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Home My WebLink About2036 CORTE DEL NOGAL; ; CB101997; Permit11-15-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No: CB101997 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: Project Title: Applicant: TRIVISTA CORP MANNY STE 423 2036 CORTE DEL NOGAL CBAD Tl Sub Type: INDUST 2130612900 Lot#: 0 Status: $129,010.00 Construction Type: 5B Applied: Reference #: Entered By: CRW SYSTEMS-TI OF 3,686 SF Plan Approved: INCLUDING NEW INT WALLS,OUTLETS,CEILING,LIGHTING, Issued: Inspect Area: Plan Check#: Owner: R U INVESTMENTS L L C C/O MICHAEL BELLO 2350 SE BRISTOL ST ISSUED 10/27/2010 LSM 11/15/2010 11/15/2010 970 W VALLEY PKWY 92025 760 294 0277 NEWPORT BEACH CA 92660 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD #3 Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'l Pot. Water Con. Fee Reel. Water Con. Fee Green Bldg Stands (SB1473) Fee Fire Expedited Plan Review $755.13 $0.00 $490.83 $0.00 $0.00 $27.09 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4.00 $250.00 Meter Size Add'l Reel. Water Con. Fee Meter Fee SDCWA Fee CFD Payoff Fee PFF (31 05540) •-,.. PFF. (4305540) License Tax (31 04 193) License Tax (43041 93)- 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 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $55.00 $20.00 $33.00 $0.00 $0.00 $0.00 $0.00 ?? TOTAL PERMIT FEES $1,635.05 Total Fees:$1,635.05 Total Payments To Date:$1,635.05 Balance Due:$0.00 Inspector: FINAL APPROVAL Date:Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717/2718/2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No.<3B JO 1 ^ Est. Plan Ck. Deposit *-t$0.%3 j<a%QM Date (O|br7//D JOB ADDRESS cr/pROJEc I PHASE if*'# OF UNITS # BEDROOMS SUITE#/SPACE#/UNIT# CONSTR.TYPE OCC. CROUP# BATHROOMS TENANT BUSINESS NAME Sterne Ivg \ e DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) AffA EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)ECKS (SF)FIREPLACE YESD#NOD AIR CONDITIONING FIRE SPRINKLERS YES JJ/ NOD CONTACT NAME (If Different Font Applicant) ADDRESS ADDRESS CITY STATE ZIP CITY ATE ZIP PHONE FAX PHON FAX EMAIL EMAIL I - -~rn V PROPERTY OWNER NAME _ P-0 CONTRACTORS^ ADDRESS ADDRESS CM- \iAUfry CITY STATE ZIP CITY TATECA ZIP PHONE FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS "•ilvh-STA cop-?.—-*600 /^%CITY BUS. UC.# (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 requirestheapplicant 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 theBusiness 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 acivil penalty of not more than five hundred dollars ($500}). Workers' Compensation Declaration: / hereby affirm under penalty ol per jury one ofthe following declarations: Q 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. I have and will maintain workers' compensation, as required by Section_37fO_jJthe Labor Code, for the performanceof the woric for which this permit is issued. My workers' compensation insurance carrier and policy ~ ^ *?fr "00° t&& Expiration Date OS~-^> ("((number are: Insurance Co._rPolicyNoT: This section need not be completed if the permit is for one hundred dollars ($100) or less. O Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' oftnpensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (8,100,000), in addition to the cost of compensation, damages a/provided for in Secf oj^)706 of the Labor code, interest and attorney's fees. >€$" CONTRACTOR SIGNATURfc^"" / hereby affirm that I am exempt from Contractors License Law for the following reason: Q 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). a 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 contractors) licensed pursuant to the Contractor's License Law). D I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. O Yes a No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / co ntractors' license number): 4.1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): vSTpROPERTY OWNER SIGNATURE l~1 OAGENT DATE 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? DYes a No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quali ty management district? G Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? OYes ONo IF ANY OF THE ANSWERS ARE YES, X 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 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 SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY 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 denwfcn or construction of structures over 3 stories in height EXPIRATION: Every permit issued by the Building Offcial under (he prov«5ifs of Kits Code shall expire by limitation and become null and void if (he building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the buldMbr work authorize/such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE City of Carlsbad Final Building Inspection Dept: Building Engineering Planning CMWD St Lite Fire Plan Checks- Permit #: Project Name: Address: Contact Person: Sewer Dist: Inspected Bv: rx Inspected Bv: Inspected Bv: Date: CB101997 PermitType: CRW SYSTEMS-TI OF 3,686 SF Sub Type: INCLUDING NEW INT WALLS,OUTLETS,CEILING,LIGHTI 2036 CORTE DEL PHILLIP CA _^/ 6 NOGAL Phone: 7606440043 Water Dist: CA Date , Inspected: \&>\ \(0. Date ' Inspected: Date Inspected: Lot: 0 it? Approved: \' Approved: Approved: 12/15/2010 Tl INDUST Disapproved: Disapproved: Disapproved: Comments: City of Carlsbad Bldg Inspection Request Inspector Assignment: RB For: 12/16/2010 Permits CB101997 Title: CRW SYSTEMS-TI OF 3,686 SF Description: INCLUDING NEW INT WALLS,OUTLETS,CEILING,LIGHTING, HVAC, & NEW ADA ei_i/"\tiiiero orairAiy D/^SMIJI o rxcri^eo Type:TI Sub Type: INDUS! Phone: 7606440043 Job Address: 2036 CORTE DEL NOGAL Suite: Lot: 0 Location: Inspector: OWNER R U INVESTMENTS L L C Owner: R U INVESTMENTS L L C Remarks: Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By: PHILLIP Entered By: JANEAN Act Comments _, Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# CV060746 CLOSED O- NO BIZ LICENSE; Inspection History Date 12/01/2010 12/01/2010 12/01/2010 11/30/2010 11/23/2010 11/23/2010 11/23/2010 11/19/2010 11/19/2010 11/19/2010 11/19/2010 11/19/2010 Description 14 34 84 17 14 17 34 14 21 24 34 44 Frame/Steel/Bolting/Welding Rough Electric Rough Combo Interior Lath/Drywall Frame/Steel/Bolting/Welding Interior Lath/Drywall Rough Electric Frame/Steel/Bolting/Welding Underground/Under Floor Rough/Topout Rough Electric Rough/Ducts/Dampers Act we CO AP AP AP PA CO PA AP AP CO we Insp RB RB RB RB RB RB RB RB RB RB RB RB Comments STILL MISSING BOXES GROUNDED T-BAR SYSTEM WALLS ONLY 1STFLROK GRND BOXES SEE NOTICE City of Carlsbad Bldg Inspection Request Inspector Assignment: RB For: 12/15/2010 Permit* CB101997 Title: CRW SYSTEMS-TI OF 3,686 SF Description: INCLUDING NEW INT WALLS,OUTLETS,CEILING,LIGHTING, HVAC, & NEW ADA Type:TI Sub Type: INDUST Phone: 7606440043 Job Address: 2036 CORTE DEL NOGAL Suite: Lot: 0 Location: Inspector: OWNER R U INVESTMENTS L L C Owner: R U INVESTMENTS L L C Remarks: Total Time: CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By: PHILLIP Entered By: CHRISTINE Act Comments Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# CV060746 CLOSED O-NO BIZ LICENSE; Inspection History Date 12/01/2010 12/01/2010 12/01/2010 11/30/2010 11/23/2010 11/23/2010 11/23/2010 11/19/2010 11/19/2010 11/19/2010 11/19/2010 11/19/2010 Description 14 34 84 17 14 17 34 14 21 24 34 44 Frame/Steel/Bolting/Welding Rough Electric Rough Combo Interior Lath/Drywall Frame/Steel/Bolting/Welding Interior Lath/Drywall Rough Electric Frame/Steel/Bolting/Welding Underground/Under Floor Rough/Topout Rough Electric Rough/Ducts/Dampers Act we CO AP AP AP PA CO PA AP AP CO we Insp RB RB RB RB RB RB RB RB RB RB RB RB Comments STILL MISSING BOXES GROUNDED T-BAR SYSTEM WALLS ONLY 1STFLROK GRND BOXES SEE NOTICE CORRECTION <!fV> CITY OF CARLSBAD NOTICE COMMUNITY & ECONOMIC DEVELOPMENT DEPARTMENT BUILDING DIVISION DATE. JOB LOCATION PERMIT NO. CB (760) 602-2700 1635 FARADAY AVENUE TIME. SW A+S > ,/> FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE?YES FOR FURTHER^NfORMagON, CONTACT THE BUILDING DIVISION AT (760) 602-2700 ISPECTOR NPDES / BMP - FOLLOW-UP INSPECTION DATE City of Carlsbad Bldg Inspection Request For: 11/19/2010 Permit* CB1 01 997 Title: CRW SYSTEMS-TI OF 3,686 SF Inspector Assignment: Description: INCLUDING NEW INT WALLS,OUTLETS,CEILING,LIGHTING, HVAC, & NEW ADA Sub Type: INDUS!Type:TI Job Address: 2036 CORTE DEL NOGAL Suite: Lot: 0 Location: OWNER R U INVESTMENTS L L C Owner: R U INVESTMENTS L L C Remarks: Phone: 7606440043 Inspector: / Total Time: CD Description 14 Frame/Steel/Bolting/Welding 24 Rough/Topout /^/ 34 Rough Electric 44 Rough/Ducts/Dampers Comments Requested By: PHIL Entered By: CHRISTINE A/<?-/ C (^ _ - Comments/Notices/Holds Date Associated PCRs/CVs/SWPPPs Original PC# CV060746 CLOSED O- NO BIZ LICENSE; Inspection History Description Act Insp Comments CITY OF CARLSBAD BUILDING DEPARTMENT NOTICE DATE / f LOCATION PERMIT NO. (760) 602-2700 1635 FARADAY AVENUE TIME // / FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? FOR FURTHER INFORMATION, CONTACT YES PHONE BUILtifNG INSPECTOR CODE ENFORCEMENT OFFICER CITY OF €^> CARLSBAD,-^ BUILDING Plan Check Comments Development Services ^^Tding Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov By. Steve BoroSSay (Contact Hours for Steve: Tues.-Fri., 1 pm - 5pm) Phone: 760-602-7541 Permit-IQ I Address-Cor-W * When corrections from all departments are received please run new prints * • Please respond by indicating location of Plan Check items on plans * Provide: A statement on the Title Sheet of the plans stating that the project shall comply with the 2007 CA Building Code, 2007 CMC, 2007 CPC, 2007 CEC and the 2008 CA Energy Efficiency Standards. Provide: A note titled "Scope of Work" describing the work to be performed under this permit. L^T /A.OO nof Approved on:.By:. • f ACCESSIBILITY TO PUBLIC BUILDINGS, PUBLIC ACCOMMODATIONS, COMMERCIAL BUILDINGS AND PUBLICLY FUNDED HOUSING G KNEE CLEARANCE 8" MIN. TOE CLEARANCE* 6" MAX. CLEAR FLOOR SPACE 17" MIN. SIDE ELEVATION ' Note: If a minimum 9 inches height of toe clearance is provided, a maximum of 6 inches of the 48 inches of clear floor space required at the fixture may extend into the toe space. 19" MAX. 17" MIN. 48" MIN. HIz ECtil so Sop PLAN VIEW THESE DIAGRAMS ILLUSTRATE THE SPECIFIC REQUIREMENTS OF THESE REGULATIONS AND ARE INTENDED ONLY AS AN AID FOR BUILDING DESIGN AND CONSTRUCTION. FIGURE 11B-1D—KNEE CLEARANCE 2007 CALIFORNIA BUILDING CODE 477 ACCESSIBILITY TO PUBLIC BUILDINGS, PUBLIC ACCOMMODATIONS, COMMERCIAL BUILDINGS AND PUBLICLY FUNDED HOUSING 59" MIN.AT FLOOR-MOUNTED W.C. WHEN DOOR SWINGS IN 56" WIN. AT WALL-MOUNTED W.C. WHEN DOOR SWINGS IN 54" WIN. 60" x 60" LEVEL AND CLEAR c THIS DIAGRAM ILLUSTRATES THE SPECIFIC REQUIREMENTS OF THESE REGULATIONS AND IS INTENDED ONLY AS AN AID FOR BUILDING DESIGN AND CONSTRUCTION' FIGURE 11B-1B—MULTIPLE-ACCOMMODATION TOILET FACILITY 2007 CALIFORNIA BUILDING CODE 475 ACCESSIBILITY TO PUBLIC BUILDINGS, PUBLIC ACCOMMODATIONS, COMMERCIAL BUILDINGS AND PUBLICLY FUNDED HOUSING 60" MIN CENTERLINEOF HAND-HELD SPRAYER MOUNTING BRACKET (a) 60" MINIMUM X 30" MINIMUM ROLL-IN SHOWER BACK/CONTROL WALL (b) ELEVATION - 60" MINIMUM X 30" MINIMUM ROLL-IN SHOWER FIGURE 11B-2A—SHOWER STALLS (continued) 478 2007 CALIFORNIA BUILDING CODE PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB ADDRESS C RESIDENTIAL RESIDENTIAL ADDITION MINOR « $17,000.00) DATE TENANT IMPROVEMENT PLAZA CAMINO REAL CARLSBAD COMPANY STORES VILLAGE FAIRE OTHER COMPLETE OFFICE BUILDING PLANNER ENGINEER DATE c<_ DATE Docs/Mlsforms/Plannlng Engineering Approvals PLANNING/ENGINEERING APPROVALS PERMIT NUMBER CB 10-1997 DATE 10/27/10 ADDRESS 2036 Corte Del Nogal RESIDENTIAL ADDITION- MINOR (<17,000.00) RETAINING WALL VILLAGE FAIRE POOL/SPA IMPROVEMENT COMPLETE OFFICE BUILDING OTHER PLANNER IX/UxJ ENGINEER .DATE DATE H:\ADMIN\CODNTER/PLANNING/ENGINEERING APPROVALS .>Daryl K. James & Associates, Inc. f^ Checked by: Matthew Ernau 205 Colina Terrace Date: 11/14/2010 Vista, CA 92084 T. (760) 724-7001 Email: kitfire@sbcglobal.net APPLICANT: Design: Trivista Corp JURISDICTION: Carlsbad Fire Department PROJECT NAME: Tl 1st & 2nd floor PROJECT ADDRESS: 2036 Corte Del Nogal PROJECT DESCRIPTION: CB101997 INSTRUCTIONS » This plan review has been conducted in order to verify conformance to minimum requirements of codes adopted by the Carlsbad Fire Department. • The items below require correction, clarification or additional information before this plan check can be approved for permit issuance. • To expedite the recheck process, please note on this list (or copy) how and where each correction item has been addressed, i.e. sheet number, note number, detail number, legend number, etc Corrections or modifications to the plans must be clouded and provided with numbered deltas and revision dates.. • Please direct any questions regarding this review to: Matthew Ernau 760-738-8279 or ernau57@cox.net • CORRECTED PLANS, DESCRIPTIVE NARRATIVE OF REVISIONS FOLLOWING EACH COMMENT ON THIS FORM, AND A COPY OF BUILDING DEPARTMENT (EsGil) COMMENTS MUST BE SUBMITTED DIRECTLY TO: • Matthew Ernau 1382 Hale Ave Escondido, CA 92029 A03 Are all doors new? Show which doors are new and existing. Identify rated doors for existing corridor and existing exit. OK 11/14/10 Show type and location of fire extinguishers in accordance with CFC 906 OK 11/14/10 A04 Are all doors new? Show which doors are new and existing. Identify rated doors for existing corridor and existing exit. OK 11/14/10 Show type and location of fire extinguishers in accordance with CFC 906 OK 11/14/10 A07&E03 On A07 &E03 provide E in symbol legend include description 90 minute battery pack OK 11/14/10 COMMENTS Provide second floor reflected ceiling plan showing exit signs and emergency lighting. OK 11/14/10 SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY UPFP# HV# BP DATE Business Name JT£M:T Business Contact Telephone # Project Address City State Zip Code APN# Mailing Address City State Zip Code Plan File# Project Contactontact .PH/U?Telephone # The following questions represent the facility's activities, NOT the specific project description. PART I: FIRE DEPARTMENT - HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: 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. 5. Organic Peroxides 9. 6. Oxidizers 10. 7. Pyrophorics 11. 8. Unstable Reactives 12. 1. Explosive or Blasting Agents 2. Compressed Gases 3. Flammable/Combustible Liquids 4. Flammable Solids Water Reactives Cryogenics Highly Toxic or Toxic Materials Radioactives 13. Corrosives 14-Other Health Hazards f5?YJone of These. D CalARP Exempt PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH - HAZARDOUS MATERIALS DIVISIONS (HMD): If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 1255 Imperial Avenue, 3IU floor, San Diego, CA 92101. Call (619) 338-2222 prior to the issuance of a building permit. FEES ARE REQUIRED. Expected Date of Occupancy: //, I ® ( I "(Q YES NO 1. D £p Is your business listed on the reverse side of this form? (check all that apply). 2. D 3C Will your business dispose of Hazardous Substances or Medical Waste in any amount? 3. D S\ w'" y°ur business store or handle Hazardous Substances in quantities equal to or greater than 55 gallons, 500 pounds, 200 cubic feet, or carcinogens/reproductive toxins in any quantity? 4. D E3\ Will your business use an existing or install an underground storage tank? 5. D $)f Will your business store or handle Regulated Substances (CalARP)? 6. D JO-' Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? Date Initials D CalARP Required Date Initials D CalARP Complete Date Initials PART III: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT: If the answer to any of the questions below is yes, applicant must contact the Air Pollution Control District (APCD), 10124 Old Grove Road. San Diego. CAJ2131-1649, telephone, (858) 586-2600 prior to the issuance of a building or demolition permit. Note: if the answer to questions 3 or 4 is yes, applicant must also submit an asbestos notification form to the APCD at least 10 working days prior to commencing demolition or renovation, except demolition or renovation of residential structures of four units or less. Contact the APCD for more information. 1. 2. YES D 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.orQ/info/facts/permits.pdf. and the list of typical equipment requiring an APCD permit on the reverse side of this from. Contact APCD if you have any questions). (ANSWER ONLY IF QUESTION 1 IS YES) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)? (Public and private schools may be found after search of the California School Directory at httD://www.cde.ca.aov/re/sd/: or contact the appropriate school district). Will there be renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non-friable asbestos? Will there be demolition involving the removal of a load supporting structural member? Briefly describe business activities:Briefly describe proposed project: y: II declare under penalty of perjury that totte best of my knowledge and belief the responses/fade herein are true and correct. Name of owner or Authorized Agent JO/ SignatunEof Owner or Authorized Agent Date FOR OFFICIAL USE ONLY:FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:. BY:DATE: EXEMPT OR NO FURTHER INFORMATION REQUIRED COUNTY-HMD APCD RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY COUNTY-HMD APCD RELEASED FOR OCCUPANCY COUNTY-HMD APCD HM-9171 (04/07)County of San Diego - DEH - Hazardous Materials Division Check a License - Contractors State License Board Page 1 of2 of Affairs Contractors State License Board Contractor's License Detail - License # 680561 g» DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. ••» CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. •* Per B&P 7071.17 , only construction related civil judgments reported to the CSLB are disclosed. •» Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. ••» Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number 680561 Extract Date: 10/27/2010 Business Information TRIVISTA INC dba ALLIANCE INTERIORS 970 W VALLEY PARKWAY #423 ESCONDIDO, CA 92025 ; Bus]ness_Phone Nujriber{76pJ[294J0277 _Entity_: _ Cor£qration_ _lsjsueJDat^_2_^^ JJ/I?Zl??lZ..-__ZZI ' 1_"ZHI - ™. ~. ..Retesuiepate 01/22/2008 _ ExpjreJJate _ __J1/31/2012 _ License Status This license is current and active. All information below should be reviewed. Additional Status: _ _ _ CLASS DESCRIPTION B Classifications: 55°_ jC33 _ ?:?____ CONTRACTOR'S BOND This license filed Contractor's Bond number 105038549 in the amount of $12,500 with the bonding company IBAyELERafiASUALIYjW^ Effective Date: 01/22/2008 Csntcactor's.BQnc|.in.g..HistQ.ry Bonding: ~~~ ' ~"BOND OF QUALIFYING INDIVIDUAL 1. The Responsible Managing Officer (RMO) MATSON TERRY ALAN certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 04/09/2009 BQI's Bonding History This license has workers compensation insurance with the EVERESIMII.QNALJMSURMCE..CQMPANY Policy Number:7600005825101 Workers'Compensation: „„,....,««..,,Effective Date: 09/11/2010 Expire Date: 09/11/2011 https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum=6... 10/27/2010 V) D >- v •• a Q Q uI uo s to Sffe CO O S 11 aia- 9 Q) O Q 1- —' 0 o s o