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HomeMy WebLinkAbout1525 FARADAY AVE; 390; CB161932; PermitCity of Carlsbad 0'6-07-2016 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No: CB161932 Building Inspection Request Line (760) 602-2725 Job Address: 1525 FARADAY AV CBADSt: 390 Permit Type: Tl Sub Type: INDUST Status: ISSUED Applied: 05/17/2016 Entered By: JMA Parcel No: 2121302700 Lot#: 0 Valuation: $179,823.00 Construction Type: 5B Occupancy Group: Reference# Plan Approved: 06/07/2016 Issued: 06/07/2016 Inspect Area Project Title: GRIFFITH, YOUNG: 3,928 SF OFF TO SAME Applicant: DESIGN CORP 4944 COLLINGWOOD DR SAN DIEGO CA 92109-2243 858-794-3222 Building Permit Add'I Building Permit Fee Plan Check Add'I Building Permit Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'I Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'I Pot. Water Con. Fee Reel. Water Con. Fee Green Bldg Stands (SB1473) Fee Fire Expedidted Plan Review $910.06 $0.00 $637.04 $0.00 $0.00 $50.35 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8.00 $0.00 Total Fees: $1,696.22 Total Payments To Date: Plan Check#: Owner: NEWPORT NATIONAL/CORNERSTONE LL C C/O SCOTT BRUSSEAU NEWPORT NATL 1525 FARADAY AVE #100 CARLSBAD CA 92008 Meter Size Add'I Reel. Water Con. Fee Meter Fee SDCWAFee CFO Payoff Fee PFF (3105540) PFF (4305540) License Tax (3104193) License Tax (4304193) Traffic Impact Fee (3105541) Traffic Impact Fee (4305541) PLUMBING TOTAL ELECTRICAL TOTAL MECHANICAL TOTAL Master Drainage Fee Sewer Fee Redev Parking Fee Additional Fees HMP Fee Green Bldg Standards Plan Chk TOTAL PERMIT FEES $1,696.22 Balance Due: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $46.00 $44.77 $0.00 $0.00 $0.00 $0.00 ?? ?? $1,696.22 $0.00 Inspector: Clearance: _____ _ NOTICE: Flea5e ta<e NOTICE that cWu.ral cf ycx.ir µtject irdudes the "lnµisitiori' cf fees, dedicatioos, reservatioos, or cther excdioos hereafter oolectively referred to as "fees'exa:iioos." You have 00 days from the date tlis pemit Woo issued to protest inµ:islticn cf tJ-ese fees'exa:iioos. If ya.i protest tt--ern ya.i rrust foilONthe protest ~ures set forth in C:ovetmalt Qxle Secticn 66020{a), and file the protest a-xi any cther req..ired irtorrraticn wth the aty Mi1ager for ptl(ESSing in a::x:.ordarre wth Calsta:I M.uidpal Qxle Secticn 3.32.030. Falu-e to tirrelyfoilONthat ~ure wll bar any subsequent lega action to atta;k, review, set aside, void, or anru treir inµ:isltion. You ae hereby R.RTI-ER NOTIREDthat ycx.ir rig-rt to protest the specified fees'exa:iioos i::xES NOf ADR...Ytowater a-xl reNar oonnecticn fees and rapacity dla7ges, nor plmng, zaing, gading or cther sinilcr applicaticn p-ocessing or seivice fees in oonnecticn wth this µtject. l\ffi i::xES IT ADFt.. Y to any fees'exa:iia,s of IAflich have ·ous1 been ·ven a NOTICE sirTilar to tlis or as to IAflich the statute of lirTitatioos has ·ous1 dherwse "red. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: OPLANNING 0ENGINEERING 0BUILDING OFIRE OHEALTH 0HAZMAT/APCD ' Plan Check No. CB{ (o.. l '1 3 Building Permit Application 2---, Ccityof 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value T/. { '1 q, f'-2-3 64- Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov www.carlsbadca.gov Date S"', (1 . I b lswPPP JOB ADDRESS 1525 Faraday Ave SUITE#/SPACE#/UNIT# rPN 212 390 -130 -27 -00 CT/PROJECT# ILOT# I PHASE# r OF UNITS r BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP 102 Griffith Joung & Lass, APC VB B DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) --, Tenant improvement within existing building. 91 LF of new non-load bearing partition wall, new electrical and adjustments to existing mechanical. No structural and no new roof mounted equipment under this permit. ~ q7.g ~&-~ .. EXISTING USE I I PROPOSED USB I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE rlR CONDITIONING I FIRE SPRINKLERS B YESO. No@ YES[Z]No0 YES[Z]NoO APPLICANT NAME Designcorp PROPERTY OWNER NAME Newport National Corporation Primary Contact ADDRESS ADDRESS 4944 Collingwood Dr 1525 Faraday Ave CITY STATE ZIP CITY STATE ZIP San Diego CA 92109 Carlsbad CA 92009 PHONE 'FAX PHONE YAX (858) 794-3222 (858) 490-0364 (760) 607-4282 EMAIL EMAIL kmalacarne@designcorpsd.com DESIGN PROFESSIONAL Kathy Malacarne CONTRACTOR BUS. NAME ::SALO~ C.01,,.. d rvo c. -/. I ".oh. ADDRESS ADDRESS ,J. I/. 4944 Collinawood Dr I OG I l_ Pras.n? v e. CITY STATE ZIP CITY 5 1'\ _/p_., ,-STATE ZIP °' 20 71 San Dieao CA 92109 a4 PHONE IFAX PHONE {;/4-'t;-c;z..-<i/t/) 'FAX (858) 794-3222 (858) 490-0364 EMAIL EMAIL t/JL-to,r n '"c..or -s). c:,on,., kmalacarne@designcorpsd.com I STATELIC. # STATE UC.# ICLAS~ lc7,!t:r ~ 617 tf<jCJ 'II 2- (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair an)I structure, prior to ,ts issuance, also requires the applicant for such permit to file a signed statement tnat he 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 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)). W0C&ffi&@9 ° <'s0CulCP@QJ~a} 'iJO@ro g Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the fa/lowing declarations: D ~and will maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permitis issued. (E I have and wlll maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio,;su7,ce carrier and policy number are: Insurance Co. -::£+,1,r~1-cg, Co'tt'f4ny of -l-/1..e.-WC;sf Policy No. w~o 502..Z.. I 1.., ~ Expiration Date lo J I b This section need not be completed if the permit is for one hundred dollars ($100) or less. ' 1 0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensatio~s provided for in Section 3706 of the Labor code, interest and attorney's fees. Ji$ CONTRACTOR SIGNATURE .-:::.C.:.. ~ 0AGENT DATE C/r1//& 0WQ.'.l@C&o©©OG,0@C& 0@<3(1~@§) 'iJO@ro t I I hereby affirm that I am exempt from Contractor's Ucense Law for the (of/owing reason: 0 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 Contracto(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). D I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contracto(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 Contracto(s License Law). D 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. 0Yes 0No 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 I 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 I address/ phone I 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 I phone I type of work): Ji5 PROPERTY OWNER SIGNATURE 0AGENT DATE ' <s@@IJ)l1@u'@ trroOf3 ~@@'u'O@QJ fY©ID QJ@QJ 0 @@900@rou'06)i1 @(!H.lQ.00QJ© f.P@@@Ouf) @roa.tr . . . 'Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Acri Yes ./ No / Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air qu9'ify management districtJ Yes VNo 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. 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 I certify that I have read the application and state that the above Information Is correctand that the Information on the plans Is accurate. I agree to comply with all City ordinances and Slate laws relating to building construction. I hereby authorize representative of the City of Ca~sbad 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 AGAINST SAID CITY IN CONSEQUENCE OFTHE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void ff the building or mrk authorized by such permit is not commenced Vvithin 180days from the date of such permit or if the building ormrk authorized by such permit is suspended or abandoned at any time after the mrk is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ~ APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY (Commercial Projects Only} Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS 625 Fl\ CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. 1) OCCUPANT (Listed above) MAIL/ FAX TO OTHER: _______________ _ _NS APPLICANT'S SIGNATURE ASSOCIATEDCB#----------- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE Inspection List Permit#: CB161932 Type: Tl _ ~a!_e___ __ Inspection Item ____ _ 07/15/2016 89 Final Combo 07/15/2016 89 Final Combo 07/11/2016 33 Service Change/Upgrade 07/11/2016 34 Rough Electric 06/22/2016 17 Interior Lath/Drywall 06/17/2016 14 Frame/Steel/Bolting/Weldin 06/17/2016 34 Rough Electric INDUST Inspector Act RI PD AP RI PD AP PD AP PD AP PD AP GRIFFITH, YOUNG: 3,928 SF OFF TO SAME Comments NRR Monday, July 18, 2016 Page 1 of 1 EsGil Corporation In <Partners/Up witli <;;ovemment for (J3ui{aing Safety DATE: 05/27/2015 JURISDICTION: Carlsbad PLAN CHECK NO.: CB16-1932 SET: I PROJECT ADDRESS: 1525 Faraday Ave. Suite 390 PROJECT NAME: Griffith Young & Lass TI a APPLICANT di-JURIS. a PLAN REVIEWER a FILE ~ 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 EsGil Corporation 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: I' ~ EsGil Corporation staff did not advise the applicant that the plan check has been completed. D EsGit Corporation staff did advise the applicant that the plan check has been completed. Person contacte~~ ~ Telephone#: Date contacted: ( . ) Email: Mail Telephone Fax Person D REMARKS: By: John Le Vey EsGil Corporation D GA D EJ D MB D PC Enclosures: 05/19/2016 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576 ·Carlsbad CB16-1932 95/2"1/2015 [DO NOT PAY -THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PREPARED BY: John Le Vey PLAN CHECK NO.: CB16-1932 DATE: 05/27/2015 BUILDING ADDRESS: 1525 Faraday Ave. Suite 390 BUILDING OCCUPANCY: B BUILDING AREA Valuation Reg. PORTION ( Sq. Ft.) Multiplier Mod. Tl Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code cb By Ordinance Bldg. Permit Fee by Ordinance Plan Check Fee by Ordinance VALUE Type of Review: 0 Complete Review D Structural Only D Repetitive Fee 3Repeats Comments: D Other D Hourly EsGil Fee i-----lHr.@• Sheet of ($) 179,824 179,824 $910.061 $591.541 $509.631 macvalue.doc + «~)} ~ CITY OF CARLSBAD PLANNING DIVISION BUILDING PLAN CHECK APPROVAL P-29 DATE: 5-18-16 PROJECT NAME: PROJECT ID: Development Services Planning Division 1635 Faraday Avenue (760) 602-4610 www.carlsbadca.e:ov PLAN CHECK NO: CB 16-1932 SET#: 1 ADDRESS: 1525 Faraday Av APN: ~ This plan check review is complete and has been APPROVED by the Panning Division. By: Chris Sexton A Final Inspection by the Planning Division is required D Yes ~ No You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance of a building permit. Resubmitted plans should include corrections from all divisions. D This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check APPROVAL has been sent to: kmalacarne@designcorpsd.com For questions or clarifications on the attached checklist please contact the following reviewer as marked: -.. PLANNING ENGINEERING FIRE PREVl:NTION 760-602-4610 760-602-2750 760-602-4665 ~ Chris Sexton D Chris Glassen D Greg Ryan 760-602-4624 760-602-2784 760-602-4663 Chris.Sexton@carlsbadca.gov Christogher.Glassen@carlsbadca.gov Gregoiy.Ryan@carlsbadca.gov D Gina Ruiz D ValRay Marshall D Cindy Wong 760-602-4675 760-602-27 41 760-602-4662 Gina.Ruiz@carlsbadca.gov ValRay.Marshall@carlsbadca.gov Cynthia.Wong@carlsbadca.gov D Veronica Morones D Linda Ontiveros D Dominic Fieri 760-602-4619 760-602-2773 760-602-4664 Veronica.Morones@carlsbadca.gov Linda.Ontiveros@carlsbadca.gov Dominic.Fieri@carlsbadca.gov Remarks: office to office ·Shay Even From: Sent: To: Cc: Subject: Good morning, Amber Ressmer Wednesday, May 18, 2016 9:46 AM kmalacarne@designcorpsd.com Building CB161932 CB161932 Griffith, Young & Lass, APC plan does not require Carlsbad Fire Department fire plan review. Thank you, Amber ' ~tyof ·1sbad Amber Ressmer Administrative Assistant Fire Prevention City of Carlsbad 1635 Faraday Ave Carlsbad, CA 92008-7314 www.carlsbadca.gov P 760-602-4665 I F 760-602-8561 1 ...,,, \ . ' INDUSTRIAL WASTEWATER DISCHARGE PERMIT Date !5/ft// {_p SCREENING SURVEY I I Business Name G~\1='"££11:l Vovt\lG <T' LASS, APG Street Address /52 6 1-AgADAY AV~ 1 CA~LSBf)V J CA 9Zooq Email Address __________________________ _ PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT: (ON REVERSE SIDE CHECK TYPE OF BUSINESS) ~ Check all below that are present at your facility: Acid Cleaning Ink Manufacturing Nutritional Supplement/ Assembly Laboratory Vitamin Manufacturing Automotive Repair Machining / Milling Painting / Finishing Battery Manufacturing Manufacturing Paint Manufacturing Biofuel Manufacturing Membrane Manufacturing Personal Care Products Biotech Laboratory (i.e. water filter membranes) Manufacturing Bulk Chemical Storage Metal Casting/ Forming Pesticide Manufacturing / CarWash Metal Fabrication Packaging Chemical Manufacturing Metal Finishing Pharmaceutical Manufacturing Chemical Purification Electroplating (including precursors) Dry Cleaning Electroless plating Porcelain Enameling Electrical Component Anodizing Power Generation Manufacturing Coating (i.e. phosphating) Print Shop Fertilizer Manufacturing Chemical Etching / Milling Research and Development Film / X-ray Processing Printed Circuit Board Rubber Manufacturing Food Processing Manufacturing Semiconductor Manufacturing Glass Manufacturing Metal Powders Forming Soap/ Detergent Manufacturing Industrial Laundry Waste Treatment I Storage SIC Code(s) (if known): _____________________ _ Brief description of business activities (Production/ Manufacturing Operations):. _____ _ L .A:l,uo OfBC 6 Description of operations generating wastewater (discharged to sewer, hauled or evaporated): Estimated volume of industrial wastewater to be discharged (gal I day): .;...b¥~~--=-------- List hazardous wastes generated (type/ volume): ______________ _ Date operation began/or will begin at this location: ______________ _ Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? Yes No If yes, when: ___________________ _ Site Contact ____ ___,;. _________ Title ____________ _ Signature. ______________ Phone No .. ___________ _ ENCi NA WASTEWATER AUTHORITY, 6200 Avenida Encinas Carlsbad, CA 92011 (760) 438-3941 FAX: (760) 476-9852 SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY RECORD ID # __________________ 1 PLAN CHECK# ________________ _ BP DATE Business Name G/2.IFF I-/ you,J b-t-LASS APC Business Contact Telephone# ProjectAddress ,...,-!: 3qQ City 162.S t::A'J2.AOF\Y AVG 0 ' CA!J2L5 AD APN# 2.12 ... J'?, o--'2:1--oo Mailing Address City Plan File# Project Contact Applicant E-mail Telephone# 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 ofThese. 4. Flammable Solids 8. Unstable Reactives 12. Radioactives PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEAL TH -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: D CalARP Exempt I 1. 2. 3. 4. 5. 6. 7. 8. YES NO D gi B I D D D D D (for new construction or remodeling projects) Is your business listed on the reverse side of this form? (check all that apply). Will your business dispose of Hazardous Substances or Medical Waste in any amount? Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or 200 cubic feet? Will your business store or handle carcinogens/reproductive toxins in any quantity? Will your business use an existing or install an underground storage tank? Will your business store or handle Regulated Substances (CalARP)? Will your business use or install a Hazardous Waste Tank System (Title 22, Article 1 0)? 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 . Date Initials 0 CalARP Required I Date Initials 0 CalARP Complete I Date Initials PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): 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 bums; residences forming part of a larger project. [·Excludes garages & small outbuildings.] 1. 2. 3. 4. 5. 6. YES NO B ~ D D Will the project disturb 160 square feet or more of existing building materials? Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition. (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance Technician? D D D 0 (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. Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet (www.sdapcd.org/info/facts/permits.pdf) for typical equipment requiring an APCD permit. 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 15: / t=r t /{o 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 permitting requirements may still apply . HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division