HomeMy WebLinkAbout2544 CAMPBELL PL; 150; CBC2020-0034; Permit(
(7clty of
Carlsbad Building Permit Finaled
1I III 11111Commercial Permitl
Permit No: CBC2020-0034
Status: Closed - Finaled
Applied: 01/29/2020
Issued: 04/09/2020
Finaled Close Out:
Print Date: 08/10/2020
Job Address: 2544 CAMPBELL PL, # 150, CARLSBAD, CA 92009-1768
Permit Type: BLDG-Commercial Work Class: Tenant Improvement
Parcel #: 2132611800 Track #:
Valuation: $631,884.86 Lot #:
Occupancy Group: B/S1/A2 Project #:
#of Dwelling Units: Plan #:
Bedrooms: Construction Type: V-8
Bathrooms: Orig. Plan Check #: Inspector: CRenf
Plan Check #: Final Inspection: 08/10/2020
Project Title:
Description: ADVANCED DIABETES SUPPLY: 13,586 SF TENANT IMPROVEMENT (11,174 SF OFFICE TO OFFICE/I 2,952 SF WAREHOUSE TO
WAREHOUSE)
Property Owner: Contractor:
SIR CAMPBELL PLACE INC ' . PACIFIC BUILDING GROUP
255 WASHINGTON ST, #300 9752 ASPEN CREEK CT, #STE 100
NEWTON, MA 02458 SAN DIEGO, CA 92126-1082
(858) 652-5088
FEE . AMOUNT
BUILDING PERMIT FEE ($2000+) $2,433.00
BUILDING PLAN CHECK FEE (BLDG) . $1,703.10
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL . . $242.00
FIRE A-2 & A-3 Occupancies - TI 1 $628.00
GREEN BUILDING STANDARDS PLAN CHECK & INSPECTION . $175.00
MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL $104.00
PLUMBING BLDG COMMERCIAL NEW/ADDITION/REMODEL $124.00
SB1473 GREEN BUILDING STATE STANDARDS FEE $26.00
STRONG MOTION-COMMERCIAL . ' . $176.93
Total Fees: $5,612.03 Total Payments To Date: $5,612.03 Balance $0.00
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
collectively, referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these
fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the
protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section
3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their
imposition. . . .
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection.
fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this
project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the
statute of limitation has previously otherwise expired.
Building Division Page 1 of 1
1635 Faraday Avenue, Carlsbad CA 92008-7314 1 760-602-2700 1 760-602-8560 f I www.carlsbadca.gov
COMMERCIAL
Plan Check (City of BUILDING PERMIT
__________ Est. Value 63( 't'- Carlsbad APPLICATION PC Deposit f1 17t'3-10
B2 Date / - 29 2.020
2544 CAMPBELL PL Job Address Suite: 150 APN: 2132611800
Tenant Name: ADVANCED DIABETES SUPPLY CT/Project#: Lot #:
Occupancy: -
B, S-i
- Construction Type: V-B Fire Sprinklers: no Air Conditioning: no
BRIEF DESCRIPTION OF WORK: SECOND GENERATION TI, SCOPE INCLUDES DEMOLITION, NEW PARTITIONS, NEW LIGHTING
AND NEW EXTERIOR PUNCHED OPENINGS WITH ASSOCIATED MECHANICAL AND ELECTRICAL-
Addition/New: New SF and Use, ___New SF and Use,
Deck SF, Patio Cover SF (not including flatwork)
Tenant Improvement: 13,586 SF, Existing Use O FF1 Proposed Use OFf (G5
SF, Existing Use Proposed Use
LI Pool/Spa: SF Additional Gas or Electrical Features?
LI Solar: KW, _Modules, Mounted, Tilt: Yes / No, RMA: Yes / No, Panel Upgrade: Yes / No
0 Plumbing/Mechanical/Electrical Only:
0 Other:
APPLICANT (PRIMARY) PROPERTY OWNER
Name: WARE MALCOMB (BRITTANY MONTGOMERY) Name: THE RMR GROUP _BOBBIE PURCELL
Address: 3911 SORRENTO VALLEY BLVD, SUITE 120 Address: 3655 NOBEL DRIVE, SUITE 120
City: SAN DIEGO State:CA Zip: 92121 City: SAN DIEGO State: Zip: 92122
Phone: 858.638.7277 Phone: (858) 427-3600
Email: bmontgomery@waremalcomb.com Email: BPURCELL@RMRGROUP.COM
DESIGN PROFESSIONAL CONTRACTOR BUSINESS
Name: WARE MALCOMB (BRITTANY MONTGOMERY) Name: PACIFIC BUILDING GROUP - ANDRE CHILDERS
Address: 3911 SORRENTO VALLEY BLVD, SUITE 120 Address: 9752 ASPEN CREEK CT
City: SAN DIEGO State:CA Zip: 92121 City: SAN DIEGO State: CA Zip: 92126
Phone: (858)638-7277X1339 Phone: (858) 552-0600
Email: bmontgomery@waremalcomb.com Email: ACHILDERS@PACIFICBUILDINGGROUP.COM
Architect State License: C33185 ( NATHAN DEAN, WARE MALCOMB)State License: Bus. License: F LOS I 2_o1f
9 f/VQ
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, rior tcl its
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, commending 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}).
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Buildingccarlsbadca.gov
El
B-2 Page 1 of 2 Rev. 06/18
.'
(OPTION A): WORICERS'COMPENSATION DECLARATION:.
I hearby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the
work which this permit is issued.
cM have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation insurance carrier and policy number are: Insurance Company Name: Old Republic General Insurance
Policy No. A-i Cw-36841 8-16 Expiration Date: 3/1/2021
0 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.
Cindy JoneL¼% LJAGENT DATE: CONTRACTOR SIGNATURE:
(OPTION B): OWNER-BUILDER DECLARATION:
I hereby affirm that lam exempt from Contractor's License Law for the following reason:
O 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).
O 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).
0 I am exempt under Section Business and Professions Code for this reason:
I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 Yes 0 No
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / 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: DAGENT DATE:
CONSTRUCTION LENDING AGENCY, IF ANY:
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name: Lender's Address:
ONLY COMPLETE THE FOLLOWING 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? 0 Yes 0Q No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 Yes IQ No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 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 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 stones 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 any time
after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT SIGNATURE: DATE:
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: BuiIdingccarIsbadca.gov
B-2 Page 2 of 2 Rev. 06/18
(OPTiON A): WORKERS'COMPENSATION DECLARATION:
I hearby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the
work which this permit is issued.
0 I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation insurance carrier and policy number are: Insurance Company Name:
Policy No. Expiration Date:
O 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: DAGENT DATE:
(OPTION B ): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
O 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).
O 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).
O I am exempt under Section Business and Professions Code for this reason:
I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 Yes 0 No
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / 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: DAGENT DATE:
CONSTRUCTION LENDING AGENCY, IF ANY:
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name: Lender's Address:
ONLY COMPLETE THE FOLLOWING 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? 0 Yes NNo
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 Yes CQ No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes CQ 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 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 stones 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 any time
after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT SIGNATURE: b2hM4x VkA DATE: 01 - 29 t'>t)
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carIsbadca.gov
B-2 Page 2 of 2 Rev. 06/18
Permit Type: BLDG-Commercial Application Date: 01/29/2020 Owner: SIR CAMPBELL PLACE INC
Work Class: Tenant Improvement Issue Date: 04/09/2020 Subdivision:
Status: Closed - Finaled Expiration Date: 01/11/2021 Address: 2544 CAMPBELL PL, #150
IVR Number: 24494 CARLSBAD, CA 92009-1768
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Date Start Date -
Status
BLDG-18 Exterior 131715-2020 Passed Tony Alvarado Complete
Lath/Drywall -
Checklist Item COMMENTS Passed
BLDG-Building Deficiency July 2, 2020: Yes
Rough frame and electrical scope of
work for two Corredor partition doorways
added to existing fire rated envelope and
exiting path of travel - approved.
Drywall nailing and fire caulking at
penetrations (4) qty. through Corridor fire
rated area - approved Per photo.
0711312020 0711312020 BLDG-85 T-Bar, Ceiling 132593-2020 Passed Chris Renfro Complete
Grids, Overhead
Checklist Item COMMENTS Passed
BLDG-Building Deficiency . . Yes
BLDG-14 Yes
Frame-Steel-Bolting-Welding
(Decks)
BLDG-24 Rough-Topout Yes
BLDG-34 Rough Electrical Yes.
BLDG-44 . . . Yes
Rough-Ducts-Dampers
0711512020 0711512020 BLDG-34 Rough 132855-2020 Partial Pass Chris Renfro Reinspection Incomplete
Electrical
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Partial pass rough electrical for pharmacy Yes
cabinet millwork areas.
0811012020 0811012020 BLDG-Final Inspection 135141-2020 - Passed Chris Renfro Complete
Checklist Item COMMENTS . Passed
BLDG-Building Deficiency . Yes
BLDG-Plumbing Final .
Yes
BLDG-Mechanical Final Yes
BLDG-Structural Final Yes
BLDG-Electrical Final . Yes
Monday, August 10, 2020 Page 3 of 3
Permit Type: BLDG-Commercial Application Date: 01/29/2020 Owner: SIR CAMPBELL PLACE INC
Work Class: Tenant Improvement Issue Date: 04/09/2020 Subdivision:
Status: Closed - Finaled Expiration Date: 01/11/2021 Address: 2544 CAMPBELL PL, # 150
IVR Number: 24494 --
CARLSBAD, CA 92009-1768
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Date Start Date Status
Checklist Item COMMENTS Passed
BLDG-Building Deficiency June 5, 2020- Yes
overhead inspection above T-bar gnd
ceiling areas in kitchen break room
area-approved.
Scope of work primarily existing
equipment With new lighting and hangers.
BLDG-14 June 5, 2020- Yes
Frame-Steel-Bolting-Welding overhead inspection above T-bar grid
(Decks) ceiling areas in kitchen break room
area-approved.
Scope of work primarily existing
equipment With new lighting and hangers.
BLDG-24 Rough-Topout June 5, 2020- Yes
overhead inspection above T-bar grid
ceiling areas in kitchen break room,
area-approved.
Scope of work primarily existing
equipment with new lighting and hangers.
BLDG-34 Rough Electrical June 5, 2020- ' Yes
overhead inspection above T-bar grid
ceiling areas in kitchen break room
area-approved.
Scope of work primarily existing
equipment With new lighting and hangers.
BLDG-44 June 5, 2020- . Yes
Rough-Ducts-Dampers overhead inspection above T-bar grid
ceiling areas in kitchen break room
area-approved.
Scope of work primarily existing
equipment with new lighting add hangers.
06112/2020 0611212020 BLDG-85 1-Bar, Ceiling 129995-2020 Passed ( Tony Alvarado Complete
- Grids, Overhead -.
Checklist Item COMMENTS Passed
BLDG-34 Rough Electrical Yes
BLDG-44 Yes
Rough-Ducts-Dampers
07/0212020 07102/2020 BLDG-14 131713.2020 Passed Tony Alvarado Complete
Frame/Stool/Bolting/We
L _Jding(Dcks) _____ __________________________••j
Checklist Item COMMENTS Passed
BLDG-Building Deficiency July 2, 2020: Yes
Rough frame and electrical scope of
work for two Corredor partition doorways
added to existing fire rated envelope and
exiting path of travel - approved.
Drywall nailing and fire caulking at
penetrations (4) qty. througti Corridor fire
rated area - approved Per photo.
Monday, August 10, 2020 Page 2 of 3
Building Permit Inspection History Finaled
city of
Carlsbad
Permit Type: BLDG-Commercial Application Date: 01/29/2020 Owner; SIR CAMPBELL PLACE INC
Work Class: Tenant Improvement Issue Date: 04/09/2020 Subdivision:
Status: Closed - Finaled Expiration Date: 01/11/2021 Address: 2544 CAMPBELL PL, #150
IVR Number: 24494 CARLSBAD, CA 92009-1768
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Dite Start Date Status
05112/2020 0511212020 BLDG-21 1 127202.2020 Passed Chris Renfro Complete
UndergroundlUnderfio
or Plumbing
Checklist Item . COMMENTS Passed
BLDG-Building Deficiency Yes
0511512020 05/1512020 BLDG-84 Rough 127657.2020 Passed Tony Alvarado Complete
Combo(14,24,34,44)
Checklist Item COMMENTS Passed
BLDG-14 Yes
Frame-Steel-Bolting-Welding
(Decks)
BLDG-24 Rough-Topout Yes
BLDG-34 Rough Electrical Yes
BLDG-44 Yes
Rough-Ducts-Dampers
05120/2020 05120I2020 BLDG-17 Interior 128033.2020 Passed Tony Alvarado Complete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency May 20,.2020: Yes
Mechanical ducting rerouted and duct
sealant - approved.
Drywall nail screw scope of
work-approved.
06/0312020 0610312020 BLDG-31 129163-2020 Partial Pass Tony Alvarado Reinspection Incomplete
Underground/Conduit-
Wiring
Checklist Item COMMENTS Passed
BLDG-Building Deficiency June 3, 2020-Underground conduit from Yes
wall to island location in kitchen for/break
room area approved only. OK to cover with
concrete.
0610512020 06105/2020 BLDG-85 T-Bar, Ceiling 129469-2020 Passed Tony Alvarado Complete
Grids, Overhead
Monday, August 10, 2020 Page 1 of 3
1
CBC2O2O-0034 PErj,,qRD
ADVANCED DIABETES SUPPLY: 13,586 SF TENANT
2544 CAMPBELL PL #150 CARLSBAD' INSPECTION
Building Division IMPROVEMENT (11,174 SF OFFICE TO OFFICE// 2,952 SF
IJ INSPECTION RECORD CARD WITH APPROVED WAREHOUSE TO WAREHOUSE)
PLANS MUST BE KEPT ON THE JOB
l• CALL BEFORE 3:00 Prn FOR NEXT WORK DAY INSPECTION 2132611800
l• FOR BUILDING INSPECTION CALL-760-602-2725 112912020
OR GO TO: www.CarIsbadca.gov/BuiIdi AND CLICK ON
"Request Inspection" CB C20 20-0034
) I -
I 'IT.'i Ii
If "YES" is.checked below that Division's approval is required prior to requesting a Final Building Inspection. If you have any question
For
please
760-602-8560,
call the applicable divisions at the phone numbers provided below. After all required
email to blclgj ectlpns@carlsbadca.gq or bring in a COPY of this card
Inspection times or to speak to an Inspector call 760-602-2700 between 7:340am-8:001lm
I
approvals are signed
to: 1635 Faraday
the day of
off- lax to
Ave., Carlsbad.
your ins p.'ctlon - Allow )'Z2 hours
COPYOFCARD
-IF MARKED "YES". APPROVAL REOUIRED PRIOR TO RECILIESTING BUILDING FINAL *-**-... RECUIRED
MM - - - I # . M ~==
MM Planning/Landscape 760-436-7327 Allow 48 hours - I4M.1I(. (Engineering -I -Inspections) I. .I:I:11
Type of Inspection Type of Inspection -
(I.T :1111 uI.)IfJ
#11 FOUNDATION
Date Inspector
.
.i.ii1Ul I;1[W
#31 D ELECTRIC UNDERGROUND 13 LIFER
Date Inspector
#12 REINFORCED STEEL #34 ROUGH ELECTRIC/ EVCHARGER
#66 MASONRY PRE GROUT #33 0 FIEC SERVICE #3213TEMPORARY
0 GROUT 0 WALL DRAINS #35 PHOTOVOLTAIC
#10 TILT PANELS ___________ #38 SIGNS
#11 POURSTRIPS BLDG-FINAL
#11 COLUMN FOOTINGS Date Inspector
#14 SUBFRAME 0 FLOOR 0 CEIUNG ___________ 041 UNDERGROUND DUCTS & PIPING
#15 ROOFSHEATHING _________ __________
#44 UCT&PLENUM DREF.PIPflIG4 sFS zo_f,,j
#13 EXT. $'EAR PANELS _________ __________ #43 HEAIMRC0NDSYSTEMS
#16 INSULATION ___________ ____________ BLDG-FINAL
#18 EXTERIOR LATH pLIJ
Date Inspector
#17 INTERI0R LATH &DRYWALL11(I L2of.2 81 UNDERGROUND(11,12.21,31)
BLDG-FINAL _____
82
tp!WT#184
DRYWALL,EICT LATH, CASTES (17,18,23)
Date
$EfER & BL/CQ.D PL/CO ç-y.
83 ROOFSHEATING, EXTSHEAR (13,15)
#22 FRAME ROUGH COMBO (14,24,34,44)
#21 UDERGROUNDWASTE DWIR " #85 T-Bar(14,24,34,44)
#24 TOPOIJT OWASTE DWTR _________ BLDG- FINAL OCCUPANCY
#27 TUB&SHOWERPAN 11 Date inspector
#23 0 GASTEST 0 GAS PIPING __________ ___________ A/S UNDERGROUND VISUAL
#25 WATER HEATER - ___________ A/S UNDERGROUND HYDRO
#28 SOLAR WATER __________ ___________ A/S UNDERGROUND FLUSH
BLDG-FINAL I A/S OVERHEAD VISUAL
EPJU Date Inspector
#51 POOL EXCAV/STEEL ____________
A/S OVERHEAD HYDROSTATIC
A/S FINAL
#52 PLUMBING ____________
F/A ROUGH-IN
#53 aEC/ CONDUIT/ WIRING ___________ F/AFINAL
#54 EQUIPOTENTIAL BOND ___________
FIXED EXTINGUISHIN1 SYSTEM ROUGH-IN
955 PREPLASTER / FENCE! ALARMS ___________ FIXED EXTING SYSTEM HYDROSTATIC TEST
57 GUNITE ___________ FIXED EXTINGUISHING SYSTEM FINAL
BLDG- FINAL MEDICALGAS PRESSURETEST
I MEDICAP lAS FINAL
RFV6!1e cl( MCi. WR cITCIAJ. i.orts
Scanned by CamScanner
. EsGil
A SAFEbuittCornpany
DATE: APR. 039 2020 (APPLICANT
JURIS.
JURISDICTION: CARLSBAD
PLAN CHECK #.: CBC2020-0034 SET: II
PROJECT ADDRESS: 2544 CAMPBELL PLACE
PROJECT NAME: ADVANCED DIABETES SUPPLY.- T.I.
The plans transmitted herewith have been corrected where. necessary and substantially comply
with the jurisdiction's building codes.
El 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.
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.
.
The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
LI The applicant's copy of the check list has been sent to:
EsGilstaff did not advise the applicant that the plan check has been completed.
F-1 EsGil staff did advise the applicant that the plan check has been completed.
Person'contacted: Brittany Montgciery Telephone #: 858-638-727T
Dontacted: q ((.by: cy) Email: bthontgomerywaremalcomb.com
Mall 'Telephone Fax In Pe!son LI rflARI<S: .. '.
By: ALl S:1ç)RE Enclosures: VI
EsGjI•.
3/16
9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576
DATE: FEB. 251, 2020
JURISDICTION: CARLSBAD
PLAN CHECK #.: CBC2020-0034
EsGV. il
A SAFEbulittompany
U PLICANT
JURIS.
SET: I
PROJECT ADDRESS: 2544 CAMPBELL PLACE
PROJECT NAME: ADVANCED DIABETES SUPPLY - T.I.
The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
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.
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.
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:
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: Brittany Montgomery Telephone #: 858-638-7277
Date contacted :y ) Email: bmontqomerv(äwaremalcomb.com
Mail Telephone Fax In Person
LI REMARKS:
By: ALl SADRE, S.E. Enclosures:
EsGil
1/30
9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576
CARLSBAD CBC2020-0034
FEB. 25, 2020
GENERAL PLAN CORRECTION LIST
JURISDICTION: CARLSBAD PLAN CHECK #.: CBC2020-0034
PROJECT ADDRESS: 2544 CAMPBELL PLACE
SCOPE: T.l.; STORIES = TWO; HEIGHT = NO CHANGE; AREA = 13,586; SPRINKLERS =
YES; CONSTRUCTION = V-B; USE = OFFICE/ STORAGE/ ASSEMBLY; OCCUPANCY =
B/S1/A2; NO CHANGE IN USE (NO NEED TO JUSTIFY ACTUAL VERSUS ALLOWABLE
AREA INCREASES); A2 = 1,932 (1ST FLR.);
DATE PLAN RECEIVED BY DATE REVIEW COMPLETED:
ESGIL: 1/30 FEB. 25, 2020
REVIEWED BY: ALl SADRE, S.E.
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 disabled access. 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
or other departments.
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. The approval of
the plans does not permit the violation of any state, county or city law.
GENERAL
Please make all corrections, as requested in the correction list. Submit FOUR new
complete sets of plans for commercial/industrial projects (THREE sets of plans for
residential projects). For expeditious processing, corrected sets can be submitted in one of
two ways:
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 and the Carlsbad Planning, Engineering and Fire
Departments.
Bring TWO corrected set of plans and calculations/reports to EsGil, 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 only will not be reviewed by the City
Planning; Engineering and Fire Departments until review by EsGil is complete.
CARLSBAD CBC2020-0034
FEB. 25, 2020
To facilitate rechecking, please identify, next to each item, the sheet of the plans
upon which each correction on this sheet has been made and return this sheet
with the revised plans.
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 on the plans. Have changes been made not resulting from this
list? E3 Yes U No
PLANS
Please revise the sheet index to include A4.2.
Please label the new door to the exterior, on Sheet A2.I, as per demo plans and add it
the door schedule on Sheet A7.1.
Please include the existing doors into the corridor with 45-mm. rating, as a part of the
one-hour fire barrier, between A2 & B/SI, on Sheet A2.I. Table 508.4.
Please complete the information for door E108, on door schedule, as per Sheet A7.I.
Please specify where doors E108, E119 & E120, per door schedule, on Sheet A7.I, are
called out on the floor plans.
Please specify the thickness of the glass in keynote #202, on Sheet A2.1.
A reminder that all the (3) doors from the break room on the 1st floor shall be equipped
with panic hardware; specify subject to field verification for the existing doors to remain.
Section 101 0.1.10.
GREEN BUILDING CODE
Please reference 2019 on the title of Sheet AO.4.
Water reduction. Show on the plans the following maximum fixture flow rates from the
table below. Revise general notes, on Sheet AO.4, to match the following, CGC 5.303:
MAXIMUM FIXTURE FLOW RATES
FIXTURE TYPE IMAXIMUM FLOW RATE
Showerheads 11.8 gpm @ 80 psi
ACCESSIBILITY
Please specify the relocated vending machines in the break room shall be HC accessible.
CBC 11 B-228 & 11B-309.
Please note on the plans that all the existing site facilities including, parking, ramps,
curbs, walks, entrances, restroom facilities, drinking fountains, stairs, etc., are HG
accessible subject to field verification.
CARLSBAD CBC2020-0034
FEB. 25, 2020
MISCELLANEOUS
Please see attached for any P/M/E items.
Electrical and energy deign are approved.
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 ALl SADRE, S.E. at EsGil. Thank you.
PLUMBING AND MECHANICAL COMMENTS
PLAN REVIEWER: Connor Reuss SET: I
PLUMBING (2019 CALIFORNIA PLUMBING CODE)
Plumbing plans comply with the jurisdiction's standards
MECHANICAL (2019 CALIFORNIA MECHANICAL CODE)
Detail the primary and secondary mechanical condensate waste design: Pipe sizing,
required cleanout, routing, and termination areas. CMC 310.0 & CPC 814.0.
All new mechanical ventilated units are required to have at minimum a MERV-13 filter
within the outside air/return air duct. Please address. CMC 401.2
Clearly specify within the mechanical plans that a duct leakage test will be conducted that
complies with CMC 603.10.1
Environmental exhaust duct terminations may be no closer than 3' from a property line or
3' from openings back into the building and 10' from forced air inlets. Revise the duct
layout or clearly note on the plans that the exhaust termination will be no closer than 3' to
the window and no closer than 10' to a forced air inlet. CMC 502.2.1
Note: If you have any questions regarding this Plumbing and Mechanical plan review list please
contact Connor Reuss at (858) 560-1468. To speed the review process, note on this list (or a
copy) where the corrected items have been addressed on the plans.
CARLSBAD CBC2020-0034
FEB. 25, 2020
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: CARLSBAD PLAN CHECK #.: CBC2020-0034
PREPARED BY: ALl SADRE, S.E. DATE: FEB. 24, 2020
BUILDING ADDRESS: 2544 CAMPBELL PLACE
BUILDING OCCUPANCY: B/S1/A2; V-B/SPR.
BUILDING
POR11ON
AREA
(Sq. FL)
Valuation
Multiplier
Reg.
Mod.
VALUE ($)
T.I. 13586
Air Conditioring
Fire Sprinklers
TOTAL VALUE 631,884
Jurisdiction Code 1GB JBy Ordinance
1997 USC Building Permit Fee LJ I tI
I 1997UBC Plan Check Fee
Type of Review: P Complete Review r Structural Only
I— Repetitive Fee .
FM Repeats
V
r Other
r Hourly 1Hr.@*
EsGil Fee I V I $1,581.621
Comments:
Sheet 1 of 1
SAN DIEGO REGIONAL I OFFICE USE ONLY
LCc
)
HAZARDOUS MATERIALS IPLAN
RECORD ID#__________________ '_______ -ooq CHECK #i2Q2..O
QUESTIONNAIRE BP DATE 1 i OZC
Business Name Business Contact Telephone # ADVANCED DIABETES SUPPLY CHRIS PIERSON (760) 579-7411
Project Address City State 2544 CAMPBELL PL,SUITE 150 CARLSBAD CA Zip Code 92009 APN# 213-261-1800
Mailing Address City State Zip Code Plan File#
2544 CAMPBELL PL,SUITE 150 CARLSBAD CA 92009
Project Contact Applicant E-mail Telephone #
WARE MALCOMB (BRITTANY MONTGOMERY) bmontgomery@waremalcomb.com 858.638.7277
The following questions represent the facility's activities, NOT the specific project description.
PART I: FIRE DEPARTMENT -HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not required for projects within the City of San
Diego): Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are circled,
applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal.
Occupancy Rating: Facility's Square Footage (including proposed project):
Explosive or Blasting Agents S. Organic Peroxides 9. Water Reactives 13. Corrosives
Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards
Flammable/Combustible Liquids 7. Pyrophoncs 11. Highly Toxic or Toxic Materials 15. None of These.
Flammable Solids 8. Unstable Reactives 12. Radioactives
If the answer to any of the
Diego, CA 92123.
Call (858) 505-6700 prior to the issuance of a building permit.
FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy:
YES NO (for new construction or remodeling projects) 0 I Is your business listed on the reverse side of this form? (check all that apply).
0 IX! Will your business dispose of Hazardous Substances or Medical Waste in any amount?
0 XI Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500
pounds and/or 200 cubic feet?
0 IX! Will your business store or handle carcinogens/reproductive toxins in any quantity?
0 IX! Will your business use an existing or install an underground storage tank? 0 I1 Will your business store or handle Regulated Substances (CatARP)?
0 IJ Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)?
0 IX! Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to
or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act).
CalARP Exempt
Date Initials
CalARP Required
Date Initials
CaIARP Complete
Date Initials
PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San
Diego, CA 92131 aocdcomo5sdcountv.ca.aov (858) 586-2650). [No stamp required if QI Yes and Q3 Yes Q4-Q6 No]. The following questions are intended
to identify the majority of air pollution issues at the planning stage. Projects may require additional measures not identified by these questions. For comprehensive
requirements contact APCD. Residences are typically exempt, except - those with more than one building on the property; single buildings with more than four
dwelling units; townhomes; condos; mixed-commercial use; deliberate bums; residences forming part of a larger project. rExcludes garages & small outbuildings.]
YES NO I 0 Will the project disturb 160 square feet or more of existing building materials?
0 91 Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition. IX! 0 (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance
Technician?
0 IX! (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification
may be required 10 working days prior to commencing asbestos removal.
0 0 Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet
(www.sdaocd.ora/info/facts/oermits.odf) for typical equipment requiring an APCD permit.
0 0 (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school
boundary
Briefly describe business activities: Briefly describe proposed project:
OFFICE & STORAGE TENANT IMPROVEMENT
to the best of my knowledge and herein are true and correct.
flI2JII2O2dO
Name of Owner ôt Authorized
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: FOR OFFICAL USE ONLY:
DATE: BY:
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
COUNTYHMD* APCD COUNTY-HMD APCD COUNTY-HMD APCD
A stamp in this box oniv exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply.
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
Battery Manufacturing/Recycling
Boat Yard
Car Wash
Dealership Maintenance/Painting
Machine Shop
0 Painting
Radiator Shop
Rental Yard Equipment
Repair/Preventive Maintenance
Spray Booth
Transportation Services
Wrecking/Recycling
CHEMICAL HANDLING
Agricultural supplier/distributor
Chemical Manufacturer
Chemical Supplier/Distributor
Coatings/Adhesive
Compressed Gas Supplier/Distributor
Dry Cleaning
0 Fiberglass/Resin Application
0 Gas Station
Industrial Laundry
Laboratory
Laboratory Supplier/Distributor
Oil and Fuel Bulk Supply
Pesticide Operator/Distributor
CHEMICAL HANDLING
Photographic Processing
0 Pool Supplies/Maintenance
Printing/Blue Printing
Road Coatings
0 Swimming Pool
Toxic Gas Handler
Toxic Gas Manufacturer
METAL WORKING
Anodizing
Chemical Milling/Etching
Finish-Coating/Painting
El Flame Spraying
O Foundry
Machine Shop-Drilling/Lathes/Mills
Metal Plating
O Metal Prepping/Chemical Coating
Precious Metal Recovery
Sand Blasting/Grinding
Steel Fabricator
Wrought Iron Manufacturing
AEROSPACE
Aerospace Industry
Aircraft Maintenance
O Aircraft Manufacturing
OTHERS AND MISCELLANEOUS
Asphalt Plant
Biotechnology/Research
Chiropractic Office
Co-Generation Plant
Dental Clinic/Office
Dialysis Center
Emergency Generator
Frozen Food Processing Facility
Hazardous Waste Hauler
Hospital/Convalescent Home
Laboratory/Biological Lab
Medical Clinic/Office
Nitrous Oxide (NOr) Control System
Pharmaceuticals
Public Utility
Refrigeration System
Rock Quarry
Ship Repair/Construction
Telecommunications Cell Site
Veterinary Clinic/Hospital
Wood/Furniture Manufacturing/Refinishing
ELECTRONICS
Electronic Assembly/Sub-Assembly
Electronic Components Manufacturing
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 (858) 505-6880.
LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES
Businesses, which include any of the following operations or equipment, will require clearance from the Air Pollution Control District.
CHEMICAL
47—Organic Gas Sterilizers
32— Acid Chemical Milling
33— Can & Coil Manufacturing
44— Evaporators, Dryers & Stills Processing
Organic Materials
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
Intermediate Refuelers
Gasoline & Alcohol Fuel Dispensing
34— Piston Internal - Combustion Engines
13— Boilers & Heaters (1 million BTU/hr or larger)
14—Incinerators & Crematories
Bum Out Ovens
Core Ovens
20— Gas Turbines, and Turbine Test Cells & Stands
48— Landfill and/or Digester Gas Flares
ROCK AND MINERAL
Hot Asphalt Batch Plants
Rock Drills
Screening Operations
Sand Rock & Aggregate Plants
Concrete Batch, CTB, Concrete Mixers, Mixers
& Silos
10— Brick Manufacturing
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
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
ELECTRONICS OTHER
29— Automated Soldering 01 - Abrasive Blasting Equipment
42— Electronic Component Mfg 03— Asphalt Roofing Kettles & Tankers
46— Reverse Osmosis Membrane Mfg
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 (08/15) County of San Diego - DEH - Hazardous Materials Division
ENCINA WASTEWATER AUTHORITY
INDUSTRIAL WASTEWATER DISCHARGE PERMIT ENOM SCREENING SURVEY WMIMAM
6200 Avenida Encinas, Carlsbad, CA 92011
Phone: 760-438-3941 Fax: 760-476-9852
SourceControl@encinajpa.com
Date:07°\.2'O'
Business Name: ONWRA 17 V1lj1
Street Address: _.?-r0'" 'L 4(Q CU'JVt'sc9cd
Email Address: (20 flMC1T 9 C31
PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT: (ON REVERSE SIDE CHECK TYPE OF BUSINESS)
Check all below that are present at your facility:
o Acid Cleaning o Food Processing o Metal Powders Forming
o Assembly o Glass Manufacturing o Nutritional Supplement/Vitamin
o Automotive Repair o Industrial Laundry Manufacturing
o Battery Manufacturing o Ink Manufacturing o Painting/Finishing
o Biofuel Manufacturing o Laboratory o Paint Manufacturing
o Biotech Laboratory o Machining/Milling o Personal Care Products
o Bulk Chemical Storage o Membrane manufacturing Manufacturing
o Car Wash (Le. water filter membranes) o Pesticide Manufacturing/ Packaging
o Chemical Manufacturing o Metal Casting/Forming a Pharmaceutical Manufacturing
o Chemical Purification o Metal Fabrication (including precursors)
o Dental Offices o Metal Finishing o Porcelain Enameling
Dental Schools Electroplating o Power Generation
Dental Clinics Electroless Plating o Print Shop
o Dry Cleaning a Anodizing o Research and Development
o Electrical Component Coating (i.e. phosphating) a Rubber Manufacturing
Manufacturing Chemical Etching/Milling o Semiconductor Manufacturing
o Fertilizer Manufacturing Printed Circuit Board o Soap/Detergent Manufacturing
o Film/X-ray Processing Manufacturing o Waste Treatment/Storage
New Business? Yes F] NoN3 SIC Code(s) if known: Date operation began/will begin:__________________
Tenant Improvement? Yes W No[] If yes, briefly describe improvement:
Description of operations generating wastewater (discharged to sewer, hauled or evaporated):
NOCOk at I cD
Estimated volume of industrial wastewater to be discharged (gal/ day): N1/I\
List hazardous wastes generated (type/volume):1\i_51\)J
Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? Yes 0 Date: No LJ
Page 1 of 2
ENCINA WASTEWATER AUTHORITY
INDUSTRIAL WASTEWATER DISCHARGE PERMIT MUM
SCREENING SURVEY WMEWATR
6200 Avenida Encinas, Carlsbad, CA 92011
Phone: 760-438-3941 Fax: 760-476-9852
SourceControl@encinajpa.com
The commercial enterprises listed below are a partial listing of businesses that are exempt from industrial wastewater
discharge permitting under normal operating 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
Cleaning Services
Carpet/Upholstery
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).
Residential 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 (no car wash/auto repair)
Public Storage Facilities
Restaurants/Bars
Retail/Wholesale Stores (no auto repair/film developing)
Theaters (Movie/Live)
CERTIFICATION STATEMENT
I certify that the information above is true and correct to the best of my knowledge.
Signature: 'Print Name:F0#oV!4 M-MM9 r
Facility Contact: _____tA1\ktThJ Title:___________________________________
ENCINA WASTEWATER AUTHORITY
6200 AVEN IDA ENCINAS, CARLSBAD, CA Phone: 760-438-3941 Fax: 760-476-9852
SourceControI@encinaipa.com
Page 2 of 2
Ocity of
Carlsbad
CLIMATE ACTION PLAN
CONSISTENCY CHECKLIST
B-50
Development Services
Building Division
1635 Faraday Avenue
(760) 602-2719
www.carlsbadca.gov
PURPOSE
This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance
requirements apply to their projects. The completed checklist must be included in the building permit application. It may be
necessary to supplement the completed checklist with supporting materials, calculations or certifications, to demonstrate
full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach
to comply with energy-related measures will need to attach to this checklist separate calculations and documentation as
specified by the ordinances.
NOTE: The following type of permits are not required to fill out this form
•• Patio • Decks I + PME (w/o panel upgrade) + Pool
4 If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance,
an explanation must be provided to the satisfaction of the Building Official.
A Details on CAP ordinance requirements are available on the city's website.
A A CAP Building Plan template (form B-55) shall be added to the title page all building plans. This template shall be
completed to demonstrate project compliance with the CAP ordinances. Refer to the building application weboacie and
download the latest form.
Application Information
Project Name/Building
Permit No.: BP No.: Ci3 C2t0 Oo1J
Property Address/APN: 2544 CAMPBELL PL #150, CARLSBAD, CA, 92009 APN: 213-261-1800
Applicant Name/Co.: BRITTANY MONTGOMERY
Applicant Address: 3911 SORRENTO VALLEY BLVD. SUITE 120 SAN DIEGO CA 92121
Contact Phone: (858) 638-7277 x 1359 Contact Email: BMONTGOMERY@WAREMALCOMB.COM
Contact information of person completing this checklist (if different than above):
Name: Contact Phone:
Company
name/address: Contact Email:
Applicant Signature: 11[k7oVJIy Date:
B-50 Page 1 of 6 Revised 08/19
City of Carlsbad Climate Action Plan Consistency Checklist.
Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project.
For alterations and additions to existing buildings, iftach Building
Building Permit Valuation (BPV) from wot $
Construction Type -
- -
Complete Section(s) I Notes:
A high-rise residential building is 4 or more stories, including a
Residential Low-rise High-rise mixed-use building in which at least 20% of its conditioned floor
area is residential use
0 New construction
2A, 3A, IB,2B,
4A 3B 4A
0 Additions and alterations:
BPV < $60,000 N/A N/A All residential additions and alterations
BPV k $60,000 IA 4A 4A 1-2 family dwellings and townhouses with attached garages
Electrical service panel upgrade only ' only
'Multi-family dwellings only where interior finishes are removed
0 BPV 21200,000 IA, 4At IB, 4A* and significant site work and upgrades to structural and
mechanical, electrical, and/or plumbing systems are proposed
E Nonresidential
0 New construction I 1B, 2B, 3B, 4B and 5
O Alterations:
Z1BPV ~! $200,000 or additions ~ 1,000 lB 5 square feet
BPV 2! $1,000,000 IB, 2B, 5
2! 2,000 sq. ft. new roof addition 2B, 5
Building alterations of ? 75% existing gross floor area
1 B also applies if BPV a $200,000
CAP Ordinance Compliance
Checklist Item
Check the appropriate boxes, explain all not applicable and exception items, and provide supporting calculations and documentation as necessary.
1. Energy Efficiency
Please refer to Carlsbad Municipal Code (CMC) sections 18.21.155 and 18.30.190, and the California Green Building Standards Code (CALGreen) for
more information when completing this section.
A. 0 Residential addition or alteration? $60,000 building permit valuation. 0 N/A___________________________
See CMC section 18.30.190. 0 Exception: Home energy score a 7
(attach certification)
Year Built Single-family Requirements Multi-family Requirements
Before 1978 Select one:
O Duct sealing 0 Attic insulation 0 Cool roof 0 Attic insulation
1978 and later Select one: O Lighting package 0 Water heating Package
Between 1978 and 1991 Select one:
O Duct sealing 0 Attic insulation 0 Cool roof
1992 and later Select one: O Lighting package 0 Water heating package
B. l] Nonresidentiar new construction or alterations? $200,000 building permit valuation,
or additions? 1,000 square feet. 0 N/A___________________________
Updated 8/15/2019 2
City of Carlsbad Climate Action Plan Consistency Checklist
See CMC 18.21 .155 and CALGreen Appendix A5, Division A5.2 - Energy Efficiency.
A5.203.1.1 Choose one: 0.1 Outdoor lighting 0.2 Warehouse dock seal doors Not installing outdoor lighting,
0.3 Restaurant service water heating (comply with California Energy Code section 140.5, as amended) C1 N/A interior scope only. Occupancy =
O A Daylight design PAR 0.5 Exhaust air heat recovery B, S-i, not restaurant
A5.203.1.2.1
Choose one as applicable: 0.95 Energy budget 9 .90 Energy budget 0 N/A A5.203.1 .2 tier 1.2.
A5.211.1**
0 On-se renewable energy 01 N/A Don't intend to use
A5.211.3" Not offered by utility provider, o Green power (if offered by local utility provider, 50% minimum renewable sources) IN N/A A21 i
A5.212.1
0 Elevators and escalators ix N/AA5.212.1, not in scope
A5.213.1
D Steel framing Cl N/ANo new steel framing, A5.213.1
* Includes hotels/motels and high-rise residential buildings
** For alterations 2! $1,000,000 BPV and affecting >75% existing gross floor area, or alterations that add 2,000 square feet of new roof addition: comply
with CMC 18.30.130 instead.
2. Photovoltaic Systems
El Residential new construction (for low-rise residential building permit applications submitted after 111120). Refer to 2019 California
Energy Code section 150.1(c)14 for requirements. Notes: 1) High-rise residential buildings are subject to nonresidential photovoltaic
requirement (213 below) instead. 2) If project includes installation of an electric heat pump water heater pursuant to CMC 18.30.150(B)
(high-rise residential) or 18.30.170(B) (low-rise residential), increase system size by .3kWdc if PV offset option is selected.
Floor Plan ID (use additional
sheets if necessary)
CFA #d.u. Calculated kWdct Exception
0
0
0
0
Total System Size: kWdc
kWdc = (CFAx.572) / 1,000+ (1.15 x #d.u.)
*Formula calculation where CFA = conditional floor area, #du = number of dwellings per plan type
If proposed system size is less than calculated size, please explain.
[1 Nonresidential new construction or alterations 2$1,000,000 BPV and affecting ?750/6 existing floor area, or addition that increases roof
area by ?2,000 square feet. Please refer to CMC section 18.30.130 when completing this section. Note: This section also applies to
high-rise residential and hotel/motel buildings.
Choose one of the following methods:
0 Gross Floor Area (GFA) Method
GFA: 13,586 Mm. System Size: 20.4 kWdc
0 If < 10,000sf. Enter: 5 kWdc
IX If 2t 10,000s.f. calculate: 15 kWdc x (GFNI0,000)
Round building size factor to nearest tenth, and round system size to nearest whole number.
0 Time- Dependent Valuation Method
Updated 8/15/2019
City of Carlsbad Climate Action Plan Consistency Checklist
5. I[Jrransportation Demand Management (TDM): Nonresidential ONLY I
An approved Transportation Demand Management (TOM) Plan is required for all nonresidential projects that meet a threshold of employee-generated ADT.
City staff will use the table below based on your submitted plans to determine whether or nor your permit requires a TDM plan. If TDM is applicable to your
permit, staff will contact the applicant to develop a site-specific TOM plan based on the permit details.
Employee ADT Estimation for Various Commercial Uses
dill ADT for z
Use 10Y0i0IMPJ
Office (all)2 20 13
Restaurant 11 11
Retail3 8 4.5
Industrial 4 3.5
Manufacturing 4 3
4 1 Warehousing
i Unless otherwise noted, rates estimated from ITE Trip
Generation Manual, 10Edition
2 For all office uses, use SANDAG rate of 20 ADTII ,000 sf to
calculate employee ADT
Retail uses include shopping center, variety store, supermarket,
gyms, pharmacy, etc.
Other commercial uses may be subject to special
consideration
Sample calculations:
Office: 20,450 sf
1. 20,450 sf/1000 x 20 = 409 Employee ADT
Retail: 9,334 sf
First 1,000 sf=8ADT
9,334sf- 1,000 sf= 8,334 sf
(8,334 sf11,000 x 4.5) + 8 =46 Employee ADT
Acknowledgment
I acknowledge that the plans submitted may be subject to the City of Casbad's Transportation Demand Management Ordinance. I agree to be contacted should
my permit require a TOM plan and understand th tan approved TDM plan is a condition of permit issuance.
Applicant Signature: _L(It~1 14"\/\JVT) Date: '29 'l)
Person other than Applicant to be con cted for TDM compliance (if applicable):
Name (Panted): Phone Number:
Email Address:
Updated 8/15/2019
: 9590 CHESAPEAKE DR, SUITE 5
SAN DIEGO, CA 92117 : PHONE (619)-474-8548
: FAX (858)-412-3305
H.M. —Pit tLabs,Jac.
July 26,2019 RECEIVED
Pacific Building Group JAN 29 2020
9752 Aspen Creek Ct. Ste. 150 CITY OF CARLSBAft
San Diego, CA 92126 BUILDING DIVISION
ATTN: Dan Monda
Re: Lab #1697 10 - 2544 Campbell Place, Carlsbad, CA 92009.
On July 19th and July 22nd 2019, Kevin Groth, AHERA Building Inspector #ASBBII 00074, and
Christian Cardenas, AHERA Building Inspector #ASBBH 00075, with H.M. Pitt Labs, Inc.,
performed limited directed asbestos sampling of materials inside the locker rooms, conference room,
break room, storage room, gym room and outer conference room at 2544 Campbell Place, Carlsbad
CA 2009'as\diected by Dan Monda with Pacific Building Group.
'puildingrnateials are identified by the EPA as asbestos containing materials (ACM) when
the fiber concentration\of the material is identified as containing asbestos fibers in excess of one
percent (>1%). Building materials are identified by Cal/OSHA as asbestos containing construction
merials (ACCM) as ving greater than 0.1% by weight. Building materials found to contain
asbestos, which wilLbej disturbed, must be abated prior to demolition by a DOSH licensed Asbestos
a1teent contra/c'—tor. Any building materials homogeneous to identified asbestos containing
mteria1s must b cnsidered asbestos containing.
Aslièstos Contlinin! Materials: This limited sampling did NOT detect asbestos containing
materials/building components in the samples that were collected and analyzed.
Attached are the lab certification, technician certification, floor plans, and bulk asbestos
analysis. If you need additional information or clarification, please call (619) 474-8548.
Sincerely,
Christian Cardenas
AHERA Building Inspector #ASBBII00075
H.M. Pitt Labs, Inc.
Kevin Groth
AHERA Building Inspector #ASBBII00074
H.M. Pitt Labs, Inc.
S S S S • S • S S S S S S S S S S • S • S • S • • S • S
CUtDZO =0 00 3I
ELIELTIFG PARTITION TO REMAIN
NOTE' ALL EXISTING TO REMAIN INDICATED BY SOLID USE
C===3 SKEITIHO PARTITION TO DEMOLISH - i I I - NOM' ALL EXISTING TODEMOUS INDICATED BY DASHED GRAY LINE
A ..UIL.. EXISTING 000IITO BE REMOVED
Fi -iuJw.r T7. w1Ff1 - U I
C] I o1 =3 °
- E EXISTING ITEM TO REMAIN -n-.,--
IL - )I 1' II)i j 'M y NOT IN SOME
DEMOLITION KEYNOTES
Fil DEMO ENTIRE EXISTING LOCKER ROOMS INCLEIDIPID PARTITIONS. CLO. LID.. FLOORING. RECYCLE MATERIALS PER CAL GREEN REQUIREMENTS. CAP OAF ALL ELECTRICAL AND PLUMBING. SPACE TO BE FUTURE TENANT SPACE. --H----H------+----< r IAIflF -- - - - I RFMOAEUUEIEARACCSTIC*LUTNVIIINRFROMFJ.ISTNGCONFERENCE
ROOM REMOVE ALLSISEL ANOFRUEISO IEAOERSISCFFITETO ALLOW FOR I CONTEUUOUGCLG. 0
- . .
. ] •3 ________ ,. REMOVE ALL FLOORINO.WAUL, BASE.WUL MOUNTED EOUPMENT. DANK
OWL TS.CELINO.A1IOUGIIT FIXTURES.
_Q) 1±1 PATCH ANDPREP WALLS FOR PAINT.
0-11
REMOVE RT EXTERIOR VNNDOWBTO OPEN WALL FOR NEW OVERIIEA0DOOR.
-' IF.L ' 1 I DEMOLITION GENERAL NOTES rA
-. REPEl TOIDG.2,GENERALNOTESPORAOCmCNALINFORMATION.
1 I . BEMOALLEL TIAGWALLCOWRING.SIEMCOATWALLLSELLSAS NEEDED.
YERAYWmI OWNER EM STORAGEOR OISFOSALOF ANY REUSABLE MATERIALS. SEE -- - - AA-1 - I&..J- I ZYPRTGUNERALNOTESFORAOCITIONALREDJIREMEJIIS.
-.0 3 NETH000POEBINS REMOIALTO BE APPROVED BY THE DJLOIIIOOWNER. I . I I 4 IWOTEC1ALL EXTERIOR CLASTI000RS AS REWIRED OIIRING DEMEJITON. NOTIFY
OWNER OFANYREQUIREDREPMRSIDAMAGE.
I S REMOVE ALL lION-REQUIRED ELECTRICAL. TEL.GRTAAND RELATED
Q I CABUNGIECUEIITAT AREAS OF DEMOLITION. (IICLLEING ALL PATCH PMELS,
R.W.000 BACKBOARDS AND SECURITY EQUIPMENT) PATCH WELLS TOMATCH
ADMCEMT FRESH. BLANK COAER PLATES WILL NOT BE ACCEPTED. 5JISTFLODR LOCKER DEMOLITION IN.AII 2 ISYFLOOR LOBBY DETITOUTION PLAN N REMOVE EXISTING BASE INARSABOF FLOON DEMO. GE. TO CLEAN ALL GLUE FROM
'., WALLS. PATCft REPAIR A PAINT WALLS TO REMAIN.
7 REMOVE EXISTING THERMOSTAT(S) IN AREAS CA DENOUTIOU RE REGUIRED
N COORDINATE AU.ELECIRCALOEUO WITH ELECTRICAL ENGINEERED PLANS.REMOV
ALL EAISTINGSMTCHIIIO TNST IS NOTWIUZED IN NEWPLAN. DC. TO PATCH AND
REPAIR REQIERED.
V CLEAR AU. AREAS TO UIIE NEW CONDITION PRIOR TO OEJVERYOF TENANT SPACE.
SE. PATCH EXISTING HOLES. ETC. AT ALL LUSTING PARTITIONS. PREP IWR NEW FINISH!
SKIM COAT.
II. REMOVE MEQUANICALSUFPLYIRElURN OWLLSAS REQUIRED. SAVE FORPOSSIBLE
IEIAN.
b.J
t'J
0
July 26, 2019
Page 3
Lab Certification
United States Department of Commerce
National Institute of Standards and Technology
Certificate of Accreditation to ISO/IEC 17025:2005
NVLAP LAB CODE: 2005910
H.M. Pitt Labs Inc.
San Diego, CA
is accredited by the National VoluntatyLaboratoiy Accreditation Program for specific services,
listed on the Scope of Accreditation. for
Asbestos Fiber Analysis
This laboratory is accredited in accordance with the recognized International Stànda,vi ISOIlEC 17025:2005.
This accreditation demonstrates technical competence fore defined scope and the Operation of laboratory quality
management system (refer to joint ISO-ILAC-lAF Communique dated January 2009).
2018-10.01 thmug20I909.3O
Effacth'e Dates \ tJ / For ft AttkW VaSt Accreditation P109mm
July 26, 2019
Page 4
Technician Certification
Cer O .q if.'rajzing
I ®r
Hu toapisiud tbe -b.ir AHERA I h.buipsdS! UT1I ii approved by Tb. Calf.ri&. Dh1i I S.fy aid U..Itb as Jews ______
Cal-OSHAC.. .mbq5-I4I45
4qiAftTscAode"
A.
!ffill
y-r -.i.--
- ,-• •••• •.., .-•.--- '.-
C'ertificate..of Training
Cbri,U.n Card,us
LutFaáiSN: 122
flopkbd the 34-beer AHIRA I. ilfiag Iaip.cr C..rs.aiappreeed by. Tb. Cariferils D[vW= O1QVpPatiDIS1 S.f.*v and Reelib ON ha. 40 tbii4ue',2oI9
I . Ca AC.. sA('bMbifCA-O4145
A.Mt c .smisiiijr*te w,der)4Z4 ddell
-490- ~
___aeLIb
.__- ... • ______
TriiiOict.i'
-
'. IIJ.PIkI ii' -:
(I47I&40 Cetdllcsts I A.SEBU 00073
- •-.-._-- erA -.--.----
H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/2312019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-600!M4-82-020
Analysis Number: 169710-1
Customer Number: 01
Classification: Ceiling tile 2 ft x 4 ft Description: White - Conference Room
Results: Non-Asbestos: 75% Cellulose Fibers in Tan Ceiling Tile
Analysis Number: 169710-2
Customer Number: 02
Classification: Ceiling tile 2 ft x 4 ft Description: White - Conference Room
Results: Non-Asbestos: 75% Cellulose Fibers in Tan Ceiling Tile
Analysis Number: 169710-3
Customer Number: 03
Classification: Ceiling tile 2 ft x 4 ft Description: White - Conference Room
Results: Non-Asbestos: 70% Cellulose Fibers & < 1% Glass Fibers in Tan Ceiling Tile
Analysis Number: 169710.4
Customer Number: 04
Classification: Drywall Description: White - Conference Room
Results: Non-Asbestos: Non-Fibrous White Drywall
• All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
OAOV~f 10 9411 APPILOVUI BY 5 Datot 01/25/2010 REVIEWED BY:_____________________
LELAND S. PITT, CIH Lee Pitt
Page 1 of 14
H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company: Date Entered: 07/23/2019
Pacific Building Group Analyzed By: Tisha Melville
9752 Aspen Creek Ct. Ste. 150 Date Analyzed: 07/26/19
San Diego, CA 92126 Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-600!M4-82-020
Analysis Number: 169710-5
Customer Number: 05
Classification: Drywall Description: White - Conference Room
Results: Non-Asbestos: Non-Fibrous White Drywall
Analysis Number: 169710-6
Customer Number: 06
Classification: Drywall Description: White - Conference Room
Results: Non-Asbestos: Non-Fibrous White Drywall
Analysis Number: 169710-7
Customer Number: 07
Classification: Carpet Glue Description: Yellow - Conference Room
Results: Non-Asbestos: Non-Fibrous White Glue
Analysis Number: 169710-8
Customer Number: 08
Classification: Carpet Glue Description: Yellow - Conference Room
Results: Non-Asbestos: 5% Synthetic Fibers in White Glue
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPIIOVUI BY DatoIl 07/25/2010 REVIEWED BY: OAfte gQev _____________
LELAND S. PITT, CIH Lee Pitt
Page 2of14
k.1I H.M. Pitt Labs. Inc. Lab Number: 169710-237971
9590 Chesapeake Dr Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company: Date Entered: 07/23/2019
Pacific Building Group Analyzed By: Tisha Melville
9752 Aspen Creek Ct. Ste. 150 Date Analyzed: 07/26/19
San Diego, CA 92126 Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
07/19/2019 Kevin Groth Lab Notes:
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-600!M4-82-020
Analysis Number: 169710-9
Customer Number: 09
Classification: Carpet Glue Description: Yellow - Conference Room
Results: A: Non-Asbestos: 90% Synthetic Fibers in Brown Carpet
B: Non-Asbestos: Non-Fibrous White Glue
Analysis Number: 169710-10
Customer Number: 10
Classification: Cove base mastic Description: Tan - Conference Room (Exit)
Results: Non-Asbestos: Non-Fibrous White Cove Base Mastic
Analysis Number: 169710-11
Customer Number: 11
Classification: Joint Compound Description: White - Conference Room
Results: Non-Asbestos: < 1% Cellulose Fibers in White Joint Compound
Analysis Number: 169710-12
Customer Number: 12
Classification: Joint Compound Description: White - Conference Room
Results: Non-Asbestos: Non-Fibrous White Joint Compound
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPROVIII BY:_ ilateit 01/25/2010 REVIEWED BY:_____________
LELAND S. PITT, CIH Lee Pitt
Page 30f14
H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-600!R-931116 AND EPA-600/M4-82-020
Analysis Number: 169710-13
Customer Number: 13
Classification: Joint Compound Description: White - Conference Room
Results: Non-Asbestos: c 1% Cellulose Fibers in White Joint Compound
Analysis Number: 169710-14
Customer Number: 14
Classification: Interior Wall Texture Coat Description: White - Conference Room
Results: Non-Asbestos: Non-Fibrous White Wall Texture
Analysis Number: 169710-15
Customer Number: 15
Classification: Interior Wall Texture Coat
Results: Non-Asbestos: Non-Fibrous White Wall Texture
Analysis Number: 169710-16
Customer Number: 16
Description: White - Conference Room
Classification: Interior Wall Texture Coat Description: White - Conference Room
Results: Non-Asbestos: Non-Fibrous White Wall Texture
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APt'HOVHI BY: Datfilt 01/25/2019 REVIEWED BY: OA4;e 'OG4'>001 ______________________
LELAND S. PITT, CIH Lee Pitt
Page 4 of 14
H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305 4•_. .(
Company: Date Entered: 07/23/2019
Pacific Building Group Analyzed By: Tisha Melville
9752 Aspen Creek Ct. Ste. 150 Date Analyzed: 07/26/19
San Diego, CA 92126 Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
07/19/2019 Kevin Groth Lab Notes:
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-600!R-93/116 AND EPA-6001M4-82-020
Analysis Number: 169710-17
Customer Number: 17
Classification: Floor tile 12 in x 12 in Description: Beige - Conference Room
Results: Non-Asbestos: Non-Fibrous Tan Ceramic Tile
Analysis Number: 169710-18
Customer Number: 18
Classification: Floor tile 12 in x 12 in Description: Beige - Conference Room
Results: Non-Asbestos: Non-Fibrous Tan Ceramic Tile
Analysis Number: 169710-19
Customer Number: 19
Classification: Floor tile 12 in x 12 in Description: Beige - Conference Room
Results: Non-Asbestos: Non-Fibrous Tan Ceramic Tile
Analysis Number: 169710-20
Customer Number: 20
Classification: Carpet Glue Description: Yellow - Conference Room (Exit)
Results: Non-Asbestos: Non-Fibrous Yellow Glue
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
IQ APPROVED BY: Datall 07/25/2010 REVIEWED BY:_____________
LELAND S. PITT, CIII Lee Pitt
Page 5of14
It H.M. Pitt Labs. Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
07/19/2019 Kevin Groth Lab Notes:
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-600!M4-82-020
Analysis Number: 169710-21
Customer Number: 21
Classification: Carpet Glue
Results: Non-Asbestos: c 1% Cellulose Fibers in Yellow/Black Glue
Analysis Number: 169710-22
Customer Number: 22
Classification: Carpet Glue
Results: Non-Abestos: 1-2% Cellulose Fibers in Yellow Glue
Analysis Number: 169710-23
Customer Number: 23
Classification: Drywall
Results: Non-Asbestos: Non-Fibrous White Drywall
Analysis Number: 169710-24
Customer Number: 24
Classification: Drywall
Results: Non-Asbestos: Non-Fibrous White Drywall
Description: Yellow - Conference Room
Description: Yellow - Conference Room
Description: White - Locker Room
Description: White - Locker Room
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPROVUI BY- Datet 01/25/2019 RE19EWED BY:4 f'G ;~
LELAND S. PITT, CIH Lee Pitt
Page 6of14
., H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-6001M4-82-020
Analysis Number: 169710-25
Customer Number: 25
Classification: Drywall Description: White - Locker Room
Results: Non-Asbestos: Non-Fibrous White Drywall
Analysis Number: 169710-26
Customer Number: 26
Classification: Joint Compound Description: White - Locker Room
Results: Non-Asbestos: Non-Fibrous White Joint Compound
Analysis Number: 169710-27
Customer Number: 27
Classification: Joint Compound Description: White - Locker Room
Results: Non-Asbestos: Non-Fibrous White Joint Compound
Analysis Number: 169710-28
Customer Number: 28
Classification: Joint Compound Description: White - Locker Room
Results: Non-Asbestos: Non-Fibrous White Joint Compound
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPROVIII BY:_ Datahl 07/25/2019 REVIEWED BY: OAeCeV'941?1 _____________
LELAND S. PITT, CIH Lee Pitt
Page 70f 14
H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-600!1110114-82-020
Analysis Number: 169710-29
Customer Number: 29
Classification: Interior Wall Texture Coat Description: White - Locker Room
Results: Non-Asbestos: < 1% Cellulose Fibers in White Wall Texture
Analysis Number: 169710-30
Customer Number: 30
Classification: Interior Wall Texture Coat Description: White - Locker Room
Results: Non-Asbestos: Non-Fibrous White Wall Texture
Analysis Number: 169710-31
Customer Number: 31
Classification: Interior Wall Texture Coat Description: White - Locker Room
Results: Non-Asbestos: Non-Fibrous White Wall Texture
Analysis Number: 169710-32
Customer Number: 32
Classification: Ceiling tile 2 ft x 4 ft Description: White - Locker Room
Results: Non-Asbestos: 80% Cellulose Fibers in Tan Ceiling Tile
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
OAOr~1106;~ APPROVUI BY: _ DateiL 01/25/2010 REVIEWED BY:_______________
LELAND S. Pin, CiH Lee Pitt
Page 80f 14
It
H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-600!M4-82-020
Analysis Number: 169710-33
Customer Number: 33
Classification: Ceiling tile 2 ft x 4 ft Description: White - Locker Room
Results: Non-Asbestos: 80% Cellulose Fibers in Tan Ceiling Tile
Analysis Number: 169710-34
Customer Number: 34
Classification: Ceiling tile 2 ft x 4 ft Description: White - Locker Room
Results: Non-Asbestos: 80% Cellulose Fibers in Tan Ceiling Tile
Analysis Number: 169710-35
Customer Number: 35
Classification: Ceiling tile 2 ft x 4 ft Description: White - Locker Room
Results: Non-Asbestos: 70% Cellulose Fibers & 10% Glass Fibers in Tan Ceiling Tile
Analysis Number: 169710-36
Customer Number: 36
Classification: Ceiling tile 2 It x 4 ft Description: White - Locker Room
Results: Non-Asbestos: 50% Cellulose Fibers & 30% Glass Fibers in Tan Ceiling Tile
• All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
Fw—"~~C OA"Pe 10 9421 API'ROVHI BY:__ DateiL 01/25/2010 REVIEWHI BY:___________________
LELAND S. PITI, CIH Lee Pitt
Page 9of14
S
H.M. Pitt Labs, Inc. Lab-Number: 169710-237971
9590 Chesapeake Dr Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
07/19/2019 Kevin Groth Lab Notes:
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-6001M4-82-020
Analysis Number: 169710-37
Customer Number: 37
Classification: Ceiling tile 2 ft x 4 ft Description: White - Locker Room
Results: Non-Asbestos: 50% Cellulose Fibers & 30% Glass Fibers in Tan Ceiling Tile
Analysis Number: 169710-38
Customer Number: 38
Classification: Floor tile 12 in x 12 in Description: Brown - Locker Room Floor Tile
Results: Non-Asbestos: Non-Fibrous Gray Ceramic Tile
Analysis Number: 169710-39
Customer Number: 39
Classification: Floor tile 12 in x 12 in Description: White - Locker Room Floor Tile
Results: Non-Asbestos: Non-Fibrous Tan Ceramic Tile
Analysis Number: 169710-40
Customer Number: 40
Classification: Floor tile 9 in x 9 in Description: Tan - Locker Room Floor Tile
Results: Non-Asbestos: Non-Fibrous Tan Ceramic Tile
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APP1IOVHI BY:___ IBM 01/25/2019 REVIEWED BY:___________________
LELAND S. PITT, CIH Lee Pitt
Page 10 of 14
H.M. Pitt Labs. Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
07/19/2019 Kevin Groth Lab Notes:
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-6001M4-82-020
Analysis Number: 169710.41
Customer Number: 41
Classification: Mastics and Glues Description: Black - Locker Room
Results: Non-Asbestos: Non-Fibrous Gray Glue
Analysis Number: 169710.42
Customer Number: 42
Classification: Gasket materials Description: Brown - Outer Conference Wall
Results: Non-Asbestos: Non-Fibrous White Gasket
Analysis Number: 169710.43
Customer Number: 43
Classification: Gasket materials
Results: Non-Asbestos: Non-Fibrous White Gasket
Analysis Number: 169710-44
Customer Number: 44
Description: Brown - Outer Conference Wall
Classification: Gasket materials Description: Brown - Outer Conference Wall
Results: Non-Asbestos: Non-Fibrous White Gasket
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPflOVBY:______________ DatoiL 07/25/2010 REflEWEDBY:4( 10 9411
LELAND S. PITT, cIH Lee Pitt
Page 11 of 14
S
H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
4... d
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-93!116 AND EPA-6001M4-82-020
Analysis Number: 169710.45
Customer Number: 45
Classification: Concrete Wall Description: Brown - Outer Conference Wall
Results: Non-Asbestos: Non-Fibrous Gray Concrete
Analysis Number: 169710-46
Customer Number: 46
Classification: Concrete Wall Description: Brown - Outer Conference Wall
Results: Non-Asbestos: Non-Fibrous Gray Concrete
Analysis Number: 169710.47
Customer Number: 47
Classification: Concrete Wall Description: Brown - Outer Conference Wall
Results: Non-Asbestos: Non-Fibrous Gray Concrete
Analysis Number: 169710-48
Customer Number: 48
Classification: Cove base mastic Description: White-Break Room
Results: Non-Asbestos: Non-Fibrous White Cove Base Mastic
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPIIOVUIBY: Fo_&G~,F*Datfilt 01/25/2010 RE1flEWED BY- /( 0*9411
LELAND S. PITT, CIH Lee Pitt
Page 12 of 14
, H.M. Pitt Labs, Inc. Lab Number: 169710-237971
9590 Chesapeake Dr Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305
Company:
Pacific Building Group
9752 Aspen Creek Ct. Ste. 150
San Diego, CA 92126
Date Entered: 07/23/2019
Analyzed By: Tisha Melville
Date Analyzed: 07/26/19
Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who Sampled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-600/R-93/116 AND EPA-600!M4-82-020
Analysis Number: 169710.49
Customer Number: 49
Classification: Cove base mastic Description: White Break Room
Results: Non-Asbestos: Non-Fibrous White Cove Base Mastic
Analysis Number: 169710-50
Customer Number: 50
Classification: Cove base mastic Description: White Office Storage
Results: Non-Asbestos: Non-Fibrous White Cove Base Mastic
Analysis Number: 169710-51
Customer Number: 51
Classification: Floor tile 12 in x 12 in Description: Beige Storage Room
Results: Non-Asbestos: < 1% Cellulose Fibers in Tan Floor Tile
Analysis Number: 169710-52
Customer Number: 52
Classification: Floor tile 12 in x 12 in Description: Beige Storage Room
Results: Non-Asbestos: c 1% Cellulose Fibers in Tan Floor Tile
All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPROVUI BY:_______________ B0107/25/2010 REVIEWED BY: 04or-elo'9411 _____________
LELAND S. PITt, CIH Lee Pitt
Page 13 of 14
I.•.i H.M. Pitt Labs. Inc. Lab Number: 169710-237971
9590 Chesapeake Dr - Ste 5 San Diego, CA 92123 Tel: 619-474-8548 Fax: 858-412-3305 4
Company: Date Entered: 07/23/2019
Pacific Building Group Analyzed By: Tisha Melville
9752 Aspen Creek Ct. Ste. 150 Date Analyzed: 07/26/19
San Diego, CA 92126 Customer P0! Claim#:
Contract Number:
Job Site: 2544 Campbell Place, Carlsbad, CA. 92009 Date Sampled Who SamPled
Lab Notes: 07/19/2019 Kevin Groth
POLARIZED LIGHT MICROSCOPY ANALYSIS REPORT - EPA-6001R-931116 AND EPA-600!M4-82-020
Analysis Number: 169710-53
Customer Number: 53
Classification: Floor tile 12 in x 12 in Description: Beige Storage Room
Results: Non-Asbestos: Non-Fibrous Tan Floor Tile
Analysis Number: 169710-54
Customer Number: 54
Classification: Cove base mastic Description: Brown Exercise Room
Results: Non-Asbestos: Non-Fibrous White Cove Base Mastic
Analysis Number: 169710-55
Customer Number: 55
Classification: Cove base mastic Description: Brown Exercise Room
Results: Non-Asbestos: Non-Fibrous White Cove Base Mastic
Analysis Number: 169710-56
Customer Number: 56
Classification: Cove base mastic Description: Brown Exercise Room
Results: Non-Asbestos: Non-Fibrous White Cove Base Mastic
• All samples tested as submitted to the lab. H.M. PITT LABS, INC. does not assume responsibility for the accuracy of the information
submitted with the samples unless done by an employee of H.M. PITT LABS, INC.
These test results relate only to the sample(s) identified above.
This report may not be used to claim endorsement by NVLAP or any agency of the Federal Government.
This report shall not be reproduced, except in full, without written approval of H.M. Pitt Labs, Inc.
Samples are archived for 90 days from date of receipt and will be disposed of properly following this period.
Quantitative value is based on PLM CVES (Calibrated Visual Estimates) with a detection limit of <1%.
APPROVED BY: Datot 01/25/2010 REVIEWED BY:_____________
LELAND S. PITT, CIH Lee Pitt
Page 14 of 14
PERMIT REPORT
r(c ity of
Carlsbad
Permit No: PREV2020-0071
CARLSBAD, CA 92009-1768 Status: Closed - Finaled
Work Class: Commercial PermitRevisi
Track #: Applied: 05/07/2020
Lot #: Issued: 06/01/2020
Project #: Finaled Close Out: 08/11/2020
Plan #:
Construction Type :V-B
Orig. Plan Check #: CBC2020-0034 Inspector:
Plan Check #: Final Inspection:
Print Date: 08/11/2020
Job Address:•• 2544 CAMPBELL PL, # 150,
Permit Type: BLDG-Permit Revision
Parcel #: 2132611800
Valuation: $ 0.00
Occupancy Group: B/S1/A2
#of Dwelling Units:
Bedrooms:
Bathrooms:
Project Title:
Description: ADVANCED DIABETES SUPPLY: CHANGES TO ARCHITECTURAL PLANS
Property Owner: Contractor:
SIR CAMPBELL PLACE INC PACIFIC BUILDING GROUP
255 WASHINGTON ST. #300 97S2 ASPEN CREEK CT, #STE 100
NEWTON, MA 02458 SAN DIEGO, CA 92126-1082
(858) 652-5088
FEE AMOUNT
BUILDING PLAN CHECK REVISION ADMIN FEE' $35.00
MANUAL BLDG PLAN CHECK FEE -
$300.00
Total Fees: $ 335.00 1 Total Payments To Date: $ 335.00 Balance Due: $0.00
Building Division Page 1 of 1
1635 Faraday Avenue, Carlsbad CA 92008-7314 1 760-602-2700 1 760-602-8560 f I www.carlsbadca.gov
CC*tyof
Carlsbad
PLAN CHECK REVISION OR
DEFERRED SUBMITTAL
APPLICATION
B-15
Development Services
Building Division
1635 Faraday Avenue
.760-602-2719
www.carlsbadca.gov
Original Plan Check Number CBC2020-0034 Plan Revision Number
702
Project Address 2544 Campbell P1. #150
General Scope of Revision/Deferred Submittal: Reduced scope of work.
Removed build out of offices, phone rooms and conference room in open offices, removed roll-up door. Existing ACT ceiling to remain at break room.
CONTACT INFORMATION:
Name Brittany Montgomery Phone 858-638-7277 Fax
Address 3911 Sorrento Valley Blvd. #120 City San Diego Zip 92121
Email Address bm0ntg0mery@waremalc0mb.com
Original plans prepared by an architect or engineer, revisions must be signed & stamped by that person.
1 . Elements revised: lJ Plans LI Calculations LI Soils EJ Energy LI Other
2
Describe revisions in detail
3.
List page(s) where each
revision is shown
Removed build out of phone rooms and conference room at (E) open office 110. Existing lighting to remain. A2.1, A3.1, A4.1
Removed build out of offices at open office 113. Existing ACT ceiling and lighting to remain. A2.1, A3.1, A4.1, A5.1
Removed interior/exterior roll-up door at break room 118. A2.1, A6.1, A7.1
Existing ACT ceiling and lighting to remain at break room 118. A4.1, AD.3
Does this revision, in any way, alter the exterior of the project? .LI Yes Eli No
Does this revision add ANY new floor area(s)? LI Yes • No
Does this revision affect any fire related issues? LI Yes U No
Is this a complete set? Wil Yes LI No
5Signature_i.tttt 7i YicX) Date 05-04-2020
1635 Faraday Avenue, Carlsbao, CA 92008 X. 760-602- 2719 E: 760-602-8558 Email: building@carlsbadca.gov
wcadsbaov
EsGil /
A SAFEbuilt Company / DATE: MAY 14, 2020 APPLICANT
/0 JURIS.
JURISDICTION: CARLSBAD (
PLAN CHECK #.: CBC2020-0034 (REV.-1) - PREV2020-0071 - SET: I
PROJECT ADDRESS: 2544 CAMPBELL PLACE, #150
PROJECT NAME: ADVANCED DIABETES SUPPLY
The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
Lj 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.
EJ 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.
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:
EsGil staff did not advise the applicant that the plan check has been completed.
E EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone #:
Date contacted:511L2( ji1/'- Email:
Mail Telephone Fax In Person
FEMARKS: The owner's revisions are under this permit to reduce the scope of work. Selected
sheets are impacted. Replacement sets are submitted for review & approval.
By: ALl SADRE S.E. Enclosures:
EsGil
5/11
9320 Chesapeake Drive, Suite 208 • San Diego, California 92123 • (858) 560-1468 • Fax (858) 560-1576
CARLSBAD CBC2020-0034 (REV.-1) - PREV2020-0071 SET: I
MAY 149 2020
(DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: CARLSBAD PLAN CHECK #.: CBC2020-0034
(REV.-1) - PREV2020-0071
PREPARED BY: ALl SADRE S.E. DATE: MAY 14, 2020
BUILDING ADDRESS: 2544 CAMPBELL PLACE, #150
BUILDING OCCUPANCY:• B/S1/A2; V-B/SPR.
BUILDING
PORTION
AREA
(Sq. Ft.)
Valuation
Multiplier
Reg.
Mod.
VALUE ($)
PLAN REV.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code 1CB By Ordinance
1997 UBC Building Permit Fee [j
1997 UBC Plan Check Fee
Type of Review: r Complete Review 1 Structural Oni
r Repetitive Fee .
r Other
Repeats .Hourly
EsGil Fee
P. V
* Based on hourly rate
I 21 Hrs. @*
$120001 I $240.001
Comments: Sheet 1ofi