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BCOM2014-1034DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type: Permit Number Property Address APN: Legal Description Property Zoning: Valuation: Building Commercial BCOM2014-1034 BUILDING PERMIT eca Qa�&a CALIFORNIA 46480 WASHINGTON ST STE 2 643020068 $150,000.00 Owner: Applicant PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 10/29/2014 ISSUED DATE: 01/14/2015 WASHINGTON 111 LTD 80618 DECLARATION AVE, INDIO, CA 92253 KRISTI HANSON ARCHITECTS 78-185 PAINTERS PATH WAY, PALM DESERT, CA 92260 Contractor: DENNIS THILL 78316 DESERT MOUNTAIN CIR, BERMUDA DUNES, CA 92201 PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE FOLLOWING: LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2) 1) They are licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and the referenced License is in full force and effect, or; 2) That they are exempt from the Contractors' State License Law for the reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or she is exempt from licensure by a valid exemption. [Section 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 Contractors' State License Law (Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code] 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).) a) As owner of the property, or my employees with wages as their sole compensation, will do all of or portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, 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 it was not built or improved for the purpose of sale.). b) As owner of the property, will be exclusively contracting with licensed c) Are exempt from licensure under the Contractors' State License Law. As an Owner -Builder, they acknowledge that, except for their personal residence in which they must have resided in for at least one year prior to completion of the improvements covered by this permit, they cannot legally sell a structure built as an owner -builder if it has not been constructed in its entirety by licensed contractors. It is understood that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application was submitted at the following Web site: http://www.leginfo.ca.gov/calaw.html. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If applicable) A construction lender will be used for completion of the improvements covered by this permit and the name and information of which is on file for public inspection during the regular business hours of the public entity. Failure of the applicant to indicate the construction lender on the WORKERS' COMPENSATION DECLARATION (1, 2 or 3) WARNING: FAILURE TO SECURE 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. 1) Has and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2) Has 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. 3) Certifies that, in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. NOTICE TO APPLICANT (1, 2 and 3) 1) Each person upon whose behalf this application was made, each person at whose request and for whose benefit work is being 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 360 days from date of issuance of such permit, or if cessation of work for 180 days will subject permit to cancellation. On or after January 1, 2019, every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 12 months after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 12 months after the time the work is commenced. 3) Certified that they read the application and state that the information provided is correct. Agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspection purposes. IMPORTANT: An Application for Permit was made to the Building Official, subject to the conditions and restrictions set forth at the time of application, which is now hereby an Issued Permit. If any part of the information being supplied on this permit is inaccurate or untrue, please contact the City of La Quinta at (760) 777-7125 immediately for correction. Printed: 11/20/24 4:43 pm Page 1 of 4 1-311111]1Z"a4 NV,IkI Permit Type: Building Commercial Permit Number: BCOM2014-1034 Property Address: 46480 WASHINGTON ST STE 2 application does not relieve that person of the n construction lender preliminary notice from that duty. Printed: 11/20/24 4:43 pm Page 2 of 4 1-31111111] 1 Z"a 4 N IT,1111 Permit Type: Building Commercial Permit Number: BCOM2014-1034 Property Address: 46480 WASHINGTON ST STE 2 TENANT IMPROVEMENTS *** TENANT IMPROVEMENT NEXT LEVEL FITNESS 3 UNITS, FIT IN 42, PERSONAL TRAINING AND BOOT CAMP. ADD NEW PARTIATION WALLS OFFICE AND LOBBY AREA. nnstructinn Det; Commercial Work Type Remodel Building/Unit B: Office, Professional Gross Square Footage 3827 Occupancy Classification(s) Conditioned Square 3827 Fire Sprinkler Square 3827 Number of Floors 1 Footage Footage Occupant Load 36 Construction Type V-B Code Edition 2013 Remodel Area Square 3827 New Electrical Square 0 Number of 30 Footage Footage Receptacle/Switch/Lig Number of Forced Air 3 Furnace(s) Transportation Uniform No Mitigation Fee Applicable Art in Public Places No Fund Exempt Number of 3 Condenser(s) Number of Dispensing 1 Units - Gas (TUMF) ht(s) Water System Install Yes or Alteration? City Development No Impact Fee Applicable I Type Group Sq Ft Value I Invoice No. Fee PERM IT-BCOM2014-1 0, REMODEL, FIRST 100 SF 4 BSAS SB1473 FEE CONDENSER/COMPRESSOR PC WATER SYSTEM INST/ALT/REP PC REPLACEMENT INSPECTION CARD DEVICES, FIRST 20 REMODEL, EA ADDITIONAL 500 SF REMODEL, EA ADDITIONAL 500 SF PC REMODEL, FIRST 500 SF PC DEVICES, ADDITIONAL DEVICES, FIRST 20 PC FURNACE SMI - COMMERCIAL DEVICES, ADDITIONAL PC FURNACE PC CONDENSER/COMPRESSOR WATER SYSTEM INST/ALT/REP Fee Amount $49.31 $6.00 $72.51 $12.09 $36.26 $24.17 $174.00 $139.20 $134.88 $24.20 $24.17 $108.78 $42.00 $6.00 $72.51 $108.78 $12.09 Total for Invoice PERMIT-BCOM2014-1034 $1,046.95 Amount Paid $49.31 $6.00 $72.51 $12.09 $36.26 $24.17 $174.00 $139.20 $134.88 $24.20 $24.17 $108.78 $42.00 $6.00 $72.51 $108.78 $12.09 Z�"I,u4n.uo Grand Total for Permit $1,046.95 $1,046.95 Workflow / Inspections Printed: 11/20/24 4:43 pm Page 3 of 4 1-311111]1Z"a4 N IT, IkI Permit Type: Building Commercial Permit Number: BCOM2014-1034 Property Address: 46480 WASHINGTON ST STE 2 Workflow Step / Action Name Action Type Start Date End Date Inspections v.1 10/29/2014 0:00 FINAL** v.4 Inspection FINAL** v.3 Inspection FINAL** v.2 Inspection FINAL** v.1 Inspection T-BAR/OVERHEAD v.1 Inspection ROUGH ELEC v.1 Inspection FRAMING v.2 Inspection DRYWALL NAIL v.2 Inspection DRYWALL NAIL v.1 Inspection FRAMING v.1 Inspection Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of any material required to allow inspection. It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this code. A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the iurisdiction shall not be valid. A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by the building official. Printed: 11/20/24 4:43 pm Page 4 of 4 Certificate of Occupancy w IX 0KPQkA= 1W Gam. G � ]IF Community Development Department This Certificate is issued pursuant to the requirements of Chapter 1 Section III of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 46-480 WASHINGTON ST STE 2 Use classification: BUSINESS — NEXT LEVEL FITNESS Building Permit No.: BCOM2014-1034 Occupancy Group: B Type of Construction: VB Land Use Zone: CR Code Edition: 2013 Sprinkler Installed: YES Occupant Load: 36 By: KIRK KIRKLAND Owner of Building: WASHINGTON 111 LTD Date: FEBRUARY 24, 2015 Address: 80618 DECLARATION AVE Building Official: BURT HANADA City, ST, ZIP: INDIO, CA, 92201 POST IN A CONSPICUOUS PLACE RIVERSIDE COUNTY FIRE PROTECTION PLANNING RECORD OF INSPECTIONS / PERMIT CARD THIS CARD IS TO REMAIN ON SITE AT ALL TIMES. INSTALLING CONTRACTOR MUST BE PRESENT FOR ALL INSPECTIONS. SEE NOTES ON REVERSE SIDE. JOB ADDRESS: 7 D Sf S1 2 3 PERMIT#: rya-/5-T/-G�/ DATE SSUED: 144005 DESCRIPTION: mxf Int4l �rlmf r CONTRACTOR: s w� ' HYDRANT SYSTEM DATE INITIALS SPECIAL SUPPRESSION DATE INITIALS Thrust block pre -pour Door fan test UG rough piping Abort test UG hydro Mechanical shutdown Flush Detector test Final E F Deluge/pre-action SPRINKLER U.G. Final EF Thrust block pre -pour UST/AST TANK UG rough piping Installation UG hydro Removal Flush Emergency shut off Final E F Primary piping FIRE SPRINKLER Secondary piping Weld inspection Dispensers & shear valves Overhead rough piping q/!� �,(LI[� Final E F Overhead hydro MISC. INSPECTIONS UG flush / OK to connect Spray booths Main drain/inspectors' test Hood/duct extinguishing High pile storage High pile rack storage In -rack sprinklers H.P. vents/access/corridors Hose racks Tract access/hydrant verification FinaIEF HOOD EXTINGUISHING OTHER CONST. PERMIT Detection system Function test Gas/electrical shut-off Nozzle model/placement Fire alarm connection Final EF SPRAY BOOTHS FIRE CODE PERMIT(S) Installation Air flow test Mechanical interlock Extinguishing system Fire alarm connection Final E F FIRE ALARM KNOX SYSTEM Rough -wire inspection Building Knox box Function test Gate access Knox box/padlock Duct detectors/velocity BUILDING INSPECTIONS 24 hr. battery test T/I final Sprinkler monitoring Shell final Final E F Final for occupancy FINAL INSPECTION DATE: INSPECTORS SIGNATURE: ""WHEN CALLING FOR AN INSPECTION PLEASE HAVE PERMIT NUMBER READY, SEE NOTES ON REVERSE SIDE" 2300 Market Street, Ste 150 • Riverside, CA 92501 . (951) 955-4777 • Fax (951) 955-4886 77-933 Las Montanas Rd., Ste 201 • Palm Desert, CA 92211 • (760) 863-8886 9 Fax (760) 863-7072 PROUDLY SERVING THE UNINCORPORATED AREAS OF RIVERSIDE COUNTY AND THE CITIES OF: BANNING BEAUMONT CALIMESA CANYON LAKE COACHELLA DESERT HOT SPRINGS EASTVALE INDIAN WELLS INDIO JURUPA VALLEY LAKE ELSINORE LA QUINTA MENIFEE MORENO VALLEY NORCO PALM DESERT PERRIS RANCHO MIRAGE RUBIDOUx CSD SAN JACINTO TEMECULA WILDOMAR BOARD OF SUPERVISORS: KEVIN JEFFRIES DISTRICT 1 JOHN TAVAGLIONE DISTRICT 2 JEFF STONE DISTRICT 3 JOHN BENOIT DISTRICT 4 MARION ASHLEY DISTRICT 5 RIVERSIDE COUNTY FIRE DEPARTMENT IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION 77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 92211-4131 • Phone (760) 863-8886 • Fax (760) 863-7072 www.rvcfire.org January 7, 2015 John Paulus 46480 Washington St. #C Thousand Palms, CA 92276 Re: Fire Sprinkler Plan Review LAQ-I5-TI-001 Next Level Fitness 46480 Washington St. Suite 2&3, La Quinta The above referenced plans have been reviewed by the Riverside County Fire Department. Please be advised the following conditions or corrections must be completed and approved by our office. 1) Part of Suite #2 does not reflect any changes and or additions All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering Staff at (760) 863 8886. Sincerely, Jacqueline Palmieri Fire Safety Specialist PROUDLY SERVING THE UNINCORPORATED AREAS OF RIVERSIDE COUNTY AND THE CITIES OF: BANNING BEAUMONT CALI M ESA CANYON LAKE COACHELLA DESERT HOT SPRINGS EASTVALE INDIAN WELLS INDIO LAKE ELSINORE LA QUINTA M ENIFEE 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 Rnremm c►outm FIRE DwARTMEW IN COOPERATION WITH THE CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION 77-933 Las Montanas Rd., Ste. #201, Palm Desert, CA 92211-4131 • Phone (760) 863-8886 . Fax (760) 863-7072 www.rvcfiire.org January 7, 2015 Kristi Hanson JAN q9 2015 72185 Painters Path Suite A CITY OF LA QUINTA Palm Desert, CA 92260 COMMUNITY DEVELOPMENT RE: TENANT IMPROVEMENT PLAN CHECK -Non Structural LAQ-I5-TI-001 Next Level Fitness 46480 Washington St. Suite 2&3 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 2013 CBC. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: Install door hardware and exit signs as per Chapter 10 of the 2013 CBC. A minimum 2A10BC 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. A durable sign stating "This door to remain unlocked when building is occupied" 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. Display street numbers in a prominent location on the address side of building(s) and rear access if applicable. All addressing must be legible, of a contrasting color with the background and adequately illuminated to be visible from the street at all hours. All lettering shall be to Architectural Standards. 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 it 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. ECEIPT City of La Quinta, 78-495 Calle Tampico, La Quinta, CA 92253 DATE , 20I 0 5 4 8 3 _*y _ 7 _ T RECEIVED F HOM ADDRESS FOR HOW PAID AMT. OF DOLLARS $ Q X V AID CHECK DUE ORDER BY r�x�r*aws+.��.*weave. ,. ... F. ..... ......... ". 1. Business Name: I V `* I (rove 1 ►,/i S F 2. Business Address: %1 W L( -e 0 '�'k S Z e City/State: 3. Mailing Address: % 5 13y City/State: N-L'1^ he L-I 4. Business Phone: 1 7bc 1 3'(� 5. Owned by: Corporation: Partnership: 6. If Corporation or Partnership, Federal Tax I.D. is required 7. Name of Owner or Officers and Title: F� -a'-1 8. Type of Business 11'Yt S "S Zip Code: Gf Zip Code: Email Address; era Individual: 0'7-2Y7 _-17b 9. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT: ❑ YES (if yes, please provide a current copy) ❑ NO 10. La Quinta Seller's Permit (SBER sale number): 11. IF BUSINESS IS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply to Building Contractors); A. Estimated Gross Business Receipts for New Businesses Only: S 3 c o , 6`6y B. Previous Year Gross Receipts for Established Businesses: $ SB-1186 State Fee $ 1.00 TOTAL FEES S Please indicate below all vehicle license plate numbers that will be used in the business: Vehicle License Number Permit Number (Finance Use Only) HEREBY CERTIFY t t all information supplied by 'me is correct and any licenses required by the County, State or Federal Government haaavd fJ issued tommje a d are in full force and eVe/ct. /. Signature: ��7 Title: V f Date: 1 % 1 IV Send Completed Form(s) to: - CITY OF LA QUINTA BUSINESS LICENSE DIVISON 78.495 Calle Tampico La Quinta, CA 92253 (760)777-7000 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CERTIFICATE OF ACCEPTANCE Outdoor Air Acceptance system Enforcement Agency: 50[arrtivs!Yon orArea!jgo: OMMISSION N RCA-MCH-02 A (Page 1 of 3) Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked ate that must demonstrate compliance. [intent, Verify measured outside airflow reading Is within +10% of the total required outside airflow. Rea'uired for oil newly installed HVAC units. Reference MECH-3C (Column H or Column 1) or Mecharlical Equipment Schedules. Construction Inspection Note: MCH-2A can be performed in conjunctfon with MCH-7A Supply Futi,, VFD Acceptance (if applicable) slnr testing activities overlap. 1. Supporting documentation needed to perform test includes: I As -built and/or design documents (for example, Mechanical Equipment Schedules, Equipment a' Start -Up Sheets or Balancing Reports). b. 2013 Building Energy Efficiency Standards Nonresidential Corrlpliance Manual (NA7.5.1.1 VerWlatron Systems: Variable Air Systems At -A -Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At A -Glance). C. 2013 Building Energy Efficiency Standards. 2- Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). I. Method and equipment used: I H. Equipment calibration date (must be within one yP,3r):_ 3. System type (check either VAV or CAV): ❑ VAV lV1 AV a. Check if Variable Air Volume (VAV) and complete the following: L Outside airflow is either factory calibrated or field calibrated. I'.I Check if factory calibrated and attach calibration certification. C Check if field calibrated and attach calibration results. li. Damper Control (must be checked): r Dynamic damper control Is being used to control outside air. (This is NOTa flxed'min€mum position). ill. One of the following dynamic controls is being utilized to control outside air (check method `�used) 1J Outdoor Air CFM Compensation ❑ Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking U Injection Fan Method ❑ Dedicated Minimum Ventilation Damper with Pressure Control Other Active Control, Describe: b. Check if Consjtnt Air Volume (CAV) and verify the following: CT System is designed to provide a fixed minimum OSA when the unit is on. I, 4. Metf delivering outside air to the unit (check one of the following): Outside ain s ducted to the return air plenum. Confirm that outside air is ducted to either ( J•� ck one of the following): 7 Within five ft. of the unit. � / ❑ Within 15 ft. of the unit, with the air directed substantially toward the unit. �3 Return air plenum is NOT used to distribute outside air to the unit. Le. outside air is ducted provided independent of the unit. 5. Pre -occupancy purge has been programmed for the 1-hour period immediately before the building is of the following methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency per person times the expected number of occupants, whichever is less. b. 3 complete air changes to the zone served by the air handler. to the unit or outside air is occupied to provide (one TABLE 120.1-A, or 15 cfm CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance ��^ June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC NRC1t-ARCH-0?-A rRP-AR rl of 1141 { l:dl IFf1HWld Fh1F ATV f^flaa�atCCtnff CERTIFICATE OF ACCEPTANCE _ ...... - -------------•- NRCA-MCH-02 A Outdoor Air Acceptance (Page 2 of 3) Pr f . ` Enforcement Agenc+,�: ! yl NumLer.� Il P dre �'v N -. If . A, 60J e• A d 4' System Name or IdRatIfInflDaftar, System Locatt lie r Sary At.'r A. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV ❑VAV Step 1: Disable demand control ventilation (if applicable) Step 2- Verify unit is not In economizer mode during test (economizer disabled). ❑ ❑ Note: Shaded boxes do not apply for CAV systems o Step 3: CAV and VAV testing at full supply airflow77 a Adjust supply air to achieve design airflow or maximum airflow at full' cooling. Record VFD speed (Hz). b. Measured outdoor airflow reading (cfm) t' . Hz C^9 cfm cfm Required outdoor airflow (cfm) (from MECH-3C, Column 1, or c Mechanical Equipment Schedules). I •/ 1 a cfrn I— cfm d. Time for outside air damper to stabilize afterfull supply airflow is achieved (minutes): CAV min VAV Step 4. VAV testing at reduced supply airflow a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD_speed (Hz). Hz b. Measured outdoor airflow reading (cfm) t, cfm C. Required outdoor airflow (cfm) (from MECH-3C, Column 1, or mechanical equipment schedules).cfm d. Time for outside air damperto stabilize after reduced supply airflow is achieved (minutes): li min Step & Return to initial conditions (check) ❑ B. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 2 a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) i i �m�s % b. %OAFA Is within 10% of design Outside Air. (%OAFA 5110%) (!�Y N Y / N C. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes)t.• Y / N Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 3 (VAV only) N a. %OAKA= Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) .k ' % b. %OAR, is within 10% of design Outside Air. (OARI 5110%) Y / N C. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) '�• ;;,;'' �, '; Y / N Note: The intent ofthis testis to ensure that 1) all air handlers provide the minimum amount of OSA and 2) controls to avoid over ventilation. ,AV air handlers use dynamic Evaluation: PASS: All Construction responses are complete and Testing Calculations & Results respons II are positive I (Y - yes) i CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance 11 June 2014 P W STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE I I r-ef t nRAIIA F1Ut=RRV r!f]halr�AfCCIf1A1 ~CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Pr J e: rr Enforcement Agen rM N 2. Zr�i Pr Anddr ❑ty: �!� II f Z��%%ZIS system N. idontlaca= Syste r norAl rea ed: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT A 1. I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Nnme. 1 V ;!5__ Documentation Author Signa e: I] n I Documentation Author Compan NaS a' O� Date Signed: 72�2_' Address: �,a I ATT Certification identification (If applicable Ctty/StatD Phone: �7 00 FIELD TECHNICIAN'S DECLARATION STATEMENT certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance I:Ield Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicabii acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the apLilicable acceptance requirements and procedures specified in Reference Non resldential;Appendix NA7- I 4. 1 have confirmed that the Certificates) of Installation for the construction or installation identified on tkis Certificate of Acceptance has been completed and signed by the responsible builder/installer and Chas been posted or inad V able -with the b ilding permit(s) issued for ding. Field Technician Name: Field Technician Signature: i i{ FleW Technician Compa N e: Position with Company (T1tle): Address: —An �J �c ATT Certification Identifirc`a ioonn (if applicabi � v— sr�"' !u, ate SIB"(,- , !� RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: l 1. 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 Certificate of Acceptance. 2 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to aceppt responsibility for the system design, construction or installation of features, materials, components, or manufactured devieel' for the scope of work Identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible,acceptance person). 3. The Information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated In the plans and speclfl ations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made aluailable with the building permit(s) Issued for the building, and made available to the enforcement agency for all applicable Inspe' lions. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the er provides to the building owner at occupancy. <---) I Responsible Acceptance Person Name: ResponslbleAcceptance Person S e:l' _ k Responsible p n e e pang me: Position with Company (Title): �'L�,.3-'•r"z' off'/ Addresr. n '1- /L l � r � CSLB License: O i:iry/Sru!etzih:"j [O �P e rJ e7F} Date signed: 1 7 (� GV CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance q June 2014 �'fe- STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY. (PACKAGED AND AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC_-NRr.A-Mr.H- 'A.A IRAwlz l nA11A1 SPLIT) CERTIFICATE OF ACCEPTANCE LNRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 3) Project Name: Enforcement Agency: uJd m ZQJr {7 JjW�rerLy+f�, �'q1r^, /,'J� yg �{ em. O Q ( 1ZIP Code: �J Gr System Name or endfication ag: System LomtIo r a Served: � A Note. Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Check e by/Date demonstrate compliance. u Construction Inspection 1. Supporting documentation needed to perform test includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NAZ5.2 C )nstant Volume, Single -zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At -A -Glance). b. 2013 Building Energy Efficiency Standards Manual. 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter bmp Meter 3. I ]latian (check If applies); A ermostat is located within the space -conditioning zone that is served by the HVAC system. 4. P ramming (check all those that apply): Thermostat meets the temperature adjustment and dead band requirements of 2013 Bulldln nual section 120.2(b). M mum heating setpoint:°F. Maximum cooling setpoint F. Deadband: -14; In Occupied, holiday Energy Efficiency Standards F. unoccupied, and schedules have been programmed per the facility's schedule. ❑ Pre -occupancy purge has been programmed to meet the requirements of 2013 Building Energ r Efficiency Standards Manual section 120.1(c 1. Check thod used to determine pre -occupancy purge: i Lesser of: conditioned floor area times ventilation rate from 2013 Building Ener ;y Efficiency Standards TABLE 120.1-A or 15cfm per person times the expected number of occupants. _ ❑ 3 complete air changes. Notes: J i STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIIj AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC NRCA�ACHdJ3-A (Revised 091141 CALI NIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE N RCA-MCH-03-A Const nt Volume 5ingle Zone Unit Packaged and Split) Air Conditioner and Heat Pump Syste ;s (Page 2 of 3) Project Na � Enforcement Agency: Prof dress: �j /"\ Q a J Cjry' �44— Zlp Code: System Name or Id en catlon/Teg: sysi m i�rlon breed: A. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpecte interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition p Step 4: Cooling load during occupied condition H Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 5 1 4 3 12 Step 2— 8: Check and verify the following for each simulation mode required 39 a. Supply fan operates continually f i b- Supply fan turns off Ion V1 C. Supply fan cycles on and off NFAWN d• System reverts to "occupied" mode to satisfy any condition e. System turns off when manual override time period expires f• Gas -fired furnace, heat pump, or electric heater stages on 9. No heating is provided by the unit h. No cooling is provided by the unit i. Compressor stages on )- Outside air damper is open to minimum position U k. Outside air damper closes completely Step 9: System returned to initial operating conditions after all tests have been completed: Y N B. Testing Results 8 17 16 15 14 13 1 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letterFm-PFirP C. Evaluation: PASS: All Construction Inspection responses are complete and all applicable Testing Results response, are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLI 0 AIR CONDITIONER AND HEAT PUMP SYSTEMS rF!`..nlrtrA_nrtrl-F_n.'La fP—F-4 nne,e, - i CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant V fume Single Zone UnitaryPackaged and Split) Air Conditioner and Heat Pump 5yste ;s (Page 3 of 3) Project Name: ! 'ddre Enforcement Agency: limb r. Pr ct .}ice ��JJ `✓�fr Cam: y iy yyy e NIA System Name or Identfficadon/Tag• System LQi Qotifrt:o servedy. DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this a ofAcceptanre doSumentation is accurate and complete. Documentation Author Name. /j,rj,� ,{ _I Documentation AutQr Sieaatufe: p f i Documentation Author Co N f , f�DateSWed: Address• )_ &r'��„, ATTCertlflcarMnldentlfication(Ifappllcahie�: Phone: G erF - FIELD TECHNICIAN'S DECLARATION STATEMENT i I� I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicabl 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. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identifl is Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or mad v . bie: ' h he building permit(s) issued fort u Ing. Field Technician Name. J Feld Technician Signature: f /J Field 7echnidan Cum y a e �� n /f��.ia f` , a Position withparry {Title}:�rjy Address Y�j�ry I�Ait,(,r� ,� ATT Certification Identfticatiann ff applicahlet City/Statej7lp: Ma 72-921 (� Pho `_ V L/"v �) iateSig+�d: ^� �L RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: I 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent a I I have reviewed the Information provided on this,Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to a !pt responsibility for the system design, construction or installation of features, materials, components, or manufactured device' for the scope of work Identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or install Iition identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifidtions approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specIfie�l in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on tl� s Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 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 a e Inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the docu ntati❑ he builder pr vides to the building owner at occupancy. Responsible Acceptance Person Nam �� l J ResponsibleAcceptanc e�ignaturg; !1 Responsible Arxeptance Perso Co p y a Roskion with Cvm n le}: I I „ ": L- Y 4tc) M *0 9 rD � I CSLB license: lQ1 � / 1 4* u ty��ra 'p: + t-1 o V.� ��I C�CJ I T'li! 06 :Zl'n 27hI— I I —{ CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance I June 2014