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11-0626 (RC)
P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 11-00000626 Property Address: 79200 CORPORATE CENTRE DR STE 101 APN: 649-820-015- - - Application description: REMODEL - COMMERCIAL Property Zoning: COMMERCIAL PARK Application valuation: 50000 Applicant: Architect or Engineer: c 3eog 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 o_f the Business and Professionals Code, and my License is in full force and effect. license Class: . License No.: Date: AeSntractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 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 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 contractors) licensed pursuant to the Contractors' State License Law.). 1 1 I am exempt under Sec. B.&'s reason ATIlate: ner: 1 f CO RUCTION LENDING AGENCY I hereby affirm under penalty of pe lury that ZrE is a construction lending agency for the performance of the work for which this permit is issued ISec 3' 97, Civ. C.). Lender's Name: Lender's Address: LQPE&NIIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/15/11 Owner: PF 4PAUL JAMES R55525 CHERRY HILLSLA QUINTA, CA 92253 i U t ii �01 OF !,A QUINTA Contractor: Owner DITION 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 a subject to the workers' compensation r ' ' of Section / *FAILURE 0 o�f the Labor e, I shall fo thw' Kcomp w' r .Date.VApplicant:WA NING: - TO URE W ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOY R TO � NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001 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 ands' e that tl ormation is correct. I agree to comply with all city and county ordinances and state laws relating uilding constr tion, and hereby authorize representative 9f..th��is c my enter upon the above-mentione property for ins urposes. Dat �gnature (Applicant or Age Application -Number 11-00000626 Permit . . . . . BUILDING PERMIT Additional desc . Permit Fee . . Permit Fee . . . . 414.50 Plan Check Fee 269.43 Issue Date . . . . Expiration Date Valuation . . . . 50000 Expiration Date Qty Unit Charge 1/11/12. Extension Qty Unit Charge Per 15.00 Extension' EA MECH VENT ----------------- INST/ DUCT ALT ------------------- BASE FEE 252.00' 25.00 ---------------------------------------------------------------------------- 6.5000 THOU BLDG 25,001-50,000 162.50 Permit . . ELECT - ADD/ALT/REM Plan Check Fee Additional desc . Valuation . . . . 0 Permit Fee . . . . 53.85, Plan Check Fee 13.46 Issue Date . . . . Extension Valuation_ 0 Expiration Date 15.00 1/11/12 EA PLB FIXTURE 42.00 Qty Unit Charge Per 7.50 Extension EA PLB WATER INST/ALT/REP BASE FEE 15.00 ,20.00 .7500 PER ELEC DEVICE/FIXTURE'1ST 20 15.00 53.00 ---------------------------------------------------------------------------- .4500 EA ELEC DEVICE/FIXTURE >20' 23.85 Permit '. . . . MECHANICAL Additional desc . Permit Fee . . 24.00 Plan Check Fee 6.00, Issue Date Valuation 0 Expiration Date 1/11/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 4.5000 -------------------------- EA MECH VENT ----------------- INST/ DUCT ALT ------------------- 9.00 . -------------- Permit . . PLUMBING Additional desc . . Permit Fee . . . . 67.50 Plan Check Fee 16.88 Issue Date- Valuation . . . . 0 Expiration Date 1/11/12 Qty Unit Charge Per Extension BASE FEE 15.00 7.00 6.0000 EA PLB FIXTURE 42.00 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 1679 SF DR'S OFFICE T.I.. SUITE 101. 2010- LQPERAIIT Application Number . . . . . 11 - 00000626 ---------------------------------------------------- Special Notes and Comments ------------------------ CODES. -------------------- .other Fees . . . ---------------------------------------------------- . . . . BLDG STDS ADMIN (SB1473) 2..00 STRONG MOTION (SMI) - COM 10.50 Fee summary Charged ---------- Paid' =--------- Credited Due ----------------- Permit Fee Total 559.85 ---------- .00 ---------- .00 559.85 Plan Check Total 305.77 .00 .00 305.77 Other Fee Total 12.50 .00 .00 12.50 Grand Total 878.12 .00 .00 878.12 LQPERMIT E Bin #L40 C C0ty of LA Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ii-O6?.b Project Address:9 7-/L /L o O Owner's Name: J A. P. Number: Address: 7ZZd� /L Legal Description: City, ST, Zip: el'�1�3 Contractor: �2 v _ Telephone:760 :•'y ? : si'`r,.)isY'.3':?:5$; ):4 0 : }:i::i i:: Address: Project Description: City, ST, Zip: Telephone: State Lie. # : City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: >.'9',:::i:3::s`:'::'µ»">:%:�c;><>•ir:'a : ` :>:" ::' `:::" :`$:::<:;?<` <>< Construction Type: . Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lie. #: f "�" Name of Contact Person: �.+...n. Sq. Ft.: # Sto #Units: Telephone # of Contact Person: Estimated Value of Project: 01000 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections t Plan Check Deposit Truss Calcs. Called Contact Person b Plan Check Balance. Tide 24 Cates. Plans picked upConstruction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2". Review, ready for correction issue Electrical Subcontactor List Called Contact Person 1 a Plumbing Grant Deed Plans picked up S.M.I. s H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue • School Fees Total Permit Fees b sou. �t �tidi1 ~-�'. •w ��cb A{P(wvw Tihf 4 4 Q" P.O. Box 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 To: Greg Butler, Building & Safety Manager BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 To PD: JUNE 9, 2011 From: Les Johnson, Planning -Director Due Date: JUNE 14, 2011 Permit #: 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: OFFICE TENANT IMPROVEMENT Address or General Location: 79-200 CORPORATE CTR DR, SUITE 101 Applicant Contact: J. PAUL — (760) 285-1363 The Planning Department finds that: ❑ ...these Building Plans do not require Planning Department approval. In...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 return them to the Planning Department for review. Les Johnson, Di or -Planning Date JUN X 9 2011 Ciiy 01 La Qdwla Planning Dogvtmenf 772-7 0 76 a - 77-7-7 --% t1 -x T y W/sIp �7yzd� CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS &2 (P7/ -L t2. PERMIT NUMBER }OWNER Q-471) BUILDER ©w�✓f— This form shall be Dosted 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 /.0 lass�frcation:,... ::a.::: Contractor .::.:::: .: :..::: _...... _. State..Contractocs.license::,: ..'.....•.::. _ _..... . , .. .........:.:::.:..-..Workeis Com ensation.Insurance :.........:.............. _.. FC�t Business.... 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) E;cp. Date (m/xx/xx) License Number (xxxx) Exp. Date (xx/xx/xx) EARTHWORK (C 12) CONCRETE:(C.'-8)`':: c`< FRAMING (G 5) 1 /l lI /'" 1' / j Q �S l STRUCT:'STEEL (C'-''51) ' . MASONRY (C-29)...;:,>; f r PLUMBING, (C 36) U �, C---? / 3 /BEFcktZQ .LATH PLASTER (C CfFkL$D J ? N0 DRYWALL (C 9) (�✓ �-^ (/o b 7 W G 029';) 'S a (o00 HVAC (C 2U) ELECTRICAL lC 1 U i1VAA ` �' _ 0 � -� -7/v od o -0/ /a /b -?3,31 SHEET METAL IC -43) FLOORING (C 15) _ <. GLAZING (C,:: -, i INSULATION SEWAGE DISP (CIV PAINTING (C 38i -q)-0 Pr?/.Ji (.UES CABINETS !C 61 1 F�� 9/3-0/// h' L P 5F Il G l� -7 33 FENCING.(67.13) LANDSCAPING (C 27} POOL (C-53):''. 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 LAKE ELSINORE LA QUINTA MENIFEE MORENO VALLEY PALM DESERT PERRIS RANCHO MIRAGE RLIBIDOUx 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 COU IFIR IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION 77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 92211-4131 • Phone (760) 863-8886 • Fax (760) 863-7072 www.rvcfire.org June 20, 2011 RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural LAQ-II-TI-0016 Dr. Bernard 79-200 Corporate Center Dr. 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 2010 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. An approved audible interior notification alarm device shall be provided in approved location. 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. 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. LI -A Sincerely, Jason Stubble Fire Safety Specialist 6V BUILDING ENERGY ANALYSIS REPORT PROJECT: DR BERNARD 78-180 CORPORATE CENTER DR LA QUINTA, CA 92248 Project Designer: RICCIARDI ARCHITECT 75-400 GERALD FORD DR PALM DESERT, CA 92211 760 408-1208 Report Prepared by: Tim Scott Scott Design and Title 24, Inc, 77-085 Michigan Drive Palm Desert, Ca 92211 (760) 200-4780 _ OF (�� j1�1TA C� 8& SAFETY DEPT. BUIL01t,IG PPR®\JF-® FOR pNSTRU .T� -cls �IIeY Job Number: 1131 Date: 7/15/2011 � 2CO The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www.energysoft.com. TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Form LTG -1-C Certificate of Compliance 3 Form LTG -2-C Lighting Controls Credit Worksheet 7 Form LTG -3-C Indoor Lighting Power Allowance 8 Form LTG -MM Lighting Mandatory Measures 9 Form MECH-3-C Mechanical Ventilation 10 EnergyPro 5.1 by EnergySoft Job Number: ID: 1131 User Number: 6712 1 CERTIFICATE OF COMPLIANCE Part 1 of 4 LTG -1C Project Name Date DR BERNARD 1 7/15/2011 Project Address Climate Zone Total Cond. Floor Area Unconditioned Floor Area 78-180 CORPORATE CENTER DR LA QUI 15 1,594 0 GENERAL INFORMATION Building Type- la Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ School ❑ Relocatable Public m Conditioned Spaces ❑ Unconditioned Spaces School Phase of Construction: ❑ New Construction ❑ Addition ❑ Alteration Method of Compliance: m Complete Building ❑ Area Category ❑ Tailored Documentation Author's Declaration Statement I certify that this Certificate of Compliance documentation is accurate and complete. Signature Name Tim Scoff —=Z�K__ Company Date Scott Design and Title 24, Inc, 7/15/2011 Address CEA # 77-085 Michigan Drive CEPE # City/State/Zip Phone Palm Desert, Ca 92211 (760) 200-4780 The Principal Lighting Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professional Code to accept responsibility for the lighting design. • This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Pages 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms, worksheets, calculatiogs, plans and specifications submitted to the enforcement agency for approval with this bui ing permi plication. Name Signature JACK SENTSEN Company Phone BENTSEN ENGINEERING /)60 324-7357 Address 70-141 SUN VALLEY DR Lice f`n • Z 3 U.t� l City/State/Zip Date RANCHO MIRAGE, CA 92270 Ughting Mandatory Measures Indicate location on building plans of Mandatory Measures Note Block: LIGHTING COMPLIANCE FORMS & WORKSHEETS check box if worksheets is included For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms; please refer to the Nonresidential Manual published the California Energy Commission. -by 0 LTG -1C Pages 1 through 4 Certificate of Compliance. All Pages required on plans for all submittals. , 0 LTG -2C Lighting Controls Credit Worksheet 0 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 EnergyPro 5.1 by Ener off User Number. 6712 RunCode: 2011-07-15T13:01:56 /D: 1131 Page 3 of 10 CERTIFICATE OF COMPLIANCE (Part 2 of 4) LTG -1C Project Name DR BERNARD Date 1 7/1512011 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Installation Certificate LTG -1- INST Retain a copy and verify form is completed and signed.) Field Inspector ❑ Certificate of Acceptance, LTG -2A and LTG -3A Retain a copy and verify form is completed and sign d. Field Inspector ❑ A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces Installed Lighting Power listed on this Lightina 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 square foot is totaled below. Luminaire (Type, Lams Ballasts Installed Watts A B C D E F G H None or Item Tea Complete Luminaire Description'Default (i.e, 31amp fluorescent troffer, F32T8 one dimmable electronic ballast) n a 3:3co How wattage Was determined y m E rj, X $ itl <:Fe1Sf: m O v CEC roi o m, From o NA8 <us i;;_€; Al (3) 4 ft Fluorescent T8 Rapid Start Elec 85.0 0 ❑ 8 680: ..................... A2 (3) 4 ft Fluorescent T8 Rapid Start E/ec 85.0 ® ❑ 8 680 ..................... <flQ ...............::.... B (3) 4 R Fluorescent T8 Rapid Start E/ec 2 Ballast 96.0 13® 2 192 .......... <zQ ........... C (2) 4 ft Fluorescent T8 Rapid Start Elec 62.0 ® ❑ 2 124 bl .................... D (2) 4 ft Fluorescent T8 Rapid Start Elec 62.0 El ❑ 1 62 ..................... 13 13 .................... ..................... ❑ ❑> ..................... .................... ..................... .................... ..................... .................... ❑ ❑ .................... I€>£> .................... .................... ❑ ❑> .................... .................... ............. ❑ ❑; .................. ..................... .................. ❑ ❑i ..................... ..................... .................... ❑ ❑ ..................... .................... .................... ..................... <> ❑ ❑>» ................... .................... ..................... . 13 ❑>❑ .................... ..................... ---------- ...... ---------- ❑ ❑`< ..................... ..................... .................... ❑ ❑>>g ..................... .................... .................... ❑ ❑>< .................... ..................... 13 ................... ..................... €>> .................... ..................... >❑< ..................... .................... Installed Watts Page Total: 1,738 ...................... ..................... ...................... ..................... Building total number of pages: Installed Watts Building Total Sum of all pages) 1, 736 Enter into LTG -1 C Page 4 of 4 1. Wattage shall be determined according to Section 130 (d and e). Wattage shall be rating of light fixture, not rating of bulb. 2. If Fail then describe on Page 2 of the Inspection Checklist Forth and take appropriate action to correct. Verify building plans if necessary. ErrewPrp 5.1 by Ener oft User Number. 6712 RunCode: 2011-07-15713:01:56 /D: 1131 Page 4 of 10 CERTIFICATE OF COMPLIANCE Part 3 of 4 LTG -1C Project Name DR BERNARD Date 7/15/2011 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Fill in controls for all spaces: a) area controls, b) multi-level controls, c) manual daylighting controls for daylit areas > 250 fe, automatic daylighting controls for daylit areas > 2,500 fe, d) shut-off controls, e) display lighting controls, f) tailored lighting controls — general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls for retail stores > 50,000 ft2, in accordance with Section 131. MANDATORY LIGHTING CONTROLS —FIELD INSPECTION ENERGY CHECKLIST Number Special Type/ Description of Units Location in Building Features ............................:.... ................................. ................................. ................................. ................................. ................................. ................................. ................................ ................................. ❑ £I>>` ................................ ................................. ................................ ❑ => II ❑ ; . ................................. a >_><`i ................................. ................................. ❑_»>❑»: :................................. ................................ ❑ :................................ ................................. ................................. ................................. :................................ ................................. ... ...... ........................ .............. ................................ ❑ ................................ ................................. ❑€>><<> ................................ Cl :................................ ................................. ................................. ................................ ................................. :................................ ................. ................................. ................................. ................................. ................................. ................................. ❑ as>: ❑ :................................ >' >`a> ................................. ................................. ................................. ................................. ................................. ❑ <>;>> >❑ ..... ................................. ............... .................................................. SPECIAL FEATURES INSPECTION CHECKLIST See Page 2 of 4 of LTG -1C The local enforcement agency should pay special attention to the items specified in this checldist. These items require special written justification and documentation, and special verification. The local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. Field Inspector's Notes or Discrepancies: EneroPT 5.1 by Ener oft User Number. 6712 RunCode: 2011-07-15713:01:56 /D: 1131 Page 5 of 10 ll CERTIFICATE OF COMPLIANCE Part 4 of 4 LTG -1C Project Name Date DR BERNARD 1 7/15/2011 CONDITIONED AND UNCONDITIONED SPACE LIGHTING MUST NOT BE COMBINED FOR COMPLIANCE Indoor Lighting Power for Conditioned S es Indoor Lighting Power for Unconditioned Spaces Watts Watts Installed Lighting 1,738 Installed Lighting 0 from Conditioned LTG -1 C, Page 2 from Unconditioned LTG -1C, Page 2 Lighting Control Credit - 348 Lighting Control Credit _ 0 Conditioned Spaces from LTG -2C Unconditioned Spaces from LTG -2C Adjusted Installed 1,390 Adjusted Installed = 0 Lighting Power LiAhtina Power Complies if Installed 5 Allowed Complies if Installed:5 Allowed Allowed Lighting Power Allowed Lighting Power Conditioned Spaces from LTG -3C or PERF -1 1'753 Unconditioned Spaces from LTG -3C)0 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for the Lighting system, LTG -2A and LTG -3A. The designer is required to check the acceptance tests and list all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. If all the lighting system or control of a certain type requires a test, list the different lighting and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Forms can be grouped by type of Luminaire controlled. Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or when ever new lighting system with controls is installed in the building or space shall be certified as meeting the Acceptance Requirements. The LTG -2A and LTG -3A forms are not considered complete forms and are not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Tide 24 Part 6. The field inspector must receive the property filled out and signed forms before the building can receive final occupancy. A copy of the LTG -2A and LTG -3A for each different lighting luminaire controls) must be provided to the owner of the building for their records. LTG -2A and Luminaires Controlled LTG -3A Controls and Sensors and Number of Automatic Luminaires Daylighting Controls Equipment Re uirin Testing Description controlled Location Acceptance Occ Sensor - Multl-Level (3) 4 ft Fluorescent T8 Rapid Start Bei 8 Zone 1 m Occ Sensor- Mufti -Level (3) 4 ft Fluorescent T8 Rapid Start E/e 8 Zone 1 m Occ Sensor- Multi -Level (3) 4 ft Fluorescent T8 Rapid Start Ele 2 Zone 1 0 Occ Sensor- Mufti -Level (2) 4 ftFluorescent T8 Rapid Start Be 2 Zone 1 m Occ Sensor - Multi-level (2) 4 R Fluorescent T8 Rapid Start Ela 1 Zone 1 m 13 13 13 13 Ener ro 5.1 by EnergySoA User Number. 6712 RunCode. 2011-0 7-15 713:01:56 /D: 1131 Page 6 of 10 LIGHTING CONTROLS CREDIT WORKSHEET Part 1 of 2 LTG -2C Project Name DR BERNARD Date 1 7/15/2011 POWER ADJUSTMENT FACTORS P FOR NON -DAYLIGHT CONTROLS A Separate PAF Worksheet Must Be Filled Out for Conditioned and Unconditioned Spaces. Control Credits listed on this schedule are only for: m CONDITIONED SPACES ❑ UNCONDITIONED SPACES A B C D E F G Watts of Power Room # Zone ID Plan Room Area Control Adjustments Areas Lighting Control Description' Reference Lighting Factor Control Credit Watts E x Zone 1 Occ Sensor- MultimLevel Al 1,594 680 0.20 136 Zone 1 Occ Sensor- Multi-level A2 1,594 680 0.20 136 Zone 1 Occ Sensor- Multi -Level B 1,594 192 0.20 38 Zone 1 Occ Sensor- Multi-level C 1,594 124 0.20 25 Zone 1 Occ Sensor - Muld-Level D 1,594 62 0.20 12 PAGE TOTAL 348 Note: Conditioned and Unconditioned Space shall be separately totaled Building total of non -daylight control credit watts for all pages of LTG -2C Pae 1 of 2 Enter building total of all daylight controls credit watts from LTG -2C Page 2 of 2 0 BUILDING TOTAL OF ALL CONTROL CREDIT WATTS (FOR BOTH NON -DAYLIGHT AND DAYLIGHT CONTROL CREDITS) 348 Enter in LTG -1C; Page 4: Lighting Control Credit as appropriate for CONDITIONED or UNCONDITIONED Spaces 1. Description shall be consistent with Type of Control defined in Table 146-C 2. Power Adjustment Factor taken from Table 146-0 EnergyPro5.1byEnergySofl UserNumber. 6712 RunCode. 2011-07-15T13:01:56 ID: 1131 Page 7 of 10 INDOOR LIGHTING POWER ALLOWANCE LTG-3C Project Name DR BERNARD Date 7/15/2011 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: 0 CONDITIONED SPACES O UNCONDITIONED SPACES COMPLETE BUILDING METHOD WATTS BUILDING CATEGORY From §146 Table 146-E PERfl? X COMPLETE BLDG. AREA = ALLOWED WATTS Comp Bldg Medical and Clinic 1.10 1,594 1,753 TOTALS AREA WATTS AREA CATEGORY METHOD WATTS BUILDING CATEGORY From §146 Table 146-F PER X Area ftp = ALLOWED WATTS TOTALS AREA WATTS TAILORED METHOD Total Allowed Watts usina the Tailored Method taken from LTG-4C Pae 1 of 4 Row 3 The indoor lighting power allowance using the Tailored Method of compliance shall he determined using the LTG-4C set of forms. A separate set of LTG- 4C forms shall be filled out for CONDITIONED and UNCONDITIONED spaces a 1 b oft UserNumber. 8712 RunCode: 2011-07-15T13.M:5B /D: 1131 Pa 8 of 10 LIGHTING MANDATORY MEASURES: NONRESIDENTIAL LTG -MM Project Name Date DR BERNARD 7/15/2011 Indoor Lighting Measures: §131(d): Shut-off Controls For every floor, all interior lighting systems shall be equipped with a separate automatic control to shut off the lighting. 1. This automatic control shall meet the requirements of Section 119 and may be an occupancy sensor, automatic time switch or other device capable of automatically shutting off the lighting. 2 Override for Building Lighting Shut-off: The automatic building shut-off system is provided with a manual, accessible override switch in sight of the lights. The area of override is not to exceed 5,000 square feet. §119(h): Automatic Control Devices Certified: All automatic control devices specified are certified, all alternate equipment shall be certified and installed as directed by the manufacturer. §111: Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for the project are certified and listed in the Directory. All installed fixtures shall be certified. §131(a): Individual Room/Area Controls: Each room and area in this building is equipped with a separate switch or occupancy sensor device for each area with floor -to -ceiling walls. Uniform Reduction for Individual Rooms: All rooms and areas greater than 100 square feet and more than 0.8 watts §131(b): per square foot of lighting load shall be controlled with bi-level switching for uniform reduction of lighting within the room. Daylight Area Control: All rooms with windows and skylights that are greater than 250 square feet and that allow for §131(c): the effective use of daylight in the area shall have 500% of the lamps in each daylit area controlled by a separate switch; or the effective use of daylight cannot be accomplished because the windows are continuously shaded by a building on the adjacent lot. Diagram of shading during different times of the year is included on plans. §131(c): Display Lighting. Display lighting shall be separately switched on circuits that are 20 amps or less.6. Outdoor Lighting Measures: §130(c)1: Mandatory lighting power determination for medium base sockets without permanently installed ballasts §132(a): All permanently installed luminaires with lamps rated over 100 Watts either have a lamp efficacy of at least 60 lumens per Watt or are controlled by a motion sensor. §132(b): All Luminaires with lamps rated greater than 175 Watts in hardscape area, including parking lots, building entrances, canopies, and all outdoor sales areas meet the Cutoff Requirements. §132(c)1: All permanently installed outdoor lighting meets the control requirements listed. §132(c): Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements listed. EnergyPro 5.1 by EnergySoft User Number: 6712 RunCode: 2011-07-15T13:01:56 /D: 1131 Page 9 of 10 MECHANICAL VENTILATION AND REHEAT MECH-3C Project Name DR BERNARD Date 7/152011 MECHANICAL VENTILATION 121 b 2 REHEAT LIMITATION (§144(d)) AREA BASIS OCCUPANCY BASIS VAV MINIMUM A B C D E F G H 1 J K L M N Min CFM REO'D Design 50% of Max. of Condition CFM Min CFM Number CFM by V.A. Ventilation Design Zone Columns Areape,By Area Of per Occupant Max of Air Supply B X 0.4 H, J, K, Zone/System ft2 ftz B X C People Person E X F D or G CFM CFM CFM / 11:2 300 CFM Design Minimum Air Transfer Set int Air Zone 1 1,594 0.15 239 239 239 System 1 Total 239 239 Totals 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 fors aces without fixed seating. H Required Ventilation Air REO'D V.A. is the larger of the ventilation rates calculated on an AREA BASIS or OCCUPANCY BASIS Column D or G). I Must be grealer than or equal to H or use Transfer Air column N to make up the difference. J Design fan supply CFM Fan CFM x 50%• or the design zone outdoor airflow rate per 121. K Condition area x 0.4 CFM / ftZ• 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 orequal to the sum of Columns H plus N. N Transfer Air must be provided where the Required Ventilation Air (Column H) is greater than the Design Minimum Air (Column M). Where required, transfer air must be greater than or equal to the difference between the Required Ventilation Air Column H and the Design Minimum Air Column M), Column H minus M. Ener Pro 5.1 by Ener Soft User Number. 6712 RunCode: 2011-07-i5T13:01:56 ID: 1131 Pae 10 of 10