07-2558 (RC)l;1
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00002558
Property Address:
79485 HIGHWAY 11 STE. 9 '
APN:
600 -020 -027 -
Application description:
REMODEL - COMMER
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
85000
Applicant: Architect or Engineer:
-----------------
LICENSED CONTRACTOR'S DE(CLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provi' s of Chapter 9 (commencing with
Section 7 00) of ivision 3 of the Business and rofessional ode, my License is in full force and effect.
License ass: is n 464856
Dat ntractor:
D
I hereby affirm under penalty of perjury I m exempt afrom I a ontractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1—) 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.).
(_ 1 I, as owner of the property, am exclusively contracting' with licensed contractors to construct the project ISec.
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
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
STAMKO DEV CO
10345 W OLYMPIC BLV 2 FL
LOS ANGELES, CA 90064
Contractor:
ULTRA CONSTRUCTION
3065 E. VERONA ROAD
PALM SPRINGS, CA 92264
(760)320-2113
Lic. No.:.464856
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/30/07
-3
'F-ocaT3 t 2 0
N - �k.6;-
---------------------------
WORKER'S COMPENSATION'BFetA'R7YTI010�"""`._—
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 STATE FUND L Policy Number 719-00 103-06
_ I certify that, in the performance of th orkA_o
mit Is=t: I shalt not employ any
pers n in any manner so as to b ome suers' ompensation laws of California,
an gree that, if I should bec a subject ensation provisions of Section
3 0 II forthwith provisions.
Dat pplicant:
WARM G: [LURE TO RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJE T AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the.applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not c menced
within 180 days from date of issuance of such permit, or essation of work for 180 a s will subject.
permit to cancellation.
I certify that have r d this application and state that the above inf motion is corre . I gre to c ply with all
city and co y ord' ances and state laws relating wlding cons uct'on, and her y au a re esentatives
of this co to a ter upon the above-mento,ed prop for in eucti purposes
P
4, Da ignA_ ature (Applicant or A eml:_
i
Application Number .
. . . . 07-00002558
------ Structure Information
3,250SF TI [MASSAGE ENVY]/V-NR/B-OC/47-0
-----
other struct info . .
. . . CODE EDITION
2001/2005.
FIRE SPRINKLERS
YES
MIXED-USE OCCUPANCY
B
OCCUPANT LOAD
47.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
3250.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
572.00 Plan Check Fee
371.80
Issue Date . . . .
Valuation . .
. . 85000..
Expiration Date : .
4/27/08
Qty Unit Charge
Per
Extension
BASE FEE
414.50
35.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
157.50
Permit . . .
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee80.00
Plan Check Fee
20.00
Issue Date . . . .
Valuation
. . 0
Expiration Date
4/27/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3250.00 .0200
----------------------------------------------------------------------------
ELEC GARAGE OR NON-RESIDENTIAL
65.00
Permit . . .
MECHANICAL
Additional desc
Permit Fee
19.50 Plan Check Fee
4.88
Issue Date . . . .
Valuation
0
Expiration Date .,
4/27/08
Qty Unit Charge
Per
Extension
BASE FEE
' 15.00
1.00 4.5000
----------------------------------------------------------------------------
EA • MECH VENT INST/ DUCT ALT.
4.50
Permit . . .
PLUMBING
Additional desc .
Permit -Fee . . . .
49.50 Plan Check.Fee
12.38
Issue Date
Valuation . .
. . 0
-Expiration Date
4/27/08
Qty Unit Charge
Per
Extension
S
LQPERMIT
Application Number . . . . . 07-00002558
Permit . . . . . . PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 6.0000 EA PLB FIXTURE
24.00
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
3,250SF TENANT IMPROVEMENT [MASSAGE
ENVY.] V-NR/B-OCCUPANCY/47-OL. 2001 CBC,
CMC, CPC, 2004 CEC, 2005 ENERGY. PRIOR
TO CERTIFICATE OF OCCUPANCY THE PROPER
LICENSES AND PERMITS FOR MASSAGE THERAPY
ESTABLISHMENTS SHALL BE OBTAINED AND
POSTED AS REQUIRED BY MUNICIPAL CODE
CHAPTER 5.32, THE REQUIREMENTS OF THIS
CHAPTER SHALL BE IN ADDITION TO THE
REQUIREMENT OF ANY OTHER LICENSE, PERMIT
OR FEE REQUIRED BY ANY LOCAL, COUNTY,
STATE.OR FEDERAL LAW. October 30, 2007
1:5.7:57 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW
37.18
ENERGY REVIEW FEE
37.18
Fee summary Charged Paid Credited
r
Due
Permit Fee Total 721.00 .00 .00
721.00
Plan Check Total 409.06 .00 .00
409.06
Other.Fee Total 74.36 .00 .00
74.36
Grand Total 1204.42 .00 .00
1204.42
Bin #
(-5D
f
City of La' Quinta.
Building U Safety Division
P.O. Box .1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
..Building Permit Application and Tracking Sheet
Permit .#
.
Project Address:' 7q i u . -& q 4-x,0
Owner's Name:11,0ia A old
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: ' L7 ` E
Telephone:
Address:
9. O,1
Project Description:
City, ST, Zip: S Q ` ,' Z Z
L
t1 ov 6: e ,
Telephone:.766Z O_Z//
State Lic. # : - 5.37 cu.D City Lic. #:
AW !26!6 25011Y"
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #: AM -
Name of Contact Person: P
1
Construction Type:. Occupancy:
P cY= .
Project type (circle one): New Add'n .Alter Repan . Demo .
Sq.FL: #Stories: # Units: .
Estimated Value of Project: J
Telephone # of Contact Person:
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING •
PERMIT FEES
Plan Sets
Plan Check submitted
g
Item Amonnt
Structural Calcs
Reviewed, ready.for corrections
Plan Check Deposit
Truss Calcs.
71
Called ContattPerson
Plan Check Balance i
Energy Cults..
Plans.picked up - 7L,
Construction
Flood plain plan
Plans resubmitted
p
A 1
Mechanical
Grading. plan
2" -Review, ready f r'correctio ue
0117
Electrical
Subcontactor List-
Called Contact Person
Plumbing
Grant Deed.
Plans picked up 1 w--\ �P-
! .
S.M.I.
Ii.O.A. Approval
Plans resubmitted
10M/'
Grading c
IN HOUSE:-
''' Review, ready for correctionsfissue.
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees '
Total Permit Fees
(01Z ON 00AI
o�o Certificate of Occupancy
OF Building & Safety Department
This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
construction and/or use.
BUILDING ADDRESS: 79-485 HIGHWAY Ill STE #9
Use classification: COMMERICAL (MASSAGE ENVY) Building Permit No.: 07-2558
Occupancy Group: B
Type of Construction: VN
Land Use Zone: RC
Owner of Building: STAMKO DEV CO Address:.10345 W OLYMPIC BLVD 2FL
City, ST, ZIP: LOS ANGELES, CA 90064
By: STEVE TRAXEL
Date: January 9, 2008
Building Official
POST IN A
John R. Hawkins
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the
Cities of:
Banning
Beaumont
Calimesa
Canyon Lake
Coachella
Desert Hot Springs
Indian Wells
❖
Indio
Lake Elsinore
La Quinta
Moreno Valley
Palm Desert
4.
Perris
4.
Rancho Mirage
Rubidoux CSD
San Jacinto
.;
Temecula
Board of Supervisors
Bob Buster,
District I
John Tavaglione,
District 2
Jeff Stone,
District 3
Roy Wilson,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY
FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
77-933 Las Montanas Rd. STE 201 Palm Desert, CA 92211-4131 (760) 863-8886 Fax (760) 863-7072
Date I
La Quinta.
Building Department
RE
The Riversides Count/y, Fire0w\1111
Department is.granting the fire clearance for the following
location -7 I — q 5 H w\1 111 �7 E /0
Please call if you should have questions. 760-863-8886. Thank You
'0
pectfully,
Jason Stubble
Fire Systems Inspector
CAUFOAHIA
epR«EAro►FonFs,Py RIVERSIDE COUNTY
aad EIRE PAOIFCI/py
►��1 FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
77-933 Las Montanas Rd., Suite 201 • Palm Desert, California 92211 • (760) 863-8886 • Fax (760) 863-7072
John R. Hawkins
Fire Chief
Proudly serving the
October 9, 2007
unincorporated
areas of Riverside
County and the
.
Citiesof
APPLICANT: ULTRA CONSTRUCTION
3065 E. VERONA ST.
Banning -
PALM SPRINGS, CA. 92262
4.
760-320-2113
Beaumont
Calimesa
Canyon Lake
RE: TENANT IMPROVEMENT PLAN CHECK
4.
LAQ-07-TI-108 / MASSAGE ENVY
Coachella
79-485 HWY. 111 STE 9-10
Desert Hot Springs
LA QUINTA, CA. 92253
Indian Wells
You have been issued a release for a tenant improvement on an existing building. THIS IS
4.
NOT AN OCCUPANCY PERMIT.
Indio
4.
Lake Elsinore
It is prohibited to use/process or store any materials in this occupancy that would classify it
•�•
as an "H" occupancy per Sec. 307 of the 2000 UBC.
La Quinta
•'•THE
Moreno Valley
FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION:
Palm Desert
4•
Install door hardware and exit signs as per Chapter 10 of the 2001 CBC.
.
Perris
Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire
Rancho Mirage
Department for review, along with a plan/inspection fee. A licensed C-16 contractor will
:•
have to submit plans for review and approval and modify the fire sprinkler system in
San Jacinto
accordance with NFPA 13, 2002 Edition. A licensed C-16 contractor shall do all sprinkler
'''
work and certification. The approved plans, with Fire Department Job card must be at the
Temecula
job site for all inspections.
Board of supervisors
Provide keys 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.
Bob Buster,
District 1
John Tava
Shelving, counters, etc., must be in place, however, no merchandise may be placed in the
is,
Distr
Dtrict 2
y
building prior to inspection .
Jeff Stone,
District
A minimum 2A10BC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a
Roy Wilson; '
visible location within 75' walking distance from any point in your building or suite. Fire
District
extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal
Marion Ashley,
District 5
2300 Market Street, Suite .150 • Riverside, California • (951) 955-4777 • Fax (951) 955-4886
39493 Los Alamos Road, Suite A 9 Murrieta, California 92563 • (951) 600-6160 • Fax (951) 600-6164
service tag attached to the extinguisher, or purchased from a retail store with a sales receipt attached. A
licensed fire extinguisher company must service extinguisher yearly.
ELECTRICAL PANEL BOX:
All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times.
OTHER REQUIREMENTS:
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. Building address numbers shall be a minimum of 12" for building(s) up to 25' in
height, and 24" in height for building(s) exceeding 25' in height. In multi -tenant buildings, businesses shall post
the business name and suite number on back doors as well as the front. Suite numbers or letters must be a
minimum of 6" in height. All addressing must be legible and of a contrasting color with the background and
adequately illuminated to be visible from the street at all hours.
A durable sign stating 'This door to remain unlocked during business hours" shall be placed on or adjacent to
the front exit door. The sign shall be in letters not less than one inch high on a contrasting background.
Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re -inspection
fee will be required if more than one (1) inspection is necessary. Requests for inspections are to be made at
least 72 hours in advance and may be arranged by calling (760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire Department Planning &
Engineering Staff at (760) 863-8886.
Sincerely,
Steve Diaz
Chief Fire Department Planner
Colleen Estrada
Fire Safety Specialist
2300 Market Street, Suite 150 • Riverside, Califomia • (951) 955-4777 • Fax (951) 955-4886
39493 Los Alamos Road, Suite A • Murrieta, Califomia 92563 9 (951) 600-6160 9 Fax (951) 600-6164
TITLE 24 REPORT
Title 24 Report for:
Massage Envy
79-485 Highway 111, Suites9/10
La Quinta, CA
Project Designer:
7
Report Prepared By:
Joan D. Hacker
Insu-form, Inc.
41-921 Beacon Hill, Suite A
Palm Desert, CA 92211
(760) 779-0657
CITY OF LA QUINTA Job Number:
BUILDING & SAFETY DEPT.
APPROVED oC12 2"200
FOR CONSTRUCTION
DA 0gy
Date: By
F90AA4T ; �. 10/19/2007
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is
authorized by the California Energy Commission for use with both the Residential and Nonresidential 2005 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC - www.energysoft.com.
EnergyPro 4.3 by EnergySoft Job Number: User Number: 2655
TABLE OF CONTENTS
Cover Page 1
Table of Contents - 2
Form LTG -1-C Certificate of Compliance 3
Form LTG -2-C Indoor Lighting Schedule 6
Form LTG -5-C Indoor Lighting Power Allowance 7
Form LTG -7-C, Room -Cavity Ratio Worksheet 8
r
EnergyPro 4.3 by EnergySoft Job Number: User Number: 2655
r
CERTIFICATE OF COMPLIANCE (Part 1 of 4) LTG -1-C
PROJECT NAME
DATE
Massage Env
10/19/2007
PROJECT ADDRESS
79-485 Highway 111, Suites9/10 La Quinta
PRINCIPAL DESIGNER - LIGHTING
TELEPHONE
Building Permit #
DOCUMENTATION AUTHOR
TELEPHONE
Checked by/Date
Insu-form, Inc.
760 779-0657
1 Enforcement Agency Use
GENERAL INFORMATION
DATE OF PLANS
BUILDING CONDITIONED FLOOR AREA
CLIMATE ZONE
3,250 Sq.Ft.
15
BUILDING TYPE ❑X NONRESIDENTIAL ❑ HIGH RISE RESIDENTIAL ❑ HOTEUMOTEL GUEST ROOM
[K CONDITIONED SPACES ❑ UNCONDITIONED SPACES ❑ INDOOR & OUTDOOR SIGNS
PHASE OF CONSTRUCTION ❑ NEW CONSTRUCTION ❑ ADDITION a ALTERATION
METHOD OF LIGHTING F-1COMPLETEBUILDING FXAREA CATEGORY F—] TAILORED ❑ PERFORMANCE
COMPLIANCE ❑ COMMON LIGHTING
STATEMENT OF COMPLIANCE
This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24,
Parts 1 and 6 of the California Code of Regulations. This certificate applies only to building lighting requirements.
The documentation preparer hereby certifies that the documentation is accurate and complete.
DOCUMENTATION AUTHOR SIGNATDAT
U E
Joan D. Hacker t0j. Ll 6-7
The Principal Lighting Designer hereby certifies that the proposk b ilding design represented in this set of construction documents
is consistent with the other compliance forms and worksheets, with he specifications, and with any other calculations submitted with
this permit application. The proposed building has been designed to meet the lighting requirements contained in Sections 110, 119,
130 - 132, 146, 148 & 149 of Title 24, Part 6.
❑ The plans & specifications meet the requirements of Part 6 (Sections 10-103a).
❑ The installation certificates meet the requirements of Part 6 (10-103a 3).
❑ The operation & maintenance information meet the requirements of Part 6 (10-103c).
Please Check One: (These sections of the Business and Professions Code are printed in full in the Nonresidential Manual.)
❑ I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document as the person
responsible for its preparation; and that I am licensed in the State of California as a civil engineer or electrical engineer, or I am a licensed architect.
❑ I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by Section 5537.2 or 6737.3 to sign this document
as the person responsible for its preparation; and that I am a licensed contractor performing this work.
❑ I affirm that I am eligible under the exemption to Division 3 of the Business and Professions Code to sign this document because it pertains to a
structure or type of work described as exempt pursuant to Business and Professions Code Sections 5537, 5538 and 6737.1.
PRINCIPAL LIGHTING DESIGNER - NAME
SIGNATURE
DATE
LIC. #
LIGHTING MANDATORY MEASURES
Indicate location on plans of Note Block for Mandatory Measures
LIGHTING COMPLIANCE FORMS & WORKSHEETS Check box if worksheet is included
®LTG -1-C, Parts 1 of 4 and 2 of 4: Certificate of Compliance. Part 1 of 4 and 2 of 4 are required for all submittals
❑LTG -1-C, Part 3 of 4: Certificate of Compliance. Part 3 of 4 submittal is required only if Control Credits are claimed
®LTG -1-C, Part 4 of 4: Certificate of Compliance. Part 4 of 4 submittal is required when lighting controls are installed
®LTG -2-C: Indoor Lighting Schedule
❑LTG -3-C: Portable Lighting Worksheet
NLTG-4-C: Lighting Controls Credit Worksheet
N LTG -5-C: Indoor Lighting Power Allowance
❑LTG -6-C: Tailored Method Worksheet
(Z LTG -7-C: Room Cavity Ratio Worksheet
❑LTG -8-C: Common Lighting Systems Method Worksheet
❑LTG -9-C: Line Voltage Track Lighting Worksheet
EnergyPro 4.3 by Energysoft User Number: 2655 Job Number: Page:3 of 8
CERTIFICATE OF COMPLIANCE (Part 2 of 4) LTG -1 -C
PROJECT NAME DATE
Massage Envy 10/19/2007
INSTALLED INDOOR LIGHTING POWER FOR CONDITIONED AND UNCONDITIONED SPACES
INSTALLED LIGHTING, CONDITIONED SPACES (From LTG -2-C)
PORTABLE LIGHTING (From LTG -3-C)
LIGHTING CONTROL CREDIT, CONDITIONED SPACES (From LTG4-C)
CONDITIONED SPACE ADJUSTED INSTALLED LIGHTING POWER
INSTALLED LIGHTING, UNCONDITIONED SPACES (From LTG -2-C)
LIGHTING CONTROL CREDIT, UNCONDITIONED SPACES (From LTG -4-C)
UNCONDITIONED SPACE ADJUSTED INSTALLED LIGHTING POWER
INSTALLED
WATTS
2,939
650
0
3,589
0
0
0
ALLOWED INDOOR LIGHTING POWER FOR CONDITIONED SPACES
❑ COMPLETE BUILDING METHOD (From LTG -5-C) ALLOWED
❑X AREA CATEGORY METHOD (From LTG -5-C) WATTS
❑ TAILORED METHOD (From LTG -5-C) ALLOWED LIGHTING POWER 3,670
ALTERNATE COMPLIANCE
❑ PERFORMANCE METHOD
❑ COMMMON LIGHTING SYSTEM (From LTG -8-C)
ALLOWED INDOOR LIGHTING POWER FOR UNCONDITIONED SPACES From LTG -5-C) 0
MANDATORY INDOOR AND DAYLIGHTING AUTOMATIC CONTROLS
CONTROL LOCATION
(Room #)
CONTROL
IDENTIFICATION
CONTROL TYPE
(Auto Time Switch, Dimming, etc.)
SPACE CONTROLLED
Check if
NOTE TO
FIELD
NOTES TO FIELD - For Building
Department Use Only
EnergyPro 4.3 by EnergySoft
User Number: 2655 Job Number: PageA of 8
CERTIFICATE OF COMPLIANCE (Part 4 of 4) LTG-1-C
PROJECT NAME
Massage Envy
DATE
10/19/2007
Designer: .
This form is to be used by the designer and attached to the plans. Listed below are all the acceptance
tests for lighting systems. The designer is required to check the boxes by all acceptance tests that
apply and list all equipment that require an acceptance test. If all equipment of a certain type requires
a test, list the equipment description and the number of systems to be tested in parentheses. The NJ
number designates the Section in the Appendix of the Nonresidential ACM Manual that describes the
test. Also indicate the person responsible for performing the tests (i.e. the installing contractor, design
professional or an agent selected by the owner). Since this form will be part of the plans, completion
of this section will allow the responsible party to budget for the scope of work appropriately.
Building Departments:
Before an occupancy permit is granted for a newly constructed building or space, or a new lighting
system system serving a building or space is operated for normal use, all control devices serving the
building or space shall be certified as meeting the Acceptance Requirements for Code Compliance.
In addition a Certificate of Acceptance, LTG-1-A, Forms shall be submitted to the building department
that:
A. Certifies plans, specifications, installation certificates, and operating and maintenance
information meet the requirements of§ 10-103(b) and Title 24 Part 6.
Test Descri tion
Test Performed BY:
❑ LTG-2-A: Lighting Control Acceptance Document
- Occupancy Sensor Acceptance
- Manual Daylight Controls Acceptance
- Automatic Time Switch Control Acceptance
Equipment requiring acceptance testing
❑ LTG-3-A: Automatic Daylighting Controls Acceptance Document
Equipment requiring acceptance testing
z
EnergyPro 4.3 by EnergySoft User Number: 2655 1 Job Number: Page:5 of 8 1
INDOOR LIGHTING SCHEDULE (Part 1 of 2) LTG -2-C
7OJECT NAME DATE
Massage Envy 10/19/2007
INSTALLED LIGHTING POWER FOR CONDITIONED SPACES
Luminaire
Lamps/Ballasts
Installed Watts
C
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F
G
H
I
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CFTR32WGX24 -3
1
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(1) 38w Compact Fluorescent 2D Elec
1
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(1) 42w Compact Fluorescent Trip/Quad
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FTR42WGX24 -4
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8
368
(2) 2 ft Fluorescent T8 Elec
717T8
2
17
1.0
33.0
X
37
1,221
(4) 4 ft Fluorescent T8 Energy Savings
Elec
=32T8
4
30
1.0
104.0
X
4
416
40w Wall Mount Incandescent
low
1
40
40.0
X,
18
720
PAGE TOTAL 2 939
BUILDING TOTAL (sum of all pages) 2,939
PORTABLE LIGHTING (From LTG -3-C) 650
CONTROL CREDIT (From. LTG -4-C) O
ADJUSTED ACTUAL WATTS 3 589
EnergyPro 4.3 by EnergySoft User Number: 2655 Job Number: Paoe:6 of 8 1
INDOOR LIGHTING POWER ALLOWANCE LTG -S -C
CT NAME
Massa a Env
L
DATE
10/19/2007
(ChooseWED LIGHTING POWER
COMPLETE BUILDING METHOD - CONDITIONED SPACES
WATTS
PER SF
COMPLETE
BLDG. AREA
ALLOWED
WATTS
BUILDING CATEGORY (From Section 146 Table 146-13)
AREA CATEGORY METHOD - CONDITIONED SPACES
AREA CATEGORY (From Section 146 Table 146-C)
"
WATTS
PER SF
AREA
(SF)
ALLOWED
WATTS
Corridor/Restroom/Support
0.60
624
374
Lobby, Main Entry
1.50
481
722
Office
1.20
2,145
2,574,
PAGE TOTAL
BUILDING TOTAL
3 250
3,670
3,250
AREA
3,670
WATTS
TAILORED METHOD - CONDITIONED SPACES
TOTAL ALLOWED WATTS
(From LTG -6-C or from computer run.)
D
UNCONDITIONED SPACES
Complete Building and Area Catagory Methods
Category (From Section 146 Table 146 -B&C)
WATTS
PER SF
AREA
(SF)
ALLOWED
WATTS
PAGE TOTAL
BUILDING TOTAL
D
D
D
Do
AREA
WATTS
TAILORED METHOD - UNCONDITIONED SPACES
TOTAL UNCONDITIONED SPACES ALLOWED WATTS
(From LTG -5-C and LTG -6-C) 0
EnergyPro 4.3 by EnergySoft User Number: 2655 Job Number: Page -7 of 8
A
B
C
D
E
F
Room
Name
Task/Activity
Description
Room
Length (L)
ft
Room
Width (W)
ft
Room Cavity
Height (H)
(ft)
Room Cay. Ratio
5xHx(L+W)
/(LxW)
A
B
C
D
E
F
Room
Name
Task/Activity
Description
Room
Area (A)
(st)
Room
Perimeter (P)
(ft)
Room Cavity
Height (H)
(ft)
Room Cay. Ratio
2.5 x H x P
/A