HomeMy WebLinkAbout1525 FARADAY AVE; 300 | 360; PC050116; PermitC.ity of Carlsbad
,, 1635 Faraday Av Carlsbad, CA 92008
05-08-2006 Plan Check Permit No: PC050116
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
Applicant:
DESIGN CORP
STE 175
444 S CEDROS
Building Inspection Request Line (760) 602-2725
1525 FARADAY AV CBAD
PLANCK
Lot#:
Status:
0 Applied: 2121302700
$0.00 Construction Type: Entered By:
PENDING
12/08/2005
RMA
Plan Approved:
Issued:
LENNAR HOMES-Tl-2 SUITES, Inspect Area:
SUITE 300=5389 SF, SUITE 360=909 SF
Owner:
NEWPORT NATIONAUCORNERSTONE LL C
C/O SCOTT BRUSSEAU NEWPORT NATL
1525 FARADAY AVE #100
SOLANA BEACH CA 92075
858 794-3222
CARLSBAD CA 92008
Plan Check Fee
Additional Fees
Total Fees:
Inspector:
$0.00 Total Payments To Date:
FINAL APPROVAL
Date: _____ _
$0.00 Balance Due:
$0.00
$0.00
Clearance: ______ _
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." 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 vou have nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has nreviouslv otherwise exnired.
PERMIT APPLICATION
FOR OFFICE USE ONh Y
PLAN CHECK NO. /+JC A) 561 { ~
V
CITY 01= CAR'LSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. _________ _
Plan Ck. Deposit----........ ~----
Validated By,l r /[A--
Date _ 2, /f(o?
Address (include Bldg/Suite #) usiness Name (at this address)
bOT \0'2.. s 13 ~o RcS:EJMZ. c H CENTEyZ
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
2. l "2. -l 'b O -2. 1 00
Assessor's Parcel #
9 o u~.,..., A-'.REr-::>.C-H , {'A t:\ 2.07 S
Name Address City State/Zip Telephone#
,4:;~ q~ Pf:19Rtff:Tt'~Q~Wr-,tl;R , ---, -
E: 1:1 E" R.r::)LD L A ic:..c;: Co rt. P. C. EN~
Name Address
Sy..1::n= , o:, C"-rLL5 ei~o tcA-&JZ.ooS
S.tate/Zip Telephon #
i_~, ". ".'(;QNT8Ji;9:n.i1f~ '¢(,iM#ANY'NAME.~ __ .. --·--. -,, · ' · ': _ {"1·<;,.-P)-:~zo··:7·,-":.·4-f•2 :8-'j_;"
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he 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 [$500)).
PA.Ctl='IL BlA.l1.-DfNG,. t;l?,ou..l" 515'-/ PAe.1p1C. C0J-rl::.l'L SL\/0.1 Sl-111'E 2.03 'SA\...)0/EG,,o1CA
Name Address City State/Zip ~'e,S',;~.,Jel@hone # "i 2..\ 2-.J
w Ss2-<:>(,,oo State License # 5 0 2-. ~ 7 lo License Class __________ City Business License # \ '.2, 0 S
'J)ESV.,Ne<:utf L:IYY s. CE"Pt'L1:>S &'IE. ifl75 S\}Ll"Ny;\ f)e/;1(1;..l ,er::. '42D:Z5 @,58)7'3'-/-3222.._
Designer Name Address City State/Zip Telephaiw '
State License# _________ _
~:,. WPRKE'itl'.V (f,qiyleeNSA Tl()N',. ·-' '.
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued. ~ have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company 1-..o c.lC:..::tt,~ \N S:'6 "-:Pr'LE Co Policy No.::t:rr:6-C 0-~<..$ l<.'..7 loA. Expiration Date 0'.3 I b I I tJ {,.
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS F.OR ONE HUNDRED DOLLARS ($100) OR LESS)
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 ddi • he cost of pensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
SIGNATURE'...e~:'.2;~-b~~LC~U:.C __ ,d_,~:2,,a::_-1.l:::.:2.!t.--1~!=::ll.Ll!~:2:]~b-DATE 12.. 7. 0~
J"' ·.· QWN.Ei!Hll!J' . ..)fp1;p1;~ .AtlPff . . . 1. 1:. •• , ....
I hereby affirm that I am exempt from the Contractor's License Law for the following 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 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).
0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
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. 0 YES ONO
·2. 1· (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 number / 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 I phone
number/ contractors license number): _____________________________________________ _
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address / phone number/ type of work): _______________________________________________________ _
PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _
;q,qMP~~TE;Tf!IS 'S~C;TIQN,' FQij NQN{RE$'IDEN,TIAL: BUlt.piNG 'PERIIJUTS .ONLY ·
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 Act? 0 YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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.
t{k.o.:g__Q~~TllU,PIIQJ'tl-F!'iDJ~§ Ml;NCY' .... --· -. .,.,. .. --.. -·-..
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME_______________ LENDER'S ADDRESS _________________________ _
(~•: . A~.e~JGANT:-.CElmflP'~l:tQN: ' ' ' ' ... : :. . . . . ' . . : ·. ' . " ' '
' '1, -~·:-;, ... : ' ~
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. I hereby authorize representatives of the Cit~ of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE 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 if the building or work
authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned
at any time after the work is commenc for a period of 180 day~ction 106.4.4 Uniform Building Code).
DATE ~/.~'.2.~._7_._o_s _____ _
PINK: Finance
EsGil Corporation
In (l'artnersliip witli <]overnment for <Bui(aing Safety
DATE: 1/4/06
JURISDICTION: City of Carlsbad
PLAN CHECK NO.: PC05-0116 SET: II
PROJECT ADDRESS: 1525 Faraday Ave Suite 300 & 360
PROJECT NAME: Greystone Homes/ Lennar Homebulding -TI
Cl APPLICANT
C::0:: JURIS.=.)
Cl PLAN REVIEWER
Cl 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 building 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:
~ Esgil Corporation staff did not advise the applicant that the plan check has been completed.
D Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#:
Date contacted: (by: ) Fax #:
Mail Telephone Fax In Person
D REMARKS:
By: Doug Moody Enclosures:
Esgil Corporation
D GA D MB D EJ D PC 12/27/05 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576
l
EsGil Corporation
In <Partnership with government for (}3ui(aing Safety
DATE: 12/19/05
JURISDICTION: City of Carlsbad
PLAN CHECK NO.: PCOS-0116 SET:I
PROJECT ADDRESS: 1525 Faraday Ave Suite 300 & 360
PROJECT NAME: Greystone Homes/ Lennar Homebulding -TI
0 APP~igNT Cb JURIS
0 PLAN REVIEWER
0 FILE
D 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 building 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 Esgil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for th~ jurisdiction to forward to the applicant
contact person.
~ The applicant's copy of the check list has been sent to:
Design Corp.
444 South Cedros Ave Studio 175, Solana Beach, CA 92075
D Esgil Corporation staff did not advise the applicant that the plan check has been completed.
~ Esgil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Design Corp. Telephone#: 858-794-3222
Date contacted: i-z..-l 1-v5 (by:~) Fax #: 858-794-3220
Mail Telephone /Fax ~ Person
D REMARKS: ·'-l~
By: Doug Moody
Esgil Corporation
D GA D MB D EJ D PC
Enclosures:
12/12/05 trnsmtl.dot
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576
-l
City of Carlsbad PC0S-0116
. 12/1,9/05'
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO.: PC0S-0116
OCCUPANCY: B
TYPE OF CONSTRUCTION: IIlH
ALLOWABLE FLOOR AREA:
SPRINKLERS?: YES
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 12/8/05
DATE INITIAL PLAN REVIEW
COMPLETED: 12/19/05
FOREWORD (PLEASE READ):
JURISDICTION: City of Carlsbad
USE: Office
ACTUALAREA: 2015~
STORIES: 3
HEIGHT:
OCCUPANT LOAD: 20
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 12/12/05
PLAN REVIEWER: Doug Moody
This plan review is limited to the technical requirements contained in the Uniform Building Code,
Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws
regulating energy conseNation, 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 1997 USC.
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. 106.4.3,
1997 Uniform 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.
TENANT IMPROVEMENTS WITHOUT SPECIFIC ENERGY DATA OR POLICY SUPPLEMENTS (1997UBC) tiforw.dot
City of Carlsbad PCOS-0116
. .'12/19/05
Please make all corrections on the original tracings, as requested in the correction
list. Submit three sets of plans for commercial/industrial projects (two 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 EsGil Corporation and the Carlsbad
Planning, Eng_ineering and Fire Departments.
2. Bring one corrected set of plans and calculations/reports to EsGil Corporation,
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 EsGil Corporation only will not be
reviewed by the City Planning, Engineering and Fire Departments until review by
EsGil Corporation is complete.
1. Provide a statement on the Title Sheet of the plans stating that this project shall
comply with the 2001 edition of the California Building Code (Title 24 ), which
adopts the 1997 UBC, 2000 UMC, 2000 UPC and the 2002 NEC.
2. Please clarify the plans the floor plans indicate detail 2 on sheet Tl-5 for the new
portion of the 1 hour corridor yet detail 2 is crossed out and not for 1 hour corridor
construction, please reference the appropriate construction details.
3. Please have the principle designer check the appropriate box in the Statement of
Compliance section of the L TG-1-C energy document and sign the appropriate
portion.
4. Please have the principle designer check the appropriate box(s) in the Statement
of Compliance System Acceptance section of the L TG-1-C documents.
5. Please provide a statement on the cover sheet of the plans that as the designer
the restrooms serving t~e area of tenant improvement and path of travel to the
area of improvement have been reviewed and fully comply with the current
disabled accessibility requirements. If not please provide complete plans and
details showing the restrooms and path of travel to be brought into compliance.
To speed up the review process, 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.
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.
City of Carlsbad PCOS-0116
· ,12/19/05
Have changes been made to the plans not resulting from this correction list? .
Please indicate:
Yes a No a
The jurisdiction has contracted with Esgil Corporation 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 Doug Moody at
Esgil Corporation. Thank you.
,J
City of Carlsbad PC05-0116
12/19/05 . .
!VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Carlsbad
PREPARED BY: Doug Moody
PLAN CHECK NO.: PC05-0116
DATE: 12/19/05
BUILDING ADDRESS: 1525 Faraday Ave Suite 300 & 360
BUILDING OCCUPANCY: B TYPE OF CONSTRUCTION: IIlH
BUILDING AREA Valuation Reg. VALUE
PORTION ( Sq. Ft.) Multiplier Mod.
Tl 2015 34.37
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb By Ordinance
Bldg. Permit Fee by Ordinance ,.. ,
Plan Check Fee by Ordinance ..-j
Type of Review: El Complete Review D Structural Only
D Repetitive Fee
3Repeats
Comments:
D Other
D Hourly I Hour *
Esgil Plan Review Fee
($)
69,256
69,256
$422.061
$274.341
$236.351
Sheet 1 of 1
macvalue.doc
PLANNING/ENCINEERINC APPROVALS
PERMIT NUMBER C ' DATE/ :J/:;--6)-.::...~-----
ADDRESS _ _,.;_.s=_J'_,S--__ h_; __ -Pfl),_---t~r--__.cEl ____ ,_Ce ___ _
"RESIDENTIAL
RESIDENTIAL ADDITION MINOR
( < $10.000.00)
·oTHER /Le_
PLANNER
ENGINEER, I
CARLSBAD COMPANY STORES
VILLACE FAIRE
COMPLETE OFFICE BUILDING
...
. Ce_
"
[ ?__;ff O 5
DATE 1v/;to/os/
I r
Carlsbad Fire Department
Plan Review Requirements Category: PLANCK ,
Date of Report: 12-19-2005
Name:
Address:
Permit#: PC050116
DESIGN CORP
STE 175
444 S CEDROS
,SOLANA BEACH CA
92075
Job Name: LENNAR HOMES-TI-2 SUITES,
Job Address: 1525 FARADAY AV CBAD
Reviewed by:_//,_. ~--
fNCOJUPLETE The item yott ha-ve submittec.4 fof l'C''dC\·1 is ineefflf}lete. At this time, this effios eant10t
adeqaa-tefy eonduet a re¥iew to determine omnplianee 'Nith &e applieable oodes andlor standaras. Please FB'lie,.v ,
ear.efully aU oornmeats a-ttaohed. Please resubmit the nooess8:fY plans uncl/or speeifiefftion:s, wtth. changes "clouded",
ta this ef:13:ee for reYiew Rf.la appro¥al.
Conditions:
Cond: CON0000970
[MET]
APPROVED: THIS PROJECT HAS BEEN REVIEWED
AND APPROVED FOR THE PURPOSES OF ISSUANCE
OF BUILDING PERMIT.
THIS APPROVAL IS SUBJECT TO FIELD INSPECTION
AND REQUIRED TEST, NOTATIONS HEREON,
CONDITIONS IN CORRESPONDENCE
AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS.
THIS APPROVAL SHALL NOT BE HELD TO PERMIT
OR APPROVE THE VIOLATION OF ANY LAW.
Entry: 12/19/2005 By: gr Action: AP
l
I . ·1
(
I
I
... . OFFICE USE ONLY
H# _______ _
SAN DIEGO REGIONAL BP DATE ____ ..__....._ __
SA/M ______ _ APCD ______ _
HAZARDOU$ MATERIALS QUESTIONNAIRE
Business Name Telephone
7&o-01.. -T11(a
Stats Zip Plan file#
State
~o ~
Zip
2.00':?
Plan File#/Permlt#
fART I; FIBE DEPARTMENT· HAZAROous· MATERIALS MANAGeMsNI DIVISION; OCCUPANCY CLASS!FICATIQbl ·
Indicate by circling the item, whether your business will use, process, ot 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, ·
1. Explosive or Blasting Agents 4. Flammable Solids 7. Pyrophorics 1 O. Cryogenics 13."Corroslves .
2. Compressed Gases 5. Organic Peroxides 8. Unstable Reactives 11. Highly roxic or Toxic Materials t 4, Other Health Hazards
3. Flammable or Combustible Liquids 6. Oxidizers 9. Water Reaotlves 12, Radioactives
PART U; SAN DIEGO COUNTY DEPARTMENT Of ENVIAQNMENIAL HEALtH • HAZARDOUS MATERIE>,LS MANAGEMENT DIVISION lHMMDl:
If the answer to any of the questions is ye.s, applicant must contact the County of Sqn Oiego Hazardous Materials Management
DMslon, 1265 Imperial Avenue, 3rd Floor, San Diego, CA 92101. Telephone 16191 338-2222 prior to the isst:ianca of a building O CalARP Exempt
department permit. ·
Date Initials
FESS MAY BE REQUIRED
·ves ~ 0 CalARP Required
1. § e::]..,.ls your business listed on the reverse side of this form?
2. tfr' WUI your business dispose of Hazardous Substanc!ls or Medical Wasta ln any amount? Date Initials
3. 0" Will your business store or handle Hazarclous Substances in quantities equal to or greater than 56 gallons,
00 pounds, 200 cubic feet or carcinogens/reproductive toxins In any quantity? 0 CalARP Complete t
Will your business use an existin,g or Install an 1,1nderground storage tank?
WIii your business store or handle Regulated Substances tCalARPI? Data Initials
WIii your business Use or install a Hazardous Waste Tank S stem (Tltla 22, Article 10) \_j
If the answ:r to any of the questions is ~es~ applicant must contact the Air PoUutlon Control District, 9160 Chesapeake Drive, San Diego, CA 92123. ·, .
Telephone r (858) 650-;4550 prior to the issuance of a building department permit.
YSS NO ••... . :
1. 0 @."' Will the !mended occupant f11Stall or use any of the equipment !lsted on the Listing ot Air-Pollution Control District Permit Categories, on the
,,../ reverse side of this form1 ·
?, 0 t!::J {ANSWER ONLY IF QUESTION 1 IS YES,! WUI the subject faci!lcy be located ·withln-1 ;ooo feet of the outer boundary of a school (K through
12) as listed In the current Directory of School and Community College Districts, publlshed by the San Diego Countv Oftiqe of Education and
he current California Private School Directory, complied in accordance with provisions of Education Code Section 33190?
3. Does the buildin or structure for which this ermlt is re uested contain an friable asbestos?
Briefly describe business activity and proposed project:
G, 1=:. i,J eM.-~ L-o"~ r \ c. ec LA-s E-
Signature !'f Owner or Authorized Agent Date
/2..1 71 OS
er penalty of perjury that to the best of my knowledge and belief the responses made herein are .true and correct.
FOR OFFICIAL USE ONL V:
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:~-------------------------------BY: __________________________ -"-______ Date:. ______________ _
EXEMPT OA NO RJRTHl:.'l lNl'ORMATtON Reau111eo IIEI.EASEO FOR SU«.OrNa PERMIT 8UT NOT FOR OCCUPANCY
COUNTY•HMMO APCO COUNTY-HMMO Al'CO
•
!U:LeASEO FOR OCCUPANC'(
COUNTY-HMMO APCD
Co\Jl!ly o/ San -Oiego
Department of-Environmental Health