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10-0438 (RC)P.O. BOX 1504 VOICE (760) 777-7012 78-4951CALLE TAMPICO FAX (760) 777-7011 LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760)'777-7153 BUILDING PERMIT Dater 7/20/10 Application Number: 10-00000438 Owner: Property Address: 78134 CALLE TAMPICO STE 100 HIGHLAND LA QUINTA II LLC APN: 770-020-012- - 80 S LAKE AVE STE 660 Application description: REMODEL - COMMERCIAL. PASADENA, CA 91101 Property Zoning: VILLAGE COMMERCIAL Application valuation: 48000 P23 --- -- '----_—_ —:_Contractor:_ , - Applicant: Architect or Engineer: TRI-KON GENERAL CONT INGWJ 20 2010 31355 SAN EL JAY AVE CATHEDRAL CITY, CA 9 CMQUINTA v (760) 880-4085 FINANCE OE" Lic. No.: 937930 -------------------------------------------------------------=----------------------------------- - - LICENSED CONTRACTOR'S DECLARATION - • WORKER'S COMPENSATION DECLARATION 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: B License No.: 937930 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is s� issued. Date: ­7 7_x!1 Contractor: - _.1 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 OWNER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EXEMPT Policy Number EXEMPT 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 . ti License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith 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: —7^21t+—Applicant: 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 WARNING: FAILURE TO SECUR ORKERS' COMPENSATION 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.) - APPLICANT ACKNOWLEDGEMENT (_ I I, as owner of the property, am exclusively contracting with'licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to. the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon; and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). _ whose benefit work is performed under or pursuant to any permit issued as a result of this application, - (_) I am exempt under Sec. , B.&P.C. for this reason _ 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. Date: Owner: 2. Any permit issued as a result of this application becomes null and void if work is not commenced .;jj,j?7 within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject CONSTRUCTI011�fNDING AGENCY permit to cancellation. - hereby affirm under penalty of perjury that there is a construct& lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ.. C.).- - city and county ordinances and state laws relating to building construction, and hereby authorize representatives Yr.. of this county to enter upon the above-mentioned property for inspection purposes. Lender's Name: Oate.,­7_�_�USignature (Applicant or Agent): Lender's Address: LQrExj111T r LQPERA4[T :;Application Number. . . . . . 10-00.000438 ----- Structure Information LQPERA4[T :;Application Number. . . . . . 10-00.000438 ----- Structure Information 1644 SF T.I SUITE 100 ----- Construction Type TYPE V, UNPROTECTED Occupancy Type . . . . . BUSINESS <50. Other struct info CODE•EDITION 2007/0.8 ENERGY FIRE SPRINKLERS YES MIXED-USE OCCUPANCY B OCCUPANT LOAD 20.00 .1ST FLOOR SQUARE FOOTAGE 1644.00 2ND FLOOR SQUARE FOOTAGE 00 Permit . . . BUILDING PERMIT Permit Fee" 401.50 Plan Check Fee 260.98 Issue Date Valuation . . 48000 Expiration Date . „ 1/16/11 Qty Unit Charge Per Extension . BASE FEE 252.00 23.00 6.5000 -----------------------------------------------------------------------------. THOU BLDG 25,001-50,000 149:50 Permit . . . ELECT - ADD/ALT%REM Additional desc . Permit Fee 58:.05 Plan Check Fee 14.51 Issue Date . . . . Valuation . . . . 0 Expiration Date 1/16/11 Qty Unit Charge Per Extension BASE FEE 15.00 20.00. .7500 PER ELEC DEVICE%FIXTURE 1ST 20 15.00 5.00 3.0000 EA ELEC APPLIANCES 15.00 29.00 .4500 ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 13.•05 Permit I. . . . MECHANICAL Additional desc . Permit Fee .. •43.50 Plan Check Fee 10.88 Issue Date . . . . Valuation 0 Expiration.Date .1/16/11 Qty Unit Charge. Per. Extension BASE FEE 15.00 2.00 .4.5000 EA MECH VENT INST/'DUCT ALT 9.00 2:00 6.5000 EA MECH VENT FAN 13.00 1.00 6.5000 EA. MECH EXHAUST HOOD 6.50 LQPERAIIT Application Number ::. .10-00000438 Permit . . . PLUMBING Additional desc . Permit Fee 82.50 Plan Check Fee 20.63 Issue .Date . . . . Valuation 0 Expiration Date . 1/16/11 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 6.0000 EA PLB FIXTURE 24.00 1".00 7.500.0 EA PLB WATER HEATER/.VENT 7.50 . 1.00 12.0000 EA PLB INTERCEPTOR 12.00 1:00 3.0000 EA PLB WATER INST/ALT/REP 3.00 ----2--0"0�---3_-0 0 0.0 __EAi�_PhB-GAS-P I PE`1= 4 -OUTLETS - .. _ ._.. _:_ _ ..... -_ _ ... _ -:6 ._0 0. _ _ .........._..-- - ....... 1.00 15.0000 EA PLB GAS METER 15.00 Special Notes and Comments RESTAURANT T.I. 1644 SF. TYPE "B" OCCUPANCY. TYPE V-B CONSTRUCTION. TOTAL OCCUPANT LOAD = 20. 2007 CODES / 2008 ENERGY. {DOMINO'S PIZZA] Other Fees . . . . . . ACCESSIBILITY PLAN REVIEW 26.10 BLDG STDS ADMIN (SB1473) 2.00 ENERGY REVIEW FEE 26.10 Fee summary Charged Paid. Credited Due Permit Fee Total 585.55 .00 .00 585.55 Plan Check Total 307.00 .00 00 307.00 Other Fee Total 54.20 .00 .00 54.20 Grand Total 946.75 .00 .00 946.75 BIn G City of La Quinta Building 8r Safety Dhwon P.O. Box 1504, 78-495 Calle Tampko La Qulnta, CA 92253 - (760) 777.7012 Building Permit Application and Tracking Sheet Permit # 3Q-, ii ((JJ " Project Address: 7Y 13qf c, Owner's Name: mac: A. P. Number. Address: Legal Description: Contractor: 'T2i – 1Cn X ,e�® tit 1{1 City, ST, Zip: Telephone: Project Description: Address: '3 13 u ✓ City, ST, Zip: .o Y CA A C �ELAN7–N) Lk 7 T-0-�— Telephone:-76 a IMcl— VDAI, S i ZZA si4e, U li! State Lic. #: 011 3 O - City Lic. #; Arch., Engr., Designer. Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Gd��!>� Construction Type: Occupancy: Project type (circle one): New. Add'n Alter Repair Demo Sq. Ft: # Stories: #Units: % Telephone # of Contact Person: C)-5C/(D Estimated Value of Project: &OV (% `e. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Seb 3 Plan Check submitted Amount Structural Cafes. Reviewed, ready for rreetlona ` Plan Check Deposit Truss Cala. Called Contact Perso 2 Pian Check Balance Title 24 Cafes. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctio ue Electrical Subcontector List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Reylew, ready for eorreetionarissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees s/av %ZAP 3 RTC -7 l7 c� Uwe Ff • . . Plan Check # 18703 RIVERSIDE COUNTY COMMUNITY HEALTH AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH FOOD ESTABLISHMENT PLAN APPROVAL NOTICE Date June 3, 2010 Project Name Dominos Pizza Address '78134 Calle Tampico #200 La Quinta CA 92253 Plans Submitted by Pedro Garcia Phone 619-253-0343 Owner Cappen Inc. Address 81940 Hwy 111 Indio Ca 92201 Phone 760-342-9975 The plans are now approved subject to the conditions listed below and the attached compliance sheet. . 1. Install additional hand sink located at the 3 compartment sink area see redline corrections on sheets 1 and P1. Hot water must be plumbed to the main hot water heater. Z. Quarry tile to be smooth under all equipment and shelving. 3. The make up air must be 100% of the exhaust air. Provide a certified air balance report for exhaust hood and make up air. 4. Provide a grease interceptor letter from the sewer agency. 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 Tracey Ford Phone 760-863-8287 1 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) Corona Hemet Indio Murrieta Palm Springs Riverside 2275 S. Main St Suite 204 800 S. Sanderson 47-950 Arabia St "A" 38740 Sky Canyon Dr 2500 N. Palm Canyon Dr 4065 County Zir (951) 273-9140 (951) 766-2824 (760) 863-8287 (951) 461-0284 (760) 320-1046 (951) 358-51-2 Fax (951) 520-8319 Fax (951) 766-7874 Fax (760) 863-8303 Fax (951) 461-0245 Fax (760) 320-1470 Fax (951) 358-3017 John R. Hawkins Fire Chief .Proudly serving the unincorporated areas of Riverside County and the Cities of. Banning . Beaumont Calimesa 0 Canyon Lake 4. Coachella Desert.Hot Springs Indian Wells •. Indio ., Lake Elsinore •: La Quinta Moreno Valley Palm Desert Perris Rancho Mirage ;. Rubidoux CSD San Jacinto :- Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jeff Stone, . District 3 John Benoit,. 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 (760) 863-8886 Fax 63-7072 p� May 26, 2010 tl 9 1010 RE: TENANT IMPROVEMENT PLAN CHECK LAQ-10-TI-018 Domino's Pizza 787134 Calle ampico a 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 2A1 OBC 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. r 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 may be 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. V 7 7 Hood%Duct suppression system plans shall be submitted for above referenced project. The hood/duct system must be monitored by the fire alarm system if building is currently monitored. 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) 863-888.6. Sincerely, By. Jason Stubble Fire Safety Specialist P2 t--nA I'TXVY T A tr AY 7 ►`.t) •.•.....vaauuun. Y t?L1AjA'. [ YY.N. Jl Jfli/�. tJJI� ].!�'.�. 1 D li w 0 M SE{S"SOWS PARCEL NUMBER 85-995 Avenue 52 C1 LL�E'�� V 7-0,)-- j oot L -/ Coachella, California 92236 —""" ------- (760) 398-2651 JUN 17 2010 APPLICATION FOR WASTEWATER INTERCEPTOI OVAL APPLICANI': Submit flus form with A copy of a SCALL'D plot plan (I" = 0' 101 " 40' SCALE) drawn to I)istriet specify ons. A nonrefundable filing fee is required when the application is submitted. Check must be made payable to the Co n>val of this Apt ication shall rCIr1A1n valid for A period 1101 to exceed One (1) year from date of pa)hnclil. 1'Imt Cllcck No. elllContractor, Con act Person Address Cit Slate zip. 1'cleplmne 4 4 417 �wrcr Address City State Zip Telephone ZZC Job Property Addr ss City l,ilr /�iird AlCo Ugal Description DBA PL t ASE COMPLETE THIS SECTION FOR RrVICW OF FOOD ESTABLISHMENTS N011: PLANS W1 1,1, NOT• BE ACCEPTED UNLESS THIS APPI,I(,A'I'ION IS COMPLETH AND '111E PIAN C111? CK PEI, I$ PAID. GENERAL CONSTRUCTION: // T)'pc of Construction: irr/!!7� New Pood racility X Itcnrodcl of Existing food Lstab)islnnent __ 1•luurs of Operation% .$, i �!4,��ing Capacity: Ilticraal Z91 External External Seating With Misters or heaters Bar with Food Service Bar Nonfood Service _tf. 2 Water Softener Service: .`_--- Multiservice (reusable) Single Service; (disposable) A -16P C,V,/ OWNlitt/RGI'Itl-.Sr:,N'I'A'rlVli Dr.C1 A1tATIUN: 1 certify Ilia( I have read tite entire application and state Thai all information is correct. I understand that the amount of fee paid is based on my declaration orinfonnatiOn Oilthis form and that iocarrocl •information is grounds for denial of the submitted plans. I also understand that plans will be discarded if mol picked up within sixty (60) days ofapproval or denial and that no inspection ofmy establishment will be conducted, or approval granted to operate, until all proper infomta quested has been received and plans have been approved and returned. _ ) Sig; nralurc it L l ,lir O — �L LJ FOR DISTRICT USE ONLY No. of Systclns Type of syslem(s) No. Dwelling Units ❑ Sand/Oil ❑ Grease Interceptor Waived Fixture Units Grease Interceptor ` New [] fxisling Q Unt Trap ❑ itapiacemcnt Q Addition Q Clarifier ❑ Connect to Sewer REMARKS: , 1001. tOr 'fh' plication it: Approved ❑ Denicd ❑ Conditional Approval'heeS //� &1 *See Remarks Check No. Date l/ O Initial —_j L, j51 BUILDING ENERGY ANALYSIS REPORT' PROJECT: Domino's Pizza t 78-134 Calle Tampico, Suite 200 La Quinta, CA 92253 Project Designer: G Design Report Prepared by: Michael Dell DELL CO. 1629 York' Drive Vista, Ca 92084 CITY OF LA C� U I N TA 760-940-0064 BUILDING &SAFETY DEPT. APPROVED FOR CONSTRUCTION 101( u GATE 6 2o`o By -P-4 It , r Job Number: ` �C �r�rrm nr5-131t Date: MAY 2.:0.2010 5/16/2010. 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 Californi.aLEnergy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www,energysoft.com. EnergyPro 5.0 by EnergySoft User Num er.• 1712 RunCode: 2010-05-16T13:18:1 ID: nr5-131t r, TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Form LTG -1-C Certificate of Compliance 3, Form LTG -3-C Indoor Lighting Power Allowance 7 Form LTG -MM Lighting Mandatory Measures 8 EnergyPro 5.0 by EnergySoft Job Number: ID: nr5-131t User Number: 1712 CERTIFICATE OF COMPLIANCE (Part 1 of 4) LTG -1 C Project Name Domino's Pizza Date 1 5/16/2010 Project Address 78-134 Calle Tampico, Suite 200 La Quinta Climate Zone 15 Total Cond. Floor Area 1,644 Unconditioned Floor Area 0 GENERAL INFORMATION Building Type: m Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ School ❑ Relocatable Public m Conditioned Spaces ❑ Unconditioned Spaces School Phase of Construction: ❑ New Construction ❑ Addition m Alteration Method of Compliance: ❑ Complete Building 12 Area Category ❑ Tailored Documentation Author's Declaration Statement I certify that this Certificate of Compliance documentation is accurate and com lets. Signature MD CA Name Michael Dell Company DELL CO. Date 5/162010 Address 1629 York Drive CEA # CEPE # NR08-90-3530 City/State/Zip Vista, Ca 92084 Phone 760-940-0064 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, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name Signature Company Phone Address License # City/State/Zip Date Lighting 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 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 EnergyPro 5.0 by EnergySoft User Number. 1712 RunCode: 2010-05-16T13:18:1 ID: nr5-131t Page 3 of 8 CERTIFICATE OF COMPLIANCE (Part 2 of 4) . LTG4C Project Name Domino's Pizza Date 5/16/2010 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST - f Installation Certificate, LTG -1- INST Retain acopy 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: m CONDITIONED SPACE ❑ UNCONDITIONED SPACE m 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 la 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, Lamps, Ballasts Installed Watts A B C D E F G H None or+ item Ta Complete Luminaire Description (Le, 3 lamp fluorescent troffer, .• F32T8, one dimmable electronic ballasts W u �, � CL `� y •E E 3 J How wattage Was determined N m c E Z J v v— co c Field Ins ectoe CEC r C, Default o �, From a H NA8 j% y a i, A (4) 4 ft Fluorescent T8 Rapid Start Elec ❑ 114.0 ® ❑ 14 1,596 ❑ ❑!, 8 F26TRT4100 8 ❑ 45.0 ® ❑ 7 315 ❑ ❑" C F26TRT4100 C ❑ 45.0 ® ❑ 5 225 ❑ ❑ II ❑ ❑ ❑ ❑ ❑; ❑ ❑ ❑ ❑ 0 ❑ ❑ ❑ , ❑ ❑. ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑` ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑' ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑. ❑ ❑ ❑ ❑ ❑- ❑ ❑ ❑ ❑ ❑- ❑ ❑ ❑ ❑ ❑. ❑ ❑ ❑❑ ❑. ❑ ❑ ❑. ❑. ❑ ❑ ❑- ❑ ❑ ❑ ' ❑ ❑ .0.❑ ❑, Installed Watts Page Total: 2,136 Building total number of pages: • Installed Watts Building Total Sum of alla es 2,136 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 . If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnergyPro 5.0 by EnergySoft User Number. 1712 • RunCode: 2010-05-16T13:18:1; ID: nr5-131t Pa e 4 of 8 k7 CERTIFICATE OF COMPLIANCE Part 3 of 4 LTG -1C Project Name Domino's Pizza Date 511612010," 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 ff, 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 fe, in accordance with Section 131. MANDATORY LIGHTING CONTROLS — FIELD INSPECTION ENERGY CHECKLIST • Field Ins ector Type/ Description Number of Units Location in Building -Special Features Pass Fail ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 ❑ 01 ❑ ❑, 13 ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ .❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 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 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 special justification and documentation submitted. Field Inspector's Notes or Discrepanclew ; Ene Pro 5.0 by EnergySoft User Number. 1712 RunCode: 2010-05-16T13:18:1 ID: nr5-131t Pa e 5 of 8 CERTIFICATE OF COMPLIANCE Part 4 of 4 LTG -1 C Project Name Date Domino's Pizza 1 5/16/2010 CONDITIONED AND UNCONDITIONED SPACE LIGHTING MUST NOT BE COMBINED FOR COMPLIANCE Indoor Lighting Power for Conditioned S aces Indoor Lighting Power for Unconditioned Spaces Watts Watts Installed Lighting 2 136 Installed Lighting 0 from Conditioned LTG -1 C, Page 2 from Unconditioned LTG -1C, Page 2 Lighting Control Credit _ 0 Lighting Control Credit _ 0 Conditioned Spaces from LTG -2C Unconditioned Spaces from LTG -2C Adjusted Installed - 2136 Adjusted Installed = 0 Lighting Power Lighting 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 2,581 Unconditioned Spaces from LTG -3C) F 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 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 form is not considered a complete form and is 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 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 -2A for each different lighting luminaire control(s) must be provided to the owner of the building for their records. Controls for Credits LTG -2A Controls and Sensors and Automatic Number of Daylighting Luminaire Controls Equipment Re uirin Testing Description controls Location Acceptance 13 13 13 11 11 13 ❑ 13 EnergyPro&ObyEne ySoh User Number: 1712 RunCode: 2010-05-16T13:18:1 ID: nr5-131t Page 6 of 8 INDOOR LIGHTING POWER ALLOWANCE LTG -3C Project Name Domino's Pizza Date 5/16/2010 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 0 UNCONDITIONED SPACES COMPLETE BUILDING METHOD BUILDING CATEGORY From §146 Table 146-E WATTS PER(ft) X COMPLETE BLDG. AREA = ALLOWED WATTS TOTALS AREA WATTS AREA CATEGORY METHOD • WATTS BUILDING CATEGORY From §146 Table 146-F PER ft? X Area ftz = ALLOWED WATTS Retail Sales, Wholesale 1.60 208 333 Corridor/Restroom/Support 0.60 49 29 Kitchen, Food Preparation 1.60 1,387 2,219 TOTALS 1,6441 2,581 AREA WATTS TAILORED METHOD Total Allowed Watts using the Tailored Method taken from LTG -4C Pae 1 of 4 Row 3 0 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 EnergyPro 5.0 by EnergySoft User Number: 1712 RunCode: 2010-05-16T13:18:1 ID: nr5-131t Page 7 of 8 LIGHTING MANDATORY MEASURES: NONRESIDENTIAL LTG-MM Project Name Date Domino's Pizza 5/16/2010 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. Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for the project are certified and listed in the §111: 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 50% 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 ad'acent 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)l : 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)l : 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 5.0 by EnergySoft User Number: 1712 RunCode: 2010-05-16T13:18:13 ID: nr5-131t Page 8 of 8 Vf 'Y�v►s� ori Bin City of La Quinta Building 8Z Safety Division P it P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Proj r 8 %a wt i CO Owner's Name: P. Nu /0 Address:. Legal Description: City, ST, Zip: Contractor: ,..,'c �., / �%i,.c�1 Telephone: »:<>:: t>:<:::>s=>r»:;<•':;;;:>::>:. Address: 72-376 i1/ �S�e X90 City, ST, Zip: L t) C 5 3 e �7 eleP hon . 7 %aZ^ �D- s State Lic. # : g 3 q $ 0 60City Lic. #: march., Engr., Designer: A ep5i h Address: g 1 4CI vu x a'a.n o- �( j City., ST, Zip:. 49 CA IT9 2- T 3 Description: n # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready or corrections `b ,� Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. 5 Plans picked up gyp,/ I6 Z Construction Mechanical. Flood plain plan Plans resubmitted Grading plan 2a° Review, ready for correctionsfissue Electrical • Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted. Grading IN I-IOUSE:- 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 6-/� J 1 SEP u b ZU13 CITY OF LA QUINTA COMMUNITY DEVELOPMENT f! , � w `(L P� T � � .... M � ,� � � �� � R .,� � " `� � � .��. R �� � � �� wfA, r °`* a � � � CITY OF LEA QUINTA BUILDING & SAFETY DEPARTMENT \(760) 777.7012 SPECTION REQUEST LINE �'C 'on'tract� W-KON Permrt ml r 10-438 P .T �N JOB IN CONSPICUOUS PLACE INSPEGfi'&' MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 78'134 CALLE JAMPICO #100 RESTAURANT T. 1644 SF. TYPE IIB" OCCUPANCY. TYPE V -B CONST UCTION. TOTAL OCCUPANT LOAD 20.2007( ../ 008 ENERGY. (D . MINOIS PIZZA) TYPE OF INSPECTION d DATE IN®R TEMPORARY POWER SETBACKS U/G PLUMBING /WASTE U/G ELECTRICAL/ GROUNDING FOOT�tNGS / STEEL ✓ CONCRS>_TE SLAB M'�' :::�; - �� o �# DO NOT POUR CONCRETE UNTIL ABOVE SIGNED R OF NAIL / PRE -ROOF O'kAY TO WRAP FRAMING COMBINATION O ROUGH ELECTRIC m✓ ROUGH PLUMBING G ROUGH MECHANICAL INSULATION J COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL O EXTERIOR LATH GAS TEST b"PTIC ABANDONMENT SEWER CONNECTION intl SEPTIC / GREASE INTERCEPTOR S 1, FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER (ALARMS / BARRIE DECK BONDING FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING r ._ .. ..-.. .. .. a ..._. .-.,.. u- z.-...-.. - _ _ • 000, , . o Cert�fica to of Occu'pan cy Ulm 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. J BUILDING ADDRESS`. 78-134 CALLE TAMPICO Use -classification: COMM f Building Permit No:: 10=438 Occupancy Group B Type of Construction: V -B Land Use Zone VC Owner. of Building: HIGHLAND LLC Address78-134 CALLE TAMPICO - City, ST; ZIP: LA QUINTA CA 92253 } B KIRK KIRKLAND Date: 9-17-2010 k - _-- Building Offic' I . POST IN A CONSPICUOUS PLACE _�� �R • _-. -_ - - __ _ w _. �-. _-" _r rte. _ -- -_ - - w. .y