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10-0402 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000402 Property Address: 79410 HIGHWAY 111 STE 112 APN: 649-820-006- - - Application description: REMODEL - COMMERCIAL Property Zoning: REGIONAL COMMERCIAL Application valuation: 30000 - --- - -Applicant arum ke I T4ht 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: E & DD 2114 ARI IN LOS ANGELES, _Contractor: Architect or Engineer: Owner 4 :*3>%An LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any agOicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ( I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. _ , B.&P.C. for this reason M Date: 0 /0404-:�' 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: LQPERN11T VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/16/10 CA 90049 Ibul"ef- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number 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 forth ' com ith those provisions. Date: Applicant: _�-• C� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 hreeuthorize representatives _ this county to enter upon the above -mentioned property for inspects rt purp II Date: t5, �o.Signature (Applicant or Agent): Application Number 10-00000402 ' ------ Structure Information' 1,680SF DININGROOM REMODEL ----- Other struct info . - . . . CODE EDITION 2007/2008 FIRE SPRINKLERS. FULLY MIXED -USE OCCUPANCY A3 OCCUPANT LOAD 93.00 1ST FLOOR SQUARE FOOTAGE ---------------------------------------------------------------------------- 1680.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 284.50 Plan Check Fee 184.93 - Issue Date . . . . Valuation 30000 -- - --- .•-__._-. �_; _ —Expiration Date'-.- 7.12/13/10 __�___. _ - ._. .. _.. - . •_ •_.•...._.. --- — Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 ---------------=-------------------------------------------- .32.50 ---------------- Permit ELECT - ADD/ALT/REM Additional desc . Permit•�Fee . . 39.00 Plan Check Fee 9.75 Issue Date Valuation . . . . 0 - Expiration Date 12/13/10 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 20.00 .4500 EA ELEC DEVICE/FIXTURE >20 9.00 -------------------------- ------------------------------------------------- Special Notes and Comments 1,680SF DINING ROOM REMODEL AT EXISTING IMPROVED 4,120SF RESTAURANT TENANT SPACE/VB/A-3/93-OL/FULLY SPRINKLED [0 SUSHI] THIS PERMIT DOES NOT INCLUDE ALTERATIONS TO THE EXISTING KITCHEN, MECHANICAL OR PLUMBING SYSTEMS OR BUILDING SIGNAGE. 2007 CALIFORNIA BUILDING CODES/2008 ENERGY CODE. June 16, 2010 12:44:58 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . ACCESSIBILITY PLAN REVIEW 18.49 BLDG STDS ADMIN (SB1473) 2.00 ENERGY REVIEW FEE 18.49 Fee summary Charged Paid Credited ----------------- ---------- ---------- ---------- Due ---------- I LQPERMIT -Application Number 10-00000402 Permit Fee Total 323.50 .00. 1.00 323.50 Plan Check Total 194.68 .00 .00 194.68 •Other Fee Total 38.9,8 .00 .00 38.98 Grand Total 557.16 .00 .00 557.16 LQPERMIT - Bin # ' City of La Quinta Building 8T Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet +• Permit # `D • Proj�,/%�'aHl/ -Owner's Name: O�At�s/7�, /•t/C Address: % 9r/ d /-/W/v /// u',/7 A. P. Number: Legal Description: -City, ST, Zip: &!!69 C.4-4 N et/7 A , C,,4 9a 2-f�? Contractor: 0GU.LF-7C Telephone: d1ov-00 Address: City, ST, Zip: Project Description: /lam �u Telephone: State Lic. # : City Lie. M. Arch., Engr., Designer: Address: City., ST, Zip: Telephone:' State Lic. #:>• Name of Contact Person: c7/ ..� >.' '•u Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Pt; #Stones: #Units: Telephone # of Contact Pe on: 21 Z mated Value of Project:�— # Submittal Req'd APPLICANT: DO -NOT WRITE BELOW THIS LINE Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item -Amount Structural Cafes. Reviewed, ready for corrections t6 Plan Check Deposit --� Tress Cates. Called Contact Person 5 Z. Plan Cheek Balance. --- Title 24 Cafes. Plans picked up /�!� Construction Flood plain play Plans resubmitted Mechanical .ram Grading plan Subcontactor List 2" Review, ready for corrections issue Called Contact Person Electrical Plumbing � •� Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading •►�' IN HOUSE:- ''' Review, ready for correctionstissue Developer Impact Fee ..—. Planning Approval Called Contact Person A.I.P.P. ...� Pub. Wks. Appr Date of permit issue ter Z 00 School Fees mil Total Permit Fees :b NS p{t �AR4u►rr Crru.Ef� b�� 2,xo _ Vcwa�+"Tre6D Llib 2ao - PLA+a A�Po✓�b3r��t CITY OF LA QUINTA SUB -CONTRA TOR LIST -JOB ADDRESS li-q&0 &e Ilu a S76 (11L PERMIT NUMBER IO- 0 0?2 OWNER &3 M BUILDER ' This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on -this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work. and/or the voidance of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. Trade ! Classification ::: .. .. .....: Contractor Lic nse:::...::....:..... State::Contractor.s e Wockers..Com ensat�on .Insurance...:Business _. _ ..... ...._.. _.._. _......p License 'Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) -Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) License Number (xxxxl Exp. Date (xx/xx/xx) EARTHWORK (C 121 CONCRETE(C 8) . FRAMING C 5) STRUCT STEEL MASONRY (C-29)' ' PLUMBING.(C 36) ' LATH PLASTER :DRYWALL (C-9) HVA. C (C-20) ,'. LECTRICAL (C 10) iAly P-I C' (NL ri l0 (0 b 6 Ph I G"w IWci 1,1 y1� 0 03/%'v(1 10141,0 i 3{ tilt ROOFING'(C'-39). SHEET METAL (C-4 ) FLOORING (C 15Y.. GLAZING:IC=17) INSULATION (C-2) SEWAGE DISP (C42) PAINTING IC733) CERAMIC TILE:(C-54) CABINET$.',('C 6) FENCING.(C-13) LAN.DSCAP,ING (.C-27) POOL (C 53) John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of - Banning Beaumont 4. Calimesa Canyon Lake Coachella Desert Hot Springs Indian Wells . 4. Indio 'Lake Elsinore 4. La Quinta Moreno Valley Palm Desert . 4. Perris ;. Rancho Mirage 4. Rubidoux CSD 4. San Jacinto 4. Temecula Board of Supervisors Bob Buster, District I John Tavagh6ne, District 2 Jeff Stone, District 3 1ohn.Benoit, District 4 Marion Ashley, District 5 RNERSIDE COUNTY l FIRE DEPARTMENT - In cooperation with the California Department of Forestry and Fire Protection 77-933 Las Montanas Rd STE 201 • Palm Desert, CA 92211 . (760) 863-8886 • Fax (760) 863-7072 June 22, 2010 RE: TENANT IMPROVEMENT PLAN CHECK LAQ-IO-TI-020 O-Sushi Japanese 79-410 Hwy I I I #112 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 20007 CBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the 2007 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. 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 may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire sprinkler system plans for the tenant improvement area are required to be submitted to the Fire Department for review. , Approved suite address shall be placed in such a position to be plainly visible and legible from the street. Said numbers shall contrast with their background. Each room with an occupancy load of over fifty people shall be posted in a conspicuous place on an approved sign near the main exit from the room. 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 RIVERSIDE COUNTY COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH FOOD ESTABLISHMENT PLAN APPROVAL NOTICE Plan Check # 18714 Date 7/1/10 Project Name O Sushi Japanese Address 79-410 Highway 111 Bid. G unit 112 La Quinta Restaurant Plans Submitted by Jin Kook Kim Phone 818-723-0172 Owner Jin Kook Kim Address 345 S. Mountain Ave. Upland CA 91876 Phone 818-723-0172 The plans are now approved subject to the conditions listed below and the attached compliance sheet. This is a remodel of an existing facility. 1. Must provide 3/8" radius cove base tile (flush with floor tile) at the new sushi area. 2. Provide a certified air balance report for the exiting hood and make up air. 3. This facility is required to have 32 .linear feet (min) of back up dry storage and 16 linear feet back up dry storage for the bar (metro type rack 18"wide 3 tiers high). 4. Provide a grease interceptor letter from the sewer agency. Note: All existing equipment and finishes must be in GOOD REPAIR (and NSF - approved). These will be evaluated at the first on -site inspection and will be subject to REPAIR OR REPLACEMENT if not found in good repair. CONSTRUCTION INSPECTIONS: Contact the Plan Checker for a Preliminary Inspection when construction is approximately 80% complete, with plumbing, rough ventilation, and rough equipment installed. Request for inspection should be made at least five (5) working days in advance. A FINAL INSPECTION MUST be made upon completion of ALL work including finished details. APPROVAL to operate shall not be granted, or remodeled areas approved to operate, until the facility has passed the FINAL INSPECTION, and "APPLICATION TO OPERATE" has been completed and PERMIT FEES have been paid. Request for inspection should be made at least five (5) working days in advance. PLANS CHECKED BY --\- Fp(? Phone Y 6a —go3 I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during construction: Signature Date Company Name DEH-SAN-178 (Rev 2/06) E & DD, LLC. 3701 Wilshire Blvd, Suite 880 Los Angeles, CA 90010 Tel:213-252-0073 Fax:213-252-0846 r June 17, 2010 City of La Quinta Building and Safety Department P.O. Box 1504 La Quinta, CA 92247 Re: 79-410 Highway 111; Suite 112, La Quinta, CA 92253 Dear Building and Safety Department, We have been informed by our new tenants,.Omashita, LLC dba 0! Sushi, who will be occupying the above referenced premises, that, the city was requiring a letter from the landlord to allow them to access certain information or to submit certain permits, in regards to building a demising wall in the foyer of Suite 112 for the above mentioned site. E & DD, LLC is the owner of the building 79-410 Highway 111, building 6, La Quinta, CA 92253. We respectfully submit this letter to you, to formally state that the owner of the building gives authorization for Omashita, LLC to do such, as long as they are within all governing codes. Warmest Regards, E & DD, LLC. ,c/ ealtyland Co., Inc. r Edward Kim Property Manager To whom it may concern, I, Change Hee Kim, the landlord of LA Quinta Valley Plaza buildings located at 79410 Highway 111 give permission for the new tenant at unit 112, Jin Kook Kim, to build a dry wall in the foyer area, located inside the premises. If you have any questions or concerns, contact will be available at (213) 434-7535 Sincerely, . 1 i ang Hee ord 4 1 y P.O. Box 1504 78-49.5 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 i i To: Greg Butler, Building & Safety Manager From: Les Johnson, Director-PDD BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 To PD: May 6, 2010 Due Date: MAY 13, 2010 Permit #: 10- 402 Status: 1ST REVIEW Building Plans Approval (This is an approval to issue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: TENANT IMPROVEMENT / OMASHITA i Address or General Location: 79410 HWY 111 UNIT 112 i Applicant Contact JIN KOOK KIM (818)-723-0172 r The Planning Development Department finds that: i ❑ ...these Building Plans do not require Planning Department approval. ...-these Building Plans are approved by the Planning Department. ❑ ...these Building Plans require corrections. Please forward a copy of the attached corrections to the applicant. When the corrections are made please turn them to the Planning Department for review. Les Johns irector-l?D ; _ Date MAY X 6 041 ofto ntv 'PlMning D`Po�ment • i � H r,rry rJF LA QUINTA G & SAFETY DEPT. PROVED ;ONSTRUCTION BY A�= . N 0 -r�t'D - t_A tA 1 f A c wno rn sushi bar partial floor plan, scale ; 1 / 4" - 1' -0" a rn . 1 ( - -T- L % 6A.- zL&4 �� ;;i:X_� --�_ N W-q n trornt ie� ,. SEE: CITY OF LA QUANTA BUILDING & SAFETY DEPT 1l,,�� APPROVED 4F6�ONSTRUCTION t7-t i 0 sc c 7—o -CIO Jc CITY OF LA'QUINTA -BLIfLDING-&-S-A-FET-Y-,-DEP[TT- -P A PROVEDi i ION 'FOR CONSTRUCTION DATE BY CERTIFICATE OF COMPLIANCE (Pap 1 of 4), LTG-1C Project Nanie: O su sh, Date: 0 6/a 91� Project Address: 4/Qy ! /2 Climate Zone: Building CFA : L A �U f .r+ �a C. �7 1 Z S 3 Unconditioned Flo r Area: General Information Building Type:. Nonresidential ® High -Rise Residential E . Iiotel/Motel. Schools Relocatable Public r3 Schools ® .Conditioned Spaces ®. Unconditioned Spaces Phase of Construction: ® New Construction ® Addition Alteration Method of Compliance: Complete Building Area Category 13 Tailored Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: T110 ko 44C � GM I Signature: Company: Date Address: % 7C/ o A1/6yW,g Y /// -' // 2 If applicable: C� DwNZ.D ( , q 2 J CEPE# City/State/Zip Phone: Principal Lighting Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the lighting design. • This Certificate of Compliance identifies be 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, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: , a Signature: Company: Phone: G, Z Address: License # f� City/State/Zip: Date: t. . ei Lighting Mandatory Measures 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. Nil 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 BUILDING & SAFETY DF=PT. ® LTG-5C Pages 1 and 2 Line Voltage Track Lighting Worksheet 100 Arr"VYM u FOR CQNSTRU �Vi 2008 Nonresidential Compliance Forms -1q-4co 111 1 LM CERTIFICATE OF COMPLIANCE (Page 2 of 4) LTG- 1C INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Project Name: Date: 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.) [3 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: 0 CONDITIONED SPACE [3 UNCONDMONED 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 lightingpower density in accordance with the Exception to §146(a). Allportable lighting in excess of 0.2 watts per s uare oot is totaled below. Luminaire Schedule e, Lamps, Ballasts Installed Watts A B C D E F G H Complete Luminaire Description (i.e, 3 lamp fluorescent troffer, F32T8, one dimmable electronic b ast _ y E cri ' How wattage was determined E E ' ' w Vz A ii Field Inspector Z CEC Default from NA8 According to §130 d or e o m J tACV 10 �W-' F, Ai D rF INSTALLED WATTS PAGE TOTAL: . Building total number of pages ' Installed Watts Building Total (Stun of all pages) Enter into ' 6 LTG -IC 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. Verify building plans i necessa . AVOM s-- August 2009 �� Wp CERTIFICATE OF COMPLIANCE (Page 2 of 4) LTG -IC INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Project Name: Date: 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) Q 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: 0 CONDMONED SPACE 0 UNCONDITIONED SPACE 13 The actual indoor lighting power listed below includes all installed permanent and portable lighting systems in accordance with 146 a Only for ofl?ces: 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 uare oot is totaled below. Luminaire Schedule a Lamps, Ballasts Installed Watts A B C D E F G H F Z(i.e, Complete Luminaire Description 3 lamp fluorescent troffer, F32T8, one dimmable electronic bWlast y .0 'E -3' How wattage was eter�m n—ed e E E ' ' _ w " A S Field Ins ctor 2"- - CEC Default from NA8 A tordmg §130 d or e) °' u .. f 137 INSTALLED WATTS PAGE TOTAL: Building total number of pages I Installed Watts Building Total (Stun of all pages) Enter into 1 r LTG- IC Page 4 of 4 1. Wattage shall be determined according to Section 130(d and e). Wattage shall berating of light fixture, not rating of bulb. 2. ff Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify buildin plans i necessa . ' vci-,-a1i. 1 r'" " M August 2009 Vito aI1 O)- INDOOR LIGHTING POWER ALLOWANCE LTG-3C Project Name: 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: El CONDITIONED spaces ❑ UNCONDITIONED spaces COMPLETE BUILDING METHOD WATTS COMPLETE ALLOWED BUILDING CATEGORY(From § 146 Table 146-E PER (if) BLDG. AREA = WATTS TOTALS AREA WATTS AREA CATEGORY METHOD — Part A A B C D WATTS ALLOWED AREA CATEGORY rom§ 146 Table 146-F PER ft X AREA f = WATTS Sum of Additional Allowed Watts from Area Method — Part B from table below TOTALS �O 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 ftZ Allowed Wattage Allowance x C Description(s) and Quantity of Special Luminaire Z 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. z. 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 LTG=4C (Page 1 of 4) Row 3 F��9 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 LTG4C forms shall be filled out for CONDITIONED and UNCONDITIONED soaces 2008 Nonresidential Compliance Forms August 2009 CERTIFICATE OF COMPLIANCE (Page 3 of 4 LTG -IC Project Name: Date: INDOOR LIGHTING SCHEDULE and FEELD INSPECTION ENERGY CHECKLIST Fill in controls for all spaces: a) area controls, b) multi -level controls, c) manual daylighting controls for daylit areas > 250 , automatic daylighting controls for daylit areas > 2,500 ft�, d) shut-off controls, e) display lighting controls, fi tailored lighting controls - general lighting controlled separately from display, ornamental and display case lighting and gj demand responsive automatic controls or retail stores > 50, 000ft2, in accordance with Section 131. MANDATORY LIGHTING CONTROLS - FIELD INSPECTION ENERGY CHECKLIST Field Inspector Type / Description Number of Units Location in Buil mg Pass Fail i sin CM p�^ � - aNt'w ® E3 Z to 6 -- LAO00�o 0 El 1:3 ® 1:3 0 0 Field Inspector's Notes or Discrepancies: 2008 Nonresidential Compliance Forms August 2009 INDOOR LIGHTING POWER ALLOWANCE LTG-3C Project Name: 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: [3 CONDITIONED spaces ® UNCONDITIONED spaces COMPLETE BUILDING METHOD WATTS COMPLETE ALLOWED BUILDING CATEGORY(From § 146 Table 146-E PER(fX BLDG. AREA = WATTS TOTALS AREA WATTS CATEGORY METHOD — Part A A AREA CA' 146 Table 1 Sum of Additional Allowed Watts from Area WATTS ALLOWED C D PER (ftt) X AREA (ft) = WATTS Method — Part B from table below TOTALS JB 2J 1�j AREA WATTS AREA CATEGORY METHOD — Part B Additional Wattage Allowance from Table 146-F Footnotes A B C D E F G Primary Function S Ft Additional Watts Per ft2 Allowed Wattage Allowance x C Description(s) and Quantity of Special Luminaire Z 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. 2. Special luminaires are fight fixtures described in the Table 146-F Footnotes that are subject to an additional wattage allowance. TAII.ORED METHOD Total Allowed Watts using the Tailored Method taken from LTG=4C (Page I of 4) Row 3 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 2008 Nonresidential Compliance Forms August 2009