HomeMy WebLinkAbout1855 ARTEMISIA CT; ; CBC2020-0194; PermitBuilding Permit Finaled
(city of
Carlsbad
Commercial Permit
Print Date: 07/21/2021
Job Address:
Permit Type:
Parcel#:
Valuation:
Occupancy Group:
#of Dwelling Units:
Bedrooms:
Bathrooms:
Occupant Load:
Code Edition:
Sprinkled:
1855 ARTEMISIA CT, CARLSBAD, CA
BLDG-Commercial
2150200700
$184,036.04
Project Title: POINSETTIA 61
Work Class: Pool
Track#:
Lot#:
Project#: DEV14060
Plan#:
Construction Type:
Orig. Plan Check #:
Plan Check#:
Permit No: CBCZ0Z0-0194
Status:
Applied:
Issued:
Fina led Close Out:
Inspector:
Final Inspection:
Closed -Fina led
06/02/2020
10/06/2020
CRenf
07/21/2021
Description: POINSETTIA 61; 1,536 SF POOL/ 172 SF SPA (POOL BLDG UNDER CBC2019-0111)
FEE
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
FIRES Occupancies< 50,000sq. ft. Tl
PLUMBING BLDG COMMERCIAL NEW/ADDITION/REMODEL
SB1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-COMMERCIAL
Total Fees: $2,184.70 Total Payments To Date: $2,184.70
Contractor:
AQUATIC TECHNOLOGIES
32232 PASEO ADELANTO, # A
SAN JUAN CAPISTRANO, CA 92675-3600
(949) 493-9548
Balance Due:
AMOUNT
$927.75
$649.42
$89.00
$373.00
$86.00
$8.00
$51.53
$0.00
Please take NOTICE that approval of your project includes the "lmposition11 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 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
Ccicyof
Carlsbad
COMMERCIAL
BUILDING PERMIT
APPLICATION
B-2
Plan CheckQ.tt:Z..O2.G-Ql°''-4
Est. Value )M1 O~U>
PC Deposit ---------
Date \J)• 2 -20
Job Address 1855 Artemsja
Tenant Name: ________________ CT/Project #: _________ Lot#: ___ _
Occupancy: _________ Construction Type: t>,) Fire Sprinklers: yes/ no Air Conditioning: yes/ no
BRIEF DESCRIPTION oF woRK: JNieeww_PPoo!l:lo!LI .aalil□ttdLSSQp!l'laL_4-±~,~-ii!-;:;sg•~~C:~··~·~s1~·EOli'iii\•:!'~•0)4-,._ _____ _
-· / I_, 25t o.,.. 1 QI ..J _...ddition New: ✓, '""' ¥ • · qq_ New SF and Use, ___________ New SF and Use,
____ Deck SF, ____ Patio Cover SF Jot including flatwork)
D Tenant Improvement: ______ SF,
_____ SF,
Existing Use ______ Proposed Use ______ _
Existing Use Proposed Use ______ _
~Pool/Spa: \15:2,1 o / /71, SF Additional Gas or Electrical Features? ___________ _
D Solar: ___ KW, __ Modules, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No
D Plumbing/Mechanical/Electrical Only: _________________________ _
D Other: __________________________________ _
APPLICANT (PRIMARY)
Name: Crystal Stone
PROPERT
Address: 32232 Paseo Adelanto, Ste A
City: San Juan Capistranostate: CA Zip: 92675
Phone: 949-493-9548 ( o) 949-338-4189 ( c)
Email: crystal@aquatictechnologjes com
DESIGN PROFESSIONAL
Name: _________________ _
Address: ________________ _
City: _______ State:. __ ... Zip: ___ _
Phone: _________________ _
Email: _________________ _
Architect State License: ___________ _
Name: -->':"',,.4::!c,l',-'L,¥~1,_-..,,-;-,l'\-,..,,;;---;--.-,-..,,..,i:-,,--,------
Address: ~-i':'J"'~~~~~~L...L:Ll.a:.l...ll,.=~~-:--::---c=
City: _ \.X \J\V\.Q_-"""'------
Phone: __________________ _
Email: ____________________ _
CONTRACTOR BUSINESS
Name: Aquatic Technologies
Address: 32232 Paseo Adelanto, Ste A
City:San Juan Capistrano State: CA Zip: "'9""2""6_7"-5 ___ _
Phone: 949-493-9548
Email: crystal@aguatictechnologies.com
State License: 7 44177 Bus. License: 1211868 -="-"=~---
(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/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
8-2
Ph: 760-602-2719 Fax: 760-602-8558
Page 1 of 2
Email: Building@carlsbadca.gov
Rev. 06/18
( OPTION A): WORKERS'COMPENSATION DECLARATION:
I hearby affirm under penalty of perjury one of the following declarations:
□ 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.
Ml 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: -=Z::u::rc:ic::::h_:Ac.::.mc:e:::..ri:.:ca:::. ______________ _
Policy No. WC4503556 Expiration Date: _1,_,0:...--'-1_,-2,..,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,
:::::;::·:;~::TURE: 0&\:Q,V\ x~.o ~R iKIAGENT DATE: __._0'"""'11--41~?1-12___._.(J)
( OPTION B ): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
□ 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).
□ 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:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No
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 address/ phone/ contractors' license number):
4. J 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):
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/ type of work):
OWNER SIGNATURE: __________________ □AGENT 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? □ Yes □ No
Is the applicant or future building occupant 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 1,000 feet of the outer boundary of a school site? □ 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 UABlllTlES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY 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 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 pe it or if the building or work authorized by such permit is suspended or abandoned at any time
APPLICANT SIGNATURE:
after the work is commenced for a period of 1 y (Section 106.4.4 Unit Buildi Cod .
-~~un------'l,,,..A.,¥i-A~l......3.__---DATE: ___ 94--'/t:::c....JAl-+.(2"""':o-'---
1635 Faraday Ave Carlsbad, CA 92008
8-2
Ph: 760-602-2719 Fax: 760-602-8558
Page 2 of 2
Email: Building@carlsbadca.gov
Rev. 06/18
PERMIT INSPECTION HISTORY' for (CBC2O20-0194)
Permit Type: BLDG-Commercial
Work Class: Pool
Status:
Scheduled
Date
Closed -Finaled
Actual Inspection Type
Start Date
Checklist Item
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
Wednesday, July 21, 2021
Application Date: 0610212020 Owner:
Issue Date: 10106/2020 Subdivision:
Expiration Date: 1211312021
IVR Number: 26677
Address: 1855 ARTEMISIA CT
CARLSBAD, CA
Inspection No. Inspection
Status
Primary Inspector Reinspection Inspection
COMMENTS
July 21, 2020:
1. Community public pool, electrical,
plumbing, mechanical, structural, and pool
equipment room, scope of work per
structural engineer's plans and detail
specifications-approved.
2. Health department inspection required.
July 21, 2020:
1. Community public pool, electrical,
plumbing, mechanical, structural, and pool
equipment room, scope of work per
structural engineer's plans and detail
specifications-approved.
2. Health department inspection required.
July 21, 2020:
1. Community public pool, electrical,
plumbing, mechanical, structural, and pool
equipment room, scope of work per
structural engineer's plans and detail
specifications-approved.
2. Health department inspection required.
July 21, 2020:
1. Community public pool, electrical,
plumbing, mechanical, structural, and pool
equipment room, scope of work per
structural engineer's plans and detail
specifications-approved.
2. Health department inspection required.
Passed
Yes
Yes
Yes
Yes
Page 2 of 2
Building Permit Inspection History Finaled
{city of
Carlsbad
PERMIT INSPECTION HISTORY f~r (CBc2qio~o194) .
Permit Type: BLDG-Commercial Application Date: 06/02/2020 Owner:
Work Class: Pool Issue Date: 10/06/2020 Subdivision:
Status: Closed -Fina led Expiration Date: 12/13/2021 Address; 1855 ARTEMISIA CT
IVR Number: 26677 CARLSBAD,CA
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Date Start Date Status
10/08/2020 10/08/2020 BLDG-81 Underground 140439-2020 Partial Pass Chris Renfro Re inspection Incomplete
Combo(11, 12,21,31)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLOG-11 Foundation-Ftg-Piers No
(Rebar)
BLDG-12 Steel-Bond Beam No
BLDG-21 Underground pool plumbing for pool house, Yes
U nderg round-Underfloor ok to backfill
Plumbing
BLDG-31 Yes
Underground-Conduit Wiring
12/21/2020 12/21/2020 BLDG-51 146672-2020 Passed Chris Renfro Complete
Excav/Steel(Pools)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
05/24/2021 05/24/2021 BLDG-64 Equlpotenllal 158033-2021 Passed Chris Renfro Complete
Bond(Pools)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Face Time inspection completed on Yes
5124/2021
06/14/2021 06/14/2021 BLDG-55 159640-2021 Passed Paul Burnette Complete
Fence/Preplaster
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
07/02/2021 07/02/2021 BLDG-Final Inspection 161029-2021 Failed Paul Burnette Reinspectlon Incomplete
Checklist Item COMMENTS Passed
BLDG-Building Deficiency No
BLDG-Plumbing Final No
BLDG-Mechanical Final No
BLDG-Structural Final No
BLDG-Electrical Final No
07/21/2021 07/21/2021 BLDG-Final Inspection 162464-2021 Passed Tony Alvarado Complete
Wednesday, July 21, 2021 Page 1 of 2
DATE: 10-05-2020
JURISDICTION: Carlsbad
PLAN CHECK#.: CBC2020-0194
✓• EsG1I
SET: II
PROJECT ADDRESS: 1855 Artemsia
PROJECT NAME: New Pool & Spa Review Only
r1 APPLICANT p JURIS.
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
IZJ 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
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:
IZJ EsGil staff did not advise the applicant that the plan check has been completed.
D EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Datecontacted:ID/5/20 (by:EJK) Email:
Mail Telephone Fax In Person
REMARKS: EsGil reviewed the new pool and spa only. Building application stated new pool
building as well yet no plans for a new building were submitted only the previous stamped and
approved building. EsGil understanding is this permit is for just new pool and spa and original
building is to be used. If new building is to be permitted submit complete new plans and calcs for
new building.
By: Erich A. Kuchar, P.E. Enclosures:
EsGil
6-4-2020
9320 Chesapeake Dtive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
DATE: 6-16-2020
JURISDICTION: Carlsbad
PLAN CHECK#.: CBC2020-0194
PROJECT ADDRESS: 1855 Artemsia
✓• EsG1I
SET: I
PROJECT NAME: New Pool & Spa and Pool Building
□ APPLICANT
□ JURIS.
0 The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
0 The plans transmitted herewith will substantially comply with the jurisdiction's codes
when minor deficiencies identified below are resolved and checked by building department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
~ The check list transmitted herewith is for your information. The plans are being held at EsGil
until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
0 The applicant's copy of the check list has been sent to:
D EsGil staff did not advise the applicant that the plan check has been completed.
~ EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: Crystal Stone Telephone#: 949-493-9548
Date contacted: (by: ) Email: crystal@aquatictechnologies.com
Mail Telephone Fax In Person
0 REMARKS:
By: Erich A. Kuchar, P.E. Enclosures:
EsGil
6-4-2020
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
Carlsbad CBC2020-0194
6-16-2020
PLAN REVIEW CORRECTION LIST
COMMERCIAL
PLAN CHECK#.: CBC2020-0194
OCCUPANCY: B/S-1
TYPE OF CONSTRUCTION: V-B
ALLOWABLE FLOOR AREA:
SPRINKLERS?:
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 6-2-2020
DATE INITIAL PLAN REVIEW
COMPLETED: 6-16-2020
FOREWORD (PLEASE READ):
JURISDICTION: Carlsbad
USE: Pool/ Spa and Pool Equipment
ACTUAL AREA:
STORIES:
HEIGHT:
OCCUPANT LOAD:
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 6-4-2020
PLAN REVIEWER: Erich A. Kuchar, P.E.
This plan review is limited to the technical requirements contained in the California version of
the International Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National
Electrical Code and state laws regulating energy conservation, noise attenuation and access for
the disabled. This plan review is based on regulations enforced by the Building Department.
You may have other corrections based on laws and ordinances enforced by the Planning
Department, Engineering Department, Fire Department or other departments. Clearance from
those departments may be required prior to the issuance of a building permit.
Code sections cited are based on the 2019 CBC, which adopts the 2018 IBC.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. Per Sec. 105.4 of
the 2018 International Building Code, the approval of the plans does not permit the violation of
any state, county or city law.
To speed up the recheck process, please note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet number, specification section, etc.
Be sure to enclose the marked up list when you submit the revised plans.
Carlsbad CBC2020-0194
6-16-2020
GENERAL
1. 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:
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 and the Carlsbad Planning,
Engineering and Fire Departments.
2. Bring ~ 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.
2. Plans submitted in electronic format, if approved by the city, must have
restrictions remove from the security settings. Electronic plans with restrictions to
markups, printing, or stamping will not be approved.
PLANS
3. Building Permit Application says new Pool and Spa and New Pool Building.
Complete SP sheet provided but random A and P sheets with no structural
sheets provided. Is this new pool and pool building being added to an existing
permitted structure? If so Submit APPROVED set of plans for the building along
with all pool and pool building plans and structural calculations.
ADDITIONAL
4. Once complete set of approved permitted drawings for building and complete
pool and pool building drawings and structural calcs are submitted a complete
review will be performed.
5. To speed up the review process, please note on this list (or a copy) where each
correction item has been addressed, i.e., plan sheet, note or detail number,
calculation page, etc.
6. 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
'·~-~---... ~-~ ... -------""-
Carlsbad CBC2020-0194
6-16-2020
7. 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 Erich A. Kuchar, P.E. at Esgil. Thank
you.
Carlsbad CBC2020-0194
6-16-2020
[DO NOT PAY-THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad
PREPARED BY: Erich A. Kuchar, P.E.
BUILDING ADDRESS: 1855 Artemsia
BUILDING OCCUPANCY: B/ S-1
Bl.lLDING AREA Valuation
PORTION (Sq.Fl) Multiplier
Pool Area and Room
Air Conditioring
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb By Ordinance
1997 UBC Bulldln Permit Fee ~; g
I 1997 UBC Plan Check F.. t:rJ
IN!'Ml,
T)1le of Review: P' ColNllete Review
r Repetitive Fee ~
I [11rl Repeats
r Other
r Howty
EaGilFee ,,
Reg.
Mod.
PLAN CHECK#.: CBC2020-0194
DATE: 6-16-2020
VALUE ($)
184,036
184,036
,
r Structural Only
1--------1] Hr. @ *
$603.08,/
Sheet 1 of 1
OFFICE USE ONLY SAN DIEGO REGIONAL
HAZARDOUS MATERIALS RECORD ID# _________________ _
QUESTIONNAIRE OL
PLAN CHECK # _________________ _
J ZO?O
Business Name
Lennar Homes Of California
Project Address (include suite)
1855 Artemsia
Mailing Address (include suite)
15131 Alton Parkway
Project Contact
Crystal Stone
Business Contact
Alan Chik
City
Carlsbad
City
Slate
CA
State
Telephone#
9492044628
,Zip Code
Zip Code
Irvine CA 92618
Applicant E-mail Telephone#
crystal@aquatictechnologies.com 949-482-9964
BP DATE
APN#
Plan File#
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):
1.
2.
3.
4.
5.
6.
7.
8.
1. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives X
2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards
3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None ofThese.
4. Flammable Solids 8. Unstable Reactives 12. Radioactives
8 ~ I
Expected Date of Occupancy:
(for new construction or remodeling projects)
Is your business listed on the reverse side of this form? (check all that apply).
Will your business dispose of Hazardous Substances or Medical Waste in any amount?
Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500
pounds and/or 200 cubic feet?
Will your business store or handle carcinogens/reproductive toxins in any quantity?
Will your business use an existing or install an underground storage tank?
Will your business store or handle Regulated Substances (CalARP)?
Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)?
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).
0 CalARP Exempt
I
Date Initials
0 CalARP Required
I
Date Initials
0 CalARP Complete
I
Date Initials
PART 111: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): The following questions are intended to identify the majority of air pollution
issues at the planning stage. Your project may require additional measures not identified by these questions. Some residential projects may be exempt from APCD
requirements. If yes is answered for either questions 1, 2 or 5 or for more comprehensive requirements, please contact APCD at apcdcomp@sdcounty.ca.qov;
(858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131.
1.
2.
3.
4.
5.
6.
YES NO
§ m ~
Will the project disturb 100 square feet or more of existing building materials?
Will any load supporting structural members be removed?
(ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by an individual that has passed an EPA-approved
building inspector course?
□
□
□
D (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Based on the survey results, will the project disturb any asbestos containing material? If yes, a
notification may be required at least 10 working days prior to commencing asbestos removal. Additionally, a notification may be required prior to
the removal of a load supporting structural member(s) regardless of the presence of asbestos. I!'.] Will the project or associated construction equipment emit air contaminants? See the reverse side of this form for typical equipment requiring an
APCD permit. If yes, contact APCD prior to the issuance of a building permit. El (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school
bounda ?
Briefly describe business activities: Briefly describe proposed project:
Commercial building New pool/spa
I declare under penalty of perjury that to the best of my knowledge and belief t e responses made herein are true and correct.
C,ystal Slono ~ J/ a,,, ~
Name of Owner or Authorized Agent Signateof OwneKrAuihorized Agent
,. I .. I _,
Date
FOR OFFICAL USE ONLY:
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION· .. _-------------------------------
BY· DATE· I I
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELE/ISED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
COUNTY-HMO' APCD COUNTY-HMO APCD COUNTY-HMO APCD
,
•A stamp 1n this box only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other perm1tt1ng requirements may still apply
HM-9171 (9/18)
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
D Battery Manufacturing/Recycling
D Boat Yard
D CarWash
D Dealership Maintenance/Painting
D Machine Shop
D Painting
D Radiator Shop
D Rental Yard Equipment
D Repair/Preventive Maintenance
D Spray Booth
D Transportation Services
D Wrecking/Recycling
CHEMICAL HANDLING
D Agricultural supplier/distributor
D Chemical Manufacturer
D Chemical Supplier/Distributor
D Coatings/Adhesive
D Compressed Gas Supplier/Distributor
D Dry Cleaning
D Fiberglass/Resin Application
D Gas Station
D Industrial Laundry
D Laboratory
D Laboratory Supplier/Distributor
□ Oil and Fuel Bulk Supply
D Pesticide Operator/Distributor
CHEMICAL HANDLING
D Photographic Processing
D Pool Supplies/Maintenance
D Printing/Blue Printing
D Road Coatings
D Swimming Pool
D Toxic Gas Handler
D Toxic Gas Manufacturer
METAL WORKING
D Anodizing
D Chemical Milling/Etching
D Finish-Coating/Painting
D Flame Spraying
D Foundry
D Machine Shop-Drilling/Lathes/Mills
D Metal Plating
D Metal Prepping/Chemical Coating
D Precious Metal Recovery
D Sand Blasting/Grinding
D Steel Fabricator
D Wrought Iron Manufacturing
AEROSPACE
D Aerospace Industry
D Aircraft Maintenance
D Aircraft Manufacturing
MISCELLANEOUS
□ Asphalt Plant
D Biotechnology/Research
D Cannabis-related
□ Manufacturing D Dispensary D Other
D Co-Generation Plant
D Dental Clinic/Office
D Dialysis Center
D Emergency Generator
D Frozen Food Processing Facility
D Hazardous Waste Hauler
D Hospital/Convalescent Home
D Laboratory/Biological Lab
D Medical Clinic/Office
D Nitrous Oxide (NO,) Control System
D Pharmaceuticals
□ Public Utility
D Refrigeration System
D Rock Quarry
D Ship Repair/Construction
D Telecommunications Cell Site
D Veterinary Clinic/Hospital
D Wood/Furniture Manufacturing/Refinishing
D Brewery/Winery/Distillery
ELECTRONICS
D Electronic Assembly/Sub-Assembly
D Electronic Components Manufacturing
D 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 (HMO) 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
24 -Ory 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
25 -Intermediate Refuelers
26 -Gasoline & Alcohol Fuel Dispensing
COMBUSTION
34 -Piston Internal -Combustion Engines
13 -Boilers & Heaters (1 million BTU/hr or larger)
14 -Incinerators & Crematories
15 -Burn Out Ovens
16 -Core Ovens
20 -Gas Turbines, and Turbine Test Cells & Stands
48 -Landfill and/or Digester Gas Flares
ELECTRONICS
29 -Automated Soldering
42 -Electronic Component Mfg
FOOD
~sh 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
ROCK AND MINERAL
04 -Hot Asphalt Batch Plants
05 -Rock Drills
06 -Screening Operations
07 -Sand Rock & Aggregate Plants
08 -Concrete Batch, CTB, Concrete Mixers, Mixers
&Silos
10 -Brick Manufacturing
OTHER
01 -Abrasive Blasting Equipment
03 -Asphalt Roofing Kettles & Tankers
46 -Reverse Osmosis Membrane Mfg
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-Cooting Towers -Registration Only
91 -Fumigation Operations
56 -W/1/TP (1 million gal/day or larger) & Pump
Station
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.
County of San Diego -DEH -Hazardous Materials Division