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Home My WebLink About2175 SALK AVE; 200; CBC2018-0155; Permit(city of Carlsbad Print Date: 06/12/2018 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 2175 Salk Ave, 200 BLDG-Commercial 2120210800 $317,291.22 Commercial Permit Work Class: Tenant Improvement Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check#: Status: Applied: Issued: Permit Finaled: Inspector: Final Inspection: Description: CONSUMER SLEEP SOL: T.l. 6,822 SF OFFICE TO OFFICE -REMAINING PORTION OF STE 200 TO BE NEW STE 225 BUILDING PERMIT FEE {$2000+) BUILDING PLAN CHECK FEE (BLDG) Owner: BROOKWOOD CB I LLC 138 Conant St Beverly, MA 01915-1665 978-720-7500 ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL GREEN BUILDING STANDARDS PLAN CHECK & INSPECTION MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL 5B1473 GREEN BUILDING STATE STANDARDS FEE STRONG MOTION-COMMERCIAL Total Fees: $2,795.67 Total Payments To Date: $2,795.67 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively 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 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 limitation has previously otherwise expired. Permit No: CBC2018-0155 Closed -Finaled 03/21/2018 04/11/2018 TFraz 6/12/2018 9:05:30AM $0.00 $1,399.90 $979.93 $89.00 $170.00 $55.00 $13.00 $88.84 1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov 10 APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING ··'-£ityof Carlsbad ADDRESS CITY PHONE EMAIL STATE Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760--602-2719 Fax: 760--602-8558 email: building@carlsbadca.gov www.carisbadca.gov SUJTEf/SPACEf/UNITI ZIP A C\ ADDRESS ZIP CITY (_P., O\ EMAIL P.t ,(._Qv-,1'1 STATE LIC. # STATE UC.# □BUILDING □FIRE Plan Check No. ZIP ZIP MATIAPCD -oo FIRE SPRINKLERS YESIK)No□ .CON'\ 0.2009 (Sec. 7031.5 Business and Professions Code: Any City or Coun_ty 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 hcensed pursuant to the provisions of the Contractor's license Law JChaoter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he 1s exem!)t therefrom, and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the apphcant to a civil penalty of not more than five hundred dollars {$5001). WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby afflrm under penalty of perjury one of the following declerations: D I have and will maintain • certificate of consent to self-Insure for 'l«>r11:ers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. IXJ I hsve 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 workers' compensation insurance carrier and policy n,mbera,s: lasora""' eo Everest National Insurance Com Polk:y No. 7600014158171 Expiralloa Date 01/01/2018 I,!1§.sectlon need not be completed if the permit is for one hundred dollars {$100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' CompensaOOn Laws of California WARNING: Failure to secure workers' cornpenSltion coverage Is unlawful, and shall subject an employer to criminal penaltl9$ and ctvH fines up to one hundred thousand dolt1ni (&100,000), in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. ,.S CONTRACTORSIGNATURE ;.-' -□AGENT DATE 03/12/18 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D 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 ot offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License law does nol apply to an owner of property who bullds or improves !hereon, and who does such work hlmsetf 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 oompletion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). □ □ I, as owner of the property, am exciusively oonlracting 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) f am exempt under Section ____ Business and Professions Code for this reason 1. l personally plan to provide the major labor and materials for construction of the proposed property improvement. Oves 0No 2. ! (have I have not) signed an applicalion for a building permit for the proposed worll. 3. I have oontracted with the following person (firm) to provide the proposed oonstruction (include name address I phone/ oontractors' license number) 4. I plan to provide portions of the wor11:, but I have hired the following persoo to coordinate, supervise and provide the major work (include name I address/ phone I contractors' license number) 5. I will provide some of tt,e wor!(, but I have contracted (hired) the following persons to provide the worll indicated (include name I address/ phone I type of wor11:): ~ PROPERTY OWNER SIGNATURE □AGENT DATE ,11 ETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY ls\ · 'uture 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 Pres--.,.. _, , ;-ff';:aroous Substarce Account Acrt Yes X No ls the applicant or future building occupant required to obtain a permit from the air pollution control district or aitguality management district? 1s the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes X No Yes XNo 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 ANO THE AIR POLLUTION CONTROL D1STRICT. I certify that I have read the application and state lhatthe abaw Information Is conect and that the lnfoimallon on the plans Is accurate. I agise to comply.-i all City ordinances and State lav,s relating to bulldlng construction. I hereby aulhOlizll representalw of the Cly of Calfsbad lo eofer upon \he abo«l menooned property llr inspecoon pu=· I AlSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSEWl AGAINST ALL UAlllLITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGANST SAID CITY IN CONSEOOENCE OF THE GRANTING OF THIS PERMIT OSHA: NI OSHA pennt is required for excavations over 5'0' deep and demoloon or conslrucoon of structures over 3 stories n height EXPIRATION: Every pemllt issued by the Building Offcial under the provisbns of ttlis Code shall expire by limitaoon and beoome null and vod W the l:xJilding or 'M'.lrk aulhofized by such permit is not oommenred 'Mthin 100days rom the date of such permit or if the building orWllk authorized by sudl pennlt is suspended or abancbned at anytime after the v.ork is rommenc:ecl for a peood of 100days (SectOO 103.4.4 Uniform Building Code). ,@S' APPLICANT'S SIGNATURE /---' DATE 03/12/18 ---------------- • STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-ll560. Email building@carlsbadca.gov or Mail the completed fonn to Cify of Carlsbad, Building Di~sion 1635 Faraday Avenue, Carlsbad, Califom~ 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS 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: _______________ _ AS APPLICANT'S SIGNATURE ASSOCIATED ce,, ___________ _ NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP ""s '""' ~ :<s,)t\;4'0!8 t , ,11 ""' , ,l0 k,"', " ~ ,, , PE~MJl,,Jf~f:!j;CTION HISTO~Y REPORT;(CBC2018-0155) Permit Type: BLDG-Commercial Application Date: 0312112018 Owner: BROOKWOOD C B I LLC Work Class: Tenant Improvement Issue Date: 0411112018 Subdivision: Status: Closed -Finaled Expiration Date: 11106/2018 Address: 2175 Salk Ave, 200 Carlsbad, CA 92008-7346 IVR Number: 10253 Scheduled Actual Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete 04/20/2018 04120(2018 BLDG-14 056632-2018 Passed Tim Frazee Complete Frame/Steel/Bolting/ Welding (Decks) Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes BLDG-34 Rough 055633-2018 Passed Tim Frazee Complete Electrical Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes 04/24/2018 04/24/2018 BLDG-17 Interior 055886-2018 Passed Tim Frazee Complete Lath/Drywall Checklist Item COMMENTS Passed BLDG-Building Deficiency Yes 05101/2018 05/01/2018 BLDG-44 056705-2018 Passed Tim Frazee Complete Rough/Ducts/Dampe "' Checklist Item COMMENTS Passed BLDG-Building Deficiency Pookie on ducts OK Yes 05/10/2018 05/10/2018 BLDG-85 T-Bar, 057694-2018 Passed Tim Fra:zee Complete Celling Grids, Overhead Checklist Item COMMENTS Passed BLDG~Building Deficiency Yes BLDG-14 Yes Frame-Steel-Bolting-Welding (Decks) BLDG-24 Rough-Topout Yes BLDG-34 Rough Electrical Yes BLDG-44 Yes Rough-Ducts-Dampers 06/01/2018 06/01/2018 BLDG-Flnal 059713-2018 Failed Tim Fra:zee Reinspection Complete Inspection Checklist Item COMMENTS Passed BLDG-Building Deficiency No BLDG-Plumbing Final No BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final Need title 24, recycling, air balance and non No residential paperwork 06/1212018 06/1212018 BLDG-Flnal 060735-2018 Passed Tim Fra:zee Complete lnspectlon June 12, 2018 Page 1 of2 \ ",,' «; '0 '½ / 1 f " < ' ' j "' ~ -CL -!, -'\, > 0 -~,RMiT JNSPECl;ION HISTOR:l J!EPO~T (C~,~.01t{c0155) Permit Type: Work Class: Status: Scheduled Date June 12, 2018 BLDG-Commercial Application Date: 03/21/2018 Tenant Improvement Issue Date: 04/11/2018 Closed -Finaled Expiration Date: 11/06/2018 IVR Number: 10253 Actual Start Date Inspection Type Inspection No. Inspection Status Checklist Item COMMENTS Owner: Subdivision: Address: Primary Inspector BLDG-Building Deficiency BLDG-Plumbing Final BLDG-Mechanical Final BLDG-Structural Final BLDG-Electrical Final Need title 24, recycling, air balance and non residential paperwork BLDG-Fire Final 069662-2018 Scheduled Dominic Fieri Checklist Item COMMENTS FIRE-Building Final BROOKWOOD C B I LLC 2175 Salk Ave, 200 Carlsbad, CA 92008-7346 Re inspection Passed Yes Yes Yes Yes Yes Passed No Complete Incomplete Page 2 of2 DATE: 4/2/2018 JURISDICTION: Carlsbad PLAN CHECK#.: CBC2018-0155 ✓• EsG1I A '.)AFEbuilt Company SETI PROJECT ADDRESS: 2175 Salk Ave. #200 □ APPLICANT ~RIS PROJECT NAME: Consumer Sleep Solutions Tenant Improvement [g] 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 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: [g] EsGil staff did not advise the applicant that the plan check has been completed. D EsGil staff did advise the applicant that the plan check has been completed. Person contacted'-. ---Telephone#: Date contacted: - Mail Telephone 0 REMARKS: By: Jason Pasiut EsGil .;;, Fax Enclosures: 3/22/2018 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 Carlsbad CBC2018-0155 4/2/2018 [DO NOT PAY -THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PREPARED BY: Jason Pasiut BUILDING ADDRESS: 2175 Salk Ave. #200 BUILDING OCCUPANCY: B BUILDING AREA Valuation PORTION ( Sq. Ft.) Multiplier 6822 46.51 Air Conditioning Fire Sprinklers TOTAL VALUE Jurisdiction Code cb By Ordinance --------------~ 1997 UBC Buildin Permit Fee ... 1 997 UBC Plan Check Fee -·;-j Type of Review: 0 Complete Review D Repetitive Fee ____ iJ Repeats Comments: D Other D Hourly EsGil Fee PLAN CHECK#.: CBC2018-0155 DATE: 4/2/2018 Reg. VALUE ($) Mod. 317,291 317,291 D Structural Only $797.981 Sheet 1 of 1 ~ 24 HOUR SERVICE CONTRACTOR LIC. NO 437153 ~ Greater San Diego ~ ~~u,:?a~~~~i~~'.~~~~~pany, Inc. (619) 469-7818 FAX (619) 469-7621 E-mail: service@gsdac.com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: AREA SERVED Unit# Make: HPl Type: __ W=S-=-H'-'p'--- Carrier --------------Model: 50PCH025ZCC5ACN1 --------------Serial: 1318V77 435 NO. OUTLET TYPE SIZE DESIGN AirflowCFM 200 PRELIMINARY AirflowCFM Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Dale: 12/16/2017 FINAL AirflowCFM PERCENT OF DESIGN ------------------- Project Manager: Aaron Plaskon Commisioning Technician: _A_n_t_h.:.onc.y<....:.Sccan~g"-e:..r_r _____ D_a_te_: _1_1..<./_2.,_/_2_0.:.16::..._ Revision Date 5/9/08 ~ 24 HOUR SERVICE CONTRACTOR LIC. NO 437153 ~ Greater San Diego ~ ~~u,:?a~~!~i~~o'..~~cA~~~pany, Inc. (619) 469-7818 FAX (619) 469 7621 E-mail service@gsdac com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: AREA SERVED n Unit# HP2 -==-WSHP Make: Carrier --------------Model: 50PCH030ZCC6ACN1 --------------Serial: 0818V75603 NO. OUTLET TYPE SIZE DESIGN AirflowCFM 200 PRELIMINARY AirflowCFM Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Date: 12/16/2017 FINAL AirflowCFM PERCENT OF DESIGN -------------- Supply Diffusers 1 T-Bar 10 210 121 193 92% 2 T-Bar 10 210 139 199 95% 3 T-Bar 8 145 140 139 96% 4 T-Bar 6 90 34 87 97% 5 T-Bar 10 115 194 110 96% 6 T-Bar 10 115 172 107 93% 7 T-Bar 10 115 163 109 95% ~ ~-~~ emmmff.i!mDI 0 en 1 T-Bar Office 2 T-Bar Office 3 T-Bar Office 4 T-Bar Office 5 T-Bar R tum Total Outside Air Project Manager: Aaron Plaskon 14 455 268 6 75 51 10 95 98 10 95 109 10 95 190 815 n6 183 433 73 87 87 91 7n 173 95% 97% 92% 92% 96% 0 0 Commisioning Technician: Anthony Sangen Date: 11/2/2016 ---'--'"-------------'--'---- Revision Date 5/9/08 ~ 24 HOUR SERVICE CONTRACTOR UC. NO 4371S3 ~ Greater San Diego ~ ~~u,:~~~!~i~~'.e~~~~~pany, Inc. {619) 469-7818 FAX {619) 469·7621 E-mail: service@gsdac.com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: AREA SERVED ni n Unit# HP6 -=~-WSHP Make: Carrier --------------Model: 50PSH048WCC60140 --------------Serial: 3611 V32084 NO. OUTLET TYPE SIZE DESIGN AirflowCFM 200 PRELIMINARY AirflowCFM --------- Supply Diffusers Breakroom Breakroom Breakroom Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Date: 12/16/2017 FINAL Airflow CFM 136 PERCENT OF DESIGN 101% 100% 101% 102% Project Manager: Aaron Plaskon CommisioningTechnician: Anthony Sangen Date: 11/2/2016 ---~-~--------~~--- Revision Date 5/9/08 ~ 24 HOUR SERVICE CONTRACTOR LIC. NO 437153 ~ Greater San Diego ~ ~!~u,:?a~~!!i~::.~~c~~?1pany, Inc. {619) 469•7818 FAX (619) 469-7621 E-mail: service·:iilgsdoc com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: n· Unit# HP7 --='-'--Make: Type: __ W=S..:.H;;;;P __ Carrier --------------Model: 50PSH048WCC60140 --------------Serial: 3611 V32080 I AREA SERVED I NO. OUTLET TYPE SIZE DESIGN AirflowCFM Supply Diffusers 0 0 0 240 200 PRELIMINARY AirflowCFM Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Date: 12/16/2017 FINAL AirflowCFM 350 PERCENT OF DESIGN Project Manager: Aaron Plaskon Commisioning Technician: Anthony Sangen Date: 11/2/2016 ---'---'"-----------'--'---- Revision Date 5/9/08 ~ 2,4 HOUR SERVICE CONTRACTOR UC. N0437153 ~ Greater San Diego ~ ~!~u,:~~~!!i~:!'.e~~cA:~~pany, Inc. (619) 469-7818 FAX (619) 469-7621 E-mail: service@gsdac com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: 200 i n Unit# HP8 ---==-Type: WSHP Make: Carrier --------------Model: 50PSH042WCC60140 --------------Seri a I: 3911 V33430 DESIGN PRELIMINARY T-Bar T-Bar Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Date: 12/16/2017 ~ ~~~lllmiiiJ'Jallll llm!mDJff.i?!'/l'l!DI 0 en 940 581 922 98% Office 120 84 119 99% Office 105 133 101 96% R tumT 1165 798 1142 9 ", 235 254 Project Manager: Aaron Plaskon Commisioning Technician: Anthony Sangerr Date: 11/2/2016 Revision Date 5/9/08 ~ 24 HOUR SERVICE CONTRACTOR LIC. NO 437153 ~ Greater San Diego ~ ~!~u;?a~~l!i~~o'..~~cA::::?'pany, Inc. (619) 469-7818 FAX (619) 469-7621 E-mail: service@gsdac com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: 200 n Unit# HP9 WSHP Make: Carrier Model: 50PSH030WCC60140 Serial: 411V34537 OUTIET DESIGN PRELIMINARY AREA SERVED NO. SIZE TYPE AirflowCFM AirflowCFM Supply Diffusers • • • 1 .. I: • • • 2 . . • • • 3 . . Office 4 . : .. Office 5 .. • I 6 Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Date: 12/16/2017 FINAL PERCENT OF AirflowCFM DESIGN I • 100% 100% 101% . • 99% 101% ~ ~~~~ lm'!llmlmff.mrmlll T-Bar 12 505 264 496 98% T-Bar 8 125 90 124 99% T-Bar 8 105 89 106 101% T-Bar 8 90 85 91 101% 825 2 817 0 0 175 188 Project Manager: Aaron Plaskon Commisioning Technician: Anthony Sangerr Date: 11/2/2016 Revision Date 5/9/08 ~ 24 HOUR Sl!RYICI!! CONTRACTOR LIC. NO 437153 ~ Greater San Diego ~ ~!~u,:?o~~~!i~!~L~~c~~~pany, Inc. (619) 469-7818 FAX (619) 469-7621 E-mail: service'figsdac com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: AREA SERVED Supply Diffusers Conference Conference n Unit# -==-WSHP Make: Carrier --------------Model: 50PSH030WCC60140 --------------Serial: 411 V34533 NO. OUTLET TYPE SIZE DESIGN AirflowCFM 55 200 PRELIMINARY AirflowCFM Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Date: 12/16/2017 FINAL AirflowCFM PERCENT OF DESIGN Project Manager: Aaron Plaskon Commisioning Technician: Anthony Sangerr Datec 11/2/2016 --~~~~--------~~--- Revision Date 5/9/08 ~ 24 HOUR SERVICE CONTRACTOR LIC. NO 437153 ~ Greater San Diego ~ :.!~u,:?o~~!~i~:!'.e~~A~~?1pany, Inc. (619) 469-7818 FAX (619) 469-7621 E-mail: ser1;ice~gsdac com Air Balance Report Project: Consumer Sleep Solutions Address: 2175 Salk Ave Suite: n Unit# --=-=--Sp it Make: Carrier --------------Model: FX4DNF037000AAAA --------------Serial: 211A84157 I AREA SERVED I NO. OUTLET TYPE SIZE DESIGN Airflow CFM Supply Diffusers Office 200 PRELIMINARY AirflowCFM Job/Dispatch: 37964 ------ Test Device Information Flow Hood# 7 Make: Shortridge Model: 8400 Calibration Date: 12/16/2017 FINAL AirflowCFM PERCENT OF DESIGN Project Manager: Aaron Plaskon Commisioning Technician: Anthony Sangerr Date, 11/2/2016 ---'--"'-------------'---'---- Revision Date 5/9/08 -SAN DIEGO REGIONAL HAZARDOUS MATERIALS QUESTIONNAIRE OFFICE USE ONLY 0 RECORD ID# __________________ , PLAN CHECK# _________________ , ' ' BP DATE 1.--00 PART I: FIRE EPARTiftENT -H Diego): Indicate by circling the ite , applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. IJ/J... C,q Occupancy Rating: Faclllty's Square Footage (including proposed project): Ottl/(J FiL.se 1. Explosive or Blasting Agents 5. Organic Peroxides 9 Water Reactives 13. Corrosives l:)JJ/Js ~ 2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards ION· 3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These. · 4. Flammable Solids 8. Unstable Reactives 12. Radioactives questions is yes, applicant must contact the aunty o an Diego azardous Materials ivision, 5500 Ove 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 § I D D D D D (for new construction or remodeling projects) ls 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 10)? 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 anons? California's Above round Petroleum Stora e Act . • If the answer to any of the an Diego, CA 92123. 0 CalARP Exempt I Date Initials 0 CalARP Required I Date D CalARP Complete I Date Initials PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT {APCOl: Any YES• answer requires a stamp from APCD 10124 Old Grove Road, San Diego, CA 92131 apcdcomp@sdcoynty.qa.gov (858) 586-2650). [*No stamp required if 01 Yes~ 03 Yes mJQ 04-06 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 dv.ielling units; townhomes: condos; mixed-commercial use; deliberate bums: residences forming part of a larger project. rExcludes garages & small outbuildings.] YES NO 1. D Kl Will the project disturb 160 square feet or more of existing building materials? 2. D !El Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition. 3. D D (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance Technician? 4. D D (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. 5. D ~ Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet (www.sdapcg.9rg/infolfactslpermits.pdO for typical equipment requiring an APCO 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 proposed project: 3 /\7... / 2.C\'B Date FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: _________________________________ _ BY 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 COUNTY4 HMD APCD *A stamp m this box only exempts businesses from completing or updating a Hazardous Matenals Business Plan. Other permIttIng requirements may still apply. HM-9171 (08/15) 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 a'II that apply: AUTOMOTIVE D Battery Manufacturing/Recycling D Boat Yard D 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 OperatorfDistributor CHEMICAL HANDLING D Photographic Processing 0 Pool Supplies/Maintenance D Printing/Blue Printing 0 Road Coatings 0 Swimming Pool D Toxic Gas Handler 0 Toxic Gas Manufacturer METAL WORKING D Anodizing D Chemical Milling/Etching □ FinishwCoating/Painting D Flame Spraying D Foundry 0 Machine Shop-Drillingtlathes/Mills D Metal Plating D Metal Prepping/Chemical Coating D Precious Metal Recovery D Sand Blasting/Grinding D Steel Fabricator D Wrought Iron Manufacturing AEROSPACE D Aerospace Industry D Aircraft Maintenance D Aircraft Manufacturing OTHERS AND MISCELLANEOUS D Asphalt Plant D Biotechnology/Research D Chiropractic Office D Co-Generation Plant D Dental Clinic/Office D Dialysis Center D Emergency Generator D Frozen Food Processing Facility D Hazardous Waste Hauler D Hospital/Convalescent Home 0 Laboratory/Biological Lab 0 Medical Clinic/Office D Nitrous Oxide (NO~) Control System D Pham,aceuticals 0 Public Utility D Refrigeration System D Rock Quany D Ship Repair/Construction D Telecommunications Cell Site D Veterinary Clinic/Hospital D Wood!Fumiture Manufacturing/Refinishing ELECTRONICS 0 Electronic Assembly/SubwAssembly D Electronic Components Manufacturing D Printed Circuit Board Manufacturing NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH lYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880. LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which include any of the following operations 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 37 -Plasma Arc & Ceramic Deposition Spray 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 Refining ORGANIC COMPOUND MARKETING (GASOLINE. ETC) 25 -Gasoline & Alcohol Bulk Plants & T enninals 25 -lntemiediate Refuelers 26 -Gasoline & Alcohol Fuel Dispensing COMBUSTION 34 -Piston Internal -Combustion Engines 13 -Boilers & Heaters (1 million BTU/hr or larger) 14-Incinerators & Crematories 15 -Bum 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 ~ 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 T ov,.,ers -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 (08/15) County of San Diego -DEH -Hazardous Materials Division INDUSTRIAL WASTEWATER DISCHARGE PE~C~ SCREENING SURVEY ,/Lil'J Date b [\ 'Z. / \ ~ M4R 2 Business Name (C>f':E0""'C.X:: $\SCR Sc\q\j Q'f\ Ctty0 1 l1JJ8 Street Address ~17 'o ~'(__ ~Yi'-· S nk 2.,DO 8 lltLo,,F C,4.~ Email Address =W-\\':i@= \.e((J,{\5~u C..bOA '"' c. C.O\<Y" ~,vc o,~~-4D 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 Biofuei Manufacturing Membrane Manufacturing Personal Care Products Biotech Laboratory (i.e. water filter membranes) Manufacturing Bulk Chemical Storage Metal Casting/ Forming Pesticide Manufacturing / Car Wash 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 I Detergent Manufacturing Industrial Laundry Waste Treatment/ Storage SIC Code(s) (if known): _____________________ _ Brief description of business activities (Production/ Manufacturing Operations): _____ _ Description of operations generating wastewater (discharged to sewer, hauled or evaporated): Estimated volume of industrial wastewater to be discharged (gal/ day): _______ _ 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: ____________________ _ '-=c---.-.--:,--.-----=-------Title. ___________ _ Signature'.=i:b/J/:,~Y!,~~~~~=:--:---:-:--::Phone No .. ___________ _ ENCi NA WA Y, 6200 Avenida Encinas Carlsbad, CA 92011 (760) 438-3941 FAX: (760) 476-9852