HomeMy WebLinkAbout2714 Loker Ave W; 100; CBC2018-0167; Permit(city of
Carlsbad
Print Date: 08/28/2018
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
2714 Loker Ave W, 100
BLOG-Commercial
2090813200
$246,782.06
Commercial Permit
Work Class: Tenant Improvement
Lot#:
Reference #:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
Description: VERTIFLEX: 5,306 SF Tl OFFICE TO OFFICE (COMBINES SUITE 100, 110 ANO 120)
Applicant: Owner:
Status:
Applied:
Issued:
Permit
Finaled:
Inspector:
Final
Inspection:
Contractor:
Permit No: CBC2018-0167
Closed -Finaled
03/28/2018
05/24/2018
MColl
8/28/2018 3:28:07PM
OK BARNETT CONSTRUCTION INC
DAVID BARNETT
BLUE HAT LLC DK BARNETT CONSTRUCTION INC
760-599-4393
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
6965 El Camino Real, 105
CARLSBAD, CA 92009
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
GREEN BUILDING STANDARDS PLAN CHECK & INSPECTION
MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
5B1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-COMMERCIAL
Total Fees: $2,344.45 Total Payments To Date: $2,344.45
2420 Grand Ave
Vista, CA 92081-7808
760-599-4393
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 APPL V 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.
$0.00
1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
$1,147.85
$803.50
$89.00
$170.00
$55.00
$10.00
$69.10
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: •PLANNING •ENGINEERING •BUILDING •FIRE •HEALTH OHAZMAT/APCD
Ccicyof Building Permit Application Plan Check No. 11
~ "'Y'\\i-Ollo]
1635 Faraday Ave., Carlsbad, CA 92008 Est. Value . }fl o, ''6"oll(J(.,..
Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@car\sbadca.gov
www.carlsbadca.gov Date:~ l:J;i(f/X ISWPPP
JOB ADDRESS 2714 Loker Avenue West, Carlsbad, CA 92010 SUITE#/S~UNITi OC'\ !"" 209 -08 -132 -00
CT/PROJECT# I LOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROQ,.,.., I TENANT 1:SUSINESS NAME I CONSTR. TYPE I occ. GROUP
Vertiflex V-B
DESCRIPTION OF WORK: fncfude Square FHt of Affected Area(s)
Remodel of interior office space. Work to be moning of non bearing walls, majority of walls to be remaining. No change to ,
occupant load, HVAC s7~~.% reused No exterior modifications.
EX.STING USE I PROPOSED USE I GARAGE \Sf} PATIOS (SF) I DECKS (SF) FIREPLACE IA1R CONDITIONING I FIRE SPRINKLERS
B, F1, S1 B, F1, S1 N/A N/A N/A YES0, N<0 YES0NoO YES0N0O
APPLICANT NAME David Barnett (D.K, Barnett Construction, Inc,) PROPERTY OWNER NAME Blue Hat LLC Primary Contact
ADDRESS ADDRESS
2420 Grand Avenue, Suite F-1 6965 El Camino Real, Suite 105-921
CITY STATE ZIP CITY STATE ZIP
Vista CA 92081 Carlsbad CA 92009
PHONE !FAX PHONE l'AX 760/519-3390 760/599-4428 760/888-0239
EMAIL EMAIL dave@barnettconstruction.net
DESIGN PROFESSIONAL Kobra Design (Herman Jack Ajamian) CONTRACTOR BUS. NAME D. K. Barnett Construction. Inc.
ADDRESS ADDRESS
10184 Kinabird Avenue 2420 Grand Avenue, Suite F-1
CITY STATE ZIP CITY STATE ZIP
Fountain Vallev CA 92708 Vista CA 92081
PHONE PHONE
714/313-6815 l'AX 714/962-5315 760/599-4393 I 'AX 760/599-4428
EMAIL EMAIL
hi a@kobradesian.net dave@barnettconstruction.net ! STATE UC.# STATE UC.# !CLASS B l CITY BUS. UC.# 688410
(Sec. 7031.5 Business and ProtessIons Code: Any City or County which requires a permit to construct, alter, improve. demolish or repair any structure, prior to its issuance, also requires the
applicant 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 the Business and Professions Code} or that he is exempt therefrom, and the basis for the alleged exemption. Any violation Of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500)).
WORKERS" COMPENSATION
Workers' Compansalion Declaration: I hereby affirm under penalty of perjury one of the folloWlng declarations: 0 I have and wlll maintain a certificate of consent lo self-insure for worl<ers' compensation as provided by Section 3700 of the Labor Code, for the performance of the worl( for which this permit is issued. 0 I have and will maintain workers' compensation, as required by n 3700 of the Labor Code, for the performance of the wo!I( for which this permit is issued. My wo!l(ers' compensation insurance carrier and policy
number are: Insurance Co. _____ ___c __ _,,__,t.C---'--=------Policy No. 463876479193 Expiration Date 111/2019
~section need not be completed if the permit is for one hundr dol rs ($100) or less. LJ Certificate of Exemption: I cerufy that in the performance ft wo!I( for which this permit is issued, 1 shaP not employ any person in any manner so as to become subject to the Worl(ers· Compensation Laws of
California. WARNING: Failure to secure wor1ms' cornpen on coverage Is unlawful, and shall subject an employer lo criminal panattias and cMI fines up lo one hundred thousand ollars (&100,000), In
addition to the cost of compensation, damages as provld r In Section 3706 of the Labor code, interesl and attorney's leas .
.6$ CONTRACTOR SIGNATURE
/ hereby affirm that I am exempt from Contractor's License Law for the following reason: D I, as owner of the property or my employees w1lh wages as their sole compensation, will do the wo!I( 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 buik:ls or improves thereon, and who does Sl!Ch wo!I( 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 ~censed contractors to construct the project (Sec. 7044, Business and Professions Code: The Conlracto(s License Law does not apply to an owner of
property who builds or improves thereon, and contracts for such projects with contractor(s) icensed pursuant to the Contractor's License Law).
I am exe1Tl)t under Section ____ Business and Professions Code for this reason:
1. I personally plan to provide the ma,or labor and materials for construction of the proposed property improvement. OYes Oo
2. I (have I have not) signed an application hr a building permit for the proposed work. ,
3. I have contracted with the following person (flrm) to provide the proposed construction (include name address I phone/ contractors' license number):
4. I plan to provide portions of the wo!I(, but I have hired the follOWing person to coordinate, s~rvise and provide the major wo!I( (include name I address I phone I contractors' license number)·
5. I will provide some of the wo!I(, but I have contracted {hired) the following persons to provide the wo!I( indicated {include name I address I phone I type ofwo!I():
~ PROPERTY OWNER SIGNATURE •AGENT DATE
'
, PERMIT INSPECTION HISTORY REPORT (CBC2018-0167)
Permit Type: BLDG-Commercial Application Dato: 0312812018 Owner:
Work Class: Tenant Improvement Issue Date: 05/24/2018 Subdivision:
Status: Closed -Finaled Expiration Dato: 0211912019 Address:
IVR Number: 10406
Actual Scheduled
Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector
08/23/2018 08/23/2018
08/28/2018 08/28/2018
August 28, 2018
BLDG-Final
Inspection
BLDG-Final
Inspection
Checklist Item
BLDG-Building Deficiency
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
BLDG-34 Rough Electrical
BLDG-44
Rough-Ducts-Dampers
067936-2018
Checklist Item
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
068314-2018
Checklist Item
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
BLDG-Electrical Final
COMMENTS
Pending Fire Dept. approval of overhead.
Partial Pass Michael Collins
COMMENTS
See card for pick up notes. Ok to set up
furniture & IT
Passed Michael Collins
COMMENTS
See card for pick up notes. Ok to set up
furniture & IT
BLUE HAT LLC
PARCEL MAP NO 18720
2714 Loker Avew , 100
Carlsbad, CA 92010-6640
Reinspection
Passed
Yes
Yes
Yes
Yes
Reinspection
Passed
No
No
No
No
No
Passed
No
Yes
No
No
No
Yes
No
Complete
Incomplete
Complete
Page 2 of 2
, PERMIT INSPECTION HISTORY REPORT (CBC2018-0167)
Permit Type: BLOG-Commercial Application Date: 0312812018 Owner:
Work Class:
Status:
Scheduled
Date
06/22/2018
06/26/2018
07/19/2018
07/25/2018
08/08/2018
August 28, 2018
Tenant Improvement Issue Date: 05/2412018 Subdivision:
Closed -Finaled Expiration Date: 02/1912019 Address:
Actual
Start Date
06/22/2018
06/26/2018
07/19/2018
07/25/2018
08108/2018
IVR Number: 10406
Inspection Type Inspection No.
BLDG-21 061821-2018
Underground/Underf
loor Plumblng
Checklist Item
BLDG-Building Deficiency
BLDG-31 061963-2018
Underground!Condu
it-Wiring
Checklist Item
BLDG-Building Deficiency
BLDG-84 Rough 061847-2018
Combo(14,24,34,44)
Checklist Item
BLDG-Building Deficiency
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
BLDG-24 Rough-Topout
BLDG-34 Rough Electrical
BLDG-17 Interior 062157-2018
Lath/Drywall
Checklist Item
BLDG-Building Deficiency
BLDG-84 Rough 064459-2018
Combo(14,24,34,44)
Checklist Item
BLDG-Building Deficiency
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
BLDG-24 Rough-Top out
BLDG-34 Rough Electrical
BLDG-34 Rough Electrical
BLDG-17 Interior 064914-2018
Lath/Drywall
Checklist Item
BLDG-Building Deficiency
BLDG-Building Deficiency
BLDG-85 T-Bar, 066345-2018
Ceiling Grids,
Overhead
Inspection Status Primary Inspector
Passed Michael Coll\ns
COMMENTS
Phase 1 sink waste at Rm 210
Passed Michael Colllns
COMMENTS
Conduit only at Rm 214
Partial Pass Michael Collins
COMMENTS
Phase 1 wall frame at Rm 210 & 214 only
Partial Pass Michael Collins
COMMENTS
1st phase walls only at Rm 210 & 214
Passed Michael Collins
COMMENTS
Phase 1 wall frame at Rm 210 & 214 only
Suite 100, Rm 151-152
Passed Michael Collins
COMMENTS
1st phase walls only at Rm 21 O & 214
Phase 2 walls
Passed Michael Collins
BLUE HATLLC
PARCEL MAP NO 18720
2714 Loker Avew , 100
Carlsbad, CA 92010-6640
Reinspection
Passed
Yes
Passed
Yes
Reinspection
Passed
Yes
Yes
Yes
Yes
Reinspection
Passed
Yes
Passed
Yes
Yes
Yes
Yes
Yes
Yes
Passed
Yes
Yes
Complete
Complete
Complete
Incomplete
Incomplete
Complete
Complete
Complete
Page1of2
DATE: 5/16/2018
JURISDICTION: Carlsbad
PLAN CHECK#.: CBC2018-0167
✓• EsG1I
A SAf.l;bu1lt Company
SET II
PROJECT ADDRESS: 2714 Loker Avenue west
PROJECT NAME: Office and Lab area T.I.
• APPLICANT • JURIS.
[:8:J The plans transmitted herewith have been corrected where necessary and substantially
comply with the jurisdiction's codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed
check list and should be corrected and resubmitted for a complete recheck.
D The check list transmitted herewith is for your information. The plans are being held at
EsGil until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the
applicant contact person.
D The applicant's copy of the check list has been sent to:
[:8:J EsGil staff did not advise the applicant that the plan check has been completed.
0 EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: / Telephone#:
Date contacted: / (by~ ) Email:
Mail Telephone Fax In Person
0 REMARKS:
By: Morteza Beheshti
EsGil
5/8
Enclosures:
'
DATE: 4/9/2018
JURISDICTION: Carlsbad
PLAN CHECK#.: CBC2018-0167
✓• EsG1I
SETI
PROJECT ADDRESS: 2714 Loker Avenue west
PROJECT NAME: Office and Lab area T.I.
~ ~PLICANT
/,uRIS
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's codes
when minor deficiencies identified below are resolved and checked by building department staff.
D 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
until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
D EsGil staff did not advise the applicant that the plan check has been completed.
~ EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: Dave Barnett Telephone#: 760.519.3390
Date contac L\}l0 (by@ ) Email: dave@barnettconstruction.net
Mail Fax In Person
0 REMARKS:
By: Morteza Beheshti
EsGil
4/2
Enclosures:
9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO.: CBC2018-0167
OCCUPANCY: B,Fl,Sl
TYPE OF CONSTRUCTION: V-B
ALLOWABLE FLOOR AREA:
SPRINKLERS?: Yes
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION:
DATE INITIAL PLAN REVIEW
COMPLETED: 4/9/2018
FOREWORD (PLEASE READ):
JURISDICTION: Carlsbad
USE: Office
ACTUAL AREA: 5306
STORIES: 1
HEIGHT:
OCCUPANT LOAD: 75
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 4/2
PLAN REVIEWER: Morteza Beheshti
This plan review is limited to the technical requirements contained in the California version of
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 2013 CBC, which adopts the 2012 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 2012 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.
GENERAL
1. Please make all corrections and submit two new complete sets of prints, to:
EsGil, 9320 Chesapeake Drive, Suite 208, San Diego, California 92123, (858)
560-1468.
EXITS
2. Exit doors shall swing in the direction of exit travel when serving a room
containing an occupant load of 50 or more persons or a Group H occupancy.
Section 1010.1.2.1.
3. All doors and gates, within the exit path to a public way from an occupancy of
Group A or E having an occupant load of 50 or more (and any occupancy of
Group H) shall not be provided with latches or locks unless they are equipped
with panic hardware. Sections 1010.1.10 and 1010.2.
EXIT SIGNS
4. Exit signs are required whenever two exits are required. Show all required exit
sign locations. Section 1013.1.
ENERGY CONSERVATION
5. Include light fixture tag or label on the forms. Plans to match.
6. Multilevel lighting controls are required in areas exceeding 100 square feet in
area and have a connected general lighting load exceeding .5 watts per square
foot (Classrooms are . 7 watts). Review ES Table 130.1-A for design
requirements. Include control placement and design on the floorplans. (AB
switching no longer complies for most fixture types).
7. Shut-Off Controls: Each floor, each space (not exceeding 5,000 square feet),
and each type (general, display, and ornamental) of lighting shall be individually
capable of being automatically shut-off when the building is unoccupied. Include
the control design. (A percentage of egress lighting is now included in the shut-
off requirement). ES 130.1 (c)
8. Generally, automatic daylighting with multilevel lighting control is required for
general lighting in daylit zones. Please provide the locations and control design.
ES 130.1 (d) Be sure to review the following three exceptions for project
applicability:
• Rooms that do not require automatic daylighting:
• Rooms with no more than 120 watts of lighting in the skylit and primary
sidelit zones combined.
• Rooms with less than 24 square feet of glazing.
a. Rooms that require automatic daylighting but not multilevel lighting levels
• Rooms with a lighting power density of 0.3 watts/sq.ft.
ELECTRICAL
9. Please provide electrical power and lighting design for review.
10. Submit plan showing location of all panels used and provide a schedule for each
panel used.
11. GFI outlets within 6' of sinks.
12. A GFCI protected receptacle outlet is required within 25 feet and on the same
level as the mechanical equipment (heating, air-conditioning, and refrigeration
equipment). Please include on the plans. NEC 210.63.
MULTIPLE ACCOMMODATION SANITARY FACILITIES
13. Show that at least one water closet fixture, located in a compartment, shall provide
the following, per Section 11 B-604:
a) The compartment shall be a minimum of 60" wide. Also, there shall be
provided a clearance of at least 59" in front of the water closet for floor-
mounted water closets (56" for wall-mounted water closets).
b) One side of the water closet shall provide 17" -18" from the centerline of
the water closet to the adjacent compartment wall.
c) For water closet compartments having side-opening doors, compliance with
the following figure must be shown on the plans. The door shall be in the
partition farthest from the water closet and shall be 4" maximum from the
front partition.
To speed up the review process, please note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If there are other changes. please briefly
describe them and where they are located in the plans.
Have changes been made to the plans not resulting from this correction
list? Please indicate: • Yes • No
The jurisdiction has contracted with EsGil, 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 Morteza Beheshti at Esgil. Thank you.
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad
PREPARED BY: Morteza Beheshti
PLAN CHECK#.: CBC2018-0167
DATE: 4/9/2018
BUILDING ADDRESS: 2714 Loker Avenue west
BUILDING OCCUPANCY:
BUILDING AREA Valuation Reg.
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb By Ordinance
--------------------
1997 UBC Building Permit Fee ...,
. -;_]
1997 UBC ~~~n Check F~~ _"."'_J
Type of Review: Complete Review
VALUE
D Structural Only
D Repetitive Fee
-..,.] Repeats
0 Other
D Hourly
EsGil Fee f-----lHr. @ •
Comments:
($)
246,782
246,782
$654.31 \
Sheet of
D
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS
QUESTIONNAIRE
OFFICE USE ONLY
RECORD ID#
PLAN CHECK-# .,...ll,_f_,.,E""?n-on1-ni-~--r+.,.,,-0,..,Bcr-fl:61"1P...-1"'o""LDr-::3 ...... '6"'8-1
BP DATE
APN#
Plan FIie#
13. Corrostves
14. Other Health Hazards
15. None of These.
q~ ons Is yes, app cant must contact the ounty an ego
call (858) 505-6700 prior to the issuance r:I a bulkllng permil
FEES ARE REQUIRED Project CompleUon Date: Expected Dale of Occupancy: 0 CalARP E,cempt
1.
2.
3.
4.
5.
6.
7.
8.
YES NO (for new construction or remodeling projects)
Is your business isled on the reverse side of this fonn? (check all that apply). • @ • @ WiU your bustness dispose of Hazardous Substances or Medical Waste In any amount? • El Will your business store or handle Hazardous Substancas in quantitl8$ greater than or equal to 55 gallons, 500
pounds end/or 200 cubic feet?
B • • •
13 Will your business store or handle carcinogens/reproductive toxins In any quantity? ~ Will your busin&11 use an existing or Install an underground storage tank?
ID Win your business store or handle Regulated Substance$ (CalARP)?
(i3 Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)?
B WII your business store peb'oleum In lanks or containers at you, fac:llty with a total faclllty slorage capacity equal to
or ater than 1 320 anons? C&llfomla's Above round Petroleum Sto Act .
Date lnitla18
0 CalARF Required
Dale lnilialS
0 CalARF Complete
Date .....
• Any YES· answer requires I
ego, CA 9 1 1 . rNo stamp required If 01 Yes i!ISt Q3 Yes pJ~fftll!iiwnG-CWld~ IN.end
to identify the ma)ority of air p utlon issues at the nnlng stage. Projects may require additional measures ldenlified~~d~"Cbinprehensi
requirements contact APCO. Residences are typk:aly exempl, except -those with more than one bulldlng• the property; single ~ with more than fo
dwalHng units; townhomes; condos; mixed-commercial use: deliberate bums; resk:lencea forming part of a la project. ["Excludes glJritgai-& small outbulldlnga
YES NO \00
1. D D wm the project dlsturb"ffl&squere feet or mOJB of existing buliding materiels?
2. D O Will any load supporting structural members be removed? Notification may be required 10
3. 0 0 (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos sUJVey been pertonnad by a
4. •
5. •
Technician? 0 (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project dl&IU
may be required 10 working days prior to commencing asbestos removal. D Wil the projed or auociated construction equipment emit air contaminants? See lhe reverse
(www,sd@DGd-ora/infplfacts/permlts.DdO for typical equipment requiring en APCD permit.
ng days prior M~n~i~nuon.
rtified Asbealos Consultant or Site Surveillanc
8. • 0 (ANSWER ONLY IF QUESTION 5 IS YES) WIii the project or aasoctated ccnslructlon equipment be located within 1,000 feat of e school
bounda
Name of Owner or Authorized A ent nt Date
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ____________________________ _
BY: DATE:
RELEAIIEO FOR BUA.DINO PSIMIT BUT NOT FOR OCCUPANCY RELEASED FOil OCCUPANCY
APCO COUNTY-HMO APCO COUNTY-HMO APCO
mpts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may sUII apply.
HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division