HomeMy WebLinkAbout1818 MARRON RD; 103; CBC2023-0337; PermitBuilding Permit Finaled
Commercial Permit
Print Date: 07/26/2024
Job Address:
Permit Type:
Parcel#:
Valuation:
Occupancy Group:
#of Dwell ing Units:
Bedrooms:
Bathrooms:
Occupant Load :
Code Edition:
Sprinkled :
Project Title:
1818 MARRON RD, # 103, CARLSBAD, CA 92008-1188
BLDG-Commercial Work Class: Tenant Improvement
1563011600 Track#:
$0.00 Lot#:
Project#:
Plan #:
Construction Type:
Orig. Plan Check #:
Plan Check#:
Description: KIMCO : (2443 SF) MINOR INTERIOR DEMOLISH AND NEW WALLS
Applicant: Property Owner:
LAHAINA ARCHITECTS
PHILIP CUDABACK
PKl NORTH PLAZA LP CO KIMCO REAL TY CORF
1621 S MELROSE DR
3268 GOVERNOR DR, # 141
SAN DI EGO, CA 92122-2902
FEE
BUILDING PLAN CHECK
VISTA, CA 92081-5471
BUILDING PLAN REVIEW -MINOR PROJECTS (LDE)
BUILDING PLAN REVIEW -MINOR PROJECTS (PLN)
CERTIFICATE OF OCCUPANCY
COMM/IND Tl-NON-STRUCTURAL
SB1473 -GREEN BUILDING STATE STANDARDS FEE
Total Fees: $2,251.31 Total Payments To Date: $2,251.31
Permit No:
Status:
{ City of
Carlsbad
CBC2023-0337
Closed -Finaled
Applied: 10/17/2023
Issued: 04/23/2024
Fina led Close Out: 07/26/2024
Final Inspection: 07/10/2024
INSPECTOR: Alvarado, Tony
Balance Due:
AMOUNT
$759.85
$197.00
$104.00
$20.00
$1,169.46
$1.00
$0.00
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
coll ectively 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 timel y 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, gra ding or other similar application processing or service fees in connection wit h 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 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov
( City of
Carlsbad
COMMERCIAL
BUILDING PERMIT
APPLICATION
8-2
Pian Check _C_B_C_2_0_23_-_0_3_37 __
Est. Value
PC Deposit
Date
Job Address 1818 MARRON ROAD Suite: 103 APN: 156-301-16-00
Tenant Name#: Kimco Office Lot#: 16 Year Built: 1987 ---------
Year Built: 1987 Occupancy: B Construction Type: V-B Fire sprinklers□ ~O) A/~
BRIEF DESCRIPTION OF WORK: T.I. OF EXISTING 2,443 SQ.FT. FOR OFFICE COR ORAT~
PROJECT INCLUDE: -MINOR INTERIOR DEMOLISHING AND NEW WALLS.
D Addition/New: ___________ New SF and Use, _________ New SF and Use
______ SF Deck, SF Patio Cover, SF Other (Specify) ___ _
SF,
____ SF,
Existing Use: B "Wellness Ce~osed Use: _____ _
Existing Use: ______ Proposed Use: _____ _
D Pool/Spa: ____ SF Additional Gas or Electrical Features? __________ _
D Solar: ___ KW, ___ Modules, Mounted: 0Roof 0Ground
D Re roof: ________________________________ _
r.;, -MECHANICAL EQUIPMENT EXISTING TO REMAIN ~ Plumbing/Mechanical/Electrical -ELECTRICAL JUST TO BE RELOCATED, NO CIRCUITS ADDED.
□Other: ___________ -_E_X_IS_T_IN_G_D_U_C_TI_N_G_T_O_B_E_R_E_L_O_C_A_TE_D_A_S_N_E_C_E_S_S_A_R_Y_. __ _
PROPERTY OWNER APPLICANT (PRIMARY CONTACT)
Name: Phil Cudaback
Address· 3268 GOVERNOR #141
Name: KIMCO REAL TY CONTACT: TONY SANTO
Address: 1621-B SOUTH MELROSE DRIVE
City· San Diego State: CA Zip: 92122 City: VISTA State: CA Zip: 92081
Phone: (760) 596-7748 Phone: (858) 357-5509
EmailPCUDABACK@LAHAINA-ARCHITECTS.COM Email: ASANTO@KIMCOREAL TY.COM
DESIGN PROFESSIONAL CONTRACTOR OF RECORD
Name: Lahaina Architects -Phil Cudaback Business Name:RJ Nichols Construction
Address: 3268 GOVERNOR #141 Address:12119 Lakeside Ave
City: San Diego State: CA Zip: 92122 City:Lakeside State:CA Zip:_9_20_4_0 ___ _
Phone: (858) 357-5509 Phone:619-7 49-4966
Email: lahainaarchitects@gmail.com Email:richard@rjnconstruction.com
Architect State License: _C_-2_5_5_9_8 _______ CSLB License#: 1056885 Class:_B _____ _
Carlsbad Business License# (Required):BLOS007 403-2020
APPLICANT CERT/FICA TION: 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. -+-1~ nc C?
NAME (PRINT): PHIL CUDABACK SIGN: __ ~ ______ DATE: 4/5/2024
1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
REV. 07/21
THIS PAGE REQUIRED AT PERMIT ISSUANCE PLAN CHECK NUMBER: CBC2023-0337
A BUILDING PERMIT CAN BE ISSUED TO EITHER A STATE LICENSED CONTRACTOR OR A PROPERTY OWNER. IF THE PERSON
SIGNING THIS FORM IS AN AGENT FOR EITHER ENTITY AN AUTHORIZATION FORM OR LETTER IS REQUIRED PRIOR TO
PERMIT ISSUANCE.
(OPTION A): LICENSED CONTRACTOR DECLARATION:
lherebyaffirmunderpenaltyofperjurythatlamlicensedunderprovisionsofChapter9(commencingwithSection7000)ofDivision3
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 declarations (CHOOSE ONE):
D1 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. Policy No. _____________________________________ _
-OR-I■ 11 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:-----~~~~~~----------
Policy No. 928420523 Expiration Date: ~0~8~/1~2=/=2~0=2~4 _______ _
-OR-
Ocertificate of Exemption: I certify that in the performance of the work for whic h this permit is issued, I shall not employ any person in any manner so as to become
subject to the workers' compensation Laws of California. WARNING: Failure to secure workers compensation coverage is unlawful and shall subject an employer to
criminal penalties and civil fines up to $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 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 al I City ordi nonces and State laws relating to bui /ding
construction.
NAME (PRINT): Richard Nichols SIGNATURE:~ A/teMtt,_ DATE:4/S/2024 ---------Note: If the person signing above is an authorized agent for the contractor provide a letter of authorization on contractor letterhead.
-OR -
(OPTION B}: OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason: n 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.
~44, 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).
-OR-
D1, 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).
-OR-□1 am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason:
AND, D FORM B-61 "Owner Builder Acknowledgement and Verification Form" is required for any permit issued to a property owner.
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 applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is
submitted or at the following Web site: http: I /www.leginfo.ca.gov/ ca law. html.
OWNER CERT/FICA TION: 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.
NAME (PRINT): SIGN: __________ DATE: ______ _
Note: If the person signing above is an authorized agent for the property owner include form B-62 signed by property owner.
1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
2 REV. 07/21
Building Permit Inspection History Finaled
{city of
Carlsbad
PERMIT INSPECTION HISTORY for {CBC2023-0337)
Permit Type: BLDG-Commercial Application Date: 10/17/2023 Owner: PK1 NORTH PLAZA LP CO KIMCO
REALTY CORP
Work Class: Tenant Improvement Issue Date: 04/23/2024 Subdivision: PARCEL MAP NO 15975
Status: Closed -Finaled Expiration Date: 12/02/2024 Address: 1818 MARRON RD, # 103
CARLSBAD, CA 92008-1188 IVR Number: 52625
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection
Date Start Date Status
05/09/2024 05/09/2024 BLDG-21 247810-2024 Passed Tony Alvarado
Underground/Underflo
or Plumbing
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Underground, electrical and underground, Yes
plumbing scope of work underwater leak
pressure test -OK.
Rough top out plumbing (only), under 10
foot high water, head pressure test -OK.
Pour back, concrete slab cut trench, with
new steel rebar, reinforcement required ,
informed contractor, representative.
BLDG-24 Rough/Topout 247956-2024 Passed Tony Alvarado
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-31 247811-2024 Passed Tony Alvarado
Underground/Conduit -
Wiring
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Underground, electrical and underground, Yes
plumbing scope of work underwater leak
pressure test -OK.
Rough top out plumbing (only), under 10
foot high water, head pressure test -OK.
Pour back, concrete slab cut trench, with
new steel rebar, reinforcement required,
informed contractor, representative.
05/20/2024 05/20/2024 BLDG-84 Rough 248899-2024 Partial Pass Tony Alvarado Reinspection
Combo(14,24,34,44)
Friday, July 26, 2024
Inspection
Complete
Complete
Complete
Incomplete
Page 1 of 4
PERMIT INSPECTION HISTORY for (CBC2023-0337)
Permit Type: BLDG-Commercial Application Date: 10/17/2023 Owner: PK1 NORTH PLAZA LP CO KIMCO
REALTY CORP
Work Class: Tenant Improvement
Status: Closed -Finaled
Issue Date: 04/23/2024 Subdivision: PARCEL MAP NO 15975
Expiration Date: 12/02/2024
IVR Number: 52625
Address: 1818 MARRON RD, # 103
CARLSBAD, CA 92008-1188
Scheduled
Date
Actual Inspection Type
Start Date
Inspection No. Inspection Primary Inspector Reinspection Inspection
06/03/2024
Checklist Item
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
BLDG-24 Rough-Topout
BLDG-34 Rough Electrical
BLDG-44
Rough-Ducts-Dampers
Status
COMMENTS
1. Rough frame vertical walls (only),
combination inspection electrical, plumbing,
and non-loadbearing partition wall
supported with kickers at 45 degrees to
roof, framing, , per structural plans of detail
specifications -OK.
2. concrete slab trench for underground
work, pour-back, steel, reinforcement,
rebar Doweling, and plastic moisture
vapor, barrier protection verified -OK.
BLDG-85 T-Bar, Ceiling 248900-2024 Failed Tony Alvarado
Grids, Overhead
Checklist Item COMMENTS
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
Not ready for T-grid overhead mechanical
electrical, plumbing, or structural inspection
-not ready.
BLDG-24 Rough-Topout
BLDG-34 Rough Electrical
BLDG-44
Rough-Ducts-Dampers
06/03/2024 BLDG-16 Insulation
Checklist Item
250640-2024
COMMENTS
BLDG-Building Deficiency
BLDG-17 Interior
Lath/Drywall
250641-2024
Checklist Item COMMENTS
BLDG-Building Deficiency
BLDG-85 T-Bar, Ceiling 250357-2024
Grids, Overhead
Checklist Item
BLDG-14
Frame-Steel-Bolting-Welding
(Decks)
BLDG-24 Rough-Topout
BLDG-34 Rough Electrical
BLDG-44
Rough-Ducts-Dampers
COMMENTS
Passed Tony Alvarado
Passed Tony Alvarado
Passed Tony Alvarado
Friday, July 26, 2024
Passed
Yes
Yes
Yes
Yes
Reinspection Incomplete
Passed
No
No
No
No
Complete
Passed
Yes
Complete
Passed
Yes
Complete
Passed
Yes
Yes
Yes
Yes
Page 2 of 4
PERMIT INSPECTION HISTORY for (CBC2023-0337)
Permit Type: BLDG-Commercial Application Date: 10/17/2023 Owner: PK1 NORTH PLAZA LP CO KIMCO
REALTY CORP
Work Class: Tenant Improvement Issue Date: 04/23/2024 Subdivision: PARCEL MAP NO 15975
Status: Closed -Finaled Expiration Date: 12/02/2024
IVR Number: 52625
Address: 1818 MARRON RD, # 103
CARLSBAD, CA 92008-1188
Scheduled
Date
Actual Inspection Type
Start Date
Inspection No. Inspection Primary Inspector Reinspection Inspection
Status
BLDG-SW-Inspection 250639-2024 Partial Pass Tony Alvarado Reinspection Incomplete
Checklist Item COMMENTS Passed
Have sediments been tracked Yes
on to the street?
Has trash/debris accumulated Yes
throughout the site?
Are portable restrooms Yes
properly positioned?
Do portable restrooms have Yes
secondary containment?
07/09/2024 07/09/2024 BLDG-Final Inspection 254117-2024 Failed Tony Alvarado Reinspection Incomplete
Checklist Item COMMENTS Passed
BLDG-Plumbing Final Not ready for final inspection No
BLDG-Mechanical Final No
BLDG-Structural Final No
BLDG-Electrical Final No
BLDG-SW-Inspection 254327-2024 Partial Pass Tony Alvarado Reinspection Incomplete
Checklist Item COMMENTS Passed
Have sediments been tracked Yes
on to the street?
Has trash/debris accumulated Yes
throughoul the site?
Are portable restrooms Yes
properly positioned?
Do portable restrooms have Yes
secondary containment?
07/10/2024 07/10/2024 BLDG-Final Inspection 254403-2024 Passed Tony Alvarado Complete
Checklist Item COMMENTS Passed
BLDG-Plumbing Final Yes
BLDG-Mechanical Final Yes
BLDG-Structural Final Yes
BLDG-Electrical Fi nal July 10, 2024; Yes
1. final inspection for tenant improvement
to existing, per structural plans and detail
specifications -approved.
2. B -59 waste recycle debris form filled
out, verified and archived in City records -
OK.
BLDG-SW-Inspection 254404-2024 Passed Tony Alvarado Complete
Friday, July 26, 2024 Page 3 of 4
PERMIT INSPECTION HISTORY for (CBC2023-0337)
Permit Type: BLDG-Commercial Application Date: 10/17/2023 Owner: PK1 NORTH PLAZA LP CO KI MCO
Work Class: Tenant Improvement
Status: Closed -Finaled
REALTY CORP
Issue Date: 04/23/2024 Subdivision: PARCEL MAP NO 15975
Expiration Date: 12/02/2024
IVR Number: 52625
Address: 1818 MARRON RD, # 103
CARLS BAD, CA 92008-1188
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Date Start Date
Friday, July 26, 2024
Checklist Item
Have sediments been tracked
on to the street?
Has trash/debris accumulated
throughout the site?
Are portable restrooms
properly positioned?
Do portable restrooms have
secondary containment?
Status
COMMENTS Passed
Yes
Yes
Yes
Yes
Page 4 of 4
Trt1e North
COMPLIANC E SERVIC S
April 11 , 2024
City of Carlsbad
Community Development Department -Building Division
1635 Faraday Ave.
City of Carlsbad -FINAL REVIEW
City Pe1mit No: CBC2023-0337
True No1th No.: 23-018-1034
Carl sbad, CA 92008
Plan Review: Tl Kimco
Address: 1818 Marron Rd Unit 103
Applicant Name: Lahaina Architects
Applicant Email: Pcudaback@ Lahaina-architects.com
OCCUPANCY AND BUil.,DING SUMMARY:
Occupancy Groups: B
Occupant Load: 46
Type of Construction: V-B
Sprinklers: No
Stories: I
Area of Work (sq. ft.): 2443 sq. ft.
The plans have been reviewed for coordination with the permit application.
Valuation: See Notes Below
Scope of Work: Confirmed
Floor Area: Confirmed
Notes: No valuation provided in permit application.
Attn: Building & Safety Department,
True No1th Compliance Services, Inc. has completed the final review of the fo llowing documents for the project
referenced above on behalf of the City of Carlsbad:
I. Drawings: One (1) copy dated February 29, 2024, by Lahain a Architects.
2. Energy Ana lysis Report: One (I) copy dated February 29, 2024, by Lahaina Architects.
The 2022 Californ ia Building, Mechanical, Plumbing, and Electrical Codes (i.e., 202 1 IBC, UMC, UPC, and 2020
NEC, as amended by the State of California), 2022 California Green Building Standards Code, 2022 Californ ia
Existing Building Code, and 2022 California Energy Code, as applicable, were used as the basi of our review.
Please note that our review has been completed and we have no furth er comments, however, we bring the
following to your attention:
I. rn order to expedite the permitting process, we have made annotations (in red ink) to sheet TS-I.
True North Compliance Services, Inc.
8369 Vickers Street, Suite 207, San Diego, CA 92111
T / 562. 733.8030
We have enclosed the above noted documents bearing our review stamps for your use. Please call if you have any
questions or if we can be of further assistance.
Sincerely,
True North Compliance Services
Review By: Alaa Atassi -Plan Review Engineer
OFFICE USE ONLY SAN DIEGO REGIONAL
HAZARDOUS MATERIALS
QUESTIONNAIRE
RECORD ID# _________________ _
PLAN CHECK# ________________ _
Business ame
KIMCO REAL TY
Business Contact
TONY SANTOS
Telephone#
760-596-77 48
BP DATE
Project Address (include suite) City
1818 MARRON RD STE 103, CARLSBAD CA 92008
State Zip Code APN#
156-301-16-00
Mailing Address (include suite)
1621-B SOUTH MELROSE DRIVE, VISTA CA 92081
Project Contact
PHILLIP CUDABACK
City State Zip Code Plan File#
Applicant E-mail Telephone#
PCUDABACK@LAHAINA-ARCHITECTS.COM 858-357-5509
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. Explosive or Blasting Agents 5. Organic Peroxides 9. Water Reactives 13. Corrosives
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 of These.
4. Flammable Solids 8. Unstable Reactives 12. Radioactives
PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEAL TH -HAZARDOUS MATERIALS DIVISION (HMDl: 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 170, 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:
1.
2.
3.
4.
5.
6.
7.
8.
YES NO (for new construction or remodeling projects)
Is your business listed on the reverse side of this form? (check all that apply). D IX □ [8l 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/reproduc;tive 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 Ill: 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.gov;
(858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131 .
YES NO
1. D ~ Will the project disturb 100 square feet or more of existing building materials?
2. D ~ Will any load supporting structural members be removed?
3. D D (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?
4. D 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.
5. D 5( 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.
6. D D (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:
REAL TY OFFICE TENANT IMPROVEMENT: REMOVE WALLS AND ADD NEW ONES
I declare under penalty of perjury that to the best of my knowledge and belief t e responses made herein are true and correct.
PHILLIP CUDABACK -----~--------10 / 11 / 2023
Name of Owner or Authorized Agent Signature of Owner or Authorized Agent Date
FOR OFFICAL 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* 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 perm1t11ng requirements may still apply
HM-9171 (9/18) County of San Diego -DEH -Hazardous Materials Division
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 tJ Car Wash
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
0 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
MET AL 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 Coati g
D Precious Metal Recovery
D Sand Blasting/Grinding
D Steel Fabricator
D Wrought Iron Manufactu ing
/
AEROSPACE/
D Aerospace Ind stry
D Aircraft Maint nance
D Aircraft Man facturirng
MISCELLANEOUS
D Asphalt Plant /
D Biotechnology}Research
D Cannabis-r~~ted
D Manufa ,(uring D Dispensary D Other
D Co-G~eration Plant
0 Derµal Clinic/Office
0 o·a1ysis Center
mergency Generator
Frozen Food Processing Facility
D Hazardous Waste Hauler
D Hospital/Convalescent Home
D Laboratory/Biological Lab
0 Medical Clinic/Office
D Nitrous Oxide (NO,) Control System
D Pharmaceuticals
D 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 Electrornic Assembly/Sub-Assembly
D Electronic Components Manufacturing
D Printed Circuit Board Manufacturing
NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TY CALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES.
ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANQ ES, USES OR DISPOS,1::S OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE
HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUt NESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880.
LIST OF AIR POLLUJION CONTROL DISTRICT PERMIT CATEGORIES
Businesses, which include any of the following perations 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 -Dry Chemical Mixing & Detergent Spray
Towers
35 -Bulk Dry Chemicals Storage
55 -Chrome Electroplating Tanks
COATINGS & ORGANIC SOLVENTS
27 -Coating & Painting 1
37 -Plasma Arc & Ceramic Depositio/pray
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 Ref~
ORGANIC COMPOUND MARKETING
(GASOLINE, ETC)
25 -Gasoline & Alcohol Bulk Plants & Terminals
25 -Intermediate Refuelers
26 -Gasoline & Alcohol Fuel Dispensing
COMBUSTION
3 -Piston Internal -Combustion Engines
-Boilers & Heaters (1 million BTU/hr or larger)
4 -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
12 -Fish 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 -Cooling Towers -Registration Only
91 -Fumigation Operations
56 -WWTP (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. >
HM-9171 (9/18) County of San Diego -DEH -Hazardous Materials Division