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Home My WebLink About2558 ROOSEVELT ST; ; CB911362; Permit.. , . B U l L D I N G P E R M I T 10/11/91 13:52 Page 1 oi 1 Job Addre~s: 2558 ROOSEVELT ST Str: Permit Ty)e: COMMERCIAL TENANT IMPROVEMEN~ Parcel No: 203-102-35-00 Valuation: 17,.661 Construction Type : NEW Occupancy Group: 82 Class Code: Description: 841 SF OFFICE SPACE STE 306 Appl/Ownr : PRESIDENTIAL PLAZA (619) 2558 ROOSEVELT ST , STE _3_0_5_~_ CARLSBAD, CA 92008 CONTRACTOR HENRY TUBBS 1991 VILLAGE PARK WAY ENCINITAS,, CA 92024 I<** Fees Required *~* *•* Fees : Adjustments: Total Fees: Building Permit Plan Check Strong Motion Fee Enter "Y" to Autocalc * BUILDING TOTAL 954.00 .00 954.00 Enter "Y' for Plumbing Enter ''Y for Electric Enter 'Y" for Remodel "ELECTRICAL TOTAL Enter Y' for Mechanical Issue Fee> Permit No: CB9113b2 Project No : A91Ul728 Development No: Fl: Ste: 4793 10/11/91 0001 01 02 C-PRHT 831-00 M_~1i Status: .SSUED Applied: 10/02/91 Apr/Issue: 10/11/91 Validated By : CD 434-1742 619-632--0332 .00 !.23. 00 297 .00 934.00 10.00 10.00 20.00 * * k y N y y N [~SP._~~ "' PROVAL DATE ((---1,,9 L: .. c_1_eA_h_~_.~_~[:_:: :.:.:.:.:.:.:.:.:.-:.-.. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 -----·~· --·--·--··-------------·--- PERMIT APPUCATION City of carlsbad Building Departaent 2075 Las Pal_. Dr., Carlsbad, CA 92009 (619) 438-1161 I. PEkM1 I hPR A -15('eommerc1al U New Butldmg ii( lenant Improvement B -D Industrial □ New Building D Tenant Improvement ~ V C -□ Residential □ Apartment □ Condo □ Single Family Dwelling □ Addition/ Alteration □ Duplex □ Demolition □ Relocation □ Mobile Home □ Electrical □ Plumbing □ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other 2. PRCllF.Cf INFORMATION Address :u ~~ i<'ooJCJe.;::r ~T. Building or Suite No. 3 0 b C-PRHT cfl.. y '&.. q) r FOR OFFICE USE ONLY Nearest Cross Street ~A- LEGAL DESCRIVI ION ~ Su&hVJs1on Name/Number 0mt No. Phase No. CHECK BEWW IF S0BMI 11 Eb: ,,,212 Energy Cales □ 2 Structural Cales □ 2 Soils Report ASSESSOR'S PARCEL ')..tj 3 -I O 7. -j '- NAME CITY NAME NAME ADDRESS □ I Addressed Envelope EXISTING USE b.£tlc.e DAY TELEPHON CITY STATE ZIP CODE DAY TELEPHONE PROPOSED USE 6 · ~tr;_u:,_ ·Tu--m~ ADDRESS lqq1 VllLAGG PK"-vi'J. #/b$ CITY £~(\f\.'.) STATE C/1. ZIP CODE C/UJ-Z..Lf DAY TELEPHONE /tt9)b 3J.. 0 3-?:: STATE LIC. #I/ti¼ ,<c LICENSE CLASS J? CITY BUSINESS LIC. # /')('4 ~ < DESIGNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WOkkERS' WMPENSAllON Workers; Compensation Oeclarauon: I hereby afftrm that I have a certUlcate of consent to self-msure issued by the VI rector of lndustnal Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection ~~ment (Section 3800, Lab. C). INSURANCE COMPANY~ G POLICY NO.~ +1-t.. EXPIRATION DATE 123-00 rtl 1cate o xempuon: ce t at m per ormance o e wor or w 1c 1s pemu ts ISSU , s a no emp oy any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNm-B0llD£k DECOOtA'IIUN Owner-Bu1ider Declaration: I hereby affirm that I am exempt from the Contracto?s Llcense Law for the foliowmg reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's Llcense 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.). D 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). □ I am exempt under Section ________ Business and Professions Code for this reason: (Sec. 7031.S Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.S by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). SIGNATURE DATE COMPLEIE IHIS S£CIION FOR NON-RESlbEN4ilAL BOILOING PERMll'S 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 2~0S, 25S33 or 25S34 of the Presley-Tanner Hazardous Substance Account Act? □ YES J<NO Is the applicant or future building occ~nt required to obtain a permit from the air pollution control district or air quality management district? □ YES NO Is the facility to be constructed within ,000 feet of the outer boundary of a school site? □ YES )'(NO IF ANY OF THE ANSWERS ARE YES, A FINALCER11FICATE OF OCCUPANCY MAYNITT BE lSSIJED AFTER JULY I, 1989 IINIBSS THEAPPUCANT HAS MET OR JS Ml!lmNG THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLII11ON WNTROL DJS11UCT. re ts a construction en mg agency or t LENDER'S NAME LENDER'S ADDRESS I certify that I have read the apphcauon and state that the a&ive mformauon 1s correct. I agree to comply with all City ordmances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purpnses. I ALSO AGREE ID SAVE INDEMNIFY AND KEEP IIARMIJ!SS THE CITY OF CARlSBAD AGAINST AIL LIAB1U11F.S, JUDGMENTS, <DSTS AND EXPENSES WIIlCH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN WNSF.QUENCE OF THE GRANTING OF TIIlS PERMIT. OSHA: An OSHA permit is required for excavations over S'0" deep and demolition or construction of structures over 3 stories in height. (' -• PERMIT# CB911362 CITY OF CARLSBAD INSPECTION REQUEST FOR 11/01/91 STE 306 DESCRIPTION: 841 SF OFFICE SPACE TYPE: CTI INSPECTOR AREA MP PLANCK# CB911362 OCC GRP CONSTR. TYPE NEW STR:** FL:**** STE: 306 JOB ADDRESS: 2558 ROOSEVELT ST APPLICANT: PRESIDENTIAL PLAZA CONTRACTOR: HENRY TUBBS PHONE: (619) 434-1742 OWNER: REMARKS: MH/HENRY/632-0332 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION 19 ST Final Structural 29 PL Final Plumbing 39 EL Final Electrical 49 ME Final Mechanical ***** DATE DESCRIPTION 103091 Rough Combo 102991 Rough Combo 101891 Interior Lath/Drywall ~~~::: 619-632-03,3? +------ INSPECTOR ft l °\.,, _ AC COMMENTS INSPECTION HISTORY ***** ACT INSP COMMENTS AP MP CEILING co MP ON CARD AP MP WALLS 101591 Frame/Steel/Bolting/Welding PA MP WALLS OK 101591 Rough Electric PA MP WALLS OK 101591 Rough/Ducts/Dampers NR MP \. .. DEPT: BUILDING FIN~ING INSPECTION ENGINEERIN✓~ PLANNING U/M PLAN CHECK#: CB911362 PERMIT#: CB911362 PROJECT NAME: 841 SF OFFICE SPACE '-STE 30~ ADDRESS: 2558 ROOSEVELT ST SUITE# 306 CONTACT PERSON/PHONE#: MH/HENRY/632-0332 SEWER DIST: CA WATER DIST: CA RECEIVE ... WATER DATE: 11/01/91 PERMIT TYPE: CTI ===================--====-----=======--====-----======--===================== INSPEq'ED DATE 11/1(9 ( APPROVE~ INSPECTED: DISAPPROVED BY: C~ INSPECTED DATE BY: INSPECTED: APPROVED DISAPPROVED INSPECTED DATE BY: INSPECTED: APPROVED DISAPPROVED ============================================----=====---===================== COMMENTS: ESGIL CORPORATION 9320 CHESAPEAKE DR., SUITE 208 SAN DIEGO, CA 92123 (619) 560-14-68 DATE: ~/---=O'--__ Z..___-_2_.,__./ __ ----,--_______ _ JURISDICTION: CA V' Is ~ q J QAPPLICANT 8JUltISDIC~ J PLAfrCHEC PLAN CHECK NO: 9) -/,J {c 2._ SET : _L Q FILE COPY QUPS QDESIGNER PROJECT ADDRESS: ~ 6 o 8 7:(_C) c s e-' ·:,I.:> /I GI-. -,.., I \., I PROJECT NAME: _ _._/_=_L'-'--____ 0 __ 7~;_'_,_~_c_· _____ _ ~-The plans transmitted herewith have been corrected where JL.)-necessary and substantially comply with the jurisdiction's building codes. □ □ □ □ The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficien- cies identified-,-------------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 h erewith is for your information. The plans are being held at Esgil Corp. until corrected plans are submitted for recheck. The applicant's copy of the check list is enclosed for the jurisdiction to return to the applicant contact person. O The applicant's copy of the check list has been sent to: ® Esgil staff did not advise the applicant contact person that -plan che ck has been compl e ted. 0 Esgil staff did advise applicant that the plan check has been comp leted. Person contacted : ------------- Date contacted: ---------Tel ephone# ________ _ □ REMARKS : _______________________ _ By «lltdJi;;J;;iEnciosures : ______ _ □GA □AA ORN ODM Date,10 -7 -'9/ Jurisdiction Q .r /-5 La..J Prepared by1 ;cf« VALUATION AND PLAN CHECK FEE □ Bldg. Dept. O Esgil PLAN CHECK NO. :J / -/3 02 2-·) BUILDING ADDRESS -;;__s S-B R,oo c. r-1 •J c /f-< 1-- APPLICANT/coNTACT ---------PHONE NO. _______ _ BUILDING OCCUPANCY R -2-DESIGNER PHONE ------ TYPE OF CONSTRUCTION / J I\) CONTRACTOR PHONE ----- BUILDING PORTION BUILDING AREA VALUATION VALUE MULTIPLIER -r I · f3 41 ~!. OC, J 7 G{;/ / - Air Conditionin£ Commercial @ .. Residential @ Res. or Comm. Fire S'Orinklers @ Total Value I / 7 {;;(; / I Building Permit fee$ plan Che ck f ee__;S;;...._ ___________________ $;:;....._.,_/_.;..)___.;;..._1_....;._,_B_s_- COM MEN TS ... :--------------------------- SHEET -I-OF / 12/87 1 2 3 S N R T D D C C C H H H E E E K K K ~□□ BUILDING PLANCHECK ENGINEERING CHECKLIST DATE: _/_0....,)/~1'-',l.___tr I ___ _ PLANCHECK NO. __ C/ l_-__c/_3_rc,_Z __ 0ITEM COMPLETE ITEM INCOMPLETE NEEDS YOUR ACTION ITEM SELECTED PROJECT ID: _,,C)C!./n'--''F'-'1'-=ce"'''--T::... -=I=-. .__ _____ _ LEGAL REQUIREMENTS Site Plan 1. ~□□ 2. Provide a fully dimensioned site plan drawn to scale. Show: north arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, right-of-way width and dimension setbacks. Show on site plan: Finish floor elevations, pad to and and ✓□□ 3 • elevations, elevations of finish grade adjacent building, existing topographical lines, existing proposed slopes, driveway with percent (%) grade drainage patterns. Provide legal description and Assessors Parcel Number. ~□□ Discretionary Approval Compliance 4. No Discretionary approvals were required. □□□ 5. Project complies with all Engineering Conditions of Approval for Project No. ________ _ □□□ 6. Project does not comply with the following Engineering Conditions of Approval for Project No. _________ _ Conditions complied with by: ________ .Date: ___ _ Field Review Gr□ 0 7. □□□ 8. □□□ □□□ □□□ Field review completed. No issues raised. Field review completed. The following issues or discrepancies with the site plan were found: A. B. c. Site lacks adequate public improvements Existing drainage improvements not shown or in conflict with site plan. Site is served by overhead power lines. P:\DOCS\H!SFORHS\FRH0010.DH REV. 02/27 /91 000 D. Grading is required to access site, create pad or provide for ultimate street improvement. 000 E. site access visibility problems exist. Provide onsite turnaround or engineered solution to problem. □□□ F. Other: _________________________ _ ~□□ □□□ Dedication Requirements 9. 10. No dedication required. Dedication required. Please have a registered Civil Engineer or Land Surveyor prepare the appropriate legal description together with an 8\" x 1111 plat map and submit with a title report and the required processing fee. All easement documents must be approved and signed by owner(s) prior to issuance of Building Permit. The description of the dedication is as follows: _______________ _ Dedication completed, Date __________ _ By: ___ _ ~Improvement Requirements DD 11. No public improvements required. SPECIAL NOTE: Damaged or defective improvements found adjacent to building site must be repaired to the satisfaction of the City inspector prior to occupancy. PUblic improvements required. This project requires construction of public improvements pursuant to Section 18.40 of the City Code. Please have a registered Civil Engineer prepare appropriate improvement plans and submit for separate plancheck process through the Engineering Department. Improvement plans must be approved, appropriate securities posted and fees paid prior to issuance of permit. The required improvements are: ___ _ Improvement plans signed, Date: _________ by: ___ _ P:\DOCS\MISFORMS\FRM0010.DH REV. 02/27 /91 D D D 13. Improvements are required. Construction of the public improvements may be deferred in accordance with Section 18.40 of the City Code. Please submit a letter requesting deferral of the required improvements together with a recent title report on the property and the appropriate processing fee so we may prepare the necessary Future Improvement Agreement. The Future Improvement Agreement must be signed, notarized and approved by the City prior to issuance of a Building Permit. Future Improvement Agreement completed, Date: ______ _ By: __________ _ DD D 13a. Inadequate information available on site plan to make a determination on grading requirements. Please provide more detailed proposed and existing elevations and contours. Include accurate estimates of the grading quantities (cut, fill, import, export). 0b O 14. No grading required as determined by the information provided on the site plan. DD D 15. Grading Permit required. A separate grading plan prepared by a registered civil Engineer must be submitted for separate plan check and approval through the Engineering Department. NOTE: The Grading Permit must be issued and grading substantially complete and found acceptable to the City Inspector prior to issuance of Building Permits. Grading Inspector sign off. Date: _____ ~by: ____ _ Miscellaneous Permits ~D D 16. Right-of-Way Permit not required. □□□ G1□□ □□□ 17. 18. 19. if□ 0 20. Right-of-Way Permit required. A separate Right-of-Way Permit issued by the Engineering Department is required for the following: ______________________ _ Sewer Permit is not required. sewer Permit is required. A sewer Permit is required concurrent with Building Permit issuance. The fee required is noted below in the fees section. Industrial waste Permit is not required. P:\DOCS\MISFORMS\FRM0010.DH REV. 02/27/91 DD D 21. Industrial Waste Permit is required. Applicant must □rJ/At- □4~ □id'N/A □~Pr □111~ D;.i/k-- complete Industrial Waste Permit Application Form and submit for City approval prior to issuance of a Building Permits. Permits must be issued prior to occupancy. Industrial Waster Permit accepted - Date: __________ .By: _______________ _ Fees Required 27. Park-in-Lieu Fee Quadrant: __ .,_ __ Fee per Unit:_~61 _____ _ Total Fees: --8::: 23. Traffic Impact Fee Fee Per Unit: e; , 24. Bridge and Thorough fare Fee Per Unit: cO Fee 25. Public Facilities Fee required. 26. Facilities Management Fee Zone: Total Fee:_--0=---- Total Fee:_~---- Fee: -&---~--- 27. Sewer Fees Permit No. _______ .EDU's V Benefit Area: __ _;0=-._· ____ _ Fee: __ -0~------- 28. Sewer Lateral Required:~t=:~-~)'!'l.iS~'-r._,_,,1~"'-"6.e_ ________ _ Fee: ________ _ ENGINEERING AUTHORIZATION TO ISSUE PERMIT ,-; P:\DOCS\MISFORMS\FRM0010.0H REV. 02/27 /91 ~ ~ ' I;') ' ~ ~ ~ m m Q Q "I ~ I ]" ]" ; ~ ... ... i u ~ ~ ~ u u ii C !! ... ... ~ ~ m Q I ]" !;;: ... u ~ ~ u iii ... Plan Chec1k1No. C//-/J62- Planner ti /JJ ?y,v J._ (Name) APN: 2o3-Cl22.·J > PLANNING CHECI<llSf Address Phone 438-1161 ext. </""J 2--r' Type of Project and Use _,Co=.c:,..,.._=~T1..:.•_aek:c._ ________ _ Zone V !<__ Facilities Management Zone --"----- Legend [Z] □ Item Complete Item Incomplete -Needs your action 1, 2, 3 Number in circle indicates plancheck number where deficiency was identified Environmental Review Required: YES _ NO J?s. TYPE ___ _ DATE OF COMPLETION: Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval ________________________ _ (3'b O Discretionary Action Required: YES _ NO 4-TYPE __ _ B'CJ □ APPROVAI./RESO. NO. __ _ DATE: _____ _ PROJECT NO. ___ _ OTHER RELATED CASES: ____________________ _ Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval ________________________ _ California Coastal Commission Permit Required: YES _ NO A DATE OF APPROVAL: San Diego Coast District, 3111 Camino Del Rio North, Suite 200, San Diego, CA. 92108-1725 (619) 521-8036 Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval ________________________ _ ~ 0 Landscape Plan Required: YES _ NO~ See attached submittal requirements for landscape plans Site Plan: 13f□ D 1. [efo □ 2. c:(o □ 3. 6□□ 4. Zoning: ✓□□ 1. ,;1/f!_p}-ffl,.J) I ;:te,11 v-1vv;,;7 ~ D NI t-i-2. 8"6 □ /J//4 3. 1Q1J □ /Jo cH;,,,oir' 4. ODD Additional Comments Provide a fully dimensioned site plan drawn to scale. Show: North arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, right-of-way width and dimensioned setbacks. Show on Site Plan: Finish floor elevations, elevations of finish grade adjacent to building, existing topographical lines, existing and proposed slopes and driveway. Provide legal description of property. Provide assessor's parcel number. Setbacks: Front: Required Shown Int. Side: Required Shown Street Side: Required Shown Rear: Required Shown Lot coverage: Required Shown Height: Required Shown Parking: Spaces Required Shown Guest Spaces Required Shown OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER ;) W d,_ DATE /O~s-'1/ PLNCK.FRM 2560 ORION WAY CARLSBAD, CA 92008 <ttitp of QCarl~bab FIRE DEPARTMENT PAGE 1 OF ----1... TELEPHONE (619) 931-2121 APPROVED .i • - DISAPPROVED ' PLAN CHECK REPORT PLAN CHECK# Jt-,_v.,. PROJECT 'IA...,,\ 1 ~ r, ADDREss ~'-=s _<:""_B'-'----'-~~b~c~~~F~='-.~'~n-=-.,., ___ f _1 _l___::u::.....,:_(r __ _ ARCHITECT _) l/1 \ , I v I> ADDRESS r1() J?L S,2f\ I) PHONE ------ OWNER 11 l "',..l /)L 1 1]]/\t I )/ (\ }/\ ADDRESS { A•~l' 6Al PHONE Lt 2 l/ -l7l1) I ',2 / OCCUPANCY -----1 _ _,_,_ _____ CONST. _'--/x......,_,,,._.. ___ TOTAL SQ. FT. ------STORIES jJ I I t.=f: Q SPRINKLERED --g TENANT IMP. _c_~ .... l~!--_.,_t_--'-1 _z. ______________________ _ __ 1. __ 2. __ 3. ~4. --5. 6. '-1.. 7. APPROVAL OF PLANS IS PREDICATED ON CONFORMING TO THE FOLLOWING CONDITIONS AND/OR MAKING THE FOLLOWING CORRECTIONS: PLANS, SPECIFICATIONS, AND PERMITS Provide one copy of: floor plan(s); site plan; sheets ____________________ _ Provide two site plans showing the location of all existing fire hydrants within 200 feet of the project. Provide specifications for the following: Permits are required for the installation of all fire protection systems ( rinklers, stand pipes, dry chemical, halon, CO2, alarms, hydrants). Plan must be approved by the fire department prior to installation. The business owner shall complete a building information letter and return it to the fire department. FIRE PROTECTION SYSTEMS AND EQUIPMENT The following fire protection systems are required: 'S Automatic fire sprinklers (Design Criteria: __._1 .... 1 .... ,_n-'--"-8---'---'-)--'""--''-'F__._1J_/\-'--L-' ~-=-------------- □ Dry Chemical, Halon, CO2 (Location: -----,--------------------- □ Stand Pipes (Type: -------------------------------- □ Fire Alarm (Type/Location: ____________________________ _ Fire Extinguisher Requirements: (_ sq. ft. or portion thereof with a travel distance to the nearest 'm One 2A rated ABC extinguisher for each 00 extinguisher not to exceed_75 feet of travel. D An extinguisher with a minimum rating of ___ to be located: D Other: ___________________________________ _ __ 8. Additional fire hydrant(s) shall be provided _______________________ _ EXITS ~ 9. Exit doors shall be openable from the inside without the use of a key or any special knowledge or effort. __ 10. A sign stating, "This door to remain unlocked during business hours" shall be placed above the main exit and doors ------------------------------------ __ 11 . EXIT signs (6" x ¼" letters) shall be placed over all required exilts and directional signs located as necessary to clearly indicate the location of exit doors. GENERAL __ 12. Storage, dispensing or use of any flammable or combustible liquids, flammable liquids, flammable gases and hazardous chemicals shall comply with Uniform Fire Code. __ 13. Building(s) not approved for high piled combustible stock. Storage in closely packed piles shall not exceed 15 feet in height, 12 feet on pallets or in racks and 6 feet for tires, plastics and some flammable liquids. If high stock pil- ing is to be done, comply with Uniform Fire Code, Article 81 . ....J 14. Additional Requirements. ------------------------------ 1) Ll:x rY l<-f /, (ti' (?;'1_-"1d 7 () T1 I~ I,,\_,. l I • ~IL 1( l: ID t'\1.: I ("( I I ' ( I / 'V" l / / 1 I L [ I L.C::: I l<'. Lu ¥ . '# I ft O __ 15. Comply with regulations on attached sheet(s). I Date--'---=-,<--/ ..:..1 ....,_J__,_J_,_/ ____ _ Report mailed to architect ___ Met with ___________ , ___ _ __ Attach to Plans • rJ 6 - COMMERCIAL/INDUSTRIAL APPLICATION fORM fOR INDUSTRIAL WASTE DISCHARGE PERMIT CITY Of CARLSBAD APPLICATION: NEW __ ')<_,-__ _ (CHECK ONE) REVISED oe::::_ ---- BY: Q_~WLO,NtA Sign:;;;i;;;;;ity Representative BUILDING P.C. NO.: 9//3'&,;2_ APPLICATION NO.: 8".13 INDUSTRIAL CLASS:_.=3;..Jfc.._ __ DATE: ID-2-91 APPLICATION fOR INDUSTRIAL WASTE DISCHARGE PERMIT A. GENERAL: f,l ' · pl ",,., /1 SITE /J r;~ (7 ~fr APPLICANT: \ R-0fvfb.IT]A-L-~lft'Rt ADDRESS:~ 0 f(cl()Sf3jfl.:f 5,f, 30(, TYPE OF BUSINESS: t2.f"eJ-~:rfilG D:ffr~ APPLICANT'S ADDREss: 2-'f.S::S: 'R,eGso)a,--~ it?Ac.; etitl(21o. qll{)';{ I ; (Check where applicable) B. WASTES AND PROCESSING: l~mestic Waste Only 1-1 Industrial Waste l=I Industrial Waste NOT -Discharged to Sewer Discharged to Sewer GENERAL DESCRIPTION OF WASTE (Chemical and Physical Characteristics of proposed waste): ----------------------~ c. ffb-rJZ-Do M.$ GENERAL DESCRIPTION OF PROCESS (If Applicable):_....,_N"'-+-f ... A-_______ _ C. WASTES TO BE DISCHARGED TO SEWER: WASTE: (Check One) TREATED: UNTREATt....,D ... :-g~-QUANTITY: (Daily) AVERAGE ____ GPO MAXIMUM...----,,--..,.... GPO (Gallons Per Day)