HomeMy WebLinkAbout2236 RUTHERFORD RD; 115; CBC2019-0188; PermitPERMIT REPORT
Commercial Permit
{city of
Carlsbad
Print Date: 05/18/2021
Job Address: 2236 RUTHERFORD RD, # 115, CARLSBAD, CA 92008-8836
Permit No:~C2019-01-&3
Status: Closed -Expired \
)i Permit Type:
Parcel#:
BLDG-Commercial Work Class: Tenant Improvement
2120612600 Track#: Applied: 04/23/2019 /
Valuation:
Occupancy Group:
#of Dwelling Units:
$10,000.00 Lot#:
Project#:
Plan#:
Bedrooms: Construction Type:
Bathrooms: Orig. Plan Check#:
Plan Check#:
Project Title:
Description: SYNERGEYES: HIGH PILE STORAGE RACKS
Applicant:
WAREHOUSE PERMITTING AND INSPECTION
SERVICE
MONTE LANDY
12562 HWY 67
LAKESIDE, CA 92040
(619) 320-8892
FEE
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
Property Owner:
AAND M CAPRE RC P LLC
2236 RUTHERFORD RD
CARLSBAD, CA 92008
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
SB1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-COMMERCIAL
Total Fees: $240.23 Total Payments To Date: $80.47
Issued:
Finaled Close Out:
Inspector:
Final Inspection:
Contractor:
WAREHOUSE SOLUTIONS INC
12562 HIGHWAY 67
LAKESIDE, CA 92040-1159
(619) 873-4410
Balance Due:
AMOUNT
$114.96
$80.47
$41.00
$1.00
$2.80
$159.76
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 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
{cicyof
Carlsbad
COMMERCIAL
BUILDING PERMIT
APPLICATION
B-2
Est. Value
PC Deposit ---------
Date <./ ~.:i ,-s-/9
Job Address 2: ,;2 5l, Q'-'l;}t..u-LJ V2J Suite: // '5
Tenant Name: S c'71er-5 £yr:-c:S CT/Project #: _________ Lot#:, ___ _
Occupancy: 8./,"i' ::t-. Construction Type: I/ ~(J Fire Sprinklers~/ no Air Conditio~ing: yes/ n~oiJ
BRIEF DESCRIPTION OF WORK: -C«:--C-'t,.Pc::.....S::-1-/Jl.=cc.'..:Aa<,._,_,.':n,.~.....:;;.,i=--~5:'--'~-"· "'-"sa;..;;<-'~=-----'-~-=-=--.. ;,:1..,__I~-'-""'-'~"'-'-===--=
D Addition/New: ___________ New SF and Use, ___________ New SF and Use,
____ Deck SF, Patio Cover SF (not including flatwork)
D Tenant Improvement: ______ SF,
_____ SF,
Existing Use ______ Proposed Use ______ _
Existing Use Proposed Use ______ _
□ Pool/Spa: _____ 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: _________________________ _
¥'other: _ __.,,$,<_J·~=...=:i;f""",.e__'==---_.c.f<_~,'""",e.LJ.4=.. _____________ _
DESIGN PROFESSIONAL
Name: $~ i 2.M ,'c :C1vc.
Addres1: _/(~ 0 i:. C ytr<. S~ 57.
City: Y,V~ State: I_ ff Zip: t:>J(f.,211
Phone: C)o•f-&?t/;2-o1rt7
Email: _________________ _
Architect State License: 2-S 9 ~ 9/
CONTRACTOR BUSINESS t
Name: WCL-ri::-b.of&-4€ ,S::o _JJ'..,,--,..p
Address: / 'J 5?,2 It,,; v CT
City: &,/t',;;'o,t...,, State: {!_f'r Zip: o/'Zc~?J
Phone: G(q-t/l,3-t./L//V
Email: ~ :be L...,,, dv@ lv<>-l"P /{Pl,<4.a5~/i,_/2',;x..,), Go-,
State License: 'l ~ ti 5 ifus. License: _____ _
(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}).
163S Faraday Ave Carlsbad, CA 92008
B-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.
~have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for th perf°.!!!!~"-iie of the O[_k for.which this permit is issued. fu; workers' compe~sation ]nsurance carrier an~olicy number are: Insurance COJllpany Name: -1--l~~~U~ ,Vc,:::._ _ _J.cS,,L:.O!:::>~---------
Policy No. WC.<Jlf 1-o f JXj'?'.L Expiration Date: 7P/I?
□ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, l 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 th the c ompensation, damages as provided for In Section 3706 of the Labor Code,
interest and attorney's fees.
CONTRACTOR SIGNATURE: ~AGENT DATE: 11¥
( 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. 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):
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:
ls 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:
J 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 AGAINSTSAIDCllY IN CONSEQUENCE OF
THE GRANTING OF THIS PERMIT.OSHA: An OSHA permit is required for excavations over S'O' deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of th·
by such permit is not commenced within 180 days from the date of r if
de shall expire by limitation and become null and void if the building or work authorized
e building or work authorized by such permit is suspended or abandoned at any time
after the work is commenced for a period of 1 Se · n
APPLICANT SIGNATURE:
1635 Faraday Ave Carlsbad, CA 92008
B-2
,ding e). DATE: ,f/~9
-602-2719 Fax: 760-602-8558
Page 2 of 2
Email: Building@carlsbadca.gov
Rev. 06/18
June 08, 2021
A AND M CAPRE RC P LLC
2236 RUTHERFORD RD
CARLSBAD, CA 92008
{City of
Carlsbad
PERMIT#: CBC2019-0188
RE: BUILDING PERMIT EXPIRATION
PERMIT TYPE: BLDG-Commercial, Tenant
Improvement
ISSUED:
ADDRESS: 2236 RUTHERFORD RD, 115
CARLSBAD, CA 92008-8836
Our records indicate that your building permit will expire by limitation of time on April 23, 2020.
18.04.030 Section 105.5 amended -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 calendar days from the date of
such permit, or if the building or work authorized by such permit is stopped at any time after the work is commenced for
a period of 180 calendar days, or if the building or work authorized by such permit exceeds three calendar years from
the issuance date of the permit. Work shall be presumed to have commenced if the permittee has obtained a required
inspection approval of work authorized by the permit by the Building Official within 180 calendar days of the date of
permit issuance. Work shall be presumed to be stopped if the permittee has not obtained a required inspection approval
of work by the Building Official within each 180 day period upon the initial commencement of work authorized by such
permit.
Before such work can be recommenced, a new permit shall be obtained to do so, and the fee therefore shall be one half
the amount required for a new permit for such work, and provided that no changes have been made or will be made in
the original plans and specifications for such work, and provided further that such suspension or abandonment has not
exceeded one year. In order to renew action on a permit after expiration, the permittee shall pay a new permit fee.
Any permittee holding an unexpired permit may apply for an extension of time within which work may commence under
that permit when the permittee is unable to commence work within the time period required by this section for good and
satisfactory reasons.
Please check below indicating your intentions and return this letter to us.
0 Project abandoned. A new permit will be obtained prior to commencing work.
0 No fee extension requested for 180 days. (Must attach a letter of explanation)
0 Renewal permit requested.
If the project has been completed and only a final inspection is needed, please call the inspection request line
at (760) 602-2725.
If you have any questions, please contact the Building Inspection Division at 760-602-2700.
Community & Economic Development
Building Division I 1635 Faraday Avenue Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
February 27, 2020
MONTE LANDY
WAREHOUSE PERMITTING AND INSPECTION SERVICE
12562 HWY 67
LAKESIDE,CA 92040
Re: Plan Check Expiration Notification for CBC2019-0188
APPLICATION DATE:
PLAN CHECK #:
ADDRESS:
EXPIRATION DATE:
PERMIT TYPE:
DESCRIPTION:
04/23/2019
CBC2019-0188
2236 RUTHERFORD RD 115
04/23/2020
BLDG-Commercial
SYNERGEYES: HIGH PILE STORAGE RACKS
Ccityof
Carlsbad
You applied to have your plans checked on the date noted above. To date, the related building permit
has not been obtained and the original plan review application will expire on the date noted above. This
courtesy notice is sent to advise you of the following provisions of the City's codes regarding expiration:
18.04.035 -Section 105.3.2 amended -Expiration of plan review. *CODE CHANGE•
Section 105. 3. 2 of the California Building Code is amended to read:
Applications for which no permit is issued within one year following the date of application shall
expire by limitation, and plans and other data submitted for review may thereafter be returned to
the applicant or destroyed by the building official. In order to renew action on an application after
expiration, the applicant shall resubmit plans and pay a new plan review fee.
Plans submitted and not retrieved from the building department prior to the plan check expiration date
noted above will be destroyed.
If you have any questions, please contact the Building Division at (760) 602-2719.
Community & Economic Development -Building Division
1635 Faraday Avenue I Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
C cityof
Carlsbad
PURPOSE
CLIMATE ACTION PLAN
CONSISTENCY CHECKLIST
8-50
Development Services
Building Division
1635 Faraday Avenue
(760) 602-2719
www.carlsbadca.gov
This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance
requirements apply to their projects. Unless none of the requirements apply, 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 .
...111 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.
...111 Details on CAP ordinance requirements are available on the city's website.
~~
·µ•',, • ·, .--'.'· -·~-,•-· ---. -~. -,· •,. -, . ··";'a•,--.'-• --•. · ,• -.. -:· .....
.-• i,, d• · I ' · • ,,\ , ... t'' -' ' -· ' ' . J • • • -• • 'i
\/~ol,.t , I , • .:,i •·+ , 11 _t.. -=-• ' I < _ I /I .._. -. • . ..,. ~ t 1 1 , • • -,_ ,: ~
Project Name/Building
Permit No.:
Property Address/APN:
Applicant Name/Co.:
Applicant Address:
Contact Phone:
BP No.:
Contact Email:
Contact information of person completing this checklist (if different than above):
Name:
Company
name/address:
B-50
Contact Phone:
Contact Email:
Page 1 of 3 Revised 04/19
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 residential alterations and additions to existing buildings, contact the building counter for the building permit valuation.
Building Permit Valuation (BPV) $ ___._( ..... D .... C/4"'--'-1/JO ________ _
D Residential
□ New construction 1A
□ Alterations: □ exempt
□ BPV ~ $60,000 1A 1-2 family dwellings and townhouses with attached garages
□ Electrical service panel upgrade 1A only
Multi-family dwellings only where interior finishes are removed
□ BPV ~ $200,000 1A and significant site work and upgrades to structural and
" mechanical, electrical, and/or plumbing systems are proposed
'"IZJ Nonresidential
'"'□ New construction 18 and 2
)lj) Alterations 2
L
1. Electric Vehicle Charging
A D Residential New construction and major alterations (or electric panel upgrade)*
Please refer to Carlsbad Ordinance CS-349 when completing this section.
□ One and two-family residential dwelling or townhouse with attached garage:
□ One EVSE ready parking space required □ Exception :
□ Multi-family residential· □ Exception ·
Total Parking Spaces EVSE Spaces
Proposed Capable I Ready I Installed
I I
Calculations: Total EVSE spaces= .10 x Total parking (rounded up to nearest whole number)
EVSE Installed = Total EVSE Spaces x .50 (rounded up to nearest whole number)
EVSE other= Total EVSE spaces -EVSE Installed
(EVSE other may be "Capable," "Ready" or "Installed.')
I Total
I
I
*Major alterations are: (1) for one and two-family dwellings and townhouses with attached garages, alterations have a building permit valuation~ $60,000 or
include an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit valuation
~ $200,000, interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed.
B D Nonresidential new construction (includes hotels/motels) □ Exception ·
Total Parking Spaces EVSE Spaces
Proposed Capable I Ready I Installed I Total
I I I
Calculation: Refer to the table below:
Total Number of Parking Spaces provided Number of reouired EV Spaces Number of reouired EVSE Installed Soaces
□ 0-9 1 1
□ 10-25 2 1
□ 26-50 4 2
□ 51-75 6 3
□ 76-100 9 5
□ 101-150 12 6
□ 151-200 17 9
□ 201 and over 10 percent of total 50 oercent of Required EV Spaces
Updated 4/ 12/20 19 2
City of Carlsbad Climate Action Plan Consistency Checklist
2. ~ransportation Demand Management (TOM)
A. List each proposed nonresidential use and gross floor area (GFA) allocated to each use.
B. Employee ADT/1,000 square feet is selected from the table below.
Use GFA Employee ADT for first Employee ADT for each
1,000 S.F. subsequent 1,000 S.F.
/1.Jn ('J,. -_J"
(/
Total
If total employee ADT is greater than or equal to 110 employee ADT, a TOM plan is required.
TOM plan required: Yes □ No 'p(l
Updated 4/12/2019
Employee ADT Estimation for Various Commercial Uses
ADT for first
1,000 s.f.
EmpADTI
1000 s.f.1
Office (all)2 20
Restaurant 11
Retaib 8
Industrial 4
Manufacturing 4
Warehousin 4
1 Unless otherwise noted, rates estimated from /TE Trip
Generation Manual, 1rJhEdition
20
11
4.5
3.5
3
1
2 For all office uses, use SAN DAG rate of 20 ADT/1 ,000 sf to
calculate employee ADT
3 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
1. First 1,000 sf= 8 ADT
2. 9,334 sf -1,000 sf = 8,334 sf
3. 8 334 sf/ 1,000 x 4.5 + 8 = 46 Em lo ee ADT
Total Employee ADT
.. I A
fl.J/#r
/'
3
OFFICE USE ONLY SAN DIEGO REGIONAL
HAZARDOUS MA TE RIALS
QUESTIONNAIRE
RECORD ID # __________________ 1 PLAN CHECK# __________________ 1
BP DATE
Business Contact Telephone#
Project Cont
~
T e fo owing questions represent t e facility's activities, NO he specific project description.
PART I: FIRE DEPARTMENT -:t\ZARDOUS 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:
1. Explosive or Blasting Agents
2. Compressed Gases
3. Flammable/Combustible Liquids
4. Flammable Solids
Facility's Square Footage (including proposed project):
5. Organic Peroxides 9. Water Reactives
6. Oxidizers 10. Cryogenics
7. Pyrophorics 11. Highly Toxic or Toxic Materials
8. Unstable Reactives 12. Radioactives
13. Corrosives
_»...Qther Health Hazards
~one of These.
PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH -HAZARDOUS MATERIALS DIVISION (HMO): If the answer to any of the
questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 110, San 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 j (for new consfruction or remodeling projects)
1. D Is your business listed on the reverse side of this form? (check all that apply).
2. D Will your business dispose of Hazardous Substances or Medical Waste in any amount?
3. D Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500
4.
5.
6.
7.
8.
□ □ □ □ □
pounds and/or 200 cubic feet? W Will your business store or handle carcinogens/reproductive toxins in any quantity? ill" 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 1 0)? W Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to
or reater than 1,320 allons? California's Above round Petroleum Stora e Act).
0 CalARP Exempt
I
Date Initials
0 CalARP Required
I
Date Initials
0 CalARP Complete
I
Date Initials
PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCDI: Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San
Diego, CA 92131 apcdcomp@sdcounty.ca.gov (858) 586-2650). [*No stamp required if Q1 Yes and Q3 Yes and 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 burns; residences forming part of a larger project. ['Excludes garages & small outbuildings.]
YES NO
1. 0 l, Will the project disturb 160 square feet or more of existing building materials?
2. 0 C'2f" Will any load supporting structural members be removed? Notification may be required 1 0 working days prior to commencing demolition.
3. D D (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance
Technician?
4. 0 D (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.
5. 0 r'lO Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet i (www.sdapcd.org/info/facts/permits.pdf) for typical equipment requiring an APCD permit.
6. D 1,Cp (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school I bounda
L/ //-5 ;ff
Date
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: __________ '------------------------
BY· DATE· I I
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
COUNTY-HMO* APCD COUNTY-HMO APCD COUNTY-HMO APCD
. . . A stamp In this box only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other perm1tt1ng requirements may still apply .
HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division