The URL can be used to link to this page

BCOM2015-0015LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 892820• Date: - 2 Contractor: OWNER -BUILDER DECLARATION ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, ttie building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon; and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Na Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: _ Policy Number: _ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:Applicant: WARNING: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT 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 Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit,, or cessation of . work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city toter upon the above• mentioned property for inspection purposes. � // Date: s —U—f) Signature (Applicant or Agent) f4�M�l/ VOICE (760) 777-7125 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Application Number: . BCOM2015-0015 , Owner: 8 Property Address: 78134 CALLE TAMPICO STE 160 LA QUINTA REALTY PROP. APN: 770020035 50415 VIA PUENTE Z Application Description: OLD TOWN ARTISAN STUDIO T.I. LA QUINTA, CA 92253 C Property Zoning: Application Valuation: $60,000.00 0 r-+ Applicant: Cont actor: y C BRIAN FITZGERALD D'OROS CONSTRUCTION 54900 SOUTHERN HILLS LA QUINTA, CA 92253 21 225 SMITH ROAD SKY VALLEY, CA 92241 (760)329-4810 Llc. No.: 892820 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 892820• Date: - 2 Contractor: OWNER -BUILDER DECLARATION ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, ttie building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon; and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Na Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: _ Policy Number: _ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:Applicant: WARNING: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT 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 Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit,, or cessation of . work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city toter upon the above• mentioned property for inspection purposes. � // Date: s —U—f) Signature (Applicant or Agent) FINANCIAL / { ,'DESCRIPTIONACCOUNT QTY, "AMOUNT �' PAID' PAID DATE BSAS SB1473 FEE 101-0000-20306 ' 0 $3.00 $0.00 :PAID BY .; ,,, ;, METHOD::.RECEIP.T # ' CHECK # . ' CLTD�BY ' Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $3.00 $0.00 .DESCRIPTION ' ACCOUNT , s xj ":" QTY._ AMOUNT. PAID PAID. DATE APPLIANCES, NON-RES 101-0000-42403 0 $96.68 $0.00 PAID BY', - METHOD" - _'RECEIPT # ' CHECK#, CLTD BY', ,.DESCRIPTION'. ACCOUNT ,�;QTY" "' AMOUNT:, PAID PAID DATE 'DEVICES, ADDITIONAL 101-0000-42403 0 $24.20 $0.00 ' -PAID BY - METHOD i. '. RECEIPT # CHECK # 'CLTD BY F.� ACCOUNT QTY fPAID,.DESCRIPTION PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 PAID BY, 4 :r 'METHOD ;RECEIPT # `' CHECK # CLTD BY Total Paid for ELECTRICAL: .$145.05 $0.00 DESCRIPTION = ACCOUNT,., _ QTY. AMOUNT ;t 'PAID. PAID DATE, OTHER MECHANICAL EQUIPMENT 101-0000-42402 0 $72.52 $0.00 PAID BY ,.. METHOD `.'RECEIP.T# , .' , s 4 :'<CHECK•# . ' CLTD. BY a DESCRIPTION _ - '.r -" 'ACCOUNT QTY =' '- AMOUNT ,. PAID, • PAID DATE VENT FAN 101-0000-42402 0 $24.18 $0.00 PAID BY « m�'. METHOD,t ";RECEIPT # ",' CHECK # ' "' CLTD BY. } Total Paid for MECHANICAL: $96.70 $0.00 DESCRIPTION '• `.: -`i ACCOUNT ';" ' ' CITY. „r;: AMOUNT ; ,PAID { -` PAID DATE BUILDING SEWER. 101-0000-42401 0 $12.09 $0.00 PAID BY = .'METHOD ` RECEIPT # CHECK #: CLTD BY ' DESCRIPTION ;'>_ . ACCOUNT y' QTY ,„ AMOUNT;. ° r y, PAID' PAID DATE FIXTURE/TRAP 101-0000-42401 0 $72.54 $0.00 PAID BY METHOD •RECEIPT# - `' 'CHECK # CLTD BY DESCRIPTION - , . ACCOUNT QTY AMOUNT r' ,,. PAID r:<: PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 u i ..:PAID BY : - s r METHOD "` " '. RECEIPT#::.`. CHECK #' CLTD BY.:. DESCRIPTION"` v. ACCOUNT s_ "'' C!TY' "AMOUNT ` PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 #; PAID BY, t METHOD �- ,. .. RECEIP,T# J' CHECK # CL TD BY Total Paid for PLUMBING FEES: $108.81 $0.00 DESCRIPTION xj "'ACCOUNT QTY AMOUNT _. " PAID * ' PAID DATE. REMODEL, EA ADDITIONAL 500 SF 101-0000-42400 0 $108.75 $0.00 PAID BY. METHOD N ,." y/ t R RE # . _ CHECK # CLTD BY,,',, DESCRIPTION F': =' " ACCOUNT r' `r QTY ; AMOUNT` PAID r PAID. DATE REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $87.00 $0.00 ':PAID BY _=r "METHOD . ;, ' i i RECEIPT:# ! ,CHECK'.# . -CLTD BY; DESCRIPTION; : J , •. ' , ACCOUNT ' ' QTY ' AMOUNT ` N ,..` , PAID : r ,PAID DATE REMODEL, FIRST 100 SF 101-0000-42400 0 $49.31 $0.00 PAID BY, "METHOD'"' ,; 7 '.RECEIPT # CHECK # CLTD BY ^-DESCRIPTION a. ACCOUNT 'n } .,,.,'_QTY AMOUNT:' F ;�. PAID k. PAID,DATE REMODEL, FIRST 500 SF PC 101-0000-42600 0 $134.88 $0.00 " PAID BY ` . `;METHODS -` RECEIPT # *° °''• ` CHECK # r , 'CLTD BY ° Total Paid for REMODEL: $379.94 $0.00 TOTALS:• $0.00 Description: OLD TOWN ARTISAN STUDIO T.I. Type: BUILDING, COMMERCIAL Subtype: REMODEL Status: APPROVED -CONDITIONS Applied: 3/31/2015 PJU Approved: Parcel No: 770020035 Site Address: 78134 CALLE TAMPICO STE 160 LA QUINTACA 92253 Subdivision: PM 35845 Block: Lot: 1 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $60,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 �HkONOLOGY� TYPE Details: TENANT IMPROVEMENT FOR "OLD TOWN ARTISAN STUDIO" SUITE 160.2480SF FT. "B" OCCUPANCY. 45 OCCUPANT LOAD. INCLUDES 4 ELECTRIC. POWERED KILNS.2013 CODES Printed: Thursday, May 21, 2015 9:44:51 AM I of 4 CV`?w-1YSTE;4S ADDITIONAL SITES CHRONOLOGY �HkONOLOGY� TYPE ACTION DXTE - COMPLETION DATE T'; ."STAFF,NAME' FOLLOW UP ON PLANNING REVIEW. SPOKE WITH BRIAN FITZGERALD (APPLICANT) TO NOTIFY NOTE BURT HANADA 4/20/2015 5/7/2015 HIME THAT PLANS ARE APPROVED. A CONTRACTOR WITH CITY BUSINESS LICENSE AND FIRE DEPT APPROVAL.IS REQUIRED PRIOR TO PERMIT ISSUANCE. COULD NOT FIND FOLDER BUT PUT PLANS WITH NOTE MARY FASANO 5/5/2015 5/5/2015 ATTACHMENTS IN BIN 3B PLAN CHECK PICKED UP PHILIP JUAREZ 4/20/2015 4/20/2015 PLANS PICKED UP BY ISREAL CHAVEZ 760-902-1932. PLAN CHECK SENT TO YOUNG ENGINEERING 3/31/2015 3/31/2015 OUTSIDE PC PLAN CHECK SUBMITTAL MARY FASANO 5/5/2015 5/5/2015 RECEIVED Printed: Thursday, May 21, 2015 9:44:51 AM I of 4 CV`?w-1YSTE;4S 4 PLAN CHECK SUBMITTAL PHILIP.JUAREZ 3/31/2015 PAID DATE RECEIPT # CHECK # METHOD ' "PAID BY CBYD 3/31/2015 INFORMATION PAID BSAS SB1473 FEE NO STRUCTURAL INVOLVED PER APPLICANT. RECEIVED $0.00 - Total Paid forBUILDING STANDARDS ADMINISTRATION .BSA: $3.00 . $0.00 y APPLIANCES, NON -RES 101-0000-42403 0 . TELEPHONE CALL BURT HANADA 4/20/2015 4/20/2015 LEFT VOICEMAIL FOR. BRIAN FITZGERALD THAT CORRECTION DEVICES, ADDITIONAL 101-0000-42403 0 $24.20 $0.00 LIST & PLANS ARE.READY FOR PICK UP. DEVICES, FIRST 20 CONDITIONS 0 $24.17. $0.00 CONDITION. , DATE DATE 'CONTACT DATE ADDED '•` - STATUS REMARKS ; M NOTES TYPE • REQUIRED SATISFIED Total Paid for ELECTRICAL: $145.05 *. t CONTRACTOR & FIRE APPROVAL REQUIRED READY TO ISSUE BURT HANADA 5/7/2015 IN PROCESS PRIOR TO PERMIT ISSUANCE. CONTACTS NAME TYPE , , �' _..NAME :;` ADDRESS1 ,• CITY STATE -ZIP 'PHONE FAX 'EMAIL,_ :4 APPLICANT BRIAN FITZGERALD 54900 SOUTHERN HILLS LA QUINTA CA 92253 (760)777-1440 CONTRACTOR D'OROS CONSTRUCTION 21225 SMITH ROAD SKY VALLEY CA 92241 (760)777-1440 DESIGNER AA DESIGN 81692 RANCHO - LA QUINTA • CA 92253 (760)777-1440 SANTANA DRIVE OWNER LA QUINTA.REALTY PROP. LLC 50415 VIA PUENTE LA QUINTA CA 92253 (760)777-1440 TENANT OLD TOWN ARTISAN STUDIO INC 51105 AVENIDA VILLA LA QUINTA CA 92253 (760)777-1440 101 - ... Printed: Thursday, May 21, 2015 9,44:51 AM _ _ 2 Qf 4 - C SYSTEMS PAID DATE RECEIPT # CHECK # METHOD ' "PAID BY CBYD FINANCIAL DESCRIPTION ACCOUNT •-y ,' .QTY -,.AMOUNT INFORMATION PAID BSAS SB1473 FEE 101-0000-20306 0 $3.00 $0.00 - Total Paid forBUILDING STANDARDS ADMINISTRATION .BSA: $3.00 . $0.00 y APPLIANCES, NON -RES 101-0000-42403 0 $96.68 $0.00 DEVICES, ADDITIONAL 101-0000-42403 0 $24.20 $0.00 DEVICES, FIRST 20 101-0000-42403 0 $24.17. $0.00 Total Paid for ELECTRICAL: $145.05 $0.00 Printed: Thursday, May 21, 2015 9,44:51 AM _ _ 2 Qf 4 - C SYSTEMS DESCRIPTION.' �, ACCOUNT � -; QTY °AMOUNT .:i. PAID ' PAID DATE. RECEIPT # CHECK #. METHOD PAID BY OTHER MECHANICAL 101-0000-42402 0 $72.52 $0.00 EQUIPMENT VENT FAN 101-0000-42402 0 $24.18 $0.00 Total Paid forMECHANICAL: $96.70 $0.00 ; BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 FIXTURE/TRAP 101-0000-42401_ 0 $72.54 WATER HEATER/VENT 101-0000-42401 0. $12.09 $0.00 WATER SYSTEM 101-0000-42401 0 1$12.09 $0.00' INST/ALT/REP Total Paid for PLUMBING FEES: $108.81 $0.00 - REMODEL'; EA 101-0000-42400 0 $108.75 $0.00- l ADDITIONAL 500 SF REMODEL, EA 101-0000 42600 0 $87.00 _ . $0.00 ADDITIONAL 500 SF PC REMODEL, FIRST 100 Sr 101-0000-42400 0 $49.31 $0.00 REMODEL, FIRST 500 SF 101-0000-42600 0 = $134.88 $0.00 PC Total Paid for REMODEL: $379.94 $0.00 TOTALS: $733.50 $0.00 INSPECTIONS PARENT PROJECTS Printed: Thursday, May 21, 2015 9:44:51 AM 3 Qf 4 YSTEMS LISA A `, ED ttachment-T ` e CREAT r _. • . ^ OWNER DESCRIPTION READY FOR APPROVAL Yp. t,� =« FIRE NO_TTINGHA : 4/17/2015' 4/24/2015. 5/15/2015 _CONDITION 78-134 CALLE TAMPICO M 4/20/2015 BURT HANADA STE. 160 T.I..docx STE. 160 T.L.docx PLANNING WALLY NESBIT 4/17/2015 4/24/2015 4/22/2015 READY FOR APPROVAL LACI -15 -TI -018 BLDNG - NON -STRUCTURAL BURT 5/5/2015. 5/12/2015 5/7/2015 APPROVED - TI OLD TOWN ARTISAN fire approval required prior to permit issuance. 0 HANADA CONDITIONS - .. BOND INFORMATION A `, ED ttachment-T ` e CREAT r _. • . ^ OWNER DESCRIPTION : r PATHNAME = _� SUBDIR ETRAKIT ENABLED t Yp. t,� =« 78-134 CALLE TAMPICO 78-134 CALLE TAMPICO DOC 4/20/2015 BURT HANADA STE. 160 T.I..docx STE. 160 T.L.docx 1 LAQ-15-TI-018 BLDNG LACI -15 -TI -018 BLDNG DOC 5/15/2015 LISA NOTTINGHAM - TI O -LD TOWN ARTISAN TI OLD TOWN ARTISAN 0 STUDIO.docx - STUDIO.docx - Bin # C'5 . Permit V O(y I d, Project Address:7 City of La Q rain to . .-Building 81: Safety Division P.O. Box 1504, .78-4.95 Calle Tampico . , La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking-Sheet Owners Name: ' �'� , Tt��l,R-� A. P. Number: Address: ��'/ 3 L/. � ` T P' Co. Legal Description:. ` City, ST, Zip: L j C. 4'1 Contractor: Telephone: Z — P Address:: 1 u D J �` ` , �� S Project Description: City; ST, Zip: iW Telephone:' J `> v n c dkRi r Stale Lie. # `.�, �• ^ —City Lic- #;:�`�� Arch., Engr., Designer: Address: City.,,ST, Zip: Te tionc: ' _ P .�<?<"�<��"�s<:.<.">< �`::��:,•.,j`';'.. �:.jvi�:T>�:ii':,'. :i �:iti?ti �:!::i>:i:i Si��: �c . ecu an cy • Coristrucfion T e. _ �✓'� .-.� r iir�` P �'• - State Lic. #: Project type (circle onc):/-New Add'n Alter Repair Demo Name of Contact. Person: ' �� r j��,,` Sq. Ft.: # Stories: #Units: Telephone #,of Contact Person Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE ., . l/ Submittal Rcq'd. Rcc'd TRACKING T. PERMIT FEES Plan Sets Plan Check submitted J Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check I3alanee Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubtditted �, .. Mechanical Grading plan 2"" Review, ready for corrections/issue.. Electrical Subeontaetor List Called Contact Person Plumbing Grant Decd Plans picked up , r a. , S.M.I. Ii.O.A. Approval Plans resubmitted Grading IN IiOUSE:- '`d Revicw, ready for corrcctions/issuc Developer Impact Fee. Planning Approval Called Contact.Person A.I.P.P.. Pub. Wks. Appr, Date of permit issue School Fees Total rerniiI secs PROUDLY SERVING THE UNINCORPORATED AREAS OF RIVERSIDE COUNTY AND THE CITIES OF: BANNING BEAUMONT CALI M ESA CANYON LAKE C OAC H E LLA DESERT HOT SPRINGS EASTVALE INDIAN WELLS INDIO JURUPA VALLEY LAKE ELSINORE LA QUINTA MENIFEE MORENO VALLEY NORCO PALM DESERT PERRIS RANCHO MIRAGE RUBIDOUX CSD SAN JACINTO TEMECULA WILDOMAR BOARD OF SUPERVISORS: KEVIN JEFFRIES DISTRICT 1 JOHN TAVAGLIONE DISTRICT 2 . JEFF STONE DISTRICT 3 JOHN BENOIT DISTRICT 4 MARION ASHLEY DISTRICT 5 RIVERSIDIE COUNTY FIRE DEPARTMENT IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION 77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 922114131 • Phone (760) 863-8886 • Fax (760) 863-7072 www. rvcfire.org May 15th, 2015 RE: , TENANT IMPROVEMENT PLAN CHECK -Non Structural LAQ-I5-TI-018 Old, Town Artisan'Studio 78134 Calle Tampico,Suite #160 La Quinta, CA You have been issued an approved 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 a '"H" occupancy per Sec. 307 of the 2013 CBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the 2013 CBC. A minimum 2AIOBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible location within 75' walking distance from any point in your building or suite. Fire extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the extinguisher, or purchased from a retail store with a sales receipt attached. A licensed fire extinguisher company must service extinguisher yearly. All breakers must be labeled and a clearance of 36 inches must be maintained'around the panel ai all times. Approved suite addresses shall be placed in such a position ,to be plainly visible and legible from the I treet. Said numbers shall contrast with their background. An approved audible interior notification alarm device shall be provided in approved location. A C- 10 licensed contractor must submit plans, designed in accordance with NFPA 72 to the Fire Department for review and approval prior to installation A durable sign stating "This door to remain unlocked during business hours" shall be placed on o- 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 Firo Department for review and for relocation of sprinkler heads.(Sprinkler system may need a 5 year certification before final is given) Air handling systems supplying air in excess of 2000 cubic feet per minute to enclosed spaces within buildings shall be equipped with an automatic shutoff. 2013 CMC(Sheet Number M 1.0). A UL300 hood/duct fire extinguishing system must be installed over the cooking equipment as required by the California Fire Code, California Mechanical Code and adopted standards. System plans must be submitted to the Fire Department for review, along with current plan check/inspecdon 'fee. SUBJECT TO FIELD INSPECTION - Nothing in our review shall be construed as encompassing structural integrity. Review of this plan does not authorize or approve any omission or deviation. from all applicable regulations. Final approval is subject to field inspection. 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. BUILDING ENERGY ANALYSIS REPORT PROJECT: Old Town Artisan Studio . 78-134 Calle Tampico #160•, ,La Quinta, .CAA 92253 , w. Project Designer: AA Design 1 x 817692 Rancho Santana Dr. _ La Quinta, CA•92253 ` ' 760-272-4285 Report Prepared by: CITY OF LA QUINTA Gina Rose BUILDING & SAFETY DEPT. EQS, Inc. APPROVED P.O. Box 170 . FOR CONSTRU TION Go Hill, OR.97525 DATE 60-218-3350 zftWEIVED MAR 312015 - Job Number: . Q CITY OF LA QUINTA ' COMMUNITY DEVELOPMENT + Date: The EnerpPro 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 2013 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC - www.energysoft.com. = " Ene P_ro 6.4_b .Ene SoFt User Number: 5862 ID: I� , x TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Form ENV -01 -E Envelope Component Approach 3 Form ENV -02-E Fenestration Worksheet 7 Form ENV -MM Envelope Mandatory Measures 9, Form LTI-01-E Indoor Lighting 10 Form LTI-02-E Lighting Controls 15 Form LTI-03-E Indoor Lighting Power Allowance, 18 Form MCH -01-E Mechanical Systems - , 20 Form MCH -02-E HVAC System Requirements 23 Form MCH -03-E Mechanical Ventilation and Reheat 25 Form MCH -04-E Required.Acceptance Tests 27 Form PLB-01-E Water Heating System' 30 HVAC System Heating and Cooling Loads Summary. e 32 f `1 t . • f f EnergyPro 6.4 by EnergySoft Job Number: ID: User Number: 5862 STATE OF CALIFORNIA ENVELOPE COMPONENT APPROACH CEC-NRCC-ENV-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E Envelope Component Approach (Page 1 of 4) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 A. GENERAL INFORMATION 1 1 Project Location: 78.134 Calle Tampico #160 6 Compliance Method: 0 Component ❑ Unconditioned (file 6 7 8 Affidavit) 2 CA City and Zip Code: La Qulnta, 92253 7 Building Front Orientation (deg or cardinal): 180 deg 3 Climate Zone: 15 8 Permitted Scope of Work I ❑ New Construction ❑ Addition ❑ Alteration 4 Total Conditioned Floor 2,480 9 Building Type(s) m Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room Required U -Factor From Tables, B, C, D Area: 1 Wall 5 ❑Schools (Public School) ❑ Relocatable Public School Bldg. la Conditioned Spaces ❑ Unconditioned Spaces 14.3.1-A5 119 ❑ Skylight Area for Large Enclosed Space > 5000 ftZ (If checked include the NRCC-ENV-04-E with submittal) B. ENVELOPE DETAILS — Framed 1 2 3 4 5 6 7 8 9 10 11 Tag/ID Assembly Type Frame Material Frame Depth Frame Spacing Appendix JA4 Reference Cavity R -value Continuous Insulation R -value Proposed U -Factor Required U -Factor From Tables, B, C, D Comments 1 Wall Wood 2x6 @ 16 1 14.3.1-A5 119 0.500 10.0 10.074 0.074 R-19 Wall 2 1 Roof Wood 12x4 @ 24 1 14.2.1-A20 130 10.0 10.031 10.031 R-30 Roof Attic C. ENVELOPE DETAILS — Non -framed 1 2 3 4 5 6 7 8 9 10 Tag/ID Assembly Type Assembly Materials ' Thickness (inches) Interior or Core Insulation . R -value Continuous Insulation R -value Appendix JA4 Reference Proposed U -Factor Required U -Factor from Tables, B, C, D Comments 1 Door Metal, Fire rated 0 0.0 4.5.1-A3 0.500 0.500 Insulated Metal Door D. ENVELOPE DETAILS - Mass 1 2 3 4 5 6 7 8 9 10 11 Tag/ID Mass Type Density (Ib/ft3l Mass Thickness (inches) Furring Strip Thickness (inches) Interior Insulation R -value Exterior Insulation R -value Appendix JA4 Reference Proposed Insulation U -factor Required U -Factor from Tables, B, C, D Comments CA Building limigy CfPLienLy 51.6nJai-di - 2013 Nonre3identiol Complienee Juno 2014 STATE OF CALIFORNIA ENVELOPE COMPONENT APPROACH CEG-NRCC-ENV-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E Envelope Component Approach (Page 2 of 4) Pr°le" Name: Old Town Artisan Studio Date Prepared: 3/29/2015 E. ROOFING PRODUCTS (COOL ROOF) 1 2 3 4 5 6 7 8 9 -10 11 Mass Roof Whole Building Air Leakage Testing Comments Proposed Minimum Required Aged Solar Thermal SRI Aged Solar Thermal SRI • 25 Ib ft2 CRRC Product or greater Roof Pitch ID Number Product Type Reflectance Emittance (Optional) Reflectance Emittance (optional) Comments ❑ ❑' ❑ ❑' ❑ ❑' ❑ An aged solar reflectance less than 0.63 is allowed provided the maximum roof / ceiling U -factor in TABLE 140.3 is not exceeded ❑ High-rise residential buildings and Hotels and Motels with low -sloped roofs in Climate Zones 1 through 8, 12 and 16 are exempted from aged Solar Reflectance and emittance requirements. ❑ High-rise residential buildings and Hotels and Motels with steep -sloped roofs in Climate Zones 1 and 16 are exempt from aged Solar Reflectance and emittance requirements. ❑ The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from aged Solar Reflectance and emittance requirements To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §110.8(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other NOTES: 1. Check the box if the aged Solar reflectance was not available in the Cool Roof Rating Council's Rated Product Directory, Then use the equation in Section 110.8(i)2 where the Initial Reflectance value from the some directory and use the equation (0.2+B(pjnjtj,j — 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance and B is either set to 0.65 for Field -Applied Coatings or it is set to 0. 70for all other roofing products other than Field -Applied Coating. 2. Calculate the SRI Value by using the SRI -Worksheet at (TBD) and enter the resulting value in the SRI Column above and attach a copy for the SRI -Worksheet NRCC-ENV-03-E to the to this form. F. Air Barrier 1 - 2 3 4 5 Tag/ID Air Barrier Material Type Air Barrier Assembly Type Whole Building Air Leakage Testing Comments CA Building Energy Efficiency Standards - 2013 Non. residentidl Cgrripliance Jung 2014 STATE OF CALIFORNIA ENVELOPE COMPONENT APPROACH CEC-NRCC-ENV-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION" CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E Envelope Component Approach (Page 3 of 4) Pmlect"ame: Old Town Artisan Studio Date Prepared: 3/29/2015 G. FENESTRATION PROPOSED AREAS AND EFFICIENCIES 1 2 3 4 5 6 7 8 9 10 11 12 Tag/ID Fenestration Type Area Orientation N, S, W, E. or Roof # of Panes Max U -Factor Overhang Max (R)SHGC Min VT Label Conditions Status Comments H. ENVELOPE MANDATORY MEASURES Indicate location on building plans of Mandatory Envelope Measures Note Block: ENV -MM INSTRUCTIONS TO APPLICANT ENVELOPE COMPLIANCE & WORKSHEETS (check box if worksheet are included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, please refer to the Nonresidential Compliance Manual. 0 NRCC-ENV-01-E -Certificate of Compliance. Required on plans for all submittals. ❑ NRCC-ENV-04-E Use when minimum skylight requirements for large enclosed spaces are required in climate zones 2 through 15. Optional on plans. r A Rpilriin8 Fnprgy Fffirianry Stpndarric . 7Q13 Mnnrgcidapthl CQrrPIiancq June 2014 STATE OF CALIFORNIA ENVELOPE COMPONENT APPROACH CEC-NRCC-ENV-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION �_ CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E Envelope Component Approach (Page 4 of 4) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Gina ROS@ Documentation Author Signature: Company:. EQS, Inc. signature Date: 3/29/2015 -- Address: P.O. BOX 170 CEA/ HERS Certification Identification (if applicable): City/state/zip: Gold HIII , OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval.with this building permit application_ 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Desi Signature: " Company: AA Design Date Signed: Address` 81-692 Rancho Santana Dr. License: City/State/Zip: La Quinta, CA 92253 Phone: 760-272-4285 t CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance • f June 2014 STATE OF CALIFORNIA FENESTRATION WORKSHEET CEC-NRCC-ENV-02-E (Revised 06/14) CALIFC ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-ENV-02-E Fenestration Worksheet (Page 1 of 3) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 A. WINDOWS DETAILS Worksheet §140.3(a)5B and C NOTE: Newly installed fenestration shall have a certified NFRC Label Certificate or use the CEC default tables found in Table 116-A and Table 1168. Site -built fenestration less than 1,000 ft, or more than or equal tot, 000 ft2 see Reference Nonresidential Appendix NA6. 1 2 3 . 4 1 5 1 6 1 7 8 1 9 10 1 11 12 13 14 Tag/I D Window Type (e.g., Window -1) Aread0.79O Fenestration Maximum Standard West Area Overhang U -Factor I SHGC VT E. Gross Exterior Wall Area Dimensions ft2 x 0.40 = 762 40% of Gross Exterior Wall Area or Calculated 3 o2 Q o- 3 Q C 2 a- 3 ¢ H V HIV (R)SHGC Proposed Max (R)SHGC Allowed 1 Window 85 0.790 0.700 0.700 0.5000.502 Window 229 0.790 0.700 0.700 0.500 0.50( B. WEST WINDOW AREA CALCULATION See §140.3(a)5A in the Energy Standards A. Gross West Exterior Wall Area0 ft2 x 0.40 = 0 ft2 40% of Gross West Facing Exterior Wall Area; or B. West Display Linear Perimeter J 0 FT x 6 ft = 0 ft2 West Display Perimeter Area C. Enter Larger of A or B 0 ft2 Maximum Standard West Area D. Enter Proposed West Window Area 0 ft2 Proposed West Window Area Note: If the PROPOSED WEST WINDOW AREA is greater than the MAXIMUM STANDARD WEST AREA then the envelope component approach may not be used. C. WINDOW AREA CALCULATION for all other orientations other than West - See §140.3(a)5A in the Energy Standards E. Gross Exterior Wall Area 1,904 ft2 x 0.40 = 762 40% of Gross Exterior Wall Area or F. Linear Display Perimeter:::d 0 FT x 6 ft = 0 ft2 Display Perimeter Area G. Enter The Larger of E or F 762 ft2 Maximum Standard Area H. Enter Proposed Window Area 314 ft2 1 Proposed Window Area Note: If the PROPOSED WINDOW AREA is greater than the MAXIMUM STANDARD AREA then the envelope component approach may D. SKYLIGHT AREA CALCULATION See §143(a)6A in the Energy Standards ACTUAL GROSS ROOF AREA STANDARD ALLOWED A IF Atrium/Skylight Height is <_ 55 ft; or 2,480 ft2 x 0.05 = 124 ft2 ft2 B. IF Atrium/Skylight Height is > 55 ft ft2 x 0.10 = C. Proposed Skylight Area (from plans) 0 fe D. Skylight SSR %' z = Proposed Skylight Area Divided by Actual Gross 0.0 _ % 1. If the SKYLIGHT SSR % is less than or equal to 5% then choose the appropriate column in Table 140.3-B and C and row in Table 140.3-D. 2. If the SKYLIGHT SSR % is greater than 5% then the Envelope Component Approach may not be used. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA FENESTRATION WORKSHEET CEC-NRCC-ENV-02-E (Revised 06/14) ENERGY COMMISSION . CERTIFICATE OF COMPLIANCE Fenestration Worksheet Project Name: Old Town Artisan Studio CALIFC N RCC -ENV -02-E ' (Page 3 of 3) Date Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature:' Gina Rose r� Company: EQS, Inc. signature Date: 3/29/2015 Address: P.O. BOX 170 CEA/ HERS Certification Identification (if applicable): City/State/Zip: Gold Hill, OR 97525 phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to. be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible D' Signature: Company: AA Design Date Signed: -'3o-rte Address: 81-692 Rancho Santana Dr. License: City/state/Zip: La Quinta, CA 92253 phone: 760-272-4285 11 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance a June 2014 x ENVELOPE MANDATORY MEASURES: NONRESIDENTIAL ENV -MM' Project Name Date t Old Town Artisan Studio 3/29/2015 DESCRIPTION Building Envelope Measures: §110.8(a): Installed insulating material shall have been certified by the manufacturer to comply with the California Quality Standards for insulating material, Title 20 Chapter 4; Article 3. All Insulating Materials shall be installed in compliance with the flame spread rating and smoke density requirements of §110.8(c): Sections 2602 and 707 of Title 24, Part 2. §1.10.8(f): The -opaque portions of framed demising walls in nonresidential buildings shall have insulation with an installed R -value of no less than R-13 between framing members. §110.7(a): All Exterior Joints and openings in the building that are observable sources of air leakage shall be caulked, gasketed, weatherstripped or otherwise sealed. Manufactured fenestration products and exterior doors shall have air infiltration rates not exceeding 0.3 cfm/ft.2 of §110.6(a): window area, 0.3 cfm/ft.z of door area for residential doors, 0.3 cfm/ft.' of door area for nonresidential single doors (swingingand slidin and 1.0 cfm/ft.2 for nonresidential double doors (swinging). §110.6(a): Fenestration U -factor shall be rated in accordance with NFRC 100, or the applicable default U -factor. §110.6(a) : Fenestration SHGC shall berated in accordance with NFRC 200, or NFRC 100 for site -built fenestration, or the applicable default SHGC. §110.6(b): Site Constructed Doors, Windows and Skylights shall be caulked between the unit and the building, and shall be weatherstripped (except for unframed glass doors and fire doors). t . F { EnergyPro 6.4 by EnergySoft User Number 5862 RunCode: 2015-03-29709:08:19 ID: Page 9 of 32 ih � Y STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCC-LTI-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE — USER INSTRUCTIONS NRCC-LTI-01-E Indoor Lighting (Page 1 of 5) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 Climate Zone: 15 Conditioned Floor Area: 2,480 YES NO FORM TITLE - YES NRCC-LIT-01-E Certificate of Compliance. All Pages required on plans for all submittals. Unconditioned Floor Area : 0 Lighting Controls, Certificate of Compliance, and PAF Calculation. All Pages required on plans for all submittals. General Information Indoor Lighting Power Allowance NO NRCC-LIT-04-E Tailored Method Worksheets NO NRCC-LIT-05-E Line Voltage Track Lighting Worksheets Building Type: ❑ Schools El Nonresidential ❑ Relocatable Public Schools ❑ El High -Rise Residential Conditioned Spaces ❑ ❑ Hotel/Motel Unconditioned Spaces Phase of Construction: ❑ New Construction ❑ Addition ❑ Alteration Method of Compliance: ❑ Complete Building ❑ Area Category 0 Tailored LIGHTING COMPLIANCE DOCUMENTS (select yes for each document included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance documents, refer to the Nonresidential Manual published by the California Energy Commission. YES NO FORM TITLE - YES NRCC-LIT-01-E Certificate of Compliance. All Pages required on plans for all submittals. YES NRCC-LIT-02-E Lighting Controls, Certificate of Compliance, and PAF Calculation. All Pages required on plans for all submittals. YES NRCC-LIT-03-E Indoor Lighting Power Allowance NO NRCC-LIT-04-E Tailored Method Worksheets NO NRCC-LIT-05-E Line Voltage Track Lighting Worksheets Summary of Allowed Lighting Power Conditioned and Unconditioned space Lighting must not be combined for compliance Indoor Lighting Power for Conditioned Spaces Indoor Lighting Power for Unconditioned Spaces Watts Watts Installed Lighting Installed Lighting 3,940 0 1. NRCC-LTI-01-E, page 4 + NRCC-LTI-01-E, page 4 + PORTABLE ONLY FOR OFFICES 2. NRCC-LTI-01-E, page 3 + Minus Lighting Control Credits 985 Minus Lighting Control Credits 0 3' NRCC-LTI-02-E, page 2 NRCC-LTI-02-E, page 2 4. Adjusted Installed Lighting Power _ 2955 Adjusted Installed Lighting Power _ 0 (row 1 plus row 2 minus row 3) (row 1 minus row 3) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance . June 2014 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCC-LTI-01-E Revised 06/14)CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE — USER INSTRUCTIONS NRCC-LTI-01-E Indoor Lighting (Page 2 of.5) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 5. Complies ONLY if Installed <_ Allowed Complies ONLY if Installed :5 Allowed Form/Title 6. Allowed Lighting Power Conditioned NRCC-LTI-03-E, page 1 496 Allowed Lighting Power Unconditioned NRCC-LTI-03-E, page 1 0 Declaration of Required Installation Certificates — Declare by selecting yes for all Installation Certificates that will be submitted. (Retain copies and verify forms are completed and signed.) YES NO Form/Title NRCI-LTI-01-E - Must be submitted for all buildings ❑ Field inspector NRCI-LTI-02-E - Must be submitted for a lighting control system, or for an Energy Management Control System (EMCS), to be recognized for compliance. _ ❑ Field Inspector NRCI-LTI-03-E - Must be submitted for a line -voltage track lighting integral current limiter, or for a supplementary overcurrent protection panel used to.energize only line -voltage track lighting, to be recognized for compliance. ❑ Field Inspector NRCI-LTI-04-E - Must be submitted for two interlocked systems serving an auditorium, a convention center, a conference room, a multipurpose room, or a theater to be recognized for compliance. ❑ Field Inspector NRCI-LTI-05-E - Must be submitted for a Power Adjustment Factor (PAF) to be recognized for compliance. ❑ Field Inspector NRCI-LTI-06-E - Must be submitted for additional wattage installed in a video conferencing studio to be recognized for compliance. ❑ Field Inspector Declaration of Required Certificates of Acceptance — Declare by checking all of the Certificates of Acceptance that will be submitted. (Retain copies and verify forms are completed and signed.) YES NO Form/Title NRCA-LTI-02-A - Must be submitted for occupancy sensors and automatic time switch controls. ❑ Field Inspector NRCA-LTI-03-A - Must be submitted for automatic daylight controls. ❑ Field Inspector NRCA-LTI-04-A - Must be submitted for demand responsive lighting controls. ❑ Field Inspector CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA INDOOR LIGHTING CERTIFICATE OF COMPLIANCE — USER INSTRUCTIONS NRCC-LTI-01-E Indoor Lighting (Page 3 of 5) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces. Installed Lighting Power listed on this Lighting Schedule is only for. ® CONDITIONED SPACE ❑ UNCONDITIONED SPACE A. INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST ❑ The actual indoor lighting power listed on this page and on the next page includes all installed permanent and planned portable lighting systems. ❑ When Complete Building Method is used for compliance, list each different type of luminaire on separate lines. ❑ When Area Category Method or Tailored Method is used for compliance, list each different type of luminaire by each different function area on separate lines ❑ Also include track lighting in schedule, and submit the track lighting compliance form (NRCC-LTI-05-E) when line -voltage track lighting is installed. B. Installed Portable Luminaires in Offices — Exception to Section 140.6(a) - ❑ This section shall be filled out ONLY for portable luminaires in offices (As defined in §100.1). All other planned portable luminaires shall be documented on next page of this compliance form. ❑ This section is used to determine if greater than 0.3 watts of portable lighting is planned for any office ❑ Fill out a separate line for each different office. Small offices that are typical (having the same general and portable lighting) may be grouped together. This allowance shall not be traded between offices having different lighting systems.. Office Portable Luminaire Office Installed Portable Luminaire Watts Per Square Office Location Field Schedule Foot Inspector A B C D E F G H I J Installed r- Z portable 9 v+ Watts If F5 0.3, Identify Office area in which 3 3 luminaire N per enter zero; Complete Luminaire Description C watts in this o`, ° square E x G these portable luminaires are N d (i.e., LED, under cabinet, furniture mounted Watts per M o — office m .» foot if F > 0.3, installed direct/indirect) Luminaire (B x C) (D / E) (F-0.3) ❑ ❑ 20 a; Enter sum total of all pages into NRCC- Total installed portable luminaire watts that are greater than 0.3 watts per square foot per office: LTI-01-E; Page 1 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA INDOOR LIGHTING . CEC-NRCC-LTI-01-E Revised 06/14 CERTIFICATE OF COMPLIANCE — USER INSTRUCTIONS Indoor Lighting Project Name: Old Town Artisan Studio J CALIFORNIA ENERGY COMMISSION - NRCC-LTI-01-E (Page 4 of 5) Date Prepared: 3/29/2015 carate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces. Installed Lighting Power listed on this Lighting Schedule is only for: ;ONDITIONED SPACE ❑ UNCONDITIONED SPACE C. INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST ' Luminaire Schedule Installed Watts Location Field Inspector' A B C D E F G H How wattage was. - determined 1. .. Vi O o, °�' - Complete Luminaire Description r ,f1 n c n o r C 3 z - 7 d 3 • I� E (i.e, 3 lamp fluorescent troffer, o', v Z M o d. 3 x a Primary Function area in which Z,= F32T8, one dimmable electronic ballast) m r9 co cu these luminaires are installed Pass fail (4) 8 ft Fluorescent 124.0 ® ❑ 20 2,480 Comp Bldg Classroom ❑ ; ❑ `'; a 6" recessed LED 14.0 ® ❑ 4 56 - Comp Bldg Classroom ,,, ❑ (2) 2 ft Fluorescent T8 Elec 54.0 ® ❑ 6 324 Comp Bldg Classroom7. ❑ & r .0 (2) 4 ft Fluorescent T8 Energy Savings Elec 54.0 El ❑ " 20 1,080 Comp Bldg Classroom -. ;❑ �„ ❑ rF ❑ ❑ xa❑ ;. ❑ ❑ Y 0 ❑ ,: ❑ 0 ❑ ❑ ❑.o ❑�e - = INSTALLED WATTS PAGE TOTAL: 940 Enter sum total of all pages into ` - NRCC-LTI-01-E; Page 2 I CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance _ - June 2014 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCC-LTI-01-E Revised 06/14 CERTIFICATE OF COMPLIANCE - USER INSTRUCTIONS 1"Indoor Lighting Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 4, JISSION NRCC-LTI-01-E (Page 5 of 5) DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ' 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Signature: -1 Documentation Author Name: . Gina Rose - - Company: EQS, Inc. signature Date:3/Z9/ZO15 Address: P.O. BOX 170 CEA/ HERS Certification Identification (if applicable): ` City/State/Zip: Gold Hill, OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury„under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of - Compliance conform to the requirements of Title 24, Part land Part 6 of the California Code of Regulations. - 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance ' documents, worksheets, calculations, plans and specifications submitted to the enforcement°agency for approval with this,building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsi a Desi ner Name: - Responsible Designer Signate: oo Company: (1�� Date Signed' �� Address:•�J� y License: City/State/Zip: Phone: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance - June 2014 STATE OF CALIFORNIA INDOOR LIGHTING — LIGHTING CONTROLS ENERGY CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E ,Indoor Lighting - Lighting Controls (Page 1 of 3) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 The NRCC-LTI-02-E shall be used to document all mandatory and prescriptive lighting controls that are applicable to the project. Mandatory Lighting Control Declaration Statements (Indicate if the measure applies by checking yes or no below.) YES NO Control Requirements Lighting shall be controlled by self-contained lighting control devices which are certified to the Energy Commission according to the Title 20 Appliance Efficiency Regulations in accordance with Section 110.9. Lighting shall be controlled by a lighting control a system or energy management control system in accordance with §110.9. An Installation Certificate shall be submitted in accordance with Section 130.4(b). One or more Track Lighting Integral Current Limiters shall be installed which have been certified to the Energy Commission in accordance with §110.9 and §130.0. Additionally, an Installation Certificate shall be submitted in accordance with Section 130.4(b). A Track Lighting Supplementary Overcurrent Protection Panel shall be installed in accordance with Section 110.9 and Section 130.0. Additionally, an Installation Certificate shall be installed in accordance with Section 130.4(b). All lighting controls and equipment shall comply with the applicable requirements in §110.9 and shall be installed in accordance with the manufacturer's instructions in accordance with Section 130.1. All luminaires shall be functionally controlled with manually switched ON and OFF lighting controls in accordance with Section 130.1(a). General lighting shall be separately controlled from all other lighting systems in an area. Floor and wall display, window display, case display, ornamental, and special effects lighting shall each be separately controlled on circuits that are 20 amps or less. When track lighting is used, general, display, ornamental, and special effects lighting shall each be separately controlled; in accordance with Section 130.1(a)4. The general lighting of any enclosed area 100 square feet or larger, with a connected lighting load that exceeds 0.5 watts per square foot shall meet the multi-level lighting control requirements in accordance with Section 130.1(b). All installed indoor lighting shall be equipped with controls that meet the applicable Shut -OFF control requirements in Section 130.1(c). Lighting in all Daylit Zones shall be controlled in accordance with the requirements in Section 130.1(d) and daylit zones are shown on the plans. Lighting power in buildings larger than 10,000 square feet shall be capable of being automatically reduced in response to a Demand Responsive Signal in accordance with Section 130.1(e). Before an occupancy permit is granted for a newly constructed building or area, or a new lighting system serving a building, area, or site is operated for normal use, indoor lighting controls serving the building, area, or site shall be certified as meeting the Acceptance Requirements for Code Compliance in accordance with Section 130.4.(a). The controls required to meet the Acceptance Requirements include automatic daylight controls, automatic shut -OFF controls, and demand responsive controls. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA INDOOR LIGHTING — LIGHTING CONTROLS CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E Indoor Lighting - Lighting Controls (Page 2 of 3) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 A separate document must be filled out for Conditioned and Unconditioned Spaces. This page is used only for the following: 0 CONDITIONED SPACES O UNCONDITIONED SPACES MANDATORY AND PRESCRIPTIVE INDOOR LIGHTING CONTROL SCHEDULE, PAF CALCULATION, and FIELD INSPECTION CHECKLIST PAF Credit Calculation 2 n (D D _n FD a Standards Complying With 1 o � r) o o :3�• Lighting Control Schedule (✓ all that apply, or enter 'E' if Exempted) w CL o -n v a o o. g - A B C D E F G H I J K L M N O Type/ Description of Lighting Control (i.e.: occupancy sensor, # N )LoN N a Location in Building automatic time switch, of o 0 0 0 0 P o dimmer, automatic daylight, Units v etc...) Suite Dimming w/Occ Sensor ✓ 324 0.25 81 •✓ ❑ [3 Suite Dimming w/Occ Sensor ✓ 1,080 0.25 270 ✓ ❑ ❑-;• Suite Dimming w/Occ Sensor ✓ 2,480 0.25 620 ✓ ❑ 'E Suite Dimming w/Oc : Sensor ✓ 56 0.25 14 ✓ < ❑ ❑ 0. Control Credit PAGE TOTAL (Sum of Column M): 985 IF MULTIPLE PAGES ARE USED, ENTER SUM TOTAL OF Control Credit for all pages HERE (Sum of all Column M): 985 Enter Control Credit total into NRCC-LTI-01-E; Page 1. 1. §130.1(a) = Manual area controls; §130.0(b) = Multi Level; §130.1(c) =Auto Shut -Off; §130.1(d) =Mandatory Daylight; §130.1(e) = Demand Responsive; §140.6(d) = Additional lighting controls installed to earn a PAF; §140.6(d) = Prescriptive Secondary Sidelit Daylight Controls. 2. Check Table 140.6-A for correct Factor. PAFs shall not be traded between conditioned and unconditioned spaces. As a condition to earn a PAF, an Installation Certificate is also required to be filled out, signed, and submitted. CA Buildiw Energy EfficiencyStandards - 2()13 NnnrPsiriential Cnmplianre Juno 2014 STATE OF CALIFORNIA INDOOR LIGHTING - LIGHTING CONTROLS CEC-NRCC-LTI-02-E Revised 06/14 CALIFORNIA ENERGY COMMISSION --AMWO" CERTIFICATE OF COMPLIANCE NRCC-LTI-02-E Indoor. Lighting -Lighting Controls (Page 3 of 3) Project Name: Old Town Artisan Studio - - Date Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: m ' 77 Gina Rose company: EQ$, Inc. signature Date: 3/29/2015 Address: P.O. BOX 170 CEA/ HERS Certification Identification (if applicable): City/state/Zip: Gold Hill, OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct., 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance - (responsible designer). _ 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer NaR 'Responsible Designer Signature Compa y .74P DG25 Date Signed: `J Address: License: City/State/Zip: Phone: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance T s - t_ _ , ._ _ . , _ _ _ _ __ _ . __ _._ _ - _ 1une.2014 _ - STATE OF CALIFORNIA - INDOOR LIGHTING POWER ALLOWANCE, CEC-NRCC-LTI-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION ' CERTIFICATE OF COMPLIANCENRCC-LTI-03-E Certificate of Compliance - Indoor Lighting Power Allowance (Page 1 of 4) Project Name: Old Town Artisan Studio - - Date Prepared' 3/29/2015 - - ALLOWED LIGHTING POWER A separate page must be filled out for Conditioned and Unconditioned Spaces. This page is 'only for: 0 CONDITIONED spaces• ❑ UNCONDITIONED spaces , A. SUMMARY TOTALS OF LIGHTING.POWER ALLOWANCES , ❑ If using Complete Building Method for compliance, use only the total in column (a) es total allowed building watts. ❑ .If using Area Category. Method, Tailored Method, or a combination of Area Category and Tailored Method for compliance, use only the total in column (b) as the total allowed building watts . r '(a) (b) 1. Complete Building Method Allowed Watts. Documented in section B of NRCC-LTI-03-E (below on this page):- 2.• Asea Category Method Allowed Watts;. Documented in section C-1'of NRCC-LTI-03-E (below on this page) 0 3. Tailored Method Allowed Watts. Documented in section A of NRCC-LTI-04-E ' - 496 - , • TOTAL ALLOWED BUILDING WATTS. Enter number into correct cell on NRCC-LTI-01, Page 2, Row 1 496 ❑ Check.here if building contains both conditioned and unconditioned areas. - B. COMPLETE BUILDING METHOD LIGHTING POWER ALLOWANCE .. A - g 0 C '0 D 0 WATTS' COMPLETE. ALLOWED TYPE OF BUILDING (From §140.6 Table 140.676) '" PER (ftZ) X BLDG. AREA = WATTS Total:Area;. Total Watts. Enter Total Watts into section A, row l (Above on this page) • C.-1 AREA CATEGORY METHOD TOTAL LIGHTING, POWER ALLOWANCES (C-2.plus.0-3) Watts Total from section C-2 0 ' -Total from section C-3 : '0 Total Watts. Enter Total Watts into section A, row 2 (Above on this page) 0 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance '. June 2014' STATE OF CALIFORNIA INDOOR LIGHTING POWER ALLOWANCE CEC-NRCC-LTI-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCGLTI-03-E Certificate of Compliance - Indoor Lighting Power Allowance (Page 4 of 4) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1.. I certify that this Certificate of Compliance documentation is accurate and complete. M Documentation Author Name: Documentation Author Signature: Gina Rose - Company: EQS, Inc. signature Date: 3/29/2015 Address: P.O. Box 170 CEA/ HERS Certification Identification (if applicable)- City/State/Zip: Gold Hill, OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Namp� Responsible Designer Signatu /�/ Company: Date Signed: Address: License: City/State/Zip: Phone: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MECHANICAL SYSTEMS CERTIFICATE OF COMPLIANCE NRCC-MCH-01-E. Mechanical Systems (Page 1 of 3) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 MECHANICAL COMPLIANCE FORMS & WORKSHEETS (check box if worksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2013 Nonresidential Manual Note: The Enforcement Agency may require all forms to be incorporated onto the building plans. YES NO Form/Worksheet # Title E3 ❑ NRCC-MCH-01-E (Part 1 of 3) Certificate of Compliance, Declaration. Required on plans for all submittals. En ❑ NRCC-MCH-01-E (Part 2 of 3) Certificate of Compliance, Required Acceptance Tests (MCH -02A to 11A). Required on plans for all submittals. 0 ❑ NRCC-MCH-01-E (Part 3 of 3) Certificate of Compliance, Required Acceptance Tests (MCH -12A to 18A). Required on plans where applicable. ® ❑ NRCC-MCH-02-E (Part 1 of 2) Mechanical Dry Equipment Summary is required for all submittals with Central Air Systems. It is optional on plans. m ❑ NRCC-MCH-02-E (Part 2 of 2) Mechanical Wet Equipment Summary is required for all submittals with chilled water, hot water or condenser water systems. It is optional on plans. El ❑ NRCC-MCH-03-E Mechanical Ventilation and Reheat is required for all submittals with multiple zone heating and cooling systems. It is optional on plans. MECHANICAL HVAC ACCEPTANCE FORMS (check box for required forms) Designer: This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for HVAC systems. The designer is required to check the applicable boxes for all acceptance tests that apply and list all equipment that requires an acceptance test. All equipment of the some type that requires a test, list.the equipment description and the number of systems. Installing Contractor: The contractor who installed the equipment is responsible to either conduct the acceptance test them self or have a qualified.entity run the test for them. If more than one person has responsibility for the acceptance testing, each person shall sign and submit the Certificate of Acceptance applicable to the portion of the construction or installation for which they are responsible. Enforcement Agency: Plancheck — The NRCC-MCH-01-E form is not considered a completed form and is not to be accepted by the building department unless the correct boxes are checked. Inspector - Before occupancy permit is granted all newly installed process systems must be tested to ensure proper operations. Test Description MCH -02A MCH -03A MCH -04A MCH -05A MCH -06A MCH -07A MCH -08A MCH -09A MCH -10A MCH -11A Equipment # of Outdoor Single Zone Air Economizer Demand Supply Fan Valve Leakage Supply Water Hydronic Automatic Requiring Testing units Air Unitary Distribution Controls Control VAV Test Temp. Reset System Demand Shed or Verification Ducts Ventilation Variable Flow Control (DCV) Control ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MECHANICAL SYSTEMS CEC-NRCC-MCH-01-E Revised 06/14 CERTIFICATE OF COMPLIANCE Mechanical Systems PmjectName: Old Town Artisan Studio - a ` CALIFORNIA ENERGY COMMISSION N RCC -MCH -01-E (Page 2 of 3) Date Prepared: 3/29/2015 - MECHANICAL HVAC ACCEPTANCE FORMS (check box for required forms) Designer: This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for HVAC systems. The designer is required to check the applicable boxes for all . acceptance tests that apply and list all equipment that requires an acceptance test. All equipment of the same type that requires a test, list the equipment description and the number of systems. Installing Contractor: The contractor who installed the equipment is responsible to either conduct the acceptance test them self or have a qualified entity run the test for them. If more than one person has responsibility for the acceptance testing, each person shall sign and submit the Certificate of Acceptance applicable to the portion of the construction or installation for which they are responsible. The following tests require a Enforcement Agency: Plancheck — The NRCC-MCH-01-E form is not considered a completed form and is not to be accepted by the building department unless the correct boxes are checked. Inspector - Before occupancy permit is granted all newly installed process systems must be tested to ensure proper operations. Test Description MCH -12A MCH -13A MCH -14A MCH -15A MCH -16A MCH -17A MCH -18A Equipment N of Fault Detection & Automatic Fault Distributed Energy Thermal Energy Supply Air Condenser Water ECMS Requiring Testing units Diagnostics for DX Detection & Storage DX AC Storage (TES) Temperature Reset Reset Controls or Verification - Units Diagnostics for Air & Systems Systems Controls Zone ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ - ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑. ❑ ❑ ❑ CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MECHANICAL SYSTEMS CEC-NRCC-MCH-01-E Revised 06114 CERTIFICATE OF COMPLIANCE ' Mechanical Systems Project Name: Old Town Artisan Studio CALIFORNIA ENERGY COMMISSION NRCC-MCH-01-E (Page 3 of 3) Date Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. f ' Documentation Author Name: Gina ROS@ Documentation Author Signature: -.+ .. Company: EQS, Inc. Signature Date: 3/29/2015 Address: P.O. BOX 170 CEA/ HERS Certification Identification (if applicable): , City/state/zip: Gold HIII , OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT - I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). - . • = 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance' are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. S. 1 will ensure that a completed signed copy of this Certificate of Compliance`shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible DesignerpW �N Responsible Designer Signa e: Company: ^ ^ ►—\ Date Signed: nom, j 3 o Address: License: City/State/Zip: - Phone: - STATE OF CALIFORNIA HVAC SYSTEM REQUIREMENTS I e CEC-NRCC-MCH-02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION -4W' CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Dry System Requirements (Page 1 of 3) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 Equipment Tags and System Description' Suite MANDATORY MEASURES Heating Equipment Efficiency3 Cooling Equipment Efficiency3 HVAC or Heat Pump Thermostats Furnace Standby Loss Control Low leakage AHLIs Ventilation Demand Control Ventilations Occupant Sensor Ventilation Contro16 Shutoff and Reset Controls' Outdoor Air and Exhaust Damper Control Isolation Zones Automatic Demand Shed Controls Economizer FDD Duct Insulation PRESCRIPTIVE MEASURES T-24 Sections Reference to the Requirements in the Contract Documents2 110.1 or 110.2(a) 110.1 or 110.2(a) 110.2(b), 110.2(c) 110.2(d) 110.2(f) 120.1(b) 120.1(c)4 120.1(c)5, 120.2(e)3 120.2(e) 120.2(f) 120.2(g) 120.2(h) 120.2(i) 120.4 Equipment is sized in conformance with 140.4(a & b) y 140.4(a&b) Supply Fan Pressure Control 140.4(c) Simultaneous Heat/Cools 140.4(d) Economizer 140.4(e) Heat and Cool Air Supply Reset 140.4(f) Electric Resistance Heating9 140.4(g) Duct Leakage Sealing and Testing. 10 140.4(1) Notes: 1. Provide equipment tags (e.g. AHU 1 to 10) and system description (e.g. Single Dud VAV reheat) as appropriate. Multiple units with common requirements can be grouped together. ' 2. Provide references to plans (i.e. Drawing Sheet Numbers) and/or specifications (including Section name/number and relevant paragraphs) where each requirement is specified. Enter"N/A" if the requirement is not applicable to this system. 3. The referenced plans and specifications must include all of the following information: equipment tag, equipment nominal. capacity, Title 24 minimum efficiency requirements, and actual rated equipment efficiencies. Where multiple efficiency requirements are applicable (e.g. full- and part -load) include all. Where appliance standards apply (110.1), identify where equipment is required to be listed per Title 201601 et seq. 4. Identify where the ventilation requirements are documented for each central HVAC system. Include references to both central unit schedules and sequences of operation. If one or more space is naturally ventilated identify where this is documented in the plans and specifications. Multiple zone central air systems must also provide a MCH -03-E form. 5. If one or more space has demand controlled ventilation identify where it is specified including the sensor specifications and the sequence of operation. 6. If one or more space has occupant sensor ventilation control identify where it is specified including the sensor specifications and the sequence of operation 7. If the system is DDC identify the sequences for the system start/stop, optimal start setback (if required) and setup (if required). For all systems identify the specification for the thermostats and time clocks (if applicable). 8. Identify where the heating, cooling and deadband airflows are scheduled for this system. Include a reference to the specification of the zone controls. Provide a MCH -03-E form. 9. Enter N/A if there is no electric heating. If the system has electric heating indicate which exception to 140.4(g) applies. 10. If duct leakage sealing and testing is required, a MCH -04-A form must be submitted. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA HVAC SYSTEM REQUIREMENTS CEC-NRCC-MCH-02-E (Revised 06/13) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE, NRCC-MCH-02-E HVAC Wet System Requirements (Page 3 of 3) Project Name: Old Town Artisan Studio Date . Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT - 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Gina Rose Company: EQS, Inc. Signature Date: 3/29/2015 Address: P.O. Box 170 CEA/ HERS Certification Identification (if applicable): City/State/Zip: Gold Hill, OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building desigri or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building -owner at occupancy. Responsible Design r Responsible Depgrrer%Signature: Company: • r W7 J J -u LQ Date Signed: S 1 S Address: License: City/State/Zip: Phone: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MECHANICAL VENTILATION' AND REHEAT CEC-NRCC-MCH-03-E Revised 06/14 CERTIFICATE OF COMPLIANCE Mechanical Ventilation & Reheat Project Name: Old Town Artisan Studio . Date Prepared: W29/2015 :NERGY COMMISSION' NRCC-MCH-03-E (Page 2 of 2) DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1.. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Gina Rose Company: EQ$, Inc. Signature Date: 3/29/2015 ' Address: - P.O. Box 170 CEA/ HERS Certification Identification (if applicable): r city/stat1. e/zip: Gold Hill, OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. lam eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design.identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. . 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed Signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement , agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible DA Name: Responsible D rSignature: - ' Company: - Date Signe r; F( J! r - Address: License: City/State/Zip: Phone: ' STATE OF CALIFORNIA ',REQUIRED ACCEPTANCE TESTS , MECHANICAL COMPLIANCE FORMS & WORKSHEETS (indicate if worksheet is included) " r For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2013 Nonresidential Manual Note: The. Enforcement Agency may t require all forms to be incorporated onto the building plans. Forms NRCC-MCH-04-E and NRCC-MECH-05-E are alternative forms to NRCC-MCH-01-E, NRCC-MCH-02-E and NRCC- MCH-03-E for projects using only single zone packaged HVAC systems. YES NO Form. Title - ~/ NRCC-MCH-04-E (1 of 2)' Certificate of Compliance. Required on.plans when used. NRCC-MCH-04-E (2 of 2) , Mechanical Acceptance Tests. Required on plans when used. NRCC-MCH-05-E (1 of 2) HVAC Prescriptive Requirements. It is required on plans when used. NRCC-MCH-05-E (2 of 2) - Mechanical SWH Equipment Summary is required for all submittals with service water heating, pools or spas. it is required on plans where applicable. STATE OF CALIFORNIA REQUIRED ACCEPTANCE TESTS :EC-NRCC-MCH-04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-04-E Required Acceptance Tests (Page 2 of 3) ``oiectName: Old Town Artisan Studio Date Prepared: 3/29/2015 Designer: This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for mechanical systems. The designer is required to check the applicable boxes by all acceptance tests that apply and list all equipment that requires an acceptance test. If all equipment of a certain type requires a test, list the equipment description and the number of systems. The NA number designates the Section in the Appendix of the Nonresidential Reference Appendices Manual that describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Enforcement Agency: Systems Acceptance. Before occupancy permit is granted for a newly constructed building or space, or a new space -conditioning system serving a building or space is operated for normal use, all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. Systems Acceptance. Before occupancy permit is granted. All newly installed HVAC equipment must be tested using the Acceptance Requirements.. The NRCC-MCH-04-E form is not considered a completed form and is not to be accepted by the building department unless the correct boxes are checked. The equipment requiring testing, person performing the test (Example: HVAC installer, TAB contractor, controls contractor, PE in charge of project) and what Acceptance test must be conducted. The following checked -off forms are required for ALL newly installed and replaced.equipment. In addition a Certificate of Acceptance forms shall be submitted to the building department that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of Section 10-103(b) and Title 24 Part 6. The building inspector must receive the properly filled out and signed forms before the building can receive final occupancy. Test Description MCH -02-A MCH -03-A MCH -04-A MCH -05-A MCH -06-A MCH -07-A MCH -11-A MCH -12-A MCH -14-A MCH -18-A Test Performed By: Equipment # of Outdoor , Single Zone Air Economizer Demand Supply Automatic FDD for Distribute Energy Requiring units Air Unitary Distribution Controls Control Fan VAV Demand Packaged d Energy Managem Testing or Duds Ventilation Shed DX Units Storage ent Verification (DCV) Control DX AC Control Systems System CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA REQUIRED ACCEPTANCE TESTS CEC-NRCC-MCH-04-E Revised 06114 J CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-04-E Required Acceptance Tests (Page 3 of 3) Project Name: Old Town Artisan Studio Date Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. /^ Documentation Author Name: Documentation Author Signature: ""' / Gina Rose Company: EQS,* Inc. Signature Date: 3/29/2015 Address: P.O. BOX 170 CEA/ HERS Certification Identification (if applicable): City/State/Zip: Gold Hill, OR 97525. Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT - I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 1 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building perm' it(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. { Responsible Designer Name: Responsible Designer Signature: Company: Date Signed: - Address: License: City/State/Zip: Phone: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance STATE OF CALIFORNIA WATER HEATING SYSTEM GENERAL INFORMATION CERTIFICATE OF COMPLIANCE NRCC-PLB-01-E Water Heating System General Information (Page 1 of 2) Project Name: Old Town Artisan Studio Date Prepared: 312912015 A. GENERAL INFORMATION/SYSTEM INFORMATION For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2013 Nonresidential Manual Note: The Enforcement Agency may require all forms to be incorporated onto the building plans. 1. Water Heater System Name: A O Smith Water Products ECT -30 2. Water Heater System Configuration: Non -Central 3. Water Heater System Type: 1 4. Building Type: 0.98 5. Total Number of Water Heaters in Systems: 1 6. Central DHW Distribution Type: n/a 7. Dwelling Unit DHW Distribution Type: Standard B. WATER HEATER INFORMATION Each water heater type requires a separate form. For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2013 Nonresidential Manual Note: The Enforcement Agency may require all forms to be incorporated onto the building plans. 1. Water Heater Type: Small Storage Electric 2. Fuel Type Electric Res 3. Number of Identical Water Heaters: 1 4. Efficiency: 0.98 5. 1 Required Minimum Efficiency: 0.98 6. Standby loss percent or Standby loss total: 0.000 7. Rated Input 15,359 8. Pilot Energy: Certificate of Installation, required on HERS verified central systems in high-rise residential, hotel/motel application. 9.' Water Heater Tank Storage Volume: 10 10. Exterior Insulation On Water Heater: 0 11. Volume of Supplemental Storage: 12. Internal Insulation on Supplemental Storage: 13. Exterior Insulation on Supplemental Storage: PLUMBING COMPLIANCE FORMS & WORKSHEETS (check box if worksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2013 Nonresidential Manual Note: The Enforcement Agency may require all forms to be incorporated onto the building plans. YES NO Form/Worksheet# Title ® ❑ NRCC-PLB-01-E Certificate of Compliance, Declaration. Required on plans for all submittals. ❑ ❑ NRCI-PLB-01-E Certificate of Installation. Required on plans for all submittals. ❑ ❑ NRCI-PLB-02-E Certificate of Installation, required on central systems in high-rise residential, hotel/motel application. t ❑ ❑ NRCI-PLB-03-E Certificate of Installation, required on single dwelling unit systems in high-rise residential, hotel/motel application. ❑ ❑ NRCI PLB-21-H Certificate of Installation, required on HERS verified central systems in high-rise residential, hotel/motel application. LJ ❑ NRCI-PLB-22-H Certificate of Installation, required on HERS verified single dwelling unit systems in high-rise residential, hotel/motel application. �OO NRCI-STH-01-E Certificate of Installation, required on any solar water heating CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA ' WATER HEATING SYSTEM GENERAL INFORMATION CEC-NRCC-PL&01-E Revised 06/14 CERTIFICATE OF COMPLIANCE Water Heating System General Information Project Name: Old Town Artisan Studio ' y N RCC -P LB -01-E (Page 2 of 2) Date Prepared: 3/29/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. ' I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Gina Rose Company: EQS, Inc. Signature Date: 3/29/2015, Address: P.O. BOX 170 . CEA/ HERS Certification Identification (if applicable): City/State/Zip: Gold Hill, OR 97525 Phone: 760-218-3350 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all.applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible i ner Name: 1� iVIJ Respo a signer Signat Company: %� / "ir✓ �-7 Date Signed:lnl-a Address: License: City/State/Zip: Phone: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance 1 ' June 2014 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Old Town Artisan Studio Date 3/29/2015 System Name Suite Floor Area 2,480 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 2 COIL CFM Total ROOM Loads 5,154 Return Vented Lighting Return Air Ducts Return Fan Ventilation 1,145 Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COOLING PEAK COIL HTG. PEAK Heating System Sensible Latent CFM Sensible Output perSystem 55,000 77,292 15,719 326 24,224 Total Output Btuh 110,000 0 Output Btuh/ ft 44.4 3,865 1,211 Cooling System 0 0 Output perSystem 57,000 45,183 12,238 1,145 53,251 Total Output Btuh 114,000. 0 3,865 1 130,204 27,958 0 Total output ons 9.5 1,211 Total Output Btuh/s ft 46.0 Total Output s ft/Ton 261.1 179,897 Air System CFM perSystem 2,000 HVAC EQUIPMENT SELECTION Airflow cfm 4,000 Existing Day and Night 91,644 15,996 68,703 Airflow cfm/s ft 1.61 68,703 Jan 1 AM Airflow cfm/Ton 421.1 Outside Air°/, 28.6% Total Adjusted System Output 1 91,644 (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK 15,996 Aug 3 PM Outside Air (cfm/ft 0.46 Note: values above given at ARI conditions HEATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak 26 OF 10t Outside Air 1,145 cfm 70 OF 57 OF 140 OF 140 OF Heating Coil Supply Fan 4,000 cfm 140 o F ROOM 70 OF COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 112/78°F Outside Air Ar 1,145 cfm 75/64°F 86/69°F 59/58°F 59/58°F c! 4' .. Cooling Coil Supply Fan 4,000 cfm ' a 60 / 58 OF 59.2 % 1. ROOM' r 74/64°F EneigyPro 6.4 by EnergySoft User Number.' 5862 RunCode: 2015-03-29709:08:19 ID: Page 32 of 32