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11-1050 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:1�— 1-00001050• Property Address: 79775 'HIGHWAY1111 APN: 600 -020 -034 - Application description: REMODEL - COMMERCIAL Property Zoning: COMMERCIAL PARK Application valuation: 20000 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: KOMAR INV 23 CORPORATE PLZ STE 247 NEWPORT BEACH, CA 92660 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/07/11 Contractor' Applicant: Architect or Engineer: K M S CONSTRUCTION SER 23 CORPORATE PLAZA, #a' NEWPORT BEACH, CA 92 a�^ (949)718-4844Qy Lic. No.: 932143 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 Professionals Code, and my License is in full force and effect. Lice a Classs: 13-C10 Lice? a o.: 932143 Date:-7-7--Z ///7� f6ntractor: % / 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).: (_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the, burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (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.). (_ 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 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-insuie 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. Y 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 ZURICH INS Policy Number WC486597005 _ 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 wi h those provisions. ate: Il� plicant: �lilA�•�'y � d � / �-' WARNING: FAILURTO ECURE WORKERS' 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 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 within180 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 county to enter upo the above-mentioned property for inspection purposes. �MsG� S' nat Date, (Applicant or Agent): Application Number . . . . . 11-00001050 ------ Structure Information SUITE 101/102 DEMISING WALL ----- Other struct info . . . . . CODE EDITION 2010 FIRE SPRINKLERS FULLY MIXED-USE OCCUPANCY N/A ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 2651.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . Permit Fee . . . . - 68.02 Plan Check Fee 17.01 Issue Date . . . . Valuation 0 Expiration Date 5/05/12 Qty Unit Charge Per Extension BASE FEE 15.00 2651.00 .0200 ---------------------------------------------------------------------------- ELEC GARAGE OR NON-RESIDENTIAL 53.02 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 207.00 Plan Check Fee 134.55 Issue Date . . . . Valuation . . . . 20000 Expiration Date . . 5/05/12 Qty Unit Charge Per Extension BASE FEE 45.00 18.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 162.00 Permit . . . MECHANICAL Additional desc . Permit Fee 37.00 Plan Check Fee 9.25 Issue Date . . . Valuation . . . . 0 Expiration Date 5/05/12 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 4.5000 EA MECH VENT INST/ DUCT ALT 9.00 2.00 6.5000 •----------------------------------- EA MECH VENT FAN ----------------------------------------- 13.00 Permit PLUMBING Additional desc . Permit Fee . . . . 60.00 Plan Check Fee 15.00 Issue Date Valuation 0 Expiration Date 5/05/12 Qty Unit.Charge Per Extension LQPERMIT Application Number . . . . . 11-00001050 Permit . . . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 4.00 6.0000 EA- PLB FIXTURE 24.00 2.00 7.5000 EA' PLB WATER HEATER/VENT 15.00 2.00 3.0000 EA PLB WATER INST/ALT/REP 6.00 ---------------------------------------------------------------------------- Special Notes and Comments 2,651SF SHELL IMPROVEMENT/VB/FULLY SPRINKLED [SUITE 101/102 DEMISING WALL] UNISEX BATHROOM, T -BAR AND LIGHTING AT EACH SUITE. THIS PERMIT DOES NOT GRANT BUILDING OCCUPANCY. 2010 CALIFORNIA BUILDING CODES. November 3, 2011 2:51:42 PM AORTEGA ---------------------------------------------------------------------------- Other Fees ... . . . . . . . ACCESSIBILITY PLAN REVIEW 13.46 ENERGY REVIEW FEE .13.46 Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 372.02 .00 .00 372.02 Plan Check Total 175.81 .00 .00 175.81 Other Fee Total 26.92 .00 .00 26.92 Grand. Total 574.75 .00 .00 574.75 Bin. # C% . .: . . city Of is Qutnta Building & Safety Ai&6r; P.O. Box 1504,78-495 Calle Tampico 1a.Qutnta, CA 92253 - (760) 777-7012 Building Permit Applicatlon' and Tracking Sheet Permit # 50 Q Project Address: 7S , Owner's Name:. APL DSS 12 + Pe&fY? 1 es U A P. Number. �� 3 Address: 2-3 &0P—PbeAw—t PLA2!A Legal Description: ( City, ST, Zip/,!T . C�► ` 2- �P�U Contractor:Telepho �A,N{��y, -71�� Address: 23 dCA / v 12A% PLAZA Project Description: City. ST- zip: KifwPoQ% t::n Z a Q D M.iS; P r- weal) iW A ai- Telephon : g(-}� L L Ani C2- A e 7a State Lie. #: City Lie'. #; g(f f A A C f k . UAN t .A Arch., Engr., Designer. Address: City., ST, Zip: Telephone: w Construction Type:. Occupancy: State Lie. #: , ~ v Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: (G��(� Sq. Ft.:#Stories: 1 # unity: [Estimated Telephone # of Contact Person: 3 = Q o Value of Project: Z Q APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Plan Sets Req'd Recd TRACMG PERMIT FEES Plan. Check submitted Amount Structural Caica Reviewed, ready for corrections )0 t 1� Plan Check Deposit. . Truss Calcs. Called Contact PersonPlan Check Balance lob Tule 24 Cates. t� Plans picked up Construction Flood plain plan X8/1 Plans resubmitted, . la+ �Q Mechanical Grading plan 2'' Review, ready for correctio Null Electrical Subcontactor List Called Contact PersonYlumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review; ready for correctlonsiissue Developer Impact Fee Planning Approval Called Contact Person J.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 4C. oft. `�i1'i4tt .0 6(4p Q9b(rC4(J P.O. BoA 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 To: Greg Butler, Building & Safety Manager From: Les Johnson, Director -Planning Permit #: BUILDING & SAFETY DEPARTMENT (7 60) 777-7012 FAX (760) 777-701 1 To CDD: q- Due Dater'" Status:_ 45Z e./G Building Plans Approval (This is an approval to issue a Building Permit) The Planning Department has reviewed the Building Plans for the following project: Description: T ! Address or General Location: % ,9� % -7,5 1 0 Applicant Contact: q?d, The Planning Department finds that: ❑ ...these Building Plans do not require Planning Department approval. ...these Building ❑ ...t ese Building alta ed correct plea return the Le 1 ins are approved by the Planning Department. ans require corrections. Please forward a copy of the is to the applicant: When the corrections are made to the Planning Department for review. lanning 0-//l e SEP 2 S 2011 City of La �t;intct i'tc�n�tin'? U��c7t:713;�t Date 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 PALM DESERT PERRIS RANCHO MIRAGE RUBIDOUX CSD SAN JACINTO TEMECULA WILDOMAR BOARD OF SUPERVISORS: BOB BUSTER DISTRICT 1 JOHN TAVAGLIONE DISTRICT 2 JEFF STONE DISTRICT 3 JOHN BENOIT DISTRICT 4 MARION ASHLEY DISTRICT 5 RivERsiDE CouNTY FIRE DEPARTMEW IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION October 3, 2011 John R. Hawkins ~ Fire Chief 210 West San Jacinto Avenue — Perris, CA 92570 (951) 940-6900 — www.rvcfire.org �--,-- _ OCT 2 0 2011v I'I' 1 RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural RE -DESIGN -_-�- LAQ-II-TI-036 Komar Desert 79-775 Hwy 111 #101-102 La Quinta, CA You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN OCCUPANCY PERMIT. It is prohibited to use/process or store any materials in this occupancy that would classify it as an "H" occupancy per Sec. 307 of the 2010 CBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the 2010 CBC. A minimum 2AIOBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible location within 75' walking distance from any point in your building or suite. Fire extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the extinguisher, or purchased from a retail store with a sales receipt 'attached. A licensed fire extinguisher company must service extinguisher yearly. All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times. Approved suite addresses shall be placed in such a position to be plainly visible and legible from the street. Said numbers shall contrast with their background. An approved audible interior notification alarm device shall be provided in approved location. A C-1 O 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 or adjacent to the front exit door. The sign shall be in letters not less than one inch high on a contrasting background. Provide key(s) to the tenant space for inclusion in the main building Knox Box. Key(s) shall have durable and legible tags affixed for identification of the correlating tenant space. Key(s) shall be provided at time of final inspection. As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire sprinkler system plans for the tenant improvement area may be required to be submitted to the Fire Department for review. K 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. Sincerel M, By: J on Stubble Fi Safety Specialist J BUILDING ENERGY ANALYSIS REPORT PROJECT: Komar Desert Center . 79-775 HWY 111 Suite 101 La Quinta, CA 92253 1 1 Project Designer: G Design Report Prepared by: Michael Dell DELL CO. 1629 York Drive Vista, Ca 92084 760-940-0064 0 CITY OF LA QUINTA ' BUILDING & SAFETY DEPT. APPROVED Job Number: FOR CONSTRUCTION _ 9-2611 DATE 1� � �'� BY Date: 11 /4/2011 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www.energysoft.com. TABLE OF CONTENTS Cover Page Table of Contents Form LTG -1 -C Certificate of Compliance Form LTG -3-C Indoor Lighting Power Allowance Form LTG -MM Lighting Mandatory Measures EnergyPro 5.1 by EnergySoft Job Number: ID: 9-2611 User Number. 1712 1 2 3 7 8 CERTIFICATE OF COMPLIANCE Part 1 of 4 LTG-1C Project Name Date Komar Desert Center 11/4/2011 Project AddressZone Total Cond. Floor Area Unconditioned Floor Area 79-775 HWY 111 Suite 101 La Quinta 77Climate 15 1,296 0 GENERAL INFORMATION Building Type: CEJ Nonresidential ❑ High-Rise Residential ❑ HoteUMotel Guest Room ❑ School ❑ Relocatable Public m Conditioned Spaces ❑ Unconditioned Spaces School Phase of Construction: m New Construction O Addition ❑ Alteration Method of Compliance: ❑ 'Complete Building m Area Category ❑ Tailored Documentation Author's Declaration Statement I certify that this Certificate of Compliance documentation is accurate and complete. Signature Name Michael Dell Date Company DELL CO. 11/42011 Address 1629 York Drive CEA # CEPS # CEA NR08-10-576 City/State zip Phone Vista, Ca 92084 760.940-0064 The Principal Lighting Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professional Code to accept responsibility for the lighting design. • This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Pages 1 and 6 of the California Code of Regulations. • The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Name G Designs Signature ' v Company Phone G Design Address License # City/State/Zip Date Lighting Mandatory Measures Indicate location on building plans of Mandatory Measures Note Block: LIGHTING COMPLIANCE FORMS & WORKSHEETS check box if worksheets is Included For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms; please refer to the Nonresidential Manual published by the California Energy Commission. m LTG-1 C Pages 1 through 4 Certificate of Compliance. All Pages required on plans for all submittals. ❑ LTG-2C Lighting Controls Credit Worksheet E3 LTG-3C Indoor Lighting Power Allowance ❑ LTG-4C Pages 1 through 4 Tailored Method Worksheet ❑ LTG-5C Pages 1 and 2 Line Voltage Track Lighting Worksheet Ener Pro 5.1 by Enefgysoft User Number., 1712 RunCode: 2011-11-04713:53:36 !D: 9-2611 Page 3 of 8 CERTIFICATE OF COMPLIANCE (Part 2 of 4) LTG -1C Project Name Komar Desert Center Date 11/4/2011 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Installation Certificate LTG -1- INST Retain a copy and verily form is completed and signed.) Field Inspector ❑ Certificate of Acceptance, LTG -2A and LTG -3A (Retain a copy and verify form is completed and si ned.) Field Inspector ❑ A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces Installed Lighting Power listed on this Lighting Schedule is only for: ® CONDITIONED SPACE ❑ UNCONDITIONED SPACE ® The actual indoor lighting power listed below includes all installed permanent and portable lighting systems in accordance with §146(a). Only for offices: Up to the first 0.2 watts per square foot of portable lighting shall not be required to be included in the ® calculation of actual indoor lighting power density in accordance with the Exception to §146(a). All portable lighting in excess of 0.2 watts per square foot is totaled below. Luminaire(Type,Lamps, Ballasts Installed Watts A B C D E F G H None Itm T ' Complete luminaire Description' (Le, 3 lamp fluorescent troffer,3 MM one dimmable electronic ballasts m E J How wattage Was determined oro E Ec Z 3 X e o t'1 Feld Inspectorz CEC Default From NA8 m o Co S IE 0 o w, § H L a _ . f LL A (2) 4 R Fluorescent T8 Rapid Stag Elec 62.0 0 ❑ le 1,116 ❑ ❑ B (1) 18w Long Compt Fluorescent T5 Twin Pin 23.0 ❑ ❑ 1 23 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ O ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Installed Watts Page Total: 1,136 Building total number of pages: Installed Watts Building Total Sum of all pages) 1.139 Enter into LTG -1 C Pacie 4 of 4 1. Wattage shall be determined according to Section 130 (d and e). Wattage shall be rating of light fixture, not rating of bulb. 2. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnemvPro 5.1 by EnergySoft User Number. 1712 RunCode: 2011-11-04T13:53:36 ID: 9-2611 Page 4 of 8 CERTIFICATE OF COMPLIANCE Part 3 of 4 LTGA C Project Name Komar Desert Center Date 11/4/2011 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Fill in controls for all spaces: a) area controls, b) multi-level controls, c) manual daylighting controls for daylit areas > 250 te, automatic daylighting controls for daylit areas > 2,500 fe, d) shut-off controls, e) display lighting controls, f) tailored lighting controls — general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls for retail stores > 50,000 fe, in aocordance with Section 131. MANDATORY LIGHTING CONTROLS — FIELD INSPECTION ENERGY CHECKLIST Field Inspector Number Special Type/ Description of Units Location in Buildina Features Pass Fail Auto Time Switch 1 Suite 101 Electrical rm ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ D ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ " ❑ ❑ ❑ ❑ ❑ ❑ O ❑ ❑ ❑ D O ❑ ❑ ❑ ❑ ❑ D ' ❑ ❑ ❑ SPECIAL FEATURES INSPECTION CHECKLIST See Page 2 of 4 of LTG -1C The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification. The local enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. Field Inspector's Notes or Discrepancies: EnergyPro 5. 10 EnergySoft User Number. 1712 RunCode: 2011-11.04713:53:36 ID: 9-2611 Pae 5 of 6 CERTIFICATE OF COMPLIANCE Part 4 of 4 LTG -1C Project Name Komar Desert Center Date 11/4/2011 CONDITIONED AND UNCONDITIONED SPACE LIGHTING MUST NOT BE COMBINED FOR COMPLIANCE Indoor Lighting Power for Conditioned S aces Indoor Lighting Power for Unconditioned Spaces Watts Watts Installed Lighting 1139 from Conditioned LTG -1C Page 2 , Installed Lighting 0 from Unconditioned LTG -1C Page 2 Lighting Control Credit _ 0 Conditioned Spaces from LTG -2C Lighting Control Credit _ 0 Unconditioned Spaces from LTG -2C Adjusted Installed N1 139 Lighting Power Adjusted Installed __ 0 Lighting Power Complies if Installed:5 Allowed Complies if Installed:5 Allowed Allowed Lighting Power Conditioned Spaces from LTG -3C or PERF -1 1,152 Allowed Lighting Power Unconditioned Spaces from LTG -3C 0 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for the Lighting system, LTG -2A and LTG -3A. The designer is required to check the acceptance tests and list all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. If all the lighting system or control of a certain type requires a test, list the different lighting and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Forts can be grouped by type of Luminaire controlled. Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or when ever new lighting system with controls is installed in the building or space shall be certified as meeting the Acceptance Requirements. The LTG -2A and LTG -3A forms are not considered complete forms and are not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Title 24 Part 6. The field inspector must receive the property filled out and signed forrns before the building can receive final occupancy. A copy of the LTG -2A and LTG -3A for each different lighting luminaire control(s) must be provided to the owner of the building for their records. Luminaires Controlled LTG -2A and LTG -3A Controls and Equipment R uirin Testing • Description Number of Luminaires controlled Location Sensors and Automatic Daylighting Controls Acceptance ATS Auto Time Switch 19 Suite 101 ❑ 13 13 13 13 13 13 13 13 ❑ EnemyPro5.1byEnemYSoJ1 User Number. 1712 RunCode: 2011-11-04713:W.36 ID: 9-2611 Pae 6 of a INDOOR LIGHTING POWER ALLOWANCE LTG -3C Project Name Komar Desert Center Date 11/4/2011 ALLOWED LIGHTING POWER Chose One Method A Separate LTG -3C must be filled out for Conditioned and Unconditioned Spaces. Indoor Lighting Power Allowances listed on this page are only for: ® CONDITIONED SPACES 0 UNCONDITIONED SPACES COMPLETE BUILDING METHOD WATTS BUILDING CATEGORY From 5146 Table 146-E PER ft X COMPLETE BLDG. AREA = ALLOWED WATTS TOTALS AREA WATTS AREA CATEGORY METHOD WATTS BUILDING CATEGORY From §146 Table 146-F PER (ft) X Area ft' = ALLOWED WATTS Office > 250 sgft 0.90 1,247 1,122 ConftrlRestroomlSupport 0.60 49 29 TOTALS 1,296 1,152 AREA WATTS TAILORED METHOD Total Allowed Watts usina the Tailored Method taken from LTG -4C Pae 1 of 4 Row 3 0 The indoor lighting power allowance using the Tailored Method of compliance shall be determined using the LTG -4C set of forms. A separate set of LTG - 4C forms shall be filled out for CONDITIONED and UNCONDITIONED spaces En Pro 5.1 by EnerovSoft User Number. 1712 RunCode: 2011-1144Tr3:53:36 ID. 9-2611 Pae 7 of 8 LIGHTING MANDATORY MEASURES: NONRESIDENTIAL LTG -MM Project Name Date Komar Desert Center 11/4/2011 Indoor Lighting Measures: §131(d): Shut-off Controls For every floor, all interior lighting systems shall be equipped with a separate automatic control to shut off the lighting. 1. This automatic control shall meet the requirements of Section 119 and may be an occupancy sensor, automatic time switch or other device capable of automatically shutting off the righting. 2 Override for Building Lighting Shut-off: The automatic building shut-off system is provided with a manual, accessible override switch in si ht of the lights. The area of override is not to exceed 5,000 square feet. §119(h): Automatic Control Devices Certified: All automatic control devices specified are certified, all alternate equipment shall be certified and installed as directed by the manufacturer. §111: Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for the project are certified and listed in the Directory. All installed fixtures shall be certified. §131(a): Individual Room/Area Controls: Each room and area in this building is equipped with a separate switch or occupancy sensor device for each area with floor -to -ceiling wails. Uniform Reduction for Individual Rooms: All rooms and areas greater than 100 square feet and more than 0.8 watts §131(b): per square foot of lighting load shall be controlled with bi-level switching for uniform reduction of lighting within the room. Daylight Area Control: All rooms with windows and skylights that are greater than 250 square feet and that allow for §131(c): the effective use of daylight in the area shall have 50% of the lamps in each daylit area controlled by a separate switch; or the effective use of daylight cannot be accomplished because the windows are continuously shaded by a building on the adjacent lot. Diagram of shading during different times of the year is included on plans. §131(c): Display Lighting. Display lighting shall be separately switched on circuits that are 20 amps or less.6. Outdoor Lighting Measures: §130(c)1: Mandatory lighting power determination for medium base sockets without permanently installed ballasts §132(a): All permanently installed luminaires with lamps rated over 100 Watts either have a lamp efficacy of at least 60 lumens per Watt or are controlled by a motion sensor. §132(b): All Luminaires with lamps rated greater than 175 Watts in hardscape area, including parking lots, building entrances, canopies, and all outdoor sales areas meet the Cutoff Requirements. §132(c)1: All permanently installed outdoor lighting meets the control requirements listed. §132(c): Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements listed. Ener Pro 5. 1 by EnefgySoft User Number: 1712 RunCode: 2011-11-04T13:53:36 ID: 9-2611 Pae 8 of 8 C19RTMCATE OF ACCEPTANCE LTG -2A Lighting Control Acceptance Document ea - e I of 3 Project Name/Address: K -a V, Vs ��- . Lei 1A 1"'U a F61( System Name or Identification/Tag: =_ . _ System Location or Area Served: kms% Enforcement Agency: Permit Number: Field echftici toP ' f . O5,O Note: Submit one Certificate of Acceptance for each system thatfnforeement Agency:Use Checked by/Date must demonstrate compliance. =_ . _ FIELD TECHNICIAN'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the person who performed the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I. certify that the constructiontinstallation identified on this form complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. • I have confirmed that the Installation Certificates) for the construction/installation identified on this form has been completed and is posted or made available with the building permit(s) issued for the building. Company Na. f ,t Field Technic Ian's Name: Field echftici toP !VilJPeJ r/J,p - - .; Date n : Position With Company (Title): continued on next page RESPONSIBLE PERSON'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, that I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this form. • 1 am a licensed contractor, architect, or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person). • I certify that the information provided on this form substantiates that the construction/installation identified on this form complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. • 1 have confirmed that the Installation Certificate(s) for the constructionrrnstallation identified on this form has been completed and is posted or made available with the building permits) issued for the building. • I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: Phone: Responsible Perso . Name: ` ve !VilJPeJ License: Date §igne Position With Company (Title): ,1 continued on next page Occupant Sensor, Manual Daylighting Control, and Automatic Time Switch Control Intent: Lights are turned off when not needed per Section 119(d) & 131(d). Construction Inspection I Instrumentation to perforTn test includes, but not limited to - a. Hand-held amperage and voltage meter b. Power meter continued on next page 2008 Nonresidential Acceptance Forms RECEIVED BY: August 2009 RX Date/Time 0210612012 11:57 02/06A2012 12:55 8182402800 FEffRTIFICATE OP ACCEPTANCE 5.1 Outdoor AiIr Aece tante roject N�me/Address: Name or Identificationfrag: .1 .-t .Enforcement Agency: Note: Submtt one Certificate of Acceptance for each system that must demonstrate compliance. 8182402800 P.001 PRECISE AIR SYSTEMS PAGE 01/06 System Location or Area Served: Permit Number: it - eo�o bztfnrecmenr.Aguicy Usa=GSeckcd bytpatc', I of FIELD TECHNICIAN'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the person who performed the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • 1 terrify that the construc6on/installation identified on this form complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures Specified in Reference Nonresidential Appendix NAT • I have confirmed that the Installation Cerrificate(s) for the constructionlinstallation idcndfied on this form has been posted or made available with the building .,�,,.,:rr�� ;�., a C-- _ , •... completed and is nr=QrvnaraL,t VtKSQN'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws Of the State of California, that I am the Field Technician, or the Field Tcohnician is acting on my behalf as my employee or my agent and t have reviewed the information provided on this form, • I am a licensed contractor, architect, or ougitteer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specked on this document and attest to the declarations in this statement (responsible person). • I certify that the information provided on this form substantiates that the construction/installation identified on this form complies with the acceptance requirements indicated in the plans and Specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT • I have confirmed that the Installation Ccrtificate(s) for the construction/insiallation identified on this forth has been completed and is posted or made available with the building permit(s) issued for the building. • I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentarian tt,a f,,,:ia , : , _ — _ ,_ 2008 Nonresidential Acceptance Forms August 2009 RX Date/Time 02/06V2012 12:55 0210612012 11:57 8182402800 8182402800 PRECISE AIR SYSTEMS P.002 PAGE 02/06 Construction 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Calibrated means to measure airflow 2 Check one of the following: O Variable Air Volume (VAV) _ Check as appropriate' a• Sensor used to control outdoor air flow must have calibration certificate or be field calibrated ❑ Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) O Constant Air Volume (CAV) - Check as appropriate: 0 System is designed to provide a fixed minimum OSA when the unit is on NA7.5.1.1 Outdoor Air Acceptance A, Functional Testing (Check appropriate column) a. Verify unit is not in economizer mode during test. check apt Step 1: CAV and VA`V testing at full supply airflow a. Adjust supply to achieve design airflow b• Measured outdoor airflow reading (cfm) c. Required outdoor airflow (efrn) 0 -0m MEC, -3C, Column 1) d. Time for outside air damper to stabilize after VAV boxes opc e. Return to initial conditions (check) Step 2: VAV testing at reduced upply airflow a. Adjust supply airflow to either the sum of the mmunum zone airflows or 30% of the total design airflow Q. Measured outdoor airflow reading (cfm) C. Required outdoor airflow (afro) (from MECH-3C, Column 1) d. Time for outside air damper to stabilize after VAV boxes open and minimum air flow achieved minutes e. Return to initial conditions (check) 13. Testing Calculations & Results Percent OSA at full supply airflow (%OAFA for Step 1) '— a. ' %OAFA = Measured outside air reading /Required outside air (Step lb/Step 1 c) b. C. Outside air damper position stabilizes within 15 minutes (Step I d < 15 minutes) Percent OSA at reduced supply airflow (%SOARA for Step 2) a. %OAeA = Measured outside air reading /Required outside air (Step2b/Step2c) b. 90%;5 %OgRA C. Outside air damper position stabilizes within 15 minutes (Step 2d < 15 minutes) Note. Shaded boxes do not apply for CAV syston,a column 2008 Nonresidential Acceptance Forms Y Y Y Y Y August 2009 RX Date/Time 0210612012 11:57 - 8182402800 P.003 02/06V2012 12:55 8182402800 PRECISE AIR SYSTEMS PAGE 03/06 2008 Nonresidential Acceptance Forms' August 2009 RX Date/Time 0210612012 11:57 8182402800 02/06i/2012 12:55 8182402800 PRECISE AIR SYSTEMS P.004 PAGE 04/06 FIELD TECHNICIAN'S DECLARATION STATEMENT • I certify under penalty of Pei jury, under the laws of the State of California, the information provided on this form is true and correct. I am the person who perforated the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I, certify that the construction/installation identified on this form complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and proccdums specifreei in Reference Nonresidential Appendix NA7. • I have confirmed that the Installation Certifcatc(s) for the construction/installation identified on this form has been completed and is posted or made available with the building permit(s) issued for the building. Company Name: Inr Field Technician's NW; ° Field Tvalutielan's Seunan, With RESPONSIBLE PERSON'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, that I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this form. • 1 am a licensed contractor, architect, or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person). • I certify that the information provided on this form substantiates that the construction/installation identified on this form complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. • I have confirmed that the Installation Certificate(s) for the construction/installation identified on this forret has been completed and is posted or made available with the building permit(s) issued for the building. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: Phone: License: (Title): 2008 NonresidenrfalAcceprance Forms August 2009 RX Date/Time 0210612012 11:57 8182402800 P.005 02/06'%2012 12:55 8182402800 PRECISE AIR SYSTEMS PAGE 05/06 CERTUICATE OF ACCEPTANCE NA,7.5.2 Constant Volaine Sivagle Zone Project NaumclAddress Name or Identificaflon/ Tag. or Area Served: Intent•l/erij� the individual components of a constant volunme, single -zone, unitary air conditioner and heat pump syslem fun incl bzg: thermostat Installation and programming, supply fan, heating, cooling, and damper operation per jVA7.5.2 Construetiou )lois ectiou 1. Instrumentation to perforin test includes, but not limited to: a. None required 2. Installation O Thermostat is located within the space -conditioning zone that is served by the RVAC system. 3. Programming (check all of the following): O Thermostat meets the temperature adjustment and dead band requirements of 122(b) O Occupied, unoccupied, and holiday schedules have been programmed per the facility's schedule. ❑ Pre -occupancy purge has been programmed to meet the requirements of Standards Section 121(c)2. A. Functional Testing R No-load d HeatiAg load durin No-load during Heating load during occr Step 1: Check and verify the following for each simulation mode required Supply fan operates continually b' Supply fan turns off c• Supply fan cycles on and off d. System reverts to "occupied" mode to satisfy any condition e. Systcm ruins off when manual override timeeriod expires xpires f• Gas-fired furnace, heat pump, or electric heater stages on g• Neither heating or cooling is provided by the unit h- No heating is provided by the unit L No cooling is provided by the unit J• Compressor stages on k. Outside air damper is open to minimum position I• Outside *air damper closes completely M. I System returned to initial operating conditions after all tests have been completed: B. Testing Results Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter MECH 3A Pa e2of3 re1�lu r. correctly, Operating Modes Toad duriiigntciipird eoodj Manual override unoccupied condition ccupied condition )ied condition condition =11 2008 Nonraidential Acceptance Forms August 2009 RX Date/Time 0210612012 11:57 8182402800 ` 02/06'/2012 12:55 ' 8182402800 PRECISE AIR SYSTEMS P.006 PAGE 06/06 C. PASS I FAIL Evaluation (check one): O PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "pass" (p) Q FAIL: Any Construction Inspection responses are incomplete OR there is one or more "Fail" (F) responses in Testing Results section. provide explanation below. Use and attach additional oaQc- if n,.--, 1008 Nonresidential Acceptance Forms August 2009