RC (06-4133)51025 Avenida Mendoza Ste 201
06-4133
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00004133 '
'Property Address: 51025 AVENIDA MENDOZA
APN: 773-073-012- -
Application description: REMODEL - COMMERCIAL
Property Zoning: VILLAGE COMMERCIAL
Application valuation: 9000
T4ht
"
-,.
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
STE 201 PATRICK & MONICA ADAMS
45795 PUEBLO ROAD
38938 ELMWOOD ST
RANCHO MIRAGE , CA, I 9,'"_2=7=
Applicant: Architect or Engineer:
Ocher z'-kowieS6,sw/A.W1
G //99/
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: _ License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
a y pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
( 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
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
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 or she did not build or
improve for the purpose of sale.).
( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who -builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _) I am exempt under Sec. , B.&P.C. for this reason
Date: -- 2=2 979l Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPE%IIIT
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
CITY O[: LA QWNTA
Date:. 12/28/06
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for 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 insurance, 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 number are:
Carrier Policy Number
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,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700,of the Labor Code, I shall rthwith co ly wit thos provisi'ns. .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and -for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, an hereby a thorize r presentatives
of this /`' gory to enter ypon the ve-mentioned prop ert c JsesA.A.. ....
ate: /i i ture (Applicant or Agentl:
Application Number . . 06-00004133
------ Structure Information OFFICE T.I. SUITE 201
-----
Other struct info . .
. . . CODE EDITION
O1BMP04E0SEN
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
B
OCCUPANT LOAD
9.00
----------------------------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
991.00
Permit . . .
BUILDING PERMIT
Additional desc
OFFICE SUITE 201 T.I.
Permit Fee . . . .
108.00 Plan Check Fee
70.20
Issue Date . . . .
Valuation . .
. . 9000
Expiration Date
6/26/07
Qty Unit Charge
Per
Extension
BASE FEE
45.00
7.00 9:0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
63.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee
39.45 Plan Check Fee
9.86
Issue Date
Valuation . .
. . 0
Expiration Date
6/26/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
20.00 .7500
PER ELEC DEVICE/FIXTURE 1ST 20
15.00
21.00 .4500
----------------------------------------------------------------------------
EA ELEC DEVICE/FIXTURE >20
9.45
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
19.50 Plan Check Fee
4.88
Issue Date . . . .
Valuation . .
. . 0
Expiration Date . .
6/26/07
Qty . Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
-----------------------------------------------------------
EA MECH VENT INST/ DUCT ALT
-----------------
4.50
Permit
PLUMBING
Additional desc . .
Permit Fee . .
46.50 Plan Check Fee
11.63
Issue Date . . . .
Valuation
0
Expiration Date . . 6/26/07
LQPEIL\1IT
Application Number . . . . . 06-00004133
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 6.0000 EA - PLB FIXTURE
6.00
1.00 15.0000 EA PLB BUILDING SEWER
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1.00 3.0000 EA PLB WATER INST/ALT/REP
------------------
3.00
----------------------------------------------------------
Special Notes and Comments
MORTGAGE OFFICE T.I. @ 2ND FLR. SUITE
201.[BARRINGTON MORTGAGE]"B" OCC. TYPE
V -N CONSTRUCTION, 9 OCCUPANT LOAD.2001
CBC,CMC,2004.CEC, 2005 ENERGY CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW
7.02
ENERGY REVIEW FEE
7.02
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 213.45 .00 .00
213.45
Plan Check Total 96.57 .00 .00
96.57
Other Fee Total 14.04 .00 .00
14.04
Grand Total 324.06 .00 .00
324.06
LQPM111T
11
Building P.O. BOX 1504 APPLICATION ONLY
78-495 CALLE TAMPICO
Address 5' I -f 2s- Ave.F—ocIZQ LA QUINTA, CALIFORNIA 92253
Owner
1,.s BUILDING: TYPE CONST. "� OCC. GRP. (D Fl -fl C lE
Mailing '
Address �t 3�TE�m vom n s—,-- A.P. Number 7t3 3 073
i o
I
ANCt� Zip Tel. Legal Description LoTs ¢-2 � , F� OF s4AIT/ZJ eaR�t--h
fitk� 70 760 3aY-S'a 9 � ✓m 6144, wTq
ntractor Project Description
W NL12 a LL4-A-- t2_T
Address !t✓v�T
& Classif.
Arch., Engr.,
Designer
I
Zip
Lic.
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
TBA, ANT 'V m PRo Ue n_ , ,.T
V '%Lic. # ��- - `� '
LIC SED CONTRACTOR'S DECLARA q� _~
0
TION
I hereby affirm that I a ensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 0 usiness and Professions Code, and my license is in full force and
effect.
SIGNATURE
DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires-the-aDo1icanLfnt-such --it m fa. o er.......a ...e........... �_.,.,,. -
APPILICANT: DO NOT WRITE BELOW THIS LINE
#
SubmitI
Req'd
Rec'd
TRACKING
la Sets
Plan Check submitted
T�
Structural Cities.
Reviewed, ready for corrections
Z / O!
Truss Calcs.
Called Contact Person
z f
Energy Cales. A10
Plans picked up
18
Flood plain plan
Plans resubmitted
�Z
Grading. plan
2" Review, ready for correctio issue
Subcotitactor List
Called Contact Person
�Z
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
IN HOUSE:-
'"' Review, ready for correctionstissue
Planning Approval
Called ,Contact Per
Pub. Wks. Appr
Date of rmit issue
I
School Fees
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer Impact Fee
A.I.P.P.
Amount
I I I I I I I Total Permit Fees 1 324. to G.
John R. Hawkins
Fire Chief
Proudly serving the
Unincorporated
Areas of Riverside
County and the
Cities of:
Banning
,.
Beaumont
:-
Calimesa
4.
Canyon Lake
Coachella
Desert Hot Springs
Indian Wells
Indio
.;
Lake Elsinore
.;
La Quinta
4.
Moreno Valley
.;
Palm Desert
e•
Perris
e. -
Rancho Mirage
4.
San Jacinto
4.
Temecula
Board of Supervisors
Bob Buster,
District 1
John Tavaglione,
District 2
Jim Venable,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire_ Protection
210 West San Jacinto Avenue • Perris, California 92570 • (909) 940-6900 • Fax (909) 940-6910
December 22, 2006
Patrick Adams
38938 Elmwood Street
Rancho Mirage, CA 92270
RE: TENANT IMPROVEMENT PLAN CHECK
LAQ-06-TI-109 / Adams Building at 51025 Avenida Mendoza #201, La Quinta, CA.
You have been issued a release for a tenant improvement on an existing building. THIS IS
NOT AN OCCUPANCY PERMIT:
It is prohibited to use/process or store any materials in this occupancy that would classify it
as an "H" occupancy per Sec: 307 of the 2000 UBC.
THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION:
Install door hardware and exit signs as per Chapter 10 of the 2000 UBC.
Install Knox Lock Boxes, Models 4400, 3200 or 1300, mounted per recommended standard
of the Knox Company. Plans must be submitted to the Fire Department for approval of
mounting location/position and operating standards. Special forms are available from this'
office for the ordering of the Key Lock Boxes. This;form must be authorized and signed by
this office for the correctly coded system to be purchased. If the building/facility is protected
with a. fire alarm system or burglar alarm system, the lock boxes will require "tamper"
monitoring.
A minimum 2A10BC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a
visible location within 75' walking distance from any point in your building or suite. Fire
extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal
service tag attached to the extinguisher, or purchased from a retail store with a sales receipt
attached. A licensed fire extinguisher company must service extinguisher yearly.
ELECTRICAL PANEL BOX:
All breakers must be labeled and a clearance of 36 inches must be maintained around the
panel at all times.
OTHER REQUIREMENTS:
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072
T
Approved building address shall be placed in such a position.a to be plainly visible and legible from the street.
Said numbers shall contrast with their background.
A durable sign stating "This door to remain unlocked during business hours" shall be placed on or adjacent to
the front exit door. The sign shall be in letters not less than one inch high on a contrasting background.
Applicant/installer shall be responsible to contact the Fire Department to schedule inspections..A re -inspection
fee will be required if more than one (1) inspection is necessary. Requests for inspections are to be made at
least 72 hours in advance and may be arranged by calling (760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire Department Planning &
Engineering Staff at (760) 863-8886.
Sincerely,
Tracy Hobday
Chief Fire Department Planner
By:
Sonia Cooley
Fire Safety Specialist
EMERGENCY SERVICES DIVISION • PLANNING SECTION • INDIO OFFICE
82-675 Highway 111, 2nd FI., Indio, CA 92201 • (760) 863-8886 • Fax (760) 863-7072
Certificate of Occupancy
U = • II,,II
_
i
isa G4
OFT9 Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was . in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 51-025 AVENIDA MENDOZA, STE. 201
Use classification: COMMERCIAL Building Permit No.: 06-4133
Occupancy Group: B Type of Construction: VN Land Use Zone: VC
Owner of Building: PATRICK ADAMS Address: 51-025 AVENIDA MENDOZA
City, ST, ZIP: LA QUINTA, CA 92253
---- By: KIRK KIRKLAND
Date: JANUARY 29, 2007
Building Official
POST IN A CONSPICUOUS PLACE
7
I TITLE 24 REPORT
Title 24 Report for:
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bld . 2nd Flr. #201
51-025 Avenida Mendoza
La Quinta, CA
Project Designer:
7
Report Prepared By:
Marc Farmer
Energy and Duct Systems
40492 Clark Drive
Hemet, CA 92544
(951) 925-0100
Job Number:
03-135
Date:
11/27/2006
LA QUINTA
'1`b ary& SAFETY DEPT.
L
/ P ROVED
FGii CONSTRUCTION .
BCo'413
rTT'9 1
NOV 2 9 2006
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is
authorized by the California Energy Commission for use with both the Residential and Nonresidential 2005 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC - www.energysoft.com.
I EnergyPro 4.3 by EnergySoft Job Number. 03135 User Number. 1268 1
q OFRCIE 66f7
TABLE OF CONTENTS
Cover Page
Table of Contents
Nonresidential Performance Title 24 Forms
Form ENV -MM Envelope Mandatory Measures
Form LTG -MM Lighting Mandatory Measures
Form MECH-MM Mechanical Mandatory Measures
HVAC System Heating and Cooling Loads Summary
1
2
3
15
16
17
19
EnergyPro 4.3 by EnergySoft Job Number. 03.135 User Number: 1268
PERFORMANCE CERTIFICATE OF COMPLIANCE Part 1 of 3 PERFA
PROJECT NAME
This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the
DATE
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg.
2nd Flr. #201
11/27/2006
PROJECT ADDRESS
Marc FarmerZl--Z,7-OC.
BUILDING CONDITIONED FLOOR AREA
51-025 Avenida Mendoza La Quinta
The Principal Designer hereby certifys that the proposed building design rellresented in this set of construction documents is
CLIMATE ZONE
1 15
PRINCIPAL DESIGNER - ENVELOPE
®
TELEPHONE
Building Permit #
DOCUMENTATION AUTHOR
PHASE OF CONSTRUCTION
TELEPHONE
Checked by/Date
Energy and Duct Systems
EXISTING + ADDITION/ALTERATION
951 925-0100
Enforcement AgencyUse ,
GENERAL INFORMATION
This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the
California Code of Regulations. This certificate applies only to a Building using the performance compliance approach.
The documentation preparer hereby certifies that the documentation is accurate and complete.
DOCUMENTATION AUTHOR
DATE OF PLANS
DATE
Marc FarmerZl--Z,7-OC.
BUILDING CONDITIONED FLOOR AREA
991 Sq.Ft.
The Principal Designer hereby certifys that the proposed building design rellresented in this set of construction documents is
CLIMATE ZONE
1 15
BUILDING TYPE
®
NONRESIDENTIAL HIGH RISE RESIDENTIAL
t 1 hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to
HOTELIMOTEL GUEST ROOM
PHASE OF CONSTRUCTION
Ej
NEW CONSTRUCTION ADDITION
®
EXISTING + ADDITION/ALTERATION
STATEMENT OF COMPLIANCE
This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the
California Code of Regulations. This certificate applies only to a Building using the performance compliance approach.
The documentation preparer hereby certifies that the documentation is accurate and complete.
DOCUMENTATION AUTHOR
SIGNATURE
DATE
Marc FarmerZl--Z,7-OC.
The Principal Designer hereby certifys that the proposed building design rellresented in this set of construction documents is
consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with thi
permit application. The proposed building as designed meets the energy efficiency requirements contained in sections 110, 116,
through 118, and 140, 142, 143 or 149 of Title 24, Part 6.
ENV. LTG. MECH.
t 1 hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to
sign this document as the person responsible for its preparation; and that I am licensed in the State of
California as a civil engineer, mechanical engineer, or I am a licensed architect.
n ❑ ❑ 2. 1 affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code Section
5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed
contractor performing this work. .
n n 3. 1 affirm that 1 am eligible under Division 3 of the Business and Professions Code to sign this document
because it pertains to a structure or type of work described as exempt pursuant to Business and Professions
Code Sections 5537, 5538, and 6737.1. (These sections of the Business and Professions Code are printed in
full in the Nonresidential Manual..)
ENVELOPE COMPLIANCE
Indicate location on plans of Note Block for Mandatory Measures
ENV -1
Required Forms
PRI E VELO D IGNER - NAME
SIGNATURE
LIC. NO.
DATE
LIGHTING COMPLIANCE
Indicate Iogatio 01 plans of Note Block for Mandatory Measures
LTG -1, LTG -2
Required Forms
PRINCIP L(GHTINd DESIGNER - NAME
SIGNATURE
LIC. NO.
DATE
MECHANICAL COMPLIANCE
Indicate location on plans of Note Block for Mandatory Measures
MECH-1 MECH-2 MECH-3 MECH-5
Required Forms
PRINCIP SIGNER -NAME
SIGNATURE
LIC. NO.
DATE
CHNIC
EnergyPro 4.3 by EnergySoft User Number 1268 Job Number. 03-135 Page:3 of 19 1
AW
PERFORMANCE CERTIFICATE OF COMPLIANCE Part 2 of 3 PERF -1
PROJECT NAME DATE
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 1
11/27/2006
ENERGY COMPONENT
Standard
Design
Conditioned Floor Area
Unconditioned Floor Area
Conditioned Footprint Area
Fuel Type
Proposed
Design
sqR
sgft.
sqft.
Compliance
Margin
1
1
10 Standard__ _ ■Proposed
Space Heating
Space Cooling
Indoor Fans
Heat Rejection
Pumps & Misc.
Domestic Hot Water
Lighting
Receptacle
Process
TOTALS:
Percent better than Standard:
1.88
2.02
-0.14
1J7C-WV
"'"R'H"im
"""`"" _
DHW
P�ewnS
"�
0 20 40 60 80'100 120 140 160 180 2o0 220
kBtufsgft-n
206.81
231.07
-24.25
41.00
40.86
0.14
0.00
0.00
0.00
0.00
0.00
0.00
17.90
17.90
0.00
79.61
51.88
27.73
91.54
91.54
0.00
0.00
0.00
0.00
438.75
435.27
3.48
process)
Roof
0.8%
( 0.8% excluding
Building Orientation
Number of Stories
Number of Systems
Number of Zones
N 0 deg
Conditioned Floor Area
Unconditioned Floor Area
Conditioned Footprint Area
Fuel Type
991
0
0
Natural Gas
sqR
sgft.
sqft.
2
1
1
470
so.
Orientation
Gross Area
Glazing Area
Glazing
Ratio
Front Elevation N
470
so.
70
sgft.
14.9%
Left Elevation E)
380
so.
60
sgft.
15.8%
Rear Elevation s
o
SCA
o
SCA
0.0%
Right Elevation
3101
sgft
48
sgft
15.5%
Total
1,160
sgft.
176
sgft.
Roof
991
sgft.sgft.
0.0%
Standard Proposed LEED,.NC v22 Energy & Atmosphere Credit
Lighting Power Density 1.200 w/sgt 0.782 wisca Savings vs. Title 24: 0.79%
Prescriptive Env. Heat Loss 234 Btuth 287 Btuth EAc1 Credit: 0 Points
Prescriptive Env. Heat Gain 23,217 Btum-F 28,356 Btum-F
Remarks:
RUI11111Ud1N/11 I1111C: 11/L//VO 10:.74:�F0 1CYI1 VYUC. I IOYV/.7L00
EnergyPro 4.3 by EnergySoft User Number. 1268 Job Number. 03-135 Page:4 of 19
PERFORMANCE CERTIFICATE OF COMPLIANCE Part 3 of 3 PERF -1
PROJECT NAME DATE
` 991 Sa. Ft. T. I. Ave. Mendoza Comm. BIdq. 2nd Fir. #201 11/27/2006
The local enforcement agency should pay special attention to the items specified in this checklist These items require special written justification
and documentation, and special verification to be used with the performance approach. The local enforcement agency determines the adequacy of
the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation
submitted.
The exceptional features listed in this performance approach application have specifically been reviewed. Adequate written justification and
documentation for their use have been provided by the applicant
kuthorized Signature or Stamp
Run Initiation Time: 11/27/0616:54:48 Run Code: 1164675288
EnergyPro 4.3 by EnergySoft User Number. 1268 Job Number: 03-135 Page:5 of 19
V
CERTIFICATE OF COMPLIANCE ENVA -C
PROJECT N 991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Flr. #201 DATE1/27/2006
OPAQUE SURFACES
#
Surface
Type
Area U -Fac.
nsulation
Cay. Cont.
Act.
Am.
Tilt
Cond:
Status
Joint Appendix
IV Reference
Location / Comments
1
Roof
99 0.051
R-19
R-0.0
0
0
New
02-A5
2nd Floor 991 Sq. FL
2
Wall
32C 0.110
R-11
R-0.0
90
90
E)dsti
09-A2
2nd Floor 991 Sq. Ft.
3
Wall
3&r 0.110
R-11
R-0.0
0
90
Blisti
09-A2
2nd Floor 991 Sq. Ft.
4
Wall
262 0.110
R-11
R-0.01
270
90
E)dstin
09-A2
2nd Floor 991 Sq. Ft -
5
Wall
1 65 0.110
R-11
R-0.0
45
90
E)astin
09-A2
2nd Floor 991 Sq. R.
2nd Floor 991 Sq. Ft.
6
Window
Front
NE
25 0.720 NFRC
0.40 NFRC
45
EAsting
Double Mtl Low E 2)
2nd Floor 991 Sq. Ft.
N, E, A, R (New, Existing, Altered,
I I More than or equal to 10,000 sq.ft of stba-built fenestration area must include a label certificate either issued by NFRC or provide a CEC Default Label Certificate using the default (Yfactors from
I I Standards Tnhle 11F.A and R rladffirain shall he filed in the mntraetets nroleet effim duan mnstruetlen and in the huildina manners office after mnshuetion
#
Type
## Exterior Shade Type
Area U -Fac'
SHGC2
Act.
Am.
Cond.
Stat.
Glazing Type
Location/
Comments
1
Window
Left
E
2 0.720 NFRC
0:40 NFRC
90
E)dstl
Double MH Low E(2)
2nd Floor 991 S . .
Ft
2
Window
Left
E
36 0.720 NFRC
0.40 NFRC
90
Double MH Low E(2)
2nd Floor 991 Sq. R.
3
Window
Front
N
21 0.720 NFRC
0.40 NFRC
0
Ustin
Double MU Low E(2)
2nd Floor 991 Sq. Ft.
4
Window
Front
N
24 0.720 NFRC
0.40 NFRC
0
E)dsbng
Double MU Low E(2)
2nd Floor 991 Sq. Ft.
5
Window
Right
48 0.720 NFRC
0.40 NFRC
270
E)dstin-q
Double Mtl Low E(2)
2nd Floor 991 Sq. Ft.
6
Window
Front
NE
25 0.720 NFRC
0.40 NFRC
45
EAsting
Double Mtl Low E 2)
2nd Floor 991 Sq. Ft.
1) U4'actor Type: 116A Default Table from Standards, Table NI -1 Default Table from me ACM Manual Appendix, NFRC Labeled value.
2) SHGC Type: 1168 Default Table from Standards, COG Center of Glass, NFRC Labeled Value
EXTERIOR SHADING
## Exterior Shade Type
SHGC
Window Overhang Left Fin Right Fin
Hgt. Wd. Len. H t. LExt.RExt. Dist. Len. Hgj. Dist. Len. H t.
1 None
0.76
2 None
0.76
3 None
0.76
7.0 3.0 6.0 0.1 6.0 6.0
4 None
0.76
5 None
0.76
6 None
0.76
MINIMUM SKYLIGHT AREA FOR LARGE ENCLOSED SPACES
The proposed building Is In climate zones 2 through 15 and contains an enclosed space with floor area greater than 25,E ft2, a ceiling height greater than 15 feet, and an LPD for general
lighting of at least 0.5 WIR2. See Section 143(c} H this box Is checked, ENV4C must be filled out. when submitting under the Prescriptive Compliance Approach.
I EnergyPro 4.3 by Enerf7VSoft User Number 1268 Job Number. 03-135 Pane:6 of 19 1
CERTIFICATE OF COMPLIANCE (Part 1 of 3) LTG -1 -C
PROJECT NAME DATE
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 11/27/2006
INSTALLED INDOOR LIGHTING POWER FOR CONDITIONED AND UNCONDITIONED SPACES
INSTALLED LIGHTING, CONDITIONED SPACES (From LTG -2-C)
PORTABLE LIGHTING (From LTG -3-C)
LIGHTING CONTROL CREDIT, CONDITIONED SPACES (From LTG4-C)
CONDITIONED SPACE ADJUSTED INSTALLED LIGHTING POWER
INSTALLED LIGHTING, UNCONDITIONED SPACES (Fran LTG -2-C)
LIGHTING CONTROL CREDIT, UNCONDITIONED SPACES (From LTG3-C)
UNCONDITIONED SPACE ADJUSTED INSTALLED LIGHTING POWER
INSTALLED
WATTS
775
0
0
775
0
0
0
ALLOWED INDOOR LIGHTING POWER FOR CONDITIONED SPACES
❑ COMPLETE BUILDING METHOD (From LTG -6-C) ALLOWED
❑ AREA CATEGORY METHOD (From LTG -6-C) WATTS
❑ TAILORED METHOD (Fran LTG -6-C) ALLOWED LIGHTING POWER F 775
ALTERNATE COMPLIANCE
❑X PERFORMANCE METHOD
❑ COMMMON LIGHTING SYSTEM (Fran LTG -8-C)
ALLOWED INDOOR LIGHTING POWER FOR UNCONDITIONED SPACES From LTG -5 -Cl 0
MANDATORY DOOR AND DAYUGHTING AUTOMATIC CONTROLS
CONTROL LOCATION CONTROL CONTROL TYPE Check if NOTE TO
(Room 1) IDENTIFICATION (Auto Trme Switch, Dimming, etc.) SPACE CONTROLLED Daylighting .FIELD
EnergyPro 4.3 by EnergySoft User Number. 1268 Job Number 03135 Page:7 of 19
ERTIFICATE OF COMPLIANCE (Part 3 of 3) LTG -1 -C
PROJECT NAME
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Flr. #201
DATE
11/27/2006
Designer:
This form is to be used by the designer and attached to the plans. Listed below are all the acceptance
tests for lighting systems. The designer is required to check the boxes by all acceptance tests that
apply and list all equipment that require an acceptance test. If all equipment of a certain type requires
a test, list the equipment description and the number of systems to be tested in parentheses. The NJ
number designates the Section in the Appendix of the Nonresidential ACM Manual that describes the
test. Also indicate the person responsible for performing the tests (i.e. the installing contractor, design
professional or an agent selected by the owner). Since this form will be part of the plans, completion
of this section will allow the responsible party to budget for the scope of work appropriately.
Building Departments:
Before an occupancy permit is granted for a newly constructed building or space, or a new lighting
system system serving a building or space is operated for normal use, all control devices serving the
building or space shall be certified as meeting the Acceptance Requirements for Code Compliance.
In addition a Certificate of Acceptance, LTG -1-A, Forms shall be submitted to the building department
that:
A. Certifies plans, specifications, installation certificates, and operating and maintenance
information meet the requirements of §10-103(b) and Title 24 Part 6.
Test Description
Test Performed By:
❑ LTG -2-A: Lighting Control Acceptance Document
- Occupancy Sensor Acceptance
- Manual Daylight Controls Acceptance
- Automatic Time Switch Control Acceptance
Equipment requiring acceptance testing
❑ LTG -3-A: Automatic Daylighting Controls Acceptance Document
Equipment requiring acceptance testing
I EneravPro 4.3 by EneravSoft User Number 1268 Job Number. 03-135 Pagel of 19 1
CERTIFICATE OF COMPLIANCE MECH-1-C
PROJECT NAME VAI L
991 So. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 11
uesigner:
This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for mechanical systems. The designer is required to
check the boxes by all acceptance tests that apply and list all equipment that requires an acceptance test. If all equipment of a certain type requires a test, list the
equipment description and the number of systems to be tested in parentheses. The.NJ number designates the Section in the Appendix of the Nonresidential
ACM Manual that describes the test. Also indicate the person responsible for performing the tests (i.e. the installing contractor, design professional or an agent
selected by the owner). Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work
appropriately.
Building Departments:
SYSTEM ACCEPTANCE. Before an occupancy permit is granted for a newly constructed building or space, or a new space -conditioning system serving a
building or space is operated for normal use, all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for
Code Compliance.
In addition a Certificate of Acceptance, MECH-1-A Form shall be submitted to the building department that certifies plans, specifications, installation
certificates and oneratina and maintenance information meet the reou cements of Section 10-103(b) and Title 24 Part 6.
STATEMENT OF COMPLIANCE
❑ MECH-2-A: Ventilation System Acceptance Document
-Variable Air Volume Systems Outdoor Air Acceptance
-Constant Air Volume Systems Outdoor Air Acceptance
Equipment requiring acceptance testing
Test required on all New systems both New Construction and Retrofit.
❑ MECH-3-A: Packaged HVAC Systems Acceptance Document
Equipment requiring acceptance testing
Test required on all New systems both New construction and Rebuilt
❑ MECH-4-A: Air -Side Economizer Acceptance Document
Equipment requiring acceptance testing
Test required on all New systems both New Construction and Retrofit. Units with economizers that are installed at the factory and certified with the
commission do not require equipment testing but do requite consbttction inspection.
❑ MECH-5-A: Air Distribution Acceptance Document
Equipment requiring acceptance testing
This test required N the unit serves 5 000172 of space or less and 25% or more of the ducts are in noncondiboned or semicondibaned space like an
attic. New systems that meet the above requirements. Retrofit systems that meet Me above requirements and either extend duct; replace ducts cr
replace the packaged unit.
❑ MECH-6-A: Demand Control Ventilation Acceptance Document
Equipment requiring acceptance testing
All new DCV controls Installed on new or existing packaged systems must be tested.
❑ MECH-7-A: Supply Fan Variable Flow Control Acceptance Document
Equipment requiring acceptance testing
All new VAV fan volume controls installed on new or existing systems must be tested
❑ MECH-8-A: -Hydronic System Control Acceptance Document
-Variable Flow Controls Applies to chilted and hot water systems.
-Automatic Isolation Controls Applies to new boilers and chillers and the primary pumps we connected to a common header.
-Supply Water Temperature Reset Controls
Applies to new constant flaw chilled and hot water systems that have a design capacity greater than crequal to 500,000 Bfu/Ar.
-Water400p Heat Pump Controls
Applies to all new waterloop heat pump systems where the combined loop pumps are greater than 5 hp.
-Variable Frequency Controls Applies to all new distribution pumps on new variable f w chilled, hydronic heat pump
or condenser water systems where Me pumps motors are greater than 5 hp.
Equipment requiring acceptance testing
EnergyPro 4.3 by EnergySoft User Number. 1268 Job Number. 03-3 135 Page:9 of 19
INDOOR LIGHTING SCHEDULE (Part 1 of 2) LTG -2-C
PROJECT NAME DATE
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 11/27/2006
INSTALLED LIGHTING POWER FOR CONDITIONED SPACES
Luminaire
Lamps/Ballasts
Installed Watts
C
D
E
F
G
H
I
J
Name
Type Description
v
C C
Q
°rim
fDA
3m
c'm
Cdr
3w3
gRv
0)
N 0
C
3!
g px
m
N
o i'm.
v0
r
C z.
7ZC
3
Cr
m
y
j
Li .
xdm
°'a
Yes
No
(1) 9w Compact Fluorescent Quad 2 Pin
sw G23-21
1
9
1.0
13.0
X
11
13
(2) 4 ft Fluorescent T8 Elec
2
3
10
62.0-X—
6 82
40w Wall Mount Incandescent
W
1
40
40.0
X
2
80
PAGE TOTAL 775
BUILDING TOTAL (sum of all pages) 775
PORTABLE LIGHTING (From LTG -3-C)
CONTROL CREDIT (From LTG -4-C) O
ADJUSTED ACTUAL WATTS 775
I EneravPro 4.3 by EnerwSoft User Number. 1268 Job Number. 03-135 Page: 10 of 19 1
s
AIR SYSTEM REQUIREMENTS Part 1 of 2 MECH-2-C
.� (PROJECT NAME DATE
L 991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 11/27/2006
SYSTEM FEATURES
ITEM OR SYSTEM TAG(S)
Number of Systems
T-24
MANDATORY MEASURES Section
Heating Equipment Efficiency
Cooling Equipment Efficiency
Heat Pump Thermostat
Furnace Controls
Natural Ventilation
Minimum Ventilation
VAV Minimum Position Control
Demand Control Ventilation
Time Control
Setback and Setup Control
Outdoor Damper Control
Isolation Zones
Pipe Insulation
Duct Insulation
PRESCRIPTIVE MEASURES
Calculated Heating Capacity x 1.43 2
Proposed Heating Capacity 2
Calculated Sensible Cooling Capacity x 1.212
Proposed Sensible Cooling Capacity 2
Fan Control
DP Sensor Location
Supply Pressure Reset (DDC only)
Simultaneous Heat/Cool
Economizer
Heating Air Supply Reset
Cooling Air Supply Reset
Duct Sealing for Prescriptive Compliance
1: For each central and single zone air systems (or group of similar units) fill in the reference to sheet number and/or specification section and paragraph number where the
required features are documented. If a requirement is not applicable, put "N/A" in the column.
2: Not required for hydronic heating and cooling. Either enter a value here or put in reference of plans and specificatons per footnote 1.
3: Enter Yes if System is: Constant Volume, Single Zone; Serves < 5,000 sqft; Has > 25% duct in unconditioned space. Duct sealing is required for Prescriptive Compliance,
see PERF -1 for performance method dud sealing requirements.
AIR SYSTEMS, Central or Single Zone
991 Sq.ft. Office HVAC
System
Reference on Plans or Specification I
112(a)
80% AFUE
112(a)
12.0 SEER / 11.2 EER
112(b)
n/a
112(c), 115(a)
n/a
121(b)
Yes
121(b)
149 cfm
121 c
No
121(c)
No
121(c), 122(e)
Program able Switch
122(e)
Heating & Cooling Required
122
Auto
122(g)
n/a
123
124
R-4.2
144 a & b
n/a
144 a & b
51,000 btuh
144 a & b
n/a
144 a & b
19,235 btuh
144 c
Constant Volume
144 (c)
144 c
Yes
144 d
No
144 a
No Economizer
144
Constant Tem
144 (f)
Constant Temp
144 (k)
No
n
WATER SIDE SYSTEM REQUIREMENTS Part 2 of 2 MECH-2-C
IPRaIECTNAME991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 DAT
11/27/2006
YSTEM FEATURES
2 WATER SIDE SYSTEMS: Chillers, Towers, Boilers, Hydronic Loops
ITEM OR SYSTEM TAG(S)
Number of Systems
T-24
MANDATORY MEASURES Section Reference on Plans or Specification
Equipment Efficiency 112(a)
Pipe Insulation 123
PRESCRIPTIVE MEASURES
Calculated Capacity
Proposed Capacity
Tower Fan Controls
Tower Flow Controls
Variable Flow System Design
Chiller and Boiler Isolation
CHW and HHW Reset Controls
WLHP Isolation Valves
VSD on CHW, CW & WLHP Pumps > 5
HP
DP Sensor Location
1: For each chiller, cooling tower, boiler, and hydronic loop (or groups of similar equipment) fill in the reference to sheet number and/or specification section and paragraph
number where the required features are documented. if a requirement is not applicable, put -WA- in the column.
2: Water side systems include wet side system using other liquids such as glycol or brine.
Service Hot Water, Pool Heating
ITEM OR SYSTEM TAG(S) DHW Heater
Number of Systems 1
MANDATORY MEASURES Reference on Plans or Specification'
Water Heater Certification
Water Heater Efficiency
Service Water Heating Installation
Pool and Spa Efficiency and Control
Pool and Spa Installation
Pool Heater - No Pilot Light
Spa Heater - No Pilot Light
113 a
113 b
113 c
114 a
114 b
115(c)
115
CHRONOMITE LABS MF -
200C W40VAC
n/a
n/a
n/a
n/a
1: For each water heater, pool heat and domestic water loop (or groups of similar equipment) fill in the reference to sheet number and/or specification section and
paragraph number where the required features are documented. If a requirement is not applicable, put "NIX ins the column.
NOTES TO FIELD - For Building Department Use Only
Run Initiation Time: 11/27/0616:54:48 Run Code: 1164675288
EnergyPro 4.3 by EnergySoft User Number. 1268 Job Number 03135 Page:12 of 19
MECHANICAL VENTILATION MECH-3-C
PROJECT NAME DATE
991 Sq Ft T I Ave. Mendoza Comm. Bldg. 2nd Fir. #201 1
11/27/2006
PRESCRIPTIVE REHEAT
LIMITATION Section 144(d))
MECHANICAL VENTILATION Section 121
b 2
AREA
BASIS
OCCUPANCY
BASIS
VAV MINIMUM
A
B
C
D
E
F
G
H
I
J
K
L
M
N
ZONE/SYSTEM
A
D
.. 0
a
m90
c
SIC
n T
` °' 3
Z
M3
M
f
o
-.
Ma
O M
7
'
m05
DICT
v
m 3
O0 IQ
000
ii ,y,G
y
<
to m'
M*
D7
3
nloo
n0
v '.
to
m
C
A
"
cis
Ca3m
U)
n0
_
C -
3-
m 0
03:
7 7
- '
D
m
0
f
D
d Floor 991 Sq. Ft.
2nd
99
0.15
149
149
149
991 Sq.ft. Office HVAC System
Total
149
149
C Minimum ventilation rate per Section 121, Table 121-A
E Based on fbced seat or the greater of the expected number of occupants and 50% of the CBC occupant load for egress purposes for spaces without fixed seating.
H Required Ventilation Air (REQ'D VA) Is the larger of the ventilation rates calculated on and AREA or OCCUPANCY BASIS (column D or G).
I Must be greater than or equal to H, or use Transfer Air (column N) to make up the difference.
J Design fan supply cfm (Fan CFM) x 30%; or
K Condition area (ft sq.) x 04 dmilt sq.; or
L Maximum of Columns H, J, K, or 300 dm
M This must be less than or equal to Column L and greater that or equal to the sum of Columns H + N.
N Transfer air must be provided where the Required Ventilation Air (column 1) is greater than the Design Minimum Air (column M). Where required, transfer air must be greater than or equal
to the difference between the Required Ventilation Air (column 1) and the Design Minimum Air (column M), column H - M.
EnergyPro 4.3 by EnergySoft User Number. 1268 Job Number. 03135 Page: 13 of 19
MECHANICAL EQUIPMENT DETAILS
Part 1 of 2 MECH-5-C
PROJECT NAME DATE
991 So Ft T I Ave_ Mendoza Comm_ Blda. 2nd Fir. #201 11/27/2006
CHILLER AND TOWER SUMMARY
I Efficiency
Tons
PUMPS
System Name
System TvDe
Equipment Name
Equipment Type
Qty.
Tot.
Qty
GPM
BHP
Motor
Eff.
Drive
Eff.
Pump
Control
Split DX
1
51,000
0.
'80%AFUE
29,40012.0
SEER/ 11.2 EER
Existing
No Economizer
D BOILER SUMMARY
Energy I Standby ANn INJUL.
Rated 1 Vol. Condition Factor Loss or Ext
System Name System Type Distribution Type Qty Input (Gals.) Status or RE Pilot R Val.
HRONOMITE LABS MF- Instant Elec Point of Use 1 31.,400 0 Existi 0.98 n/a n/a
r 0- r IAnver n9
CENTRAL SYSTEM RATINGS
HEATING
COOLING
System Name
System TvDe
Qtv
Outout
Aux.
kW
Eff.
outout
Efficienc
Condition
Status
EconomizerType
8/t%n S E 12.0 SEEER 2-
Split DX
1
51,000
0.
'80%AFUE
29,40012.0
SEER/ 11.2 EER
Existing
No Economizer
ENVELOPE MANDATORY MEASURES ENV -MM
PROJECT NAME 991 Sa. Ft. T. I. Ave. Mendoza Comm. Bid4. 2nd Fir. #201 IDATE 11/27/2006
DESCRIPTION
Designer
Enforcement
§11 8(.) Installed Insulating Material shall have been certified by the manufacturer to comply
with the California Quality Standards for insulating material, Title 20, Chapter 4, Article
3.
X❑ § 118(c) All Insulating Materials shall be installed in compliance with the flame spread rating
and smoke density requirements of Sections 2602 and 707 of Title 24, Part 2.
RX § 117(a) All Exterior Joints and openings in the building that are observable sources of air
leakage shall be caulked, gasketed, weatherstripped or otherwise sealed.
0 §116(b) Site Constructed Doors, Windows and Skylights shall be caulked between the unit
and the building, and shall be weatherstripped (except for unframed glass doors and
fire doors).
§ 116(a)1 Manufactured Doors and Windows installed shall have air infiltration rates not
exceeding those shown in Table Number 1-E. of the Standards. Manufactured
fenestration products must be labeled for U -value according to NFRC procedures.
§118(e) Demising Walls in Nonresidential Buildings:
The opaque portions of framed demising walls in nonresidential buildings shall have
insulation with an installed R -value of no less than R43 between framing members.
EnergyPro By EnergySoft User Number. User Job Number: 03-135 Page: 15 of 19
LIGHTING MANDATORY MEASURES LTG -MM
PROJECT NAME DATE
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 11/27/2006
DESCRIPTION
Designer
Enforcement
F] §131(d)1 For every floor, all interior lighting systems shall be equipped with a separate automatic
control to shut off the righting. This automatic control shall meet the requirements of
Section 119 and may be an occupancy sensor, automatic time switch, or other device
capable of automatically shutting off the lighting.
F] §131(d)2 Override for Building Lighting Shutoff: The automatic building shutoff system is
provided with a manual, accessible override switch in sight of the lights. The area
of override is not to exceed 6,000 square feel
F§119(h) Automatic Control Devices Certified: All automatic control devices specified are
certified, all alternate equipment shall be certified and installed as directed by the
manufacturer.
F§111 Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for
the project are certified and listed in the Directory. All installed fixtures shall be
certified.
§132 Tandem Wiring for One and Three Lamp Fluorescent Fixtures: All one and three
lamp fluorescent fixtures are tandem wired with two lamp ballasts where required
by Standards Section 132; or all one and three lamp fluorescent fixtures are
specified with electronic high -frequency ballasts and are exempt from tandem
wiring requirements.
0 §131(a) Individual Room/Area Controls: Each room and area in this building is equipped
with a separate switch or occupancy sensor device for each area with floor -to -
ceiling walls.
n§131(b) Uniform Reduction for Individual Rooms: All rooms and areas greater than 100
square feet and more than 0.8 watts per square foot of lighting load shall be
controlled with bi-level switching for uniform reduction of lighting within the room.
§131(c) Daylight Area Control: All rooms with windows and skylights that are greater than
260 square feet and that allow for the effective use of daylight in the area shall
have 60% of the lamps in each daylit area controlled by a separate switch; or the
effective use of daylight cannot be accomplished because the windows are
continuously shaded by a building on the adjacent lot. Diagram of shading during
different times of the year is included on plans.
® §131(e) Display Lighting. Display lighting shall be separately switched on circuits that
are 20 amps or less.
EnergyPro 4.3 by EnergySoft User Number. 1268 Job Number. 03135 Page: 16 of 19
MECHANICAL MANDATORY MEASURES Part 1 of 2 MECH-MM
PROJECT NAME DATE
991 So. Ft. T. I. Ave. Mendoza Comm. Bldq. 2nd Flr. #201 _11/27/2006
DESCRIPTION
Designer
Enforcement
Equipment and Systems Efficiencies
0 §111 Any appliance for which there is a California standard established in the Appliance
Efficiency Regulations will comply with the applicable standard.
a§ 115(a) Fan type central furnaces shall not have a pilot Iight.
n§ 123 Piping, except that conveying fluids at temperatures between 60 and 105 degrees
Fahrenheit, or within HVAC equipment, shall be insulated in accordance with
Standards Section 123.
FX § 124 Air handling duct systems shall be installed and insulated in compliance with
Sections 601, 602, 603, 604, and 605 of the 2001 CIVIC Standards.
Controls
§ 122(e) Each space conditioning system shall be installed with one of the following:
§ 122(e)1A Each space conditioning system serving building types such as offices and
manufacturing facilities (and all others not explicitly exempt from the requirements
of Section 112 (d)) shall be installed with an automatic time switch with an
accessible manual override that allows operation of the system during off -hours for
up to 4 hours. The time switch shall be capable of programming different
schedules for weekdays and weekends and have program backup capabilities that
prevent the loss of the device's program and time setting for at least 10 hours if
power is interrupted; or
F] § 122(e)1B An occupancy sensor to control the operating period of the system; or
F] § 122(e)1C A 4 -hour timer that can be manually operated to control the operating period of the
system.
§ 122(e)2 Each space conditioning system shall be installed with controls that temporarily
restart and temporarily operate the system as required to maintain a setback
heating and/or a setup cooling thermostat setpoint.
§ 122(g) Each space conditioning system serving multiple zones with a combined
conditioned floor area more than 25,000 square feet shall be provided with isolation
zones. Each zone: shall not exceed 25,000 square feet; shall be provided with
isolation devices, such as valves or dampers, that allow the supply of heating or
cooling to be setback or shut off independently of other isolation areas; and shall
be controlled by a time control device as described above.
® § 122(aft) Each space conditioning system shall be controlled by an individual thermostat
that responds to temperature within the zone. Where used to control heating, the
control shall be adjustable down to 55 degrees F or lower. For cooling, the control
shall be adjustable up to 85 degrees F or higher. Where used for both heating and
cooling, the control shall be capable of providing a deadband of at least 5 degrees
F within which the supply of heating and cooling is shut off or reduced to a
minimum.
0 § 122(c) Thermostats shall have numeric setpoints in degrees Fahrenheit (F) and adjustable
setpoint stops accessible only to authorized personnel.
X❑ § 112(b) Heat pumps shall be installed with controls to prevent electric resistance
supplementary heater operation when the heating load can be met by the heat
pump alone.
EnergyPro By EnergySoft User Number. User Job Number. 03135 Page: 17 of 19
MECHANICAL MANDATORY MEASURES Part 2 of 2 MECH-MM
ii PROJECT NAME DATE
991 So. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Fir. #201 1
11/27/2006
Description
Designer
Enforcement
Ventilation
r§ 121(e) Controls shall be provided to allow outside air dampers or devices to be operated at
the ventilation rates as specified on these plans.
§ 1220 Gravity or automatic dampers interlocked and closed on fan shutdown shall be
provided on the outside air intakes and discharges of all space conditioning and
exhaust systems.
§ 1 0 All gravity ventilating systems shall be provided with automatic or readily accessible
manually operated dampers in all openings to the outside, except for combustion air
openings.
§ 121(f)1 Air Balancing: The system shall be balanced in accordance with the National
Environmental Balancing Bureau (NEBB) Procedural Standards (1983), or
Associated Air Balance Council (AABC) National Standards (1989); or
XJ § 121(f)2 Outside Air Certification: The system shall provide the minimum outside air as
shown on the mechanical drawings, and shall be measured and certified by the
installing licensed C-20 mechanical contractor and certified by (1) the design
mechanical engineer, (2) the installing licenced C-20 mechanical contractor, or (3) the
person with overall responsibility for the design of the ventilation system; or
§ 121(f)3 Outside Air Measurement: The system shall be equipped with a calibrated local or
remote device capable of measuring the quantity of outside air on.a continuous
basis and displaying that quantity on a readily accessible display divice; or
0 § 121(f)4 Another method approved by the Commission.
Service Water Heating Systems
§113(b)2 If a circulating hot water system is installed, it shall have a control capable of
automatically turning off the circulating pump(s) when hot water is not required.
0 § 113(c) Lavatories in restrooms of public facilities shall be equipped with controls to limit the
outlet temperature to 110 degrees F.
EnergyPro By EnergySoft User Number. User Job Number. 03-135 Page: 18 of 19
t
s
-IVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
PROJECT NAME
991 Sq. Ft. T. I. Ave. Mendoza Comm. Bldg. 2nd Flr. #201
DATE
11/27/2006
SYSTEM NAME
991 S .ft. Office HVAC System
FLOOR AREA
991
Outside Air (cfMsgft) 1 0.15
Note: values above
IEATING SYSTE
25.0 ° F
Outside Air
149 cfm
69.3 OF
SYSTEM LOAD
Total Room Loads
Return Vented Lighting
Return Air Ducts
Return Fan
Ventilation
Supply Fan
Supply Air Ducts
TOTAL SYSTEM LOAD
COIL COOLING PEAK
I COIL HTG. PEAK
CFM
ISensiblel
Latent
CFM
I Sensible
3,814
32,440
3,94
601
19,963
68.5% R.H. ROOMS
0
1,622
998
0
0
149
5,189
-930
149
6,844
0
0
1,622
998
40.873F 3,0117 28 803
80% AFUE 12.0 SEEER 2-1/2 ton Sys 19,235 9,881 51,000
Total Adjusted System Output 19235 9881 51 000
(Adjusted for Peak Design Conditions)
TIME OF SYSTEM PEAK Jul 3 pm Jan 12 am
at ARI conditions i L_
YCHROMETRICS (Airstream Tel
64.2 OF 101.90F
Heating Coil
0.
Supply Fan
1270 cfm
101.QOF
—� Supply Air Ducts
101.2 OF
ROOMS
70.0 OF
f% Return Air Ducts `i
12.0/77.9 OF 83.0/71.5OF 68.8/66.6 OF 68.8/66.6 OF
- - *- 5 Su I Air Ducts
Outside Air
149 cfm
79.2/70.6 OF
Cooling Coil
0--
ppY
Supply Fan
70.0 / 67.0 OF
1270 cfm
68.5% R.H. ROOMS
6 Return Air Ducts y
78.0/70.2 OF
EneravPro 4.3 by ErtergySoft User Number. 1268 Job Number. 03135 Page: 19 of 19 1
T4tv,,
W "
78-105 CALLE ESTADO = LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
FAX (619) 564-5617
March 18,,1993
Mr. & Mrs. Peggy Otis
P.O. Box 8097
Anaheim, CA 92803
Dear Mr. & Mrs. Otis:
The wall at 151-035 Mendoza has been removed the satisfaction of
this Department.
Thank you for your cooperation on this matter.
Sincerely,
BUILDING AND SAFETY DEPARTMENT
Tom Hartung
Director of Building and Safety
kt
cc: Bonded Rigging
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
P.O. BOX 1504 TdY4J,
No. 10682
Building
Address 51$035 MENDOZA LA QUINTA CALIFORNIA 92253 7
Owner
.. PETER & PEGGY OTIS ]BUILDING: TYPE CONST. - OCC: GRP.
Address P 0 BOX 8097
A.P. Number
City ANAHEIM, CAZip
Tel.
isA—@8*N1F*
192803
1714-099-0553
Legal Description
Project Description
RESIDENT DEMOLITION
Contractor
BONDED RIGGING & HEAVY TRANSPORT
Address
P 0 BOK 1774
CityZip
RANCHO &IRA fi
92270
Tel.:
325-5523
State Lic.
City
& Classif. A, C-21, HAZ ASB
Lic. #
Sq. Ft.
No. No. Dw.
,
Size
Stories Units
Arch., Engr.,
• Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am 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
_reffect.
t SIGNATURE " DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
Permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
❑ 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, Buisness 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.)
Estimated Valuation
Q 1 4
Y 3
PERMIT
AMOUNT
Dep.
Plan Chk. Bal.
COf1St. $pQ
Mech.
Electrical
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct 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 who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason
S.M.I.
Grading
Driveway Enc.
Date Owner
Infrastructure
Demolition
$30.00
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
3 a
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the perm/t is for one hundred dollars ($100) valuation
or less.)
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.
REMARKS
i
3.L1 f;+i.: j-3 ;: i U j AL 1
Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
FINAL DATE
Side Street Setback from Center Line
Side Setback from Property Line
INSPECTOR
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives .of this city to enter the above-.
mentioned property for inspection purposes.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES .r
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT, ®
CAR P. Q. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPIEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP POLE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® VVac
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPIEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
/
GJ
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION '•
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Sgp")v y,COagt
-ty• ,
Mai gz:mrnt l3 ict
M,.+MrblSrv.r " "r
AS'BZSTOS DEMOLITION/RENOVATION NOTIFICATION
rROJECI' JCB #&o4 __- ___-- i)Cancellation Revision (Protect Dates) Revision (ocher)
For Cancrllattoo or Revision, 1`111 out scttons 1403(d)(1)(A)(1), (if), 0v) avid others that apply.
` Notif:
Completed By:_.t-.._Date: ppl) c1,- i c, a
Date Rec:
Company:3onded Ripg i.tlp Telephone: ( 619) 325 55_2,3
YAit, TO: POSTMARK:
South Coast Air Quality Management bitvtrict Status Code:
Hazardous Materials Section/Enforcement
9150 Flair Drive Quarter:
El Monte$ CA 91731
Entered By:
SCAQXD—t1SE-0NLY—
} 1403(d)(1)(A) 1,'M Vr'ItTI'I N ONLY$ Incomplete No !lcadou will irtsutt to Enforcement Action.
1 , d):(i)(,A)(i) olzeretor/Coatruetpr. (For a Demolition Job, please fist Demolition & Renovation Conttiaors.)
Name:Bonded Rigging, & Heavy Transport
Address: p 0 Box 1 774
City, State Zip -code: Hancho Mirage, Ca 92270
_... -` Site Supervising Person: Edward Gonzales
` r
hone: Fele
. P (619) 346 1.307 _
1.403(dl(1)(A)(t) Property Owuer(s).
Name: Peter T. and Peggy Otis
Address: 1301 Arroyo Lindo Drive
City, S tate Zip -code: Santa Ana, Ca* 92705
Contact Person: p e p s y Otis
Telephone: ( 714) 731-6204
i :i'(d?(;l)(,4) (11) Facility location. (Please we tadee whets indicated)
Site dame:
Street Address: 51-035 Calle rdendoza
City, State ZiCode: La Quinta, Ca 92253
' ountr. Riverside
i DeI17ol1tI0i3 f e ition: D ,)emolltioo , em&M Qrdesrd Demolition me
y Renovation
Y443(d}(1)(A,}(iii) FvzctltlY IDebc luoi , Rkact we code: where indicated)
x'
Size (Sq. F°t: :-1600 s f t
y `1
Age cars : 1950
Number of Floors: 1
Building e : R L mmeroial HospiW Industrial Dirks ,!ubtic Building Raidem 'Behovl
Prior Use , iz LommeKW 1Joq9W Jnduarw QKtce Vuelis Euiwltta 2rsidcna School
Number of Dwelila Units:- ' `i`
f 3 (For Rssidartcs Only) - r
Work Location (Described: `Throughout
1403(d)(:)(A)(ty) Project Dates.
Start Date: 2130/ 92
Completion mate: 3/05/92 SCAQMD Rule 1403 Notification Form (1403.FM Page i of 2
P1ROJECr JOB
1403(d)(1)(A)(v)1r41ratt Worts Practices ao�,� s�lateeNltg Cowro!s., oteftmoce IM3(d)(1)(0)(1) tbrottgh (v),
Z?CeQiilYC: jet / A c,,w (1odicste 1, 2, a, 4, or S. Vic multiple it applicable. 4 & S Require Astochmenu.)
'140(d)(1)(A)(4) Amount of Friable, Class 1, and Glass It nontriable Asbestos Containing Material (ACM).
Friable Lip -ear Feet: tit/A
Square Feta:
Class I Unear Feet:
Square Feet:
1Y 3.14 d - (Dtotnescr or Pipe and ACM in Feet)
Unear Ft. Equivaient (Sq.Ft.) . (TI )(d)(Unear Ft.)
Surface A eQ Equivalent.- N / A (fb'IA►L o(Unear Feet Equivalent and Square Feet (Friable and Clue i))
Class );i. Linear Peet:
Square meet: N / A
Surface Ana Egalvalent: NIA CrOTAL of Linear Fest Equiv%knt and Square Feet (Ctau 11))
Dexcil-ile Friable:
Clcss I. N / A
Citts9 If:
i4&Rd,)(0(A)(vi1) Waste Disposal Site.
Landfill wine: N/A
Address:
City, State Zlp•code:
Permit #:
Promdurtl to be followtd it unexpected asbestos is found or tnontriable ACM becomes triable.
N/A
1403(d)(1)(A)(lx). Pmf or California State ConttractorCertitltntlou and Cal/OSHA Registration.
Contractors Ucexsse #: 529442-A, C- 21, H a z, A s b
000SHA Registration #:
1403(d)(1)(A)(x) Lomdoz of otr-site storage arca forrasbestos containing waste mrterial.
Iti / A
14M(d)(1)(A)(A) Name ottmatporttr(s) used to transport waste to disposal slta..
N/A
Emergency R,tnovv>tatlon. `
Autlno>; ized. Person: N / A
Telephone:
11103(d)(1)(B)(0) Energeocy (Ordered) Demolition. (! %o ordered the demolition?)
Agency:
Name: N / A
Title:
Telephone-.
Authority:
SCAQMD Rule 1403 Notification Form (1403.FRM) Page 2 of 2
'11
till•; ,
�}a• +
AMS HATEC
03i1Ci42 17tela is i�19 369 3146.
t s
}SAMLES- ANALYSIS REPORTK
Report ootot 4$/03/9!
%mq! jo0 lot 1 00759C01
CUst9tixrI pomonP volley Cqui.pwnt Rontel ine.
kenc it�om g
i'300 Pornohe
Blvd -CA' of�6a intpootlert Oeter 0;/04/Oi
lna ctort Not Applicable 0
dob kantOi Vacant Rtsldence Pepe Nu*ert 1
Job+N"umbers NONE b10S5 Avd Handalo
La 6uints, cA
opo..cre♦aprrCCCeeeet
►6tneYfsePP.df-L•S.EV4R�calCCLtCcecauYlE.vecCei7VLPf P►r.aeOCN Pa.ebntrlCprbpue�saPpep PfatlaPP9PPf,1sM:allia6l6lOpOq
semis a�bcrr 1 z 3 sAMP@ o�t:cttintt611 ago lOGaitON
1pWago Cabo oto
ut>)retOry WLpbor:
$6509
36510
36511
�651Y
l
b9�,Astoa i+rsooi�t l
N
N
A
�
L"
Ac�estas
tvr�6
0
0
0
'ntNoilr. fiborts
AW
hpHCR,ktAUS
0
0
yermlculitot
0
,r
attlICP1/Y VPf��a9t
ti+ry00ti10)
00
06
OQ
00
e�silot.
00
00
00
00
x
CrpCidOtjtai
00
00
00
Go
C61tIt®:
tre�tltol
00
00
00
00
x
Aatlaolttet
00
00
Oo
00
I
Ant hc'fhy'tlitoI
00,
oo•y
00
00
,� t1ll,1fiKlAlSt
�►vf:►tpt9¢Otrlu•
tlev� 4+col;
0
0
D
0
k�in4reie!
K
n
x
x
ilbroua COW
0
0
0
0
'ntNoilr. fiborts
0
0
0
0
yermlculitot
0
0
10
0
coituloiol
K
Y,
x
x
WPod1
0
0
0
0
C61tIt®:
a
0
n
0
84-mler/0 (tort
x
0
0
0
sPruter gatcrfelr
0
0
0
Q
for:
0
0,
n
0
eAcr motbfia; it
0
khat m4teriII 21
0
a
0
0
G het istsritt. for sirr*le .2t Paint
tffid of,
1 Nett Dlavtor
Wroom 01
2 stall Kloster
bedroom 0
3 Welt 1`49ttr
bedroom N3
4 Collin* Paster
Living Ago)
FROM POMO 714 5912303 03/12/92 11:46 P. 7 TOTAL P. 7
•tiY6�1��i�w,.o+sid�oM.'Mi9i)h .r..+M"
es/is/92 l6t59 2t 81t 364 5:66 AMS HATEC
�-j 4e„ los 1100 0001
�,etr+�ct 'veno lnorrrme
(iftt(,Aqtepr ftt ,tlCeb4 #
rW*tow , e Job HtrW f "K
•per �.
6 •�
E.NvIRONMENTAL SERVICES. INC
BULK SAMPLEs ANALYSIS REPORT
CuOlo"r: PO(mno Vollry EgUIOM,lt Rental Inc.
mo Do"Ma s, 6.
Poponj, CA 91768
w,L Nehlol 46Cant Resida',
51035 AVO Mendora
^A
Report bates oslosiol!
Anoyell batsr 0310SM
Intpittlon baht 03MI92
tov6r llttOr
' (.0 OUintO
•.illlillltiMN.f.'.l'JP,lYw4b. �RR QRRsaM.[flf1►►tY.6lN9iA>16.L'Ctl.�•►r![titi/f i f6OC��Y�cr/.f \Yrfil. BltiwY.f,l9►/�ar
M W!!!!M! i! r•slff etflf ff ff
Four samples were colleoted from
the above
referenced
ef erencedthe iJob�ale+ of
The anal s;iss of samples i p
t7hl
�ri ed ligh microscopy and d (_d in On t}legeationell v lunta.�yn?Laboraitory
M" thods and proosdurea deta ed i n Ina.
°editetion pro rap under which AMS-NRTEC Environments ltSerVi.agAs m�ie,vInc
J# *oordi.ted. ggnte should ry�t c2 that carr
ary
timated p
e on
a tial,ly between oPwtheaeama"gampleti.g the®samerlNb,&n �rcer�tad even eseie>ars
V�Q>>aowaasalV4 t
tded to the nearest whole percent • TnaFormseam lej}r®sul tlt�tha►t erAhrt
ltd the symbol eyoyy mesas, "gloater than". For
is quanMied using point
#e rr ed as 10 or ]ass, described
�c�_ << t;ng prooeduYB>a as QQscr i ted it) 40 cox 163, stibQrlrt i4 , Appendix A.
Sayoples were tested as submitted by Cl;ent unless inRPOOti.on and ea►mp"
i•ng ,'by AMS is epaaifted. The report epplins r -)ply to the samplt3e
IeF: t;ed. It may not
gov*rnmental Bsd to bUncy. aItrrr.aalnot; beaendorsement
reproduc retho
produced ospt
laboratory or. any g
in full and with wxitt� e�eto`is� zoQucefrom
upthe
to fiveaCop%% ofithesreport
hereby exppreesl perm rr�cords of school inspeo-
for prinoipal>;a in real estate trangarct ions,
tion and tenting or for their. for their clients) reriord�•
These tests were pgrWdrt�gd;nert!:llygac-ceptedQtegtnn tho laboratorywprinai-
parsd in aocordlance i g
'
pals and practices. This warranty ig in lieu of a 1 other t�alrrentioa
expresteed or implied.
nee1v:e11 sv'_ .. -
vvt, , thomar
F ROM Per 0 7 1 4 5S 1.: � : 3 L, Z) Q: ,C_ , , : .I Z) �- . o �IiAN rr A kaoi . CAY (R1AI.160-5166
AT YOUR SERVICE
i
CLIENT:
PROJECT:
i
I I
I
DATE:
AMU T:
1 , I
C and'H LABORATORY TEL No.714-991-1742 Feb 20,92 12:43 No 005 P.02
BONDED RIGGING & HEAVY TEL:1-6197325-5523 Feb 17 92 5:12 No.001 P.02
l
South coast
Air gement District ASBESTOS Dk;MOLITION RENOVATI
/ ON NOTIFICATION
PROJECT JCB : [ j Cancellation [ J Revisiou *(Project Date&) ' [ Revision (other)
For cuasllifi6if Mi fill out sections 1403(d)(1)(A)(i), (ti), 00 and others that apply.
completed RX: Date:
Companyt ! - Telephone:
MAIL TO:
South Coast Air Quality Kahal6latht bistiriot
Hazardous Materials seotion/Entoreament
„,. 9150 Flair Drive
ElkMohte; CA 91731
Motif 0:
Date Root
POSZ''MARK
status Codes
Quarters
Entered Sy: s
4AQXD-USE-0NLY-
14030)(1)(A) e`'I' LNVRITTEN ONLY# Incomplete Noti!teation will result in Enrorrement Action.
1403(d)(1)(A)(1) Operator/Contractor. (For a Mmotition )ob, pmw list DefnolitioA /t;tenovrttor, Canttaetont,)
Name:
Address:
City, State Zip -Code:
Site Supervising Person:
'Telephone;
1403(d)(1)(A)(0 Property owver(s).
Name: Pa+ r r T, 01, is 4-. ?eS'9 Y O f ).$
Address: t 3o 1 A i- rc,y c h► 1.-i j o b r -
y G�ty, State Zip -coda:
-6"+a. .Ana , " Ca, , q A 70 s
x Contact Person: ?e yejy 0+15
Telephone: 714 � 731,420q (N) 7�'� - 99'92'�05-53• lw )
1403(d)(1)(A)(ll) iRAcility Location. (Plus vie *as whets indlated)
X Site Name:
X Street Address: 5 1- o 35 Cc► Ifs }'1e,►c:�az�:.
19 City, State Zip -code: L eL Qu i of R, Co- . 0.7. 2 s 3
County: ?.i Vert; id e
Demolition/Renovation: DCM114on &mwW - Q146,od Denlwition E+ n,,c"roq 1e00 -611M.
1403(d)(1)(A)011) Facility Description. MOM the cow Aisne tnalpttw)
Size (S Ft
Age ears:
Number o doors.
Bufidixt$ T
!! :ann�erciat jliospltatr ;�nau.�ri.t-��rGse=i+biae B�iliaj�r'ce chow .Y
_ Nor" V.P� : k•�.`.e - ofkln67R�it "j�p�l:fi �D4ULttisi�'�OtltlC 011iid{O� t� ppC ^OOt "v.:t�
Nuntbir of Dv ilUn& LlWts: (F" �"'
' Work Lo Iani4enee only)
� ,.
Location (Describe).
_ 140�(d)(1)(A)(ih 1�roject Aotea, .
Start Date:
Completion Date:
• •
SCAQMD Rule 1403 Notification Form (1803.1F'R1►� Par I ort .
Imo• - -
11 ..
C andH LABORATORY TEL No.714-991'-1742 Feb 20,92 12:43 No.005 P.01
S ENTEJKPRISES.
P.O. sox 3099
ANAMEt". CAIMPORNLA 92603
714 999.0883
a FAX COVER SREET
TOi�Qn�c�� cd
FROM
NUMBER OF PAGES (.including this one):
COMMENTS: -�
a
If you do not'reaeive'all pages, or you have any, questions, please feel free
to call (714) 999-0553.
THANK YOU.
C' and H LABORATORY TEL No.714-991-1742 Feb 20,92 12:41 No.005 P.01
T & S ENTERPRISES
P.O. BOX 8007
ANAHEIM. CAIXFORNIA 92803
714 099A859
j
FAX COVER SHEET
TO y l I
FROM
NUMBER OF PAGES (including this one):
COMMENTS:
l
if you do not receive all pages, or you have any questions, please feet free
to call (714) 9990553.
THANK YOU.
4'w - LH-7 -�� . TEL 'du .,1-;-99? -i-4?
Orlando Gonvales
Bonded Rigging!
P.O. Box 1774
Rancho Mirage, CA 92270
N . S ENTERPRISE -8
.ny
Y.A nox 6697
ANAIiL* M, OALMORMA ORM4
713 90"Kh8
march 16, 1992
Har 1u,92 1-:59 No.001 P.01
Re: House located at 51-035
Avenida Mendoza in the
City of Iia Quinta
Dear :,,3r. Gonza)es:
This le..t,ter is to acknowledge receipt, of n negative Asbestos
report from► Environmental Services, Trac, on the Kbove mentioned
property and are hereby authorizing you to proceed with
demolition of said property as per our agreement.
Shots -Id further information or assistance be nece%sar•y,
Nl��rise feel free to contact. me.
Sincerely yours,
Per y Otis_��.
OWIIO T'
bf 4 4,Q�w
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 51-035 Mendoza LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address P. 0. BaX 868
CityZip Tel.
Quinta :2253 564-1153
Contractor
Aaaress ._
N0. 003747
BUILDING: TYPE CONST.—OCC.- GRP. -
A.P. Number 773-075-006
Legal Description
Project Description New tank and pit
P. 0. BOX 868
City' -
Quinta
Zip 1' -
92253
Tel.
$64--115€
State Lic.
& Classif. 368149
City
Lic. # 1052
Sq. Ft. No. No. Dw.
Size • Stories- Units
Arch:; Engr., — -'
' Designer
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
~
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am 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 .
SIGN_ A_TURE DATE
" OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S,Business and Professions Code: Any city or county which requires a
permit to construct,` atter, improve, demolish, or repair .:any structure, prior to -its issuance also
requires the applicant for such permit to file a signed. statement that he is licensed pursuant. to
the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
for the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500): . -'
❑ 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner o/ 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.) . - . ,
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Seca 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 contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O I am exempt. under Sec. B. 8 P.C. for this reason
EStlmatcd Valuation
i+ ��
$
- AMOUNT
PERMIT -'
Plan Chk. Dep. •-
Plan Chk. Bal.
Const.
'
Mech. .
Electrical
Plumbing - $40.00
S. M. 1.
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
Thereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) -
Lender's Name
Lender's Address
f This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 certify that I have read this application and state that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
HARD COPY
TOTAL
REMARKS
ZONE: • BY:
Minimum Setback Distances:
Front Setback from Center.Line
Rear Setback from Rear Prop. Line
Side Street Setback from -Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued:by: Date 3/25/8$13ermit
Validated by:
Validation;_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
—
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
ROUGH WIRING
FLOOR DRAIN
MECHANICAL FEES
DUCT WORK
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
OTHER APPJEOUIP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
TEMP. POLE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GROUT
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE; TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
ROOFING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
VENTILATION
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FIRE ZONE ROOFING
GAS PIPING
PERMIT FEE
FIREPLACE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
FORMS
ROUGH PLUMB. Al
SEWER OR SE TIC TA
BONDING
ROUGH WIRING
HEATING (ROUGH)
STORAGE TANK
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL