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BCOM2021-0029BUILDING PERMIT DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type: Building Commercial Permit Number: BCOM2021-0029 Property Address: 78065 MAIN ST STE 100 APN: 770121012 Legal Description Property Zoning: Valuation: $40,000.00 PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 06/14/2021 ISSUED DATE: 10/27/2021 CALIFORNIA Owner: OLD TOWN LA QUINTA LLC 78010 MAIN ST NO 201, LA QUINTA, CA 92253 Applicant: D B K GROUP 74985 Highway 111 Suite B, Indian Wells, CA 92210 Contractor: MARVIN INVESTMENTS INC 78100 MAIN STREET #203, LA QUINTA, CA 92253 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 application does not relieve that person of the requirement to give 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: 5/14/25 8:51 am Page 1 of 4 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2021-0029 Property Address: 78065 MAIN ST STE 100 construction lender preliminary notice from that duty. Printed: 5/14/25 8:51 am Page 2 of 4 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2021-0029 Property Address: 78065 MAIN ST STE 100 BE SO COFFEE / 1,228SF COFFEE SHOP TENANT IMPROVEMENT *** BE SO COFFEE / 1,228 SF COFFEE SHOP TENANT IMPROVEMENT [VB/B-OCC/41-OL/SPRINKLERED]. ENTRANCE THRESHOLDS, CURB RAMP AND PARKING SIGNAGE TO BE CORRECTED AS PATH OF TRAVEL UPGRADES. TUMF ASSESSMENT NOT TRIGGERED PER 2018 HANDBOOK. THIS PERMIT DOES NOT INCLUDE BUILDING SIGNAGE, STRUCTURAL ALTERATIONS, HVAC EQUIPMENT REPLACEMENT OR USE OF EXTERIOR PATIO. 2019 CALIFORNIA BUILDING CODES. #111# BE SO COFFEE / 1,228SF COFFEE SHOP TENANT IMPROVEMENT *** REVISION 2 - ARCHITECTURAL AS -BUILT, INCLUDING LAYOUT AND LIGHTING CHANGES, AND REVISION TO LIGHTING COMPLIANCE, ADD INSTALLATION OF PATIO DINING ENCLOSURE. #111# BE SO COFFEE / 1,228SF COFFEE SHOP TENANT IMPROVEMENT *** REVISIO 1 - PLUMBING AS -BUILT BASED ON INVESTIGATION INSPECTION OF WORK COVERED WITHOUT INSPECTION. ninstruction Dpt;. Commercial Work Type Remodel Building/Unit B: Office, Professional Conditioned Square 1228 Occupancy Footage Classification(s) Fire Sprinkler Square 1228 Occupant Load 41 Construction Type V-B Footage Code Edition 2019 Number of Plumbing 6 Fixtures/Traps City Development No Impact Fee Applicable Remodel Area Square 1228 Footage Water System Install Yes or Alteration? Art in Public Places No Fund Exempt New Electrical Square 1228 Footage Transportation Uniform No Mitigation Fee Applicable Type Group Sq Ft Value Invoice No. Fee PERM IT-BCOM2021-00, FIRE COMMERCIAL TI 9 BSAS SB1473 FEE TECHNOLOGY ENHANCEMENT FEE FIXTURE/TRAP REMODEL, FIRST 100SF NON-RESIDENTIAL, FIRST 2,000SF PC FIRE COMMERCIAL TI PC RECORDS MANAGEMENT FEE - MAJOR HOURLY CHARGE - CITY BUILDING STAFF REMODEL, FIRST 100SF PC REMODEL, EA ADDITIONAL 500SF PC WATER SYSTEM INST/ALT/REP PC WATER SYSTEM INST/ALT/REP NON-RESIDENTIAL, FIRST 2,000SF ALTERATIONS/ADDITIONS - NON-RESIDENTIAL REMODEL, EA ADDITIONAL 500SF FIXTURE/TRAP PC SMI - COMMERCIAL Total for Invoice PERMIT-BCOM2021-0029 Fee Amount Amount Paid $161.00 $161.00 $2.00 $2.00 $5.00 $5.00 $80.52 $80.52 $54.74 $54.74 $93.38 $93.38 $242.00 $242.00 $21.00 $21.00 $40.25 $40.25 $149.73 $149.73 $57.96 $57.96 $13.42 $13.42 $13.42 $13.42 $120.75 $120.75 $161.00 $161.00 $72.45 $72.45 $80.52 $80.52 $11.20 $11.20 $1,380.34 $1,380.34 Grand Total for Permit $1,380.34 $1,380.34 Printed: 5/14/25 8:51 am Page 3 of 4 BUILDING PERMIT Permit Type: Building Commercial Permit Number: BCOM2021-0029 Property Address: 78065 MAIN ST STE 100 Workflow Step / Action Name Action Type Start Date End Date Inspections v.1 06/14/2021 0:00 ---------------------------------------------------------------------------------------------------------------------------------------- FINAL** v.4 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- FINAL** v.3 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- FINAL** v.2 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- FINAL FOR OCCUPANCY v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- UNDERGROUND PLBG v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- FINAL** v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- ROUGH ELEC 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: 5/14/25 8:51 am Page 4 of 4 Tjhf 4 414�a" DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 (760) 777-7125 FAX (760) 777-7011 PATH OF TRAVEL UPGRADE DETERMINATION DATE: 7.31.21 STATUS: PLAN CHECKED BY: Jake Fuson TELEPHONE NUMBER: 760.777.708 ADDRESS: 78065 Main Steet Ste100 DESCRIPTION: Coffee Sho APPLICANT: Mario Apostoloff PLAN CHECK #: BCOM20210029 In accordance with the 2019 California Building Code (CBC) Section 1113-202.4, exception 8, the cost of compliance with Section 116-202.4 is allowed to be limited to 20% of the adjusted construction cost of the alterations, structural repairs or additions when the adjusted construction cost does not exceed the current valuation threshold. Construction cost for proposed project (not including costs of improvements to the path of travel to the area of alteration): $ 40,000.00 (A) Cost of alterations to areas on this path of travel undertaken during the preceding three-year period which did not provide an accessible path of travel to the area of alteration (as applicable): $ 0.0 (B) Adiusted construction cost (C) = (A) + (B) S 40,000.00 (C) PATH OF TRAVEL CONSTRUCTION COSTS: Elements serving the area of alteration based on priority Is element in compliance with current Chapter 116? (Y/N) If not, will element be upgraded to current Chapter 11B? (Y/N) Proposed cost of compliance with current Chapter 11B 1. An accessible entrance NO YES $800.00 2. An accessible route (interior and exterior) to the altered area. NO YES —truncated domes @ 1 locations. $600.00 3. At least one accessible restroom for each gender or a single accessible unisex, single user or family restroom NO YES — door sign & door modification. $1200.00 4. Accessible public telephones N/A N/A $ 5. Accessible drinking fountains N/A N/A $ 6. When possible, additional accessible elements such as: a. Parking NO YES -update signage $500.00 b. Storage N/A N/A $ c. Signs N/A N/A $ d. Alarms N/A N/A $ e. Other N/A N/A $ Total cost of providing compliant path of travel elements: $ 3,100.00 (D) COST OF PATH OF TRAVEL UPGRADES AS PERCENTAGE OF ADJUSTED CONSTRUCTION COST: Compliance of path of travel upgrades as % of adjusted construction cost: (E)% = (D) / (C) Note: This may not be less than 20% 3,100/ 40,000=7.75%(E) Page 1 of 1 AJ Ortega From: Katy Abel <katy@oldtownlaquinta.com> Sent: Thursday, October 7, 2021 10:43 AM To: AJ Ortega Subject: FW: Permit for Suite 100 EXTERNAL: This message originated outside of the City of La Quinta. Please use proper judgement and caution when opening attachments, clicking links or responding to requests for information. Thank you, Katy Abel Property Manager Old Town La Quinta 78-100 Main St., Ste. 203 La Quinta, CA 92253 Cell: 760.600.0758 From: Stephan Stephanoff <sstephanoff@hotmail.com> Sent: Wednesday, October 6, 2021 1:18 PM To: Katy Abel <katy@oldtownlaquinta.com> Cc: wellsmarvin@gmail.com Subject: Re: Permit for Suite 100 Dear Katy, Yes you have my permission to pull the permit and use our plans as necessary. Please let me know if you need anything else. Respectfully, Stephan Stephanoff Executive Manager theDBKGroup.com i DBK Lic# 1036671 PH: 442-666-4508 This email may contain confidential and privileged material for the sole use of the intended recipient(s). Any review, use, distribution or disclosure by others is strictly prohibited. If you are not the intended recipient (or authorized to receive for the recipient), please contact the sender by reply email and delete all copies of this message. From: Katy Abel <katy@oldtownlaquinta.com> Sent: Wednesday, October 6, 2021 1:02 PM To: Stephan Stephanoff <sstephanoff@hotmail.com> Cc: wellsmarvin@gmail.com <wellsmarvin@gmail.com>; Katy Abel <katy@oldtownlaquinta.com> Subject: Permit for Suite 100 Good afternoon Stephan, I left you a voicemail yesterday regarding the permit for 78065 Main Street, Suite 100. We will be pulling the permit to finish the work that is required there. The city says that we can do so but will need permission from D B K (as you are the permit applicant) to take over the application. This can be done via email. Can you please send me an email giving us permission to do this? Please let me know if you have any questions. Thank you, Katy Abel Property Manager Old Town La Quinta 78-100 Main St., Ste. 203 La Qu i nta, CA 92253 Cell: 760.600.0758 CAL FIRE - RIVERSIDE UNIT RIVERSIDE COUNTY FIRE DEPARTMENT uCv BILL WEISER — FIRE CHIEF OFFICE OF THE FIRE MARSHAL — LA QUINTA 78495 Calle Tampico, La Quinta, CA 92253 • Phone (760) 777-7074 • www.rvcfire.org June 21, 2021 Be So Coffee Dan Apostoloff 76755 Robin Drive Indian Wells, CA 92210 Re: Tenant Improvement Construction - Fire Plan Review — BE SO COFFEE BCOM2021-0029 / 78065 MAIN ST #100, LA QUINTA, CA 92253 The building plans you submitted for the above referenced project have been reviewed by Riverside County Fire Department - Office of the Fire Marshal personnel and are approved with the following conditions. Fire Department approval is based upon the 2019 CBC requirements for B occupancies. It is prohibited to use, process or store any materials in the occupancy that would classify it as a Group H occupancy, without further review and approval. DEFERRED SUBMITTALS REQUIRED 1) FIRE SPRINKLER SYSTEM - Tenant Improvement plans must be submitted and reference the installing contractor performing the work. Permit fees will be required. 2) FIRE ALARM/MONITORING SYSTEM - Where existing Fire Alarm system has notification appliances existing within the tenant space, Fire Alarm - Tenanat Improvement plans must be submitted per NFPA 72 as required by the California Building Code, California Fire Code and designed in accordance with adopted standards. A C-10 licensed contractor must submit plans to the Office of the Fire Marshal for review and approval prior to installation. Permit fees will be required. PRIOR TO FINAL 1) Minimum 6" tall suite addressing shall be provided to both the front and rear entrances. All addressing must be legible and of a contrasting color with the background to be visible from the street at all hours. 2) Provide keys to the tenant space (all tenants), utility rooms and elevator services for inclusion in the main building Knox Box. Key(s) shall have durable and legible tags affixed for identification of the correlating tenant space. 3) Install portable fire extinguishers per Title 19, but not less than 2AIOBC in rating. Contact a certified extinguisher company for proper placement and spacing of equipment. 4) A durable sign stating: "THIS DOOR TO REMAIN UNLOCKED WHEN THIS SPACE IS OCCUPIED" shall be placed on or adjacent to the front exit doors. The sign shall be in letters not less than one inch high on a contrasting background (A <300, B, F, M and S). 5) Illuminated Exit Signage and Egress Illumination placement and functional test will be witnessed by OFM Fire Inspector at time of final inspection. The Fire Department approved plans and conditions letter must be at the job site. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 48 hours in advance and may be arranged by calling (760)777-7131. All questions regarding the meaning of these conditions should be referred to the Office of the Fire Marshal staff at (760)777-7074. Kohl Hetrick - Fire Safety Specialist Kav Al R77 COACHELLA VALLEY WATER DISTRICT �NATER 75-515 Hovley Lane East Palm Desert, California 92211 �js�� ,(� (760) 398-2651 APPLICATION FOR WASTEWATER SOURCE CONTROL PLAN APPROVAL APPLICANT Submit this form with a copy of a SCALED plot plan (1"-20' to 1"-40' SCALE) drawn to District specifications A nonrefundable filing fee is required when the application is submitted. Check must be made payable to the Coachella Valley Water District. Approval of this application shall remain valid for a period not to exceed one (1) year from date of payment. NOTE: ALL USERS DISCHARGING FAT, OIL, A0D/OR GREASE, LOCATED IN A NIULTI- SUITE BUILDING w1LL REQUIRE A SEPAR%TE LATERAL OFF THE MAIN SEWER LINE FOR GREASE INTERCEPTOR CONNECTION. CV WD Source Control will inspect the exposed grease plumbing and the installed interceptor. Please call (760) 398-2661 X3710 48 hours in advance to schedule inspections . Agent. Contractor. Contact Person Address City State Zip Telephone STEPHAN STEPHANOFF 74985 HWY 111 SUITE B INDIAN WELLS, CA 92210 442.666.4508 Owner Address City State Zip Telephone DAN APOSTOLOFF 76755 ROBIN DRIVE INDIAN WELLS, CA 92210 Job Site Address city Zip 78065 MAIN STREET STE 100 LA QUINTA, CA 92253 Business Type Doing Business As COFFEE SHOP I BE SO COFFEE NOTE: NO PLANS WILL BE APPROVED UNTIL THIS APPLICATION IS COMPLETE AND PLAN CHECK FEES ARE PAID. Type of Construction: ❑ New 04 Remodel Hours of O eration: Cooling Tower(s) ❑ For Vehicle Service: For Food Service: ❑ Wand Bays ❑ Trench Drains ( ft) ❑ Water Softener ❑ Garbage Grinder(s) ❑ Digester(s) ❑ Roll over ❑ Service ba)(s) Multiservice (reusable) % Single Service (disposable)—= % ❑ Tunnel(s) ❑ Parts Washer Seating Capacity: Internal External ❑ Spill Containment (Solvent ❑ Aqueous ❑) Seating with Misters or Heaters ❑ Hydraulic Lifts ❑Work Sinks) Bar Seating 0 Bar Seating with Food Service 0 OWN ER/REPRESENTATIVE DECLARATION: I certify that I have read the entire application and state that all information is correct. I understand that the fee amount is based on my declaration of information on this form and that incorrect information is grounds for rejection of the submitted plans. I also understand that plans maybe discarded if not picked up within sixty (60) days of approval or return and that no District inspection of my establishment will be conducted all requested information has been received and plans have been approved. uunnttil Signature �� ( Date 2021.06.17 FOR DISTRICT USE ONLY No. of Systems Type of System(s) Pretreatment Equipment: ❑ Grease Interceptor ® Grease Interceptor Waived ❑ New ❑ Existing ❑ Sand/Oil 0 ® Connect to Sewer ❑ Addition ❑ Lint Trap ❑ Point of Connection Sample Station ❑ Replacement ❑ Clarifier ❑ Digester(s) Size: gals REMARKS: 1 . No grease interceptor will be required at this establishment at this moments if upon a follow-up inspection it is determined that high grease production is occuring. then a grease interceptor will be re uired. 2). CVWD encourages our customers to establish and follow good Best Management Practices. 3). Only water softener systems with exchangeable bottles are allowed. Thank you! This application is: ® Conditionally Approved' ❑ Approved �� PZ LID 'See Remarks Fee $ _ 6 — Check No.IvIi S A Q. Signature �/.aI✓L Date Initial Date 6-28-2021 C V WD-921 Rev 6 20 County of Riverside V; DEPARTMENT OF ENVIRONMENTAL HEALTH www riwoeh orb 4 SUPPLEMENTAL REPORT TO SAN. FORM E _ DATE SUBJECT i _ A Cw\ .. _ ..� PERW NO. ADDRESS n_ , DISTRICT • INSPECTOR �Gn REMARKS` \ , ► L\ C\ \ e a t a o f �{ a w� I .- A f h✓ r � 1 ntl 1� Vat/ E. t �\ r � CO r 0 -Cava f\ / I z'. O U jr RECEIVED BY: (�� l 40 w"llt-uRK., CJNMRY-Owrw Protecting People and the Envimnnneet^r i Plan Check# County of Riverside DEPARTMENTOF ENVIRONMENTAL HEALTH P.O. BOX 7909 • RIVERSIDE, CA 92513-7909 KEITH JONES, DIRECTOR FOOD ESTABLISHMENT PLAN APPROVAL NOTICE 51495 Date 7-28-2021 Project Be So Coffee Name Address 78065 Main Street Ste 100, La Quinta CA Plans Submitted by Yasmany Flores Phone 760-984-8764 Owner Mario Apostoloff Address 76755 Robin Drive, Indian Wells Phone None listed The plans are now approved subject to the conditions listed below and the attached compliance sheet 1. The dishwasher to be places on casters or 4 inch legs. 2. Sneeze guard protection will be evaluated onsite. Note: waiver for the grease interceptor letter received. CONSTRUCTION INSPECTIONS: Contactthe Plan Checkerfor a Preliminary Inspection when construction is approximately 80% complete, with plumbing, rough ventilation, and rough equipment installed. Requestfor inspection should be made at least five (5) working days in advance. "ALL ELECTRICAL, PLUMBING, MECHANICAL, AND STRUCTURAL REPAIRS AND INSTALLATIONS SHALL BE DONE UNDER PERMIT FROM THE APPROPRIATE BUILDING & SAFETY DEPARTMENT (CITY OR COUNTY)" A FINAL INSPECTION MUST be made upon completion of ALL work including finished details. APPROVALto 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 Tracev Ford Phone 760-863-8287 I acknowledge the corrections noted herein and as indicated on the plans and agree to incorporate them during construction: Signature Date Company Name Corona Hemet 2275 S. Main St #204 800 S. Sanderson #200 Corona, Ca 92882 Hemet, Ca 92545 (951) 273-9140 (951) 766-2824 Indio Murrieta 47-950 Arabia St "R' 38740 Sky Canyon Dr Indio, Ca 92201 Murrieta, Ca 92563 (760) 863.8287 (951) 461-0284 Palm Springs 544 S. Pasco Dorotea Palm Springs, Ca 92264 760-320-1048 Riverside -west 4065 County Circle Riverside, Ca 92503 (951)358-5172 Riverside -East 3880 Lemon St. Riverside, Ca 92501 (951) 955-8982 Office Locations • Blythe • Corona • Hemet • Indio • Murrieta • Palm Springs • Riverside Phone (888)722-4234 www.rivcoeh.org AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-03-A (Revised 01120) CERTIFICATE OF ACCEPTANCE Automatic Daylighting Control AcceptanrA Docum nt irortt N«�+y,, /f� e� ( h LO (fit i s c, , - .- / D n - . ri � _ E"raceme^t iV�^v. chy issloN 1MM 0 ____ NRCA-LTI-03-A (Page 1 of 6) Compliance Results: Enforcement Agency Use Checked by/pate ICOMPUES a OOES NOT COMPLY) Intent: This document is used to demonstrate compliance with acceptance requirements in 130.4 and Reference Nonr 3 esidential Appendix NA7.6.1 for automatic daylighting controls. Attach additional sets of pages 2 through 5, as required, for all controls must be tested. that bwkah am control (methods used for this project: - -- — — __- Continuous dimming controls (Sections A and B-2 of this document should be completed) , C_ Stepped switching / stepped dimming controls (Sections A and 8-2 of this document should be completed) A. 0tructlon Impaction (NA7.8.1.11 -- _ a The general lighting in skyht and primary sidelit daylit zones, or the general lighting in the combined primary and secondary sidelit da lit zones in parking garages, is controlled by automatic daylighting controls. (§130.�fd1) The daylit zones are shown on page(s) of plans; 1K b. OR The da lit zones are drawn in on pa e(s) — of as -built plans (attached). ( 130 1 d - ` d C. The automatic daylighting controls provide separate control for luminaires in each type of daylit zone. Luminaires that fall In both a s lit and prima sidelit da lit zone are controlled as part of the skylit zone t 0 1(d)21 d For photosensors located within a daylit zone, at least one photos~. or Is not readily accessible to unauthorized personnel. 30. d 4 e. The location where calibration adjustments are �ao'-,�r the automatic daylighting controls is readily accessible to authorized rsonnel includi inside a locked case or undthat re uires a tool for access. 130. d Construction Inspection Compliance: Complies QrDd%&Not Comply Jsea�co � Jai 11\ �o � P CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-AX.A rao ,i mr3n, CERTIFICATE OF ACCEPTANCE Automatic Daylighting Control Acceptance Document a Name aij I fbrn I Z ( RP,D 6,ton'ment Agerny; P t �dore,t d-L CCoagnuous Mmmbtg Control Systems Functio-nal Testing c ioor U RIX— NRCA-LTI-03-A (Page 2 of 6) rmM Number _.. I C Control is representative of sample. (NA7.") If sampling method is used, attach a page listing untested controls in sample. Step 1• Identify the reference location (the minimum daylighting location in the controlled zone). (hA7.6 1 2 ifal) For parking garages, illuminance levels should be measured at the farthest edge of the secondary sidelit zone away from the.glazing or o ening. (1 d a. Specify the power estimation method to be used: default ratio of power to light (Dfc), cut sheet ratio of power to light (CSfc) - cut sheet must be attached, measured Amps multiplied by Volts (VA), or measured watts W). Step 2: No daylight test. Simulate or provide conditions without daylight. N 7.6.1.2.1(d ) b Indicate the method used to simulate or provide conditions without daylight: night time manual measurement (Night), night time illuminance to ing (Log), cover fenestration(CIF),or cover hotosensor (CP C. Enter the reference illuminance value in footcandles (fc), as measured at the reference location. (ILA7.6.1.2.1(d{2) This is the electric lighting illuminance without an daylight. d Enter the measured full bad power in Volt -Amps (VA) if power estimation method (line a) = VA or in watts W ( ) if power estimation method = W. OR Indicate not applicable (N/A) if power estimation method (line a) =Dfc or CSfc. e Automatic daylight control system provides appropriate control so that the electric lighting system is providing full light output unless otherwise specified by design documents. NA7.6.1.2.1(d 1) Enter yes (Y) Or no (N) f. Light output is stable with no discernable flicker. 0A7.6. 2.1 3 Enter yes (Y) onto (N). Step 3: Full daylight test. Simulate or provide bright conditions where the daylight illuminance Is greater than 150% of the reference Illuminance measured In Step 2. (NAL6.1.2.1 e , 130 1 d 3C, §130 1(d)3n) Enter the daylight illuminance (light level with the electric lighting turned off) value in fdp andles (fc) measured at the g• reference location. h. Calculate the ratio of daylight illuminance to the reference illuminance in %. (Ifine g / line c) x 100) I. The ratio of daylight illuminance to the reference iflumina Enter yes Y) or no (line h) is greater than 150%. (§130.ifd13C. §130.1(d13D) (N . Enter the total Illuminance (combined daylight and electric light hiuminance) igfootcandles (fc) measured at the J. reference location If power estimation method (line a) = Dfc or..C3fc. OR Enter the measured power in Volt -Amps (VA) if power estimation method (line a) :- VA, or In watts W if _ ( ) _power estimation method (line a) = W. k Calculate the electric lighting illuminance in footcandles(fc) at the reference location If power estimation method (line a)= Dfc or CSfc. (line i -line g) OR indicate not aRlicable (N/j if power estimation method (line a) - VA or W I Calculate the fraction of rated ti OR Indicate not applicable output in % If power estimation method (line a) = Dfc or CSfc. ((line k / fine c) x 100) licable N/A if er est1mati01) method (line a) = VA or W. Enter the dimmed luminaire fraction of rated power in % if power estimation method (line a) = Dfc or CSfc, and Tlabelm. the control system being tested on the manufacturer's cut sheet or the default graph on page 3. OR Indicate no a Iktimable. N)< if ower esation method (line a = VA or W. Cakuiate the system power reduction in %. If power estimation method (line a) = Dfc or CSfc, system power reduction = (1 - dimmed luminaire fraction of ra n. power (line m)). OR If power estimation method (line a) = VA or W, system power reduction = [1 - measured power (line j)/full load power (line d . For areas other than parking garages, the system lighting power reduction of controlled luminaires (line o) is at least o. 1 65%. (NA7.6.1.2.1(e11, §130.1(d13C) OR For parking garages, the controlled li htin 1:' 0 1 d D Enter yes (Y) or no (NI. g g power consumption is zero. P. Dimmed lamps are stable with no discernable flicker. (NA7.6.1.2 11e11) Enter yes (Y) or no (N). 4 Only the luminaires in the daylit zones are affected by daylight control. A7. 1 2.1(e{2{ Enter yes (Y) or no (N). (.N�• r If a PAF is claimed for daylight dimming plus OFF controls, the system automatically turns off the luminaires that are receiving this credit. (NA7.6.1.2.1(,ej3, .6 2H Enter yes (Y), no (N), or not applicable (N/A). Step 4: Partial daylight test. Simulate or provide daylight conditions where illuminance (fc) from daylight only at the reference location is between 60 and 95% of the reference illuminance measured in Step 2. NA7,6.1. .1 ❑ There are 0 control steps between ON and OFF. (Indicate not applicable (N/A) for lines s through aa.) s. Indicate method used to simulate or provide conditions with partial daylight: natural daylight manual measure (NO), light logging (Log), partially cover fenestration (PCFpn I. oen Innn Outint Ai..-__. I—... ment CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 b I A It U+ CALIPORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-03.A (Ramose Ot/20) CERTIFICATE OF ACCEPTANCE CALIFORNIA ENERGY Commis Automatic Daylighting Control Acceptance Document NRCA-LTI-03-A w. (Page 3 of 6) P sU 1 CQ C1z! I fr�rn 1 Enlorcemem Weer cy amaoal - °I 11-L Contirwotts Dimming Control system FwxlWnal Testing (NA7,6.1.2.1) - t. Enter the daylight illuminance (light level without electric light) in footcandles (fc) measured at the reference location. 1 U. Calculate the ratio of daylight illuminance to the reference illuminance in %. ((line t / line c) x 100) V. The ratio of daylight illuminance to the reference illuminance (fine u) is between 60 and 95%. (NA7.6.1.2 1(fl) Enter yes Y or no N). W. Enter the total Illuminance (combined daylight and electric light illuminance) in footcandles (fc) measured at the reference location. X. The total illuminance (line w) is greater than or equal to the reference Illuminance (line c). (NA7.6.1.2.1(f11_ 130 1 (d)3 ) Enter yes Y or no N). Y. Calculate the ratio of total illuminance to the reference illuminance in %. ((line w / line c) x 100) The ratio of totl Illuminance to the reference illuminance (line y) is less than or equal to 150%, z. yes (Y) or no (Na)- (I�A71 f 7.) Enter aa. I The light output is stable with no discernable flicker. (NA7 6 i 2 rf►�) Enter yes (Y) or no (N). Functional Testing Compliance: Q Complies n Does Not Comply Default fraction of rated power to fraction of light output (used on line rn on page 2) 100% .. .... 3 80% c 70% HID ,'+'' f ---- 00, 40% Fluorescein _ !' - - - ° 30% f . ./' • 'LED LL 10% -- -- ------ O% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0 Fraction of rated light output CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 o, n i c ur i.HUrVKNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT C_ EC-NRCA-LTW3-A (Revisod 01120� CERTIFICATE OF ACCEPTANCE Automatic Daylighting Control Acceptance Doctlment g-L S 84AWM,d: r t 1r t r EMOMcMtnt Aden,, i Switchh* or Stepped DimwMg Control Systems Functional Testing (NA7.6.1.2.2) KO, NRCA-LTI-03-A (Page 4 of 6) __ 6 a01I - a`1 G I Control is representative of sample, N67..1.2) If sampling method is used, attach a page listing untested controls In sample Step 1, Identify the reference location (the minimum daylighting location in the controlled zone). (NA7.6.1.2.2fa1) For parking garages, illuminance levels should be measured at the farthest edge of the secondary sidelit zoway from the lazin or o Wing. 130 1 d a. Specify the control type: stepped dimming (SO) or stepped switching (SW). Specify the power estimation method to be used: counting (C) - only for stepped switching, cut sheet (CS) - ballast cut b. sheet with steps of power and light must be attached, measured Amps multiplied by Volts (VA), or measured watts fW1 Step 2: No daylight test. Simulate or provide conditions without daylight. (NAL 1.2.2(bl) Indicate the method used to simulate or provide conditions without daylight: night time manual measurement C. (Night), night time illuminance logging (Log) - attach plot of illuminance or power, cover fenestration (CF), or cover hotosensor CP . d Enter the reference Illuminance value in footcandles (fc), as measured at the reference location. This W the electric lighting illuminance level without any daylight. (NA7.6.1. .2 Enter the measured Amps multiplied by Volts in Volt -Amps (VA) if power estimation method (line b) - VA. OR Enter e. the measured watts (W) if power estimation method (line b) - W. OR Indicate not applicable (N/A) If power estimation method (line b) = C or CS. Automatic daylight control system turns on all stages of controlled lights unless it is docur►tOtsted that multi level f. luminaires have been tuned to less than full output and the design Illuminance levels are provided. (NA7.6.1.2.2(b12) Enter yes � or no (N). The stepped dimming control system provides reduced flicker over the entire operating range as specified by §110.9. g NA7.G 1.2. Enter s Y or no (N). OR Indicate not a icable N A if control type line a = SW. ��I p Step 3. Full daylight test. Simulate or provide bright conditions where the daylight illuminance is greater than ISO% of the reference illuminance measured in Step 2. (NA7.6.1.2.21c). 41T0.11 i�C 1 0 . d 0) h Enter the daylight Illuminance (light level with the electric lighting turned offj Maine in footcandles (fc) measured at the reference location. i. Calculate the ratio of daylight illuminance to the reference illuminance In%. ((line h / lined) x 100) The ratio of daylight illuminance to _the reference illuminance (line i) Is greater than 150%. (�13Q.1(�13C, §1301f d13D1 I Enter yes Y) or no (N) k. ( ? or VA p Enter the measured system power in Volt -Amps w power estimation method (line b) = VA or W. OR flits (W) if Indicate not a potable (N/A) if power estimation method (line b) = C or CS. I Enter the fraction of'system wattage turned off in % if the power estimation method (line b) = C. OR Indicate not licable A) if the power estimation method (line b) = CS, VA or Wter the power reduction of dimmed lamps calculated from the manufacturer's cut sheet if the power estimation q:a - line b = CS. OR Indicate not alicable N A if the power estimation method (line b) - C, VA, or W. lculate the system power reduction in %. If power estimation method (line b) = C, system power reduction = fraction of system wattage turned off (line 1). OR .If power estimation method (line b) = CS, system power reduction = power reduction of dimmed lamps (line m). OR If power estimation method (line b) = VA or W, system power reduction = (1 - measured system power at dimmed stage I line k)/full load system power line e) . For areas other than parking garages, the system lighting power reduction of the controlled luminaires (line n) is at o. least 6596. (NA7.6.1 2.2(c)1, 1130.11413C) OR For parking garages, the controlled lighting power consumption is zero. 130.1 d 3D Enter yes (Y) or no (NI. P. Only the luminaires in the daylit zones are affected by daylight control. (NA7.6.1.2.21c12) Enter yes (Y) or no (N). Q' If a PAF is claimed for daylight dimming plus OFF controls, the system automatically turns off the luminaires that a -re - receiving this credit. ( 1 .6 2H) Enter yes (Y), no (N), or not applicable (N/A). Step 4: Partial daylight test. For each control stage tested In this step, the control stages with lower setpoints than the staged tested are left on and those stages of control with higher setpoints are dimmed or controlled off. Simulate or provide conditions so that each control stage turns on and off or dims. (NA7.6.1.2.2(d)) CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January2020 b I A I It Uh L ALWUHNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI 03-A (Revised ot12o) CERTIFICATE OF ACCEPTANCE C� Automatic Daylighting Control Acceptance Document &2. Stepped Switching or 4'00'�' F ntorc•nem AQen•y �- - - — - - City Control Systems Furth nW Tasting Room. — Control NRCA-LTI-03-A (Page 5 of 6) wril Number: comaoa.) -ao� Enter the number of control steps between ON and OFF. If the control has 1 to 3 steps, all control stages must be r. tested. If the control has more than 3 steps, testing 3 control stages is sufficient for showing compliance. (NA7.6.1.2) If the control has 0 steps between ON and OFF, the partial daylight test is not necessary. ❑ There are 0 control steps between ON and OFF. (Indicate not applicable (N/A) for lines s through kk.) s. Indicate method used to simulate or provide conditions with partial daylight: natural daylight manual measurement NO), light to ing (Log), partial) cover fenestration WF). open loon cntnninr rn. CA First stage of control (partial daylight test) t Enter the total illuminance (combined daylight and electric light Illuminance) in footcandles (fc) measured at the reference location just after the first stage of control dims or shuts off a star of lighting. NA7.6.1. .2 d U. The total illuminance (line t) is greater than or equal to the reference illuminance (line d). (NA7.6.1.2 21d12A, §130.1 d 38) Enter es Y or no (N). 60 V. Calculate the ratio of total illuminance to the reference illuminance in %. ((Ilne t / line d) x 100) }• ' The ratio of total illuminance to the reference illuminance (line v) is less than or equal to 150%. (N W. A7.6.1.2._ d 18) Enter yes (Y) or no (N). X. The control stage does not cycle on and off between dim and undimmed while daylight illuminance remains constant. {NA7.6.1.2.2102) Enter yes 1Y) or no (tut y• Only the luminaires in the daylit zones are affected by daylight control. 2.2 Enter yes (Y) or no (N). Second stage of control (partial daylight test) t' C There is only 1 control step between ON and OFF. (Indicate wrap cable (N/A116r lines z through kk.) z Enter the total illuminance (combined daylight and electsk light illuminance) in footcandles (fc) measured at the reference location just after the second stage of control dims or shuts off a stage of lighting. NA7.6 1 2 2(d)1) aa. The total illuminance (line z) is greater than or equal to the reference illuminance (line d). (NA7.6.1.2 2ld111& 130.1 d 3B Enter yes (Y or no (N). bb. Calculate the ratio of total illuminance tothe reference illuminance in %. Mine z / line d) x 100) The ratio of total illuminance to the reference dlumirtance (line bb) A less than or equal to 150%. (NA7.6.1.2.21MB) CC. Enter yes (Y) or no (N). The control stage does not cycteon and offbetween dim and undimmed while daylight illuminance remains constant ( A7.6.1. .2 2) Enter yes (Y) or no(N). ee. Only the luminaires in the daylit zones are affected bgdaylight control. (NA7.6.1.2.2(d13) Enter yes (Y) or no (N). Third stage of control (partial daylight test) nEherEary ly 2 control stepsbetween ON and OFF. (Indicate not applicable (N/A) for lines ff through kk.) ntlal illuminance (combined daylight and electric light illuminance) in footcandles (fc) measured at the fercation just after the third stage of control dims or shuts off a stage of lighting (NA7 6 1 2 2(d)11 he total illuminance (line ff) Is greater than or equal to the reference Illuminance (line d). (NA7.6.1 2 2(d)1A, 13 .i d 38 Enter yes (Y) or no N). hh. Calculate the ratio of total Illuminance to the reference illuminance in %. ((line ff / line d) x 100) ii The ratio of total illuminance to the reference illuminance (line hh) is less than or equal to 150%. (NA7.6.1.2 2(d)18 Enter es Y) or no IN). ) The control stage does not cycle on and off between dim and undimmed while daylight illuminance remains constant. (NA7.6.L .7 d 2) Enter es (Y) or no (N). kk. Only the luminaires in the daylit zones are affected by daylight control. (NA7.6.1.2.2(d)3) Enter yes (Y) or no (N). Step 5: Veritytime delay. (NA7.6.12.2(e) II The time delay automatically resets to normal mode within 60 minutes. (NA7.6i1.2.2(e)1, §130.9(b12A)Enter yes (Y) or no N). mm. Set the normal mode time delay to at least 3 minutes. (NA7 6_ 12 2(e)2) nn. me There is at least a 3-minute tidelay between when Illuminance exceeds the setpoint fora given dimming stage and when the control dims or switches off the controlled lights. (NA7.6.1.2.2 e 3 Enter yes Y or no N . Functional Testing Compliance: Q Complies (; Does Not Comply CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CERTIFICATE OF ACCEPTANCE Automatic Daylighting Control Acceptance Docu ent Prgect Enlorcement Aacncv c all P,olc<t AAdress: ` DDCIJMENTATJON AUTHOR'S DECLAnA CALIFORNIA ENERGY COMMISSION NRCA-LTI-03-A (Page 6 of 6) Prrmtl Numtter I,v Code TION STATEMENT I certify that this Certificate Acceptance of documentation is accurate and complete. Documentation Author Name: YASMANY FLORE$ °cxumentatbn Authnr 9pnature: — _J Documentation Author Company Name: -- --- ---��- STUDIOS 2007 °aie 5`BnP� 2FEB22 Address CEA/ATT Certification Identification (If appllcabk,l: 73330 HWY 111 SUITE A _ _ _ _ _ _ city/state/zip PALM DESERT, CA 92260 _---- ph'760.984.8764 FIELD TECHNKIAN'S DECWIATM STATEMENT — --_._.-- I certify the following under penalty of penury, 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 (fieW Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable 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 identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) Issued for the building. Field Tec. nlc+an Name: , `i )� , I Field T Signature: J..Y -n Field Technician Company Name L Position 9 h C (Tate Address. ,,^ q S Pl-v \ ,� , 1 C� V I a r! , Ct t J` AR Cert+ kNtu Wenw,cation (if applicable): City/state/Zlp: t-_ I >!A t C ,3 tall Mta,lrs� ! wa•wa.wa, ` Ph ��L 1 (�. 7> >. DateSigncA' ll "fit wcaiwsrraMtaa,c -cnaou y a LIC%AAKATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California. 1. 1 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 Cede in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices 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 specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified In Reference Nonrepirepttal Appendix NA7. 4. 1 have confirmed that the Certificates) 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 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. Responsible Person Namc: ; 1 '► n ,�y� Respons,D Per .Signature -- W (C 1 1 \I Responsible Person Company Name. _ T Position with Company (I itlel 1 �s1f1'�Q n H s .Il— e-s en- +r r•N/State/Zlp La d I aio . CR • r �� -2P?f! r.\ r �,r, _ ��c v Date Sgned:11 t-A euitaing tnergy Etticiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA INDOOR LIGHTING rcc_uarv_i n_n,_r. ,o.,,,��..., n.•on� 0 CERTIFICATE OF INSTALLATION _ t..�Lirvnrvw trvt►cCiT GVMMI551VN � NRCI-LTI.01-E Indoor Lighting (Page 1 of 2) p•olect Name , (�_ call*(V(n,4.lhrn�o tntomemint Agemv � �Q 1 protect Addreu' 'j/ _ C J} . l 'l{: l.� , V i0 �. 1 rip Code: c-135 GENERAL INFORMATION DATE OF BUILDING PERMIT: PERMIT N BUILDING TYPE '%Nonresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION ❑New Construction ❑Addition L�Alteratlon ❑ Unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy efficiency measures for the scope of responsibilityfor this Installation Certificate. In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Date Approved By Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. the Enforcement Agency— - —� CA Building Energy Efficiency Standards - 2119 Nonresidential Compliance January 2020 CA Building Energy Efficiency Standards - 2119 Nonresidential Compliance January 2020 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCI-LTI-01-E (Rawsed Ot120) _CERTIFICATE OF INSTALLATION Indoor Lighting (� Prplect NamCe ^ f�() i '`7 :n I f , rntorcavreni Asencv� Protect Address V �� I~o f C". Era _ r,)l DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author "ame: YASMANY FLORES Documentat on Author Signat�,e tiocumenlation Author Cnmpany Name STUDIOS 2007 i;atr Signed: Address, CEA Certdkat:on Idenfificatio (if 73330 HWY 111 SUITE A aWKaD1e) IatY/State/Zip: PALM DESERT, CA 92260 Phone: 760.984.8764 RESPONSIBLE PERSON'S DECLARATION STATEMENT lip [ode MISSION is NRCI-LTI-01-E (Page 2 of 2) I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work Identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/Installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a completed signed copy of this Certificate of Installation 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 completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Budder/installer Name: fiesponsr a Bu IderJlnstaller naturc:J Company Name; (InstaUuS bcontnor ctor or Genera; Contractor Buier/owner) position With Company ( ldTitle); C1n rr Y.,, AddTess- CSLB LKense: _ Ri09,3 Ve veI!W c o C4y/5tate/Zip: P e U -[i��? Date Signed: CA Budding Energy Effinency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL ACCEPTANCE DOCUMENT , t:16-INIKUA-1..I1-W-A (Keyi8ed 01/19) CERTIFICATE OF ACCEPTANCE Shut -Off lighting Control Acceptance Document PrD t Na F+AerCement Agency. rp ( e Compliance Results; (COMPLIES or DOES NOT COMPLY) =ORNIA ENERGY COMMISSION N RCA-LTI-02-A (Page 1 of 3) rmx Nwnbtr. I — Enforcement Agency Ilse- Checked by/Date This document is used to demonstrate compliance with acceptance requirements In 4130.4(a)4 and Reference Nonresidential [intent: Appendix NA7.6.2 for shut-off lighting controls. Attach additional sets of pages 1 through 2, as required, for all controls that must be tested. N�dlcate aq types of shut -aril controls tested for this project: - - - - -- -- - — Automatic time switch lighting controls (Sections A-1 and B-1 of this document should be completed) Occupant sensing lighting controls (including occupant sensors, partial -ON occupant sensors, partial -OFF occupant sensors, and/or r vacancy sensors) (Sections A-2 and B-2 of this document should be completed) Autonwtle Time Switch LigMWS -- Controls - - - - ---- — - III •• ,,lr , A-1. Automatic Time Switch Lighting Control Construction Inspection Automatic time switch controls are programmed with acceptable weekday, weekend, and holiday (if applicable) schedules. a. (NA7.6,2.4 110.9 b 1Aii, 130.1 c 1A, 130.1L}4) b _ Document for the owner weekday, weekend, and holidays schedules, as well as all set-up and preference program settings. N 7.6.2.4 b t, The correct time and date are properly set in the time switch. (1%7-.5 2_tl(.()) ❑ d. The battery backup (if applicable) is installed and energized. (NA7.6,2.�1 6110<9(bI1) e• Override time limit Is no more than 2 hours. (NA7.6.2,dfe), §110.9 IlA1. §130.1(0313) OR The automatic time switch control's override time is exempt from the 2-hour limit. TION t c 3B Override switches remote from area with controlled luminaires have annunciator lights. (NA7.6.2.C% §130.1(c)3A. 130.1 ) 16/ f. OR The manual override switch is exempt from being in the same enclosed area with the lighting it controls. (EXCEPTION 1 to 1 0,1 a ) Construction Inspection Compliance: `) Complies (_; Does Not Comply 11111-1 Automatic Time Switch Ughting ConVol Functional Testing (NA7 . .S Confirm compliance (Y - yes / N - no)forthe control being tested. _ Step 1: Simulate occupied condition. -- a. All lights can be turned on and off by tftiair respective area control switch. ( A b The switch only operates lighting in the enclosed space Iceiling-height partitioned area) in which the switch is located. (NA7.6.2. 2, 13U_1 c For the area controlled by an automatic time switch control with a time override located in and for the area, the C. lightfngcan be turned on manually by initiating the time override. The lighting is configured to remain on for no more than 2 hours, unless the area is exempt from the 2-hour time override limit. (NA7.6,2.51a)3, §110.9(b)lAi. §130.1(c L3B , Y LXCLPhION to 313) 130.1 c For the area controlled by an automatic time switch control with an automatic holiday shut-off feature, the lighting in cl the area can be turned off automatically by initiating the holiday shut-off. (NA7.6.2.5(a)4, §110.9(b)lAii, 13 .] c 4) OR The automatic time switch control is exempt from incorporating an automatic holiday shut-off feature (EXCEPTION to S 130. 4) 1V For the area controlled by an automatic time switch control with manual -on mode configured, the lighting in the area e. can be turned on manually when it is manually activated. (NA7.6.2.5ialS §130.1(c11E) OR The automatic time switch k j control does not include or utilize a manual -on mode. ( 130.1 c ) Step 2: Simulate unoccupied condition. (NA7.6.2.5 b ,) All non-exempt lighting turns off 1n accordance with the programmed time switch schedules. (NA7.6.2.5(b)1, a. D� §130.1 c lA) Manual override switch allows only the lights in the enclosed space (ceiling height partitioned) where the override b. switch is located to turn on or remain on until the next scheduled shut off occurs. (NA 7.6.2.Sib12. §J 30.1(c)ic S 130.1 c 3) Functional Testing Compliance: Complies r) Does Not Comply CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2019 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA- TI-02-A (Revised 01; 191 rrRTIFIr'ATF ng: Ar'r'LOTANir'r Shut -Off lighting Control Acceptance Document Project Eniomtem"t �Ye"cr Crty tGY COMMISSION IS NRCA-LTI-02-A (Page 2 of 3) Pet meryt Number. I 0CPAppt Sensing Ughtlin Controls --.--. --_ _— Room .. ___ -- � __ __. - - B4d0 nK Teloo• _- I I Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. A-2.Occupant Sensing lighting Control Construction Inspection ( A7. 2) a. Occupant sensors have been located to minimize false signals. (NA7,6.2.2(al) b. Occupant sensors are located no closer than four (4) feet from any HVAC diffuser. (NA7.6.2.2(b)) c. Passive infrared sensor pattern does not enter into adjacent zones. (NA7.6.2.2(cl) d. Occupant sensors do not encounter any obstructions that could adversely affect desired performance. (NA7.6.2.2(d1) e. Ultrasonic occupant sensors do not emit audible sound. (NA7.6.2.2(a. §110.9(b)6Bii) Construction Inspection Compliance: C) Complies I Does Not Comply B-2. Occupant Sensing lighting Control Functional Testing (NA7.6.2,3) Confirm compliance (Y - yes / N - no) for the control being tested. _ Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)1 Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from start of an unoccupied condition. (NA7.I,2.Ka�1, J110.9(b)4A) in the partial off state, partial -OFF occupant sensors automatically reduce lighting power Mat least 50% (§130.1(c)6A- C, §130.1167A), OR: • For metal halide or high pressure sodium lighting in warehouses, automatically reduce lighting power by at least 40% (EXCFPTION 2 to c 6 ). • In aisle ways and open areas In warehouses in which the Installed lighting power is 80% or less of the value a allowed under the Area Category Method, automatically reduce lighting power by at least 40% (LXCEPTION l t to §130.1(c)6A). 4 1W • In corridors and stairwells In which thelnstalled lighting power is 80% or less of the value allowed under the Area Category Method, automatically reduce lighting power by at least 40% (EXCEPTION to §130 1(c)7A). Occupant sensing controls in parking garages, parking areas, and loading and unloading areas have at least one control step between 20 to 50% of design lighting power (§130.1(c)7B). OR Occupant sensing controls for metal halide luminaires with a lamp plus ballast mean system efficacy of 75 lumens per watt in parking garages, parking areas, and loading and unloading areas have at least one control step between 20 to 60% of design lighting power EXCEPTION to 130.1 r17B). b The occupant sensing control does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation. (L&62 3 a)2 Q c...1 Signal sensitivity is adequate to achieve desired control. (NA7.6.2 3(a13) For library book stacks or warehouse aisles,G beyond r activity the stack or aisle shall not activate the lighting in the stack or aisle. ( 13Q.1 c 6A, 13Q.1 c 6B) Step 2: Simulate an occupied condition. (NA7 6.1..3(b1) a. Status indicator or annunciator operates correctly. (NA7.6.2.3(bll, §11Q.9(b)4C) Immediately upon an occupied condition (NA7_f7. .lLbJ2): • Lights controlled by an occupant sensor or a partial -OFF occupant sensor turn on; OR • A vacancy sensor indicates a space is "occupied" and lights may be turned on manually; OR b • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. QS (§130 1(C)SA) After the first stage occurs for partial -ON occupant sensors, manual switches allow an occupant to activate the alternate set of lights, activate 1 % of the lighting power, and manually deactivate all of the lights. Functional Testina Comniianrp• r :• r,e. ii, , n,...,- E.L.. r M•...� � vvc� nv, t.uueNey CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2019 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A tReyiseif 01/19i CERTIFICATE OF ACCEPTANCE Shut -Off Lighting Control Acceptance Document Addres is1 / t fniacement Ager<y. cny: 9 I_fi n-�CA_ MISSION NRCA LTI-02-A (Page 3 of 3) rmt humper 21p 53 OOCWMENTATION AUTHOR'S DECLARATION STATEMENT - - - - certify that this Certificate of Acceptance documentation is accurate and complete. u Documpn`atfinn Author Name YASMANY FLORES Documentation Author signature Documentation Author Company Name: STUDIOS 2007 Date shined:- 3FE622 _ Address: CEA/ATT Certification Idenlrilcatron (if applicable► 73330 HWY 111 SUITE A city/state/71r, PALM DESERT, CA 92260 Phone:760.984.8764 FIELD TECHNICIAN'S DECLARATION STATEMENT --- I certify the following under penalty of penury, 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 applicable 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 ur installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name Fred htrjrgnati.1 ��r�d fie. L� n�. � . ; i,..�� _ , Posrtlptiwhh Company (Tltlel.*�r Freld technician Company Name- 1 L ty' i Lp�� !► Address' ATT Certihcat.On kllntifKation (A applicable); 4 H ar £S �„ Liu; e City/Sfat Zip: -- C -- . ( (� 7 Pho e: Date Signed '1 _may n,-T it F-' o- � � RESPONSI11111111►FRSON'S DECLARATION STATEMENT I certify the following under penalty of penury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Techrucran is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices 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 specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT 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 available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. 1 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. Responsible Person. Name: ] t 1 y) (1 Responsible wTson signature Position with panyITrtte) 1 Responsible Person Company Name. � ^' � f Address: 1� —* �� CSLB lkense city/State/zip: Lo, t ri 9 a s i, "nod) Date a �a I=1 CA Building Energy Efficiency Standards 2019 Nonresidential Compliance January 2019 STATE OF CALIFORNIA POWER ADJUSTMENT FACTORS Am CEC-NRCI-LTI-05-E Revised 01120) _ - CALIFORNIA ENERGY COMMISSION 4V CERTIFICATE OF INSTALLATION _ __ NRCI LTI 05-E Power Adjustment Factors (Page 1 of S) Proicct Name- it - CAI( (-n (S' �^ Enforceffwnl AKoncy it Nu ue, Prgect Address Ma lb t ^ /l "' 1 U ito code, 7 UtnItKAL IIVFUKMATIUIPI DATE OF BUILDING PERMIT: PERMIT #: BUILDING TYPE ` Nonresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF -- CONSTRUCTION ❑ New Construction ❑ Addition Alteration ❑ Unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate, Date: Power Adjustment Factor (PAF) §130.4(b) - Before a Power Adjustment Factor will be allowed for compliance with Section 140.6 of Part 6 of Title 24, the person who is eligible under Division 3 of the Business and Professions Code to accept responsibility for the construction or installation of features, materials, components, or manufartured devices shall sign and submit this Installation Certificate. §140.6(a) 2 - Reduction of wattage through controls. In calculating adjusted Indoor lighting power, the installed watts of a luminaire providing general lighting in an area listed in TABLE 140.6-A may be reduced by the product of (i) the number of watts controlled as described in TABLE 140.E-A, times (ii) the applicable Power Adjustment Factor (PAF), if all of the conditions in this Certificate of Installation are met. If any of the requirements in this Installation Certificate fail, the installation shall not be eligible for using the PAF. Check all that apply: PART 1 Certificate of Compliance Correctly Filled Out ❑ In addition to this Certificate of Installation, the PAF has been correctly documented on page 2 of NRCC-LTI-02-F Certificate of Compliance submitted to the building department. PART 2 Type of PAF ❑ A. This installation qualifies for the following PAFs: ❑ 1. This installation qualifies for the PAF for a Daylight Dimming plus OFF control ,n TABLE 140.6-A because it meets all of the following requirements: ❑ a. The PAF applies only to the luminaires in the primary sidelit daylit zone and the skylit daylit zone; and O b. The PAF used is 0.10; and Cl c. The daylight control and controlled luminaires comply with Automatic Daylighting Control requirements of Section 130.1(d); and ❑ d. The daylight dimming plus OFF controls is verified by the acceptance test required by Section 130.4(a)3; and ❑ e. The daylight dimming plus OFF controls is verified by the acceptance test required by Section 130.4(a)7; and ❑ f. This daylight dimming plus OFF control turn lights completely OFF when the daylight available in the daylit zone is greater than 150% of the illuminance received from the general lighting system at full power. CA Budding Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA POWER ADJUSTMENT FACTORS CERTIFICATE OF INSTALLATION Power Adjustment Factors Project Wmef /' _ -.. I rnlo MnWM Agency a NRCI-LTI-05-E (Page 2 of 5) Pfged , cvb l.' 1. V{-L � l AdWK1-�rKD(�yS m A-il ��- �� , J r'Y. . ❑ 2. This installation qualifies for the PAF for an occupant sensing control controlling the general lighting in large open plan office areas above workstations, in accordance with TABLE 140.6•A, because the following requirements have been met: ❑ a. The occupant sensing controls are in large open plan offices that are greater than 250 ft' and in addition: ❑ i. The PAF used is 0,40 for sensing controlled area no larger than 125 ft' ❑ ii. The PAF used is 0.30 for occupant sensing controlled area from 125 to 250 ft' ❑ iii. The PAF used is 0.2.0 for occupant sensing controlled area from 251 to 500 ft' ❑ b. This PAF is only being applied to office areas which contain workstations; and ❑ c. Controlled luminaires are only those which provide general lighting directly above the controlled area, or furniture mounted luminaires that comply with Section 140.6(a)2 and provide general lighting directly above the controlled area; and ❑ d Qualifying luminaires have been controlled by occupant sensing controls that meet all of the following requirements, as applicable: ❑ i. Infrared sensors have been equipped by the manufacturer, or fitted in the field by the installer, with lenses or shrouds to prevent them from being triggered by movement outside of the controlled area. ❑ ii. Ultrasonic sensors have been tuned to reduce their sensitivity to prevent them from being triggered by movements outside of the controlled area. ❑ iii. All other sensors have been installed and adjusted as necessary to prevent them from being triggered by movements outside of the controlled area. ❑ 3. This installation qualifies for the PAF for an Institutional Tuning in Table 140.6-A, because the installation meets all of the following requirements: ❑ i. The lighting controls limit the maximum output or maximum power draw of the controlled lighting to 85% or less of full light output or full power draw; and ❑ ii. The means of setting the limit is accessible only to authorized personnel; and ❑ iii. The setting of the limit is verified by the acceptance test required by Section 130.4(a)7; and ❑ iv. The construction documents specify which lighting systems have their maximum light output or maximum power draw set to no greater than 85% of full light output or full power draw. ❑ 4. This installation qualifies for the PAF for a Demand Responsive Control in TABLE 140.E-A, because the installation meets all of the following requirements• ❑ 1. The building is 10,000 W or smaller; and ❑ ii. The PAF used is 0.05. Note that luminaires that qualify for other PAFs may also qualify for this demand responsive control PAF. ❑ iii. The controlled lighting is capable of being automatically reduced in response to a demand response signal; and ❑ iv. Lighting has been reduced in a manner consistent w th uniform level of illumination requirements in TABLE 130.1-A; and ❑ v. Spaces that are non -habitable have not been used to comply with this requirement, and ❑ vi. Spaces with a lighting power density of less than 0.5 W/ ft. have not been counted toward the building's total lighting power CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 J I A t OF CALIFORNIA POWER ADJUSTMENT FACTORS CEC-NRCI-LTI-05-E (ReVi"d 01120) CERTIFICATE OF INSTALLATION Power Adjustment Factors PmKu ".mfO� (-e. C61 %{b r n i Project Address -�� 0 5 --Mai n S4- CALIFORNIA ENERGY COMMISSION 0 NRCI-LTl-05-E (Page 3 of S) _ffiMb I- Z'D Coda ❑ 5. This installation qualifies for the PAF for clerestory fenestration in TABLE 140.6-A, because the Installation meets all of the following requirements: ❑ I. The PAF applies only to the luminaires in primary or secondary daylit areas adjacent to the clerestory fenestration; and O h. The PAF applies only to the luminaires with continuous dimming daylighting controls meeting the requirements of Section 130.1(d) are installed; and ❑ iii. The installed clerestory fenestrations comply with the requirements in Section 140.3(d)1. ❑ 6. This installation qualifies for the PAF for horizontal slats in TABLE 140.E-A, because the installation meets all of the following requirements: ❑ 1, The PAF applies only to the luminaires in primary or secondary daylit areas adjacent to the horizontal slats; and ❑ ii. The PAF applies only to the luminaires with continuous dimming daylighting controls meeting the requirements of Section 130,1(d) are installed; and ❑ iii. The Installed horizontal slats comply with the requirements in Section 140.3(d)2. ❑ 7. This installation qualifies for the PAF for light shelves in TABLE 140.6-A, because the installation rneets all of the following requirements: ❑ i. The PAF applies only to the luminaires In primary or secondary daylit areas adjacent to the light shelves; and ❑ ii. The PAF applies only to the luminaires with continuous dimming daylighting controls meeting the requirements of Section 130.1(d) are installed; and O iii. The installed light shelves comply with the requirements in Section 140.3(d)3. PART 3 PAF Minimum Requirements Check all that apply: ❑ A. The lighting control used to earn the PAF is designed and installed in addition to all manual, and automatic lighting controls otherwise required in 130.1(a) through (e) ❑ EXCEPTION. The lighting control used to earn a PAF has been designed and installed for the sole purpose of compliance with Section 130.1(b)3, and this lighting control is designed and installed in addition to all other manual, and automatic lighting controls otherwise required in Section 130.1. ❑ B. The installed luminalre wattage has been determined in accordance with Section 130.0(c). ❑ C. Space types that qualify for the PAF comply with the definition for that space type in Section 100.1(b). ❑ D. Lighting controls and luminaires used to earn the PAF comply with Section 110.9 and Section 130.0 and 130.5. ❑ E. When using a lighting control system to earn a PAF, also submit the Installation Certificate for Energy Management Control System and Lighting Control System (NRCI-LTI-02-E). O F. The controls are permanently installed nonresidential -rated lighting controls. ❑ G. The controlled lighting used to earn this PAF is a permanently installed general lighting system. ❑ Furniture mounted luminaires qualify as general lighting system for the purpose of earning this PAF because the general lighting is in an office, and the furniture mounted luminaires comply with all of the following conditions: i. The furniture mounted luminaires have been permanently installed no later than the time of building permit inspection; and CA Budding Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 51AIE OF CALIFORNIA POWER ADJUSTMENT FACTORS CEC-NRCNLTI-OS-E (Revised 01;20L CERTIFICATE OF INSTALLATION Power Adjustment Factors Protect Name: Projm Address rnrone"m Apmy V�'r �t t I 1 1 1 tJ�� IYD fnd� MISSION 0 NRCI-LTI-05-E (Page 4of 55) 1 -mil ii. The furniture mounted luminaires have been permanently hardwired; and iii. The furniture mounted lighting system has been designed to provide indirect general lighting; and iv. Before multiplying the installed watts of the furniture mounted luminaire by the applicable PAF, 0.3 W/ ft' of the area illuminated by the furniture mounted luminaires has been subtracted from installed watts of the furniture mounted luminaires; and v. The lighting control for the furniture mounted luminaires complies with all other applicable requirements in Section 140.6(a)2. ❑ H. At least 50% of the light output of the controlled luminaire is within the applicable area listed in TABLE 140.6-A. Luminaires on lighting tracks are within the applicable area In order to qualify for a PAF. ❑ I. Only one PAF from TABLE 140.6-A has been used for each qualifying luminaire. PAFs have not been added together unless specifically allowed in TABLF 140.6-A. ❑ L. Only lighting wattage directly controlled in accordance with Section 140.6(a)2 has been used to reduce the installed watts as allowed by Section 140.6(a)2 for calculating the adjusted indoor lighting power. O Only a portion of the wattage in a luminaire is controlled In accordance to Section 140.6(a)2, and only that portion of controlled wattage has been reduced in calculating adjusted indoor lighting power. CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 6 1 A I t OF CALIfURNIA POWER ADJUSTMENT FACTORS CEC-NRCI-LTl-05-E (Revised 01r20) CERTIFICATE OF INSTALLATION is Power Adjustment Factors Prolecl Nome^.. Proles I Addreis fnforcernent Agency. - -7-& Ql.,trlR DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name t?ocumentatron Author Signature: YASMANY FLORES 41111111100". Documentation Author Companv Name: Date signed STUDIQS 2007 i a �- AdareisCEA Ceruficatlon Identification ff ( amikabi.): city/stan/zip-��3330 HWY 1-11 SUITE A _ PALM DESERT, CA 92260 P1io"` - _ 60.984.8764 RESPONSIBLE PERSON'S DECLARATION STATEMENT Ap Code NRCI-LTI-05-E (Page 5 of 5) I certify the following under penalty of perjury, under the laws of the State of California: I. The Information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the Installation) Identified on this Certificate of installation conforms to all applicable codes and regulations, and the Installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation 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 completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Restxsnsi� l�ail�r Name: 'pL r i n /, Respup ible Builder/ins ta r 51gna re; company Name: IniteUnig 115ubcontiactor�o-r GGene, 1racl^C•ontranor or / Cr ��^ Positlbn With Compen tfc� Awlder/owner) no T / t—'.1 .� � 1..." , Addio.s. CSIg L / L 1/ �j l C) ']li[cnsc Clty/State/Zlp: I v`- �/ C I � 1"OE-Y: � ��3�i Date Sigrittd a a a a Third Percy Quality Control Program (TPQCP) SUtus: Name of T PQCP (if aPPIKable). CA Building Energy Efficiency Standards 2019 Nonresidential Compliance January 2020 January 27, 2022 Dear City of La Quinta, Attention: Kohl Hetrick This letter is to provide information that Comtron took over the Existing Fire Alarm System located at 78-065 Main Street Building C La Quinta, CA 92253 with all existing devices in place. There are no As Built plans on file. Currently we have not had a request for additional devices for T.I's that may be required as needed. Please advise if we can be of any further assistance. Thank you, 800Yt11t�I m. COMT 770.88 . P.O. BOX 1347U PALM DE'SU1(C, CA 92255.3470 (760) 776-8811 FAX (760) 341-5971 SHASTA 760/404-1350 FAX 7601404-1354 CA LIC. NO. 476633 FIRE PROTECTION, INC AZ LIC. NO. 101519 info@shastafire.com 72120 Northshore St. Suite C Thousand Palms, CA 92276 City of La Quinta Riverside County Fire Department Att: Fire Safety Specialist Kohl Hetrick Re: Be So Coffee TI — MCOM2021-0029 / 78065 Main St. #100, La Quinta, CA 92253 To whom this may concern, Shasta Fire Protection, Inc. has been inspecting the Old Town La Quinta buildings annually since its origination. This letter is to confirm that the current tenant improvement at 78065 Main Street Suite 100 has no fire sprinkler system modifications, nor does it need any. Sincerely, Jonathan Stahl Vice President F�yp'9(i� COy� UNG CALIFOKN�P BCOM2021-0029 CITY OF LA QUINTA BUILDING DIVISION REVIEWED FOR CODE COM PLIANCE BY: A n _-6_ _ DATE: 011311-90, g REVISION 1 - PLUMBING AS -BUILT BASED ON INVESTIGATION INSPECTION OF WORK COVERED WITHOUT INSPECTION. 2" 41.01 "AY 11-0' TOL 24 F-Xlywlrw vaz i <' PluuWi» lo'1A t_ Fiv v5 Eo Zo Certificate of Occupancy Design and Development Department — GEM of the DESEKI' — This Certificate is issued pursuant to the requirements of Chapter 1 Section 111 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: 78065 MAIN ST STE 100 Use classification: BUSINESS - RESTAURANT (<50 OCCUPANTS) Occupancy Group: B Code Edition: 2019 M AJ ORTEGA Date: 9/21/2022 Building Official: AJ ORTEGA Type of Construction: VB Sprinkler Installed: YES Permit No.: BCOM2021-0029 Land Use Zone: VC Occupant Load: 41 Owner of Building: OLD TOWN LA QUINTA LLC Address: City, ST, ZIP: POST IN A CONSPICUOUS PLACE 78010 MAIN ST NO 201 LA QUINTA, CA 92253