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0107-260 (CSCS)LICENSED CONTRACTOR DECLARATION `-:yl hereby affirm under penalty of perjury that I am licensed under provisions of 'pChapter 9 (commencing with Section 7000) of Division 3 of the Business and rofessionals Code, and my Licenseis in full force and effect. License # t Lic. Class Exp. Date - 709064 D Date - �� ' t Signature of Contractor OWNER -BUILDER DI-CLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting' with licensed contractors to construct the project (Seo. 7044, 3usiness & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner 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 & policy no. are: Cartier Policy No. (This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:1. '? Applicant Q_/ -r -j -.✓�� Warning: Failure to secureWorkers' Compensation coWe'ra'ge-is-unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 applicaton agrees to, & shall, indemnity & hold harmless the City of La Quinta, its officers, agents and employees. 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 State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. _Signature (Owner/Agent) t`) n , LIZ � i DateZ_2 BUILDING PERMIT PERMITk ` DATE VALUATION TRACT LOTiv ** ggaaf/ Ty Vit l ":1)e517'Fw �D P J6 e.✓.E+FI«F,. Riff)A. JOB SITE APN ADDRESS ..„c� :GH13i'AxY 3.1 a —S -Fr.. 3 0 0 - - OWNER CONTRACTOR/DESIGNER/EN INEER :�l+l�.Ca.1[i�'I'�'C) reg'wpi�d'y� AL ,S'q�t`RV.![,':. DC+�+y3'AZ B.y��i�:":�7�S, �Tldt" 1 219 �P7.3,�. y !'Yi.5i7lo. 15ME7 200 J ' p �p� /�7 �� 893 J 1>017G:I.O! 5 111 `a.IRCIZ C* -STA MENIA CIA 92627 PMRSIDE CA 92508 (949)500_21 7.8 117PU USE OF PERMIT S: 'P•".A'NT i'.MPt'.W'V F-tt4n4T PER APPR..0VXD P1,A113 Catt«+I Y PLAIN CH 4='LE 10 1 - 000-43 9-3 1 S $133.1.1 C'ON-S RUCTIC'i'PT FEE 10,1_000,418-1000 $313, ¢ MECHANICAL MR 101. -IS00-421-000 $30.00 ZLILC'r; R1C'tJ. V11rF 101-000-420-000 $10n.tt� PLa3MBFI G -00.0-419-000 �bD.ilA S712S:sT, D NO7,10M PEX - Comm 100-000-2,21-000 $13.10 •-•••-.. i`,?C� 'aE "•.� .P'15.:�J'iw.[4 M7tdiLF.11t.t,(..1.'+JAV .1'AJ:!IA.! 1.`d."/'lN C+L7A:A+F.Y.. 1 &RD PRE, -PAT..% 000 s1:,()72-38 $0,00 2001 TOM FMW1 111 FURS DUE NOW J U L Z 7 f L (y RECEIPT DATE < / BY DATE FINALED INSPECTOR Fit INSPECTION RECORD t OPERATION DATE T INSPECTOR OPERATION DATE INSPECTOR - BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts ' Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final Grp— 'BLOCKWALL APPROVALS POOLS - SPAS Steep Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster - Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground .Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: < , Telephone: a 7k" '».;: . 3 � State Lic. # :-- f%p C Ciy ty Lic.-�—: 1 Arch., Engr., Designer: Address: City, ST, Zip: l Coro Ate _ qq 9 - `de T tag 7 % Telephone: �p� �^,II •�W C�-t/ UI !✓ ::>:. � #i``Construction Type: ::::: .::;;•;:;;.: ...::•:;;.::_........ YP Occupancy: Stat eL ic. ay: ............. Project type (circle one): New Add'n Alte Repair Demo (` Name of Contact Person: p ti_�j��� ', q Ft.:3 S 7 aY Stories: q Units: Telephone# of Contact Person: - i ated Value of Project: (CANT- nn NAT- f Submittal Req'd B'n" TRACKING Ci' of La Quinta � Plan Sets BuMm: eT Safety Division Permit #P.O. Box 1504, 78.495 Calle Tampico 010 Structural Calts. La Quinta, G4 92253 - (619) 777.7012 Reviewed, ready for corrections Building Permit Application and Tracking Sheet Project Address: — S S' 11-v �� �� Owner's Name: c / A P. Number: 3©� Address: T Z Cf �► �S d Legal Description: v City, ST, Zip: C,, Contractor: bha / (�/� C,1, -q Cay/,-.,, _ c, _ Title 24 Gales. Address: g 3 06 f, a [Telephone: G. Cr v l Project Description: Q 4-4 Plans picked up City, ST, Zip:A. , Telephone: a 7k" '».;: . 3 � State Lic. # :-- f%p C Ciy ty Lic.-�—: 1 Arch., Engr., Designer: Address: City, ST, Zip: l Coro Ate _ qq 9 - `de T tag 7 % Telephone: �p� �^,II •�W C�-t/ UI !✓ ::>:. � #i``Construction Type: ::::: .::;;•;:;;.: ...::•:;;.::_........ YP Occupancy: Stat eL ic. ay: ............. Project type (circle one): New Add'n Alte Repair Demo (` Name of Contact Person: p ti_�j��� ', q Ft.:3 S 7 aY Stories: q Units: Telephone# of Contact Person: - i ated Value of Project: (CANT- nn NAT- f Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submittedZy Item _ Amount Structural Calts. Reviewed, ready for corrections ` J Plan Check Deposit Truss Cala. Called Contact Person L&K, • Plan Check Balance Title 24 Gales. Plans picked up Construction Grant Deed Plans resubmitted �% Mechanical 3� School Fees Subcontactor List Planning Approval 2" Review, ready for correction slue Called Contact Person Plans picked up or I L Electrical Plumbing S.M.I. ov et1 �� Pub. Wks. Appr Plans resubmitted Grading Developer Impact Fee A.I p p 7 H.O.A. Approval 1 3" Review, ready for correctionsrssue � I . Called Contact Person Date of permit issue Total Permit Fees Tom Tisdale Fire Chief ,Proudly serving the unincorporated areas of Riverside County and the Cities of: , Banning 4. Beaumont Calimesa r,. Canyon Lake Coachella Desert Hot Springs Indian Wells Indio Lake Elsinore 4. La Quirlta Moreno Valley .;. Palm Desert 4.4 Penis 4. Rancho Mirage 4. San Jacinto 4. Temecula Board of Supervisors Bob Buster, District. I John Tavaglione, District 2 Jim Venable, Distrix 3 Roy Wilson, District.4 Tom Mullen, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT 117 c0c!pc1c1i077 114117 111C California Depot-Imem bl' oresli-v unci P -ii -e I'rn1ec11on 210 West San Jacinto Avenue -teems, California 92570 - (909) 940-6900 - Fax (_"__)_9725-_6_91O May 1,2001 To: G.M. Benson Design Box 213 Apple Valley, CA 92307 Re: Non -Structural Building T/I Plan Review LAQ-01-BLDG-026 / Pacific Dental Services Fire Department personnel have completed a review of the plans you submitted for the above referenced project. Please be advised the following conditions apply as a part of the conditions for the issuance of a building permit. 1) Fire Dbpartment approval is based upon the 1997 UBC requirements for Group B occupancies. It is prohibited to use, process or store any materials in the occupancy that would classify it as a Group H occupancy per Sec. 307 of the 1997 UBC. 2) Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire Department for review, along with a planfinspection fee. The approved plans, with Fire Department Job card must be at the job site for all inspections. 3) Install Knox Key Lock box, Model 3200, mounted per recommended standard of the Knox Company. Special forms are available from this office for the ordering of the Key Switch, 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. 4) Install portable fire extinguisher's per NFPA, Pamphlet #10, but not less than 2A1 OBC in rating. Contact certified extinguisher company for proper placement of equipment. 5) Approved building address shall be placed in such a position as to be plainly visible and legible from the street and rear access if applicable. In strip centers, businesses shall post the business name and suite number on back doors as well as the front. All addressing must be legible and of a contrasting color with the background. Applicantrnstaller shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 24 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, FRANK KAWASAKI Chief Fire Department Planner By '" �0,4, Walter Brandes Fire Safety Specialist H:IPEAWPDATA1tAOUIMA1PItOJECTSTN_IMPRV AO.01-BLDO-02B.doe EMERGENCY SERVICES DIVISION - PLANNING SECTION - INDIO OFFICE 82-675 Highway 111, 2"4 FI., Indio, CA 92201 - (760) 863-8886 - Fax (760) 863-7072 r City o.La Quinta Developers Project Approval Form Prior to the. issuance of Building Permits for the project listed below, the following Departmental clearances must be obtained. Please return this form to the Building and Safety Department after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Dental Office - Bldg 3 78-595 Highway 111 Applicant Contact: Don Webb - 714-822-4616 Application / Circulation Date:.. 05/09/2001 Date Community Development Department Christine Di Iorio, Planning Manager Date Public Works Department Steve Speer, Senior Engineer \ Building and Safety- Department Greg Butler, Building and Safety Department Manager Nickie Gormley Counter Technician Building & Safety G /1-3 e / ate Date O City o Quinta La Developers Project Approval Form Prior to the issuance of Building Permits for the project listed below, the following Departmental clearances`must be obtained. Please return this form to the Building and Safety Department ot* after approval. Contact applicant for resolution of conditions preventing or delaying approval. Project: Dental Office - Bldg\z. 78-595 Highway 111 Applicant Contact: Don Webb - 7147822-4616 Application / Circulation Date: 05/09/2001 �5Q s I ••Date Community Development DepartmentNIA t Christine Di Iorio, P arming Manager Date Public Works Department Steve Speer, Senior Engineer ; Building and'`Safety Department Greg Butler, Building and Safety Department Manager Nickie Gormley Counter Technician S od� , Building & Safety You Date Date Certificate of Occupancy City of La Quinta t Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the. various ordinances of the City regulatingbui/ding construction or use. For the following: BUILDING ADDRESS: Use Classification: COMMERCIAL Occupancy Group: B Type of Construction: 78-595 HIGHWAY 111, SUITE 300 Owner of Building: PACIFIC DENTAL SERVICES, INC Building Official Bldg. Permit No.: 0107-260 Land Use Zone: CC Address: 129 WEST WILSON, SUITE 200 City: COSTA MESA, CA 92627 By: KIRK KIRKLAND Date: APRIL 4, 2002 POST IN A CONSPICUOUS PLACE Certificate of -Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the. requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was.in compliance with the various ordinances of the City regu/sting bui/ding construction or use. For the fo/%wing: BUILDING ADDRESS: 78-595 HIGHWAY 111, SUITE 300 Use Classification: COMMERCIAL - DENTAL OFFICE Bldg. Permit No.: 0107-260 Occupancy Group: . B Type of Construction: V1 Land Use Zone: CR Owner of Building: PACIFIC DENTAL SERVICES TEMPORARY CERTIFICATE OF OCCUPANCY SEE EXHIBIT A, ATTACHED Building Official Address: 129 W. WILSON, SUITE 200 City: COSTA MESA, CA 92627 By: RICHARD KIRKLAND Date: 11/29/01 EXP. 03/15/02 POST IN A CONSPICUOUS PLACE TEMPORARY CERTIFICATE OF OCCUPANCY — 30 DAYS c Certificate of Occupancy City of La Quinta Building and Safety Department This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code, certifying that, at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: BUILDING ADDRESS: 78-595 HWY 111 Use Classification: COMMERCIAL Bldg. Permit No.: 0107-260 Occupancy Group: B Type of Construction: VN Land Use Zone: CC Owner of Building: PACIFIC DENTAL SERVICES INC Building Official Address: 129 WEST WILSON SUITE 200 City: COST MESA CA 92627 By: KIRK KIRKLAND Date: 11-28-01 POST IN A CONSPICUOUS PLACE r -- TITLE 24 REPORT. e o Title 24 Report for: Pacific Dental Service Tenant Developement La Quinta Court, Bldg. 2 La Quinta, CA y o Project Designer: G. M. Benson Building Design P.O. Box 213 Apple Valley, CA (760) 247-8270 Report Prepared By: Larry N. Nelson - C.E.P.E. ENERCALC 19098 LINDSAY ST. HESPERIA,. CA 92345-671 (760) 244-6055 042301-C Date: Q� Z � Q Z O ::) i>--UJU LL-LLJ m �O U) CC �� �zsfrz CD "� OU _ o J <o U m LA- Q 0 o o 4/23/2001 The EnergyPro computer program has been used to perform the calculations summarizes in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 1998 Building Energy Efficiency Standards. This program developed by Gabel Dodd/EnergySoft, LLC (415) 883-5900. EnergyPro 2.1 By EnergySoft Job Number. 042301-C User Number. 1248 a TITLE 24 REPORT Title 24 Report for: Pacific Dental Service Tenant Developement La Quinta Court, Bldg. 2 La Quinta, CA Project Designer: G. M. Benson Building Design P.O. Box 213 Apple Valley, CA (760) 247-8270 Report Prepared By: Larry, N. Nelson - C.E.P.E. ENERCALC 19098 LINDSAY ST. HESPERIA, CA 92345-6716 (760) 244-6055 J 042301-C Date: 4/23/2001 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 1998 Building Energy Efficiency Standards. This program developed by Gabel Dodd.fEnergySoft, LLC (415) 8835900. EnergyPro 2.1 By EnergySoft Job Number. 042301-C User Number. 1248 TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Nonresidential Performance Title 24 Forms 3 Form ENV -3 Proposed Construction Assembly 12 Form ENV -MM Envelope Mandatory Measures 14 Form LTG -4 Tailored LPD Summary and Worksheet 15 HVAC System Heating and Cooling Loads Summary 16 EnergyPro 2.1 By EnergySoft Job Number. 042301-C User Number. 1248 PERFORMANCE CERTIFICATE OF COMPLIANCE Part 1 of 3 PERF -1 PROJECT NAME This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 DATE Pacific Dental Service Tenant Develo ement BUILDING CONDITIONED FLOOR AREA 3,576 Sq.Ft 4/23/2001 PROJECT ADDRESS NONRESIDENTIAL HIGH RISE RESIDENTIAL E:] HOTELIMOTEL GUEST ROOM PHASE OF CONSTRUCTION La Quinta Court, Bldg. 2 La Quinta ENV. LTG. MECH. n F-] n 1. 1 hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Permit # PRINCIPAL DESIGNER - ENVELOPE TELEPHONE Building G. M. Benson Building Design (760) 247-8270 responsible for its preparation; and for the following reason: DOCUMENTATION AUTHOR TELEPHONE Checked by/Date ENERCALC (760) 244-6055 Enforcement Agency Use GENERAL INFORMATION This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 DATE OF PLANS DOCUMENTATION AUTHOR Lar N. Nelson - C.E.P.E. BUILDING CONDITIONED FLOOR AREA 3,576 Sq.Ft CLIMATE ZONE 1 15 BUILDING TYPE ® NONRESIDENTIAL HIGH RISE RESIDENTIAL E:] HOTELIMOTEL GUEST ROOM PHASE OF CONSTRUCTION NEW CONSTRUCTION ADDITION ® ALTERATION EXISTING + ADDITION 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 State Building Code. This certificate applies onlWto a Building sing the performance compliance approach. DOCUMENTATION AUTHOR Lar N. Nelson - C.E.P.E. SI URE C P 71E Z� The Principal Designers hereby certify that the propose design epresented in the construction documents and modelled for this permit application are consistent with all oth r forms and worksheets, specifications, and other calculations submitted with this permit application. The proposed building as designed meets the energy efficiency requirements of the State Building Code, Title 24, Part 6. ENV. LTG. MECH. n F-] n 1. 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 as a civil engineer, mechanical engineer, electrical engineer or architect. �D-�. I affirm that I am eligible under the exemption to Division 3 of the Business and Professions Code by Section 5537.2 of the Business and Professions Code to sign this document as the person responsible for its preparation; and that I am a licensed contractor preparing documents for work that I have contracted to perform. ❑ ❑ ❑ 3. 1 affirm that I am eligible under the exemption to Division 3 of the Business and Professions Code by Section of the Code to sign this document as the person responsible for its preparation; and for the following reason: ENVELOPE COMPLIANCE Indicate location on plans of Note Block for Mandatory Measures ENV -1 Requir orms PRINCIPAL ENVELOPE DESIGNER - NAME SI T RE M. Benson Buildin Desi n jl-' NO l D ZG. �fko"9'r LIGHTING COMPLIANCE Indicate location on plans of Note Block for Mandatory Measures Requ !ed orms LTG -1 PRINCIPAL LIGHTING DESIGNER - NAME SI!� LIC. N D MECHANICAL COMPLIANCE Indicate location on plans of Note Block for Mandatory Me res MECH-1 MECH-2 MECH-3 Require s PRINCIPAL MECHANICAL DESIGNER - NAME SI RE N D E Z Run Initiation Time: 04123101 14:12:07 Run Code: 988060327 EnergyPro 2.1 By Energysoft User Number. 1248 Job Number. 042301-C Page:3 of 16 PERFORMANCE CERTIFICATE OF COMPLIANCE Part 2 of 3 PERF -1 DATE Pacific Dental Service Tenant Develo ement 4/23/2001 ANNUAL SOURCE ENERGY USE SUMMARY kBtu/s ft- r ENERGY COMPONENT Standard Design Proposed Design Compliance Margin f. sp m Prop�d Space Heating Space Cooling Indoor Fans Heat Rejection Pumps Domestic Hot Water Lighting Receptacle Process TOTALS: 0.56 0.36 0.20 �'""ro �� sp" CW"° "°°°`F" "dR1 -- ""4`""" °'"" "°'"° Rft%*KM "°`"' 0 10 z0 so ,0 50 s0 60.15 58.47 1.68 24.92 22.23 2.68 0.00 0.00 0.00 0.00 0.00 0.00 6.77 6.71 0.06 x1.19 39.01 2.18 25.42 25.42 0.00 o.o0 0.00 0.00 159.00 152.21 6.80 BUILDING COMPLIES GENERAL INFORMATION Building Orientation Number of Stories Number of Systems Number of Zones (South)180deg Conditioned Floor Area 3,576 sqft. 1 Unconditioned Floor Area 0 sqft. 2 Conditioned Footprint Area 3,576 sqft. 1 Orientation Front Elevation (South) Left Elevation (west) Rear Elevation (North) Right Elevation (East) Total Roof Gross Area sqft. sqft. sqft sgfto sqft. sgftsgft. Glazin4 Area Glazina sgft sqft. sgft sgft. sqft. Ratio 742 220. 29.7% 0 o 0.0% 948 0 0.0% 784 o.o% 2,474 220 8.9% 3,576 0.0% Standard Proposed Lighting Power Density 1.400 w/sgft. 1.326 w/sgft. Prescriptive Env. Heat Loss 787 693 Prescriptive Env. Heat Gain 58,299 50,710 Remarks: Standard Building (Compliance) Run Initiation Time: 04/23/01 13:37:45 Run Code: 988058265 EnergyPro 2.1 By Energysoft User Number: 1248 Job Number. 042301-C PageA of 16 PERFORMANCE CERTIFICATE OF COMPLIANCE Part 3 of 3 PERF -1 PROJECT NAME Pacific Dental Service Tenant Develo ement DATE 4/23/2001 ZONE INFORMATION Floor Inst. Area LPD System Name Zone Name Occupancy Type (sgfL) (Wlsf)1 Ctrl. Credits (W/sf)2 Tailored Proc. Loads (W/sf) LPD Vent. (W/sf)3 (Cfm/sf) Mech. System Dental Office Medical/Clinical Care 3,576 1.326 Notes: 1. See LTG -1 (items marked with asterisk, see LTG -2 by others) 2. See LTG -3 3. See LTG -4 hems above require special documentation EXCEPTIONAL CONDITIONS COMPLIANCE CHECKLIST Tne local entorcement agency snouia pay special attention to the Items specmea in tnis cnecKltst. Tnese 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. I Pl.n I Fiotd 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. Authorized Signature or Stamp I Run Initiation Time: 04123/0113:37:45 0 8058 65 EnergyPro 2.1 By Energysoft User Number. 1248 Job Number: 042301-C Page:5 of 16 ENVELOPE COMPLIANCE SUMMARY Performance ENV -1 PROJECT NAME Pacific Dental Service Tenant Develo ement DATE 4/23/2001 OPAQUE SURFACES # Solar Surface Framing Act. Gains Type Type Area U -Val. Azm. Tilt YIN Form 3 Reference Location I Comments 1 Wall Metal 948 0.141 0 90 X I 1101' 3D Composit Panels Dental Office 2 Roof Wood 3.576 0.022 0 1 0 X I I R-38 Roof Flat BuiRu Dental Office 3 Wall Metal 522 0.141 180 90 X I 110" 31) Composit Panels Dental Office 4 Wall Metal 784 0.182 90 90 x 1 17" 3D Composit Panels Dental Office Ll FENESTRATION SURFACES # Type Act. Area U -Val. Azm. SHGC Glazing Type Location I Comments 1 Window 66 1.190 180 0.87 Single Clear Default RM ental Office 2 Window 21 1.250 180 0.87 Single Clear Default RM ental Office 3 Window 21 1.250 180 0.87 Sin le Clear Defauft RM ental Office 4 Window 112 1.190 180 0.87 Single Clear Default RM ental Office EXTERIOR SHADING # Exterior Shade Type Window SHGC Hgt. Wd. Overhang Left Fin Right Fin Len. H t. LExt.RExt. Dist. Len. H t. Dist. Len. 1 None 0.76 7.0 9.5 4.0 0.1 4.0 4.0 2 None 0.76 0.0 0.0 4.0 0.1 4.0 4.0 3 None 0.76 0.0 0.0 4.0 0.1 4.0 4.0 4 None 0.76 7.0 16.0 4.0 0.1 4.0 4.0 Initiation 1 Code:Run 1 13:37:45 Run EnergyPro 2.1 By EnergySoft User Number: 1248 Job Number: 042301-C Page:6 of 16 LIGHTING COMPLIANCE SUMMARY Performance LTG -1 PROJECT NAME Pacific Dental Service Tenant Develo ement DATE 4/23/2001 INSTALLED LIGHTING SCHEDULE LAMPS BALLASTS Luminaire Code LUMINAIRE DESCRIPTION TYPE DESCRIPTION # Watts er Lamp DESCRIPTION # (gyp +Ballast) # Watts Total Waw 2 36w/39w Fluorescent Twin Ma EE G 2 36 Magnetic Ener Efficient 2 0 132 (3) 36w/39w Fluorescent Twin MagEE FT36W/2G11 3 361 Magnetic Ene[gy Efficient 2.01 30 117.0 3,510 100w Recessed Incandescent 100W 1 100 No Ballast 11 100-01 1,100 Subtotal from this Page 4 742 Building Total 4 742 Less Control Credit Watts (From LTG -3) 0 Adjusted Actual Watts 4 742 MANDATORY AUTOMATIC CONTROLS CONTROL LOCATION (Room #) CONTROL IDENTIFICATION CONTROL TYPE (Auto Time Switch, Exterior, etc.) SPACE CONTROLLED NOTE TO FIELD CONTROLS FOR CREDIT CONTROL LOCATION (Room # or Dwg. #) CONTROL IDENTIFICATION CONTROL TYPE (Occupant, Daylight, Dimming, etc.) LUMINAIRES CONTROLLED NOTE TO FIELD TYPE # OF LUMINAIRES NOTES TO FIELD - For Building Department Use Only I Run Initiation Time: 04/23/0113:37:45 ode• 988058265 EnergyPro 2.1 By EnergySoft User Number. 1248 Job Number: 042301-C Pagel of 16 CERTIFICATE OF COMPLIANCE Performance MECH-1 PROJECT NAME DATE Pacific Dental Service Tenant DevelODement I 4/23/2001 SYSTEM NAME TIME CONTROL SETBACK CONTROL ISOLATION ZONES HEAT PUMP THERMOSTAT? ELECTRIC HEAT? FAN CONTROL VAV MINIMUM POSITION CONTROL? SIMULTANEOUS HEAT/COOL? HEATING SUPPLY RESET COOLING SUPPLY RESET VENTILATION OUTDOOR DAMPER CONTROL ECONOMIZER TYPE DESIGN AIR CFM MECH-3, COLUMN H HEATING EQUIPMENT TYPE HEATING EQUIPMENT EFFICIENCY COOLING EQUIPMENT TYPE COOLING EQUIPMENT EFFICIENCY MAKE AND MODEL NUMBER HEATING DUCT LOCATION R -VALUE COOLING DUCT LOCATION R -VALUE DUCT TAPE ALLOWED? PIPE TYPE (SUPPLY, RETURN, ETC.) PIPE INSULATION REQUIRED? MECHANICAL SYSTEMS DHW Heater I I Mech. System n/a n/a n/a n/a n/a n/a Na n/a n/a n/a n/a n/a n/a n/a Gas Fired 78% n/a n/a Standard Gas 50 gal or Less n/a n/a n/a n/a n/a Supply & Return HW Yes Manual Timer Heating & Cooling Required n/a n/a n/a Constant Volume No No Constant Tem Constant Tem Natural Gravity No Economizer 715 cfm Gas Furnace 81% AFUE Packaged DX 10.0 SEER / 8.5 EER Standard 5ton Unit Ducts in Conditioned n/a Ducts in Conditioned n/a No Yes CODE TABLES: Enter code from table below into columns above. HEAT PUMP THERMOSTAT? SETBACK CTRL. ELECTRIC HEAT? FAN CONTROL VAV MINIMUM POSITION CONTROL? H: Heating SIMULTANEOUS HEAT / COOL? Y: Yes N: No HEAT AND COOL SUPPLY RESET? C: Cooling HIGH EFFICIENCY? P: Variable Pitch DUCT TAPE ALLOWED? PIPE INSULATION REQUIRED? NOTETO FIELD TIME CONTROL SETBACK CTRL. ISOLATION ZONES FAN CONTROL S: Prog. Switch H: Heating Enter Number of 1: Inlet Vanes 0: Occupancy C: Cooling Isolation Zones. P: Variable Pitch Sensor B: Both V: VFD M: Manual Timer 0: Other C: Curve VENTILATION OUTDOOR DAMPER ECONOMIZER O.A. CFM B: Air Balance A: Auto A: Air Enter Outdoor Air C: Outside Air Cert G: Gravity W: Water CFM. M: Out Air Measure N: Not Required Note: This shall be n D: Demand Control less than Col. H on N: Natural MECH-3. I EnergWro 2.1 By EnergySoft User Number. 1248 Job Number. 042301-C Page:8 of 16 1 MECHANICAL EQUIPMENT SUMMARY Part 1 of 2 MECH-2 PROJECT NAME DATE Pacific Dental Service Tenant Develo ement 4/23/2001 ICHILLER AND TOWER SUMMARY CFM BHP Tons PUMPS CFM BHP Equipment Name Equipment Type Qty.FEfficiency Tot. Qty GPM BHP Motor Eff. Drive Eff. Pump Control none 1DHW / BOILER SUMMARY Energy Factor or Recovery Efficiency Standby Loss or Pilot TANKINSUL. System Name System Type Distribution Type Qty Rated Input (Gals.) Vol. Ext. R -Val. Standard Gas 50 gal or Less Small Gas Standard 1 40,000 50 0.53 n/a 12 CENTRAL SYSTEM RATINGS HEATING COOLING System Name System Type Qty. Output Aux. kW Eff. O ut Sensible Efficiency Economizer Type Standard 5ton Unit Packaged DX 2 77,140 0.0 81%AFUE 60,000 57,20 10.0 SEER /8.5 EER No Economizer CI IDDI V CAM I I QCTI IDM CAW 11 System Name Fan Type Motor Location CFM BHP Motor Eff. Drive Eff. CFM BHP Motor Eff. Drive Eff. Standard Ston Unit Constant Volume Blow -Through 1,995 1.00 82.5% 100.0% none ■ F EnergyPro 2.1 By EnerovSoft User Number: 1248 Job Number. 042301-C Page:9 of 16 1 MECHANICAL EQUIPMENT SUMMARY Part 2 of 2 MECH-21 PROJECT NAME DATE Pacific Dental Service Tenant DevelODement 4/23/2001 EXHAUST FAN SUMMARY AV TERMINAL BOX Min. CFM Reheat Coil System Typg Ratio Type DeltaT FRatio I CFM I BHP I lowMEff. Eff.Driveoto EXHAUST FAN EXHAUST FAN Room Name Qty. CFM BHP Motor Eff. Drive Eff. Room Name Qty. CFM BHP Motor Eff. Drive Eff. I EnergyPro 2.1 By EneravSoft User Number: 1248 Job Number: 042301-C Paoe:10 of 16 1 MECHANICAL VENTILATION MECH-3 PROJECT NAME DATE Pacific Dental Service Tenant Develo ement 4/23/2001 MECHANICAL VENTILATION o a a a o o© o 0 0. o C Minimum Ventilation Rate per Section 121, Table 1-F. E Based on Expected Number of Occupants or at least 50% of Chapter 10 1997 UBC Occupant Density. I Must be greater than or equal to H, or use Transfer Air. Design Outdoor Air includes ventilation from Supply Air System & Room Exhaust Fans. K Must be greater than or equal to (H minus 1), and, for VAV, greater than or equal to (H -J). I EnergyPro 2.1 By EnergySoft User Number: 1248 Job Number. 042301-C Pagel1 of 16 1 AREA BASIS OCCUPANCY BASIS REQ'D O.A. (MAX OF D OR G) DESIGN OUTDOOR AIR CFM ZONEISYSTEM COND. AREA (SF) CFM PER SF MIN. CFM (B x C) NO. OF PEOPLE CFM PER PERSON MIN. CFM (ExF) Dental Office 3,576 0.15 536 536 715 Mech. System Total 536 715 C Minimum Ventilation Rate per Section 121, Table 1-F. E Based on Expected Number of Occupants or at least 50% of Chapter 10 1997 UBC Occupant Density. I Must be greater than or equal to H, or use Transfer Air. Design Outdoor Air includes ventilation from Supply Air System & Room Exhaust Fans. K Must be greater than or equal to (H minus 1), and, for VAV, greater than or equal to (H -J). I EnergyPro 2.1 By EnergySoft User Number: 1248 Job Number. 042301-C Pagel1 of 16 1 IPRO*POSED CONSTRUCTION ASSEMBLY ENV -3 PROJECT NAME DATE Pacific Dental Service Tenant Develo ement 4/23/2001 SUBTOTAI R -VALUE DESCRIPTION kMING OUTSIDE SURFACE AIR FILM ASSEMBLY NAME ASSEMBLY 10" 3D Composit Panels Floor 2 Membrane, Vapor -Permeable Felt 3 Insulation, Polystyrene, Smooth Skin 4 1 Gypsum or Plaster Board TYPE (check one) X Wall 6 0.34 W 0ISEE PLANS LI Ceiling I Roof INSIDE SURFACE AIR FILM FOR DETAILS N MATERIAL Metal 'O FRAMING % 15% Framing % 15%(16" o.c. Wall) 12% (24" o.c. Wall) 10%(16" o.c. Floor/Cell.) SKETCH OF ASSEMBLY 7%(24" o.c. Floor/Ceil.) SUBTOTAI R -VALUE DESCRIPTION kMING OUTSIDE SURFACE AIR FILM 1 Stucco 2 Membrane, Vapor -Permeable Felt 3 Insulation, Polystyrene, Smooth Skin 4 1 Gypsum or Plaster Board 5 1.16 6 0.34 7 0.26 8 9 INSIDE SURFACE AIR FILM SUBTOTAI R -VALUE THICK- NESS (in.) kMING ❑ ❑ © ❑ El El 1.750 0.010 7.750 0.500 38.750 0.06 0.450 0.02 1.16 0.29 SUBTOTAI R -VALUE CAVITY R -VALUE (Rc) WOOD FRAME R -VALUE 0.170 0.350 0.060 0.20 38.750 0.06 0.450 0.02 1.16 0.29 0.34 2.08 0.26 0.54 0.680 40.46 KC Kr 0�W 'HEAT CAPACITY (Optional) WALL WEIGHT (Ibs/sf) SPECIFIC HEAT (Btu/F-Ib) HC (A X B) (Btu/F-sf) 16.92 0.20 3.38 0.06 0.35 0.02 1.16 0.29 0.34 2.08 0.26 0.54 20 2 TOTAL HC 4.3 *NOTE: Weight and Specific Heat values for materials penetrated by wood framing include the effects of the framing members. [� X �] + [� X L 1 / Rc 1 - (Fr°/a / 100) 11 Rf Fr%/ 100 ASSEMBLY U -VALUE This assembly contains metal framing. The Assembly U -Value has been calculated using the ASHRAE/CEC Zonal Cavity Method. I EnergyPro 2.1 By EnregySoft User Number: 1248 Job Number: 042301-C Page:12 of 16 1 PROPOSED CONSTRUCTION ASSEMBLY ENV -3 I PROJECT NAME Pacific Dental Service Tenant Devel DATE 4/23/2001 ' CONSTRUCTION COMPONENTS 1 ICK - NESS DESCRIPTION 0.010 OUTSIDE SURFACE AIR FILM ASSEMBLY NAME ASSEMBLY T' 3D Composit Panels Floor 2 Membrane, Vapor -Permeable Felt 3 Insulation, Polystyrene, Smooth Skin 4 Gypsum or Plaster Board TYPE (check one) XWall 6 o SEE PLANS w Ceiling I Roof NFRAMING FOR DETAILS MATERIAL Metal v—, 1 g.g Z FRAMING % 15 % Framing 159/° (16" o.c. Wall) 12%(24" o.c. Wall) 10%(16" o.c. Floor/Cell.) SKETCH OF ASSEMBLY 7%(2,4" o.c. Floor/Ceil.) ' CONSTRUCTION COMPONENTS 1 ICK - NESS FRAMING ❑ ❑ © ❑ El El El DESCRIPTION 0.010 OUTSIDE SURFACE AIR FILM 1 Stucco 2 Membrane, Vapor -Permeable Felt 3 Insulation, Polystyrene, Smooth Skin 4 Gypsum or Plaster Board 5 6 7 8 9 INSIDE SURFACE AIR FILM FRAMING ❑ ❑ © ❑ El El El 1.750 0.010 4.750 0.500 R -VALUE CAVITY WOOD R -VALUE FRAME (Rc) R -VALUE 0.170 0.350 0.060 23.750 0.450 0.680 OAC OAC •HEAT CAPACITY (Optional) WALL SPECIFIC HC WEIGHT HEAT (A X B) (Ibs/sf) (Btu/F-Ib) (Btu/Fsf) 16.92 0.20 3.38 0.06 0.35 0.02 0.71 0.29 0.21 2.08 0.26 0.54 TOTAL HC 4 2 SUBTOTA 25.461 E Rc Rf *NOTE: Weight and Specific Heat values for materials penetrated b wood framinginclude the effects of the framingmembers. 1 Co x + Co x F 0.182 1 / Rc 1 - (Fr -/6 100) 1 / Rf Fr%/ 100 ASSEMBLY U -VALUE COMMENTS This assembly contains metal framing. The Assembly U -Value has been calculated using the ASHRAE/CEC Zonal Cavity Method. i - ' EnergyPro 2.1 By EnregySoft User Number: 1248 Job Number: 042301-C 1 . 3of16 1 g.g SUBTOTA 25.461 E Rc Rf *NOTE: Weight and Specific Heat values for materials penetrated b wood framinginclude the effects of the framingmembers. 1 Co x + Co x F 0.182 1 / Rc 1 - (Fr -/6 100) 1 / Rf Fr%/ 100 ASSEMBLY U -VALUE COMMENTS This assembly contains metal framing. The Assembly U -Value has been calculated using the ASHRAE/CEC Zonal Cavity Method. i - ' EnergyPro 2.1 By EnregySoft User Number: 1248 Job Number: 042301-C 1 . 3of16 ENVELOPE MANDATORY MEASURES ENV -MM PROJECT NAME DATE Pacific Dental Service Tenant Develo ement I 4/23/2001 DESCRIPTION Designer Enforcement 0 §118(a) 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. RX §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. ❑ § 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. R§ 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). R§ 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 R-11 between framing members. EnergyPro 2.1 By EnergySoR User Number. 1248 Job Number. 042301-C Page: 14 of 16 TAILORED LPD SUMMARY and WORKSHEET Part 1 of 3 LTG4 NAME DATE 1 1. Watts for Illuminance Categories A -D (from column G) > 3,9211 watts 2. Watts for Illuminance Categories E4 (from LTG -4 Part 2) 0 watts 3. Watts for Display Lighting (from LTG -4 Parts 2 & 3) 0+ 1 0+ 1 0= 01 watts Public Area Display Sales Feature Floor Sales Feature Wall Display Display 4. Total Allowed Watts (lines 1+2+3) 3,92 1watts TAILORED LPD - Illuminance Categories A B C and D and Gross Sales Area 0 © © ❑D ❑E ROOM NAME Pack Dental Office TASKIACTIVITY Health Care Dental - General ILLUMINANCE CATEGORY ROOM CAVITY RATIO FLOOR AREA ALLOWED LPD ALLOWED WATTS (E x F) D 0.00 3,961 0.99 3,921 PAGE TOTAL 3.9 3,9211 BUILDING TOTAL 3,5761 3,9211 SF WATTS EnergyPro 2.1 By EnergySoft User Number. 1248 Job Number. 042301-C Page: 15 of 16 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY PROJECT NAME Pacific Dental Service Tenant Develo ement DATE 4/23/2001 SYSTEM NAME FLOOR AREA Mech. System 3,576 Number of Systems 2 Heating System Output per System 77,140 Total Output (Btuh) 154,280 Output (Btuh/sgft) 43.1 Cooling System Output per System 60,000 Total Output (Btuh) 120,000 Total Output (Tons) 10.0 Total Output (Btuh/sgft) 33.6 Total Output (sqf /Ton) 357.6 Air System CFM per System 1,995 Airflow (cfm) 3,990 Airflow (cfm/sgft) 1.12 Airflow (cfm/Ton) 399.0 Outside Air (%) 17.9 Outside Air (cfm/sgft) 0.20 Note: values above given at ARI conditions 24.0 OF 0 Outside 715 cfm 69.5 of Total Room Loads Return Vented Lighting Return Air Ducts Return Fan Ventilation Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COIL COOLING PEAK COIL HTG. PEAK CFM ISensiblel Latent CFM Sensible 5776 69,310 11,843 275 39,608 0 3,466 1,980 0 0 715 28,146 14,160 715 35,412 0 0 3,466 1,980 104,41T-26 002 78 981 Standard 5ton Unit 108,333 0 154,280 Total Adjusted System Output108,333 0 154,280 (Adjusted for Peak Design Conditions) TIME OF SYSTEM PEAK Aug 3 pm Jan 12 am 61.4 OF 61.4 OF 96.9OF —W - f— Supply Fan Heating Coil 3990 cfm Supply Air Ducts 96.5 of ROOMS 70.0 of 11E 11E Return Air Ducts `SIt DOLING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Cooling Peak 111.0/78.40F 81.3/65.70F 81.3/65.7OF 56.3/54.8OF O2A Supply Air Ducts Outside Air 715 cfm Supply Fan Cooling Coil 57.1 / 55.1 of 3990 cfm 51.8% R.H. ROOMS 74.8/62.50F 74.0/62.3OF et Retum Air Ducts I EnergyPro 2.1 By EnergySoft User Number. 1248 Job Number. 042301-C Page: 16 of 16 1