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Home My WebLink About2701 Loker Ave W; 100; CBC2019-0313; Permit(City of Carlsbad Commercial Permit Print Date: 09/17/2019 Permit No: CBC2019-0313 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 2701 Loker Ave W, 100 BLDG-Commercial 2090812200 $22,422.40 Work Class: Demo Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Description: PALOMAR CREST: 3640 SF INTERIOR DEMO (NO OCCUPANCY UNDER THIS PERMIT) BUILDING PERMIT FEE ($2000+) BUILDING PLAN CHECK FEE (BLDG) 5B1473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-COMMERCIAL Total Fees: $398.74 Owner: REEF PALOMAR LLC 2701 Loker Ave CARLSBAD, CA 92008 Total Payments To Date: $398.74 Status: Applied: Issued: Permit Fina\ed: Inspector: Final Inspection: Contractor: SP W CONSTRUCflON INC 2524 Gateway Rd Carlsbad, CA 92009-1742 760-931-1130 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitation has previously otherwise expired. Closed -Finaled 06/24/2019 06/28/2019 9/17/2019 2:33:SSPM $0.00 $230.27 $161.19 $1.00 $6.28 1635 Faraday Avenue, Carlsbad, CA 92008-7314 ,I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov " -.... (cicyof COMMERCIAL cBc2.012-031? BUILDING PERMIT Plan Check Est. Value 1I '1... 'll:J_z 2. . 'fO - Carlsbad APPLICATION PC Deposit B-2 Date (:;/'Z-<j_/!f_ Job Address 27-01 Loizev Avev1,1A.e west Sulte:_1_oo __ APN: ?r)'f-Ogf-22:::00 Tenant Name: "-1l'l CT/Project#: __________ Lot#: ___ _ Fire Sprinkler~ no Air Conditioning:~/ no BRIEF DESCRIPTION OF WORK: c!eV\,\,0Lltiov1, of exlstiv1,g wnlls Clv1,ci fi,v1,lsvies, V\,\,[v1,oy gvlc! vepnlvs, pntcvi nv1,ci , tJ U40 :,e,,vi ov 0 Addition/New: ___________ New SF and Use, ___________ New SF and Use, ____ Deck SF, Patio Cover SF (not including flatwork) 0 Tenant Improvement: _____ SF, _____ SF, Existing Use ______ Proposed Use ______ _ Existing Use Proposed Use ______ _ 0 Pool/Spa: ____ SF Additional Gas or Electrical Features? ____________ _ D Solar: ___ KW, __ Modules, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No D Plumbing/Mechanical/Electrical Only: ________________________ _ l!ll Other: "-O tev1,nv1,t fov tvie s nee -denv1,1A. nv1,ci cieV\,\,o o StA.cte ov1,L APPLICANT (PRIMARY) Name: SPW Cov1,Stv1A.ctiov1, Address: 2524 c;ntewn 1;;1 R.Onci City: cnvlsbnci State: CA Zip: 92009 Phone: J"G0,931.1130 Email: vl,(Ol v\-C !j@WVl lteco v\,S tv1A.ctLo,cLv1,c. co V\,\, DESIGN PROFESSIONAL Name: AVR.P SR!jpovt Address: JD3 1Gtvi stveet Sl/4cte 200 City: Snv1, D,ego State: CA Zip: ,22101 Phone: b1'):f04.2700 Email: _______________ _ Architect State License: __________ _ PROPERTY OWNER Name: R.eef PnLoV\,\,nv, LLC clo uv1,cve R.enL Estnte Address: 1200 Enst lvwpevlnl ttcgviwn!-J StA.cte 20s City: lsven State: CA Zip: 92221 Phone: J-11:-;l;)0.21,00 Email: /nc!zHn rv~ !M,l'l vc@tA.v1,[ye9vo1A.:p.coV\,\, CONTRACTOR BUSINESS Name: SPW Cov1,StY1A.Ctiov1, Address: 2524 c;ntewn19 R.OClci City: c0vLsb0d State: CA Zip: 92009 Phone: ZG0.')31.1130 Ema ii: v1,1, v1,c 1;;1 ®wvi ,teco v1,s tmct,o "''"'c. COV\,\, State License: 1023256 Bus. License: lsL NR.000431-02-2C (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 \ts Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's license Law {Chapter 9, commendlng with Section 7000 of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any appllcant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 1 of 2 Email: Building@carlsbadca.gov Rev. 06118 , .... ( OPTION A): WORKERS'CQMPENSAJION DECLARATION; I hearby affirm under penalty of perjury QM. 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 ls issued. GYI have and will maintain worker's compensation, as requlred 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: State Compensation Ins. Fund Polley No. 9243036-19 Expiration Date: 0110112020 □ 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 be come 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. CONTRACTOR SIGNATURE: --i?:=::=-+ _______________ lJAGENT DATE: ....... r ... o ... fo-fl'-'-l/~1g'-'--_ 6)-----I I ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: 0 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 e)(clusively contracting with licensed contractors to construct the project (Sec. 7044, Busine55 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). n I am e)(empt under Section _______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. D Yes □ 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 narne /address/ phone/ contractors' license number): S. I 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): OWNER SIGNATURE: LJAGENT ---------------------DATE: _____ _ CONSTRUCTION LENDING AGENCY. IF ANY: r 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: ____________________ _ ONLY COMPLETE THE FOLLOWING SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY: IS the applicant or future bullding occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 2550S, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ Yes .SJ No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes 11 No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes -No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. APPLICANT CERTIFICATION: 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 CHY 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 e)(cavations over S'O' deep and demolition or construction of structures over3 stories In height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at anytime after the work ls commenced for a period of 180 days (Sectlon 106.4.4 Uniform Building Code). APPLICANT SIGNATURE: ----'r'-' __________________ DATE: _b_l_:;,_-1-_1_1-')"'----- 1635 Faraday Ave Carlsbad, CA 92008 B-2 Ph: 760-602-2719 Fax: 760-602-8558 Page 2 of 2 Email: Building@carlsbadca.gov Rev. 06/18 C '-,:;•, Si; '1 1 " ' , 1 I \ ~ , 0 1 j : ;. 0 \) , PERMIT INSPECTION HISTORY REPORT (CBC2019-0313) 1a ,$ \~¼ " " <' ~ 1 "j "' Permit Type BLDG-Commercial Application Date: 06/24/2019 Owner: Work Class Demo Issue Date: 06/28/2019 Subdivision: Status Closed -Finaled Expiration Date: 03/16/2020 Addrnss: !VR Number: 19948 Scheduled Date Actual Start Date Inspection Type Inspection No. Inspection Status Primary Inspector 09/1712019 0911712019 September 17, 2019 BLDG-11 FoundatlonlFtglPier s (Rebar) 104403-2019 BLDG-Final Inspection Checklist Item BLDG-Building Deficiency 104402-2019 Checklist ltern BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final Passed Paul York COMMENTS Passed Paul York COMMENTS REEF PALOMAR LLC CARLSBAD TCT#74-21 2701 Loker Avew , 100 Carlsbad, CA 92010-6637 Reinspection Yes Passed Yes Yes Yes Yes Yes Complete Complete Complete Page 1 of 1 lei -818-&71-8900 ket -1!51-781-4522 fai -818·677·9009 Pa1tlollall.!1ll11 66•0 Ill!-Bird., Suite A-100, Silll Diego, CA 9Ztll June 17, 2019 Darrin Ward White Construction 2524 Gateway Road Carlsbad, CA 92009 Re: Limited Asbestos Inspection Palomar Crest Suite 100 2701 Loker Avenue Suite 100 Carlsbad, CA 92008 Claim No: NIA Project No: SD129383 Dear Mr. Ward, .. ~-~·------- RECFl\!Ff) JUN 2 A 2019 CITY C,;· l..." C ;,j. ,U BUILDING DIVISION On June 14, 2019, California DOSH Certified Site Surveillance Technician, Mr. Francisco > Barney (CSST 14-5283) of Patriot Environmental Laboratory Services, Inc. (Patriot) performed f- a limited asbestos inspection at the above subject property located in Carlsbad, California. The purpose of the inspection was to determine if asbestos is present in any of the building 0- materials soon to be disturbed by an upcoming renovation at the subject property. Summary of Findings No asbestos was detected in the building materials sampled. Property Description The subject property is a commercial structure. The subject building is a multi-story wood, brick, and metal frame building set on a cement slab foundation. Scope of Work On June 14, 2019, Mr. Francisco Barney, (CSST 14-5283) of Patriot conducted a limited asbestos inspection at the subject property. The interior of the building was visually inspected for the purpose of inventorying any suspect asbestos containing materials soon to be disturbed by an upcoming renovation at the subject property. Once the inventory of suspect materials was created, physical bulk samples were collected of the materials from representative locations. Samples were collected in airtight containers. Upon collection, sample numbers, descriptions, and collection locations were entered on to a chain of custody for transportation to Patriot's NVLAP accredited laboratory. Sampled Suspect Materials Samples of the following suspect materials were collected: Drywall & Joint Compound Carpet Mastic Brown 4" Cove Base with Mastic 2"x4" Acoustic Ceiling Tiles White 12"xl2" Vinyl Floor Tile Grey 12"xl2" Vinyl Floor Tile with Mastic with Mastic Yellow Fiberglass Insulation ---- Sample ProtocoVAnalvsis Samples were collected in accordance with the Asbestos School Hazard Emergency Response Act (40 CFR 763 Subpart E) as mandated by Cal/OSHA (Title 8 Section 1529). Physical bulk samples were analyzed by Patriot. Patriot is accredited by the National Voluntary Laboratory Accreditation Program (200358-0). The method of analysis was Polarized Light Microscopy (EPA 600/M4-82-020). Recommendations No asbestos was detected in the building materials sampled. Therefore, no recommendations are warranted at this time. Disclaimer Limited destructive sampling was conducted at the subject property. If additional suspect materials are discovered during renovation, all work should cease until a Certified Asbestos Consultant is contracted to ascertain the possibility of asbestos content. This inspection was performed in accordance with current regulations and state of the art practices. The inventory of asbestos containing materials and determination of their condition are based upon conditions observed at the time of inspection. Patriot does not assume responsibility for future regulatory changes or changes in the condition of the building. Enclosed is the laboratory analysis report. Please contact our office if there are any questions regarding this inspection. Sincerely, Cristopher J. Meile Certified Asbestos Consultant 08-4340 Enclosure: Laboratory Results Certificate of Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer Location 770554-001 Lobby Wall Total Asbestos None Detected 770554-00lA Lobby Wall Total Asbestos None Detected 770554-001B Lobby Wall Total Asbestos None Detected 770554-002 Office 1 Wall 2 Total Asbestos None Detected 770554-002A Office I Wall 2 Total Asbestos None Detected tel-858·677-8900 free -855-781-4522 fax -858-677-9009 Patriotlab.com 6640 Lusk Blvd., Suite A-100, San Diego, CA 92121 PAm Environmental Laboratory Services. Inc. Report Number: 770554 Project Number: SD129383 Project Name: Palomar Crest Suite 100 Project Location: 2701 Loker Avenue Suite 100 Carlsbad, 92008 Collected By: Francisco Barney Claim Number: PO Number: Number of Samples: 44 Material Description Color Composition ( % ) Drywall and Joint White 80% Sulfate Compound 10% Cellulose 6% Carbonate 2% Paint 2% Glass Fibers Drywall White 84% Sulfate 12% Cellulose 4% Glass Fibers Joint Compound White 95% Carbonate 5% Paint Drywall and Joint White 80% Sulfate Compound I 0% Cellulose 6% Carbonate 2% Paint 2% Glass Fibers Drywall White 84% Sulfate 12% Cellulose 4% Glass Fibers Page I of9 Certificate of Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer Location 770554-002B Office 1 Wall 2 Total Asbestos None Detected 770554-003 Conference Room Wall 3 Total Asbestos None Detected 770554-003A Conference Room Wall 3 Total Asbestos None Detected 770554-003B Conference Room Wall 3 Total Asbestos None Detected 770554-004 Office 6 Wall 4 Total Asbestos None Detected Report Number: Project Number: Project N arne: Project Location: Collected By: Claim Number: PO Number: Number of Samples: tel· 858-677-8900 free• 85i-787-4512 tax -858-6n-9009 Patriotlab.rom 6640 Lusk Blvd., Suite A-100, San Diego, CA 92121 770554 SDl29383 Palomar Crest Suite 100 2701 Loker Avenue Suite 100 Carlsbad, 92008 Francisco Barney 44 Material Description Color Composition ( % ) Joint Compound . White 95% Carbonate 5% Paint Drywall and Joint White 80% Sulfate Compound 10% Cellulose 6% Carbonate 2% Paint 2% Glass Fibers Drywall White 84% Sulfate 12% Cellulose 4% Glass Fibers Joint Compound White 95% Carbonate 5% Paint Drywall and Joint White 80% Sulfate Compound 10% Cellulose 6% Carbonate 2% Paint 2% Glass Fibers Page 2 of9 Certificate of Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer Location 770554-004A Office 6 Wall 4 Total Asbestos None Detected 770554-004B Office 6 Wall 4 Total Asbestos None Detected 770554-005 Breakroom Wall 5 Total Asbestos None Detected 770554-005A Breakroom Wall 5 Total Asbestos None Detected 770554-005B Breakroom Wall 5 Total Asbestos None Detected Report Number: Project Number: Project N arne: Project Location: Collected By: Claim Number: PO Number: Number of Samples: tel • 858-677-8900 free -855-787-4512 ta1 -858-671-9009 Patriotlab.com 6640 Lusk Blvd., Suite A-100, San Diego, (A 92121 770554 SD129383 Palomar Crest Suite 100 2701 Loker Avenue Suite 100 Carlsbad, 92008 Francisco Barney 44 Material Description Color Composition ( % ) Drywall White 84% Sulfate 12 % Cellulose 4% Glass Fibers Joint Compound White 95% Carbonate 5% Paint Drywall and Joint White 80% Sulfate Compound I 0% Cellulose 6% Carbonate 2% Paint 2% Glass Fibers Drywall White 84% Sulfate 12% Cellulose 4% Glass Fibers Joint Compound White 95% Carbonate 5% Paint Page 3 of9 Certificate of Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer 770554-006 6 Total Asbestos 770554-007 7 Total Asbestos Location Corridoe I -Breakroom Floor None Detected Corridoe I -Breakroom Floor None Detected Report Number: Project Number: Project Name: Project Location: Collected By: Claim Number: PO Number: tel· 858-677-8900 free -855-787-4522 fax -858-6n-9009 Patriotlab.oom 6640 Lusk Blvd., Suite A-100, San Diego, CA 92121 770554 SD129383 Palomar Crest Suite 100 2701 Loker A venue Suite 100 Carlsbad, 92008 Francisco Barney Number of Samples: 44 Material Description Color Carpet Mastic Yellow Carpet Mastic Yellow Composition ( % ) 100% Non- Fibrous Material 100% Non- Fibrous Material 770554-008 8 Phone Room -Corridor 2 Floor Carpet Mastic Yellow 100% Non- Fibrous Material Total Asbestos 770554-009 9 Total Asbestos 770554-010 10 Total Asbestos 770554-011 II Total Asbestos None Detected Conference Room Floor None Detected Lobby Floor None Detected Office 2 Wall None Detected Carpet Mastic Yellow Carpet Mastic Yellow 4 Inch Cove Base Brown 100%Non- Fibrous Material 100% Non- Fibrous Material 100% Non- Fibrous Material Page 4 of9 Certificate of Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer 770554-012 12 Total Asbestos 770554-013 13 Total Asbestos 770554-014 14 Total Asbestos Location Office 2 Wall None Detected Office 4 Wall None Detected Office 4 Wall None Detected Report Number: Project Number: Project Name: Project Location: Collected By: Claim Number: PO Number: tel • 858-677-8900 free -855-787-4522 fax · 858-6n-9009 Patriollab.rom 6640 Lusk Blvd., Suite A-100, San Diego, CA 92121 770554 SDl29383 Palomar Crest Suite 100 2701 Loker Avenue Suite 100 Carlsbad, 92008 Francisco Barney Number of Samples: 44 Material Description Color Mastic Beige 4 Inch Cove Base Brown Mastic Beige Composition ( % ) 100% Non- Fibrous Material 100% Non- Fibrous Material 100% Non- Fibrous Material 770554-015 15 Open Space Column Wall 4 Inch Cove Base Brown 100% Non- Fibrous Material Total Asbestos 770554-016 16 Total Asbestos 770554-017 17 Total Asbestos None Detected Open Space Column Wall None Detected Lobby Ceiling None Detected Mastic 2x4 Inch Acoustic Ceiling Tiles Beige Beige 100% Non- Fibrous Material 65% Cellulose 20% Mineral Wool 12% Perlite 3% Paint Page 5 of9 Cer.tificate of Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer Location 770554-018 Corridor I Ceiling 18 Total Asbestos None Detected 770554-019 Open Space Ceiling 19 Total Asbestos None Detected 770554-020 Breakroom Floor 20 Total Asbestos None Detected 770554-021 Breakroom Floor 21 Total Asbestos None Detected 770554-022 Breakroom Floor 22 Total Asbestos None Detected tel· 858-677-8900 free -855-787•4522 fax • 858-677-9009 Patriotlab.com 6640 Lusk Blvd., Suite A-100, San Diego, CA 92121 Report Number: 770554 Project Number: SD129383 Project Name: Palomar Crest Suite 100 Project Location: 270 I Loker Avenue Suite 100 Carlsbad, 92008 Collected By: Francisco Barney Claim Number: PO Number: Number of Samples: 44 Material Description Color Composition ( % ) 2x4 Inch Acoustic Beige 65% Cellulose Ceiling Tiles 20% Mineral Wool 12% Perlite 3% Paint 2x4 Inch Acoustic Beige 65% Cellulose Ceiling Tiles 20% Mineral Wool 12% Perlite 3% Paint 12xl2 Inch Vinyl Beige 100% Non- Floor Tile Fibrous Material Mastic Yellow 100% Non- Fibrous Material 12x12 Inch Vinyl Beige 100% Non- Floor Tile Fibrous Material Page 6 of9 Certificate nf Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer Location 770554-023 Breakroom Floor 23 Total Asbestos None Detected 770554-024 Breakroom Floor 24 Total Asbestos None Detected 770554-025 Breakroom Floor 25 Total Asbestos None Detected 770554-026 Phone Room Floor 26 Total Asbestos None Detected 770554-027 Phone Room Floor 27 Total Asbestos None Detected 770554-028 Phone Room Floor 28 Total Asbestos None Detected Report Number: Project Number: Project Name: Project Location: Collected By: Claim Number: PO Number: Number of Samples: tel· 858-677-8900 free -855-787-4522 tai -858-6n-9009 Patriotlab.com 6640 Lusk Blvd., Suite A-100, San Oie~o. CA 92121 770554 SD129383 Palomar Crest Suite I 00 270 I Loker Avenue Suite 100 Carlsbad, 92008 Francisco Barney 44 Material Description Color Composition ( % ) Mastic Yellow 100% Non- Fibrous Material 12xl2 Inch Vinyl Beige 100% Non- Floor Tile Fibrous Material Mastic Yellow 100% Non- Fibrous Material 12xl2 Inch Vinyl Grey 100% Non- Floor Tile Fibrous Material Mastic Yellow 100% Non- Fibrous Material 12xl2 Inch Vinyl Grey 100% Non- Floor Tile Fibrous Material Page 7 of9 Certificate pf Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer Location 770554-029 Phone Room Floor 29 Total Asbestos None Detected 770554-030 Phone Room Floor 30 Total Asbestos None Detected 770554-031 Phone Room Floor 31 Total Asbestos None Detected 770554-032 Plenum Surface 32 Total Asbestos None Detected 770554-033 Plenum Surface 33 Total Asbestos None Detected 770554-034 Plenum Surface 34 Total Asbestos None Detected tel -858-677·8900 free -85,-787-4522 fax -858-6n-9009 Patriotlab.com 6640 Lusk Blvd., Suite A-100, San Diego, CA 92121 Report Number: 770554 Project Number: SD129383 Project Name: Palomar Crest Suite I 00 Project Location: 2701 Loker Avenue Suite 100 Carlsbad, 92008 Collected By: Francisco Barney Claim Number: PO Number: Number of Samples: 44 Material Description Color Composition ( % ) Mastic Yellow 100% Non- Fibrous Material l 2x 12 Inch Vinyl Grey 100% Non- Floor Tile Fibrous Material Mastic Yellow 100% Non- Fibrous Material Fiberglass Insulation Yellow 100% Glass Fibers Fiberglass Insulation Yellow 100% Glass Fibers Fiberglass Insulation Yellow 100% Glass Fibers Page 8 of9 Certificate of Analysis PLM Asbestos Identification White Construction Darrin Ward 2524 Gateway Road Carlsbad, CA 92009 Date Collected: 6/14/2019 Date Received: 6/14/2019 Date Analyzed: 6/14/2019 Date Reported: 6/14/2019 Lab/Client ID/Layer Location Lexy Parra -Analyst Report Number: Project Number: Project Name: Project Location: Collected By: Claim Number: PO Number: tel· 858·677·8900 free -855-787-4522 fax -sss-6n-9009 Patriotlab.rom 6640 Lusk Blvd., Suite A-100, San Diego, CA 92121 770554 SDI29383 Palomar Crest Suite I 00 2701 Loker Avenue Suite 100 Carlsbad, 92008 Francisco Barney Number of Samples: 44 Material Description Color Composition ( % ) Michelle Lavallee -Approved By Bulle sample(s) submitted was (were) analyzed in accordance with the procedure outlined in the US Federal Register 40 CFR 763, Subpart F, Appendix A; EPA-600/R-93/116 (Method for Determination of Asbestos in Building Materials), and EPA-600/M4-82-020 (US EPA Interim Method for the Determination of Asbestos in Bulk Insulation Samples).Samples were analyzed using Calibrated Visual Estimations (CVES); therefore, results may not be reliable for samples of low asbestos concentration levels. Samples of wall systems containing discrete and separable layers are analyzed separately and reported as composite unless specifically requested by the customer to report analytical results for individual layers. This report applies only to the items tested. Results are representative of the samples submitted and may not represent the entire material from which the samples were collected. ''None Detected" means that no asbestos was observed in the sample. "< 1 %" (less than one percent) means that asbestos was observed in the sample but the concentration is below the quantifiable level of 1 %. This report was issued by a NIST/NVLAP (Lab Code 200982-0) and CADOHS-ELAP (Cert. No. 2805) accredited laboratory and may not be reproduced, except in full without the expressed written consent of Patriot Environmental Laboratory Services, Inc. This report may not be used to claim product certification, approval or endorsement by NIST, NVLAP, ELAP or any government agency. Page 9 of9 ab Us~ Only:· 11 (Jt;Q I tel· 4t8-45l-9700 ~-85S-!4HSOO fall • 408-lll8-G945 um Around_ 1:11_!!?: }ERS ~HRS Pal!lollab.CDDI ZIB6 Pl!i!lOD DriYe, san !Ille, CA 95131 ) 48 HRS { ) 72 HRS . ASBESTOS FIELD SULK SAMPLE COC ' oJect ~i9: · .t ~ . · · ·.;.lo~. ·Xi. '3\M~I \Qt I Proj~\2'\ ~'3 ·oject At'~\s: 1, f\ • .,.. .~M-te· 1 ,$) City:$(Ar-\,s\ J. · "7""0\· '·-, Office Use Only: ' □MH ~ R" · .. ~ unple Sample Location . Material Type F NF Condition Notes ID •· . \ \.o'd..., \.>..la\\ . ~\~C x \i'C)oa ' 2-\ I ' .,l.r•,.e. ~\ - 3 /1, rCJ. R~'Ch I -~ lt _..,., ' lol(o .... I .r\ "l'1P'" ' ~ 5 ~--. o .. _ .... ...... -- I~ ' .. -cf/(,,..,.., ,._, / ' ' (o -. .f.\,...._'(" ~"" ..... , .. _ ~ 4 • "" -'' ' 1• ~ ,· 1-• ~ n, ,t..i... rm"iA..-'2.. ~\-me ' ' "I wvn.-. ' 9 • l'\,..c..ra.nc..~ ~-.. ' \() \_o\\..,, ~ I -...... ..... ~ 1:111-X'i i;" • - ,_ \ \\\2. '"" --\\ 2. W1=1\ \ I •• • • A )( \~\* ()[~-·-¼\'-\ ~ ' . \5,\\o ..... 1'19"""· ~c.-e. CJ>'· ~ \/Jil)\\ -.. • 2; • ~-,1 un, ·r r. •:25P \1 I .. \...hi · ~\\re :"It 't r,1;;.,· '~. --,( \, \ " -Vb CtmJ..of 'll \ ' .L ' \q 0\li!n.~M_Oe .. _ .. .. . ~~~ .'!"!:~' ~1" .• 1,°'1,\ ~-~-~\m< ./ ' ' • i,;l,(Z.., '1, T v v \ .L r ' r , Samuled/Relinaulshed Bv: Sion: ~ • I • ~ Dat-1 ' l'1 Time: . r I..YYL Samples Received By: Sign: \\ A • " . I ..... Date: /J r-r•· /V'l Time: I Page'-"' t" -~f ~~ • 1 Bulk Sa p leCOCRev 12.27.2017 3ample ID Sample Location · ,.,aterlal Type F NF Condition Notes ---"-+----------+--""~----4;,;..;....;;..+-+___.;H+:&..,.;:..:,.,.P,;:.:.-.-'----'--l ... ---i--__:.__~~~~ Sam Sam Date Date:, Bull<. Sample COC Rev 1227.2017 OFFICE USE ONLY SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE RECORD ID #-~=---~------------I PLANcHEcK# C'3c 2019-43u. BP DATE -·2'2-o D The following questions rep sent 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 1 O. 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 11: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH -HAZARDOUS MATERIALS DIVISION (HMO): 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: 1. 2. 3. 4. 5. 6. 7. 8. YES NO (for new construction or remodeling projects) D B' ls your business listed on the reverse side of this form? (check all that. apply). D Er' Will your business dispose of Hazardous Substances or Medical Waste in any amount? D [3' Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 D D D D D pounds and/or 200 cubic feet? [3" Will your business store or handle carcinogens/reproductive toxins in any quantity? N Will your business use an existing or install an underground storage tank? Q-Will your business store or handle Regulated-Substances (CalARP)? [3" Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? [§/ Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to or reater than 1,320 gallons? (California's Aboveground Petroleum Storage Act). 0 CalARP Exempt I Date Initials 0 CalARP Required I Date Initials 0 CalARP Complete I Date Initials PART 111: 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 01 Yes and 03 Yes and 04-06 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. rExcludes garages & small outbuildings.] YE$. N□O 1. [3 Will the project disturb 160 square feet or more of existing building materials? 2. Q,, !il' Will any load supporting structural members be removed? Notification may be required 1 O working days prior to commencing demolition. 3. t:::::l D (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. D G" (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification may be required 1 O working days prior to commencing asbestos removal. 5. D s' 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. D D (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school bounda Briefly describe proposed project: du-no ~i,st,o(I 1.1.:o-llS •• tln,s1~ 1'Y"!10c, lie responses ma e herein are true and correct. Qf.Q I 24 t2'.0(v Date FOR OFFICAL 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-HMO* APCO COUNTY-HMO APCO COUNTY-HMO APCO . A stamp m this box only exempts busmesses from completing or updatmg a Hazardous Materials Business Plan. Other permitting requirements may still apply . HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division