HomeMy WebLinkAbout1923 CALLE BARCELONA; 143; CBC2022-0446; Recycle(city of
Carlsbad
CONSTRUCTION WASTE
MANAGEMENT PLAN
B-59
Development Services
Building Division
1635 Faraday Avenue
442-339-2719
www. car/sbadca. gov
APPLICABLE TO NEW CONSTRUCTION. ALL RESIDENTIAL ADDITIONS AND ALTERATIONS AND
COMMERCIAL ADDITIONS AND ALTERATIONS OVER.....$.J00K If you have questions about the recycling
requirement or completing this form, please contact Republic Services at (760) 332-6464 a certified C&D
recycler, or the Carlsbad Building Division at (442) 339-2700. Please note: Unless you are self-hauling, Republic
Services or approved haulers must be used for all construction projects within the City of Carlsbad.
PART 1 Complete and submit this form when applying for a Building Permit. Note: Permits will not be issued
without a completed Construction Waste Management Plan.
Applicant Information
Permit No. Cl3C -2.022 -0 4±<:; Project Title __,__A~L~O~------------~
Project Address _ _\ \1.3. CAL..LE BA~CELONA ~\."(E_"l.ltJ APN
Owner C~ A□rchitect
Applicant Name H A'-(1>8AJ ~\/I I> D ~
Last First
-n+
Applicant Address 'ZCJ6 "34 N, 2.£> 5~P.et" 5°1A\Th ;p-l!O ftiOaJIK AZ 0SOG'Cl
E-mail Address d bA~clevl@atrier1tpfl fe:h~.i \ eo11.,. eo,.,.
Applicant Mailing Address
(if different than project address)
Project Type
(check all that apply):
Brief Description
Residential □
TEaJAtJf"
I -Public Building □ 0
Project Size __ ?~-~S'_0_2--_____ ~Estimated Cost of Project$ ________________ _
(square footage)
Please check the appropriate box: LJ /I plan on using REPUBLIC SERVICES roll-off bin(s) for all materials and will provide all receipts after construction.
L0" I plan on using a City Approved Hauler and will provide all receipts after construction.
□ This is a proposed LEED certified project and I plan on separating materials on site in conjunction with Republic
Acknowledgement: I certify under penalty of perjury under the laws of the State of California that the information
provided in and with this form pertains to construction and demolition debris generated only from the project listed
in PART 1, that I have reviewed the accuracy of the information, and that the information is true and correct to the
best of my knowledge and belief.
Print Name '2/l"-'ll? HNi2€t-/
Page 1 of 3 Rev, 05122
PART 2 Complete before final inspection, obtain City Approved hauler receipts and return prior to final
building approval.
DEBRIS RECYCLING REPORT (ACTUAL):
Acknowledgement
I certify under penalty of perjury under the laws of the State of California that the information provided In and with
this form pertains to construction and demolition debris generated only from the project listed in PART 1, that I have
reviewed the accuracy of the Information, and that the Information Is true and correct to the best of my knowledge
and belief.
Permit No. c.@:::1412'2--t2W~
Address / f. tAtU ~H'I :i'
Date Material Type
Examr1.le:
01/01/2020 Concrete (broken)
~~
A
Actual Amt
Reused or
Salvaged
Print Name
B C
Actual Amt Actual Amt Destination Facility
Recycled Disposed In (Name, Address, Phone)
Landfill
Palomar Transfer Station, 5960 El
5 tons Camino Real
-760 603-0153
7, ~
~ t t7 ~
d,6f
Diversion Rate Achieved
Contractor/Owner Signature ·
Attach the following docume atlon to this Report:
Original recycling weight ticket , landfill weight tickets
Original donation receipts with photos and/or itemized descriptions
Any other relevant Information to support Recycling Report
City of Carlsbad
Building Division (1st Floor)
1635 Faraday Avenue
Carlsbad, CA 92008
Page 3 of 4
~
Rev. 04/22
FALLBROOK WASTE & RECYCLING
550 WEST AVIATION
FALLBROOK, CA 92028
(760) 728-6114
Customer: 0000 Ticket: 65924
Date: 04/13/23
MISC. CASH DRIVE UP
Commodity Rate
•
In: 10:32
Out: 10:44
105.00 per TON
INVOICE
Truck: 0000
Container: a
R~ute: 0"5654
Origin:P56 FALLBROOK
54 CERTIFIED C&D
[Gross(In): 3.42 tons
Units
.51
Scl#l Tare 2.91 tons Scl#l Net: .51
·Extended
Charge
75.00
tons]
PAID CREDIT CARD 75.00
Construction & Demolition Diversion Certificate --Diversion Percentage 69%
This certifies that the company listed above has utilized an EDCO facility to divert construction demolition materials in accordance
with L~ED requirement. The diversion tonnage is based on an overall tonnage percentage of the respective EDCO facility.
CESAR CAMPOS Driver
FALLBROOK WASTE & RECYCLING
550 WEST AVIATION
FALLBROOK, ',.CA 92028
(760) 728-6114
Customer: 0000 Ticket: 66947
Date: 04/21/23
COASTAL KINGDOM
JOB: LULLABAR
Commodity Units Rate
In: 9: 23
Out: 9:38
C&D 1. 59 105.00 per TON
INVOICE
Truck: 4300/4300
Container:
Route: 05354
Origin: 053 CARLSBAD
54 CERTIFIED
[Gross ( In) : 7.10 tons Man Wt Tare 5.51 tons Man Wt Net: 1.59
Extended
Charge
166.95
tons]
PAID CREDIT CARD 166,.95
Construction & Demolition Diversion Certificate --Diversion Percentage 65%
This certifies that the company listed above has utilized an EDCO facility to divert construction demolition materials in acco,,.,_
with LEED requirement. The diversion tonnage is based on an overall tonnage percentage of the respective EDCO 1" · ·
RODRIGO Driv~r
\
EDCO Di';h/,Al FALLBRK
550 W AVIAllilli ~[I
FALLBllOOK, I', i!!l;tl321.9
H)l)O!J
:211d 11
~:·1ip ca,a:
\ID
il~"
l,1td1 I:
ls VOICE
\pprov;1I Code : ,ti, M,U1od
/iocle·
fo Amount:
CRtDfT CARD
VISA SALt
o:xiXiY:tAXI Xii O ;-;
VlSA ( Rl[1 I
A,jl)QOOOO(IJ' 0 [
. i'
/.
CUSTOIIER. COP'I
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ein:ic:-·1
Contaclt{ I
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