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07-2753 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ' 07-00002753 c Property Address: 79680 HIGHWAY 111 STE 102 APN: 649-020-014-4 -31143 - Application description: REMODEL - COMMERCIAL Property Zoning: REGIONAL COMMERCIAL Application valuation: 122850 Applicant: Architect or Engineer: ----------------- UCE�ISED CONTRACTOR'S DEC4:FiATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury yrt I am licensed and �rdev.n isio of hapter 9 (commencing with Section 7000) of Division 3 of the Bu s'n s �td Professionsy cense is in f I force and effect. license Clas : B c No 4 9105 Date:Vontractor. L t OWNER.BUILDER DEC 4 ATION 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).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 1, 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 contractorls) licensed pursuant to the Contractors' State License Law.). 1 1 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 Name:. Lender's Address: LQPERMIT Owner: DUNES BUSINESS PARK LLC, THE 3550 W 6TH ST STE 400 LOS ANGELES, CA 90020 Contractor: BEST BUILT CONSTRUC' 6995 MISSION GROVE RIVERSIDE, CA 92506 (951)733-1675 Lic. No.: 419105 VOICE (760) 777-7012 _ FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/25/08 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 t� issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1396892-7 _ 1 certify that, in the perfor ce of the work for which this permit' i ued, I shall not employ any person in any manner as to become subject to the workers' om ensation laws of California, and agree that, iTub e subject tofpk s'co pen anon provisi ns Section 3700 of the Laborthwith coho ro sions. Dat Applicant: WARNING: AILURE TO SECURE WORKERS' COMPENSATION COVERAGUNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T- I ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of h pre mit cessation of work f 80 days will subject permit to cancellation. I certify that I have read this application and state th t above information is rrect I agr a to comply with all city and county ordinances and state laws relating to b it ing construction a h e auth riZ>? repre Lives of this c my t enter upon the above-mentioned pr r y for inspection r se . —�.-. Date: ~Signature (Applica t or Age Application Number . . . . . 07-00002753 ------- Structure Information EXISTING SHELL BLDG "C" SUITE 102 ----- Other struct info . . . . . CODE EDITION O1BMP04E05EN FIRE SPRINKLERS YES MIXED-USE OCCUPANCY A-3 B OCCUPANT LOAD 87.00 1ST FLOOR SQUARE FOOTAGE 2625.00 ----------------=----------------------------------------------------------- 2ND FLOOR SQUARE FOOTAGE .00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 720.00 Plan Check Fee 468.00 Issue Date . . . . Valuation . . . . 122850 Expiration Date 8/23/08 Qty Unit Charge Per Extension BASE FEE 639.50 23.00 3.5000 ---------------------------------------------------------------------------- THOU BLDG 100,001-500,000 80.50 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . 134.95 Plan Check Fee 33.74 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/23/08 Qty, Unit Charge Per Extension _ BASE FEE 15.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 6.00 3.0000 EA ELEC APPLIANCES 18.00 2.00 18.5000 EA ELEC SVC <=600V/<=200A 37.00 111.00 .4500 •------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 --------------------- 49.95 Permit . . . . . MECHANICAL Additional desc . Permit Fee . . . . 95.50 Plan Check Fee 23.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 8/23/08 Qty Unit Charge Per Extension BASE FEE 15..00 2.00 4.5000 EA MECH VENT INST/ DUCT ALT 9.00 3.00 6.5000 EA MECH VENT FAN 19.50 2.00 6.5000 EA MECH EXHAUST HOOD 13.00 6.00 `-6.5000 -------=-------------------------------------------------------------------- EA MECH OTHER MECH EQUIPMENT 39.00 LQPERAIIT Application Number . . . . . 07-00002753 Permit . . . PLUMBING Additional desc . Permit Fee . . 198.00 - Plan Check Fee 49.50 Issue Date Valuation . . . . 0 Expiration Date 8/23/08 Qty Unit Charge Per Extension BASE FEE 15.00 21.00 6.0000 EA PLB FIXTURE 126.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 .00 12.0000 EA PLB INTERCEPTOR .00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 7.5000 EA PLB OTHER BACKFLOW <=2 INCH 7.50 3.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 9.00 1.00 15.0000 EA PLB GAS METER 15.00 ---------------------------------------------------------------------------- Special Notes and Comments TENANT IMPROVEMENT SUITE 102 - "SCHLOTZSKY'S" [HACKBARTH CO.. ASSOCIATED RESTAURANTS) 2625 SF, A-3 OCCUPANCY TYPE ` V -N CONSTRUCTION. 87 OCCUPANT LOAD. 2001 CBC,CMC,CPC, 2004 CEC, 2005 -ENERGY CODES. ---------------------------- Other Fees . . . . . ------------------------------------------------ . . . . ACCESSIBILITY PLAN REVIEW 46.80 ENERGY REVIEW FEE 46.80 STRONG MOTION (SMI) - COM 25.79 Fee summary Charged --------------------------- Paid Credited ---------- Due Permit Fee Total -------------------- 1148.45 .00 .00 1148.45 Plan Check Total 575.12 .00 .00 575.12 Other Fee Total 119.39 .00 .00' 119.39 Grand Total 1842.96 .00 .00 1842.96 LQPERMIT '(9 Bin City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # r%r2�%Cj Project Address: 77 -00 11w 1 0/6 Owner's Name: A. P. Number: Address: 3S,ro e Legal Description: City, ST, Zip: /oS n CA Contractor: U� I Telephone: hone: Address: T16 I Project Description: T 1 rUje. City, ST, Zip: — r^O S Foy- !s : I Y14-e.v t Telephone: hone: T8 D <> .....................................: GWI 0 o k % ew ar State Lic. # : T&D. City Lic. #.: %rQp v S-ew i M e�t�.,�..il r— ' Arch., Engr., Designer: Address: Q H . c1tj1 City, ST, Zip: I -TV PA X7.2 6j y Tele hone: ;:.s::<:::.;: P 5 - 9 II C 0 )2S H 7 State Lic. #: C- l 6 3 Name of Contact Person: Mq rk _ %Sr . �� Construction cti n T o e: Type: Occupancy: V B P Y� A Z Project type (circle e one : New Add' „ e air Demo Sq. Ft.: Z y 5 7 # Stories: I # Units: I Telephone # of Contact Person: y1 j -7 Estimated Value of Project: 12 Z 01P -72,3- SAPPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted 1Q 1� 01 Item Amount Structural Calcs. Reviewed, ready for corrections 10 S Plan Check Deposit Truss Cates. Called Contact Person C Plan Check Balance, Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for correction issue Electrical Subcontactor List Called Contact Person i Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted M Grading IN HOUSE:- ''" Review, ready for corrections/issue D,Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Z . r�Jk Z,2 V COACH ELLA VALLEY WATER DISTRICT ASSEMR'S PARCAL NUMMU 8S99S Avenut S2 Cote belLt, Ctr<tifoml& 92236 (768)398-2651 APPLICATION FOR.WAST$WATERMUCBP't'ORIMARATOR APtROVAL APFLr-A r-.. Submit d& tam wM a aM of a scALw pb pjw (I' - W to 1',-.10' SCALA dswrn to • DWtict qmc i6� A nomelYna bWc � fw in mquhW wiles the-appliation is aibmieaL 'Cboek:gim.be made pwj" to the Valley Water DWuft Appmd of tbb sbaill remain valid lbr a period not to c==d oae (I) year Com dde of p"=wL PLo CbeckNo. AMoKQftiaot cCosWPmw Adhm My Stab Zip. (*f�Td*bme owwr Addeew city. Sulo Zip C9r1JTdepb— le11Aalo1r e iov C4 91gua, ?3 -//.?$ Jobl4opatrAddnar ciw 7Jp LewDaMofow + . T l< /s PLEASE COMPLETE THIS_SECTION FOR REVIEW OFFOOD ESTABLISHMENTS NOTRr PLANS WILL NOT u ACC6TI p UNimimA1' mATION IS COARl n Ali1D TAR nm amwK nz. a pAm GGPNR&tL COYMMUMON; Nw Food Faoi6br X Reowdel of BbtwS Food wMd", srt Ham of Opamim ` SatFo cw iw.. ht Md -: - Betaml EltemaSawbg:_w"Min=.arllpalaa :BarwhyFotidBaVfoc 8s•;iangodSavim WoWSodtww . liiarrrlee:. 1�[°IDsaviodfi+�b!°)'. Sia�eSavioe.�d�o�fe) .. O ATlVSD®CiARATIdNi. :l eat[tj/ ttiat I brveread the tofae.ap�lieatleo aod:mr6t6at ail ittb�.dm is erarat 1 �daatmd fhetthe amomtt of fee prid it bad as rqq despoilof kf=Mdit On ft j=nd.*0 bemnrf loRrsalon fa--pwM* c deaia cfdw ubmkW ply I dw noid Mw d &t phae wM be disaded d.ifad pie>Q :up wuia..abttq 00) '. of apt 0 0 a derilal gad dot m.inpootitta of my tooN sbsaat wN be eaodocted<or approval Sntd b.opaam um7 a1i txvpa mq«thd aed'pFivr ine been appmvedaad>dmned �� Dliia° //- 3a• � � 7 Mm I ;Ido.otSyata� �YpatdSY is) Na:Dwd>i thft 13 &%1& M_ 0miso ateocpwWaived� '[I �ameeuaea �. Nov D etilft Q UdTV 0 O Additloo O' caatea Q Corned to Sewer cI.I. REMAW; j o . 3 o•. Denied CoodidwW Approrata P«.: geek Ne. 14 -18 2702- •See.RmaQb Dila /a i taw s CVWD-921 RIVERSIDE CGUNTY COMMUNITY 4F -ALT -H -AGENCY FOOD ESTABLISHMENT PLAN APPROVAL NOTICE Plan Check # 9518 Project Name SCHLOTZSKrS Plans Submitted by MARK RABER Owner Address Date .11/20/07 Address 79-680 HWY 111, L.Q. Phone (949)250-4117 Phone The plans are now approved subject to the conditions listed below' and the attached compliance sheet. 1). Install approved finishes 3' around front drink station. Vinyl planks, rubber topset and acoustical ceiling panels are not approved in this area. Commercial sheet vinyl or quarry tile and vinyl ceiling panels are required. 2) Base cove inside of restrooms must be integral with the floor and form a 3/8" radius. 3) Quarry tile inside of kitchen must be smooth under equipment.. Textured tile may only be installed in traffic areas and walk -ways. 4) A sample of the "textured" tile must be submitted to this Department for review BEFORE installation. (CONT'D) 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 Dan Blum Phone (760) 320-1048 I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during construction: Signatiu Date 1/3 6/"o Company Name i ..v-ya -SS oG I DEH -SAN -178 (Rev 2/06) Corona Hemet Indio Murrieta Palm Springs Riverside 2275 S. Main St Suite 204 (951) 273-9140 800 S. Sanderson (951) 766-2824 47-950 Arabia St "A" (760) 863-8287 38740 Sky Canyon Dr 2500 N. Palm Canyon Dr (951) 461-0284. 4065 County Cir Fax (951) 520-8319 Fax (951) 766-7874 Fax (760) 863-8303 (760) 320=1048 Fax (951) 461.0245 Fax (760) 320.1470 (951) 358-5172 Fax (951) 358-5017 i RIVERSIDE'COUNTY CQMMUNrrY HEALTH AGENCY` SUPPLEMENTAL REPORT TO SAN. FORM # DATE 11/20/07 SUBJECT SCHLOTZSKY'S PLAN CHECK # 9518 ADDRESS 79-680 HWY 111, LQ INSPECTOR DAN BLUM REMARKS: 5) Remove insta-hot water heater and replace with a commercial approved, storage type water heater. Water heater must be a minimum 75 gallon and produce 76,000 btu's if gas or. 17total connected kilowatts if electric. 6) Install an NSF approved air curtain above back delivery door. Unit must be hard-wired'and micro -switch activated with no "on/off' or "high/low" switches. 7) Provide a certified' air balance report for exhaust hoods and make-up air. 8) Exhaust hoods and make-up air must be inner -connected by one common switch. 9) A sneeze guard may be required at front counter in front of soup warmers. Will evaluate at field inspections. 10) Install an approved RPP backflow assembly device on water line prior to soda carbonator. Device must drain indirectly to an approved floor sink. 11) Provide a grease interceptor sizing letter from Riverside County Environmental Health, Land Use, Division at (760) 393-3390. 12) Interior walls and flooring of trash enclosure must be smooth and sealed. John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the Cities of: Banning Beaumont Calimesa Canyon Lake Coachella Desert Hot Springs Indian Wells .; Indio Lake Elsinore La Quinta . Moreno Valley Palm Desert Perris Rancho Mirage San Jacinto 4. Temecula Board of Supervisors Bob Buster, District 1 John Tavaglione, District 2 Jeff Stone, District 3 Roy Wilson, District 4 Marion Ashley, District 5 t RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 77-933 Las Montanas Rd., Suite 201 • Palm Desert, California 92211 • (760)'863-8886 • Fax (760) 863-7072 October 24, 2007 Applicant: Tarlos and Associates 17802 Mitchell North Irvine, ca. 92614 (949) 250-4117 RE:. TENANT IMPROVEMENT PLAN CHECK LAQ-07-TI-120 / SCHLOTZSKY'S Fire Department personnel have completed a review of the plans you submitted for the above referenced project. Please be advised the following conditions or corrections must be completed and approved by the Riverside County Fire Department before a building permit can be issued. 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 2000 UBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the 2001 CBC. Fire sprinkler system plans for the tenant improvement area must be submitted to the Fire Department for review, along with a plan/inspection fee. A licensed C-16 contractor will have to submit plans for review and approval and modify the fire sprinkler system in accordance with NFPA 13, 1999 Edition. A licensed C-16 contractor shall do all sprinkler work and certification. The approved plans,, with Fire Department Job card must be at the job site for all inspections. Provide keys to the tenant space for -inclusion in the main building Knox Box. Key(s) shall have durable and legible tags affixed for identification of the correlating tenant space. Install Knox Lock Boxes, Models 4400, 3200 or 1300, mounted per recommended standard of the Knox Company. Plans must be submitted to the Fire Department for approval of mounting location/position and operating standards. Special forms are available from this office for the ordering of the Key Lock Boxes.. This form must be authorized and signed by this office for the correctly coded system to be purchased. If the building/facility is protected with a fire alarm system or burglar alarm system, the lock boxes will require "tamper" monitoring. Shelving, counters, etc., must be in place, however, no merchandise may be placed in the building prior to inspection 2300 Market Street, Suite 150 • Riverside, California • (951) 955-4777 : Fax (951) 955-4886 39493 Los Alamos Road, Suite A • Murrieta, California 92563 • (951) 600-6160 0 Fax (951) 600-6164 minimum 2A1013C 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. ELECTRICAL PANEL BOX: All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times. OTHER REQUIREMENTS: SPRINKLERS: - 1) A statement that the building will be automatically fire sprinklered must appear on the Title page of the building plans. OR 2) In lieu of fire sprinkler requirements, building(s) must be area separated as per Sec. 504.6.2 of the 2001 CBC. The separation must be continuous and must be of four 4 hour fire -resistive construction without openings. Approved. building address shall be placed in such a position as to be plainly visible and legible from the street and rear access if. applicable. Building address numbers shall. be a minimum of 12° for buildings) up to 25' in height, and 24" in height for building(s) exceeding 25' in height. In multi -tenant buildings, businesses shall post the business name and suite number on back doors as well as the front. Suite numbers or letters must be a minimum of 6° in height. All addressing. must be legible and of a contrasting color with the background and adequately illuminated to be visible from the street at all hours. A durable sign stating "This door to remain unlocked during business hours" shall be placed on or adjacent to the front exit' door. The sign shall be in letters not less than one inch high on a contrasting background. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re -inspection fee will be required if more than one (1) inspection is necessary. Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling (760) 863-8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering Staff at (760) 863-8886. , Singly, - i Colleen E. Estra Fire Safety Specialist~ 2300 Market Street, Suite 150 • Riverside, Califomia • (951) 955-4777 • Fax (951) 9554886 39493 Los Alamos Road, Suite A • Murrieta,'Califomia 92563 • (951) 600-6160 • Fax (951) 600-6164 CERTIFICATE OF COMPLIANCE (Part 1 of 4) LTG -1 -C PROJECT NAME DATE Schlotzsk 's 2/13/2008 PROJECT ADDRESS--- --- La- ' 79-680 Highway -111 t PRINCIPAL DESIGNER - LIGHTING TELEPHONE Building Permit # Tuan Anh Vu 949-250-4117 DOCUMENTATION AUTHOR Tarlos & Associates TELEPHONE (949) 250-4117 Checked by/Date Enforcement A enc Use GENERAL INFORMATION DATE OF PLANS BUILDING CONDITIONED FLOOR AREA ATE ZONE 10/05/07 2,624 sq.Ft. TCL'm 15 BUILDING TYPE ❑X NONRESIDENTIAL ❑ HIGH RISE RESIDENTIAL ❑ HOTEUMOTEL GUEST ROOM ❑X CONDITIONED SPACES ❑ UNCONDITIONED SPACES ❑ INDOOR & OUTDOOR SIGNS PHASE OF CONSTRUCTION ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION METHOD OF LIGHTING ❑ COMPLETE BUILDING AREA CATEGORY ❑ TAILORED ❑ PERFORMANCE COMPLIANCE ❑ COMMON LIGHTING STATEMENT OF COMPLIANCE This Certificate of Compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations. This certificate applies only to building lighting requirements. The documentation preparer hereby certifies that the documentation is accurate and complete. DOCUMENTATION AUTHOR SIGNATURE DATE Tuan Anh Vu a3 The Principal Lighting Designer hereby certifies that the proposed g design re&AJhXd Mis of or4s I I oc uments is consistent with the other compliance forms and worksheets, with the specificati nB�yiyiM„�T,ty #, a fitQNaCeL-tCAtidrF- i If i ed with this permit application. The proposed building has been designed to meet the ligh ing req ui rf1_e_�ts eantmnvd�m'-See tions 110, 119, 130 - 132, 146, 148 & 149 of Title 24, Part 6. /`1f- r 0 V V [y The plans & specifications meet the requirements of Part 6 (Sections 10-103a). FOR C NSTRUCTION ❑ The installation certificates meet the requirements of Part 6 (10-103a 3). ❑ The operation & maintenance information meet the requirements of Part 6 (10-103c).. DATE 2 OvBY� Please Check One: (These sections of the Business and Professions Code are pr—inted in 1,01 in the Nonresiaential Manuall Ii I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document as the person responsible for its preparation; and that I am licensed in the State of California as a civil engineer or electrical engineer, or I am a licensed architect. ❑ I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code by Section 5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed contractor performing this work. ❑ I affirm that I am eligible under the exemption to Division 3 of the Business and Professions Code to sign this document because it pertains to a structure or type of work described as exempt pursuant to Business and Professions Code Sections 5537, 5538 and 6737.1. PRINCIPAL LIGHTING DESIGNER - NAME SIGNATURE DATE, LIC. # Tuan Anh Vu cQ -/3- LIGHTING MANDATORY MEASURES Indicate location on plans of Note Block for Mandatory Measures LIGHTING COMPLIANCE FORMS & WORKSHEETS Check box if worksheet is included ®LTG -1-C, Parts 1 of 4 and 2 of 4: Certificate of Compliance. Part 1 of 4 and 2 of 4 are required for all submittals ❑LTG -1-C, Part 3 of 4: Certificate of Compliance. Part 3 of 4 submittal is required only if Control Credits are claimed ® LTG- 1-C, Part 4 of 4: Certificate of Compliance. Part 4 of 4 submittal is required when lighting controls are installed 19 LTG -2-C: Indoor Lighting Schedule IR LTG -3-C: Portable Lighting Worksheet ®LTG -4-C: Lighting Controls Credit Worksheet ®LTG -5-C: Indoor Lighting Power Allowance ❑LTG -6-C: Tailored Method Worksheet ❑LTG -7-C: Room Cavity Ratio Worksheet D ❑LTG -8-C: Common Lighting Systems Worksheet ❑LTG 2008 -9-C: Line Voltage Track Lighting Worksheet FEB19 EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number: 702.002 LU U Page: of 8 L13Y-----' �'erm'r5t' CERTIFICATE OF COMPLIANCE (Part 2 of 4) LTG -1-7C (PROJECT NAME DATE IL Schlotzsky's 2/13/2008 INSTALLED INDOOR LIGHTING POWER FOR CONDITIONED AND UNCONDITIONED SPACES INSTALLED LIGHTING, UNCONDITIONED SPACES (From LTG -2-C) 0 LIGHTING CONTROL CREDIT, UNCONDITIONED SPACES (From LTG -4-C) 0 UNCONDITIONED SPACE ADJUSTED INSTALLED LIGHTING POWER 0 ALLOWED INDOOR LIGHTING POWER FOR CONDITIONED SPACES ❑ COMPLETE BUILDING METHOD (From LTG -5-C) ALLOWED ❑X AREA CATEGORY METHOD (From LTG -5-C) WATTS ❑ TAILORED METHOD (From LTG -5-C) ALLOWED. LIGHTING POWER 3,397 ALTERNATE COMPLIANCE ❑ PERFORMANCE METHOD. ❑ COMMMON LIGHTING SYSTEM (From LTG -8-C) ALLOWED INDOOR LIGHTING POWER FOR UNCONDITIONED SPACES From LTG -5 -Cl 0 MANDATORY INDOOR AND DAYLIGHTING. AUTOMATIC CONTROLS CONTROL LOCATION (Room #) CONTROL IDENTIFICATION CONTROLTYPE (Auto Time Switch, Dimming, etc.) SPACE CONTROLLED Check if NOTE TO FIELD I EnergyPro 4.3 by EnergySoft . User Number: 5355 Job Number: 702.002 Paoe:2 of 8 INSTALLED WATTS INSTALLED LIGHTING, CONDITIONED SPACES (From LTG -2-C) 2,977 PORTABLE LIGHTING (From LTG -3-C) 0 LIGHTING CONTROL CREDIT, CONDITIONED SPACES (From LTG -4-C) 0 CONDITIONED SPACE ADJUSTED INSTALLED LIGHTING POWER 2,977 INSTALLED LIGHTING, UNCONDITIONED SPACES (From LTG -2-C) 0 LIGHTING CONTROL CREDIT, UNCONDITIONED SPACES (From LTG -4-C) 0 UNCONDITIONED SPACE ADJUSTED INSTALLED LIGHTING POWER 0 ALLOWED INDOOR LIGHTING POWER FOR CONDITIONED SPACES ❑ COMPLETE BUILDING METHOD (From LTG -5-C) ALLOWED ❑X AREA CATEGORY METHOD (From LTG -5-C) WATTS ❑ TAILORED METHOD (From LTG -5-C) ALLOWED. LIGHTING POWER 3,397 ALTERNATE COMPLIANCE ❑ PERFORMANCE METHOD. ❑ COMMMON LIGHTING SYSTEM (From LTG -8-C) ALLOWED INDOOR LIGHTING POWER FOR UNCONDITIONED SPACES From LTG -5 -Cl 0 MANDATORY INDOOR AND DAYLIGHTING. AUTOMATIC CONTROLS CONTROL LOCATION (Room #) CONTROL IDENTIFICATION CONTROLTYPE (Auto Time Switch, Dimming, etc.) SPACE CONTROLLED Check if NOTE TO FIELD I EnergyPro 4.3 by EnergySoft . User Number: 5355 Job Number: 702.002 Paoe:2 of 8 CERTIFICATE OF COMPLIANCE (Part 4 of 4) LTG - PROJECT NAME Schlotzsk 's DATE 2/13/2008 Designer:. This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for lighting systems. The designer is required to check the boxes by all acceptance tests that apply and list all equipment that require an acceptance test. If all equipment of a certain type requires a test, list the equipment description and the number of systems to be tested in parentheses. The NJ number designates the Section in the Appendix of the Nonresidential ACM Manual that describes the 'test. Also indicate the person responsible for performing the tests (i.e. the installing contractor, design professional or an agent selected by the owner). Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Building Departments: Before an Occupancy permit is granted for a newly constructed building or space, or a new lighting system system serving a building or space is operated for normal use, all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. In addition a Certificate of Acceptance, LTG -1-A, Forms shall be submitted to the building department that: A. Certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of§ 10-103(b) and Title 24 Part 6. Test Description Test Performed B ❑ LTG -2-A: Lighting.Control Acceptance Document - Occupancy Sensor Acceptance. - Manual Daylight Controls Acceptance - Automatic Time Switch Control Acceptance Equipment requiring acceptance testing ❑ LTG -3-A: ,Automatic Daylighting Controls Acceptance Document Equipment requiring acceptance- testing EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number: 702.002 Page:3 of 8 1 INDOOR LIGHTING SCHEDULE (Part 1 of 2) LTG -2-C PROJECT NAME DATE Schlotzsky's 1 2/13/2008 INSTALLED LIGHTING POWER FOR CONDITIONED SPACES Luminaire Lamps/Ballasts Installed Watts C D E F G H I J Name Type Description v3 nl r r. Z 3yQ N N m m o 3m. y root 5a- N '10D m m o r 9'm N y m dm _ 0 Q r �'oCr _ H X d v N rD a Yes A/AE�11e18w Compact Fluorescent Triple 4 Pin CFM 18W/GX24 -2 1 18 1.0 21.0 X 401 840 �) 18w Compact Fluorescent Quad 4 Pin lec C FO 1 8WLG24q--2-1 18 1.0 21.0 X 1 21 PleCBW Compact Fluorescent Triple 4 Pin FM 18W/GX24 -2 11 18 1.0 21.0 X 9 189 B P) 18w Compact Fluorescent Triple 4 Pin lec CFM 18W/GX24 -2 1 18 1.0 21.0 X 8 168 C 20w Low Voltage Halogen matt L 1 20 1.0 23.0 X 7 161 D/D1 20w Low Voltage Halogen O -Nat 1 7 161 F (1) 4 ft Fluorescent T8 Rapid Start Elec 2 1 32 1.0 32.0 X 8 256 G/GE (3) 4 ft Fluorescent T8 Rapid Start Elec I3 2 1 7 651 (2) 4 ft Fluorescent T8 Rapid Start Elec 2 32 1.0 62.0 X 2 124 H P) 55w Lng Cmpt T5 Fluorescent Twin lecM 11 1 55 1.0 58.0 X 7 406 PAGE TOTAL 2 977 BUILDING TOTAL (sum of all pages) 2,977 PORTABLE LIGHTING (From LTG -3-C) W CONTROL CREDIT (From LTG -4-C) � 0 ADJUSTED ACTUAL WATTS 977 EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number: 702.002 Page:4 of 8 PORTABLE LIGHTING WORKSHEET LTG -3-C (PROJECT NAME tz_7DATE Schlosk 's 2/13/2008 TOTAL WATTS BUILDING TOTAL TABLE 1 - PORTABLE LIGHTING NOT SHOWN ON PLANS FOR OFFICE AREAS >250 SQUARE FEET A B C D ROOM # OR ZONE ID DEFAULT (Wfsgft) AREA (SF) TOTAL WATTS (B X C) # OF FIXT. LUMIN. TASK WATTS PER AREA FIXTURE (SF) # OF TASK AREAS TOTAL AREA (SF) (D x E) TOTAL WATTS (C x E) TOTALI. 0 0 TABLE 2 - PORTABLE LIGHTING SHOWN ON PLANS FOR OFFICE AREAS >250 SQUARE FEET TOTAL WATTS BUILDING TOTAL 0 0 A B C D E F G ROOM # OR ZONE ID PORTABLE LIGHTING Description # OF FIXT. LUMIN. TASK WATTS PER AREA FIXTURE (SF) # OF TASK AREAS TOTAL AREA (SF) (D x E) TOTAL WATTS (C x E) TOTAL 0 0 TABLE 3 - PLANS SHOW PORTABLE LIGHTING IS NOT REQUIRED FOR OFFICE AREAS > 250 SQUARE FEET ROOM # TOTAL AREA OR ZONE ID (SF) TOTAL 0 BUILDING SUMMARY - PORTABLE LIGHTING Designer needs to provide detailed documentation that the lighting level provided by the overhead lighting meets the needs of the space. The details include luminaire types and mounting locations relative to work areas. BUILDING SUMMARY TOTAL AREA (SF) (FROM TABLES 1+2+3) TOTAL WATTS BUILDING TOTAL 0 0 EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number 702.002 Page:5 of 8 INDOOR LIGHTING- POWER ALLOWANCE LTG - PROJECT NAME Schlotzsk 's DATE 2/13/2008 ALL WED LIGHTING POWER (Choose ne Method) COMPLETE BUILDING METHOD - CONDITIONED SPACES ALLOWED WATTS WATTS PER SF COMPLETE BLDG. AREA ALLOWED WATTS BUILDING CATEGORY (From Section 146 Table 146-13) AREA CATEGORY METHOD - CONDITIONED SPACES WATTS PER SF AREA (SF) ALLOWED WATTS AREA CATEGORY (From Section 146 Table 146-C) Corridor/Restroom/Support 0.60 209 125 Office 1.20 40 48 Kitchen Food Preparation 1.60 1,223 1,9571 Dining 1.10 1,152 1,267 0 EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number: 702.002 Page:6 of 8 PAGE TOTAL 2,624 3,397 BUILDING.TOTAL 2,624 3,397 AREA WATTS TAILORED METHOD - CONDITIONED SPACES TOTAL ALLOWED WATTS (From LTG -6-C or from computer run.) UNCONDITIONED SPACES Complete Building and Area Catagory Methods Category (From Section 146 Table 146 -B&C) WATTS PER SF AREA (SF) ALLOWED WATTS PAGE TOTAL BUILDING TOTAL O �� AREA WATTS TAILORED METHOD - UNCONDITIONED SPACES TOTAL UNCONDITIONED SPACES ALLOWED WATTS (From LTG -5-C and LTG -6-C) 0 EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number: 702.002 Page:6 of 8 LIGHTING MANDATORY MEASURES LTG -MM PROJECT NAME Schlotzs DATE 2/13/2008 DESCRIPTION Designer Enforcement RX §131(d)1 For every floor, all interior lighting systems shall be equipped with a separate automatic control to shut off the lighting. 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. X] §131 (d)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. FX §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. 0 §111 Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for the project are certified and listed in the Directory. All installed fixtures shall be certified. R§132 Tandem Wiring for One and Three Lamp Fluorescent Fixtures: All one and three lamp fluorescent fixtures are tandem wired with two lamp ballasts where required by Standards Section 132; or all one and three lamp fluorescent fixtures are specified with electronic high -frequency ballasts and are exempt from tandem wiring requirements. X§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. X❑ §131(b) Uniform Reduction for Individual Rooms: All rooms and areas greater than 100 square feet and more than 0.8 watts per square foot of lighting load shall be controlled with bi-level switching for uniform reduction of lighting within the room. §131(c) Daylight Area Control: All rooms with windows and skylights that are greater than 250 square feet and that allow for 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 adjacent lot. Diagram of shading during different times of the year is included on plans. ® §131(e) Display Lighting. Display lighting shall be separately switched on circuits that are 20 amps or less. EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number: 702.002 Page:7 of 8 LIGHTING INSPECTION CHECKLIST LTG -I PROJECT NAME INSPECTION DATE Schlotzskv's 2/13/2008 FIXTURE CODE TYPE DESCRIPTION LAMP TYPE LAMP QUANT. NUMBER OF FIXTURES WATTS PER FIXTURE FIELD NOTES A/AE 1 18w Compact Fluorescent Triple 4 Pin Elec CFM 1 40 21.0 Al/A1E 1 18w.Compact Fluorescent Quad 4 Pin Elec 1 1 21.0 Al/A1E 1 18w Compact Fluorescent Triple 4 Pin Elec CFM 1 9 21.0 .B 1 18w Compact Fluorescent Triple 4 Pin Elec CFM 1 8 21.0 C 20w Low Voltage Halogen 220 Watt 1 7 23.0 D/D1 20w Low Voltage Halogen ArRaft 1 7 23.0 F 1 4 ft Fluorescent T8 Rapid Start Elec HH8 1 8 32.0 G/GE 3 4 ft Fluorescent T8 Rapid Start Elec F32T8 3 71 93.0 G1/GlE 2 4 ft Fluorescent T8 Rapid Start Elec F32T8 2 2 62.0 H 1 55w Lng Cmpt T5 Fluorescent Twin Elec 1 .7 58.0 Type DESCRIPTION MH METAL HALIDE INC INCANDESCENT INC/LV INCANDESCENT LOW VOLTAGE CFL COMPACT FLUORESCENT FL FLUORESCENT O OTHER EnergyPro 4.3 by EnergySoft User Number: 5355 Job Number: 702.002 Page:8 of 8 1 ,- Certificate of Occupancyo OF 9► Y p 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 4 construction and/or use. BUILDING ADDRESS: 79-680 HIGHWAY 111, STE. 102 Use classification: COMMERCIAL — SCHLOTZSKY'S Building Permit No.: 07-2753 Occupancy Group: A3 Type of Construction: V -N Land Use Zone: CC Owner of Building: DUNES BUSINESS PARK, LLC Address: 3550 W. 6T" STREET, STE. 400 City, ST, ZIP: LOS ANGELES, CA 90020 By: AJ ORTEGA Date: JUNE 27; 2008 Building Official ` POST IN A CONSPICUOUS PLACE