HomeMy WebLinkAbout2744 LOKER AVE; 103; CBC2021-0130; PermitBuilding Permit Finaled
(city of
Carlsbad
Commercial Permit
Print Date: 08/19/2021 Permit No: CBC2021-0130
Job Address: 2744 LOKER AVE W, # 103, CARLSBAD, CA 92010-6612 Status: Closed -Finaled
Permit Type: BLDG-Commercial Work Class: Tenant Improvement
Parcel#: 2090813300 Track#:
Valuation: $44,184.50 Lot #:
Occupancy Group: B, 5-1
#of Dwelling Units:
Project#:
Plan#:
Bedrooms:
Bathrooms:
Construction Type:I11 B
Orig. Plan Check #:
Occupant Load: Plan Check#:
Code Edition:
Sprinkled:
Project Title:
Description: AVISTA TECHNOLOGIES: 950 SF T.I. (OFFICE TO OFFICE)
Applicant: Property Owner:
GEORGE BARULICH TRI VISTA INC
JOSH GIBBS
116 MARKET PL
ESCONDIDO, CA 92029-1352
(760) 294-0277
2744 LOKER AVE W, # STE 101
CARLSBAD, CA 92010-6612
(714) 330-0518
FEE
BUILDING PERMIT FEE ($2000+)
BUILDING PLAN CHECK FEE (BLDG)
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
SB1473 GREEN BUILDING STATE STANDARDS FEE
STRONG MOTION-COMMERCIAL
Total Fees: $738.17 Total Payments To Date: $738.17
Applied:
Issued:
Finaled Close Out:
Inspector:
Final Inspection:
Contractor:
TRI VISTA INC
04/15/2021
06/09/2021
TKers
08/19/2021
116 MARKET PL
ESCONDIDO, CA 92029-1352
(760) 294-0277
Balance Due:
AMOUNT
$374.00
$261.80
$43.00
$45.00
$2.00
$12.37
$0.00
Please take NOTICE that approval of your project includes the II lmposition11 of fees, dedications, reservations, or other exactions hereafter
collectively referred to as 11fees/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.
Building Division Page 1 of 1
1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
. ----------
Cci~of
Carlsbad
COMMERCIAL
BUILDING PERMIT
APPLICATION
B-2
Plan Check GEfa(p)./ -OJ;{)
Est. Value~I, 1 {[4.,m
PC Deposit _______ _
Date !-/-I S -&-\
Job Address Z 74L/ l.-0\leR A--J~ \.>&,',T
Tenant Name: A-..Jtc.,TPr T~t-,(6\..-0G,l~
Suite:_l.:..o...;3;.__APN: 2-o"l -oe> \ -3 3-60-
Lot#:
Year Built: _____ Occupancy:_ .... :J?:;.___ Construction Type•_\,_\l,_-_P:, __ ..rFire Sprinklers:~ t;;;JA/c:'!l t;;;J
BRIEF DESCRIPTION OF WORK:
D Addition/New: __________ ,New SF and Use, __________ ,New SF and Use,
___ Deck SF, Patio Cover SF (not including flatwork)
Existing Use $ C,,-1 ' Proposed Use No C/fblbf JKi Tenant Improvement: tf5b P SF,
_____ SF, Existing Use ______ Proposed Use _____ _
D Pool/Spa: _____ S,F Additional Gas or Electrical Features?--~--=------==
DD DD DD D Solar: ___ KW,, ___ Modules, ___ Mounted, Tilt: Yes/ No, RMA: Yes/ No, Panel Upgrade: Yes/ No
D Plumbing/Mechanical/Electrical Only: -------------------------
□ Other:
This permit ls to be issued in the name of the Property Owner as Owner-Builder, licensed contractor or Authorized Agent of the
owner or contractor. The person listed as the Applicant below will be the main point of contact throughout the permit process.
PROPERTY OWNER APPLICANT 0 PROPERTY OWNERS AUTHORIZED AGENT APPLICANT 0
Name: A~l'1[A;T'ei:+fr-JOL{l61~ 1 (NC; Name: __________________ _
Address: l4o O;,o~r,nf::ll, P.,LI/Q Address: _________________ _
City: :-,W M.@ ~ State: CA: Zip: 1Ub:j City: _________ .State: ___ ,Zip: ___ _
Phone: '-/,s4.. ,'l.2-. 4,<1,1~ Phone: _________________ _
Email: 1q1,i;; l"<>e12e.. A\Jl'>T/r11iC.tl:. CoM Email: __________________ _
DESIGN PRJFESSIONAL APPLICANT O CONTRACTOR BUSINESS
Name: C <;~U.E ~ U>NTllMIL) ➔ Name: }Rl\l\">tA: 1 /NC,.
APPLICANT~
Address: _______________ Address: 11 lp \.Mcll,¥:?C fk
City: _______ .State: ___ .Zip: ____ City: \;be,,111blt>p State: CA; Zip:_q.._~~z,_q.._ __ _
Phone: Phone: J (o Q VI,~ 02--17
Email: Email: :i~ e,jj11.{ l'-IA c..,, ~P-Co/lJ'.
Architect State License: State License: IP0OS(e) Bus. License: ~t,0$\'Z.2.JpZ.'i(p
1635 Faraday Ave Carlsbad, CA 92008
B-2
Ph: 760-602-2719 Fax: 760-602-8558
Page 1 of 2
Email: Building@carlsbadca.gov
Rev. 08/20
IDENTIFY WHO WILL PERFORM THE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW:
(OPTION A): LICENSED CONTRACTOR DECLARATION:
I hereby affirm under penalty of perjury that I om licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also affirm under
penalty of perjury one of the following declarations:
D I have and will maintain a certificate of consent to self•insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of
the work which this permit is issued. Polley No. ________________________ _
lvf1 have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the performance of the work for whic r My workers' compensation insurance arrier and policy number are: lnsuranceCompany Name: '\?6a, S: \(2.f-
Policy No. \),! C. 2-\ Expiration Date: --'lL/-J.L+.oe:::1-,:i. ___________ _
D 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 $100,000.00, in addition the to the cost of compensation, damages as provided for in Section 3706 of the
Labor Code, interest and attorney's fees.
CONSTRUCTION LENDING AGENCY, IF ANY:
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name: _____________________ Lender's Address: ____________________ _
CONTRACTOR PRINT: _\..,)""'D_':4.._6""""'"1q,_f!>_S ___ _ DATE:
(OPTION B): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
D 1, 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).
DI, 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).
DI am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason:
D "Owner Builder acknowledgement and verification form" has been filled out, signed and attached to this application. Proof of identification attached.
D Owners "Authorized Agent Form" has been filled out, signed and attached to this application giving the agent authority to obtain the permit on the owner' behalf.
Proof of identification attached.
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the
improvements covered by this permit, I cannot legally sell a structure that l have built as an owner-builder if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is
submitted or at the following Web site: http://www.Jeginfo.ca.gov/caJaw.html.
OWNER PRINT: ____________ SIGN: _________ DATE: ______ _
APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL
By my signature below, I certify that: I am the property owner or State of California Licensed Contractor or authorized to act on the property
owner or contractors behalf 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 Jaws 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 LIABILfrlES, 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.
APPLICANT PRINT:~<-) 0_7_lf_Gt ____ l11,_I+_~ __ _ SI N:
1635 Faraday Ave Carlsbad, CA 92008
B-2 Page 2of 2
-602-8558
DATE: ~1-1--/1~;z,_/io__._.M~-
Email: Building@carlsbadca.gov
Rev. 08/20
---~-¼¼s"'"v.;;~+§r¼ ~'1 1::~::-.l"" ~' "~¼ ½ t~F,z¼ --~lv--*'.¼'0~£:¼ ---"~
PERM1T INSPECTION HJS'tORY for.tCBS:,:2021.;;0130) .. ~ ' .
Permit Type: BLDG-Commercial Application Date: 04/15/2021 Own~r: GEORGE BARULICH
Work Class: Tenant Improvement Issue Date: 06/09/2021 Subdivision: PARCEL MAP NO 19442
Status: Closed -Finaled Expiration Date: 01/18/2022 Address: 2744 LOKER AVE W, # 103
IVR Nurnbor: 32762 CARLSBAD, CA 92010-6612
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Date Start Date Status
Thursday, August 19, 2021 Page 2 of 2
Building Permit Inspection History Finaled
( City of
Carlsbad
Permit Type: BLDG-Commercial Application Date: 04/15/2021 Owner: GEORGE BARULICH
Work Class: Tenant Improvement Issue Date: 06/09/2021 Subdivision: PARCEL MAP NO 19442
Status: Closed -Finaled Expiration Date: 01/18/2022 Address: 2744 LOKER AVE W, # 103
IVR Number: 32762 CARLSBAD, CA 92010-6612
Scheduled Actual Inspection Type Inspection No. Inspection Primary Inspector Reinspection Inspection
Date Start Date Status
06/15/2021 06/15/2021 BLDG-14 169717-2021 Passed Tim Kersch Complete
Frame/Steel/Bolting/We
!ding (Decks)
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-34 Rough 159718-2021 Passed Tim Kersch Complete
Electrical
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
06/16/2021 06/16/2021 BLDG-17 Interior 159820-2021 Passed Tim Kersch Complete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
07/07/2021 BLDG-85 T-Bar, Celling 16127 4-2021 Passed Tim Kersch Complete
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
07/21/2021 07/21/2021 BLDG-31 162460-2021 Passed Tim Kersch Complete
Underground/Conduit•
Wiring
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
08/19/2021 08/19/2021 BLDG-Final Inspection 164573-2021 Passed Tim Kersch Complete
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
BLDG-Plumbing Final Yes
BLDG-Mechanical Final Yes
BLDG-Structural Final Yes
BLDG-Electrical Final Yes
Thursday, August 19, 2021 Page 1 of 2
DATE: 05/24/2021
JURISDICTION: Carlsbad
PLAN CHECK#.: CB-CBC2021-0130
✓• EsG1I
SET: II
PROJECT ADDRESS: 2744 Loker Ave W #103
PROJECT NAME: AVISTA Technologies TI
□ APPLICANT
□ JURIS.
[SJ 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:
Josh
[SJ 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#: (760) 294-0277
Date contacted: (by: ) Email: josh@trivistacorp.com
Mail Telephone
0 REMARKS:
By: Steven Miller
EsGil
Fax In Person
Enclosures:
05/07
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
1
DATE: 05/07/2021
JURISDICTION: Carlsbad
PLAN CHECK#.: CB-CBC2021-0130
✓• EsG1I
A SAH:.built Company
SET: I
PROJECT ADDRESS: 2744 Loker Ave W #103
PROJECT NAME: AVISTA Technologies TI
□ APPLICANT
□ JURIS.
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's 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.
t8J 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.
t8J The applicant's copy of the check list has been sent to:
Josh
D EsGil staff did not advise the applicant that the plan check has been completed.
t8J EsGil staff did advise the applicant that the plan check has been completed.
Person contacted: Telephone#: (760) 294-0277
Date contacted:
Mail Telephone
0 REMARKS:
By: Steven Miller
EsGil
(by: ) Email: josh@trivistacorp.com
Fax In Person
Enclosures:
05/07
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576
Carlsbad CBC2021-0130
05/07/2021
PLAN REVIEW CORRECTION LIST
COMMERCIAL
PLAN CHECK#.: CB-CBC2O21-O13O JURISDICTION: Carlsbad
OCCUPANCY: B, Sl USE: Office
TYPE OF CONSTRUCTION: IIIB ACTUAL AREA: Existing 8827 sq ft
TI 950 sq ft
ALLOWABLE FLOOR AREA: 76,000 STORIES: 1 no change
HEIGHT: 20' no change
SPRINKLERS?: YES
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION: 04/15/2021
DATE INITIAL PLAN REVIEW
COMPLETED:O5/O7/2O21
FOREWORD (PLEASE READ):
OCCUPANT LOAD: 113
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 04/19/2021
PLAN REVIEWER: Steven Miller
This plan review is limited to the technical requirements contained in the California version of
the International Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National
Electrical Code and state laws regulating energy conservation, 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 2019 CBC, which adopts the 2018 IBC.
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. 105.4 of
the 2018 International 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.
•
'
Carlsbad CBC2021-0130
05/07/2021
NOTICE: CITY AND ESGIL'S HOURS OF OPERATION ARE AFFECTED BY
THE CURRENT COVID-19 EPIDEMIC. PLAN REVIEWER MAY NOT BE
AVAILABLE TO ANSWER QUESTIONS BY PHONE, BUT MAY BE
REACHED BY E-MAIL AT stmiller@esgil.com . (858) 225-2775
GENERAL
1. Please make all corrections, as requested in the correction list. Submit FOUR new
complete sets of plans for commercial/industrial projects (THREE 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 and the Carlsbad Planning,
Engineering and Fire Departments.
2. Bring TWO corrected set of plans and calculations/reports to EsGil, 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 only will not be reviewed by the
City Planning, Engineering and Fire Departments until review by EsGil is complete.
2. Plans may be submitted in electronic format, subject to the jurisdiction's
approval. If so, they must have restrictions removed from the security settings.
Electronic plans with restrictions to markups, printing, or stamping will not be
approved.
3. A reminder that due to Covid-19, the City will not permit counter corrections.
Please make sure all the items are satisfied; otherwise, another round of
corrections will be necessary.
4. City of Carlsbad requires that all plans provide completed Climate Action Plan
(CAP) Consistency Checklist, city form B-50. I have been asked to have everyone
provide a completed B50 Form, even if you must put N/A on everything you still
need to provide a completed form.
MISCELLANEOUS LIFE/SAFETY
5. Page A2.2 Please provide notes on the plans to show the suspended ceilings
in Seismic Design Categories D, E & F comply with ASCE 7-16 Section
13.5.6.2.2 as follows:
a. The width of the perimeter supporting closure angle or channel shall be
not less than 2.0 in. unless qualified perimeter supporting clips are used.
CMsbad CBC2021-0130
05/07/2021 •
b. Closure angles or channels shall be screwed or otherwise positively
attached to wall studs or other supporting structures. Perimeter supporting clips
shall be qualified in accordance with approved test criteria per Section 13.2.5.
c. Perimeter supporting clips shall be attached to supporting closure angle or
channel with a minimum of two screws per clip and shall be installed around the
entire ceiling perimeter.
d. In each orthogonal horizontal direction, one end of the ceiling grid shall be
attached to the closure angle, channel, or perimeter supporting clip. The other
end of the ceiling gird in each horizontal direction shall have a minimum 0. 75-in
clearance from the wall and shall rest upon and be free to slide on a closure
angle, channel, or perimeter supporting clip.
e. Ceiling areas over 2500 ft.2 must have seismic separation joints or full
height partitions.
f. Ceilings without rigid bracing must have 2" oversize trim rings for
sprinklers and other ceiling penetrations. ·
ADDITIONAL
6. To speed up the review process, please 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.
7. 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.
Have changes been made to the plans not resulting from this correction
list? Please indicate: □ Yes □ No
8. The jurisdiction has contracted with EsGil, 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 Steven Miller at Esgil. Thank you.
Carlsbad CBC2021-0130
05/07/2021
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad
PREPARED BY: Steven Miller
BUILDING ADDRESS: 2744 Loker Ave W #103
BUILDING OCCUPANCY: B,S1
BUILDING I AREA
I
Valuation
PORTION ( Sq. Ft.) Multiplier
Tl B 0cc 950 46.51
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code CB By Ordinance
: 1997 UBC Buildin Permit Fee g ~
1997 UBC Plan Check Fee • i
Type of Review:
D Repetitive Fee ~ Repeats
Comments:
Complete Review
□ Other
0 Hourly
EsGilFee
PLAN CHECK#.: CB-CBC2021-0130
DATE: 05/07/2021
Reg_ VALUE ($)
Mod.
44,185
44,186
□ Structural Only
$243.42!
Sheet 1 of 1
{cicyof
Carlsbad
OWNERS
AUTHORIZED
AGENT FORM
8-62
Development Services
Building Division
1635 Faraday Avenue
760-602-2719
www.carlsbadca.gov
OWNER'SAUTHORIZED AGENT FORM
Only a property owner, contractor or their authorized agent may submit plans and opp/lcotlons for building
permits. To authorize a third-party agent ta sign for a building permit, the owner's third party agent must bring
this signed form, which identifies the agent and the owner who s/he is representing, and for what jobs s/he
may obtain permits. The farm must be completed in its entirety to be accepted by the Oty for each separate
permit application.
Note: The following Owner's Authorized Agent form is required to be completed by the
property owner only when designating on agent to apply far a construction permit
on his/her behalf.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Property Owner Acknowledgement, the execution of which I understand is my personal responsibility,
I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary
to obtain an Owner-Builder Permit for my project.
S<:ope of Construction Project (or Description of Work); Ofh c..f I ~l 0/l.. lets\ At-Ii \M (tZ... \h:;IJ.'chlt
Project Location or Address: _::.,Z,:.....1_,±f..J_.:..Lo:.,.Kcfl.='-~'-'-"-..:.W:..:e.:_,91'"-,,_f;/_/:.....()~'---C-'#"---th'-Pl_'lt:.....(l_t_A__,q:.....z._bt:.....D __ _
Name of Authorized Agent: __ ,.,,_,_}.c...b(,_l{.,_,6)"'·_,_\-'-~',-"-"'~--------Tel No. 11,0. vt../-. O'J...17
Address of Authorized Agent:._:.....l\:....l,_l.l___:.~_:___:__.,_P.:.~...;.::.;:::.....~~:.:..::Co:-,.;N,__O_l:.....f:7<>:::.......::lA.:.:....._~qt..ei,c:=J.-i1'------
I declare under penalty of perjury that I am
out the above information and certify its
or the address listed above and I personally filled
£/JP Fin111nce_,; rscFO
1
-.
C
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS
QUESTIONNAIRE
OFFICE USE ONLY
RECORDID# __________________ I
PLAN CHECK# ________________ I
BP DATE
Business Name Business Contact
f\101,661 I l:;4 G,12, l£ \~
City
lllo?, C tM-0 State c.+
City State
Telephone#
Zip Code
f()
ZpCode
Telephone#
85e>. ;~z.. e>en,;;
APN#
;to .oe,(-33·00
Plan File#
Occupancy Rating: Faclllty'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. Olher Health Hazards
3. Flammable/Combustible Liquids 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These.
4. Flammable Solids 8. Unstable Reactlves 12. Radloactlves
p ART H; rN DIEG~ COUNTY DEPARTMENT OF ENV1f.!NMENTAL HEAL TH -~AZARD~S MATE!3JALS DM~l~N IHMR); If the answer lo any of the
questions yes, applcant must contact the County of San ego Hazardous Materia!slvtslon. 50 OVerian Avenu< uie f10, an Diego, CA 92123.
Call (858) 505-6700 prior to the Issuance of a building permit. i
FEES ARE REQUIRED Project Completion Date: ~/1 (zr Expected Date of Occupancy: ft 'J.,/2,/ □ CalARP Exempt
YES NO (for new construction or remodelin prbj~cts)
1. D I ls your business listed on lhe reverse side of this form? (check all that apply). Date lnlHals
2. D Will your business dispose of Hazardous Substances or Medical Waste ln any amount?
3. D Will your business store or handle Hazardous Substances in quantities greater than or equal ta 55 gallons, 500 D CalARP Required
4.
5.
6.
7.
8.
1.
2.
3.
4.
5.
6.
□ □ □ □ □
□
□
□
pounds and/or 200 cubic feet?
[2l Will your busJness store or handle carcinogens/reproductive toxins In any quantity?
I WIii your business use an existing or install an underground storage tank?
WIii your business store or handle Regulated Substances (CelARP)?
WIii your business use or install a Hazardous Waste Tank System (TIiie 22, Article 10)?
WIii your business store patroleum In tanks or containers at your facility wtth a total facility storage capacity equal lo
or reater than 1,320 allons? Callfomla's Above round Petroleum Sto Act •
Date Initials
0 CalARP Complete
Dale Initials
WIii the project disturb 160 square feet or more of existing building materials?
WIii any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demoiltlon.
(ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certllled Asbestos Consultant or Site Surveillance
Technician? 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. l;iJ Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet
<www.sdapcd.org/lnfo/facts/permits,pdf) for typical equipment requiring an APCD pennit. 0 (ANSWER ONLY IF QUESTION 5 IS YES) WIii the project or assocleted construction equipment be localed within 1,000 feet of a school
bounda
Briefly describe proposed project:
'ft,-IA,..1 \ f /tf\le,M t't-1
1 I I z-.. /1.1>$. I
Date
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
COUNTY-HMO• APCO COUNTY-HMO APCD COUNTY-HMO APCD
/,of'! Co-,,:. o,.. .i R;.>v,_ ~
~nl-ALF '.e
D~tel1Mia1$
;..'
sj'~ <:# "I O,e,go
*A stamp m this box only exempts businesses from completing or updating a Hazardous Matenals Business Plan. Other permitting requirements may still apply.
□ □ □ □ □ □ □ □ B
ENCINA WASTEWATER AUTHORITY
INDUSTRIAL WASTEWATER DISCHARGE PERMIT
SCREENING SURVEY
6200 Avenida Encinas, Carlsbad, CA 92011
Phone: 760-438-3941 Fax: 760-476-9852
SourceControl@encinajpa.com
Date: '(J-/2@.f . .
Business Name: ,,,4v!Sfa., --Jec:J,no/d,IWJ Jbc_,
StreetAddress: 27t;t./ Ltik:.er Ar&, ~ #lg] c,t:YJrbe/ r:-9 9~tD
Email Address: 6-L £;LS & e At!;:J:;rm--ra;tl, con--;
PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT (ON REVERSE SIDE CHECK TYPE OF BUSINE~
Check all below that are present at your facility:
Acid Cleaning D Food Processing D Metal Powders Forming
Assembly D Glass Manufacturing D Nutritional Supplement/Vitamin
Automotive Repair D Industrial Laundry D Manufacturing
Battery Manufacturing D Ink Manufacturing D Painting/Finishing
Biofuel Manufacturing D Laboratory B Paint Manufacturing
Biotech Laboratory D Machining/Milling Personal Care Products
Bulk Chemical Storage D Membrane manufacturing D Manufacturing
Car Wash D (i.e. waterfilter membranes) D Pesticide Manufacturing/ Packaging
Chemical Manufacturing D Metal Casting/Forming D Pharmaceutical Manufacturing
Chemical Purification D Metal Fabrication D (including precursors)
D Denial Offices D Metal Finishing D Porcelain Enameling D Dental Schools D Electroplating D Power Generation D Dental Clinics D Electroless Plating D Print Shop
D Dry Cleaning D Anodizing D Research and Development
□ Electrical Component D Coating (1.e. phosphating) D Rubber Manufacturing
□ Manufacturing □Chemical Etching/Milling D Semiconductor Manufacturing
□ Fertilizer Manufacturing D Printed Circuit Board D Soap/Detergent Manufacturing
□ Film/ X-ra y Processing D Manufacturing D Waste TreatmenUStoraAe
New Business? YesON~ICCode(s}ifknown: ______ Date oper~ti~n be.gan/will begin: rff -.
Tenant Improvement? Ye~NoO If yes, briefly describe improvement: felJ1/;,<, t"l)tJ/1,,, . ~ d,lf'/f>'J
:& E!:·1:11) ~ Ro ~ "1kt: 111¢ 1iL du~. /,Jo e.6-n--~ YJtWI.
Description of operations generating wastewater (discharged to sewer, hauled or evaporated): _________ _
Admn~ ofl/te; tKe.d LJe1/~ 6
Estimated volume of industrial wastewater to be discharged (gal/ day) : ~--gr4~""""-----------------
List hazardous wastes generated (type/volume}: __ .,/J~-"~'---="-----------------------
Have you applied for a wastewater Discharge Permit from the Encina Wastewater Authority? YesO Date: _____ ,N~
Page 1 of 2
ENCINA WASTEWATER AUTHORITY
INDUSTRIAL WASTEWATER DISCHARGE PERMIT
SCREENING SURVEY
6200 Avenida Encinas, Carlsbad, CA 92011
Phone: 760-438-3941 Fax: 760-476-9852
SourceControl@encinajpa.com
The commercial enterprises listed below are a partial listing of businesses that are exempt from industrial wastewater discharge
permitting under normal operating conditions. They are exempt because (a) they discharge no process wastewater (i. e .. they
only discharge sanitary wastewater with no pollutants exceeding any local limits ). and (o) they have no potential to negatively
impact the EWPCF or other wastewater treatment plants in the ESS. Any questions regarding exemptions should be referred
to EWA Source Control staff.
D Automobile Detailer s
D Barber/Beauty Shops D Business/Sales Offices D Cleaning Services
D CarpeVUpholstery
D Childcare Facilities D Churches
D Community Centers
D Consulting Services
D Contractors
D Counseling Services D Educational Services (no auto repair/film developing)
D Finanoal Institutions/Services
D Fitness Centers
D Gas Stations (no car wash/auto repair) D Grocery Stores (no film developing)
D Residential based Businesses
CERTIFICATION STATEMENT
D Hotels/ Motels (no laundry)
D Laundromats
D Libraries D Medical Offices (no x-ray developing)
D Mortuaries
D Museums D Nail Salons
D Nursing Homes &2r. Office Buildings (no process flow)
~ Optical Services D Pest Control Services (no pesticide repackaging for sale)
D Pet Boarding/Grooming Facilities
D Postal Services (no car wash/auto repair) D Public Storage Facilities
D Restaurants/Bars D Retail/Wholesale Stores (no autorepair/film
developing)
D Theaters (Movie/Live)
n·e i.-. rrmrand correu to the best (Jfmy knmd,:t~{!e.
Signature: Date: ¾;&-/
Facility Contact: __________ _ Title: fip 'til'¥I@ 't'C/="D
ENCINA WASTEWATER AUTHORITY
6200AVENIDA ENCINAS. CARLSBAD, CA Phone: 760-438-3941 Fax: 760-476-9852
SourceControl(@encihajpa.com
Page 2 of 2
Ccicyof
Carlsbad
PURPOSE
CLIMATE ACTION PLAN
CONSISTENCY CHECKLIST
B-50
Development Services
Building Division
1635 Faraday Avenue
(760) 602-2719
www.carlsbadca.gov
This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance
requirements apply to their projects. The completed checklist must be included in the building permit application. It may be
necessary to supplement the completed checklist with supporting materials, calculations or certifications, to demonstrate
full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach
to comply with energy-related measures will need to attach to this checklist separate calculations and documentation as
specified by the ordinances.
NOTE: The following type of pennits are not required to fill out this form
❖ Patio I ❖ Decks I ❖ PME (w/o panel upgrade) I ❖ Pool
.IIA If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance,
an explanation must be provided to the satisfaction of the Building Official.
.liA Details on CAP ordinance requirements are available on the city's website .
.IIA A CAP Building Plan template (form B-55) shall be added to the title page all building plans. This template shall be
completed to demonstrate project compliance with the CAP ordinances. Refer to the building application webpaqe and
download the latest form.
Project Name/Building
PermitNo.: 4vt'i'A-~ T~t \\}-f~~~-r BPNo.: C/)c...c?Q;21,....0L~
Property Address/APN: 1--7 c.{Lf l,.o~ l).J~,r t [o~ / ~-O~l -~ 3 -CO
Applicant Name/Co.:
Applicant Address:
Contact Phone: 7iPD, 2-'i4. 0117 Contact Email:
Contact information of person completing this checklist (if different than above):
Name:
Company
name/address:
Contact Phone:
Contact Email:
Applicant Signature: d-----1r--~ Date: Lf /1-v f z,1
\Jn'!)Q_/\ o2Cb K ;=-ft:~
8-50 Page 1 of 6 Revised 06/18
City of Carlsbad Climate Action Plan Consistency Checklist
Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project.
For alterations and additions to existing buildings, attach Building Permit Valuation worksheet.
Building Permit Valuation (BPV) from worksheet: $ -t-~ 'S ±, U>D
D Residential
□ New construction
D Additions and alterations:
□ BPV < $60,000
□ BPV ~ $60,000
□ Electrical service panel upgrade only
□ BPV ~ $200,000
I lXJ Nonresidential
□ New construction
□ Alterations:
□ BPV ~ $200,000 or additions ~ 1,000
square feet
□ BPV ~ $1 ,000,000
□ ~ 2,000 sq. ft. new roof addition
A high-risa residential building is 4 or mare stories, induding a
Low-rise High-rise mixed-use building in which at least 20% of its conditioned floor
area is residential use
2A, 3A,
4A
N/A
1A, 4A
1A, 4A•
1B, 2B,
3B,4A
N/A
4A
1B, 4A'
1 B, 2B, 3B, 4B and 5
18,5
1B,2B,5
2B,5
All residential additions and alterations
1-2 family dwellings and townhouses with attached garages
only
•Multi-family dwellings only where interior finishes are removed
and significant site work and upgrades to structural and
mechanical, electrical, and/or plumbing systems are proposed
Building alterations of~ 75% existing gross floor area
1B also applies if BPV ~ $200,000
Please refer to Carlsbad Municipal Code (CMC) sections 18.21.155 and 18.30.190, and the California Green Building Standards Code (CAL Green) for
more information \I/hen completing this section.
A O Residential addition or alteration ~ $60,000 building pennit valuation.
See CMC section 18.30.190.
Year Built Single.family Requirements
□ Before 1978 Select one:
□ Duct sealinq [J Attic insulation □ Cool roof
□ 1978 and later Select one:
Cl Lighting package Cl Water heating Package
□ Between 1978 and 1991
□ 1992 and later
Jt) N/A N 0~ .. ~IQ@kl,..,
□ Exception: Home energy score 2: 7
(attach certification)
Multi.family Requirements
□ Attic insulation
Select one:
C Duct sealing ClAttic insulation []Cool roof
Select one:
□Lighting package []Water heating package
B. D Nonresidential* new construction or alterations ~ $200,000 building pennit valuation,
or additions ~ 1,000 square feet.
Updated 8/15/2019
I
2
City lr Carlsbad Climate Action Plan Consistency Checklist
See CMC 18.21.155 and CALGreen Appendix AS, Division A5.2-Energy Efficiency.
A5.203.1 .1 Choose one: D .1 Outdoor lighting IJ .2 Warehouse dock seal doors
El .3 Restaurant service water heating (comply with California Energy Code section 140.5, as amended)
C .4 Daylight design PAFs [l.5 Exhaust air heat recovery
A5.203.1.2.1
Choose one as applicable: 0 95 Energy budget □.90 Energy budget I! N/A
A5.211 .1 ..
0 On-site renewable energy i3 N/A
I
A5.211.3**
□ Green power (if offered by local utility provider, 50% minimum renewable sources) II N/A
' A5.212.1
[] Elevators and escalators 'm N/A
A5.213.1
\ Cl Steel framing N/A
* lndudes hotels/motels and high-rise residential buildings
•• For alterations 2: $1,000,000 BPV and affecting > 75% existing gross floor area, or alterations that add 2,000 square feet of new roof addition: comply
with CMC 18.30.130 instead.
2. Photovoltaic Systems
A. D Residential new construction (for low-rise residential building pennit applications submitted after 1/1/20). Refer to 2019 California
Energy Code section 150.1(c)14 for requirements. Notes: 1) High-rise residential buildings are subject to nonresidential photovoltaic
requirement (28 below) instead. 2) If project includes installation of an electric heat pump water heater pursuant to CMC 18.30.150(8)
(high-rise residential) or 18.30.170(8) (low-rise residential), increase system size by .3kWdc if PV offset option is selected.
Floor Plan ID (use additional CFA #d.u. Calculated kWdc*
sheets if necessary)
Total System Size:
kWdc = (CFAx.572) / 1,000 + (1.15 x #d.u.)
*Formula calculation where CFA = conditional floor area, #du = number of dwellings per plan type
If proposed system size is less than calculated size, please explain.
Exception
D
D
D
D
kWdc
~o-r N~\>J Co ~£;1t-,vc..--n~ ~ OJ r✓ 1s L • zw~ 8. D Nonresidential new construction or alterations ~1,000,000 BPV and affecting ~75% existing floor area, or addition that increases roof
area by ~.ooo square feet Please refer to CMC section 18.30.130 when completing this section. Note: This section also applies to
high-rise residential and hotel/motel buildings.
Choose one of the following methods:
□ Gross Floor Area (GFA) Method
GFA:
Olf < 10,000s.f. Enter: 5 kWdc
Min. System Size:
□If ~ 10,000s.f. calculate: 15 kWdc x (GFA/10,000) **
___ kWdc
**Round building size factor to nearest tenth, and round system size to nearest whole number.
□ Time-Dependent Valuation Method
Updated 8/15/2019 3
City of Carlsbad Climate Action Plan Consistency Checklist (
Annual TDV Energy use:*** ______ x .80= Min. system size: ____ _ kWdc
***Attach calculation documentation using modeling software approved by the California Energy Commission.
3. Water Heating
A D Residential and hotel/motel new construction
Please refer to CMC sections 18.30.150 and 18.30.170 when completing this section.
D For systems serving individual dwelling units choose one:
□ Heat pump water heater AND Compact hot water distribution AND Drain water heat recovery (low-rise
residential only)
□ Heat pump water heater AND PV system .3 kWdc larger than required in CMC section 18.30.130 (high rise
residential hotel/motel) or CA Energy Code section 150.1 (c) 14 (low-rise residential)
□ Heat pump water heater meeting NEEA Advanced Water Heating Specification Tier 3 or higher
□ Solar water heating system that is either .60 solar savings fraction or 40 s.f. solar collectors IA) Exception: NoN -P..E~ ttzNTi A: L-
D For systems serving multiple dwelling units, install a central water-heating system with all of the following:
D Gas or propane water heating system
D Recirculation system per CMC 18.30.150(8) (high-rise residential, hotel/motel) or CMC 18.30.170(8) (low-
rise residential)
D Solar water heating system that is either:
□ .20 solar savings fraction
□ .15 solar savings fraction, plus drain water heat recovery :E: Exception: N ON -~ l t? e.-J n kl,
8. D Nonresidential new construction
Please refer to Carlsbad Ordinance CMC section 18.30.150 when completing this section.
D Water heating system derives at least 40% of its energy from one of the following (attach documentation):
D Solar-thermal C Photovoltaics □ Recovered energy
□Water heating system is (choose one):
Cl Heat pump water heater
□ Electric resistance water heater(s) m □Solar water heating system with .40 solar savings fraction
'F-Exception: 1,10\\-fLe"2 IQ~ Tit(L-
Updated 8/15/2019 4
· City !t Carlsbad Climate Action Plan Consistency Checklist
4. Electric Vehicle Charging
A D Residential New construction and major alterations*
B.
Please refer to Carlsbad Ordinance CMC section 18.21.140 when com letin this section.
One and two-family residential dwelling or townhouse with attached garage:
D One EVSE Ready parking space required @Exception : MoN -J?-~1 tlf:NI'A::k:
D Multi-family residential· D Exception ·
Total Parking Spaces EVSE Spaces
Proposed Capable Ready I Installed
I
Calculations: Total EVSE spaces = .10 x Total parking (rounded up to nearest whole number)
EVSE Installed = Total EVSE Spaces x .50 (rounded up to nearest whole number)
EVSE other= Total EVSE spaces-EVSE Installed
(EVSE other may be "Capable," "Ready" or "Installed.")
l
I
Total
*Major alterations are: (1) for one and two-family dwellings and townhouses with attached garages, alterations have a building permit valuation ~ $60,000
or indude an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit
valuation ~ $200,000, interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing
systems are proposed.
D Nonresidential new construction (includes hotels/motels) OC] Exception : NbW -~ roe:,Jnrru
Total Parking Spaces ' EVSE Spaces
Proposed Caoable I Ready I Installed I Total
I I l
Calculation: Refer to the table below:
Total Number of ParkinQ Soaces orovided Number of required EV Soaces Number of reQuired EVSE Installed Spaces
□ 0-9 1 1
□ 10-25 2 1
□ 26-50 4 2
□ 51-75 6 3
□ 76-100 9 5
101-150 12 6
151-200 17 9
201 and over 10 percent of total 50 percent of Required EV Spaces
Updated 8/15/2019 5
City of Carlsbad Climate Action Plan Consistency Checklist f
S. D Transportation Demand Management {TOM): Nonresidential ONLY
AA approved Transportation Demand Management (TOM) Plan is required for all nonresidential projects that meet a threshold of employeeiJenerated ADT.
City staff will use the table below based on your submitted plans to determine whether or nor your permit requires a TOM plan. If TOM is applicable to your
permit, staff will contact the applicant to develop a site-specific TOM plan based on the permit details.
Acknowledgment:
Restaurant 11
Retail3 8
Industrial 4
Manufacturing 4
Warehousin 4
1 Unless otherwise noted, rates estimated from /TE Trip
Generation Manual, 1(JlhEdition
4.5
3.5
3
1
2 For all office uses, use SANDAG rate of 20 ADT/1,000 sf to
calculate employee ADT
3 Retail uses include shopping center, variety store, supermarket,
gyms, pharmacy, etc.
Other commercial uses may be subject to special
consideration
Sample calculations:
Office: 20,450 sf
1. 20,450 sf/ 1000 x 20 = 409 Employee ADT
Retail: 9,334 sf
1. First 1,000 sf = 8 ADT
2. 9,334 sf -1,000 sf = 8,334 sf
3. 8,334 sf / 1,000 x 4.5 + 8 = 46 Em lo ee ADT
I acknowledge that the plans submitted may be subject to the City of Carlsbad's Transportation Demand Management Ordinance. I agree to be contacted should
my permit require a TOM plan and understand that an approved TOM plan is a condition of permit issuance.
Applicant Signature: __________________ _ Date: ______ _
Person other than Applicant to be contacted for TDM compliance (if applicable):
Name (Printed): __________________ _ Phone Number. _____ _
Email Address: ___________________ _
Updated 8/15/2019 6