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10-0919 (RC)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000919 Property Address: 78935 HIGHWAY 111 APN: 643-020-029- - Application description: REMODEL - COMMERCIAL Property Zoning: REGIONAL COMMERCIAL Application valuation: 750000 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: TARGET CORP 1000 NICOLLET ,ALL #12 MINNEAPOLIS, MN 55403 (612)375-0029 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/29/11 Applicant: Architect or Engineer: WHITING -TURNER CONTR CO, ;I HL I I i6 250 COMMERCE STE 150 ha R 2 0-11 r IRVINE, CA 92602 L (9 4 9) 8 6 3- 0 8 0 0 "-"c^-----.. .�� I 6 G!'dYta r,A,yxrU LiC. No.. 311107 raRt4arr 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. License Class: A B License No.: 311107 Date:�l 2q Co actor: 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: Contractor:ID 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 ZURICH AMERICAN Policy Number WC386588207 _ 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 �RE f hLabor Code, I shall forthwith comply with those provisions. te: nt: WARNINGCURE W RKERS' 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 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 co my to enter upon he above -mentioned property Afor ins ction purposes. Date: yr a 1 I ' nature (Applicant or Agent):'7/ /� LQPERMIT Application Number . . . . . 10-00000919 ------ Structure Information REMODEL TO EXISTING RETAIL STORE ----- Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . . . MERCANTILE Other struct info . . . . . CODE EDITION 2007/08 ENERGY FIRE SPRINKLERS YES MIXED -USE OCCUPANCY M/S OCCUPANT LOAD 3653.00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 124862.00 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 2789.50 Plan Check Fee 1813.18 Issue Date . . . . Valuation . . . . 750000 Expiration Date 10/26/11 Qty Unit Charge Per Extension BASE FEE 2039.50 250.00 3.0000 -------------------------------------=-------------------------------------- THOU BLDG 500,001-1,000,000 750.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 273.60 Plan Check Fee 68.40 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/26/11 Qty Unit Charge Per Extension BASE FEE 15.00 20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 15.00 1.00 3.0000 EA ELEC APPLIANCES 3.00 2.00 7.5000 EA ELEC PWR APP >1 TO <=10 15.00 3.00 18.5000 EA ELEC SVC <=600V/<=200A 55.50 378.00 .4500 ---------------------------------------------------------------------------- EA ELEC DEVICE/FIXTURE >20 .170.10 Permit . . . MECHANICAL Additional desc . . Permit Fee . . . . 79.50 Issue Date . . . . Expiration Date . . 10/26/11 Plan Check Fee . . Valuation . . . . Qty Unit Charge Per BASE FEE 1.00 9.0000 EA MECH FURNACE <=100K 1.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 1.00 6.5000 EA MECH EXHAUST HOOD 19.88 0 Extension 15.00 9.00 16.50 6.50 LQPERMIT Application Number . . . . . 10-00000919 Permit . . . . . . MECHANICAL Qty Unit Charge Per Extension 5.00 6.5000 EA MECH OTHER MECH EQUIPMENT 32.50 -------------------------------------------=-------------------------------- Permit . . . PLUMBING Additional desc . . Permit Fee . . . . 94.50 Plan Check Fee 23.63 Issue Date . . . . Valuation . . . . 0 Expiration Date 10/26/11 Qty Unit Charge Per Extension BASE FEE 15.00 11.00 6.0000 EA PLB FIXTURE 66.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments REMODEL TO EXISTING RETAIL STORE "TARGET". ADD FREEZERS, WALK-IN COOLER FIXTURES IN MARKET AREA AND BACK STOCKROOM. WORK INCLUDES ROOF TOP HVAC EQUIP, FLOOR COVERING, LIGHTING, MECHANICAL, PLUMBING & ELECTRICAL WORK. 2007 CODES.2008 ENERGY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ACCESSIBILITY PLAN REVIEW 181.32 ART IN PUBLIC PLACES-COM 3730.00 BLDG STDS ADMIN (SB1473) 30.00 ENERGY REVIEW FEE 181.32 STRONG MOTION (SMI) - COM 157.50 Fee summary Charged Paid Credited Due Permit Fee Total 3237.10 .00 .00 3237.10 Plan Check Total 1925.09 .00 .00 1925.09 Other Fee Total 4280.14 .00 .00 4280:14 Grand Total 9442.33 .00 .00 9442.33 LQPERMIT Bin # 0 City of La Quinta v Building & Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico �'� La Quinta, CA 92253 - (760) 777-7012 forp � Building Permit Application and Tracking Sheet Project Address: 3.S G/S /�� Owner's Name: 7�/ k6j`- ' Cvl,EPgDA4 7 o4l A. P. Number: �p 3 —Q Zp — D2 i Address:Y BPS Legal Description: City, ST, Zip: Contractor. 6 Address: Project Description: %Z�/1/7-- 1411/ZO✓_* '�� City, ST, Zip: 96/V4>1 (Q/(J.i/S`r /V kvA4 A< Telephone: :ii'F,.•,4:!'<•'$::J'R':::' S J::.r;Jir t�� State Lic. # : City Lic. Arch., Engr., Designer: A'�WXI/S h�F>-77f Address: �� O ��WF� so�Vp�/Q� Lp IIv�101'R. City, ST, Zip: A-L4M4=-70.4 �/¢ / L `D� �%P`P/ D E t� Telephone: S% 4IT6 o/� :•;::;c::.::;...:::x:::::;;;n.s,`.•<F:�:F:Fftf•:4:.F:.. :' s%:>:z<::>;<:><:sti::.::;<::.:' �'� Ica...,.,.::..:;;;r;.,.'>r:�<�i::::;F?:: Construction Type: S Occupancy. . State Lic. #: `:, ..;y j.;;. Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: CCL S O Au Sq. Ft.: (75-0 I# Stories: # Units: Telephone # of Contact Person: Jt—/© ��ps �� 3 Estimated Value of Projec �-ofd 60t) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitte Item Amount Structural Calcs. Reviewed, ready r correction Plan Check Deposit Truss Calcs. Called Contact Pe Asek Plan Check Balance. Title 24 Cates. Plans picked up f, (e Construction Flood plain plan Plans resubmitted A0 a j' Mechanical Grading plan 2°" Review, ready for correction issue 1..E 2 Electrical Subcontactor List Called Contact Person/w/ ill 4t Plumbing Grant Deed Plans picked up S.M.I. H.Q.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees M I I I I 1 I I Total Permit Fees i/ j 1Z / - /, 6 SR# DEPARTMENT ENVIRONMENTAL HEALTH FOOD ESTABLISHMENT PLAN APPROVAL NOTICE �-"°'� � ,10 Date 10/4/10 Project Name Target Address 78935 Hwy I I I LA Quinta Plans Submitted by Celso Riveria Phone 510-865-8863 Owner Target Corporation Address 50 S. 10t' St. Minneapolis MN 55440 Phone The plans are now approved subject to the conditions listed below and the attached compliance sheet. This is for a remodel, addition of new refrigeration cases, freezer, dairy cooler, dry storage, and produce area. 1. The Acorn Vac system is only approved for condensate use only. 2. Have this system test at inspection. 3. The quarry tile flooring must be smooth and have 3/8" 4. Provide grease interceptor (or waiver) letter from your sewer agency. CONSTRUCTION INSPECTIONS: Contact the Plan Checker for a Preliminary Inspection when construction is approximately 80% complete, with plumbing, rough ventilation, and rough equipment installed. Request for inspection should be made at least five (5) working days in advance. A FINAL INSPECTION MUST be made upon completion of ALL work including finished details. APPROVAL to operate shall not be granted, or remodeled areas approved to operate, until the facility has passed the FINAL INSPECTION,. and "APPLICATION TO OPERATE" has been completed and PERMIT FEES have been paid. Request for inspection should be made at least five (5) working days in advance. PLANS CHECKED BY Tracey Ford, EHS III Phone (760) 863-8287 I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during construction: DEH-SAN-178 (Rev 2/06) Corona 2275 S. Main St Suite 204 (951)273-9140 Fax (951) 520-8319 Signature Company Name, Hemet 800 S. Sanderson (951) 766-2824 Fax (951) 766- 7874 Indio 47-950 Arabia St «A„ (760)863-8287 Fax (760) 863- 8303 Date Murrieta 38740 Sky Canyon Dr . (951) 461-0284 Fax (951) 461-0245 Department Web Site — www.rivcoeh.org Palm Springs 554 S. Paseo Dorotea (760) 320-1048 Fax (760) 320-1470 Riverside 4065 County Cir (951) 358-5172 Fax (951) 358- 5017 $'A L/THON/A L/GNT/NG- FEATURES & SPECIFICATIONS INTENDED USE Ideal for applications requiring attractive die-cast aluminum signage, superior illumination and low energy consumption. CONSTRUCTION Precision -molded, die-cast aluminum construction — ultra -slim, compact housing. Fine-grain brushed aluminum faceplate with matte black electrostatic polymeric trim. Clear lacquer finish on brushed face inhibits fingerprints and other surface contaminants. Fully overlapping light seal prevents light leaks. Universal directional chevron knockouts are completely concealed and easily removed. Hinged faceplate and spring latches for easy lamp compartment access. Letters 6" high with 3/4" stroke. U.S. Patent No. 5,954,423. OPTICS Lamp is constructed using new LED technology. Provides perfectly uniform illumination to meet 3/4" letter stroke required by code. LED life exceeds 25 years, based on continuous operation. Unique LED lamp platform accommodates both single -face and double -face exits. Low energy consumption — red lamp consumes .81 watts (120V); green lamp consumes one watt (120V). INSTALLATION Universal mounting (top, end or back). Completely concealed, easily -removed mounting knockouts. No exposed hardware. Die-cast aluminum canopy provided. LISTINGS UL listed. Meets UL 924, NFPA 101 (current Life Safety Code), NEC and OSHA illumi- nation standards, and state of Minnesota energy -efficient legislation requiring less than 20W consumption. Listed and labeled to comply with Canadian Standards C-860 and C-22.2 No. 9 (see options). WARRANTY Five-year warranty, including lamps. All life safety equipment, including emergency lighting for path of egress must be maintained, serviced, and tested in accordance with all National Fire Protection As- sociation (NFPA) and local codes. Failure to p erform the required maintenance, ser- vice, or testing could jeopardize the safety of occupants and will void all warranties. ORDERING INFORMATION LE Family Face type LE LED S Stencil surface P Panel' mount Housing color (blank) Matte black, brushed aluminum face BZ Dark bronze W White B Matte black NOTES: 1 Panel face available for special wording only. 2 Not available with CSA option. Catalog Number Notes Type Die -Cast Aluminum Exits LE LED Lamps For shortest lead times, configure product using standard options (shown in bold). 120/277 Number Letter Inputvoltage of faces color 120/277 Dual volt- 1 Single R Red age face G Green 2 Double D (ECIEDVE OCT 2 5 2010 D Example: LE S 1 R 120/277 Options TP Two tamperproofTorx-head screws VR Vandal -resistant shield W13"thick polycarbonate)° FI Fire alarm flashing interface' X2 Lamp wired on two separate cir- cuits,,,,, DL UL listed for damp location LDC12/24 12V - 48V DC input for LED lamps' CSA Listed and labeled to comply with Canadian standards 3 Only available with CSA option. Accessories' 4 VR contains tamper -proof screws. Order as separate items. 5 Must specify input voltage i120Vor277VI.Not available indual voltage. ELAUSI2 12°stem kit 6 UL listed as emergency lighting equipment. 7 See spec sheet ELA-Stem Kits. Emergency 78- 133F t4wV It( Sheet #: LE SIEX - 100 LE Surface LED, Signature SPECIFICATIONS ELECTRICAL Primary Circuit Rated Supply No. of Input Max. _Type LED life* voltage faces watts amps Red 25+years 120 1 or2_.81 .05 Red 25+years 277/347 1 or 1.2 .06 Green 25+years 120 1 or2_1.05 .05 Green 25+years 277 1 or2_1.32 .06 * Based on continuous operation. Supplemental Emergency Circuit No. of Nominal Electrical Input Type faces lamnvoltape watts amps LDC12/48 1 or 2 12 1.5 .12 LDC12/48 1 or 2 24 1.5 .06 LDC12/48 1 or 2 32 1.5 .05 LDC12/48 1 or 2 48 1.6 .04 KEY FEATURES Unique LEDs provide extremely long life and low energy consumption. MOUNTING All dimensions are inches (millimeters). Canopy required for back mounting with X2, FI, or LDC12/48 options only. For VR option, add 1/4" to height and width. Add 1/8' depth for single face; 1/4" depth for double face. Shipping weight: 5lbs. (2.3 kgs.) END MOUNTING TOP MOUNTING 1-9/16 (40) 4-112 I F (114) 6 7-7/8 (152) 11 EXIT(200) 9-7/16 121-83/8� yl (9) 12-15/1 1-3/4 (329) (44) BACK MOUNTING O� O 3-15/16 (200) 1100) 5-11/16 (144) 11-3/8 (289) L/THON/A L/GHT/NG® An IrMcuitvBrands Company Sheet #: LE ©1994-2010 Acuity Brands Lighting, Inc. All rights reserved. Rev. 7/14/10 Lithonia Lighting Emergency Lighting Systems One Lithonia Way, Conyers, GA 30012 Phone:800-334-8694 Fax:770-981-8141 www.lithonia.com CERTIFICATE OF COMPLIANCE Part 1 of 4 LTG-1 C Project Name Date T-1867 La Quinta, CA 91112010 Project Address Climate Zone Total Cond. Floor Area Unconditioned Floor Area 78935 US Hwy 111 La Quinta 15 103.207 I 0 GENERAL INFORMATION Building Type: m Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room ❑ School ❑ Schooltable Public 10 Conditioned Spaces ❑ Unconditioned Spaces Phase of Construction: ❑ New Construction ❑ 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. Sign e Name � � Company LTaf Gausman & Moore Associates, Inc. 9/1/2010 Address 1 n` C4�c W Y ���17.�1 EA # CEPE# City/State/Zip CA G1► 3 S l7 Phone 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 tans and specifications submitted to the enforcement agency for approval with this (ding a map cati " Name EDWARD STUDNISKI + Company one GAUSMAN & MOORE 661-291-1978 Address 26415 CARL BOYER DR, #205 License # Q� F 10)7 -71 jt • � u ✓ _/ City/State/Zip SANTA CLARITA, CA 91350 Date Lighting Mandatory Measures Indicate location on building plans of Mandatory Measures Note Block: LIGHTING COMPLIANCE FORMS & WORKSHEETS (check box if worksheets is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms; please refer to the Nonresidential Manual published by the California Energy Commission. © LTG-1 C Pages 1 through 4 Certificate of Compliance. All Pages required on plans for all submittals ❑ LTG-2C Lighting Controls Credit Worksheet LTG-3C Indoor Lighting Power Allowance CITY W © LTG-4C Pages 1 through 4 ailored Method Worksheet ❑ LT - ine Voltage Track Lighting Worksheet Fft On" 201 0 FOR CONSTRUCTION_ OCT 2 5 SATE 11 q 20"D BY En rgyPro 5.0 b User Number. 5623 RunCode: 2010-09-01T15:06:2 ID: Page 1 of 6 - CERTIFICATE OF COMPLIANCE (Part 2 of 4) LTG-1 C Project Name T-1867 La Quinta, CA Date 91112010 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Installation Certificate, LTG-1- INST (Retain a copy and verify form is completed and signed.) Field Inspector ❑ Certificate of Acceptance, LTG-2A (Retain a copy and verify form is completed and signed.) Field Inspector ❑ A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces Installed Lighting Power listed on this Lighting Schedule is only for: m CONDITIONED SPACE ❑ UNCONDITIONED SPACE m The actual indoor lighting power listed below includes all installed permanent and portable lighting systems in accordance with §146(a). Only for offices: Up to the first 0.2 watts per square foot of portable lighting shall not be required to be included in the m calculation of actual indoor lighting power density in accordance with the Exception to §146(a). All portable lighting in excess of 0.2 watts per square foot is totaled below. Luminaire (Type, Lamps, Ballasts) Installed Watts A B C D E F G H None or Item TagF32T8, Complete Luminaire Description' (Le, 3 lamp fluorescent troffer, one dimmable electronic ballasts m O i0 LL ro o N CL y y `° J How wattage Was determined O N .ro a .5 > j Z LL X 0 �? �� Field Ins ectoi2 CEC Default From NA8 a� O O co 6, ci O ¢ ~ a , LL ' Al Al-2X4 FL Troffer (2)F32T8 ❑ . 75 m ❑ 31 2,325 ❑ ❑ Al ex Al-2X4 FL Troffer (3)F32T8 ❑ 97 m ❑ 997 96,709 © ❑ ; B3 B3-2X4 FL Troffer (4)F28T8 ❑ 84 0 ❑ 3 252 a❑ ❑ C11 C11-4' Wet Location (2)F32T8 ❑ 72 ❑ ❑ 4 288 ❑ ❑ C2 ex C2-4' FL Tandem Strip (2)F28T8 ❑ 51 0 ❑ 3 153 _�❑ `� C3 ex C3-8' FL Tandem Strip (4)F28T8 ❑ 95 0 ❑ 48 4,560 0 `❑ ' C9 C9-8' Wet Location (4)F32T8 ❑ 144 ❑ ❑ 5 720 ❑ ❑ D10 135w Metal Halide ❑ 44 IZ ❑ 6 264 ❑ ❑ T8 45w per ft Track Light ❑ 45 0 ❑ 30 1,350 V1 V1 6' Fluorescent - SL Valance Fixture ❑ 64 0 ❑ Vl ex VI 6' Fluorescent - SL Valance Fixture ❑ 64 0 ❑ 30 1,920 ❑ ❑ V2 V2 4' Fluorescent - SL Valance Fixture ❑ 34 m ❑ 86 2,924 0 y❑ V2 ex V2 4' Fluorescent - SL Valance Fixture ❑ 34 IZI ❑ 151 5 1134 ❑ ❑ ,& ❑ ❑ ❑ ❑"gig❑ „a= ❑ ❑ ❑ © o: ❑ ❑ ❑ ❑ ❑: ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑' ❑ Installed Watts Page Total: Building total number of pages: Installed Watts Building Total Sum of all pages) 121,079 Enter into LTG-1 C Page 4 of 4 1. Wattage shall be determined according to Section 130 (d and e). Wattage shall be rating of light fixture, not rating of bulb. 2 . If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnerqyPro5.0 by EnerqySoft User Number: 5623 RunCode: 2010-09-01 T15:06:2: ID: Pa e 2 of 6 CERTIFICATE OF COMPLIANCE Part 3 of 4 LTG-1C Project Name T-1867 La Quinta, CA Date 91112010 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Fill in controls for all spaces: a) area controls, b) multi -level controls, c) manual daylighting controls for daylit areas > 250 fe, automatic daylighting controls for daylit areas > 2,500 fe, d) shut-off controls, e) display lighting controls, f) tailored lighting controls — general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls for retail stores > 50,000 ft2, in accordance with Section 131. MANDATORY LIGHTING CONTROLS — FIELD INSPECTION ENERGY CHECKLIST Field Ins ecior" Type/ Description Number of Units Location in Building Special Features Passe Fail ❑ ❑ ❑ ❑...a ❑ 0__ o ❑ ❑ �Y; o ❑0 ❑ ❑ Q ❑ ❑` o" ❑ ❑ ❑ ❑ o ❑ $o o ❑ ❑ o ❑ D 0 ❑ �0 0 ❑ a 0 ❑ ❑ a ❑ ❑ [a ❑ ❑, SPECIAL FEATURES INSPECTION CHECKLIST See Page 2 of 4 of LTG-1C The local enforcement agency should pay special attention to the items specified in this 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 5.0 by Energ Soft User Number 5623 RunCode: 2010-09-01 T15:06:2 ID: Page 3 of 6 CERTIFICATE OF COMPLIANCE Part 4 of 4 LTG-1 C Project Name Date T-1867 La Quinta, CA 91112010 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 121 079 Installed Lighting 0 from Conditioned LTG 1 C, Pa e 2 from Unconditioned LTG-1 C, Page 2 Lighting Control Credit _ 719 Lighting Control Credit Conditioned Spaces from LTG-2C Unconditioned Spaces from LTG-2C 0 Adjusted Installed 120,360 Adjusted Installed Lighting Power Lighting Power — 0 Complies if Installed 5 Allowed Complies if Installed 5 Allowed Allowed Lighting Power Allowed Lighting Power Conditioned Spaces from LTG-3C or PERF-1 158,935 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. The designer is required to check the acceptance tests and list all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. If all the lighting system or control of a certain type requires a test, list the different lighting and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Forms can be grouped by type of Luminaire controlled. Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or when ever new lighting system with controls is installed in the building or space shall be certified as meeting the Acceptance Requirements. The LTG-2A form is not considered a complete form and is not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Title 24 Part 6. The field inspector must receive the properly filled out and signed forms before the building can receive final occupancy. A copy of the LTG-2A for each different lighting luminaire control(s) must be provided to the owner of the building for their records. Controls for Credits LTG-2A Controls and Sensors and Automatic Number of Daylighting Equipment Requiring Testing Descri lion Luminaire controls Location Controls Acce tance Occ Sensor - <= 250 sgft C3-8' FL Tandem Strip (4)F28T8 2 127 STOCKROOM m Occ Sensor - Storage C2-4' FL Tandem Strip (2)F28T8 2 133 STOCKROOM m Occ Sensor- Storage C3-8' FL Tandem Strip (4)F28T8 46 133 STOCKROOM p Occ Sensor - <= 250 sgft C2-4' FL Tandem Strip (2)F28T8 1 185 PUMP ROOM m El El El EnerqvPro 5.0 by EnerqySofl User Number: 5623 RunCode: 2010-09-01 T15:06:2 ID: Page 4 of 6 INDOOR LIGHTING POWER ALLOWANCE LTG-3C Project Name T-1867 La Quinta, CA Date 91112010 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: m CONDITIONED SPACES ❑ UNCONDITIONED SPACES COMPLETE BUILDING METHOD BUILDING CATEGORY From §146 Table 146-E WATTS PER ft2) X COMPLETE BLDG. AREA = ALLOWED WATTS TOTALS AREA WATTS AREA CATEGORY METHOD BUILDING CATEGORY From §146 Table 146-F WATTS PER (ft2) X Area ft2 = ALLOWED WATTS Commercial, Industrial Storage 0.60 5,239 3,143 Commercial, Industrial Refrigerated 0.70 1,064 745 Retail Sales, Wholesale 1.60 96,904 155,046 TOTALS 103,207 158,935 AREA WATTS TAILORED METHOD Total Allowed Watts using the Tailored Method taken from LTG-4C (Page 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 EnergyPro5.0byEnergySoft User Number: 5623 RunCode: 2010-09-01T15:06:2 ID: Page 5 of 6 LIGHTING MANDATORY MEASURES: NONRESIDENTIAL LTG-MM Project Name Date T-1867 La Quinta, CA 91112010 Indoor Lighting Measures: §131(d): Shut-off Controls For every floor, all interior lighting systems shall be equipped with a separate automatic control to shut off the lighting. 1. This automatic control shall meet the requirements of Section 119 and may be an occupancy sensor, automatic time switch, or other device capable of automatically shutting off the lighting. 2 Override for Building Lighting Shut-off: The automatic building shut-off system is provided with a manual, accessible override switch in sight of the lights. The area of override is not to exceed 5,000 square feet. §119(h): Automatic Control Devices Certified: All automatic control devices specified are certified, all alternate equipment shall be certified and installed as directed by the manufacturer. §111: Fluorescent Ballast and Luminaires Certified: All fluorescent fixtures specified for the project are certified and listed in the Directory. All installed fixtures shall be certified. Tandem Wiring for One and Three Lamp Fluorescent Fixtures: All one and three lamp fluorescent fixtures are tandem §132: 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. §131(a): Individual Room/Area Controls: Each room and area in this building is equipped with a separate switch or occupancy sensor device for each area with floor -to -ceiling walls. Uniform Reduction for Individual Rooms: All rooms and areas greater than 100 square feet and more than 0.8 watts §131(b): per square foot of lighting load shall be controlled with bi-level switching for uniform reduction of lighting within the room. Daylight Area Control: All rooms with windows and skylights that are greater than 250 square feet and that allow for §131(c): the effective use of daylight in the area shall have 50% of the lamps in each daylit area controlled by a separate switch; or the effective use of daylight cannot be accomplished because the windows are continuously shaded by a building on the adjacent lot. Diagram of shading during different times of the year is included on plans. §131(c): Display Lighting. Display lighting shall be separately switched on circuits that are 20 amps or less.6. Outdoor Lighting Measures: §130(c)1: Mandatory lighting power determination for medium base sockets without permanently installed ballasts §132(a): All permanently installed luminaires with lamps rated over 100 Watts either have a lamp efficacy of at least 60 lumens per Watt or are controlled by a motion sensor. §132(b): All Luminaires with lamps rated greater than 175 Watts in hardscape area, including parking lots, building entrances, canopies, and all outdoor sales areas meet the Cutoff Requirements. §132(c)1: All permanently installed outdoor lighting meets the control requirements listed. §132(c): Building facades, parking lots, garages, canopies, and outdoor sales areas meet the Multi -Level Lighting Requirements listed. EnergyPro 5.0 by EnergySoR User Number: 5623 RunCode: 2010-09-01 T15:06:25 ID: Page 6 of 6