HomeMy WebLinkAbout2808 ROOSEVELT ST; ; CB910593; PermitB U I L D I N G P E R M I T . Permit No: CB910593
04/24/91 13:00 . Project No: A9100703
Page 1 of I Development No:
Job Address: 2808 ROOSEVELT ST Str.: Fl:, Ste:
Permit Type: COMMERCIAL TENANT IMPROVEMENT - 2057 04/24/91 0001 01 02 Parcel No: 203-182-04-00 C-MT 88.00-
Valuation: 38,499 --
Construction Type: VN
Occupancy Group: B2 Class Code: •. Status: ISSUED
Description: 1878 SF OFFICE JMTELEVISION .-- Applied: 04/08/91
Apr/Issue: 04/24/91
- . Validated By CD
Appl/Ownr : WHITE CONSTRUCTION 619 753-9272
7720 EL CAMINO REAL
CARLSBAD, CA 92009
OWNER : YELLAND PROPERTIES .' f\ Li~'> OWNER 714 472 2495
23282 HILLCREKRD _
LAGUNK HILI'S, CA2'53 J.cç/) -
*** Fees Required /** Fees' Coi'ected &Credits
Fees: / 611\.O0/" \'6°) \ .
Adjustments:. / /L .óo . %M`t~'otal Credits: \ . . .00
Total Fees: 6t1'00 -- \ 223.00
7 Due: . 38.00
Fee description ( Ext fee Data
Buildirtg Permit 'TLPlan Check 223.00 7 ji )343.00
Strong Motion Fee \ ... \\ 1 fi $' / / 6.00
* BUILDING TOTAL. \ '\ // /C-- / . 572.00
Enter UH for Plumbing Issue\FeèIb(>JOO,OO .7 / N
Enter "Y" for Electric Issue Fee > '°" V - 5.00 Y.
Enter IIH for Remodel\ -2 \S / 10.00 Y
* ELECTRICAL TOTAL ($10\M11rn)8 / 15.00
Enter 'Y' for MechanicalNIsueF,e .- Oi\s 7' 15.00 Y
Install Furn/Ducts ) \•-/ 1.00- 9.00 9.00
* MECHANICAL TOTAL . - __ . . 24.00
- /'L APPROVAL
S tNsIc .
CLEARANCE
-
:.
-
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 . . .
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
1. PERMIT TYPE OR I
A - p COMMERCIAL qNEW TENANT IMPROVEMENT
B 0 INDUSTRIAL 11 NEW DTENANT IMPROVEMENT
C - DRESIDENTIAL (I APARTMENT [-]CONDO [-]SINGLE FAMILY DWELLING DADDITION/ALTERATION
DDUPLEX ODEMoLITIoN DRELOCATION []MOBILE HOME DELECTRICAL []PLUMBING
DMECHANICAL DPOOL [-]SPA [-]RETAINING WALL [-]SOLAR DOTHER
- - - ..
EST. VAL 9 C1
PLAN CX DEPOSIT
VALID. BY BY 1 C
DATE
i.xF IJØ/ 7.1 1J. Lii
Address
egkne r.
suitaing or suite NO.
Nearest Cross Streets 944t7 Jë1
Calcs
ASSESSOR'S PARCEL — EXISTING USE PROPOSED USE
W4t' /
BLDG. SO. FIG.
3. CONTACT P
j9, i-f4 11-44 ,/ P'A/W ffT-4 -r i-n
,, 1' Wfl2-l 4<L-' Wrr~HJ 4*k9
(1 #OFST0RIES/Y
ERSON - P-1 4J ADDRESS 71' %/;44 jPO-
CITY ST,TEN ZIP CODE DAY TELEPHONE -'L9— 0I 717L3
SIGNATURE
DAGENT FOR CONTRACTOR DOWNER ,AGENT FOR OWNER
ADDRESS
STATE 45A ZIP CODE DAY TELEPHONE
0 LESSEE DTENANV'
CITY[4[.1W _fl_ DAY TELEPHONE STAT EA ZIP CODE
I
___________________
77 7(4
CONTRACTOR 6. NAME '444' p4J
CITY STATE.
STATE LIC. #____________
SIGNATURE TITLE DATE
DESIGNER NAME '4J (3ø KIA
CITY STATE i,.ZIP CODE __DAY TELEPHONE
-
-WoFk—ers- Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of Industrial Relations,
or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the
insurer thereof filed with the Building Inspection Department (Section 3800, Lab. Q.
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
Certificate of Exemption: I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner
so as to became subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNER-BUILDER DECLARATION
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
D 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 Cede: 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 sate.).
0 I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cede:
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).
0 I am exempt under Section Business and Professions Code for this reason:
(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 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, commencing with Section 7000 of Division 3 of the Business and Professions Cede) 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 (55003).
SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
DYES ONO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
DYES ONO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
DYES DNa
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY RAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS PET OR IS MEETING THE REQUIREMENTS
OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROl. DISTRICT.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
APPLICANT'S SIGNATURE I certify that I have read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating
to building construction. I hereby authorize representatives 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, JWONENTS, COSTS AND EXPENSES WHICH RAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
Expiration. Every permit issued by the Building Official under the provisions of this Cede 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 any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
APPLICANT'S SIGNATURE JNER DCONTRACTOR DBY PHONE APPROVED BY.
1Pass-71'4.L4_.4 DATE:
?fr' / ,t ?g1.1 tWHITE: File YELLOW: Applicant PINK: Finance
APPLICANT OCONTRACTOR NAME 7/7
CITY L9
PROPERTY OWNER
NAME %460'1 , ..o Lt7
ADDRESS 77
ZIP CODE e .7ll1 DAY TELEPHONE
LICENSE CLASS CITY BUSINESS LIC.
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB910593 FOR 05/30/91
DESCRIPTION: 1878 SF OFFICE JM TELEVISION
TYPE: CTI
JOB ADDRESS: 2808 ROOSEVELT ST
APPLICANT: WHITE CONSTRUCTION
CONTRACTOR:
OWNER: YELLAND PROPERTIES
REMARKS: RS/TRAVIS/931-1130
SPECIAL INSTRUCT:
INSPECTOR AREA PD
PLANCK# CB910593
0CC GRP
CONSTR. TYPE VN
STR: FL: STE:
PHONE: 619 753-9272
DUfThTt'.
PHONE: 714 47 AGR
INS PECTOR________________________
TOTAL TIME:
--RELATED PERMITS-- PERMIT# TYPE STATUS
SE900163 SWCI ISSUED
CD LVL DESCRIPTION
19 ST Final Structural
29 PL Final Plumbing
39 EL Final Electrical
49 ME Final Mechanical
ACT COMMENTS
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
050391 Interior Lath/Drywall AP TP
050291 Interior Lath/Drywall PA PD
050191 Frame/Steel/Bolting/Welding PA PD
050191 Rough Electric PA PD
RECEIVED MAY 31 1,%l
FIN
,
J-BVT NG INSPECTION
DEPT: BUILDING ENGINEERING tFIRE PLANNING U/M WATER
PLAN CHECK#: CB910593 DATE: 05/30/91
PERMIT#: CB910593 PERMIT TYPE: CTI
PROJECT NAME: 1878 SF OFFICE JM TELEVISION
ADDRESS: 2808 ROOSEVELT ST
CONTACT PERSON/PHONE#: TRAVIS/931-1130
SEWER DIST: CA WATER DIST: CA
INSPECTE DATE
BY: Ll____ INSPECTED: APPROVEDIZ DISAPPROVED
INSPECT DATE
BY: INSPECTED: APPROVED - DISAPPROVED -
INSPECTED DATE
BY: INSPECTED: APPROVED - DISAPPROVED -
COMMENTS:
.7,i''," . - - --.- - %- p.. •!p_L!*P, . .. - -
--..
ESGIL. CORPORATION
9320 CHESAPEAKE DR., SUITE 208
SAN DIEGO, CA 92123
(619) 560-1468
DATE: 4(o\( DAPPL1CA.N
.NZURLSDI CTPLO-
JURISDICTION: J IAN CHECKER
DFILE COPY
PLAN CHECK NO: SET: E.tJPS
DESIGNER
PROJECT ADDRESS: _
PROJECT NAME:O
The plans plans transmitted herewith have been corrected where
L necessary and substantially comply with the jurisdiction's
building codes.
D The plans transmitted herewith will substantially comply
with the jurisdiction's building codes when minor deficien-
cies identified are resolved and
checked by building department staff.
U The plans transmitted herewith have'-significant deficiencies
identified on the enclosed check list and should be corrected
and resubmitted for a complete recheck.
Li The check list transmitted 'herewith is for your information.
The plans are being held at Esgil Corp. until corrected
plans are submitted for recheck.
Li The applicant's copy of the check list is enclosed for the
jurisdiction to return to the applicant contact person.
The applicant's copy of the check list has been sent to:
Esgil staff did not advise the applicant contact person that
plan check has been completed. -
[j Esgil staff did advise applicant that the plan check has
been completed. Person contacted:_______________________
Date contacted: Telephone
[].REMARKS:. .
D fl
By: .J(fi GL4i&) Enclosures:rLr-l4
ESGIL CORPORATION
GA DAA EIRN -D DM 7'9
141
Dates 4(01 0 Jurisdiction- CA.&L,5SftQ
Prepared by: Bldg. Dept.
VALUATION AND PLAN CHECK FEE 0 Esgil
PLAN CHECK NO. _)-S3
BUILDING ADDRESS ossr' Sr,
APPLICANT/CONTACT 4i) tPHONE NO. 43o zo
BUILDING OCCUPANCY bAi_r DESIGNER PHONE It
TYPE OF CONSTRUCTION CONTRACTOR PHONE__________
BUILDING PORTION BUILDING AREA VALUATION
MULTIPLIER
VALUE
• 47, ________
• ..• 1
Air ConditioninE
Commercial
Residential-
-
Res. or Comm.
Fire Sorinklers •
Total Value
Buildirid Permit Fee. $_ • 3.00 • •
••
Plan Check Fee $ $
COMMENTS
SHEET OF 12/87
Z[:] [:] 3.
BUILDING PLNCHECK
ENGINEERING CHECKLIST
DATE: 19) /PR C)) ZITEM- COMPLETE
PLANCHECK NO. 91 ITEM INCOMPLETE
NEEDS YOUR ACTION
3 OOSVB-r ITEM SELECTED
R
D
C C C
H H H
E E E
K K K
[Z El El
PROJECT ID:___________________________
LEGAL REQUIREMENTS
Site Plan
1. Provide a fully dimensioned site plan drawn to scale.
Show: north arrow, property lines, easements, existing and
proposed structures, streets, existing street improvements,
right-of-way width and dimension setbacks.
Show on site plan: Finish floor elevations, pad
elevations, elevations of finish grade adjacent to
building, existing topographical lines, existing and
proposed slopes, driveway with percent (%) grade and
drainage patterns.
Provide legal description and Assessors Parcel Number.
Discretionary Approval Compliance
No Discretionary approvals were required.
Project complies with all Engineering Conditions of
Approval for Project No._________________
Project does not comply with the following Engineering
Conditions of Approval for Project No.___________________
Conditions complied with by: Date:________
WA Field Review
E 7. Field review completed. No issues raised.
8. Field review completed. The following issues or
discrepancies with the site plan were found:
A Site lacks adequate public improvements
Existing drainage improvements not shown or in
conflict with site plan.
Site is served by overhead power lines.
P:\D0CS\M1SF0RMS\FRM0010.DH REV. 02/27/91
Grading is required to access site, create pad or
provide for ultimate street improvement.
Site access visibility problems exist. Provide ônsite
turnaround or engineered solution to problem.
ELIE F. Other:
Dedication Reauirements
LI LI. 9. No dedication required.
LI LI LI 10. Dedication required. Please have a registered Civil
Engineer or Land Surveyor prepare the appropriate legal
description together with an 8½" x 11" plat map and submit
with a title report and the required processing fee. All
easement documents must be approved and signed by owner(s)
prior to issuance of Building Permit. The description of
the dedication is as follows:__________________________
Dedication completed, Date By:
Improvement Reauirements
LI LI No public improvements required. SPECIAL NOTE: Damaged or
to occupancy.
LI LI E12• Public improvements required. This project requires
construction of public improvements pursuant to Section
18.40 of the City Code. Please have a registered Civil
Engineer prepare appropriate improvement plans and submit
for separate plancheck process through the Engineering
Department. Improvement plans must be approved,
appropriate securities posted and fees paid prior to
issuance of permit. The required improvements are:_______
Improvement plans signed, Date: by:
P : \DOCS\MISFORMS\FRMOO1O.DH REV. 02/27/91
r
E E 13. Improvements are required. Construction of the public
improvements may be deferred in accordance with Section
18.40 of the City Code. Please submit a letter requesting
deferral of the required improvements together with a
recent title report on the property and the appropriate
processing fee so we may prepare the necessary Future
Improvement Agreement. The Future Improvement Agreement
must be signed, notarized and approved by the City prior to
issuance of a Building Permit.
Future Improvement Agreement completed, Date:_____________
By:_____________________
E E 13a. Inadequate information available on site plan to make a
determination on grading requirements. Please provide more
detailed proposed and existing elevations and contours.
Include accurate estimates of the grading quantities (cut,
fill, import, export).
No grading required as determined by the information
provided on the site plan.
Grading Permit required. A separate grading plan prepared
by a registered Civil Engineer must be submitted for
separate plan check and approval through the Engineering
Department. NOTE: The Grading Permit must be issued and
grading substantially comolete and found acceDtable to the
City Inspector prior to issuance of Building Permits.
Grading Inspector sign off. Date: by:
Miscellaneous Permits
81110 16. Right-of-Way Permit not required.
E E EJ 17. Right-of-Way Permit required. A separate Right-of-Way
Permit issued by the Engineering Department is required for
the following:
El 18. Sewer Permit is not required.
El El E 19. Sewer Permit is required. A sewer Permit is required
concurrent with Building Permit issuance. The fee required
is noted below in the fees section.
El 20. Industrial Waste Permit is not required.
P:\DOCS\H1SFORNS\FRNOO1O.DH REV. 02/27/91
Industrial Waste Permit is required. Applicant must
complete Industrial Waste Permit Application Form and
submit for City approval prior to issuance of a Building
Permits. Permits must be issued prior to occupancy.
Industrial Waster Permit accepted
Date: By:
Fees Reauired
0 N/14 27. Park-in-Lieu Fee
Quadrant: Fee per Unit:
Total Fees:-
[-] NIP 23.
ON/A 24.
25.
Traffic Impact Fee
Fee Per Unit: Total Fee:
Bridge and Thorough fare Fee
Fee Per Unit: Total Fee:
Public Facilities Fee required.
ON/A 26. Facilities Management Fee Zone: Fee:____
[I N/A 27. Sewer Fees Permit No. EDU's_______
Benefit Area: Fee:_______________
28. Sewer Lateral Required:
Fee:_________________
0 29. REMARKS:________________________________________
ENGINEERING AUTHORIZATION TO ISSUE PERMIT
BY: S.Ci) EbELL DATE:S
P:\D0CS\MISF0RMS\FRM0010.DH REV. 02/27/91
PLANNING CHECKLIST
Plan Check No. Address Zc '
Planner
________
Phone 438-1161 ext.
(Name)
APN:
Type of Project and Use 611,4x ZZ
Zone Facilities Management Zone
Legend
Item Complete
El Item Incomplete - Needs your action
1, 2, 3 Number in circle indicates plancheck number where deficiency was
identified
iD 0 Environmental Review Required: YES - NO - TYPE
DATE OF COMPLETION: ft
Compliance with 'conditions of approval? If not, state conditions which require action.
Conditions of Approval
El 0 Discretionary-Action Required: YES NO - TYPE
APPROVALJRESO. NO. DATE:
PROJECT NO.
OTHER RELATED CASES: -
Compliance with conditions of approval? If not, state conditions which require action.
Conditions of Approval
El 0 California Coastal Commission Permit Required: YES NO -
DATE OF APPROVAL:
San Diego Coast District, 1333 Camino Del Rio South, Suite 125, San Diego, CA. 92108-3520
(619) 297-9740
Compliance with conditions of approval? If not, state conditions which require action.
Conditions of Approval
El Landscape Plan Required: YES NO
See attached submittal requirements for landscape plans
Site Plan:
0 0 El Provide a fully dimensioned site plan drawn to scale. Show: North
arrow, property lines, easements, existing and proposed structures,
streets, existing street improvements,, right-of-way width and
dimensioned setbacks.
0 El El Show on Site Plan: Finish floor elevations, elevations of finish grade
adjacent to building, existing topographical lines, existing and proposed
slopes and driveway.
0 El El Provide legal description of property.
El El El Provide assessor's parcel number.
Zoning:
0 1111 1 Setbacks:
- Front: Required Shown
* Int. 'hide: Required Shown
Street Side: Required Shown
Rear: Required Shown
0 El El Lot coverage: Required Shown
0 0 El Height: Required Shown
El El El Parking: Spaces Required Shown
Guest Spaces Required Shown
El 0 0 Additional Comments
. t - OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER 3r' 4 DATE 41
PLNCK.FRLM
•.••..'•-.-.
p t'
2560 ORION WAY
CARLSBAD, CA 92008
TELEPHONE
(619) 931-2121
(Up of Car1bab
FIRE DEPARTMENT
PLAN CHECK REPORT
PAGE 10F_L.
APPROVED
DISAPPROVED
PLAN CHECK#
PROJECT 7LI)IS,t)i4J P&)OUC1.t)t3 ADDRESS %'D OteL)ei-/I,
ARCHITECT 13 k fli ADDRESS f14M4Si6A4Q PHONE L13 R -
OWNER tk/IUitD AfoffynFS ADDRESS 4#161J #.1/11S
OCCUPANCY i5- CONST. ___________ TOTAL SQ. FT. __________ STORIES /
0 SPRINKLERED II4NANT IMP.
APPROVAL OF PLANS IS PREDICATED ON CONFORMING
TO THE FOLLOWING CONDITIONS AND/OR MAKING
THE FOLLOWING CORRECTIONS:
PLANS, SPECIFICATIONS, AND PERMITS
- 1: Provide one copy of: floor plan(s); site plan; sheets
Provide two site plans showing the location of all existing fire hydrants within 200 feet of the project.
Provide specifications for the following:
Permits are required for the installation of all fire protection systems (sprinklers, stand pipes, dry chemical, halon,
CO2, alarms, hydrants). Plan must be approved by the fire department prior to installation.
The business owner shall complete a building information letter and return it to the fire department.
FIRE PROTECTION SYSTEMS AND EQUIPMENT
The following fire protection systems are required:
Automatic fire êprink!ers (Design Criteria:
O Dry Chemical, Halon, CO2 (Location:
Stand Pipes (Type:
0 Fire Alarm (Type/Location:
! 7. Fire Extinguisher Requirements:
Ii'dne 2A rated ABC extinguisher for each (,,fl?) ii sq. ft. or portion thereof with a travel distance to the nearest
extinguisher not to exceed 75 feet of travel.
O An extinguisher.with a minimum rating of to be located:
Other:
8. Additional fire hydrant(s) shall be provided
EXITS
Exitdoors shall be openable from the inside without the use of a key or any special knowledge or effort.
A signstating, This door to remain unlocked during business hours" shall be placed above the main exitand
QorS' .
..............11. EXIT signs (6" x 3%" letters) shall be placed over all required exis and directional signs located as necessary to
clearly indicate the location of exit doors.
GENERAL
.............12. Storage, dispensing or use of any flammable or combustible liquids, flammable liquids, flammable gases and
hazardous chemicals shall comply with Uniform Fire Code.
_13. Building(s) not approved for high piled combustible stock. Storagein closely packed piles shall not exceed 15 feet
in height, 12 feet on pallets or in racks and 6 feet for tires, plastics and 'some flammable liquids. If high stock pil-
ing is to be done, comply with Uniform Fire Code, Article 81'.
Additional 'Requirements.
'.
0A913i40?F- ôo
Comply with regulations on attached sheet(s). '
Plan Examiner ) A)CI
Report mailed mailed to architect ______ Met with
Date IA
Attach to Plans
COMMERCIAL/INDUSTRIAL
APPLICATION FORM FOR INDUSTRIAL WASTE DISCHARGE PERMIT
CITY OF CARLSBAD
APPLICATION: NEW_____________ BUILDING P.C. NO.:___________
(CHECK ONE) REVISED__________ APPLICATION NO.: 37
INDUSTRIAL CLASS: _9I
BY: Signature 'ity Representative
DATE:
APPLICATION FOR INDUSTRIAL WASTE DISCHARGE PERMIT
A. GENERAL:
SITE
APPLICANT: JtA i1./ifltJ lc*J\DDRESS: 27
TYPE OF BUSINESS: _../I gneR
APPLICANT'S ADDRESS:
B. WASTES AND PROCESSING:
Domestic Waste Only
GENERAL DESCRIPTION OF
proposed waste):_______
(Check where applicable)
Industrial Waste fl Industrial Waste NOT
Discharged to Sewer Discharged to Sewer
WASTE (Chemical and Physical Characteristics of
'I
GENERAL DESCRIPTION OF PROCESS (If Applicable):
C. WASTES TO BE DISCHARGED TO SEWER:
WASTE: TREATED:__ QUANTITY: AVERAGE GPD
(Check One) UNTREATED: (Daily) MAXIMUM _ GPD
(Gallons Per Day)
APPLICANT OR REPRESENTATIVE OF FIRM:Lhfr.n_keff3kJ J?.4-tl..fiy 'PuEL.(
Print)
TITLE: LU97k2P7 'kZ*?
SIGNATURE: 2II2 DATE:
-
of Carlsbad
INDUSTRIAL WASTE PERMIT
You are applying for a building permit that requires an Industrial
Waste Application per City Sewer Ordinance 13.16.
The attached application should be completed and returned to the
Development Processing Services Division as soon as possible.
This permit will be reviewed and forwarded to the Encina Water
Pollution Control facility or San Diego County Department of Public
Works for investigation of capacity and usage.
If this is not returned before planchecking is cdmpleted, your building
permit áould be delayed.
2075 Las Palmas Drive.Carlsbad, California 92009-4859.(619) 438-1161