX No. 8585601649 P. 001 Souza & Souza Construction. Inc. 9222 Chesapeake Dr. Email: mvandyk@souzaandsouzaconstructioninc.com San Diego, CA 92123 CA Lie. 860458 Office: (858) 560-1479 Fax: (858) 560-1649 1/20/10 City of Carlsbad 163 5 Faraday Ave. Carlsbad, CA 92008 Attn: Development Department To Whom It May Concern: Please be advised that I herby give authorization for Ashley Prikosovits or PQ Design Studio to pull permits on behalf of Souza & Souza Construction, Inc. Contractors License #860458 Please call our office with any questions. Thank you, Michael Van ] Souza & Souzi Construction, Lac. Check a License or Home Improvement Salesperson (HIS) Registration - Contractors Stat... Page 1 of 1 Department of Consumer Affairs Contractors State Contractor's License Detail - License # 860458 *»^ DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. ••'*> CSLB complaint disclosure is restricted by law (B&P7124.6). If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. » Per B&P 7071,17, only construction related civil judgments reported to the CSLB are disclosed. -» Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. * Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number: Business Information: Entity: Issue Date: Expire Date: License Status: Classifications: 860458 Extract Date: 01/20/2010 SOUZA AND SOUZA CONSTRUCTION INC 9222 CHESAPEAKE DR SAN DIEGO, CA 92123 Business Phone Number: (858) 560-1479 Corporation 06/17/2005 06/30/2011 This license is current and active. All information below should be reviewed. CLASS DESCRIPTION GENERAL BUILDING CQNIBACIQR CONTRACTOR'S BOND This license filed Contractor's Bond number 91 0201 11 in the amount of $12,500 with the bonding company Bonding: Workers' Compensation: Effective Date: 01/01/2007 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL 1. The Responsible Managing Officer (RMO) DANIEL PATRICK SOUZA certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 06/17/2005 This license has workers compensation insurance with the REDWOOD FIRE AND'CASUALTYINSURANCE CO Policy Number: 7600000798091 Effective Date: 01/01/2009 Expire Date: 01/01/2010 Workers' Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses. Personnel List I Other Licenses Conditions of Use | Privacy Policy Copyright © 2010 State of California https://www2.cslb.ca.gov/OnlineServices/CheckLicense/LicenseDetail.asp 01/20/2010 CB091983 2675 GATEWAY RO 101 FROOTS RESTAURANT-1085 SF SHPI I TO RPRTAIIRAMT \\tLQ cm* Approved Date Building . 10 Planning * Engineering HaiMat APCD Health I/ Zo/lb Forml/Feej , Encina HazHealthAPCD PE&M ||Q School Sewer Stormwater Comments Building Planning Engineering NeedT. Application Complete? v N Fees Complete? v N By By