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12-1267 (RC)P.O. BOX 1504 . 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - Owner: INLAND AMERICAN P.O. BOX 9271 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/16/12 LAQUINTA PAVIL HINSDALE, IL 60521 D e Contractor: Applicant: Architect or Engineer: COASTAL DESIGNS, INC. 2936 GARNET PLACE NOV 19 2012 CARLSBAD, CA 92009 (760) 564-7321 CIt�jP� Lic. No.: 895248 FIfNANCFpEPT ---------------------------------------------------------------------------.---------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: 13 License No.: 895248 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is G issued. Date: ,' -1 �( Contractor: _ 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 UILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that exempt from the Contractor's State License Law for the Carrier EVEREST NTL Policy Number 760009365121 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor C rthwith comply with those provisions. 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)•: Date: �� Applicant: (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECUR ERS' CO COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . 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.). (_ 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 ISec. 3097, Civ. C.). Lender's Name: — Lender's Address: I LQPERMIT 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 16 6is county/to enpon the above-mentio t'tYy-far-i ection purposes. Date: ��(7 f Signature (App' or Agentl: n r -"Application Number: 12-0000126 ' 7 L Property Address: 79024 HIGHAY 111 STE 102 APN: 649-820-999- - - Application description: REMODEL - COMMERCIAL Property Zoning: REGIONAL COMMERCIAL Application valuation: 87000 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - Owner: INLAND AMERICAN P.O. BOX 9271 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/16/12 LAQUINTA PAVIL HINSDALE, IL 60521 D e Contractor: Applicant: Architect or Engineer: COASTAL DESIGNS, INC. 2936 GARNET PLACE NOV 19 2012 CARLSBAD, CA 92009 (760) 564-7321 CIt�jP� Lic. No.: 895248 FIfNANCFpEPT ---------------------------------------------------------------------------.---------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: 13 License No.: 895248 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is G issued. Date: ,' -1 �( Contractor: _ 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 UILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that exempt from the Contractor's State License Law for the Carrier EVEREST NTL Policy Number 760009365121 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor C rthwith comply with those provisions. 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)•: Date: �� Applicant: (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECUR ERS' CO COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . 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.). (_ 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 ISec. 3097, Civ. C.). Lender's Name: — Lender's Address: I LQPERMIT 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 16 6is county/to enpon the above-mentio t'tYy-far-i ection purposes. Date: ��(7 f Signature (App' or Agentl: Application Number . . . . . 12-00001267 ------ Structure Information EXIST COMMERCIAL SHELL SUITE 102 ----- Other struct info . . . . . CODE EDITION 2010 FIRE SPRINKLERS YES MIXED-USE OCCUPANCY B/S OCCUPANT LOAD 22.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 1400.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 581.00 Plan Check Fee 377.65 Issue Date . . . . Valuation . . . . 87000 Expiration Date .5/15/13 Qty . Unit Charge Per Extension BASE FEE 414.50 37.00 4.5000 -------------------------- THOU BLDG 50,001-100,000 ---------------------------------- ----- 166.50 ----------- Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 43.00 Plan Check Fee 10.75 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/15/13 Qty Unit Charge Per Extension BASE FEE 15.00' 1400.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR'NON-RESIDENTIAL 28.00 Permit . . . MECHANICAL. Additional desc . Permit Fee . . . . 46.50 Plan Check Fee 11.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 5/15/13 , Qty Unit Charge Per Extension BASE, FEE 15.00 7.00 4.5000 EA MECH VENT INST/ DUCT ALT 31.50 Permit . . . ..PLUMBING Additional desc . Permit Fee . . . . 85.50 Plan Check Fee 21.38 Issue Date . . . . Valuation . . . 0 Expiration Date 5/15/13 Qty Unit Charge Per Extension LQPERMIT „ Application Number . . . . . 12-00001267 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 10.00 6.0000 EA PLB FIXTURE 60.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP ------------------------------ 3.00. ----------------------------------------------- Special Notes and Comments INTERIOR T.I. SUITE 102 "SPORT CLIPS” 1400 SF. TYPE V -B CONSTRUCTION W/ FIRE SPRINKLER. "B" OCCUPANCY CLASSIFICATION 2010 CODES. ENGINEER: ANDY NHAN DANG C63640. --------------------------------------- ------------------------------------ Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 37.76 BLDG STDS ADMIN (SB1473) 4.00 ENERGY REVIEW FEE 37.76 Fee summary Charged Paid Credited ------------------------------ Due --------------------------- Permit Fee Total 756.00 .00 .00 756.00 Plan Check Total 421.41 .00 .00 421.41 Other Fee Total 79.52 .00 .00 79.52 Grand Total 1256.93 .00 .00 1256.93 LQPERMIT .. s,►r.# G cit}/ Of J.c1 Qillfitc Buridlog 8r Safety Division Box 1504,78-495 Cafe Tampico s'[r .I0 .Quanta, CA 92253.:(760) 777 7012 Bultdin rmit •Application and Tracking Sheet Permit #P.O. 1 Project Address: r% 4,Z y , ,,'I 1 S �, }�- 1 Owner's Name: -TL-1 A P.Number Address: .1'q%? Cr' Legal Description:City, ` 1 Contractor. o q S tom• \ �S 1 �► ST, Zip. C Telephone: G - t: -,2,11- 7 - Address: Address: aCi3 6 Ga✓ me �- �4c �. Pr`oj`ect Description:c� City,ST,Zip: �c.✓�5��.� C,A��.,wt�iti Telephone: %G U - �6 O ' Li`#C' State Lie. 4: 8 9 Sy �p104t(x� �' IC r lL `•��nC ff I 11N.4 �.�--► , w�.\ `� 1't l%►t L�%��-� Arch., Engr., Designer. C"ca, h tr c v 400 w o i l-� o. l _ Address: 5 8� —�'� �' �� ✓� �. �` City.,ST,Zip: c-4 e►�`G��( Telephone:I 7� - q?S� Y State Lie. #: C 3 G yo M ' Construction Type:. V Occupancy: Project type (circle one): New Add'n Alter Repair Demo #Unit$: / Sq. Ft.: ///c) # Stories�4-7, Name of Contact Person: --t) C.w Telephone # of Contact Person: %(j - AGO - 39 7% Estimated Value of Project O DO APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKNG PERMfrFEES- Plan Sets Pian Check submitted Item Amount Structural CaIcs. Reviewed, ready for caftvefims Mie— t tan Check Deposit. . Truss Cates. Called Contact Person tt ( n Check Balance. Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted.'. Mechaelcal Grading plan 2" Review, ready for correctioWasue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN ROUSE.- '^' Review, ready for correctlonsAssue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees T -d* P.O. BOX 1504 { BUILDING & SAFETY DEPARTMENT 78-495 CALLS TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 To: Burt Hanada, Plans Examiner, Inspection Supervisor From: Les Johnson, Planning Director Building Plans Approval To CDD: O ,2j / o't Due Date: Status: The Community Development Department has reviewed the Building Plans for the following project: Description: 7-/. Address or general location: 00A4 Wiz, /11 /oa Applicant Contact: 7&0- 9&0- 3977 The Community Development Department finds that: O ...these Building Plans do not require Community Development Department approval. ...these Building Plans are approved by the Community Development Department. 0 .'..these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant. When the corrections are made please return them to the Community Development Department for review. Les Johnson,)Planning Director ]a Date received OCT 24 2012 City of La 9utnto Planning Department R Riverside County Fire Department Fire Protection Planning Section Riverside Office: 2300 Market St., Ste. 150, Riverside, CA 92501 Ph. (951) 955.4777 Fax (951) 9554886 Murrieta Office: 39493 Los Alamos Rd., Ste A, Murrieta, CA 92563 Ph. (951) 600.6160 Fax (951) 600-6164 Palm Desert Office: 77-933 Las Momahas Rd., x 201 Palm Desert, CA 92211-4131 Ph. (760) 863.8886 (760) 863-7072 Fire Department Clearance/Release Date: �' I Fax: Tract/Parcel Map #: ll Permit/Lot Job Site Address: I "'0C- Final For Recordation Release For Building Perm'it(s) Shell Final Only (No Tenant) . Final For Occupancy Building Plan Check Fees Paid Building Plan Check Fees Not Paid Other Fees Fees Not Required If you should have any questions, please contact the appropriate Riverside County Fire Protection Planning office for further assistance. t I I It / 1 N V/ 1 I 1 Authlzing Signature For Release — j 4 '(0Sty L Print Name Zn Form C — Revised 11/21/2012 �l u r r1 CERTIFICATE OF COMPLIANCE (Page 1 of 4) LTG -1C Project Name: 1 . Date: SPORT CLIPS. 10/18/2012 ;t Project Address: 79024 HIGHWAY 111, SUITE 2, UNIT #14 Climate Zone: Building CFA :1400 SF LA QUINTA, CALIFORNIA Unconditioned Floor Area: 15 General Information Building Type: fel Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel ❑ Schools ❑ Relocatable Public 23 Conditioned Spaces ❑ Unconditioned Spaces Schools Phase of Construction: ❑ New Construction ❑ Addition n Alteration Method of Compliance: ❑ Complete Building M Area Category ❑ Tailored Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: ANDY DANG Signature: Company: AD ENGINEERING, LLC ^ Date: 10/18/2012 BI.U�LD' UI Address: If applicable: Q "EPr CEA 9587 DAPPLE GRAY PL. PSG' & SAFE ## INT CEPS City/State/Zip 400 rl ELK GROVE, CA 95624 F OR CONS D Phone: (916) 761-4858 Principal Lighting Designer's DeclaratiStatement U ` `� • I am eligible under Division 3 of dI Ffessi Cod to ac t responsibility for the lighting design. • This Certificate of Compliance identifies the lighting features an ce cations 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, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: ANDY DANG Signature: Company: AD ENGINEERING, LLC V Phone: (916) 761-4858 Address: 9587 DAPPLE GRAY PL. License # C63640 City/State/Zip: ELK GROVE, CA 95624 Date: 10/18/2012 Lighting Mandatory Measures E-2 Indicate location on building plans of Mandatory Measures Note Block: LIGHTING 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 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 ® 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 2008 ATonresidential Compliance Forms IDrM �T OCT 2420127 sy— I ust 2009 CERTIFICATE OF COMPLIANCE (Page 2 of 4) LTG-1C INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Project Name: Date: SPORT CLIPS 10/18/2012 Installation Certificate, LTG-I-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 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 s ware oot is totaled below. Luminaire Schedule (Type, Lamps, Ballasts Installed Watts A B C D E F G H How wattage was Field determined Ins ctor 2 w=-=---==----- � X - o CEC According . 0 Complete Luminaire Description Default to °' ;d Q) Q (i.e, 3 lamp fluorescent troffer, from §130 _ Z F32T8, one dimmable electronic ballast) -0 NA8 d or e) L1 2X4 STANDARD, FLUORESCENT ❑ 72 (2 1 ❑ 5 1360 L2 6" RECESS, CFL ❑ 26 G ❑ 9 234 ❑;;..;;;,;,.p;;_: L3 4" DOWN LIGHT, CFL ❑ 32 12 ❑ 1 32 ::1>.-:::::: _:.:::: ::. : ............ ........... ...._....._.... L4. 6" DOWN LIGHT, INCANDESCENT ❑ 35 ® ❑ 5 175 ;.:_.;_p:_: ❑;.;,;. L5 6" CFL ❑ 26 12 ❑ 1 26 _❑;:::;_> _p L6 48" FLOURESCENT ❑ 54 12 ❑ 8 432 ❑........ __._❑.._, ❑ ❑ ❑ _ o::::: ........a ;;; _........ ❑ ❑ a::::: o.. ❑ ❑ ❑ ❑ o_ ..... ❑ ❑ ❑ ❑_ : o: ❑ ❑ ❑ o ......:......................................... ....._.._..._. ❑ ❑ ❑ _.... o a; ; INSTALLED WATTS PAGE TOTAL: 1259 = - Installed Watts Building Total Building total number of pages 1 1259 (Sum of all pages) Enter into LTG-1C 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. I Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Vertbuilding plans ifnecessary. 2008 Nonresidential Compliance Forms August 2009 CERTIFICATE OF COMPLIANCE (Page 3 of 4) LTG -1C Project Name: Date: SPORT CLIPS 110/18/2012 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 > 250f?, automatic daylighting controls for daylit areas > 2, 500,12, d) shut-off controls, e) display lighting controls, J) tailored lighting controls - general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls or retail stores > 50, 000 2, in accordance with Section 131. MANDATORY LIGHTING CONTROLS - FIELD INSPECTION ENERGY F►eld _1 ,,:_:::._ CHECKLIST 111.::__._ Inspector Number �, Type / Description of Units Location in Building`r' w :.::Bass::::..._.::Fart::::;: LIGHTING CONTROL 1 ALL AREAS ❑ :_:......_ . _...:.........._ ....:_ ❑ _._..❑:. x. _.- ._._ .❑:_::: ❑ .. .-. o_ ❑ ............ ❑::._..... _. _ ...... _ ❑ ❑❑_ .............. _ ...... 11 Ima 011-- ❑ ❑ a;- .❑ ..... ............................ .. ................._..........._........._..... : ❑................. .......... .. ❑ ._ .❑ SPECIAL FEATURES INSPECTION CHECKLIST (See Pae 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 s ecial 'usti kation and documentation submitted. Field Inspector's Notes or Discrepancies: 2008 Nonresidential Compliance Forms August 2009 CERTIFICATE OF COMPLIANCE (Page 4 of 4) LTG -1C Project Name: SPORTCLIPS 77- 10/18/2012 Conditioned and Uncondition—e—Tspace Lighting must not be combined for compliance Indoor Lighting Power for Conditioned Spaces Indoor Lighting Power for Unconditioned Spaces Watts Watts Installed Lighting Installed Lighting (from Conditioned LTG -1C Page 2) 1259 (from Unconditioned LTG -1C Pae 2) Lighting Control Credit Lighting Control Credit Conditioned Spaces (from LTG -2C ) _ 0 Unconditioned Spaces (from LTG -2C) _ Adjusted Installed = 1259 Adjusted Installed = Lighting Power Lighting Power Complies if Installed < Allowed = Complies if Installed < Allowed Allowed Lighting Power Allowed Lighting Power Conditioned Spaces (from LTG -3 C) 1873 Unconditioned Spaces (from LTG -3C) 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 controU.ed Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building orspace 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 andlor filled and signed. In addition, a Certificate ofAcceptanee 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 -24 for each different lighting luminaire control(s) must be provided to the owner of the buildin or their recorzls. Luminaires Controlled LTG -2A Controls and z y Sensors and v i c Automatic Daylighting Controls Equipment Rc uirin Testing Description z `0 V Location Acceptance ALL AREAS AUTO TIMER 1 UTILITY ROOM RETAIL AREAS MULTI-LEVEL SWITCHING 2 RETAIL AREAS RECEPTION, WAITING AREAS SEPARATE SWITCHES 1 WAITING AREA ❑ 13 ❑ 2008 Aronresidential Compliance Forms August 2009 INDOOR LIGHTING POWER ALLOWANCE LTG -3C Project Name: SPORT CLIPS 77:/1812012 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 16 this page are only for. ® CONDITIONED spaces ❑ UNCONDITIONED spaces COMPLETE BUILDING METHOD WATTS COMPLETE ALLOWED BUILDING CATEGORY(From § 146 Table 146-E PER(ft) X BLDG. AREA = WATTS TOTALS AREA WATTS AREA CATEGORY METHOD — Part B Additional Wattage Allowance from Table 146-F Footnotes A B C D E F G Primary Function Sq Ft Additional Watts Per ft2 Allowed Wattage Allowance x C Description(s) and Quantity of Special Luminaire 2 Types in each Primary Function Area Total Design Watts ALLOWED WATTS Smaller of D or F TOTALS — Enter into Area Category Method — Part A (table above) ' Additional watts available only when allowed according to the footnotes on bottom of Table 146-F for chandelier or sconce; art, craft, assembly or manufacturing specialized task work; precision commercial/ industrial work; or lab specialized task work. I Special luminaires are light fixtures described in the Table 146-F Footnotes that are subject to an additional wattage allowance. TAILORED METHOD Total Allowed Watts using the Tailored Method taken from LTG4C (Page 1 of 4) Row 3 The indoor lighting power allowance using the Tailored Method of compliance shall be determined using the LTG4C set of forms. A separate set of LTG -4C forms shall be filled out for CONDITIONED and UNCONDITIONED spaces 2008 Aronresidential Compliance Forms August 2009 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Page 1 of 5) MECH-IC Project Name: SPORT CLIPS Date: 10/18/2012 Climate Zone: 15 Project Address: 79024 HIGHWAY 111, SUITE 2, UNIT #14, LA QUINTA, CALIFORNIA Conditioned Floor Area: 1400 SF General Information Building T ® Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ Schools (Public School) ❑ Relocatable Public School Bldg. ® Conditioned Spaces ❑ Unconditioned Spaces Phase of Construction: 13New Construction [3Addition ® Alteration Approach of Compliance: ® Component ❑ + Overall Envelope TDV Energy ❑ Unconditioned (file affidavit Front Orientation: N, E, S, W or in Degrees: I N HVAC SYSTEM DETAILS FIELD INSPECTION ENERGY CHECKLIST Meets Criteria or Requirements Equipment2 Inspection Criteria Special Feature' Pass Fail - Describe Reason' Item or System Tags (i.e. AC -1, RTU -1, HP -1) AC -1 ❑ ❑❑ Equipment T e4: PKG ❑ _ ❑ .. _ __❑. __...__ No of Systems 1 ❑ ❑ __ _.. ...... ❑: Max Allowed HeatingCapacity 50,000 BTU O . Minimum Heating Efficiency 82 ❑ ❑ _ _ - ❑ Max Allowed CoolingCapacity 37,000 BTU 13= ❑ Cooling Efficiency 10 ❑ ❑ ............... .._.._. _: Duct Location/ R -Value 8 [3::_ ❑ :. < _ .... .._._. _.__ ... _..:_.... Duct Leakage Testing - If Yes, a MECH-4A must be submitted NO ❑ .. _ ❑ Economizer N/A ❑ - ❑ .. .. ❑. Thermostat YES [3. .._ Fan Control YES 13_ ❑ ❑ FIELD INSPECTION ENERGY CHECKLIST Equipment Z Inspection Criteria Special Feature' Pass Fail - Describe Reason3 Item or System Tags (i.e.'AC-1, RTU -1, HP -1) 13❑ _ ❑ T e': =Equipment No of Systems [30... ......... ❑ Max Allowed Heating Capacity 13❑ ❑._. Minimum Heating Efficiency ❑ .. ❑ . Max Allowed Cooling Capacity ❑❑ _ ❑ _ Cooling Efficiency ❑_ _0...._ ............ :._.- .. Q ..... ........._....._............ ...._...._......__._.........._...._...:.....:_._._....:_:: 2008 Aronresidential Compliance Forms j August 2009 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 3 of 5) MECH-IC Project Name Date SPORT CLIPS 10/18/2012 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for mechanical systems. The designer is required to check the applicable boxes by all acceptance tests that apply and list all equipment that requires an acceptance lest. ]fall equipment of a certain type requires a lest, list the equipment description and the number of systems. The NA number designates the Section in the Appendix of the Nonresidential Reference Appendices Manual that 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. Enforcement Agency: Systems Acceptance. Before occupancy permit is granted for a newly constructed building or space, or a new space -conditioning system serving a building or space is operated for normal use, all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. Systems Acceptance. Before occupancy permit is granted. All newly installed HVAC equipment must be tested using the Acceptance Requirements. The MECH-1 C form is not considered a completed form and is not to be accepted by the building department unless the correct boxes are checked. The equipment requiring testing, person performing the test (Example: HVAC installer, TAB contractor, controls contractor, PE in charge ofproject) and what Acceptance test must be conducted. The. following checked -of forms are required for ALL newly installed equipment. In addition a Certificate of Acceptance forms shall be submitted to the building department that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) and 'Title 24 Part 6. The building inspector must receive the properlyfilled out and si ned orms before the building can receive mal occupancy, Test Descri tion MECH-2A 1\,ECH-3A MECH-4A MECH-5A MECH-6A MECH-7A MECH-8A MECH-9A MECH-10A MECH-11A Outdoor Ventilation Constant Demand Hydronic for Volume & Air Control Supply Valve System Automatic Equipment Requiring Testing or # of VAV & Single -Zone Distribution Economizer Ventilation Fan Leakage Supply Water Variable Flow Demand Shed Verification units CAV Unitary Ducts Controls DCV VAV Test Temp. Reset Control Control AC -1 1 0 a ❑ a O ❑ O a a ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a a ❑ a ❑ a o a o 0 ❑ O a ❑ ❑ ❑ ❑ O ❑ ❑ 0 o a a ❑ o ❑ o ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a ❑ 13 o a CI o ❑ a ❑ ❑ ❑ a ❑ ❑ a ❑ Cl a D a ❑ a o ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 2008 Nonresidential Compliance Forms August 2009 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 5 of 5) MECH-IC Project Name: Date: SPORT CLIPS 10/18/2012 Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: ANDY DANG Signature: Company: AD ENGINEERING; LLC ate: 10/18/2012 Address: If Applicable 9587 DAPPLE GRAY PL. CEA # CEPE # City/State/Zip ELK GROVE, CA 95624 Phone: (916) 761-4858 Principal Mechanical Designer's Declaration Statement • I 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: ANDY DANG Signature: Company Name: AD ENGINEERING, LLC V Date: 10/18/2012 Address: 9587 DAPPLE GRAY PL. License # 63640 City/State/Zip ELK GROVE, CA 95624 Phone: 761-4858 (916) Mandatory Measures Indicate location on building Tans 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, refer to the 2008 Nonresidential Manual Note: The En orcementA ency may require allforms to be incorporated onto the building plans. ® MECH-1C Certificate of Compliance. Required on plans for all submittals. ® MECH-2C Mechanical Equipment Summary is required for all submittals. ® MECH-3C Mechanical Ventilation and Reheat is required for all submittals with mechanical ventilation. 0 MECH-4C Fan Power Consumption is required when for all prescriptive submittals. 2008 Nonresidential Compliance Forms August 2009 AIR SYSTEM REQUIREMENTS (Part 1 of 3) MECH-2C PROJECT NAME: DATE: ' SPORT CLIPS 10/18/2012 Indicate Air Systems Type (Central, Single Zone, Package, VA or etc...) Item or System Tags __ ____ ___ N/A (i.e. AC -1, RTU -1, HP 1) No. of Systems Indicate Page Reference on the Plans or Schedule list or list information below MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC or Heat Pump Thermostats. Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation PRESCRIPTIVE MEASURES Calculated Design Heating Load Calculated Design Cooling Load Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating Heat Rejection System Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted T-24 Sections 112(a) 112(a) 112(b), 112(c) 112(c), 115(a) 121(b) 121(b) 121(c) 121(c) 122(e) 122(e) 122(f) 122(g) 123 124 144(a & b) 144(a & b) 144(c) 144(c) 144(c) 144(d) 144(e) 144(f) 144(g) §144 (h) §144 (i) 144(k) 1. Total installed capacity (A01u/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() a 1 . 2008 Nonresidential Compliance Forms August 2009 WATER SIDE SYSTEM REQUIREMENTS Part 2 of 3 MECH-2C . PROJECT NAME: DATE: SPORT CLIPS 10/18/2012 WATER'SIDE SYSTEMS: Chillers, Towers, Boilers, Hydronie Loops Item r to o SystemTags (i.e. AC - 1, RTU -1, HP -1, CT -1, etc...)' N/A No. of Systems Indicate Pae Re erence on Plans or S eci tcation2 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 144(j) CHW and HHW Reset Controls 144(j) WLHP Isolation Valves 144 0) VSD on CHW, CW & WLHP Pumps >5HP 144(j) DP Sensor Location 1440) 1. The Proposed equipment need to match the building plans schedule or specifications. If a requirement is not applicable, put 'N/A" 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 andlor specification section and paragraph number where the requiredfeatures are documented. Ifa requirement is not applicable, put "NIA " in the column next to applicable section. 2008 Nonresidential Compliance Forms August 2009 SERVICE HOT WATER & POOL/SPA REQUIREMENTS Part 3 of 3 MECH-2C PROJECT NAME: DATE: SPORT CLIPS 10/18/2012 Service Hot Water, Pool Heating Item or System Tags WH -1 (i.e. WH -1, WHP, DHW, etc... )1 No. of Systems 1 Indicate Pa a Re erence on Plans or Schedule' MANDATORY MEASURES T-24 Section SERVICE HOT WATER Certified Water Heater §111, §113 (a) YES Water Heater Efficiency §113 (b) 80 Service Water Heating Installation §113 (c) N/A Pipe Insulation §123 N/A POOL AND SPA Pool and Spa Efficiency and Control §114 (a) N/A §114 (b) N/A Pool and Spa Electric Resisting Heating Exception Pool and Spa Installation §114 (b) N/A Pool Heater — No Pilot Light §115 (c) N/A Spa Heater — No Pilot Light §115 (d) N/A Pipe Insulation §123 YES 1: The Proposed equipment need to match the building plans schedule or specifications. If a requirement is not applicable, put "N/A" in the column next to the measure. 2: For each water heater, pool heat and domestic water loop (orgroups of similar equipment) fill in the reference to sheet number andlor specification section and paragraph number where the required features are documented. If a requirement is not applicable, put "N/A" in the column. 2008 Nonresidential Compliance Forms August 2009 MECHANICAL VENTILATION AND REHEAT MECH-3C PROJECT NAME SPORT CLIPS DATE 10/18/2012 MECHANICAL VENTILATION §121(b)2 REHEAT LIMITATION §144(d) AREA BASIS �D�E OCCUPANCY BASIS VAV Minimum A B C F G H I J K L M N Zone/ S stem(ft') Condition Area CFM per ftz Min CFM by Area B x C Num 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 cfm B x 0.4 cfm/ft' Max of Columns H, J, K 30 cfm Design minimum Air setpoint Transfer Air AC -1 1400 0.4 560 22 15 330 560 560 1000 560 1000 560 15 15 15 15 15 15 15 15 15 15 15 Totals 22 560 560 Column I 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 for egress purposes for spaces without fixed seating. 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). j Must be greater than or equal to H, or use Transfer Air (column N) to make up the difference. J Design fan supply cfm (Fan CFA4) x 50%; or the design zone outdoor airflow rate per §121. K Condition area (ft) x 0.4 efnr/ft'; or L Maximum of Columns H, J, K, or 300 cfm M This must be less than or equal to Column L and greater than or equal 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 a ral to the difference between the Required Ventilation Air Column H and the Design Minimum Air Colum: M), Column H minus M. ' 2008 Nonresidential Compliance Forms I August 2009 FAN POWER CONSUMPTION MECH-4C PROJECT NAME: DATE: SPORT CLIPS 10/18/2012 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 (CAI/ Fan Systems or Variable Air Volume (VAT/) Systems when using the Prescriptive Approach. See Power Consumption of fits§144(c). A B C I D E F FAN DESCRIPTION DESIGN BRAKE HP EFFICIENCY NUMBER OF FANS PEAK WATTS B x E x 746 / C x D MOTOR DRIVE N/A Totals and Adjustments FILTER PRESSURE ADJUSTMENT Equation 144-A in § 144(c) of the Energy Standards. If filter pressure drop (SPe) is greater than 1 inch W. C. or 245 Pascal then enter SP,, on line 4. Enter Total Fan pressure drop across the fan (SPt) ^ on Line 5. B) Calculate Fan Adjustment and"enter on line 6. C) Calculate Adjusted Fan Power Index and enter on Row 7 1) TOTAL FAN SYSTEM POWER (WATTS, SUM COLUMN F 2) SUPPLY DESIGN AIRFLOW (CFM) 3) TOTAL FAN SYSTEM POWER INDEX (Row 1 / Row 2)' W/CFM 4) SP,, 5) SPt 6) Fan Adjustment = 1-(SPe — 1)/SPt 7) ADJUSTED FAN POWER INDEX (Line 3 x Line 6)' W/CFM 1. TOTAL FAN SYSTEM POWER INDEX or ADJUSTED FANPOITER INDEX must not exceed 0.8 w/cfm for Constant Volume systems or 1.25 w/cfm for VA systems. 2008 Nonresidential Compliance Forms August 2009 MANDATORY MEASURES LTG -MM PROJECT NAME SPORT CLIPS DATE 10/18/2012 1. BUILDING LIGHTING SHUT-OFF O The building lighting shut-off system consists of an automatic time switch, with a zone for each floor. 2. OVERRIDE FOR BUILDING LIGHTING SHUT-OFF The automatic building lighting 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 sf. 3. AUTOMATIC CONTROL DEVICES CERTIFIED All automatic control devices specified are certified. All alternate equipment shall be certified and installed as directed by the manifacturer. 4.'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. 5. TANDEM WIRING FOR TWO -LAMP BALLAST'S All one and three lamp fluorescent fixtures are tandem wired with two (2) lamp ballast where required by Standards C�? Subchapter 132; or a All three lamp fluorescent fixtures are specified with electronic high -frequency ballasts and are exempt from two -lamp tandem wiring requirements. F 6. INDIVIDUAL ROOM/AREA CONTROLS ❑X 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. 7. UNIFORM REDUCTION FOR INDIVIDUAL ROOMS ❑X All rooms and areas greater than 100 square feet and more than 0.8 watt per square foot of light load shall be controlled with bi-level switching for uniform reduction of lighting within the room. 8. DAYLIT AREA CONTROL ❑X All rooms with windows and skylights, that are greater than 250 square feet, and that allow for 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 ve aocomblished because the windows are continuously shaded by a building on the adjacent lot. Diagram of shading during different times of year is Included on plans. 9. CONTROL OF EXTERIOR LIGHTS Exterior mounted fixtures and served from the electrical panel inside the building are controlled with a directional photo cell control on the roof and a corresponding relay in the electrical panel. 5 MECHANICAL MANDATORY MEASURES MECH-MM PROJECT NAME DESCRIPTION Equipmet and System Efficiencies DATE 1 011 8/201 2 ❑X Any appliance for which there is a California standard established in the Appliance Efficiency Regulations will comply with the applicable standard. ❑ Fan type central furnaces shall not have a pilot light ❑ Piping, except that conveying fluids at temperatures between 60 and 105 degrees Fahrenheit, or within HVAC equipment, shall be insulated in accordance with Standard Section 123. Air handling duct systems shall be installed and insulated in compliance with Sections 601, 603 and 604 of the Uniform Mechanical Code. Controls Each space conditioning system shall be installed with one of the following: ❑X Each space conditioning system serving building type such as offices and manifacturing 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 ovedde 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 capabalities the prevent the loss of the device's program and time setting for at least 10 hours if power is interrupted; or ❑ An occupancy sensor to control the operating period of the system; or ❑ A 4 hour timer that can be manually operated to control the operating period of the system. ❑ Each space conditioning system shall be installed with controls that temporarily restart and temporary operate the system as required to maintain a setback heating and/or a setup cooling thermaostat setpoint ❑ Each space conditioning system serving multiple zones woith a combined conditioned floor area more than 25,000 square feet shall be provided with isolated 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 isolationarea; and shall be controlled by a time control device as described above. ❑X Each space conditioning system shall be controlled by an individual thermostat that responds to temperature with the zone. Where used to control heating, the control shall be adjustible down to 55 degrees F or lower. For cooling, the control shall be adjustible 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. ❑X Thermostats shall have numeric setpoints in degrees Fahrenheit(F) and adjustable setpoint stops accessible only to authorized personel. ❑ 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. , MECHANICAL MANDATORY MEASURES MECH-MM PROJECT NAME SPORT CLIPS DATE 10/18/2012 DESCRIPTION Ventilation ❑X Controls shall be provided to allow outside air dampers or devices to be operated at the ventilation rates as specified on these plans. Gravity or automatic dampers interlocked and closed on fan shutdown shall be provided on the outside air intakes and discharges of all space conditioning and exhaust systems. ❑X All gravity ventilation systems shall be provided with automatic or readily accessible manually operated dampers in all openings to the outside, except for combustion air openings. . ❑X Air Balancing: The system shall be balanced in accordance with the National Environmental Balancing Bureau (NEBB) Procedural Standards (1983), or Associated Air Balance Council (AABC) National Standards (1989); or ❑X Outside Air Certification: The system shall provide the minimum outside air as shown on the mechanical drawings, and shall be measured and certified by the installing licensed C-20 mechanical contractor, or(3) the person with overall resposibility for the design of the ventilation system; or Outside Air measurement: The system shall be equipped with a calibrated local or remote device capable of measuring the quantity 191 of outside air on a continuous basic and displaying that quantity on a readily accessible display device; or FX Another method approved by the Commission. Service Water Heating Systems ❑ If a circulating hot water system is installed, it shall have a control capable of automatically turning off the circulating pump(s) when hot water is not required. ❑ Lavatories in restrooms of public facilities shall be equipped with controls to limit the outlet temperature to 110 degrees F. Q Lavatories in restrooms of public facilities shall be equipped with one of the following: Outlet devices that limit the flow of hot water to a maximum of 0.5 gallon per minute. Foot actuated control valves, and outlet devices that limit the flow of hot water to a maximum of 0.75 gallon per minute. Proximity sensor actuated control valves, and outlet devices that limit the flow of hot water to a maximum of 0.75 gallon per minute. Self-closing valves, and outlet devices that limit the flow of hot water to a maximum of 2.5 gallons per minute, and 0.25 gallon per cycle (circulating system). Self -losing valves, and outlet devices that limit the flow of hot water to a maximum of 2.5 gallons per minute, and 0.50 gallon per cycle (non -circulating system). Self -dosing valves, and outlet devices that limit the flow of hot'water to a maximum of 2.5 gallons per minute, and 0.75 gallon per cycle (foot switches and proximity sensor controls). PROUDLY SERVING THE UNINCORPORATED AREAS OF RIVERSIDE COUNTY AND THE CITIES OF: BANNING BEAUMONT CALIMESA CANYON LAKE COACHELLA DESERT HOT SPRINGS EASTVALE INDIAN WELLS INDIO JURUPA VALLEY LAKE ELSINORE LA QUINTA MENIFEE MORENO VALLEY PALM DESERT PERRIS RANCHO MIRAGE RUBIDOUX CSD SAN JACINTO TEMECULA WILDOMAR BOARD OF SUPERVISORS: BOB BUSTER DISTRICT 1 JOHN TAVAGLIONE DISTRICT 2 JEFF STONE DISTRICT 3 JOHN BENOIT DISTRICT 4 MARION ASHLEY DISTRICT 5 RNMUN C®UNN FIRE DEPARWENT, IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION John R. Hawkins - Fire Chief 210 West San Jacinto Avenue — Perris, CA 92570 (951) 940-6900 -- www.rvcfire.org November 5, 2012 RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural LAQ-I2-TI-056 Sports Clips 79-024 Hwy 111 #102 La Quinta, CA You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN OCCUPANCY PERMIT. It is prohibited to use/process or store any materials in this occupancy that would classify it as an "H" occupancy per Sec. 307 of the 2010 CBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the CBC. A minimum 2AIOBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible location within 75' walking distance from any point in your building or suite. Fire extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the extinguisher, or purchased from a retail store with a sales receipt attached. A licensed fire extinguisher company must service extinguisher yearly. All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times. Approved suite addresses shall be placed in such a position to be plainly visible and legible from the street. Said numbers shall contrast with their background. An approved audible interior notification alarm device shall be provided in approved location. A C-1 O licensed contractor must submit plans, designed in accordance with NFPA 72 to the Fire Department for review and approval prior to installation A durable sign stating "This door to remain unlocked during business hours" shall be placed on or adjacent to the front exit door. The sign shall be in letters not less than one inch high on a contrasting background. Provide key(s) to the tenant space for inclusion in the main building Knox Box. Key(s) shall have durable and legible tags affixed for identification of the correlating tenant space. Key(s) shall be provided at time of final inspection. As it may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire sprinkler system plans for the tenant improvement area may be required to be submitted to the Fire Department for review. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re -inspection fee will be required if more than one (1) inspection is necessary. Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling (760) 863-8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering Staff at (760) 863-8886. Sincerely, By: Jason Stubble Fire Safety Specialist I - r Certificate of Occupancy . Tdf 4 xP a" Building &Safety Department This Certificate is issued pursuant to the requirements of Chapter 1 Section 111 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 79-024 HIGHWAY 111, STE 102 Use classification: BUSINESS — SPORTS CLIPS HAIRCUTS Occupancy Group: B Type of Construction: VB Code Edition: 2010 Sprinkler Installed: YES Owner of Building: Address: City, ST, ZIP: Fva 6(*G &wwa By: Building Official Date: POST IN A CONSPICUOUS PLACE Building Permit No.: 12-1267 Land Use Zone: CR Occupant Load: 22 INLAND AMERICA PO BOX 9271 HINSDALE, IL 60521 AJ ORTEGA JANUARY 16, 2013 11