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10-1041 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation:' Applicant: �I�t/TX�.GTo� 10-000010 17 78477 HIGHWAY 111 604-050-008- - REMODEL - COMMERCIAL COMMUNITY COMMERCIAL 160000 TWyl 4 4 Q" BUILDING & SAFETY DEPARTMENT ,'BUILDING PERMIT Architect or Engineer: AZ�o ky 1�i TGOAlE c- goJE5D 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: B License No.: 837914 ✓Dat6:L'� � �' U ontractor: 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 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, 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 1 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.). ( ) I am exempt under Sec. , B.&P.C. for this reason Date: 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 LQPERMIT Owner: M.& H REALTY PARTNERS II C/O PETER MERLONE 353 SACRAMENTO ST 21ST SAN FRANCISCO, CA 9411 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/01/10 U ,r`: 012;20710[ Contractor: SUTTON REMODELING SPEC AL OF LA 78162 CALICO GLEN DRI F(!�!!?,;LE BERMUDA DUNES, CA 92203 -'-' (760)200-4222 Lic. No.: 837914 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 EXEMPT Policy Number EXEMPT 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, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith com ly with those provisions. Datel 2' l - 10 plicant: WARNING: FAILURE TO SE URE 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, and hereby authorize representatives I county to enter upon the above-mentioned property for inspection purposes. Dat@:2 ignature (Applicant or Agent): " Application Number . . . . . 10-00001041 LQPERn4IT Structure Information Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . . ASSEMBLY BLDG <1000 Other struct info . . . . . CODE EDITION 2007/08 ENERGY FIRE SPRINKLERS YES MIXED-USE OCCUPANCY. A -2/B/ S-1 OCCUPANT LOAD 121.00 ---- 1ST FLOOR SQUARE FOOTAGE 4059.00 . Permit " BUILDING PERMIT Additional desc REST. T.I. "LA BRASSERIE" Permit Fee . . . 849.50 Plan Check Fee 552.18 Issue Date . . . . ' Valuation 160000 Expiration Date . 5/30/11 Qty Unit Charge 'Per Extension BASE FEE 639.50 60.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG.100,001-500,000 210.00 Permit . . . ELECT - ADD/ALT/REM . Additional desc . Permit Fee 55.20 Plan Check Fee 13.80 Issue'Date Valuation . . . 0 - Expiration Date 5/30/11 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 56.00 .4500 ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 25.20 Permit . . .. MECHANICAL Additional desc . Permit Fee 48.00 Plan Check Fee 12.00 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/30/11 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 4.5000 EA MECH VENT INST/ DUCT ALT 13.50 3.00 6.5000 ---------------------------------------------------------------------------- EA MECH VENT FAN 19.50 Permit . . . PLUMBING Additional desc . LQPERn4IT :- _ Application Number . . . . 10-00001041 , Permit . . . . . . PLUMBING Permit Fee 120.00 Plan Check Fee 30.00 Issue Date. Valuation 0 Expiration Date 5/30/11 Qty Unit .Charge Per Extension BASE FEE 15.00 14.00 6:0000 EA PLB FIXTURE 84.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 6.00 3.0000 EA PLB FIXTURE DRAIN/VENT. REP/ALT 18.00 -------------------------------------------,--------------------------------- Special Notes and Comments INTERIOR REMODEL T.I. FOR RESTAURANT "LA 'BRASSERIE" 4059 S.F..A-2 OCCUPANCY, TYPE V -B CONSTRUCTION. 121 OCCUPANT LOAD.2007 CODES 2008 ENERGY.[EXIST PATIO = 1121 SF 75 OCCUPANTS - 2 EXITS REQUIRED] ---------------------------------------------------------------------------- Other Fees . . . . . . . . 1. .ACCESSIBILITY PLAN -REVIEW 55.21 BLDG STDS ADMIN (SB1473) 7.00 ENERGY REVIEW FEE 55.21 STRONG MOTION (SMI) - COM 33.60 Fee summary Charged Paid Credited Due -- - - - - - - - - - - - - - ------ - - - - ------ - - - - ------ - - - - -- ----------- Permit Fee Total 1072.70- .00 .00 1072.70 Plan Check Total 607.98 .00 .00 607.98 Other Fee Total 151.02 .00 .00 151.02 Grand Total 1831.70 .00 .00 1831.70 LQPERAIIT Bin # 6� City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ; Building Permit Application -and Tracking Sheet F Permit # �\ 1� Project Address: �� ' 7 Owner's Name: } w ° ~ .Y �•� . w Man L4 A. P. Number:.e,r. �i.SldF�jt.,�i Legal Description: ")i 5uv, u Contractor: -5„M@n RQ m O Q (n eCr�� f ' Address7g16 Z l cA IC p C- en ( C -4-e,,\ City, ST, Zip?e'rrhLtcU- UK•j lam' -1 "/ Z2,03 Telgpho 5�7- — s «< Y r ..'.Y•;,, 6 City, ST, Zip:(� Q Nin, e-JZZS 3 Y 0 Telephone: :Proec •9es"'i tion: r I OHS Q, i A�1.1.',, f = ' . G.�:=►"+a 11:6 State Lic. # : '93 7914City Lia d D SSS' Pj ; Zwn a �q Arch.,Engr., Designer. Address: 7 D —7 LSO City, ST, Zip: Desi (A ! 2ZIOD pj * Telephone: - 5 — Z7� � '%;iv<:::7n�.•Y(,•..l:.<:L�+y.;xYt.•T`�, rH.• ,. $ r?a „�.•: Construction Type: 1Occupancy: 1212 - Pro ' e, circle N • dd'efl Alter . R ,� L '�? "i V*,....A - 4pajr.L�.D.e3id} . State Lic. #: XV Name of Contact Person: (;�r� J a✓� I Sq. Ft. #Stories: #Units: r Telephone'# C-ai!QctP rsoii�: ', - = ,'.� % .• , ,.� Estimated Value of Project: 000 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted �� Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance, Title 24 Calm Pians picked up Construction Floodplain plan Plans resubmitted 1 Mechanical Grading plan 2°" Review, ready f�korrection ssue Electrical Subcontactor Llst Called Contact Per, uw, 1� 'JJ Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted 1i yf0 Grading IN HOUSE:- ''d Review, ready for correction tissue 12 / Developer Impact Fee Planning Approval Called Contact Person ��, A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees , /0-7 !044; RjG l2eitiF.A.4 ID 11 WA"454 AXUZoe&+ &WknW445 tilos saiow11 �a rOhs.a OF %Aft, Art L 014 fLft4s P,� rs�s Nor w flit4VCof cSr..J ��,an,;,Ci� L�curz e�.I kN� 6v�K�{' i�0urwAttY Db �(a, �,Ecou►u.� � G S'tof4�`E�c..a'vs�t�-c ® Qt%o,. c0044 Y r t � ^ Y COACHELLA VALLEY WATER DISTRICT ASSESSOR'S PARCEL NUMBER 85-995 Avenue 52 Coachella, California 92236 ------- ------- (760) 398-2651 C25 0 19 APPLICATION FOR WASTEWATER INTERCEPTOR/SEPARATOR APPROVAL APPLICANT: Submit this form with a copy of SCALED plot plan (I"= 20'to 1" = 40' SCALE) drawn to District specifications. A nonrefundable filing fee is required when the application is submitted. Check must be made payable to the Coachella Valley Water District. Approval of this application shall remain valid for a period not to exceed one (1) year from date of payment. Plan Check No. A ent, Contractor, Contact Person Address City State Zip 7-9 D' �t'_.r, Qt.i O, Telephone Owner �r,c"�ue_A Jar ,. Address City State Zip 70930 7�'�u L�,�(� ,.-,�c� GA q�53 Telephone (.t<j4-� 5-7`160 Job Property Address Cit y Zip Legal Description (� l , DBA b;,- PLEASE COMPLETE THIS SECTION FOR REVIEW OF FOOD ESTABLISHMENTS NOTE: PLANS WILL NOT BE ACCEPTED UNLESS THIS APPLICATION IS COMPLETE AND THE PLAN CHECK FEE IS PAID. GENERAL CONS'T'RUCTION: Type of Construction: I O "d--5 e -n New Food Facility Remodel of Existing Food Establishment �_ Hours of Operation�,a,;, Seating Capacity: Internal �� External [? External Seating with Misters or Heaters _Q Bar with Food Service Bar Nonfood Service 0 Water Softener Service: Multiservice (reusable) Single Service (disposable) OWNER/REPRESENTATIVE DECLARATION: I certify that I have read the entire application and state that all information is correct. I understand that the amount of fee paid is based on my declaration of information on this form that incorrect and information is grounds for denial of the submitted plans. I also understand that plans will be discarded if not picked up within sixty (60) days of approval or denial and that no inspection of my establishment will be conducted, or approval granted to operate, until all proper information requested Las been received and plans have been approved and returned. Signature ���L �RN t� Date U! U FOR DISTRICT USE ONLY No. of Systems Type of System(s) No. Dwelling Units ❑ Sand/Oil ❑ Grease Interceptor Waived ❑ New 13E.xisting Fixture Units Grease Interceptor ❑ Lint Trap ❑ Replacement ❑ Addition ❑ Clarifier ❑Connect to Sewer REMARKS: This application is: 10 Approved ❑ Denied ❑ Conditional Approval* Fee S *See Remarks - ' Check No. Date U Initial Signature a Date CVWD-921 r- COUNTY OF RIVERSIDE • COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH FOOD ESTABLISHMENT INSPECTION FORM FACILITY DBA 4/2 RECORD ID q / EXP. DATE 4/2 PHONE DATE t r r I P., 4/2 I A)4',,) P 14/2 In N/A 20. Licensed health care facilities/public & private schools; prohibited I food, y 2 ADDRESS CITY ZIP CODE In 21. Hot and cold water available - Water Temp: ❑ i DISTRICT REINSP. DATE q 1 d- >A _ M 6 %A rt Ola 4 / 2 33 NAME & TITLE OF PERSON IN,CHARGE 23. No rodents, insects, birds or animals Z _ PERMIT HOLDERP.E./ Ik" SERVICE TIME IN I OUT ME CONDITIONS LISTED BELOW CORRESPOND TO VIOLATIONS OF THE CALIFORNIA HEALTH AND SAFETY CODE AND/ OR RIVERSIDE COUNTY ORDINANCES LISTED AND MUST BE CORRECTED 1S INDICATED BY THE ENFORCEMENT OFFICER. THE DEPARTMENT OF ENVIRONMENTAL HEALTH APPRECIATES YOUR COOPERATION. PUBLIC HEALTH IS EVERYONE'S RESPONSIBILITY. In - In Compliance / N/O = Not Observed / N/A = Not Applicable I COS = Corrected on Site I MAJ = Major Violation I Out = Out of compliance I PTS = Points `DEMONSTRATION OF KNOWLEDGE COS Mal OUT PTs n N/O 11. Food safety certification I I - 1 2 HEALTH AND HYGIENIC PRACTICES 2. Communicable disease; reporting, restrictions and exclusions 4 4/0 3. No persistent discharge from eyes, nose, mouth _ 2 4/0 4. Proper eating, tasting, drinking or tobacco use 2 R PREVENTING CONTAMINATION BY HANDS r n ) n r I 1/015. Hands clean and properly washed; gloves used properly 4/2 6. Adequate handwashing facilities supplied & accessible " 2 TIME AND TEMPERATURE RELATIONSHIPS I N/O V/A n N/O 4/A n N/O �/A n N/O !/A b N/O ,,/A 11. FROM CONTAMINATION 7. Proper hot and cold holding temperatures 4/2 8. Time as a public health control; procedures and records 4/2 9. Proper cooling methods = 4/2 10. Proper cooking time and temperature 4/2 11. Proper reheating procedures for hot holding 14/2 In N/O 12. Returned and reservice of food 13. Food: unadulterated, no spoilage, no contamination 14. Food contact surfaces; clean and sanitized Iodine n Hot Water C Other FOOD FROM APPROVED SOURCES f`n 15. Food obtained from approved sources (n N/O •c n r, ati a �--- ..--. 3.: - A......... WA n /A 4CONFORMANCE WITH APPROVED PROCEDURES fl fIn N/A 18. Compliance with variance, specialized process & HACCP Plan Z 2 2 1 !CONSUMER ADVISORY 1 to N/0 19. Consumer advisory provided for raw or undercooked foods � /A , . 1 ;SCHOOL AND HEALTH CARE PROHIBITED FOODS 37. Equipment and utensils: storage and use In N/A 20. Licensed health care facilities/public & private schools; prohibited I food, y 2 1 ;WATER I HOT WATER ❑ In 21. Hot and cold water available - Water Temp: ❑ i 4 12 kLIQUID WASTE DISPOSAL 1 In 22, Sewage properly disposed ❑ C 4 / 2 t VERMIN to 23. No rodents, insects, birds or animals Z _ _14/21 RECEIVED BY• � - f VERMIN OUT PTs [7247 -Vermin proofing, air curtains, self closing doors ❑ 1 SUPERVISION I PERSONAL CLEANLINESS 25. Person in charge present and performs duties, demonstration of fl 2 26. Personal cleanliness and hair restraints [11 1 GENERAL FOOD SAFETY REQUIREMENTS 27. Approved thawing methods used, frozen food storage ❑ 2 28. Food separated and protected from contamination ❑ 2 29. Washing fruits and vegetables U 1 30. Toxic Substances properly Identified, stored, used U 1 FOOD STORAGE I DISPLAY I SERVICE 31. Self service: utensils, food types, maintained (31 32. Consumer self-service ❑ 1 33. Food properly labeled & honestly presented, adequate storage I I 1 EQUIPMENT I UTENSILS I LINENS 34. Utensils and equipment approved, good repair ❑ 2 35. Warewashing: installed, maintained, proper use, test materials ❑ 1 36. Equipment / Utensils: installed, clean, adequate capacity ❑ 2 37. Equipment and utensils: storage and use ❑ 1 38. Adequate ventilation and lighting; designated areas; use ❑ 1 39. Thermometers provided and accurate ❑ 1 40. Linens and wiping cloths: property used and stored U 1 PHYSICAL FACILITIES 41. Plumbing, properly installed, good repair, wastewater disposal r32 42. Refuse properly disposed; facilities maintained ❑ 1 43. Toilet facilities: properly constructed, supplied, cleaned ❑ 1 44. Personal item storage and cleaning items storage ❑ 1 PERMANENT FOOD FACILITIES 45. Floors, walls and ceilings: good repair / fully enclosed ❑ 1 46. Floors, walls and ceilings: clean ❑ 1 47. No unapproved private homes / living or sleeping quarters n1 SIGNS I REQUIREMENTS 48. Last inspection report available ❑ 49. Foodworker cards available, current, complete ❑ 1 50. Grade card and signs posted, visible p COMPLIANCE AND ENFORCEMENT l 51. Plans approved / submitted I ❑-I 52. Permit available and current ❑ I �' 153. Permit suspended / revoked 1 ❑ 1 1. INSPECTION I TOTAL NUMBER OF SUMMARY MAJOR VIOLATIONS = ENVIRONMENTAL HEALTH SPECIALIST (PRINT) SIGNATURE / INITIALS TOTAL POINTS TOTAL NUMBER OF + POSSIBLE = 100 POINTS DEDUCTED GRADE A B C SCORE !U 1 of Si e P/ COUNTY OF RIVERSIDE • COMMUNITY HEALTH A�GENCY� DEPARTMENT OF ENVIRONMENTAL HEALTH Major I Minor Violations: Major Violations are those that pose an imminent riWk to public health and warrant immediate closure of the food facility or immediate correction. Minor Violations are those violations that do not pose an imminent public health risk, but do warrant correction. GRADES REPRESENT THE FOLLOWING RANGES: A = 100-90 Passed inspection I meets minimum health standards; B = 89-80 Did not pass inspection / does not meet minimum health standards; C = 79-0 Failed Inspection / conditions exist which may pose a potential or actual threat to public health and safety. This facility is required to display a grade card in a conspicuous place selected by the Enforcement Officer. The grade card shall not be concealed and can only be removed by the Enforcement Officer. Per County Ordinance 4921 County Code Section 8.40.020 OBSERVATIONS AND CORRECTIVE ACTIONS <Jn-Sr�t ✓\l1ACL ±1:� uP. {�() (1A d,JPF'( /J Ctitartull a } 1,± ✓'¢ S Y1 Q f; r r , j Ir.rtfi L' i1rQf�i;x ' 't)� EQC! t r ) X:r r ��;� S //1 rlJ { I? re `J. 4_, sJ I ^[',:1r` 'A A _ n ref i '>f 7 - 1 l' 1 �%f J 1 + Y f)!' . J, ✓t k W i 1 / e?i? i J I /n .,� r I ( �f!' 1/ rt i k .,f ! t t j 1/ y A c� vi 0, ` /f Q lY11X GttrS �', r� isi r/1 �t?!•`';rt'/v Uf'/r� t1rCi?l • t1 A) flyl f -q �f tic J J � •�. � , t er.. � ! tJ : i r` r ✓\ tti r1 , � rr r r � l ' 6} LtJ � : f r �i :d LF�YI lit.i (?' �J /t /" ri r,P- r 7uf � I/ r� t� � r'I 4, 1v li,r 18 vr•' an Z*u r- .,4 1 t t F✓ !h t I � ✓ i�✓� v t� � � a f6 NAP aJ � / �` ' i lfl ; Y� r t; ,.A ;�•4 r. e� L! ! /r J `�� ,G (� / �'. �% p "�t1 l-• t� f � � :'� i/i .I f' G � l! i'A ^ \i J Y1 1~It , :/,'ftt ari?it ±r /•.Ii':J (�r�Jv3 r 'u. P. 1r,� U, r`vk/vi P•f'`J ° f"Y 1i?. it uAJ< f t, Ali i /i r i 'of 9 ir-U t /I : 1 >YJ r /� l M �( ` ? Lc r—' / `" r9 d fi /1 J" : t i . E% \4 0 i I .-' rSJ 1'✓ n J ,1 V 11 r f vt f z r � t:f if. �! >'" 1 (,i 'i¢ !± f if h I{ A"n0, AD a i U;' r f.r11 aYxAt / /Lf 4 rp i. — et Urt r�{ r LEJ �✓j �J Jf1 !J�/G� �` ✓ L j} ^' 0 It: 'J r - { ! t 1r" s� GL C f? � �v r i / r? :9 a () A 4k I PANI\Ue epi�- `01, A. ( `4n @S{r�J !, fnyr-cU)9-, i J Jar (Ir ✓ v 9 t r- t 1 {i/1 i , ± t r N !�r iu' Jnt?t !d 11 fnli �GtJr i1; iJ n is �1',1 ^%iiA✓�"{? !/ {vl(/�i . RECEIVED BY EHS INITIALS '01 i J/ter,` 2 of _OE.FIGF5'IN: RIVERSIDE, BLYTHE, CORONA, HEMET, INDIO, MURRIETA AND PALM SPRINGS i For more information call (888) 722-4234 or visit the Deoartment Web Site — wWW.rivcoeh.ora COUNTY OF RIVERSIDE • COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH Naior / Minor. Violations: Major Violations are those that pose"an imminent risk to public health and warrant immediate closure of the food facility or immediate correction. Minor Violations are those violations that do not pose an imminent public health risk, but do warrant correction. 3RADES REPRESENT THE FOLLOWING RANGES: A = 100-90 Passed inspection / meets minimum health standards; B = 89-80 Did not pass inspection / does not meet minimum health standards; C = 79-0 Failed inspection / conditions east which may pose a potential or actual threat to public health and safety. This facility is required to display a grade card in a conspicuous place selected by the Enforcement Officer. The grade card shall not be concealed and can only be removed by the Enforcement Officer. Per County Ordinance 492 / County Code Section 8.40.020 OFFICES`IN: RIVERSIDE, BLYTHE, CORONA, HEMET, INDIO, MURRIETA AND'PALM SPRINGS —H rflQa\ 777_A')gA nr %rich tha rlunnrtmont UVah Cite _ www rivrnch.nra e OBSERVATIONS AND CORRECTIVE ACTIONS tr .J i de ar, a hAfovR(\ S44 -;A lefl S v,4? ��il -f fd at -(I k— ,AAI's rti /GGfiCil}�? } P('4" ln'4�fl`Q i)G f I t , f (,ith Z, sup' �_! 404w4)d U!14 e� VfNri �vr' 1 kan1 'ry'1Fe j h!i rk 'C^ r a A a D_a roo 9.q, 1J(1'aA rQ R plp� 0a.__4?r s v /)A �,ru, Cf` i i Y'fG ,r . rKlk `J/0. rt ArAt'rrlLA01 / f r A jita f ! J ! v ° oa lr-' GtA fi i A2 4'16 1, r 1. rx { OP. a� l W Of e 41"'A u , r x U r-�"a t , Qu1/G r Emit/1 U C Cit•) it�f Qi" a mr"J'A An i / n3 1 tarnly ' ; �r A P";A s r J rQ .0� a �:10 J'e r -m J i' L� 6j' } ` a+ 4 !� u / r 0 M IP�n 1 P'A k 04(' r v � 1�� f n' 000 �In sogLS ,r r rte r Jrr,G0 , % Pro Vf` 14 V gr- l A4r' a 40,r !Gt a Al/Ai L4 1111 If a Ap ro. uP, 4 v t vi r�1 I O-� u �` f t� ar f Srnr �ta ) I �t r�ri �..� �,� QG���� ! -,df 'r h Q' 4crf ( %e t+` a i" r- Qli ao 1 e A. ev,1 r RECEIVED I3Y-' �----^ ?"' DATE EHS INIT17 OFFICES`IN: RIVERSIDE, BLYTHE, CORONA, HEMET, INDIO, MURRIETA AND'PALM SPRINGS —H rflQa\ 777_A')gA nr %rich tha rlunnrtmont UVah Cite _ www rivrnch.nra e COUNTY OF RIVERSIDE •COMMUNITY HEALTHAGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH Malor / Minor Violations: Major Violations are those that pd. an imminent risk to public health and warrant immediate closure of the food facility or immediate correction. Minor Violations are those violations that do not pose an imminent public health risk, but do warrant correction. GRADES REPRESENT THE FOLLOWING RANGES: A = 100-90 Passed inspection I meets minimum health standards; B = 89-80 Did not pass inspection / does not meet minimum health standards; C = 79-0 Failed inspection / conditions exist which may pose a potential or actual threat to public health and safety. This facility is required to display a grade card In a conspicuous place selected by the Enforcement Officer. The grade card shall not be concealed and can only be removed by the Enforcement Officer. Per County Ordinance 492 / County Code Section 8.40.020 Vrrwrw IN: rc1Vt:K0IlJr, tILT I nt, UVKVNA, MIVIL 1. INUIU, MURRIETA AND PALM SPRINGS / Fnr mnra infnrmatinn rail 1ARRI 777-47'44 nr vi -,it tha DAnarimAnt W ah Rita - www.rivenah.nra OBSERVATIONS AND CORRECTIVE ACTIONS 0 r t % ( P I i ! r,^a` ) I rpt n /.t\ 4 Ocia P 0mQLA ^'I R., r vel ( r ! a I %t ) J Yi p r 1A dA &S; All0 1 ..1 U, r" f n \)A ' A t v. ( 0r M t r P S n"I I O 1 A /'q j'1 7 Jo J 8 i% v}V r Q) r .� r -,l 1 . w� I i'"� �l .i a I Q t�1 i1 �. 1 f7 / . r � 1 `�1, fl t / i%i A) -(" a / J4� tt J i,t I to U. {7 4.Q I 1 / / u ),-I ' 0 / /\ J 0 f 4:i1 ✓ _ ppI �i a 0 �1 I r ur\, 4 S .lA r At1 d �r a, it r i GIQGI'� t6 rrid GGVf q0,S\0- 41,01-A4\00.) , 1 Ior il a i a k - r U1 , � .0 -',r� U n �� fi �7u.jG v� �l p OUI rd / rw Innv4r � ,ail _6 f zr.'o / - r'. Lrs . If' \A � Pfi � b 41, 'o Ah " eA! A 'o r- s,lik, U / toa minjzwom r / ! /" qqo" °f1 A4U.rr rf I k1A ilo 0 rx 1 Cn Gita. as ( i R! ca a C 1 `` s� u LK 3 A r_, o d ✓ �! ` r t _4r t; r� . G ho !"/, cr ; In i •, J - / -cud /�l -f� f� i� n � � ,P14 fy5n do a I I i. 1 n 6r J V I A -" 6'i`I i' P' f /! N, ?r n i ;n rp.AkAjr-64 a/ r, aAla_ 1^1 .urs fill a1r' CIL, ONI !A rA ;4 (,io h tin r A J 19! ECEIVED BY / DATE "18 EHS INITIALS Of Vrrwrw IN: rc1Vt:K0IlJr, tILT I nt, UVKVNA, MIVIL 1. INUIU, MURRIETA AND PALM SPRINGS / Fnr mnra infnrmatinn rail 1ARRI 777-47'44 nr vi -,it tha DAnarimAnt W ah Rita - www.rivenah.nra COUNTY OF RIVERSIDE • COMMUNITY HEALTH AGENCY Z.j�\'VDEPARTMENT OF ENVIRONMENTAL HEALTH Malor I Minor Violations: Major Violations are those that pose an imminent risk to public health and warrant immediate closure of the food facility or immediate correction. Minor Violations are those violations that do not pose an Imminent public health risk, but do warrant correction. GRADES REPRESENT THE FOLLOWING RANGES: A = 100-90 Passed inspection I meets minimum health standards; B = 89-80 Did not pass inspection / does not meet minimum health standards; C = 79-0 Failed inspection / conditions epst which may pose a potential or actual threat to public health and safety. This facility is required to display a grade card in a conspicuous place selected by the Enforcement Officer. The grade card shall not be concealed and can only be removed by the Enforcement Officer. Per County Ordinance 492 / County Code Section 8.40.020 • • -- - __ _ ---,Urrr%or=Q IPI: r%1Vr-1%Q1VC, 0L T I nc, V VRUIYA, nC1YIC I , IIVUIU, nnUKKIt 1 A ANU PALM SPRINGS For more information call (888)722-4234 or visit the Department Web Site — www.rivcoeh.ora OBSERVATIONS AND CORRECTIVE ACTIONS 5 '� } i/ ti f0 of ` 0, J I '0 i? r-3,0/! r' f"lafil a i�61f 1. I A /" x� r0�1 �t ]J' C�r A11 s P'!n f r a)t:{ fr ^ t'., rte r h ')J �rJN� I C/'( 1/1 (Gi A �v rf R r 11 A ef- ..I I r 6 r, I 1� i t � r, -Y' -V^;( A P r ,9 1 f �' �Y .� ►"t% �%[-C.� RECEIVED BY ' DATE / f� J%r �j 1 � V 74S INITIALS �I �'� LOT -moi • • -- - __ _ ---,Urrr%or=Q IPI: r%1Vr-1%Q1VC, 0L T I nc, V VRUIYA, nC1YIC I , IIVUIU, nnUKKIt 1 A ANU PALM SPRINGS For more information call (888)722-4234 or visit the Department Web Site — www.rivcoeh.ora BUILDING ENERGY ANALYSIS REPORT PROJECT: La Brasserie Tenant Improvement 75-417 8 Highway 111 La Quinta, Ca 92253 Project Designer: Stoney Creek Design Studios 74-070 Highway 111 Suite J7 �� a Palm Desert, CA 92260, (877) 515-2724 CITY OZ BUILDIN �� Report Prepared b :. P p Y ' FOR C Tim Scott Scott Design and Title 24, rw�rE of77-085 Michigan DriveI� t Palm Desert, Ca 92211 ©q • (760) 200-4780 � S' .9080 Novi 012010 kt-AV214 �1 Date: V VV 1110114610 11/1/2010 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 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www.energysoft.com. EnergyPro 5:1 by EnergySoft User Number-, 6712 RunCode: 2010-11-01T11:14:44 ID: �r 'r • i TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Form LTG -1-C Certificate of Compliance 3 Form LTG -2-C Lighting Controls Credit Worksheet 7 Form LTG -3-C Indoor Lighting Power Allowance 8 Form LTG -MM Lighting Mandatory Measures 9 Form MECH-1-C Certificate of Compliance 10 Form MECH-2-C Air & Water System Requirements 13 Form MECH-3-C Mechanical Ventilation 15 Form MECH-4-C HVAC Misc. Prescriptive Requirements 16 Form MECH-MM Mechanical Mandatory Measures f V 17 EnergyPro 5.1 by EnergySoft Job Number. ID: User Number. 6712 CERTIFICATE OF COMPLIANCE (Part 1 of 4) LTG -1C Project Name Date La Brasserie Tenant Improvement 11/1/2010 Project Address Climate Zone Total Cond. Floor Area Unconditioned Floor Area 78-448 Highway 111 La Quinta 15 2,903 1 0 GENERAL INFORMATION Building Type: m Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ School ❑ Relocatable Public p Conditioned Spaces ❑ Unconditioned Spaces School Phase of Construction: ❑ New Construction ❑ Addition ❑ Alteration Method of Compliance: ❑ Complete Building [a Area Category ❑ Tailored Documentation Author's Declaration Statement I certify that this Certificate of Compliance documentation is accurate and complete. Signature Name Tim Scott Company Date Scott Design and Title 24, Inc, 1 11/12010 Address CEA # 77-085 Michigan Drive CEPE # City/State/Zip Phone Palm Desert Ca 92211 (760) 200-4780 The Principal Lighting Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professional Code to accept responsibility for the lighting design. • This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Pages 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms, worksheet , lation ans and specifications submitted to the enforcement agency for approval with this bu ding mit pplica n. Name Signa ure Robyn S. Ritchey Company Stoney Creek Phone Design Studios aII Address —�7 �i(rt�Y.L %(j4./ License # Q City/State/Zip Palm Desert, CA 92260 Date / Lighting Mandatory Measures Indicate location on building plans of Mandatory Measures Note Block: LIGHTING COMPLIANCE FORMS & WORKSHEETS check box if worksheets is included For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms; please refer to the Nonresidential Manual published by the California Energy Commission. ❑✓ LTG -1C Pages 1 through 4 Certificate of Compliance. All Pages required on plans for all submittals. ❑✓ LTG -2C Lighting Controls Credit Worksheet Q LTG -3C Indoor Lighting Power Allowance ❑ LTG -4C Pages 1 through 4 Tailored Method Worksheet ❑ LTG -5C Pages 1 and 2 Line Voltage Track Lighting Worksheet Ener Pro 5.1 by EnefgySoft User Number. 6712 RunCode: 2010-11-01T11:14:44 ID: Page 3 of 17 CERTIFICATE OF COMPLIANCE (Part 2 of 4) LTG -1C Project Name La Brasserie Tenant Improvement Date 11/1/2010 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Installation Certificate, LTG -1- INST Retain a copy and verify form is completed and signed.) Field Inspector ❑ Certificate of Acceptance, LTG -2A (Retain a copy and verify form is completed and signed.) Field Inspector ❑ A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces Installed Lighting Power listed on this Lighting Schedule is only for: CONDITIONED SPACE ❑ UNCONDITIONED SPACE The actual indoor lighting power listed below includes all installed permanent and portable lighting systems in accordance with §146(a). Only for offices: Up to the first 0.2 watts per square foot of portable lighting shall not be required to be included in the 21 calculation of actual indoor lighting power density in accordance with the Exception to §146(a). All portable lighting in excess of 0.2 watts per square foot is totaled below. Luminaire (Type, Lamps, Ballasts Installed Watts A B C D E F G H None or Item Ta Complete Luminaire Description' (Le, 3 lamp fluorescent trotter, F32T8, one dimmable electronic ballasts m 3 (4 u m CL a m W S m � J How wattage Was determined ` > >� Z J ll X a U r° 3: Field Ins actor, m CEC 5 C Default o w, From 0o NA8 Q ~ u, o' m a. u- 150 150w Surface Mount Incandescent ❑ 150.0 ® ❑ 2 300 ❑ ❑ 18OW C 60w Low Voltage Halogen ❑ 60.0 ® ❑ 12 720 ❑ ❑ 6" 50w Low Voltage Halogen ❑ 50.0 ® ❑ 34 1,700 ❑ ❑ 60 75w Low Voltage Halogen ❑ 75.0 El ❑ 5 375 ❑ ❑ 60WLVH 60w Low Voltage Halogen ❑ 60.0 0 ❑ 2 120 ❑ ❑ FI (1) 13w Compact Fluorescent ❑ 13.0 ® ❑ 23 t 299 ❑ ❑ led LED Rope ❑ 5.0 ❑ 0 64 320 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Installed Watts Page Total: 3,834 Building total number of pages: Installed Watts Building Total Sum of all pagges 3,834 Enter into LTG -1 C Page 4 of 4 1. Wattage shall be determined according to Section 130 (d and e). Wattage shall be rating of light fixture, not rating of bulb. 2 . If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnergyPro 5.1 by EnergySoft User Number. 6712 RunCode: 2010-11-01T11:14:44 ID: Pa - e 4 of 17 CERTIFICATE OF COMPLIANCE Part 3 of 4 LTG -1C Project Name La Brasserie Tenant Improvement Date 11/1/2010 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Fill in controls for all spaces: a) area controls, b) multi-level controls, c) manual daylighting controls for daylit areas > 250 fe, automatic daylighting controls for daylit areas > 2,500 fe, d) shut-off controls, e) display lighting controls, f) tailored lighting controls — general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls for retail stores > 50,000 W, in accordance with Section 131. MANDATORY LIGHTING CONTROLS — FIELD INSPECTION ENERGY CHECKLIST Field Inspector Number Special Type/ Description of Units Location in Building Features Pass Fail ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ SPECIAL FEATURES INSPECTION CHECKLIST See Page 2 of 4 of LTG -1C 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. 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. Field Inspector's Notes or Discrepancies: EnergyPro 5.1 by EnergySoft User Number. 6712 RunCode: 2010-11-01T11:14:44 ID: Page 5 of 17 CERTIFICATE OF COMPLIANCE Part 4 of 4 LTG -1C Project Name Date La Brasserie Tenant Improvement 11/1/2010 CONDITIONED AND UNCONDITIONED SPACE LIGHTING MUST NOT BE COMBINED FOR COMPLIANCE Indoor Lighting Power for Conditioned S aces Indoor Lighting Power for Unconditioned Spaces Watts Watts Installed Lighting 3,834 Installed Lighting 0 from Conditioned LTG -1C, Page 2 from Unconditioned LTG -1C, Page 2 Lighting Control Credit - 363 Lighting Control Credit _ 0 Conditioned Spaces from LTG -2C Unconditioned Spaces from LTG -2C Adjusted Installed — 3,471 Adjusted Installed - 0 Lighting Power Lighting Power Complies if Installed:5 Allowed Complies if Installed:5 Allowed Allowed Lighting Power Allowed Lighting Power Conditioned Spaces from LTG -3C or PERF -1 3,484 Unconditioned Spaces from LTG -3C 0 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for the Lighting system, LTG -2A. The designer is required to check the acceptance tests and list all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. If all the lighting system or control of a certain type requires a test, list the different lighting and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test. 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. Forms can be grouped by type of Luminaire controlled. Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or when ever new lighting system with controls is installed in the building or space shall be certified as meeting the Acceptance Requirements. The LTG -2A form is not considered a complete form and is not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Title 24 Part 6. The field inspector must receive the properly filled out and signed forms before the building can receive final occupancy. A copy of the LTG -2A for each different lighting luminaire control(s) must be provided to the owner of the building for their records. Controls for Credits LTG -2A Controls and Sensors and Automatic Number of Daylighting .Luminaire Controls Equipment Re uirin Testing Description controls Location Acceptance Occ Sensor - Multi -Level (1) 13w Compact Fluorescent 19 Storage/ Employee Toilet Dimming - Manual 50w Low Voltage Halogen 19 Bar Dimming - Manual 75w Low Voltage Halogen 1 Bar Dimming - Manual 75w Low Voltage Halogen 4 Restaurant El Dimming - Manual 50w Low Voltage Halogen 15 Restaurant Dimming - Manual 60w Low Voltage Halogen 12 Restaurant Occ Sensor - Multi -Level (1) 13w Compact Fluorescent 4 Restroom El Occ Sensor - Multi -Level 60w Low Voltage Halogen 2 Restroom El ❑ ❑ EnergyPto 5.1 by Ene Soft User Number- 6712 RunCode: 2010-11-01T11:14.44 ID: Page 6 of 17 LIGHTING CONTROLS CREDIT WORKSHEET (Part 1 of 2) LTG -2C Project Name La Brasserie Tenant Improvement Date 11/1/2010 POWER ADJUSTMENT FACTORS PAF FOR NON -DAYLIGHT CONTROLS A Separate PAF Worksheet Must Be Filled Out for Conditioned and Unconditioned Spaces. Control Credits listed on this schedule are only for: CONDITIONED SPACES 0 UNCONDITIONED SPACES A B C D E F G Watts of Power Room # Zone ID Plan Room Area Control Adjustments Areas Lighting Control Description' Reference(ft) Lighting Factor Control Credit Watts E x Storage/Employee Occ Sensor- Multi -Level FI 376 247 0.20 49 Bar Dimming - Manual 6" 293 950 0.10 95 Bar Dimming - Manual 60 293 75 0.10 8 Restaurant Dimming - Manual 60 2,016 300 0.10 30 Restaurant Dimming - Manual 6" 2,016 750 0.10 75 Restaurant Dimming - Manual 180W C 2,016 720 0.10 72 Restroom Occ Sensor- Multi -Level FI 218 52 0.20 10 Restroom Occ Sensor - Multi -Level 60WLVH 218 120 0.20 24 PAGE TOTAL 363 Note: Building total of non -daylight control credit watts for all pages of LTG -2C Pae 1 of 2 Conditioned and Unconditioned Enter building total of all daylight controls credit watts from LTG -2C Page 2 of 2 0 Space shall be separately totaled BUILDING TOTAL OF ALL CONTROL CREDIT WATTS (FOR BOTH NON -DAYLIGHT AND DAYLIGHT CONTROL CREDITS) Enter in LTG -1 C; Page 4: Lighting Control Credit as appropriate for CONDITIONED or UNCONDITIONED Spaces 363 1. Description shall be consistent with Type of Control defined in Table 146-C 2. Power Adjustment Factor taken from Table 146-C EnergyPro5.1byEnergySoft User Number: 6712 RunCode: 2010-11-01T11:14:44 ID: Pae 7 of 17 INDOOR LIGHTING POWER ALLOWANCE LTG -3C Project Name La Brasserie Tenant Improvement 711/1/2010 Date ALLOWED LIGHTING POWER Chose One Method A Separate LTG -3C must be filled out for Conditioned and Unconditioned Spaces. Indoor Lighting Power Allowances listed on this page are only for: m CONDITIONED SPACES ❑ UNCONDITIONED SPACES COMPLETE BUILDING METHOD WATTS BUILDING CATEGORY From §146 Table 146-E PER(ft) X COMPLETE BLDG. AREA = ALLOWED WATTS TOTALS AREA WATTS AREA CATEGORY METHOD WATTS BUILDING CATEGORY From §146 Table 146-F PER(ft) X Area ft' = ALLOWED WATTS Comp Bldg Restaurant 1.20 2,903 3,484 TOTALS 2,903 3,484 AREA WATTS TAILORED METHOD Total Allowed Watts using the Tailored Method taken from LTG -4C Pae 1 of 4 Row 3 0 The indoor lighting power allowance using the Tailored Method of compliance shall be determined using the LTG -4C set of forms. A separate set of LTG - 4C forms shall be filled out for CONDITIONED and UNCONDITIONED spaces EnergyPro 5.1 by EnergySoft User Number. 6712 RunCode: 2010-11-01T11:14.44 ID: Pa e 8 771 LIGHTING MANDATORY MEASURES: NONRESIDENTIAL LTG -MM Project Name Date La Brasserie Tenant Improvement 11/1/2010 Indoor Lighting Measures: §131'(d): Shut-off Controls For every floor, all interior lighting systems shall be equipped with a separate automatic control to shut off the lighting. 1. 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 li htin . 2 Override for Building Lighting Shut-off: The automatic building shut-off system is provided with a manual, accessible override switch in sight of the lights. The area of override is not to exceed 5,000 square feet. §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. §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. §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. Uniform Reduction for Individual Rooms: All rooms and areas greater than 100 square feet and more than 0.8 watts §131(b): per square foot of lighting load shall be controlled with bi-level switching for uniform reduction of lighting within the room. Daylight Area Control: All rooms with windows and skylights that are greater than 250 square feet and that allow for §131(c): the effective use of daylight in the area shall have 50% 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(c): Display Lighting. Display lighfing shall be separately switched on circuits that are 20 amps or less.6. Outdoor Lighting Measures: §130(c)l : Mandatory lighting power determination for medium base sockets without permanently installed ballasts §132(a): All permanently installed luminaires with lamps rated over 100 Watts either have a lamp efficacy of at least 60 lumens per Watt or are controlled by a motion sensor. §132(b): All Luminaires with lamps rated greater than 175 Watts in hardscape area, including parking lots, building entrances, canopies, and all outdoor sales areas meet the Cutoff Requirements. §132(c)1: All permanently installed outdoor lighting meets the 'control requirements listed. §132(c): Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements listed. EnergyPro 5.1 by Ener Soft User Number. 6712 RunCode: 2010-11-01T11:14:44 ID: Page 9 of 17 CERTIFICATE OF COMPLIANCE and (Part 1 of 5.) MECH-1 C FIELD INSPECTION ENERGY CHECKLIST Project Name La Brasserie Tenant Improvement Date 11/1/2010 Project Address 78-448 Highway 111 La Quinta 777 Climate Zone 15 Total Cond. Floor Area 2,903 Addition Floor Area n/a GENERAL INFORMATION Building Type: ® Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ Schools (Public School) ❑ Relocatable Public School Bldg. 10 Conditioned Spaces ❑ Unconditioned Spaces affidavit Phase of Construction: ❑ New Construction ❑ Addition ❑ Alteration Approach of Compliance: ❑ Component ❑ Overall Envelope TDV ❑ Unconditioned (file affidavit) Energy Front Orientation: N, E, S, W or in Degrees: 1o deg HVAC SYSTEM DETAILS FIELD INSPECTION ENERGY CHECKLIST E ui ment2 Inspection Criteria Meets Criteria or Requirements Pass Fail — Describe Reason Item or System Tags i.e. AC -1, RTU -1, HP -1 DHW Heater ❑ ❑ Eq ui �ment Type 3: Electric Res DHW Boiler ❑ ❑ Number of Systems 3 ❑ ❑ Max Allowed Heating Capacity' 5,120 Btu/hr ❑ ❑ Minimum Heating Efficiency' 0.95 EF ❑ ❑ Max Allowed Cooling Capacity' n/a ❑ ❑ Cooling Efficiency' n/a ❑ ❑ Duct Location/ R -Value n/a ❑ ❑ When duct testing is required, submit & MECH-4-HERS n/a 13 13MECH-4A Economizer n/a ❑ ❑ Thermostat n/a ❑ ❑ Fan Control n/a ❑ ❑ E ui ment2 Inspection Criteria FIELD INSPECTION ENERGY CHECKLIST Pass Fail — Describe Reason Item or System Tags AC -1, RTU -1, HP -1 Existing HVAC ❑ 13i.e. Equipment T e3: Packaged DX ❑ ❑ Number of Systems 3 ❑ ❑ Max Allowed Heating Capacity' 187,220 Btu/hr ❑ ❑ Minimum Heating Efficiency' 75% AFUE ❑ ❑ Max Allowed Cooling Capacity' 336,333 Stu/hr ❑ ❑ Cooling Efficiency' 10.0 SEER/9.0 EER ❑ ❑ Duct Location/ R -Value R-4.2 ❑ ❑ When duct testing is required, submit & MECH-4-HERS No ❑ 13MECH-4A Economizer No Economizer ❑ ❑ Thermostat Setback Required ❑ ❑ Fan Control Constant Volume ❑ ❑ 1. If the Actual installed equipment performance efficiency and capacity is less than the Proposed (from the energy compliance submittal or from the building plans) the responsible party shall resubmit energy compliance to include the new changes. 2. For additional detailed discrepancy use Page 2 of the Inspection Checklist Form. Compliance fails if a Fail box is checked. 3. Indicate Equipment Type: Gas (Pkg or, Split), VAV, HP (Pkg or split), Hydronic, PTAC, or other. JEnergyPro5.1byEnergySoft User Number. 6712 RunCode: 2010-11-01 T11:14.44 ID: Pae 10 of 17 CERTIFICATE OF COMPLIANCE and (Part 2 of 5) MECH-1C FIELD INSPECTION ENERGY CHECKLIST Project Name Date La Brasserie Tenant Improvement 11/1/2010 11 CERTIFICATE OF COMPLIANCE Part 5 of 5 MECH-1C Project Name Date La Brasserie Tenant Improvement 11/1/2010 Documentation Author's Declaration Statement I certify that this Certificate of Compliance documentation is accurate and complete. Signature Name Tim Scott Company Scott Design and Title 24, Inc, Date 11/12010 Address 77-085 Michigan Drive CEPS # City/State/ZipPalm Desert Ca 92211 Phone (760) 200-4780 The Principal Mechanical Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the mechanical design. • This Certificate of Compliance identifies the mechanical features and performance specifications required for compliance with Title-24, Parts 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name Jon Scott Signature Company Scott Design and Title 24, Inc. Date Address 77-085 Michigan Drive License # City/State/Zip palm Desert, Ca 92211 Phone (760) 200-4780 Mandatory Measures i Indicate location on building plans of Note Block for Mandatory Measures MECHANICAL COMPLIANCE FORMS & WORKSHEETS (check box if worksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, please refer to the 2008 Nonresidential Manual. Note: The Enforcement Agency may require all forms to be incorporated onto the building plans. 0 MECH-1 C Certificate of Compliance. Required on plans for all submittals. 0 MECH-2C Mechanical Equipment Summary is required for all submittals. 0 MECH-3C Mechanical Ventilation and Reheat is required for all submittals with mechanical ventilation. 0 MECH-4C Fan Power Consumption is required for all prescriptive submittals. JEneMyPro5.1byEnergySoft User Number. 6712 RunCode: 2010-11-01T11:14:44 ID: Pae 12 of 17 AIR SYSTEM REQUIREMENTS Part 1 of 2 MECH-2C Project Name Date La Brasserie Tenant Improvement 11/1/2010 Indicate Air Systems Type Central, Single Zone, Packa e, VAV, or etc... Item or System Tags i.e. AC -1, RTU -1, HP -1 Existing HVAC Number of Systems 3 Indicate Pa a Reference on Plans or Schedule and indicate the applicable exception(s) MANDATORY MEASURES T-24 Sections Heating Equipment Efficiency 112(a) 75% AFUE Cooling Equipment Efficiency 112(a) 10.0 SEER/9.0 EER HVAC Heat Pump Thermostat 112(b), 112(c) Na Furnace Controls/Thermostat 112(c), 115(a) n/a Natural Ventilation 121 b Yes Mechanical Ventilation 121 b 2,468 cfm VAV Minimum Position Control 121 c No Demand Control Ventilation 121 c No Time Control 122(e) Programmable Switch Setback and Setup Control 122(e) Setback Required Outdoor Damper Control 122(f) Auto Isolation Zones 122 n/a Pipe Insulation 123 Duct Insulation 124 R-4.2 PRESCRIPTIVE MEASURES, Calculated Design Heating Load 144(a & b 187,220 Btu/hr Proposed Heating Capacity 144(a & b 192,999 Btu/hr Calculated Design Cooling Load 144(a & b 235,433 Btu/hr Proposed Cooling Capacity 144(a & b 141,998 Btu/hr Fan Control 144(c) Constant Volume DP Sensor Location 144(c) Supply Pressure Reset (DDC only) 144(c) Yes Simultaneous Heat/Cool 144(d) No Economizer 144(e) No Economizer Heat Air Supply Reset 144(f) Constant Temp Cool Air Supply Reset 144(f) Constant Temp Electric Resistance Heating' 144 Air Cooled Chiller Limitation 144(i) Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(k) No 1. Total installed capacity (MBtu/hr) of all electric heat on this project exclusive of electric auxiliary heat for heat pumps. If electric heat is used explain which exception(s) to §144(g) apply. EnergyPro 5.1 by EnergySoft User Number. 6712 RunCode: 2010-11-01711:14:44 ID: Page 13 of 17 WATER SIDE SYSTEM REQUIREMENTS Part 2 of 2 MECH-2C Project Name Date La Brasserie Tenant Improvement 11/1/2010 WATER' SIDE SYSTEMS: Chillers, Towers, Boilers, H dronic Loops Item or System Tags (i.e. AC-1, RTU-1, HP-1)' Number of Systems Indicate Page Reference on Plans or Specification 2 MANDATORY MEASURES T-24 Sections Equipment Efficiency 112(a) Pipe Insulation 123 PRESCRIPTIVE MEASURES Cooling Tower Fan Controls 144(a & b Cooling Tower Flow Controls 144(h) Variable Flow System Design 144(h) Chiller and Boiler Isolation 1440) CHIN and HHW Reset Controls 1440) WLHP Isolation Valves 1440) VSD on CHIN, CW & WLHP Pumps>5HP 1440) DP Sensor Location 1 1440) 1. The proposed equipment need to match the building plans schedule or specifications. If a requirement is not applicable, put "WA" in the column next to applicable section. 2. 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 "N/A" in the column next to applicable section. Service Hot Water, Pool Heatin Item or System Tags (i.e. WH-1, WHP, DHW, etc...)' DHW Heater Number of Systems 3 Indicate Pa a Reference on Plans or Schedule' MANDATORY MEASURES T-24 Sections SERVICE HOT WATER Certified Water Heater 111, 113(a) AO SMITH ELJF-06' Water Heater Efficiency 113(b) 0.95 EF Service Water Heating Installation 113(c) Controls Req. Pipe Insulation 123 n/a POOL AND SPA Pool and Spa Efficiency and Control 114(a) n/a Pool and Spa Installation 114(b) Na Pool Heater — No Pilot Light 115(c) Na Spa Heater — No Pilot Light 115(d) n1a Pipe Insulation 123 Required 1. The Proposed equipment needs to match the building plans schedule or specifications. If a requirement is not applicable, put "WA" in the column next to applicable section. 2. For each water heater, pool heater 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 "N/A" in the column. Ener Pro 5.1 by EnergySoft User Number 6712 RunCode: 2010-11-01T11:14:44 ID: Pae 14 of 17 FAN POWER CONSUMPTION MECH-4C Project Name La Brasserie Tenant Improvement Date 11/1/2010 NOTE: Provide one copy of this worksheet for each fan system with a total fan system horsepower greater than 25 hp for Constant Air Volume (CAV) Fan Systems or Variable Air Volume (VAV) Systems when using the Prescriptive Approach. See Power Consumption of fan §144(c). A B C D E F Fan Description Design Brake HP Eff ici ncy Number of Fans Peak Watts B X E X 746 / C X D Motor Drive Supply Fan 0.750 77.0% 100.0% 3.0 21180 TOTALS AND ADJUSTMENTS FILTER PRESSURE ADJUSTMENT Equation 144-A in §144(c) of the Energy Standards. 1 TOTAL FAN SYSTEM POWER WATTS, SUM COLUM F 2,180 2 SUPPLY DESIGN AIRFLOW CFM 5,199 A) If filer pressure drop (SPa) is greater than 1 inch W. C. or 245 Pascal then enter SP, on line 4. Enter Total.Fan pressure drop across the fan (SP,) on Line 5. 3 TOTAL FAN SYSTEM POWER INDEX Row 1 / Row 2 W/CFM 4 SPa 5 SP, B Calculate Fan Adjustment and enter on line 6. 6 Fan Adjustment = 1 SPa-1 / SP, C) Calculate Adjusted Fan Power Index and enter on Row 7 7) ADJUSTED FAN POWER INDEX (Line 3 x Line 6)' 0.419 W/CFM 1. TOTAL FAN SYSTEM POWER INDEX or ADJUSTED FAN POWER INDEX must not exceed 0.8 W/CFM for Constant Volume systems or 1.25 W/CFM for VAV systems. EnervyPro 5.1 b EnenaySaft leer Number,- 6712 RdnCeder 8010.11.01711;14:44 to Peoe 16 of 17 MECHANICAL VENTILATION AND REHEAT MECH-3C Project Name La Brasserie Tenant Improvement Date 11/1/2010 MECHANICAL VENTILATION 121 b 2 REHEAT LIMITATION (§144(d)) AREA BASIS OCCUPANCY BASIS VAV MINIMUM A B C D E F G H I J K L M N Zone/System Condition Area (ft2) CFM per fe Min CFM By Area B X C Number Of People CFM per Person Min CFM by Occupant E X F REQ'D V.A. Max of D or G Design Ventilation Air CFM 50% of Design Zone Supply I CFM B X 0.4 CFM / ftz Max. of Columns H, J, K, 300 CFM Design Minimum Air Setpoint Transfer I Air Storage 376 0.38 143 1 143 226 Bar 293 0.38 111 111 268 Restaurant 2,016 0.38 766 766 1,844 Restroom 218 0.38 83 83 131 Existing HVAC Total 1,103 2,468 Totals Column 1 Total Design Ventilation Air C Minimum ventilation rate per Section 121, Table 121-A. E Based on fixed seat or the greater of the expected number of occupants and 50% of the CBC occupant load foregress purposes fors aces without fixed setting. H Required Ventilation Air REQ'D V.A. is the larger of the ventilation rates calculated on an AREA BASIS or OCCUPANCY BASIS Column D or G). I Must be greater than orequal to H or use Transfer Air column N to make up the difference. J Desion fan supply CFM Fan CFM x 50%• or the design zone outdoor airflow rate per 121. K Condition area(ft) x 0.4 CFM / ftz; or L Maximum of Columns H, J, K, or 300 CFM M This must be less than orequal to Column L and greater than orequal to the sum of Columns H plus N. N Transfer Air must be provided where the Required Ventilation Air (Column H) 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 H and the Design Minimum Air Column M Column H minus M. EnefgyPro 5.1 by EnergySoft User Number: 6712 RunCode: 2010-11-01T11:14:44 ID: Pae 15 of 17 FAN POWER CONSUMPTION MECH-4C Project Name La Brasserie Tenant Improvement Date 11/1/2010 NOTE: Provide one copy of this worksheet for each fan system with a total fan system horsepower greater than 25 hp for Constant Air Volume (CAV) Fan Systems or Variable Air Volume (VAV) Systems when using the Prescriptive Approach. See Power Consumption of fan §144(c). A B C D E F Fan Description Design Brake HP Effici ney Number of Fans Peak Watts B X E X 746 / (C X D) Motor Drive Supply Fan 0.750 77.0% 100.0% 3.0 2,180 TOTALS AND ADJUSTMENTS FILTER PRESSURE ADJUSTMENT Equation 144-A in §144(c) of the Energy Standards. 1 TOTAL FAN SYSTEM POWER WATTS, SUM COLUM F 2.180 2 SUPPLY DESIGN AIRFLOW CFM 5,199 A) If filer pressure drop (SP.) is greater than 1 inch W. C. or 245 Pascal then enter SP, on line 4. Enter Total Fan pressure drop across the fan (SP,) on Line 5. 3 TOTAL FAN SYSTEM POWER INDEX Row 1 / Row 2 W/CFM 4 SP. 5 S B Calculate Fan Adjustment and enter on line 6. 6 Fan Adjustment = 1 SPa-1 / SP, C) Calculate Adjusted Fan Power Index and enter on Row 7 7) ADJUSTED FAN POWER INDEX (Line 3 x Line 6)' 0.419 W/CFM 1. TOTAL FAN SYSTEM POWER INDEX or ADJUSTED FAN POWER INDEX must not exceed 0.8 W/CFM for Constant Volume systems or 1.25 W/CFM for VAV systems. Ener Pro 5.1 by Ener Soft User Number. 6712 RunCode: 200-11-01T11:14:44 ID: Pae 16 of 17 MECHANICAL MANDATORY MEASURES: NONRESIDENTIAL MECH-MM Project Name Date La Brasserie Tenant Improvement 11/1/2010 Equipment and System Efficiencies §111: Any appliance for which there is a California standard established in the Appliance Efficiency Regulations will comply with the applicable standard. §115(a): Fan type central furnaces shall not have a pilot light. §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. §124: Air handling duct systems shall be installed and insulated in compliance with Sections 601, 602, 603, 604, and 605 of the CMC Standards. Controls §122(e): Each space conditioning system shall be installed with one of the following: 1 A. 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 1 B. An occupancy sensor to control the operating period of the system; or 1 C. A 4 -hour timer that can be manually operated to control the operating period of the system. 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. Each space conditioning system serving multiple zones with a combined conditioned floor area more than 25,000 §122(g): 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(c): Thermostats shall have numeric setpoints in degrees Fahrenheit (F) and adjustable setpoint stops accessible only to authorized personnel. §122(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 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 §122(a&b): 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. Ventilation §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. §122(f): 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. Ventilation System Acceptance. Before an occupancy permit is granted for a newly constructed building or space, or a §121(f): new ventilating system serving a building or space is operated for normal use, all ventilation systems serving the building ors ace shall be certified as meeting the Acceptance Requirements for Code Compliance Service Water Heating Systems §113(c) Installation 3. Temperature controls for public lavatories. The controls shall limit the outlet Temperature to 110° F. 2 Circulating service water -heating systems shall have a control capable of automatically turning off the ci�ciilabng pump when hot water is not required. r� Ener Pro 5.1 by EnergySoft User Number. 6712 RunCode: 2010-11-O1T11:14.44 ID: Pae 17 of 17