HomeMy WebLinkAbout2808 ROOSEVELT ST; 101; CBC2021-0180; PermitBuilding Permit Finaled
(city of
Carlsbad
Commercial Permit
Print Date: 08/06/2021 Permit No: CBC2021-0180
Job Address: 2808 ROOSEVELT ST, # 101, CARLSBAD, CA 92008-1688 Status: Closed -Finaled
Permit Type: BLDG-Commercial Work Class: Tenant Improvement
Parcel#: 2031820400 Track#:
Valuation: $54,602.74 Lot#:
Occupancy Group: M, 52 Project#:
#of Dwelling Units: Plan#:
Bedrooms:
Bathrooms:
Construction Type:VB
Orig. Plan Check#:
Occupant Load:
Code Edition:
Sprinkled:
Project Title:
33
2019
Yes
Plan Check#:
Description: HOME DECOR & GIFTS: 1,174 SF Tl TO CONVERT HAIR SALON TO RETAIL
Applicant: Property Owner:
JACK CARTER
6828 RICHARD ST
ROOSEVELT TAMARACK INVESTMENTS
PROPERTY HOLDING LLC
SAN DIEGO, CA 92115-1730-SAN DIEGO
(760) 310-2439
FEE
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
3161 MICHELSON DR
IRVINE, CA 92612-4400
(760) 487-8751
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
SB1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-COMMERCIAL
Total Fees: $851.14 Total Payments To Date: $851.14
Applied:
Issued:
Finaled Close Out:
Inspector:
Final Inspection:
Contractor:
05/21/2021
07/12/2021
TKers
08/06/2021
SPW CONSTRUCTION DBA WHITE
CONSTRUCTION
2524 GATEWAY RD
CARLSBAD, CA 92009
(760) 931-1130
Balance Due:
AMOUNT
$428.15
$299.70
$60.00
$45.00
$3.00
$15.29
$0.00
Please take NOTICE that approval of your project includes the 111mposition" 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
{ City of
Carlsbad
COMMERCIAL
BUILDING PERMIT
APP LI CATION
8-2
Plan CheckC\::Ct2.0'2\-a<oO
Est. Value f)\..\ ,\.9.03
PC Deposit _______ _
Date 5-Z\-· Zl
Job Address 2808 Roosevelt St., Carlsbad, CA 92008
Tenant Name: Home Decor & Gift Store
Suite:._1_01 ____ APN: __________ _
Lot#:
Year Built: _____ Occupancy:_M ___ _ Construction Type_• V_B ____ fire Sprinklers:1v:s' ~A/C:t;s j ~
BRIEF DESCRIPTION OF WORK: Demolition of existing non-bearing partitions and ceiling soffits -cleanup
of gyp. bd. ceiling & walls, paint and flooring
0 Addition/New:. ___________ New SF and Use,, ___________ New SF and Use,
___ Deck SF, Patio Cover SF (not including flatwork)
~ Tenant lmprovement:._1_. 1_7_4 ___ SF, Existing Use Hair Salon (M) Proposed Use _R_e_ta_il -'--(M-'-) __ _
_____ SF, Existing Use ______ Proposed Use _____ _
O Pool/Spa: _____ SF Additional Gas or Electrical Features? ___________ _
rlr-1 Dl:!J DC!:I D Solar: ___ KW,, ___ Modules,, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No
0 Plumbing/Mechanical/Electrical Only: -------------------------
O Other:
This permit is to be issued in the name of the Property Owner as Owner-Builder, licensed contractor or Authorized Agent of the
owner or contractor. The person listed as the Applicant below will be the main point of contact throughout the permit process.
PROPERTY OWNER
Name: Roosevelt Tamarak-John Yelland
Address: 6 Venture, Ste. 215
APPLICANT O PROPERTY OWNERS AUTHORIZED AGENT
Name: John Yelland
APPLICANT 0
Address: _________________ _
City: Irvine State:_C_A ___ Zip:92618 City: __________ State: ___ Zip:. ____ _
Phone: 949-727-0284
Email: Johny@pouchselfstorage.com
DESIGN PROFESSIONAL
Name: Jack Carter, Architect
Address: 6828 Richard St.
APPLICANT Ii)
Phone: __________________ _
Email: johny@pouchselfstorage.com
CONTRACTOR BUSINESS APPLICJ\NT 0
Name: 5Pcu CcrrJ ST ~\.)c_ n DN
Address:. _________________ _
City: San Diego State:_C_A __ Zip: 92115 City: ________ State: ____ Zip:. _____ _
Phone: 760-310-2439 Phone: -------------------Em a ii: jackcarteraia@yahoo.com Email:
Architect State License: _c_2_70_2_7 ________ State L,_ic_e_n_s-e:_/_0_d-__,3r-,~,-5)--,.k;a_u_s_. L-ic_e_n_s-e: _____ _
1635 Faraday Ave Carlsbad, CA 92008
8-2
Ph: 760-602-2719 Fax: 760-602-8558
Page 1 of2
Email: Building@carlsbadca.gov
Rev. 08/20
IDENTIFY WHO WILL PERFORM THE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW:
(OPTION A): LICENSED CONTRACTOR DECLARATION:
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also affirm under
penalty of perjury one of the following dee/orations:
D I have and will maintain a certificate of consent to self-insure for workers' compensation provided by Section 3 700 of the Labor Code, for the performance of
the work which this p'E!rmlt Is Issued. Policy No. _______________________ _
IX! I have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the w~rk for which this permit Is issued.
My workers' compensation insurance carrier and policy number are: Insurance Company Name: State Compensation Insurance Fund
Policy No. 9243036-21 Expiration Date: .....,.,01"-'/.,.,01"-'/=-20::.:2==2,__ __________ _
D 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 crlminal penalties and civil fines up to $100,000.00, in addition the to the cost of compensation, damages as provided for In Section 3706 of the
Labor Code, Interest and attorney's fees.
CONSTRUCTION LENDING AGENCY, If ANY:
I hereby affirm that there is a construction lending agency for the performance of the work this permit Is issued (Sec. 3097 (I) Civil Code).
Lender's Name: ____________________ Lender's Address: ___________________ _
CONTRACTOR PRINT: Sean Malley, Vice President ~/4,.,j// SIGN: 'f/ Vice Presjdent DATE: _0_1_,1_2_12_0_2_1 __ _
(OPTION B): OWNER-BUILDER DECLARATION:
I hereby affirm that I om exempt from Contractor's License Law for the following reason:
DI, as owner of the property or my employees with wages as their sole compensatlon,.will do the work and the structure ls not Intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who does such
work himself or through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement Is
sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
DI, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s)
licen$ed pursuant to the Contractor's License Law).
01 am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason:
D "Owner Builder acknowledgement and verification form" has been filled out, signed and attached to this application. Proof of identification attached.
D Owners "Authorized Agent Form" has been filled out, signed and attached to this application giving the agent authority to obtain the permit on the owner' behalf.
Proof of Identification attached.
By my signature below I acknowledge that, except for my personal residence In which I must have resided for at least one year prior to completion of the
Improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed In Its entirety by licensed
contractors. / understand that a copy of the opplicoble low, Section 7044 of the Business and Professions Code, is availob/e upon request when this application is
submitted or at the following Web site: http://www.leglnfo.ca.gov/ca/aw.html.
OWNER PRINT: ____________ SIGN: _________ DATE: ______ _
APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL
By my signature below, I certify that: I am the property owner or State of California licensed Contractor or authorized to act on the property
owner or contractor's behalf. I certify that I hove read the appllcotion 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 SA VE,
INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDG , OSTS AND EXPENSES WHICH MAY IN ANY WAY
ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
deep and demolition or construct/on of structures over 3 stories In height.
APPLICANT PRINT: Jack E. Carter
1635 Faraday Ave Carlsbad, CA 92008
B-2
Ph: 760-602-2719 Fax: 760-602-8558
Page 2 of2
Email: Building@carlsbadca.gov
. Rev. 08/20
Building Permit Inspection History Finaled
(_ City of
Carlsbad
Permit Type; BLDG-Commercial Application Date: 05/21/2021
Work Class: Tenant Improvement Issue Date:
Status:
Scheduled
Date
07/14/2021
08106/2021
Closed -Finaled Expiration Date:
IVR Number:
Actual Inspection Type
Start Date
Inspection No.
07/14/2021 BLDG-43 Air
Cond./Furnace Set
161885-2021
Checklist Item COMMENTS
BLDG-Building Deficiency
BLDG-84 Rough
Combo(14,24,34,44)
161884-2021
Checklist Item
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
BLDG-34 Rough Electrical
BLDG-44
Rough-Ducts-Dampers
COMMENTS
08/06/2021 BLDG-Final Inspection
Checklist Item
163759-2021
COMMENTS
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Mechanical Final
BLDG-Structural Final
BLDG-Electrical Final
07/12/2021
01/10/2022
33498
Inspection
Status
Partial Pass
Passed
Passed
Owner: ROOSEVELT TAMARACK
INVESTMENTS PROPERTY HOLDING
LLC
Subdivision: SEASIDE LANDS
Address: 2808 ROOSEVELT ST, # 101
CARLSBAD, CA 92008-1688
Primary Inspector Reinspection Inspection
Tim Kersch Reinspectlon Incomplete
Passed
Yes
Tim Kersch Complete
Passed
Yes
Yes
Yes
Tim Kersch Complete
Passed
Yes
Yes
Yes
Yes
Yes
Friday, August 6, 2021 Page 1 of 1
DATE: 07/07/2021
JURISDICTION: CARLSBAD
PLAN CHECK#.: CB-CBC2021-0180
• 1W
INTERWEST
SET II
PROJECT ADDRESS: 28008 Roosevelt St #101
PROJECT NAME: Home Decor Store -TI
□ APPLICANT
□ JURIS.
IZJ 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 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 lnterwest
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 lnterwest staff did not advise the applicant that the plan check has been completed.
D lnterwest staff did advise the applicant that the plan check has been completed.
Person contacted:
Date contacted:
Mail Telephone
0 REMARKS:
By: Steven Miller
lnterwest
Telephone#:
(by: ) Email: johny@pouchselfstorage.com
Fax In Person
Enclosures:
06/14
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
DATE: 06/14/2021
JURISDICTION: CARLSBAD
PLAN CHECK#.: CB-CBC2021-0180
• lW
INTERWEST
A .SAF"£built COMPANY
SETI
PROJECT ADDRESS: 28008 Roosevelt St #101
PROJECT NAME: Home Decor Store -TI
□ APPLICANT
□ JURIS.
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
D 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 lnterwest
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.
~ The applicant's copy of the check list has been sent to:
D lnterwest staff did not advise the applicant that the plan check has been completed.
1:8] lnterwest staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted: (by: ) Email: johny@pouchselfstorage.com
Mail Telephone
0 REMARKS:
By: Steven Miller
lnterwest
Fax In Person
Enclosures:
06/14
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
CARLSBAD CBC2021-0180
06/14/2021
PLAN REVIEW CORRECTION LIST
COMMERCIAL
PLAN CHECK#.: CB-CBC2021-0180
OCCUPANCY: M, S2
TYPE OF CONSTRUCTION: VB
ALLOWABLE FLOOR AREA:
SPRINKLERS?: YES
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION:
DATE INITIAL PLAN REVIEW
COMPLETED: 06/14/2021
FOREWORD (PLEASE READ):
JURISDICTION: CARLSBAD
USE: Retail
ACTUAL AREA: 2167 Existing sq ft
1174Tlsqft
STORIES: 1 No Change
HEIGHT: 20' No Change
OCCUPANT LOAD: 33
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 05/24/2021
PLAN REVIEWER: Steven Miller
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 CBC2021-0180
06/14/2021
NOTICE: CITY AND ESGIL'S HOURS OF OPERATION ARE AFFECTED BY
THE CURRENT COVID-19 EPIDEMIC. PLAN REVIEWER MAY NOT BE
AVAILABLE TO ANSWER QUESTIONS BY PHONE, BUT MAY BE
REACHED BY E-MAIL AT stmiller@esgil.com . (858) 225-2775
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 lnterwest and the Carlsbad Planning,
Engineering and Fire Departments.
2. Bring TWO corrected set of plans and calculations/reports to lnterwest, 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 lnterwest only will not be reviewed by
the City Planning, Engineering and Fire Departments until review by lnterwest is
complete.
2. Plans may be submitted in electronic format, subject to the jurisdiction's
approval. If so, they must have restrictions removed from the security settings.
Electronic plans with restrictions to markups, printing, or stamping will not be
approved.
3. A reminder that due to Covid-19, the City will not permit counter corrections.
Please make sure all the items are satisfied; otherwise, another round of
corrections will be necessary.
PLANS
4. City of Carlsbad requires that all plans provide completed Climate Action Plan
(CAP) Consistency Checklist, city form B-50.
5. Provide a Building Code Data Legend on the Title Sheet. Include the following
code information for each building proposed:
♦ Occupancy Classification(s) M,S2
♦ For Mixed Occupancy Buildings, state whether the "nonseparated" or
"separated" option was chosen from Sections 508.3/508.4.
♦ Description of Use Retail
♦ Type of Construction VB
CARLSBAD CBC2021-0180
06/14/2021
♦ Sprinklers: Yes or No YES
♦ Stories 1 no change
♦ Height no change
♦ Floor Area 2167 existing sq ft/ 117 4 Tl sq ft
♦ Occupant Load 33
6. Provide a note on the plans indicating if any hazardous materials will be stored
and/or used within the building which exceed the quantities listed in IBC Tables
307.1(1) and 307.1(2).
7. Page A2.1 proposed floor plan detail callout AfA5.1 and page A5.1 is missing
from the plans.
8. Page A9.1 Detail 23 Please provide notes on the plans to show the suspended
ceilings in Seismic Design Categories D, E & F comply with ASCE 7-16 Section
13.5.6.2.2 as follows:
a. The width of the perimeter supporting closure angle or channel shall be
not less than 2.0 in. unless qualified perimeter supporting clips are used.
b. Closure angles or channels shall be screwed or otherwise positively
attached to wall studs or other supporting structures. Perimeter supporting clips
shall be qualified in accordance with approved test criteria per Section 13.2.5.
c. Perimeter supporting clips shall be attached to supporting closure angle or
channel with a minimum of two screws per clip and shall be installed around the
entire ceiling perimeter.
d. In each orthogonal horizontal direction, one end of the ceiling grid shall be
attached to the closure angle, channel, or perimeter supporting clip. The other
end of the ceiling gird in each horizontal direction shall have a minimum 0.75-in
clearance from the wall and shall rest upon and be free to slide on a closure
angle, channel, or perimeter supporting clip.
e. Ceiling areas over 2500 ft.2 must have seismic separation joints or full
height partitions.
f. Ceilings without rigid bracing must have 2" oversize trim rings for
sprinklers and other ceiling penetrations.
ENERGY CONSERVATION
9. The plans state the existing square feet is 2167, and the Tl as 1174 square feet.
Page E3.0 and form NCCCL TI-Estate that the Tl has 11345 conditioned square
feet please clarify.
ADDITIONAL
10. 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.
CARLSBAD CBC2021-0180
06/14/2021
11. 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
12. 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 Steven Miller at Esgil. Thank you.
CARLSBAD CBC2021-0180
06/14/2021
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: CARLSBAD
PREPARED BY: Steven Miller
PLAN CHECK#.: CB-CBC2021-0180
DATE: 06/14/2021
BUILDING ADDRESS: 28008 Roosevelt St #101
BUILDING OCCUPANCY: M, S2
BUILDING AREA Valuation
PORTION ( Sq_ Fl} Multiplier
Tl M Occ1.nancv 1174 46.51
Ajr Conditiol'Wlg
Fire Sprinders
TOTAL VALUE
Jurisdiction Code CB By Ordinance
1997 UBC Buildin Permit Fee g ...
I 1997 USC Plan Check Fee
TypeofR-: ~ Complete Review
Reg_ VALUE
Mod_
r Structural Only
rRE,-ree li:J Repeats
..
,,
r other
r Hourly
EIIGII Fee ,,
~Hr.@•
Comments:
($}
54,603
54,603
$275.117
Sheet 1 of 1
•
Hazardous Materials Questionnaire
County of San Diego, Department of Environmental Health and Quality
PO Box 129261, San Diego, CA 92112-9261
Record ID#: Not in System
Plan Check#: DEH2021-HHMBP-
010225
(858) 505-6700 (800) 253-9933 www.sdcdehq.org
Business Name Business Contact Telephone# Plan File#
Decor Gift Angela Slevinsky 7609311130
City Zip Code APN# Project Address
2808 Roosevelt St Carlsbad
I State
CA 920081688 203-182-04-00
Applicant Applicant E-Mail Applicant Telephone #
Angela Slevinsky angela@whiteconstructioninc.com 7609311130
The following questions represent the facility's activities, NOT the specific project description.
PART I· EIRE DEPARTMENT -HAZARDOUS METERIALS DIVISION: OCCUPANCY CLASSIFICATION· (Not required for projects within the City of San Diego.)
Indicate by selecting the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are selected, Applicant must
contact the Fire Protection Agency with jurisdiction prior to plan submittal.
Occupancy Rating: M, S2
D Explosive or Blasting Agents
D Compressed Gases
D Flammable/Combustible Liquids
□ Flammable Solids
D Organic Peroxides
D Oxidizers
D Pyrophorics
D Unstable Reactives
Facility's Square Footage (including proposed project): 1174
D Water Reactives D Corrosives
D Cryogenics
D Highly Toxic or Toxic Materials
D Radioactives
D Other Health Hazards
D None of These
PART II" SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH · HAZARDOUS MATERIALS DIVISION (HMDI: If the answer to any of the questions is
yes, applicant must contact the County of San Diego Hazardous Materials Division, in person at 5500 Overland Ave., Suite 110, San Diego, CA 92123, or by phone at (858)
505-6700 prior to issuance of a building permit. FEES ARE REQUIRED.
Project Completion Date: 6/11/2021
1.
2.
3.
4.
5.
6.
7.
8.
YES NO
D IBJ
D IBJ
□
D
D
D
D
D
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 equal to or greater than
55 gallons, 500 pounds, or 200 cubic feet?
Will your business handle carcinogens or 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 storage capacity
equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act).
D
D
D
CalARP Exempt
CalARP Required
CalARP Complete
Review Date:
PART 111· SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCDI: If the answer to Question #1 is 'Yes' and the answer to Question #2 is 'No', the applicant
must contact the APCD prior to the issuance of a building or demolition permit. If any answer to Questions #3, #4, or #5 is 'Yes', the applicant must contact the APCD prior to
the issuance of a building or demolition permit. If the answer to Question #3 or #4 is 'Yes', the applicant may need to submit an asbestos notification form to the APCD at
least 1 O working days prior to commencing demolition or renovation (some residential projects may be exempt from the notification requirements). Contact the APCD at
10124 Old Grove Road, San Diego, CA 92131 or telephone (858) 586-2600 for more information.
1.
2.
3.
4.
YES NO
IBJ D
IBJ D
1B] □
□ 00
Will any existing building materials be disturbed as part of this project? (If the answer is 'Yes', an asbestos survey may be required.)
Has a survey been performed to determine the presence of asbestos containing materials?
Will the project involve handling or disturbance of any asbestos containing materials?
5. D 00
Will the project involve the removal of any load supporting structural member?
Will the subject facility or construction activities include operations or equipment that emit or are capable of emitting an air contaminant? (See the APCD
factsheet at http://www.sdapcd.org/info/facts/permits.pdf
6. D (ANSWER ONLY IF QUESTION 5 IS 'YES') Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)?
Search the California School Directory at http://www.cde.ca.gov/relsd/ for public and private schools or contact the appropriate school district.
Briefly describe business activities:
Retail Shop
Briefly describe proposed project:
Convert a Hair Salon to a Retail Gift Shop
I declare under penalty of perjury that to the best of my knowledge and belief, the responses made herein are true and correct. 00; Fees Acknowledged: IBl
Angela Slevinsky, Project Coordinator 6/23/2021
Name of Owner or Authorized Agent Date
FOR OFFICIAL USE ONLY
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:
BY: DATE: ___________ _
EXEMPT OR NO FURTHER INFORMATION
REQUIRED
RELEASED FOR BUILDING PERMIT BUT NOT FOR
OCCUPANCY
RELEASED FOR OCCUPANCY
COUNTY-HMO'
~ 1:'f or ·8.iCv 02 ~ ~,,,
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'A stamp in this box l2ruY. exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply.
DEHQ HMO HMBP Questionnaire v 1 .34 (212021)
Printed on: 71\12021@ 1:55 PM
NOT TRANSFERABLE
UC.NUMBER
OATEISSUEO
11/09/2020
NAICSCOOE
236220
~RFIAMOR
CORPORAlKm HAAtE
CITY ANO STATE
CITY OF CARLSBAD
1135 Faraday Ave, Carlsbad CA 92008
N-'JCS DESCRIPTION
Commercial and Institutional Building
Construction
S PW CONSTRUCTION INC
VVHITE CONSTRUCTION
2524 GATEWAY RD
Carlsbad, CA 92009-17 42
BUSINESS LOCATION
POST IN COHSPiCIJOIJS Pt.ACE
I USINESS REGlST'RATION CIUfflFICAff:
2524 GATEWAY RD
exPIR"TION O"TE
01/31/2022
(cicyof
Carlsoad
KEEP FOR YOUR RECORDS
LICENSE NUMBER
BLNR000431-02-2017
DATE ISSUED
11/09/2020
EXPIR"TION O"TE
01/31/2022
BUSINESS NAME
S P W CONSTRUCTION INC
BUSINESS LOCATION
2524 GATEWAY RD
t.UCSPNOINACC,0ftOAHCl_Ytln1CllYl\nlH(S3 lllX ott~N«:L
CITY OF CARLSBAD
t> ,.-• I # • t • • .-• ♦ • c:::1c:a CONTRACTORS STATE LICENSE BOARD
ACTIVE LICENSE
,m,,_ 1023856 ,,.~ CORP
,,._,,_ SPW CONSTRUCTION INC DBA
WHITE CONSTRUCTION
._..,,,,""" 02/28/2023 www.cslb.ea.gov ~
□ □ □ □ □ □ □ □ □ □
ENCINA WASTEWATER AUTHORITY
INDUSTRIAL WASTEWATER DISCHARGE PERMIT
SCREENING SURVEY
6200 Avenida Encinas, Carlsbad, CA 92011
Phone: 760-438-3941 Fax: 760-4 76-9852
SourceControl@encinajpa.com
Date: 05/12/2021
Business Name: Home Decor & Gift Shop
StreetAddress: 2808 Roosevelt St., Ste. 101, Carlsbad, CA 92008
Email Address: 760-212-7019
PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT : (ON REVERSE SIDE CHECK TYPE OF BUSINESS) I ✓ I
Check all below that are present at your facility:
Acid Cleaning D Food Processing D Metal Powders Forming
Assembly D Glass Manufacturing D Nutritional SupplemenWitamin
Automotive Repair D Industrial Laundry D Manufacturing
Battery Manufacturing D Ink Manufacturing D Painting/Finishing
Biofuel Manufacturing D Laboratory D Paint Manufacturing
Biotech Laboratory D Machining/Milling D Personal Care Products
Bulk Chemical Storage D Membrane manufacturing D Manufacturing
Car Wash D (i.e. waterfilter membranes) D Pesticide Manufacturing/ Packaging
Chemical Manufacturing D Metal Casting/Forming D Pharmaceutical Manufacturing
Chemical Purification D Metal Fabrication D (including precursors)
D Dental Offices D Metal Finishing D Porcelain Enameling 0 Dental Schools D Electroplating D Power Generation
O Dental Clinics D Electroless Plating D Print Shop
D Dry Cleaning □Anodizing D Research and Development
D Electrical Component D Coating (i.e. phosphaling) D Rubber Manufacturing
□ Manufacturing D Chemical Etching/Milling D Semiconductor Manufacturing
□ Fertilizer Manufacturing D Printed Circuit Board D Soap/Detergent Manufacturing
□ Film/ X-ra y Processing D Manufacturing D Waste TreatmenUStorage
New Business? YesONoE] SIC Code(s) if known: ______ Date operation began/will begin:_2_0_1_8 ____ _
Tenant Improvement? Yes E]NoO If yes, briefly describe improvement: Remove existing Ceiling Soffits, Repair Ceiling and walls
patch/repair, repaint as needed, new flooring, new lighting
Description of operations generating wastewater (discharged to sewer, hauled orevaporated):_N_/_A ________ _
Estimated volume of industrial wastewater to be discharged (gal/ day) : _N_/_A __________________ _
List hazardous wastes generated (type/volume): N/A (Gypsum Wall Board, metal wall studs only -40c.f. +/-to landfill
Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? YesODate: _____ ,No~
Page 1 of 2
ENCINA WASTEWATER AUTHORITY
INDUSTRIAL WASTEWATER DISCHARGE PERMIT
SCREENING SURVEY
6200 Avenlda Encinas, Carlsbad, CA 92011
Phone: 760-438-3941 Fax: 760-476-9852
SourceControl@encinajpa.com
The commercial enterprises listed below are a partial listing of businesses that are exempt from industrial wastewater discharge
permitting under normal operating conditions. They are exempt because (a) they discharge no process wastewater (i. e., they
only discharge sanitary wastewater with no pollutants exceeding any local limits}, and (b) they have no potential to negatively
impact the EWPCF or other wastewater treatment plants in the ESS. Any questions regarding exemptions should be referred
to EWA Source Control staff.
□ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □
Automobile Detailers
Barber/Beauty Shops
Business/Sales Offices
Cleaning Services
Carpet/Upholstery
Childcare Facilities
Churches
Community Centers
Consulting Services
Contractors
Counseling Services
Educational Services (no auto repair/film
Financial Institutions/Services
Fitness Centers
Gas Stations (no car wash/auto repair)
Grocery Stores (no film developing)
Residential based Businesses
developing)
□ □ □ □ □ □ □ □ □ □ □ □ □ □ □ [!]
□
Hotels/ Motels (no laundry)
Laundromats
Libraries
Medical Offices (no x-ray developing)
Mortuaries
Museums
Nail Salons
Nursing Homes
Office Buildings (no process flow)
Optical Services
Pest Control Services (no pesticide repackaging for sale)
Pet Boarding/Grooming Facilities
Postal Services (no car wash/auto repair)
Public Storage Facilities
Restaurants/Bars
Retail/Wholesale Stores (no autorepair/film
developing)
Theaters (Movie/Live)
e information above is true and correct to the best of my knowledge.
Home Decor & Gift Retail Store 05/12/2021 Print Name: ____________ _ Date: ____ _
Title:_-1-tffib--'--':..J.L-'--rwr!....!£1Ll------
ENCINA WASTEWATER AUTHORITY
6200AVENIDA ENCINAS, CARLSBAD, CA Phone: 760-438-3941 Fax: 760-476-9852
SourceControl@encinajpa.com
Page 2 of2
PERMIT: c ;;21-01 ro
APPLICATION
(completeness, contractor/owner)
CAP FORM
RES. ovet 60,000/COIVI/VI. ave,
100,000/NEW CONSTR.
CFD LETTER
CFD is "YES" in the GIS Tab (NEW)
ENCi NA WASTE WATER
NEW& Tl
HAZMAT
COMM: Tl, NEW, ADD
HEALTH
Restaurants
OWNER/BUILDER
I} lib tbhtldltbl, reqa11eS Bbl, vetl}Y
ownership
SCHOOL
IVE vv CONS I/RES ADD uve;
500sqft/COMM add
FILE REVIEW
REQUIRED REC:1:'Z ,/ •
v V
✓
SEWER (LECADIA) (VALLECITO_,S) ______ _
NEW & Tl /if outside Carlsbad)
SPECIAL INSPECTOR
required by Esgil
SW POLLUTION PREVENTION
NEW/ADDITION/POOL/RH WALL
WASTE DISPOSAL
IVEVVJAOOJ/IOIV}COIVIIVI OVER
$200,000/DEMO
OTHER
COMMENTS
C City of
Carlsbad
PURPOSE
CLIMATE ACTION PLAN
CONSISTENCY CHECKLIST
B-50
Development Services
Building Division
1635 Faraday Avenue
(760) 602-2719
www.carlsbadca.gov
This checklist is intended to help building permit applicants identify which Climate Action Plan (CAP) ordinance requirements
apply to their project. This completed checklist (B-50) must be included with the building permit application for all projects
that require CAP compliance. The Carlsbad Municipal Code (CMC) can be referenced during completion of this
document by clicking on the provided links to each municipal code section.
NOTE: The following type of permits are not required to fill out this form
❖ Patio I ❖ Decks I ❖ PME (w/o panel upgrade) I ❖ Pool
Consultation with a certified Energy Consultant is encouraged to assist in filling out this document.
Non-licensed individuals should not attempt to fill this out without cons u It at ion. Appropriate certification includes, but
is not limited to: Licensed, practicing Architect, Engineer, or Contractor familiar with Energy compliance, IECC/
HERS Compliance Specialist, ICC G8 Energy Code Specialist, RESNET HERS rater certified, certified ICC
Residential Energy Inspector/Plans Examiner, ICC Commercial Energy Inspector and/or Plans Examiner, ICC CALgreen
Inspector/Plans Examiner, or Green Building Residential Plan Examiner.
If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance,
check NIA and provide an explanation or code section describing the exception.
Details on CAP ordinance requirements are available at each section by clicking on the municipal code link provided. The
project plans must show all details as stated in the applicable Carlsbad Municipal Code (CMC) and/or Energy Code and
Green Code sections.
Project Name/Building
Permit No.: Tenant Improvement
Property AddresS/APN: 2808 Roosevelt St . Carlsbad CA 92008
Applicant Name/Co.: Jack Carter -Archtect
Applicant Address: 6828 Richard St., San Diego, CA 92115
Contact Phone: 760-310-2439
BPNo.:CfX,202\-GIW
Contact Email: jackcarteraia@yahoo.com
Contact information of person completing this checklist (if different than above):
Name:
Company
name/address:
B-50
Jack Carter Contact Phone: 760-310-2439
Contact Email:
Page 1 of 7 Revised 04/21