HomeMy WebLinkAbout2558 ROOSEVELT ST; 201; CB004244; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
12/12/2000 Commercial/Industrial Permit Permit No: CB004244
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
Project Title:
Applicant:
2558 ROOSEVELT ST CBAD St: 201
Tl Sub Type:
2031023500 Lot #:
$68,376.00 Construction Type:
Reference #:
PRO, INC/ OFFICE REMODEL
NEW CEILING, NEW LIGHTS
COMM
0
NEW
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
PRESIDENTIAL PLAZA
ISSUED
11/14/2000
CB
12/12/2000
12/12/2000
ROYAL PACIFIC CONSTRUCTION
STEA C/O GST DEVELOPMENT 6372 12/12/00 0002 01. 02
136 N. CEDROS AVE
SOLANA BEACH, CA 92075
760-792-2220
Total Fees: $915.52
Building Permit
Add'I Building Permit Fee
Plan Check
Add'I Plan Check Fee
Plan Check Discount
Strong Motion Fee
Park Fee
LFM Fee
Bridge Fee
BTD #2 Fee
BTD #3 Fee
Renewal Fee
Add'I Renewal Fee
Other Building Fee
Pot. Water Con. Fee
Meter Size
Add'I Pot. Water Con. Fee
Reel. Water Con. Fee
POBOX1667 CGP :,,;9.9!
CARLSBAD CA 92018
Total Payments To Date: $315.61 Balance Due: $599.91
$485.55 Meter Size
$0.00 Add'I Reel. Water Con. Fee $0.00
$315.61 Meter Fee $0.00
$0.00 SDCWA Fee $0.00
$0.00 CFD Payoff Fee $0.00
$14.36 PFF $0.00
$0.00 PFF (CFD Fund) $0.00
$0.00 License Tax $0.00
$0.00 License Tax (CFD Fund) $0.00
$0.00 Traffic Impact Fee $0.00
$0.00 Traffic Impact (CFD Fund) $0.00
$0.00 LFMZ Transportation Fee $0.00
$0.00 PLUMBING TOTAL $41.00
$0.00 ELECTRICAL TOTAL $35.00
$0.00 MECHANICAL TOTAL $24.00
Master Drainage Fee: $0.00
$0.00 Sewer Fee: $0.00
$0.00 Redev Parking Fee: $0.00
TOTAL PERMIT FEES $915.52
FINAL APPROVAL
Date: I /;1/b/
I 7 Clearance:
NOTICE: Please take NOTICE at approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." 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 capactiy
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 ou have revious\ been iven a NOTICE similar to this, or as to which the statute of limitations has revlousl otherwise ex ired.
FOR OFFICE USE ONLY
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
PLAN CHECK NO. C...f:J(g)'f 211
EST. VAL. <ce·3tW . ,,.
Plan Ck. Deposit ·31 S: 1 { ~ I
Validated Br L--0
Date / I _ I f / Cit)
rooms
2.
Name
.J.
Name
4. P~ERTY OWNER " !!v I5 , LT'.,L
Name Address
IAsbt
City
(&,
State/Zip
6. CONTRACTOR -COMPANY NAME
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of t he Contractor's License Law
!Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code( or that he is exempt therefrom, and the basis for the alleged
e -"'""-'='-'='--==----. .
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
O I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the_?"< for which this permit is issued.
g/i have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compe sation insurance carrie'...and policy number are: • JJ, 1 QI~ , /,!:
Insurance Company ...!,,.;;::&2l!IJl.l~'..l..--'!!e::id:..J,I!/-~~=--------Policy No. fV wa ~/r;;(..f_-iv Expiration Date q /.../J)../;-U I
HE PERMIT IS FOR ONE HUNDRED DOLLARS 1$100) OR LESS) /
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 become 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 one hundred
thousand dollars ($1 0), in dition to the cost of compensation, damages as provided for in Section 3706 of the Lab r cod interest and attorney's fees.
SIGNATURE:_~~l.,q~-.L.ls;,-=---------------------DATE -L/-H'--1-µ~._...i!....__
7. OWNER-B LDER DECLARA ------~-
he Contractor's License Law for the following reason:
O I, as owner of the property or my employees with wages as their sole compensat ion, 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 wor 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 · in one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
I, as owner of the property, am exclusively contracting with 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:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
2. I (have / have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name I address / phone number / contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number / contractors license number):, ______________________________________________ _
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): ________________________________________________________ _
PROPERTY OWNER SIGNATURE ______________________ _ DATE __________ _
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air lity management district? 0 YES
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES
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.
8. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a nstruction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME __ _;j./,-+-l-JL----------LENDER'S ADDRESS. ________________________ _
9. 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 representatives of the Cit\' 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 stories in height.
EXPIRATION: Every permit issued bY. e 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 permtt is not com e ced within 0 days from the date of such permit or if the building or work authorized by sue permit is suspended or abandoned
at any time after the work is com f ape · d 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE _...g.._~!1<11,j!...._~-~~~--------------DATE -~-1-1-=-h+-'-""'-"!...._-----
YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 01/11/2001
Permit# CB004244
Title: PRO, INC/ OFFICE REMODEL
Description: NEW CEILING, NEW LIGHTS
Type:TI
Job Address:
Suite:
Location:
Sub Type: COMM
2558 ROOSEVELT ST
201 Lot 0
APPLICANT ROYAL PACIFIC CONSTRUCTION
Owner: PRESIDENTIAL PLAZA
Remarks:
Total Time:
CD Description Act Comments
19 Final Structural ~
29 Final Plumbing
39 Final Electrical
49 Final Mechanical
Associated PCRs
lnsgection Histo[)I
Date Description Act lnsp Comments
12/20/2000 84 Rough Combo AP PY T-BAR
12/15/2000 14 Frame/Steel/Bolting/Welding AP PY
12/15/2000 17 Interior Lath/Drywall AP PY
12/15/2000 24 Rough!Topout AP PY
12115/2000 34 Rough Electric AP PY
12113/2000 14 Frame/Steel/Bolting/Welding PA PY WALLS
12/13/2000 34 Rough Electric AP PY
Inspector Assignment: PY ---
Phone: 7604275011
Inspector: -----
Requested By: ROB PHILLIPS
Entered By: CHRISTINE
EsGil Corporation
In Partnership with Government for Building Safety
DATE: 12/12/00
JURISDICTION: City of Carlsbad
PLAN CHECK NO.: 00-4244 SET:11
PROJECT ADDRESS: 2558 Roosevelt Street Suite 201
PROJECT NAME: Pro Inc -TI
~ The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's building codes
when minor deficiencies identified below are resolved and checked by building department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
D The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
~ Esgil Corporation staff did not advise the applicant that the plan check has been completed.
D Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted: (by: ) Fax#:
Mail Telephone Fax In Person
~ REMARKS: Applicant requested to hand carry plans directly to city. The city may have other
corrections this does not assure a permit will be issued.
By: Doug Moody
Esgil Corporation
D GA D MB D EJ D PC
Enclosures:
12/4/00 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
,
EsGil Corporation
In Partnership with Government for Building Safety
DATE: 11/28/00
JURISDICTION: City of Carlsbad
PLAN CHECK NO.: 00-4244 SET:I
□ APPLICANT ~
□ PLAN REVIEWER
□ FILE
PROJECT ADDRESS: 2558 Roosevelt Street Suite 201
PROJECT NAME: Pro Inc -TI
□
□
□
[8J
□
[8J
□
[8J
□
The plans transmitted herewith have been corrected where 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 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
Corporation 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:
Mike Day
5245 Avenida Encinas Suite F, Carlsbad, Ca.92008
Esgil Corporation staff did not advise the applicant that the plan check has been completed.
Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Mike Day (-1 -1-{.~ Telephone#: 760-602-9555
Date contacted: 11 /2g'/oo (by: (t--.. ) Fax #:
Mail LAelephonev Fax In Person
REMARKS:
By: Doug Moody
Esgil Corporation
0 GA O MB O EJ O PC
Enclosures:
11/16/00 tmsmtl.dot
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
City of Carlsbad 00-4244
•. 11/28/00
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO.: 00-4244
OCCUPANCY: B
TYPE OF CONSTRUCTION: VN
ALLOWABLE FLOOR AREA:
SPRINKLERS?: Unknown
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 11/14/00
DATE INITIAL PLAN REVIEW
COMPLETED: 11/28/00
FOREWORD (PLEASE READ):
JURISDICTION: City of Carlsbad
USE: Office
ACTUAL AREA: 24
STORIES:
HEIGHT:
OCCUPANT LOAD: 37
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 11/16/00
PLAN REVIEWER: Doug Moody
This plan review is limited to the technical requirements contained in the Uniform Building Code,
Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws
regulating energy conservation, noise attenuation and access for the disabled. This plan review
is based on regulations enforced by the Building Department. You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department,
Fire Department or other departments. Clearance from those departments may be required
prior to the issuance of a building permit.
Code sections cited are based on the 1997 UBC.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 106.4.3,
1997 Uniform Building Code, the approval of the plans does not permit the violation of any
state, county or city law.
To speed up the recheck process. please note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet number. specification section. etc.
Be sure to enclose the marked up list when you submit the revised plans.
TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC) tiforw.dot
' City of Carlsbad 00-4244
11/28/00
Please make all corrections on the original tracings, as requested in the correction
list. Submit three sets of plans for commercial/industrial projects (two sets of plans
for residential projects). For expeditious processing, corrected sets can be
submitted in one of two ways:
1. 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 Corporation and the Carlsbad
Planning, Engineering and Fire Departments.
2. Bring one corrected set of plans and calculations/reports to EsGil Corporation,
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 Corporation only will not be
reviewed by the City Planning, Engineering and Fire Departments until review by
EsGil Corporation is complete.
1. Each sheet of the plans must be signed by the person responsible for their
preparation, even though there are no structural changes. Business and
Professions Code.
2. Provide a statement on the Title Sheet of the plans stating that this project shall
comply with the 1998 edition of the California Building Code (Title 24 ), which
adopts the 1997 UBC, UMC and UPC and the 1996 NEC.
3. Glazing in the following locations should be of safety glazing material in
accordance with Section 2406.4 (see exceptions):
a) Fixed and sliding panels of sliding door assemblies and panels in swinging
doors other than wardrobe doors.
b) Fixed or operable panels adjacent to a door where the nearest exposed
edge of the glazing is within a 24-inch arc of either vertical edge of the door
in a closed position. And where the bottom exposed edge of the glazing is
less than 60 inches above the walking surface.
4. Please provide construction details for the hallway gypsum ceiling and the soffit in
the conference room.
5. Where the occupant load is at least 30, two exits are required. See Offices.
Table 10-A. please show the required second exit from the office space.
6. Provide multiple switch lighting controls per Title 24, Part 6.
7. Please note on the plans "AC Cable is not allowed. NM cable is restricted
(without City approval) to one and two family dwellings. Note on plans that an
equipment ground conductor is to be installed in all flexible conduits". Per City of
Carlsbad.
, City of Carlsbad 00-4244
11/28/00
8. Note or show mechanical ventilation in all rooms, capable of supplying outside
air at a minimum rate of 15 cubic feet per minute per occupant. UBC, Section
1202.2.1.
9. Provide complete plumbing plans, including:
a) Complete drain, waste and vent plans.
b) Show water heater size, type and location on plans. UPC, Section 501.0
1 O. Show that water heater is adequately braced to resist seismic forces. Provide
two straps (one strap at top 1/3 of the tank and one strap at bottom 1/3 of the
tank). UPC, Section 510.5.
11. Show P & T valve on water heater and detail drain line route from P & T valve to
the exterior. UPC Section 608.4.
12. Revise plans to show that the minimum strike edge distances are provided at the
level area on the side to which a door swings for the main entrance door, per
Section 1133B.2.4.3.
a) ~12" on the push side, if the door has both a latch and a closer.
13. Plans indicate proposed showers. Revise plans to show, or note, compliance with
the following requirements, per Section 1115B.6.2 and California Plumbing Code:
a) Compartments are either:
i) 42" in width between wall surfaces, and 48" minimum in depth
(having an entrance opening ~ 42"), or,
ii) ~60" in width between wall surfaces, and 30" minimum in depth
(having a full opening width on the long side). As an alternate,
showers 60" minimum in width may be 36" minimum in depth as long
as the entrance opening width is a minimum of 36 inches.
b) Grab bars comply with Section 1115B.8 located:
i) On walls adjacent to and opposite the seat.
ii) Mounted ~33" but s;35" above the shower floor.
c) If a threshold or recessed drop is used, it shall be:
i) s;½" in height.
ii) Be beveled or sloped s;45o from the horizontal.
d) Indicate a folding seat, located on the wall adjacent to the controls, 18"
above the floor.
e) The soapdish shall be located on the control wall s;40" above the shower
floor.
f) If a separate shower compartment is not provided, the shower is be:
, City of Carlsbad 00-4244
11/28/00
i) Located in a corner, with L-shaped grab bars extending along two
adjacent walls.
ii) A folding seat adjacent to the shower controls is to be provided.
g) A flexible hand-held shower unit is required with:
i) A hose ~60" long.
Head mounted 48" above finished floor. ii)
NOTE: Two wall-mounted heads may be installed in lieu of the hand-held
unit in areas subject to excessive vandalism, per Section 5-1505.
To speed up the review process, note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
Please indicate here if any changes have been made to the plans that are not a
result of corrections from this list. If there are other changes, please briefly
describe them and where they are located in the plans.
Have changes been made to the plans not resulting from this correction list?
Please indicate:
Yes □ No □
The jurisdiction has contracted with Esgil Corporation 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 Doug Moody at
Esgil Corporation. Thank you.
I City of Carlsbad 00-4244
11/28/00
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Carlsbad
PREPARED BY: Doug Moody
PLAN CHECK NO.: 00-4244
DATE: 11/28/00
BUILDING ADDRESS: 2558 Roosevelt Street Suite 201
BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: VN
BUILDING AREA Valuation Reg. VALUE
PORTION ( Sq. Ft.) Multiplier Mod.
Tl 2442 28.00
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb By Ordinance
I 1994 UBC Building Permit Fee •I
I 1994 UBC Plan Check Fee
Type of Review: 0 complete Review 0 Structural Only
D Repetitive Fee
[GRepeats
Comments:
00ther
D Hourly
Esgil Plan Review Fee
($)
68,376
68,376
I 485.451
315.541
252.431
Sheet 1 of 1
macvalue.doc
November 27, 2000
TO: BUILDING DEPARTMENT
FROM: Management Analyst, Redevelopment Department
TENANT IMPROVEMENTS TO EXISTING OFFICE BUILDING LOCATED AT 2558
ROOSEVELT STREET (BRITTANY COURT) -PLAN CHECK NO. CB004244
I have reviewed the building plans for the above referenced project. The project is
exempt from the redevelopment permit process because the proposed work qualifies
as a maintenance activity. Therefore, no land use permit is required. I do not have
any objections to the issuance of the building permit tor this project. This information
has been entered into Permits Plus. If you have any questions, please contact me at
x2813.
6,{~-\."'---"
LORI H. ROSENSTEIN
PLANNING/ENGINEERING APPROVALS
p~NUMBB qt uQ · .. ¼'Llf(f
•
RESIDENTIAL
. RES1DE11RAL ADDfflON MINOR
1<$10,000.00)
DATE ¢,/2
s& ;){)1
, ~·TENANI: ~IIPROVEIIENT
. _ CPRLCSAD COMPANY Sl'ORES
VILLAGE FAIRE
COMPLETE OFRCE ~ILDINC
OTHER__...~~-..:..·u._~---'7-.:... __ ·...,.a@b...i.:.-=------------
· PLANNER _______ _ DATE ------
DATE~
•
Carlsbad Fire Department 004244
1635 Faraday Ave.
Carlsbad, CA 92008
Plan Review Requirements Category:
Fire Prevention
(760) 602-4660
Date of Report: 1210112000
Building Plan
Reviewed by: ------------Name: Royal Pacific Const.
Address: 136 N. Cedros Ave. #A
City, State: Solana Beach CA 92037
Plan Checker: Job #: 004244 -------
Job Name: Pro, Inc. Bldg #: CB004244 ------------------Job Address: 2558 Roosevelt St. Ste. or Bldg. No. 201
[8J Approved
D Approved
Subject to
D Incomplete
Review
FD Job#
------
The item you have submitted for review has been approved. The approval is
based on plans, information and I or specifications provided in your submittal;
therefore any changes to these items after this date, including field
modifications, must be reviewed by this office to insure continued conformance
with applicable codes and standards. Please review carefully all comments
attached as failure to comply with instructions in this report can result in
suspension of permit to construct or install improvements.
The item you have submitted for review has been approved subject to the
attached conditions. The approval is based on plans, information and/or
specifications provided in your submittal. Please review carefully all comments
attached, as failure to comply with instructions in this report can result in
suspension of permit to construct or install improvements. Please resubmit to
this office the necessary plans and I or specifications required to indicate
compliance with applicable codes and standards.
The item you have submitted for review is incomplete. At this time, this office
cannot adequately conduct a review to determine compliance with the
applicable codes and I or standards. Please review carefully all comments
attached. Please resubmit the necessary plans and I or specifications to this
office for review and approval.
1st
004244
2nd
FD File#
3rd Other Agency ID
lazardous Materials
SAN DIEGO REGIONAL .,1,.:..:u~·· , .....
·:•'-.. -~ . .
: . -~'.
.• PIUJIIII CIIJll. lllllla \._,
0
c HAZARDOUS MATERIALS QUESTIONNAIRE
Management Division c,,.,, ., ., ......
Business Name Contact Person Telephone
,
Zip Plan File#
p RT I: FIRE DEPARTMENT . HAZARDOUS MATERIALS MANAGEMENT DIVISION: OCCUPANCY CLASSIFICATION
Indicate by circling the item, whether your bu■ineH will u■e, proces■, or ■tore any of the following hazardous materials. If any oi the items ar~
circled, applicant must cont■ct the Fire Protection Agency with juriediction prior to plan ■ubmittal.
1. Explosive or Blasting Agents 4. Aammable Solids 7. Pyrophorics 10. Cryogenics 13. Corrosives
2. Compressed Gases 5. Organic Peroxides 8. Unstable Reactive■ 11. Highly Toxic or Toxic Materials 14. Other Health Ha s
3. Flammable or Combu■tible Liquid■ e. Oxidizer■ 9 . Water Reactive■ 12. Radioactive■
PART II: COUNTY OF SAN DIEGO HEALTH DEPARTMENT · HAZARDOUS MATERIALS MANAGEMENT DIVISION:
CONTINGENCY PLAN REVIEWi
If the answer to any of the questions is yes, applicant mu■t contact the County of San Diego Hazardou■ Materials Management
Division, 1255 Imperial Avenue, 3rd Floor, San Diego, CA 92186-5261 . Telephone 18191338-2222 prior to the i11uance of a
building permit.
FEES MAY BE REQUIRED
Yes
1.0 2.0 a.o
4.0 5,0
1ine11 listed on the rever■e side of this form7
ur bu1ines1 dispose of Hazardous Sub■tance■ or Medical We■te in any amount7
Wil our busi • store or handle Hazardou■ Sub■tances in quantities equal to or greater then 55 gallon■,
0 P-•• 200 cubic feet or carcinogen■/reproductive toxins in any quantity7 w· our bu■ineH use an existing or install an underground storage tank7
ill your business store or handle Acutely Hazardous Materials7
PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT
OFFICE USE ONLY
□ RMPP Exempt
Date Initials 0 RMPP Required
Date Initials 0 RMPP Completed
Date Initials
If the answer to any of the questions is yes, applicant must contact the Air Pollution Conuol District, 9150 Chesapeake Drive, San Diego, CA 92123.
Telephone (6191 694-3307 prior to the iHuance of a building permit.
YES NO
1 . O O Will the intended occupant install or use any of the equipment listed on the Listing of Air Pollution Control District Permit Categories, on the
reverse side of this form7
2. 0 0 (ANSWER ONLY IF QUESTION 1 IS YES.I Will the subject facility ba located within 1,000 feat of the outer boundary of a school lK through
1 21 a■ listed In the current Directory of School and Community Collage Oistricu, published by the San Diego County Office of Educstion end
the current California Private School Directory, compiled in accordance with provilion■ of Education Code Section 331907 n
Name o
i:;.:~~~~~~..:.Jclare under penalty of perjury that to the be■t of my knowledge and belief the respon
Data: ;.-1,,f-/,~J,f-....,~_.~--
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: _______________________________ _
BY: ___________________________________ Date: ________________ _
EXEMPT l'l'l0M PEIIMIT IUQUIIIIMINTI
COUNTY-HMMD
EnvirOIIIIICll&al Heallb Scrvicca
DHS:HM-9171 (619'2)
APCD
.-OVID '°" IUILDING PEIIMIT IUT NOT OCCUPANCY ~YID '°" OCCUPANCY
COUNTY-HMMD APCD COUNTY-HMMD APCD