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Home My WebLink About1350 POINSETTIA LN; ; CB102519; Permit12-30-2013 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit PermitNo: CB102519 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: Project Title: 1350 POINSETTIA LN CBAD COMMIND 2150704900 $1,962,522.00 Sub Type: COMM Lot #: 0 Construction Type: 3A Reference # Status: Applied: Entered By: Plan Approved: Issued: Inspect Area Plan Check #: ISSUED 12/22/2010 RMA 12/30/2013 12/30/2013 NORTH COAST CALVARY CHAPEL 17,972 SF TOTAL ( CHAPEL,-COFFEE/BOOKSTORE, MULTIPURPOSE ROOM , SHELL) & 3895 SF DECK. 1284 SF COVERED WALKWAY Applicant: CALVARY CHAPEL NO COAST Owner: CALVARY CHAPEL NO COAST 1330 POINSETTIA LN CARLSBAD CA 92011 1330 POINSETTIA LN CARLSBAD CA 92011 Building Permit $5,619.84 Meter Size Add'l Building Permit Fee $0.00 Add'l Red. Water Con, Fee $0.00 Plan Check $3,652.90 Meter Fee $0.00 Add'l Building Permit Fee $0.00 SDCWA Fee $0.00 Plan Check Discount $0.00 CFD Payoff Fee $17,477.77 Strong Motion Fee $412.13 PFF (3105540) $545.45 Park Fee $0.00 PFF (4305540) $0.00 LFM Fee $0.00 License Tax (3104193) $0.00 Bridge Fee $0.00 License Tax (4304193) $0.00 BTD #2 Fee $274,104.00 Traffic Impact Fee (3105541) $26,190.00 BTD #3 Fee $0.00 Traffic Impact Fee (4305541) $0.00 Renewal Fee $0.00 PLUMBING TOTAL $496.00 Add'l Renewal Fee $0.00 ELECTRICAL TOTAL $410.00 Other Building Fee $0.00 MECHANICAL TOTAL $169.00 Pot. Water Con. Fee $0.00 Master Drainage Fee $0.00 Meter Size Sewer Fee $9,604.42 Add'l Pot. Water Con. Fee $0.00 Redev Parking Fee $0.00 Reel. Water Con. Fee $0.00 Additional Fees $0.00 Green Bldg Stands (SBl 473) Fee $76.00 HMP Fee $0.00 Fire Expedidted Plan Review $0.00 Green Bldg Standards Plan Chk ?? TOTAL PERMIT FEES $338,757.51 Total Fees: $338,757.51 Total Payments To Date: $338,757.51 Balance Due: $0.00 nspector: FINAL APPROVAL Date: 0^66//5 Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactlons DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactinns of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously othenvise expired. 12-30-2013 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW100559 Job Address: Permit Type: Parcel No: Reference #: CB#: Project Title: 1350 POINSETTIA LN CBAD SWPPP 2150704900 CB102519 NO COAST CALVARY CHAPEL Lot #: Status: Applied; Entered By: Issued: Inspect Area: Tier: 13,442 SF CHAPEL/COFFE/BOOKSTORE & MULTIPURPOSE Priority: M Applicant: CALVARY CHAPEL NO COAST 1330 POINSETTIA LN CARLSBAD CA 92011 Owner: CALVARY CHAPEL NO COAST 1330 POINSETTIA LN CARLSBADCA 92011 ISSUED 12/23/2010 RMA 12/30/2013 1 Emergency Contact: JACK SHUBIN 760-929-0029 SWPPP Plan Check SWPPP Inspections Additional Fees $0.00 $208.00 $0.00 TOTAL PERMIT FEES $208,00 Total Fees: $208.00 Total Payments To Date: $208.00 Balance Due: $0.00 FINAL APPROVAL DATE g^/gg/Zg CLEARANCE, SIGNATURE Uy^^^ I CITY OF CARLSBAD Building Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov Plan Check No. EstValue f L f£2,<SrZ^^- Plan Ck. Deposit SWPPP JOB ADDRESS # Tl-OT# [PHK SUITE#/SPACE#/UNIT# APN 070 - ^ -^O CT/PROJECT # # OF UNITS # BEDROOMS # BATHROOMS TENAI>(T BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet ofAtfected Area(s) (ISTING USE 3^0rfl*ROPOSEDUSE | GARAGE (SF) | PATIOS (SF) | DEt^KS (SF) |TIREPLACE | AIR CONDIimiNG IFIRESPRITO EXISTING USE GARAGE (SF) coNTAS^ME^^...^^^^^ J/MfA^^ X^C^ ^^C m^iTM^O^ ADDRESS ~ ' I /StTrTtTl ADDRESS ~ 7i _ Z "/ PATIOS (SF) DECKS (SF) IREPLACE YESD #_ NOD AIR CONDITIONING YES •NOD FIRE SPRTlmERS YES • NOD .rr SJATE ZIP cw 5»TE PHONE I I jFAX ZIP PHONE EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS g^/5M ^ 92o// CITY STATE ZIP PHONE FAX ARbivDESIGNER NAME & ADDRESS ^ EMAIL CLASS CITY BUS. LIC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permitto construct, alter, improve, demolish or repair any structure, priorto its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7CX)0 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any vioiation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred doiiars ($500)). WORKERS- COMPENSATION Workers' Compensation Declaration: / herety affimi under pena/lc ofpeijuty one of fte follomng declaralbns: O I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this pemiit is issued, O 1 have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the perfomiance of the worii fbr which this pemiit is issued. My woriters' compensation insurance canier and policy number are: Insurance Co. Policy No. Expiralion Date This section need not be completed ifthe permit is for one hundred dollars ($100) or less. n Certificate of Exemption: I certify that in the performance of the worit for which this pemiil is issued, I shall not employ any person in any manner so as to become subject to the Woriters' Compensation Laws of California. 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. CONTRACTOR SiGNATURE • OAGENT DATE OWNER-BUILOEil DECLARATION / hereby affiim that I am exempt from Contractor's Ucense Law for the follomng reason: • I, as owner of the praperty or my employees with wages as their sole compensation, will do the worit and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such wortt himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). .Business and Professions Code for this reason: • Yes • No X • I am exempt under Section _ 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement, 2,1 (have / have not) signed an application for a building permit for the proposed worit, 3,1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4,1 plan to pravide portions of the worit, but I have hired the following person to coordinate, supenrise and provide the major worit (include name / address / phone / contractors' license number): 5.1 will provide some of the worit, but I have contracted (hirod) the following persons to provide the worit indicated (include name / address / phone / type of worit): ^^Jk<rj^-^Aji^, p ^^^^ ^^-^ 2J^A(n vgTpROPERTY OWNER SIGNATURE Ci'OMPLETi THIS SECTION FOR NON-RESIOENTIAL BUILOING PERMITS ONLV ^Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505,25533 or 25534 of the r»esley-Tanner Hazardous Substance Account Ad? • Yes • No Is the applicant or future building occupant requirod to obtain a pennit from the air pollution control district or air quality management district? • Yes • No Is the facility to be constmcted within 1,000 feet of the outer boundary of a school site? • Yes • No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFiCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AGCHtV I hereby affimi tliat there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code), Lender's Name Lender's Address APPIICANT CERTIFICATION I certily that I have read the application and state thatthe above infonnatian Is conect and that the Infonnatian on the pians Is accuiate. i agree to comply with all City oidinances and State laws relatingto buikling constmction. I hereby auihorize nepresentative of the City of Carisbad to enter upon tie above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST Aa LIABILfTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT, OSHA An OSHA perniit is required for excavations over 5'0' deep and demolition or constnidion of staictures over 3 stories in heighL EXPIRATION: Eveiy pemilt issued by the Building Oflicial under the preivislons of this Code shall expire by Iriltation and become nuH and void if lhe bulding or worit authorized by such pennit is not commenced wilhin 1 SO days from the date of such pennil or if the buiding Qrwo4authorizedby sudipennit is suspenciedjir abandoned at any Ume afler the worit is commenced for a peiiod of 180 days (Section 106,4,4 Unifoim Building Code), JB^WPIKAHTS SiGNATURE pennit or if the buiding qr worit authorized by such oennit is susoendedpr abandoned at any Ume afler the worit is commen Zo/d COMPLETE THIS SECTION FOR N O N - R E S I D E N T I A L BUILDING PERMITS ONLY Is the applkant or future buikling occupant required fo submit a business pian, acutely hazardous materials registration form or risk management and prevention program under Sectfons 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account AcT? Yes No Is the applicant or future buikling occupant required fo obtain a pemilt from the air pollutfon control district or air quality management districT? Yes No Is the fadlity fo be constructed within 1,000 feet of the outer boundaiy oia school site? Yes No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY NAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERViCES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENOING AGENCY I hereby affirm that there is a constniction lending agency for the perfomiance of the woik this pennit is issued (Sec. 3097 (i) Civil Code). Lender'sName Lender's Address APPLICANT CERTIFICATION I ceiti^ that I haw lead the appllcatkm and slate that the abow kifomiatlcn is oonect and that the Infoim I heieby auihorize representative of the City of Cartstiad to enter upon the above mention^ AGAINST ALL UABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA An OSHA pemilt is requirad for excavalkxis over S'O'deep and denrnlitlon or constn^^ EXPIRATION: Every permit issued by the Building Olfcial under the provisions of this Code shall expne by limitatton and become nul and void if Ihe building or vmk authorized by such pemiit is not commenced wthin 180 days from Ihe dale of such permit or if Ihe buiUing or vtorit authorized by such permit is suspended or aband^ ^ETAPPLICANT'S SIGNATURE OATE STOP: THIS SECTION NOT REQUIRED FOR BUiLDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602.8560, Email buildinalScarlsbadca.OOV or Mail the completed fonn to City of Carisbad, Building Division 1635 Faiaday Avenue, Carisbad, Califomia 92008. C0#: (Offlee Use Only) CONTACTNAME OCCUPANT NAME BUILDING ADDRESS ADDRESS crrY STATE ZIP cmr STATE Carlsbad CA ZIP J>H0NE FAX rru>6\ ^2A• 002A \h^e^ jz^• o\(o°[ ^MAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Usted above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: (IcONTACT(UstedaboveQ OCCUPANT (Listedabove) CONTRACTOR (On Pg. 1) ASSOCIATED CB#- MAIL/FAXTOO'mER: >efApS^T'S SIGNATURE Z' J NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION DATE Inspection List Permit*: CB102519 Type: COMMIND COMM NORTH COAST CALVARY CHAPEL 17,972 SF TOTAL ( CHAPEL,-COFFEE/BO Date Inspection Item Inspector Act Comments 04/03/2015 89 Final Combo -Rl 04/02/2015 89 Final Combo -Rl 04/02/2015 89 Final Combo MC Fl SHELL ONLY 04/01/2015 89 Final Combo MC PA SEE CARD FOR NOTES 04/01/2015 89 Final Combo -Rl 03/27/2015 29 Final Plumbing -Rl 03/27/2015 39 Final Electrical -Rl 03/27/2015 49 Final Mechanical -Rl 03/26/2015 29 Final Plumbing -Rl 03/26/2015 39 Final Electrical -Rl 03/26/2015 49 Final Meciianical -Rl 03/26/2015 89 Final Combo MC PA 03/25/2015 29 Final Plumbing -Rl 03/25/2015 39 Final Electrical -Rl 03/25/2015 49 Final Mechanical -Rl 03/25/2015 89 Final Combo MC PA 03/24/2015 29 Final Plumbing MC WC 03/24/2015 29 Final Plumbing -Rl 03/24/2015 49 Final Mechanical MC AP RECEIVED T-24 REPORT 03/24/2015 49 Finai Mechanical -Rl 03/23/2015 29 Final Plumbing MC AP RESTROOMS/CAFf 03/23/2015 29 Final Plumbing -Rl 03/20/2015 89 Final Combo MC PA UPPER FLOOR PRE-LIM 03/19/2015 89 Final Combo MC PA PRE-WALK 03/18/2015 89 Final Combo MC PA PRE-FINAL WALK 03/17/2015 39 Final Electrical MC PA SEE CARD 03/16/2015 39 Final Electrical PD CA 03/10/2015 39 Final Electrical MC PA ROOF EQUIPMENT ONLY 02/26/2015 11 Ftg/Foundation/Piers MC NR 1 ST STOP 02/26/2015 11 Ftg/Foundation/Piers MC AP 2ND STOP 02/23/2015 92 Compliance Investigation MC PA ACCESS 02/20/2015 11 Ftg/Foundation/Piers MC PA 02/18/2015 11 Ftg/Foundation/Piers MC NR 02/06/2015 14 Frame/Steel/Bolting/Weldin MC AP ROTUNDA HARD LID 02/06/2015 34 Rough Electric MC AP ROTUNDA HARD LID 02/06/2015 44 Rough/Ducts/Dampers MC AP ROTUNDA HARD LID 02/05/2015 14 Frame/Steel/BoltingAA/eldin MC NR 02/05/2015 34 Rough Electric MC NR 02/04/2015 17 Interior Lath/Drywall MC PA RM 105 EXCEPT ROTUNDA 02/04/2015 34 Rough Electric MC WC 02/03/2015 17 Interior Lath/Dryw/all MC PA Friday, April 03, 2015 Page 1 of 4 02/03/2015 34 Rough Electric MC WC 01/30/2015 85 T-Bar PD AP 01/29/2015 17 Interior Lath/Drywall MC PA 01/29/2015 34 Rough Electric MC WC 01/28/2015 17 Interior Lath/Drywall MC PA 01/28/2015 34 Rough Electric MC NR 01/28/2015 44 Rough/Ducts/Dampers MC NR 01/27/2015 17 Interior Lath/Drywall MC PA 01/27/2015 34 Rough Electric MC NR 01/26/2015 85 T-Bar MC AP 2ND STOP, RM 102 SUSPENDED HARD LID 01/26/2015 85 T-Bar MC NR 1ST STOP 01/23/2015 18 Exterior Lath/Drywall MC WC 01/23/2015 34 Rough Electric MC WC 01/23/2015 85 T-Bar MC NR 01/22/2015 17 Interior Lath/Drywall MC AP SEE CARD 01/22/2015 84 Rough Combo MC AP HARD LIDS, SEE CARD 01/21/2015 18 Exterior Lath/Drywall PD CA 01/20/2015 85 T-Bar PD AP 01/15/2015 17 Interior Lath/Drywall MC PA RM 101 01/15/2015 18 Exterior Lath/Drywall MC WC 01/14/2015 17 Interior Lath/Drywall MC NR NO SUPER AVAILABLE 01/13/2015 17 Interior Lath/Drywall MC PA LOWER LEVEL CHAPEL, SEE CARD 01/12/2015 14 Frame/Steel/BoltingAA/eldin MC AP PROSCENIUM WALLS 01/12/2015 17 Interior Lath/Drywall MC AP RM 10,1 NORTH SOFFIT 01/08/2015 17 Interior Lath/Drywall MC AP RM 100, 105 01/07/2015 17 Interior Lath/Drywall MC AP RM 207,211 01/06/2015 17 Interior Lath/Drywall MC PA ROOMS 102-103, 107-108, 111-113 12/31/2014 17 Interior Lath/Drywall MC PA 12/30/2014 14 Frame/Steel/BoltingAA/eldin MC PA WALL FRAME AT RM 211, SOFFIT Frame/Steel/BoltingAA/eldin FRAME AT RM. 102 12/30/2014 17 Interior Lath/Drywall MC PA INTERIOR DRYWALL SHEAR, RM 207 12/29/2014 17 Interior Lath/Drywall MC PA DRYWALL SHEAR, SEE CARD 12/24/2014 16 Insulation MC PA 12/24/2014 17 Interior Lath/Drywall MC PA RM. 204, 215-218 12/23/2014 17 Interior Lath/Drywall MC PA SEE CARD 12/23/2014 18 Exterior Lath/Drywall MC AP 12/22/2014 14 Frame/Steel/BoltingAA/eldin MC AP INTERIOR SHEAR WALLS AT 2ND FLOOR 12/22/2014 16 Insulation MC AP RM 201, 211 HARD LID AREAS 12/19/2014 18 Exterior Lath/Drywall PD AP 12/18/2014 16 Insulation MC PA SEE CARD 12/18/2014 17 Interior Lath/Drywall MC PA SEE CARD 12/17/2014 16 Insulation MC PA SEE CARD 12/17/2014 18 Exterior Lath/Drywall MC NR 12/17/2014 84 Rough Combo MC PA SEE CARD 12/16/2014 14 Frame/Steel/BoltingAA/eldin MC PA SEE CARD 12/16/2014 16 Insulation MC PA CEILING, RM 101 12/16/2014 17 Interior Lath/Drywall MC PA SEE CARD Friclay, April 03, 2015 Page 2 of 4 12/16/2014 34 Rough Electric MC PA CAFe 12/15/2014 14 Frame/Steel/BoltingAA/eldin MC PA SEE CARD 12/15/2014 16 Insulation MC NR 12/15/2014 18 Exterior Lath/Drywall MC NR 12/15/2014 34 Rough Electric MC PA SEE CARD 12/12/2014 16 Insulation MC NR 12/12/2014 18 Exterior Lath/Drywall MC PA SEE CARD 12/11/2014 16 Insulation MC PA SEE CARD 12/05/2014 17 Interior Lath/Drywall PD CA 12/04/2014 14 Frame/Steel/Bolting/Weldin MC PA INTERIOR DOUBLE SHEAR WALLS 12/04/2014 23 Gas/Test/Repairs MC AP 12/03/2014 23 Gas/Test/Repairs MC NR 1ST STOP 12/03/2014 23 Gas/Test/Repairs MC NR 2ND STOP 12/03/2014 84 Rough Combo MC NR 12/02/2014 16 Insulation MC PA SEE CARD 12/02/2014 34 Rough Electric MC PA SEE CARD 12/01/2014 15 Roof/Reroof MC AP ELEVATOR 12/01/2014 24 Rough/Topout MC PA BUILDING SUPPLY/CAFe 11/26/2014 16 Insulation MC PA NORTH BLDG. 2ND FLOOR WALLS, SHEAR PRE LIM 11/26/2014 18 Exterior Lath/Drywall MC PA SEE CARD 11/25/2014 24 Rough/Topout MC PA WASTEA/ENT 11/25/2014 44 Rough/Ducts/Dampers MC PA 11/24/2014 84 Rough Combo MC PA 11/19/2014 24 Rough/Topout PD AP 11/18/2014 17 Interior Lath/Drywall PD AP 11/18/2014 18 Exterior Lath/Drywall PD AP 11/18/2014 66 Grout PD AP 11/11/2014 14 Frame/Steel/BoltingAA/eldin MC PA 11/11/2014 18 Exterior Lath/Drywall MC PA DENS-GLAS 11/11/2014 24 Rough/Topout MC PA ROOF DRAINS, SEE CARD 11/06/2014 14 Frame/Steel/BoltingAA/eldin MC PA PRE-LIM 11/05/2014 14 Frame/Steel/BoltingAA/eldin MC PA COLUMN/ARCHWAY FRAME/ELECTRICAL AT LINE A 11/05/2014 18 Exterior Lath/Drywall MC PA DENSGLAS, 1ST/2ND FLOORS. SEE CARD. 11/04/2014 18 Exterior Lath/Drywall MC PA BASE LAYER DENS-GLAS, SEE CARD 10/31/2014 15 Roof/Reroof MC PA VESTIBULE, EYEBROW 10/31/2014 17 Interior Lath/Drywall MC PA SECOND LAYER, SEE CARD 10/30/2014 15 Roof/Reroof MC NR AFTER STOP 10/28/2014 15 Roof/Reroof MC PA SEE CARD 10/23/2014 17 Interior Lath/Drywall MC PA PER-LIM 10/20/2014 14 Frame/Steel/BoltingAA/eldin MC PA PER-LIM SHEAR TRANSFER, SEE CARD 10/09/2014 15 Roof/Reroof MC PA MECHANICAL WEEL FLAT ROOF 10/02/2014 15 Roof/Reroof MC PA PERIMETER AT MECH. WELL ONLY 09/16/2014 11 Ftg/Foundation/Piers MC NR 1 ST STOP 09/16/2014 11 Ftg/Foundation/Piers MC AP 2ND STOP, SEE CARD 09/15/2014 11 Ftg/Foundation/Piers MC NR 09/11/2014 11 Ftg/Foundation/Piers MC AP EAST STAIRS Friday, April 03, 2015 Page 3 of 4 09/10/2014 11 Ftg/Foundation/Piers 09/09/2014 11 Ftg/Foundation/Piers 09/03/2014 11 Ftg/Foundation/Piers 07/31/2014 11 07/25/2014 11 07/25/2014 23 07/24/2014 21 07/24/2014 23 07/21/2014 31 07/17/2014 92 07/16/2014 92 07/11/2014 11 07/10/2014 11 07/10/2014 31 07/09/2014 21 07/08/2014 21 07/03/2014 11 06/27/2014 11 06/16/2014 11 05/30/2014 21 05/30/2014 31 05/29/2014 21 05/19/2014 22 05/19/2014 92 05/01/2014 92 Ftg/Foundation/Piers Ftg/Foundation/Piers Gas/Test/Repairs Underground/Under Floor Gas/Test/Repairs Underground/Conduit-Wrin Compliance Investigation Compliance Investigation Ftg/Foundation/Piers Ftg/Foundation/Piers Underground/Conduit-Wrin Underground/Under Floor Underground/Under Floor Ftg/Foundation/Piers Ftg/Foundation/Piers Ftg/Foundation/Piers Underground/Under Floor Underground/Conduit-Wirin Underground/Under Floor Sewer/Water Service Compliance Investigation Compliance Investigation MC MC MC MC MC MC MC MC PD PD PD MC MC MC MC MC MC PY MC MC MC MC MC MC MC PA PA PA AP AP PA PA CO AP CA AP PA PA PA PA PA PA NR PA PA PA PA WC PA PA COMPLETION 2ND FLOOR PAN DECK PAN DECK, SEE PLANS, EXTERIOR STAIR LANDING AT LINE A BIO-SWALE S.O.G. POC TO BLDG. BLDG.SUPPLY PROVIDE TEST SEE CARD GRADE BEAMS, SEE CARD UFER ELEVATOR PIT DRAIN TO BIO-SWALE BIO SWALE, 12 IN DRAIN TO POC ELEVATOR PIT WALLS ONLY PAD FOOTINGS/STEEL, SEE CARD WASTE TO POC CONDUIT ONLY(2-4 IN) MEET W/ITH DAN AND JACK FOR PRE- CON QUESTIONS ABOUT SITE CONDITIONS Friday, April 03, 2015 Page 4 of 4 •x^ • • . CAf?L&4p INSPECTION RECORD Building Division !i/etui r 44:: CB102519 1350 POINSETTIA LN :^ / NORTH COAST CALVARY CHAPEL . ' I"'- 17,972 SF TOTAL ( CHAPEL,-COFFEE/BOOKSTORE, ' MULTIPURPOSE ROOM , SHELL) & 3895 SF DECK, 1284 SF COVERED WALKWAY COMMIND COMM Lot#: CALVARY CHAPEL NO COAST RECORD COPY 0 INSPECTION RECORD CARD WITH APPROVED PLANS MUST BE KEPT ON THE JOB 0 CALL BEFORE 3:30 pm FOR NEXT WORK DAY INSPECTION 0 FOR BUILDING INSPECTION CALL: 760-602-2725 OR GO TO: www.Carlsbadca.qov/Buildinq AND CLICK ON "Request Inspectioty ^ DATE: 'sf: I ? IF "YES" IS CHECKED BELOW THAT DIVISION S APPROVAL IS REQUIRED PRIOR XO^REQUESTING A FlNAL BUILDING INSPECTION. IF YOU HAVE ANY QUESTIONS PLEASE CALL THE APPLICABLE DIVISIONS AT THE PHONE NUMBERS PROVIDED BELOW, AFTER ALL REQUIRED APPROVALS ARE SIGNED OFF- FAX TO 760-602-8560. ElvlAIL TO BLDGINSPECTIONS@CARLSBADCA.C;nv OR BRING IN A COPY OF THIS CARD TO: 1635 pARADAY AVE.. CARLSBAD. CA 92008. BuiLDING INSPECTORS CAN BE REACHED AT 760-602-2700 BETWEEN 7:30 AM - 8:00 AM THE DAY OF YOUR INSPECTION. NO YES Required Prior to Requesting Building Final If Checlced YES Date Inspector Notes >^ Planning/Landscape (2,^ 760-944-8463 Allow 48 hours / CM&I (Engineering Inspections) 760-438-3891 Call before 2 pm /•' ' •' X Fire Prevention 760-602-4660 Allow 48 hours X JJ^ViD ^\CKi LAK5>j)EV htiS 7l.C:(e^'Z,-27.31 Ijiukois / Type of Inspection CODE # BUILDING #11 FOUNDATION Date #17. REINFORCED STEEL Inspector Type of Inspection CODE # ELECTRICAL Oate #34 ROUGH ELECTRIC #31 • ELECTRIC UNDERGROUND JZIIFER |o'7^Le^tA Inspector MASONRY PRE GROUT #33 • ELECTRIC SERVICE DTEMPORARY • GROUT n WALL DRAINS #35 PHOTOVOLTAIC #10 TILTPANELS #11 POURSTRIPS #11 COLUMN FOOTINGS #39 FINAL CODE # MECHANICAL #41 UNDERGROUND DUCTS & PIPING #14 SUBFRAME • FLOOR • CEILING #44 • DUCT&PLENUM • REF. PIPING #15 ROOFSHEATHING #43 HEAT-AIR COND. SYSTEMS #13 EXT. SHEAR PANELS #16 INSULATION #18 EXTERIOR LATH #49 FINAL CODE # COMBO INSPECTION #81 UNDERGROUND (11,12,21,31) #17 INTERIOR UTH & DRYWALL #82 ORYWALLEXT UTH, GAS TES (17,18,23) #51 POOLEXCA/STEEL/BOND/FENCE #83 ROOFSHEATING, EXTSHEAR (13,15) #55 PREPLIVSTER #84 FRAME ROUGH COMBO (14,24,34,44) W7 #19 FINAL CODE # PLUMBIN^ #22 ^gf EWER & BL/CO PL/CO #85 T-Bar (14,24,34,44) Date I0WASTE #21 UNDERGROUNp,grWASTE • WTR #24 TOPOUT ;zrWASTE DWTR 114 Inspector #89 FINAL OCCUPANCY (19,29,39,49) FIRE He 1^ Inspector A/S UNDERGROUND VISUAL #27 TUB & SHOWER PAN A/S UNDERGROUND HYDRO #23 jatlAS TEST • GAS PIPING #25 WATER HEATER A/S UNDERGROUND FLUSH A/S OVERHEAD VISUAL #28 SOUR WATER A/S OVERHEAD HYDROSTATIC #29 FINAL GODE # STORM WATER #600 PRE-CONSTRUCTION MEETING A/S FINAL F/AROUGH-IN F/A FINAL #603 FOLLOW UP INSPECTION FIXED EXnNGUISHING SYSTEM ROUGH-IN #605 NOTICETOCLEAN FIXED EXTING SYSTEM HYDROSTATICTEST #607 WRITTEN WARNING FIXED EXTINGUISHING SYSTEM FINAL #609 NOT!CEOFVIOUTION MEDICAL GAS PRESSURETEST #610 VERBALWARNING MEDICAL GAS FINAL PEV10C012 SEE BACK FOR SPECIAL NOTES Section 5416. Health and Safety Code, State of California <a) Ti'i-*;,e shall be not less than one water closet for eacI: 20 employees or fractional part thereof working i-f. it Oonstruction job site. The water closet shall consist of a patented chemical type toilet. (b) For the purpose of this section the term construction site sl-rdll moan the location on which actual construction of a building is in progress. (c) A violation of this section shall constitute a misdemeanor. All constmction or work for which a permit is required shall be subject to inspection and all such construction or work shall remain accessible and exposed for inspection purposes until approved by the inspector. Work shall not be done beyond the point indicated in each successive inspection without first obtaining the approval of the inspector. DATE ADDITIONAL NOTES 2 1 • ^ • »—^ t —• ^— 7 —^ pn,/^'mpc^ AT /..JALC^ u4f? ^ » A.-? ^ . I ^ Mgi MB^. t>XE^ ^>titMUt*k, fiMUfSe^ ofribrr ^ •, Section 5416. Health and Safety Code, State of California . I , • {a) .'i;'r-ie shdll be not less than one water closet for eacN 20 employees or fractional part thereof vyorkin^j, a.r « construction job site. The water closet shall consist of a patsnt.ed chemical type toilet. (b) For the purpose of this section the term construction site shall mean the location on which actual construction of a - building is in progress. (c) A violation of this section shall constitute a misdemeanor. All construction or work for which a permit is required shall be subject to inspection and all such construction or work shall remain accessible and exposed for inspection purposes until approved by the inspector. Work shall not be done beyond the point Indicated in each successive inspection without first obtaining the approval of the inspector. DATE ADDITIONAL NOTES 7^ T , » < L3 —... -—5;— bK'T^rifo/u //t-T^ Sf^^f S^A-S^-T^g/^ tZM UgUt^fc. ^ofptrs A-r ^ log-/ tgv^^pT ^K" ^ot^V0^ Lf^-t^t.ut^ fir m I.OO ^ to^-^mT<^ K< Section 5416. Health and S;afety Code, State of California (a,' 'i'hfir3 shall be not less than one water closet for oach 20 employees or fractional part thereof working .u a* constmction job aite. The water closet shall consist of a iDatented chemical type toilet. (b) For the purpose of this section the tenn constmction site shall mean the location on which actual constmction of a building is in progress. (c) A violation of this section shall constitute a misdemeanor. All constmction or work for which a permit is required shall be subject to inspection and all such constmction or work shall remain accessible and exposed for inspection purposes until approved by the inspector. Work shall not be done beyond the point indicated in each successive inspection without first obtaining the approval of the inspector. DATE ADDITIONAL NOTES 1 t ioki/[A K V, 41^14-jZisef ^^dc^ t^f^ A-r A t 1 - 2.-?^ UJ£ I ^ 2. ^ A.^-R^ li/W\4 t^p Otir o\/L. -tb 0^ /?4-f^oC 6v!AW-*i. D/d. to «0(U:ak9 ^cffft^f (tAAffelj AT ^I4ICAAL6& «^ <^ftE.^ ^v5aTt>ie- rofri£6 IZat" ^UIa\T7^<Alfe|^|yi(: 1-2/04/(4 Section 5416. Health and Safety Code, State of California (a) .There shall be not less than one water closet for -each 20 employees or fractional part thereof working at a constmction job site. The water closet shall consist bf a>patented chemical type toilet. (b) For the purpose of this section the term constmction site shall mean the location on which actual constmction of a building is in progress. (c) A violation of this section shall constitute a misdemeanor. All constmction or work for which a permit is required shall be subject to inspection and all such constmction or work shall remain accessible and exposed for inspection purposes until approved by the inspector. Work shall not be done beyond the point indicated in each successive inspection without first obtaining the approval of the inspector. DATE ADDITIONAL NOTES X^iUi, It <icFFcr t^siXSMJ^MT Li^ A.^-z>k-A , LuAs. 6 If C.[ ^tAO lAT jo^ J |2M tlly PM loo ^ o[c^ -fb tKi6ou<ire <^U<iW AT -zo^^f f f44ft> UP tPpTbULU Ar IgK LQ4 ^gv^fT gofc?Jfe^^f^ 4^ 4 V Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-39 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 ^/\^ on orjjj- Tel: (760) 342-4677 Fax:(760) 342-4525 ^^'-^ "CityofCarlsbad Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 BUILDING DIVISION Date Printed: 3/26/2015 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0112 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (Ibs.) (psi) Fracture 28 3/25/2015 2X4 3.14 10,920 3,480 N/A 28 3/25/2015 2X4 3.14 10,400 3,310 N/A 28 3/25/2015 2X4 3.14 10,480 3,340 N/A Specified Strength: 1,800 PSI Sampled By: PAT SIMMONS Location: EAST CMU WALL ASTM €172 Date Sampled: 2/25/2015 Date Received: 2/26/2015 Concrete Supplier: SPECIFIED MIX Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: Remarks: 2ND TO BOTTOM LIFT Mix Time: 5 Concrete Temp: 72 Ambient Temp: 65 °F ASTM C1064 °F ASTM C1064 Slump: in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 3380 PSI 28-day compression test complies with the specified strength. Geotechnical Engineering Construction Inspection Materiais Testing Environmental Ornt t L(K, \ fuy-'S C OliPOR A TF BftWi. ii I'-m E La Pdhm ,'\vfnue Siiile A A.nalieim C.A ^il'^lHy Id: 7l4h.^2.2*:i<-/ Fits 714 632.2974 iMl't RIVl (. <n N»V Suiic C Sun Dicgw C -X '^r;l 2! IVI hS^ sj,i Mm H4h7 Meridian Parkv-av Building 2A Rivcreidc, ( A 925iS I-ax' 45! ,653 46f!fi iNOiO 44917 <K>irt^'nk'[ F'ki Suite I IiH!i.>, ( A ''22U1 Vel 760 i42 4f,'7 Fax im..m 4525 0<; ''l.A^lM VM» E.MFIM Disf\ fCli S88 84 4 vm iiiisliocciii March 24, 2015 MTGL Project No.: 1109A01 MTGL Log No. 15-1068 North Coast Calvary Chapel 1330 Poinsettia Lane Carlsbad, Califomia 92011 Attention: Mr. Jack Shubin Subject: FINAL VERIFIED REPORT OF SPECIAL INSPECTIONS AND MATERIALS TESTING - CITY OF CARLSBAD PERMIT NUMBER CB102519 North Coast Calvary Chapel 1330 Poinsettia Lane Carlsbad, Califomia Dear Mr. Shubin: To the best of my knowledge, work identified below performed by MTGL, Inc. for the subject project from June 20, 2014 through Febmary 26, 2015, requiring special inspection and materials testing were essentially in conformance with the approved plans, specifications, and applicable workmanship provisions of the 2013 Califomia Building Code as adopted by the City of Carlsbad. The following special inspection and testing services were provided during constmction of the subject project. Reinforcing steel placement inspection Concrete placement inspection Concrete, grout, and mortar compression testing Epoxy dowel placement inspection Ultrasonic testing of shop welding Field welding inspection Ultrasonic testing of field welding High strength bolt installation High strength nuts, bolts and washer laboratory testing Masonry inspection Masonry veneer inspection Fireproofing inspection Fireproofing density laboratory testing Page 1 of 2 North Coast Calvary Chapel Carlsbad. Califomia MTGL Project No. 1109A01 MTGL Log No. 15-1068 Our verification applies to conditions, in the subject areas, observed and/or tested by us as of the dates indicated in this report. Our firm is not responsible for work not observed by us or for any changes that may occur outside of our purview, or after our inspections. Our work is considered to be in accordance with the usual standards of the profession and local practice. Respectfully submitted, MTGL, Inc. Sam E. Valdez, RCE 56226 Vice President | Chief Engineer Page 2 of2 Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, hidio, CA 92201 CHV Tel: (760) 342-4677 Fax: (760) 342-4525 ofCa Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 g^lg.i^^]rfed:'-^'/^0V2015 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0101 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 28 3/19/2015 2X4 3.14 11,320 3,600 N/A 28 3/19/2015 2X4 3.14 9,660 3,070 N/A 28 3/19/2015 2X4 3.14 10,820 3,440 N/A Specified Strength: 1,800 PSI Sampled By: PAT SIMMONS Location: CMU WALL - ELEVATOR TOWER BOTTOM SECTION ASTMC172 Date Sampled: 2/19/2015 Date Received: 2/21/2015 Concrete Supplier: SPECIFIED MIX Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: Remarks: EASTSIDE Mix Time: 5 Concrete Temp: 60 Ambient Temp: 64 °F ASTM C1064 "F ASTMC1064 Slump: in. ASTM C143 Tested at: SanDiego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 3370 PSI 28-day compression test complies with the specified strength. Corporate: Branch: Branch: Branch: 2992 E, La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax:(858) 537-3990 C r''\A^. 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 P\tV O' Td: (951)653-4999 Fax: (951) 653-466^ ^ 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 BUILDING DIV-'O^ Date Printed: 3/19/2015 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0092 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (Ibs.) (psi) Fracture 28 3/17/2015 2X4 3.14 7,800 2,480 N/A 28 3/17/2015 2X4 3.14 9,220 2,930 N/A 28 3/17/2015 2X4 3.14 8,320 2,650 N/A Specified Strength: 1,800 PSI Sampled By: PAT SIMMONS Location: EAST CMU WALL - ELEVATOR TOWER ASTMC172 Date Sampled: 2/17/2015 Date Received: 2/18/2015 Concrete Supplier: ON SITE MIX Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: Remarks: Mix Time: 5 mm. Concrete Temp: 60 Ambient Temp: 65 °F ASTMC1064 °F ASTMC1064 Slump: in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 2690 PSI 28-day compression test complies with the specified strength. Corporate: Branch: Branch: Branch: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 fjt Qgi' Tel: (951) 653-4999 Fax: (951) 65Gi*4lf 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 Date Printed: 3/19/2015 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0100 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 28 3/18/2015 2X4 3.14 10,560 3,360 N/A 28 3/18/2015 2X4 3.14 10,600 3,370 N/A 28 3/18/2015 2X4 3.14 10,460 3,330 N/A Specified Strength: 1,800 PSI Sampled By: PAT SIMMONS Location: CMU WALL - ROUND WALL SECTION ASTMC172 Date Sampled: 2/18/2015 Date Received: 2/19/2015 Concrete Supplier: SPECIFIED MIX Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: Remarks: LOWER SOUTH SIDE Mix Time: 5 min. Concrete Temp: 61 Ambient Temp: 64 °F ASTMC1064 °F ASTM C1064 Slump: in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 3350 PSI 28-day compression test complies with the specified strength. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4( Branch: 44917 Golf Center Parkway #1, hidio, CA 92201 Td: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 ^ity of Carlsbad BUILDING DIVISION D ^' bate Printed: 3/19/201: CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0091 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 28 3/16/2015 2X4 3.14 13,680 4,350 N/A 28 3/16/2015 2X4 3.14 13,920 4,430 N/A 28 3/16/2015 2X4 3.14 13,940 4,440 N/A Specified Strength: 1,800 PSI Sampled By: PAT SIMMONS Location: CMU WALL - ROUND SECTION, TOP OF WALL ASTMC172 Date Sampled: 2/16/2015 Date Received: 2/17/2015 Concrete Supplier: ON SITE MIX Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: Remarks: NORTH END Mix Time: 5 Concrete Temp: 60 Ambient Temp: 64 °F ASTM C1064 °F ASTM C1064 Slump: 5.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 4410 PSI 28-day compression test complies with the specified strength. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Td: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Td: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Td: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Td: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL 760) 342-4525 City ot carisbaa BUILDING DIVISION Date Printed: 3/13/2015 File No.: PermitNo.: CBl 02519 ProjectNo.: 1109 AOI Project Name: NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Set No.: 15-0081 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 28 3/13/2015 2X4 3.14 6,480 2,060 N/A 28 3/13/2015 2X4 3.14 6,790 2,160 N/A 28 3/13/2015 2X4 3.14 5,980 1,900 N/A Specified Strength: 1,800 PSI Sampled By: PAT SIMMONS Location: CMU WALL - NORTH SIDE OF CHURCH STEEPLE ASTMC172 Date Sampled: 2/13/2015 Date Received: 2/15/2015 Concrete Supplier: SPECIFIED MIX Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: Remarks: Mix Time: 5 Concrete Temp: 79 Ambient Temp: 74 °F ASTMC1064 °F ASTM C1064 Slump: in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 2040 PSl 28-day compression test complies with the specified strength. www.mtglinc.com MTGL Project t j ( ^ PG L OF L Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pk\wy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 Permit DAILY INSPECTION REPORT DSA/CITY File #:. DSA/OSHPD APPLii DSA/LEA >! Report # PG_ Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. THE WORK WAS *i^S NOTC] Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WASH WAS MOTG N/A©^ Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Oflice Owner School District THE WORK INSPECTED MET B^DID NOT MEET • The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken: Weather: / i/0^\ ^^l%mo: M^p- ~- ^'7 '^F of Special Inspector Certification #; ^ccit Print Name Verified by: www.mtglinc.com MTGL Projact#: ( I 0^/^& f Corporate: 2992 E, La Palma Ave. Ste, A Anaheim, CA 92806 Tel: 714,632,2999 Fax: 714.632.2974 Dispatch: 800.491,2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858,537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 IVIeridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 Permit #_ Report #_ 4 DAILY INSPECTION REPORT OSA/CITY File #;. DSA/OSHPD APPL #:. OF DSA/LEA ii Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. TIME ARRIVED TIME DEPARTED SUB CONTRACTOR ICH TIME I INSPECTION ADDRESS A ADDRESS OF PROJECT TYPE OF INSPECTION .:i ENGINEERED FILL FOUNDATION ::; BACKFILL ! BATCH PLANT PT CONCRETE SHOTCRETE i CONCRETE ^ 3i^'MAS0NRY(^<i^jUli^<£ J/i:-H^ FIREPROO_FING HIGH STRfcMGrH BOLIING WELDING SHOP WELD L . CEILING WIRE ANCHOR/DOWEL NDE FIELD NDESHOP DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS Yi>'!\i; SOIL REPORT YL^N : SPECS: Y'-f^NH APPROVED SHOP DRAWING YH Ni THE WORK WASB^ASN0T:J Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WAS :^f^AS NOT!.] N/A;_ Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Oepartment DSA Regional Office Owner School Distnct THE WORK INSPECTED MET g^D NOT MEET • The requirements of the DSA/OSHPD/PROJECT approved docunmjits. Samples taken^ t^^^v ^^Temi^>^7^ - h S~h Weather:_ Signatuffiof Special Inspector Certi' Verified by' Print Name Corporate: 2992 E, La Palma Avenue, Suite A, Anaheim, CA 92806 Td: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Td: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Td: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Td: (760) City of carfsbad 342-4677 Fax:(760)342-4525 gy|LQ\HG OVV^SlON Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 Date Printed: 2/23/2015 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0047 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 28 2/20/2015 2X4 3.14 10,100 3,210 N/A 28 2/20/2015 2X4 3.14 9,280 2,950 N/A 28 2/20/2015 2X4 3.14 9,200 2,930 N/A Specified Strength: 1,800 PSI Sampled By: LOU HICKAM Location: TOP OF CMU WALL - GRID LINE4.5 / E ASTMC172 Date Sampled: 1/23/2015 Date Received: 1/24/2015 Concrete Supplier: ORCO Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: II/V Remarks: Mix Time: Concrete Temp: 60 Ambient Temp: 58 °F ASTM C1064 °F ASTMC1064 Slump: in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 3030 PSl 28-day compression test complies with the specified strength. Corporate: 2992 E, La Palma Avenue, Suite A, Anaheim, CA 92806 Td: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Td: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Td: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, hidio, CA 92201 Td: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0039 CUvofCar\sbad City of Carlsbad FEB 2 4 2015 Community & Economic Development Department Date Printed: 2/20/2015 File No.: Permit Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 28 2/19/2015 2X4 3.14 7,980 2,540 N/A 28 2/19/2015 2X4 3.14 6,860 2,180 N/A 28 2/19/2015 2X4 3.14 7,700 2,450 N/A Specified Strength: 1,800 PSI Sampled By: LOU HICKAM Location: CMU WALL - LOWER HALF, ROUND WINDOW WALL ASTMC172 Date Sampled: 1/22/2015 Date Received: 1/23/2015 Concrete Supplier: ORCO Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: II/V Remarks: Mix Time: 10 Concrete Temp: 65 Ambient Temp: 63 °F ASTMC1064 °F ASTM C1064 Slump: in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 2390 PSI 28-day compression test complies with the specified strength. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Td: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Td: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Td: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway # 1, hidio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-MORTAR ASTM C270 Date Printed: 2/20/2015 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 15-0038 File No.: Perniit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 28 2/18/2015 2X4 3.14 7,500 2,390 N/A 28 2/18/2015 2X4 3.14 6,740 2,150 N/A 28 2/18/2015 2X4 3.14 6,620 2,110 N/A Specified Strength: 1,800 PSI Sampled By: LOU HICKAM ASTM C172 Date Sampled: 1/21/2015 Date Received: 1/22/2015 Location: CMU WALL, EAST FACING - UPPER HALF WITH ROUND WINDOW Concrete Supplier: ORCO Mix No.: TYPE S Ticket No.: Water added at Site: gal. By Cement Type: Remarks: Mix Time: Concrete Temp: 70 Ambient Temp: 68 °F ASTM C1064 °F ASTM C1064 Slump: in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 2220 PSI 28-day compression test complies with the specified strength. www.mtglinc.com MTGL Project #:„ Corporate: 2992 E. La Palma Ave, Ste, A Anaheim, CA 92806 Tel: 714,632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/lmperlal County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844,5060 Inland Empire: 14467 Meridian Pkw,, Bldg, 2-A Riverside, CA 92518 Tel: 951,653,4999 Fax: 951,653,4666 Dispatch: 800.491.2990 Indio: 44917 Golf Center Pkv\/y, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 Permit t Report #_ PG. 1_ OF_L DAILY INSPECTION REPORT DSA/CITY File #:. DSA/OSHPD APPL #:. DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed bythe special inspector conducting the inspection. rvT:^ O^rdoJc Ciiypuy C^^s^^ DATE TIME ARRIVED TIME DEPARTED TRAVELTIME LUNCH TIME /% SUB CONTRACTOR ADDRESS OF PROJECT TYPE OF INSPECTION • ENGINEERED FILL r FOUNDATION • BACKFILL BATCH PLANT i J PT CONCRETE n SHOTCRETE n CONCRETE i<^MASONRYiiUUiiU<Si.- \An4£<l,FIREPR00FING '^L] HIGH STRENGTH BOLTING • ANCHOR/DOWEL • WELDING G NDE FIELD ii SHOP WELD • NDE SHOP • CEILING WIRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS Y CKN L; SOIL REPORT Yfi^NL SPECS: YQ^NL' APPROVED SHOP DRAWING YLi W. MATEBIAt=S USED BY COJ^TRACTOR (INCLUDE RESEARGH REPORT NO. OB MATERIAL TEa RE/oflTS): 7j Ti U' i J CONTRACTORS ECfalPMENT / MANPOWER USE&- // R ' ' I / \ . f / -»\ —~- A AREA GRID LINES, PIECES INSPECTED: JRAL Nom DEWORW^^ /T acci^ M(ji^(. LORRffSUSED;D _ , mf^HS, mCLUDIIfS MEETINCK-. / ]g) l\ s AA H<1 REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE, THE WORK WASJi^ASNOTLJ Inspected in accordance with the requirements of the DS/VOSHPD/PROJECT approved documents. MATERIAL SAMPLING WASH WAS NOT Ll N/AL Performed in accordance with DSA/OSHPO/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METiirDID NOT MEET • The requirements of the DS/VOSHPD/PROJECT approved documents. Samples take Weather: taken. .Temp: ^narare of Special Inspector 0¥r ^i/iA ^^sM^ Certification #:^ Verified by:_ Pnnt Name www.mtglinc.com uispatch MTGL Project #: { I 0^ /vO I Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714,632.2999 Fax: 714,632,2974 Dispatch: 800.491.2990 San Diego/imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw,, Bldg, 2-A Riverside, CA 92518 Tel: 951.653,4999 Fax: 951.653.4666 Dispatch: 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 India, CA 92201 Tel: 760.342,4677 Fax: 760.342,4525 Dispatch: 800.491.2990 Permit Report f PG |_ OF I DAILY INSPECTION REPORT DSA/CITY File #: DSA/OSHPD APPLi! DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. 2^/(9 /is IT NAMET ^f_r DATE TIME ARRIVED TRAVELTIME TIME DEPARTED SUB CONTRACTOR 4^ CfOR II«P£CTI6NA£DRESS /P Ji L, y\ TYPE OF INSPECTION V. BATCH PLANT LUNCH Tl ADDRESS OFfROJECT TYPE • ENGINEERED FILL • FOUNDATION n BACK FILL Li PT CONCRETE n SHOTCRETE i: CONCRETE ] MASONRYd<^V^J^ {j-K^ja FIREPROOFING • TronrrfflNGTH BOLTING n ANCHOR/DOWEL n WELDING L MDE FIELD [ ] SHOP WELD n NDE SHOP CEILING WIRE n DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS Y i; J N [ SOIL REPORT YH ND SPECS: YQ NZI APPROVED SHOP DRAWING Yn |\|:; MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO, OR MATmiAI/JEXT REPORTS), 1 USED; {J I I / .\ ^ j AREA, GRID LINES, PIECES INSPECTED: cry\ S. mCLUOm MEETINGS. REWORK AS PERCENT OF ALL WORK TODAY: THE WORK WASa^WAS NOTn Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WAS isS^AS NOT • N/AQ Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District PERCENT PROJECT COMPLETE: THE WORK INSPECTED METJg^lD NOT MEETC The requiremente.of the DSA/O^HPD/PROJECT approved docuniaols. Samples taksfl: Weather: Signature of Special Inspector Certification 1KJ^C!!<1,^ Print Name Verified by: Corporate: 2992 E, La Palma Ave, Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 www.mtglinc.com MTGL Project # Permit #. Report* San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951,653,4666 Dispatch: 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 DAILY INSPECTION REPORT OSA/CITY File #:. DSA/OSHPD APPL #:. PG_ _L OF L DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. DATE TIME ARRIVED , , TIME DEPARTED ^ EpJWEER /j STRACTOR _Jr—~ LUNCH TIME SUB CONTRACTOR 0 ' 1^ ADDRESS OF PROJECT TYPE OF INSPECTION J ENGINEERED FILL J FOUNDATION ] BACKFILL BATCH PLANT PT CONCRETE SHOTCRETE CONCRETE mmK<mvstAa^ iAt. FIREPROOFING • HIGH STRENGTH BOLTING • ANCHOR/DOWEL n WELDING • NDE FIELD n SHOP WELD n NDE SHOP SOIL REPORT Y« NE • CEILING WIRE • • • DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: . APPROVED PLANS Y^Z Nf SPECS: Y« Nf APPROVED SHOP DRAWING YD ND MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR M^TER|ALiTEST REPORJS); " ij /I J ~-4~ f ) C 1 CONTRACTORS EQUIPMEIWTMANPOWER USED: . / y / «^ jf \ —f /7 AREA, GRfCl LINES, PIECES INSPECTED: t& (u/ueAi^ fV\^d^^ (pj^ /Kx S1& STRUCTURAL NOTES, DE/IL, OR RFIS USED: /L/^~T CT 7 jC' REMARKS,//vau^WG Mf£T/NGS; . , - / r ( v , /]/] - j I > J A '"^ <~ /'i \ t /I REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS^^ASNOTfL Inspected in accordance with the requirements ofthe DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WAS t/wAS NOT flj N/A • ,i Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET f3^D NOT MEET • The requirements of the DSA/OSHPD/PROJKT approved documents. Samples takerw. ^^wg. .^M^^ ? ^dv^^^^^^-, Weather: (^^^0^^ Jem^: i0^^f=~~ Sfgpature of Special Inspector Print Name Certificatii Verified by: www,mtglinc.com MTGL Project #:.. Permit; ^16 ^ 0 Z •S'/ ^ Report # PG i Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632,2974 Dispatch; 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 DAILY INSPECTION REPORT DSA/CITY File #:. 0F_ DSA/OSHPD APPL #;_ DSA/LEA#: Special Inspection Reports must be distnbuted to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT mm/'' / / // ^/ /} ENGINEER n TIME ARRIVED // 7 /(S . TIME DEPARTED —5 /~\ (( '00 AM /^m /Ttf 1 HMr'U Tlft^C ^ ENGItlEER n TRAVEL TIME CONTRACTOR LUNCH TIM; SUB CONTRACTOR iJPECTION ADDRESS yl -,,1/. ADDRESS OF PROJECT TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACKFILL BATCH PLANT L! PT CONCRETE • SHOTCRETE • CONCRETE NLJ MASONRYL n HIGH STRENGTH BOLTING • WELDING • SHOP WELD • FIREPROOFING n ANCHOR/DOWEL • NDE FIELD fj NDE SHOP • CEILING WIRE n • • SOIL REPORT Ya^Nf SPECS: YgfNn APPROVED SHOP DRAWING Y[ DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS YS<Na ND MATERIALS USED BY CONTRACTOR (INCLUDERESEARCH REPORT NO. OR MATERIAL TEST RH'ORTS): AREA, GRIQtlNES, PIECES INSPECTED STRUCTURAL NOIES, DETAIL, RFIS USED:/ /> &7 // ^^"^ [mod/ (^j ZA/0 REMARKS, INCLUDING MCETmS: r^jZ^ riJLf3A£L£ ^)OA^J^^ ijza^^^^ Maj^OA^ 2 5'? ^.^U>^ \A:^J^i)oA^ M/ ^ 1 PERCENT PROJECT COMPLETE: REWORK AS PERCENT OF ALL WORK TODAY: THE WORK WASi^AS NOT • Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WASLS^SNOT LJ N/AfJ Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architeci Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET g^D NOT MEET The requirements^^the DSA/OSHPD/IJROJECT approved documents Samples takett: C^l^yU^. -, Weather;. utu I approveu uocumenis^/ mpO 6^ "'F - 6 t^ 3_. TempV (£.Z^ ature of Special Inspector s Print Name Certification #: Verified by; ^^^^X->>--"'"^"'^ • Corporate: San Diego/Imperial County 2992 E, La Palma Ave, Ste. A 6295 Ferris Square, Suite C www.mtglinc.com Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg, 2-A Riverside, CA 92518 Tel: 951,653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 MTGL Project #: II 69 /^'^ f J_ OF I Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760,342,4525 Dispatch; 800.491.2990 Permit DAILY INSPECTION REPORT DSA/CITY File #: DSA/OSHPD APPL #:_ Report;! PG. DSA/LEA i Special Inspection Reports must be distributed to the parties listed below within 14 days ofthe inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. -//c6 / PROJECT NAMEi/- / J / 77~ IS jaecHffECT TIME ARRIVED (\^ ^DAfVl TIME DEPARTED 3: ?a fA? TRAyELTIME LUNCHTIME , ^ SUBCONTRACTOR ADDRESS OF PROJECT ^VS] MASONRYOilL^ii^RW I TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACKFILL • BATCH PLANT • PT CONCRETE n SHOTCRETE [• CONCRETE n HIGH STRENGTH BOLTING • WELDING J SHOP WELD REPROOFING Tl ANCHOR/DOWEL • NDE FIELD U NDE SHOP. CEILING WIRE n g/N'n i\i DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: / APPROVED PLANS Y^/Nf SOIL REPORT Y SPECS: Y^ Nil APPROVED SHOP DRAWING Yfj Nf MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REi CONIIIAGMRS EjlUIPMENt? MANPOWER USED: , i - - t 7 7/ \ >-'7 ^\ —> ^7 ^n.iFnT nnwpi FTF- ^ PERCENT f ROJECT COMPLETE: THE WORK WAS A^WAS NOT • Inspected in accordance with the requirements ofthe DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WASa^ASNOT Ll N/Afl": Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structurai Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METfeTDID NOT MEETC The requirementsof the DSA/OSHPO/PROJECT approved docummas Samplestakea.(^/^ /k^ZPTOf- > ^^S^"^^. ^ Weather: LiCMT^ TemV. ^2 p — 66 P - Signature of Special Inspector Print Name Certification: Verified by:. www.mtglinc.com MTGL Project*:. 11(99/1 g I Corporate: 2992 E, La Palma Ave, Ste, A Anaheim, CA 92806 Tel: 714.632,2999 Fax: 714,632,2974 Dispatch: 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 Permit i Reporti PG (. 0F_ 4 DAILY INSPECTION REPORT DSA/CITY File #:_ DSA/OSHPD APPL #:. DBA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. REWORK AS PERCENT OF ALL WORK TODAY: THE WORK WAs'i^WSNOT' Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WAS .^/^AS HOT N/A Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET iX DID NOT MFE f^ The requirements of the DSA'OSHPD/PROJECT appioved ilor.iiiiiDijIs. Samples takeiy, 0/fSt~/QSkAT^/r ? ^S^-<'i^T3'^ »^ Weathe, (j2l^ /^JZIW j>\ Signature ol Special Inspocloi V ' Print Name Corporate 2992 E La Palma Ave. Ste. A /Anaheim, CA 92806 Tel; 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/Imperial County 7313 Carroll Rd.Ste.G San Dlego, CA 92121 Tel: 858.537.3999 Fax; 858.537.3990 Inland Empire 14467 Meridian Pkwy., Bldg 2A Riverside, CA92518 Te(i95J<(^3.4999 53.4666 MTGL PROJECT*; 1109-A01 Pennit # CB102519 Dispatch; 888.844.50^'^^y tlispatch: 800.491.2990 DAILY INSPECTIOfeU\LD\^^S^FiS#^ REPORT DSA/OSHPD Appl.#. DSfiJLEA# Report#04Page 1 of 1 Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection on a daily basis. Each report shall be oompieted and signed by the special inspector conducting the inspection. PROJECT NAME; North Coast Calvary Chapel Veneer Date; 1/23/2015 ARCHITECT; Timeless Arch. TIME ARRIVED: 7;00AM TIME DEPARTED: 11;00AM ENGINEER: TRAVEL TIME N/A LUNCHTIME: .N/A CONTFIACTOR; Grant General Contractor SUB CONTFIACTOR ;Lyons & Son Masonry/Able Ste INSPECTION ADDRESS; 1330 Pointsettia ^ Carlsbad, CA • BATCH PLANT ADDRESS OF PROJECT: same TYPE OF INSPECTION • ENGINEERED FiLL • FOUNDATION • BACK FILL • PT CONCRETE • SHOTCRETE • CONCRETE [a MASONRY • HIGH STRENGTH BOLTING E WELDING • SHOP WELD • FIREPROOFING • AiNCHOR/tXlWEL • NDE FIELD • NDE SHOP • CEILING WIRE • • SPECS; YD NEI APPROVED SHOP DRAWING Y • N E! DSA/OSHPD PROJECT APPROVED DOCUMENTS AVAILABLE APPROVED PLANS Y El N • SOIL REPORTYDND MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS); Eldorado Stone( ESR1215) Oreo Mac Mortar VBM, A500 B,HSS tube steel, E71T8-A2-Ni H16, NR 203 Nickel. CONTRACTORS EQUIPMENT/MANPOWER USED; Lyon Masonry; 2 masons & 1 tender mixer, hand tools. Able Steel; 2 Welders; Alfredo Navano, AWS, FCAW, Rommel Banuelos, AWS, FCAW. AREA, GRID LINES, PIECES INSPECTED; Inspected placing of veneer on plastered wall @ 4.7/E Veneer was applied per manufactures recommendtlons. Work in progress. 3 VBM mortar samples were made. Able Steel; Inspected Welding for canopy @ 5-6/D-A.7. Tube steel trellis was welded with fillet welds per 2/S506. Woric in progress. STRUCTURAL NOTES, DETAIL OR RFIS USED: 22/S506, 2/8506 REMARKS, INCLUDING MEETINGS: Wotk was done to Califomia Building Code 2007 Section 21 and ACI 530.1-5 & 530-5/ASCE5-05/TMS 602-05. REWORK AS PERCENT OF ALL WORK TODAY: THE WORK WAS 12 WAS NOT • — Inspected in accordance with the requirements of the DS/VOSPHD Project approved documents. MATERIAL SAMPLING WAS S WAS NOT • N/AD Performed in accordance with DS/VOSPHD Project approved documents. Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District DID NOT MEET • The requirements of the DS/VOSPHD Project approved documents. Samples taken; 3 mortar Weather; Clear Temp; 72 degree Signature of Special Inspector Louis Hickam Certi Verified by Corporate 2992 E La Palma Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax; 714.632.2974 Dispatch; 800.491.2990 San Diego/lmperlal County 7313 Can^oll Rd., Ste. G San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire 14467 Meridian Pkwy., Bldg 2A Riverside, CA 92518 Tel; 951.653.4999 Fax; 951.653.4666 Dispatch; 800.491,2990 MTGL PROJECT*; 1109-A01 Pemiit # CB102519 DAILY INSPECTION REPORT DS/VCITY File* DS/VOSHPD Appl. #. DSA/LEA # Report#02 Pagelofi Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. ___ PROJECT NAME; North Coast Calvary Chapel Veneer Date; 1/21/2015 ARCHITECT; Timeless Arch. TIME ARRIVED; 10;00AM TIME DEPARTED; 3;30PM ENGINEER; TRAVEL TIME N/A LUNCHTIME; .5hr CONTFIACTOR; Grant General Contractor. SUB CONTFIACTOR ;Lyons & Son Masonry/Able Ste " INSPECTION ADDRESS : 1330 Pointsettia / \7jy> Carlsbad, CA ^ .1 T ^ TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACK FILL • BATCH PLANT • PT CONCRETE •SHOTCRETE • CONCRETE ADDRESS OF PROJECT; same MASONRY • HIGH STRENGTH BOLTING E WELDING • SHOP WELD AVAILABLE /s^PPROVED PLANS Y • N • SOILREPORTYD ND • FIREPROOFING • ANCHOR/DOWEL • NDE FIELD • NDE SHOP • CEILING WIRE • • • DSA/OSHPD PROJECT APPROVED DOCUMENTS MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS); Eldorado Stone( ESR1215) Oreo Mac Mortar VBM, A500 B.HSS tube steel, E71T8-/\2-NI H16, NR 203 Nickel. SPECS: Y • N b APPROVED SHOP DRAWING Y • N • | CONTRACTORS EQUIPMENT/MANPOWER USED; Lyon Masonry; 3 masons & 1 tender; mixer, hand tools. Able Steel; 2 Welders; Alfredo Navan-o, AWS, FCAW, Rommel Banuelos, AWS, FCAW. AREA, GRID LINES, PIECES INSPECTED; Inspected placing of veneer on plastered wall @ E/4.3-4.7. Veneer was applied per manufactures recommendtions. 3 VBM mortar samples were made. Able Steel; Inspected Welding for canopy @ 5-6/D-A.7. Tube steel trellis was welded with fillet welds per 2/S506. Woric in progress. STRUCTURAL NOTES, DETAIL OR RFIS USED: 22/S506, REMARKS, INCLUDING MEETINGS: REWORK AS PERCENT OF ALL WORK TODAY: THE WORK WAS la WAS NOT • Inspected in accordance wilh the requirements of the DSA/OSPHD Project approved documents. MATERIAL SAMPLING WAS El WAS NOT • N/AQ Perfomied in accordance with DSA/OSPHD Project approved documents. PERCENT PROJECT COMPLETE: DID NOT MEET • THE WORK INSPECTED MET | The requirements of the DSA/OSPHD Project approved documents. Samples taken; 3 mortar Weather. Clear Temp; 68 degree Project Architect Structural Engineer DSA Regional Office School District Contractor Building Department Owner Signature of Special Inspector Louis Hickam FfiRTName Certification #;85764I JgC ^ason&Weld Verified by;. Corporate 2992 E La Palma Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax; 714.632.2974 Dispatch; 800.491.2990 San Diego/lmperiai County 7313Can-oll Rd., Ste. G San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire 14467 Meridian Pkwy., Bldg 2A Riverside, CA92518 Tel; 951.653.4999 Fax; 951.653.4666 Dispatch; 800.491.2990 MTGL PROJECT*: 1109-A01 Pennit # CBI 02519 DAILY INSPECTION REPORT Report #03 Page lofl DSA/CITY File* DSA/OSHPD Appl. #. DS/VLEA* Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME; North Coast Calvary Chapel Veneer Date: 1/22/2015 ARCHITECT; Timeless Arch, TIME ARRIVED; 7;00AM TIME DEPARTED: 11;30AM ENGINEER: TRAVEL TIME N/A LUNCHTIME: .N/A CONTRACTOR : Grant General Contractor. SUB CONTRACTOR ;Lyons & Son Masonry//\ble Ste INSPECTION ADDRESS ; 1330 Pointsettia/ I^Z/^O Carlsbad, CA i - ADDRESS OF PROJECT; same TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACK FILL • BATCH PLANT • PT CONCRETE • SHOTCRETE • CONCRETE M MASONRY • HIGH STRENGTH BOLTING la WELDING • SHOP WELD • FIREPROOFING • /SiNCHOR/DOWEL • NDE FIELD • NDE SHOP • CEILING WIRE • • • " SPECS; Y • N • APPROVED SHOP DRAWING Y • N • DSA/OSHPD PROJECT APPROVED DOCUMENTS AVAILABLE APPROVED PLANS Y • N • SOiLREPORTYnNQ MATERIALS USED BY CONTRACTOR (INCLUDE RESE/^RCH REPORT NO. OR MATERIAJ. TEST REPORTS); Eldorado Stone( ESR1215) Oreo Mac Mortar VBM, A500 B.HSS tube steel, E71T8-/S2-Ni H16, NR 203 Nickel. CONTRACTORS EQUIPMENT/MANPOWER USED; Lyon Masonry; 3 masons & 1 tender; mixer, hand tools. Able Steel: 2 Welders; Alfredo Navan-Q. AWS, FCAW, Rommel Banuelos, AWS, FCAW. AREA, GRID LINES, PIECES INSPECTED; Inspected placing of veneer on plastered wall @ E/4.3-4.7. Veneer was applied per manufactures recommendtions. Woric in progress. 3 VBM mortar samples were made. Able Steel; Inspected Welding for canopy @ 5-6/D-A.7. Tube steel trellis was welded with fillet welds per 2/S506. Woric in progress. STRUCTURAL NOTES, DETAIL OR RFIS USED: 22/S506, 2/S506 REMARKS, INCLUDING MEETINGS; REWORK AS PERCENT OF ALL WORK TODAY; THE WORK WASH WAS NOT • ==---_============== Inspected in accordance with the requirements of the DSA/OSPHD Project approved documents. MATERIAL SAMPLING WASH WAS NOT • N/A • Perfonned in accordance with DSA/OSPHD Project approved documents. PERCENT PROJECT COMPLETE: THE WORK INSPECTED MET H DID NOT MEET • The requirements of the DSA/OSPHD Project approved documents. Samples taken; 3 mortar Weather Clear Temp; 72 degree Project Architect Structural Engineer DSA Regional Office School District Contractor Building Department Owner Signature of Special Inspector Louis Hickam h'nnt Name Certification #;857641, IQC Mason & Weld Verified by Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Report of: COMPRESSIVE STRENGTH-GROUT ASTM C1019 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0764 Fax: (760:^l^^2Df C^^'^^^^^ Date Prinl Date Prin^tj^^l 8/2014 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 11/26/2014 3X3X6 10.27 15,600 1,520 N/A 28 12/17/2014 3X3X6 9.49 21,650 2,280 N/A 28 12/17/2014 3X3X6 10.18 23,850 2,340 N/A 28 12/17/2014 3X3X6 9.83 20,850 2,120 N/A 28 H 12/17/2014 Specified Strength: 2,000 PSI Sampled By: GEORGE WOELCKEN Location: CMU WALL - CANOPY ASTMC172 Date Sampled: 11/19/2014 Date Received: 11/21/2014 Concrete Supplier: PALOMAR TRANSIT MIX Mix No.: 386201 Ticket No.: 237709 Water added at Site: 25.00 gal. By CONTRACTOR Cement Type: II/V Mix Time: 120 Remarks: MIDDLE Concrete Temp: 75 Ambient Temp: 64 °F ASTM C1064 °F ASTM C1064 Slump: 8.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 2250 PSI 28-day compression test complies with the specified strength. Corporate: Branch: Branch: Branch: 2992 E, La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 _ af\S^ 14467 IVIeridian Parkway Bldg 2A, Riverside, CA 92518 Q'^ Tel: (951)653-4999 Fax: (951) 65^19^ j..* 44917 Golf Center Parkway # 1, Indio, CA 92201 r C C\ '2' Tel: (760) 342-4677 Fax:(760)342-4525 V^C^ ^ Report of: COMPRESSIVE STRENGTH-GROUT ASTM C1019 Date Printed: 12/1/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Chent: NORTH COAST CALVARY CHAPEL Set No.: 14-0764 File No.: Permit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 11/26/2014 3X3X6 10.27 15,600 1,520 N/A 28 12/17/2014 28 12/17/2014 28 12/17/2014 28 H 12/17/2014 Specified Strength: 2,000 PSI Sampled By: GEORGE WOELCKEN Location: CMU WALL - CANOPY ASTMC172 Date Sampled: 11/19/2014 Date Received: 11/21/2014 Concrete Supplier: P/U.OMAR TRANSIT MIX Mix No.: 386201 Ticket No.: 237709 Water added at Site: 25.00 gal. By CONTRACTOR Cement Type: II/V Mix Time: 120 Remarks: MIDDLE Concrete Temp: 75 Ambient Temp: 64 °F ASTM C1064 °F ASTM C1064 Slump: 8.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. Corporate 2992 E La Palma Ave, Ste, Ajiabeim, CA 92806 Tel: 714.632.2999 Fax; 714.632.2974 Dispatch; 800.491.2990 San Diego/Imperial County 7313 Carroll Rd,, Ste, G San Diego, CA 92121 Tel: 858,537.3999 Fax: 858.537.3990 Dispatch: 888.844,5060 DAILY INSPECTION REPORT MTGL PROJECT*: 1109-A01 Report # 01 Page 1 of 1 Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection on a dally basis Each report shall be completed and signed by the special inspector conducting the inspection. inland Empire 14467 Meridian Pkwy., Bldg 2A Riverside, CA 92518 Tel: 951.653,4999 Fax; 951.653.4666 DEC 0 2 M« DS/VCITY File * „ o i DS/VLEA # PROJECT NAME; North Coast Calvary Chapel Screen Wall Date; 11/19/2014 ARCHITECT; Timeless Arch. TIME ARRIVED; 8:30AM TIME DEPARTED; 12;00PM ENGINEER : TRAVEL TIME N/A LUNCHTIME; N/A CONTFIACTOR ; Grant General Contractor. SUB CONTF5ACTOR : Lyons and Son Masonry INSPECTION ADDRESS ; 1330 Pointsettia Carisbad, CA ADDRESS OF PROJECT: same TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACK FILL • BATCH PLANT • PT CONCRETE • SHOTCRETE • CONCRETE El MASONRY • HIGH STRENGTH BOLTING • WELDING • SHOP WELD • FIREPROOFING • ANCHOR/DOWEL • NDE FIELD • NDE SHOP • CEILING WIRE • • • DSA/OSHPD PROJECT APPROVED DOCUMENTS AVAILABLE APPROVED PLANS Y • N • SOILREPORTYD NO SPECS: Y • N • APPROVED SHOP DRAWING Y • N • MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO, OR MATERIAL TEST REPORTS): 8x16 gray precisio CMU 2000 PSI grout Palamar #386201, CONTRACTORS EQUIPMENT/MANPOWER USED; 4 men; Grout pump , vibrator and hand tools. AREA, GRID LINES, PIECES INSPECTED: Inspected grout pour for canopy screen wall and panter wall @ 6/D-A.7- Monitored splump, consolidation and made 4 grout samples. Walls were thoroughly consolidated and tolerances maintained. Grout aid was added at the tieginning of the pour. No exceptions found. STRUCTURAL NOTES, DETAIL OR RFIS USED; 22/S506, REMARKS, INCLUDING MEETINGS; REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASH WAS NOT • Inspected in accordance with the requirements ofthe DS/VOSPHD Project approved documents. MATERIAL SAMPLING WASH WAS NOT • N/A • Perfomied in accordance with DS/VOSPHD Project approved documents. THE WORK INSPECTED MET H DID NOT MEET • The requirements of the DS/VOSPHD Project approved documents. Samples taken: 4 GROUT Weather Clear Temp; 68 degree Project Architect Structural Engineer DSA Regional Office School District Contractor Building Department Owner Signature of Special Inspector Louis Hickam Certifi- Verified by; www.mtglinc.com MTGl Project *: ..^ii^:' Permit # Corporate: 2992 E- La Palma Ave Ste A Anaheim, CA 92806 Tel: 714.632,2999 Fax: 714-632.2974 Dispatch; 800.491.2990 San Diago/lmperial County 6295 Ferris Square. Suite C San Diego CA 92121 Tel; 858.537.3999 Fax: 858,537.3990 Dispatch, 888.844.5060 Inland Empire: 14467 Meridian Pkw.. Bldg 2-A Riverside. CA 92518 Tel 951 6534999 Fax: 951.653.4666 Dispatch: 800.491.2990 Intlio: 44917 Golf Center Pkwy, #1 Indio. CA 92201 Tel: 760.342.4677 Fax: 760,342.4525 Dispatch; 800.491.2990 DAILY INSPECTION REPORT Report # P6 OF DSA'CITY Fiie n DSA'OSHPD AT OSA/LEAr DEC.lliO^^ Speciai inspection Reports must be ciistributed to tiie parties listed telov,' wtthin 14 days of the inspectiori Reports ot non-compliant conditions must be distribuf8tlirams!M«W:»Ki Separate reports shall be prepared for each tv'pe o' specia! inspection, on a daiiy basis Each repor! shall be completed and signed by ite specfaQ^tfet©j({hlMi!»gii¥nnection 0A1f :^.iM-^L£y^. . ^..^ ARCHiTECl CO'iiRACiOR WSPtCFIorjAODHfSS KAVF: 'I'M: ;;i'!; CO'JI'M v:ibH 1 UHCH TiM? TYPE OF INSPECTION ENGINEERED Fit! FOUMDATIOW B,ACK FILL DSA/OSHPO/PROJECT: APPROVED DOCUMENTS: BATCH PUNT PT CONCRETf SHOTCRETt CONCRETE A\ffilLA.SLE- APPROVED PLAN'S '/^ MASONRY HREPROOflNG HIGH STRENGTH BOLIlfJG ~<rANCHOR.''DOWEL WELDING • NOE FIELD SHOP WELO WOE SHOP CEilWG WlRl- SOli REPORT Y" H SPECS' \X ^ APPROVED SHOP DRAWil'jG Y t>l WATffiiSiS USFO BV SOfiIRACIOa liriP -rf- RKEARCIi RtPOP' lil! ow VA-tf:!Al IES! Ri COMlHACiOHS tOUlf'HS'JI ' MA'POWFB USti) 2r /^CjO^ 13^^^ H £'&:^f' ^^^^"^ ABEA GSilOgf.tS.PIiiiiSiriSi'FCTEU f SIRUCnmAI. NOftS DiiAii ORRHSUSHI ^ REWORK AS PERCENT OF ALL WORK TODAY. PERCENT PROJECT COMPLETE: THE WORK WA^ WAS NOT Inspected in accorUancs v/itt) the requiiements of the DSA/OSHPD/PROJECT approved documents MATERIAL SAMPLING WAS WAS NOT N,'4s6 Performed in accordance •aitti DSA'OSHPD'PROJECT appioved documems ct Project Arctiitect Contractoi Structural Engineer Building Depaitment DSA Regional Office Ovmer School District THE WORK INSPECTED MET)( DID NOT MEET Ttie requirennents oUfce DSA'OS^PD.'PROJECT approved documents Samples taken ip' Weather CertificatHj Verified b'y" SignalureoLSpecial Inspector '^c-^ML- '^^^A£^7k£ Print Name Corporate: 2992 E, La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferns Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 IVIeridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 City of Carlsbad OCT 2 2 2014 BUILDING DIVISION Date Printed: 10/17/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0572 File No.: Perinit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 9/24/2014 4X8 12.57 36,950 2,940 Cone & Split 28 10/15/2014 4X8 12.57 48,650 3,870 Cone & Split 28 10/15/2014 4X8 12.57 48,090 3,830 Cone & Shear 28 10/15/2014 4X8 12.57 48,290 3,840 Cone & Split 28 H 10/15/2014 Specified Strength: 3,000 PSI Sampled By: MIKE DUTEMPLE Location: FOOTING - NORTH EAST STAIR ASTMC172 Date Sampled: 9/17/2014 Date Received: 9/18/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 490583 Water added at Site: 10.00 gaL By CONTRACTOR Cement Type: Mix Time: 60 Remarks: Concrete Temp: 90 Ambient Temp: 77 °F ASTMC1064 °F ASTM C1064 Slump: 4.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECnON DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 3850 PSI 28-day compression test complies with the specified strength. India: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 www.mtglinc.com «T3LP,*«_41£a^^fCityof C^rti* INSPECTION P.,.»Oe> OCT i 2 im REPORT Report # PG OF / Special Inspection Reports must be distributfiiJlHaiSiflJl^^tgpefilgApi^ days ofthe inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a cBiff basis. Each report shall be completed and signed by the special inspector conducting the inspection. Corporate: 2992 E, La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San DIega/lniperlal County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 IVIeridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951,653.4999 Fax: 951.653.4666 Dispatcfi: 800.491.2990 DSA/CITY File #: DSA/OSHPD APPL ^ DSA/LEA #; PROJECT NAME ARCHITECT lAME . AJ ^ DATE TIME ARRIVED TIME DEPARTED LUNCH Til/IE ENGINEER TRAVEL TIME CONTRACTOR SUBCONTRACTOR INSPECTION AODRESS /S - / / ' J /I ADDRESS OF PROJECT ^-j j TYPE OF INSPECTION • EMGINEERED FILL FOUNDATION BACK FILL n BATCH PLANT •:; PT CONCRETE • SHOTCRETE L: CONCRETE • MASONRY G FiK3H STRENGTH BOLTING Vi^ELDING • SHOP WELD 11 FIREPROOFING J ANCHOR/DOWEL J NDE FIELD J NDE SHOP • CEILING WIRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS Y' SOIL REPORT Yn NI SPECS: YD WD. APPROVED SHOP DRAWING YC^-^C MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS): FACTOR (INCLUDE RESEARCH CONTRACTORS EQUIPMENT / MANPOWlf R USED/ UIPMENT/MANPqWfRUSED/ , J 1^ •#v » / A , D I AREA, GRID LINES, PIECES INSPEC STRUCTURAL NOTES, DETAIL, OR RFIS USI REMARKS, INCLUDING MEETINGS: REWORK AS PERCENT OF ALL WORK TODAY: PERCEI S\^A; PERCENT PROJECT COMPLETE. ElX^DN THE WORK WASS^WASNOTLJ Inspected in accordance with the requirements ot the DSA/OSHPD/PROJECT approved documents, IVIATERIAL SAMPLING WASH WAS NOTI , N/Av>^^ Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MEIX^DID NOT IVIEET i J The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken:_ Weather: C^Cst^tA Temp: I Signature of Special Inspector Print Name Corporate: 2992 E, La Palma Avenue, Suite A, Anaheim, CA 92806 X I A TeL (714) 632-2999 Fax: (714) 632la*Hy OT V/ariSDaU Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 IVIeridian Parkway Bldg 2A, Riverside, CA 92518 QQJ \ 5 2G';4 Tel: (951)653-4999 Fax:(951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-452p|anning DivisiOP Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 10/10/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0563 File No.: Permit No.: Project No.: Project Name: CB 102519 1109 AOI NORTH COAST C/U.VARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 9/18/2014 4X8 12.63 61,650 4,880 Cone & Split 28 10/9/2014 4X8 12.57 79,560 6,330 Columnar 28 10/9/2014 4X8 12.57 76,640 6,100 Cone & Split 28 10/9/2014 4X8 12.57 73,750 5,870 Cone & Split 28 H 10/9/2014 Specified Strength: 4,000 PSI Sampled By: MIKE DUTEMPLE Location: DECK - 2ND FLOOR ASTMC172 Date Sampled: 9/11/2014 Date Received: 9/12/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 4063545 Ticket No.: 490475 Water added at Site: gal. By Cement Type: Mix Time: 50 Remarks: Concrete Temp: 89 Ambient Temp: 72 °F ASTMC1064 °F ASTMC1064 Slump: 6.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECnON DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 6100 PSI 28-day compression test complies with the specified strength. ( eiUral Diipalcli (800)491-2990 Office l.ocatiion'i { orporatc BrancSi Orange f'otsnt} 2*)92 f.. I,a Painta. Suitf .\ .\naheim. ( a 92S«fi lei: 800 4') 1-2990 Fii\: 714 632-2974 tirantli Offices Indio I.os ,\iit;eles / Ventura Couut) San BernavdijKi ' Riverside Sail Dieao ' liirpefia! <: ertil'vin,i< .\geneie<. Stale of falit'onii:! D.S.A OSHPD An»ericati Assoc, of .Slaie IlijJhvvais C al Trans (CRI CeiiieiiS & f ijiicrcic Reference I aboratorj I.os An<;ek'i L A t't)uiii> LA<it5 MTA Orange CountK OCiA Orange ( oiiiilj Ein iroimieiihi! % hi i 3; V n I e 11 i A '4 e i j c > .Sail Diego San Diego ( if) Sail Diego ( oiiiiti SD Water Authoritv (iiiand Empire ( !f> of Riierside ( oiiiit\ of Riverside October 10,2014 North County Calvary Chapel 1330 Pomsettia Lane Carlsbad, Califomia Geotechnical Engineering Construction Inspection Materials Testing Environmental MTGL Project No. 1109AOI MTGL Log No. 14-1191 Attention: Mr. Jack Shubin Subject: FIREPROOFING DENSITY TEST REPORT, LAB 655 TO 658 ProjectName: Building A Expansion Sampled By: MTGL. Inc. Manufacturer CAFCO Type 300AC Project Specification / Minimum Density (pcf) 15.0 pcf (min. average) 14.0 pcf (min. individual) TESTING INFORMATION Lab No. Sample Date Sample Location Average Thickness (in) Average Dry Density (pcf) 655 9/29/14 Column, Grid Line C/5 0.7813 17.7 656 9/29/14 Column, Grid Line A.4/6 1.4167 19.7 657 9/29/14 Beam, Grid Line A.2/1 1.3125 21.6 658 9/29/14 Beam, Grid Line A.5/1 1.2708 20.4 ASTM Test Method: E605-93 (2006) The Material B WAS • WAS NOT Sampled and Tested in Accordance with the Requirements of the Approved Documents The Material Tested 11 MET • DID NOT MEET The Requirements of the Approved Documents. Respectfully submitted, MTGL, Inc. Sam E. Valdez, PE Vice President/Chief Engineer Corporate: Branch: Branch: Branch: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 ^ , „ Tel: (714) 632-2999 Fax: (714) 632-2^||V 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 44917 Golf Center Parkway #1, Indio, CA 92201 Q0- Tel: (760) 342-4677 Fax: (760) 342-^^,' OCT 0 6 2014 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 10/3/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0529 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 9/11/2014 4X8 12.57 54,570 4,340 Cone 28 10/2/2014 4X8 12.57 71,500 5,690 Cone & Split 28 10/2/2014 4X8 12.57 73,810 5,870 Columnar 28 10/2/2014 4X8 12.57 74,840 5,960 Columnar 28 H 10/2/2014 Specified Strength: 4,000 PSI Sampled By: DON CARD Location: OFFICE - SLAB ON GRADE ASTMC172 Date Sampled: 9/4/2014 Date Received: 9/5/2014 Concrete Supplier: Mix No.: 4063545 Ticket No.: 546077 Water added at Site: Cement Type: Remarks: HANSON AGGREGATE gal. By Mix Time: 36 Concrete Temp: 80 Ambient Temp: 72 °F ASTM C1064 °F ASTMC1064 Slump: 5.00 in. ASTM €143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 5840 PSI 28-day compression test complies with the specified strength. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 IVIeridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 9/18/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Chent: NORTH COAST CALVARY CHAPEL Set No.: 14-0563 File No.: Permit No.: Project No.: Project Name: CBl02519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (Ibs.) (psi) Fracture 7 9/18/2014 4X8 12.63 61,650 4,880 Cone & Split 28 10/9/2014 28 10/9/2014 28 10/9/2014 28 H 10/9/2014 Specified Strength: 4,000 PSI Sampled By: MIKE DUTEMPLE Location: DECK - 2ND FLOOR ASTMC172 Date Sampled: 9/11/2014 Date Received: 9/12/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 4063545 Ticket No.: 490475 Water added at Site: gal. By Cement Type: Remarks: Mix Time: 50 Concrete Temp: 89 Ambient Temp: 72 °F ASTM C1064 °F ASTM C1064 Slump: 6.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. www.mtglinc.com MTGL Projects, Corporate: 2992E. LaPaimaAve. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego.CA92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw.. Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800,491.2990 India: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch: 800.491.2990 Permit •U CJ?n\OlA^\^ Report #_ DAILY INSPECTION REPORT DSA/CinRISii OF -4- DSA/OSHPD APPLii DSA/LEA #; Special Irtspectlon Reports must be distributed to the parties listed below within 14 days of the inspection. Reports ol non-compliant conditions must be distributed Immediately. Separate reports shall be prepared for each type of specia! inspection, on a daily basis. Each report shall be completed and signed by fhe special inspector conducting the inspection. ARCHITECT " ' J TIME ARRIVEO TIME DEPARTED ENGINEER TRAVELTIME LUNCHTIME CONTRACTOR SUB CONTRACTOR INSPECTION ADDRESS —l-fr ADDRESS OF PROJECT TYPE OF IHSPECTION • ENGINEERED FiLL • FOUNDATION • BACKFILL • BATCH PLANT • PT CONCRETE • SHOTCRETE :j CONGRETE • MASONRY • HIGH STRENBTH BOLTING • WELDING • SHOP WELD O A tREPROOFING ANCHOR/DOWEL • NDE FIELD • NDESHOP • CEILING WIRE o_ • ^ • DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: .^AVAILABLE:. m\ RFPORT vn Kin ••^PFCS: vn Nn APPROVED PLANS YO ND APPROVED SHOP DRAWING YD Nf MATERWLS USED BY CONTRACTOR (IMCIUOE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS): CONTRACTORS EQUIPMENT/ MAKPOWER USED: AREA. GRID LINES, PIECES IKSPECTED: STRtfCrURAL NOTES, DETAiL, 03 fiFlS ITSEO: REMARKS. mCLUOm MfETWfiS; REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK INSPECTED METD DID WOT MEETD ^ The requirements ofthe DSA/OSHPD/PROJECT approved doouments. Samples taken: / Weather: fV/M/' THE WORK WASD WAS NOTO Inspected in accordance withthe requirements ofthe DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASfl] WAS NOT • N/Afj Performed In accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regionai Office Ovmer School District CertificatiQnil Verified by:. Print Name jnspectaL. Corporate: San Diego/lmperlal County Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 www.mtglinc.com Dispatch: 800.491.2990 MTGL Project #: | / ^ Permit*. 2992 E. La Raima Ave. Ste. A 6295 Ferris Square, Suite C San Diego, CA 92121 Tei: 858.537.3999 Fax: 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 Indio: 44917 Golf center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 Report # PG J. OF -I DAILY INSPECTION REPORT DSA/CITY File #:. DSA/OSHPD APPL #:_ DSA/LEA#. , Specia! inspection Reports must be distributed to the parties listed below/ within 14 days of the Inspection. Reports of non-compliant conditions must be distributed Immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed bythe special inspector conducting tbe inspection. PROJECT MAME "I I ' V TIME ARRIVED 73 ARCHITECT TIME DEPARTED ENGINEER TRAVEL TIME LUNCHTIME CONTRACTOR SUBCONTRACTOR INSPECTION ADDRE! ADDRESS QF PROJECT TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACK FILL • BATCH PLANT n PT CONCRETE n SHOTCRETE "^^OWCRETE • MASONRY n HIGH STRENGTH BOLTING • WELDING • SHOP WELD • FIREPROOFING • ANCHOR/DOWEL • NDE FIELD C! NOE SHOP • CEILING WIRE n • DSA/OSHPO/PROJEXI— APPROVED DOCUMENTS: -AVAILABLE- APPROVED PLANS ND -SOILREPORT.YD .-N•_. _S£E^;Sl-:a^iL^L APPROVEDSH0PDRAWING YD NP iS USED BY COMRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS); , ^ MATERIALS USED BY COMRACTOR (INCLUDE BES CONTRACTORS EQUIPMENT / MANPOWER USED: AREA. GRID LINES,P1ECES INSKECTED: MJQ-^ S(\t?p>a^ -pg^i:^- STRUCTURAL NOTES. DETAIL, OR RFIS USED: 5 ^^\ REMARKS. mCLiimnG, VSMEBmBS:/ , 3-4 REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WA^^WASNOTD Inspected in accordance vi/iththe requirements ofthe DSAi'OSHPD/PROJECT approved documents. MATERIAL SAMPLING WAS,^ WASNOTD N/AD Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTEO METV DID MOT IVIEET • The requirements of tf^^A/OSHPD/PROJECT approved documents. Samples taken: Weather:. 1'^ Signature of Specialjnspector p/mt Name CartiflK Verified by: Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 9/11/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD. CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0529 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 9/11/2014 4X8 12.57 54,570 4,340 Cone 28 10/2/2014 28 10/2/2014 28 10/2/2014 28 H 10/2/2014 Specified Strength: 4,000 PSI Sampled By: DON CARD Location: OFFICE - SLAB ON GRADE ASTMC172 Date Sampled: 9/4/2014 Date Received: 9/5/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 4063545 Ticket No.: 546077 Water added at Site: gal. By Cement Type: Mix Time: 36 Remarks: nun. Concrete Temp: 80 Ambient Temp: 72 °F ASTM C1064 "F ASTM C1064 Slump: 5.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. ( CHtrai Dispiitcii (KS8) 844-5060 Office Locations Brancli Addrcss 6295 i-frris S<jiiarf, Suite C Sail Oiego, CA <>2l2i I'd: (85.H) S37-.W> Fav: (HSS) .^37-399!) Branch OiTiccs indio (h-aiijjc ( ouiilj Los Angeles.' VeiUuni Countv Siiii Diego Ifiipcria! Coti ntics liiiiind tnipire San Beriiiirdiiio Riverside Certif} iny AnencieN State of ( aliforiiiu D.S.A OSHPD Aniericiii! Assoc. of Stale lii<;!n\a>s Cai Trans ( ( KL CenieiK & ( oncreie Reference Lahorators I.os \!!<;cies I , A ( 0(1 ntv I.A Cits MFV Oran<;e ( ount} <>< 'I A Orange County F,i!%in)iinientai .Ma!ias»eiiicnl .\iicnc> San Diego San Oietjo C it\ Saii Diego ( oui!i> SD Water Aulhoril) inland Empire C its of Riverside Geotechnical Engineering Construction Inspection Materials Testing Environmental Septembers, 2014 North County Calvary Chapel 1330 Poinsettia Lane Carlsbad, Califomia 92011 Attention: Mr. Jack Shubin Subject: MTGL Project No. 1109A01 MTGL Log No. 14-1133 HIGH STRENGTH BOLTS, NUTS & WASHERS RESULTS LAB NUMBERS 542 THRU 546 Project: BUILDING 'A' EXPANSION North County Calvary Chapel 1330 Poinsettia Lane, Carlsbad, CaHfomia 92011 Location in Structure: Unknown Sample Date: Aug. 22. 2014 by MTGL TESTING INFORMATION SPECIMENS - LAB NUMBER 542 (Set Lot No. 15893-20188640) TYPE MANUFACTURER SET LOT NO. ASTM SPEC. MARKINGS DIAMETER LENGTH BOLTS UNYTITE 15893-20188640 A325 A325TC, USA 5/8" 2'A" NUTS UNYTITE 15880-M49697 A563 DH,U 5/8" - WASHERS UNYTITE C6619 F436 F436, P 5/8" - SPECIMEN # ROCKWELL HARDNESS (HRC) PROOF LOAD (LBS.) WEDGE TENSILE (LBS.) SPECIMEN # TEST RESULTS (avg) SPECIFIED TEST RESULTS SPECIFIED TEST RESULTS SPECIFIED min. Bolt 1 30 34 Max 20,800 20,800 34,285 27,100 Bolt 2 32 34 Max 20,800 20,800 35,015 27,100 Bolts 30 34 Max 20,800 20,800 34,635 27,100 Nut 1 28 24-38 39,550 39,550 Nut 2 29 24-38 39,550 39,550 Nut 3 31 24-38 39,550 39,550 Washer 1 41 38-45 Notes: ASTM Test Method: F606. A325. A490. A563. F436.F1852 Proof Load: S - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Washer 2 41 38-45 Notes: ASTM Test Method: F606. A325. A490. A563. F436.F1852 Proof Load: S - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Washer 3 40 38-45 Notes: ASTM Test Method: F606. A325. A490. A563. F436.F1852 Proof Load: S - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation North County Calvary Chapel - Building 'A' Expansion Carlsbad, Califomia MTGL Project No. 1109A01 Log No. 14-1133 SPECIMENS - LAB NUMBER 543 (Set Lot No. 16965-5172551) TYPE MANUFACTURER SET LOT NO. ASTM SPEC. MARKINGS DIAMETER LENGTH BOLTS UNYTITE 16965-5172551 A325 A325TC, USA %" NUTS UNYTITE 16984-M52134 A563 DH, CA - WASHERS UNYTITE C7154 F436 F436, P %" - SPECIMEN # ROCKWELL HARDNESS (HRC) PROOF LOAD (LBS.) WEDGE TENSILE (LBS.) SPECIMEN # TEST RESULTS (avg) SPECIFIED TEST RESULTS SPECIFIED TEST RESULTS SPECIFIED min. Boltl 30 25-34 30,700 30,700 52,275 40,100 Boh 2 28 25-34 30,700 30,700 51,360 40,100 Boh 3 30 25-34 30,700 30,700 51,355 40,100 Nut 1 32 24-38 58,450 58,450 Nut 2 33 24-38 58,450 58,450 Nut 3 35 24-38 58,450 58,450 Washer 1 42 38-45 Notes: ASTM Test Method: F606. A325. A490. A563. F436.F1852 Proof Load: S - No permanent yield or defonnation - Accepted • - Not Accepted due to yield or deformation Washer 2 39 38-45 Notes: ASTM Test Method: F606. A325. A490. A563. F436.F1852 Proof Load: S - No permanent yield or defonnation - Accepted • - Not Accepted due to yield or deformation Washer 3 40 38-45 Notes: ASTM Test Method: F606. A325. A490. A563. F436.F1852 Proof Load: S - No permanent yield or defonnation - Accepted • - Not Accepted due to yield or deformation SPECIMENS - LAB NUMBER 544 (Set Lot No. 18290-20315890) TYPE MANUFACTURER SET LOT NO. ASTM SPEC. MARKINGS DIAMETER LENGTH BOLTS UNYTITE 18290-20315890 A325 A325TC, USA 7/8" 2%" NUTS UNYTITE 18241-143973 A563 DH,U 7/8" - WASHERS UNYTITE C8109 F436 F436, P 7/8" - SPECIMEN # ROCKWELL HARDNESS (HRC) PROOF LOAD (LBS.) WEDGE TENSILE (LBS.) SPECIMEN # TEST RESULTS (avg) SPECIFIED TEST RESULTS SPECIFIED TEST RESULTS SPECIFIED min. Boltl 33 25-34 42,500 42,500 68,060 55,450 Boh 2 32 25-34 42,500 42,500 67,340 55,450 Null 28 24-38 80,850 80,850 Nut 2 30 24-38 80,850 80,850 Washer 1 42 38-45 Notes: ASTM Test Method: F606, A325. A490. A563, F436 Proof Load: lil - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Washer 2 42 38-45 Notes: ASTM Test Method: F606, A325. A490. A563, F436 Proof Load: lil - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Page 2 of 4 North County Calvary Chapel - Building 'A' Expansion Carlsbad, Califomia MTGL Project No. 1109A01 Log No. 14-1133 SPECIMENS - LAB NUMBER 545 (Set Lot No. SS711) TYPE MANUFACTURER SET LOT NO. ASTM SPEC. MARKINGS DIAMETER LENGTH BOLTS UNYTITE SS711 A325 A325TC, USA 7/8" VA" NUTS UNYTITE SP461 A563 DH, CA 7/8" - WASHERS UNYTITE WC3698 F436 F436, P 7/8" - SPECIMEN # ROCKWELL HARDNESS (HRC) PROOF LOAD (LBS.) WEDGE TENSILE (LBS.) SPECIMEN # TEST RESULTS (avg) SPECIFIED TEST RESULTS SPECIFIED TEST RESULTS SPECIFIED min. Bok 1 32 34 Max 42,500 42,500 74,850 55,450 Bolt 2 30 34 Max 42,500 42,500 75,955 55,450 Nut 1 28 24-38 80,850 80,850 Nut 2 27 24-38 80,850 80,850 Washer 1 43 38-45 Notes: ASTM Test Method: F606, A325. A490. A563, F436.F1852 Proof Load: E - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Washer 2 40 38-45 Notes: ASTM Test Method: F606, A325. A490. A563, F436.F1852 Proof Load: E - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation SPECIMENS - LAB NUMBER 546 (Set Lot No. WM921) TYPE MANUFACTURER SET LOT NO. ASTM SPEC. MARKINGS DIAMETER LENGTH BOLTS UNYTITE WM921 A325 A325TC, USA 1" 2'/2" NUTS UNYTITE WJ961 A563 DH, CA 1" - WASHERS UNYTITE C5868 F436 F436, P 1" - SPECIMENS ROCKWELL HARDNESS (HRC) PROOF LOAD (LBS.) WEDGE TENSILE (LBS.) SPECIMENS TEST RESULTS (avg) SPECIFIED TEST RESULTS SPECIFIED TEST RESULTS SPECIFIED min. BoU 1 30 25-34 55,750 55,750 92,125 72,700 Bolt 2 30 25-34 55,750 55,750 93,220 72,700 Bolt 3 31 25-34 55,750 55,750 93,740 72,700 Nut 1 30 24-38 90,900 90,900 Nut 2 30 24-38 90,900 90,900 Nut 3 28 24-38 90,900 90,900 Washer 1 42 38-45 Notes: ASTM Test Method: F606. A325, A490. A563. F436.F1852 Proof Load: 13 - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Washer 2 41 38-45 Notes: ASTM Test Method: F606. A325, A490. A563. F436.F1852 Proof Load: 13 - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Washer 3 41 38-45 Notes: ASTM Test Method: F606. A325, A490. A563. F436.F1852 Proof Load: 13 - No permanent yield or deformation - Accepted • - Not Accepted due to yield or deformation Page 3 of 4 North County Calvary Chapel Carlsbad, Califomia Building 'A' Expansion MTGL Project No. 1109A01 Log No. 14-1133 The Materials E WAS • WAS NOT Sampled and Tested in Accordance with The Requirements of the Approved Documents The Materials Tested S MET • DID NOT MEET The Requirements ofthe Approved Documents. We appreciate this opportunity to be of continued service to you. If you have any questions regarding this report, please do not hesitate to contact us at your convenience. Respectfully submitted, MTGL, Inc. Sam E. Valdez, PE Vice President | Chief Engineer Page 4 of 4 www. mtglinc.com Corporate: 2992 E. La Palma Ave. Sfe. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Dlego, CA 92121 Tel: 858.537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951,653.4666 Dispatcti: 800.491.2990 India: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 MTGL Project #:. Permit #„ Report DAILY IKSPECTION REPORT mmm Rie #;. PG OF, OSA/OSHPD APPL #:_ DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days ot the inspection Reports of non-compliant conditions must be distributed immediateiy. Separate reports stiall be prepared for each type of special inspection, on a daiiy basis. Each report shall be completed and signed by ttte special inspector conducting the inspection. ?>- 3-- TIME ARRIVED L A,Ai TIME DEPARTED CONTRACTOR TflAVEL TME LUNCHTIME SUB COI INSPECTION ADDRESS, . ADDRESS OF BpJECr > . . / /^^ i I I TYPE OF INSPECTiON • ENGINEERED FILL n FOUNDATION BACK FILL BATCH PU^NT L PT CONCRETE • SHOTCRETE J CONCRETE LJ MASONRY Ll Vt\m STRENGTH BOLTING WELDIMG n SHOP WELD • FIREPROOFWG • ANCHOR/DOWEL n KDE RELD • NDE SHOP n CEILWGWIRE • LJ I DSA/OSHPD/PBOJECT; APPROVED OQCUMENTS: AVAILABLE: APPROVED PUMS Y» N!. SOiL REPORT YG l\lf SPECS: YIK WG APPROVED SHOP DRAWING YE Ni MATERIALS USED BY CONTRACTOfl (INaUOF RESEARCH REPORT MO OR MATERIAL TEST REPORTS): A^G. Aini-. Aro<:^ ^rh. sAAA^'.^iadt £Lozz- CONTRACTORS EOUIPMENT / MANPOWER USED; GRID LINES PlEpfS WSPECreo- • (J^ • j • . (L/ ,^ d S^ch£>n JtJ: rgHfliiMa VtoPf dt^ck. QjrtA A("Z^ "7- .^ J ES PIECES MSPECTED- k UJri^(>^ ^ 7/^^'^"fu.J^A& U-^AJ tJ^ \r^(a.K fool '^inJ Ari.l-l) ^=,f ^- -.-^i-- ^ = T^-w ^•^...-T = • —^->- « =-« y-y - « — - • • Q ^/£f*<^ ^k^^ SU^ i^UJ^^ t-^fU^r.t ^/jr/z/ftiU-f ^ ; StRflCTURAlJIQTES. OEBIL, OH RFIS USED: 7~ ' ~. ^ ~ ' p / / ^ T" REMARKS, f«a£f»»Bfl&I?»CS; If i S / i h fl 1 ' t • la •^'S REWORK AS PERCEMT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS RIOT • Inspected in accordance with the requirements of tlie DSA/OSHPO/PROJECT approved documents, IVIATERIALSAMPLiKG WASU WASNOTD N/'ATJ Performed in accordance with DSA/OSHPD/PROJECT approved doouments. ec Project Architect Contractor Stnjctural Engineer Buifding Oepartment OSA Regional Office Owfner School District THE WORK IKSPECTED MEIK B5D I^OT iWEET I i Tlie tequirements of the DSA/OSHPO/PROJECT approved documents. Samples taken; Weather: Temp;. ^BSSBm^S^mm www.mtgltnc.com MTGL Project #: ll 0 3 At? t Corporate: 2992 E. La Palma Ave. Ste. A Anaheim. CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch; 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 IVIeridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951.653.4666 Dispatcti: 800.491.2990 Indio: 44917 Golf Center Pkwy,#1 Indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 Pemiit # Report #_ PG_ 0F_ DAILY INSPECTION REPORT DSA/CITY Fiie #; DSA/OSHPD APPL#;_ DSA/LEA #; Special Inspection Repoits must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed bythe special inspector conducting the inspection. RCHITECT—— ~, '. .•.J., ~, ' DATE W^R!® — 'Ja PARTED (f S<=>AAA - -v . \o AM ARCHITECT ENGINEER TRtVEL TIME, CONTRACTOR WSPECTIOt! AOORESS CA. SUBCONTRACTOR ADORESSI)F PROJECT . , .rt ( A TYPE OF (HSPECTfON IJ ENGItilEERED FILL n FOUNDATIOfif • BACKFILL • BATCH PLANT • PT CONCRETE • SHOTCRETE • CONCRETE 13 MASONRY n HiGH STRENGTH BOLTING » WELDING n SHOP WELD • FIREPROOFING [J ANCHOR/DOWEL • NDE FIELD 1 i NDE SHOP • CEIUNG WIRE • DSfl/BSHPD/PROJECT APPROVED DOCUKENTS: AVAILABLE; APPROVEO PLANS Yl SOIL REPORT Yl„ Nl NQ SPECS: YD ND APPROVED SHOP DRAWING Y • N \ MATERIALS 8YCONTRACTOR (INCLUDE RESEARCH REPORT NQ. OR MATERIAL TEST flFPORTS|- NTRACTORS EQUIPMENT; MANPOWER USED;\J CONTRACTORS EQU.r,.,c„, , »,™.ru.,tr.uoi;u,^ AREA. GRiB t MES. PIECES INSPECTED: ^- a) ^^^^ u&LA-c^ rtM.^=Llie L^x^i^ f,^^ ^sMi^cje,^ s'L^.p TUBAL NOTES, DETAIL. OR RRS USED: ^ ^ T ^ t ( TT f STRJCTURAL ss REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WOW WAS:^ WAS NOT L I Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. IWATERIALSAMPLING WASlJ WASNOTD N/AiJ Performed in accordance with DSA/OSHPD/PROJECT appraved documents. cc Project Architect Contractor Stmctural Engineer Building Department OSA Regional Office Owner School District THE mm ISSPECTEB MET DID NOT MEET • Tha requirements of the DSA'OSHPD/PROJECT approved documents. Samples taken: Weather: Temp;. slgnawfe of Spsdal inspector Print Name CerWication^ f^C i- f(H, ^S^ Verified by: I Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax: 714.632.2974 www.mtglinc.com Dispatch: 800.491,2990 ^1 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 IVIeridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.553.4565 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy. #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 MTGL Project*. Pemit #_ Report #_ 102 DAILY INSPECTION REPORT DSA/CITY File DSA/QSHPD APPL #: PG_ OF DSA/LEA #; Special Inspection Reports must be distributed to the parties iisted below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reporfs shall be prepared for each type of special inspection, on a daily basis. Each report shal! be completed and signed by the special inspector conducting the inspection. m DATE ARCHITECT Fttm€ /€-SS A'TcLJiktscJUxr-e.^ TIMEAR^O SO AkM. TIME DEPARTED ENGINEER CONTRACTOR TRAVELTIME / LUNCH TIME INSPECTION ADDRESS ^^^e( <a6g^^ ADDRESS QE PROJECT • i TYPE OF tHSPECTiON j EFJGINEEREOFILL \ FOUNDATION I BACK FiLL n BATCH PLAMT 1 PT COMCRETE J SHOTCRETE 1 CONCRETE n MASONRY X HIGH STRENGTH BOLTING * WELDINQ n SHOP WELD J FIREPROOFING D ANCHOR/DOWEL • NDE RELD • NDE SHOP • CEILING WIRE • n DSA/OSHPB/PBOJECT: APPROVEO BOCUMEHTS: AVAILABLE; APPROVED PUNS Y • N : SOIL REPORT YD Ni SPECS; Yll NC APPROVED SHOP DRAWING Y[J N • MATERIALS USED SST COdfTRACTOR (INCLUDE RESEARCH REPORT NO- OR MATERIAL TEST REPORTSJ: All-- A^^jL . AJCO ^*-S. A 1 2-r_ 7. CONTRACTORS EOUIPMENT ,'MAHPOWEH USED: f f rcpcc pMctrcrrnTn- » rJ < \m UfiES, PtEGES E! 3] Ai- _ ,— j-g. 1^ —, — ~ • ———fv—'—^— STRUCTUF?AL NOTES, OeaiL OB SEIS USED: / - i -v — 1^ \J ' ' SL NOTES, OeaiL OB SEIS USED: / - i -v REMARKS. mammmmTms: REWORK AS PERCEMT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASS^ WAS MOT • Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. mTEitALSAIiPUtfS WASD WAS NOTu N/ALJ Performed in accordance with D'SA/OSHPO/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK WSPECTEi MET-ifi. DID NOT MEET • The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; ^ Weather;. Temp;.. *SignattM of specia 'SignattM of Spectal Inspector ezAttM^'.esi^ Cei Verified by: Print teme www.mtgfinc.coiTt Corporate: 2992 E. La Palma Ave. Ste. A Anatieim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Oiego/lmperral County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 IVIeridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951.653.4666 Dispatch; 800.491.2990 (ndio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 MTGL Project*;. Permit # PG OF / DAILY INSPECTION REPORT DSA/CITY File #:. DSA/OSHPD APPL < DSA/LEA #: Report #_ Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant condftions must be distnbuted immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. pflq.JE! ARCHITECT T1MEARRIVED_ TIMEDEPARTEO 3 • oo TPA-^ EIVGMEEB TRAVEL TIME H LUNCH TIME CONTRACTOR INSPECTION AUOHESS 2A^e^ ^T^f SUBCONTRACTOR ~Z 7~i / if _ .ADDRESS OF PHgjECT I ^ I TYPEOFIMSPECTtOM L ENGINEERED FILL U FOUNDATION r BACK FILL BATCH PLANT L i PT CONCRETE ;j SHOTCRETE J. CONCRETE • MASONRY HIGH STRENGTH BOLTING %. WELDING [ ] SHOP WELD • FIREPROOFING n ANCHOR/DOWEL n NDE FIELD .n NDE SHOP • CEILING WIRE • DSA/OSHPO/PROJECT: APPROVEO DOCUMENTS: AVAILABLE; APPROVED PUNS Y3^ Ni SOIL REPORT YD W \ SPECS: Y!X ND APPROVED SHOP DRAWING Y*E Nl MATERIALS USED BY CONTRACTOR (INCtUK RESEARCH REPORTNO OR MATERIAL TEST REPORTS! f. / * CONTRACT(JBfc EOUiPHE.W I MANPOWER USED- te. GRID LIWS, PiECES INSPECTED:.. A// TT ~ f , ^ 1 ~ !1&. GRID WS, PiECES INSPECTED:.. J \l J r ' / J t r~ TJA-E STRUCTURAL NOTES. OETAIL, QR WIS USttt, \J \ T — REMARKS, mammevimum: REWORK AS PERCENT CF ALL WORK TODAY: PERCENT PROJECT COIVIPLETE: THE WORK WASH WAS NOT i : Inspected in accorttance with ttte requirements of the DSA/'OSHPD/PROJECT approved documents. MATERtftt SAMPLfHG WftS • WAS NOT . : K/A ; Performed in accordance with DSA/QSHPD/PRQJECT approved documents. cc Project Architect Contractor Structural Eegitieer BuiWing Department DSA Regional Office Owner School Oistiiet THE WORK mSPECTEO METi* DID NOT MEB f i The requirements of the OSA/OSHPD/PROJECT approved documents. Samples taken; Weather. Temp:_ lecial Inspector nt Name Certi5«rtit»#; l^g^fef^ C}-Z^Ht^8^l^T^i^ VerifiStrtJTT Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/29/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0384 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 8/4/2014 4X8 12.57 36,330 2,890 Columnar 28 8/25/2014 4X8 12.57 52,480 4,180 Columnar 28 8/25/2014 4X8 12.57 50,170 3,990 Columnar 28 8/25/2014 4X8 12.57 55,030 4,380 Columnar 28 H 8/25/2014 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: SLAB ON GRADE - GRID LINE A.8 / 1.5 ASTMC172 Date Sampled: 7/28/2014 Date Received: 7/29/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 540667 Water added at Site: gal. By Cement Type: Mix Time; 40 Remarks: Concrete Temp: 90 Ambient Temp: 88 °F ASTM C1064 °F ASTM C1064 Slump: 5.25 in. ASTM €143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 4180 PSI 28-day compression test complies with the specified strength. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway # I, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/29/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0383 File No.: Permit No.: Project No.: Project Name: CB102519 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 8/4/2014 4X8 12.57 42,990 3,420 Columnar 28 8/25/2014 4X8 12.57 51,850 4,130 Columnar 28 8/25/2014 4X8 12.57 51,180 4,070 Columnar 28 8/25/2014 4X8 12.57 50,800 4,040 Columnar 28 H 8/25/2014 Specified Strength: 2,500 PSI Sampled By: MIKE KINGERY Location: SLAB ON GRADE, GRID LINE D / 4 ASTMC172 Date Sampled: 7/28/2014 Date Received: 7/29/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 540609 Water added at Site: gal. By Cement Type: Mix Time: 35 Remarks: Concrete Temp: 89 Ambient Temp: 82 °F ASTM C1064 °F ASTM C1064 Slump: 5.00 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 4080 PSI 28-day compression test complies with the specified strength. Corporate; 2992 E. La Palma Ave. Ste. A Anaheim, GA 92805 Tel; 714.632.2999 Fax: 714.632,2974 www.mtglinc.com Dispatch; 800.491.2990 MTGL Project t. / / A Permit # CB~ lOlSl^ / OF / San Diego/Imperial Counly 6295 Ferris Square, Suile C SanDiego, CA 921:21 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire; 14467 Meridian Pkw., Bldg. 2-A Riverside, GA 92518 Tel; 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 Indio: 44917 Golf Genter Pkwy, #1 Indio. CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch: 800.491.2990 DAILY INSPECTION REPORT DSA/CITY file #;_ Report #_ PG. DSA/OSHPD APPL #:. DSA/LEA #: Special Inspection Reports must be distributed to the parties listed belov; within 14 days ol lhe inspection. Reports of non-compliant condilions must be distributed immediately. Separate reports shall be prepared for each type ot special jnspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. "lypT^ (%<aS4r Cdu^r^ Ci^^^f DATE ARCHITEC T7^ e /^-sr Anr c^Lti^d-Aif^e 3 > oof Af ENGINEER TRAVEL TIMS LUNCHTIME CONTRACTOR SUB CONTRACTOR _ . / i—,/5f^^ , 1^ /^BLE iiZotJ IAJD^HS . JA}<L INSPECnOUAODHESS iCTION : 1 BATCH PL/M ' ADDRESS or PROJECT /y ' J / } / TYPE OF INSPECTION n E:NGINEERED FILL •• i FOUNDATION : 1 BACKFILL BATCH PL/S : J PT CONCRETE iJ SHOTCRETE r; CONCRETE MASONRY D: HIGH STRENGTH BOLTING ;>irWELDING ' . SHOP WELD •J. FIREPROOFING ; '• ANCHOR/DOWEL : : NDE FIELD D NDE SHOP CEILING WIRE DSA/OSHPD/PROJECT; APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS YJ>f I\l SOIL REPORT YD N^ SPECS: Y>r N:,.. APPROVED SHOP DRAWING YhJf NL MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT MO. Ofi MATERIAL TEST R£PORTS:i: CONTRACTORS EOUIPMENT,' MANPOWER USED: ; . P TD 7 ' '. ^ .A AREA GRIDLINES, PIECES INSPECTED » • i I J (, J > !H*1¥:TIIRAI MIJFS nPTAII OR RFI<)TlSFn-» ^ ' ' I I A \/ fES DETAIL. OR REIsTlSEO:' /ll / if' J ^ -v ^ Uar l:Ao^M £AouOu W ^ ctU '^^'•-<M^«-L' e::Xg^ ^''^"'^ DfV- r ^ CLUDING MCETINES: , I-Z !/ i ^ 1 t<r.iiJKULUOlllG MEFnUBS: , — n 1 V / "^"^ 1 I I I A I i ?"> >V f C^x^^ /aJ' ^4 W<::L C^M^U G.'^)^ Wi-e^f tl^t^. I^hk. Lei/^f Prd<Ar^are • SiUg^ Uin^ iw-<ucLAt^ LOf U^- sU<^ I^EWORK AS PERCENT OF ALL WORK TODAY: -J PERCENT PROJECT COMPLETE: THE WORK WASS< WAS NOT I • Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. IVIATERIAL SAMPLING WAS : WAS NOT i N/A Perfomied in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Ovi/ner School District THE WORK INSPECTEO MET'X DID NOT MEET i The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken: Weather: Temp: Signfture of I ^—Sic Signature of S^Mial Inspector ^r'^t^me Corporate: San DiegD/lmperial County 2992 E. La Palma Ave. Ste. A 6295 Ferris Square, Suite C Inland Empire; Indio: 14467 Meridian Pkw., Bldg. 2-A 44917 Golf Center Pkwy, #1 www.mtglinc.com Anaheim, GA 92806 Tel: 71'1.632.2999 Fax; 714.632.2974 Dispatch: 800.491.2990 San Diego, GA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Riverside, CA 92518 Tel: 951.653,4999 Fax: 951.653.4666 Dispatch: 800,491.2990 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 1(0^ Ao( h/TGL Project #:. Permit # jDZS/f I DAILY INSPECTiON REPORT DSA/CITY File #:_ DSA/OSHPD APPL #:_ Report • PG. 0F_. DSA/LEA #: Special Inspection Reports must be distributed to the parties listed belov; Vi/lthin 14 days of the inspection. Reports of non-compliant condihons must be distributed immediately. Separate reports shall be prepared for each lype of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting lhe inspection. PfiOJ5,GIiNAME V DATE AFiCHITECT TIME ARRIVED TIME DEPARTED aj Ti»iic .' .7 EWSINEER TRAVEL TIME LUNCH TIME CONTRACIOR SUB COfiTRACTi INSPECTION ADDRESS ADDRESS OF PmiECT / / ' 1 ^ / J t A TYPE OF INSPECTION •• ENGINEERED FILL I FOUNDATION ; ! BACK FILL BATCH PLANT PT CONCRETE SHOTCRETE CONGRETE IVIASONRY ' ' HIGH STRENGTH BOLTING X WELDING ' SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDE SHOP CEILING WIRE DSA/OSHPD/PROJECT; APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS YX SOIL REPORT Y; N. SPECS: Y-K, Ni ; APPROVED SHOP DRAWING Y><, l\l: MATERiALS USfD COI-mAGTOR lIHGlUDE RESEARCH REPORT HO. OR MATERlAl TEST RECOHTS) <, 4^ X zy, AS ^7^^ , "'bwnf' CO^nRACT0RS EQUIPMENT/MANPOWER USEU- i y AREA. GRID I INES, PIECES IWSP=:''TFD: ^ /g, ^A. Jii^ o i L-r^.^ <sA^ci LJ<-ir>c. i/i-e.iA^ csS) 2c^J ^^r. <rd -<! ck> URAL NOTES. DETAIL. OR RFIS USED • ^ \ 1 4 c/l REMARKS, (AiaUflWCMEETWCS:., s-A-A^ u)..(iA(iA-iSj g*-^ REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS WAS NOTU Inspected in accordance with the requirements of the DSA/OSHPO/PROJECT approved documents, MATERIAL SAMPLING WAS.^ WAS NOT LJ N/A ' , Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET;< DID NOT MEET ii The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; Weather: T) '^^^^'z:::^ ..^--'-'SlgnMii.re ot SpecWlnspector rii^^to PrinVName Certlficationjf__UU^ » id 4 V^'=\ V. ^W.^iT Verified by:. www.mtglinc.com Corporate: 2992 E. La Palma Ave. Ste, A Anaheim, CA 92806 Tel: 714,632,2999 Fax: 714,632,2974 Dispatch: 800.491,2990 San Die(|0/Imperial County 6295 Ferris Square, Suite C San Diego, GA 92121 Tel; 858.537.3999 Fax: 858,537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw.. Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653,4666 Dispatch: 800.491.2990 Indio; 44917 Golf Center :Pkwy, #1 Indio, CA 92201 Tel: 760.342,4677 Fax: 760,342,4525 Dispatch: 800.491.2990 MTGL Project Permrt #_ Report; PG DAILY INSPECTION REPORT OF. DSA/CITY Rle #;. DSA/OSHPD APPL#;. DSA/LEA#:. Special Inspection Reports must be distributed tothe parties listed below vjlihin 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily t)asis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT ARCHITECT- tTor-iL. ^ASIT CiX.i'A^'^j C-L^*f-e-l TIME ARRIVED Cs '.l^ AAA, TIME DEPARTED ENGINEER CONTRACTOR TRAVEL TIME LUNCHTIME SUEl CONTRACTOR . _ _ , ,1 ABLE. /JlorJ lA)mkS, l/Oc INSPECTION ADDRESS TYPE OF INSPECTION . ENGINEERED FILL • FOUNDATION BACKFILL BATCH PLANT PT CONCRETE SHOTCRETE COMCRETE : : MASONRY ^ : HIGH STRENGTH BOLTING X WELDING K SHOP WELD ; 1 FIREPROOFING "i ANCHOR/DOWEL : NDE FIELD : : NDE SHOP CEILING WIRE n. DSA/OSHPD/PROJECT; APPROVEO DOCUMENTS: AVAILABLE; APPROVED PLANS Y X SOIL REPORT Y r\l SPECS: YSX Ms ! APPROVED SHOP DRAWING YH? N; MATERIALS USED BY COiSTRACTDR IINCLUDE RESEARCH REPORT NO OR kSATERlAL TEST REPORTS) i. y. CDNJBttTORSEOUIPMEN'l-'MANPOWER USED: ,^ . /> INES PIECES INSPECTED- U . ' y,'^ ' j A' - . ' AREA GRID LINES. PIECES INSPECTED- U •• ^ j ! STRUCTURAL W0TE5.0ETAIL. Dp RFIS USEj* t , * REMARKS, INCLUOING MffTHKSS; REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS^ WASNOTf : Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WAS,: WAS NOT i: N/A Performed in accordance wrth DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METi< DID NOT MEET [ • The requirements of the DSA/OSHPD/PROJECT approved documents Samples taken: Weather:__ Temp: ^i^^^^^^^ature'^^t ^-r^ ^-'bignatu^remSpecial Inspector PrimName Certification Verified by:. Corporate: 299-2 E, La Palma Ave, Ste, A Anaheim, CA 92806 TeT, 714.632.2999 Fax: 714.632.2974 www.mtglinc.com Dispatch: 800,491,2990 MTGL Proiect #: jJ^_l_AfJ San Diego/Imperial County 6295 Ferris Square, Suite C SanDiego, GA92121 Tel; 858.537.3999 Fax; 858,537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 IVIeridian Pkw., Bldg. .2-A Riverside, GA 92518 Tel: 951.653,4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Intlio: 44917 Golf Center Pkwy,#1 Indio, CA 92201 Tel; 760.342.4677 Fax: 760.342.452S Dispatch; 800.491.2990 Permit # Report #_ DAILY INSPECTION REPORT DSA/CITY File #:. DSA/0SH.PDAPPL#:. PG. OF DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days ot the inspection. Reports of non-compliant condilions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each leport shall be compleled and signed by the speciai inspector conducting the inspeclion. ARCHITECT, ENGINEER DATE TIME ARF\IVED TIME DEPARTED TRAVELTIME , LUNCHTIME S.U3 COflTRACTOR NSPECTION ADDRESS <AA LANT . JiDDHESS OF PSajf GT . A^ I I I I3SO rP/*i^g.gfflV (a»v-g- , Cgv'-i-S UD^ TYPE OF INSPECTION :"! ENGINEERED FILL FOUNDATION J BACK FILL BATCH PLANT PT CONCRETE SHOTCRETE CONGRETE , ; MASONRY ; HIGH STRENGTH BOLTING X. WELDING , SHOP WELD : FIREPROOFING ; ANCHOR/DOWEL NDE FIELD : NDESHOP CEILING WIRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE; APPROVED PLANS YH Ni SOIL REPORT Y: , N, SPECS; y>K. NU APPROVED SHOP DRAWING Y'A Ni J MATERIfflSUSEDBYCWRACTOnilNCLUDERESEARCHREPORTNO, OR WCTERIAL TEST REPORTS): , , ^ , XS*^CfOKS EaUlf'MtNI/MANRDWtRUSED: y AREA GRIDLINES^ PIECES INSEFCTED: A, ^ , f , h i / UclJ^tAl fo T/^ k>^^ fioA'-Att... hdAi»^ ^J^h irfLi*^ItTD F'^S ioyj^ x^fi^ SffiuCTUHAL NOTES, DETAiL, OR BFIS USf 0: /, , , , . ^ » J »V/„ JfUCTUHAL NOTES, DETAiL, OR BFIS USfO: J . f J I n //\ Jl / •\ ^ jr ^JA:k!^ mCLUDINB MCniNGS: .J J REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS*t WAS NOTU Inspected in accordance with the requirements ol the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WAS , WAS NOT : N/A Performed in accordance with DS/VOSHPD/PROJECT approved documents, GC Project Architect Contractor Structural Engineer Buiiding Department DSA Regional Office Owner School District THE WORK INSPECTED MET»; DID NOT MEET: The requirements ol the DSA/OSHPD/PROJECT appioved documents. Samples taken: Weather: Temp: ^SignatureVfSpe jngnatureVf Special Inspector Pr^ Name cert^#.^<^^ %(oQA^M-%H^l^^H Verified by:.. it. www.mtglinc.com Corporate: 2992 E, La Palma Ave, Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax; 714.632.2974 Dispatch; 800.491,2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Oiego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch: 888.644.5060 Inland Empire: 14467 f\/leridian Pkw., Bldg. 2-A Riverside, CA 92518 Tei: 951.653.4999 Fax; 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel; 760,342,4677 Fax: 760.342.4525 Dispatch: 800.491.2990 MTGL Project i Permit / OF. / DAILY INSPECTION REPORT DSA/CITY Rle #:_ Reports PG. DSA/OSHPD APPLii DSA/LEA #; Special Inspection Reports must be distributed to the parties lisled below within 14 days ol the inspection. Reports ot non-compliant condilions must be distributed immediateiy. Separate reports shall be prepared for each hype of special inspection, on a daily basis. Each report shall be compleled and signed by the special inspector conducting the inspection. ihlor'-U.. CoA£-f Ct-iv^^-^y C^-:±f^ ^ ARCHITECT -7— / . / •} i" TIME ARRIVED liVED _ 4 s ° -^-^ TIME DEPARTED 2^ ,« j ENGIMEER TRAVEL TIME LUNCH TIME CONTRACTOR &'LA INSPECTION AODRESS SllBCO-NTRACTOR TYPE OF INSPECTION • E-NGINEERED FILL n FOUNDATION U BACKFILL BATCH PLANT PT CONCRETE SHOTCRETE CONCRETE , IVIASONRY : HIGH STRENGTH BOLTING XWELDING " SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDE SHOP CEILING WIRE OSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE; APPROVED PLANS YX N SOIL REPORT y : N: SPECS: Yi^ N: ' APPROVED SHOP DRAWING Y'X N MATERIALS USED BY COHTRACTOR (IHCLUDE RESEARCH REPOfff NO OR MATERIAL TST REPORTS): COfTTRACTORS EQUIPMENT/MANPOWER USED: • . . , AREA,GHTDLINIS, PIECES INSPECTED:, ^1 L f\ F/A FiouMf<t'- Pl^iJ^i ^ dl Ui^U^c:^ Ao r /s L STRUCTURAL NOTES, DETAIL. DR RflS USED, REMARKS. WCt(yB«SMff7//IH5S,- f) I 1, / REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASK WAS NOT i j Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASu WAS NOT u N/A, , Performed in accordance with DSA/'OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department OSA Regional Office Owner School District THE WORK INSPECTED MET DID NOT MEET i : The requirements ot the DSA/OSHPD/PROJECT approved documents. Samples taken; Weather: . JSIBT Signature of Ecial Inspector Print Name : ICC A Lti^Z^^'i^ik'i.SS. <ff a Certification #: Verified by; Corporate: San Dlego/lmperial County 2992 £. La Palma Ave, Ste. A 6295 Ferris Square, Suite C www.mtglinc.com MTGL Project #; j/Q9- AO'^ Pemrit # CB^1-0 2S Report # PG L_ OF L Anaheim, GA 92806 Tel; 714.632,2999 Fax: 714.632.2974 Dispatcfi: 800.491.2990 San Diego.CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch; 888.844.5060 Inland Empire; 14467 IVIeridian Pkw., Bldg, 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951.653.4666 Dispatch: 800.491.2990 Indio: 44917 fiolf Center Pkwy,#1 Indio, CA 92201 Tel: 760.342.4677 Fax; 760,342,4525 Dispatch; 800.491.2990 DAILY INSPECTION REPORT DSA/Gir/ File #:. DSA/OSHPD APPL« DSA/LEA#: Special Inspection Reports must be distributed to the parties iisted below within 14 clays of the inspection. Reports of non-compliant conditions must be dislribuled immediately Separate reports shall be prepared for each type ot special inspection, on a daily basis. Eacti report shall be oompieted and signed by the special inspector conducting the inspection. PROJECTNAME , /"> J ^ / J t inHITFCT . ; . .,>-». I DATE ARCHITECT _ _ . TIME A.RRIVED 4 vJfi' A*A TIME DEPARTED 3 fOt> fA ENGINEER CONTRACTOR S Ni k. TTan TRAVELTIME LUNCH TIME INSPECTION ADDRESS /•? / / (F t^&AS^l SUB CONTRACTOR ~ I x t . ABM ^A^^ A/ lA/^A.kS , /A/e ADDRESS Of PROJECT . , \ TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACK FILL • BATCH PLANT C PT CONCRETE • SHOTCRETE • COt\lCRETE • MASONRY • HIGH STRENGTH BOLTING 5C WELDING • SHOP WELD • FIREPROOFING • ANCHOR/DOWEL • NOE FIELD • NDE SHOP • CEILING WIRE • • DSA/OSHPD/PROJECT: APPROVEO OOCUMENTS; AVAILABLE: APPROVED PLANS YSf Nl SOIL REPORT YL: NTI SPECS: Yp ND APPROVED SHOP DRAWING Y«i NU MATERIALS USED BY CONTRACTOR (INCLUt£ RESEARCH REPORT NO, OR MATERIAL TEST REPORTS)' 3^ ;tefORSlClUIPrtMT/MAJ)PdWERUSEb: CONTRACTORSIEQUIPR. „, ^Slt^ (Aemc*^ A^ 2A\^ Atc>t- trA^cA •ec^^ z- ^ o /<L •~f<. :TllRAi MOTES DFTAII OR RFIRIISFD ^ ' ^ '' ^T"^ I STrarCTUJtALMOTES. DETAIL. OR RFIS USED: . . y _ v %%.mammGmrTmGS: ,J 7~ , . ^7 , \A , t T* ; MEETINGS: A O I i '-^ a. '•^ t / L / f/\.^^-^g-A ^i^r-iA LA^rA&d<>^ ^( So<^aX. ^^i^eAAjAj ^ CO /CIA^-^^ IF REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASJ?V WASNOTD Inspected in accordance with the requirements of the OSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASD WASNOTD N/AD Periormed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET5? DID NOT MEET D The requirements of the OSA/OSHPD/PROJECT approved documents. Samples taken: . Weather: ^ Temp: S^igaatare of mm Print Name Certification #; I ALC. » (^s iF%7 HST^ k H, ^jf Verified by:} /2't.-»—<. Corporate: 2992 £, La Palma Ave. Ste. A Anaheim. CA 92806 Tei: 714.632.2999 Fax: 714.632,2974 Dispatch: 800.491,2990 MTGL Project*:.. Permit ) www.mtglinc.com San Diego/lmperlal County 5295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch; 888,844,5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel; 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 DAILY INSPECTION REPORT DSA/CITY File i DSA/OSHPD APPL* Report*. PG OF DSA/LEA i Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports ol non-compliant conditions must be distributed immediately. Separate reports shall be prepared tor sach type ol special inspection, on a daily basis. Each report shall be compleled and signed by the special Inspector conducting the inspeclion. PROJECT NAME t ^ i ^ , ^ j r^DrH^ <^^r sjyrj Fl^<^ e-^ / ZF 14 ARCHITECT TIHE ARRIVEO TIME DEPARTED 3 T 06P/^ ENGINEER CONIRACIOR TRAVEL TIME 2-Cf LUNCHTIME INSPECTION ADDRESS sw CONTRACTOR TYPE OF mSPECTION D ENGIMEERED FILL • FOUNDATiON • BACK FILL • BATCH PLANT O PT CONCRETE n SHOTCRETE •• CONCRETE • MASONRY D HIGH STRENGTH BOLTING iSf WELDING • SHOP WELD D FIREPROOFING • ANCHOR/DOWEL • NDE FIELD • NDE SHOP D CEILING WIRE D • D DSA/OSHPD/PROJECT; APPROVED DOCUMENTS: AVAILABLE; APPROVED PLANS YiX. ND SOIL REPORT YD NG SPECS: Yi» ND APPROVED SHOP DRAWING YiX ND MATERIALS USEp BY CONTRACTOfi (INCLUDE RESEARCH REPORT NO, OR MATERIAL TEST REPORTS): UL CONTRACWRS erUiPMENT / MANPOWER USED, . ^ ^ — ^ - • . . RtA^lllJ UMES, PIECES INSPECTED: , 7^^ AAI ~F) A _ , , - , , ~ . l ^ jErURAl IWffiS, OHAIL, DR RflS USED: , j. . i iTi , I i /i A . i J s, iNCLuma mcvNBS: • „ - ^ JA\. <P^^A fA<^i^fie(A F)^Ui^^ {z>i- t/<yuC^ '^LL'tlAAj , 60i>rAi^^^UY REWORK AS PERCENT OF ALL WORK TODAY; PERCENT PROJECT COMPLETE: THE WORK WAS 1*1 WAS NOT Ll Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WASD WASNOTD N/AD Performed in accordance with OSA/OSHPD/PROJECT appraved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School Oistnct THE WORK INSPECTED MET K. DID NOT MEET D The requirements of the DSA/OSHPD/PROJECT approved documents Samples taken: Weather; Temp: Signatum^l SpeciaWnspector K^oA^i^" Fl Print Nan Certitication #; Verified www.mtglinc.com MTGL Project #: Corporate: 2992 E. LaPaimaAve. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714,632.2974 Dispatch: 800.491.2990 San Diego/Imperial Count/ 6295 Ferris Square, Suite C San Diego.CA92121 Tel; 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw.. Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio; 44917 Golf Center Pkv/y, #1 indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 Permi t# c^ioi.5/<r PG. XOFZ. DAILY INSPECTION REPORT DSA/CITY Fiie; DSA/OSHPD A'PL#;. DSA/LEA #: Report #_ Speciai Inspection Reports must be distributed to the parties listed below within 14 days of the inspec ion. Reports of non-compliant conditioi s must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report sh; II be completed and signed by the spec al inspector conducting the inspection. ARCHITECT , ~ ^> / TIME ARRI' 'ED . , ENGINEER ' 7» _1 TRAVELTIHE TIME DEPARTED LUNC I TIME COIlTRACTOR 'JSPECTIQW ADDRESS sua CONTF ACTOR ADDRESS C F PROJECT TYPE OF INSPECTION D ENGINEERED FILL FOUNDATION Z BACK FiLL BATCH PLANT PT CONCRETE SHOTCRETE CONCRETE D MASONRY D HIGH STRENGTH B0L1NG AfSMXam D SHOP WELD • FIREPROOFING • ANCHOR/DOWEL Z NDE FIELD Z NDESHOP CEILING WIRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE; APPROVED PLANS Y: SOIL REPORT YZ N: NZ SPECS: YZ NZ APPROVED SHOP DRAWIN3 YZ N: l,',AT£RitLSUSEDBYCQNTRACTOR!lHCLUDERESy.RCHREP0RTM0.QBMATERlALTESTREPORTSj; / / COtiTRACTORS EQUIPNC/JT' MANPDVilER USE« / fef^CTED: A- . , ' / _ ./ \ GIID LINES PIECES ifePECTED Y^ilj) F \ >^>-/ /Z}:/'ZAJ( ^/^' ^^t/^/ ^A(A^^<:^Af<ir U A^fZ A ^/i .. 'T^It ^J.^ .^.tJ/./'"H. . , AT^ iJ^rt A). ^AO ~ 1^ A^J URAlf NOTEI '¥f"PdMij^ u^diiPAi^ ho&^lT-y^ ^nm\i,L.Vis^ ^^i^o,mmNG!i^ I, r - //^^ ^LA<^\i.^ A ' ..^ ^..^ -T- -P^r^^X tl. ^n/.A A-TA Li. w ? lAV y TT It • ' ~}i I „ r . y J ty A y ^ REWORK AS PERCENT OF ALL WORK TODAY: PERCEDT PROJECT COMPLETE: THE WORK WAS i^LWAS NOT Z inspected in accordance with the requirements Of the DSA/OSHPO/PROJECT approved documents, IVIATERIAL SAMPLING WASZ WAS NOTZ N/AZ Performed in accordance v^iith DSA/OSHPD/PROJECT approved documents. CC Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WOf IK INSPECTED MET gf DID NOT MEET Z The requTements of the DSA/OSHPD/PROJECT approved documents. Samples ;aken: Weather; ^ Temp;. Certificatiin #: Verified b /; Print Name Corporate 2992 E La Palma Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax: 714,632,2974 Dispatch: 800.491,2990 San Diego/lmperiai County 6295 Ferris Square Ste. C San Diego, CA 92121 Tel: 858.537,3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire 14467 Meridian Pkwy., Bldg 2A Riverside, CA 92518 Tel; 951.553.4999 Fax: 951.853.4666 Dispatch: 800,491,2990 Indio 44917 Golf Center Pkwy,, Ste.1 Indio, CA 92201 Tel; 760.342.4677 Fax:780.342.4525 Dispatch; 800.491.2990 MTGL PROJECT*: Permit #6^{n2,^i9 DAILY INSPECTION REPORT Report#. . Page of DSA/CITY File*.. DSA/OSHPD ApF , DSA/LEA # Special Inspection Reports must be ciistributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions Tiust be distributed immediately. Separate reports shall be prepared for each type of speciai inspection on a daily basis. Each reporl j hall be completed and signed by the speci 3l inspector conducting the inspection. PROJECT NAME nate: \RTED ARCHITECT' TIME /\RR1VED TltVl .PARTEI ENGINEER TFIAVE:L TIME LUNCHTIME CONTRACTOR INSPECTION ADDRESS SUB CONTRACTOR ADDRIHSS PROJECT . ^ ^ , tTrS&Trtfc tAAi9 AyH^iASSA^ TYPE OF INSPECTION ENGINEERED FILL FOUNDATION BACK FILL BATCH PLANT PT CONCRETE SHOTCRETE CONCRETE MASONRY HIGH STRENGTH BOLTING WELDING I SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDE SHOP CEILING WIRE iVECrgHOP DSA/OSHPD PROJECT APPROVED DOCUMENTS AVAlLABL£_AP£BOVED PLANS Yj 3LEAPPRC »-MNU SOIL REPOftT Y QNQ SPECS: APPRO' DRAWING Y^ND MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS); . A _ CONTRACTORS EOClPMENT/MANF'OWER USED: / 7 fi^iAi? /<^^A^.i/A^ ;A, GRID LINES, PIECES INSPECTED AFTFZFFFIFTFFFAFTF/^FAAJA /yy^^ /?^^ JiAAFF'T^ <yA.AS> /i Ai./Z yye^ A9,J)s^ fijA^JUC^ A^h^Mz^L.. ATAC - ]^A/2A^i///? SAi:>F/2eAk(/- /A)6^^M ^Af^yAT- AAl^ern^ A^^€A^ ^t^/yb/^TTT 'A^^<JiASO . SOX f^o4 S^ypeT^uf . STRUCTURAL NOTES, DETAILOR RFIS USED: KS, INCLUDING MEETINGS: AA ^nfX0\AFmA{^ /^LOAtA^/^'f ,<£Acii^A^/C^ REWORK AS PERCENT OF ALL WORK TODAY: THE Vi^ORK WA§(i<^WAS N0T|_J PERCENT PROJECT COMPLETE; THE WORK INSPECTED MEig, DID NOT MEET Q The req jirements of the DS/V/OSPHD Projsct approved documents. Sample:; taken: Inspected in accordance with the requirements ofthe DS/VOSPHD Project approved documents. MATERIAL SAMPLING WAS-D WAS NOT • N/AQ- Performed in accordance with DSA/OSPHD Project approved documents. Weathe Temp Project Architect Structural Engineer DSA Regional Office School District Contractor Buiiding Department Owner Certificat Verified Signature of Spe cial Inspector Corporate: 2992 E, La PaimaAve. Ste. A Anaheim, CA 92806 Tel: 714,632,2999 Fax: 714.632,2974 Dispatch; 800.491.2990 *• :, A'-.y San Oiego/imperial County 6295 Ferris Square. Suite C San Diego. CA 92121 Tel: 858,537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire; 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951,653,4666 Dispatch: 800.491.2990 Indio: 44917 GoH Center Pkwy. #1 Indio, CA 92201 Tel; 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 OF. i DAILY INSPECTION REPORT OSA/CITY File #;. DSA/OSHPD APPL #;. DSA/LEA #: Specia! Inspection Reports must be distributed to the parties listed below wittiin 14 days of the inspection. Reports of non-compliant condilions must be distributed immediately Separate reports shall be prepared for each lype of special inspection, ona daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECUIAME OA ARCHITECT DATE TIME ARRIVED 4 AM TIME DEPARTED ENGINEER S'^€»iAr\ Nik. ~7TQQ TRAVEL TiMi .2-A*" J LUNCHTIME i" • CONTRACTOR INSPECTION ADDRESS SUB CONTRACTOR ESS / / 'O / J AODRESSiF PROJECT f j> TYPE OF INSPECTION D ENGINEERED FILL • FOUMDATlOtJ D 8ACK FILL • BATCH PLANT • PT CONCRETE D SHOTCRETE O CONCRETE D MASONRY • HIGH STRENGTH BOLTING JJi;^ WELDING • SHOP WELD D FIREPROOFING • ANCHOR/DOWEL D NDE FIELD D NDE SHOP D CEiLlNGWIRE • _ D D DSA/OSHPO/PROJECT; APPROVEO DOCUMENTS: AVAILABLE; APPROVEO PLANS YjK- N f. SOIL REPORT YD ND SPECS: YFi^ND APPROVED SHOP ORAWING Y>r NG MATERIALS USED BY CONTRACTOR (INCLUDE fiESEARCH REPORT NO, OR MATERIAL TEST BEPORTSj: CONTRACTORS EOUIPNtENT / MANPOWER USEDjj ' /] F('^{J' ^rr^C^r^ 'FA ^ AiW-f GRID LINES. PIECES WSPEftEDt , . » , " . i P t . I PiE^Bj^PEp^ ^^^^AA<i^') T/A ^e^PU^< 's^i^^M^JiPL ^i^s^\ CAJ-^V LiAi L A\ Mss 11^sT/^ \D z .Tr ^r A^<A ^.^4^JF (II s CTURAL NOTES, DETAIL, OR RFIS USED: f , - , / f D i it' t / I A , . , >r ,r , _ Fli . 'i FFJ^ Al / •> _ J . mclm SMEETINBS: , . r ^ ^ y nmms. mcloome nsETiNGS: ro<Hg r •AtA^i .AZIM. re -ASLA REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASa WASNOTD Inspected In accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASD WASNOTD N/AD Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET 8^ DID NOT MEET D The requirements of the DSA/OSHPO/PROJECT approved dopuments. Samples taken; Weather; Temp;_ peOTtrns ^ "Signat^ of SpeOTtrnspector 'nnt raaiTif Print Certfeti&ii #; ( <^ ^ ^ Verified by;. www.mtglinc.com (1^1 MTGL Project #:_ Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax; 714.632.2974 Dispatcti: 800.491.2990 A San Diego/imperial Counly 6295 Ferris Square, Suite C SanOiego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951,653,4666 Dispatch; 800,491,2990 Indio: 44917 Golf Center Pkwy, #l Indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch: 800,491.2990 Permit # Report # 'PG. OF ' DAILY INSPECTiON REPORT DSA/CITY File #:_ DSA/OSHPD APPL#;, DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days ofthe inspection. Reports of non-compliant conditions musl be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. Tcr-T . ^ ' . . . 3~ I TIME ARRIVED ARCHITECT Fffyx^e ies^ A tc-lA^-^^z'^ are. TIME ARRIVED 4 TIME DEPARTED ENGINEER '^^iAjti__AJ\k. F]o(A TRAVEL TIMS LUNCHTIME /ZJ^AS_ CONTHACTOR sw CO/STRACTOR INSPECTION ADDRESS ! , ADDRESS OFPROJECT • 1 / TYPE OF INSPECTION D ENGINEERED FILL D FOUNDATION D BACK HLL a BATCH PLANT • PT CONCRETE O SHOTCRETE O CONCRETE A MASONRY • HIGH STRENGTH BOLTING SgL.WEL01NG D SHOP WELD • FIREPROOFING D ANCHOR/DOWEL D NDE FIELD D NDE SHOP • CEIUNG WIRE D . D D DSA/OSHPD/PBOJECT: APPROVED DOCUMENTS; AVAILABLE: APPROVED PLANS YiX ND SOIL REPORT YD ND SPECS: YS- ND APPROVEO SHOP ORAWING Yi^VND MATERIALS USED BV CONTRACTOR (INCLUDE RESEARCH REPORT NO OR MATERIAL TEST REPORTS): COmSCTORS EOUiPMENT / MANPOWER USED; ' ' ' 7j ' " ?f ' Z ~A I 2^ S CA^^ cA S<^P':>A-U'ka^ puts. A£U^IT^LA <£tc i^Ss f^^t^e-H^Ai^^^^^ PIECF^ INSPaSTED: , 7/ 1 Ai I ~ , ( I .] ^ „ AREA, GRID LINES, PIECF^; per. {Aic> {/L\,..e4\i f \ X\ FuU ,f n>^«£ A)'Li<^ TIP. io<MA, f^i^u*^ (k(A^h fUi^a.. SLUAO^ tA.^ . OR RFIS USED; ^ '. ] ' TZ .. . :^ H.,b«<AAi^ STRI F Z An ^Athhd^TiA^ . "[WORK," REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE; THE WORK WAS5K WASNOTD Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASD WASNOTD N/AD Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structurai Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METM DID NOT MEET D The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken;. , Weather: Temp; Certlficai Verified by: C2 Am§k wv\'W,mtglinc.coiTi Corporate; 2992 E. La Raima Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax; 714.632.2974 Dispatch: 800.491.2990 San Dlego/lmperial County 6295 Ferris Square, Suite C San Diego.CA92121 Tel: 858.537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside. CA92518 Tel: 951.653.4999 Fax: 951.653,4666 Dispatch: 800.491.2990 indio: 44917 Golf Center Pkvvy. #1 indio, CA 92201 Tel: 760.342.4677 Fax; 760,342.4525 Dispatch; 800.491.2990 MTGL Project #;_/M.f AA Permit # Cf^^ MAJ^/A" . Repoit # PG ol OF Special Inspection Reports must be distritiiited to the parties listed below v^ltriin 14 days of the inspection. Reports of noii-complianl conditions must be distnbuted immsdiatsly. Separate reports shall be prepared far each type of special Inspection, on a dally basis. Each report sinall be completed and signed by the special inspector conducting the inspection. DAILY INSPECTION REPORT DSA/CITY File t DSA/OSHPD APPL #: OSA/LEA#; PKDJLCrHAME ARCHITECT DATE TIME ARRIVED CONTRAGTOn INSPtCTlO'l r.DDRESS SAaiA/A/ A/A TRAVEL Tlf,1E A:ac^A^ TlMt DEPARTED LUWCH TIME SUB CCINTRACTOR ADDRESS OF PROJECT TYPE OF INSPECTION D ENGINEERED FILL D FOUNDATION C BACK FILL D BATCH PLANT D PT CONCRETE • SHOTCRETE D CONCRETE D MASONRY 1 HIGH STRENGTH BOLTING D WELDING • SHOP WELD D FIREPROOFING J AjllCHOR/DOWEL 'i+WE FIELD ! I NDESHOP D CEILIf-JGVifIRE DSA/OSHPO/PROJECT: APPROVEO aoCUMENTS: AVAILABLE: APPROVED PLANS YU SOIL REPORT YD l>ir SPECS: YJ APPROVED SHOP DRAWING YI. N1 MATFR-,.V,S USen sv CONTRACTOR UfJClUOE RESEARCH REPORT NO, OR MATERIAL lEST REPaRTS): CONTRACTORS EOIJIFMENT,' MAWA'ER USED; *Kfca i-.iF.IO LIMES. PIECES INSPECTED: STRLCIU3AL NOTES, OETAIL, OR RFIS USED: PEHARKS mcLmimmmms: <AfA REWORK AS PERCENT OF ALL WORK TODAY: THE WORK WAS iT3^AS NOTO Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved doouments. PERCENT PROJECT COMPLETE: MATERIAL SAMPLING WAS HJ'^WAS NOTD f^/A' Perfor/r'eri in accordance with DSA/OSHPD/PROJECT approved documents. CO Project Architect Contractor Structural Engineer Building Departinent DSA Regional Office Owner School bisliici THE WORK INSPECTEO MET Sr^lD NOT MEET D The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; A//A Wfiather; Temp: Certification #: Signature of Special Inspector A^ f C/S-/£.rAtA> Aif Print Name Verified by:. DaUy Pield Report Supplemental Attachment I UT-1, Ultrasonic Bxammation Report Page (^2. of aZ. Reporf Wo:. ^ w, .v^HV"'""- Date: ^//fflj:>/f M T W(3 F S sun ProJact-SitB Timo: start LuiKtt, min: CcmplAUd: Totat twurs; DWG wm Sketch: PC Mark: ^^^^'J^J Test Metftod standard: A t^.S QL^f Acceptance Standard: S'AS^ A^ Equipment: Cal/braffon BJocJc PC. Mark am Deabefs Indication Remarks W£jfA'£'o'J PC. Mark am A B c D » Disltincxs X ftom V Remarks W£jfA'£'o'J X ^C»fJjr-J, SA*<I( Atx A ^7 u>ti7> 70* 70 >< 70" s-7 X &71^Ah £Aksr ^AiJ 70" f^if A^(A >< A •• ij^ALi, 70^ Ui£A/- £A/J :L/.D i^<em < 7CA >< WAld ASIOA/IC • • Inspectors Signstum-.^aJ^/!^^^^yf±::^ Cartifaatfan ALewt JF . www.mtglrnc.com Corporate: 2992 E. La Palma Ave. Sle. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkvi/y.#1 Indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 MTGL Project #: M 9 -A a 1 Permit #_ DAILY INSPECTION REPORT DSA/CITY File #;. Report •!. PG OF. DSA/OSHPD APPL#:. DSA/LEA #: Special Inspection Reports must be distributed to the parties listed betow within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports stiall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME tsLc ARCtUgP. DATE TIMEASPIVED TIME DEPAR-TED ILE" IN J TRAVELTIME i LUNCH TIME CONTRACTOR SUBCONTRACTOR , r\ £ v « i ^ i INSPECTIOM ADDRESS / ADDRESS OF PROJECT i y.-, , , f. TYPE OF INSPECTJON D ENGINEERED FILL • FOUNDATION D BACK FILL • BATCH PLANT • PT CONCRETE D SHOTCRETE • CONCRETE D MASONRY D HIGH STRENGTH BOLTING 5f WELDIfiG D SHOP WELD D FIREPROOFING D ANCHOR/DOWEL • NDE FIELD D NOESHOP • CEIUNG WIRE D D D DSA/OSHPOffROJECT: APPROVED DOCUMENTS; AVAILABLE; APPROVED PLANS YO ND SOIL REPORT Y D N D SPECS: YD ND APPROVED SHOP DRAWING YD ND MATERIALS USED Bf CONTRACTOR (INCLUOE HESEARCH REPORT NO. OR MATERIAL TEST REPORTS): A-g 4. • A^'^^.. A^a<^yB> • f='cAuJF7^ F^ E ^ AJ/Z ZS iNmnSTOHS EQUIMENT /MANPOWER U^O: >m. GRID LINES, PIECtS INSPECTED; J , s D ~ C \ i / > •STRUCTURAL wares, O-ajlL, OR BFIS USED: T"^^ 7~\ . 'l / < ^ A t \ / ^(tAf^i^ -P Csu^;j5-He. • ^ F L f pi. REWORK AS PERCi CENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS&* WASNOTD Inspected in accordance with the requirements ot the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPUNG WASD WASNOTD N/AD Performed in accordance with OSA/OSHPD/PROJECTapproved documents. cc Project Architect Contractor Structural Engineer Building Department OSA Regionai Office Owner School District THE WORK INSPECTEO METjSl, DID NOT MEET D The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; Weather: Temp:__ ^ Sigitature of Sp«tSal Inspector mtlrami PrinrWame certification^^ C » ^lil t'(, ^A Verified bv;» ^^y^it-c-t. Corporate: San Diego/lmperiai County 2992 E. La Palma Ave. Ste. A 6295 Ferris Square, Suite C inland Empire: Indio: 14467 Meridian Pky./.. Bldg. 2-A 44917 Golf Center Pkv.(y, #1 wvv'w mtglinc.com eel t 7/^f Aof Anaheim, CA 92806 Tel; 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491,2990 San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Riverside, CA 92518 Tel: 951,653,4999 Fax; 951,653,4666 Dispatch; 800.491.2990 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 MTG Pern lit = .C^ :^../<?...,&r77 Report = PG OF ^ DAILY INSPECTION REPORT DSA.'CITYFile,#':_ DSA,;OSHPD APPL#; OSA/LEA #: Special Inspection Reports must be distributed to the parties listed belovi' within 14 days of the inspection. Reports of non-compliani conditions must be distributed immediately. Sepacate reports shall ne prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed bythe special inspector conducting the inspection. PROJECT I.A.-'.IE ARCi-rE'OT DAIL FMBIMFER TIME ARRIVED UME DEF.WTED .ZJS-F^M TRA'.'EL 1 lli'iE LUNCH TIME AL-tiAjA INSFLCTIO'-i (iDD^LSS"^ ] mw / : DflTru 01 SUS CCW-RACI OR /4i//5 X/ZJSAIA ADDRESS OF PROJECT TYPE OF INSPECTION ENGIMEERED FILL FOUNDATION " BACK FiLL _ BATCH PLANT ..i PT CONCRETE D SHOTCRETE ' CONCRETE MASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING - ANCHOR.'DOWEL JrlTre FIELD D NDE SHOP CEiLlNGWIRE DSA/OSHPD/PROJECT; APPROVEO DOCUMENTS; AVAILABLE; APPROVED PLANS Y LI SOIL REPORT YL N NT SPECS; Y"^ Nr- APPROVED SHOP DRAWING Y LSUSEDBv :CNT "OR lINCLUOERESFARC'riRLPDRI fJO OR MATER AL TEST REPORTS;- ^DNTRiC'OnEECjPaEfJT/ HAfc^OWiR USED: -ILA .i=;OLNE; PIECES IMSPFCT=r;- STRUrUFA- i-iOTE.5 UtTA L. OR RFIS USED: REMARKS. mCLUma MEETINGS: F^Atpiett^ArJ U/AA^^'^'^^"^ oAfi Ca ^^APA,^^^ •c7efA^f'A^''"^^f''*^":> F-AJAS. TF^ f.^/S A^ REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK V^ks AmS NDT I, Inspected in accordance with fhe requirements ol ihe DSA/OSHPiyROJECf^ approved documents. THE WORK INSPECTED MET i^lD NOT MEET The requirements ofthe DSA/'OSHPD/PROJECT approved documents. Samples taken; A///f MATERIAL SAMPLING WASi WAS NOT N/A' Performed in accordance 'with DSA/OSHPD/PROJECT approved documents. cc Project Architeci Contractor Structural Engineer Building Department DSA Regional 0<^ice Owner Schof;! Dist'iC'- Weather:_ Temp:_ Signature of Special Itispector Print Name Certitii^n #: C-^T- '^•r-aZ/SZr//'CA^ ^ ( jF Verified ^y^^'^^CC'^'-^K..''-'''''^^^ DaUy Field Report Supplemental Attachment I UT-1, Ultrasonic (Examination Report Pagea^ ofQ^ ReportNo: Date: A.3 Aa/<A M T wn F S Sun Projeot Nmmf^: ^(^^^ r^^^f ^^.^ r^A„^^r ^Q^M^ ^SO<^ PrOfectSHe Time: stait Lm^,n*i: CaapUud: Total HOUIS: Contraa: OWG Weld Sketcti: AsserrOjIy: fli^Mt^iAtt /^MftJC PC Mark: k:At<A4A Test M^od Sfartdard: AU>5 fA/,f AcceptancB Standard: Qgft.> ^ Equipment CaSbraeon Block: PC. Mark am Dedbels Indication Remarks <^a.S-r£AAj PC. Mark am TrwroKfjcmr A 8 c D J Orsfsoce X Distance From Y Remarks <^a.S-r£AAj /a" S-7 failFlA\ ''A S-7 ujssr &At£i KASptAk, 7o'^ S-7 >A tO^eiA AA^ taa.^Jt i s-7 >< 70" ^7 X SdlT'AJI W/i£ A//i >f<av^jcr s-j n-AA/^ 7o' 52 / F S 7 • • Inspectors Signatufe: Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 www.mtglinc.com Dispatch: 800,491.2990 II 0^ Ao i San Diego/lmperlal County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw,, Bldg, 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, GA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 MTGL Project #;„ Permit #_ DAILY INSPECTION REPORT DSA/CITY Flle#:_ DSA/OSHPD APPL #:_ Report # PG_ OF DSA/LEA #; Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant cjonditions must be distributed immediately. Separate reports shall be prepared tor each type ot special inspection, on a daily basis. Each report shaJJ be completed and signed by the special inspector conducting the inspection. '''f^TvAL a>.^A C[v.A^^ CTA^^A g-^ /•!- /-f HITECT _r 'fi A ~f TTZJ i J TIME ARRIVED D '~, " -/ — • TRAVELTIME - ARCHITECT TIME DEPARTED 3 i f^Af ENGINEER CONTRACTOR aiAJn AJ I k G :L IIMt / 2. Frj LUNCHTIME INSPECTION ADDRESS GAAtl SUBCONTRACTOR , / J/\/>iJc i,l , ^ ADDRESS OF PROJECT . ' .7 ., / 5Sb i^dfAvs--^ -i fl .M- Ut^ix- • C a:r Is h >^Fi CA TYPE OF INSPECTION D ENGINEERED FILL D FOUNDATION BACK FILL D BATCH PLANT • PT CONCRETE O SHOTCRETE D CONCRETE D MASONRY D HIGH STRENGTH BOLTING » WELDING D SHOP WELD D FIREPROOFING D ANCHOR/DOWEL • NDE FIELD D NOE SHOP D CEiLlNGWIRE • • DSA/OSHPD/PROJECT: APPROVED DOCUMENTS; AVAILABLE: APPROVED PLANS YM Mr SOIL REPORT YD ND SPECS: Y3iJ NLI APPROVEO SHOP DRAWING Y,Si ND MATERIALS USeO BY CONTRACTOR (INCLUOE RESEARCH REPORTNO, OR MATERIAL TEST REPORTS): A\^. Av^-^ 1. A.ra6 <^i R. FC AFl Fl i-T.. S - A//g r CON'fRAGTOHS EQUIPMENT / MANPOWER USED: (\ , ^ AREA. GRID LINi ^,Au ]{\.AJ- L^^JiJl ^xH T.Si^l^^^ ^yJ!2 rljS, Sj.A^s'h iA-e.L U r^FA^t^ l?B, WECES mSPECTEO: A , . ~ — kCJ ^ STRUCTURAl rURAbNOTES. DETAIL, OR WEilSEOj .• , / j ^ ,t U t , t . 0 /T . TTT rh^^^ pLJU. ^-^^ u^U UJl. |t((.^f ?> .TrV/g^ REMARKS, IKimmCUEErmGS: REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS>^ WASNOTD Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASD WASNOTD N/AD Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METi>r DIDNOTMEETD The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken: . Weather: Temp: A~t:e^*tZ.^ F) Print NaiTO certifioatiaa^^Ccc if ioClJ^^j SH^UJi^ Verified by;. Cofporata 2932 E La Palma Ave. Ste. A Anaheim, CAS:»06 Tet714.63i2999 Fax: 714.632.2074 Dispatch: 800.491.2990 San DIega/lmperial County 6295 Ferris Square, Suite C SanOiego, CA 92121 Tel: 858.537.3999 Fax: aS6.S3ir.waQ Dispatch: 888.844.5060 Inland Empire 14467 MeriiSan Pkwy.. Bldg 2A t«verade,CA 92518 Tet 951.653.4999 Fax; 951.653.4666 Dispatch; 600.491.2990 Indio 44917 GoW Cenier Pkwy.,Ste 1 Indio, CA 92201 Tel 760.342.4677 Fax 760.342.4525 Dispatch: 800.491.2990 DAILY INSPECTION REPORT APPROVAL# PROJECT* MTGL PROJECT*: IJ (i'i f\0 \ BUILDINGPERMIT*: C3,\09^^^'^ Report* PageO[of07^ Reports must be distrib Separale reports shall be pr^ared ftir each type of spedal inspection on a daily basis! Each report shall be cont)deted and signed by the spedal ^ispector conducting the inspecSon. DSA/LEA* Special Inspection Reports must be distribued to the palies lisled beiow within 14 days of the inspection. Reports of non-compliant conditians tnust be disttibuted invnediaiely. PROJECTNAME: ^hfdlrV^ (AfL<i^ Cjfi,\MA^^ rU;^^\. f\ F Date: F ARCHITECT 1 ' ^ TIME ARRIVED //;oo rtm TIME DEPARTED EV4GINEER TRAVELTIME LUNCHTIME CONTRACTOR SUB CONTFIACTOR 1NSPECT1QJ4 ADDRESS 1ff: JSfiir. LAWE J rj\s\<^AA, rPi ,9ZD )) ADtJRESS OF PROJECT • ENGINEERED FILL • FOUNDATION • BACKFILL • PT CONCRETE •SHOTCRETE • CONCRETE • HIGH STRENGTH BOLTING • WELDING • SHOP WELD • ANCHOR/DOWEL HI^DE FIELD • NDE SHOP • EPOXY • AVAILABLE /W>PROVED PLANS Y B N • | SOIL REPORT Y • N • DSA/OSHPD PROJECT /APPROVED DOCUMENTS MATEFUALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS) SPECS: Y H N fll APPROVED SHOP DF^kVWNG Y13 N • CONTRACTORS EQUIPMENT/MANPOWER USED: AREA, GRID LINES, PIECES INSPECTED: STRUCTURAL NOTES, DETAIL OR RFIS USED: REMARK^, INCLUDING MEETINGS: fcM^oe-^e"^ U\tFHftSeiA.|4t> Tests OM Ccnj^)ef^ C^p iAJelii»u,eiJts O-f henv*^ "Vo Celuy^miJ Mor^ehii- Ff-fvmc Cois)iJectio»JvS L^cf\\e\i Old Fri^t e:\e:\e}/o^\t>t\. See: /^-ftf^cKeb SufflemeiAtrt) SKeet Fop- e^^D Uf\e i-ocnMoidsi REWORK AS PERCENT OF ALL WORK TODAY: THE WORK WAS ^ WAS NOT • Inspected in accoidance with the requireinente of the DSA/OSPHD/ Project approved documents MATERIAL SAMPUNG WAS • WAS NOTO N/AS Perfonmed in accordance vwth DSA/OSPHD Project approved documents THE WORK INSPECTED METD DID NOT MEET • The requirements of the DSA/OSPHD Project approved documents Samples taken: N/A Weather Temp: Cc Project Architect Structural Engineer DSA Regional Office School District Contractor Building Department Ovvner ^ AI ^^yA \ Signalue of Specia! In Signatue of Special Inspector Print Name Certification#LP. 1/^/ IT - lffeft?<:/-.. A ^ lb Verified By: DaUy Held Report SuppUmental Attachment I UT-1, Ultrasonic Examination Report Paae 02- of OZ ReportNo:, Date: n^'12'ZOi^ M^W Th F S sun Cwtract: DWG Assembly:IBS'f* Co lur*?J 1^ Oscibefs B toiglb PC Mark: CsiOuaSon BtosSc tnc&isatron X Y "sift Rems^s U. 3£ iLQ. 3QI 70" Ifil 5a. 1>-It7 7<D' 12: 20! JCL no. 32! Ttir> f 70* -Z.H ill Uli J2- HIL 5IL 20! :22! 20! ifisp&i£oi^ ^natum: -yF^^ Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632,2999 Fax: 714.632.2974 DispatGh; 800.491.2990 MTGL Project #:_ Permit #_ cp,^ loom ^:-:':^:W^^^^ www.mtglinc.com San Diego/lmperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatcti; 888.844.5060 Inland Empire: 14467 Meridian Pkvi/., Bldg. 2-A Riverside, CA 92518 Tel; 951.653.4999 Fax: 951.653,4666 Dispatch; 800,491.2990 Indio: 44917 Golt Center Pl<wy,#1 Indio, CA 92201 Tel; 760.342.4677 Fax: 760,342.4525 Dispatch: 800,491.2990 f OF i' DAILY INSPECTION REPORT DSA/CITY File #:. DSA/OSHPD APPL #:_ DSA/LEA #; Report* PS. Special Inspection Reports must be distriljuted to the parties listed below within 14 days of the inspection. Reports ot non-compliant c:onditions must be distributed immediately. Separate reports shall be prepared for each type ot special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conductioB the inspection. ri't^ 'j ' S 3 .-^ : ' OATE / (yn^i^sr A\rckF&FrLKrt, %~ il- I A ARCHITECT TIME ARpiVED iMpivtu 1 TIME DEPARTED , 3 f£^<^T/-f ENGINEER TRAVELTIME , LUNCHTIME f CONTBAGTOR INSPECTION ADORESS SUBCONTRACTOR 1 % I l.j, AMkC- XT^AS OODvks (yi c_ CA<!^f 3 lid^ ADDRESS OF PMJECT , i y-, \ \ i TYPE OF INSPECTION • EMGINEERED FILL • FOUNDATION • BACK FILL • BATCH PLANT • PTCOMCFiETE • SHOTCRETE O CONCRETE • MASONRY • HIGH STRENGTH BOLTING WELDING • SHOP WELD • FIREPROOFING • ANCHOR/DOWEL • NDE FIELD • NDE SHOP • CEiLlNGWIRE • • • DSA/OSHPD/PROJECT: APPROVED OOCUWIEMTS: AVAILABLE: APPROVED PLANS Yi^ NO SOIL REPORT YD ND SPECSrYCJliNa APPROVED SHOP DRAWING YB^- ND MATERIALS USED BY COHTRACTOR (INCLUOE RESEARCH REPORT NO, OR MATERIAL TEST REPORTS): , CMIRACTORS EQUIPMENT/MANPOWER USED: , I J A^ -fo A>. AREA, GRID LINES, PIECES INSPECTED' ^ A^or^^4- 'pinx-t.^^ c^K^At^cAio Cj€.l<dcc<^ ^-et^ S Fo 2- u A-tAF ( y/ss^ Fu.t( Pe<4 ^roo-c. CJe^CJ FJB^ bJe^Ao (^LtKA>vf ia>^^ju. S h fi- .iL-^'^^^i^ tAa^ CJA:F LJI bij 7/A A ^ f I ((•AJA CTURAL NOTES, OETAIL, OMFIS USED; . ,{J A ft p ~ STRUCTURAL REMAR' fQ LAUL h,<o <Jl ly C/.7 REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COIVIPLETE; THE WORK WAS 8 WASNOTD Inspected in accordance with the requirements of the OSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WASD WASNOTD N/AD Perfomed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Oftice Owner School District THE WORK INSPECTED MET gf OiD NOT MEET D The requirements of fhe DSA/OSHPO/PROJECT approved documents. Samples tal<en: Weather: Temp: ^—"'SIgnawre of SpJjIal Inspector PrimName Certificatlnn^: ( CC ^ [^^2^^. 'KH^^S^I'^ Verified by:_ Corporats 2992 E La Palma Ave. Sle. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San OisgoAmperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 858.537.3999 Fax: 858.537.3990 Dispatch; 888.844.5060 inland Empire 14467 Meridian Pkwy., Bldg 2A Ftiverside, CA92S18 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800.491.2990 Indio 44917 Golf Certter Plwy.,Ste 1 Indio, CA 92201 Tei 760.342.4677 Fax: 760.342.4525 Dispatch; 600.491.2990 BUILDING PERMIT*: Report* DAILY INSPECTION REPORT APPROVAL* PROJECT* MTGL PROJECT*: | \0*l f\0 \ PageOlof03 DSArt.EA* Special Inspection Reports iTMjst be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliait conditions must be distributed immediately. Separate reports stiall tie prepared for each type of speciai inspeclion on a daiiy basis. Each report shatl be completed and signed by the special inspector conducting the inspection. j PROJECTNAME: Date: 1 ARCHfTgCT ' • -J TIME ARRIVED I'OO fiwi TIME DEPARTED IV'OO Avy\ j ENGINEER TRAVEL TIME LUNCH TIME 5 CONTRACTOR ' SUB CONTRACTOR j INSPECTION ADDRESS ADDRESS OF PROJECT TYPE OF INSPECTION • ENGINEERED FILL • FOUNDATION • BACK FILL BATCH PLANT • PT CONCRETE •SHOTCRETE • CONCRETE • MASONRY • HIGH STRENGTH BOLTING • WELDING • SHOP WELD d FIREPROOFING • ANCHOR^WEL BiiDB FIELD • NDE SHOP • CEIUNG WIRE • EPOXY DSA/OSHPD PROJECT | AVAILABLE APPROVED PLANS Y EI N • APPROVEO DOCUMENTS SOILREPORTYDND SPECS: Y • N H APPROVED SHOP DRAWING YI MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS) CONTRACTORS EQUIPMENTrtVlANPOWER USED: AREA, GRID LINES, PIECES INSPECTED; STRUCTURAL NOTES. DETAIL OR RFIS USED: REMARKS. INCLUDING MEETINGS: of Benw/x- -Vo Co\v^w\\l Kovn^NHr ff-f^wye C^>y^t^cc\^ofiS Aoci\\&r> ^se ;^itf^cVvet> 5vAff\e!viehiVfv\ sweet Gv^;x> pvie ^cprhv^^ \ UL\Vf-i^^a»JC) Test feSvi^te.fot^UvJfNWe \o -test U)6B ^TP u»cii>«rte»itS Due 4o &,\^ Tlw-V Tes^ ftggftS ftV Fo^W.Ja l^ftt>o^i5= flrU/ft-l.^ /B-J.*|/B-1.^ REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE:' THE WORK WAS ^ WASNOTD Inspected in accordance with the requirements ofthe DSA/OSPHD/ Project approved documents MATERIAL SAMPUNG WAS • WASNOTD N/A SI Performed in accordance with DS/VOSPHD Project approved documenls THE WORK INSPECTED METD DIDNOTMEETD The requirements ofthe DS/VOSPHD Project approved documents Samples tal<en: N/ A Weather Temp: Cc Project Architect Structurai Engineer DSA Regional Office School Dlstnct Contractor Building Department Owner /A l^^^A' Sienature of Spedal Inspector Signature or Speciai Inspector Pmt Name Certification # jL/Ti/;?/ ^ -1A ^t^^ft ^r.. i Verified By: DaUy Field Report Supplemental Attacliment I UT-1, Ultrasonic Examination Report Page OZ- of o3 ReportNo: Date: - U-2o ]M (g)T w Th F s sun Prcjaci-Site Tbne: stmt Compleud: ^cSfS 80s Tamlhaats: Qmlrsct: DWS Assembly: B^ftv^ 1*» ColoMwi Weki Sketch: PC. Warfc B Oefcnav PC Mark Test ftfetftod Sfanitei& A VJO.^ ^ > 1 Aecsjirfanee Sfandafrf: Effluent: ^por.kr ^ CalibraSoa Block: JlTlVvl Indication (Xstsnea fiom X ftom Remarks 70" HO 20! 70« 7PP rf^^^l^g 10" 1:211 Ho 10: JO. iio. ill 11:: lis VO TOP rut^e 10" 10" HV EE 701 Tor r 32! 101 HJL O HI 30! 20: Inspector's Signature: y^^^ DaUy Meld Report Supplemental Attachment I UT-ij UitrasoniG Examination Report Page 03 of 03 ReportNo:, Date: D$-}!-2ol^ ^TWTh F s sun ppojsct-Sta Tone: sait Cen^lsied^ 2cc2f Actus: AGt»pianca SteudaiEC ert* 4 CaSbfStfon Btocto T* X! £?ftffnaj Cfc fis totSlcaffon 'A S c D £?ftffnaj Cfc fis Ocstsnss X lXstS)S9 Y 'A S c D £?ftffnaj s Ocstsnss X lXstS)S9 Y C-l e ^0 lo' HQ e W HQ HO 7D*> Ho b-n 7P' HQ Tof Pi-jtii<is HO 10" HO • ( ! -"" • \ I -k j j { j -1 1 i inspedor's ^nature: www.mtglinc.com Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax; 714.632.2974 Dispatch: 800.491.2990 San Diego/lmperlal County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire; 14467 IVIeridian Pkw,, Bldg, 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951.653,4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel; 760.342.4677 Fax; 760.342.4525 Dispatcti; 800.491.2990 MTGL Proiect #:, Permit #_ CB^ 7t>2sl1 F OF f DAILY INSPECTION REPORT DSA/CITY Fiiei DSA/OSHPD APPL#:. Report #_ PG DSA/LEA #: Special Inspection Reports must be distributed to the parties listed balow within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. DATE IA- /f ' TIME ARRIVED HME DEPARTED TRAVELTIME LUNCHTIME CONTRACTOR &FAi\JT SUB CONTRACTOR INSPECTiON ADDRESS F^Ak,f>-e-7 ^Lc^f AOORESS Qf PROJEC; ,- , . A^ i A TYPE OF IMSPECTION O EMGINEERED FILL O FOUNDATION O SACK FILL n BATCH PLANT • PT CONCRETE [,1 SHOTCRETE • CONCRETE U MASONRY iJ? HIGH STREWGTH BOLTING » WELDING • SHOP WELD • FiREPROOFING • ANCHOR/DOWEL • NDE FIELD • NDE SHOP • CEiLlNGWIRE • • BSA/OSHPO/PfiOJECT: APPROVED DOCUWEMTS: AVAILABLE: APPROVED PLANS ¥39^ NO SOIL REPORT YO U U SPECS: Y^ND APPROVED SHOP DRAWING YI& l\lt SWTERIALS USEO BY COSn-RACTSH (INCLUDE RESEMCH REPORT MO, OR MATERIAL TEST REPORTS); ^ ^ U I AIL. ^aa-L • A57>& c-^'B. Aitr , ^'(f <j>^ /.^ 4^ Yr^ CONffiAerORS EOUIPMENT/SttNPOWfR USEO ffl LtNES, PIECES IMSFECTEO;.. v CJ ' ^ AREA. LtNES, PIECES IMSFECTEO; v F(&-yA^^ pTcur'^e <^^<^^ciiaii ^^LJ(r~j pe.r STQI^^ F^^hn'il 7/F To{ PL Of ^ F. jwfHai MArcc ncTtff! An DCIC i/cen- . ~ * f ' ^ 3 ~ . ^ ^ Vtritc:AidL f cxU ivNv fto^n,OAi_ CAdxtJis^ ALJ^ \ AT // / « () r ^ t-f n f n A STRUOVflAL MOTES, DETAIL, OR RFP USI REMARKS, mcuiaim Mwmas: (S) F'7 ci L-^A (A c (AS F i-t-^e. rife *L-i?g iJ< ^.^A^jid^rCjPt^^ri esA Cq JUt .' r REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS» WAS NOT • Inspected in accordance witli the requirements of the DSA/OSHPD/PROJECT approved documents, Wf ATERIAL SAMPUNG WASC WASNOTD t^AG Performed in accordance with DSA/OSHPD/PROJECT approved docttmeiits, ce Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET [» DID NQT IVIEET • The Samples Weather: Temp: t S-e requirements ot the DS5/OSHPD/PROJECT approved docijjnents. iDles taken:^'•^^^^'tfi "^f^^^^ ^(^^ F{^ FV ^ •"Sipaturl^f Speeiaf iWpi SpeeiaijRg)! ector Print Name Verified by: www.mtglinc.com ilOJ Abl Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tet; 858,537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire; 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951.653,4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel; 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 MTGL Project #:. Permit #_C5__/026~/JL Report #_ PG. OF. DAILY INSPECTION REPORT DSA/CITY File #;_ DSA/OSHPD APPL #; DSA / LEA #. Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports ot non-compliant conditions must be distributed immediately Separate reports shall be prepared tor each type of special inspection, on a daily basis. Each report shall be completed and signed by the speciai inspector conducting the inspection. ARCHiTECT—n ; ~, ^r~"n ^. OATE ///^^/ejc .Air oCuJreAi-i.t TIMEARRIVED 6 •,3^'^^ TIME DEPARTED 1, - OQ/'// TRAVELTIME I llVICy LUKCHTIME AzJiF COmRACTOR SUB CONI RACTOR INSPECTION ADORESS .3 / . T? A A ADDRESS OF PRjJJECT . y , TYPE OF INSPECTIOM n ENGINEERED FILL .• FOUNDATION • BACK FILL • BATCH PLANT • PT CONCRETE n SHOTCRETE • CONCRETE • MASONRY iiif HIGH STRENGTH BOLTING 15<; WELDING • SHOP WELD • FIREPROOFING • AMCHOR/DOWEL n MDE FIELD U NDESHOP L CEILING WIRE n LJ Cl DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS Y-??r N • SOIL REPORT YLJ Nl, SPECS: Y?5 ND APPROVED SHOP DRAWING YD NC »«ATERIAiSUSEDeYCONTRACTOR(MCLUDERE3EARCHHEPOflTNO,0RMATERtALTESTREeaRTS)- ' * ^ ~, COIiLRACTORS EQU IPMENT / MANPOWER USED: / A 1"LF ^A A -h Ak 4v> -^'Af AREA, GRID LINES, PIECESilNSPtCTED: \ x J .A) JL "-^Z ^- V V - • '^'"^ff ^'--'"-^<A^'^<^ ) on if f RFIS USED: l\ I , . . ^ , AA&, ^ STRliCtURALNO^ DETAIL, OR RFIS USED: _9-^r>v^ ^ALh::> CdUt g L)lyJ/F^iF^ ^"^^^ j^c^ CJ-A..A^ REMARKS, mcLuoma Kimmcs: 2) ^ 11, J>rQC e:dlu.A^ ^ oM^a^ AA-^^(A.At -i.^.^^ c A^JF^-^ J- . ^0 JA^U^i-i ^- REWORK AS PERCENT OF ALL WORK TODAY: PERCEMT PROJECT COMPLETE: THE WORK WAS 8 WAS NOTC Inspected In accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, IVIATERIAL SAMPLING WASO WAS NOTC N/AQ Performed in accordance with OSA/OSHPD/PROJECT approved documents, CC Prulecl Arcliiteci Contiactor structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED IMETgS DID MOT MEEFU The requirementsof the DSA/OSHPD/PROJECT approved documents. Samples taken: Weather; ^ Temp: Signatu "ririS^ ^AUJ:KA^^ latur^f SpefefTlnspector Certiticatigi Verified by: Print Name Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 IVIeridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax; (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/8/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 F/kRADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0340 File No.: Permit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/18/2014 4X8 12.57 37,230 2,960 Columnar 28 8/8/2014 4X8 12.57 53,170 4,230 Cone & Split 28 8/8/2014 4X8 12.57 52,370 4,170 Cone & Split 28 8/8/2014 4X8 12.57 52,640 4,190 Cone & Split 28 H 8/8/2014 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: FOOTING - GRID LINE E / 5 ASTMC172 Date Sampled: 7/11/2014 Date Received: 7/14/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 538030 Water added at Site: gal. By Cement Type: Mix Time: Remarks: Concrete Temp: 87 Ambient Temp: 92 "F ASTM C1064 °F ASTMC1064 Slump: 4.50 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST C/U.VARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 4200 PSI 28-day compression test complies with the specified strength. Corporate; 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/8/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0339 File No.: Perniit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/18/2014 4X8 12.57 39,180 3,120 Columnar 28 8/8/2014 4X8 12.57 49,940 3,970 Cone & Split 28 8/8/2014 4X8 12.57 49,910 3,970 Columnar 28 8/8/2014 4X8 12.57 52,680 4,190 Cone & Split 28 H 8/8/2014 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: FOOTING - GRID LINE C / 2 ASTMC172 Date Sampled: 7/11/2014 Date Received: 7/14/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 537950 Water added at Site: gal. By Cement Type: Remarks: Mix Time: 60 Concrete Temp: 84 Ambient Temp: 79 °F ASTM C1064 °F ASTMC1064 Slump: 4.25 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALLVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 4040 PSI 28-day compression test complies with the specified strength. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch; 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/8/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 CHent: NORTH COAST CALVARY CHAPEL Set No.: 14-0384 File No.: Perinit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (Ibs.) (psi) Fracture 7 8/4/2014 4X8 12.57 36,330 2,890 Columnar 28 8/25/2014 28 8/25/2014 28 8/25/2014 28 H 8/25/2014 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: SLAB ON GRADE - GRID LINE A.8 /1.5 ASTMC172 Date Sampled: 7/28/2014 Date Received: 7/29/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 540667 Water added at Site: gal. By Cement Type: Mix Time: 40 Remarks: Concrete Temp: 90 Ambient Temp: 88 °F ASTMC1064 °F ASTMC1064 Slump: 5.25 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway # 1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/8/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0383 File No.: Perinit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 8/4/2014 4X8 12.57 42,990 3,420 Columnar 28 8/25/2014 28 8/25/2014 28 8/25/2014 28 H 8/25/2014 Specified Strength: 2,500 PSI Sampled By: MIKE KINGERY Location: SLAB ON GRADE, GRID LINE D / 4 ASTMC172 Date Sampled: 7/28/2014 Date Received: 7/29/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 540609 Water added at Site: gal. By Cement Type: Mix Time: 35 Remarks: Concrete Temp: 89 Ambient Temp: 82 °F ASTMC1064 °F ASTM C1064 Slump: 5.00 in. ASTM CI43 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway # I, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/8/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0331 File No.: Permit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Noininal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/14/2014 4X8 12.57 39,880 3,170 Columnar 28 8/4/2014 4X8 12.57 59,520 4,740 Columnar 28 8/4/2014 4X8 12.57 57,950 4,610 Cone & Shear 28 8/4/2014 4X8 12.57 52,600 4,190 Columnar 28 H 8/4/2014 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: ELEVATOR PIT - GRID LINE 5.5 / D. 1 ASTM C172 Date Sampled: 7/7/2014 Date Received: 7/8/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 537039 Water added at Site: gal. By Cement Type: Mix Time: Remarks: Concrete Temp: 87 Ambient Temp: 78 °F ASTMC1064 °F ASTM C1064 Slump: 4.25 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. 4510 PSI 28-day compression test complies with the specified strength. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway BIdg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 8/1/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0320 File No.: Perinit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/7/2014 4X8 12.57 44,180 3,520 Columnar 28 7/28/2014 4X8 12.57 54,000 4,300 Columnar 28 7/28/2014 4X8 12.57 53,330 4,240 Columnar 28 7/28/2014 4X8 12.57 57,230 4,550 Cone & Shear 28 H 7/28/2014 Specified Strength: 3.000 PSI Sampled By: MIKE KINGERY Location: ELEVATOR PIT GRADE BEAM - GRID LINE 5 / D.l Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 536251 Water added at Site: gal. By Cement Type: Mix Time: mi: Reinarks: ASTMC172 Date Sampled: 6/30/2014 Date Received: 7/1/2014 Concrete Temp: 72 Ambient Temp: 64 °F ASTM C1064 "F ASTMC1064 Slump: 4.25 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. 2> Sam Valdez, R.C.E. 4360 PSI 28-day compression test complies with the specified strength. www.mtglinc.conn MTGL Project # H 0^ A'P I Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tei: 714.632.2999 Fax: 714.632.2974 Dispatch; 800.491,2990 San Diego/lmperlal County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch: 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 Permit # Report #_ PG 1 OF ' DAILY INSPECTION REPORT DSA/CITY File #: DSA/OSHPD APPL #; DSA/LEA #; Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. HKOJbCI NAME A\ A\ A\ ARCHITECT I I DATE TIME ARRIVED TIME DEPARTED ENGINEER TRAVELTIME LUNCH TiME CONTEWCTOR SUB CONTRACTOR INSPECTION ADORESS ADDRESS GF PROJECT TYPE OF INSPECTION ,, ENGINEERED FILL FOUNDATION BACK FILL BATCH PLANT PT CONCRETE SHOTCRETE CONCRETE IVIASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDESHOP C CEiLlNGWIRE OSA/OSHPD/PROJECT: APPROVED DOCUMENTS; AVAILABLE; APPROVED PLANS Y , N SOIL REPORT Y . N SPECS: Y: , N T APPROVED SHOP DRAWING Y , MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTSI' CONTRACTORS EQUIPMENT / MANPOWER USED AREA, GRID LINES, PIECES INSPECTED ITfiUCTURAL NOTES, DETAIL, OR RFIS USED: mmms. INCLUDINB MCETIUGS: (7 rr A \ \ \ i^^^f ^>Vrr45 '/?1?/<^^^7 REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS-'^WASNOTC Inspected in accordEm&e with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WAS S< WAS NOT N/A Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School Distnct THE WORK INSPECTED MET*' DID NOT MEET ^ The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; Weather; Ctpjyjft Temp; ^O'^ 2t ignature of Special Inspector Tint Name Certitieatipn #: Verified bv; ni7t\ HBOBMIMIIIIL WWW, mta ii no, com Corporate: 2992 E, La Palma Ave. Ste. A Anaheim. CA 92806 Tel: 714,632,2999 Fax: 714,632,2974 Dispatch: 800,491,2990 San Dlego.lmperial Ciiinty 6295 Fer-is Squire, Si;::9C San Diego, CA 92121 Tei: 858.537,3999 Fax: 853,537,3990 Dispatch; 888.844,5060 Inland Empire: 14467 Meridian Pkw,, Bldg, 2-A R-\.3rside, OA 92518 Tel: 951,653,4999 Fax: =51.653,4666 Dispatch; 800,491,2990 Indio: 44917 Golf Center Pkwy, # indiCCA 92201 Tei: 760,342,4677 Fax; 760.342.4525 Dispatch: 800.491,2990 MTGL Proieci Permit--_._,(Lg^XO-a Sl^ Report =. PG 1 0F_] DAILY INSPECTION REPORT DSA'CiTY File #: DSA'OSHPD APPL #:. DSA/LEA#: Special Ins.oect'on Reports must be distributed to the parties lis:ed belo.v v/ithip 14 days ofthe inspection. Reports of non-ccmpfant conditions must be distributeid immediately. Separate reports shall be prepared tor each ^/pe of specia! inspection, on a daily basis. Each report shall be completed ard signee by the speciai inspector conducting the inspection. DATE TIME ARRIVED IME DEPARTED ENG:'i£ER TRAVEL LUNCH TIME SJECOfj'^RAC^OR NSPECTiOf; ADDRESS ADDRESS OF PROJECT TYPE OF INSPECTION ' ENGINEERED FILL ,. FOUNDATiON BACK FILL ::, BATCH PLANT PT CONCRETE SHOTCRETE ^ CONCRETE MASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDESHOP CEILING WIRE DSA/OSHPD/PROJECT; APPROVED DOCUMENTS; AVAILABLE: APPROVED PLAMS Y N SOIL SiEPORT y- H. SPECS; Y M I APPROVED SHOP DRAWING Y: VIATERIALS USED 3^' CONTRACTOR JiNCLUDE RESEARCH REPORT r.o OR VWTERiAL TEST REPOSES :0>iTRACTORS EQU'=MEf,T MAfjPOWER USED: p\Ar<\ p AREA, GR:p LIMES. PIECES INSPECTED _SJJ STRUCTURAL NOTES. DETAiL. OR RF S USEO: mMKS. INCLUDIHG MEETINGS: , C? rr / lit i-^A^f ^r^rcis p\Q^tJ^ '/?1?/<^^^7 REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS^V WAS NDT inspected in accordarice with the requirements of the OSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WAS s< WAS NOT N'A ,. Performed in accordance v/ith DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METJS'DID NOT MEET "I The requirements ofthe DSA/OSHPD/PROJECT approved documents. Samples taken; Weather: Temp: ignature of Special Inspector nt Name CertitieaUpn #: Verified by:.' ^ www.mtglinc.com Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Oiego/Imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pl<w., Bidg. 2-A Riverside. CA 92518 Tei; 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 MTGL Project #: //0 9Aol Permit# 06' Report* PG. I OF f DAILY INSPECTION REPORT DSA/CITY File #; DSA/OSHPD APPL #;_ DSA/LEA #; Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type o1 special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME ^W^<'^^^ QyftS*- G»lucrw Cl>Apt { iCfllTECT I ' DATE ARCHITECT TIMEARRIVED TIME DEPARTED ENGINEER TRAVEL TIME LUNCH TIME CONJfiACTOR SUB CONTRACTOR INSPECTION ADDRESS . s TYPE OF INSPECTiON ENGINEERED FILL FOUNDATION BACK FILL . BATCH PLANT PT CONCRETE SHOTCRETE "^CONCRETE ADORESS OF PROJECT MASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDESHOP . £EJLIN(iJrt/lRE DSA/OSHPD/PRDJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS Y N SOIL REPORT Y N : SPECS: Y N ; APPROVED SHOP DRAWING Y MATEFJIALSJiSED BY CONTRACTOR (INCI UDE RESEARCH REPORT NO OR MATERIAL TEST REPORTSr lATEHIALS USED E CONTRACTORS EQUIPMENT / MANPOWER USED AREA, GRID LINES, PiECES INSPECTED' STRUCTURAL NOTES. DETAIL, OR RFIS USED . EMARKS, / Rmms. INCLUDING McnmGS: r7 O O <->! » /I / n REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE; THE WORK WAS^yWASNOT Inspected in accordance with the requirements of the DSA/OSHPO/PROJECT approved documents, MATERIAL SAMPLING WAS ,, WAS NOT N/*y Periormed in accordance with DSA/OSHPD/PROJECTapproved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET^x D'^ NOT MEET 1 The requirements of the DSA/dSHPD/PROJECT approved documents. Samples taken:_ Weather: C- lauetu Temp: 7^ 3 Signature of Special Inspector rint Name Certificatit3 Verified I latitf Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92I2I Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax; (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 7/25/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHALPEL Set No.: 14-0340 File No.: Permit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/18/2014 4X8 12.57 37,230 2,960 Columnar 28 8/8/2014 28 8/8/2014 28 8/8/2014 28 H 8/8/2014 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: FOOTING E-5 ASTMC172 Date Sampled: 7/11/2014 Date Received: 7/14/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 538030 Water added at Site: gal. By Cement Type: Mix Time: Remarks: Concrete Temp: 87 Ambient Temp: 92 °F ASTM C1064 °F ASTM C1064 Slump: 4.50 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Squaie, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway # 1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 7/25/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0339 File No.: Perinit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/18/2014 4X8 12.57 39,180 3,120 Columnar 28 8/8/2014 28 8/8/2014 28 8/8/2014 28 H 8/8/2014 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: FOOTING C-2 ASTMC172 Date Sampled: 7/11/2014 Date Received: 7/14/2014 Concrete Supplier: Mix No.: 3033510 Ticket No.: 537950 Water added at Site: Cement Type: Reinarks: HANSON AGGREGATE gal. By Mix Time: 60 Concrete Temp: 84 Ambient Temp: 79 °F ASTM C1064 °F ASTM C1064 Slump: 4.25 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. vvww.mtalinc.com Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel; 714.632.2999 Fax; 714.632.2974 Dispatch: 800.491.2990 San Diego/lmperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw, Riverside. CA 92518 Tel: 951,653.4999 Fax; 951,653.4666 Dispatch; 800.491;i Indio: 2-A 44917 Golf Center Pkwy, # Indio, CA 92201 Tel; 760.342.4677 Fax: 760.342.4525 Dispatch: 800.491.2990 MTGL Project #; | f ft 9 ft>0 > Permit# CB'/O^^/^ Report # PG {_ 0FJ_ DAILY INSPECTION REPORT DSA/CITY File #; DSA/OSHPD APPL #;_ DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special Inspector conducting the inspection. PROJECT NAME DATE ARtlHlTECT TIMEARRIVED TiME DEPARTED UNCH ENGINEER TRAVELTIME LUNCH TIME C0NI8ACT0R ^{ A'-J I. SUB CONTRACTOR INSPECTION AODRESS (.—^ TYPE OF INSPECTiON Z ENGINEERED FILL Z FOUNDATION Z: BACK FILL C BATCH PUNT • PT CONCRETE Z SHOTCRETE >£. CONCRETE ADDRESS OF PROJECT U MASONRY • HIGH STRENGTH BOLTING • WELDING O SHOP WELD •Z FIREPROOFING • ANCHOR/DOWEL Z NDE FIELD Z NDE SHOP fiaLIN(L)W f^.)F IRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS; AVAILABLE; APPROVED PLANS Y[ SOIL REPORT YZ NZ N; SPECS; YZ NZ APPROVED SHOP DRAWING YZ N; MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO, OR MATERIAL TEST REPORTS): CONTRACTORS EOUIPMENT / MANPOWER USED; AREA, GRID LINES. PIECES INSPECTED: STRUCTURAL NOTES. DETAIL. OR RFIS USED: , p Kmms, mcLUPiNB Mceriites: Us-rr<J C-if^J<. / rr',..;C,rf:>ir *"3' REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS5/WASN0TZ Inspected in accordance with the requirements ofthe DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASZ WAS NOTZ N//?9 Performed in accordance with DSA/OSHPD/PROJECT approved document's. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METQ DID NOT MEET Z The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; 0 Weather;_Qj£)^j£i. Temp; 10 S Signature of Special Inspector O rint Name CertificatioiT*: Iff '^ Al '^'T)^?/ Verified by: Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax: (858) 537-3990 Branch: 14467 Meridian Parkway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway # 1, hidio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Dafe Printed: 7/21/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0331 File No.: Permit No.: Project No.: Project Name: 1109 AOI NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/I4/20I4 4X8 12.57 39,880 3,170 Columnar 28 8/4/2014 4X8 12.57 28 8/4/2014 4X8 12.57 28 8/4/2014 4X8 12.57 H Specifled Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: SUB GRADE ELEVATOR PIT 5.5 AND D.l ASTMC172 Date Sampled: 7/7/2014 Date Received: 7/8/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 537039 Water added at Site: gal. By Cement Type: Mix Time: Remarks: Concrete Temp: 87 Ambient Temp: 78 °F ASTM C1064 "F ASTM C1064 Slump: 4.25 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** City of Carlsbad JUL 2 3 2014 Communit'/ & Economic Development Dopartment Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 www.mtglinc.com Dispatcti; 800.491.2990 MTGL Project #:. San Diego/lmperial County 6295 Ferris Square, Suite C San Oiego, CA 92121 Tel: 858.537.3999 Fax; 856.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 IVIeridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Goif Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342,4525 Dispatch; 800,491,2990 Permit #_ Report i PG. ) DAILY INSPECTION REPORT DSA/CITY File #;_ OF. DSA/OSHPD APPL #:. DSA/LEA #; Special Inspection Reports must be distributed to the parties listed below v/ithin 14 days ot the inspection. Reports ol non-compliant conditions must be distributed immediately. Separate reports shall be prepared tor each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspeclion. ' ? : tvi^^ ' TIWIFARRIVFtl I PRpJEfT NAME , ARCHITECT TIMEARRIVED i 2 ? oo TIME DEPARTED ^<-' It A. ENG SNEER TRAVELTIME 2. CONTRACTOR INSPECTION ADDRESS TYPE OF INSPECTION • EMGINEERED FILL • FOUNDATION BACK FILL SUB COmrtACTOR ABL g AOSiSSOFPROtECr BATCH PLANT ri PT CONCRETE • SHOTCRETE • CONCRETE f t,r>^<,eAiiF^ i-(Ai. Ccx*-Ul^<^c^ • MASONRY • HIGH STRENGTH BOLTING » WELDING • SHOP WELD O FIREPROOFING • ANCHOR/DOWEL • NDE FIELD O NDE SHOP • CEILING WIRE • • • DSA/OSHPD/PROJECT; APPROVED DOCUMENTS; AVAILABLE: APPROVED PLANS Y» NZ SOIL REPORT YZ ND SPECS: Ya^ ND APPROVED SHOP DRAWING Yf l Ni l MATERIALS USED BY CONTRACTOR (INCLUOE fiESEARCH REPORT NO. OR MATERIAL TEST REPORTS): /r 3 ^ • AS-Qcy <2rA E \ fcAoJ Bl ^ CONTACTORS EOUIPMENT) ^MANPOWER USED: ' t-e I APt LAAr IAH 'tF |~o w t o og-yt to>v^ ^ BA<^€^pUi-i C{u.^^_^ ^^-^ H Ss ^^%y^^)9 A^ ^iAi.tLs 1> d(F.l :A, GRID LINES. PIECES WSPECIED: es ICTURAL NqjSS, DETAIL, OR RFIS USED: :1AIL UR RFIS UStU: ^ ^ ^ ; _ , A'l . — REMARKS, mcLumuG mmmes: (/^•^SrA><Le^:^Uf€. ^ AlMz>c/A AA^^A£^A^A^ ^CAF^MCIO'^S • REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE; THE WORK WAS><- WAS NOT • Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. IVIATERIAL SAMPLING WASZ WAS NOTZ N/A^ Periormed in accordance with DSA/OSHPD/PROJECT approved documents. THE WDRK INSPECTED METi?<. DID NOT MEET • The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; '- Weather: -—" Temp: Project Architect Structural Engineer DSA Regional Office School Dislrict Contractor Building Department Owner ^j^A^ F^ re<»<Specia(4f(spe Signatureot^pecii Print Name Certifiaticm</; ( C^A!' Verified by;_ j Z^^^A^*i L:FzFilJl}LMM' www.mtglinc.com Corporate: 2992 E. La Palma Ave. Ste. A Anaheim. CA 92806 Tel: 714.632.2999 Fax; 714.632.2974 Dispatch: 800.491,2990 San Diego/lmperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel; 951.653.4999 Fax; 951.653.4666 Dispatch; 800.491.2990 Indio: Y 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 MTGL Project # /yo9pO/ Permit# CB' tdQ^^l Report* PG L OF i_ DAILY INSPECTION REPORT DSA/CITY File #: DSA/OSHPD APPL#:. DSA/LEA #: Special Inspection Reports must be distnbuted to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspechon, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECTNAME _ _ . ^ ICHTTECT ' f DATE ARCHITECT TIME ARRIVED o9oQ TIME DEPARTED ENGINEER LUNCH Tir.lE CONTRACTOR EtmON ADDRESS sue CONTRACTOR EtmON ADDRESS^ AS , ADDRESS OF PROJECT TYPE OF INSPECTION ENGINEERED FILL : FOUNDATION BACK FILL BATCH PLANT PT CONCRETE SHOTCRETE CONCRETE IVIASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING •>< ANCHOR/DOWEL NDE FIELD NDESHOP CEILING WIRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS; AVAILABLE; APPROVED PLANS Y N SOIL REPORT Y N SPECS: Y N APPROVED SHOP DRAWING Y N MATERIALS USED BY CONTRACTOR (INCLUOE RESEARCH REPORT NO OR MATERIAL TEST REPORTS; CONTRACTORS EQUIPMENT / MANPOWER USED , AREA GRID LINES. PIECES INSPECTED STRUCTURAMIOTES, DETAIL. OR RFIS USED: ;S, DETAIL. OR RFI nmmKS. INCLUDING MEETINGS: , —rr " r .. O -i . / . . REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WAS«J: WAS NOT .. Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WAS WAS NOT N/Ay Performed in accordance with DSA/OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School Distnct THE WORK INSPECTED MET* DID NOT MEET The requirements of th^SA/OSHPD/PROJECT approved documents. Samples taken: Weather: C lauA Temp; 7^*3 VJ r p ignature of Special Inspector Certihcatio Verified by: Print Name ^lAC v/ww.mtglinc.com Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax; 714.632.2974 Dispatch; 800.491.2990 San Diego/imperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy. #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 MTGL Project #:JiALML Permit# CS - < e'3. 5T 9 Report* PG L OFL DAILY INSPECTION REPORT DSA/CITY File #:. DSA/OSHPD APPL#:. DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME lOaf4-U Cj»ft^>» CVljart C^i^pt./ 7-//-/V ARCHITECT TIME ARRIVED T3o TIME DEPARTED ENGINEER TRAVEL TIME LUNCHTIME CONTRACTOR SUB CONTRACTOR INSPECTION ADDRESS ADDRESS OF PROJECT TYPE OF INSPECTION ENGINEERED FILL FOUNDATION " BACK FILL BATCH PLANT , PT CONCRETE SHOTCRETE y-CONCRETE MASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDESHOP CEiLlNGWIRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE; APPROVED PLANS Y SOIL REPORT Y N SPECS: Y ' : N ,:: APPROVED SHOP DRAWING Y MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT ND Ofl MATERIAL TEST REPORTS) CONTRACTORS EQUIPMENT / MANPOWER USED: v V ^ J AREA. GRID LINES, PIECES INSPECTED: . ^ STRUCTURAL NOTES, DETAIL. OR RFIS USED REMARKS. WCtWDWfiMffrweS; p O I \ VaoX p\iOCVAvt»jV ^1 V»;|^AVt'0^ CoU5«ho(t4t-To/ ^icty^wiCo/ I Jt laC<t;a,iO S'i^ATcU/ REWORK AS PERCENT OF ALL WORK TODW: PERSNT PROJECT COMPLETE; THE WORK WASji^ WAS NOT Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASS/ WAS NOT N/A , Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET")? DID NOT MEET The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken: Weather;Ol<.Af Temp; 1«S lc> if Special Inspector Tint Name Certification #; Verified by:. www/.mtglinc.com MTGL Project #: < / O ^ A O Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714,632.2974 Dispatch; 800.491.2990 San Diego/lmperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkw/y, #1 Indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 Permit i Report #_ e^- /6a S"L? PG. L OF < DAILY INSPECTION REPORT DSA/CITY File #:_ DSA/OSHPD APPL #:. DSA/LEA #: Special Inspection Reports must be distributed to the parties listed below within 14 days ot the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME DATE 7-/0- / Y ARCHITECT TIME ARRIVED 7 30 '/^•'^Q TIME DEPARTED TRAVEL TIME LUNCHTIME CONTRACTOR SUB CONTRACTOR INSPECTION ADDRESS ADOflESS OF PROJECT TYPE OF INSPECTION ENGINEERED FILL FOUNDATION BACK FILL BATCH PLANT PT CONCRETE SHOTCRETE <^ CONCRETE t\flASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDESHOP :, CEILINGL,W1RE c' aixcjL^tji ^ DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS Y"^ N SOIL REPORT Y N SPECS; YA N , APPROVED SHOP DRAWING Yy. N MATERIALS USED SY CONTRACTOR (INCLUDERESEARCH REPORT NO OR MATERIAL TEST REPORTS): CONTRACTORS EOUIPMENT ' MANPOWER USED AREA. GRID LINES. PIECES INSPECTED: O A ^ D STRUCTURAL NOTES, DETAILJR RFIS USED: i O I mmKS. INCLUDING MrniNGS: , O * PV '-^ y REMARKS. INCLUDING M££HNGS: gpo<L^ otovait-b p)»c*^j kolt- Jr'.Ut.^ Ur^tc 4-^w<0 olooci CL1LAA>C<4 U>T^>K *^U. J io.ru&K ^ Co^prt.&StJ ft^r/^paXY l^^p-f^i^'o^ di»U^ UA. Ira^/AJt^-d REWORK AS PEftiSNT OF ALL WORK TODAY: PERCENT PROJECT COMPtETE: ^ THE WORK WAS)t WAS NOT : Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASZ WAS NOTC N//^ Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Departmenf DSA Regional Office Owner School District THE WORK INSPECTEO MET^^^ DID NOT MEET 7 The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken:. Weather:J^orii^V Ctos^^S Temp: ^fi'^ Signature of Special Inspector O Prim Name Certification #: Verified by: Corporate: 2992 E. La Palma Avenue, Suite A, Anaheim, CA 92806 Tel: (714) 632-2999 Fax: (714) 632-2974 Branch: 6295 Ferris Square, Suite C, San Diego, CA 92121 Tel: (858) 537-3999 Fax; (858) 537-3990 Branch: 14467 Meridian Paricway Bldg 2A, Riverside, CA 92518 Tel: (951) 653-4999 Fax: (951) 653-4666 Branch: 44917 Golf Center Parkway #1, Indio, CA 92201 Tel: (760) 342-4677 Fax: (760) 342-4525 Report of: COMPRESSIVE STRENGTH-CONCRETE ASTM C39 Date Printed: 7/7/2014 CITY OF CARLSBAD-BLDG INSPECTION DEPT. 1635 FARADAY AVENUE CARLSBAD, CA 92008 Client: NORTH COAST CALVARY CHAPEL Set No.: 14-0320 File No.: Perinit No.: Project No.: Project Name: 1109A01 NORTH COAST CALVARY CHAPEL - BUILDING A 1330 POINSETTIA LANE CARLSBAD, CA 92011 Age Date Nominal Actual Area Load Strength Type of (Days) Tested Size (Sq. Inch) (lbs.) (psi) Fracture 7 7/7/2014 4X8 12.57 44,180 3,520 Columnar 28 7/28/2014 4X8 12.57 28 7/28/2014 4X8 12.57 28 7/28/2014 4X8 12.57 28 H 7/28/2014 4X8 12.57 Specified Strength: 3,000 PSI Sampled By: MIKE KINGERY Location: ELEVATOR PIT GRADE BEAM - GRID LINE 5 / D.l ASTM C172 Date Sampled: 6/30/2014 Date Received: 7/1/2014 Concrete Supplier: HANSON AGGREGATE Mix No.: 3033510 Ticket No.: 536251 Water added at Site: gal. By Cement Type: Mix Time: Remarks: Concrete Temp: 72 Ambient Temp: 64 °F ASTMC1064 "F ASTMC1064 Slump: 4.25 in. ASTM C143 Tested at: San Diego Distribution: NORTH COAST CALVARY CHAPEL CITY OF CARLSBAD-BLDG INSPECTION DEPT. **LAB COPY** Respectfully Submitted, MTGL, Inc. Sam Valdez, R.C.E. www.mtglinc.com MTGL Project #; / / C>9tfO/ Permit# C^- / t> Q 5"i f Report* PG L Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax; 714.632.2974 Dispatch; 800.491.2990 San Diego/lmperial County 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax; 951.653.4666 Dispatch: 800.491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 DAILY INSPECTION REPORT DSA/ClTf File #;. DSA/OSHPD APPL #;. OF. DSA/LEA #; Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME ilcT I I DATE 7-7-/y ARCHITECT INEER TIME ARRIVED ?3o TIME DEPARTED ENGINI TRAVEL TIME LUNCH TIME CONTSAPTOR SUB CONTRACTOR INSPECTION ADDRESS ADDRESS OF PROJECT TYPE OF INSPECTION ENGINEERED FiLL FOUNDATION BACK FILL BATCH PLANT , PT CONCRETE ": SHOTCRETE CONCRETE MASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDESHOP CEILING WIRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE; APPROVED PLANS YV N . SOIL REPORT Y : , N_ SPECS; Yy. NA APPROVEO SHOP DRAWING Y: N MATERIALS USED BY CQJJJRACTORflNCLUDE RESEARCH REPORT NO, OR MATERIAL TEST REPORTS) 3OOP YST CONTRACTORS EQUIPMENT / MANPOWER USED: AREA, GRID LINES, PIECES INSPECTED: STRUCTURAL NOTES, DETAIL, OR RFIS USED: KmHKS. INCLUOING MEETINGS: _ p / O REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASV WAS NOT ,:, Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WAS^ WAS NOT :; N/A , : Performed in accordance with DSA'OSHPD/PROJECT approved documents, cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED METfjf DID NOT MEET ~ The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken; ST Cc^c/^i-^-t, V V Weather; C/M^Af, Temp; Hytp'^r 7C nature of Special Inspector O Print Name Verified by: Corporate: 2992 E, La Palma Ave, Ste. A Anaheim. CA 92806 Tel: 714.632.2999 Fax; 714.632.2974 Dispatch: 800.491.2990 San Diego/lmperial County 6295 Ferris Square. Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 838.844.5060 DAILY INSPECTION REPORT Inland Emp re: 14467 Meiidian Pkw., Bldg. 2-A Riyerside, CA 92518 Tel; 951,653.4999 Fax: 951,653.4666 Dispatch: 800.491.2990 DSA/CITY File #: DSA/OSHPD APPL#: DSA/LEA #; Indio: 44917 Golf Center Pkwy,ii Indio. CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.299C Special Inspection Reports must be distributed to the parties listed below within 14 days cf the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection PROJECT NAME '"i , MTE ARCHITECJ. , "V. 5 i ! TIMEARRIVED TIME DEPARTED ENGINEER TRAVELTIME LUNCHTIME CONJfl^CTOR SUB CONTRACTOR INSPECTION ADDRESS,—, l?>vo 'Yo'^^H^^'k-^^ /•-^ ADDRESS OF PROJECT TYPE OF INSPECTION Z BATCH PLANT Z MASONRY Z FIREPROOFING Z Z ENGINEERED FILL Z PT CONCRETE Z HIGH STRENGTH BOLTING Z ANCHOR/DOWEL Z Z FOUNDATION Z., SHOTCRETE Z WELDING Z NDE FIELD Z Z BACKFILL ^'CONCRETE ZSHOPWE:_D Z NDE SHOP Z fJElLlNG WtRE DSA/OSHPD/PROJECT: AVAILABLE; SOIL REPORT Y Z N Z SPECS; Y'S? N Z APPROVED DOCUMENTS; APPROVED PIAHS f^II N Z APPROVED SHOP DRAWING Y Z N MATERIALS USED BY cpNTRADTOR (INCLUDE f^EARCH REPORT NO, OR MATERIAL TEST REPORTSi: o — CONTRACTORS EQUIPMENT,'MANPOWER USED: AREA, GRID LINES, PIECES INSPECTED: i ""' ' ' -i.i.iT~ , • • •, , , , • STRUCTU3f,L^0TES^DETA!., <JR^flSJJ^Eb: REMARKS, INCLUDING mETIHGS: rt;»jtcc;o\ locA^.^j Foc..:ii /{\ Fo^c. CA p i —, _ -J ^ t:i^ |i\Al\. to -/--•A.A". uMfJ QJ ct:) F-'-Ai cW' O.; C)i/3Ci r^»:^)*s- '• f i . , • -.J ? t,i.,3P-i-'C \A-^ ,x)Vofc..-H hit 1^: REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE; THE WORK WA3st WAS NOT Z inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIAL SAMPLING WASZ WAS NOT Z HII^ Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET "S^ DID NOT MEET Z The requirements of Jhe DS,A/OSHPD/PROJECT approved documents. Samples taken;_fe^ ^ Weather;(""* If-fef h Temp: ' {^3 i.. . SlMature of Special Inspector iUiify Prim fiame Certification #: 'i.c c. €' ..J ^5 S'l 7 Verified by;_ V www.mtglinc.com Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/lmperial County 6295 Ferris Square, Suite C SanDiego, CA 92121 Tel: 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch; 800.491.2990 Indio: 44917 Golf Center Pkwy,#1 Indio, CA 92201 Tel: 760.342.4677 Fax; 760.342.4525 Dispatch; 800.491.2990 MTGL Project #: Jf <^o/ Permit#0^5- /o^ S/ ^ Report #_ PG_ OF, / DAILY INSPECTION REPORT DSA/CITY File#: DSA/OSHPD APPL K DSA/LEA#: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME fO^rV^ CQAS^ (_ ki^fti i ARCHITECL ^ f I DATE TIMEARRIVED TIME DEPARTED ENGINEER TRAVEL TIME LUNCH TIME C0Ht»4CT0R SUBCONTRACTOR NSPHITION ADDRESS OAK \sk,y^<^ ADDRESS DF PROJECT TYPE OF INSPECTION ENGINEERED FILL ,, FOUNDATION Z BACK FILL " BATCH PLANT :. PT CONCRETE ^,,SHOTCRETE •S4/C0NCRETE MASONRY HIGH STRENGTH BOLTING WELDING SHOP WELD Z FIREPROOFING Z ANCHOR/DOWEL ,,, NDE FIELD NDE SHOP Z CEILING \IWRE DSA/OSHPD/PROJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS fV N SOIL REPORT Y , N SPECS: Y^ N„ APPROVED SHOP DRAWING Y: N , MATERIALS USED BY CONTRACTOR IINCLUDE FpEARCH REPORT NO OR MATERlAl TEST REPORTS): s CONTRACTORS EQUIPMENT / MANPOWER USED, AREA, GRID LINES, PIECES INSPECTED STRUCTURAL NOTES, DETAIL, OR RFISIBED: REMARKS, INCLUDING MEETINGS: >io REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASst, WAS NOT " Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents, MATERIAL SAMPLING WAS WAS NOT .:: N//(^ Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School District THE WORK INSPECTED MET"5ii DID NOT MEET Z The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken;. WeatherO ItHrC A Temp: (^Q S Priilr Name Certification i Verified by: MTGL PROJECT*: Permit # Corporate 2992 E. La Palma Ave,, Suile A Anaheim, CA 92806 Tel; 714,632,2999 Fax: 714,632,2974 Dispatch: 800,491,2990 1109-A01 n/a San Dtego/imperiat County: 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 868.537,3999 Fax: 858,537,3990 Dispatch: 888,844,5060 REPORT OF ULTRASONIC TESTING OF WELDS Inland Empire: 14467 Meridian Pkwy,, Bldg 2A Riverside. CA 92518 Tel: 951,653,4999 Fax: 951,653,4666 Dispatch: 800,491,2990 Report # 5 Page 1 of DSA/CITY File # DSA/OSHPD Appl, # DSA/LEA# n/a n/a n/a Special Inspection Reports must be distributed tothe parties listed below within 14 days ofthe inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of special inspection on a daily basts. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECT NAME: North Coast Calvary Chapel 7/2/14 ARCHITECT n/a TIMEARRIVED 9:00 AM TIME DEPARTED 5:00 PM ENGINEER n/a TRAVELTIME n/a LUNCHTIME n/a CONTRACTOR n/a SUB CONTRACTOR Able Iron PROJECTADDRESS SHOP ADDRESS Carlsbad, Ca. 222 Hershey St. Pomona, Ca Shop: ^ Specifications: Work: New Fieid: AWS Dl.l table 6,2 Procedure: M012 Repair Coupiant: Cellulose Gel Coupiant: Description of items tested: Test BlocIc: DSC Transducer: Scope: NDT Systems Avenger EZ SN# Sensitivity Level: 55 dB Scan Levei: 69 dB Mettiod: ^ Shear Longitudinal Angie: 62"x.62" @ 2.25 MHz 8084186 70 Performed ultrasonic testing of complete joint penetration welds @ HSS column sections to spliced in continuity plates at beam connection area. Continuity plates to flanges of W-flange columns. Doubler plates to W-flange column webs. I a = Indication Level b = Reference Level c = Attenuation Factor d = a-b-c for instruments in Gain b-a-c for instruments in Attenuation ! Welding Process: FCAW Decibels Indications Weld Commen Reject Accept Location Weld ID Angle Face abed Length SP From X From Y Depth Size Type Class Commen Reject Accept 14A Continuity Plates A n/a 8 0 0 8 SB Continuity Plates A n/a 8 0 0 8 " Reiect#1 Conl. PI A 55 55 2 -2 4" 2,047 0 0 0,70 0,825 T4 A 0 1 1 1 Reiect#2 Cont. PI A 57 55 2 0 4" 1,988 0 0 0,68 0,825 T4 A 0 1 1 1 • Doubler Plate A n/a 2 0 0 2 2B Conlinuily Plales A n/a 8 0 0 8 14B Continuily Plales A n/a 8 0 0 8 7A Continuity Plales A n/a 8 0 0 8 9A HSS Continuity PI, A n/a 4 0 0 4 9B HSS Continuity PI, A n/a 4 0 0 4 13A Continuity Plates A n/a 8 0 0 8 2A Conlinuilv Plales A n/a 8 0 0 8 6B Continuity Plales A n/a 8 0 0 8 Doubler Plale A n/a 2 0 0 2 Discontinuity evaluation/Comments: 2 rejects found on this date. Rejects were repaired and retested. No outstanding rejects as of this date. SSL Rep, Totals INTERPRETATION OF THE TEST RESULTS OBTAINED FROM THE TEST IS NOT TO BE CONSTRUED AS A GUARANTEE OR WARRANTY OF THE MATERIALS TESTED. MTGL Inc. SHALL NOT BE HELD LIABLE FOR LOSS, DAMAGE, INJURY OR DEATH RESULTING FROM USE OF THE TESTED PART FINAL RESPONSIBILITY IN INTERPRETATION OF TEST RESULTS RESTS WITH THE CUSTOf We, the undersigned certify that the statements in this record are correcl and that the welds were prepared in accordance wilh lhe requirements of Seclion 6 Pari F - Inspected By: Seth Helton Level: ASNT SNT-TC-1 A, CP-189 Level II Technician A^ Verified By: Hours: Reg. 8 Signature: Signature: O.T. n/a THE MATERIAL: WAS WAS NOT THE MATERIAL TESTED: MET DID NOT MEET Sampled and Tested In Accordance With the Requirements of lhe DSA Approved Documents The Requirements of the DSA Approved Documenls. Corporate: 2992 E. La Palma Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 www.mtglinc.com Dispatch: 800.491.2990 MTGL Proiect #: | 1 0 ^ L San Diego/lmperial Gounty 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858.537.3999 Fax; 858.537.3990 Dispatch; 888.844.5060 Inlanil Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel; 951.653.4999 Fax; 951.653.4666 Dispatch; 800.491.2990 indio: 44917 Golf Center Pkwy,#1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342.4525 Dispatch; 800.491.2990 Permit* DAILY INSPECTION REPORT DSA/CITY File #:. Report #_ PG. OF. DSA/OSHPD APPL #;. DSA/LEA#: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the special inspector conducting the inspection. PROJECTNAME A\ , AS { f*., 'fOgriVv \A_^A,SA^ L-iftljnvts Ct^/^p^l./ ARCHITECT I I DATE TIMEARRIVED TIM^ DEFACED ENGINEER TRAVEL TIME LUNCHTIME CONTR/WjOR SUB CONTRACTOR INSPECTION ADDRESS^ ADDRESS OF PROJECT TYPE OF INSPECTION Z ENGINEERED FILL Z FOUNDATION " BACKFILL Z BATCH PLANT ; PT CONCRETE Z SHOTCRETE •>^ONCRETE MASONRY Z HIGH STRENGTH BOLTING A WELDING Z SHOP WELD FIREPROOFING ANCHOR/DOWEL NDE FIELD NDE SHOP CEILING WIRE DSA/OSHPO/PROJECT: APPROVED DOCUMENTS: AVAILABLE; APPROVED PLANS Y : N' SOIL REPORT Y:" NZ SPECS; YZ NZ APPROVED SHOP DRAWING YZ N: MATERIALS USED BY CWRACTORilNCLUDE RESEARCH REPORT NO, OR MATERIAL TEST REPORTS): x , , • CONTRACTORS EQUIPMENT / MANPOWER USED: AREA, GRID LINES, PIECES INSPECTED: STRUCTURAL NOTES, DETAIL. OR RRS USED: . REmmS. INCLUDING MEqiNGS: p in / t<>\^<^t( <yt: J pUcv,M.cJ^ «g S /%b c^ArttS CeOcrLV^ /oc>v4:%«J Ak)aO'^/raucrt^c is: REWORK AS PERCENT OF ALL WORK TODAY: PERCENT PROJECT COMPLETE: THE WORK WASVWASNOTZ Inspected in accordance with the requirements of the DSA/OSHPD/PROJECT approved documents. MATERIALSAIWPLING WAS|fwASNOTZ N/AZ Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional Office Owner School Distnct THE WORK INSPECTED MEVI DID NOT MEETZ The requirements of the DSA/dsHPD/PROJECT approved documents. Samples taken,, St.^ <o V F^- 'VX ^ " WeathaTN Q fe** Ctt-/ Temp; C(^<Fc^ Signature of Special Inspector . - . bignaiure oi apeciai ii Print Name Certification #; Verified by;_,"'/ """^^ZAO^ Corporate 2992 E, La Palma Ave,, Suite A Anaheim, CA 92806 Tel: 714,632,2999 Fax: 714,632,2974 Dispatch: 800,491,2990 San Diego/lmperial County: 6295 Ferris Square, Suite C San Diego, CA 92121 Tel: 658,637,3999 Fax: 858,537,3990 Dispatch: 888.844,5060 Inland Empire: 14467 Meridian Pkwy., Bldg 2A Riverside, CA92518 Tel: 951,653,4999 Fax: 951.653,4666 Dispach: 800.491,2990 MTGL PROJECT#:_ Permit # 1109-A01 N/A REPORT OF ULTRASONIC TESTING OF WELDS Page 1_ of 1_ Test Date: 6/30/14 DSA/CITY File # DSA/OSHPD Appl. # DSA/LEA # N/A N/A N/A Project Name: North Coast Calvary Chapel Architect: N/A Project Address: Carlsbad, Ca Engineer: N/A Shop: Able Iron Worlds Field: Contractor: N/A Specifications: AWS D1.1 table 6.2 Procedure: CTOI 2 Sub-Contractor: Able iron Worlds Scope: NDT Systems Avenger EZ sm 8084163 Test BlocIc: DSC Transducer: .75"x.75" ( g 2.25 MHz Worl<: v' New Repair Coupiant: Cellulose Gel Sensitivity Level: 46 dB Scan Level: 60 dB Description of Iteins tested: IMethod: Shear Longitudinal Angle: 70 - Performed ultrasonic testing of complete joint penetration welds at HSS column at HSS columns to base plates, and doubler plate to W- shape column web, and column flanges. (Please see items below for materials tested & test results). sections to spliced in continuity plates, & top and bottom continuity plates to a = Indication Level b = Reference Level c = Attenuation Factor d = a-b-c for instruments in Gain Welding Process: FCAW Decibels Indications Weld Complet e Reoair Reject Accept Piece Number Weld ID Angle Face abed Length) SP From X From Y Depth Size Type Class Complet e Reoair Reject Accept Col, SB HSS Continuity PI, 70 A n/a 8 0 0 8 HSS Continuity PI, 70 A n/a 8 0 0 8 HSS Col, to base 70 A n/a 4 0 0 4 Col, 3A Doubler PI. ® web 70 A n/a 0 2 2 2 Col, 6A Continuity PI. @ fifls 70 A n/a 8 0 0 8 Doubler Pl. @ web 70 A n/a 2 0 0 2 Col, 5A Dontinuity PI. @ figs 70 A n/a 8 0 0 8 Doubler PI. @ web 70 A n/a 2 0 0 2 Col, 13B Dontinuity PI. @ figs 70 A n/a 8 0 0 8 Discontinuity evaluation/Comments: 2 outstanding rejects were repaired, retested, and found UTOK. Their is no outstanding rejects as of this date. Comp Totals INTERPRETATION OF THE TEST RESULTS OBTAINED FROM THE TEST IS NOT TO BE CONSTRUED AS A GUARANTEE OR WARRANTY OF THE MATERIALS TESTED, MTGL Inc, SHALL NOT BE HELD LIABLE FOR LOSS, DAMAGE, INJURY OR DEATH RESULTING FROM USE OF THE TESTED PART FINAL RESPONSIBIUTY IN INTERPRETATION OF TEST RESULTS RESTS WITH THE CUSTOl We, the undersigned certify that the statements in this record are correct and that the welds were prepared in accordance with the requirements of Section 6 Part F - Inspected By: Louis Barraza Time In: 6:00 AM Hours: Reg. 6 Level: ASNT SNT-TC-1 A, CP-189 Level 11 Time Out: 12:00 PM O.T r7/a Tecimician A // • A Verified By: Signature: Fy/^/F^ Signature: THE MATERIAL: WAS WAS NOT Sampled and Tested In Accordance With the Requirements of the DSA Approved Documents THE MATERIAL TESTED: MET The Requirements of the DSA/Approved Documents, DID NOT MEET 08 40 Ji a rn uo- ifl-<;ui,i! Corpurate: $30 Oieoo/lropeHal Coaoty 2992 EUi Fauna Ave. Ste. A 6296 Ferris Square, SuitB C www.mtgfinc.com Anaheiin.CA 92806 Ts!: 714.632.2999 Fix: 714.832.2974 Oispaict): 800.4911990 San Diego, CA 92121 Te!:8S8.5S7.553S Fax: 858.537.^ Dispatch: 888.844.5060 r-. 14467 Meridian Pfcw., Bldo. 2-A Riverside. CA92S18 Tei; S51.6SS.4339 Fax: 961.663.4666 Dispatch: m491.2990 ladio: 44917 Goif Centar Plmy, #1 Indio, CA 92201 Tel: 760.3^^.4677 Fax: 760,342.4525 Diepaieh: 800.491.2890 MTSLPro)eet#: 1)6^ 4^ / Rsport #_ PB_J OF \ DAILY INSPECTION REPORT DSWOTYRIa#: OSA«)SHPDAPPL/L sp«c^ iitstnction Hepofts tntm oe otsvnmed tfi tte ^ SepiMattreperttittti fae prepared tof eaai^/pa of spwMliit^^ BisiEir— natew Tir SU!£(Wm.»C«M TYpeoFMsramioN • ENGII«e6R£DFIIl • FOUNDATION D BACK RLL a PTCONCflEli 0 SHOTCRETE •^COfKSSETE • MASONRY • WSHSTHiNGTHSOLnNG • VISING • SHOP WEU) • FIREPBOfflWG JS^WCHOR/DOWEL • NDERaj) • Nut SHOP • CEIUNQ WIRE Q • D m/mn/mMT: APraoyEooocuMorrs: AvAiLASlt: APPRWEO PLANS YD ND SOIL REPORT Yu N~ 3i^: YD HO APPnOVQ)SNOP«MMNG ¥• NO MWk Min UMES. PKtsmsrem , , ~. , _ ^ EWORK AS PERCENt OF ALL WORK TODKY; ' S>ERCENT PROJECT COMPLETE ^ REWDRKAS Tiff WORX WA6^ WAS NOTC InspscM ftl acconianca with the requirtnier^ apptoved OocumftMs. NU(rERiALSAMi>Utt6 WASO WASW3T0 WKt$ Petlomted in accont&ntt witit OSA/OSHPO^ROJECT appraved Ooniments. cc PrtHsetArcltltsct Goittraetn' Stmctural EnglnMr SuNdlnB Miiartmant DSARaoiorHlOffiise Owno- Scftool District THEWOfKHWESTa MEiVwN&rii^a The re(]tiireiTiems of fte DSA/DSKPD/PKUECT 2vprt>^ SamptestalceiK__Q ^ WBattwt: C/^.xd^ Temn: 7 O Print Name VftrifiMi bv: MTGL PROJECT*: Permits Report* Corporate 2962 E. La Palma Ave,, Suile A Anaheim, CA92806 Tel: 714.632.2899 Fax: 714.632.2974 Dispatch; 800,49" .2990 1109-A01 n/a San Disso/imperfal County: 6295 Ferris Square, Suite C San Dlego, CA 92121 Tel: 858.537.3999 Fax: 858.537,3990 Dispatch: 888.844,5060 REPORT OF ULTRASONIC TESTING OF WELDS Inland Empire; 14467 Meridian Pkwy., Bldg 2A Riverside, CA92S18 Tel; 951.653.4999 Fax: 951.653,4666 Dispatch; 800.491.2990 3 Page DSA/CITY File # DSA/OSHPD Appl. # OSA/LEA# n/a n/a n/a Speciel Inspection Reports rtiLst be (fistritiuled lo the parties listed below wittiin 14 daya of the Inspection. Reports of nar^:QiDpl!ant conditions must be distributed ImmedlalBiy. Separate reports sha'l be prepared tor eactt type of speclal inspection on a daHy basis. Each report shall be contplatad and signed by the special inapector conducting Itie Inspeclion. PROJECTNAME North Coast Calvary Chapel 6/27/14 n/a TIMEARRIVED 10:00 AM TIME DEPARTED 6:00 PM ENGINEER n/a TRAVELTIME n/a LUNCH TIME n/a CONTRACTOR n/a SUB CONTRACTOR Able Iron PROJECTADDRESS SHOPADDRESS Carlsbad, Ca. 222 Hershey St. Potnona, Ca Shop: Field: Specificalions: AWS Dl.l table 6.2 Procedure: M012 Work: ^ New , Repair Coupiant: Cellulose Gel Description of Items tested: TeslBloi:k: DSC Transducer: .62"X.62" @ 2.25 MIHz Scope: NDT Systems Avenger EZ SN* 8084186 SenslUvlty Level: 55 dB Scan Level: 69 dB Melhod; A Shear . Longitudinal Angle: 70 Pei^ornned ultrasonic testing of complete joint penefration welds @ HSS colunfin sections to spliced in continuity plates at beam connection area, HSS columns to base plates. Continuity plates to flanges of W-flange columns. Doubler plates to W-flange column webs. a = IncScatlon Level b - Reference Level c = Atlenuaiion Faclor r(SP-1)x 21 rounded = a-b.c for instrutrienls in Gain b-a-c fer Inslrumanls In Allenuation Welding Process: FCAW Decibels Indications Weld Mil i S 1 1 Location Wtid ID Angle Face abed Lenglh SP FromX FromY Depth Size Typa Class Mil i S 1 1 29A HSS Col. to base A n/a 4 0 0 4 29A HSS Col. Io base A n/a 4 0 0 4 29A HSS Col, to base A n/a 4 0 0 4 29A HSS Col, 10 base A n/a 4 0 0 4 29A HSS Coi, lo baae A n/a 4 0 0 4 29A HSS Col, lo baae A n/a 4 0 0 4 IOA Conlinuily Plates A n/a 8 0 0 8 17B HSS Continuity R. A n/a 8 0 0 8 » HSS Col. to base A n/a 4 0 0 4 9A HSS Conlinuily PI. A n/a 8 0 0 8 9B HSS Contiiuily PI. A n/a 8 0 Q 8 4A Conlinuily Plales A n/a 8 0 0 6 NOTE; piece above reguires more weldina on the Doubler plale before it can be tested. Test will be performed once complete IB Conlinuily Plales A n/a 8 0 0 a IOB Continuity Plates A n/a 8 0 0 8 IA Continuity Plates A n/a 8 0 0 8 7B Continuity Plales A n/a' 8 0 0 8 DlsoomlnultyevaluatlonA:omm6nts: reject found on this date. Totals INTERPRETATION OF THE TEST RESULTS OBTAIMED FROM THE TEST 13 NOT TO BE CONSTRUED AS A QUABANTEE OR WARRANTY OF THE MATERIALS TESTED. MTOL Inc, SHALL NOT BE HELD UABLE FOfl LOSS. DAMAGE. INJURV OR DEATH RESULTING FROM USE OF THE TESTED PART, FlNAL RESPONSIBILITY IN INTERPRETATION OF TEST RESULTS RESTS WITH THE CUSTOl We, the undersigned certify that the statements In this record are correct and lhal tbe »»elda were prepared In accordance with the requirements of Section 6 Pan F - ANSI/AWS D1.1 Welding Specificaiion. maatcied By: Seth Helton Level; ASNT SNT-TC-1 A, CP-189 Level 1 Technician Signature: Verifiecl By: Signature: Hours: Reg. O.T. THE MATERIAL: WAS WAS NOT Sampled and Tested In Accodance Witii the Rettubemenlsof tlie DSA A)3provGd Documails THE MATERIAL TESTED: MET Ttis RequksmanlE of Ihe DSAApoRy/ftd Documente. DID NOT MEET MTGL PROJECT#: Permii # Report* Corporate 2992 E, La Palma Ave,, Suite A Anaheim, CA 92806 Tel; 714,632,2999 Fax; 714,632,2974 Dispatch; 800,491.2990 1109-A01 n/a San Diego/lmperial County: 6295 Fen-is Square, Suite C San Diego, CA 92121 Tel; 858,537,3999 Fax; 858,537,3990 Dispatch; 888,844,5060 REPORT OF ULTRASONIC TESTING OF WELDS inland Empire; 14467 Meridian Pkwy,, Bidg 2A Riverside, CA 92518 Tel; 951,653,4999 Fax; 951,653,4666 Dispatch; 800,491,2990 2 Page DSA/CITY File # DSA/OSHPD Appl, # DS/VLEA # n/a n/a n/a Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compiiant conditions must be distnbuted immediately Separate reports shalt be prepared for each type of speciai inspection on a daily basis. Each report shalt be completed and signed by the special inspector conducting the inspection. PROJECT NAME; North Coast Calvary Chapel 6/23/14 ARCHITECT n/a TIMEARRIVED 8:30 Atvl TIME DEPARTED 10:00 AM n/a TRAVEL TIME n/a LUNCH TIME n/a CONTRACTOR n/a SUB CONTRACTOR Able Iron PROJECTADDRESS Carlsbad, Ca. SHOP ADDRESS 222 Hershey St. Pomona, Ca Shop; Field; Specifications: AWS Dl .1 table 6.2 Procedure: iVI012 Work: New Repair Coupiant: Cellulose Gel Description of Items tested: Test Block: DSC Transducer: Scope: NDT Systems Avenger EZ SN* Sensitivity Level: 55 dB Scan Level: 69 dB Method: ^ Shear Longitudinal Angli 62"x.62" @ 2.25 MHz 8084186 70 Performed ultrasonic testing of complete joint penetration welds @ HSS column sections to spliced in continuity plates at beam connection area. • a = Indicaiion Level b = Reference Level = Atlenuaiion Faclor d = a-b-c for instruments in Gain b-a-c for instruments in Attenuation ; Welding Process: FCAW Decibels Indications Weld Repair Reject Accept Location Weld ID Angle Face abed Length SP From X From Y Depth Size Type Class Repair Reject Accept ISA HSS Conlinuily PI, A n/a 8 0 0 8 17A HSS Continuity PI, A n/a 4 0 0 4 17B HSS Conlinuily PI. A n/a 4 0 0 4 Discontinuity evaluation/Comments: reject found on this date. SSL Rop. Totals INTERPRETATION OF THE TEST RESULTS OBTAINED FROM THE TEST IS NOT TO BE CONSTRUED AS A GUARANTEE OR WARRANTY OF THE MATERIALS TESTED. MTGL Inc. SHALL NOT BE HELD LIABLE FOR LOSS. DAMAGE, INJURY OR DEATH RESULTING FROM USE OF THE TESTED PART FINAL RESPONSIBILITY IN INTERPRETATION OF TEST RESULTS RESTS WITH THE CUST0^ We, the undersigned ceriify lhal the slalemenis in this record are correcl and lhal the welds were prepared in accordance wilh the requirements of Seclion 6 Pan F - ANSI/AWS D1,1 Weldinq Specification, Inspected Bv: Seth Helton ASNTStilT-TC-IA, CP-189 Level I Technician Signature: Veritied By: Siqnature: Hours: Reg. O.T THE MATERIAL: WAS WAS NOT Sampled and Tested In Accordance With ttie Requirements of the DSAApproved Documents THE MATERIAL TESTED: MET The Requirements of the DSAApproved Documents DID NOT MEET A ^^^^^ OiuKr. »nAi»!>; ^Diegii CAQ^?! T4 flH5JT»ra AH U7 3990 TH Fur HlfiS3<«E tl c '^ A-oi Imases of Items Tested or Inspected nf ^ Nnnh Coiil C ilvirv TliHirl t'/ji/l'* MTGL PROJECT*; Permit * Report * Corporate 2992 E, La Palma Ave,, Suile A Anaheim. CA 92806 Tel; 714,632,2999 Fax; 714,632,2974 Dispatch; 800,491,2990 1109-A01 n/a San Diego/lmperiai County: 6295 Ferris Square, Suite C San Diego, CA 92121 Tel; 858,537,3999 Fax; 858,537,3990 Dispatch; 888,844,5060 REPORT OF ULTRASONIC TESTING OF WELDS inland Empire; 14467 Meridian Pkwy,, Bldg 2A Riverside, CA92518 Tel; 951,653,4999 Fax; 951,653,4666 Dispatch; 800,491.2990 DSA/CITY File * _ DSA/OSHPD Appl,* n/a n/a 1 Page 1 of DSA/LEA # n/a Special Inspection Refiorts must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compliant conditions must be distributed immediately Separate reports shall be prepared for each type of speciai inspection on a daily basis. Each report shall be completed and signed by ttie special inspector conducting the inspection. PROJECT NAME; North Coast Calvary Chapel 6/20/14 ARCHITECT n/a TIMEARRIVED 6:00 AM TIME DEPARTED 12:00 AM ENGINEER n/a TRAVELTIME n/a LUNCH TIME n/a CONTRACTOR n/a SUB CONTRACTOR Able Iron PROJECTADDRESS Carlsbad, Ca. SHOPADDRESS 222 Hershey St. Pomona, Ca Shop: Field: Specifications: AWS D1.1 table 6.2 Procedure: MOI 2 Work: New Repair Coupiant: Cellulose Gel Description of Items tested: Test Block: DSC Transducer: Scope: NDT Systems Avenger EZ SN* Sensitivity Level: 55 dB Scan Level: 69 dB Metiiod: Shear Lonaitudinal Angle: 62"x.62" @ 2.25 MHz 8084186 70 Performed ultrasonic testing of complete joint penetration welds i connection area. HSS columns to base plates. HSS column sections to spliced in continuity plates at beam ' a = Indicaiion Level b = Reference Level = Attenuation Factor d = a-b-c for instruments in Gain b-a-c for instruments in Attenuation Welding Process: FCAW Decibels Indications Weid complete Repair Reject Accept Location Weld ID Angle Face abed Length SP From X From Y Depth Size Type Class complete Repair Reject Accept 170 HSS Conlinuily PI. A n/a 8 0 0 8 •• HSS Col. to base A n/a 4 0 0 4 17D HSS Conlinuitv PI. A n/a 8 0 0 8 •• HSS Col, to base A n/a 4 0 0 4 17D HSS Conlinuily PI. A n/a 16 0 0 16 Piece Above remains in progress. Ultrasonic testing was performed on all welds compleled on this piece as of this dale, 150 I HSS Continuity PI, I I A | | | | | | | j | I I I n/a I 24 I 0 I 0 I 24 Piece Above remains in progress. Ultrasonic leslinq was performed on all welds compleled on this piece as of this dale, 15D I HSS Conlinuilv PL I I A | | | | | | | j | I I I n/a I 24 I 0 I 0 I 24 Piece Above remains in progress. Ultrasonic testinq was performed on all welds compleled on this piece as of this dale, 15B I HSS Conlinuitv PI, I I A | j | | | j j j | I I n/a I 16 I 0 I 0 I 16" Piece Above remains in progress. Ultrasonic testing was perfofmed on all welds completed on this piece as of this date. Discontinuity evaluation/Comments: reject found on this date. SSL Rep, Comp Totals INTERPRETATION OF THE TEST RESULTS OBTAINED FROM THE TEST IS NOT TO BE CONSTRUED AS A GUARANTEE OR WARRANTY OF THE MATERIALS TESTED. MTGL Inc. SHALL NOT BE HELD LIABLE FOR LOSS. DAMAGE, INJURY OR DEATH RESULTING FROM USE OF THE TESTED PART FINAL RESPONSIBILITY IN INTERPRETATION OF TEST RESULTS RESTS WITH THE CUSTOl We, the undersigned certify thai the statements in this record are correcl and lhal the welds were prepared In accordance with the requirements of Seclion 6 Part F - ANSI/AWS Dl l Weldinq Specificaiion, Inspected By: Seth Helton ASNT SNT-TC-1 A, CP-189 Level I Technician Siqnature: Verified By: Signature: Hours: Reg. O.T THE MATERIAL: WAS WAS NOT Sampled and Tested In Accordance With the Requirements of the DSAApproved Documents THE MATERIALTESTED; MET The Requirements of the DSA Approved Documents. DID NOT MEET A rti 7iJE3??m 3An DtigailiiifHrliL Cc^iity: Fe-rlH a^iuari, SulUi C Fa. kilpnd EnvliB. Ii4fi7htaiji=n Pkwy. BlODl* T«f 951 tl5?'^ Fa. mi 653 *6» Images of Etenis Tested or Inspected "•"Be of Srihhch-r I DinniPlPi Corporate 2992 E. La Palma Ave., SuiteA Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch; 800.491.2990 San Diego/lmperial County: 6295 Ferris Square. Suite C San Diego, CA 92121 Tel: 858,537,3999 Fax: 858,537.3990 Dispatch: 888,844.5060 Inland Empire: 14467 Meridian Pkwy., Bldg 2A Riverside, CA 92518 Tel: 951.653,4999 Fax; 951,653,4666 Dispach: 800,491,2990 MTGL PROJECT*: 1109-A01 REPORT OF ULTRASONIC DSA/CITY File # N/A Permit # N/A TESTING OF WELDS DSA/OSHPD Appl. # N/A Page 1_ of 1 Test Date: 6/20/14 DSAA.EA# N/A Project Name: North Coast Calvary Chapel Architect: N/A Project Address: Carlsbad, Ca Engineer: N/A Shop: Able Iron Works Field: Contractor: N/A Specifications: AWS Dl.l table 6.2 Procedure: CT012 Sub-Contractor: Able Iron Works Scope: NDT Systems Avenger EZ SN# 8084163 Test Block: DSC Transducer: .75"x.75' @ 2.25 MHz Work: v' Nevv Repair Coupiant: Cellulose Gel Sensitivity Level: 46 dB Scan Level: 60 dB Description of items tested: Method: Shear Longitudinal Angle 70 - Performed ultrasonic testing of complete joint penetration welds at HSS column sections to spliced in continuity plates, & at HSS columns to base plates. (Please see items below for materials tested & test results). •a = Indication Level b = Reference Level c = Attenuation Factor [(SP-1)x 2] rounded d = a-b-c for instruments in Gain b-a-c for instruments in Attenuation Welding Process: FCAW Decibels Indications Weld Camplet e Repair Reject Accept Piece Number Weld ID Angle Face abed Length SP From X From Y Depth Size Type Class Camplet e Repair Reject Accept 17A HSS Continuity PI. 70 A n/a 8 0 0 8 ISA HSS Continuity PI. 70 A n/a 8 0 0 8 " HSS Col. to base 70 A n/a 4 0 0 4 16B HSS Continuity PI. 70 A n/a 8 0 0 8 16C HSS Col. to base 70 A n/a 4 0 0 4 17B HSS Col. to base 70 A n/a 4 0 0 4 Discontinuity evaluation/Comments: No rejects found on this date. Totals 36 INTERPRETATION OF THE TEST RESULTS OBTAINED FROM THE TEST IS NOT TO BE CONSTRUED AS A GUARANTEE OR WARRANTY OF THE MATERIALS TESTED, MTGL Inc, SHALL NOT BE HELD LIABLE FOR LOSS, DAMAGE. INJURY OR DEATH RESULTING FROM USE OF THE TESTED PART FINAL RESPONSIBILrTY IN INTERPRETATION OF TEST RESULTS RESTS WTTH THE CUSTO^ We, the undersigned certify that the statements in this record are correct and that the welds were prepared in accordance with the requirements of Section 6 Part F - ANSI/AWS Dl.l Welding Specification, Inspected By Louis Barraza Level: ASNT SNT-TC-1A, CP-189 Level II 4:00 PM Time Out: 9:00 PM Hours: Reg. O.T n/a Technician Signature: Verified By: Signature: THE MATERIAL: WAS WAS NDT Sampled and Tested In Acct>rdance VUHh the Requirements of the DSAApproved DcKwments THE MATERIAL TESTED: MET The Requirennents of ttie DSAApproved Documents. DID NOT MEET -GECrrECHNlCAL PROFESSIONALS INC. PAGE OF DAILY FIELD SUMMARY GPl PROJ. HO.ASllFF PROJ. NAMEi ^ FILL LOCATION/PURPOSE REQUIRED COMPACTION EQUIPMENT USED FF SOURCE OF FILL: ONSITE IMPORT SOIL TYPE{S) DEPTH OF FILL/BACKFILL GENERAL SUMMARY OF OBSERVATIONS . • iit>%X<-i^. -F'-A'-F'i. yi.AA.^-ff--AA "^f^^^lfMhJ.^ ^pBwgpgL- ^^^.ju^vu^' A$^..^_^. AREAS OF CONCERN BY JPsr^ jJ 7 • zA-rA^''---- RECEIVED BY FOR: GEOTECHNiCAL PROFESSIONALS, INC. FORi FORMS/F-1(8/89) <^€> [0'Z>^i'^ 'f=buj ^fTH^ COMMERCIA n;W-ER-.iCf-NSE cLRSS:fiM,5 :MOOPS:N MICHAEL DEfiNKIMGERY 396S3WILD FLO«S OR MURRIETft Cfi VaS63 SEX:M HT:6-a4 Hf^IR:Bf?N WT:188 EYES:HZL RSTR: CORR LENS M/lZ/ZOiB e.7Z 88 fP/lS American Concret, "L'S card ute catfon.org '«'"^v'«^o/tt;^";,"*"se:„ff,f ' nction. • CMF>^\ o c o o TJ o o c o to c c m *-J 1= C x: I a; -g UJ Q-^ tu CD " O Q. « M OJ C S 1= £ .3 O m .5 4) -Q ° .£ r: O) S E •o c .2 a 11 - .2 01 05 ll § d) ° 3 f f O 0) Tl O 05 H-3 O O OJ Si >,» « c s s o> 8 B fi a CO ra c o I r o o a to O C Z! o o 01 T3 O O c g CO w ffl C Z aT c o S3 S 5. o < OJ >, o CB C -> O 5 ? in > o © c .£ I .e Q 3 ^ III UJ «> ® o " 2 — "> <u c g C £ O ffl -o o ,c -c ca S E c .2 <o T) ,_ „ S a <B E 5 a. <c c c O « I " D o -= •ox:.;:; •5 « <« ^ « s W /t, ci> c -S o — o o 2, 3 8 X> O ; O P 0 10 .C CO 8 s ii= o 15 " c St XJ a. 1 E c O! g »: .•w CO -Sl tfi 1.1 • z O c o ® 2 > o < CM 05 C 8 I O ,E « ,S UJ <B x o " 2 05 O O- «3 — « (B C S <= £ .0 S XJ O ,C .c CO S E -o .£ -B S « > » ?S OJ '-co si g " 3 O 3 •I 8 § c .3; o <» 2, 3 y' lfl S P o u: O 0) ». S O O 0) X- O) a ^ IC O d) 0 •£ . >, 0) n •o a.,S gel 1» B> s p ra 1.1 1 8 CALIFORNIA COMMef=!Clft.L OWER LICENSE rf^^<,. ,,. , .11-1^ 1, 'Ts •'.£•$617i ;NDORS:N IHICHftELOEflNKINGEF?¥ 396S3WILD FLOWER DR B' I MURRIETft Cft 92S63 ||# SEX:« HftlRrBRN EY£S:HZL HT:6-04 WT:180 -1.3 56 il RSTR: CORR LENS ACI Concrete Field Testing Technician Grade I MICHAEL KINGERY Certification ID #01008558 Expires (in: 12/14/^^ 1: 4') certitication Verify at CheckACI.org If! If i Hi ffi. ^ ; If. S 5>f Si CO ^3 GEOTECHNICAL PROFESSIONALS INC March 30, 2015 North Coast Calvary Chapel 1350 Poinsettia Lane Carlsbad, California 92011 Attention: Mr. Jack Shubin Subject: Report of Observation and Testing During Construction Phase IIA-Chapel Building Project North Coast Calvary Chapel 1350 Poinsettia Lane Carlsbad, California GPl ProjectNo. 2015.2C Dear Mr. Shubin: In accordance with the requirements of the City of Carlsbad, this is our report of observation and testing during construction at the subject project site. Earthwork and foundation recommendations were provided in our report of Geotechnical Investigation dated March 2, 2005 and report update letter (References land 2). Rough grading for the site was documented in our report of Observation and Testing during Pad Grading dated May 19, 2014 (Reference 3). Our scope of services performed and the earthwork activities observed are summarized in the subsequent sections ofthis report. These results are incorporated herein. Our scope of services performed and the earthwork activities observed are summarized in the subsequent sections of this report. SCOPE OF SERVICES The scope of services performed by GPl during work covered by this report inciuded the ollowing: Observation of footing excavations forthe building; In-place density testing of plumbing and electrical lines in building interior In-place density testing of site utility trench backfill for storm drain and electrical; In-place density testing of backfill for storm drain box; In-place density testing of backfili at elevator pit; 2015-2C-02R.CIOC (3/15) 5A3G Corporate Avenue • Cypress, CA 90630 • (71 4] 220-2211 • FAX [71 4] 220-21 22 North Coast Calvary Chapel March 30, 2014 Chapel Building Project, Carlsbad, California GPl Project No. 2015.2C Observation of compaction ofthe permeable base in permeable pavement area; In-place density testing of aggregate base for parking area with utility line installation; In-place density testing of subgrade in flatwork area with pavers; Observation of compaction ofthe permeable base in paver area; Laboratory testing, including maximum density/optimum moisture detenninations; Review of gradation for permeable rock material provided by supplier; Providing engineering consultation when needed; Preparation of this report. Laboratory maximum density/optimum moisture relationships for the on-site soils were determined in general accordance with ASTM D 1557. In-place moisture content and dry densities were determined for fill materials in accordance with ASTM D 1556 (sand cone method) and in accordance with ASTM D 6938 (nuclear gauge method). The results of laboratory maximum density/optimum moisture determinations tests summarized in Table 1. In-place moisture/density test results are summarized in Table 2. The approximate locations of our field density tests for construction are shown on Figure 1. A summary of our observations is presented below. OBSERVATIONS DURING CONSTRUCTION GPl responsibility for observation and testing during construction included the building footings, utility lines within the buildings, electrical and storm drain lines, permeable pavement area, and pavers for flatwork surrounding building. Observation of Footing Excavations A representative of GPl also observed the bottom of excavations for the footings for the chapel building. GPl observed the bottom of the footing excavations to consist of competent compacted fill and to be clean of loose soils and debris prior to the placement of concrete. Interior Utility Trench Backfill GPl provided on-call geotechnical testing ofthe trench backfill ofthe interior plumbing and electrical lines in the building. Probing ofthe lines or density testing was performed ofthe trench backfill. The relative compaction ofthe soil backfill was found to be equal to at least 90 percent ofthe maximum dry density at the test locations. Where probed, the soil backfill was found to be firm, competent and consistent with the compacted soils within the building 2015-2C-02R.doc (3/15) 2 North Coast Calvary Chapel March 30, 2014 Chapel Building Project, Carlsbad, California GPl Project No. 2015,2C pad. The fills ranged from approximately 1 to 4 feet deep. Fills were placed in lifts of approximately 8 inches or less and compacted using a backhoe mounted "sheepsfoot" wheel and handwhackers. The fills consisted of on-site silty sands. Storm Drain GPl provided on-call geotechnical testing ofthe trench backfill forthe storm drain and storm drain cleanout box. Probing or density testing was performed ofthe trench and box backfill. The relative compaction ofthe soil backfill was found to be equal to at least 90 percent of the maximum dry density (ASTM D 1557) at the test locations. In general, the fills ranged from approximately 1 !4 to 3 feet deep. Where probed, the soil backfill was found to be firm, competent and consistent with properly compacted soils. The fills were placed in lifts of approximately 8 inches or less and compacted using a backhoe mounted "sheepsfoot" wheel and hand-whackers. In general, we observed clean sand placed as bedding material and shading for the storm drain lines. The fills above the pipe zone consisted of on-site silty sands. Electrical Line GPl provided on-call geotechnical testing ofthe trench backfill ofthe electrical line in the parking area west ofthe building. Fills of approximately 2 feet deep, were placed in lifts of 6 to 12 inches and compacted using a backhoe mounted "sheepsfoot" wheel and handwhackers. The fills consisted of on-site silty sands and crushed miscellaneous base. The base material was placed in the upper 4 inches of fill directly below the surrounding pavement Where tested, the relative compaction ofthe soil backfill was found to be equal to at least 90 percent of the maximum dry density (ASTM D 1557) at the test locations. Where probed, the soil backfill was found to be firm, competent and consistent with properly compacted soils. Where tested, the relative compaction ofthe miscellaneous base section was found to be equal toat least 95 percentof the maximum dry density (ASTM D 1557) at the test locations. Elevator Pit Backfill GPl provided on-call geotechnical testing ofthe backfill ofthe elevator pit forthe building. We observed placement of approximately 2 feet of %-inch clean crushed rock at the bottom ofthe pit. We observed the remaining portion ofthe excavation backfilled with silty sand. We obsen/ed placement of filter fabric overthe clean rock priorto placing the soil backfill. Fills were placed in lifts of approximately 8 inches or less and compacted using handwhackers. Probing or density testing was performed ofthe soil backfill. The relative compaction ofthe soil backfill was found to be equal to at least 90 percent ofthe maximum dry density at the test locations. Where probed, the soil backfill was found to be firm, competent and consistent with the compacted soils within the building pad. The total fill depth (rock and soil) was approximately AYz feet. 2015-2C-02R.doc (3/15) 3 North Coast Calvary Chapel March 30, 2014 Chapel Building Project, Carlsbad, California GPl Project No. 2015.2C Flatwork Subgrade A representative of GPl provided on-call geotechnical obsen/ation and testing during the compaction of subgrade soils north of the building. The subgrade soils were processed and moisture-conditioned as necessary and compacted, in general, with a small vibratory roller and handwhackers. The subgrade soils consisted of on-site silty sands. Where probed, the soil backfill was found to be firm, competent and consistent with the properly compacted fill. Where tested, the relative compaction of the subgrade was found to be equal to at least 90 percent ofthe maximum dry density (ASTM D 1557) attest locations. We observed the placement of permeable base over the subgrade and below the pavers. Filter fabric was placed between the soils and permeable base. We observed the compaction ofthe penneable base with vibratory plates. Based on the submittal from the supplier, the permeable base met the requirements of Caltrans Class II Permeable Material (Caltrans Section 68). Permeable Pavement Area GPl provided on-call geotechnical observation during the construction of the permeable pavement area in the existing parking lot south ofthe building. We observed the placement of approximately 62 inches of permeable base in the biorention area for the permeable pavement. We observe the placement of filter fabric on the sides of the permeable base exposed to soil. We observed the compaction of the permeable base with roller and handwhackers. The permeable base was compacted in lifts of approximately 6 to 12 inches. Based on the submittal from the supplier, the permeable base met the requirements of Caltrans Class II Permeable Material (Caltrans Section 68). Test results indicated the percent passing the No. 200 sieve ofthe permeable base was approximately 1.5 percent. CONCLUSIONS AND RECOMMENDATIONS General Based on the results of our observations and field density testing, the aforementioned earthwork activities were, in general, performed in accordance with the project plans, our reports and recommendations, the requirements of the City of Carlsbad, and customary standards of practice. GPl may not be aware of areas where the contractor or their subcontractors did not notify us to observe and test their work or minor areas of temporary fills not removed and replaced with engineered fills. 2015-2C-02R.doc (3/15) North Coast Calvary Chapel Chapel Building Project, Carlsbad, California March 30, 2014 GPl ProjectNo. 2015.2C LIMITATIONS Observations and testing sen/ices described herein have been limited to activities performed between May 20, 2014 and February 20, 2015. The conclusions and recommendations contained herein have been based upon our observations and testing as noted. No representations are made as to the quality or extent of materials not observed. Only the specific activities/fills discussed in the report were observed and or tested. Our services were performed using generally accepted engineering approaches and principles available at this time and the degree of care and skill ordinarily exercised under similar circumstances by reputable geotechnical engineers practicing in this area. No other representation, either expressed or implied, is included or intended in our report. This report should be considered subject to review by the appropriate regulating agencies. The opportunity to be of service is appreciated. If you have any questions, please call. Very truly yours, Geotechnical Professionals Inc. Donald A. Cords, GE. Principal DAC:sph Enclosures: References Figure 1 Table 1 Table 2 m 3 0 2015 - Site Plan - Summary of Laboratory Testing - Summary of Field Density Tests Distribution: (1) Addressee (4) Dan Owens, Grant General Contractors 2015-2C-02R.doc (3/15) North Coast Calvary Chapel March 30, 2014 Chapel Building Project, Carlsbad, California GPl Project No. 2015,2C REFERENCES 1. Geotechnical Professionals Inc., "Geotechnical Investigation, Proposed North Coast Calvary Chapel Building Project, Aviara Parkway and Poinsettia Lane, Cartsbad, Califomia,"Pro\ect No. 2015.1, dated March 2, 2005. 2. Geotechnical Professionals Inc., "Updated of Geotechnical Engineenng Report, Proposed Chapel Building, Phase II-A, 1350 Poinsettia Lane, Cartsbad, Califomia," Project No. 2015.1, dated March 7, 2013. 3. Geotechnical Professionals Inc., "Report of Observation and Testing During Pad Grading, Phase IIA - Chapel Building Pad, North Coast Calvary Chapel, 1350 Poinsettia Lane, Carlsbad, Califomia," Pro\ect No. 2015.2C, dated May 19, 2014. 2015-C-02R.doc (5/08) EXPLANATION APPROXIMATE LOCATIONS OF IN-PLACE DENSITY TESTS S.H3.J93}ift:B aesmrfontummcE -'"'V^OAGjl^iC'^ T'ON Apf 'BiuPErEtmjN MREf. •= TO SPIgXl FLOW rmOIXH SSW. —.. r pmaum oHDcmm Pipe _ <tlS5 , J00.8,1(r!') 30 60 FEET BASE PLAN REPRODUCED FROM BMP SITE PLAN PROVIDED BY O'DAY CONSULTANTS: DATED 06-14-2014 GEOTECHNICAL PROFESSIONALS, INC. NORTH COAST CALVARY CHAPEL GPl PROJECT NO.: 2015.2C SCALEI" = 30' SITE PLAN FIGURE 1 North Coast Calvary Chapel North Coast Calvary Chapel Building, Carlsbad, California March 30, 2015 GPl ProjectNo. 2015.2C TABLE 1 LABORATORY TESTING CURVE NO. SOIL DESCRIPTION MAXIMUM DRY DENSITY (pcf) OPTIMUM MOISTURE CONTENT (%) 1 Silty Sand (SM) 122 11.0 2 Silty Sand (SM) 125 11.0 3 Crushed Miscellaneous Base 122 10.0 2015-2C-02T (3/15) North Coast Calvary Chapel North Coast Calvary Chapel Building, Carlsbad, California March 30, 2015 GPl ProjectNo. 2015.2C TABLE 2 SUMMARY OF FIELD DENSITY TESTS TEST NO. DATE 2014 ELEV. (ft) MOIST. (%) DRY DENSITY (pcf) CURVE NO. COMP. (%) REMARKS 1001&1002 NOTA PART OF THIS REPORT SD 1003 5/20 303 8.4 115 2 92 SD 1004 5/20 303 9.9 122 2 98 SD 1005 5/20 302 9.8 120 2 96 SD 1006 5/20 303 7.9 124 2 99 SD 1007 5/20 303 8.7 119 2 95 SD 1008 6/2 302 10.9 116 2 93 INTERIOR UTILITY 1009 6/2 302 11.1 110 1 90 INTERIOR UTILITY 1010 6/2 302 11.1 115 2 92 INTERIOR UTILITY 1011 6/2 302 10.1 119 2 95 INTERIOR UTILITY 1012 6/2 302 12.6 114 2 91 INTERIOR UTILITY 1013 6/2 302 11.0 114 2 92 INTERIOR UTILITY 1014 6/2 302 12.7 114 2 91 INTERIOR UTILITY 1015 6/2 302 18.5 119 2 95 INTERIOR UTILITY 1016 6/2 302 10.0 110 1 91 INTERIOR UTILITY 1017 6/2 302 11.9 113 91 INTERIOR UTILITY 1018 6/2 303 17.7 111 1 91 INTERIOR UTILITY 1019 6/2 303 10.4 117 94 INTERIOR UTILITY 1020 6/2 303 19.6 111 1 91 INTERIOR UTILITY 1021 6/2 303 9.8 110 1 90 INTERIOR UTILITY 1022 6/3 301 21.5 105 1 86 ELEC RETESTED BY#1022R 1022R 6/3 301 14.4 113 1 93 ELEC-RETEST OF #1022 1023 6/3 301 20.5 105 1 86 ELEC RETESTED BY#1023R 1023R 6/3 301 12.3 114 1 94 ELEC - RETEST OF #1023 1024 6/3 301 19.5 108 1 89 ELEC RETESTED BY #1024 1024R 6/3 301 13.3 116 1 95 ELEC - RETEST OF #1024 1025 6/3 301 11.1 121 1 99 ELEC 1026 6/3 301 10.7 113 1 92 ELEC 1027 6/4 302 15.9 118 3 97 BASE 1028 6/4 302 11.2 122 3 100 BASE 2015-2C-02T(3/15) North Coast Calvary Chapel Proposed North Coast Calvary Chapel Building Project, Carlsbad, California March 30, 2015 GPl Project No. 2015.C SUMMARY OF FIELD DENSITY TESTS - CONTINUED TEST NO. DATE 2014 ELEV. (ft) MOIST. (%) DRY DENSITY (pcf) CURVE NO. COMP. (%) REMARKS 1029 6/4 302 11.7 114 3 94 BASE - RETESTED BY #1029R 1029R 6/4 302 11.3 118 3 98 BASE-RETEST OF #1029 1030 6/4 302 10.3 116 3 96 BASE 1031 6/4 302 12.0 116 3 96 BASE 1032 7/8 297 11.1 119 2 95 SD TRENCH 1033 7/8 299 10.7 117 2 94 SD TRENCH 1034 7/8 300 10.5 119 2 95 SD TRENCH 1035 7/9 300 10.2 120 2 96 SD TRENCH 1036 7/9 301 10.9 120 2 96 SD TRENCH 1037 7/10 301 11.1 121 2 97 SD TRENCH 1038 7/15 296 7.9 115 2 92 SD VAULT 1039 7/15 298 6.9 108 2 86 SD VAULT RETESTED BY #1040 1040 7/15 298 6.8 113 2 90 SD VAULT RETEST OF #1039 1041 7/15 298 7.2 113 2 90 SD VAULT 1042 7/15 300 7.1 118 2 94 SD VAULT 1043 7/15 300 6.0 119 2 95 SD VAULT 1044 7/18 301 11.4 119 2 95 ELEVATOR PIT 1045 7/18 302 11.1 120 2 96 ELEVATOR PIT 2015 1046 2/17 303 11.4 120 2 96 PAVER SG 1047 2/17 303 11.1 120 2 96 PAVER SG 2015-2C-02T (3/15) Carlsbad 102519 7129IlZ EsGil Corporation In (PartnersHip witH government for (BuiCding Safety DATE: 7129IlZ • APPLICANT aTjURIS. JURISDICTION: Carlsbad • PLAN REVIEWER • FILE PLANCHECKNO.: 102519 SET:V PROJECTADDRESS: 1330 Poinsettia Lane PROJECT NAME: North Coast Calvary Chapel, Phase II I 1 The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. ^ The plans transmitted herewith will substantially comply with the jurisdiction's building codes when minor deficiencies identified below are resolved and checked by building department staff. I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. I I The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. I I The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. I I The applicant's copy of the check list has been sent to: ^ Esgil Corporation staff did not advise the applicant that the plan check has been completed. I I Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Date contacted: (by: ) Fax #: Mail Telephone Fax In Person ^ REMARKS: Enclosed is one set of complete approved plans and one set of replacement sheets. The replacement sheets must be incorporated into the city set of plans in order to make a 2"*^ set of approved plans. By: Chuck Mendenhall Enclosures: EsGil Corporation • GA • EJ • PC 7/19/13 Carlsbad 102519 6/18/13 EsGil Corporation In PartnersHip with government for Guiding Safety DATE: 6/18/13 •.APPLICANT (djURIS? JURISDICTION: Carlsbad • PLANREVIEWER • FILE PLANCHECKNO.: 102519 SET: IV PROJECTADDRESS: 1330 Poinsettia Lane PROJECT NAME: North Coast Calvary Chapel, Phase II I I The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. I I The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. XI The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. I I The applicant's copy of the check list is enclosed for the jurisdiction to fonward to the applicant contact person. XI The applicant's copy of the check list has been sent to: Timeless Architecture, Att'n: Jim Thayer 9891 Irvine Center Dr., Suite 140, Irvine, CA 92618 I I Esgil Corporation staff did not advise the applicant that the plan check has been completed. Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Jim Thayer Telephone #: (949) 831-8110 Date contacted:u(»"i^]) (by: y:^ ) Fax #: (949) 951-2820 Mail Telephone Fax-^ In Person • REMARKS: By: Chuck Mendenhall Enclosures: EsGil Corporation GA H EJ • PC 6/11/13 Carlsbad 102519 6/18/13 NOTE: The items listed below are from the previous correction list. These remaining items have not been adequately addressed. The numbers ofthe items are from the previous check list and may not necessarily be in sequence. The notes in bold font are current. • Please make all corrections, as requested in the correction list. Submit FOUR new complete sets of plans for commercial/industrial projects (THREE sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: 1. Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760) 602-2700. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. 2. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. • ARCHITECTURAL LIFE SAFETY REVIEW All OK . STRUCTURAL NOTE: The items listed below are from the previous correction list. These remaining items have not been adequately addressed. The numbers of the items are from the previous check list and may not necessarily be in sequence. The notes in bold font AND CAPS are current. 26. The location of the lateral resisting system comprised of moment frames at the first level are shown on page 124 ofthe calc's. the location shown in the calc's looks nothing like what is shown on the plans on sheets S111 & S112. Provide a design consistent with the plans. The rotational analysis of the rigid diaphragm at the 2"^ floor is design based on the location of the moment frames shown on sheet 123 ofthe calc's. These locations do not match what is shown on the plans. C. In all cases the moment frame connection between the columns and beam are referenced to detail 15/S501 on the frame elevations on sheet S502. this detail is generic and satisfactory but it does not address the welding ofthe continuity plates to the column web and does not address the need for column web doubler plates. The computer design of the connection for code compliance in all cases requires doubler plates and welding of the continuity plates to the column web. The sizes ofthese welds and doubler plates vary for each of the frames. How do you intend to address the additional details for each of the frames? THE BEAM / COLUMN MOMENT CONNECTION IS REFERENCED TO DETAIL 07/S501. THIS IS THE CORRECT DETAIL REFERNCE BUT DETAIL 04/S501 SHOULD ALSO BE REFERENCED AT THE CONNECTION SINCE THIS IS THE DETAIL LISTING THE REQUIRED SIZE OF THE DOUBLER PLATES AND THE CONTINUITY PLATES. Carlsbad 102519 6/18/13 H. The foundation design for the spread footings is found on page 217 ofthe calc's. The footing at line ^ @A must be 5'-0" sq. The plans list footing as PF-3 on sheet S111 which is only 4'6" sq. THE RESPONSE INDICATES "SEE SHEET S111-5'-3" PAD FOOTING IS PROVIDED" . THE PAD FOOTING SCHEDULE FOUND ON SHEET S111 LISTS PF-5 AS 4'- 0" SQ X 18" DEEP. REVISE THE PLAN CONSISTENT WITH THE DESIGN. I. The foundation design on page 217 requires the spread footing as line '\@ B to be 9'-6" sq. The plans show the spread footing at this location to be PF-2 or 4'-0" sq. SOMETHING IS WRONG WITH THE PAD FOOTING SCHEDULE FOUND ON SHEET S111. THE RESPONSE TO THIS ITEM INDICATES PAD FOOTING AT B-1 IS NOT PART OF THE MOMENT FRAME. THIS FOOTING IS CALLED OUT AS 4'-0" SQ x 16" BUT THE PLANS REFERNCEPF-4 WHICH IS LISTED IN THE SCHEDULE AS 3'-6" SQ x18" AND THE RESPONSE GOES ON TO INDICATE THE MOMENT FRAME PAD FOOTING FOR FRAME F-1 AT 1-A.6 IS DEFINED AS 10'-6" SQ X 21". THE PLANS SHOW THIS FOOTING AS PF-10 WHICH ON THE PAD SCHEDULE IS 5'-9" SQ x 18" D. END OF STRUCTURAL RECHECK ( 6/18/13 ) To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, calculation page, etc. The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Chuck Mendenhall at Esgil Corporation. Thank you. • ELECTRICAL and ENERGY RECHECK (4/26/13) PLAN REVIEWER: Eric Jensen ELECTRICAL (2005 NATIONAL ELECTRICAL CODE) 1. Include the service location on the site plan. Latest: Odd number of feeder conductors from "MSB" to chapel building disconnect: (6)? Please review: Neutral, equipment ground? Note: Ifyou have any questions regarding this Electrical and Energy plan review list please contact Eric Jensen at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. NOTE: The items listed below are from the previous correction list. These remaining items have not been adequately addressed. The numbers ofthe items are from the previous check list and may not necessarily be in sequence. THE NOTES IN BOLD CAP FONT ARE CURRENT REMAINING ITEMS. PLUMBING AND MECHANICAL CORRECTIONS • JURISDICTION: Carlsbad DATE: 6/17/2013 Carlsbad 102519 6/18/13 • PLAN REVIEW NUMBER: 102519 SET: IV PLAN REVIEWER: Glen Adamek GENERAL AND ARCHITECTURAL PME ITEMS 1. THE FINAL SET OF CORRECTED DRAWINGS TO BE REVIEWED FOR SIGNING AND SEALING JUST BEFORE THE PERMITS ARE TO BE ISSUED. Each sheet ofthe plans must be signed by the person responsible for their preparation, even though there are no structural changes, before the permits are issued. Business and Professions Code. 3. THE INSTALLATION INSTRUCTIONS, LISTING DATA AND CUT-SHEETS FOR THE FIREPLACE VENT CAP SHOWN IN THE DETAIL 17 ON SHEET A505 HAS NOT BEEN PROVIDED. THE ROOF OVER THE FIREPLACE VENT CAP IS NOT ALLOWED IF THE FIREPLACE VENT CAP IS NOT LISTED FOR THE PROPOSED INSTALLATIONTHE FIREPLACE INSTALLATION INSTRUCTIONS DOES NOT ADDRESS THE FIREPLACE VENT CAP SHOWN IN THE DETAIL 17 ON SHEET A505.. PLEASE CORRECT. The cut-sheets, listing data and installation instructions for the prefab fireplace, flue svstem and vent cap are not ine the plan packages provided to Esgil Corp. Also note. Esgil Corp. no longer have anv old plan packages. Please provide listing data, installation instructions, and design calculations for the proposed Heatilator "Castlewood 42" exterior fireplace In detail 17 on sheet A505 and details 9 & 10 on sheet A401; and provide listing data, installation instructions, and design calculations forthe proposed interior fireplace in details 15 & 17 on sheet A401. B) Please correct correct the flue cap details including detail 17 on sheet A505. Please provide listing data and installation instructions for the proposed prefab chimney caps to be installed under the tile roof systems. Chimney flue caps must extent to "above the roof system" or per the installation instruction ofthe listed prefab chimney cap. C) The cut-sheets, listing data and installation instructions for the vent cap are not ine the plan packages provided to Esgil Corp. Please provide listing data and installation instructions for the prefab metal flue systems. PLUMBING (CALIFORNIA PLUMBING CODE) 5. PLEASE EXPLAIN HOW THE EXISTING WATER MAIN SIZE OF 2 INCH IN THE PLAN SET III ARE NOW 3 INCH AND Tk INCH WATER LINES. PLEASE PROVIDE DATA (EXISTING APPROVIDED CONSTRUCTION DRAWING OR EXPOSE THE EXISTING WATER MAIN) TO SHOW EXISTING WATER MAIN SIZES. Please correct on the private site plumbing the following items: Provide the site plumbing plans showing the sizes and locations of the gas meters and water meter; and the sizes, routes, and slopes of the building sewer, storm drainage system, site gas lines, and site water lines. The Sheets POIO and P011 are incomplete private site plumbing plans for private water system. Private Sewer system, and Private Gas system to complete review of the existing and new systems for the existing plus new demands. Please correct to show all piping materials for gas, water and sewer systems; show the sizes and slopes of the new and existing private sewer lines; show the pipe sizes of the new and existing gas lines; and show the pipe sizes of the new and existing Carlsbad 102519 6/18/13 water lines. (Also, the existing private water, sewer and gas systems seem to all run under the future Youth Ministry Building. Please address.) A) On sheet POIO the 2 inch PVC water main is undersized for the total water demand of 477.25 fixture units. Onlv about 155 flush valve type fixture units mav be on a 2 inch PVC water line with maximum 8 feet per second flow rate. Most all of the existing 2 inch PVC water the water mains from the public water meters the branches to each ofthe building connection need to be up sized to minimum 3 inch. Please correct. 14. THE TWO HORIZONTAL, UNDER-FLOOR VENTS FROM THE TWO RESTROOM FLOOR DRAINS, MAY NOT BE COMBINED TO A SINGLE VENT STACK UNTIL THE SEPARATE VENTS ARE MORE THAN 6 INCHES ABOVE THE FINISHED FLOOR LEVEL. PLEASE CORRECT THE REVISED VENTING. Please provide riser or isometric drain waste and vent plumbing plans clearly show the sizes of all piping and each fixture type. Please correct the drain waste and vent plans on sheet P401: A) Please address the following: Show the required vents for each of the floor drains and for each of the urinals. Please address the following: 3) The two floor drains iust down stream from the back to back water closets, need to have minimum 3 inch trap arms for trap arm lengths of more than 60 inches but not more than 72 inches as per CPC. Table 10-1. please correct MECHANICAL (CALIFORNIA MECHANICAL CODE) A) The mechanical plan sheet numbering have been changed. But the mechanical section cross-reference symbols do not show the new sheet numbers. Please correct 24. THE NOTES ON SHEETS Ml 11 & Ml 12 DO NOT CHANGE THE OVERFLOW DRAIN LINES SHOWN TO BE DISCHARGING OVER THE LAVATORIES IN THE RESTROOM. PLEASE CORRECT THE PIPING ROUTES AND DISCHARGE LOCATIONS ON SHEETS Mill & Ml 12. Please correct the overflow condensate drainage svstems shown on the sheets Mill & Ml 12. The overflow condensate drains mav not drain to the restrooms. Detail the primary and secondary mechanical condensate waste design: Pipe sizing, routing, and termination areas. UMC 310.0 & UPC 807.2 Correct the secondary (overflow) condensate drainage systems on sheet M-5. The secondary condensate drainage piping may not be combined into a single drain line. And the each secondary condensate drainage discharge location must be "readily observable" by the occupants in the area served by the A/C being served by the overflow condensate drain. Note: If you have any questions regarding this Plumbing and Mechanical plan review list please contact Glen Adamek at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. Carlsbad 102519 4/26/13 EsGil Corporation In (Partnersliip witH government for (BuiCding Safety DATE: 41261 IZ • APPLICANT •CjURIS. JURISDICTION: Carlsbad • PLANREVIEWER • FILE PLANCHECKNO.: 102519 SET: III PROJECTADDRESS: 1330 Poinsettia Lane PROJECT NAME: North Coast Calvary Chapel, Phase II I I The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. I I The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. X The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. I I The applicant's copy of the check list is enclosed for the jurisdiction to fonward to the applicant contact person. X The applicant's copy of the check list has been sent to: Timeless Architecture, Att'n: Jim Thayer 9891 Irvine Center Dr., Suite 140, Irvine, CA 92618 I I Esgil Corporation staff did not advise the applicant that the plan check has been completed. Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Jim Thayer Telephone #: (949) 831-8110 Date contacted: H\ lis (f3(by: \^) Fax #: ( 949) 951-2820 Mail^ Telephone Fax-^ In Person • REMARKS: By: Chuck Mendenhall Enclosures: EsGil Corporation GA EJ • PC 4/18/13 Carlsbad 102519 4/26/13 • Please make all corrections, as requested in the correction list. Submit FOUR new complete sets of plans for commercial/industrial projects (THREE sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: 1. Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760) 602-2700. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. 2. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. . ARCHITECTURAL LIFE SAFETY REVIEW All OK . STRUCTURAL NOTE: The items listed below are from the previous correction list These remaining items have not been adequately addressed. The numbers of the items are from the previous check list and may not necessarily be in sequence. The notes in bold font AND CAPS are current SOMETHING IS VERY WRONG WITH THE COORDINATION OF THE PLANS. THE DESIGN CALC'S AND THE RESPONSES TO THE PREVIOUS CORRECTIONS. PRIOR TO SUBMITTING FOR RECHECK VERIFY THE FOLLOWING. a. THE ENGINEER OF RECORD FOR THE PROJECT. SHAWN NIKJOO. MUST STAMP AND SIGN EACH SHEET OF THE STRUCTURAL PLANS. b. THE STRUCTURAL RESPONSES MUST BE COORDINATED WITH THE PLANS AND CALC'S. MANY OF THE RESPONSES TO THE PREVIOUS ITEMS REFER TO THE DESIGN CALC'S PAGES THAT HAVE NOTHING TO DO WITH CORRECTION AND DO NOT RELATE IN ANY WAY TO THE RESPONSE. c. THE MOMENT FRAMES ARE FOUND ON SHEET S502. ALL THE CONNECTION DETAILS REFERENCED ON THIS PAGE MAKE NO SENSE. FOR INSTANCE THE BEAM / COLUMN MOMENT CONNECTION IS REFERENCED TO 15/S501 OR 21/S501. THERE ARE NO DETAILS 15 OR 21 ON SHEET S501. d. SUBMIT A COPY OF THE SOIL REPORT FOR THIS PROJECT. APPARENTLY THIS PLAN CHECK IS IN EXCESS OF 3 YEARS OLD. ALL PREVIOUS DOCUMENTS HAVE BEEN DISCARDED Carlsbad 102519 4/26/13 20. Note 'C on sheet S131 references detail 19 indicates " Heavy Timber Wood Truss 19/A501". Detail 19/A501 does not depict the HT roof trusses. The structural plans contain no details forthe HT wood trusses shown on sheet SI 31. Provide complete structural details for the HT wood trusses spanning 40ft above the chapel area. See pages 9 thru 18 ofthe calc's.. Revise Note #1 on sheet S131 to reference the details on sheet S507 for construction of the HT trusses. Include in detail 15/S507 the connection ofthe HSSl 2X12 column to the bottom chord ofthe HT truss which is an 8X10 RS wood member. THE RESPONSE INDICATES "NOTE 1 ON SI 31 HAS BEEN REVISED. SEE 15/S507" NOTE 1 ON SHEET SI 31 INDICATES TRUSSES DETAIL ARE FOUND ON 18/S507. THERE IS 18 ON S507. THE TRUSS CONSTRUCTION IS FOUND IN DETAIL 13/S507. PROVIDE CONSISTENT REFERENCING. 25. Provide complete structural details for the curved roof trellis located at the 2"^^ floor circulation deck. See architectural section R/A304. & 13/A401. There are no structural details for the members sizes or the connections between members. See structural calc's, pages 205 & 206. The response indicates "SEE PAGES 264 & 265 OF CALC'S" . It doesn't appear that there is any horiz. Support member for the columns. See the framing shown on sheet SI 31. PAGES 264 & 265 OF THE CALC'S DO NOT ADDRESS THE LATERAL SUPPORT OF THE CIRCULAR STRUCTURE. PAGES 264 & 265 OF THE CALC'S IS RISA DESIGN OF FRAME F- 5, 26. The location of the lateral resisting system comprised of moment frames at the first level are shown on page 124 ofthe calc's. the location shown in the calc's looks nothing like what is shown on the plans on sheets S111 & S112. Provide a design consistent with the plans. The rotational analysis ofthe rigid diaphragm at the 2"^^ floor is design based on the location ofthe moment frames shown on sheet 123 ofthe calc's. These locations do not match what is shown on the plans. The response is " Plans modified to show the location of the frames consistent with the calculations." The frame locations are shown on page 91 of the design calc's. The following applies to the frames as designed in the calc's and shown on the plans: THE RESPONSES TO ALL THE ITEMS LISTED BELOW REFER TO SHEETS IN THE CALCULATIONS THAT HAVE NOTHING TO DO WITH THE CORRECTION. FOR INSTANCE ITEM 'A' REQUESTS DESIGN OF THE BEAM/COLUMN CONNECTION OF FRAME ON LINE C.l. THE RESPONSE DIRECTS ME TO SHEET 101 OF THE CALC'S . SHEET 101 OF THE CALC'S IS PART OF THE DESIGN OF FLOOR BEAM FB6A. ALL THE ITEMS LISTED BELOW STILL APPLY A. The moment frame resisting lateral loads along grid line C.l at the balcony is design on pages 102 thru 106. The column sizes are very different on the plans than the design . Provide design that is consistent with the plans. Also, Include In this design of this frame the connection ofthe beams to the HSSl 2X12X1/2 columns and include on the plans a detail of this moment connection. B. The moment frame loading summary found on pages 135 thru 137 does not include frames F3, F4, F5 & F12 as shown on page 91 of the calc's. Include in the calc's a loading summary for frames F3, F4, F5 & F12, C. In all cases the moment frame connection between the columns and beam are referenced to detail 15/S501 on the frame elevations on sheet S502. this detail is generic and satisfactory but it does not address the welding of the continuity plates to the column web and does not address the need for column web doubler plates. The computer design of the connection for code compliance in all cases requires doubler plates and welding of Carlsbad 102519 4/26/13 the continuity plates to the column web. The sizes of these welds and doubler plates vary for each of the frames. How do you intend to address the additional details for each of the frames? D. The typical frame base plates are referenced on sheet S502 to the typical detail 2/S501. this detail does not include information for the base plate such as dimensions, thickness, welding of the base plate to the columns and the number and size of the anchor bolts. E. Detail 2/S501 includes a section detail ofthe base plate referenced to 29/S501. There is no detail 29/S501. F. The frame design on pages 138 thru 147 in the calc's does not include the frames F7 along line 2 between C-D , frame F3 along grid line 1 between D.5 -D.S and frame F-4 along grid line D.5 between 4-5. G. The frame design on page 146 of the calc's includes a frame along line 2.7.1 find no frame on sheet Al 21 ofthe plans along grid line 2.7. Please clarify. H. The foundation design for the spread footings is found on page 217 ofthe calc's. The footing at line 1 (g A must be 5'-0" sq. The plans list footing as PF-3 on sheet S111 which is only 4'6" sq. I. The foundation design on page 217 requires the spread footing as line 1(g B to be 9'-6" sq. The plans show the spread footing at this location to be PF-2 or 4'-0" sq. The organization and accuracy of the calculations and consistency with the plans should be carefully reviewed by the engineer of record prior to resubmittal for recheck 29. Beam #11 design found on page 47 of the calc's does not include any concentrated loads. The plans show that the 2"^^ floor roof beam is supported on beam #11 at approx. 7ft from the end support. Include in the design ofthis beam the concentrated loads from the roof above. The design ofthis beam now shows the reactions of 117.5K and 116K. See page 22 ofthe current calc's summary of loading and reactions. The connection of this beam to the web ofthe support columns is detailed in 10/S505 as referenced on sheet SI 21. This connection shows 6-1" A325 single shear bolts and a 7/16" shear tab. The capacity of this connection base on the AISC Tables for single shear connections is only 82.2K. Also the weld between the shear tab and web must be min. 3/8" fillet weld as listed in the AISC shear connection tables. END OF STRUCTURAL RECHECK ( 4/26/13 ) To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, calculation page, etc. The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Chuck Mendenhall at Esgil Corporation. Thank you. ELECTRICAL and ENERGY RECHECK (4/26/13 ) Carlsbad 102519 4/26/13 PLAN REVIEWER: Eric Jensen ELECTRICAL (2005 NATIONAL ELECTRICAL CODE) 1. Include the service location on the site plan. If the distance from the service to the chapel disconnecting means exceeds 150', provide feeder voltage drop calculations. It seems that the conductor length is 184' (on sheet E010 & E002 (voltage drop calculation) but 782' on the single line and (scaled) on the site plan about 550'? VD calculation is at 2% I think for the 184' length, I'm not sure what it'd be @ 550'? I don't know what you used with your calculation, please provide the amperage used: Is the 400 ampere potential or the actual building load calculation? Part of the problem is that the single line does not match the panel schedules: Panel "L" is 400 amperes (panel schedule, 100 amperes (single line), there isn't a DP-1 schedule but there is one on the single line, impossible to determine building load. Note: If you have any questions regarding this Electrical and Energy plan review list please contact Eric Jensen at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. PLUMBING AND MECHANICAL CORRECTIONS • JURISDICTION: Carlsbad DATE: 4/25/2013 • PLAN REVIEW NUMBER: 102519 SET: III PLAN REVIEWER: Glen Adamek NOTE: The items listed below are from the previous correction list These remaining items have not been adequately addressed. The numbers of the items are from the previous check list and may not necessarily be in sequence. THE NOTES IN BOLD UNDERLINED FONT ARE CURRENT REMAINING ITEMS. GENERAL AND ARCHITECTURAL PME ITEMS 1. The final set of corrected drawings to be reviewed for signing and sealing iust before the permits are to be issued. Each sheet of the plans must be signed by the person responsible for their preparation, even though there are no structural changes, before the permits are issued. Business and Professions Code. 3. The cut-sheets, listing data and installation instructions for the prefab fireplace, flue svstem and vent cap are not ine the plan packages provided to Esgil Corp. Also note. Esgil Corp. no longer have anv old plan packages. Please provide listing data, installation instructions, and design calculations for the proposed Heatilator "Castlewood 42" exterior fireplace in detail 17 on sheet A505 and details 9 & 10 on sheet A401; and provide listing data, installation instructions, and design calculations for the proposed interior fireplace in details 15 & 17 on sheet A401. Carlsbad 102519 4/26/13 B) Please correct correct the flue cap details including detail 17 on sheet A505. Please provide listing data and installation instructions for the proposed prefab chimney caps to be installed under the tile roof systems. Chimney flue caps must extent to "above the roof system" or per the installation instruction ofthe listed prefab chimney cap. C) The cut-sheets, listing data and installation instructions for the vent cap are not ine the plan packages provided to Esgil Corp. Please provide listing data and installation instruActions for the prefab metal flue systems. 4. Please correct the plans to show the full one hour fire rated floor ceiling between the elevator machinery room and the attic area above. Note the 5/8 inch Type 'X' drvwall ceiling is not a one-hour horizontal assembly. Please provide the drywall on both sides of the ceiling framing members over the elevator machinery room. An elevator machinery room is required to be separated from the remainder of the building by fire barriers (706) and horizontal assemblies (711). Please detail how these ratings will be maintained for the mechanical openings shown. CBC 3006.4 Correct the sheet M-5 to show the required smoke and fire dampers at exhaust duct opening and make-up air opening through the fire rated enclosure around the elevator equipment room. PLUMBING (CALIFORNIA PLUMBING CODE) 5. Please correct on the private site plumbing the following items: Provide the site plumbing plans showing the sizes and locations of the gas meters and water meter; and the sizes, routes, and slopes ofthe building sewer, storm drainage system, site gas lines, and site water lines. The Sheets POIO and P011 are incomplete private site plumbing plans for private water system. Private Sewer system, and Private Gas system to complete review ofthe existing and new systems for the existing plus new demands. Please correct to show all piping materials for gas, water and sewer systems; show the sizes and slopes of the new and existing private sewer lines; show the pipe sizes ofthe new and existing gas lines; and show the pipe sizes of the new and existing water lines. (Also, the existing private water, sewer and gas systems seem to all run under the future Youth Ministry Building. Please address.) A) On sheet POIO the 2 inch PVC water main is undersized for the total water demand of 477.25 fixture units. Onlv about 155 flush valve type fixture units may be on a 2 inch PVC water line with maximum 8 feet per second flow rate. Most all of the existing 2 inch PVC water the water mains from the public water meters the branches to each ofthe building connection need to be up sized to minimum 3 inch. Please correct B) On sheet POIO please show the minimum 2% slope for the new 4 Inch building sewer line from the new Chapel Building to the existing 8 inch private sewer main. C) On sheet PO11 please show the developed gas pipe length from the public gas meter to each ofthe gas pressure regulators at each building. 11. Please provide riser or isometric gas line plans. Please complete the gas line plans on sheet P401 to show the following: Carlsbad 102519 4/26/13 C) Correct the gas sediment trap (Dirt Leg) as per the attached. Show the locations of the gas piping sediment traps in the Gas Isometric drawing on sheet P401. Between the gas fired equipment shut-off valve and the gas fired equipment E) SDG&E must review the proposed changes to the medium pressure gas plans. (Provide a letter to the Building Dept from SDG&E.) 12. Provide gas line plans and calculations, showing gas pressures, piping types, pipe lengths, gas demands and pipe sizing method used. UPC Section 1217.0. Correct the gas line sizing calculations on sheets P103 and P401: A) Please show the developed gas pipe lengths used in sizing both the low pressure gas system as per CPC. Table 12-8 and the 5 psi gas system as per CPC. Table 12- 11. As per CPC. Table 12-11 for the new and existing gas demands and the 450 foot or more, developed gas pipe length the 5 psi gas mains are undersized. Please correct B) Please provide cut-sheets and installation instructions for the prefab gas fireplaces and the gas fired BBQ showing the gas demands. 14. The following still have not been corrected: Please provide riser or isometric drain waste and vent plumbing plans clearly show the sizes of all piping and each fixture type. Please correct the drain waste and vent plans on sheet P401: A) Please address the following: Show the required vents for each of the floor drains and for each of the urinals. Please address the following: 1) Still no vent show for the third (unlabled) urinal near the lavatories. 2) Still no vent show for the two floor drains near on the two drain lines from the upper floor near the lavatories. 3) The two floor drains iust down stream from the back to back water closets, need to have minimum 3 inch trap arms for trap arm lengths of more than 60 inches but not more than 72 inches as per CPC. Table 10-1. please correct MECHANICAL (CALIFORNIA MECHANICAL CODE) A) The mechanical plan sheet numbering have been changed. But the mechanical section cross-reference symbols do not show the new sheet numbers. Please correct 23. Please correct the mechanical plans to agree with the reguired outside are amounts shown for the HVAC units in the Eguipment Schedule on sheet M004. The MECH-3C form reguires 3.900 cfm of outside air for the Chapel Assemble (101). But the mechanical plans and Eguipment Schedule on sheet M004. show that FC-10. FC-11 & FC-12 serving the Chapel Assemble (101) supply only 3.000 cfm to the Chapel Assemble (101). Please correct to show the reguired 900 cfm additional outside air. Please correct Please provide the corrected MECH-3-C forms showing the required mechanical ventilation rates for the new or revised conditioned spaces. Coordinate the mechanical schedules & plans and the Title 24 outside air design. CMC 403.0 & Title 24 121(b)2 & (d). The MECH-3C forms on sheet M-3 show required conditioned "Transfer Air" (conditioned outside air) as per column N of MECH-3C forms, but the plans and the MECH-3C forms do not show the source of the required conditioned "Transfer Air". Please correct Carlsbad 102519 4/26/13 24. Please correct the overflow condensate drainage systems shown on the sheets Mill & Ml 12. The overflow condensate drains may not drain to the restrooms. Detail the primary and secondary mechanical condensate waste design: Pipe sizing, routing, and termination areas. UMC 310.0 & UPC 807.2 Correct the secondary (overflow) condensate drainage systems on sheet M-5. The secondary condensate drainage piping may not be combined into a single drain line. And the each secondary condensate drainage discharge location must be "readily observable" by the occupants in the area served by the A/C being served by the overflow condensate drain. Note: If you have any questions regarding this Plumbing and Mechanical plan review list please contact Glen Adamek at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. Carlsbad 102519 4/26/13 Gas supply ifiiet To equipment inlet u. -Tie flttlig Nipple Cap--*-£• 3 in. (80 mm) mininuim L FIGURE 12-1 METHOD OF INSTALLING A TEE FITTING SEDI- MENT TRAP. n F- 1-4 q^.i ,¥.'H.yg- F £q it t f'-Hi >• Ci>^A Page 1 of 4 TO: City of Corlsbad DATE: June 7, 2013 FROM: Timeless Architecture PROJECT: North Coast Calvary Chapel, Phase II 1330 Poinsettia Lane, Carlsbad, CA 92011 SUBJECT: Plan Review No.: 102519 The following responses are relative to the correction list Set III prepared by Esgil Corporation doted 04/26/13 (Plan Reviewer: Chuck Mendenhall). PLEASE NOTE: In reviewing the previous structural calculations we hove discovered that the foundation was originally designed assuming an allowable soil bearing pressure of 1500 psf, while the soils report allows 3000 psf. For this reason we hove had our structural engineer redesign the foundation accordingly, which has engendered a set of auxiliary calculations numbering about 100 pages, two copies of which ore enclosed with this set of responses. The foundation plan (Sheet Sl 11) is the ONLY sheet of these plans that was affected by these revisions. Responses by Item No. STRUCTURAL Coordination notes: a. See structural plan for Shown Nikjoo's stamp and signature. b. Responses hove been coordinated with the plans and calcs. The structural engineer has revised the page numbers. This caused the previous coordination between cole pages and working drawings to be incorrect. The coordination has been revised to reflect the new page numbers. c. References on moment frame sheet S502 have been corrected. d. Copy of soils report with letter of update from geotechnical engineer is provided as a part of these responses to the plan check corrections. See attached. 20. Note 1 on sheet S131 has been revised to reflect the correct detail number 13/S507. 25. See calc pages 281 and 282. 26. Moment frame locations are shown on page 103 of calcs - see also sheet Sl 21 of the construction documents. A. Moment frame resisting lateral loads on line C.l is on original calculations pages 113-119. Please also see pages 2 and 3 of the revised coles doted 5-15-13. Column sizes indicated on original coles page 113 are HSS 12 x 12 x 5/8 below the beam, and HSSl 2 x 12 x '/2 above the beam, which is what is shown on the framing plans, sheets S121 and S131 (see also page 2 of revised calcs doted 5-15- 13). Detail of the moment frame connection shown on 12/S501 - see also frame elevation C.l on sheet S502, and pages 2 and 3 of revised calcs dated 5-15-13. Page 2 of 4 B. Moment frame loading summary is now on pages 147 - 150. Frames F-3 and F-12 ore included on page 147, frames F-4 and F-5 ore included on page 150. C. See details 4, 7 and 10 on sheet S501. See also generic moment frame details on sheet S508. D. Footing and base plate detail 2/S501 has been revised to 1/S501. Note has been added to detail 1/S501 referencing base plate details on sheet S504. All relevant base plate information is provided on details 12-19/S504 and 27/S504. E. Footing and base plate detail 2/S501 has been revised to 1/S501. Detail reference on 1/S501 has been revised - see item D above. F. Coles include the referenced frame designs, as follows: a) Frame F-3: see pages 147, 153, 165, 185 -192 and 286 - 287. b) Frame F-4: see pages 150, 162, 165, 255 - 262 and 286 - 287. ej Frame F-7: see pages 148, 155, 165, 201 - 208 and 286 - 287. G. I find no frame in the coles defined as being along line 2.7. I believe that the referenced frame is Frame F-5, occurring along line 4.7. (Looking only at the gridlines at the bottom of the page, this would make sense). Frame F-5 is on calculation pages 150, 163, 165, 263-270, 286, and 288. H. Pod footing at 1 near A is the Nl footing for frame F-1. Coles for this footing are on page 287 and 290-292, requiring o 5'-3" sq. x 16" deep pad. This equates to PF-5 on the pod footing schedule - see sheet Sill- 5'-3" sq. pad footing is now provided. I. See Calc page 288 for Line B (W10 x 45). The W10 x 45 is not port of a moment frame, and its footing is called out as 4'-0" sq. x 16" deep. The N4 pad for the moment frame F-1 is at 1 -A.6, and is defined as 10'-3" sq. x 21" deep on pages 287 and 293-295, i.e., a PF-10 per the pod footing schedule on sheet Sill. 29. This beam connection has been revised - it now features (8) - 1" 0 A325n m.b.'s with a 1 /2" shear tab, with 3/8" fillet weld - see 10/S505 and beam connection 11 on sheet S121. ELECTRICAL AND ENERGY 1. The following changes primarily resulted from better definitions of the AV loads. A. The service to the Chapel was increase to 500 amps; circuit breakers, wire, voltage drop calculations. B. DPI was increased to 600 amps. C. Load for dimmer rock was added. D. Bldg. Ground was added to DPI. E. Panel L was changed to 225 amps; revised C/B and wire. F. Loads revised on DP2. G. Ground fault added to service entrance circuit breaker. PLUMBING AND MECHANICAL * ARCHITECTURAL PME Page 3 of 4 1. All sheets hove been stamped and signed. 3. b) Entire fireplace, flue and cop systems ore listed under ULl 27. Manufacturer's Installation instructions for both the Heatilator Castlewood 42 and the NDV4842 ore enclosed. 4. The elevator equipment room has been provided with 1 hr. rated walls and ceilings (see revised details 11/A501 and 12/A501) - see also Floor Plan sheet Al 1 and Reflected Ceiling Plan sheet Al 12. * PLUMBING 5. A. Corrected onsite domestic water pipe sizes hove been shown on sheet POIO. B. Note on sheet POIO has been revised to specify min. 2% slope for building sewer line. C. Developed gos pipe lengths hove been added to sheet POl 1. 11. See sheet P401. C. Gas piping sediment valve has been revised on isometric between water heater appliance and shut-off valve as per Fig. 12-1. Please note that gos fireplaces and outdoor grilles ore not required to have sediment traps per CPC Sec. 1212.7. E. Letter of review from SDG&E attached. 12. See sheets P103 and P401. A. Developed gas pipe lengths hove been shown on Site Gas plan POl 1. Low pressure gos per CPC Table 12-8 has been sized using 190' (200 or less) for the longest run from pressure regulator (per CPC Sec. 1217.1.3 for hybrid pressure), while the 5 psi gas system per CPC Table 12-11 has been sized using 423' (450 or less) for the longest run from gas meter to the most remote pressure regulator. B. Cut sheets and installation instructions for fireplaces and barbecue hove been included as a part of these plan check corrections. 14. See sheet P401. A. Floor drains and urinals hove been connected to vents. 1. All urinals now show vents, including third urinal (now labeled). 2. Floor drains ore now showing vents. 3. Trap arms hove been shortened to 59" - see sheets P102 and P401. * MECHANICAL A. Mechanical Section reference symbols hove been corrected. 23. See sheet M004 - Units FC 10, FC 11 and FC 12 on the Equipment Schedule have been revised to require a min. 1300 O.S.A. each in order to provide the 3,900 cfm OS per the MECH-3C form. Page 4 of 4 24. Condensate drains hove been revised - see sheets Ml 11, Ml 21, and details 22/A508, 3/M502 and 6/M502. EsGil Corporation In PartnersHip witH government for (BuiCding Safety DATE: 6/16/11 JURISDICTION: Carlsbad aTOFTREVIEWER • FILE PLANCHECKNO.: 102519 SET: II 50 PROJECTADDRESS: 1330 Poinsettia Lane PROJECT NAME: North Coast Calvary Chapel, Phase II I I The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. I I The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. n > I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. X The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. I I The applicant's copy of the check list is enclosed for the jurisdiction to fonward to the applicant contact person. X The applicant's copy of the check list has been sent to: Timeless Architecture, Att'n: Jim Thayer 9891 In/ine Center Dr., Suite 140, In/ine, CA 92618 I I Esgil Corporation staff did not advise the applicant that the plan check has been completed. IX Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Jim Thayer Telephone #: (949) 831-81-10 Date contacted: U F^%FM Fax #: 0949) 951-2820 Mail i^/^elephone Fax \F^x\ Person • REMARKS: By: Chuck Mendenhall Enclosures: EsGil Corporation 13 GA Kl EJ • PC 6/8/11 9320 Chesapeake Drive, Suite 208 • San Diego, Califomia 92123 • (858)560-1468 • Fax (858) 560-1576 Carlsbad 102519 6/16/11 NOTE: The items listed below are from the previous correction list These remaining items have not been adequately addressed. The numbers ofthe items are from the previous check list and may not necessarily be in sequence. The notes In bold font are current Please make all corrections, as requested in the correction list. Submit FOUR new complete sets of plans for commercial/industrial projects (THREE sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: 1. Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760) 602-2700. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. 2. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. . ARCHITECTURAL LIFE SAFETY REVIEW All OK • STRUCTURAL 20. Note 'C on sheet SI 31 references detail 19 indicates " Heavy Timber Wood Truss 19/A501". Detail 19/A501 does not depict the HT roof trusses. The structural plans contain no details for the HT wood trusses shown on sheet SI 31. Provide complete structural details for the HT wood trusses spanning 40ft above the chapel area. See pages 9 thru 18 ofthe calc's.. Revise Note #1 on sheet SI 31 to reference the details on sheet S507 for construction ofthe HT trusses. Include in detail 15/S507 the connection ofthe HSSl 2X12 column to the bottom chord of the HT truss which is an 8X10 RS wood member. 25. Provide complete structural details for the curved roof trellis located at the 2"'' floor circulation deck. See architectural section R/A304. & 13/A401. There are no structural details for the members sizes or the connections between members. See structural calc's, pages 205 & 206. The response indicates " Details provided" . There are no details for this circular structure. The architectural plans depict what is proposed but the structural detailing is incomplete. Detail the size of the knee braces and the connection of the knee braces to the column and curved HSS4X8X1/4. Clarify how the vertical column HSS6X6X1/4 shown in 13/S506 is supported at the top. It doesn't appear that there is any horiz. Support member for the columns. See the framing shown on sheet SI31. 26. The location of the lateral resisting system comprised of moment frames at the first level are shown on page 124 ofthe calc's. the location shown in the calc's looks nothing like what is shown on the plans on sheets S111 & S112. Provide a design consistent with the plans. The rotational analysis of the rigid diaphragm at the 2"^ floor is design based on the location of the moment frames shown on sheet 123 of the calc's. These locations do not match what is shown on the plans. The response is " Plans modified to show the location of the frames consistent with the calculations." The frame locations are shown on page 91 of Carlsbad 102519 6/16/11 the design calc's. The following applies to the frames as designed in the calc's and shown on the plans: A. The moment frame resisting lateral loads along grid line C.l at the balcony is design on pages 102 thru 106. The column sizes are very different on the plans than the design . Provide design that is consistent with the plans. Also, Include in this design of this frame the connection ofthe beams to the HSS12X12X1/2 columns and include on the plans a detail of this moment connection. B. The moment frame loading summary found on pages 135 thru 137 does not include frames F3, F4, F5 & F12 as shown on page 91 ofthe calc's. Include in the calc's a loading summary for frames F3, F4, F5 & F12. C. In all cases the moment frame connection between the columns and beam are referenced to detail 15/S501 on the frame elevations on sheet S502. this detail is generic and satisfactory but it does not address the welding of the continuity plates to the column web and does not address the need for column web doubler plates. The computer design of the connection for code compliance in all cases requires doubler plates and welding of the continuity plates to the column web. The sizes of these welds and doubler plates vary for each of the frames. How do you intend to address the additional details for each of the frames? D. The typical frame base plates are referenced on sheet S502 to the typical detail 2/S501. this detail does not include information for the base plate such as dimensions, thickness, welding of the base plate to the columns and the number and size of the anchor bolts. E. Detail 2/S501 includes a section detail ofthe base plate referenced to 29/S501. There is no detail 29/S501. F. The frame design on pages 138 thru 147 in the calc's does not include the frames F7 along line 2 between C-D , frame F3 along grid line 1 between D.5 -D.S and frame F-4 along grid line D.5 between 4-5. G. The frame design on page 146 ofthe calc's includes a frame along line 2.7.1 find no frame on sheet Al 21 ofthe plans along grid line 2.7. Please clarify. H. The foundation design for the spread footings is found on page 217 of the calc's. The footing at line ^ @A must be 5'-0" sq. The plans list footing as PF-3 on sheet S111 which is only 4'6" sq. I. The foundation design on page 217 requires the spread footing as line 1(g B to be 9'-6" sq. The plans show the spread footing at this location to be PF-2 or 4'-0" sq. The organization and accuracy of the calculations and consistency with the plans should be carefully reviewed by the engineer of record prior to resubmittal for recheck 29. Beam #11 design found on page 47 of the calc's does not include any concentrated loads. The plans show that the 2""^ floor roof beam is supported on beam #11 at approx. 7ft from tl end support. Include in the design of this beam the concentrated loads from the roof above Carlsbad 102519 6/16/11 The design ofthis beam now shows the reactions of 117.5K and 116K. See page 22 of the current calc's summary of loading and reactions. The connection ofthis beam to the web of the support columns is detailed in 10/S505 as referenced on sheet SI 21. This connection shows 6-1" A325 single shear bolts and a 7/16" shear tab. The capacity of this connection base on the AISC Tables for single shear connections is only 82.2K. Also the weld between the shear tab and web must be min. 3/8" fillet weld as listed in the AISC shear connection tables. END OF STRUCTURAL RECHECK To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, calculation page, etc. The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Chuck Mendenhall at Esgil Corporation. Thank you. ELECTRICAL and ENERGY RECHECK PLAN REVIEWER: Eric Jensen ELECTRICAL (2005 NATIONAL ELECTRICAL CODE) 1. Include the sen/ice location on the site plan. If the distance from the service to the chapel disconnecting means exceeds 150', provide feeder voltage drop calculations. It seems that the conductor length is 184' (on sheet E010 & E002 (voltage drop calculation) but 782' on the single line and (scaled) on the site plan about 550'? VD calculation is at 2% I think forthe 184' length, I'm not sure what it'd be @ 550'? ENERGY CONSERVATION 2. The wall assembly type on the ENV-IC is the "metal framed" not the wood framed used on the ENV-IC forms. Please review. 3. Include the demand control specification on the mechanical schedules for the appropriate mechanical equipment. Correct the Note on sheet M-11 to include all units requinng DCV by the energy run. 4. The MECH-3C form lists large amounts of transfer air. Please review this form and reevaluate the source of transfer air available. What is the transfer air source forthe outside air in the assembly location? Note: If you have any questions regarding this Electrical and Energy plan review list please contact Eric Jensen at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. PLUMBING AND MECHANICAL RECHECK Carlsbad 102519 6/16/11 • JURISDICTION: Carlsbad DATE: 6/13/2011 • PLAN REVIEW NUMBER: 102519 SET: II PLAN REVIEWER: Glen Adamek GENERAL AND ARCHITECTURAL PME ITEMS 1. The final set of corrected drawings to be reviewed for signing and sealing just before the permits are to be issued. Each sheet of the plans must be signed by the person responsible for their preparation, even though there are no structural changes, before the permits are issued. Business and Professions Code. 3. Please provide listing data, installation instructions, and design calculations for the proposed Heatilator "Castlewood 42" exterior fireplace in detail 17 on sheet A505 and details 9 & 10 on sheet A401; and provide listing data, installation instructions, and design calculations forthe proposed interior fireplace in details 15 & 17 on sheet A401. B) Please provide listing data and installation instructions for the proposed prefab chimney caps to be installed under the tile roof systems. Chimney flue caps must extent to "above the roof system" or per the installation instruction of the listed prefab chimney cap. C) Please provide listing data and installation instructions for the prefab metal flue systems. 4. An elevator machinery room is required to be separated from the remainder of the building by fire barriers (706) and horizontal assemblies (711). Please detail how these ratings will be maintained for the mechanical openings shown. CBC 3006.4 Correct the sheet M-5 to show the required smoke and fire dampers at exhaust duct opening and make-up air opening through the fire rated enclosure around the elevator equipment room. PLUMBING (2010 CALIFORNIA PLUMBING CODE) 5. Provide the site plumbing plans showing the sizes and locations of the gas meters and water meter; and the sizes, routes, and slopes ofthe building sewer, storm drainage system, site gas lines, and site water lines. The Sheets POIO and P011 are incomplete private site plumbing plans for private water system. Private Sewer system, and Private Gas system to complete review of the existing and new systems for the existing plus new demands. Please correct to show all piping materials for gas, water and sewer systems; show the sizes and slopes ofthe new and existing private sewer lines; show the pipe sizes ofthe new and existing gas lines; and show the pipe sizes ofthe new and existing water lines. (Also, the existing private water, sewer and gas systems seem to all run under the future Youth Ministry Building. Please address.) The water line sizing calculations on sheet POOI show two 2 inch public water meters but sheet POIO shows only a single 2 inch public water meter. Please correct to agree. 7. Please show the upstream sewer manhole rim and finished floor elevations. Provide backwater valves for all fixtures installed on floor levels below the next upstream manhole rim elevation. (Only fixtures installed on floor levels below the next upstream manhole rim elevation may flow through a backwater valve.) UPC 710.1. The plans do not show any Carlsbad 102519 6/16/11 sewer manholes on the private site sewer system on sheets POIO and P011. Note, as per the private sewer plans all manholes on the public sewer system are downstream of the connections between the separate buildings on the private sewer system. Please correct 11. Please provide riser or isometric gas line plans. Please complete the gas line plans on sheet P401 to show the following: A) Show the existing and new gas line sizes from the public gas meter to the new gas fixtures. And the existing plus new gas demands on the existing gas lines. B) Show the locations of all required gas pressure regulators and required vents and gas shut-off valves. C) Show the locations of the gas piping sediment traps in the Gas Isometric drawing on sheet P401. Between the gas fired equipment shut-off valve and the gas fired equipment D) Show the locations of the required manual gas shut-off valves as per CPC, Section 1211.10. E) SDG&E must review the proposed changes to the medium pressure gas plans. 12. Provide gas line plans and calculations, showing gas pressures, piping types, pipe lengths, gas demands and pipe sizing method used. UPC Section 1217.0. Correct the gas line sizing calculations on sheets PI03 and P401: A) Correct the gas rating used as per SDG&E In Btu per cubic foot Plans and calculations show the gas is rated at 1,100 Btu per cubic foot But SDG&E gas is only rated at between 1,000 to 1,050 Btu per cubic foot Please correct B) Provide cut-sheets and installation instructions for the prefab gas fireplaces and the gas fired water heater to show they are designed to use the 5 psi medium pressure gas, or redesign the gas system for low pressure gas systems showing gas pressure regulators. C) Clearly show all existing plus new gas demands on the existing gas system. (Provide a letter to the Building Dept from SDG&E. 14. Please provide riser or isometric drain waste and vent plumbing plans clearly show the sizes of all piping and each fixture type. Please correct the drain waste and vent plans on sheet P401: A) Show the required vents for each of the floor drains and for each of the urinals. B) Correct the size of the cleanout near the janitor's sink on the 4 inch drain line. As per CPC, Table 7-6 the VA inch cleanout is undersized. 16. All water closet seats, except those within dwelling units, shall be of the open front type or have an automatic seat cover dispenser, as per UPC, Section 408.2.2. Please show in the plumbing fixture schedule "the make and model of the toilet seat with automatic seat cover dispenser" called out in the Notes #32 on sheet POOL MECHANICAL (2010 CALIFORNIA MECHANICAL CODE) Carlsbad 102519 6716711 21. Provide exhaust ventilation as per UMC, Section 403.7 and Table 4.4. The plans and the response do not address the required exhaust fan for Janitor's Room #111. Please correct 23. Please provide the corrected MECH-3-C forms showing the required mechanical ventilation rates forthe new or revised conditioned spaces. Coordinate the mechanical schedules & plans and the Title 24 outside air design. CMC 403.0 & Title 24 121(b)2 & (d). The MECH-3C forms on sheet M-3 show required conditioned "Transfer Air" (conditioned outside air) as per column N of MECH-3C forms, but the plans and the MECH-3C forms do not show the source ofthe required conditioned "Transfer Air". Please correct 24. Detail the primary and secondary mechanical condensate waste design: Pipe sizing, routing, and termination areas. UMC 310.0 & UPC 807.2 Correct the secondary (overflow) condensate drainage systems on sheet M-5. The secondary condensate drainage piping may not be combined into a single drain line. And the each secondary condensate drainage discharge location must be "readily observable" by the occupants in the area served by the A/C being served by the overflow condensate drain. Note: If you have any questions regarding this Plumbing and Mechanical plan review list please contact Glen Adamek at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. EsGil Corporation * In (PartnersHip witH government for (BuiCding Safety DATE: 1110111 • APPI ICANT JURISDICTION: Carlsbad • PLANREVIEWER • FILE PLANCHECKNO.: 102519 SET: I PROJECTADDRESS: 13^0 Poinsettia Lane PROJECT NAME: North Coast Calvary Chapel, Phase II I I The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's codes. I I The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. I I The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. X The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. I I The applicant's copy of the check list is enclosed for the jurisdiction to fonward to the applicant contact person. ^ The applicant's copy of the check list has been sent to: Timeless Architecture, Att'n: Jim Thayer 9891 In/ine Center Dr., Suite 140, Irvine, CA 92618 I I Esgil Corporation staff did not advise the applicant that the plan check has been completed. Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: .Jim Thayer Telephone #: (949) 831-8110 Date contacted: ' H^ff^ {by/^ Fax #: 0949) 951-2820 Mail VTelephone Fax Person • REMARKS: By: Chuck Mendenhall Enclosures: EsGil Corporation IEI GA S EJ • PC 12/27/10 9320 Chesapeake Drive, Suite 208 • San Diego, Califomia 92123 • (858)560-1468 • Fax (858) 560-1576 Carlsbad 102519 1/10/11 PLAN REVIEW CORRECTION LIST COMMERCIAL PLANCHECKNO.: 102519 JURISDICTION: Carlsbad OCCUPANCY: A-3 USE: Youth Center and Assembly Chapel TYPE OF CONSTRUCTION: III A ACTUAL AREA: 17,972 sq ft ALLOWABLE FLOOR AREA: 23,800 STORIES: two HEIGHT: Bldg = 31ft approx. per CBC Tower= 52 ft at top SPRINKLERS?: Yes OCCUPANT LOAD: 810 REMARKS: Automatic fire sprinklers used as substitute for one hour const. CBC Table 601, FN e DATE PLANS RECEIVED BY JURISDICTION: DATE PLANS RECEIVED BY ESGIL CORPORATION: 12/27/10 DATE INITIAL PLAN REVIEW COMPLETED: 1/10/11 PLAN REVIEWER: Chuck Mendenhall FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the International Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and access for the disabled. This plan review is based on regulations enforced by the Building Department. You may have other corrections based on laws and ordinances enforced by the Planning Department, Engineering Department, Fire Department or other departments. Clearance from those departments may be required prior to the issuance of a building permit. Code sections cited are based on the 2007 CBC, which adopts the 2006 IBC. The following items listed need clarification, modification or change. All items must be satisfied before the plans will be in conformance with the cited codes and regulations. Per Sec. 105.4 of the 2006 International Building Code, the approval of the plans does not permit the violation of any state, county or city law. To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e.. plan sheet number, specification section, etc. Be sure to enclose the marked up list when you submit the revised plans. Carlsbad 102519 1/10/11. ' • Please make all corrections, as requested in the correction list. Submit FOUR new complete sets of plans for commercial/industrial projects (THREE sets of plans for residential projects). For expeditious processing, corrected sets can be submitted in one of two ways: 1. Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 1635 Faraday Ave., Carlsbad, CA 92008, (760) 602- 2700. The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments. 2. Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (858) 560-1468. Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments. NOTE: Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete. 1. All sheets of the plans are required to be signed by the licensed architect or engineer responsible for the plan preparation. 2. Provide a statement on the Title Sheet of the plans, stating that this project shall comply with the 2007 California Building Code, which adopts the 2006 IBC, 2006 UMC, 2006 UPC and the 2005 NEC. 3. The building information found on the cover sheet of the plans lists the building occupancy as A-3, type II-A construction. You have analyzed the allowable area as a non-separated use per CBC Section 508.3.2 ( You have shown 'E' occupancies on the 2"'' floor on sheet A121) NOTE as part ofthe area analysis that the building is being considered "non-separated" use per CBC 508.3.2. 4. The type of construction is listed a lll-A (fire rated ) but you have chosen to use automatic fire sprinklers in lie of the actual one hour construction required by Table 601. Footnote 'e' in Table 601 indicates that fire sprinklers may be used as a substitute for fire rated construction " if no othenwise required by this code". Code section 903.2.1.3 requires fire sprinklers in an A-3 occupancy with a "Fire Area" greater than 12,000 sq ft or an occupant load > 300 in each fire area. Include as part of the area analysis the location of the fire areas and clearly show the required fire walls or fire barriers that will enclose the fire areas per code section 702.1. 5. You have labeled the 2"'^ floor areas on sheet A121 as 'E' occupancies. Are these areas to be used for full time education as described in CBC Section 305.1? Religious education accessory to the main place of worship is considered an A-3 occupancy not an 'E' assuming the occupant load is less than 100. 6. When two or more buildings are on the same property, the buildings shall have an assumed property line between them forthe purpose of determining the required wall and opening protection and roof cover requirements, per Section 704.3. An exception is provided ifthe combined area ofthe buildings is within the limits specified in Chapter 5 for a single building. If this exception is used, show how the building(s) will comply. Section 503.1.2. Include on the site plans the distance between the proposed Chapel and the existing Children's Carlsbad 102519 1/10/11 Ministry Bldg. Note that Table 602 requires min. of SOft to a P/L or imaginary P/L between buildings in orderto have non rated exterior walls. 7. 8. 10. Incidental use areas may need to be separated from the main occupancy. See Table 508.2 below. Please address the following specific areas: Storage room 106, storage room 207. The walls of these room must extend to the floor or roof deck and the doors must be self closing. ROOM OR AREA SEPARATION AND/OR PROTECTION Storage rooms over 100 square feet 1 hour or provide automatic fire-extinguishing system The elevator equipment room must be 1 HR fire rated (walls and ceiling ) per CBC Section 3006.4. The door to the elevator equipment room 1 HR rated, self closing. EXITS All doors and gates, within the exit path to a public way from an occupancy of Group A or E having an occupant load of 50 or more shall not be provided with latches or locks unless they are equipped with panic hardware. Sections 1008.1.9 and 1002. Doors 105B, 109B, 104F all must be equipped with panic hardware. When additional doors are provided for egress purposes, they also shall conform to the requirements of Section 1008 (width, swing, hardware, etc.). Section 1008.1. There shall be no enclosed usable space under exterior exit stainways, unless the space is completely enclosed in 1-hour fire-rated construction. Section 1009.5.3. This applies to storage area 116 beneath exterior stairs. ROOFS 11. Specify on the plans the following information for the roof and roof deck materials, per Section 1506.3: This applies to the flat roof area above Rm 205, The exterior deck areas above the Multipurpose room, and the tile roof areas. • Manufacturer's name. • Product name/number. • ICC approval number, or equal. 12. How do you intend to provide the required overflow drains for the roof / deck areas with multiple drains? See A131 ofthe plans. • FIRE ALARMS 13. Note on the plans that A Fire Alarm System shall be installed under the following conditions, per Section 907 (see exceptions): • Group A occupancies having an occupant load of 300 or more. DISABLED ACCESS REVIEW LIST DEPARTMENT OF STATE ARCHITECT TITLE 24 Carlsbad 102519 1/10/11 14. The seating diagram on sheet Al 13 shows that you intend to install a platform within room 104. provide disabled accessible ramp to the top ofthe platform. Ramps shall have a minimum width of 48 inches, per Section 1133B.5.2. Where a ramp serves as the only exit discharge path and serves an occupant load of 300 or more, the minimum clear width shall be 60 inches. ACCESSIBLE MEANS OF EGRESS (IBC Section 1007) Note: Previously, Refuge Areas were not required in buildings having supervised sprinkler systems. This is no longer the case (except for most 2 story buildings). 15. Accessible means of egress shall be continuous to the public way and shall consist of the following components, per CBC Section 1007.2, as applicable: a) Stairs. Section 1007.3. i) Where an exit stainway is open to the exterior, the accessible means of egress shall include either an area of refuge or an exterior area for assisted rescue. Section 1007.2. b) Exterior Areas for Assisted Rescue. Sections 1007.8. i) If exterior areas are used for assisted rescue, they must comply with the size requirements for Areas of Refuge in Section 1007.6.1. ii) Where walls or openings are between the exterior areas and the interior of the building, the building exterior walls within 10' horizontally ofa nonrated wall or unprotected opening shall have a fire-resistance rating of not less than 1 hour. Openings within such exterior walls shall have a rating of not less than ^X-hour. This construction shall extend vertically from the ground to a point 10' above the floor level of the area for assisted rescue (or to the roof line, whichever is lower). Section 1007.8. iii) Exterior stainways that are part of the exterior area for assisted rescue shall provide a clear width of 48" between handrails. There is no exception to this requirement, even ifthe building has a sprinkler system. Carlsbad 102519 1/10/11 1 o 48- MIN , MANEUVERING CLEARANCE PER ICC A117.1 CLEAR BETWEEN HANDRAILS 60" MIN. PER ALCOVE PROVISIONS INICCAt17,1 GUARD PER SECTION 1013.1 . F^jTERIORftREAQE RESCUE ASSISTANCE EXTERIOR AREA OF RESCUE ASSISTANCE '/.-HOUR OPENING PROTECTIVE 1-HOUR PROTECTION '/.-HOUR OPENING PROTECTIVE 10'-0' MIN. OR ROOF LINE RESCUE ASSISTANCE EXTERIOR AREA OF RESCUE ASSISTANCE SINGLE ACCOMMODATION FACILITIES 16. Doors in the room shall not swing into the clear floor space required for any fixture. Maintain the required clearances at the lavatory/water closet without the entry door swinging into those areas. Section 1115B.3.2.2. Detail 10/A401 shows the single accommodation rest room doors swing into the required fixture clear space. Carlsbad 102519 1/10/11 • COUNTERS 17. The tops of counters shall be 28" to 34" from the floor. The disabled access section of counter shall be located at a section of counter that is at least 36" wide and no more than 28" to 34" high. Section 1122B.4. See sen/ing counters shown in details 3 & 4 on sheet A401. END OF ARCHITECTURAL LIFE SAFETY REVIEW STRUCTURAL 18 Foundation note #11 on sheet S111 indicates " See details 2,3,4 & 5 on sheet S502 for column base plates". Sheet S502-D3 does not include any details 2, 3, 4 5 depicting base plates. Please clarify. 19 The moment frame elevations found on sheet S502-D3 reference the frame location by grid number. There are no grid line designations found on the foundation plan, sheet S111, or the framing plan, sheet SI21, SI 31. Include on the foundation and framing plans the grid line locations consistent with the referencing listed on sheet 502-D3. 20 Note 'C on sheet SI 31 references detail 19 indicates " Heavy Timber Wood Truss 19/A501". Detail 19/A501 does not depict the HT roof trusses. The structural plans contain no details for the HT wood trusses shown on sheet SI 31. Provide complete structural details for the HT wood trusses spanning 40ft above the chapel area. See pages 9 thru 18 ofthe calc's.. 21 Provide manufacturers design and construction information for the" RED-L roof joists shown on sheet A131 or provide the ICC approval number for this product. 22 Provide truss details and truss calculations for manufactured trusses shown on sheet S131. Specify on the plans the truss identification numbers. 23 Please provide evidence that the engineer-of-record (or architect) has reviewed the truss calculation package prepared by others (i.e., a "review" stamp on the truss calculations or a letter). Section Al 06.3.4.1. 24 Detail 9/S506 lists the trellis roof beams as "Corten" steel beams. What are "Corten" steel beams? Provide manufacturers structural details and specification for these beams. 25 Provide complete structural details for the curved roof trellis located at the 2"" floor circulation deck. See architectural section R/A304. & 13/A401. There are no structural details for the members sizes or the connections between members. See structural calc's, pages 205 & 206. 26 The location of the lateral resisting system comprised of moment frames at the first level are shown on page 124 ofthe calc's. the location shown in the calc's looks nothing like what is shown on the plans on sheets S111 & S112. Provide a design consistent with the plans. The rotational analysis ofthe rigid diaphragm at the 2"^ floor is design based on the location ofthe moment frames shown on sheet 123 of the calc's. These locations do not match what is shown on the plans. Carlsbad 102519 1/10/11 27 • Specify the size of the headers at the 2"*^ floor light gauge steel framing. See page 6 of the design calc's. 28 The foundation design found on page 210 of the calc's references the footing location by line numbers. Provide a plan schematic that includes the lines numbers as used in the calc's. Without the specific locations referenced there is no way for me to accurately determine where on the foundation plan you are referencing or whether the design is consistent with the plans. 29 Beam #11 design found on page 47 of the calc's does not include any concentrated loads. The plans show that the 2"*^ floor roof beam is supported on beam #11 at approx. 7ft from tl end support. Include in the design ofthis beam the concentrated loads from the roof above 30 The roof framing plan on sheet SI 31 indicates "Moment Frame Below" between the support columns of the wood trusses over the raised roof of the chapel. What is meant by "Moment Frames Below"? Where are these moment frames detailed on the plans. 31 The lateral design of the Chapel with raised roof assumes the columns resist lateral loads by cantilever actions. The surrounding lower system resist lateral loads by moment frames. Provide seismic separation between the two systems. If you do not include a seismic separation clearly show that the cantilevered column loads include a contribution from the surrounding lower diaphragm that is supported by moment frames. ASCE 7-05 12.12.3. See pages 89 thru 94 of the design calc's. 32 A complete review of the structural design will be made when the above items have been addressed. The review was a cursory review based on what could be determined from the plans. There was no grid system shown on the plans and no schematic provided in the calc's that would allow a reference between the plans and calc's. A complete review ofthe lateral design and foundation design will be made after the grid references and foundation line references used in the calc'[s are included on the plans or as part ofthe calc's. 33 Provide a Table of Contents at the beginning of the design calculation book to clearly show where the various parts ofthe structural design can be found. END OF STRUCTURAL REVIEW To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i.e., plan sheet, note or detail number, calculation page, etc. The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the plan review for your project. If you have any questions regarding these plan review items, please contact Chuck Mendenhall at Esgil Corporation. Thank you. ELECTRICAL and ENERGY COMMENTS PLAN REVIEWER: Eric Jensen ELECTRICAL (2005 NATIONAL ELECTRICAL CODE) Carlsbad 102519 1/10/11 1. • Include the service location on the site plan. If the distance from the service to the chapel disconnecting means exceeds 150', provide feeder voltage drop calculations. 2. Provide the location for panelboard "P2" on the floorplans. Note: There is an additional panel ("GD") shown installed onto the existing electrical system on the single line diagram. Where is this panel located? 3. The mechanical equipment is provided ("M" sheets). Reevaluate the electrical design: Mechanical equipment is listed as "future". Include OC device protection, GFCI receptacles @ roof), fan coil circuiting, disconnect sizing, and the rooftop branch circuit sizing as appropriate. ENERGY CONSERVATION 4. Correct the lighting form LTG-IC, it's not a list of installed lighting as much as an allowance of installed lighting? 5. Judging from the PERF form, the area does include the unimproved area locations for density however no appreciate lighting is shown in these areas (second floor). Please address. 6. Rerun the EnergyPro software with a current edition: The 5.0 version has not been acceptable since August 2010. 7. The energy forms show a large instantaneous water heater, the plumbing does not show this type of heater. Please coordinate design. 8. Include the demand control specification on the mechanical schedules for the appropriate mechanical equipment. 9. The MECH-3C form lists large amounts of transfer air. Please review this form and reevaluate the source of transfer air available. Note: Ifyou have any questions regarding this Electrical and Energy plan review list please contact Eric Jensen at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. PLUMBING AND MECHANICAL CORRECTIONS • JURISDICTION: Carlsbad DATE: 1/6/2011 • PLAN REVIEW NUMBER: 102519 SET: I PLAN REVIEWER: Glen Adamek GENERAL AND ARCHITECTURAL PME ITEMS 1. The final set of corrected drawinqs to be reviewed for siqninq and sealing iust before the permits are to be issued. Each sheet of the plans must be signed by the person responsible for their preparation, even though there are no structural changes, before the permits are issued. Business and Professions Code. 2. Please correct the drawings to show the required 42 inch tall "Guards" (guard rails) as per IBC, Section 1013.5: "Where appliances, equipment, fans, roof hatch openings or other Carlsbad 102519 1/10/11 components that require sen/ice are located within 10 feet of a roof edge or open side of a walking surface..." 3. Please provide listing data and design calculations for the fireplace in detail 17 on sheet A505. a) Provide engineers design for the concrete and brick firebox and smoke chamber. Show the required steel, concrete thickness, footing design, and post, beam, floor and hold- down construction for the complete fireplace construction design. b) The wood members may not be in the field constructed cap (roof) over the fireplace flue discharge. c) Please provide listing data and installation instructions for the prefab metal flue system. 4. An elevator machinery room is required to be separated from the remainder of the building by fire barriers (706) and horizontal assemblies (711). Please detail how these ratings will be maintained for the mechanical openings shown. IBC 3006.4 PLUMBING (2006 UNIFORM PLUMBING CODE) 5. Provide the site plumbing plans showing the sizes and locations ofthe gas meters and water meter; and the sizes, routes, and slopes ofthe building sewer, storm drainage system, site gas lines, and site water lines. 6. Identify the extent of the private sewer, water, and gas systems on the plumbing site plan. Clearly specify, on the plans, which City Department is responsible for the permitting, plan check, and inspections for the private utility systems. If private, the responsibility of the City Building Department, and under the Uniform Plumbing Code, provide complete civil site utility plans for plan check, or obtain a separate permit from the City for the civil site plans. 7. Please show the upstream sewer manhole rim and finished floor elevations. Provide backwater valves for all fixtures installed on floor levels below the next upstream manhole rim elevation. (Only fixtures installed on floor levels below the next upstream manhole rim elevation may flow through a backwater valve.) UPC 710.1 8. Provide a plumbing material schedule on the plans describing the following systems: Potable water piping, the drain, waste, and vent piping, gas piping, and the roof drains. 9. Provide Separate Facilities for each sex as per UPC, Section 412.3. Detail the separate male and female restrooms at the upper floor level. 10. Correct the calculations on sheet POOI to show compliance with UPC Section 412.0 & Table 4-1, (Minimum Plumbing Facilities). Please address the required number of men's urinals and men's water closets. It seems minimum ofthree men's urinals are required and only two have been provided. 11. Please provide riser or isometric gas line plans. 12. Provide gas line plans and calculations, showing gas pressures, piping types, pipe lengths, gas demands and pipe sizing method used. UPC Section 1217.0. Carlsbad 102519 1/10/11 13r Include the gas piping sediment trap installed as close as possible to the appliance inlet with the plumbing design. Exceptions: Appliances with an internal sediment trap,(or) ranges, clothes dryers, gas fireplaces, and outdoor grilles. UPC 1212.7. 14. Please provide riser or isometric drain waste and vent plumbing plans clearly show the sizes of all piping and each fixture type. 15. On the water line plans please clearly show the locations of the Thermostatic Mixing Valves as called for in the Note: #63 on sheet POOI. Hot water supplied to a public use lavatory is limited to a maximum temperature potential of 120 degrees. Detail how this temperature limitation is achieved. Note: The water heater thermostat may not be used for compliance with this Code section. UPC 413.1. 16. All water closet seats, except those within dwelling units, shall be of the open front type or have an automatic seat cover dispenser, as per UPC, Section 408.2.2. 17. New or relocated water closets and associated flushometer valves, if any, shall use no more than 1.6 gallons per flush, UPC, Sections 402.1 & 402.2; and shall meet performance standards, established by the American National Standards Institute Standard Al 12.19.2, H & S Code, Section 17921.3(b). 18. New or relocated urinals and associated flushometer valves, if any, shall use no more than one gallon per flush, UPC, Section 402.1 & 402.3; and shall meet performance standards established by the American National Standards Institute Standard A112.19.2. H&S Code, Section 17921.3(b). 19. Floors shall slope to the floor drain(s) location(s). Please detail on the architectural floor plans. UPC 411.4 20. Detail how the floor drain trap seal is to be maintained. UPC 1007.0 MECHANICAL (2006 UNIFORM MECHANICAL CODE) 21. Provide exhaust ventilation as per UMC, Section 403.7 and Table 4.4. 22. Provide smoke detection in the supply air duct of an "air-moving system" for required shut-off of equipment for smoke control. UMC Section 609.0 An "air-moving system" is a system designed to provide heating, cooling, or ventilation in which one or more air-handling units are used to supply air to a common space or to draw air from a common plenum or space. UMC Section 203.0 23. Please provide the corrected MECH-3-C forms showing the required mechanical ventilation rates for the new or revised conditioned spaces. Coordinate the mechanical schedules & plans and the Title 24 outside air design. CMC 403.0 & Title 24 121 (b)2 & (d). 24. Detail the primary and secondary mechanical condensate waste design: Pipe sizing, routing, and termination areas. UMC 310.0 & UPC 807.2 25. Provide the independent ventilation or the air conditioning system required for the elevator equipment room to prevent the overheating ofthe electrical equipment. IBC 3006.2 Carlsbad 102519 1/10/lL Note:'If you have any questions regarding this Plumbing and Mechanical plan review list please contact Glen Adamek at (858) 560-1468. To speed the review process, note on this list (or a copy) where the corrected items have been addressed on the plans. Carlsbad 102519 1/10/11 [DO NOT PAY- THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLANCHECKNO.: 102519 PREPARED BY: Chuck Mendenhall DATE: 1/10/11 BUILDING ADDRESS: 1330 Poinsettia Lane BUILDING OCCUPANCY: A-3 TYPE OF CONSTRUCTION: III A BUILDING PORTION AREA ( Sq. Ft) Valuation Multiplier Reg. Mod. VALUE ($) Chapel 17972 87.79 1,577,762 canopies 1284 8.87 11,389 Decks 3895 14.41 56,127 Air Conditioning 17972 4.66 83,750 Fire Sprinklers 17972 2.88 51,759 TOTAL VALUE 1,780,787 Jurisdiction Code cb By Ordinance Bldg. Permit Fee by Ordinance • $5,246.74 Plan Checic Fee by Ordinance Type of Review; I I Repetitive Fee Repeats • Complete Review • Other |—I Hourly EsGil Fee • Structural Only Hr. @ * $3,410.38 $2,938.17 Comments: Sheet 1 of 1 macvalue.doc + PLAN CHECK PLAN CHECK Community & Economic ^ ^^^^ ^ CITY OF REVIEW Development Department 1635 FaradayAvenue CARLSBAD TRANSMITTAL Carlsbad CA 92008 www.carlsbadca.gov DATE: 7/17/2013 PROJECT NAME: NORTH COAST CALVARY_CHAPEL BUILDING PLAN CHECK NO: CBI 0-2519 SET#: IV ADDRESS: 1350 POINSETTIA LN VALUATION: $1,962,522 PROJECT ID:MS 04 02 APN: 215-070-49 X SCOPE OF WORK: 17,972 SF TOTAL (CHAPEL,-COFFEE/BOOKSTORE, MULTIPURPOSE ROOM) UPDATED 7/17/2013 This plan check review is complete and has been APPROVED by: LAND DEVELOPIVIENT ENGINEERING DIVISION A Final Inspection by the Land Development Engineering Division is required X Yes No This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check Comments have been sent to: jack@northcoastcaivary.org PLANNING 760-602-4610 Chris Sexton 76(; ' -624 760^602^4675 iiiiiaiiiijz7carlsuacjca.gov ENGINEERING 760-602-2750 Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov X Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.gov FiRE PREVENTION 760-602-4665 ;c;-? rtvan Gregory.Ryan@carlsbadca.gov Cindy Wong 76C76Q2-4662 Cyrithia.Worig@caf1sbadca.gov DoiTiinic Fieri 7607502-4664 Oom! ri i c, F i e 1 i@ca rIs ba d ca .go V Remarks: ******************************************************************** INTERNAL USE ONLY: Please add Land Development Engineering, Attn: David Rick to the final \ inspection sign off for BMP verification purposes. SWl 30151, SWMP1308, APPROVED 7/12/2013 ******************************************************************************************************************************* ^ |l3|l3 - l^^^W^rrv-^ ^piUvJL VF^J[_^-AJL^^ FA^ PLAN CHECK Community & Economic CITY OF REVIEW Development Department 1635 Faraday Avenue CARLSBAD TRANSMITTAL Carlsbad CA 92008 www.carlsbadca.gov DATE: 6/19/2013 PROJECT NAME: NORTH COAST CALVARY_CHAPEL BUILDING PLAN CHECK NO: CBI0-2519 SET#:IV ADDRESS: 1350 POINSETTIA LN PROJECT ID:MS 04 02 APN: 215-070-49 VALUATION: $1,962,522 SCOPE OF WORK: 17,972 SF TOTAL (CHAPEL,-COFFEE/BOOKSTORE, MULTIPURPOSE ROOM) This plan check review is complete and has been APPROVED by: LAND DEVELOPMENT ENGINEERING DIVISION A Final Inspection by the Construction Mgmt & inspection Division is required X Yes No This plan check review is NOT COIVIPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check Comments have been sent to: jack@northcoastcalvary.org PLANNING 760-602-4610 ENGINEERING 760-602-2750 FIRE PREVENTION 760-602-4665 Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov Linda Ontiveros 760-602-2773 Linda.Ontlveros@carlsbadca.gov Cinciy Wong /Si)-602 4tjl>7 Dorninic Fieii 760-602-4664 DominicFien#car(sbadca.,;:;ov Remarks: *********************************************************** SWMP, SWMP1308, CURRENTLY IN CIVIL REVIEW *********************************************************** ^ CITY OF CARLSBAD PLAN CHECK REVIEW TRANSMITTAL Community 8i Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carlsbadca.gov DATE: 4/29/13 PROJECT NAIVIE: NORTH COAST CALVARY^CHAPEL BUILDING PLAN CHECK NO: CB10-2519 SET#:III ADDRESS: 1350 POINSETTIA LN VALUATION: $1,962,522 PROJECT ID:MS 04 02 APN: 215-070-49 SCOPE OF WORK: 17,972 SF TOTAL (CHAPEL,-COFFEE/BOOKSTORE, MULTIPURPOSE ROOM) This plan check review is complete and has been APPROVED by: LAND DEVELOPIVIENT ENGINEERING DIVISION A Final Inspection by the Construction Mgmt & Inspection Division is required X Yes No This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check Comments have been sent to: jack@northcoastcaivary.org PLANNING 760-602-4610 ENGINEERING 760-602-2750 FIRE PREVENTION . 760-602-4665 ' Chris Sexton 760-602-4624 Cliris.Sexton@carisbacJca.gov Kathleen Lawrence I 760-602-2741 Kathleen.Lawrence@carlsbadca.gov t • — Greg Ryan |i 760-602-4663 \ Gregory.Ryan7>carlsbaclca.gov | Gina Ruiz * 760-602-^4675 : G i n a. R ll i z7'c a ri s sn ad c, r gov \/ Linda Ontiveros /\ 760-602-2773 Linda.Ontiveros@carlsbadca.gov t Cindy Wong I 760-602-4662 } Cyrithia.Wong7carlsbadca.gov I Dominic Fieri 3 760-602^4664 i Dominic-Fieri''¥ca rlsbadca.gov J Remarks: NORTH COAST CALVARY CHAPEL BUILDING PLAN CHECK NO # CBM)-2519r Please Read Instructions: Outstandins issues are marked with X . Once necessary corrections for compliance are made, re-submit to the Building division. Items that conform to permit requirements are marked with F or have intentionally been left blank. 1. SITE PLAN Provide a fully dimensioned site plan drawn to scale. Show: __j North arrow _J Existing & proposed structures J Existing street improvements __ J Property lines (show all dimensions) I Easements I Right-of-way width & adjacent streets Driveway widths I Existing or proposed sewer lateral Existing or proposed water sen/ice Submit on signed approved plans: DWG No. stiow on site plan: I I Drainage patterns r "~1 Building pad surface drainage must maintain a minimum slope of one percent towards an adjoining street or an approved drainage course. r~~j ADD THE FOLLOWING NOTE: "Finish grade will provide a minimum positive drainage of 2% to swale 5' away from building". j Existing & proposed slopes and topography JSize, location, alignment of existing or proposed sewer and water service(s) that sen/es the project. Each unit requires a separate service; however, second dwelling units and apartment complexes are an exception. J Sewer and water laterals should not be located within proposed driveways, per standards. Include on title sheet: 1 Site address L ...J Assessor's parcel number Legal description/lot number For commercial/industrial buildings and tenant improvement projects, include: total building square footage with the square footage for each different use, existing sewer permits showing square footage of different uses (manufacturing, warehouse, office, etc.) previously approved. Show all existinq use of SF and new proposed use of SF. Example: Tenant improvement for 3500 SF of warehouse to 3500 SF of office. Lot/Map No.: Subdivision/Tract: Reference No(s): E-36 Page 2 of 6 REV 6/01/12 NORTH COAST CALVARY CHAPEL BUILDING PLAN CHECK NO # CBlO-2519 2. DISCRETIONARY APPROVAL COMPLIANCE / J Project does not comply with the following engineering conditions of approval for project no. 3. DEDICATION REQUIREMENTS Dedication for all street rights-of-way adjacent to the building site and any storm drain or utility easements on the building site is required for all new buildings and for remodels with a value at or exceeding $ 20,000.00 , pursuant to Carlsbad Municipal Code Section 18.40.030. For single family residence, easement dedication will be completed by the City of Carlsbad, cost $605.00. / Dedication required as follows: 4. IMPROVEMENT REQUIREMENTS All needed public improvements upon and adjacent to the building site must be constructed at time of building construction whenever the value of the construction exceeds $100,000.00, pursuantto Carlsbad Municipal Code Section 18.40.040. / Public improvements required as follows: Construction of the public improvements must be deferred pursuant to Carlsbad Municipai Code Section 18.40. Please submit a recent property title report or current grant deed on the property and processing fee nf $ 441 nn so we may prepare the necessary Neighborhood Improvement Agreement This agreement must be signed, notarized and approved by the city prior to issuance of a building permit. Future public improvements required as follows: E-36 Page 3 of 6 REV 6/01/12 NORTH COAST CALVARY CHAPEL BUILDING PLAN CHECK NO # CBlO-2519' 5- GRADING PERMIT REQUIREMENTS The conditions that require a grading permit are found in Section 15.16 of the Municipal Code. CI llnadequate information available on site plan to make a determination on grading requirements. Include accurate grading quantities in cubic yards (cut, fill, import, export and remedial). This information must be included on the plans. If no grading is proposed write: "NO GRADING" FFI Grading Permit required. NOTE: The qradinq permit must be issued and rouqh gradinq approval obtained prior to issuance of a buildinq permit. FF Graded Pad Certification required. (Note: Pad certification may be required even if a grading permit is not required.) All required documentation must be provided to your Engineering Construction Inspector . The inspector will then provide the engineering counter with a release for the building permiL [' "71 No grading permit required. • Minor Grading Permit required. See attached marked-up submittal checklist for project- specific requirements. 6. MISCELLANEOUS PERMITS [^/l RiGHT-OF-WAY PERMIT is required to do work in city right-of-way and/or private work adjacent to the public right-of-way. Types of work include, but are not limited to: street improvements, tree trimming, driveway construction, tying into public storm drain, sewer and water utilities. J Right-of-way permit required for: E-36 Page 4 of 6 REV 6/01/12 NORTH COAST CALVARY CHAPEL BUILDING PLAN CHECK NO # CBlO-2519 7. STORM WATER Construction Compliance Project Threat Assessment Form complete. Enclosed Project Threat Assessment Form incomplete. Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form and return (SW ) X Requires Tier 2 Storm Water Pollution Prevention Plan. Post-Development (SUSMP) Compliance Storm Water Standards Questionnaire complete. X Storm Water Standards Questionnaire incomplete. Please make the corrections, re-sign the questionnaire and resubmit with next submittal. Project is subject to Standard Storm Water Requirements. See city Standard Urban Storm Water Management Plan (SUSMP) for reference. http://www.carlsbadca.qov/business/buildinq/Documents/EnqStandsw-stds-vol4-ch2.pdf Project needs to incorporate low impact development strategies throughout in one or more ofthe following ways: Rainwater harvesting (rain barrels or cistern) Vegetated Roof Bio-retentions cell/rain garden Pervious pavement/pavers Flow-through planter/vegetated or rock drip line Vegetated swales or rock infiltration swales Downspouts disconnect and discharge over landscape Other: E-36 Page 5 of 6 REV 6/01/12 NORTH COAST CALVARY CHAPEL BUILDING PLAN CHECK NO # CBlO-2519 9. WATER METER REVIEW FYI Domestic (potabie) Use What size meter is required? Where a residential unit is required to have an automatic fire extinguishing system, the minimum meter size shall be a 1" meter. NOTE: the connection fee, SDCWA system capacity charge and the water treatment capacity charge will be based on the size of the meter necessary to meet the water use requirements. For residential units the minimum size meter shall be 5/8", except where the residential unit is larger than 3,500 square feet or on a lot larger than one quarter (1/4) acre where the meter size shall be 8. FEES LI 1 / Required fees have been entered in building permit. Drainage fee applicable Added square feet Added square footage in last two years? Permit No. Permit No. Project built after 1980 Impervious surface > 50% Impact unconstructed facility Fire sprinklers required I jyes Upgrade Fl V^^ No fees required ]yes • I yes yes yes no LJ no L,Jno no (is addition over 150' from center line) no 10. Additional Comments Attactiments: E-36 Engineering Application Storni Water Form Page 6 of 6 Rlght-of-Way Applicatlon/lnfo. Reference Documents REV 6/01/12 NORTH COAST CALVARY CHAPEL BUILDING PLAN CHECK NO # CBlO-2519 9. WATER METER REVIEW Domestic (potable) Use / What size meter is required? FYI FYI Where a residential unit is required to have an automatic fire extinguishing system, the minimum meter size shall be a 1" meter. NOTE; the connection fee, SDCWA system capacity charge and the water treatment capacity charge will be based on the size of the meter necessary to meet the water use requirements. For residential units the minimum size meter shall be 5/8", except where the residential unit is larger than 3,500 square feet or on a lot larger than one quarter (1/4) acre where the meter size shall be %". 8. FEES / j Required fees have been entered in building permit Drainage fee applicable Added square feet Added square footage in last two years? Permit No. Permit No. Project built after 1980 Impervious surface > 50% Impact unconstructed facility Fire sprinklers required iyes Upgrade yes No fees required iyes iyes yes lyes : no no no no no (is addition over 150' from center line) no 10. Additional Comments Attachments: E-36 Engineering Application Storm Water Form Rlght-of-Way Appllcation/lnfo. Page 6 of 6 Reference Documents REV 6/01/12 Fee Calculation Worksheet ENGINEERING DIVISION NORTH COAST CALVARY CHAPEL PHASE II MS 04-02 Prepared by: LINDA ONTIVEROS Date: 3/28/13 Acidress: 1350 POINSETTIA LN Fees Update by: 4/29/13 Date: Fees Update by: GEO DATA: LFMZ: 2d B&T: 2 Bldg. Permit#: CB102519 Date: EDU CALCULATIONS: List types and square footages for all uses. Types of Use: CHURCH Types of Use: 489 SEATS Types of Use: Types of Use: Sq.Ft./Units 1.33/150 SEATS Sq.Ft./Units 489/150 = 3.26 Sq.Ft./Units 3.26X 1.33 = 4.34 Sq.FL/Units ADT CALCULATIONS: List types and square footages for all uses. EDU's EDU's EDU's EDU's TOTAL: 4.34 EDU's Sq.Ft./Units 15/1000 (SF) Sq.Ft./Units 0.015X17,972 Sq.Ft./Units Sq.Ft./Units 9/1000 (SF) Types of Use: CHURCH Types of Use: 17,972 SF Types of Use: Types of Use: *BTD USE ONLY* FEES REQUIRED: Within CFD: V YES (no bridge & thoroughfare fee in District #1, reduces Traffic Impact Fee) ADT's ADT's ADT's ADT's TOTAL: 270 ADT's BTD: 162 ADT's NO 1. PARK-IN-LIEU FEE: NW QUADRANT ADT'S/UNITS: 2. TRAFFIC IMPACT FEE: ADT'S/UNITS: 270 3. BRIDGE & THOROUGHFARE FEE ADT'S/UNITS: 162 4. FACILITIES MANAGEMENT FEE ADT'S/UNITS: 5. SEWER FEE EDU's 4.34 BENEFIT AREA: L EDU's 4.34 6. DRAINAGE FEES: ACRES: 7. POTABLE WATER FEES: UNITS CODE X X X X X X PLDA: I X ;NE QUADRANT FEE/ADT: FEE/ADT: W DIST.#(// FEE/ADT: vm ZONE: FEE/SQ.FT./UNIT: FEE/EDU: 842 FEEEDU-F^rm^ HIGH FEE/AC: :SE QUADRANT IW QUADRANT I =$ PARK DEDICATED / DIST.#2 =$ 273,942 =$ 0 =$ 3,654.28 =$ 5,945.80 UM =$ DIST.#3 MED LOW CONN. FEE METER FEE SDCWA FEE TOTAL Page 4 of 4 BUILDING PLANCHECK Develooment Services ^^^^ ^ CITY OF CHECKLIST Land Development Engineering 1635 FaradayAvenue 760-602-2750 www.carlsbadca.gov CARLSBAD E-36 Land Development Engineering 1635 FaradayAvenue 760-602-2750 www.carlsbadca.gov DATE; 4G ADDRESS: PLANCHECK NO.: >c jo-^tf) SW {0~5B3 BUILDING ADDRSSS: \'^^?0 ^( fS^^gTr > A ^^KJ . ^ . PROJECT DESCRIPTION; fKA^'IL> Cm^tT^CnoN C^Ctl ^OQ\A ^ ASSESSOR'S PARCEL NUMBER; - 5 TO - ^~ OO EST. VALU E; 1 ,J^^d^i (3> ^ • ENGINEERING DEPARTMENT APPROVAL The item you have submitted for review has been approved. The approval is based on plans, information and/or specifications provided in your submittal; therefore any changes to these items after this date, including field modifications, must be reviewed by this office to ensure continued conformance with applicable codes. Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to build. n A Right-of-Way permit is required prior to construction of the following improvements: DENIAL 36 see the attached list of outstanding issues marked with ^• y Make necessary corrections to plans or specifications for ipliance with applicable codes and standards. Submit corrected plans and/or specifications to the Building Dept for resubmittal to the Engineering Dept Onlv the applicable sheets have been sent. Date; Date: By By ff Date: Date: By: FOR OFFICIAL USE ONLY ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT: Date: ATTACHMENTS • Engineering Application n Dedication Checklist Q Neighborhood Improvement Agreement • Grading Submittal Checklist • Reference Documents • Right-of-Way Permit Application and Info Sheet Storm Water Applicability Checkpst/Storm Watec Wl GOTnp<ianaei-xeniptten Forn\S'(£'32(i5S!,3i^^ E-36 Name: email; Phone: ENGINEERING DEPT. CONTACT PERSON Linda Ontiveros City of Carlsbad linda.ontiveros(gcarlsbadca.gov 760-602-2773 Fax: 760-602-1052 NOTE: If there are retaining walls associated with your project, please check with the building department if these walls need to be pulled by separate RETAINING WALL PERMIT. Page Vof 7 REV 6/30/10 SITE PLAN I ST ,N0 ,RD • OJ • 1. Provide a fuliy dimensioned site plan drawn to scale. Show: North arrow Existing & proposed structures Existing street improvements Property lines (show all dimensions) Easements Right-of-way width & adjacent streets ^F Driveway widths Existing or proposed sewer lateral [3' Existing or proposed water service B"^ Existing or proposed irrigation service • Submit on signed /approved plans; DWG No. • 2. Show on site plan: ^.^Q-Drainage patterns 1. Building pad surface drainage must maintain a minimum slope of one percent towards an adjoining street or an approved drainage course. 2. ADD THE FOLLOWING NOTE; "Finish grade will provide a minimum positive drainage of 2% to swale 5' away from building". 'O' Existing & proposed slopes and topography Q Size, type, location, alignment of existing or proposed sewer and water service(s) that serves the project Each unit requires a separate service; however, second dwelling units and apartment complexes are an exception. B-Sewer and water laterals should not be located within proposed driveways, per standards. 3. Include on title sheet: m)site address - Cd^CT 1^ f ^-AlM ^tT 7 I 0 'H)! N^eTTl/V Assessor's parcel number H^egal description/lot number For commercial/industrial buildings and tenant improvement projects, include: total building square footage with the square footage for each different use, existing sewer permits showing square footage of different uses (manufacturing, warehouse, office, etc.) previously approved. Show all existinq use of SF and new proposed use of SF. Example: Tenant improvement for 3500 SF of warehouse to 3500 SF of office. EXISTING PERMIT NUMBER DESCRIPTION Lof Map No. Subdivision/Tract: Reference no(s): E-36 Page 2 of 7 .| ST 3RD DISCRETIONARY APPROVAL COMPLIANCE -Q- D D D Project does not comply with the following engineering conditions of approval for project no._ .J ST 3RD 3RD • All conditions are in compliance. Date; DEDICATION REQUIREMENTS • • • Dedication for all street rights-of-way adjacent to the building site and any storm drain or utility easements on the building site is required for all new buildings and for remodels with a value at or exceeding $ 17.000.00 . pursuant to Carlsbad Municipal Code Section 18.40.030. For single family residence, easement dedication will be completed by the City of Carlsbad, cost $605.00. Dedication required as follows; Dedication required. Please have a registered civil engineer or land surveyor prepare the appropriate legal description together with an 8 14" x 11" plat map and submit with a title report. All easement documents must be approved and signed by owner(s) prior to issuance of building permit. Attached please find an application form and submittal checklist for the dedication process. Submit the completed application form with the required checklist items and fees to the engineering department in person. Applications will not be accepted by mail or fax. Dedication completed by; Date; IMPROVEMENT REQUIREMENTS • • All needed public improvements upon and adjacent to the building site must be constructed at time of building construction whenever the value of the construction exceeds $ 82,000.00. Ff pursuant to Carlsbad Municipal Code Section 18.40.040. Public improvements required as follows; n Construction of the public improvements may be deferred pursuant to Carlsbad Municipal Code Section 18.40. Please submit a recent property title report or current grant deed on the property and processing fee of $ 441.00 so we may prepare the necessary Neighborhood Improvement Agreement This agreement must be signed, notarized and approved by the city prior to issuance of a building permit E-36 Page 3 of 7 Future public improvements required as follows; .|ST 2^0 3RD .| ST 2^0 3RD • Enclosed please find your Neighborhood Improvement Agreement Please return agreement signed and notarized to the engineering department. Neighborhood Improvement Agreement completed by; Date; No public improvements required. SPECIAL NOTE; Damaged or defective improvemerits found adiacent to buildinq site must be repaired to the satisfaction of the citv inspector prior to occupancv. GRADING PERMIT REQUIREMENTS The conditions that invoke the need for a grading permit are found in Section 15.16 of the Municipal Code. • • • Inadequate information available on site plan to make a determination on grading requirements. Include accurate grading quantities in cubic yards (cut, fill, import, export and remedial). This information must be included on the plans. • Grading Permit required. NOTE; The qradinq permit must be issued and rouqh qradinq approval obtained prior to issuance of a buildinq permit • Graded Pad Certification required. (Note; Pad certification may be required even if a grading permit is not required.) All required documentation must be provided to your Engineering Construction Inspector. The inspector will then provide the engineering counter with a release for the building permit 0^No grading permit required. MISCELLANEOUS PERMITS • • DA RIGHT-OF-WAY PERMIT is required to do work in city right-of-way and/or private work adjacent to the public right-of-way. Types of work include, but are not limited to; street improvements, tree trimming, driveway construction, tying into public storm drain, sewer and water utilities. Riqht-of-way permit required for: VV/WC 6;c|^DUCX^ l/V (THvi^ IP f> • • • INDUSTRIAL WASTE PERMIT If your facility is located in the City of Carlsbad sewer \ service area, you must complete the attached Industrial Wastewater Discharge Permit Screening Survey. Fax or mail to Encina Wastewater Authority, 6200 Avenida Encinas, Carlsbad, CA 92011, (760) 438-3941, Fax (760) 476-9852. E-36 Page 4 of 7 ITH H y bl^OMO Dl Fl CAT?Oi.' VI £ w ^ .| ST 2^0 3RD STORM WATER - Construction Compliance • • \ l^'-r^j'^^t Thrsat A.s..;f»ssmftnt Fnrm r^nmplPt>»;><&^,T CJJ(]JIPL'E TBbI>, ^ VyfeAse F^^^ OUT 2. /^eTtfffi^r • Project Threat Assessment Form incorrectly completed. • Requires Tier 1 Storm Water Pollution Prevention Plan. Please complete attached form and return (SW ) • Requires Tier 2 Storm Water Pollution Prevention Plan. Requires submittal of Tier 2 SWPPP, payment of processing fee and review by city. Post-Development (SUSMP) Compliance ^ ST 2"^° 3RD f • ) Storm Water Standards Questionnaire complete.AW'^T CVlApLt 1 €rP j ^—^ fiLto^r2: ^TUj€^) w\ri{ (^-suSimfp^^, ^ • Storm Water Standards Questionnaire incorrectly completed. Please make the corrections, re-sign the questionnaire and resubmit with next submittal. • Project is subject to Standard Storm Water Requirements. See city Standard Urban Storm Water Management Plan (SUSMP) for reference. • Disconnect discharges per SUSMP. Do not connect runoff from impervious surfaces to storm drains without first discharging water over landscape areas. See SUSMP. • Minimize use of impervious surfaces per SUSMP. Redesign to reduce the excessive use of impervious area (pavement) on project Use a balanced design of pervious surfaces (landscape area, planters, etc.) and impervious surfaces. See SUSMP. • Trash storage areas must be designed per city standards (GS-16) to avoid contact with storm runoff. • Project is subject to Priority Development Project Requirements. • Prepare and submit a Storm Water Management Plan (SWMP). Requires payment of processing fee and review by city. • Project does not comply with recommendations of the approved SWMP. Redesign to comply and resubmit FEES • ) • • rn lfi bc deferluiW. mce. fkccuvat^^ ^^-Mfi • Drainage fee applicable Added square feet Added square footage in last two years? yes no Permit No. Permit No. Project built after 1980 yes no Impervious surface > 50% yes no Impact unconstructed facility yes no • Fire sprinklers required yes no (is addition over 150' from center line) Upgrade yes no • No fees required E-36 Page 5 of 7 REV 4/30/10 WATER METER REVIEW 3RD • • • Domestic (potabie) Use Ensure that the meter proposed by the owner/developer is not oversized. Oversized meters are inaccurate during low-flow conditions. If it is oversized, for the life of the meter, the city will not accurately bill the owner for the water used. • Where a residential unit is required to have an automatic fire extinguishing system, the minimum meter size shall be a Tmeter. NOTE: The connection fee, SDCWA system capacity charge and the water treatment capacity charge will be based on the size of the meter necessary to meet the water use requirements. • For residential units the minimum size meter shall be 5/8", except where the residential unit is larger than 3,500 square feet or on a lot larger than one quarter (1/4) acre where the meter size shall be %; • If owner/developer proposes a size other than the "standard", then owner/developer must provide potable water demand calculations, which include total fixture counts and maximum water demand in gallons per minute (gpm). A typical fixture count and water demand worksheet is attached. Once the gpm is provided, check against the "meter sizing schedule" to verify the anticipated meter size for the unit • Maximum service and meter size is a 2" service with a 2" meter. Q- Irrigation Use (where recycled water is not available) All irrigation meters must be sized by the landscape architect based on the flow demand in gallons per minute (gpm) for the area to be irrigated. The minimum size meter(s) shall be capable of supplying the peak irrigation water demand determined. • If the project is a newer development (newer than 1998), check the recent improvement plans and observe if the new irrigation service is reflected on the improvement sheets. If so, at the water meter station, the demand in gpm may be listed there. Irrigation services are listed with a circled "1", and potable water is typically a circled "W". • If the improvement plans do not list the irrigation meter and the service/meter will be installed via another instrument such as the building plans or grading plans (w/ a right of way permit of course), then the applicant must provide irrigation calculations for estimated worst-case irrigation demand (largest zone with the farthest reach). Typically the planning department landscape consultant has already reviewed this if landscape plans have been prepared, but the applicant must provide the calculations to you for your use. Once you have received a good example of irrigation calculations, keep a set for your reference. In general the calculations will include; • Hydraulic grade line • Elevation at point of connection (POC) • Pressure at POC in pounds per square inch (PSI) • Worse case zone (largest, farthest away from valve) • Total sprinkler heads listed (with gpm use per head) • Include a 10% residual pressure at point of connection E-36 Page 6 of 7 REV 6/30/10 I ST 2ND 3RD <Q-^ Irrigation Use (where recycled water is available) 1. Recycled water meters are sized the same as the irrigation meter above. 2. If a project fronts a street with recycled water, then they should be connecting to this line to irrigate slopes within the development For subdivisions, this should have been identified and implemented on the improvement plans. Installing recycled water meters is a benefit for the applicant since they are exempt from paying the San Diego County Water Capacity fees. However, if they front a street on which the recycled water is there, but is not live (they are charged with potable water until recycled water is available), then the applicant must pay the San Diego Water Capacity Charge. If recycled water is eventually supplied to the service connection and meter within one year of the original application for Water meter Permit, the customer must prepare and submit the San Diego County Water Authority's "Capacity Charge Refund Request" form to CMWD for verification to request the connection fee refund. • • Additional Comments: 1^) a\7 (AU3) 9H0(^'< AltTrAL Sl(KT{H6 /)f 4^9^ V^Al nt^hL, If ^D, IRAMSFO^ TO QuyEpT-ior^S, Cmvf\CC f^FiBCr ^f^Oimtl^j J>^v^i> 5/i»M' PjlT^KU Af^^r ^T(LL A?PLV, fc)MA!n[>\ V(ew at Hv/DR^Mpri\oKi E-36 Page 7 of 7 REV 6/30/10 ENGINeEMNQ DEPARTMENT FEE CALCULATION WORKSHEET • y Estimate based on unconfirmed information from applicant. n Calculation based on building plancheck plan submittal. Address: Prepared by: ~F Date: Bldg . Permit No. jO-^F)[ 9 Checked by: Date: EDU CALCULATIONS: List types and squara footagas for all uses. Typos of Use: C^-^Ut^Ci^ Types of Use: Types of Use: Types of Use: . Sq. Ft/Units: Sq. Ft./Units: Sq. Ft./Units: Sq. Ft./Units: ADT CALCULA TIONS: List types and square footages for all uses. Ft./Units:^JlOl^2__ Types of Use: t^^^C^ Types of Use: Types of Use: Types of Use: Sq. Sq. Ft./Units: Sq. Ft./Units: Sq. Ft./Unlts: EDU's: EDU's: EDU's: EDU's: ADT's:. ADT's:. ADT's:. ADT's: FEES REQUIRED: WITHIN CFD: • YES (no bridge & thoroughfare fee in District #1, reduced Traffic Impact Fee) • NO • 1. PARK-IN-UEU FEE: NW QUADRANT FEE/UNIT:_ O 2. TRAFFIC IMPACT FEE ADT's/UNITS: NE QUADRANT X NO. UNITS:. X FEE/ADT: _ SE QUADRANT SW QUADRANT • 3. BRIDGE AND THOROUGHFARE FEE (DIST. #1 DIST. #2 ADT's/UNITS: X FEE/ADT: DIST. #3 • 4. FACILITIES MANAGEMENT FEE . UNIT/SQ.FT.: • 5. SEWER FEE EDU's: BENeRTAREA: EDU's: ZONE:. X FEE/SQ.Fr.AJNIT: X FEE/EDU.- 6. DRAINAGE FEES ACRES: PLDA_ FEE/EDU:. HIGH /LOW_ X FEE/AC:. • 7. POTABLE WATER FEES UNITS CODE CONNECTION FEE METER FEE SOCWA FEE IRRIGATION • • ENGiNEERING DEPARTMENT FEE CALCULATION WORKSHEET Estimate based on unconfirmed information from applicant Calculation based on building plancheck plan submittal Address _ Bldg Permit No Checked by Date Prepared by Date EDU CALCULATIONS List types and square footages for all uses Types of Use Types of Use Sq Ft /Units APT CALCULATIONS List types and square footagp<« fnr aii ii<!o<; Types of Use C^^U^cJ-t /ScflFt\lnits Types of Use Sq R/Units EDU's EDU's ADT's ADT's FEES REQUIRED WITHIN CFD • YES (no bridge & thoroughfare fee in Distnct #1 reduced Traffic Innpact Fee) • NO • 1 PARK IN LIEU FEE FEE/UNIT PARK AREA & # X NO UNITS = $ • 2 TRAFFIC IMPACT FEE ADT s/UNITS FEE/A/DT • 3 BRIDGE AND THOROUGHFARE FEE. (DIST #1 ADT s/UNITS nrMnc rce luio i H\ DIST #2 ' ^ uioi /e^ ^ v./ "^""mr^. -.^^d^ DIST #3 • 4 FACILITIES MANAGEMENT FEE UNIT/SQ FT • 5 SEWER FEE ZONE X FEE/SO FT /UNIT EDU s BENEFIT AREA EDU s A^ FEE/EDU ^ -.AfF A fi', ->oc S«««_ 7oy,in.= ^7fry c^^si'iy • 6 SEWER LATERAL ($2 500) • 7 DRAINAQE FEES PLDA_ ACRES ,/ HIGH X FEE/AC ^ - /LOW_ • 8 POTABLE WATER FEES (WJITS CODE CONNECTION FEE METER FEE SDCWA FEE IRRIGATION Wanl\Don\MI>lornu\Fac Calculation Workihaal 1 of2 ^ CITY CARLSBAD O F PROJECT THREAT ASSESSMENT WORKSHEET FOR DETERMINATION OF CON$TRUCTION SWPPP itER LEVEL E-32 Develooment Services Land Oevelopment Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov 1 Project Storm Water Threat Assessment Criteria* Construction 1 SWPPP Tier Level 1 Slqniflcant Threat Assessment Criteria • My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres includmg any associated construction staging, equipment storage, stockpiling, pavement rennoval, refueling and maintenance areas; or, • My project is part of a phased devetopment plan that will cumulatively result in soil disturisance totaling one or more acres including any associated construction staging, equipment storage, refueling and maintenance areas; or, • My project is located inside or within 200 feet of an environmentally sensitive area (see city ESA proximity map) and has a significant potential for contributing pollutants to nearisy receiving waters by way of storm water runoff or non-stonn water discharge(s). Tiers Moderate Threat Assessnfient Criteria My prpject does not meet any of the significant threat assessment criteria described above and meets one or more of the following criteria: • Project requires a grading plan pursuant to the Carisbad Grading Ordinance (Chapter 15.16 of the Carisbad Municipal Code); or, • Project will result in 2,500 square feet or more of soils disturibance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more of the additional following criteria: • located within 200 feet of an environmentally sensitive area or the Pacific Ocean; and/or, • disturised area Is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical; and/or • disturbed area is located along or within 30 feet of a stonn drain inlet, an open drainage channel or watercourse; and/or • construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). Tier 2 Low^reat Assessment Criteria Tierl My project does not meet any of the significant or moderate threat criteria, is not an exempt ^ permit type (see city's list of pennit types exempt from construction SWPPP requirements) and project meets one or more of the following criteria: • results in some soil disturbance; and/or • includes outdoor construction activities (such as roofing, saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling) Tierl No Threat Project Assessment Criteria Exempt • My project is in a category of permit types exempt firom city constiuction SWPPP requirements (see city's list of permit types exempt firom constiuction SWPPP requirements) and/or does not meet any of the high, moderate or low tiireat criteria described above. Exempt *The city engineer may authorize minor variances from the stomi water threat assessment criteria in special circumstances where it can be shown that a lesser or higher constiruction SWPPP tier level is warranted in the opinion of the city engineer E-32 Page 1 of 1 REV 4/30/10 ^ CITY OF CARLSBAD PROJECT THREAT ASSESSMENT WORKSHEET FOR DETERMINATK)N OF CONSTRUCTION SWPPP TIER LEVEL E-32 Develooment Services Land Oevelopment Engineering 1635 Faraday Avenue 760-602-2750 www.carisbadca.gov 1 1 Project Storm Water Threat Assessment Criteria* Construction 1 SWPPP Tier Level 1 Sionificant Threat Assessment Criteria • My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres including any associated consti'uction staging, equipment storage, stockpiling, pavement removal, refueling and maintenance areas; or, • My project is part of a phased devetopment plan that will cumulatively result in soil disturisance totaling one or more acres including any associated constiruction staging, equipment storage, refueling and maintenance areas; or, • My project Is located inside or within 200 feet of an environmentally sensitive area (see city ESA proximity map) and has a significant potential for contributing pollutants to nearby receiving waters by way of storm water ainoff or non-stonn water discharge(s). Tiers Moderate Threat Assessment Criteria My project does not meet any of tiie significant threat assessment criteria described above and meets one or more of the following criteria: • Project requires a grading plan pursuant to the Carisbad Grading Ordinance (Chapter 15.16 of the Carisbad Municipal Code); or, a Project will result in 2,500 square feet or more of soils disturisance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more of tiie addittonal fbllowing criteria: • located within 200 feet of an environmentally sensitive area or the Pacific Ocean; and/or, • disturised area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical; and/or • disturised area is located along or within 30 feet of a stonn drain inlet, an open drainage channel or watercourse; and/or • construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). Tier 2 Low Threat Assessment Criteria Tierl • My project does not meet any of the signjficant or moderate threat criteria, is not an exempt pemiit type (see city's list of permit types exempt firom conshojction SWPPP requirements) and project meets one or more of tiie following criteria: • results in some soii disturbance; and/or • includes outdoor construction activities (such as roofing, saw cutting, equipment washing, material stockpiling, vehicle fijeling, waste stockpiling) Tierl No Threat Project Assessment Criteria Exempt • My project is in a category of permit types exempt from city constmction SWPPP requirements (see city's list of pennit types exempt from construction SWPPP requiremente) and/or does not meet any of the high, moderate or low threat criteria described above. Exempt The city engineer may authorize minor variances fiom the storm water threat assessment criteria in special circumstances where it can be shown that a lesser or higher constiruction SWPPP tier level is wan-anted in the opinion ofthe city engineer E-32 Page 1 of 1 REV 4/30/10 ^ CITY OF CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Engineering Department 1635 Faraday Avenue 760-602-2750 www.carisbadca.gov INSTRUCTIONS: To address post-development pollutants that may be generated from development projects, the City requires that new development and significant redevelopment priority projects incorporate Permanent Storm Water Best Management Practices (BMP's) into the project design per the City's Standard Urban Stormwater Management Plan (SUSMP). Initially this questionnaire must be completed by the applicant in advance of submitting for a development application (subdivision, discretionary permits and/or construction permits). The results of the questionnaire determine the level of stomi water standards that must be applied to a proposed development or redevelopment project. Depending on the outcome, your project will either be subject to 'Standard Stormwater Requirements' or be subject additional criteria called 'Priority Development Project Requirements'. Many aspects of project site design are dependent upon the stomi water standards applied to a project. Applicant responses to the questionnaire represent an initial assessment of the proposed project conditions and impacts. City staff has responsibility for making the final assessment after submission of the development application. If staff detemiines that the questionnaire was incorrectiy filled out and is subject to more stringent storm water standards than initially assessed by the applicant, this will result in the return of the development application as incomplete. In this case, please make the changes to the questionnaire and resubmit to the City. If applicants are unsure about the meaning of a question or need help in determining how to respond to one or more of the questions, they are advised to seek assistance from Land Development Engineering staff. A separate completed and signed questionnaire must be submitted for each new development application submission. Only one completed and signed questionnaire is required when multiple development applications for the same project are submitted concurrently. In addition to this questionnaire, applicants for construction permits must also complete, sign and submit a Project Threat Assessment Form to address construction aspects of the project. Please answer the questions below, follow the instructions and sign the form at the end. 1. Is your project a significant redevelopment? OEFINmOtt significant redevelopment Is defined as the creation, addition or replacement ofat least 5,000 square feet of impervious surface on an already existing developed site. Slimhcant redevelopment includes, but is not limited to: the expansion of a building footprint; addition to or replacement of a stmUure; structural development including an increase in gross floor area and/or exterior construction remodeling: replacement of an impeivious surface that is not part of a routine maintenance activity; and land disturbing activities related with structural or impervious surfaces. Replacement of impervious surfaces includes any activity that is not part of a routine maintenance activity where Impervious material(s) are removed, exposing underiying soil during construction. Note: Ifthe Significant Redevelopment results in an increase of less than fifty percent ofthe impen/ious surfaces of a previously existing development, and the existing development was not subject to SUSMP requirements, the numeric sizing criteria discussed in Section 2 of the SUSMP applies only to the addition, and not to the entire development. If your project IS considered significant redevelopment, then please skip Section 1 and proceed with Section 2. If your pmject IS NOT considered significant redevelopment, then please proceed to Section 1. E-34 Page 1 of 3 REV 3/22/10 CITY OF CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Engineering Department 1635 Faraday Avenue 760-602-2750 www.carisbadca.gov SECTION 1 NEW DEVELOPMENT PRIORmr PROJECT TYPE Does you project meet one or more of the following criteria: YES NO 1. Houslna subdMslona of 10 or more dwellina units. Examoles: sinale familv homes, multi-familv homes, condominium and apartments 2. Commercial - areater than 1-acre. Anv develooment other than heaw industrv or residential. Examoles: hosoitais: laboratories and other medical facilities; educational institutions; recreational facilities; municipal facilities; commercial nurseries; multi-apartment buildings; car wash facilities; minl-malls and other business complexes; shopping malls; hotels; office buildings; public warehouses; automotive dealerships; airfields; and other light industrial facilities. 3. Heaw Industrial / Industry- areater than 1 acre. Examoles: manufacturino olants. food orocessina olants. metal woriting facilities, printing plants, and fleet storage areas (bus, truck, etc.). 4. Automotive reoalr shoo. A facilitv cateoorized in anv one of Standard Industiial Classification fSIC) codes 5013. 5014, 5541, 7532-7534, and 7536-7539 5. Resteurants. Anv facilitv tiiat sells oreoared foods and drinks for consumotion. includina stationarv lunch counters and refreshment stands selling prepared foods and drinks for Immediate consumption (SIC code 5812), where the land area for development is greater than 5,000 square feet Restaurants where land development is less than 5,000 square feet shall meet all SUSMP requirements except for structural treatinent BMP and numeric sizing criteria requirements and hydromodification requirements. 6. Hillside develooment. Anv develooment that creates 5.000 sauare feet of imoervious surface and is located in an area with known erosive soil conditions, where the development will grade on any nahjral slope that Is twenty-five percent (25%) or greater. 7. Environmentallv Sensitive Area (ESA)\ All develooment located within or directly adiacent^ to or discharaina directly^ to an ESA (where discharges from the development or redevelopment will enter receiving waters within the ESA), which either creates 2,500 square feet of impervious surfece on a proposed project site or increases the area of imperviousness of a proposed project site to 10% or more of its naturally occurring condition. ^ Parldna lot Area of 5.000 sauare feet or more, or with 15 or more oarkina soaces. and ootentialiv exoosed to urban runoff 9. Streeto. roads, hiahwavs. and freewavs. Anv oaved surface that is 5.000 sauare feet or areater used for the transportation of automobiles, trucks, motorcycles, and other vehicles 10. Retail Gasoline OutMa. Servina more than 100 vehicles oer dav and qreater than 5.000 sauare feet 11. Coastal Develooment Zone. Anv oroiect located within 200 feet of the Pacific Ocean and (1) creates more Uian 2500 square feet of impermeable surface or (2) increases impermeable surface on property by more than 10%. 12. More than 1-acre of disturbance. Proiect results in the disturbance of more than 1-acre or more of land and is considered a Pollutant-generating Development Project^. 1 Environmentally Sensitive Areas Include but are not limited to all Clean Water Act Section 303(d) Impaired water t)odles; areas designated as Areas of Speclal Biological significance by the State Water Resources Controi Board (Water Quality Control Plan for tiie San Dlego Basin (1994) and amendments); water bodies designated witli the R/U)E benefidal use by the State Water Resources Control Board (Water Quality Control Plan for the San Dlego Basin (1994) and amendments); areas designated as preserves or their equivalent under the Multl Species Consen/atlon Program within the Cities and County of San Dlego; and any other equivalent environmentally sensitive areas which have been Identified by the Copermittees. 2 'Directly adjacenr means situated within 200 feet of the Environmentally SensKlve Area. 3 'Discharging directly to' means outflow from a drainage conveyance system that Is composed entirely of flows from the subject development or redevelopment site, and not commingled with flow from adjacent lands. 4 Pollutant-generating Development Projects are those prajects that generate pollutants at levels greater than background levels. In general, these Include all projects that contribute to an exceedance to an Impaired water body or which create new Impervious surfaces greater than 5000 square feet and/or Introduce new landscaping areas that require routine use of fertilizers and pesticides. In most cases linear pathway projects that are for Infrequent vehicle use, such as emergency or maintenance access, or for pedestrian or bicyde use, are not considered Pollutant-generating Development Projects if they are built with pervious surfeces or if they sheat flow to surrounding pervious surfaces. Sectloni Resulte: .If you answered YES to ANY of the questions above your project is subject to Priority Development Project requirements. Please check the "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3. A Stonn Water Management Plan, prepared in accordance with City Storm Water Standards, must be submitted at time of application. If you answered NO to ALL of the questions above, then your project is subject to Standard Stonnwater Requiremente. Please check the "does not meet PDP requirements' box in Section 3. E-34 Page 2 of 3 REV 3/22/10 «!•> ^ CITY OF CARLSBAD STORM WATER STANDARDS QUESTIONNAIRE E-34 Development Services Engineering Department 1635 Faraday Avenue 760-602-2750 www.carisbadca.gov SECTION 2 SIGNIFICANT REDEVELOPMENT Complete the questions below regarding your redevelopment project: YES NO 1. Project results in the disturt>ance of more than 1-acre or more of land and is considered a Pollutant-generating Development Project (see definition in Section 1). If you answered NO, please proceed to question 2. If you answered YES, then you ARE a significant redevelopment and you ARE subject to PRIORPFY DEVELOPMENT PROJECT requirements. Please check the "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3 below. 2. is the project redeveloping an existing priority project type? (Priority projects are defined in Section 1) If you answered YES, please pnsceed to question 3. If you answered NO, then you ARE NOT a significant redevelopment and your project is subject to ST/VNDARD STORMWATER REQUIREMENTS. Please check the "does not meet PDP requirements' box in Section 3 below. 3. Is the project solelv limited to just one of the followinq: a. Trenching and resurfacing associated with utility wori<? b. Resurfacing and reconfiguring existing surface parking lots? c. New sidewalk construction, pedestrian ramps, or bike lane on public and/or private existing roads? d. Replacement of existing damaged pavement? If you answered NO to ALL of the questions, then proceed to question 4. If you answered YES to ANY of the questions then you ARE NOT a significant redevelopment and your project is subject to Standard Stormwater Requirements. Please check the "does not meet PDP requirements' box in Section 3 below. 4. Will your redevelopment project create, replace, or add at least 5,000 square feet of impervious surfaces on an existing development or, be located within 200 feet of the Pacific Ocean and (1 )create more than 2500 square feet of impermeable surface or (2) increases impermeable surface on the property by more than 10%? If you answered YES, you ARE a significant redevelopment, and you ARE subject to PRIORITY DEVELOPMENT PROJECT requirements. Please check tiie "meets PRIORITY DEVELOPMENT PROJECT requirements" box in Section 3 below. If you answered NO, then you ARE NOT a significant redevelopment and your project Is subject to STANDARD STORMWATER REQUIREMENTS. Please check the "does not meet PDP requirements' box in Section 3 below. SECTION 3 Questionnaire Results: • • My project meets PRIORITY DEVELOPMENT PROJECT (PDP) requirements and must comply with additional stormwater criteria per the SUSMP and must prepare a Stonn Water Management Plan for submittal at time of application. My project does not meet PDP requirements and must only comply witii STANDARD STORMWATER REQUIREMENTS per the SUSMP. Applicant Inforniation and Signature Box TTiis Box for Cly Ust Only Address: Assessor's Parcel Number(s): Applicant Name: Applicant Titie: Applicant Signature: Date: City Concurrence: YES By: NO Dats: ProjectID: E-34 Page 3 of 3 REV 3/22/10 ! CM rs (P CP tc Q. 0. • • • • • • • • • • PLANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST Plan Check No. CB102519 Address 1330 Poinsettia Lane Planner Van Lvnch Phone (760) 602- 4613 APN: 215-070-49-00 Type of Project & Use: church chapel/multipurpose rooms Net Project Densitv:n/a DU/AC Zoning: R-1 General Plan: RLM Facilities Management Zone: 20 CFDninmut) #_Date of participation:05/07/91 Remaining net dev acres: Circle One (For non-residential development: Type of land used created by this permit: Church) ^ Item Complete (^^j Item Incomplete - Needs your action Environmental Review Required: YES • NO |3 TYPE MND Legend: DATE OF COMPLETION: PC Reso 5784 11/17/2004 Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval: Discretionary Action Required: YES • NO |EI TYPE CUP 04-05 APPROVAL/RESO. NO. 5789 DATE 11/17/2004 PROJECT NO. CUP 04-05 OTHER RELATED CASES: SDP 04-02/HDP 04-01/CDP 04-03 Compliance with conditions or approval? If not, state conditions which require action. Conditions of Approval: _ Coastal Zone Assessment/Compliance Project site located in Coastal Zone? YES IXI NO fl CA Coastal Commission Authority? YES O NO M If California Coastal Commission Authority: Contact them at - 7575 Metropolitan Drive, Suite 103, San Diego, CA 92108-4402; (619) 767-2370 Determine status (Coastal Permit Required or Exempt): cdp 04-03 Habitat Management Plan - No impacts Data Entry Completed? YES • NO • If property has Habitat Type identified in Table 11 of HMP, complete HMP Permit application and assess fees in Permits Plus (A/P/Ds, Activity Maintenance, enter CB#, toolbar. Screens, HMP Fees, Enter Acres of Habitat Type impacted/taken, UPDATE!) Inclusionary Housing Fee required: YES l~l NO 1^ (Effective date of Inclusionary Housing Ordinance - May 21, 1993.) Data Entry Completed? YES • NO • (A/P/Ds, Activity Maintenance, enter CB#, toolbar, Screens, Housing Fees, Construct Housing Y/N, Enter Fee, UPDATE!) H:\ADMIN\Template\Building Plancheck Review Checklist.doc Rev 4/08 Site Plan: man Provide a fully dimensional site plan drawn to scale. Show: North arrow, property lines, easements, existing and proposed structures, streets, existing street improvements, right-of- way width, dimensional setbacks and existing topographical lines (including all side and rear yard slopes). Provide legal description of property and assessor's parcel number. Policy 44 - Neighborhood Architectural Design Guidelines IEI • • 1. Applicability: YES • NO IE! • • • 2. Project complies: YES • NOD • • • • Zoning: 1. Setbacks: Follows SDP/CUP site plan Front: Required 50 Shown 145 Interior Side: Required n/a Shown n/a Street Side: Required 10 Shown 185 Rear: Required 20 Shown 20 Top of slope: Required _ Shown _ 2. Accessory structure setbacks: N/A Front: Required. Interior Side: Required . Street Side: Required . Rear: Required . Structure separation: Required . Shown Shown Shown Shown Shown • • 3. Lot Coverage: Required n/a Shown • • 4. Height: Required 35 Shown 34'11" (tower to 53 feet, shown 52 feet) ^ IZI CH 5. Parking: Spaces Required 594 Shown 842 (breakdown by uses for commercial and industrial projects required) Residential Guest Spaces Required _ Shown _ Kl D D Additional Comments OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER U. (y^t^-— DATE \ 'F'2^20lO H:\ADMIN\Template\Building Plancheck Review Checklist.doc Rev 4/08 L ^ CERTIFICATION OF Development Services COMPLETION LANDSCAPE Planning Division ^ CITY OF INSTALLATION iess Faraday Avenue ^ A nt cn A r\. (760)602-4610 LAKLODAU P-25(D) www.carlsbadca.gov Project Name: North Coast Calvary Chapel - Chapel Building Permit Adciress: ^ 350 Poinsettia Lane, Carisbad Permit Number: Drawing Number: 429-5L / certify that I have inspected the planting and irrigation system and that: 1) All landscape work has been installed and completed per the plans and specifications approved by the City of Carlsbad; 2) All required soil amendments were incorporated; 3) The installed irrigation system is functioning as designed and approved; 4) The irrigation control system was properly programmed in accordance with the irrigation schedule; and 5) The person operating the system has received all required maintenance and irrigation plans. Project Landscape Architect or Professional of Record Date License Number and Expiration Date: 2348, 3/31/17 Firm Name: ADL Planning Associates Phone number: 760.729.8637 Following receipt of this Certification of Completion by the City, a final review of the installation will be performed by the City. Fax the certification letter to: 760-602-8559 Call the Landscape Inspection Request Phone Line at 760-602-4602 to schedule the inspection. Inspection Contact Name: Phone Number: Contactor Firm Name: P-25(D) Page 1 of 1 Revised 04/12 ^ CITY OF BUILOING DEP t ^ CITY OF PLAN CHECK Cori^10p|^.& Economic ^ CITY OF REVIEW Development Department 1635 FaradayAvenue CARLSBAD TRANSMITTAL Carlsbad CA 92008 www.carlsbadca.gov DATE: 07/23/2013 PROJECT NAME: NCCC PROJECT ID: CB102519 PLAN CHECK NO: 4 SET#: 1 ADDRESS: 1350 POINSETTIA LN APN: • This plan check review Is complete and has been APPROVED by the FIRE Division. By:GR A Final Inspection by the FIRE Division is required ^ Yes • No This plan check review Is NOT COIVIPLETE. Items missing or Incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check Comments have been sent to: NCCC Ybu may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance ofa building permit Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checl<list please contact the following reviewer as marked: PLANNING 760602-4610 ENGINEERING 760-602-2750 FIRE PREVENTION 76&602-4665 1 1 Chris Sexton 760-602-4624 Chris.Sexton@carlsbadca.gov Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov X Greg Ryan 760-602-4663 Gregorv.Rvan@carlsbadca.gov 1 1 Gina Ruiz 760-602-4675 Gina.Ruiz@carisbadca.gov 1 1 Linda Ontiveros 760-602-2773 Linda.Ontlveros@carlsbadca.gov []] Cindy Wong 760-602-4662 Cvnthia.Wong@carlsbadca.gov • • Domlnlc Fieri 760-602-4664 Dominic.Fieri@carlsbadca.gov Remari<s: See Attached RECEIVED SEP 17 2013 CITY OF CARLSBAD BUILDING DIVISION BUiLDING DEPT Carlsbad Fire Department COPY Plan Review Requirements Category: COMMIND , COMM Date ofReport: 09-13-2013 Reviewed by: Name: CALVARY CHAPEL NO COAST Address: 1330 POINSETTIA LN CARLSBAD CA 92011 Permit #: CB102519 Job Name: NORTH COAST CALVARY CHAPEL Job Address: 1350 POINSETTIA LN CBAD Please review carefully all comments attached. CITY OF CARLSBAD FIRE DEPARTMENT - APPROVED: THIS PROJECT HAS BEEN REVIEWED AND APPROVED FORTHE PURPOSES OF ISSUANCE OF BUILDING PERMIT. THIS APPROVAL IS SUBJECTTO FIELD INSPECHON AND REQUIRED TEST, NOTATIONS HEREON, CONDITIONS IN CORRESPONDENCE AND CONFORMANCE WTTH ALL APPLICABLE REGULATIONS. THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW. Site plan shall indicate the location of proposed fire sprinkler supply mains. Sheet PlOl indicates the presence of a "onsite fire loop line" this statement is misleading as there is no dedicated fire-loop-line. All fire sprinkler systems are tied into the site water-main and protected by double-detector-check-valve assemblies then a feed main to the sprinkler riser. Provide monument sign for project. Submit plan for sign to fire department for review and approval. Provide additional street names for proposed private drives. Submit plan to fire department for review and approval. Entry: 07/23/2013 By: GR Action: AP Provide 'Knox' key-boxes for this project. The location for the key box(es) shall be at the Main Entry and at each utility space if not together. Entry: 07/23/2013 By: GR Action: AP Provide a exterior accessible fire sprinkler riser room with a minimum interior dimension of 36- inches by 60 inches for fire sprinkler riser only. You may elect to add the Fire Alarm Control Panel to this space along with telephone equipment. You are required to provide a minimum of 18-inches of separation between the riser and any other appliance. Entry: 07/23/2013 By: GR Action: AP Provide portable fire extinguishers along the means of egress within 75-feet of travel from any location and in each utility room. Entry: 07/23/2013 By: GR Action: AP Please provide a Photometric plan of interior emergency lighting. Please take into account the location of seating and fixed items that may create shadowing and diffuse light. Exits shall be illuminated at any time the building is occupied with light having intensity of not less than 1-foot-candle at floor level. The power supply for exit illumination shall comply with the Building Code. Low level exit signs SHALL be intemally illuminated with either a battery back-up or other approved emergency electrical source. ' Entry: 01/29/2013 By: GR Action: CO Entry: 07/23/2013 By: GR Action: AP Please defibl m^ filectrical Equipment Room [204] is this an A/V equipment room or is it for service panels >200 A and switch gear?. Entiy: 07/23/2013 By: GR Action: AP Show HC egress fi-om second floor. Entiy: 07/23/2013 By: GR Action: AP Sheet El 21 does not show exit signage at each exit stair to lead occupants off of second floor. Entiy: 07/23/2013 By: GR Action: AP Provide note that in accordance with Sections 407, 509,605, 607 and 608 that the appropriate Hazard Commimication and Identification signage shall be placed on or adjacent to the point of entry to all rooms and spaces. Entiy: 05/22/2013 By: GR Action: CO Entry: 07/23/2013 By: GR Action: AP ^ CITY OF ^ CITY OF PLAN CHECK \ Community & Economic ^ CITY OF REVIEW Development Department 1635 Faraday Avenue CARLSBAD TRANSMITTAL Carlsbad CA 92008 www.carlsbadca.gov DATE: 05/22/2013 PROJECT NAIVIE: NCCC PROJECT ID: CB102519 PLAN CHECK NO: 3 SET#: 1 ADDRESS: 1350 POINSETTIA LN APN: Q This plan check review Is complete and has been APPROVED by the FIRE Division. By: GR A Final Inspection by the FIRE Division is required Yes • No ^ This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check Comments have been sent to: NCCC You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the issuance ofa buiiding permit. Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checklist please contact the following reviewer as marked: J^^^^^BfiNINlNG^- • 760-602-4610 ENGINEERING 760-602-2750 FIREiipl^lllflaN 760-602:4665 1 1 Chris Sexton 760-602-4624 Chris.Sexton@carlsbadca.gov 1 1 Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov X Greg Ryan 760-602-4663 Gregory.Ryan@carlsbadca.gov 1 1 Gina Ruiz 760-602-4675 Gina.Ruiz@carlsbadca.gov 1 1 Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.gov Cindy Wong 760-602-4662 Cynthia.Wong@carlsbadca.gov • • Domlnlc Fieri 760-602-4664 Dominic.Fieri@carlsbadca.gov Remarks: See Attached Carlsbad Fire Department %\<jic^. J>vtn 0<rs Plan Review Requirements Category: COMMIND , COMM Date of Report: 05-22-2013 Reviewed by: /rf^Jf — Name: CALVARY CHAPEL NO COAST Address: 1330 POINSETTIA LN CARLSBAD CA 92011 Permit #: CBl 02519 Job Name: NORTH COAST CALVARY CHAPEL JobAddress: 1350 POINSETTIA LN CBAD INCOMPLETE The item you have submitted for review is incomplete. At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and/or standards. Please review carefully all comments attached. Please resubmit the necessary plans and/or specifications, with changes "clouded", to this office for review and approval. Conditions: Site plan shall indicate the location of proposed fire sprinkler supply mains. Sheet PlOl indicates the presence of a "onsite fire loop line" this statement is misleading as there is no dedicated fire-loop-line, all fire sprinkler systems are tied into the site water-main and protected by double-detector-check-valve assemblies then a feed main to the sprinkler riser. Provide monument sign for project. Submit plan for sign to fire department for review and approval. Provide additional street names for proposed private drives. Submit plan to fire department for review and approval. Provide 'Knox' key-boxes for this project. The location for the key box(es) shall be at the Main Entry and at each utility space if not together. Provide a exterior accessible fire sprinkler riser room with a minimum interior dimension of 36- inches by 60 inches for fire sprinkler riser only. You may elect to add the Fire Alarm Control Panel to this space along with telephone equipment. You are required to provide a minimum of 18-inches of separation between the riser and any other appliance. Provide portable fire extinguishers along the means of egress within 75-feet of travel from any location and in each utility room. Please provide a Photometric plan of interior emergency lighting. Please take into account the location of seating and fixed items that may create shadowing and diffuse light. Exits shall be illuminated at any time the building is occupied with light having intensity of not less than 1-foot-candle at floor level. The power supply for exit illumination shall comply with the Building Code. Low level exit signs SHALL be intemally illuminated with either a battery back-up or other approved emergency electrical source. Please define the Electrical Equipment Room [204] is this an A/V equipment room or is it for service panels >200 A and switch gear? Show HC egress from second floor. ^ . , Sheet El 21 does not show exit signage at each exit stair to lead occupants off of second floor. ^ Provide note that in accordance with Sections 407, 509, 605, 607 and 608 that the appropriate Hazard Communication and Identification signage shall be placed on or adjacent to the point of entry to all rooms and spaces. Entry: 05/22/2013 By: GR Action: CO EiLbl^ DEPT LbPH DATE: 04/29/2013 PROJECT NAIVIE: NORTH COAST CALVARY CHAPEL PROJECT ID: CB102519 PLAN CHECK NO: 3 SET#: 1 ADDRESS: 1350 POINSETTIA LN APN: Kl • This plan check review is complete and has been APPROVED by the FIRE Division. ByiGR A Final Inspection by the FIRE Division is required |^ Yes • No This plan check review is NOT COMPLETE. Items missing or incorrect are listed on the attached checklist. Please resubmit amended plans as required. Plan Check Comments have been sent to: You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be req : ired prior to the issuance ofa Luilding permit. Resubmitted plans should include corrections from all divisions. For questions or clarifications on the attached checklist please contact the following reviewer as marked: PLANNING 760-602-4610 ENGINEERING 760-602-2750 FIRE PREVENTION 760-602-4665 1 1 Chris Sexton 760-602-4624 Chris.Sexton@carlsbadca.gov 1 1 Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov X Greg Ryan 760-602-4663 Gregorv.Rvan@carlsbadca.gov 1 1 Gina Ruiz 760-602-4675 Gina.Ruiz@carlsbadca.gov 1 1 Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.gov 1 1 Cindy Wong 760-602-4662 Cvnthia.Wong@carlsbadca.gov • • Dominic Fieri 760-602-4664 Dominic.Fieri@carlsbadca.gov Remarks: Carlsbad Fire Department Plan Review Requirements Category: COMMIND , COMM Date of Report: 04-29-2013 Reviewed by: ^ f Name: CALVARY CHAPEL NO COAST Address: 1330 POINSETTIA LN CARLSBAD CA 92011 Permit #: CB102519 Job Name: NORTH COAST CALVARY CHAPEL JobAddress: 1350 POINSETTIA LN CBAD INCOMPLETE The item you have submitted for review is incomplete. At this time, this office cannot adequately conduct a review to determine compliance with the applicable codes and/or standards. Please review carefully all comments attached. Please resubmit the necessary plans and/or specifications, with changes "clouded", to this office for review and approval. Conditions: Cond: CON0006264 Site plan shall indicate the location of all existing and proposed fire hydrants within 300 feet of the project and existing and proposed fire sprinkler supply mains. Cond: CON0006265 Provide 'Knox' key-boxes for this project. The loc^^-ion for the key box(es) shall be at the M-;n Entry and at each utility space if not together. Cond: CON0006266 • Provide an exterior accessible fire sprinkler riser room with a minimum interior dimension of 36- inches by 60 inches for fire sprinkler riser only. • You may elect to add the Fire Alarm Control Panel to this space along with telephone equipment. • You are required to provide a minimum of 18-inches of separation between the riser and any other appliance. Cond: CON0006267 Provide portable fire extinguishers along the means of egress within 75-feet of travel from any location and in each utility room. Cond: CON0006269 • Please provide a Photometric plan of interior emergency lighting. • Please take into account the location of seating and fixed items that may create shadowirig and diffuse light. • Exits shall be illuminated at any time the building is occupied with light having intensity cf not less than 1-foot-candle at floor level. • The power supply for exit illumination shall comply with the Building Code. Low level exit signs SHALL be internally illuminated with either a battery back-up or other approved emergency electrical source. Entry: 04/29/2013 By: GR Action: CO GEOTECHNICAL PROFESSIONALS INC. May 8, 2013 North Coast Calvary Chapel 1350 Poinsettia Lane Carlsbacl, California 92011 Attention: Mr. Jack Shubin Subject: Update of Geotechnical Engineering Report Proposed Chapel Building, Phase II-A 1350 Poinsettia Lane Carlsbad, California GPl ProjectNo. 2015.C Dear Mr. Shubin: In accordance with your request, we have prepared this letter to update the geotechnical report (Reference 1) for the subject project site. Reference 1 included recommendations for the Chapel Building (Phase II-A). The pad for the Chapel Building was graded during the construction performed at the site in 2006. We observed and tested the building pad for the Chapel Building (Reference 2). We understand that the Chapel Building is now planned to be constructed at the location shown in References 1 and 2. Except as specifically appended or modified herein, the conclusions and recommendations <^ presented in Reference 1 may be used for design and construction of the proposed r^V^ Chapel Building. Seismic Considerations We assume the seismic design of the proposed development will be in accordance with the California Building Code (CBC), 2007 edition. For the 2007 CBC, a Site Class C may be used. The seismic code values can be obtained directly from the tables in the building code using the above values and appropriate United States Geological Survey web site (Reference 3). The seismic design method should be determined bythe Project Structural Engineer. During the life ofthe project, the site will likely be subject to strong ground motions due to earthquakes on nearby faults. We have computed that the site could be subjected to a peak ground acceleration of 0.33g. This acceleration has been computed utilizing 40 percent of the SDS for the project. The structural design of the facility will need to incorporate measures to mitigate the effects of strong ground motion. 2015-0-15L.doc (5/13) 573B Corporate Avenue • Cypress, CA 90B30 • [714) 220-S211, FAX 220-2122 North Coast Calvary Chapel Proposed Chapel Project, Carlsbad. Califomia Mays, 2013 GPl Proiect No. 2015.C Earthwork The existing pad forthe Chapel Building should be stripped of vegetation. All deleterious material generated during the clearing operation should be removed from the site. The pad subgrade should be scarified to a depth of 8 inches, moisture-conditioned, and compacted to at least 95 percent of the maximum dry density in accordance with ASTM D-1557. Closing We trust this information satisfies the requirements of the City of Carlsbad to update our previously approved report. The opportunity to be of service is appreciated. If you have any comments or questions, please call. Very truly yours, Geoteohnical PTiofessionals Inc. Donald A. Cords, G.E. Principal MAY - 8 2013 DAC:sph cc: (3) Mr. James Thayer, Timeless Architecture, (for City Submittal) 2015-C-15L.doc (5/13) North Coast Calvary Chapel May 8,2013 Proposed Chapel Project, Carlsbad, California GPl Project No. 201 S.C REFERENCES Geotechnical Professionals Inc., "Report of Geotechnical Investigation, Proposed North Coast Calvary Chapel Building Project, Aviara Parkway and Poinsettia Lane, Carlsbad, California," GPl Project No. 2015.1, dated March 2, 2005. Geotechnical Professionals Inc., "Reportof Observation and Testing During Rough Grading, North Coast Calvary Chapel Building, NEC Poinsettia Lane and Aviara Parkway, Carlsbad, California," GPl Project No. 2015.C, dated November 20,2006. http://earthauake.usqs.gov/research/hazmaps/design/ for determination of Ss and SI vaiues 2015-C-15L.doc(5/13) am GEOTECHNICAL PROFESSIONALS INC. December 16, 2010 North Coast Calvary Chapel 1330 Poinsettia Lane Carlsbad, California 92009 Attention: Mr. Jack Shubin Subject: Update of Geotechnical Investigation North Coast Calvary Chapel Building Project NEC Poinsettia Avenue & Aviara Parkway Carlsbad, California GPl ProjectNo. 2015.1 Dear Mr. Shubin: A geotechnical investigation (Reference 1) was prepared in March 2005, for the building project for North Coast Calvary Chapel in Carlsbad, Califomia. Reference 1 included recommendations for Phase 2, which included the Chapel Building. We understand that the Chapel Building is now planned to be constructed atthe location shown in Reference 1. The recommendations contained in Reference 1 remain applicable for the new Chapel Building proposed for the site. We understand no significant changes to the project that has been described in our report. We trust this information satisfies the requirements of the City of Carlsbad to update our report. Please do not hesitate to call if you have any questions on the contents of this letter. lly submitted, ssionals inc. 0 Donald A. Cor Associate DAC:sph Enclosures: Reference cc: Mr. Jim Thayer, Timeless Architecture 2015-l-04L.doc (12/10) DEC I 6 2010 573B Corporate Avenue • Cypress, CA 90630 • C714D 220-2211 , FAX C7,^'^') SSO-^^S ^^\\A\ (3k \ Oa-^^ I North Coast Calvary Chapel December 16, 2010 Proposed Chapel Building Project, Carlsbad, California GPl Project No. 2015.1 REFERENCE 1. Geotechnical Professionals, Inc., "Geotechnical Investigation, Proposed North Coast Calvary Chapel Building Project, Aviara Parkway and Poinsettia Lane, Carlsbad, California," GPl Project No. 2015.1, dated March 2, 2005. 2015-l-04L.doc (12/10) REPORT GEOTECHNICAL INVESTIGATION PROPOSED NORTH COAST CALVARY CHAPEL BUILDING PROJECT AVIARA PARKWAY AND POINSETTIA LANE CARLSBAD, CALIFORNIA Prepared for: North Coast Calvary Chapel 7220 Avenida Encinas, Suite 204 Carisbad, California 92009 Prepared by: Geotechnical Professionals Inc. 6640 Lusk Boulevard, Suite A204-C San Diego, California 92121 (858) 623-9551 Project No. 2015.1 March 2, 2005 CBIO North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 TABLE OF CONTENTS PAGE 1.0 INTRODUCTION 1 1.1 GENERAL 1 1.2 PROPOSED DEVELOPMENT 1 1.3 PURPOSE OF INVESTIGATION 2 1.4 PREVIOUS GEOTECHNICAL REPORTS 2 2.0 SCOPE OF WORK 3 3.0 SITE CONDITIONS 4 3.1 SURFACE CONDITIONS 4 3.2 SUBSURFACE CONDITIONS 4 3.3 SITE GEOLOGIC CONDITIONS 5 3.4 GROUNDWATER AND CAVING 6 4.0 CONCLUSIONS AND RECOMMENDATIONS 7 4.1 GENERAL 7 4.2 SEISMIC CONSIDERATIONS 8 4.2.1 General 8 4.2.2 Strong Ground Motion Potential 9 4.2.3 Ground Rupture 9 4.2.4 Liquefaction 9 4.2.5 Seismic Ground Subsidence 9 4.3 EARTHWORK 10 4.3.1 Clearing and Grubbing 10 4.3.2 Excavations 10 4.3.3 Subgrade Preparation 12 4.3.4 Material for Fill 12 4.3.5 Placement and Compaction of Fills 13 4.3.6 Shrinkage and Subsidence 13 4.3.7 Trench and Retaining Wall Backfills 13 4.3.8 Observation and Testing 14 4.4 FOUNDATIONS 14 4.4.1 General 14 4.4.2 Allowable Bearing Pressures 14 4.4.3 Minimum Footing Width and Embedment 15 4.4.4 Estimated Settlements 15 4.4.5 Lateral Load Resistance 16 4.4.6 Foundation Concrete 16 4.4.7 Footing Excavation Observation 16 4.5 BUILDING FLOOR SLABS 16 4.6 RETAINING WALLS 17 4.7 SLOPES 18 4.8 DRAINAGE 19 4.9 EXTERIOR CONCRETE AND MASONRY FLATWORK 19 4.10 PAVED AREAS 19 4.11 GEOTECHNICAL OBSERVATION AND TESTING 20 5.0 LIMITATIONS 21 REFERENCES 2015-I-03R (3/05) North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 TABLE OF CONTENTS - CONTINUED APPENDICES A EXPLORATORY BORINGS B LABORATORY TESTS LIST OF FIGURES FIGURE NO. 1 2 3 4 Site Location Map Site Plan Fill Slope Detail Backdrain Detail APPENDIXA A-1 to A-8 Logs of Borings APPENDIX B B-1 to B-2 B-3 to B-5 Consolidation Test Results Direct Shear Test Results 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 1.0 INTRODUCTION 1.1 GENERAL This report presents the results of a geotechnical investigation performed by Geotechnical Professionals Inc. (GPl) for the proposed church campus in Carlsbad, California. The geographical location of the site is shown on the Site Location Map, Figure 1. 1.2 PROPOSED DEVELOPMENT The project will consist of the design and construction of a new church campus with a multi-purpose/family center, chapel, and other associated buildings. The project will be located on an undeveloped 26-acre parcel on the northeast corner of Poinsettia Lane and Aviara Parkway. The proposed site of the buildings is situated on a relatively level area with 14 buildable acres above slopes cut during the grading of Poinsettia Lane and Avaria Parkway. We understand the project will be constructed in phases. The first phase will include the Multi-Purpose Building/Family Center with a footprint of approximately 29,000 square feet, and a Preschool Building with a footprint of approximately 12,260 square feet. The second phase will include the Chapel Building with a footprint of 11,557 square feet, a Youth Building with a footprint of 6,978 square feet and a Gymnasium (7,770 square feet) connecting to the Multi-Purpose Building. The buildings will be located in the center of the site surrounding the plaza area and playground areas surrounding the buildings. On the perimeter of the buildings/plaza/playground areas, there will be parking spaces for 842 cars. The parking areas will extend north of the building areas along the edge of Aviara Parkway and be connected over a lower level entrance road by a single-span bridge. The bridge will span approximately 45 feet between the abutments and will include approach slabs and wingwalls. The lower level entrance will be cut through the existing slopes from Aviara Parkway. An existing entrance into the site through the slopes north of the proposed bridge site will be filled. Adjacent to the parking area on the north development line of the project will be an unpaved access roadway and stormwater retention basin. The development line for the project will be a minimum of 20 feet from the edge of the parking lot. A storm drain will run under the access road to the retention basin, which outlets into the adjacent canyon. The total paved parking area will be approximately 264,000 square feet. In addition, concrete flatwork for the project will cover approximately 43,000 square feet. A retaining wall with heights of up to 11 feet will be required between the buildings and the lower level parking area to the east of the buildings. This wall may consist of mechanically stabilized embankment (MSE). Current project plans appear to indicate that the northeast wall of the Multi-Purpose Building/Family Center will he supported near the edge of the proposed retaining wall. At other areas of the site, smaller retaining walls typically less than 6 feet high will also be required. The second phase will expand the facility including a gymnasium connecting to the Multi-Purpose Building/Family Center, a bookstore/Chapel Building, and a Youth Building. A future elevated parking deck is planned above the phase 1 parking area to the north and east ofthe Multi-Purpose building/Family Center. The second phase buildings and parking deck will not likely be developed for several years. 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 We have assumed metal framing and studs for the construction of the Multi- Purpose/Family Center and masonry block or wood-frame construction for the Preschool Building. With the exception of a partial basement at the Multi-Purpose Building, basement construction for the other buildings is not planned; however, minor amounts of cut and fill are anticipated to develop the site as discussed below. The proposed site configuration is shown on the Site Plan, Figure 2. Based upon preliminary information provided by the Structural Engineer, we have assumed maximum isolated column and continuous wall loads of 86 kips and 2 kips per lineal foot, respectively. Structural loading information for the bridge, future parking deck, or gymnasium was not available at the time this report was prepared. For the bridge structure, we have assumed vertical abutment loads of approximately 13 kips/linear foot. We have assumed the future parking deck will have typical interior and exterior column loads of 150 and 75 kips, respectively. For the gymnasium, column loads of 150 to 200 kips are anticipated. The finished floor of the buildings will be vary from about Elevation 303 to 304 feet, which is within about 2 feet of the existing site grades in the vicinity of all buildings except the family center. At the site of the proposed family center, fills of on the order of 8 to 9 feet will be required. The recommendations given in this report are based upon preliminary structural and grading information. We will need to review more detailed plans as the project progresses when the actual loads and/or grade changes are known to either confirm or modify our recommendations. 1.3 PURPOSE OF INVESTIGATION The purpose of this investigation and report is to provide an evaluation of the existing geotechnical conditions at the site, as they relate to the design and construction ofthe proposed improvements. More specifically, this investigation was aimed at providing geotechnical recommendations for earthwork and design of foundations, retaining structures, and pavements. 1.4 PREVIOUS GEOTECHNICAL REPORTS A geotechnical investigation was previously performed at the site (Reference 1 and 2). We reviewed the information provided in the reports. 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 2.0 SCOPE OF WORK Our scope of work for this investigation consisted of review of existing geotechnical reports, field exploration, laboratory testing, geologic and engineering analysis, and the preparation of this report. The field exploration consisted of eight (8) exploratory borings and nineteen (19) test pits. The locations ofthe subsurface explorations are presented on the Site Plan, Figure 2. The borings were drilled using bucket auger equipment and extended to depths ranging between 20 to 35 feet below existing site grades. Two ofthe deepest borings were downhole- logged by our certified engineering geologist. The test pits were excavated using a backhoe to depths of 4 to 13 feet below existing site grades. A description of field procedures and logs of borings are presented in Appendix A. Laboratory soil tests were performed on selected representative soil samples as an aid in soil classification and to evaluate the engineering properties of the soils. The geotechnical laboratory testing program included determinations of moisture/density, shear strength (direct shear), compressibility (consolidation), expansion potential, compaction, gradation, R-value, and corrosion potential. Laboratory testing procedures and results are summarized in Appendix B. R-value testing was performed by GeoLogic, Inc. under subcontract to GPl. The test results are presented in Appendix B. A soil corrosivity study was performed by M.J. Schiff and Associates under subcontract to GPl. The results are provided in Appendix B of this report. A geologic evaluation of the site was performed by our consulting certified engineering geologist. The evaluation included downhole-logging of two of our exploratory borings and review of available published and unpublished data. The geologic-seismic evaluation is incorporated herein. Engineering evaluations were performed to provide earthwork criteria, foundation, retaining structure, and slab design parameters, and assessments of seismic hazards. The results of our evaluations are presented in the remainder of this report. 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 3.0 SITE CONDITIONS 3.1 SURFACE CONDITIONS The site is bounded by Aviara Parkway to the west, Poinsettia Lane to the south, a relatively flat empty lot to the east, and a downward sloping, undeveloped parcel to the north. The majority of the property is located above slopes cut during the construction of Aviara Parkway and Poinsettia Lane. Based on existing topographic information, the existing ground surface grades in the building and parking areas range from approximately Elevation 305+ feet near the southwest side of the site to Elevation 275+ at the southeastern site limit. The existing ground surface grades at the bottom of the slopes along Aviara Parkway range from approximately Elevation 270+ feet on the south limit of the site to Elevation 285+ at the north limit of the site. The existing ground surface grades at the bottom of the slopes along Poinsettia Lane range from approximately Elevation 285+ feet on the west limit ofthe site to Elevation 290+ at the east limit of the site. At the time of our field investigation, the site was undeveloped with much of the surface soils vegetated with grasses and small brush and in a very loose condition. We understand the property was used for agricultural purposes in the past. We observed abandoned fragmented plastic pipes from past agricultural uses ofthe property buried in the upper surface soils. Atthe northeastern portion of the site, we observed dumped fill material. A gravel access road entering the site exists along the northern portion of the site and cuts through the slopes from Aviara Parkway. The most significant site feature is the 25 to 30+ feet high slope descending to Aviara Parkway and Poinsettia Lane along the western and southern site limits. These slopes are unvegetated and exhibit moderate to significant gullies from erosion due to rain water falling on the slopes or flowing over the sides of the slopes. An abandoned water line crosses the site from the northeastern portion ofthe site to the center ofthe site to the slopes above Aviara Parkway. Based upon discussions with an engineer from the City of Carisbad, we understand this pipe to be a 24-inch diameter steel pipe with about 3+ feet of cover. We understand the pipe was abandoned without backfilling the interior of the pipe with grout. 3.2 SUBSURFACE CONDITIONS Our field explorations disclosed a subsurface profile generally consisting of undocumented fills and natural materials. Detailed descriptions of the materials encountered are shown on the Log of Borings and Test Pits, Appendix A. The geologic conditions are also discussed in a following section. The natural materials encountered at the site consisted predominately of relatively thin layers of residual soils/colluvium underiain by the sedimentary bedrock. In general, the site is covered with 1 to 4 feet of residual/colluvium soils with the exception ofthe cut slopes and roadway from Aviara Parkway and the undocumented fill at the northeastern end of the site. The residual/colluvium soils general consist of predominately clayey sand and silty sand with varying amounts of clay. In general, these materials are very loose to loose with moisture contents from very moist to wet. These soils are very compressible in their present state. As the site was previously used for agricultural uses, we anticipate topsoils will have varying amounts of organics and may be expansive. 2015-I-03R (3/05) 4 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 The underiying sedimentary bedrock general consists predominately of sandstone composed of silty sands with varying degrees of cementation. In general, these materials are dense to very dense with moisture contents from slightly moist to moist. The bedrock soils exhibit low compressibility and moderate to high strength characteristics. In general, the sandstone materials exhibit a low potential for expansion. Traces of clay materials were observed in the sandstone. Past investigations (References 1 and 2) encountered a highly expansive siltstone bed at an elevation ranging from approximately 275+ feet to 290+ feet. Fill soils were encountered at the northeastern portion ofthe site as shown in Figure 2 and in one of our borings and a test pit (Boring B-1 and Test Pit TP-4). The depths ofthis fill material in our explorations range from 8 to 12/2 feet below existing grades. The fill soils generally consist of silty sands and trace construction debris in a loose to very loose state. No oversize material was observed in the fill but should be anticipated during grading. The moisture content of the fill soils encountered was moist to saturated. The depth of fill appears to increase towards the undeveloped parcel to the north and is shallower towards the proposed building and parking areas. This fill material appears to extend outside the property development line. 3.3 SITE GEOLOGIC CONDITIONS The project site is located in coastal San Diego County just north of Batiquitos Lagoon in the City of Carlsbad, California. The site has a maximum elevation of approximately 305 feet, and published maps (Reference 3) correlate the area to the highest of four marine terraces (Qt4) that occur in the local coastal area. Much ofthe site is in a more-or-less natural condition, although the property has been used for agricultural purposes in the past, and remnants of plastic pipes etc. are found on the site. Previous grading includes controlled grading of 25- to 30-foot high cut slopes along Aviara Parkway (west facing) and Poinsettia Avenue (south, southeast facing) along the west and south margins ofthe property. Other grading includes what appears to be a borrow site cut in the northwest corner, and an access driveway cut into the cut slope along Aviara Parkway. Undocumented fill, with a maximum thickness of at least 121^ feet, has been placed in the canyon area in the north-portion of the site adjacent to Parcel 1, planned for open space uses (Figure 2, Site Plan). This undocumented fill appears to be uncompacted and includes construction rubble and trash. The site is underiain by bedrock ofthe Santiago Formation, which generally consists of poorly cemented, fine to medium-grained, light gray to yellowish brown sandstone with lenses of rounded, cobble conglomerate, and beds of gray, green and red claystone and siltstone. The sandstone is generally massive to very pooriy bedded, but is locally cross-bedded. Based on mapping of a continuous claystone/siltstone bed in the existing cut slopes along Aviara Parkway and Poinsettia Lane, bedding in the formation is approximately horizontal. Based on existing exposures in the cut slopes, as well as from the borings on site, the uppermost 10 feet of the sandstone, below existing surface grades, oxidizes to an orange brown rust color. Previous reports (Reference 1) have classified this oxidized zone as a terrace deposit. Based on our observations, the oxidized zone observed is a weathering phenomenon on the upper surface of the Santiago Formation. No terrace deposits were observed. Mantling the bedrock are topsoil and residual soils, ranging in thickness from 1 to 4 feet, consisting ofvery moist to saturated, dark brown silty sand. 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 3.4 GROUNDWATER AND CAVING Perched groundwater was encountered in one exploratory boring (Boring B-1) at the contact of the undocumented fill and the bedrock deposits. This perched groundwater was encountered at depths of 8 feet below existing grades, which corresponds to an elevation of approximately +274 feet above mean sea level. The source of the perched groundwater is likely from infiltration of rain runoff and past irrigation practices. The depth to permanent groundwater at the site is expected to occur at depths greater than 50 feet. Minor caving was encountered in our exploratory borings in saturated native soils immediately above the bedrock contact in Boring B-1. 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 4.0 CONCLUSIONS AND RECOMMENDATIONS 4.1 GENERAL Based on the results of our investigation, it is our opinion that, from a geotechnical viewpoint, it is feasible to develop the site as proposed, providecl the recommendations contained herein are incorporated into the design and construction of the project. The major geotechnical constraints related to the proposed construction are as follows: • Prior to placement of fills or construction of buildings, all existing undocumented fills and any natural soils above the bedrock in the proposed building areas should be removed and replaced as properiy compacted fill. Any topsoils with organic matter should be removed from the site or disposed of in landscape areas. These materials need to be densified to provide adequate support for the building foundations. The depths of removal and details regarding excavations are provided in the "Earthwork" section ofthis report. • Uncompacted fills were encountered in our explorations within the Phase 1 parking area (and phase 2 parking deck) north of the buildings to depths of between 5 and 12/4 feet below existing grades. The upper natural soils (residual and colluvium) encountered immediately beneath the fill have variable strength and consolidation characteristics. As such, these soils are not considered to be suitable for support of the planned future parking deck foundations, pavement, and compacted fills. We recommend that all undocumented fills be removed and replaced as properiy compacted fill, where not removed by cut. The depths of removal and details regarding excavations are provided in the "Earthwork" section of this report. The uncompacted fills extend beyond the development line limit in the northeast portion of the project. We estimate the fills and compressible soils at the development line limit may be up to 10 feet deep. The base of removals for the undocumented fill should extend laterally beyond the unpaved access roadway line a minimum distance of 5 feet orthe depth of overexcavation/compaction below finished grade (i.e., a 1:1 projection below finished grade of access road), whichever is greater. If environmental constraints do not allow removal of undocumented fill outside the development line, we recommend the fills be excavated from the development line to firm and competent natural material (bedrock). If uncompacted fill remains within the lateral distance described above from the access road line, periodic maintenance ofthe unpaved road can be anticipated. The depths of removal and details regarding excavations are provided in the "Earthwork" section of this report. Some ofthe on-site residual soils and colluvium soils may be expansive and should not used as retaining wall backfill or within the upper 3 feet of building pads or hardscape areas. These soils should be incorporated into deeper fills or pavement areas. Fill soils under the future parking deck and within the existing access road cut from Aviara Parkway should consist of on-site or imported sandy soils and should be compacted to at least 95 percent of the maximum dry density (ASTM D 1557) to help 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 mitigate differential settlements and long-term fill settlement. • The bridge footings adjacent to descending slopes should be deepened to allow for a lateral distance of at least one-half of the slope height, but not less than 15 feet, between the base of the footing and the face of the slope. • We recommend that MSE walls be avoided under structures as lateral displacements inherent in these types of walls could result in settlement of buildings. Retaining walls support in structures should be designed for at-rest pressures and the surcharge loads due to the structures. An alternate method of design would be to deepen the structure foundations to avoid surcharging the wall. GPl should review the geotechnical aspects of the design of the walls when details are available. • The footings for the parking structure will be founded on bedrock and a variable thickness of compacted fill. The footings may be supported directly on the bedrock and fill. However, we recommend the footing bearing on fill be deepened such that no more than 5 feet of fill will remain between the bottom of the footing and the top of the bedrock. The recommendation is intended to help mitigate the potential differential settlements. Survey control during grading will be needed to document the elevation of the bedrock during removals. • As noted in the geologic assessment of the site, the bedrock encountered in our explorations and observed in the existing cut slopes was noted to be horizontally bedded. As such, the stability of excavations extending into the bedrock material is not anticipated to be adversely affected by the potential for adverse bedding. We recommend that our geologist be on-site during the excavation ofthe new access road into the site to confirm the actual subsurface conditions encountered. • Some repair of the existing eroded slopes at the site is anticipated. Thin sliver fills should not be placed over the existing slope face. Recommendations for fill placement are provided are provided in the "Slopes" section of this report. • Slopes should be seeded or planted as soon as possible to reduce the erosion potential. We recommend deep-rooted plants adapted to semi-arid climates be used. Other protective measures, such as installing drains and grading the top ofthe slope to drain away from the slope face, should be taken. 4.2 SEISMIC CONSIDERATIONS 4.2.1 General The site is located in a seismically active area typical of Southern California and is likely to be subjected to strong ground shaking due to earthquakes on nearby faults. We assume the seismic design of the proposed development will be in accordance with California Building Code (CBC)/Uniform Building Code (UBC) criteria. The site is located within Seismic Zone No. 4. For the 2001 CBC/1997 UBC, a Site Soil Profile Sc may be used. A Type B Seismic Source with a distance to seismic source of approximately 8 kilometers should be used 2015-I-03R (3/05) 8 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 with Tables 16S and 16T: Na=1.0 Nv=1.0 The actual method of seismic design should be determined by the Project Structural Engineer. 4.2.2 Strong Ground Motion Potential Based on published information presented in Reference 4, the most significant fault in the proximity of the site is the Coronado Bank Fault, which is located approximately 6 kilometers from the site. Based on information provided in Reference 5, the site could be subjected to strong ground motion on the order of 0.32g. This acceleration has a 10 percent chance of being exceeded in 50 years. 4.2.3 Ground Rupture There are no known active faults crossing or projecting toward the site. The site is not located in an Alquist-Priolo Earthquake Fault Zone. Based on this information, the potential for ground rupture at the site is considered remote. 4.2.4 Liquefaction Liquefaction is a phenomenon in which saturated soils undergo a temporary loss of strength during severe ground shaking and acquire a degree of mobility sufficient to permit ground deformation. In extreme cases, the soil particles can become suspended in groundwater, resulting in the soil deposit becoming mobile and fluid-like. Liquefaction is generally considered to occur primarily in loose to medium dense deposits of saturated sands and silts. Thus, three conditions are required for liquefaction to occur: (1) a sand or silt of loose to medium density; (2) saturated conditions; and (3) rapid, large strain, cyclic loading, normally provided by earthquake motions. The site is not located within an area identified by the State of California as having a potential for soil liquefaction. The subsurface materials remaining in-place after construction of the buildings will consist of dense to very dense granular soils, and bedrock. The only groundwater encountered was perched on top ofthe bedrock. Based on these findings, we do not anticipate liquefaction to adversely impact the proposed development. 4.2.5 Seismic Ground Subsidence Seismic ground subsidence, not related to liquefaction, occurs when loose, granular (sandy) soils are densified during strong earthquake shaking. Significant subsidence during a strong earthquake is not expected to occur if the recommended earthwork is performed because the on-site sandy soils are predominantly dense to very dense. 2015-I-03R (3/05) North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 4.3 EARTHWORK The earthwork anticipated at the project site will consist of clearing and grubbing, excavations, subgrade preparation, and the placement and compaction of fill. 4.3.1 Clearing and Grubbing Prior to grading, the areas to be developed should be stripped of vegetation, cleared of all debris from past agricultural uses, old foundations, and abandoned utilities, etc. All deleterious material generated during the clearing operation should be removed from the site. Where appropriate, existing underground utilities should be removed in their entirety and properiy capped. Should cesspools or other buried obstructions be encountered in the building areas during construction, they should be removed in their entirety. The resulting excavations should be backfilled as recommended in the "Subgrade Preparation," "Material for Fill," and "Placement and Compaction of Fill" sections of this report. As an alternative, any cesspools can be backfilled with lean sand-cement slurry. At the conclusion of the clearing operations, the Geotechnical Engineer should observe and accept the site prior to any further grading. 4.3.2 Excavations Excavation at the site will include removal of existing undocumented fill and compressible natural soils, excavation to finish subgrade, footing excavations, and trenching for utility lines. Prior to placement of fills or construction of buildings, all existing undocumented fills and any natural soils above the bedrock in the proposed building areas should be removed and replaced as properiy compacted fill. These materials need to be densified to provide adequate support for the building foundations. Any topsoils with organic matter should be removed from the site or disposed of in landscape areas. For planning purposes, we recommend that removals within building areas extend to a depth of 3 feet below existing grades or 2 feet below footings, whichever is deeper. The proposed buildings, except the parking deck, should be supported on at least 2 feet of compacted fill over the bedrock. The bridge foundations are expected to be supported in bedrock material excavated at depths of at least 3 feet below the existing site grades. For support of the foundations of the future parking deck, excavation depths of at least 2 feet below the finished grade can be anticipated except in compacted fill areas, where the footing excavations may be deeper. Deeper removals may be required in localized thicker zones of compressible soils. The actual depths of removals will need to be determined during grading in the field by a representative of GPl. Ifany building pad areas will be located on a cut-fill transition, we recommend the outside ofthe pad be overexcavated a minimum of 3 feet below all footings throughout the entire building pad area. This will allow the entire building to be supported on compacted engineered fill and help mitigate potential differential settlement. The base of removals should extend laterally beyond the building line or perimeter footings a minimum distance of 5 feet or the depth of overexcavation/compaction below foundations (i.e., a 1:1 projection below the bottom edge of footings), whichever is greater. Building lines include all canopies, loading docks, site walls, and other foundation supported improvements. 2015-I-03R (3/05) 10 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl ProjectNo. 2015.1 Uncompacted fills were encountered in our explorations within the Phase 1 parking area (Phase 2 parking deck) north of the buildings to depths of between 5 and 1272 feet below existing grades. The upper natural soils (residual and colluvium) encountered immediately beneath the fill have variable strength and consolidation characteristics. As such, these soils are not considered to be suitable for support of the planned future parking deck foundations, pavement, and compacted fills. We recommend that all undocumented fills be removed and replaced as properiy compacted fill, where not removed by cut. The uncompacted fills extend beyond the development line limit in the northeast portion of the project. We estimate the fills and compressible soils at the development line limit may be up to 10 feet deep. The base of removals for the undocumented fill should extend laterally beyond the unpaved access roadway line a minimum distance of 5 feet or the depth of overexcavation/compaction below finished grade (i.e., a 1:1 projection below finished grade of access road), whichever is greater. If environmental constraints do not allow removal of undocumented fill outside the development line, we recommend the fills be excavated from the development line to firm and competent natural material (bedrock). If uncompacted fill remains within the lateral distance described above from the access road line, periodic maintenance ofthe unpaved road can be anticipated. The base of removals for the undocumented fill should extend laterally beyond the edge ofthe proposed parking lot a minimum distance of 5 feet or the depth of overexcavation/compaction below finished grade (i.e., a 1:1 projection below finished grade of parking lot), whichever is greater. The lateral limits of any removals should be confirmed and certified by the project surveyor. GPl does not practice surveying, therefore, we cannot confirm any lines, grades or limits of earthwork. Where not removed by the aforementioned excavations, existing utility trench backfill should be removed and replaced as properiy compacted fill. This is especially important for deeper fills such as existing sewers and storm drains. For planning purposes, removals over the utilities should extend to within 1 foot of the top of the pipe. For utilities that are 5 feet or shallower, the removal should extend laterally 1 foot beyond both sides of the pipe. For deeper utilities, the removals should include a zone defined by a 1:1 projection upward (and away from the pipe) from each side ofthe pipe. Any abandoned utility pipes should be removed or backfilled with a sand-cement slurry. The actual limits of removal will be confirmed in the field. We recommend that all known utilities be shown on the grading plan. Excavations in sandstone materials will require light to moderate ripping. Localized cemented layers in the sandstone materials will require moderate to heavy ripping. Temporary construction excavations may be made vertically without shoring to a depth of 5 feet below adjacent grade. For deeper cuts up to 20 feet within the existing fill soils, the slopes should be properly shored or sloped back to at least 1:1 or flatter. No surcharge loads should be permitted within a horizontal distance equal to the height of cut from the top of the excavation or five feet from the top ofthe slopes, whichever is greater, unless the cut is properiy shored. Excavations that extend below an imaginary plane inclined at 45 degrees below the edge of any adjacent existing building or settlement sensitive structure should be properly shored to maintain support of such adjacent elements. All excavations and shoring systems 2015-I-03R (3/05) 11 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 should meet the minimum requirements given in the most current State of California Occupational Safety and Health Standards. Based on the results of our borings and laboratory testing, the topsoils, residual, and fill soils encountered on the site exhibit moisture contents from moist to very moist. Drying and mixing of the wet materials may be required during grading and should be included in the earthwork bids. The grading contractor should determine the equipment most suited to the site conditions. 4.3.3 Subgrade Preparation Prior to placing fills, the subgrade should be scarified to a depth of 12 inches, moisture- conditioned, and compacted to at least 90 percent (95 percent for granular soils) of the maximum dry density in accordance with ASTM D 1557 and to a firm and unyielding condition. In areas to receive pavements, the top 12 inches below the pavement base should be scarified, moisture conditioned, and compacted to a minimum of 95 percent of the maximum dry density. 4.3.4 Material for Fill With the exception of minor amounts of topsoil, in general, the on-site soils are suitable for use as compacted fill. However, any on-site clays, if encountered, should not be used as retaining wall backfill or within the upper 3 feet of building pads or hardscape areas. Drying and mixing of some of these materials will be required to obtain near optimum moisture conditions prior to placement and compaction. Some ofthe on-site residual soils and colluvium soils may be expansive and should not used as retaining wall backfill or within the upper 3 feet of building pads or hardscape areas. These soils should be incorporated into deeper fills. We expect that non-expansive soils, derived from the sandstone and some on-site soils, are available from cut materials. Provided it is acceptable to the reviewing governmental agencies and owner, crushed, inert demolition debris, such as concrete and asphalt, may be used in fills outside the building pads provided it is crushed to a well graded mixture with maximum particle size of IV2 inches and blended with the on-site soils. The undocumented fill at the site may be suitable for use as fill material, provided organic debris, and other deleterious material is removed. Imported fill material should be predominately granular (contain less than 40 percent fines- portion passing the No. 200 sieve) and non-expansive (an Expansion Index of 20 or less). The Geotechnical Engineer should be provided with a sample (at least 50 pounds) and notified of the location of any soils proposed for import at least 72 hours in advance of importing. Each proposed import source should be sampled, tested and accepted for use prior to delivery ofthe soils to the site. Soils imported prior to acceptance by the Geotechnical Engineer may be rejected if not suitable. Both imported and existing on-site soils to be used as fill should be free of deleterious debris and particles larger than 6 inches in diameter. 2015-I-03R (3/05) 12 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 4.3.5 Placement and Compaction of Fills Fill soils should be placed in horizontal lifts, moisture-conditioned, and mechanically compacted to at least 90 percent (silts and clays) of the maximum dry density (ASTM D 1557). Granular soils (sands, silty sands, and clayey sands) should be compacted to at least 95 percent. Fill soils under the future parking deck and within the existing access road cut from Aviara Parkway should be compacted to at least 95 percent of the maximum dry density (ASTM D 1557) to help mitigate differential settlements and long-term fill settlement. The optimum lift thickness will depend on the compaction equipment used and can best be determined in the field. The following uncompacted lift thickness can be used as preliminary guidelines. Plate compactors, track equipment 4-6 inches Small vibratory or static rollers 6-8 inches Scrapers and heavy loaders 8-12 inches The maximum lift thickness should not be greater than 12 inches. Each lift should be thoroughly compacted and accepted prior to placement of the next lift of fill. The moisture content of the clayey fill materials should be within 2 to 4 percent over the optimum moisture content to readily achieve the required degree of compaction and reduce the potential for moisture related swell or subsidence. For the sandy fill materials, the moisture content should be within 0 to 2 percent over the optimum moisture content. The moisture content of existing near surface soils, in general, is variable and will require both drying and moistening prior to compaction. Earthwork contractors should include moisture conditioning of the existing soils prior to recompaction in the bids. During backfill of excavations, the fill should be properiy benched into the construction slopes of greater than 5:1 (horizontahvertical) as it is placed in lifts. Benching should be at least 10-foot wide with a minimum of 4 feet vertically between benches within firm natural ground, competent bedrock or engineered compacted fill. 4.3.6 Shrinkage and Subsidence Shrinkage is the loss of soil volume caused by compaction of fills to a higher density than before grading. Subsidence is the settlement of in-place subgrade soils caused by loads generated by large earthmoving equipment. For earthwork volume estimating purposes, an average shrinkage value of 10 to 15 percent may be assumed for the existing on-site soils. Fills derived from the bedrock may bulk on the order of 5 percent. Subsidence of the bedrock is expected to be negligible. These values are estimates only and exclude losses due to removal of vegetation, debris, or existing underground structures. Actual shrinkage and subsidence will depend on the types of earthmoving equipment used and should be determined during grading. 4.3.7 Trench and Retaining Wall Backfills Utility trench and wall backfill should be mechanically compacted in lifts. Wall backfill should consist of the on-site or imported silty sands or sands. Some moisture conditioning of the on- site soils should be anticipated prior to replacement as trench backfill. Lift thickness should not exceed those values given in the "Compacted Fill" section ofthis report. Jetting or flooding of backfill materials should not be permitted. A representative of GPl should observe and test all 2015-I-03R (3/05) 13 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 trench and wall backfills as they are placed. In backfill areas where mechanical compaction of soil backfill is impractical due to space constraints, sand-cement slurry may be substituted for compacted backfill. The slurry should contain one sack of cement per cubic yard and have a maximum slump of 5 inches. The slurry placed within the building areas should contain two sacks of cement per cubic yard. When set, these mixes typically have the consistency of compacted soil. 4.3.8 Observation and Testing A representative of GPl should observe all excavations, subgrade preparation and fill placement activities. Sufficient in-place field density tests should be performed during fill placement to evaluate the overall compaction of the soils. Soils that do not meet minimum compaction requirements should be reworked and tested prior to placement of any additional fill. A geologist should observe the conditions exposed during the mass excavation. If conditions are different than expected, alternate recommendations, based on the actual conditions encountered, may be required. 4.4 FOUNDATIONS 4.4.1 General The proposed structures may be supported on conventional isolated and/or continuous shallow footings provided the subsurface soils are prepared in accordance with the recommendations given in this report. All footings for the church buildings should be supported on properiy compacted fill. All footings for the bridge structure should extend at least 2-feet into the undisturbed bedrock. The footings for the future parking deck may be supported on properiy compacted fill and bedrock, provided the footings are supported on no more than 5 feet of fill. Deepening of some of the footings may be needed to achieve this recommendation. 4.4.2 Allowable Bearing Pressures Based on the shear strength and elastic settlement characteristics of the recompacted on-site soils (new fills), a static allowable bearing pressure of up to 3,000 pounds per square foot (psf) may be used forthe continuous footings and isolated column footings forthe church buildings, retaining walls, and future parking deck. Based on the shear strength and elastic settlement characteristics ofthe undisturbed on-site bedrock, a static allowable bearing pressure of up to 5,000 pounds per square foot (psf) may be used for the bridge structure abutment footings. These bearing pressures are for dead load-plus-live loads, and may be increased one-third for short-term, transient, wind and seismic loading. The actual bearing pressure used may be based on economics and structural loads, and will determine the minimum width for footings as discussed below. The maximum edge pressures induced by eccentric loading or overturning moments should not be allowed to exceed these recommended values. 2015-I-03R (3/05) 14 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 4.4.3 Minimum Footing Width and Embedment The following minimum footing widths and embedment are recommended forthe corresponding allowable bearing pressure. Church Buildings, Retaining Walls and Parking Deck Static Bearing Pressure 3,000 Minimum Footing Width (inches) 24 Minimum Footing* Embedment (inches) 24 2,500 18 18 Static Bearing Pressure (psf) Minimum Footing Width (inches) Minimum Footing* Embedment (inches) 5,000 24 36 4,000 24 24 * Refers to minimum depth below lowest adjacent grade. Footings adjacent to descending slopes should be deepened to allow for a lateral distance of at least one-half of the slope height, but not less than 15 feet, between the base of the footing and the face of the slope. We should be provided with the foundation and grading plans to review the footing conditions relative to the proposed adjacent grades prior to bidding the project. We recommend that MSE walls be avoided under structures as lateral displacements inherent in these types of walls could result in settlement of buildings. Retaining walls support in structures should be designed for at-rest pressures and the surcharge loads due to the structures. An alternate method of design would be to deepen the structure foundations to avoid surcharging the wall. GPl should review the geotechnical aspects of the design of the walls when details are available. Minimum footing widths and depths of 18 inches should be used even if the actual bearing pressure is less than 2,500 psf. 4.4.4 Estimated Settlements Based on the load information assumed for the buildings (column loads of 75 kips or greater), the total static foundation settlement is estimated to range from about % to % inches. Maximum differential settlements between similariy loaded adjacent footings are expected to be on the order of % to y2-inch. Based on the load information assumed for the bridge structure (abutment loads of 13 kips/lineal foot), the total static foundation settlement is estimated to range from about % to V2 inches. Maximum differential settlements between similariy loaded abutment footings are expected to be on the order of Vi-inch. Based on the load information assumed for the parking deck (column loads of 150 kips) and 2015-I-03R (3/05) 15 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 foundation support previously described, the total static foundation settlement is estimated to range from about % to % inches. Maximum differential settlements between similariy loaded adjacent footings are expected to be on the order of >2-inch. The majority of the above estimated settlements are anticipated to occur during construction. The above estimates are based on the assumption that the recommended earthwork will be performed and that the footings will be sized in accordance with our recommendations. 4.4.5 Lateral Load Resistance Soil resistance to lateral loads will be provided by a combination of frictional resistance between the bottom of footings and underiying soils and by passive soil pressures acting against the embedded sides ofthe footings. For frictional resistance, a coefficient of friction of 0.35 may be used for design of the church building footings and parking deck footings supported on the properiy compacted fills. A coefficient of friction of 0.40 may be used for design of the bridge structure footings supported on the undisturbed bedrock. In addition, an allowable lateral bearing pressure equal to an equivalent fluid weight of 300 pounds per cubic foot may be used for the church buildings and parking deck, provided the footings are poured tight against compacted fill soils. An allowable lateral bearing pressure equal to an equivalent fluid weight of 400 pounds per cubic foot may be used for the portion ofthe bridge structure footings that are poured tight against the undisturbed bedrock. These values may be used in combination without reduction. 4.4.6 Foundation Concrete Laboratory testing and corrosivity analyses were performed by M.J. Schiff and Associates. The results of their work are presented in Appendix B. Based on the test results, concrete in contact with the on-site soils should conform to the requirements outlined in Table 19-A-4 ofthe 1997 UBC (Table 19-A-A-4 ofthe 2001 CBC) for negligible levels of soluble sulfate exposure. 4.4.7 Footing Excavation Observation Prior to placement of concrete and steel, a representative of GPl should observe and approve all footing excavations. 4.5 BUILDING FLOOR SLABS To help mitigate the potential for slab heaving due to expansive soils, slab-on-grade floors should be supported on a minimum of 24 inches of granular (sandy) non-expansive, compacted soils as discussed in the "Placement and Compaction of Fill" section. Based on our explorations, these materials may be available on-site. A vapor/moisture barrier should be placed under any slabs that are to be covered with moisture- sensitive floor coverings (parquet, vinyl, tile, etc.). Currently, common practice is to use 10-mil polyethylene as a vapor barrier, placed either directly on the subgrade or over a thin layer of sand. Recently, other types of vapor barriers with much lower permeance and higher puncture resistance have become available and should be considered as an alternative. Polyolefin in 10-mil or 15-mil thickness is such a material and could be considered for this projecL This material should be covered by a layer of clean sand (less than 5 percent by weight passing the 2015-I-03R (3/05) 16 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 No. 200 sieve) having a minimum thickness of 2 inches. Based on our explorations and laboratory testing, the soils at the site are not suitable for this purpose. The function ofthe sand layer is to protect the vapor barrier during construction and to aid in the uniform curing of the concrete. This layer should be nominally compacted using light equipment. The sand placed over the vapor barrier should only be slightly moist. If the sand gets wet (for example as a result of rainfall or excessive moistening) it must be allowed to dry prior to placing concrete. It should be noted that the material used as a vapor barrier is only one of several factors affecting the prevention of moisture accumulation under floor coverings. Other factors include maintaining a low water:cement ratio for the concrete used for the floor slab, effective sealing of joints and edges (particulariy at pipe penetrations) as well as excess moisture in the concrete. The manufacturer of the floor coverings should be consulted for establishing acceptable criteria for the condition of the floor surface prior to placing moisture-sensitive floor coverings. Forthe elastic design of slabs supporting sustained concentrated loads, a modulus of subgrade reaction (k) of 200 pounds per cubic inch (pounds per square inch per inch of deflection) may be used. For lateral resistance design, a coefficient of friction value of 0.35 between the properiy compacted subgrade soils and concrete may be used. For a slab on a moisture barrier (such as polyethylene or polyolefin), a coefficient of 0.1 should be used. 4.6 RETAINING WALLS The cut between the buildings and parking areas is planned to be supported by an independent retaining system near the Preschool Building and by the exterior basement wall of the Multi- purpose Building. The following recommendations are provided for walls 11 feet in height or less. Active earth pressures can be used for designing cantilevered walls that can yield at least ^/4-inch laterally in 10 feet under the imposed loads. For cantilever walls with level backfill comprised of granular soils, the magnitude of active pressures are equivalent to the pressures imposed by a fluid weighing 35 pounds per cubic foot (pcf). For sloping backfill with a 2:1 inclination, the active pressure would be about 52 pcf. For restrained walls that remain rigid enough to be essentially non-yielding, an at-rest lateral earth pressure should be used for design. For restrained walls with level backfill comprised of granular soils, the magnitude of at-rest pressure is equivalent to the pressure imposed by a fluid weighing 52 pounds per cubic foot (pcf). For a seismic earth pressure, we recommend using an inverted triangular distribution of 15H in pounds per square foot, where H is the height of the wall in feet. Walls subject to surcharge loads should be designed for an additional uniform lateral pressure equal to one-third and one-half the anticipated surcharge pressure for unrestrained and restrained walls, respectively. We can provide more specific lateral earth pressures resulting from surcharge loads when further details on the surcharge load are available. 2015-I-03R (3/05) 17 North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 The recommended pressures are based on the assumption that the supported earth will be fully drained, preventing the build-up of hydro-static pressures. For traditional backfilled retaining walls, a drain consisting of perforated pipe surrounded by gravel and wrapped in filter fabric should be used. As a minimum, one cubic foot of rock should be used for each lineal foot of drain. The fabric (non-woven filter fabric, Mirafi MON or equivalent) should be lapped at the top. The Structural Engineer should specify the use of select, granular wall backfill on the plans for conventional retaining walls. Wall footings should be designed as discussed in the "Foundations" section. 4.7 SLOPES Based on the available information, the cut slopes descending to Aviara Parkway and Poinsettia Lane will have minor grading as part ofthe development ofthe site. All permanent slopes at the site should be constructed at an inclination of 2:1 (horizontal to vertical) or flatter. All slopes and modifications to the existing slopes should be overbuilt by at least 3 feet during rough grading and trimmed back to a hard and unyielding surface. The existing slopes with significant gullying and erosion should also be trimmed back to a hard and unyielding surface or blanketed with a new zone of compacted fill, properiy benched into the existing slope. This blanket should also be overbuilt by at least 3 feet during rough grading and trimmed back to a hard and unyielding surface. Slope rolling to achieve a finished compacted surface should not be used. A keyway at least 3 feet deep and equal in width to one-half the slope height, but not less than 10 feet, should be excavated prior to filling the slope. Details of typical slope construction are shown in Figure 3. As noted in the geologic assessment of the site, the bedrock encountered in our explorations and existing cut slopes was noted to be horizontally bedded. As such, the stability of excavations extending into the bedrock material is not anticipated to be adversely affected by the potential for adverse bedding. We recommend that our geologist be on-site during the excavation of the new access road into the site to confirm the actual subsurface conditions encountered. Setbacks of structures from the top and toe of the planned slopes should be maintained as directed by the regulatory agency. We recommend a backdrain be placed along the bedrock contact in the benching where over 10 feet of fill will be placed over the bedrock. The backdrain should consist ofat least 3 cubic feet/foot of Class 2 permeable material or fabric wrapped ^/4-inch gravel. The backdrain pipe may be 4-inch Schedule 40 PVC or similar with 8 uniformly spaced perforations per foot placed 90 degrees offset on underside of pipe. We recommend the backdrain be outletted at spacings limited to 100 feet. The outlet pipe should be non-perforated 4-inch Schedule 40 PVC or similar. Details for typical slope backdrain are shown in Figure 4. Slopes should be seeded or planted as soon as possible to reduce the erosion potential. We recommend deep-rooted plants adapted to semi-arid climates be used. Other protective measures, such as installing drains and grading the top of the slope to drain away from the slope face, should be taken. We recommend thatthe condition ofthe existing slopes on-site be periodically reviewed to confirm that the erosion protection measures are in good repair. 2015-I-03R (3/05) 18 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 4.8 DRAINAGE Positive surface gradients should be provided adjacent to all structures so as to direct surface water run-off and roof drainage away from foundations and slabs toward suitable discharge facilities. Long-term ponding of surface water should not be allowed on pavements or adjacent to structures. Subsurface drainage should be provided on walls below grade as discussed in a previous section. 4.9 EXTERIOR CONCRETE AND MASONRY FLATWORK Exterior concrete and masonry flatwork should be supported on a zone of non-expansive compacted fill if differential heave is not tolerable. The use of clayey soils within 3 feet of slab subgrade is not recommended. Prior to placement of concrete, the subgrade should be prepared as recommended in "Subgrade Preparation" section. 4.10 PAVED AREAS Preliminary pavement design has been based on an R-value of 50. The California Division of Highways Design Method was used for design of the recommended preliminary pavement sections. These recommendations are based on the assumption that the pavement subgrades will consist of the existing silty sands or clayey sand on-site soils. Locally, lower R-value soils may be exposed in deeper cut. We recommend that a cap having a minimum thickness of 12 inches of on-site silty sands be placed in areas of cuts where lower R-value soils are exposed during grading. Final pavement design should be based on R-value testing performed near the conclusion of rough grading and may change from those provided below. The following pavement sections are recommended for planning purposes only. PAVEMENT SECTIONS ASSUMED SECTION THICKNESS (inches) PAVEMENT AREA ASSUMED ASPHALT AGGREGATE PAVEMENT AREA TRAFFIC INDEX CONCRETE BASE COURSE Asphalt Concrete Auto Parking 4 3 4 Auto Circulation Drives (light trucks) 5 3 4 Truck Driveways 6 3 5 CONCRETE Portland Cement Concrete Auto Parking 4 5.5 — Auto Circulation Drives (light trucks) 5 6.0 — Truck Driveways 6 6.0 2015-I-03R (3/05) 19 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 PAVEMENT SECTION PAVEMENT AREA ASSUMED TRAFFIC INDEX SECTION THICKNESS (inches) PAVEMENT AREA ASSUMED TRAFFIC INDEX ASPHALT CONCRETE AGGREGATE BASE COURSE Asphalt Concrete Collector 6 4 6 Light Industrial 7 4 6 Secondary Arterial 8 4 7 Major Arterial 8.5 5 6 The pavement subgrade underiying the aggregate base or concrete should be properly prepared and compacted in accordance with the recommendations outlined under "Subgrade Preparation". The concrete used for paving should have a modulus of rupture of at least 550 psi (equivalent to an approximate compressive strength of 3,700 psi) at the time the pavement is subjected to truck traffic. The pavement base course should be compacted to at least 95 percent of maximum density (ASTM D-1557). Aggregate base should conform to the requirements of Section 26 of the California Department of Transportation Standard Specifications for Class II aggregate base (three-quarter inch maximum) or Section 200-2 of the Standard Specifications for Public Works Construction (Green Book) for untreated base materials, except processed miscellaneous base. The above recommendations are based on the assumption that the base course and compacted subgrade will be properly drained. The design of paved areas should incorporate measures to prevent moisture build-up within the base course which can otherwise lead to premature pavement failure. For example, curbing adjacent to landscaped areas should be deep enough to act as a barrier to infiltration of irrigation water into the adjacent base course. 4.11 GEOTECHNICAL OBSERVATION AND TESTING We recommend that a representative of GPl observe all earthwork during construction to confirm thatthe recommendations provided in our reportare applicable during construction. The earthwork activities include grading, compaction of all fills, subgrade preparation, pavement construction and foundation excavations. If conditions are different than expected, we should be afforded the opportunity to provide an alternate recommendation based on the actual conditions encountered. 2015-I-03R (3/05) 20 North Coast Calvary Chapel Proposed Building Project, Carlsbad, Califomia March 2, 2005 GPl ProjectNo. 2015.1 5.0 LIMITATIONS The report, exploration logs, and other materials resulting from GPI's efforts were prepared exclusively for use by North Coast Calvary Chapel and their consultants in designing the proposed development. The report is not intended to be suitable for reuse on extensions or modifications of the project or for use on any project other than the currently proposed development as it may not contain sufficient or appropriate information for such uses. If this report or portions of this report are provided to contractors or included in specifications, it should be understood that they are provided for information only. Soil deposits may vary in type, strength, and many other important properties between points of exploration due to non-uniformity of the geologic formations or to man-made cut and fill operations. While we cannot evaluate the consistency ofthe properties of materials in areas not explored, the conclusions drawn in this report are based on the assumption that the data obtained in the field and laboratory are reasonably representative of field conditions and are conducive to interpolation and extrapolation. Furthermore, our recommendations were developed with the assumption that a proper level of field observations and construction review will be provided by GPl during grading, excavation, and foundation construction. If field conditions during construction appear to be different than is indicated in this report, we will need to assess the impact of such conditions on our recommendations. If construction phase geotechnical services are provided by others, the use ofthis report and its contents will be solely at their risk. In addition, the firm will need to accept full responsibility for all geotechnical aspects of the project, including the recommendations contained herein. Our investigation and evaluations were performed using generally accepted engineering approaches and principles available at this time and the degree of care and skill ordinarily exercised under similar circumstances by reputable geotechnical engineers practicing in this area. No other representation, either expressed or implied, is included or intended in our report. Respectfully submitted, Geotechnical Professionals Inc ia/i5/io Thomas G. Hill, C.E.G. Consulting Engineering Geologi MAR 0 2 2005 James E Principal 2015-I-03R (3/05) J North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl Project No. 2015.1 REFERENCES 1. Leighton & Associates, Inc., February 13, 1998 (Revised May 14, 1998), "Geotechnical Investigation, Proposed Carisbad Commercial Site, Carisbad, California," Project No. 498005-001. 2. Leighton & Associates, Inc., January 27, 2004, "Update Geotechnical Evaluation, Proposed North Coast Calvary Chapel Northeast of the Intersection of Poinsettia Avenue and Aviara Parkway, Carlsbad, California," Project No. 980005- 003. 3. Tan, S.S., and Kennedy, M.P., 1996, "Geologic Maps ofthe Northwestern Part of San Diego County, California, Plate 2, Geologic Maps of the Encinitas and Rancho Santa Fe 7.5' Quadrangles," California Division of Mines and Geology, Open File Report 96-02, Map Scale 1:24,000. 4. Blake, T.F. (1989), "EQFAULT, A Computer Program forthe Deterministic Prediction of Peak IHorizontal Acceleration from Digitized California Faults," Unpublished Private Program: Updated 2000. 5. Blake, T.F. (2000), "FRISKSP, A Computer Program forthe Probabilistic Estimation of Uniform-Hazard Spectra Using Faults as Earthquake Sources, User's Manual," Version 4.00. 6. City of Carisbad (2004), "Standard Drawings," Department of Public Works, Supplemental Standard No. GS-17, June, 2004. 2015-I-03R (3/05) 33[ -^vifiv. -J I i N SITE LOCATION MAP REPRODUCED FROM MS STREETS 98 GEOTECHNICAL PROFESSIONALS, INC. NCCC-CARLSBAD GPl PROJECT NO. 2015.1 NO SCALE SITE LOCATiON MAP FIGURE 1 MATCHLINE B-1 TP-1 EXPLANATION APPROXIMATE LOCATION AND NUMBER OF EXPLORATORY BORING APPROXIMATE LOCATION AND NUMBER OF TEST PIT UNDOCUMENTED FILL N 100 200 FEET BASE PLAN REPRODUCED FROM SITE PLAN PROVIDED BY O'DAY CONSULTANTS DATED DECEMBER 2003 GEOTECHNICAL PROFESSIONALS, INC. NCCC-CARLSBAD GPl PROJECT-NO. :2015.1 SCALE: 1"=100' SITE PLAN IFIGURE 2A MATCHLINE r i '^'^ B-1 EXPLANATION APPROXIMATE LOCATION AND NUMBER OF EXPLORATORY BORING APPROXIMATE LOCATION AND NUMBER OF TEST PIT 100 BASE PLAN REPRODUCED FROM SITE PLAN PROVIDED BY ODAY CONSULTANTS DATED DECEMBER 2003 200 FEET GEOTECHNICAL PROFESSIONALS, INC. NCCC-CARLSBAD GPl PROJECT NO.:2015.I SCALE: 1"=100' SITE PLAN FIGURE 2B FINAL NATURAL SLOPE LIMITS OF FINAL EXCAVATION TOE OF SLOPE SHOWN ON GRADING PLAN MINIMUM DOWNSLOPE KEY DEPTH PROVIDE BACKDRAIN A8 REQUIRED PER RECOM- MENOATIONS OF 60IL8 ENGINEER DURING GRADING WHERE NATURAL SLOPE GRADIENT IS 6:1 OR LE$8. BENCHING IS NOT NECESSARY. HOWEVER. FILL IS NOT TO BE PLACED ON COMPRESSIBLE OR UNSUIT- ABLE MATERIAL. GEOTECHNICAL PROFESSIONALS, INC. GPl PROJECT NO.: NOT TO SCALE FILL SLOPE ABOVE NATURAL GROUND DETAIL FIGURES 3 FT*^ IMUM FINISH SURFACE SLOPE LINEAL FOOT APPROVED FILTER ROCK*OR 3 CUBIC FEET PER UNEAL FOOT OF 3/4' GRAVEL WRAPPED IN NON-WOVEN FILTER FABRIC (MIRAFI 140N OR EQUIVALENT) 4' MINIMUM DIAMETER SOLID OUTLET PIPE SPACED PER GOIL ENGINEER REQUIRE- MENTS DURING GRADING 4" MINIMUM APPROVED PERFORATED PIPE** (PERFORATIONS DOWN) MINIMUM 2% GRADIENT TO OUTLET BENCH INCLINED TOWARD DRAIN TYPICAL BENCHING DETAIL A-A -TEMPORARY FILL LEVEL 12' MINIMUM COVER- COMPACTED BACKFILL •4' MINIMUM DIAMETER APPROVED SOLID OUTLET PIPE 12' MINIMUM- **APPROVED PIPE TYPE: SCHEDULE 40 POLYVINYL CHLORIDE . (P.V.C.) OR APPROVED EQUAL. MINIMUM CRUSH STRENGTH 1000 PSI. *FILTER ROCK TO MEET FOLLOWINQ SPECIFICATIONS OR APPROVED EQUAL: SIEVE PERCENTAGE PASSING 1' 3/4' 3/8' NO.4 NO.30 NO.50 NO.200 100 00-100 40-100 25-40 6-16 0-7 0-3 GEOTECHNICAL PROFESSIONALS. INC. PROJECT NO.: NOT TO SCALE TYPICAL BACKDRAIN DETAIL FIGURE APPENDIXA North Coast Calvary Chapel March 2, 2005 Proposed Building Project, Carlsbad, California GPl ProjectNo. 2015.1 APPENDIX A EXPLORATORY BORINGS The subsurface conditions at the site were investigated by drilling and sampling eight exploratory borings. The borings were advanced to depths of 20 to 35 feet. The boring locations are shown on the Site Plan, Figure 2. The borings were drilled using bucket auger truck-mounted bucket auger equipmenL Relatively undisturbed samples were obtained using a brass-ring lined sampler (ASTM D3550). The nng samples were driven into the soil by a 3,500-pound hammer dropping 12 inches. At depths below 25 feet, the hammer weight was approximately two-thirds of the aforementioned weight. The number of blows needed to drive the sampler into the soil was recorded as the penetration resistance. It is noted that the number of blows, in this case, is much lower than Standard Penetration Resistance, because of the greater driving weight. One blow with the 3,500-pound Kelly bar (upper 25 feet) typically provides equivalent penetration of 10 to 16 blows in the Standard Penetration Test. The drive sampler has an inside diameter of 2.42 inches and an outside diameter of 3.25 inches. The brass rings have an inside diameter of 2.42 inches and a height of 1- inch. In addition, relatively disturbed bulk samples were obtained at various depths. The field explorations for the current investigation were performed under the continuous technical supervision of GPI's representative, who visually inspected the site, maintained detailed logs of the borings, classified the soils encountered, and obtained relatively undisturbed samples for examination and laboratory testing. The soils encountered in the borings were classified in the field and through further examination in the laboratory in accordance with the Unified Soils Classification System. Detailed logs of the borings are presented in Figures B-1 to B-8 in this appendix. Borings B-3 and B-5 were down-hole logged by our engineering geologist to evaluate bedding conditions. All borings were backfllled with cuttings from the holes and the backfill compacted with a stomper. The deeper borings were backfilled with soil and layers of bentonite in general conformance of the requirements of the County of San Diego for large diameter borings. Nineteen backhoe test pits were performed at the site. The test pits were excavated with a Cat 436C with an 18-inch wide bucket. The test pits were logged by a staff engineer. The test pits extended to depths of 4 to 13 feet below the existing grades. The test pits were backfilled with soil without compaction and a PVC pipe placed within the backfill to identify during grading of the site. The subsurface conditions encountered in the test pits are described in Table A-1 of this appendix. The borings and test pits were laid out in the field by GPl. The ground surface elevations shown on the boring logs were estimated based on the topographic plan provided by O'Day Consultants. 2015-l-03X.doc (3/05) A-1 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl Project No. 2015.1 TABLE A-1 LOGS OF TEST PITS TEST PIT NO. DEPTH (ft) GROUND SURFACE ELEV. (ft) MOISTURE CONTENT DESCRIPTION TP-1 0-4 291 13.1% @ 1-2 ft 11.4% @ 3-4 ft Santiaqo Formation: Sandstone (SP-SM), yellow/brown, slightly moist, dense Total Depth: 4 feet TP-2 0-2 305 Residual Soil: Silty Sand (SM), dark brown, very moist, very loose, with trace of clay 2-772 7.9% @3-4ft Santiaao Fonnation: Sandstone (SP), red/brown/gray, slightly moist, dense 772-8 Sandstone (SM), yellow brown, slightly moisL dense TotalDepth: 8feet TP-3 0-72 295 Residual Soil: Silty Sand (SM), dark brown, very moisL very loose, with trace of clay 72-3 10.5% @3-4ft Santiaao Formation: Sand w/Silt (SP-SM), yellow/brown and red/brown, moist, dense 3-4 Sandstone (SM), yellow brown and beige, moist, dense Total Depth: 4 feet TP-4 0-1272 1272-13 281 11.4% @ 1-2 ft 9.2% @ 3-4 ft Undocumented Fill: Silty Sand (SM), dark brown, moist to very moist, loose, with pieces of asphalt concrete, concrete, trash. Santiaao Formation: Sandstone (SP), yellow brown, moist, dense Total Depth: 13 feet 2015-l-03X.doc (3/05) A-2 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2,2005 GPl ProjectNo. 2015.1 TABLE A-1 LOGS OF TEST PITS -continued- TEST PIT NO. DEPTH(ft) GROUND SURFACE ELEV. (ft) MOISTURE CONTENT DESCRIPTION TP-5 0-1.5 1.5-8 305 Residual Soil: Silty Sand (SM), dark brown, very moist, very loose, with trace of clay Santiaao Formation: Sandstone (SM), yellow/brown, slightly moisL dense, trace clay Total Depth: 8 feet TP-6 0-1 300 Residual Soil: Silty Sand (SM), dark brown, very moist, very loose, with trace of clay 1-4 10.8% @ 3-4 ft Sandstone (SP), red/brown, slightly moist to moist, dense Total Depth: 4 feet TP-7 0- 1 1- 372 372-4 303 11.0% @ 1-2 ft Residual Soil: Silty Sand (SM), dark brown to brown/gray, very moist, very loose, with trace of clay Santiaao Formation: Sand (SP), brown/gray, moist, dense, with clay Sandstone (SP), red/brown, wet, dense TotalDepth: 4feet TP-8 0-1 292 14.1 @ 1-2 ft Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay 1-372 372-4 6.3% @ 3-4 ft Santiaao Formation: Sand (SP), brown/gray, moist, dense, with clay Sandstone (SM), yellow brown, slightly moist, dense, silty Total Depth: 4 feet 2015-l-03X.doc (3/05) A-3 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl Project No. 2015.1 TABLE A-1 LOGS OF TEST PITS -continued- TEST PIT NO. DEPTH(ft) GROUND SURFACE ELEV. (ft) MOISTURE CONTENT DESCRIPTION TP-9 0- 1 1- 372 303 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay Santiaao Formation: Sand (SP), brown/gray, moist, dense, with clay 372-4 7.8% @ 3-4 ft Sandstone (SP), red/brown, moist, dense TotalDepth: 4feet TP-10 0-1 305 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay 1-8 15.6% @ 3-4 ft Santiaqo Formation: Sandstone (SP), red/brown, slightly moist, dense, with sandy clay lenses Total Depth: 8 feet TP-11 0-1 303 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay 1-8 6.2% @ 7-8 ft Santiaqo Formation: Sandstone (SP), red/brown, moisL dense Total Depth: 8 feet TP-12 0-1 303 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay 1-8 6.8% @ 7-8 ft Santiaqo Formation: Sandstone (SP), red/brown, slightly moist, dense, Total Depth: 8 feet 2015-l-03X.doc (3/05) A-4 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 TABLE A-1 LOGS OF TEST PITS -continued- TEST PIT NO. DEPTH(ft) GROUND SURFACE ELEV. (ft) MOISTURE DESCRIPTION TP-13 0-272 303 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay 272-8 10.8% @ 3-4 ft 7.8% @ 7-8 ft Santiaqo Formation: Sandstone (SP), red/brown, moist, dense Total Depth: 8 feet TP-14 0-2 301 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay 2-772 11.0% @ 3-4 ft Santiaao Formation: Sandstone (SP), red/brown, slightly moist, dense 772-8 7.9% @ 7-8 ft Sandstone (SM), orange-yellow/brown, slightly moisL dense Total Depth: 8 feet TP-15 0-2 2-6 6-8 284 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose, with trace of clay Santiaao Formation: Sandstone (SM), yellow brown, moist, dense Sandstone (SP-SM), mottled yellow brown - beige, moist, dense Total Depth: 8 feet 2015-l-03X.doc (3/05) A-5 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 TABLE A-1 LOGS OF TEST PITS -continued- GROUND TEST PIT SURFACE MOISTURE DESCRIPTION NO. DEPTH(ft) ELEV. (ft) CONTENT TP-16 0-172 298 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose. with trace of clay Santiaao Formation: 172-4 Sandstone (SM), tan, moist, dense 4-6 Sandstone (SP-SM), mottled tan and rust/brown. moist, dense Total Depth: 6 feet TP-17 0-172 307 Residual Soil: Silty Sand (SM), brown/gray, very moisL very loose, with trace of clay Santiaao Formation: 172-9 Sandstone (SP-SM), tan, moist dense - at 9 feet becomes more cemented Total Depth: 9 feet TP-18 0-2 302 Residual Soil: Silty Sand (SM), brown/gray, very moist, very loose. with trace of clay Santiaao Formation: 2-7 Sandstone (SP-SM), yellow-orange brown, moist, dense 7-9 Sandstone (SP-SM), tan/gray, moist dense TotalDepth: 9feet 2015-l-03X.doc (3/05) A-6 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 TABLE A-1 LOGS OF TEST PITS -continued- DEPTH(ft) 0-572 572-6 GROUND SURFACE ELEV. (ft) 289 MOISTURE CONTENT DESCRIPTION Residual Soil/Colluvium: Silty Sand (SM), brown, very moist very loose, with trace of clay Santiaao Formation: Sandstone (SM), tan/beige, moist, dense TotalDepth: 6feet 2015-l-03X.doc (3/05) A-7 LU a: OTC. O 8.8 4.9 8.1 16.1 w „ zu. Ill o Q Q. >- ^ tL Q 114 105 124 112 HO ^~ CO arm Push 8/11" 8/9" UJ a. UJ _i Q. 2 < D D D D 10- 15- DESCRIPTION OF SUBSURFACE MA TERIALS This summary applies only at the location of this boring and at the time of drilling. Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. 20- Undocumented Fill: SILTY SAND (SM)dark brown, very moist, very loose, trace clay, fine to medium grained sand 4 to 5 feet, metal fragments < ^ 280 Residual Soil: SILTY SAND (SM) dark brown, moist, very loose, minor pinhole porosity, fine grained sand @, 8 feet, water, perched on bedrock contact Santiaqo Formation: SANDSTONE (SM) yellow-brown and light olive-grey, moist, very dense, mottled, fine grained sand (g 20 feet, moist to very moist dense, trace clay and jcobbles (well-rounded) Total Depth 20 feet Hole belled and caved from 6 to 9 feet. Backfilled with cuttings and tamped. 275 270 265 SAMPLE TYPES [C] Rock Core [S] Standard Split Spoon [p] Drive Sample [B] Bulk Sample [T| Tube Sample DATE DRILLED: 1-27-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Perched water at 7-8 feet PROJECT NO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-1 FIGURE A-1 a: CO O 9.2 6.7 OT _, 2 u. UJ O Q OL >- a 19.3 17.6 7.2 115 116 QoO < <H-Qil-OT I- OTg a. °^ SS. 8/8" UJ Q. O. < D D 108 104 8 3 8/10" B DESCRIPTION OF SUBSURFACE MATERIALS This summary applies only at the location of this boring and at the time of drilling. Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. D B 10- 15- 20- 25- Residual Soil: SILTYSAND (SM)dark brown, very moist, very loose, \trace clay Santiaqo Formation: SANDSTONE (SM) yellow-brown and light olive-grey, very moist, loose to medium dense, fine grained sand, mottled @ 5 feet, moist very dense, fine to medium grained sand @ 10 feet fine to coarse grained sand, trace fine gravel (rounded) (g 12 to 14 feet claystone, red and light grey-brown, moist, hard, mottled, pocket penetrometer > 4.5 tsf @ 15 to 25 feet light grey, moist, dense, micaceous o „ ill t Ul 305 300 295 290 Total Depth 25 feet Backfilled with cuttings and tamped. 285 SAMPLE TYPES [C] Rock Core [S] Standard Split Spoon [p] Drive Sample \B\ Bulk Sample [T] Tube Sample DATE DRILLED: 1-27-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Not Encountered I PROJECT NO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-2 FIGURE A-2 Ul Q: I- Co OT c. O 5 10.3 10.8 OT „ 2 U-ui o Q Q. > OL O S Ul I-QoO I- z o < < y- H W > z<«0 115 Push 8/6" 113 Ul 5 < w D D 5-. 10- 15-- 20- 25- 30- DESCRIPTION OF SUBSURFACE MA TERIALS This summary applies only at the location of this boring and at the time of drilling. Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. SILTY SAND (SM) dark brown, very moist to wet, very Aloose, trace clay 35- Residual Soil: Santiaqo Fonnation: SANDSTONE (SM) yellow-brown and light grey-brown, moist, very loose, massive, mottled, fine grained sand @ 4 to 7 feet, yellow-brown, very dense, cemented, fine to coarse grained sandstone @ 5 feet, very dense, fine to medium grained sand @ 7 to 12 feet, very dense, massive, fine to coarse sandstone, irregular lower contact near horizontal @ 12 to 25 feet light grey, fine to coarse grained, micaceous @ 14 feet, light olive-grey, fine grained sand @ 15 feet, light olive-grey, moist very dense, massive @, 24 to 24 Vi feet clayey sandstone @ 25 to 26 Vl feet, claystone, red and light grey-brown, hard, massive @ 27 feet, light olive-grey, moist very dense, massive @ 30 feet, 6 to 12-inch thick, cross-bedded sandstone, micaceous z o ^ 5 LU in U- 305 300 295 290 285 280 Total Depth 35 feet Backfilled with cuttings and tamped. Backfilled with Bentonite as follows: 5-7 feet; 9-10 feet 19-20 feet; 29-30 feet and 33-35 feet. 275 SAMPLE TYPES |C] Rock Core H] Standard Split Spoon [B] Drive Sample ID Bulk Sample [T] Tube Sample DATE DRILLED: 1-27-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Not Encountered PROJECTNO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-3 FIGURE A-3 Ul a: o 9.6 7.1 13.3 OT ^ Z u. UJ O Q CL >-a: a 99 102 5 Ul • QoO i-zo < < y-a:i-o5 I- OTS 2«0 Q. "JL m 113 8/6" 8/10" Ul CL Ul _l a. < OT It DESCRIPTION OF SUBSURFACE MA TERIALS D D 8/11" D 5- 10- 15- 20- This summary applies only at the location ofthis boring and at the time of drilling. Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. Residual Soil: SILTY SAND (SM) dark brown, very loose, wet, trace \clay Santiaqo Formation: SANDSTONE (SM) yellow-brown, moist to very moist very dense, fine to coarse grained sand, trace fine to medium gravel (rounded), massive o„ 5 UJ ui t Ul 300 @ 11 feet, light grey, moist fine grained sand, massive, micaceous (g 16 to 17 feet, red claystone Total Depth 22 feet Backfilled with cuttings and tamped. 295 290 285 SAMPLE TYPES [C] Rock Core {S} Standard Split Spoon jo] Drive Sample [g Bulk Sample |T| Tube Sample DATE DRILLED: 1-27-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Not Encountered PROJECT NO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-4 FIGURE A-4 Ul on n „ OT o OT ^ Z U. Ul O Q D. >- '~' Ct Q 10.1 7.3 8.0 15.0 27.2 110 111 112 105 ^ LU QoO K Z O < <\i-Q^l-OT l-OTS Z^^O 8/10" UJ CL LU —I a. < OT This summary applies only at the location of this boring and at the time of drilling. Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. D B 95 Push D D D 5- 10- 15- 20- 25- 30- 35- DESCRIPTION OF SUBSURFACE MATERIALS Residual Soil: SILTY SAND (SM) dark brown, very loose, wet, trace \clay Santiaqo Formafion: SANDSTONE (SM) yellow-brown, moist very dense, massive, fine grained sand 7 to 14 feet, alternating fine and fine to coarse grained sandstone beds, contacts are irregular, gradational, near horizontal (g 10 to 11 feet, fine to coarse grained sand, trace medium grained gravel (rounded) @ 12 to 14 feet cobbles (up to 6-inches in diameter) @ 14 feet tan, 2-inch thick sandstone bed, continuous, irregular, near horizontal @ 17 72 feet light olive-grey, very moist, fine grained sand, trace clay @ 18 to 24 14 feet interbedded sandstone and claystone, with relatively steeply dipping bedding, cross bedded, channel? fill deposits @ 18 feet B: N55E, 18SE 119 feet B: N60E, 15SE CLAYSTONE (CL) light grey-brown, pocket penetrometer = 3.5 tsf !21 feet B: N57E, 17SE SANDSTONE (SM) yellow-brown, fine to coarse grained sand @ 30 Yt to 32 Yz feet, conglomeratic sandstone, dark rust color @ 32 Yz feet light grey, fine grained sandstone 2 O ^ 305 300 295 290 285 280 Total Depth 35 feet Backfilled with cuttings and Bentonite at 5-7 feet; 9-10 feet 19-20 feet; 29-30 feet and 33-35 feet 275 SAMPLE TYPES |C] Rock Core [S] Standard Split Spoon \D\ Drive Sample [B] Bulk Sample Ixl Tube Sample DATE DRILLED: 1-28-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Not Encountered PROJECTNO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-5 FIGURE A-5 Ul a: 7.2 6.5 16.0 OT ^ Zu. Ul o a a. > tr a 106 113 cr\- t- OT ^OT 13.9 15.7 111 110 8/11" 8/11" LU —I CL s < OT D 8 D CL Ul UJ 5- 10- 15- DESCRIPTION OF SUBSURFACE MATERIALS This summary applies only at the location of this boring and at the time of drilling. Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. 20- 25- Residual Soil: SILTY SAND (SM)dark brown, very moist to wet, soft, \trace clay Santiaqo Formation: SANDSTONE (SM) yellow brown, moist to very moist, dense to very dense, massive @ 5 feet fine to coarse grained sand 12 feet light brown-grey, fine grained sand, trace clay 124 to 25 feet, with clay z o^ Ul 305 300 295 290 285 Total Depth 27 feet Backfilled with cuttings and tamped. 280 SAMPLE TYPES \C\ Rock Core \S} Standard Split Spoon [D] Drive Sample H] Bulk Sample [T| Tube Sample DATE DRILLED: 1-28-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Not Encountered PROJECTNO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-6 FIGURE A-6 tr I- 5 OT Sl o 5 7.2 10.8 15.8 Z u. Ul o a 9^ >-tr a 117 115 114 SujP QoO < < t o: I- OT HOT^ z^o Ul a Ul _i < 1^ 13.9 15.6 113 116 8/11" D D D D 5- 10- 15- 20-: 25- DESCRIPTION OF SUBSURFACE MA TERIALS This summary applies only at the location ofthis boring and at the time of drilling. Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. Residual Soil: SILTY SAND (SM)dark brown, very moist very loose, itrace clay Santiaqo Formation: SANDSTONE (SM) yellow brown, moist, dense to very dense, fine grained sand, massive @ 6 feet, medium to coarse grained sand (g 11 to 12 34 feet light olive-grey, fine grained sand, interbedded with sandy claystone, massive @ 12 V2 feet light olive-grey, moist, very dense, fine grained sand, massive o _ uit 305 300 295 290 @ 22 to 24 feet claystone and siltstone, red and light olive-grey @. 24 feet, light olive-grey, moist very dense, massive Total Depth 26 feet Backfilled with cuttings and tamped. 285 280 SAMPLE TYPES |C] Rock Core m Standard Split Spoon [D] Drive Sample [B] Bulk Sample [T] Tube Sample DATE DRILLED: 1-28-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Not Encountered PROJECTNO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-7 FIGURE A-7 ce 1- vO OT £1 o 10.8 9.2 10.6 OT _^ Z u. Ul O Q CL >- ^ tr Q 113 115 111 10.6 z o <LL — § OT Q Uiy a: m Push 109 8/11" 8/10" Ul CL Q. < OT D D DESCRIPTION OF SUBSURFACE MA TERLiLS g u_ This summary applies only at the location of this boring and at the time of drilling. " Subsurface conditions may differ at other locations and may change at this location with the passage of time. The data presented is a simplification of actual conditions encountered. 10- D D 15- 20- Residual Soil/Colluvium: SILTYSAND (SM)dark brown, moist loose, trace gravel 5 feet, brown Santiaqo Formation: SANDSTONE (SM) yellow brown, moist dense, fine to medium grained sand, trace fine to coarse gravel (well rounded), massive @ 9 feet fine grained sand @^^ feet light grey-brown, moist to very moist fine grained sand, massive Total Depth 20 feet Minor caving, 1 to 4 feet Backfilled with cuttings and tamped. z o uit _1 Ul SAMPLE TYPES ^ Rock Core 1^ Standard Split Spoon [D] Drive Sample \B} Bulk Sample |T| Tube Sample DATE DRILLED: 1-28-05 EQUIPMENT USED: 30" Bucket Auger GROUNDWATER LEVEL (ft): Not Encountered PROJECT NO.: 2015.1 N. COAST CALVARY LOG OF BORING NO. B-8 FIGURE A-8 APPENDIX B North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 APPENDIX B LABORATORY TESTS INTRODUCTION Representative undisturbed soil samples and bulk samples were carefully packaged in the field and sealed to prevent moisture loss. The samples were then transported to our Cypress office for examination and testing assignments. Laboratory tests were performed on selected representative samples as an aid in classifying the soils and to evaluate the physical properties of the soils affecting foundation design and construction procedures. Detailed descriptions of the laboratory tests are presented below under the appropriate test headings. Test results are presented in the figures that follow. MOISTURE CONTENT AND DRY DENSITY Moisture content and dry density were determined from a number of the ring samples. The samples were first trimmed to obtain volume and wet weight and then were dried in accordance with ASTM 2216-71. After drying, the weight of each sample was measured, and moisture content and dry density were calculated. Moisture content and dry density values are presented on the boring logs and test pit logs in Appendix A. PERCENT PASSING NO. 200 SIEVE A total of three soil samples were dried, weighed, soaked in water until individual soil particles were separated, and then washed on the No. 200 sieve. That portion of the material retained on the No. 200 sieve was oven-dried and weighed to determine the percentage of the material passing the No. 200 sieve. The results are tabulated as follows: BORING NO. DEPTH (ft) SOIL DESCRIPTION PERCENT PASSING NO. 200 SIEVE B-4 7-8 Sandstone (SM) 15 TP-7 1-2 Silty Sand (SM) 24 TP-8 3-4 Sandstone (SM) 18 2015-l-03X.doc (3/04) B-1 North Coast Calvary Chapel Proposed Building Project, Carlsbad, California March 2, 2005 GPl ProjectNo. 2015.1 CONSOLIDATION One-dimensional consolidation tests were performed on undisturbed ring samples in accordance with ASTM D 2435. After trimming the ends, the samples were placed in the consolidometer and loaded to up to 0.4 ksf. Thereafter, the samples were incrementally loaded to a maximum load of up to 12.8 ksf. The samples were inundated under a maximum load of 3.2 ksf. Sample deformation was measured to 0.0001 inch. Rebound behavior was investigated by unloading the sample back to a minimum of 0.4 ksf. Results of the consolidation tests, in the form of percent consolidation versus log pressure are presented in Figures B-1 and B-2. DIRECT SHEAR Direct shear tests were performed on selected undisturbed samples in accordance with ASTM D 3080. The samples were placed in the shear machine, and a normal load comparable to the in-situ overburden stress was applied. The samples were inundated, allowed to consolidate, and then were sheared to failure. Shear stress and sample deformation were monitored throughout the test. The results of the direct shear tests are presented in Figures B-3 to B-5. EXPANSION INDEX Expansion index tests were performed on bulk samples. The tests were performed in accordance with ASTM 4829 to assess the expansion potential of the on-site soils. The results of the tests are summarized below: BORING NO. DEPTH (ft) SOIL DESCRIPTION EXPANSION INDEX B-5 4-5 Silty Sand (SM) 7 B-6 0-2 Clayey Sand (SC) 23 COMPACTION TEST Maximum dry density/optimum moisture tests were performed in accordance with ASTM D1557 on a representative bulk sample of the surficial soils. The test results are as follows: BORNG 1 NO. DEPTH (ft) SOIL DESCRIPTION OPTIMUM MOISTURE (%) MAXIMUM DRY DENSITY (pcf) 1 1 B-2 5-6 Silty Sand (SM) 11 122.5 2015-l-03X.doc (3/04) B-2 North Coast Calvary Chapel proposed Building Project, Carlsbad, California March 2, 2005 GPl Project No. 2015.1 R-VALUE Suitability of the near-surface soils for pavement support was evaluated by conducting an R-Value test. The test was performed in accordance with ASTM D 2844 by Geologic Associates under subcontract to GPl. The result of the test is as follows: BORING NO. DEPTH (ft.) SOIL DESCRIPTION R-VALUE BY EXPANSION B-2 5 Silty Sandy (SM) 63 CORROSIVITY TESTING Soil corrosivity testing was performed by M.J. Schiff and Associates on soil samples provided by GPl. The test results are enclosed in Table 1 of this Appendix. 2015-l-03X.doc (3/04) B-3 2 < a: 10 15 20 25 30L_ 100 1,000 10,000 10' STRESS, psf Sample inundated at 3200 psf Sample Location Classification DD.pcf MC,% • B-7 6.0 SANDSTONE (SM) 115 10.8 PROJECT: N. COAST CALVARY PROJECTNO.: 2015.1 CONSOLIDATION TEST FIGURE B-1 z < IT h-W 10 15 20 25 30L_ 100 1,000 10,000 10= STRESS, psf Sampfe inondafed af 3200 psf Sample Location Classification DD.pcf MC,% • B-8 19.0 SANDSTONE (SM) PROJECT: N. COAST CALVARY PROJECTNO.: 2015.1 CONSOLIDATION TEST FIGURE B-2 6,000 5,000 4,000 Q. X CD z a 3,000 w tr I OT 2,000 1,000 ( » / < 1,000 Friction Angle= 44 degrees Cohesion= 0 psf 2,000 3,000 4,000 NORMAL PRESSURE, psf 5,000 6,000 Sample Location Classification DD.pcf MC.% • B-3 10.0 SANDSTONE (SM) 113 10.8 PROJECT: N. COAST CALVARY PROJECTNO.: 2015.1 DIRECT SHEAR TEST RESULTS FIGURE B-3 r 6,000 5,000 4,000 X I-o z UJ a. \-w tr < Ul X w 2,000 1,000 / ( > 1,000 Friction Angle= 40 degrees Cohesion= 808 psf 2,000 3,000 4,000 NORMAL PRESSURE, psf 5,000 6,000 Sample Location Classification DD.pcf MC,% • B-6 12.0 SANDSTONE (SM) 16.0 PROJECT: N. COAST CALVARY PROJECTNO.: 2015.1 DIRECT SHEAR TEST RESULTS FIGURE B-4 6,ooor 5,000 4,000 X I-CD 2 Ul tr I- OT tr < LU X w 2,000 1,000 i 1,000 Friction Angle= 36 degrees Cotiesion= 432 psf 2,000 3,000 4,000 NORMAL PRESSURE, psf 5,000 6,000 Note: Sample remolded to 95% of maximum dry density. Sample Location Classification DD.pcf MC.% • TP-6 116 PROJECT: N. COAST CALVARY PROJECT NO.:2015.I DIRECT SHEAR TEST RESULTS FIGURE B-5 M. J. Schiff & Associates, Inc. Consulting Corrosion Engineers - Since 1959 431 W. Baseline Road Claremont, CA 91711 Phone: (909) 626-0967 Fax: (909) 626-3316 E-mail lab@mjschiff.com website: mjschiff.com Table 1 - Laboratory Tests on Soil Samples GPl NCCC, Carlsbad, CA YourniOlS.I, MJS&A #05-0095LAB 28-Jan-05 Sample ID Resistivity as-received saturated pH Electrical Conductivity Chemical Analyses Cations calcium magnesium sodium Anions carbonate bicarbonate chloride sulfate Other Tests Ca^ Mg' Na' 2+ Units ohm-cm ohm-cm mS/cm mg/kg mg/kg mg/kg COj'- mg/kg HCO3'" mg/kg Cl' mg/kg SO/- mg/kg ammonium NH4'* mg/kg NO3'" o2- mtrate sulfide Redox mg/kg qual mV B-5 @4-5' Sand 9,100 1,200 7.1 0.14 16 24 72 ND 88 55 142 na na na na Electrical conductivity in millisiemens/cm and chemical analysis were made on a 1:5 soil-to-water extracL mg/kg = milligrams per kilogram (parts per million) of dry soil. Redox = oxidation-reduction potential in millivolts ND = not detected na = not analyzed Page 1 of 1 BUILDING ENERGY ANALYSIS REPORT PROJECT: NORTH COAST CALVARY CHAPEL 1330 POINSETTA LANE CARLSBAD, CA. 92011 Project Designer: TIIVIELESS ARCHITECTURE, INC. 9891 IRVINE CENTER DRIVE SUITE #140 IRVINE,, CA. 92618 949-831-8110 Report Prepared by: ROBERT LOPEZ Robert Lopez 9506 melita street Pico Rivera, Ca. 90660 562-695-5969 Job Number: 2-20-2010 Date: 10/30/2010 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with twth the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC - www.energysoft.com. EnergyPro 5.0 by EnergySoft User Number: 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Nonresidential Performance Title 24 Forms 3 Form ENV-MM Envelope Mandatory Measures 30 Form MECH-MM Mechanical Mandatory Measures 31 EnergyPro 5.0 by EnergySoft Job Number: 10:2-20-2010 UserNumber: 1488 PERFORMANCE CERTIFICATE OF COMPLIANCE (Part 1 of 3) PERF-1 C Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 Project Address ^330 POINSETTA LANE CARLSBAD Climate Zone CA Climate Zone 07 Total Cond. Floor Area 74,626 Addition Floor Area n/a GENERAL INFORMATION Building Type: 0 Nonresidential • • Relocatable - indicate • High-Rise Residential • specific climate zone • Hotel/Motel Guest Room all climates Phase of Construction: B New Construction • Addition • Alteration STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations. This certificate applies only to a Building using the performance compliance approach. The documentation author hereby certifies that the documentation is accurate and complete. Documentation Author Name ROBERT LOPEZ Signature Company Robert Lopez Date 10/30/2010 Address 9506 melita street Phone 562-695-5969 City/State/Zip ^a. 90660 The Principal Designer hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application. The proposed building has been designed to meet the energy efficiency requirements contained in sections 110, 116 through 118, and 140 through 149 of Title 24, Part 6. Please check one: ENV. LTG. MECH. I hereby affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code to sign this document as the person responsible for its preparation; and that I am licensed in the State of California as a civil engineer, mechanical engineer, electrical engineer, or I am a licensed architect. I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Gode by section 5537.2 or 6737.3 to sign this document as the person responsible for its preparation; and that I am a licensed contractor performing this work. I affirm that I am eligible under Division 3 of the Business and Professions Code to sign this document because it pertains to a structure or type of work described as exempt pursuant to Business and Professions Code Sections 5537, 5538 and 6737.1. Principal Envelope Designer Name TIMELESS ARCHITECTURE, INC. Signature Company TIMELESS ARCHITECTURE, INC. Date Address 9891 IRVINE CENTER DRIVE SUITE #140 License # City/State/Zip ^A. 92618 Phone 949.83t-gtto Principal Mechanical Designer Name TIMELSS ARCHITECTURE, INC. Signature Company TIMELESS ARCHITECTURE, INC. Date Address 989t IRVINE CENTER DRIVE SUITE #140 License # City/State/Zip ipi^,^E„ CA. 92618 Phone g4g.s31.8i10 Principal Lighting Designer Name Signature Company Date Address License # City/State/ZIp Phone INSTRUCTIONS TO APPLICANT COMPLIANCE & WORKSHEETS (check box if worksheets are included) 13 ENV-IC Certificate of Compliance. Required on plans. 13 MECH-IC Certificate of Compliance. Required on plans. 13 LTG-1 C Certificate of Compliance. Required on plans. 13 MECH-2C Air/Water Side/Service Hot Water & Pool Requirements. • LTG-2C Lighting Controls Credit Worksheet. 13 MECH-3C Mechanical Ventilation and Reheat. • LTG-3C Indoor Lighting Power Allowance. |3 MECH-5C Mechanical Equipment Details. EnergyPro 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 3 of 31 PERFORMANCE CERTIFICATE OF COMPLIANCE (Part 2 of 3) PERF-1 C Project Name Date NORTH COAST CALVARY CHAPEL 70/30/2070 ANNUAL TDV ENERGY USE SUMMARY (kBtu/sqft-yr) Standard Proposed Compliance Energy Component Design Design Margin Space Heating 1.13 1.16 -0.02 Space Cooling 146.55 157.57 -11.01 Indoor Fans 81.15 73.98 7.17 Heat Rejection 0.00 0.00 0.00 Pumps 8i Misc. 0.00 0.00 0.00 Domestic Hot Water 76.89 88.65 -11.76 Lighting 82.57 46.39 36.18 Receptacle 47.15 47.15 0.00 Process 0.00 0.00 0.00 Process Lighting 0.00 0.00 20.56 TOTALS 435.45 414.90 Percent better than Standard 4.7% { 4.7% excluding process) BUILDING COMPLIES GENERAL INFORMATION Building Orientation Number of Stories Number of Systems Number of Zones (E) 90 deg 14 Conditioned Floor Area Unconditioned Floor Area Conditioned Footprint Area Natural Gas Available On Site 14,626 11,134 Natural Gas sqft. sqft. sqft. Orientation Gross Area Glazing Area Glazing Ratio Front Elevation <E) 2,166 sqft. 342 sqft. 15.8% Left Elevation (S) 3,056 sqft. 693 sqft. 22.7% Rear Elevation m 1,580 sqft. 186 sqft. 11.8% Right Elevation (N) 3,524 sqft. 547 sqft. 15.5% Total 10,326 sqft. 1,768 sqft. 171 % Roof 10,147 sqft. 0 sqft. 0.0% Standard Lighting Power Density Prescriptive Envelope TDV Energy 1.303 335,382 w/sqft. Proposed 0.819 335,391 W/sqft. Remarks: EneravPro 5.0 bv EnemvSoft UserNumber 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Paae 4 of 31 PERFORMANCE CERTIFICATE OF COMPLIANCE (Part 3 of 3) PERF-1 C Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 ZONE INFORMATION Svstem Name Zone Name Occupancy Type Floor Area (sqft.) Inst LPD (W/sf)^ Ctrl. Credits {\N/sif Allowed LPD Proc. Loads (W/sf) Svstem Name Zone Name Occupancy Type Floor Area (sqft.) Inst LPD (W/sf)^ Ctrl. Credits {\N/sif Area (W/sf)^ Tailored (W/sf)" Proc. Loads (W/sf) ASSEMBLE CHAPEL CHAPEL ASSEMBLY Religious Worship 3,037 *f.500 BOOK STORE AREA/FOYE BOOK STORE AREA Retail Sales, Wtioiesale 2,491 0.000 RESTROOM Conidor/Restroom/Support 672 •0.600 CLASS ROOM #105 CLASS ROOM #105 Classroom, Lecture, Trainini 2,359 *7.200 CLASS ROOM #104 CLASS ROOM #104 Classroom, Lecture, Trainim 2,575 0.000 ROOM #204 UNFINISHED i UNFINISHED Classroom, Lecture, Traininc 797 '1.200 ROOM #205 UNFINISHED ROOM #205 Classroom, Lecture, Traininc 2,066 '1.200 ROOM #203 UNFINISHED S ROOM 203 UNFINISHED Classroom, Lecture, Traininc 629 '1.200 Notes: 1. See LTG-IC (items marked with asterisk, see LTG-1 -C by others) 2. See LTG-2C 3. See LTG-3C (by others) 4. See LTG-4C Items above require special documentation EXCEPTIONAL CONDITIONS COMPLIANCE CHECKLIST The local enforcetnent agency should pay special attention to the items specified In this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The local enforcement agency determines the adequacy of the justifications, and may reject a building or design that otherwise complies based on the adequacy of the special iustification and documentation submitted. The DHW System Takagi T-K2 is a non-NAECA large storage gas water heater Verify DHW details. The HVAC System ASSEMBLE CHAPEL includes Demand Control Ventilation per Standards Section 121. The HVAC System ASSEMBLE CHAPEL incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the MECH-4-A. The HVAC System ASSEMBLE CHAPEL assumes a Constant Volume Baseline for spaces with Space Pressurization Relationship Requirements. The HVAC System BOOK STORE ARE/VFOYER includes Demand Control Ventilation per Standards Section 121. The HVAC System BOOK STORE ARE/VFOYER incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the MECH- The HVAC System BOOK STORE ARE/VFOYER assumes a Constant Volume Baseline for spaces with Space Pressurization Relationship Requirements The HVAC System CLASS ROOM #105 incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the MECH-4-A. The HVAC System CLASS ROOM #104 incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the MECH-4-A. The HVAC System ROOM #204 UNFINISHED SHELL incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the ME The HVAC System ROOM #205 UNFINISHED SHELL incorporates HERS verified Duct Leakage. Target leakage is cakulated and documented on the Ml The HVAC System ROOM #203 UNFINISHED SHELL incorporates HERS verified Duct Leakage. Target leakage is calculated and documented on the Ml The exceptional features iisted in this performance approach application have specifically been reviewed. Adequate written justification and documentation for their use have been provided by the appiicant. Authorized Signature or Stamp EnergyPro 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 5 of 31 CERTIFICATE OF COMPLIANCE AND FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 3) ENV-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: ei Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) • Relocatable Public School Bldg. B Conditioned Spaces • Unconditioned Spaces • Skylight Area for Large Enclosed Space ^ 8000 ft (If checked include the ENV-4C with submittal) Phase of Construction: B New Construction • Addition • Alteration Approach of Compliance: • Component B Overall Envelope • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg FIELD INSPECTION ENERGY CHECKLIST Tag/iD' Assembly Frame Type' Surface Area (ft') Surface Orientation N, E, S, W Cavity R-Value Continuous R-Vaiue n O) c *c i. 3 u. Furring R-Vaiue* Condition status^ Special Feature' Pass n u. Wall Wood Framed 582 (E) R-19 0.0 • New • • • Wall Wood Framed 1,048 (S) R-19 0.0 • New • • • Wall W(X)d Framed 448 (N) R-19 0.0 • New • • • Wall Wood Framed 528 (N) R-19 0.0 • New • • • Roof Wood Framed Rafter 3,037 (N) R-19 0.0 • New • • • Slab Unheated Slab-on-Grade 3,037 (N) None 0.0 • New • • • Wall Wood Framed 144 (S) R-19 o.c • New • • • Wall Wood Framed 720 (N) R-19 0.0 • New • • • 1. Indicate the identifying name of the frame type (i.e. Wall -1, Ceiling-1, Roof -1, and Floor-1). 2. Indicate type of Assembly Type such as Wood 2x4 or LW CMU 8". For additional other assembly types see Reference Joint Appendix, JA4-1. 3. If furring is checked refer to EN\/-2C Mass and Furring Strips Construction worksheet. 4. Indicate furring R-value when furred wall are being used. 5. Indicate Status of fenestration (New, Existing or Upgrade). 6. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 7. If Fail, then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. FENESTRATION SURFACE DETAILS Tag/iD' Fenestration Type" Surface Area Surface Orientation N, E, S, W #of Panes Max U-Factor n 0) U 3 O t/J Max (R)SHGC Source' Overhang Conditions status" Special Feature'^ Pass 1 1 Window 648 (S) 0.550 Default 0.550 Default • New • • a 2 Window 259 (N) 0.550 Default 0.550 Default New • • • 3 Window 342 (E) 0.550 Default 0.550 Default • New • • • 4 Window 130 (W) 0.550 Default 0.550 Default • New • • • 5 Window 56 (W) 0.550 Default 0.550 Default El New • • • 6 Window 288 (N) 0.550 Default 0.550 Default • New • • • 7 Window 45 (S) 0.550 Default 0.550 Default El New • • • • • • • 1. Indicate the identifying name of the frame type (i.e. Window #1). 2. Indicate type of construction Type such, Window, Glass Door, Curtain wall. Skylight, or other. 3. Indicate if the efficiency values are from the NFRC Label Certificate or from the CEC Default Values. Enter NFRC or CEC (FC-1 and FC-2). 4. Indicate status of fenestration (New, Existing or Upgrade). 5. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 6. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correcL Verify building plans if necessary. EnergyPro 5.0 by EnergySoft UserNumber 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 6 of 31 CERTIFICATE OF COMPLIANCE AND FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 3) ENV-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Fioor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: Bi Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) Relocatable Public School Bldg. B Conditioned Spaces • Unconditioned Spaces • Skylight Area for Large Enclosed Space s 8000 ft (If checked include the ENV-4C with submittal) Phase of Construction: B New Construction • Addition • Alteration Approach of Compliance: • Component B Overall Envelope • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg FIELD INSPECTION ENERGY CHECKLIST Tag/iD' Assembly Frame Type' Surface Area (ft') Surface Orientation N, E, S, W Cavity R-Value Continuous R-Vaiue Furring' Furring R-Value* Condition Status' Special Feature' Pass 1*- 1 Wall Wood Framed 764 (E) R-19 0.0 • New • • • Roof Wood Framed Attic 2,056 (N) R-22 0.0 • New • • • Slab Unheated Slab-on-Grade 2,49f (N) None 0.0 • New • • • Slab Unheated Slab-on-Grade 672 (N) None 0.0 • New • • • Wall W(x>d Framed 478 (S) R-19 0.0 • New • • • Wall Wood Framed 144 (E) R-19 0.0 • New • • • Wall Wood Framed 472 (W) R-19 0.0 • New • • • Slab Unheated Slab-on-Grade 2,359 (N) None 0.0 • New • • • 1. Indicate the identifying name of the frame type (i.e. Wall -1, Ceiling-1, Roof -1, and Floor-1). 2. Indicate type of Assembly Type such as Wood 2x4 or LW CMU 8". For additional other assembly types see Reference Joint Appendix, JA4-1. 3. If furring is checked refer to ENV-2C Mass and Furring Strips Construction worksheet. 4. Indicate furring R-value when furred wall are being used. 5. Indicate Status of fenestration (New, Existing or Upgrade). 6. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 7. If Fail, then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correcL Verify building plans if necessary. FENESTRATION SURFACE DETAILS Tag/ID' Fenestration Type' Surface Area Surface Orientation N, E, S, W # of Panes Max U-Factor Source' Max (R)SHGC Source' Overhang Conditions Status" Special Feature' Pass «^ a u. • • • • • • • • • • • • • • • • • • • • • • • • • P • • • • • • 1. Indicate the identifying name of the frame type (i.e. Window #1). 2. Indicate type of construction Type such, Window, Glass Door, Curtain wall. Skylight, or other. 3. Indicate if the efficiency values are from the NFRC Label Certificate or from the CEC Default Values. Enter NFRC or CEC (FC-1 and FC-2). 4. Indicate Status of fenestration (New, Existing or Upgrade). 5. Indicate Special Feature on Page 2 of the Inspection Checklist Form tjelow. 6. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnergyPro 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 7 of 31 CERTIFICATE OF COMPLIANCE AND FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 3) ENV-IC Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: B Nonresidential • Relocatable Public School High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) • Bldg B Conditioned Spaces • Unconditioned Spaces • Skylight Area for Large Enclosed Space 5 8000 ft^ (If checked include the ENV-4C with submittal) Phase of Construction: B New Construction • Addition • Alteration Approach of Compliance: • Component B Overall Envelope • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg FIELD INSPECTION ENERGY CHECKLIST Tag/ID' Assembly Frame Type' Surface Area (ft") Surface Orientation N, E, S, W Cavity R-Value Continuous R-Value Furring' Furring R-Vaiue' Condition Status' Special Feature' Pass 1 Roof Span Deck or Concrete 2,359 (N) None 14.0 • New • • D Wall Wood Framed 544 (W) R-19 0.0 • New • • a Wall Wood Framed 593 (N) R-19 0.0 • New • • • Slab Unheated Slab-on-Grade 2,575 (N) None 0.0 • New • • • Wall Wood Framed f53 (N) R-19 0.0 • New • • • Wall Wood Framed f29 (S) R-19 0.0 • New • • • Wall Wood Framed 18 (E) R-19 0.0 • New • • • Roof Wood Framed Attic 0 (N) R-22 0.0 • New • • • 1. Indicate the identifying name of the frame type (i.e. Wall -1, Ceiling-1, Roof -1, and Floor-1). 2. Indicate type of Assembly Type such as Wood 2x4 or LW CMU 8". For additional other assembly types see Reference Joint Appendix, JA4-1. 3. If furring is checked refer lo ENV-2C Mass and Furring Strips Construction worksheet. 4. Indicate furring R-value when furred wall are being used. 5. Indicate Status of fenestration (New, Existing or Upgrade). 6. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 7. If Fail, then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. FENESTRATION SURFACE DETAILS Tag/ID' Fenestration Type' Surface Area Surface Orientation N, E, S, W # of Panes Max U-Factor Source' Max (R)SHGC Source' Overhang Conditions status" Special Feature' Pass (D • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 1. Indicate the identifying name of the frame type (i.e. Window #1). 2. Indicate type of construction Type such. Window, Glass Door, Curtain wall. Skylight, or other. 3. Indicate if the etficiency values are from the NFRC Label Certificate or from the CEC Default Values. Enter NFRC or CEC (FC-1 and FC-2). 4. Indicate Status of fenestration (New, Existing or Upgrade). 5. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 6. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building pians if necessary. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 8 of 31 CERTIFICATE OF COMPLIANCE AND FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 3) ENV-IC Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: B Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) Relocatable Public School Bldg. B Conditioned Spaces • Unconditioned Spaces • Skylight Area for Large Enclosed Space > 8000 ft (If checked include the ENV-4C with submittal) Phase of Construction: B New Construction • Addition • Alteration Approach of Compliance: • Component B Overall Envelope • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg FIELD INSPECTION ENERGY CHECKLIST Tag/ID' Assembly Frame Type' Surface Area (ft') Surface Orientation N, E, S, W Cavity R-Value Continuous R-Vaiue Furring' Furring R-Value" Condition status' Special Feature' Pass 1 Wall Wood Framed 363 (N) R-19 0.0 • New • • • Wall Wood Framed 389 (S) R-19 0.0 • New • • • Wall Wood Framed f36 (E) R-19 0.0 • New • • • Wall Wood Framed 378 (W) R-19 0.0 • New • • • Roof W(X)d Framed Attic 2,066 (N) R-22 0.0 • New • • • Wall Wood Framed f72 (N) R-19 0.0 • New • • • Wall Wood Framed f75 (S) R-19 0.0 • New • • • Wall Wood Framed 180 (E) R-19 0.0 • New • • • 1. Indicate the identifying name of the frame type (i.e. Wall -1, Ceiling-1, Roof -1, and Floor-1). 2. Indicate type of Assembly Type such as Wood 2x4 or LW CMU 8". For additional other assembly types see Reference Joint Appendix, JA4-1. 3. If furring is checked refer to ENV-2C Mass and Furring Strips Construction worksheet. 4. Indicate furring R-value when furred wall are being used. 5. Indicate Status of fenestration (New, Existing or Upgrade). 6. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 7. If Fail, then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. FENESTRATION SURFACE DETAILS Tag/ID' Fenestration Type' Surface Area Surface Orientation N, E, S, W # of Panes Max U-Factor Source' Max (R)SHGC Source' Overhang Conditions Status" Special Feature' Pass 1 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 1. Indicate the identifying name of the frame type (i.e. Window #1). 2. Indicate type of construction Type such, Window, Glass Door, Curtain wall. Skylight, or other. 3. Indicate if the efficiency values are from the NFRC Label Certificate or from the CEC Default Values. Enter NFRC or CEC (FC-1 and FC-2). 4. Indicate Status of fenestration (New, Existing or Upgrade). 5. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 6. If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 9 of3f CERTIFICATE OF COMPLIANCE AND FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 3) ENV-IC Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: Bl Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) Relocatable Public School Bldg. B Conditioned Spaces • Unconditioned Spaces • Skylight Area for Large Enclosed Space > 8000 ft (If checked include the ENV-4C with submittal) Phase of Construction: B New Construction • Addition • Alteration Approach of Compliance: • Component El Overall Envelope • Unconditioned (file affidavit) Front Orientation: N, E, 8, W or in Degrees: 90 deg FIELD INSPECTION ENERGY CHECKLIST Tag/iD' Assembly Frame Type' 8E <^ ra 3 _ tn < c = 5 r .0) UJ 3 i -(OOZ X •> = ra ra O > m 3 O O -7 U X X .£ a) t3 3 ra 11. > c o €S u tn «£ (O u. (» Roof Wood Framed Attic 629 (N) R-22 0.0 New • • 1. Indicate the identifying name of the frame type (i.e. Wall -1, Ceiling-1, Roof -1, and Floor-1). 2. Indicate type of Assembly Type such as Wood 2x4 or LW CMU 8". For additional other assembly types see Reference Joint Appendix, JA4-1. 3. If furring is checked refer to ENV-2C Mass and Furring Strips Construction worksheet. 4. Indicate furring R-value when furred wall are being used. 5. Indicate Status of fenestration (New, Existing or Upgrade). 6. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 7. If Fail, then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. FENESTRATION SURFACE DETAILS Tag/ID' Fenestration Type' Surface Area Surface Orientation N, E, S, W # of Panes Max U-Factor Source' Max (R)SHGC Source' Overhang Conditions Status" Special Feature' Pass • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 1. Indicate the identifying name of the frame type (i.e. Window #1). 2. Indicate type of construction Type such. Window, Glass Door, Curtain wall. Skylight, or other. 3. Indicate if the efficiency values are from the NFRC Label Certificate or from the CEC Default Values. Enter NFRC or CEC (FC-1 and FC-2). 4. Indicate Status of fenestration (New, Existing or Upgrade). 5. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 6. If Fail then descritse on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 10 of 31 CERTIFICATE OF COMPLIANCE AND FIELD INSPECTION ENERGY CHECKLIST (Part 2 of 3) ENV-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 ROOFING PRODUCT (COOL ROOFS) (Note if the roofing product is not CRRC certified, this compliance approach cannot be used). Go to Overall Envelope Approach or CHECK APPLICABLE BOX BELOW IF EXEMPT FROM THE ROOFING PRODUCT "COOL ROOF" REQUIREMENTS: Pass Fair N/A • Roofing compliance ngl required in Climate Zones 1 and16 with a Low-Sloped. 2:12 pitch or less. • Roofing compliance not required in Climate Zone 1 with a Steep-Sloped with less than 5 Ib/ft'. Greater than 2:12 pitch. PI Low-sloped Wood framed roofs in Climate Zones 3 and 5 are exempted. Solar reflectance and thermal emittance or SRI that have a U-factor of 0.039 or lower, see Opaque Surface Details roof assembly, Column H of ENV-2C. • • • |-| The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempted. Solar reflectance and thermal emittance or SRI, see spreadsheet calculator at vww.enerav.ca.aov/title24/ • • • •-| Roof constructions that have thermal mass over the roof membrane with a weight of at least 25 ItVft^ are exempt from the Cool Roof criteria below. • • • |-| High-rise residential buildings and hotels and motels with low-sloped roofs in Climate Zones 1 through 9,12 and 16 are exempted from the low-sloped roofing criteria. • • • 1. If Fail then describe on this page of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. CRRC Product ID Number' Roof Slope S 2:12 >2:12 Product Weight < 5lb/ft' 2 5lb/ft^ Product Type' Aged Solar Reflectance' Thermal Emmitance SRI= Special Feature' Pass Fair • • • • n' • • • • • • • n* • • • • • • • n* • • • • • • • n* • • • • • • • n' • • • • • • • n' • • • 1. The CRRC Product ID Numtier can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.ora/products/search.php 2. Indicate the type of product is being used for the roof top, i.e. single-ply roof, asphalt roof, metal roof, etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2-H0.7(pinitiai - 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance from the Cool Roof Rating Council's Rated Product Directory. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. The SRI value needs to be calculated from a spreadsheet calculator at http://www.enerav.ca.aov/title24/ 6. Indicate Special Feature on Page 2 of the Inspection Checklist Form below. 7. If Fail then describe on this page of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating: • Aluminum-Pigmented Asphalt Roof Coating • Cement-Based Roof Coating • Other SPECIAL FEATURES INSPECTION CHECKLIST The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification. The local enforcement agency determines the adequacy of the justification, and may reject a building or design that othenwise complies based on the adequacy of the special iustification and documentation submitted. Discrepancies: EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 11 of 31 CERTIFICATE OF COMPLIANCE (Part 3 of 3) AND FIELD INSPECTION ENERGY CHECKLIST ENV-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for Envelope Fenestrations system. The designer is required to check the acceptance tests and list all the fenestration products that require an acceptance test. If all the site-built fenestration of a certain type requires a test, list the different fenestration products and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Enforcement Agency: Systems Acceptance. Before Occupancy Permit is granted for a newly constructed building or space or whenever new fenestration is installed in the building or space shall be certified as meeting the Acceptance Requirements. The ENV-2A form is not considered a complete form and is not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Title 24 Part 6. The field inspector must receive the properly filled out and signed forms before the building can receive final occupancy. A copy of the ENV-2A for each different fenestration product line must be provided to the owner of the building for their records. Test Description. ENV-2A Test Performed By: Fenestration Products Name or ID Requiring Testing or Verification Area of like Products Building Envelope Acceptance Test Double Non Metal Tinted f,768 El • • • • • • • • • • • • • • • • • • • • • • • • • EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 12 of 31 CERTIFICATE OF COMPLIANCE (Part 1 of 3) LTG-1 C Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Installation Certificate, LTG-1- INST (Retain a copy and verify form is completed and signed.) Field Inspector • Certificate of Acceptance, LTG-2A (Retain a copy and verify form is completed and signed.) Field Inspector • A separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces Installed Lighting Power listed on this Lighting Schedule is only for: El CONDITIONED SPACE • UNCONDITIONED SPACE 1^ The actual indoor lighting power listed below includes all installed permanent and portable lighting systems in accordance ^ with §146(a). Only for offices: Up to the first 0.2 watts per square foot of portable lighting shall not be required to be included in the 0 calculation of actual indoor lighting power density in accordance with the Exception to §146(a). All portable lighting in excess of 0.2 watts per square foot is totaled below. Luminaire (Type, Lamps, Ballasts) Installed Watts A B C D E F G H None or Item Tag Complete Luminaire Description' (i.e, 3 lamp fluorescent troffer, F32T8, one dimmable electronic ballasts) Special Features Watts per Luminaire How wattage Was determined Number of Luminaires Installed Watts (C X F) Field Inspector^ None or Item Tag Complete Luminaire Description' (i.e, 3 lamp fluorescent troffer, F32T8, one dimmable electronic ballasts) Special Features Watts per Luminaire CEC Default From NA8 According To §130 (dore) Number of Luminaires Installed Watts (C X F) Pass CO u. Standard Allowance: 3037 sqft at 1.500 w/sf • • • 4,556 • • Standard Allowance: 672 sqft at 0.600 w/sf • • • 403 • • Standard Allowance: 2359 sqft at 1.200 w/sf • • • 2,83f • • Standard Allowance: 797 sqft at 1.200 w/sf • • • 956 • • Standani Allowance: 2066 sqft at 1.200 w/sf • • • 2,479 • • Standard Allowance: 629 sqft at 1.200 w/sf • • • 755 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Installed Watts Page Total: 11,980 Building total number of pages: Installed Watts Building Total (Sum of all pages) 11,980 Building total number of pages: Enter into LTG-1 C Page 4 of 4 11,980 1. Wattage shall be determined according to Section 130 (d and e). Wattage shall be rating of light fixture, not rating of bulb. 2 . If Fail then describe on Page 2 of the Inspection Checklist Form and take appropriate action to correct. Verify building plans if necessary. EnergvPrn 5.0 by EnergvSoft UserNumber 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Paae 13 of 31 CERTIFICATE OF COMPLIANCE (Part 2 of 3) LTG-IC Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 INDOOR LIGHTING SCHEDULE and FIELD INSPECTION ENERGY CHECKLIST Fill in controls for all spaces: a) area controls, b) multi-level controls, c) manual daylighting controls for daylit areas > 250 ft, automatic daylighting controls for daylit areas > 2,500 ft^, d) shut-off controls, e) display lighting controls, f) tailored lighting controls - general lighting controlled separately from display, ornamental and display case lighting and g) demand responsive automatic controls for retail stores > 50,000 ft^, in accordance with Section 131. MANDATORY LIGHTING CONTROLS - FIELD INSPECTION ENERGY CHECKLIST Type/ Description Number of Units Location in Building Special Features Pass Fail • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Field SPECIAL FEATURES INSPECTION CHECKLIST (See Page 2 of 4 of LTG-IC) The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification. The local enforcement agency determines the adequacy of the justification, and may reject a building or design that othen/vise complies based on the adequacy of the special justification and documentation submitted. Field Inspector's Notes or Discrepancies: EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Page 14 of 31 CERTIFICATE OF COMPLIANCE (Part 3 of 3) LTG-1 C Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 CONDITIONED AND UNCONDITIONED SPACE LIGHTING IV UST NOT BE COMBINED FOR COMPLIANCE Indoor Lighting Power for Conditioned Spaces Indoor Lighting Power for Unconditioned Spaces Watts Watts Installed Lighting (from Conditioned LTG-1 C, Page 2) 11,980 Installed Lighting (from Unconditioned LTG-IC, Page 2) 0 Lighting Control Credit Conditioned Spaces (from LTG-2C) 0 Lighting Control Credit Unconditioned Spaces (from LTG-2C) 0 Adjusted Installed Lightinq Power 11,980 Adjusted Installed Lighting Power 0 Complies if Installed ^ Allowed ^ Complies if Installed ^ Allowed \ \ Allowed Lighting Power Conditioned Spaces (from LTG-3C or PERF-1) 11,980 Allowed Lighting Power Unconditioned Spaces (from LTG-3C) 0 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below is the acceptance test for the Lighting system, LTG-2A. The designer is required to check the acceptance tests and list all control devices sen/ing the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. If all the lighting system or control of a certain type requires a test, list the different lighting and the number of systems. The NA7 Section in the Appendix of the Nonresidential Reference Appendices Manual describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Forms can be grouped by type of Luminaire controlled. Enforcement Agency: Systems Acceptance. Before Occupancy Permii is granted for a newly constructed building or space or when ever new lighting system with controls is installed in the building or space shall be certified as meeting the Acceptance Requirements. The LTG-2A form is not considered a complete form and is not to be accepted by the enforcement agency unless the boxes are checked and/or filled and signed. In addition, a Certificate of Acceptance forms shall be submitted to the enforcement agency that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of §10-103(b) of Title 24 Part 6. The field inspector must receive the properly tilled out and signed forms before the building can receive final occupancy. A copy of the LTG-2A for each different lighting luminaire control(s) must be provided to the owner of the building for their records. Luminaires Controlled LTG-2A Equipment Requiring Testing Description Numtjer of Luminaire controls Location Controls and Sensors and Automatic Daylighting Controls Acceptance • • • • • • • • • • • • • • • • EnemvPm 5.0 by EnergySoft User Numben 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Page 15 of 31 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 4) MECH-IC Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: B Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) • Relocatable Public School Bldg. 0 Conditioned Spaces Unconditioned Spaces (affidavit) Phase of Construction: B New Construction • Addition • Alteration Approach of Compliance: • Component B Overall Envelope TDV Energy • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg HVAC SYSTEM DETAILS FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Meets Criteria or Requirements Equipment" Inspection Criteria Special Feature^ Pass Fall* Item or System Tags (i.e. AC-1, RTU-1, HP-1) DHW Heater • • • Equipment Type": Electric Res DHW Boiler • • • Number of Systems 4 • • • Max Allowed Heating Capacity 185,000 Btu/hr • • • Minimum Heating Efficiency 85% • • • Max Allowed Cooling Capacitv n/a • • • Coolinq Efficiency n/a • • • Duct Location/ R-Value n/a • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted n/a • • • Economizer n/a • • • Thermostat n/a • • • Fan Control n/a • • • Equipment" Inspection Criteria FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Special Feature^ Pass Fail* Item or System Tags (i.e. AC-1, RTU-1, HP-1) ASSEMBLE CHAPEL • • • Equipment Type": Packaged DX • • • Number of Systems 4 • • • Max Allowed Heating Capacity 57,000 Btu/lir • • • Minimum Heating Efficiency 8.30 HSPF • • • Max Allowed Cooling Capacity 57,000 Btu/hr • • • Cooling Efficiency 13.0 SEER/10.8 EER • • • Duct Location/ R-Value R-6.0 • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted Yes • • • Economizer No Economizer • • • Thermostat Setback Required • • • Fan Control Constant Volume • • • 1. Indicate special feature DETAILS on Page 2 of the Inspection Checklist Form. 2. If the Actual installed equipment performance efficiency and capacity is less than the Proposed (from the energy compliance submittal or from the building plans) the responsible party shall resubmit energy compliance to include the new changes. 3. For additional detailed discrepancy use Page 2 of the Inspection Checklist Form. 4. Indicate Equipment Type: Gas (Pkg or, Split), VAV, HP (Pkg or split), Hydronic, PTAC, or other. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 16 of 31 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 4) MECH-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: B Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) • Relocatable Public School Bldg. B Conditioned Spaces Unconditioned Spaces (affidavit) Phase of Construction: 0 New Construction • Addition • Alteration Approach of Compliance: • Component B Overall Envelope TDV Energy • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg HVAC SYSTEM DETAILS FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Meets Criteria or Requirements Equipment" Inspection Criteria Special Feature^ Pass Fall* Item or Sysiem Tags (i.e. AC-1, RTU-1, HP-1) BOOK' STORE AREA/FOYER • • • Equipment Type": Packaged DX • • • Number of Systems 2 • • • Max Allowed Heating Capacity 57,000 Btu/hr • • • Minimum Heating Efficiency 8.30 HSPF • • • Max Allowed Cooling Capacity 57,000 Btu/hr • • • Cooling Efficiencv 13.0 SEER/10.8 EER • • • Duct Location/ R-Value R-6.0 • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted Yes • • • Economizer No Economizer • • • Thermostat Setback Required • • • Fan Control Constant Volume • • • Equipment" Inspection Criteria FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Special Feature^ Pass Fall* Item or System Tags (i.e. AC-1, RTU-1, HP-1) CLASS ROOM #705 • • • Equipment Type": SpW DX • • • Number of Systems 2 • • • Max Allowed Heating Capacity 47000 Btu/hr • • • Minimum Heating Efficiencv 8.70 HSPF • • • Max Allowed Cooling Capacity 48,000 Btu/hr • • • Cooling Efficiency 13.0 SEER/10.5 EER • • • Duct Location/ R-Value R-6.0 • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted Yes • • • Economizer No Economizer • • • Thermostat Setback Required • • • Fan Control Constant Volume • • • 1. Indicate special feature DETAILS on Page 2 of the Inspection Checklist Form. 2. If the Actual installed equipment performance efficiency and capacity is less than the Proposed (from the energy compliance submittal or from the building plans) the responsible party shall resubmit energy compliance to include the new changes. 3. For additional detailed discrepancy use Page 2 of the Inspection Checklist Form. 4. Indicate Equipment Type: Gas (Pkg or. Split), VAV, HP (Pkg or split), Hydronic, PTAC, or other. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 17 of 31 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 4) MECH-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: B Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) • Relocatable Public School Bldg. 0 Conditioned Spaces Unconditioned Spaces (affidavit) Phase of Construction: B New Construction • Addition • Alteration Approach ot Compliance: • Component 0 Overall Envelope TDV Energy • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg HVAC SYSTEM DETAILS FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Meets Criteria or Requirements Equipment" Inspection Criteria Special Feature^ Pass Fall* Item or System Tags (i.e. AC-1, RTU-1, HP-1) CLASS ROOM #104 • • • Equipment Type": Split DX • • • Number of Systems 2 • • • Max Allowed Heating Capacity 47,000 Btu/hr • • • Minimum Heating Efficiency 8.70 HSPF • • • Max Allowed Cooling Capacity 48,000 Btu/hr • • • Cooling Efficiency 13.0 SEER/10.5 EER • • • Duct Location/ R-Value R-6.0 • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted Yes • • • Economizer No Economizer • • • Thermostat Setback Required • • • Fan Control Constant Volume • • • Equipment" Inspection Criteria FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Special Feature^ Pass Fail* Item or System Tags (i.e. AC-1, RTU-1, HP-1) ROOM #204 UNFINISHED SHELL • • • Equipment Type": Split DX • • • Number of Systems 1 • • • Max Allowed Heating Capacitv 35,000 Btu/hr • • • Minimum Heating Efficiency 8.70 HSPF • • • Max Allowed Cooling Capacity 35,000 Btu/hr • • • Cooling Efficiency 13.0 SEER/11.2 EER • • • Duct Location/ R-Value R-8.0 • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted Yes • • • Economizer No Economizer • • • Thermostat Setback Required • • • Fan Control Constant Volume • • • 1. Indicate special feature DETAILS on Page 2 of the Inspection Checklist Form. 2. If the Actual installed equipment performance efficiency and capacity is less than the Proposed (from the energy compliance submittal or from the building plans) the responsible party shall resubmit energy compliance to include the new changes. 3. For additional detailed discrepancy use Page 2 of the Inspection Checklist Form. 4. Indicate Equipment Type: Gas (Pkg or. Split), VAV, HP (Pkg or split), Hydronic, PTAC, or other. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 18 of 31 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 1 of 4) MECH-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 Project Address 7330 POINSETTA LANE CARLSBAD Climate Zone Total Cond. Floor Area 74,626 Addition Floor Area 74,626 GENERAL INFORMATION Building Type: B Nonresidential • High-Rise Residential • Hotel/Motel Guest Room • Schools (Public School) • Relocatable Public School Bldg. 0 Conditioned Spaces Unconditioned Spaces (affidavit) Phase of Construction: 0 New Construction • Addition • Alteration Approach of Compliance: • Component P] Overall Envelope TDV Energy • Unconditioned (file affidavit) Front Orientation: N, E, S, W or in Degrees: 90 deg HVAC SYSTEM DETAILS FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Meets Criteria or Requirements Equipment" Inspection Criteria Special Feature^ Pass Fall* Item or System Tags (i.e. AC-1, RTU-1, HP-1) ROOMit205 UNFINISHED SHELL • • • Equipment Type": Packaged DX • • • Number of Svstems 2 • • • Max Allowed Heating Capacity 57,000 Btu/hr • • • Minimum Heating Efficiency 8.30 HSPF • • • Max Allowed Cooling Capacity 57,000 Btu/hr • • • Cooling Efticiency 13.0 SEER/10.8 EER • • • Duct Location/ R-Value R-6.0 • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted Yes • • • Economizer No Economizer • • • Thermostat Setback Required • • • Fan Control Constant Volume • • • Equipment" Inspection Criteria FIELD INSPECTION ENERGY CHECKLIST Equipment" Inspection Criteria Special Feature^ Pass Fail* Item or System Tags (i.e. AC-1, RTU-1, HP-1) ROOM #203 UNFINISHED SHELL • • • Equipment Type": Split DX • • • Number of Svstems 1 • • • Max Allowed Heating Capacity 35,000 Btu/hr • • • Minimum Heating Efficiency 8.70 HSPF • • • Max Allowed Cooling Capacity 35,000 Btu/hr • • • Cooling Efficiency 13.0 SEER/11.2 EER • • • Duct Location/ R-Value R-8.0 • • • Duct Leakage Testing - If Yes, a MECH-4A must be submitted Yes • • • Economizer No Economizer • • • Thermostat Setback Required • • • Fan Control Constant Volume • • • 1. Indicate special feature DETAILS on Page 2 of the Inspection Checklist Form. 2. If the Actual installed equipment performance efficiency and capacity is less than the Proposed (from the energy compliance submittal or from the building plans) the responsible party shall resubmit energy compliance to include the new changes. 3. For additional detailed discrepancy use Page 2 of the Inspection Checklist Form. 4. Indicate Equipment Type: Gas (Pkg or. Split), VAV, HP (Pkg or split), Hydronic, PTAC, or other. EnergyPm S.O by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 19 of 31 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 2 of 4) MECH-IC Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 SPECIAL FEATURES INSPECTION CHECKLIST The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification. The local enforcement agency determines the adequacy of the justification, and may reject a building or design that othenwise complies based on the adequacy of the special justification and documentation submitted. Discrepancies: EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 20 of 31 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 3 of 4) MECH-1 C Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 Required Acceptance Tests Designer: This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for mechanical systems. The designer is required to check the applicable boxes by all acceptance tests that apply and listed all equipment that requires an acceptance test. If all equipment of a certain type requires a test, list the equipment description and the number of systems. The NA number designates the Section in the Appendix of the Nonresidential Reference Appendices Manual that describes the test. Since this form will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Building Departments: Systems Acceptance: Before occupancy permit is granted for a newly constructed building or space, or a new space-conditioning system serving a building or space is operated for normal use, all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. Systems Acceptance: Before occupancy permit is granted. All newly installed HVAC equipment must be tested using the Acceptance Requirements. The MECH-IC form is not considered a completed form and is not to be accepted by the building department unless the correct boxes are checked. The equipment requiring testing, person performing the test (Example: HVAC installer, TAB contractor, controls contractor, PE in charge of project) and what Acceptance test must be conducted. The following checked-off forms are required for ALL newly installed equipment. In addition a Certificate of Acceptance forms shall be submitted to the building department that certifies plans, specifications, installation, certificates, and operating and maintenance information meet the requirements of §10-103(b) and Title-24 Part 6. The building inspector must receive the properly filled out and signed forms before the building can receive final occupancy. TEST DESCRiPTION MECH-2A MECH-3A MECH-4A MECH-5A MECH-6A MECH-7A MECH-8A MECH-9A MECH-10A MECH-11A Equipment Requiring Testing or Verification Qty. Outdoor Ventilation For VAV & CAV Constant Volume & Single-Zone Unitary Air Distribution Ducts Economizer Controls Demand Control Ventilation DCV Supply Fan VAV Valve Leakage Test Supply Water Temp. Reset Hydronic System Variable Flow Control Automatic Demand Shed Control Camer 25HCB3-60-5/FX4D060 8 El El • El • • • • • CARRIER 25HCB3-48-5/FX4D048 4 El • • • • • • • • CARRIER 25BC4 -36-5/FX4D036 2 El • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • EnemyPm 5.0 by EnemvSoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Paae 21 of 31 CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 4 of 4) MECH-1 C Project Name Date NORTH COAST CALVARY CHAPEL 10/30/2010 TEST DESCRIPTiON MECH-12A MECH-13A MECH-14A MECH-15A Equipment Requiring Testing Qty. Fault Detection & Diagnostics for DX Units Automatic Fault Detection & Diagnostics for Air & Zone Distributed Energy Storage DX AC Systems Thermal Energy Storage (TES) Systems Test Performed By: Canier 25HCB3-60-5/FX4D060 8 • • • • CARRIER 25HCB3-48-5/FX4D048 4 • • • • CARRIER 25BC4 -36-5/FX4D036 2 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 22 of 31 AIR SYSTEM REQUIREMENTS (Part 1 of 2) MECH-2C Project Name Date NORTH COAST CALVARY CHAPEL 10/30/2010 Item or System Tags (i.e. AC-1, RTU-1, HP-1) Indicate Air Systems Type (Central, Single Zone, Packag e, VAV, or etc..) Item or System Tags (i.e. AC-1, RTU-1, HP-1) ASSEMBLE CHAPEL BOOK STORE AREA/FOYER CLASS ROOM #105 Number of Systems 4 2 2 MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation Indicate Page Reference on Plans or Schedule and indicate the applicable exception(s) MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation T-24 Sections MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(a) 8.30 HSPF 8.30 HSPF 8.70 HSPF MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(a) 13.0 SEER/10.8 EER 13.0 SEER/10.8 EER 13.0 SEER/10.5 EER MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(b), 112(c) Yes Yes Yes MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(c), 115(a) n/a n/a n/a MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(b) No No No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(b) 3.254 cfm 1,272 cfm 896 cfm MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(c) No No No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(c) Yes Yes No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(e) Programmable Switch Pmgrammable Switch Programmable Switch MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(e) Setback Required Setback Required Setback Required MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(f) Gravity Auto Gravity MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(g) n/a n/a n/a MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 123 MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 124 R-6.0 R-6.0 R-6.0 PRESCRIPTIVE MEASURES Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) n/a n/a n/a Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) 174,417 Btu/hr 87,209 Btu/hr 71,909 Btu/hr Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) n/a n/a n/a Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a & b) 199,119 Btu/hr 98,413 Btu/hr 84,681 Btu/hr Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(c) Constant Volume Constant Volume Constant Volume Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(c) Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(c) No No No Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(d) No No No Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(e) No Economizer No Economizer No Economizer Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(f) Constant Temp Constant Temp Constant Temp Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(g) Constant Temp Constant Temp Constant Temp Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(1) Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(k) Yes Yes Yes 1. Total installed capacity (MBtu/hr) of all electric heat on this project exclusive of electric auxiliary heat for heat pumps. If electric heat is used explain which exception(s) to §144(g) apply. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Page23of31 AIR SYSTEM REQUIREMENTS (Part 1 of 2) MECH-2C Project Name Date NORTH COAST CALVARY CHAPEL 10/30/2010 Item or System Tags (i.e. AC-1, RTU-1, HP-1) Indicate Air Systems Type (Central, Single Zone, Packag e, VAV, or etc..) Item or System Tags (i.e. AC-1, RTU-1, HP-1) CMSSROOM#f04 )0M #204 UNFINISHED SHE )OM#205 UNFINISHED SHE Number of Systems 2 1 2 MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation Indicate Page Reference on Plans or Schedule and indicate the applicable exception(s) MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation T-24 Sections MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(a) 8.70 HSPF 8.70 HSPF 8.30 HSPF MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(a) 13.0 SEER/10.5 EER 13.0 SEER/11.2 EER 13.0 SEER/10.8 EER MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(b), 112(c) Yes Yes Yes MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(c), 115(a) n/a n/a n/a MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(b) No No No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(b) 386 cfm 303 cfm 785 cfm MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(c) No No No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(c) No No No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(e) Pmgrammable Switch Pmgrammable Switch Programmable Switch MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(e) Setback Requimd Setback Required Setback Requimd MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(f) Gravity Gravity Gravity MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(Q) n/a n/a n/a MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 123 MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 124 R-6.0 R-8.0 R-6.0 PRESCRIPTIVE MEASURES Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a& b) n/a n/a n/a Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) 71,909 Btu/hr 26,775 Btu/hr 87,209 Btu/hr Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) n/a n/a n/a Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a& b) 92,326 Btu/hr 24,230 Btu/hr 101,032 Btu/hr Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(c) Constant Volume Constant Volume Constant Volume Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(C) DCV Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(C) No No No Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(d) No No No Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(e) No Economizer No Economizer No Economizer Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(f) Constant Temp Constant Temp Constant Temp Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(g) Constant Temp Constant Temp Constant Temp Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(1) Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(k) Yes Yes Yes 1. Total installed capacity (MBtu/hr) of all electric heat on this project exclusive of electric auxiliary heat for heat pumps. If electric heat is used explain which exception(s) to §144(g) apply. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Page 24 of 31 AIR SYSTEM REQUIREMENTS (Part 1 of 2) MECH-2C Project Name Date NORTH COAST CALVARY CHAPEL 10/30/2010 Item or System Tags (i.e. AC-1, RTU-1, HP-1) Indicate Air Systems Type (Central, Single Zone, Packag e, VAV, or etc..) Item or System Tags (i.e. AC-1, RTU-1, HP-1) DOM #203 UNFINISHED SHE Numbier of Systems 1 MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation Indicate Page Reference on Plans or Schedule and indicate the applicable exception(s) MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation T-24 Sections MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(a) 8.70 HSPF MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(a) 13.0 SEER/11.2 EER MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(b), 112(c) Yes MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 112(c), 115(a) n/a MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(b) No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(b) Ocfm MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(c) No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 121(c) No MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(e) Programmable Switch MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(e) Setback Requimd MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(f) Gravity MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 122(g) n/a MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 123 MANDATORY MEASURES Heating Equipment Efficiency Cooling Equipment Efficiency HVAC Heat Pump Thermostat Furnace Controls/Thermostat Natural Ventilation Mechanical Ventilation VAV Minimum Position Control Demand Control Ventilation Time Control Setback and Setup Control Outdoor Damper Control Isolation Zones Pipe Insulation Duct Insulation 124 R-8.0 PRESCRIPTIVE MEASURES Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) n/a Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) 26,775 Btu/hr Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) n/a Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(a&b) 28,744 Btu/hr Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(c) Constant Volume Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(c) Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(c) No Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(d) No Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(e) No Economizer Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(f) Constant Temp Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(g) Constant Temp Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(1) Calculated Design Heating Load Proposed Heating Capacity Calculated Design Cooling Load Proposed Cooling Capacity Fan Control DP Sensor Location Supply Pressure Reset (DDC only) Simultaneous Heat/Cool Economizer Heat and Cool Air Supply Reset Electric Resistance Heating' Air Cooled Chiller Limitation Duct Leakage Sealing. If Yes, a MECH-4-A must be submitted 144(k) Yes 1. Total installed capacity (MBtu/hr) of all electric heat on this project exclusive of electric auxiliary heat for heat pumps. If electric heat is used explain which exceptlon(s) to §144(g) apply. EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Page 25 of 31 WATER SIDE SYSTEM REQUIREMENTS (Part 2 of 2) MECH-2C Project Name Date NORTH COAST CALVARY CHAPEL 10/30/2010 WATER" SIDE SYSTEMS: Chillers, Towers, Boilers, Hydronic Loops Indicate Page Reference on Plans or Specification" T-24 Sections 112(a) 123 Item or System Tags (i.e. AC-1, RTU-1, HP-1)' Number of Systems MANDATORY MEASURES Equipment Efficiency Pipe Insulation PRESCRIPTIVE MEASURES Cooling Tower Fan Controls Cooling Tower Flow Controls Variable Flow System Design Chiller and Boiler Isolation CHW and HHW Reset Controls WLHP Isolation Valves VSD on CHW, CW & WLHP Pumps>5HP DP Sensor Location 144(a&b) 144(h) 144(h) 144(j) 144(i) 144(i) 144(j) 144(j) 144(h) Heat Rejection System 1. The proposed equipment need to match the building plans schedule or specifications. If a requirement is not applicable, put "N/A" in the column nest to applicable section. 2. For each chiller, cooling tower, boiler, and hydronic loop (or groups of similar equipment) fill in the reference to sheet number and/or specification section and paragraph number where the required features are documented. If a requirement is not applicable, put "N/A" in the column next to applicable section. Service Hot Water, Pool Heating Item or System Tags (i.e. WH-1, WHP, DHW, etc...)' DHW Heater Number of Systems 4 Indicate Page Reference on Plans or Schedule" MANDATORY MEASURES T-24 Sections SERVICE HOT WATER Certified Water Heater 111, 113(a) Takagi T-K2 Water Heater Efficiency 113(b) 85% Service Water Heating Installation 113(c) Pipe Insulation 123 n/a POOL AND SPA Pool and Spa Efficiency and Control 114(a) n/a Pool and Spa Installation 114(b) n/a Pool Heater - No Pilot Light 115(c) n/a Spa Heater - No Pilot Light 115(d) Pipe Insulation 123 1. The Proposed equipment needs to match the building plans schedule or specifications. If a requirement is not applicable, put "N/A" in the column next to applicable section. 2. For each water heater, pool heater and domestic water loop (or groups of similar equipment) fill in the reference to sheet number and/or specification section and paragraph number where the required features are documented. If a requirement is not applicable, put "N/A" in the column. EneravPm 5.0 bv EnemvSoft User Number 1488 RunCode: 2010-10-30715:59:3 ID: 2-20-2010 Paae 26 of 31 MECHANICAL VENTILATION AND REHEAT MECH-3C Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 MECHANICAL VENTILATION (§121(b)2) REHEAT LIMITATION (§144(d)) AREA BASIS OCCUPANCY BASIS VAV MINIMUM A B c D E F G H 1 J K L M N Zone/System Condition Area (ft') CFM per ft' Min CFM By Area BXC Number Of People CFM per Person Min CFM by Occupant EXF REQ'D V.A. Max of DorG Design Ventilation Air CFM 50% of Design Zone Supply CFM BXO.4 CFM / ft' Max. of Columns H, J, K, 30 CFM Design Minimum Air Setpoint Transfer Air CHAPEL ASSEMBLY 3,037 1.07 3,250 3,250 3,254 ASSEMBLE CHAPEL Total 3,250 3,254 BOOK STOREAREA 2,49f 0.25 623 623 872 RESTROOM 672 0.15 101 101 400 BOOK STORE AREA/FOYER Total 724 1,272 CLASS ROOM #105 2,359 0.38 896 896 896 CLASS ROOM #105 Total 896 896 CLASS ROOM #104 2,575 0.38 979 979 386 592 CLASS ROOM #104 Total 979 386 UNFINISHED 797 038 303 303 303 ROOM #204 UNFINISHED SHEL Total 303 303 ROOM #205 2,066 038 785 785 785 ROOM #205 UNFINISHED SHEL Total 785 785 ROOM 203 UNFINISHED 629 038 239 239 0 239 ROOM #203 UNFINISHED SHEL Total 239 0 Totals Column 1 Total Design Ventilation Air C Minimum ventilation rate per Section §121, Table 121-A. E Based on fixed seat or the greater of the expected number of occupants and 50% of the CBC occupant load for egress purposes for spaces without fixed setting. H Required Ventilation Air (REQ'D V.A.) is the larger of the ventilation rates calculated on an AREA BASIS or OCCUPANCY BASIS (Column D or G). 1 Must be qreater than or equal to H, or use Transfer Air (column N) to make up the difference. J Design fan supply CFM (Fan CFM) x 50%; or the desiqn zone outdoor airflow rate per §121. K Condition area (ft^) x 0.4 CFM / ft^ or L Maximum of Columns H, J, K, or 300 CFM M This must be less than or equal to Column L and greater than or equal to the sum of Columns H plus N. N Transfer Air must be provided where the Required Ventilation Air (Column H) is greater than the Design Minimum Air (Column M). Where required, transfer air must be greater than or equal to the difference between the Required Ventilation Air (Column H) and the Design Minimum Air (Column M), Column H minus M. EnergyPro 5.0 by EnergySoft UserNumber 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 27 of 31 MECHANICAL EQUIPMENT DETAILS (Part 1 of 2) MECH-5C Project Name NORTH COAST CALVARY CHAPEL Date 70/30/2070 CHILLER AND TOWER SUMMARY PUMPS Equipment Name Type Qty. Efficiency Tons Qty. GPM BHP Premium Eff. Motor Pump Controi • • • DHW / BOILER SUMMARY System Name Type Distribution Qty. Rated Input Vol. (Gais). Energy Factor or RE Standby Loss or Pilot Tank Ext. R-Vaiue Status Takagi T-K2 Large Elec. Kitchen Pipe Ins 4 185,000 0 0.85 0.00% 0.0 New MULTI-FAMILY CENTRAL WATER HEATING DETAILS Hot Water Pump Hot Water Piping Length (ft) Control Oty. HP Type in Plenum Outside Buried Add V2" insuiation • • • CENTRAL SYSTEM RATINGS HEATING COOLING System Name Type Qty. Output Aux. kW Efficiency Output Efficiency Status Camer 25HCB3-60-5/FX4D060 Packaged DX 8 57,000 0.0 8.30 HSPF 57,000 13.0 SEER/10.8 EER New CARRIER 25HCB3-48-5/FX4D048 Split DX 4 47,000 0.0 8.70 HSPF 48,000 13.0 SEER/10.5 EER New CARRIER 25604 -36-5/FX4D036 Split DX 2 35,000 0.0 8.70 HSPF 35,000 13.0 SEER/11.2 EER New CENTRAL SYSTEM FAN SUMMARY SUPPLY FAN RETURN FAN System Name Fan Type Economizer Type CFM BHP Premium Eff. Motor CFM BHP Premium Eff. Motor Carrier 25HCB3-60-5/FX4D06Q Constant Volume No Economizer 2,000 1.00 • none • CARRIER 25HCB3-48-5/FX4D048 Constant Volume No Economizer 1,600 1.00 • none • CARRIER 25BC4 -36-5/FX4D036 Constant Volume No Economizer 1,200 0.75 • none • • • • • • • • • EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 28 of 31 MECHANICAL EQUIPMENT DETAILS (Part 2 of 2) MECH-5C Project Name Date NORTH COAST CALVARY CHAPEL 70/30/2070 ZONE SYSTEM SUMMARY SYSTEM VAV Fan Premium Eff. Motor Fan Cycles ECM Motor Zone Name System Name Type Qty. Heating Cooiing Min CFM Ratio Reheat Coil CFM BHP Premium Eff. Motor Fan Cycles ECM Motor Outside Air • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • EXHAUST FAN SUMMARY EXHAUST FAN Room Name Qty. CFM BHP 3 O E = a. LU EXHAUST FAN Room Name Qty. CFM BHP E S 3 O 1 = ft- c a. IU EXHAUST FAN Room Name Qty. CFM BHP E S 3 O IS £*: O, UJ RESTROOMS 2.0 200 0.10 • CLASS ROOM #104 2.0 100 0.10 • • EnergyPm 5.0 by EnergySoft User Number 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 29 of 31 ENVELOPE MANDATORY MEASURES: NONRESIDENTIAL ENV-MM Project Name NORTH COAST CALVARY CHAPEL Date 10/30/2010 DESCRIPTION Building Envelope Measures: §118(a): Installed insulating material shall have been certified by the manufacturer to comply with the California Quality Standards for insulating material, Title 20 Chapter 4, Article 3. §118(c): All Insulating Materials shall be installed in compliance with the flame spread rating and smoke density requirements of Sections 2602 and 707 of Title 24, Part 2. §118(f): The opaque portions of framed demising walls in nonresidential buildings shall have insulation with an installed R-value of no less than R-13 between framing members. §117(a): All Exierior Joints and openings in the building that are observable sources of air leakage shall be caulked, gasketed, weatherstripped or othenwise sealed. Manufactured fenestration products and exterior doors shall have air infiltration rates not exceeding 0.3 cfm/ft.^ of §116(a) 1: window area, 0.3 cfm/ft.^ of door area for residential doors, 0.3 cfm/ft.^ of door area for nonresidential single doors (swinging and sliding), and 1.0 cfm/ft.^ for nonresidential double doors (swinging). §116(a) 2: Fenestration U-factor shall be rated in accordance with NFRC 100, or the applicable default U-factor. RAiai \r> Fenestration SHGC shall be rated in accordance with NFRC 200, or NFRC 100 for site-built fenestration, or the §nb(a) J. applicable default SHGC. SI iR^hV Constructed Doors, Windows and Skylights shall be caulked between the unit and the building, and shall be ^ ^ weatherstripped (except for unframed glass doors and fire doors). EnergyPm 5.0 by EnemvSoft UserNumber 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 30 of 31 MECHANICAL MANDATORY MEASURES: NONRESIDENTIAL MECH-MM Project Name NORTH COAST CAL VARY CHAPEL Date 70/30/2070 Equipment and System Efficiencies §111: Any appliance for which there is a California standard established in the Appliance Efficiency Regulations will comply with the applicable standard. §115(a): Fan type central furnaces shall not have a pilot light. §123: Piping, except thaf conveying fluids at temperatures between 60 and 105 degrees Fahrenheit, or within HVAC equipment, shall be insulated in accordance with Standards Section 123. §124: Air handling duct systems shall be installed and insulated in compliance with Sections 601, 602, 603, 604, and 605 of the CMC Standards. Controis §122(e): Each space conditioning system shall be installed with one of the following: IA. Each space conditioning system serving building types such as offices and manufacturing facilities (and all others not explicitly exempt from the requirements of Section 112 (d)) shall be installed with an automatic time switch with an accessible manual override that allows operation of the system during off-hours for up to 4 hours. The time switch shall be capable of programming different schedules for weekdays and weekends and have program backup capabilities that prevent the loss of the device's program and time setting for at least 10 hours if power is interrupted; or IB. An occupancy sensor to control the operating period of the system; or 1C. A 4-hour timer fhat can be manually operated to control the operating period of the system. 2. Each space conditioning system shall be installed with controls that temporarily restart and temporarily operate the system as required to maintain a setback heating and/or a setup cooling thermostat setpoint. §122(g): Each space conditioning system serving multiple zones with a combined conditioned floor area more than 25,000 square feet shall be provided with isolation zones. Each zone: shall not exceed 25,000 square feet; shall be provided with isolation devices, such as valves or dampers that allow the supply of heating or cooling to be setback or shut off independently of other isolation areas; and shall be controlled by a time control device as described above. §122(c): Thermostats shall have numeric setpoints in degrees Fahrenheit (F) and adjustable setpoint stops accessible only to authorized personnel. § 122(b): Heat pumps shall be installed with controls to prevent electric resistance supplementary heater operation when the heating load can be met by the heat pump alone §122(a&b): Each space conditioning system shall be controlled by an individual thermostat that responds to temperature within the zone. Where used to control heating, the control shall be adjustable down to 55 degrees F or lower. For cooling, the control shall be adjustable up to 85 degrees F or higher. Where used for both heating and cooling, the control shall be capable of providing a deadband of at least 5 degrees F within which the supply of heating and cooling is shut off or reduced to a minimum. Ventilation §121 (e): Controls shall be provided to allow outside air dampers or devices to be operated at the ventilation rates as specified on these plans. §122(f): All gravity ventilating systems shall be provided with automatic or readily accessible manually operated dampers in all openings to the outside, except for combustion air openings. §121 (f): Ventilation System Acceptance. Before an occupancy permit is granted for a newly constructed building or space, or a new ventilating system serving a building or space is operated for normal use, all ventilation systems serving the buildinq or space shall be certified as meeting the Acceptance Requirements for Code Compliance Service Water Heating Systems §113(c) Installation 3. Temperature controls for public lavatories. The controls shall limit the outlet Temperature to 110° F. 2. Circulating service water-heating systems shall have a control capable of automatically turning off the circulating pump when hot water is not required. EnergyPm 5.0 by EnergySoft UserNumber 1488 RunCode: 2010-10-30715:59:31 ID: 2-20-2010 Page 31 of 31 CERTIFIED TEST, ADJUST, AND BALANCE REPORT DATE March 20, 2015 PROJECT North Coast Calvary Chapel ADDRESS 1350 Poinsettia Lane Carlsbad, CA 92011 ARCHITECT Timeless Architecture, Inc. ADDRESS 9891 In/ine Center Drive, Suite 140 In/ine, CA 92618 PHONE/FAX 949-831-8110 / 949-951-2820 ENGINEER N/A ADDRESS PHONE/FAX HVAC CONTRACTOR Slayton Mechanical ADDRESS 9824 Vine Street Lakeside, CA 92040 PHONE/FAX 619-390-4900 / 619-390-4901 NEBB TAB FIRIM Hartmanaire ADDRESS P.O. Box 2495 Corona, CA 92878 PHONE/FAX 951-479-6855 / 949-215-1001 TABLE OF CONTENTS SECTION I - PROJECT INFORMATION CERTIFICATION 1 NEBB'S CERTIFICATE 2 WARRANTY 3 INSTRUMENTS 4 ABBREVIATIONS 5 SECTION II - UNIT REPORTS CEILING UNIT DATA 6 SECTION III - AIR DISTRIBUTION REPORT AIR DISTRIBUTION (IN/OUT) REPORT FOR UNITS 10 SECTION IV - OTHER DATA MECHANICAL PLAN 17 CERTIFICATION PROJECT ADDRESS North Coast Calvary Chapel 1350 Poinsettia Lane Carlsbad, CA 92011 THE DATA PRESENTED IN THIS REPORT IS AN EXACT RECORD OF SYSTEM PERFORMANCE AND WAS OBTAINED IN ACCORDANCE WITH NEBB STANDARD PROCEDURES. ANY VARIANCES FROM DESIGN QUANTITIES WHICH EXCEED NEBB TOLERANCES ARE NOTED THROUGHOUT THIS REPORT. THE AIR DISTRIBUTION SYSTEMS HAVE BEEN TESTED & BALANCED AND FINAL ADJUSTMENTS HAVE BEEN MADE IN ACCORDANCE WITH NEBB "PROCEDURAL STANDARDS FOR TESTING, ADJUSTING BALANCING OF ENVIRONMENTAL SYSTEMS" AND THE PROJECT SPECIFICATIONS. NEBB TAB FIRM REG. NO. 3060 CERTIFIED BY Arthur J. Hartman DATE 3/20/2015 (Air Tab Supervisor) THE HYDRONIC DISTRIBUTION SYSTEMS HAVE BEEN TESTED & BALANCED AND FINAL ADJUSTMENT HAVE BEEN MADE IN ACCORDANCE WITH NEBB "PROCEDURAL STANDARDS FOR TESTING, ADJUSTI BALANCING OF ENVIRONMENTAL SYSTEMS" AND THE PROJECT SPECIFICATIONS. NEBB TAB FIRM REG. NO. CERTIFIED BY DATE (Hydronic Tab Supervisor) SUBMITTED & CERTIFIED BY: NEBB TAB FIRM TAB SUPERVISOR REG. NO. 3060 HARTMANAIRE Artlnur J Hartman SIGNATUR DATE 3/20/2015 ^^4. THIS IS TO CERTIFYTHAT J-fartmanaire in CoronUy CJA HAS MET ALL REQUIREMENTS FOR RENEWM. OF NEBB CERTinCATION IN THE FOLLOWING DISCIPLINE <Jlil &l c^yckonics Systems FOR THE BOARD OF DIRECTORS: Txp. Marcfl 31, 2016 J-fartmanaire/CJA J\fo, 3060 NEBB Cert. No. President President-Elect P O Sox 2495 Corona, CA 92878 951-479-6855 Warranty PROJECT: North Coast Calvary Chapel - Carlsbad, CA Warranty of Services Hartmanaire warranties the TAB work for one year from the date of this report. Hartmanaire reserves the right to correct errors or omissions in the collection of data. The Warranty covers Balancing Issues. Off Season Testing: Typical balance report covers testing and balancing of all scheduled equipment, regardless of the outside air temperature. An Off Season test will generally cover temperature measurements Balancing Issues: Any balancing issues or concerns that arise, Hartmanaire will return to the site any time during the warranty period. Systems will be rechecked and verified that tested items adhere with the reported test date, ATNO CHARGE. Warranty Procedures For all warranty items Balancing Issues, Hartmanaire requires a written request. The written request should be specific on the areas of concern, such rooms, or equipment, and the type of issue the occupants are having. Once written notification is received Hartmanaire will schedule a Technician. It is recommended that an Owner, or Architect, or Engineer be on site at that time. Voided Warranty and Additional Charges If a complaint issue is due to a mechanical equipment failure, control or maintenance related, the return trip maybe subject to a service charge, not covered under warranty. Hartmanaire reserves the right to resolve any TAB issues. If a third party or competing Test & Balance/Commissioning firm test or adjust any equipment, all project warranty is voided. (This is typical standard for the Mechanical industry, as Manufacture, Mechanical and Control Contractor voids all warranty when a competing firm test or manipulates their systems.) Any return trip to the job site is subject to a service charge and a purchase order will be required before returning to the job site. Document Archiving An electric file of all test documents will be kept on file until the end of the Warranty period. During that time an electronic copy of the test date will be provided a no charge. Any additional hard bound copies requested will be subject to a fee. Building owner should retain all documentation for future reference. All documentation pertaining to this project will be destroyed in accordance with our record retention schedule. 3 H anill^HMjLr e INSTRUMENT C.\LIBRATION FUNCTION MINIMUM RANGE ACCURACY RESOLUTION INSTRUMENT INFORMATION Calibration interval date Rotation measurement 0 to 5000 rpm ± 2% of reading ± 5 rpm Name/Type Digital Tachometer (6 Months) Manufacture & Model Extec Instuments Serial No. L735549 4/30/2015 m Temperature Measurement Air -40 to 240° F ± 1% of reading 0.2°F Name/Type Digital Tachometer (6 Months) Manufacture & Model Extec/421307 Serial No. 631249 4/30/2015 Immersion -40 to 240°F ± 1 % of reading 0.2°F Name/Type Digital Tachometer (6 Months) Manufacture & Model Extec / 39240 Serial No. 3034 4/30/2015 Contact -40 to 240° F ± 1 % of reading 0.2"F Name/Type Digital Tachometer (6 Months) Manufacture & Model Extec/421307 Serial No. 631249 4/30/2015 ''SSP?'-?'"''; Electrical Measurement Voits AC 0 to 600 VAC ± 2% of reading 1.0 Volt Name / Type Fluke / Volt-Amp Meter (6 Months) Amperes Oto 100 Amps ± 2% of reading 0.1 Ampere Manufacture & Model 333 Serial No. 8.9E+07 4/30/2015 i:„:iV}v.'^ :... ' | • • :/.,v-i, f/rxctj" ^ ; . ^ :—' Air Pressure Measurement Oto 10.00 in w.g. ± 2% of reading 0.01 in. w.g. si in. w.g. Name / Type Air Flow Meter (6 Months) Manufacture 8. Model Shortridge / 850 Serial No. M00187 4/30/2015 .• - Air Velocity Measurement 50 to 2500 fpm ± 5% of reading 20 fpm Name 1 Type Vain Anemometer (6 Months) (Not For Pitot tube traverses) Manufacture & Model Airflow / LCA6000 Serial No. A13562 4/30/2015 Humidity Measurement 10 to 90% RH 2% RH 1% Name/Type Check-it Superheat-Humidity Set (6 Months) Manufacture & Model CHECK-IT 0628 Senal No. 40950 4/30/2015 Direct Reading Hood 100 to 2000 cfm ± 5% of reading Digital-1 cfm Name / Type Air Flow Meter (6 Months) Analog-Not applicable Manufacture & Model Shortridge / 850 Serial No. M00187 4/30/2015 . . - . -< •% Pitot Tubes (2 required) 18" minimum not applicable Not applicable Wame / Type Dwyer Not Required adequate length for intended use Manufacture & Model 18"/36"/50" Senal No. NA Hydronic Pressure Measurement -30" hg to 60 psi ± 2% of reading 0.5 psi Name / Type Compound & Pressure Gage (6 Months) (Pressure Gauges) Manufacture & Model USG 190/150003 1X587 Serial No. 1771 4/30/2015 0 to 100 psi ± 2% of reading 1.0 psi Name / Type Pressure Gage 0 to 100 (6 Months) Manufacture & Model USG 190/ 1X599 Serial No 3452 4/30/2015 0 to 200 psi ± 2% of reading 2.5 psi Name / Type Pressure Gage 0 to 200 (6 Months) Manufacture & Model USG 190/150003 1X630 Serial No. 1774 4/30/2015 • •" .••••-r.vv• ' - Hydronic Difterential Pressure 0 to 100 in. w.g. ± 2% of reading 1.0 in. w.g. Name / Type Waier Meter / Differential Manometer (6 Months) Measurement Oto 100ft. w.g. ± 2% ot reading 1.0 fl. w.g. Manufacture & Model Turb-0-Flow/DP2 Serial No. 2973 4/30/2015 P 0 Box 2495 Corona, CA 92878 951-479-6855 ABBREVIATIONS ACT Actual AK Free Area Factor AHU Air Handling Unit CD Ceiling Diffuser CER Ceiling Exhaust Register CFM Cubic Feet per Minute CR Ceiling Retum Register D.B. Dry Bulb DD Direct Drive DDC Direct Digital Controls: EMS Control System forthe HVAC DL Drum Louver DNL Data Not Listed EF Exhaust Fan EMS Energy Management System ERU Energy Recovery Unit ENT Entering FH Flowhood (Measures CFM Directly SO FPM and AK factors are not required). FPM Feet per Minute GPM Gallons per Minute H.P. Horsepower LVG Leaving MBH 1,000 BTUH NA Not Available / No Access NVL No Valid Location O.S.A. Outside Air P.D. Pressure Drop R.A. Retum Air REQ Required RPM Revolutions per Minute RTU Roof Top Unit S.A. Supply Air S.F. Service Factor S.P. Static Pressure SWS Side V/ail Supply SWR Side V^/all Retum TAB TesL Adjust, and Balance TSP Total Static Pressure Traverse CFM readings take in at a point in the ductwork VAV Variable Air Volume; box that contains a motorized damper that modulates airflow W.B. Wet Bulb W.G. Water Gauge 5 pi Nf Bf RTU / HP / AC UNIT REPORT PROJECT FC-1 FC-2 FC-3 FC-4 N/S N/S N/S N/S N/S N/S N/S N/S CARRIER CARRIER CARRIER CARRIER FX4DNF037 FX4DNF037 FX4DNF049 FX4DNF049 2114A88070 2114A88069 2114A88084 2114A88077 DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL 1200 NVL 1200 NVL 1600 NVL 1600 NVL 1200 1175 1200 1167 1850 1692 1600 1179 900 1100 900 1086 877 959 877 886 300 75 300 81 725 734 725 731 0.35 0.30 0.33 0.32 0.14 0.16 0.15 0.12 0.5 0.49 0.5 0.46 0.5 0.48 0.5 0.44 GENTEQ GENTEQ GENTEQ GENTEQ 1/2 1/2 3/4 3/4 208 211 208 211 208 211 208 211 1 1 1 1 1 1 1 1 7.6 6.7 7.6 6.5 6.0 5.2 6.0 5.2 MULTI MULTI MULTI MULTI 1.0 1.0 1.0 1.0 DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE FAN NAME SERVICE LOCATION MANUFACTURER MODEL* SERIAL* CFM TOTAL FAN TOTAL OUTLETS RETURN AIR OUTSIDE AIR STAT PRESS DISCHARGE SUCTION ESP MOTOR/FAN MANUFACTURER HORSEPOWER VOLTAGE PHASE AMPERAGE RPM/SPEED SERVICE FACTOR ORIVE MOTOR SHEAVE SIZE % CLOSED FAN SHEAVE SIZE FAN RPM CENTER TO CENTER BELT SIZE / # OF NI Bf RTU / HP / AC UNIT REPORT PROJECT FAN NAME SERVICE LOCATION MANUFACTURER MODEL* SERIAL* CFM TOTAL FAN TOTAL OUTLETS RETURN AIR OUTSIDE AIR STAT PRESS DISCHARGE SUCTION ESP MOTOR/FAN MANUFACTURER HORSEPOWER VOLTAGE PHASE AMPERAGE RPM/SPEED SERVICE FACTOR DRIVE MOTOR SHEAVE SIZE % CLOSED FAN SHEAVE SIZE FAN RPM CENTER TO CENTER BELT SIZE / * OF FC-5 FC-6 FC-7 FC-8 N/S N/S N/S N/S N/S N/S N/S N/S CARRIER CARRIER CARRIER CARRIER FX4DNF049 FX4DNF049 FX4DNF049 FX4DNF049 2414C63584 2114a88033 3414389929 2114388075 DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL 1600 NVL 1600 NVL 1600 NVL 1600 NVL 1600 1569 1598 1582 1596 1589 1600 1577 612 578 712 684 712 689 612 582 988 991 888 898 888 900 988 995 0.36 0.28 0.25 0.29 0.20 0.23 0.14 0.17 0.5 0.56 0.5 0.51 0.5 0.39 0.5 0.46 GENTEQ GENTEQ GENTEQ GENTEQ 3/4 3/4 3/4 3/4 208 211 208 211 208 211 208 211 1 1 1 1 1 1 1 1 6.0 5.3 6.0 5.5 6.0 5.3 6.0 5.4 MULTI MULTI MULTI MULTI 1.0 1.0 1.0 1.0 DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE Nf Bf RTU / HP / AC UNIT REPORT PROJECT FC-9A FC-9B FC-10 FC-11 N/S N/S N/S N/S N/S N/S N/S N/S CARRIER CARRIER CARRIER CARRIER FX4DNF049 FX4DNF049 FX4DNF061 FX4DNF061 2014a83705 3414386620 3614A81881 2514C63818 DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL 1600 NVL 1600 NVL 2000 NVL 2000 NVL 1596 1576 1600 1596 2000 1949 2000 1993 780 764 780 780 1000 900 1000 976 820 812 820 816 1000 1049 1000 1017 0.35 0.30 0.33 0.32 0.14 0.16 0.15 0.12 0.5 0.49 0.5 0.46 0.5 0.48 0.5 0.44 GENTEQ GENTEQ GENTEQ GENTEQ 3/4 3/4 1 1 208 211 208 211 208 211 208 211 1 1 1 1 1 1 1 1 6.0 5.2 6.0 5.0 7.6 6.4 7.6 6.5 MULTI MULTI MULTI MULTI 1.0 1.0 1.0 1.0 DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE FAN NAME SERVICE LOCATION MANUFACTURER MODEL* SERIAL* CFM TOTAL FAN TOTAL OUTLETS RETURN AIR OUTSIDE AIR STAT PRESS DISCHARGE SUCTION ESP MOTOR/FAN MANUFACTURER HORSEPOWER VOLTAGE PHASE AMPERAGE RPM/SPEED SERVICE FACTOR DRIVE MOTOR SHEAVE SIZE % CLOSED FAN SHEAVE SIZE FAN RPM CENTER TO CENTER BELT SIZE/# OF Nf Bf RTU / HP / AC UNIT REPORT PROJECT FAN NAME SERVICE LOCATION MANUFACTURER MODEL* SERIAL* CFM TOTAL FAN TOTAL OUTLETS RETURN AIR OUTSIDE AIR STAT PRESS DISCHARGE SUCTION ESP MOTOR/FAN MANUFACTURER HORSEPOWER VOLTAGE PHASE AMPERAGE RPM/SPEED SERVICE FACTOR DRIVE MOTOR SHEAVE SIZE % CLOSED FAN SHEAVE SIZE FAN RPM CENTER TO CENTER BELT SIZE/* OF FC-12 N/S N/S CARRIER FX4DNF061 2014383705 DESIGN ACTUAL 2000 NVL 2000 1937 1000 900 1000 1037 0.35 0.14 0.5 0.49 GENTEQ 1 208 211 1 1 7.6 6.7 MULTI 1.0 DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE DIRECT DRIVE Nf^J Bf INOUT REPORT PROJECT CALVARY CHAPEL ' ' AREA.' . Na !KIND SEE' IJSK. '•, ^REUM FMAL ' FPU HBIAilKS FC-1 N/S 1 CD 12X12 1.0 300 290 2 CD 12X12 1.0 300 304 N/S 3 CD 12X12 1.0 300 297 N/S 4 CD 12X12 1.0 300 284 1200 1175 FC-1 RETURN 1 RG 12X12 1.0 282 280 N/S 2 RG 12X12 1.0 282 278 N/S 3 RG 12X12 1.0 282 275 N/S 4 RG 12X12 1.0 281 287 OSA 1127 1100 75 FC-2 WS 1 CD 12X12 1.0 600 586 H/S 2 CD 10X10 1.0 150 154 WS 3 CD 10X10 1.0 150 142 N/S 4 CD 10X10 1.0 150 146 N/S 5 CD 10X10 1.0 150 139 1200 1167 OSA N/S 1 RG 12X12 1.0 564 1086 81 Nf|BJ Bf INOUT REPORT PROJECT CALVARY CHAPEL :-Amsh Na KIND SRE 1 'iqc' U CSlGN jPRGLM FINAL FC-3 N/S 1 CD 10X10 1.0 250 226 N/S 2 CD 10X10 1.0 250 228 'N/S" 3 CD 10X10 1.0 250 225 N/S 4 CD 10X10 1.0 175 160 N/S 5 CD 10X10 1.0 175 163 N/S 6 CD 10X10 1.0 175 165 N/S 7 CD 10X10 1.0 175 163 N/S 8 SWS 16X8 1.0 400 362 1850 1692 FC-3RETURN N/S 1 RG 24X24 1.0 877 959 FC-4 N/S 1 CD 12X12 1.0 200 204 N/S 2 CD 12X12 1.0 200 193 N« 3 CD 12X12 1.0 200 188 N/S 4 CD 12X12 1.0 200 200 N/S 5 CD 12X12 1.0 200 204 N/S 6 CD 12X12 1.0 200 220 N/S 7 CD 12X12 1.0 200 218 N/S 8 CD 12X12 1.0 200 190 1600 1617 FC-4 RETURN N/S 1 CD 24X24 1.0 877 886 OSA 734 OSA 731 Nf^J Bf INOUT REPORT PROJECT CALVARY CHAPEL AREA :• Hb.'^ '.tOHD AK DESIGN PKEIM FWAL FPU FC-5 N/S N/S WS N/S N/S N/S N/S N/S FC-5 RETURN N/S WS N/S N/S ^'"^'^WS N/S N/S N/S"""" FC-6 RETURN N/S RD RD RD RD RD RD RD RD RG CD CD CD CD CD CD CD RG 24X24 12X12 12X12 12X12 12X12 12X12 12X12 12X12 24X24 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 200 200 200 200 200 200 200 200 1600 612 266 200 200 200 200 266 266 1598 712 197 184 210 204 192 188 186 208 1569 578 260 205 209 190 188 270 260 1582 684 OSA 991 OSA 898 Nf^f INOUT REPORT PROJECT CALVARY CHAPEL N/S WS ws ws ws "'^"^^ ws WS FC-8 WS N/S N/S WS ws' N/S WS'^ rc-sREruRN ws NO. KIND SIZE AfC DESIGN 1 CD 12X12 1.0 228 2 CD 12X12 1.0 228 3 CD 12X12 1.0 228 4 CD 12X12 1.0 228 5 CD 12X12 1.0 228 6 CD 12X12 1.0 228 7 CD 12X12 1.0 228 1596 1 RG 24X24 1.0 712 1 RD 8 1.0 200 2 RD 8 1.0 200 3 RD 8 1.0 200 4 RD 8 1.0 200 5 RD 8 1.0 200 6 RD 8 1.0 200 7 RD 8 1.0 200 8 RD 8 1.0 200 1600 1 RG 24X24 1.0 612 230 240 221 220 227 229 222 1589 689 220 180 188 209 211 190 195 184 1577 582 OSA 900 OSA 995 Nf[Bf INOUT REPORT PROJECT CALVARY CHAPEL JMA NO. KIND SIZE AK oiaiBH ^MEL ON FWAL - FPH HaMM 1 RD 8 1.0 266 260 2 RD 8 1.0 266 273 3 RD 8 1.0 266 280 4 RD 8 1.0 266 245 5 RD 8 1.0 266 257 6 RD 8 1.0 266 261 1596 1576 OSA 1 RG 24X24 1.0 780 764 812 1 RD 8 1.0 200 190 2 RD 8 1.0 200 199 3 RD 8 1.0 200 210 4 RD 8 1.0 200 213 5 RD 8 1.0 200 188 6 RD 8 1.0 200 193 7 RD 8 1.0 200 200 8 RD 8 1.0 200 203 1600 1596 OSA 1 RG 24X24 1.0 780 780 816 1 SWS 24X12 1.0 500 500 2 SWS 24X12 1.0 500 476 3 SWS 24X12 1.0 500 482 4 SWS 24X12 1.0 500 491 2000 1949 OSA 1 RG 48X24 1.0 1000 900 1049 FC-9A WS WS WS WS WS WS FC-9A RETURN WS JF0.9B WS WS N/S N/S N/S WS WS FC-9B RETURN WS FC-io ws ws ws ws FC-10 RETURN WS MI]BJ Bf INOUT REPORT PROJECT CALVARY CHAPEL • "-AfgA '•'>"^.t • ito. 'WtiD FC-11 N/S M« N/S WS WS WS WS WS WS WS FC-11 RETURN WS^"'"^ FC-12 N/S WS" ws N/S FC-12 RETURN WS SIZE AK iDEBieN WgLIM FBwk ' FPM ^jawilMCS 1 SWS 14X8 200 211 2 SWS 14X8 200 209 3 FG 14X10 200 182 4 FG 14X10 200 188 5 FG 14X10 200 196 6 FG 14X10 200 200 7 FG 14X10 200 213 8 FG 14X10 200 204 9 CD 14X10 200 194 10 CD 14X10 200 196 2000 1993 1 RG 48X24 1.0 1000 976 1 SWS 24X12 1.0 500 488 2 SWS 24X12 1.0 500 476 3 SWS 24X12 1.0 500 482 4 SWS 24X12 1.0 500 491 2000 1937 1 RG 48X24 1.0 1000 900 OSA 1017 OSA 1037 pi NflBf INOUT REPORT PROJECT CALVARY CHAPEL AREA EF-1 N/S iF-2 N/S EF-3 N/S EF-4 WS EF-5 WS EF-6 WS EF-7 N/S N/S EF-8 N/S EF-9 N/S KIND SIZE AK iDESfGN /PBBJli FBHAL EG 10X10 1.0 300 302 EG 10X10 1.0 300 312 EG 10X10 1.0 90 92 EG 10X10 1.0 90 93 EG 10X10 1.0 90 90 EG 10X10 1.0 90 95 EG 10X10 1.0 150 160 EG 10X10 1.0 200 180 350 340 EG 10X10 1.0 350 337 EG 10X10 1.0 350 340 Duct Notes All supply and return air ductwork in ceiling space to be Class #1 lined flex. All ductwork in exposed ceiling space to be galvanized metal. First 10'-0' from fan coil to be lined with r sound insulation. Increase size of duct 2' in diameter for insulation. Connect all ductwork to fans, fan casings or fan plenums with flexible sleeves. Install each sleeve with at least 7" slack across a clear metal-to-metal gap of at least 4". NOTE' RECOMMENDED NOISE CRITERION PER AREA SERVED AS RECDMMENDED BV (ACDUSTIC DIMENSIONS^ CHAPEL MAX. MC= 25 YDUTM ROOMS MAX, NC= 30 STORE , MAX. NC^ 35 ACTUAL: CHAPEL TITUS 30Q NC=16 YOUTH RDDM 104 TITUS TMRA ROUND MAX. NC =16 YOUTH RDOM 105 TITUS 250-AA HflX, NC.^16 BDOK STORE TITUS g50-AA HAX. NC.=1& L RETURN AiR GRILLES TO BE EGG CRATE NOTE: MIN. OUTSIDE AIR PER SYSTEMi CHAPEL FC-10,n ANE FC-1?. 1, MIN. C.F.M. EACH. MAX.DEMAND VENTILATION =2,000 EACH •C-1 Second Floor Otttefi •0-2 SecorxJ Fkjor Offices •C-3 Boo*slore 102 (4 Fayer) 'C-4 etKA store 102 •C-S MPR 104 •C-6 Reception 105 •C-T Reception 105 ^C-B MPR 104 •C-9 A Class room Z05 -C-9B Classroom 205 •C-10 Chapel 101 •cn Chapel 101 •C-12 Chapel 101 Mech First Floor SCALE 1/8" =" i'-o- PEVI51C NS DELTA DATE DESCRIPTION 02/18(11 06/27114 I0/D3'14 *Dfl - AMD Hmly B r g SbiB^q • IB lEKISlH ADR - lte«si t f ••- C:*= a^r™ -3^ HWIO V V V V V V V V CONSU LTANT TIMELESS ARCHITECTURE use. REPRODUCTION, PUBLICATION. OR REUSE BY ANY METHOD, IN WHOLE OR PART WITHOUT THE EXPRESS CONSENT OF TIMELESS ARCHITECTURE. IS PROHIBITED. TITLE TO THE PLANS AND; SPECIFICATIONS REMAIN WITH TIMELESS ARCHITECTURE INC. WITHOUT PREJUDICE VISUAL CONTACT WITH THESE PLANS AND SPECIFICATIONS SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF THE ACCEPTANCE OF THESE RESTRICTIONS. THIS DRAWING SHALL NOT BE USED FOR CONSTRUCTION UNTIL SIGNED BY THE ARCHITECT North Coast Calvary Ctiapel Chapel Building SFTE ADDRESS: 1350 Poinsettia Lane Carlsbad, CA 92011 PH 760.929.0029 214-550-01; 215-070-13 & 26 11/10/14-4:31 PM LAST SAVED BY: Alan Rinderer FILENAME: 10003 Chapel Mdl2 [i5-iMac-Thane- Right local] First Floor Mechanical Plan Mill Duct Notes All supply and return air ductwork in ceiling space to be Class #1 lined flex. All ductwork in exposed ceiling space to be galvanized metal. Firsl 1 D'-O" from fan coil to be lined with 1' sound insulation. Increase size of duct 2" in diameter for insulalion. Connect all ductwork to fans, fan casings or fan plenums with flexible sleeves. Install each sleeve with at least 7" slack across a clear metal-to-metal gap of at least 4". NORTH IS' O.S.A. uo troir below (tor FC-6, FC-7 anB FC-8). Tolal ol 2.764 dm-sae Roof Plan SECOND FLOOR PLAN Mech Second Floor TIMELESS ARCHITECTURE REVISIC NS DELTA DATE DESCRIPTION V w D2l2tlU \y 05/23/14 w 07/30114 ^•m-csx. ind tar mi.-a R«n!OS 10^1(14 \m:H V V V V V V V CONSU LTANT USE. REPRODUCTION, PUBLICATION, OB REUSE BY ANV METHOD, IN WHOLE QR PART. WITHOUT THE EXPRESS CONSENT OF TIMELESS ARCHITECTURE INC IS PROHIBITED TITLE TO THE PLANS AND SPECIFICATIONS REMAIN WITH TIMELESS ARCHITECTURE INC WITHOUT PREJUDICE. VISUAL CONTACT WITH THESE PLANS AND SPECIFICATIONS SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF THE ACCEPTANCE OF THESE RESTRICTIONS. THIS DRAWING SHALL NOT BE USED FOR CONSTRUCTION UNTIL SIGNED BY THE ARCHITECT North Coast Calvary Chapel Chapel Building srrE ADDRESS: 1350 Poinsettia Lane Carlsbod, CA 92011 PH 760.929.0029 214-550-01; 215-070-13 & 26 11/10/14-4:31 PM LAST SAVED BY: Alan Rinderer FILENAME: 10003 Chapel Mdl2 [15-1 Mac-Thane -RighMocal] Second Floor Mechanical Plan M121 Kathleen Beck From: John Sandahl Sent: Monday, March 23, 2015 1:54 PM To: Kathleen Beck Subject: FW: Title-24 form Attachments: Mech title24 forms.zip Please make a copy for my files. Thanks, js From: Adam Slayton [mailto:adam@slaytonmechanical.com] Sent: Monday, March 23, 2015 1:18 PM To: Daniel Owen Cc: John Sandahl Subject: Title-24 form All title-24 forms attached minus the Mech 4-H, this comes from the HERS rater. I should have these forms soon. Thank you Dan. Adam W. Slayton Estimator/P.M 9824 Vine St Lakeside CA 92040 (619) 390-4900/ (619) 390-4901 fax (619) 549-2076 cell www.slavtonmechanical.com Total Control Panel Login To: isandahl(a).erantgc.com Retnove this sender from my allow list From: adamfalslavtonmechanical.com You received this message because the sender is on your allow list. STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CAUFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Enforc«m«nt Aaencv: Permit Number: Project Addriit: .—. • ( Zip Cod«: Syitam NamM iddpttFlcatlon/TiB: ., * _ SystSlff Location or Area'Served: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use; Checked by/Date Intent: Verify meosured outside airflow reading Is withir) ±10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MECH-3C (Column H or Column I) or Mechanical Equipment Schedules. Construction Inspection Wote; MCH-2A can be peiformed in conjunction with MCH-7A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. 2. Supporting documentation needed to perform test Includes: As-bullt and/or design documents (for example. Mechanical Equipment Schedules, Equipment Start-up sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At-A-Glance and NA7.S.1.2 Constant Voiume Systems Outdoor Air Acceptance At-A-Glance). c. 2013 Building Energy Efficiency Standards. 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: II. Equipment calibration date (must be within one year); System type (check either VAV or CAV): • VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ^ Check If factory calibrated and attach calibration certification. C Check If field calibrated and attach calibration results, li. Damper Control (must be checked): 0 Dynamic damper controi Is being used to control outside air. (This is NOT a fixed minimum position), iii. One of the following dynamic controls Is being utilized to control outside air (check method used) • Outdoor Air CFM Compensation D Energy Balance Method ( i Demand Control Ventilation • Return Fan Tracking • Injection Fan Method • Dedicated Minimum Ventilation Damper with Pressure Control • Other Active Control, Describe: b. Check if Constent Air Volume (CAV) and verify the following: JSC System is designed to provide a fixed minimum OSA when the unit Is on. Method of delivering outside air to the unit (check one of the following): C Outside air is ducted to the return air plenum. Confirm that outside air Is ducted to either (check one of the following): • Vi/lthlnflveft.oftheunlt. 0 Within 15 ft. of the unit, with the air directed substantially toward the unit. Q Return air plenum Is NOT used to distribute outside air to the unit. I.e. outside air Is ducted directly to the unit or outside air is provided independent of the unit, Pre-occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one ofthe following methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever Is less. 3 complete air changes to the zone served by the air handler. CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Enforcement Agency: Perrnit Nujnber; Zip CMe: System N«rn« or id^tiflcatJon/^g: System Locitlon or Area Served; A. NA7.5.1.1 Outdoor/Mr Acceptance Functional Testing >tAV • 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 Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full cooling. Record VFD speed {Hi.). Hz b. Measured outdoor airflow reading (cfm) cfm cfm Required outdoor airflow (cfm) (from M£CH-3C, Column!, ar Mechanical Equipment Schedules). ffm cfm ^ Time for outside air damper to stabilize after full supply airflow is achieved (minutes): min Step 4: VAV testing at reduced supply alrflaw CAV VAV a. Adjustsupplyalrflowtoeltherthesumoftheminimumzoneairflows, full heating, or 30% of the 1,^ '4'^^'•ilsrwr total design airflow. Record VFD speed (Hz). ^wMl^iS Hz b. Measured outdoor airflow reading (cfm) cfm c. Required outdoor airflow (cfm) (from MECH-3C, Coiumn 1, or mechanical equipment schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow Is achieved (minutes); min Step 5: Return to Initial conditions (check) ^ j • B. Testing Calcuiations & Results Determine Percent Outside Air at full supply airflow (%0AFA) for Step 2 a, %OAFA " Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %OAu is within 10% of design Outside Air. [%OAFA i 110%) Y/N c. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%QA|,A) for Step 3 (VAV oniy) a. %OA|M = Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) % b. %OARA is within 10% of design Outside Air. (OA^ S110%) Y/N c. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) Y / N Note: The Intent of this test is to ensure that 1) all air handlers provide the mihlmu m amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. 1^ Evaluation: PASS: All Construction inspection responses are complete and Testing Calculations & Results responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-1V1CH-02-A Outdoor Ai r Accepta nee (Page 3 of 3) Project Name: . ^ Enforcement Ajancy; f>erm)t Uumher. ProjectAddress: ^ ' ll' '{/ Zip Code: System Mime or IdVntlfketlon/lig; Sy&tem Location Of Afea Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Acceptance documentation Is accurate and complete, anv Name: ^1 ^ . A Documentation Author Name: _/J^ ATT Certification Identificatiofi (If applicable): Documentation /Ujthor Signatures Documentation Author Company Name: CIty/State/Zip: phone; FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, underthe laws ofthe State of California: 1. The Information provided on this Certificate of Acceptance is true and correct. 2. I am the person who perfonmed 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. I 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 permlt(s) Issued for the building. Field Technician Name: Reld Technician Signaturer Fleld Technician Company Name: Position with Company (Title): Address: ATT Certification Identification (if applicable): City/State/ZIp: Phone: Date Signed: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 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. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responslblllty 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). 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 tothe applicable acceptance requirements and procedures specified In Reference Nonresidential Appendix NA7. I have confirmed that the Certiflcate(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 bullding permlt(s) issued for the buildlng. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permlt(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 Acceptance Person Name: Responsible Acceptance Person Signatyfe: Responsible Acceptance Person Company Position with Company (Title); Address: L', CSLB License: aty/State/2lp: Phone; Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compilance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (PagelofS) Enforccntent Agency: Permit Number Project Addnesf: ^—^ * . / ZfpCode: Sy^e/n Name or Id^Dllficitlon/IfKl SystSfn Location or Area Served: Note: Submit one Certificate of Acceptance for each system tbat must demonstrate compilance. Enforcement Agency Use; Checked by/Date Intent: Verify measured outside airflow reading is within ±10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MECH-3C (Column H or Column I) or Mechanicai Equipment Schedules. Construction inspection Wote: MCH-2A can be performed In conjunction with MCH-7A Supply Fan VFD Acceptance (if applicabie) since testing activities overlap. Supporting documentation needed to perform test includes: As-built and/or design documents (for example, Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports), 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At-A-Glance and WA 7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At-A-Glance). c. 2013 Building Energy Efficiency Standards, Instrumentation needed to perform test Includes: ^ Watch b. Calibrated means to measure airflow (I.e. hot-wire anemometer, velocity pressure probe, etc.). I. Method and equipment used:___ , II. Equipment calibration date (must be within one year): System type (check either VAV or CAV): • VAV J>ii< CAV a. Check if Variable Air Volume (VAV) and complete the following: i. Outside airflow is either factory calibrated or field calibrated. ^ Check If factory calibrated and attach calibration certification. • Check Iffleld calibrated and attach calibration results, li. Damper Control (must be checked): a Dynamic damper control is being used to control outside air. (This Is NOT a fixed minimum position), ili. One of the following dynamic controls is being utilized to control outside air (check method used) • Outdoor Air CFM Compensation • Energy Balance Method Demand Control Ventilation • Return Fan Tracking Q Injection Fan Method 0 Dedicated Minimum Ventilation Damper with Pressure Control a Other Active Control, Describe: b. Check if Constant Air Volume (CAV) and verify the following: System Is designed to provide a fixed minimum OSA when the unit is on. Method of delivering outside air to the unit (check one of the following): G Outside air Is ducted to the return air plenum. Confirm that outside air Is ducted to either (check one ofthe following): a Within five ft. ofthe unit. • Within 15 ft. of the unit, with the air directed substantially toward the unit. C Return air plenum is NOT used to distribute outside air to the unit. I.e. outsidB air is ducted directly to the unit or outside air is provided independent of the unit. Pre-occupancy purge has been programmed for the 1-hour period Immediately before the bulldlng is normally occupied to provide (one ofthe following methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or IS cfm per person times the expected number of occupants, whichever is less. 3 complete air changes to the zone served by the air handler. CA Bulldlng Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Enforcement Agency: Permit Number: Project Addreii: ' / - 1 Zip Code: Syitam Nimeor Me^itlfkatiorV^g: System Locition or Area Served: A NA7.5.1.1 Outdoor Air Acceptance Functional Testing >tAV • 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 "in";-,—".,'"/. .M! Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm cfm Required outdoor airflow (cfm) (from MECH-3C, Column 1, or Mechanical Equipment Schedules). cfm cfm ^ Time for outside air damper to stabilize after full supply airflow is achieved (minutes): min Step 4: VAV testing at reduced suppty airflow | CAV VAV a. Adjust supply airflow to eltherthe sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD speed (Mz). ^^^^^^^y Hz b. Measured outdoor airflow reading (cfm) cfm c. Required outdoor airflow (cfm) (/rom MECH-3CCo;um/7(, or mecten/co/e(ju/pmentsc/)edi//es;. |l^^j:^,J)^'j^SL!J cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): ll min Steps: Return to Initial conditions (check) • B. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%0AFA) for Step 2 a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %PAFA is within 10% of design Outside Air. (%0A„ S110%) Y/N c Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%0ARA) for Step 3 (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) % b. %OA|u is within 10% of design Outside Air. (OA^ £ 1^0%) Y/N c. Outside air damper position stabilizes within 5 minutes (Step 3d < S minutes) si.n.flslFiesl^s.'! Y/N Note; The Intent of this test Is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. Evaluation: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y-yes) CA Building Enargy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CAUFORNIA ENERGY COMMISSION ^"t^ CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) ProjectName: , 1 £nforcement Agency: Permit Number; Pro^ct Address: ' • 1 1 . ' ^l' Zip Code: System Name or Idi^rtlFicitioiVffti: Syitem Location orXfn Served; DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation Is accurate and complete. y\ ' I J I Documentation Author Signature;/ //y A' ATT Certification IcTentiricatio^i (If applicable): Documentation Authvor Name: Documentation Author Company Name: Address: Clty/5tate/Zlp: Phone; FIELD TECHNICIAN'S DECLARATION STATEMENT 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 applicable acceptance requirements Indicated in the plans and specifications approved by the enforcement agency, and conforms to the appiicable acceptance requirements and procedures specified in Reference Nonresidential Appendix I^1A7. 4. 1 have confirmed that the Certlflcate{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 Technidan Name; Field Technician Signaturer Field Technician Company Name; Positian with Company (Title): Address: ATT Certification Identiffcatlon [if applicable): City/State/Zip: Phone: Date Signed; RESPONSIBLE PERSON'S DECLARATION STATEMENT 1. I I certify the following under penalty of perjury, under the laws of the State of California: 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. 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). The Information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance compiles with the acceptance requirements indicated In the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I have confirmed that the Certificate(s) of Installation for the construction or Installation Identified on this Certificate of Acceptance bas been completed and is posted or made available with the building permit(s) Issued for the building. 1 wlll ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permlt(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 bullding owner at occupancy. St Responsible Acceptance Person Name: flesponslble Acceptance Person Company Address; Clty/State/Zlp: CSIB License: Responsible Acceptance Person Signatme; Position with Company (TitleJ UMii^l Phone; Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 V STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (PagelofS) Enforcement Agency: Permit Number: Project AddreiK .—. • . / l'^^) (\/(>xAV^ 1 .yAMJy Zip Code: 3!5n2Ss:nr«-^/ficfD^</«^ Svtt'Mi Location o AreaSenred: Wote; Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency LJse; Checked by/Date Intent: Verify measured outside airflow reading Is within ± 1096 ofthe total required outside airflow. Required for all newiy installed HVAC units. Reference MECH-3C (Column H or Column 1) or Mechanical Equipment Schedules. Construction inspection Wote; MCH-2A can be performed in conjunction with MCH-7A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. (P 4. Supporting documentation needed to perform test includes: As-built and/or design documents (for example. Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation 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. Instrumentation needed to perform test Includes: yf Watch b. Calibrated means to measure airflow (I.e. hot-wire anemometer, velocity pressure probe, etc.). I. Method and equipment used: ___ II. Equipment calibration date (must be within one year): System type (check eitherVAV or CAV): VAV CAV a. Check If Variable Air Volume (VAV) and complete the following: i. Outside airflow is either factory calibrated or field calibrated. Check if factory calibrated and attach calibration certiflcation, • Check if field calibrated and attach calibration results. ii. Damper Control (must be checked): 0 Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). iii. One of the following dynamic controls Is being utilized to control outside air (check method used) • Outdoor Air CFM Compensation G Energy Balance Method !, I Demand Control Ventliation • Return Fan Tracking n Injection Fan Method • Dedicated Minimum Ventilation Damper with Pressure Control 0 Other Active Control, Describe: b. Check if Constant Air Volume (CAV) and verify the following: System Is designed to provide a fixed minimum OSA when the unit is on. Method of delivering outside air to the unit (check one of the following): G Outside air is ducted to the return air plenum. Confirm that outside air is ducted to either (check one of the following); • Within five ft. of the unit. G Within 15 ft. of the unit, with the air directed substantially toward the unit. C Return air plenum Is NOT used to distribute outside air to the unit. I.e. outside air is ducted directly to the unit or outside air is provided Independent of the unit. Pre-occupancy purge has been programmed forthe 1-hour period immediately before the building Is normally occupied to provide (one ofthe fotlowing methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120,1-A, or 15 cfm per person times the expected number of occupants, whichever is less. 3 complete air changes to the zone served bythe air handler. CA Bullding Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION ' CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page Zof 3} '"""f^ p^^l^ f^o^: C 'A\}myu EnRorceme/it Agency: PermS Number; Proj ect Addresst * f • \ Zip Code; System Name or lde>itiflcatior\^: System Location or Area Served: A, NA7.5.1.1 Outdoor Air Acceptance Functional Testing JftAV •VAV Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit Is not in economizer mode during test (economizer disabled). a Wote; Shaded boxes do not apply for CA V systems Step 3: CAV and VAV testing at full supply airflow ^ if.-I'I i:: Adjust supply air to achieve design airflow or maximum airflow at full cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm cfm Required outdoor airflow (cfm) (from MECH-3C, Column 1, or Mechanical Equipment Schedules). cfnrt cfm ^ Time for outside air damper to stabilize after full supply airflow is achieved (minutes); ^ Time for outside air damper to stabilize after full supply airflow is achieved (minutes); min Step 4: VAV testing at reduced supply airflow LHV VAV 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) 11.1- . , ^ - cfm c. Required outdoor airflow (cfm) i^rom MECH-3C, Column i, or mechanical equipment schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow Is achieved (minutes): • •'if.ft ju^te' m)n Step 5: 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) % % b. %0^f^, is within 10% of design Outside Air, (%0AFA £ 110%) Y / N c. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 3 (VAV only) a. KOARA = Measured outdoor airflow reading/Required outdoor airflow reading (Step3b/Step3c) % b. %OAM is within 10% of design Outside Air. (OA,* S 110%) Y/N c. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) Y / N Note: The Intent ofthis test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. Evaluation: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA^^H-02-A (Revised 06/11) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Kami Enfarcerrent Agency: Permit Numben ro)ect Address: , ^""^ t System Namftorld^nttfjcatlor\/T^: Zip Code: System Location or Afea Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete. iarwNamei ^ I I ^ A Documentation Author Name: DocumentaUon Author Signature: ATTCertincationldBntlficaliufi (if applicable): ^-"-^ Documentation Author Company Name: Address; City/State/ZIp: Phone: FIELD TECHNICIAN'S DECURATION STATEMENT 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. I 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 confonns to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I have confirmed that the Certlficate(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 pennlt(s) issued for the building. Field Technician Name; Field Technician Signaturer Field Technician Company lUame: Position with Company (Title); Address: ATT Certification Identification (if applicable): City/Slate/Zlp; Phone: Date Signed: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: I am the Field Technician, orthe 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. 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). The Information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance compiles 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 Nonresidentia) Appendix NA7. I have confirmed that the Certiflcate{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 permlt(s) Issued for the building. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) Issued for the building, and made available to the enforcement agency for all applicable Inspections. I understand that a signed copy of this Certificate of Acceptance Is required to be included with the documentation the buildjer provides to the building owner at occupancy. Responsible Acceptance Person Name: A jH Responsible Acceptance Person Signati Responsible Acceptance Person Company Position with Company (Titlelj Address: , ... I.nr ^ Oty/State/zlp. Phone: Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (PagelofS) Enforcement Agency: Permit Number: ProjectAddress: . • — ' / y^t/i Zip Code: System Name or Wintlflcatlon/Tag: Systein Location or Area'Served: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use: Checked by/Date Intent: Verify measured outside airflow reading is within ± 1096 of the total required outside airfiow. Required for all newly instaiied HVAC units. Reference MECH-3C (Coiumn H or Column I) or Mechanical Equipment Schedules. ' Constniction Inspection Wote; MCH-2A can be performed in conjunction with MCH-7A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. Supporting documentation needed to perform test Inciudes: /Vs-bullt and/or design documents (for example, Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At-A-Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At-A-Giance). c, 2013 Bullding Energy Efficiency Standards. 2. Instrumentation needed to perform test includes; yf Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used:^ , il. Equipment calibration date (must be within one year); 3. System type (check either VAV or CAV): 0 VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: 1. Outside airflow is either factory calibrated or field calibrated. ^ Check if factory calibrated and attach calibration certification. 0 Check if field calibrated and attach calibration resutts. ii. Damper Control (must be checked); • Dynamic damper control is being used to control outside air. (This Is NOT a fixed minimum position). IIL One of the following dynamic controls Is being utilized to control outside air (check method used) • Outdoor Air CFM Compensation • Energy Balance Method 1 i Demand Control Ventilation • Return Fan Tracking • Injection Fan Method • Dedicated Minimum Ventilation Damper with Pressure Control ;j Other Active Control, Describe: b. Check if Constant Air Volume (CAV) and verify the following: System is designed to provide a fixed minimum OSA when the unit is on. 4. Method of delivering outside air to the unit (check one of the following): IT! Outside air Is ducted to the return air plenum. Confirm that outside air is ducted to either (check one of the following): • Within five ft. of the unit. ij Within 15 ft. ofthe unit, with the air directed substantially toward the unit. C Return air plenum Is NOT used to distribute outside air to the unit. I.e. outside air Is ducted directly to the unit or outside air is provided Independent of the unit. 5. Pre-occupancy purge has been programmed for the 1-hour period immediately before the building Is normally occupied to provide (one of the following methods must be verified and checked); a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less. 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENEFiGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Enforcement Agency: Perm'ft Number; ProjectAddress; ' / - 1 Zip Code: System Name or Identlficatlon/t^g; System'Location or Area Served: /L NAT.S.l.l Outdoor Air Acceptance Functional Testing JftAV •VAV Step 1: Disable demand conlrol ventilation (if applicable) Step 2: Verify unit Is not in economizer mode during test (economizer disabled). • Wote; Shaded boxes do not apply fiir CAV systems pnn i'^*iii:::;i:^f >c.0*nj|: Step 3: CAV and VAV testing at full supply airflow (^''Frr^rM^^^'t- ^ Adjust supply air to achieve design airflow or maximum airflow at full cooling. Record VFD speed (Hz). «^»r^ Hz b. Measured outdoor airflow reading (cfm) cfm cfm Required outdoor airflow (cfm) (from MECH-3C, Column t, or IVIechanical Equipment Schedules). cfrn cfm ^ Time for outside air damper to stabilize after full supply airflow is achieved (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% ofthe total design airflow. Record VFD speed (Hz). ^^^^ Hz b. Measured outdoor airflow reading (cfm) cfm c. Required outdoor airflow (cfm) (from MECH-3C, Column 1, or mechanical equipment schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min StepS: Return to Initial conditions (check) • B. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%0AFA) for Step 2 a. %0AFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %OAfA Is within 10% of design Outside Air. (%0AFA S 110%) V/N c. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%0ARA) for Step 3 (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) ••' •• -. - % b. %OARA is within 10% of design Outside Air. (OAB* S 110%) Y / N c. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) I Y/N Note; The Intent of this test Is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. .5 PC" Evaluation: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Naffle; . y' Enforcement Agancy: PeiTnlt Number PiJjKtAddlKi: • , '—, 1 , I ' ^ Zip Code: S^tem nfame or Id^ntlflcitlon/fiB: Syitem Location or Area'Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: i Documentation Author Signature; Documentation Author Company Name; /I _ ATTCertificatlonli{entificatlan (if applicable); ^""^ Address: Clty/StaU/Zip: Phone: Ul^ ^^D V FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, underthe laws ofthe State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. lam 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. I have confirmed that the Certiflcate(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 forthe building. Field Technician Name; Field Technician Signaturer Held Technician Company Name; Position with Company (TitIa); Address: ATT Certification identilication (if applicable): City/State/Zlp: Phone; RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California; 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 informatton provided on this Certificate of Acceptance. 2. I am eligible under Division 3 of the Business and Professions Code In the applicable dassification 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 Certlflcate 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 NA7. 4. I 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. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permlt(s) Issued for the building, and made available to the enforcement agencyfor all applicable inspections. I understand that a signed copy of thts Certificate of Acceptance Is required to be included with the documentation the builder provides to the building owner at occupancy. , /) J y^""!! Responsible Acceptance Person Name; Responsible Acceptance Person Signature: Responsible Acceptance Person Company Nam^_ Position with Company {Tltle)j Address: aty/State/ZIp: Phone: Date signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE i CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page lof 3) Enforcement Agency: Permit l*iniber: ProjectAddress: • , — . ' / l'^) \ y A/MV,. °YAi\<:>baA Zip Cods: SyitSffTLocaUon or AreaServed: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use: Checked by/Date Intent: Verify measured outside airflow reading Is within ± 10% ofthe total required outside airflow. Required for all newly installed HVAC units. Reference MECH-3C (Column H or Column I) or Mechanical Equipment Schedules. Construction Inspection Note: MCH-2A can be performed in conjunction with MCH- 7A Supply Fan VFD Acceptance (If applicable) since testing activities overlap. Supporting documentation needed to perform test includes: As-bui\t and/or design documents (for example, Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventliation Systems: Variable Air Systems At-A-Glance and NA7.5.1.2 Constant Voiume Systems Outdoor Air Acceptance At-A-Glance). c. 2013 Building Energy Efficiency Standards. Instrumentation needed to perform test Includes: yf Watch b. Calibrated means to measure airflow (I.e. hot-wire anemometer, velocity pressure probe, etc.). I, Method and equipment used: li. Equipment calibration date (must be within one year): System type (check either VAV or CAV): • VAV a. Checkif Variable Air Volume (VAV) and complete the following: i CAV Outside airflow is either factory calibrated or field calibrated. ^ Check If factory calibrated and attach calibration certification. • Check if field calibrated and attach calibration results. Damper Control (must be checked): 0 Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). One of the following dynamic controls Is being utilized to control outside air (check method used) • Outdoor Air CFM Compensation 0 Energy Balance Method Demand Control Ventilation 0 Return Fan Tracking Q Injection Fan Method • Dedicated Minimum Ventliation Damper with Pressure Control Q Other Active Control, Describe: b. Check if Constant Air Volume (CAV) and verify the following: System is designed to provide a fixed minimum OSA when the unitis on. 4. Method of delivering outside air to the unit (check one of the following): , tj Outside air is ducted to the return air plenum. Confirm that outside air is ducted to either (check one of the following): • Within five ft. of the unit. 0 Within 15 ft. of the unit, with the air directed substantially toward the unit. C Return air plenum is NOT used to distribute outside air to the unit. I.e. outside air Is ducted directly to the unit or outside air Is provided independent of the unit. 5. Pre-occupancy purge has been programmed for the 1-hour period Immediately before the building is normally occupied to provide (one ofthe following methods must be verified and checked); a, The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less. 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION m CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) '""""Vpi^V^ f^OA^:CA\}AJUA Enforcement Agerxy: Pernrit Number: ProjectAddress:- * / • * Zip code: System Name or Ide^tfflDtlan/faK' System Location or Area Served: 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). • Wote; Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airftow Adjust supply air to achieve design airflow or maximum airflow at full cooling, Record VFD speed (Hz). Hz b. Measured outdoor airfiow reading (cfm) cfm cfm Required outdoor airflow (cfm) (from MECH-3Q Column i, or Mechanicai Equipment Schedules). cfm cfm J Time for outside air damper to stabilize after full suppty airflow is achieved (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the totat design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm c, Required outdoor airflow (cfm) (from MECH-3C, Column 1, or mechanicai equipment schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow Is achieved (minutes): min Step 5: Return to Initial conditions (check) • B. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%0AFA) for Step 2 a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %OAFA IS within 10% of design Outside Air. (%OAF,:, S 110%) yf/fi Y/N c. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%OAKA) for Step 3 (VAV only) a. %OA|M = Measured outdoor airftow reading /Required outdoor airflow reading (Step3b/Step3c) mmmm % b. %OAftA Is within 10% of design Outside Air. (OAm 5110%) Y/N c. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) Y / N Note; The intent ofthis test Is to ensure that 1) all air handlers provide the minimum amountof OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. 1^ Evaluation: y PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Enforcement Agency: Permit Number: Protect Address: " • < / , ' f Zip Code: System Name or Ic^tiflcation/fag: Syitem Location or Afea Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1 certify that this Certificate of Acceptance documentation is accurate and compiete. Documentation Author Name: Documentation Author Signaturey •• ATT Certification laentiflcatiqn (if applicable); Documentation Author Company Name: Address: City/State/Zip: Phone; FIELD TECHNICIAN'S DECURATION STATEMENT I certify the following under penalty of perjury, underthe laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. I am the person who performed the acceptance veriflcation 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 speciflcations approved bythe enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I have confirmed that the Certlficate(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. Held Technician Name: Field Technician Signaturer Fleld Technician Company Name: Position with Company (Title); ATf Certification Identification (if applicable): Date^-gned: aty/State/ZIp; Phone: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California; I am the Field Technician, orthe Field Technician Is acting on my behalf as my employee or my agent and I have reviewed the Information provided onthis Certificate of Acceptance. I am eligible under Division 3 ofthe Business and Professions Code in the applicable classification to accept responsibility forthe 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 deciarations in this statement (responsible acceptance person). The information provided on this Certificate of Acceptance substantiates that the construction or Installation identified on this Certlflcate 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 NA7. I have confirmed that the Certificate(s) of Installation forthe construction or Installation Identified on this Certificate of Acceptance has been completed and is posted or made available with the buitding permlt(s) Issued for the building. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) Issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance Is required to be Induded with the documentation the builder provides to the building owner at occupancy. / / J .'''^^^i Responsible Acceptance Person Name; l/)/lVy J/l A, Responsible Acceptance Person Signatui Responsible Acceptance Person Company bfam^:^ Position wilh Company (Title] Address; CIty/Slale/Zip: CSLB Ucense; bU7\^\ A}1^ I Phone: 'bi^i^^J 11^ Pi) Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (PagelofS) Enforcement Agency; Permit Number: Project Address: ^—» • . . / "'/^ii.ii^baA Zip Coda: Swtem Name or Id^ti^cation/Tao: • ^ Syst^location or Ares Served: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use: Checked by/Date Intent: Verify measured outside airflow reading is within ± 10% ofthe total required outside airflow. Required for ali newly Installed HVAC units. Reference MECH-3C (Column H or Column I) or Mechanical Equipment Schedules, Construction Inspection Wote; MCH-2A can be performed in conjunction with MCH-7A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. Supporting documentation needed to perform test includes: As-built and/or design documents (for example. Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.S.1.1 Ventilation Systems: Variable Air Systems At-A-Glance and NA7.S.1.2 Constant Volume Systems Outdoor Air Acceptance At-A-Glance). c. 2013 Building Energy Efficiency Standards. Instnjmentatlon needed to perform test includes: yf Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.), I. Method and equipment used: II. Equipment calibration date (must be within one year): System type (check either VAV or CAV): • VAV ^^>^ CAV a, Check If Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ^ Check if factory calibrated and attach calibration certification. • Check If field calibrated and attach calibration resutts. II. Damper ContTO\ (must be checked): G Dynamic damper control is being used to control outside air. (This is NOT a flxed minimum position), iil. One of the following dynamic controls is being utilized to control outside air (check method used) • Outdoor Air CFM Compensation • Energy Balance Method Demand Controt Ventilation D Return Fan Tracking G Injection Fan Method D Dedicated Minimum Ventilation Damper with Pressure Contral 0 Other Active Control, Describe: b. Check If Constant Air Volume (CAV) and verify the following: System Is designed to provide a fixed minimum OSA when the unitis on. Method of delivering outside air to the unit (check one of the following): G Outside air is ducted to the return air plenum. Confirm that outside air Is ducted to either (check one of the following): • Within five ft. of the unit. i:i Within 15 ft. ofthe unit, with the air directed substantially toward the unit. G Return air plenum is NOT used to distribute outside air to the unit. I.e. outskle air is ducted directly to the unit or outside air is provided independent of the unit. Pre-occupancy purge has been programmed forthe 1-hour period Immediately before the building Is normally occupied to provide (one of the following methods must be verified and checked); a. The conditioned fioor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less, 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Comptiance June 2014 STATE OF CAUFORNIA OUTDOOR AIR ACCEPTANCE CAUFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Naffie; r y ( Asf^MAA Enforcement Agency: Pennit Numtier: Project Addreii: ^ ^ ' < , ""/^ U WAA Zip Code: System Namearlde'htiflcation/taE: System Location oi* Area Served: A. NA7.S.1.1 Outdoor Air Acceptance Functional Testing >tAV • 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 appiy for CA V systems Ml .r. I.' * rffc Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full cooling, Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm cfm Required outdoor airflow (cfm) (from MECH-3C, Column 1, or Mechanicai Equipment Schedules). cfm cfm ^ Time for outside air damper to stabilize after full supply airflow Is achieved (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust suppty airftow to either the sum ofthe minimum zone airflows, full heating, or30% ofthe total design airflow. Record VFD speed (Hz). 1 "^^^^^^uii^eU'. Hz b. Measured outdoor airflow reading (cfm) cfm c. Required outdoor airflow (cfm) (from MECH-3C, Column (, or mechanicai equipment schedules). ^-te^^ew^^ cfm d. Time for outside air damper to stabilize after reduced suppty airflow is achieved (minutes): ' •" -rit- •• i min Step 5: Return to initial conditions (check) • B, Testing Calcuiations & Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 2 a, %OAFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %OAFA IS within 10% of design Outside Air. (%OAFA S 110%) ^/N Y/N c. Outside air damper position stabilizes within 5 minutes (Step 2d < S minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%0ABA) for Step 3 (VAV only) a. %0A|« = Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) % b. %0ARA is within 10% of design Outside Air. (OABA S 110%) Y/N c. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) Y/N Note: The intent of this test Is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. Evaluation; PASS: All Constructton inspection responses are complete and Testing Calculations & Results responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compilance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Enforcement Agency: Permit Number: ProteoAddress: ' ^1 Zip Code: System Name or Id^ntiflcatlon/Tag: System Location or Afei'Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT I certify that this Certificate of /Acceptance documentation is accurate and complete, Documentation Author Name: Documentation Author Signature- Documentation Author Company Name: <^\A^^Wt^Ai^:n''-- -• ' AH Certification identiricatlohllf applicable): ^""^ Address; City/State/Zlp; Phone: FIELD TECHNICIAN'S DECURATION STATEMENT 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. I 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. I have confirmed that the Certlficate(s) of Installation for the construction or Installation identified on this Certlflcate 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 Technidan Name: Field Technician Signaturer Field Technician Company Name: Positian with Company (Title); Address: ATT Certt^Cdtton Identification [If applicable): Oty/State/Zip: Phone: RESPONSIBLE PERSON'S DECURATION STATEMENT 4. I certify the following under penalty of perjury, under the laws of the State of California; 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. I am eligible under Division 3 of the Business and Professions Code In the applicable classification to accept responslblllty for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certlflcate of Acceptance and attest to the declarations in this statement (responsibte acceptance person). 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 specifled in Reference Nonresidential Appendix NA7. 1 have confirmed that the Certiflcate(s) of Installation for the construction or Installation identifled on this Certificate of Acceptance has been completed and Is posted or made available with the building permit(s) issued forthe bulldlng. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. St Responsible Acceptan(£ Person Name: Responsible Acceptance Person Signature: Responsible Acceptance Person Company Niam^: Position with Company (Tide): Address; CSLB License: 'bU7{H\ aty/State/ap; Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 06/14) f CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Al r Accepta nee (Page lof 3) Enforcement Agency: i>ermit Number: ProjectAddress: • . « j / "/Ali^^baA Zip Code: >itftefniiameorid^tl7icatlon/Tag: , ^ Sysfern Location or Area'Sen/ed: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use: Checked by/Date Intent: Verify measured outside airfiow reading is within ±10% ofthe total required outside airflow. Required for all newly Instaiied HVAC units. Reference MECH-3C (Column H or Column I) or Mechanical Equipment Schedules. Construction Inspection Wote; MCH-2A can be performed In conjunction with MCH-7A Supply Fan VFD Acceptance (if applicable) since testing activities overiap. Supportmg documentation needed to perform test includes: As-built and/or design documents (for example, Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Comptiance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At-A-Glance and NA7.S.1.2 Constant Volume Systems Outdoor Air Acceptance At-A-Glance). c. 2013 Building Energy Efficiency Standards, Instrumentation needed to perform test includes: ^ Watch b. Calibrated means to measure airflow (I.e. hot-wire anemometer, velocity pressure probe, etc.). i, Method and equipment used: 11. Equipment calibration date (must be within one year): System type (check eltherVAV or CAV): • VAV a. check if Variable Air Volume (VAV) and complete the following: CAV 1. Outside airflow is either factory calibrated or field calibrated. ^ Check if factory calibrated and attach calibration certiflcation. • check if field calibrated and attach calibration results, il. Damper Control (must be checked): Q Dynamic dampercontrol is being used to control outside air. (Thisis NOT a fixed minimum position), iil. One of the following dynamic controls is being utilized to control outside air (check method used) • Outdoor Air CFM Compensation Q Energy Balance Method 0 Demand Control Ventilation D Return Fan Tracking G Injection Fan Method • Dedicated Minimum Ventilation Damper with Pressure Control 0 Other Active Control, Describe: , b. 4. check if Constant Air Volume (CAV) and verify the foltowing: )s:^ System is designed to provide a fbted mmimum OSA when the unitis on. Method of delivering outside air to the unit (check one of the followmg): 0 Outside air is ducted to the return air plenum. Confirm that outside air Is ducted to either (check one of the following): • Within five ft. of the unit. Q Within 15 ft. of the unit, with the air directed substantially toward the unit. C Return air plenum Is NOT used to distribute outside air to the unit. I.e. outside air is ducted directly to the unit or outside air is provided independent of the unit. Pre-occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one ofthe foltowing methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less. 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION ft CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Enforcement Agency: Permit Numben ProlectAddress: < . . ' ""/^ [4. WAA Zip Code: System Name or lde^tlflcation/1?£: System Location or Arei Served: K NA7.5.1.1 Outdoor Air Acceptance Functional Testing ^V • VAV Step 1: Disable demand control ventilation (if applicable) Step 2; Verify unit is not in economizer mode during test (economizer disabled). a Wofe; Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow - Adjust supply air to achieve design airflow or maximum airflow at full cooling. Record VFD speed (Hz). fc- 'fil."'l«U-H2Li|^.» I ^jrl.™W':'s.".=,!i''ii-S-:-'i = Hz b. Measured outdoor airflow reading (cfm) cfm cfm Required outdoor airflow (cfm) (from MECH-3Q Column 1, or Mechanicai Equipment Schedules). cfm cfm ^ Time for outside air damper to stabilize after full supply airflow is achieved (mmutes): min Step 4: VAV testing at reduced supply airflow 1, 1, . CAV VAV a. Adjust supply airflow to either the sum ofthe minimum zone airflows, full heating, or 30% ofthe total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm c. Required outdoor airflow (cfm) (from MECH-3C, Column 1, or mechanicai equipment schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step S: Return to initial conditions (check) • B. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%0AFA) for Step 2 a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %OAFA is within 10% of design Outside Air. (%OAFA £ 110%) y/N c. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%OASA) tor Step 3 (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) iiiiiiii % b. %0A|« is within 10% of design Outside Air. (OABA S 110%) ••iT" "-.fcTiTi'.ijt.""-'^-**!!. 1:= T • . Y / M c. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) i:??.spin;^i?!«^ Y/ N Note: The Intent ofthis test Is to ensure that 1) all air handlers provide the minimum amountof OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. Evaiuation: y PASS; All Construction Inspection responses are complete and Testtng Calculations & Results responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) ProjectName: • y' 1 Enforcement Agency; Permit Number; ProiECt Address: * » ' t \ * \ ^1 K^t> p^l/l^yitrijl^. L/SAA./. Zip Code: System Nameorld^ntlffcation/tSg: System location or Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1 certify that this Certificate of Acceptance documentation is accurate and complete, lanv [slame: t I t7 . i Documentation Author Name' Documentation Author Company Name: Documentation Author Signature; Address: 1 (if api^Icable): City/State/Zlp; Phone FIELD TECHNICIAN'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of Caltfornia: 1. The Information provided on this Certificate of Acceptance is true and correct. 2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identifled on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved bythe enforcement agency, and conforms to the appiicable aaeptance requirements and procedures specified in Reference Nonresidential Appendfa< NA7. 4. I 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 bultdtng permit(s) issued for the buitding, Reld Technician Name: Field Technician Signaturer; Reld Technician Company Name; Position with Company (Title); Address: ATTCerdricatlon identilication (if applicable): DateSigned: | City/State/Zlp: Phone: RESPONSIBU PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 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. 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). 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 NA7. I 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 avaitabte with the building permit(s) issued for the building. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. /) J .^''y^'^ \ Responsible Acceptance Person Name: Responsible Acceptance Person Signat)ife; .y(^J^\ / Responsible Acceptance Person Company Nami fin Wh.Ahm\r4 Position with Company (Title] Address: CSLB License; bU7i V; City/State/Zlp: Phone; Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 06/14) H CALIFORNIA ENERGY COMMISSION CERTlFtCATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page lof 3) Project Nai Enforcement Agency: ProjectAddress: -—- . F Yy^) Yf}vA^^\ A \yA/V\J^ PTT-SS^I it a .'r apCode: :e^^^lne or Id^fjcatlon/Tag: System Location or Area Senred: Wote: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use: Checked by/Date Intent; Verify measured outside airflow reading is within ±10% ofthe total required outside airflow. Required for all newly installed HVAC units. Reference MECH-3C (Coiumn H or Column I) or Mechanical Equipment Schedules. Construction Inspection Wote: MCH-2A con fce performed In conjunction with MCH-7A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. Supporting documentation needed to perform test includes: As-built and/or design documents (for example, Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At-A-Glance and NA 7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At-A-Glance). c, 2013 Building Energy Efficiency Standards. 2. Instrumentation needed to perform test Includes: Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). 1. Method and equipment used: ii. Equipment calibration date (must be within one year): 3. System type (check either VAV or CAV): • VAV ^.^C CAV a. Check if Variable Air Volume (VAV) and complete the following; i. Outside airftow is either factory calibrated or field calibrated, ^ Check if factory calibrated and attach calibration certiflcation. • Check if field calibrated and attach calibration results. ii. Damper Control (must be checked): Q Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position), ili. One of the following dynamic controls is being utilized to control outside air (check method used) 0 Outdoor Air CFM Compensation 0 Energy Balance Method Demand Control Ventilation D Return Fan Tracking • Injection Fan Method Dedicated Minimum Ventilation Damper with Pressure Control • Other Active Control, Describe; b. Check if Constant Air Volume (CAV) and verify the following; jk^ System Is designed to provide a fixed minimum OSA when the unitis on. 4. Method of delivering outside air to the unit (check one ofthe following): D Outside air is ducted to the return air plenum. Confirm that outside air is ducted to either (ched< one ofthe following): • Within five ft. of the unit. • Within 15 ft. ofthe unit, with the air directed substantially toward the unit. C Return air plenum is NOT used to distribute outside air to the unit. Le. outside air is ducted directly to the unit or outside air is provided Independent of the unit, 5. Pre-occupancy purge has been programmed forthe 1-hour period Immediately before the building is normally occupied to provide (one ofthe following methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or IS cfm per person times the expected number of occupants, whichever is less, ''• 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE m I •'?!! CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Nacne- 1 /" y ' / Nmh i .DA^' ( AA\}AfU/l Enforcement Agency: Permit Number ProjectAddress: , . 'i-l ""/^ U10AA Z'lp Code: System Name or id^tifitatlon/tag: System Location or Area Served: A. NA7.5.1.1 Outdoor Air Acceptance Functional Testing | J^AV a VAV Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit is not in economizer mode during test (economizer disabted). • Wote; Shaded boxes do not apply for CAV systems .»rf>=Ji?r„3'.^.«" Step 3: CAV and VAV testing at full supply airflow ^ Adjust supply air to achieve design airflow or maximum airflow at full cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm cfm ^ Required outdoor airflow (cfm) (from MECH-3C, Column 1, or Mechanical Equipment Schedules). cfm cfm J Time for outside air damper to stabilize after full supply airflow is achieved (minutes): . . .1. min Step 4; VAV testing at reduced supply airftow LAV VAV a. Adjust supply airflow to eitherthe sum ofthe minimum zone airflows, full heating, or30% ofthe total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm c. Required outdoor airflow (cfm) (from MECH-3Q Column 1, or mechanical equipment schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step 5: Return to Initial conditions (check) o B. Testing Calculations 8i Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 2 a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %0AfA is within 10% of design Outside Air. (%OAFA i 110%) yffti Y/N c. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced suppty airflow {%OAfiA) for Step 3 (VAV only) a. %OA|u^ = Measured outdoor airflow reading /Required outdoor airflow reading {Step3b/Step3c) 4iH=3!f liiii) 3i*4P=i »!!: % b. %0ARA is within 10% of design Outside Air. (OAHA S 110%) = •f!;s«*i^;;ei-:.?^?*|i. Y/N c. Outside air damper position stabilizes within 5 minutes (Step 3d < S minutes) Y/N Note; The intent ofthis test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. Evaluation; y PASS: All Construction Inspection responses are comptete and Testing Calculations & Resutts responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFDRNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) ProjectName: • y' /^'St^t-/ Enforcement Agency: Pftrmit Number: ProjectAddress: ' . '—, l ' vo^/:^ p^iA^y^xti.^, S^/AAAJ. Zip code: System Name or td^nUflcation/l^g*. Syitem Location or Afea Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. i certify that this Certificate of Acceptance documentation Is accurate and complete. Documentation Author Name: | Documentation Author Signature; ^^D^teSlgned; 3/^3//;^ kTT Certification irfentlficaticifi (If applicable): Documentation Author Company Name; Address; ATT Certification identlficaticih (If applicable): aty/State/ZIp: phone: UV\ IfAP H'^e V FIELD TCCHNICIAN'S DECURATION STATEMENT 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. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Fteld Technician). 3. The construction or Installation identifled 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. I have confirmed that the Certificate(s) of Installation for the construction or Installation identifled 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; Field Technician Signature." Field Technician Company Name: Position with Company (Title): Address; ATT Certification Identification |if applicable): City/State/Zip: Phone: DateSigned; RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and 1 have reviewed the Information provided on this Certificate of Acceptance. I am eligible under Division 3 of the Business and Professions Code in the applicable classiflcation to accept responslblllty 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). 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 NA7. 1 have confirmed that the Certiflcate(s) of Installation forthe construction or installation Identified on this Certlflcate of Aaeptance has been completed and Is posted or made available with the building permlt(s) Issued for the building. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit{s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance fs required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name; [\ I , y Responsible Acceptance Person signal Responsible Acceptance Person Company ilamrf: 71, Position with Com pany (Titlelj Addrass; CSLB License; bl^7l^} aty/State/Zip: Phone: b^w k^Pb DateSigned; CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA OUTDOOR AIR ACCEPTANCE CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page lof 3) '"""'"'iN/fffha ^l?d^^/Al.l^lU Enforcement Agency: Permit Niunber: Project Addrass: —^ • . " ( ypyA<^\A lyAAfu'.^ °^/^A(i4,baA Zip Code; SyUraiiJame or IddntlTication/Tag: SyitSfn Location or Area'Senred: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use; Checked by/Date Intent: Verify measured outside airflow reading is within ±10% ofthe total required outside airflow. Required for all newly instaiied HVAC units. Reference MECH-3C (Column H or Column I) or Mechanical Equipment Schedules. Construction Inspection Wote; MCH-2A can be performed in conjunction with MCH-7A Supply Fan VFD Acceptance (if appiicable) since testing activities overlap. (P Supporting documentation needed to perform test includes: As-built and/or design documents (for example. Mechanical Equipment Schedules, Equipment Start-Up Sheets or Balancing Reports). 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At-A-Glance ond NA7.5.1,2 Constant Volume Systems Outdoor Air Acceptance At-A-Glance). c, 2013 Building Energy Efficiency Standards. Instrumentation needed to perform test includes: /f Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: ^ ll. Equipment calibration date (must be within one year); System type (check eitherVAV or CAV): a VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or fleld calibrated. ^ Check if factory calibrated and attach calibration certification, a Check if fleld calibrated and attach calibration results. II. Damper Control (must be checked): 0 Dynamic damper control is being used to control outside air. (Tliis is NOT a fixed minimum position), lli. One of the following dynamic controls is being utilized to control outside air (check method used) D Outdoor Air CFM Compensation • Energy Balance Method ri Demand Control Ventilation • Return Fan Tracking U Injection Fan Method • Dedicated Minimum Ventilation Damper with Pressure Controt 0 Other Active Control, Describe: b. Check if Constant Air Volume (CAV) and verify the following: .is;^ System Is designed to provide a fixed minimum OSA when the unit is on. Method of delivering outside air to the unit (check one of the following): Outside air is ducted to the retum air plenum. Confirm that outside air Is ducted to either (check one ofthe following): D Within five fi:. of the unit. • Within 15 ft. of the unit, with the air directed substantially toward the unit. C Retum air plenum is NOT used to distribute outside air to the unit. I.e. outside air is ducted directly to the unit or outside air is provided independent of the unit. Pre-occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less, ^' 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION lw CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) "°"^yh\^ f,OA^.CA\)AIMA Enforcen'tent Agency: Permit Number: ProjectAddress: ^ ' 1 • \ ^ Zip Code: System Name or IdeViticatlon/tag: System Location or Area Served: A. NA7.5.1.1 OutdoorAir Acceptance Functional Testing Jt^tAV oVAV Step 1: Disable demand control ventilation [If applicable) Step 2; Verify unit is not In economizer mode during test (economizer disabled). D Wote; Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at fuil supply airflow Tl,l Jl g Adjust supply air to achieve design airflow or maximum airflow at full cooling, Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm cfm ^ Required outdoor airflow (cfm) (from MECH-3C Coiumn 1, or Mechanicai Equipment Schedules). cfm cfm ^ Time for outside air damper to stabilize after full supply airflow is achieved (minutes): •••.T-^i==£!':i"';i••r;.-Ji: min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to eitherthe 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) cfm c. Required outdoor airflow (cfm) (from MECM-3C, Column f, or mechanical equipment schedules). cfin d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): riiilj;KS-:M*':"'*ir-ii-J!S;» .'• min Steps: Return to initial conditions (check) )^ • B. Testing Calculations & Resutts Determine Percent Outside Air at full supply airflow (%0AFA) for Step 2 a. %OArA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) % % b. %OAFA is within 10% of design Outside Air. (%OAFA «110%) Y/N c. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y/N Determine Percent Outside Air at reduced supply airflow (%OA|,A) for Step 3 (VAV only) a. %OABA = Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) % b. %OA,A is within 10% of design Outside Air. (OARA S 110%) Y / N c. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) Y/N Note: The Intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. Evaluation: PASS; All Construction Inspectton responses are complete and Testtng Calculations 8i Results responses are positive (Y-yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Namj: . yy j/^ 1 Enforcement A^ncy: Permit Number Pro^Address: ^ . ' " 1/ Zip Code: System Mime or id^ntiftcition/fag: System Location cr Afea Served; DOCUMENTATION AUTHOR'S DECURATION STATEMENT I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Documentation Author Company Name: •* "ATT Certification iSntificatlati (if applicable); 22 Address: City/State/Zip; Phpne: FIELD TECHNICIAN'S DECURATION STATEMENT 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. I am the person who performed the acceptance veriflcation 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 specifled In Reference Nonresidential Appendix NA7. 4. I have confirmed thatthe Certlflcate(s) of installation forthe construction or installation identified on this Certlflcate 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 bulldlng. Reld Technician Name: Field Technician Signaturer: Field Technician Company Name; Position with Company (Title): Address: ATT Certification identification (If applicable): .S,ned; ^ | ^5-" City/Stats/Zip: Phone; RESPONSIBLE PERSON'S DECURATION STATEMENT 1 certify the fotlowing under penalty of perjury, under the laws of the State of California: I am the Field Technician, or the Field Technician Is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certificate of Acceptance. 1 am eligible under Division 3 ofthe 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). 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 specifled in Reference Nonresidential Appendix NA7. I have confirmed that the Certiflcate(s) of Installation forthe construction or Installation identifled on this Certlflcate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. I will ensure that a completed, signed copy ofthis Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made avaiiable 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 bullding owner at occupancy. Responsible Acceptance Person Name: Responsible Acceptance Person SIgnati Responsible Acceptance Person Company^m^: fw./.Mm\r4] Position with company (Tide] Address: "1 CSLB License; bU7i^} City/Slate/Zlp: Phone; Date Signed; CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 0.'L 3-/A STATE OF CALIFORNIA CONSTANT VOLUME SINGllE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 3) Ertforcement Agency; Permit Number: ProjectAddress: ^ V^bO foi«istTTiA LAvit- CIK Zip Code: ffi&fiSS} Nama WT-riflcatiorvTag; System Localion or Area Served: K c^ - bp </ ^xc^-ouo Note: Submit one Certificate of Acceptance for each system that must demonstrate compilance. Enforcement Agency Use: Checked by/Date Construction Inspection 1. Supporting documentation needed to perform test Includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.S.2 Constant 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 b. Amp Meter 3. Installation (check if applies): ^ Thermostat Is located within the space-conditioning zone that Is served by the HVAC system. 4. Programming (check all those that apply): 13 Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efflciency Standards Manual section 120,2(b).__ - ^ Minimum heating setpoint: °F. Maximum cooling setpoint T>S °F. Deadband: _^__°F. Occupied, unoccupied, and holiday schedules have been programmed perthe fajcljjjy's schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Btilldlng Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: C Lesser of: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or 15cfm per person times the expected number of occupants. 3 complete air changes. Notes: CA Buiiding-.Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-IVICH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) Project Name: ^ r i \ '\ Enforcement Agency: Permit Number ProjectAddress: City: San Diego Zip Code: System^!me or Identification/Tag: System lotion or Area Served: A. Functional Testing Requirements Operating Modes Step 1; Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3; No-load during occupied condition Step 4; Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating toad during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 4 3 Step 2-8: Checli and verify the fallowing for each simulation mode required J _ - a. Supply fan operates continually i 7 'l" i > b, Supply fan turns off iMll Hi c. Suppty fan cycles on and off J > y Hlli"' IT-, A: 11 d. System reverts to "occupied" mode to satisfy any condition e. System turns off when manual override time period expires V »• -fi ]" f. Gas-flred furnace, heat pump, or electric heater stages on 11 g-No heating Is provided by the unit y y X h. No cooling is provided by the unit y ...... ' y 1. Compressor stages on X tulrt y j-Outside air damper Is open to minimum position K • : X k. Outside air damper closes completely m K y m is;ji Step 9: System returned to initial operating conditions after all tests have been completed: ^N B. Testing Results 8 7 6 S 4 3 2 Indicate If Passed (P), Failed (F), or N/A (X), fill In appropriate letter P P P ? P C. Evaluation: Pf&S: All Construction Inspection responses are complete and atl applicable Testing Results responses are "Pass" (P) CA Building Energy Efflciency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Ravlsed 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) ProJectNime:. i » ^ 1 \^»\\)^r ooi^f ^f/yl/i/n/a Enforcement Agency: Permit Number: ProjectAddress; 'pv • . j «• Vy- V J Zip Code: * . System Name orldentificatl4n/Tag: System Location or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name; Adam Slayton Documentation Author Slgnsturj Documentation Author Company Name; Slayton Mechanical Date Signed: 3n Rientificatibn (If applic Address: 9824 Vine St, ATT Certification fdentlficatibn (if applicable): City/State/Zlp: Lakeside Ca 92040 Phone: 619-390-4900 FIEU> TECHNICIAN'S DECURATION STATEMENT 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. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician), 3. The construction or Installation identified on this Certlflcate of Acceptance complies with the applicable acceptance requirements indicated in the plans and speciflcations approved bythe enforcement agency, and conforms to the applicable acceptance requirements and procedures specifled in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certiflcate(s) of Installation for the construction or installation Identified on this Certlflcate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permlt(s) Issued for the building. Field Xeichnlclan Name; Field Techniclan^gyature: Field Technician Company Name; Slayton Mechanical Position with Company (Title); Service Tech Address; 9824 Vine St, ATT Certification Identification (if applicable); City/State/Zlp: Lakeside Ca 92040 Phone; 619-390-4900 Date signed: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws ofthe State of California: I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certlflcate of Acceptance. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibitity 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). The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance compiles with the acceptance requirements Indicated In the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specifled in Reference Nonresidential Appendix NA7. I have confirmed that the Certlficate(s) of Installation forthe construction or installation Identified on this Certificate of Acceptance has been completed and is posted or made available with the building permlt(s) issued forthe buiiding. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) Issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy ofthis Certificate of Acceptance is required to be included with the documentation the bulld^ provides toj^hg.^ullding owner at occupancy. Responsible Acceptance Person Name: Adam Slayton Responsible Acceptance Person Company Name; Slayton Mechancia Responsible Acceptance Person Signaturej Position with Company (Title); VP Address; 9824 Vine St, CSLB Ucense: 662141 aty/state/zip;L3]^ggj_^g Ca, 92040 Phone: g]_9_39o_,g 900 DateSigned; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CAJ-IFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (PagelofS) TiofH^W Cffa-iT C(\yjt^f^ CJA^P<J Enforcement Agency: Permit Number: ProlectAdllress:^ ^ ' l"550 LoiO^triiA LAr^JC- City; (CAT l<i%Afs, ZipCode; <(1.0I V System Name or Identificatkin/Tag; System Location or Area Served: • — T Wote; Submit one Certificate of Acceptance for each system that must demonstrate compiiance. Enforcement Agency Use; Checked by/Date Construction inspection 1. Supporting documentation needed to perform test Indudes, but not limited to; a. 2013 Bulldlng Energy Efficiency Standards Nonresidential Compliance Manual (NA7.S.2 Constant Volume, Single-zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glance). b. 2013 Bullding Energy Efflciency Standards Manual. 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter 3. Installation (check if applies): /E Thermostat is located within the space-conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply); D Thermostat meets the temperature adjustment and dead band requirements of 2013 Buitding Energy Efficiency Standards Manual section 120.2(b), . Minimum heating setpoint: "F. Maximum cooling setpoint feS °F. Deadband; _£_.°F- f i Occupied, unoccupied, and holiday schedules have been programmed per the fiicif|y's schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Buitding Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: D Lesser of; conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. 3 complete air changes. X- Notes; CA Buiiding-.Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 06/14) CALIFORNIA ENERGY COMMISSION_ CERTtFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) Project Name: T t \ Enforcement Agency: Permit Number: Project Addresi: r\ City: San Diego Zip Code: Syitem Name or tdendncatlor/Tag: ^\J4X'^-M—^ Syitem tJcatiopjirArea Sen/ed: A Functional Testing Requirements 1 Operating Modes Step 1: Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2; Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition 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: Manuai override 8 7 6 5 4 3 2 Step 2-8: Check and verify the following for each simulation mode required a. Supply fan operates continually Y - T •y \ 1 1 V b. Supply fan turns off '•jv's; • Sy; V i>il.Th c. Supply fan cydes on and off >' V 1 • d. System reverts to "occupied" mode to satisfy any condition im e. System turns off when manual override time period expires -y m 'Jiff ii f. Gas-flred furnace, heat pump, or electric heater stages on jifSjli g. No heating is provided bythe unit y X X h. No cooling is provided by the unit ' II, •ii.< X i. Compressor stages on i.'.-'S X ii !#' jjgri M )• Outside air damper Is open to minimum position ><' X x X k. Outside air damper closes completely X Step 9: System returned to initial operating conditions after ali tests have been completed; ^N B. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter P ? P C. Evaluation: PASS; All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRGA-MCH-03-A (RevlaBd D8/14> _ CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Voiume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Rump Systems (Page 3 of 3) Project Name: Enforcement Agency: Pemwt Numben ProjectAddress: City. Zip Coife: System Nanie orldendflcatton/Tag: System Location or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEIVIENT 1. I certify that this Certlflcate of Acceptance documentation is accurate and complete. Documentation Author Name; Adam Slayton Documentation Author Sl/>atuj Documentation Author Company Name; Slayton Mechanical Date Signed; Address: 9824 Vine St. aty/State/ZIp:^^^^^.^^ Ca 92040 ATT Certification Identification |lf applicablj '"'"'"^•619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT 1 certify the foibwing 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. lam 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 speciflcations approved by the enforcement agency, and confornns to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certiflcate(s) of Installation for the construction or Installation Identified on this Certlflcate 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 Tsfhnician Name; Field Technician ^nature: Field Technician Company Name: Slayton Meclianical Position with Company (Title): Service Tech Address: 9824 Vine St. ATT Certification Identification (if applicable): aty/State/Zip; Lakeside Ca 92040 Phorw: 619-390-4900 Date Signed: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of C^alifornla; 1 am the Field Technician, orthe 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. I am eligible under Division 3 ofthe Business and Professions Code In the applicable classiflcation 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). The information provided on this Certificate of Acceptance substantiates that the construction or installation identifled on this Certificate of Acceptance compiles with the acceptance requirements indicated In the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I have confirmed that the 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. I will ensure that a completed, signed copy ofthis Certificate of Acceptance shall be posted, or made available with the buildmg permlt(s) issued for the building, and made available to the enforcement agency fbr all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is requlredto be Induded with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Companv Name; Slayton Mechancia;. Position with Company ITtle): VP Address: 9824 Vine St, CSLB Ucense; 662141 aty/state/zip:Laiceside Ca, 92040 Phone;gl9_390-4900 Date Signed: CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS B CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 3) iJorvW Ccw^-r C<X\/i^r-^ CjA^f<^^ Enforremsnt Agency: Permit Number: ProlectAddress:— ' ' ZipCode: ft.01 V System Name orldentlFlcacion/Tis: System Location or Arei Served: Note; Submit one Certificate of Acceptance for each system that must demonstrate compiiance. Enforcement Agency Use: Checked by/Date Construction Inspectton 1. Supporting documentation needed to perform test Includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compilance Manual (NA7.5.2 Constant Volume, Single-zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Giance). b. 2013 Building Energy Efficiency Standards Manual, 2. Instrumentation to perform test mcludes, but not limited to; a. Temperature Meter b. Amp Meter 3. Installation (check if applies): ^ Thermostat is located within the space-conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply); • Thermostat meets the temperature adjustment and dead band requirements of 2013 Bullding Energy Efficiency Standards Manual section 120.2(b). ^ Minimum heating setpoint: _SS_°F. Maximum cooling setpoint H'-S "F. Deadband: fe> °F, ', 1 Occupied, unoccupied, and holiday schedules have been programmed per the fa.citjjy's schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Bij(tdlng Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: • Lesser of: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupa nts. 3 complete air changes. X: Notes: CA Buiiding-.Energy Efl^ldency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) ProjectName: T I I IN KftrT^k CoMsr CAWARV ^\AAr^)£L_ Enforcement Agency: Permit Number: Project AddresK r\ City: San Diego Zip Code: System Name or IdentiflcationAa^'-System Location or Area Served: A. Functional Testing Requirements Operating Modes Step 1; Disable economizer control and demand-controlled ventilation (If applicable) to prevent unexpected Interactions, Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition StepS: Manual override 8 7 6 S 4 •3, 2 Step 2-8: check and verify the following for each simulation mode required -1^ a. Supply fan operates continually / If b. Supply fan turns off \ X 'j c. Supply fan cycles on and off y y »"••• H d. System reverts to "occupied" mode to satisfy any condition ' 'l H i '^H e. System turns off when manual override time period expires 1 - 1 1 US'' f. Gas-flred furnace, heat pump, or electric heater stages on « X' 8-No heating Is provided by the unit y X I," h. No cooling Is provided by the unit m y y X i. Compressor stages on X '•'4 x n>V> m j-Outside air damper Is open to minimum position xL X k. Outside air damper closes completely y '-/^ Step 9: System retumed to initial operating conditions after atl tests have been completed: ^N B. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate tetter P P P P c Evaluation: VASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) Proiect Name: Enforcement Agency: Permit Number: ProjectAddress: City: Zip Code: System Name or liJentifiCBtian/Tag: System Localion or Area Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certifleate of Acceptance documentation Is accurate and complete. Documentation Author Name; 'Adam Slayton Documentation Author Signature; Documentation Author Company Name; Slayton Mechanical Date Signed; Address; 9824 Vine St, ATTCertfficaUon identification (If applicable); Clty/State/Zlp: Lakeside Ca 9204O Phone: 619-390-4900 FIELD TECHNICIAN'S DEaARATiON STATEMENT 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. I am the person who performed the acceptance veriflcation reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identifled on this Certificate of Acceptance complies with the applicable acceptance requirements Indicated in the plans and spedfications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures spedfied 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 lethnldan Name; Field Technidan Company Name: Slayton Mechanical Field Technidan S)g,natiJre; Position with Company (Title): Service Tech Address; 9824 Vine St. ATT Certification Identification (if applicable): City/State/Zlp: Lakeside Ca 92040 Phone: 619-390-4900 Date Signed: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penatty of perjury, underthe laws of the State of California: 1 am the Field Technidan, 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. 1 am eligible under Division 3 ofthe Business and Professions Code inthe applicable classification to accept responsibility forthe system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certlflcate of Acceptance and attest to the declarations in this statement (responsible acceptance person). The Information provided on this Certificate of Acceptance substantiates that the construction or Installation Identified on this Certificate of Acceptance compiles with the acceptance requirements Indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicabie acceptance requirements and procedures specified In Reference Nonresidential Appendix NA7. I have conflrmed that the Certlficate(s) of Installation forthe construction or installation Identifled on this Certificate of Acceptance has been completed and is posted or made availabte with the bulldlng permit(s) issued forthe bulldlng. 1 will ensure that a completed, signed copy of this Certlflcate 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 bulldlng owner at occupancy. Responsible Acceptance Person Nama; Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name; Slayton Mechancia!. Posltlon with Company (Title): VP Address: 9824 Vine St, CSLB Ucense: 662141 aty/state/zip:j^3j^gg^j^g Ca, 92040 Phone: g2^9_39Q_^9QQ DateSigned; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGl^E ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 06/14) CALIFORNtA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page lof 3) f^of^L CcoA-r CCv.KfC>( Enforcement Agency: ProjectAddress:^ Sp Code: System Name or Idsntfficatlon/Tac: System Location or Area Served: Note: Submit ane Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use; Checked by/Date Construction Inspection 1. Supporting documentation needed to perform test includes, but not limited to: a. 2013 Building Energy Effidency Standards Nonresidential Compliance Manual (NA7.52 Constant Volume, Single-zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glance). b. 2013 Buitding Energy Efficiency Standards Manual. 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter 3. Installation (check If applies): /S Thermostat is located within the space-conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): D Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual section 120,2(b). ^ Minimum heating setpoint: _SS_°F- Maximum cooling setpoint °F, Deadband: fe> °F. i i Occupied, unoccupied, and holiday schedules have been programmed per the facility's schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manuai section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: • Lesser of: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. 3 complete air changes. X; Notes: CA Building; Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPUT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-(y|CH-03-A (Revised DB/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systenns . (Page 2 of 3) ProjectName: ^ P \ \ Enforcement Agency: Permit Number: ProjectAddress: r\ City: San Diego Zip Code: System Name or Identificatlon/Tag: System Undon or Area Senred: A. Functional Testing Requirements Operating Modes Step 1; Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected Interactions. Occupied Mode Step 2; Heating load during occupied condition step 3: No-load during occupied condition Step 4; Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6; Heating load during unoccupied condition Step 7; Cooling load during unoccupied condition StepS: Manual override 8 7 6 5 4 3 2 Step 2-8: Check and verify the following for each simulation mode required ^ r a. Suppty fan operates continually 1, ---•y 1 V b. Supply fan turns off y c. Supply fan cydes on and off w y M T U flif ,1 1 — d. System reverts to "occupied" mode to satisfy any condttion y It!'Pi y M T U flif ,1 1 — e. System turns off when manual override time period expires r •- f. Gas-flred fiirnace, heat pump, or electric heater stages on "J -~ >- g. No heating is provided bythe unit X X m h. No cooling is provided by the unit m X M X 1. Compressor stages on X X j-Outside air damper is open to minimum position < S I** X X k. Outside air damper closes completely ^ 1 ><: m fM Step 9: System returned to initial operating conditions after all tests have been compteted: ^N B. Testing Resutts 8 7 6 S 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), flil in appropriate letter 0 P P P P P Evaluation: Xi PASS; All Construction Inspection responses are complete and atl applicable Testing Results responses are "Pass" (P) CA Building Energy Effidency Standards -2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) Project Name; Enforcement Agency: Permit Number: Project Address; City; Zip Code: System Name or tdentlfication/Tag: System Locadon or Area Se'n/ed: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. I certify that this Certlflcate of Acceptance documentation is accurate and complete Documentation Author Name; Adam Slayton Documentation Author Signage: Documentation Author Company Name: Slayton Mechanical Date Signed: Address: 9824 Vine St, ATT Certification Identification (If applicable): CIty/State/ZIp: Lakeside Ca 92040 Phone; 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT 1 certify the following under penalty of perjury, under the laws ofthe State of California: 1. The Information provided on this Certificate of Acceptance is true and correct. 2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identifled on this Certificate of Acceptance complies withthe applicable acceptance requirements Indicated In the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I 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 permlt(s) issued for the building, Field I^nldan Name: Field Technidan Signature; Field Technidan Company Name: Slayton Mechanical Position with Company (Title); Service Tech Address: 9824 Vine St, ATT Certification Identification (if applicable); City/State/Zip; Lakeside Ca 92040 Phone: 619-390-4900 Date Signed: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws ofthe State of California: I am the Field Technidan, 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. I am eligible under Division 3 of the Business and Professions Code in the applicable dassification to accept responsibility for the system design, construction or Installation of features, materials, components, or manufactured devices for the scope of work identifled on this Certificate of Acceptance and attest to the declarations In this statement (responsible acceptance person). The Information provided on this Certlflcate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements Indicated in the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specifled in Reference Nonresidential Appendix NA7. 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 forthe buildlng. I will ensure that a completed, signed copy ofthis Certificate of Acceptance shall be posted, or made available withthe building permit(s) Issued for the building, and made available to the enforcement agency for all applicable inspections. 1 understand that a signed copy ofthis Certifleate of Acceptance Is required to be Included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name; Adam Slayton Responsible Acceptance Person Signature; ResponslbteAcceptancePersonCompanyName; g jL^y^^^^ Mechancia Position with Company (Tide); VP Address: 9824 Vine St, CSLB Ucense; 662141 atv/state/zip;Laj^ggj^^g Ca, 92040 Phone; g2 9-3 90-4 900 DateSigned; CA Building Energy Effldency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 06/14) CALIFORNIA ENERGY COMMISSIOJl CERTIFICATE OF ACCEPTANCE NRCA-1V1CH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page I of 3) Enforcement Agency: Permit Number: Project Address: ^ \ * [i>so uio^tniA tfrvie Clt^ Zip Code: System Name or Identificatipn/Tai: Syitem Location or Area Served: ^ I • - Note; Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use: Checked by/Date Construction Inspection 1. Supporting documentation needed to perform test Includes, but not limited to; a. 2013 Building Energy Efflciency Standards Nonresidential Compliance Manual (NA 7.5.2 Constant 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 b. Amp Meter 3. Installation (check if applies): Thermostat is located within the space-conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): • Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual section 120.2(b),_^ - ^ Minimum heating setpoint: °F. Maximum cooling setpoint o5 "F. Deadband: fe» °F. i! Occupied, unoccupied, and holiday schedules have been programmed per the fa,djfty's schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Bijflding Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: Q Lesser of: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. ^1 3 complete air changes. Notes: CA Building;Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) Project Name; T 1 I Enforcement Agency; Permit Number: Project Address: r\ City: San Diego Zip code: Syitem Name or Identification/Tap System Igcairon or Area Served: A. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected Interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4; Cooling toad during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step S: Manual override 8 7 6 5 3 2 Step 2-8: Check and verify the foilowing for each simulation mode required ) -.' tl a. Supply fan operates continually b. Supply fan turns off s -f - c. Supply fan cycles on and off y ' " -, •. d. System reverts to "occupied" mode to satisfy any condition / '4 ' ,,," e. System turns off when manual override time period expires ffi "rii f. Gas-fired fumace, heat pump, or electric heater stages on X H >- g. No heating is provided by the unit y m y IX px h. No cooling is provided by the unit •i X y X X i. Compressor stages on X i X j-Outside air damper is open to minimum position >< i X X k. Outside air damper closes completely n. m X. wm •-t Step 9: System returned to inlttat operating conditions afterall tests have been completed: B. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), flil in appropriate letter P P P P P C. Evaluation: X^ P/^SS; All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 06/14) CALIFORNIA ENERGY COMMISSION.. CERTIFICATE OF ACCEPTANCE NRCA-MCH-03'A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) ProjectName: Enforcement Agency: Penrilt Number: ProjectAddress: City: opcode: System Name or Identification/Tag: System Locatlan or Area Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: • Adam Slayton Documentation Author Company Name: Slayton Mechanical Documentation Author Signature; Date Signed: Address: 9824 Vine St. ATT Certification Identircation (if applicable): aty/State/Zip: Lakeside Ca 92040 Phone: 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT I certify the fotlowing 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. I am the person who performed the acceptance verification reported on this Certlflcate 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 conflrmed that the Certificate(s) of InstaHation forthe construction or installation identifled 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 permlt(s) Issued for the building. Field Xe^nician Name: Field Technician Signature: Field Technician Company Name: Slayton Mechanical Position wtth Company (Title); Service Tech "^9824 Vine St. Lakeside Ca 92040 RESPONSIBLE PERSON'S DECURATION STATEMENT ATr Certification IdentlficatlDn (if applicable); ^^"""619-390-4900 | I certify the following under penalty of perjury, under the laws of the State of California: I am the Field Technician, orthe Field Technician is acting on my behaif as my employee or my agent and 1 have reviewed the information provided on this Certlflcate of Acceptance. I am eligible under Division 3 ofthe 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). The Information provided on this Certificate of Acceptance substantiates that the constmction or installation identified on this Certificate of Acceptance compiles with the acceptance requirements Indicated In the plans and spedfications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specifled in Reference Nonresidential Appendix NA7. I 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 permlt(s) issued forthe building. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Accepta nee is required to be included with the documentation the builder provides to the building owner at occupancy, Responsible Acceptance Person Name; Adam Slayton flesponslble Acceptance Person Signature: Responsible Acceptance Person Company Name: Slayton Mechancia;. Posltlon with Company (Title); VP Address; 9824 Vine St. CSLB Ucense: 662141 aty/state/zip;La]ceside Ca, 92040 Phone; g2^g_3gQ_^ggQ DateSigned; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page lof3) l^orvW ^<;n«i-r CcWv-r-s CJA\^^ Erifotcement Agency: Permit Number: Project Address:^ * ' \^So Uio^tfiiA UAvie CltK ZipCode: <(t.OI V System Name or Idendficatlon/Tag: System Location or Area Served; \ - " Note; Submit one Certificate of Acceptance for each system that must demonstrate compilance. Enforcement Agency Use: Checked by/Date Construction Inspection 1. Supporting documentation needed to perform test indudes, but not limited to: a, 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.2 Constant Vo/ume, Smgfe-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 b. Amp Meter 3. installation (check If applies): /S Thermostat Is located within the space-conditioning zone that Is served by the HVAC system. 4. Programming (check all those that apply); • Thermostat meets the temperature adjustment and dead band requirements of 2D13 Building Energy Efficiency Standards Manual section 120.2(b).___ Minimum heating setpoint; "aS "F. Maximum cooling setpoint feS "p. Deadband: ^ °F. l.l Occupied, unoccupied, and holiday schedules have been programmed per the facil^'s schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Btlilding Energy Efflciency Standards Manual section 120.1(c)2. 1, Check method used to determine pre-occupancy purge: 0 Lesser of; conditioned floor area times ventilation rate from 2013 Building Energy Effidency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. ?1 3 complete air changes. Notes; CA Building;Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3} ProjectName: T 1 ^ fj*rr\k Cm^ CAVuAaV '^vi.4v>Ev_ Enforcement Agency: Permit Number: ProjectAddress: City: San Diego Zip Code: System Name or Identificatlon/Ta^: system tjcation or Area Sensed: A. Functional Testing Requirements Operating Modes Step 1; Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected Interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode StepS; No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7; Cooling toad during unoccupied condition Step 8; Manual override 8 7 6 S 4 3 2 Step 2-8: Check and verify the following for each simulation mode required --> a. Suppty fan operates continually v Y b. Supply fan turns off , c. Supply fan cydes on and off y y d. System reverts to "occupied" mode to satisfy any condition e. System turns off when manual override time period expires ,. {• -I'lii iL«|tf=: f. Gas-flred furnace, heat pump, or electric heater stages on ""f A'-X g-No heating is provided by the unit y X X\ m h. No cooling is provided by the unit X y X 1. Compressor stages on X X J. Outside air damper Is open to minimum position x; m X X X k. Outside air damper closes completely X y. Iiigp cr _ Step 9: System returned to initial operating conditions after all tests have been completed: ^N B. Testing Resutts 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill In appropriate letter P l> P P P ? Evaluation: X^ PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Buildmg Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Pacl<aged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3} Project Name: Orcement Agency: Permit Number: ProjectAddress: City: Zip Code: System Nama or Identlflcadon/Tag: System Location or Area Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name; Adam Slayton Documentation Author Company Name; Slayton Mechanical Documentation Author Signatur/ Date Signed: ^"""9824 Vine St. aty/State/ZIp: Lakeside Ca 92040 FIELD TECHNICIAN'S DECURATION STATEMENT ATT Certification identification (if applicabli ••^"'^ 619-390-4900 I certify the following under penalty of penury, underthe laws ofthe State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. I 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 compiles with the applicable acceptance requirements indicated in the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specifled in Reference Nonresidential Appendix NA7. 4. I have conflrmed that the Certiflcate(s) of Installation forthe construction or instailation 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 permlt(s) issued for the bullding. Field lEshnician Name; ^ Field Technidan Sjgnatcre: Field Technidan Company Name: Slayton Mechanical Position with Company (Titie): Service Tech Address; 9824 Vine St. ATT Certification Identification (if applicable); aty/State/ZIp: Lakeside Ca 92040 Phcme; 619-390-4900 Date Signed: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws ofthe State of California: 1 am the Field Technician, or the Fleld Technician is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certificate of Acceptance. 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 ofwork Identified on this Certlflcate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 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 speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I have conflrmed that the Certlflcate(s) of Installation forthe construction orinstallation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permlt(s) issued for the building. 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 ofthis Certificate of Acceptance is required to be induded with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name; slgytOn Mechancia Position with Company (Title): VP Address: 9824 Vine St. CSLB Ucense: 662141 City/State/Zlp:La,^gg^^g Ca, 92040 Phone; g]_g_29Q_4gQ0 DateSigned; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Purnp Systems (PagelofS) l^of^L C(fc*'?.r C(\,yjKr^ C4^f^^ Enforcement Agency: Permtt Number: Proiect AtMiwsiQ * ' \^So uio^tTTiA L.^vl6 Zip Code: <|7.0I V System Name or (dentlficatlort/Tag: System Location or Area Served: ,——————.—ii_ ' Note: Submit one Certificatk of Acceptance foreaci Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement /\gency Use: Checked by/Date Construction Inspection Supporting documentation needed to perform test Includes, but not limited to: a. 2013 Building Energy Efficiency Standarels Nonresidential Compliance Manual (NA7.S.2 Constant Volume, Single-zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glance). b, 2013 Building Energy Efficiency Standards Manual. Instrumentation to perform test Includes, but not limited to: a. Temperature Meter b. Amp Meter Installation (check If applies): Thermostat Is Ideated within the space-conditioning zone that Is served by the HVAC system. Programming (dieck all those that apply); • Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Effidency Standards Manual section 120.2(b).__ , ^ Minimum heating setpoint: "F. Maximum cooling setpoint r>S °F. Deadband: t» °F. i! Occupied, unoccupied, and holiday schedules have been programmed per the fasjlp's schedule. Q Pre-occupancy purge has been programmed to meet the requirements of 2013 BufMlng Energy Efficiency Standards Manual section 120. l(c)2. 1. Check method used to determine pre-occupancy purge: • Lesser of: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. 3 complete air changes. Notes: CA Building, Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03'A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) ProJectNime: r l{ ^ Enforcement Agehcy: Permit Number ProjectAddress: r\ aty: San Diego Zip Code: System Name or IdenttficitiDn/Teg: System t^aliojH.or jyea Served; A. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step S: No-load during unoccupied condition Step 6; Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8; Manual override 4 Step 2-8: Check and verify the following for each simulation mode required Supply fan operates continually Supply fan turns off Supply fan cycles on and off System reverts to "occupied" mode to satisfy any condition System turns off when manual override time period expires Gas-fired furnace, heat pump, or electric heater stages on No heating is provided by the unit No cooling Is provided by the unit Compressor stages on Outside air damper is open to minimum position k. Outside air damper closes completely Step 9: System retumed to Initial operating conditions after all tests have been completed: B. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter P P P 9 P l> C. Evaluation: Xi VASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS «BHrti CEC-NRCA.MCH-03-A (Rgvlrod 06/14) CALIFORNIA ENERGY COMMISSION ^ CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Singie Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems Projea Name: (Page 3 of 3) Project A[ddrei]: System Name or Menttfi cation/Tag: Enforcement Agency; City: System Ijicatlon or Area Senred: Permit Number: Zip Code: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete Documentation Author Name: Adam Slayton Documentation Author Company Name: Slayton Mechanical Documentation Author Signati Date Signed; Address: 9824 Vine St, ATT Certification identification (If applicablel Clty/State/Zlp; Lakeside Ca 92040 Phone; 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws ofthe State of Califamia: 1. The information provided on this Certlflcate of Acceptance Is true and correct. 2. 1 am the person who perfomied the acceptance veriflcation reported on this Certificate of Acceptance (Field Technician), 3. The construction or Installation identified on this Certlflcate of Acceptance complies with the applicable acceptance requirements Indicated In the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I have confirmed that the Certiflcate(s) of Installation forthe construction or installation identified on this Certlflcate 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 Xe^nidan Name; Field Technidan lawre; Fleld Technidan Company Name; Slayton Mechanical Position with Company (Title); Service Tech Address; 9824 Vine St, ATT Certification ldentllicatlon{lf appiicable); CIty/State/Zip: Lakeside Ca 92040 Phone: 619-390-4900 Date signed: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the foltowing under penatty of perjury, under the laws of the State of California: I am the Field Technidan, or the Field Technician is acting on my behalf as my employee or my agent and 1 have reviewed the Information provided on this Certificate of Acceptance. I am eligible under Division 3 of the Business and Professions Code in the applicable classiflcation to accept responsibility for the system design, construction or Installation of features, materials, components, or manufactured devices for the scope of work Identifled on this Certificate of Acceptance and attest to the declarations In this statement (responsible acceptance person). The information provided on this Certlflcate 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 bythe enforcement agency, and conforms to the applicable acceptance requirements and procedures spedfied in Reference Nonresidential Appendix NA7. I have conflrmed that the Certlf{cate(s) of Installation for the construction or installation Identifled on this Certlflcate of Acceptance has been completed and Is posted or made available with the building permlt(s) issued for the buitding. 1 will ensure that a completed, signed copy of this Certifleate of Acceptance shall be posted, or made available with the building permlt(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 Acceptance Person Name: Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name; Slayton Mechancia Position with Company (Title): VP Address: 9824 Vine St, CSLB License: 662141 aty/state/zip:Lg]^Q3j^^g Ca, 92040 Phone: gJ5_35Q_^ QQQ DateSigned CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page lof 3) fjoovL Cau'^'r Tc^v/Vv C^Kfof Enforcement Agency: Permtt Number Project Aildress:— ^ ' 13be? UiO^tTTiA Citj; Zip Coda: System Name or lclentincatio;>/Teg: . ^•f^?^^ ......... System Location or Area Senred: i ,— . —" ' Note; Submft one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use; Checked by/Date Construction Inspection Supporting documentation needed to perform test includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.2 Constant Volume, Single-zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glance). b. 2013 Building Energy Effidency Standards Manual. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter Installation (check if applies): /S Thermostat is located within the space-conditioning zone that Is served by the HVAC system. Programming (check all those that apply); • Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efflciency Standards Manual section 120.2(b)y ^ Minimum heating setpoint: "^S °F. Maximum cooling setpoint 7>S °F. Deadband: fe> "F. i I Occupied, unoccupied, and holiday schedules have been programmed perthe facility's schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Bij'ifding Energy Effidency Standards IVIanual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: G Lesser of; conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. ^ 3 complete air changes. Notes; CA Building; Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 06/14) CALIFORNIA ENERGY COH/lfi^lSSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) Project Name: I 1 <s. Enforcement Agency: Permit Number: Project AcWress: r\ City: San Diego System NUTLC or Identification/Tag-, System Ijcatiortor Ares Served: A. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected Interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3; No-load during occupied condition Step 4: Cooiing load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6; Heating load during unoccupied condition Step 7; Cooling load during unoccupied condrtion StepS: Manual override 8 7 6 5 4 3 2 Step 2-8: Check and verify the following for each simulation mode required '- a. Supply fan operates continually „ b. Supply fan turns off c, Supply fan cycles on and off d. System reverts to "occupied" mode to satisfy any condition e. System turns off when manual override time period expires V f. Gas-flred furnace, heat pump, or electric heater stages on * ir >^ g. No heating is provided by the unit )C h. No cooling Is provided by the unit —1 X y 1. Compressor stages on X • t \~ B ^ X mm J. Outside air damper Is open to minimum position X X — j j X-X k. Outside air damper closes completely V :.? Step 9: System returned to initial operating conditions after all tests have been completed: ^N B. Testing Resutts 8 7 6 5 4 3 2 Indicate If Passed (P), Failed (F), or N/A (X), fill In appropriate letter P P P P C. Evaluation: Xi PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH'03-A (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE r4RCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) Proiect Name: Enforcement Agency: Permit Number. Project Address: City: ZipCode: System Name or tdentificatkin/Tag: System Location or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. I certify that this Certificate of Acceptance documentation Is accurate and complete. DocumentationAuthorName; SlaytOn Documentation Author Signal; Documentation Author Company Name: Slayton Mechanical Date Signed; Address; 9824 Vine St. ATT Certification Identification (if applicable); City/state/zip; Lakeside Ca 92040 619-390-4900 FIELD TECHNICIAN'S DECURATION 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 Technidan). 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 conflrmed that the Certlficate(s) of Installation for the construction or instailation 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 permlt(s) issued forthe buiiding, Reld hnidan Name: Field Technician Sfg.nature: Fleld Technidan Company Name: Slayton Mechanical Position with Company (Title): Service Tech Address: 9824 Vine St. ATT Certification Identification (if applicable); City/State/Zlp: Lakeside Ca 92040 Phone: 619-390-4900 Date Signed: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the taws ofthe State of California: I am the Field Technidan, 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. 1 am eligible under Division 3 ofthe Business and Professions Code in the applicable classification to accept responslblllty 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). 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 spedfications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified In Reference Nonresidential Appendix NA7. 1 have conflrmed that the Certiflcate(s) of Installation for the construction or installation identified on this Certlflcate of Acceptance has been completed and is posted or made avaiiabie with the building permit(s) issued for the bullding. 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 ofthis Certifleate of /^ceptance is required to be induded with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: g ]_^y ^on Me chanC ia Position with Company |Tltle): VP Address: 9824 Vine St, 662141 Cily/State/Zip:La3^ggi(^e Ca, 92040 Phone: g2 9-3 90-4 900 DateSigned; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-(«IRCA-MCH-Q3-A (Raviged 06/141 CERTtFICATE OF ACCEPTANCE CALIFORNIA ENERGY COMMISSION NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (PagelofS) Projest Name: . A { N'o<'^W-Cggyr Uiv/t^rv C4KP^' Enforcement Agency: Permit Number: ProjectAddress:^ System Mime or ldentificitio;>/Tag; Cite Zip Code: ^2.cH V System Location or Area Served; —> "T '^ Note; Submif one Certificate of Acceptance for each system that must demonstrate compiiance. Enforcement Agency Use: Checked by/Date Construction Inspection 1. Supporting documentation needed to perform test indudes, but not limited to; a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.S.2 Constant Voiume, 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 b. Amp Meter 3. Installation (check if applies); Thermostat Is located within the space-conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): • Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual section 120.2(b). _ IVlinimum heating setpoint: °F. Maximum cooling setpoint _^&_°F. Deadband: _£_°F. i 1 Occupied, unoccupied, and holiday schedules have been programmed per the facif^'s schedule. 0 Pre-occupancy purge has been programmed to meet the requirements of 2013 BiJiWing Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: • Lesser of; conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. % 3 complete air changes. Notes: CA Building,Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) ProjectName: T i ( rv Enforcement Agency: Permit Number: ProjectAddress: r\ City: San Diego ZipCode: System Name at tdenttflcatlon/Tag: A. Functional Testing Requirements 1 Operating Modes Stepl; Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected Interactions. Occupied Mode Step 2: Heating load during occupied conditton Step 3; No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5; No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition StepS: Manual override 8 7 6 S 4 3 2 Step 2-8: Check and verify.the following for each simulation mode required a. Supply fan operates continually i b. Supply fan turns off c. Supply fan cycles on and off V d. System reverts to "occupied" mode to satisfy any condition X I. e. System turns off when manual override time period expires f. Gas-flred furnace, heat pump, or electric heater stages on - g' No heating Is provided by the unit y y h. No cooling Is provided bythe unit X \ 1. Compressor stages on . .•. ]. Outside air damper is open to minimum position yy y \ k. • utside air damper closes completely i^ Step 9: System returned to initial operating conditions after alt tests have been completed; ^N B. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter 0 p P P P Evaluation: PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-IV1CH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) Project Name: Enforcement Agency: Permit Number Project Address: aty. Zip Code: System Name or Identification/Tag: System Location or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. Icertlfythat this Certlflcate ofAcceptance documentation is accurate and complete. /V/O DocumentadonAuthorName: ^^^^ Slayton Documentation Author SIgnatury' ^ y "T^^Si^v^ Documentation Author Company Name; «n j_ .. i , n Slayton Mechanical Date Signed: y^ ^ "'"'""9824 Vine St. ATT Certification Identification (If applicable); aty/State/.p;^^j^^^,^^ Ca 92040 "••""^^ 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT 1 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 veriflcation reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identifled on this Certlflcate of Acceptance complies with the applicable acceptance requirements indicated in the plans and speciflcations 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 Instaliation 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 bullding. Field X^dinician Name; T>&u\rX McLM-it^t-L Field Technidan Mature: Field Technician Company Name; Slayton Mechanical Position with Company (Title); Service Tech Address:gg2 4 Vine St. ATr Certification identiflcation(lf applicable): aty/state/zip:^^^^^,^^ Ca 92040 '"'=-619-390-4900 "'''"''""^ RESPONSIBLE PERSON'S DECURATION STATEMEDTF I certify the following under penalty of perjury, under the laws of the State of California: 1 am the Field Technician, or the Field Technidan Is acting on my behalf as my employee or my agent andl have reviewed the information provided on this Certificate ofAcceptance. I am eligible under Division 3 ofthe Business and Professions Ckide 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 ofAcceptance and attest to the declarations in this statemert (responsible acceptance person). The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate ofAcceptance compiles with the acceptance requirements indicated In the plans and spedfications approved bythe enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential /Vppendix NA7. I have confirmed thatthe Certificate(s) of Installation forthe construction or installation Wentified on this Certificate ofAcceptance has been completed and is posted or made available with the building permlt(s) issued for the building, I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permlt(s) issued for the building, and made available to the enforcement agencyfor all applicable mspections. I understand that a signed copy of this Certificate of Acceptance Is required to be induded with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name; , . , Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name; g ]_ gy.^ Q ChanC i a Position with Company (Title): yp Address; gg24 Vine St. CSLB License: 662141 aty/state/zip;L^]^ggi^g Ca, 9204 0 Phone; 619-3 90-4900 DateSigned; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH.03-A (Ravlsad 06/14) CALIFORNIA ENERGY COMMiSSION CERTtFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 3) Kfor^iy,, (_acy^ C<XyjK^s. (iM.^a-ti Eriforcement Agency; Permit Numben ProjectAddress:.- ' ' I'S5(9 f»iv)4&ritA Ui6rvje Cite Zip Code: System Name or Identification/Tag: System Location or Area Served: 1— • •• - • '•• Note; Submit one Certificate of Acceptance for each system that must demonstrate compiiance. Enforcement Agency Use: Checked by/Date Construction Inspection 1. Supporting documentation needed to perform test indudes, but not limited to; a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.2 Constant 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 b. Amp Meter 3. Installation (check If applies): M Thermostat is located within the space-conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): 0 Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual section 120.2(b). _ ^ Minimum heating setpoint: 'aS °F. Maximum cooling setpoint 7^ "F. Deadband: _ii__°F. 1 i Occupied, unoccupied, and holiday schedules have been programmed per the facijliy's schedule. :• Pre-occupancy purge has been programmed to meet the requirements of 2013 Btlifding Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: • Lesser of; conditioned floor area times ventilation rate from 2013 Building Energy Effidency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. 3 complete air changes. Notes: CA Building.Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) ProjictName; T I I l^»rV^ C<»^&T CA\vjAa^ ^Ui.4:V€^ Enforcement Agency. Permit l^jmber: ProjectAddress: r\ City: San Diego ZipCode: System Namao!J|lwillfieelieo£ra|: System lotion or Area Senrad: A. Functional Testing Requirements Operating Modes Step 1; Disable economizer control and demand-controlled ventliation (If applicable) to prevent unexpected Interactions. Occupied Mode Step 2; Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition 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 S 4 3 2 Step 2-8: Check and verify the following for each simulation mode required * 't ^ . :: ' i a. Supply fan operates continually .... >»fu .... •; ;-t 9 Iff y V Y b. Supply fan turns off •• 1.- c. Supply fan cydes on and off y V \?2s: *. ^ d. System reverts to "occupied" mode to satisfy any condition / • I fit e. System turns off when manual override time period expires y % "«(•• ' f Gas-fired furnace, heat pump, or electric heater stages on X •V > • g, No heating is provided bythe unit y y ii h. No cooling is provided by the unit X X r X 1. Compressor stages on X X % j. Outside air damper is open to minimum position 2 X X k. Outside air damper closes completely X. X i Step 9: System returned to Initial operating conditions afterall tests have been completed: ^N B. Testing Results 8 7 6 5 4 3 2 Indicate If Passed (P), Failed (F), or N/A (X), fill in appropriate letter F i> P P P P Evaluation; y^ PASS; All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS S CEC-NRCA-MCH-03-A (RBVlsod 06/14> TAI ipnnwiA FUForsv r^nuuissinN ' ••=' CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systenr>s (Page 3 of 3) Proiect Name: Enforcement Agercy: Permit Number: Project Address: aty: Zip Code: System Name or Identlflcatton^ag: Systein Location or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. I certify that this Certificate of Acceptance documentation Is accurate and complete. Documentation Author Name; Adam Slayton Documentation Author Signatuj Documentation Author Company IMame: Slayton Mechanical Date Signed: Address: 9824 Vine St, ATT Certification Identification (if applicablel City/State/Zlp: Lakeside Ca 92040 Phone; 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT 1 certify the following under penalty of perjury, under the laws ofthe State of California: 1. The information provided on this Certificate ofAcceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate ofAcceptance (Field Technician). 3. The construction or installation identifled 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. I have conflrmed that the Certificate(s) of Installation for the construction orinstallation idiantified onthis Certificate of Acceptance has been completed and signed by the responsibte builder/Installer and has been posted or made available with the building permit(s) Issued for the building. Field l££hl jinidan Name: Field Technidan S Field Technidan Company Name: Slayton Mechanical Position with Company (Title): Service Tech Address; 9824 Vine St, ATT Certification Identification (if appiicable): City/State/Zip: Lakeside Ca 92040 Phone: 619-390-4900 Date Signed; RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California; I am the Field Technidan, or the Field Technidan is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certificate ofAcceptance. I am eligible under Division 3 of the Business and Professions Code in the applicable classiflcation 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). The information provided on this Certificate of Acceptance substantiates that the construction or Installation identified on this Certificate of Acceptance compiles with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specifled in Reference Nonresidential Appendix NA7. 1 have confirmed that the Certiflcate(s) of Installation for the construction or installation Identifled on this Certifleate of Acceptance has been completed and is posted or made available with the building permlt(s) issued for the buildlng. I will ensure that a completed, signed copy ofthis Certlflcate ofAcceptance 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 Certlflcate of Acceptance Is required to be Included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name; Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name; 51 gyt on Me Chan C i 3 Position with Company (Title); VP Address: 9824 Vine St. CSLB Ucense: 652141 aty/State/Zlp; •Lakeside Ca, 92040 Phone: 6]_9_39Q_4900 DateSigned: CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 3) Nor™L {;tfti4,-f Tciv'v.rs (JU'^f<^^ Enforcement Agency: Permit Numiier: Project Address: A ^ * ate Zip Coda; System Name or ldeiitift'cetloi\n'»K: system Location or Area Senred: \- -• Note: Submit one Certificate of Acceptance for each system that must demonstrate complionce. Enforcement Agency Use: Checked by/Date Constructton Inspection 1. Supporting documentation needed to perfonn test Indudes, but not limited to; a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manua! (NA7.5.2 Constant 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 b. Amp Meter 3. Installation (check If applies): )Si Thermostat Is located within the space-conditioning zone that Is served by the HVAC system. 4. Programming (check all those that apply): Ci Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efflciency Standards Manual section 120.2(b). - ^ Minimum heating setpoint: °F. Maximum coollni; setpoint °F. Deadband: J^_''F. 1! Occupied, unoccupied, and holiday schedules have been programmed perthe fapfjlty's schedule. • Pre-occupancy purge has been programmed to meet the requirements of 2013 Biftding Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge; D Lesser of; conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. 3 complete air changes. Notes; CA Building; Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (RevlGBd 06/14) CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) ProjectName: ^ T t \ Enforcerrent Agency; Permit Number: ProjectAddress: pk aty: San Diego Zip Code: Systein Natne or IdentlfFcatlon/Tair: Syg^g^^^ony ^laSe^^^^^ Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected Interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition 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 4 3, • 2 Step 2-8: Check and verify the following for each simulation mode required - • >• a. a. Supply fan operates continually i V b. Supply fan turns off , c. Supply fan cydes on and off -'— 1. d. System reverts to "occupied" mode to satisfy any condition y , e. System turns off when manual override time period expires 1 J 1 -* f. Gas-fired fumace, heat pump, or electric heater stages on • « 1 X •- ^*!; X g' No heating is provided by the unit y lsl»l' y X h. No cooling Is provided by the unit *i X y m r X 1. Compressor stages on . f X ^> j-Outside air damper is open to minimum position X X. X X k. Outside air damper doses completely m X X ' 1 Step 9: System returned to initial operating conditions after all tests have been completed: B. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter ? l> P P P Evaluatton: PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Singie Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) Protect Name: Enforcement Agency: Permit Number ProjectAddress; City: Zip Code: System Nime or tdentlflcBtlon/Tag: System Location or Area Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certlflcate ofAcceptance documentation Is accurate and complete. Documentation Auttwr Name; 'Adam Slayton Documentation Author SIgnauire; Documentation Author Company Name: Slayton Mechanical Date Signed: Address: 9824 Vine St ATT Certification Identificatfon (If applicable); Oty/State/ZIp; Lakeside Ca 92040 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT 1 certify the following under penalty of perjury, underthe laws ofthe State of California: 1, The information provided on this Certificate ofAcceptance is true and correct. 2. 1 am the person who performed the acceptance veriflcation reported on this Certificate ofAcceptance (Field Technidan). 3, The construction or installation identified on this Certificate of Acceptance complies withthe applicable acceptance requirements indicated In the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I 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 Xeshnldan Name: Field Technician Sienature: FleldTechnlclan Company Hame: Slayton Mechanical Position vAth Company fTltle): Service Tech Address: 9824 Vine St. ATT Certification Identification (if applicable); aty/State/ZIp: Lakeside Ca 92040 Phone: 619-390-4900 Date Signed: RESPONSIBLE PERSON'S DECURATION STATEMENT 1 certify the following under penalty of perjury, under the laws of the State of California: 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 Certlflcate ofAcceptance. I am eligible under Division 3 of the Business and Professions Code in the applicable dassification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identifled on this Certlflcate of Acceptance and attest to the declarations in this statement (responsible acceptance person). The information provided on this Certlflcate ofAcceptance substantiates that the construction or installation identified on this Certlflcate of Acceptance complies with the acceptance requirements indicated in the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I have conflrmed that the Certlflcate(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(5) issued for the building. I wlll ensure that a completed, signed copy of this Certlflcate 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. Responsble Acceptance Petson Name: Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Slayton Mechancia Position with Company (Title): VP Address: 9824 Vine St. 662141 City/State/Zip: Lakeside Ca, 92040 Phone:g-[.9-390-4900 DateSigned: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) ProjectName: ^ C i\ Enforcement Agency: Permit Number: ProjectAddress: r\ City: San Diego Zip Code: System liication t>r Area Senred: A. Functional Testing Requiretnents Operating Modes Stepl: Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6; Heating load during unoccupied condition Step 7; Cooling load during unoccupied condition StepS; Manual override 8 7 6 5 4 3 2 Step 2-8: Check and verify the following for each simulation mode required ••i 1 I-T M 9-a, Supply fan operates continually •\ T M 9-If b. Supply fan turns off 1 c. Supply fan cycles on and off y y • \,' - d. System reverts to "occupied" mode to satisfy any condition \ F«i Op i * i "i* ) e. System turns off when manual override time period expires y '•*' 1 tip Ji f. Gas-fired furnace, heat pump, or electric heater stages on - 1 •fsp' V V g-No heating is provided by the unit 1 y y y iX h. No cooling is provided by the unit \ y X 1. Compressor stages on V J. Outside air damper Is open to minimum position X A' sy y k. Outside air damper closes completely M X: y Step 9: System returned to Initial operating conditions after all tests have been compieted: ^N B. Testing Resutts 8 7 6 5 4 3 2 indicate If Passed (P), Failed (F), or N/A (X), fill In appropriate letter l> P P F P Evaluation: Xd PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS ft CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) Project Name: Enforcement Agency: Permit Number: Projact Address: City: Zip Code: System Name or Identifjcatlon/Tac: System (.ocation or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Oocuc^nUtlonAuthorName: ^^^^ g^^^^ Documentation Author Slgnatiare; Documentation Author Company Name; Slayton Mechanical Date Signed: Address: 9824 Vine St. ATT Certification Identification (If applicable] City/State/ZIp: Lakeside Ca 92040 Phone: 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT 1 certify the following under penalty of perjury, under the laws ofthe 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 Technidan). 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 specifled in Reference Nonresidential Appendix NA7. 4. I have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate ofAcceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permlt(s) issued for the bulldlng. Field XethnKian Name; Field Technician ^gLnature; Field Technidan Company Name: Slayton Mechanical PosiUon with Company (Title); Service Tech Address; 9824 Vine St. ATT Certification identification (If applicable): Clty/State/ap: Lakeside Ca 92040 Phone; 619-390-4900 Date Signed; RESPONSIBLE PERSON'S DECURATION STATEMENT I cerdfy the following under penalty of periury, underthe laws of the State of California: I am the Fleld Technician, or the Field Technidan is acting on my behalf as my employee or my agent and 1 have reviewed the Information provided on this Certificate ofAcceptance. 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 ofwork identifled on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). The Information provided on this Certificate ofAcceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated In the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I have conflrmed that the Certif lcate(s) of Installation for the construction or installation identified on this Certlflcate ofAcceptance has been completed and is posted or made available with the bullding permlt(s) Issued for the building. I will ensure that a completed, signed copy of this Certifleate ofAcceptance shall be posted, or made available with the bulldlng 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 Acceptance Person Name; Adam Slayton Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name; Slayton Mechancia'. Position with Company (Title): VP Address: 9824 Vine St, CSLB Ucense; 662141 aty/state/zip:Lakesicle Ca, 92040 Phone: g]^9_39Q_^9QQ DateSigned; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 3) Eiiforcement Agency: Permit Numtwr; Project Address: ^ ^ l^So roiosfcTTiA t^vie ZipCode: System Name or EdendficBtlon/TaK; Syitem LocaUonor Area Served: 1 , ~ , -m^ _——^ . , Note: Submit one Certificate of Acceptance for each system that must demonstrate compiiance. Enforcement Agency Use: Checked by/Date Construction Inspection 1. Supporting documentation needed to perform test indudes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA 7.5.2 Constant Volume, Single-zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glance). b. 2013 Building Energy Efflciency Standards ManuaL 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter 3. Installation (check if applies): ^ Thermostat Is located within the space-conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply); • Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual sectton 120,2(b), /- _ Minimum heating setpoint: °F. Maximum cooling setpoint °F. Deadband: !> °F. I! Occupied, unoccupied, and holiday schedules have been programmed per the facility's schedule, • Pre-occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre-occupancy purge: iJ Lesser of; conditioned floor area times ventilation rate from 2013 Bulldlng Energy Efficiency Standards TABLE 120.1-A or IScfm per person times the expected number of occupants. 3 complete air changes, Notes; CA Building;Energy Efficiency Standards - 2013 Nonresidentiai Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume Single Zone Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) ProjectName: ^ T 1 ( 'N Enforcement Agency: Pmnit Number: ProjectAddress: r\ [ISO |^<?{ioSt,T\\A \AP^ Gty: San Diego ZipCode: System Name or IdentlflcaClon/TBg: System Iccatiop or Area Senfed: A, Functional Testing Requirements Operating Modes Step 1; Disable economizer control and demand-controlled ventilation (if applicable) to prevent unexpected Interactions. Occupied Mode Step 2; Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition StepS: Manual override 3 7 6 S 4 3 2 Step 2-8: Check and verify the foilowing for each simulation mode required "i ^- a. Supply fan operates continually : b. Supply fan turns off c. Supply fan cydes on and off • ^ U 1 d. System reverts to "occupied" mode to satisfy any condition i e. System turns off when manual override time period expires 1 .1 u. i - f. Gas-flred furnace, heat pump, or electric heater stages on y ' e X g' No heating Is provided by the unit F! IP-y # h. No cooling Is provided by the unit V y V X i. Compressor stages on V i ft 1 J. Outside air damper is open to minimum position X < X k. Outside air damper closes completely v m Step 9: System returned to initial operating conditions after all tests have been completed: B. Testing Results 8 7 6 5 4 3 2 Indicate If Passed (P), Failed (F), or N/A (X), fill in appropriate letter P P P F C. Evaluation: X(^ VASS: All ConstrucUon Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA CONSTANT VOLUME SINGLE ZONE UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-h^CH-03-A (Revised 06/14) CALIFORNIA ENERGY COINMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volunne Singie Zone Unitary (Paclcaged and Split) Air Conditioner and Heat Pump Systems (Page 3 Of 3) Project Name: Enforcement Agency: Permit Number: ProjectAddress: City: Zip Coda: System Name or IdentiRutiofl/Tag: System Location or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Adam Slayton Documentation Author Signati Documentation Author Company Name: Slayton Mechanical Date Signed: Address: 9824 Vine St, ATT Certification Identification (If applicable): Oty/State/ZIp: Lakeside Ca 92040 Phone: 619-390-4900 FIELD TECHNICIAN'S DECURATION STATEMENT I certify the fbllowing under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate ofAcceptance is true and correct. 2. 1 am the person who performed the acceptance veriflcation reported on this Certlflcate 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 spedfled in Reference Nonresidential Appendix NA7. 4. 1 have conflrmed that the Certlflcate(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 permlt(s) issued for the bulldlng. Field SnIclan Name; Field Technician %nature: Field Technician Company Name: Slayton Mechanical Position with Company (Title): Service Tech Address; 9824 Vine St. ATT Certification Identification (if applicable): City/State/Zlp: Lakeside Ca 92040 Phone: 519-390-4900 Date Signed; RESPONSIBLE PERSON'S DECURATION STATEMENT 1 certify the foliowing under penalty of perjury, under the laws of the State of California: 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 Certlflcate of /Acceptance. I am eligible under Division 3 of the Business and Professions Code in the applicable classiflcation to accept responsibility for the system design, construction or Installation of features, materiais, 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). The Information provided on this Certlflcate ofAcceptance substantiates that the construction or installation Identifled 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 /Vppendix NA7. I have confirmed that the Certlficate(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 permlt(s) Issued forthe buildlng. I will ensure that a completed, signed copy of this Certificate of Acceptance shali be posted, or made available with the building permlt(s) issued for the building, and made available to the enforcement agency for all applicable jnspectlons. 1 understand that a signed copy ofthis Certlflcate ofAcceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Adam Slayton Responsible Acceptance Person Signature; Responsible Acceptance Person Company Name; Slayton Mechancial. Position with Company (Title): VP Address: 9824 Vine St, CSLB Ucense: 662141 ci,y/state/zip;L3ke3i^je ^a, 9204 0 Phone:g-J^9_39Q_^9Qg DateSigned: CA Building Energy Efficiency Standards - 2013 Nortresidential Compliance June 2014 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (PagelofS) Enforcement Agency; Permit Number: ProlectAddress: > 1 H ¥'< • •fljrry r „ f r , System Neme or Idendficatlrfn/Tag; ' »^ Systern Location or Area Served: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use: Checked by/Date K. Construction inspection 1. Supporting documentation needed to perform test Indudes; fl. 2013 Building Energy Effidency Standards Nonresidential Comptiance Manual (NA7.S.4Alr Economizer Controls Acceptance At-A- \j Glance). b. 2013 Bullding Energy Efficiency Standards. 2. instrumentation to perform test includes; Hand-held temperature probe Calibration Date; I /9i>j/(must be within last year) b. Device capable of calculating enthalpy Calibration Date; ^(must be within last year) c. 1.2 k Ohm Resistor (when specifled by the manufacturer) 3' Installation: (all of the following boxes should be checked) Economizer high limit shutoff control complies with Table 140.4-B found in the 2013 Building Energy Efficiency Standards Section 140.4{e)3. • Economizer reliability features are present per 2013 Building Energy Efflciency Standards Section 140.4(e)4: a. 5-year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product specification sheet proving compliance with AMCA Standard 500 damper leakage at 10 cfm/sf at 1.0 In w.g, A product specification sheet showing the manufacturer's results after following the testing procedures of AMCA Standard SOO or AMCA certification by a third party under AMCA Publication 511 can be used to satisfy this requirement (Class lA, 1, and 2 are acceptable). d. If the high limit setpoint is flxed dry-bulb or fixed enthalpy •^ fixed dry-bulb then the control shall have an adjustable setpoint e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: I. Drybulb and wetbulb temperatures accurate to ±2''F over the range of 40''F to 80"F II. Enthalpy accurate to +3 Btu/lb over the range of 20 Btu/lb to 35 Btu/lb til. Relative humidity (RH) accurate to ±5% over the range of 2054 to 80% RH f. Check that the sensor performance curve(s) is provided by the factory and sensor output values measured during sensor calibration are plotted on the performance curve(s) g. Sensors used for high limit control shall be located to prevent false readings, including but not limited to being properly shielded from direct sunlight. .3 Unitary systems with an economizer have control systems, including two-stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling G System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. 0 For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. • For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) Entorcement Agency: Permit Number: ProjectAddress: ^ .^rr-.^^y, aty: Zip Code: System Nama or ldentificatlon/Ta|; System tocation or Area Senred: B. Functional Testing Results Step 1: Disable demand controt ventilation systems (if appiicable) Step 2; Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open. Verify the following: 3- Economizer damper modulates 100% open. O/N b- Return air damper modulates 100% closed. ^/N c. For systems that meet the criteria of 2013 Building Energy Effidency Standards Section 140.4(e)l, verify that the economizer remains lOOK open wtth the use of mechanicai cooling. This occurs when the cooling demand can no longer be met by the economizer alone. (£Y>N d- All applicable fans and dampers operate as Intended to maintain building pressure. <^/N e- The unit heating is disabled (if applicable). Step 3: Disable the economizer and simulate a cooling demand. Verify the foltowing; 3' Economizer damper doses to its minimum position. ^/N All applicable fans and dampers operate as intended to maintain building pressure. c. The unit heating Is disabled (if applicable). '(aJ/N/NA Step 4: Ifthe unit Is equipped with heating, simulate a heating demand and enable the economizer. Verify the following: ^- Economizer damper closes to its minimum position. v^/N/NA b. Return air damper opens. !j)/fifNA Step 5: Turn off the unit and verify the following: a. Economizer damper closes completely. Step 6: System returned to initial operating conditions C. Testing Resutts PASS / FAIL Step 2: Simulate cooling load and enable the economizer (all answers are Y). P Step 3: Simulate cooling load and disable the economizer (all answers are Y). Step 4: Simulate heating demand and enable the economizer (all answers are Y). P Step 5: Turn off the unit (all answers are Y). D.. Evaluation: 2 PASS: All Construction Inspection responses are complete and alt Testing Results responses are "Pass" Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CAUFORNIA ENERGY COMMISSION M CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Project Nama; / , Enforcement Agency: Permit Number ProjeaAdsre«i n . TL y Zip Code: ^ System Natne or Idendfldtly^ag: . System Location or Area Semid: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. 1 certify that this Certificate ofAcceptance documentation Is accurate and complete. Documentation Author Name: Documentation Author Signature; Documentation Author Company Name: Date Signed: Address: ATT Certifjcatiofl Identification (if applicable): Oty/State/Zip; Phone; FIELD TECHNICIAN'S DECURATION STATEMENT I certify the following under penalty of perjury, underthe laws ofthe 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 ofAcceptance (Field Technidan), 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 specifled In Reference Nonresidential Appendix NA7. 4. I have conflrmed that the Certiflcate(s) of Installation for the construction or Installation identified on this Certificate of Acceptance has been compieted and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued forthe building. Field Technician Name; Field Technician Signatun Fleld Technician Company Name: Position with Company (Title): Address: ATT Certification Identification (if appiicabie); aty/State/Zlp: Phone: Date Signed; RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, underthe taws ofthe State of California: 1 am the Field Technician, or the Field Technidan is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certlflcate ofAcceptance. 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 ofwork identified on this Certificate of Acceptance and attest to the declarations In this statement (responsible acceptance person). The information provided on this Certlflcate of Acceptance substantiates that the construction or installation identified on this Certlflcate ofAcceptance compiles with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures spedfied in Reference Nonresidential Appendix NA7. I have confirmed that the Certlficate(s) of Installation for the construction or installatton identifled on this Certificate of Acceptance has been completed and is posted or made available with the building permlt(s) issued for tiie building. I wlli ensure that a completed, signed copy ofthis Certificate ofAcceptance shall be posted, or made available with the building permlt(s) issued for the building, and made available to the enforcement agency for all applicable Inspections. I understand that a signed copy ofthis Certlflcate of Acceptance Is required to be included with the documentation the buijijer provides to ttj^ building owner at occupancy. Responsible Acceptance Pe,rson Name: Responsible Acceptance Person Signati Responsible Acceptanite Person Company Name; Po&ition with Company (Titie): Address: U07i 4/ aty/State/Zip; Phone: , CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 1 of 3) Enforcement Agency: ProjectAddress: _ § 1 ^ t ' Zip Code: imAtomeofldentlficatMn/Tig: . / i . . Syftem tiicatlon orArea Served; Note; Submtt one Certificate ofAcceptance for each system that must demonstrate compliance. Enforcement Agency IJse; Checked by/Date A. Constructton Inspection 1. Supporting documentation needed to perform test Includes: 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.4Air Economizer Controls Acceptance At-A- Glance). b. 2013 Bullding Energy Effidency Standards. Instrumentation to perform test includes: Hand-held temperature probe Calibration Date: {/B^^I^ (must be within last year) b. Device capable of calculating enthalpy Calibration Date: (must be within last year) c. 1.2 k Ohm Resistor (when specified by the manufacturer) 3. Installation: (all of the following boxes should be checked) Economizer high limit shutoff control complies with Table 140.4-B found in the 2013 Building Energy Efficiency Standards Section 140.4(e)3. ill Economizer reliability features are present per 2013 Building Energy Effidency Standards Sectton 140.4(e)4: a. 5-year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product speciflcation sheet proving compliance with AMCA Standard 500 damper leakage at 10 cfm/sf at 1.0 in w.g. A product speciflcation sheet showing the manufacturer's results after following the testing procedures of AMCA Standard 500 or AMCA certification by a third party under AMCA Publication 511 can be used to satisfy this requirement (Class lA, 1, and 2 are acceptable). d. If the high limit setpoint is fixed dry-bulb or fixed enthalpy + fixed dry-bulb then the control shall have an adjustable setpoint e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: 1. Drybulb and wetbulb temperatures accurate to ±2°f overthe range of 40''F to SO'F ii. Enthalpy accurate to ±3 Btu/lb over the range of 20 Btu/lb to 36 Btu/lb lii. Relative humidity (RH) accurate to ±5% over the range of 20% to 80% RH f. Check that the sensor performance curve(5) is provided by the factory and sensor output values measured during sensor calibration are plotted on the performance curve(s) g. Sensors used for high limit control shali be located to prevent false readings. Including but not limited to being properly shielded from direct sunlight. Q Unitary systems with an economizer have control systems, including two-stage or electronic thermostats, that cyde compressors off when economizers can provide partial cooling • System has retum fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. 0 For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. G For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Effidency Standards - 2013 Nonresidential Compilance June 2014 STATE OF GALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 06/14) CALIFORNIA Et^ERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) E ntorcem a nt Age ncy: ProjectAddress: City: System Name or identfflcation/Tag: System Lication or Area Senred: B. Functional Testing Results Step 1: Disable demand control ventilation systems (if applicable) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fufly open. Verify the following; 3- Economizer damper modulates 100% open. Return air damper modulates 100% closed. ^/N c. For systems that meet the criteria of 2013 Building Energy Efficiency Standards Section 140,4(e)l, verify that the economizer remains 100% open with the use of mechanical cooling. This occurs when the cooling demand can no longer be met by the economizer alone. ^- All applicable fans and dampers operate as intended to maintain building pressure. ^/N The unit heating is disabled (if applicable). l^'/N/NA Step 3: Disable the economizer and simulate a cooling demand. Verify the following: 3- Economizer damper closes to its minimum position. ^/N ^- All applicable fans and dampers operate as intended to maintain building pressure. ^- The unit heating Is disabled (if applicable). tc^/N/NA Step 4: If the unit ts equipped with heating, simulate a heating demand and enable the economizer. Verify the following: a- Economizer damper closes to Its minimum position. (j)fN/m b. Return air damper opens. (j)fH/HA Step 5: Turn off the unit and verify the foilowing: a. Economizer damper closes completely. Step 6: System returned to Initial operating conditions ;_V)/N C. Testing Results PASS / FAIL Step 2: Simulate cooling load and enable the economizer (all answers are Y). P Step 3: Simulate cooling load and disable the economizer (all answers are Y). Step 4; Simulate heating demand and enable the economizer (all answers are Y). P Step S: Tum off the unit (all answers are Y). Evaluation: PASS: All Construction Inspection responses are complete and all Testing Resutts responses are "Pass" Notes: CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE I CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Enforcement Agency: Permit Number: ProjectAddreui >. . ^. K^'^V^^''^ Zip Cade: —. System Naine or Identifidtb^^ag: . System Location or Area Senred: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name; Documentation AuthorSlgnature; Documentation Author Company Name; Date Signed: Address: ATT Certification Idendfkatlon (If applicable): City/State/Zip; Phone: FIELD TECHNICIAN'S DECURATION STATEMENT 1 certify the following under penalty of perjury, under the laws of the State of California: 1. The Information provided on this Certificate ofAcceptance is true and correct. 2. I am the person who performed the acceptance veriflcation reported on this Certificate ofAcceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements Indicated in the plans and spedfications approved by the.enforcement agency, and conforms to the applicable acceptance requirements and procedures spedfied In Reference Nonresidential Appendix NA7. 4. I have conflrmed 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 pennlt(5) issued forthe building. Reld Technician Name: Field Technician Signaturo; Fleld Technidan Company Name: Position with Con-ipany (Tltte| Address: ATT Certification Identification (if applicable): Clty/State/Zlp: Date Signed; RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California; 1 am the Field Technidan, 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. I am eligible under Division 3 ofthe Business and Professions Code In the applicable classification to accept responslblllty for the system design, construction or installation of features, materials, components, or manufactured devices forthe scope ofwork identified on this Certlflcate of Acceptance and attest to the declarations in this statement (responsible acceptance person). The Information provided on this Certlflcate ofAcceptance substantiates that the construction or installation identifled on this Certlflcate 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 NA7. ! have conflrmed that the Certificate(s) of Installation for the construction or Installation identifled on this Certificate of Acceptance has been completed and is posted or made available with the building permlt(s) issued forthe building, I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permlt(s) Issued for the building, and made available to the enforcement agency for all applicable Inspections. I understand that a signed copy ofthis Certificate ofAcceptance is required to be included with the documentation the buljjjer jDrovidesjo^ building owner at occupancy. Responsible Acceptance Pe,rson Name: &nu Msma- r I ' A A Responsible Acceptance Person Signatiire: Responsible Acceptance Per^n Company Name Position with Company (Title); Address; CSLB Ucense: City/state/zip: Phone; ^ ^^in\ b/^^ji ^ CA Bullding Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-OS-A (Revlaed 06/14) CAUFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (PagelofS) Enforcement Agency: Permit Number: Project Address: _ SkstemNimeorldentHicitldn/raK: i n ZipCode: System Location orArea Senred: Note; Submit one Certificate ofAcceptance for each system that must demonstrate compliance. Enforcement Agency IJse; Checked by/Date A. Construction Inspection 1. Supporting documentation needed to perform test Indudes: 2013 Building Energy Effidency Standards Nonresidential Compliance Manual (NA7.5.4 Air Economizer Controls Acceptance At-A- Glance). b. 2013 Building Energy Effidency Standards. 2. Instrumentation to perform test includes: Hand-held temperature probe Calibration Date; ) /9^j/(must be within last year) b. Device capable of calculating enthalpy Calibration Date: (must be within last year) c. 1.2 k Ohm Resistor (when specifled by the manufacturer) Installation: (all of the following boxes should be checked) Economizer high limit shutoff control complies with Table 140.4-B found In the 2013 Bulldlng Energy Effidency Standards Section 140.4(e)3. • Economizer reliability features are present per 2013 Building Energy Efficiency Standards Section 140.4(e)4: a. 5-year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product speciflcation sheet proving compliance with AMCA Standard 500 damper leakage at 10 cfm/sf at 1.0 in w.g. A product specification sheet showing the manufacturer's results after following the testing procedures of AMCA Standard 500 or AMCA certiflcation by a third party under AMCA Publication 511 ean be used to satisfy this requirement (Class lA, 1, and 2 are acceptable). d. Ifthe high limit setpoint Is fixed dry-bulb or fixed enthalpy + fixed dry-bulb then the control shall have an adjustable setpoint e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: i. Drybulb and wetbulb temperatures accurate to ±2*F over the range of 40*F to 80'F 11. Enthalpy accurate to ±3 Btu/lb over the range of 20 Btu/lb to 36 Btu/lb iil. Relative humidity (RH) accurate to ±5% over the range of 20% to 8054 RH f. Check that the sensor performance curve(s) Is provided by the factory and sensor output values measured during sensor calibration are plotted on the performance curve(s) g. Sensors used for high limit controt shall be located to prevent false readings, induding but not limited to being properly shielded from direct sunlight. • Unitary systems with an economizer have control systems, Induding two-stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling n System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization In full economizer mode. • For systems with DDC controls, sensor used for economizer lockout has been factory or fleld calibrated. • For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) Enforcement AgerKy: Permit Number: ProjectAddSus: ^ 1 ' City: Zip Code: System Name or tdentiflcatlor^ag: System Utcatlon or Area Served: B. Functional Testing Results Step 1: Disable demand control ventilation systems (if applicable) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open. Verify the following: 3- Economizer damper modulates 100% open. tl- Return air damper modulates 100% closed. c. For systems that meet the criteria of 2013 Building Energy Efficiency Standards Section 140.4(e)l, verify that the economizer remains 100% open with the use of mechanical cooling. This occurs when the cooling demand can no longer be met by the economizer alone. (£YyN d- Atl applicabte fans and dampers operate as Intended to maintain building pressure. C^/N e. The unit heating is disabled (if applicable). 0/H/NA Step 3: Disable the economizer and simulate a cooling demand. Verify the following: ^- Economizer damper closes to Its minimum position. ^/N b. All applicable fans and dampers operate as Intended to maintain building pressure. The unit heating Is disabled (If applicable). b^/N/NA Step 4: If the unit is equipped with heating, simulate a heating demand and enable the economizer. Verify the following: a- Economizer damper doses to its minimum position. ^/N/NA b. Return air damper opens. (^r'/N/NA Step 5: Tum off the unit and verify the following: a. Economizer damper doses completely. <^ Step 6: System returned to Initial operating conditions CJ/N C. Testing Results PASS / FAIL Step 2; Simulate cooling load and enable the economizer (all answers are Y). P Step 3: Simulate cooling load and disable the economizer (all answers are Y). Step 4: Simulate heating demand and enable the economizer (all answers are Y). r Step 5: Turn off the unit (all answers are Y). 2 Evaluation : PASS: Alt Construction Inspection responses are complete and atl Testtng Resutts responses are "Pass" Notes: CA Building Energy Effldency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Enforcement Agency: Permit Number: ProjectAddrsji f-) , iV >fvwr«j^ Zip Code: j%. System Name or (dentlfliltlt|«frag; . System Location or Area Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. 1 certify that this Certificate ofAcceptance documentation is accurate and complete. Documentation Author Name; Documentation Author Signature: Documentation Author Company Name: DateSigned: Address: ATT Certification Identffica^on (If applicable}; Ctty/State/Zip; Phone; FIELD TECHNICIAN'S DECURATION STAHMENT I certify the fotlowing under penalty of perjury, underthe laws ofthe State of California: 1. The information provided on this Certlflcate of Acceptance ts true and correct. 2. I am the person who performed the acceptance verification reported on this Certificate ofAcceptance (Field Technician). 3. The construction or Installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and spedfications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified In Reference Nonresidential /Vppendix NA7. 4. I 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 bullding permit(s) Issued for the building. Field Technician Name: Field Technician Signature; Fleld Technician Company Name: Position with Company (Titlep Address; ATT Certification Identification (If applicafale): ^/l^-//5' City/State/Zlp: Phone: Date Signed; RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the taws of the State of California: I am the Field Technician, or the Fleld Technician Is acting on my behalf as my employee or my agent and I have reviewed the Information provided on this Certificate ofAcceptance. I am eligible under Division 3 of the Business and Professions Code In the applicable classiflcation to accept responsibility for the system design, construction or Installatian of features, materials, components, or manufactured devices for the scope of work identified on this Certificate ofAcceptance and attest to the declarations In this statement (responsible acceptance person). The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate ofAcceptance complies with the acceptance requirements Indicated In the plans and spedfications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified In Reference Nonresidential Appendix NA7. I have confirmed that the Certlflcate(s) of Installation for the construction or Installation identified on this Certificate ofAcceptance has been completed and is posted or made available with the building permit(s) Issued for the bulldlng. I will ensure that a completed, signed copy of this Certificate of Accepta nee 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 ofthis Certificate ofAcceptance is required to be included with the documentation the bul|i^er ^ovidesjo tfc^ building owner at occupancy. Responsible Acceptance Pei^n Name: Responsible Acceptance Person Signature: Responsible Acceptani^e Person Company Name:, Position with Company (Title): Address; CSLS Ucense: aty/State/Zip: Date Signed: CA Building Energy Effldency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFOFTNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 06/14) CAUFORNIA ENERGY COMMISSION . CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page lof 2) Project Nrfta: . y . I X^O^ ( ( MiJA/iyfA Entorcement Agency: Permit Number Protej^ Address: y-. * - . Zip Code: System Nam«orldentification/ra|: Syftem Location or Area Served: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agancy Use: Checked by/Date Intent: Verify that systems required to employ demand Controlled ventliation (refer tc §121(c)3j can vary outside ventilation fiow rates based on maintaining interior carbon dioxide (COJ concentration setpoints Construction Inspection Instrumentation to perform test may Indude, but not limited to; a. Calibrated hand-held CO^ analyzer b. Manufacturer's calibration kit ^j^^rtalibrated CoVair mixtures Installation • The sensor is located in the high density space between 3ft and 6 ft above the floor or at the antidpated level of the occupants' heads. Documentation of all carbon dioxide control sensors includes (check one of the following); a. Calibration method Factory-calibration (certificate calibration cert must be attached) ° Field calibrated b. Sensor accuracy • Certified by manufacturer to be no more than •*•/- 75 ppm calibration cert must be attached A. Functional Testing Results a. Disable economizer controls b. Outside air CO^ concentration (measured dynamically using CO^ sensor) ppm c. Interior CO^ concentration setpoint (Outside CO^ concentration + 600 ppm) DBm Step 1: Simulate a signal at or silghtly above the CO' setpoint or foltow manufacturers recommended testing procedures. • For single zone units, outdoor air damper modulates opens to satisfy the total ventilafion air called for In the Certlflcate of Compilance. • For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone ventilation requirements. Step 2: Simulate signal welt below the CO' setpoint or follow manufacturers recommended procedures. o For single zone units, outdoor air damper modulates to the destgn minimum value. a For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone ventilation requirements. Step 3: System returned to Initial operattng conditions S. Testing Results IPASS J FAIL a Step 1; Simulate a high CO^ load (check box complete) • Step 2: Simulate a low CO^ load (check box complete) G. Evaluation: PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass n CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 2 of 2) Project Nanie: , . yy^ i Enforcement Agency: . Permit Number: ProiectAddreJs: . . /"^ | Zip Coda: System Name or idendncatlon/Tag: System Location orArea Served: DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. I certify that this Certlflcate ofAcceptance documentation is accurate and complete, Documentation Author Nami fWkty\ ^^^f^ Documentation Author Signati Documentatton Author Company Nai Address: City/State/Zlp: Phone: FIELD TECHNICIAN'S DECURATION STATEMENT I certify the following under penalty of perjury, underthe laws ofthe State of California: The information provided on this Certificate ofAcceptance Is true and correct. 1 am the person who performed the acceptance verification reported on this Certlflcate ofAcceptance (Field Technician). The construction or installation identifled on this Certlflcate ofAcceptance complies with the applicable acceptance requirements Indicated In the plans and speciflcations approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified In Reference Nonresidential Appendix NA7. I have conflrmed that the Certlflcate(s) of Installation forthe construction or installation identified on this Certificate ofAcceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the buiiding permit(s) issued forthe building. Slgnature;^:^^ ^/>^ Fieid Technician Name: Field Technician Sil Field Technician Company Name; Position with Company (Title); ATT Certification Identification (if applicable); City/State/Zlp: Phone: Date Signed;. RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: I am the Field Technician, or the Field Technidan is acting on my behaif as my employee or my agent and 1 have reviewed the Information provided on this Certificate ofAcceptance. 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 ofAcceptance and attest to the declarations in this statement (responsible acceptance person). The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate ofAcceptance complies with the acceptance requirements Indicated in the plans and spedfications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures spedfled in Reference Nonresidential Appendix NA7. I have confirmed that the Certlficate(s) of installation for the construction or Installation Identified on this Certificate of Acceptance has been completed and Is posted or made avaitable with the building permlt(s) issued forthe building. I will ensure that a completed, signed copy ofthis Certificate of Acceptance shall be posted, or made avaitable with the buildtng 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 ofAcceptance is required to be Included with the documentation the builder provides to the building owner at occupancy. ^ XiX) X^X^r Responsible Acceptance Person Kimt-.^j^^^ ^7n' 5. Responsible Acceptance Person SIgnatui Responsible Acceptance Person Cdfnp^y Nam j/l/iJmani^l I Position with Company (Title): Address; CSLB Ucense; City/State/Zlp; Phone; Date Signed: CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFOfVJlA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Controt Ventilation Systems Acceptance (Page lof 2) ProjenNdte: . y 1 Vio ffVi ( DM; : ( .M\)A/iy^^ Enforcenwit Agency: Permit Number: Zip Code: S^tem Name or Ideiftificatton/Tag: System Location orArea Served: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use; Checked by/Date Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use; Checked by/Date Intent: li'en;^' t/iot systems required to employ demand Controlled ventilation (refer to §121(c)3) can vary outside ventilation flow rates based on maintaining interior carbon dioxide (COJ concentration setpoints Constructton Inspection Instrumentation to perform test may Include, but not limited to: a. Calibrated hand-held CO^ analyzer b. Manufacturer's calibration kit ^^ftallbrated COValr mixtures Installation • The sensor Is tocated in the high density space between 3ft and 6 ft above the floor or at the antidpated level ofthe occupants' heads. Documentation of all carbon dioxide control sensors Includes (check one ofthe following): a. Calibration method 13 Factory-calibration (certificate calibration cert must be attached) ° Field calibrated b. Sensor accuracy 13 Certified by manufacturer to be no more than +/- 75 ppm calibration cert must be attached A. Functional Testing Resutts a. Disable economizer controls b. Outside alrCO^ concentration (measured dynamically using CO' sensor) ppm c, Interior CO^ concentration setpoint (Outside CO^ concentration -f 600 ppm) ppm Step 1: Simulate a signal at or slightly above the CO' setpoint or follow manufacturers recommended testing procedures. • For singie zone units, outdoor air damper modulates opens to satisfy the total ventilation air called for in the Certlflcate of Compliance. • For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone ventilation requirements. Step 2: Simulate signal well belowthe CO' setpoint or follow manufacturers recommended procedures. • For single zone units, outdoor air damper modulates to the design minimum value. • For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone ventilation requirements. Step 3: System returned to Initial operating conditions a. Testing Results C^RASi-? FAIL • Step 1: Simulate a high CO' load (check box complete) • Step 2: Simulate a low CO^ load (check box complete) C. Evaluation: PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CAUFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 2 of 2) ProjectNe.^^^^ ^ Enforcement Agency: Pemnit Number: ProlectAddress: i . " l'?>4^^> YaiA4yfM\^ \/Aj\AJy Zip Code: System Name or [denllficatlorVTag; System Location orArea Served; DOCUMENTATION AUTHOR'S DECURATION STATEMENT 1. I certify that this Certifteate ofAcceptance documentation is accurate and complete Documentation Author Nam, Docunnentation Author Signati Docu mentation Author Company Nai Date signed: ATT Certification id(ntlflcatlAn (If applicable): Clty/State/Zlp:, Phone: FIELD TECHNICIAN'S DECURATION STATEMENT i certify the following under penalty of perjury, under the laws of the State of California: The information provided on this Certificate of Acceptance is true and correct. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technidan). The construction or installation identified on this Certificate ofAcceptance compiles with the applicable acceptance requirements indicated In the plans and specifications approved by the enforcement agency, and conforms to the applicabie acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT. 1 have confirmed that the Certlflcate(s) of Installation for the construction or installation identifled 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 bullding. Field Technician Name; Field Technician Signature;'' Field Technidan Company Name; Position with Company (Title); Address; ATT Certification identification (if applicable); aty/State/Zip: Phone: Date Signe: RESPONSIBLE PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, underthe taws ofthe State of California: 1. lam 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 ofAcceptance. 2. lam eligible under Division 3 of the Business and Professions Code in the applicable dassiflcation to accept responsibtltty for the system design, construction or installation of features, materials, components, or manufactured devices for the scope ofwork identified on this Certifleate ofAcceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certlflcate of Acceptance substantiates that the constnjction 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 confonns to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT. 4. I have conflrmed that the Certlflcate(s) of Installation forthe construction or installation Identified on this Certlflcate ofAcceptance has been completed and is posted or made available with the building permit(s) issued for the bullding. 5. I wlll ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permlt(s) Issued forthe building, and made available to the enforcement agency for all applicable Inspections. 1 understand that a signed copy ofthis Certificate of Acceptance is required to be Included with the documentation the builder provides to the bullding owner at occupancy. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-Oe-A (Revliied 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page lof 2} Project NIJM: I y . /—• 1 Enforcement Agency: Permit Number; ZipCode: System Name or Ideifuncatton/Tag: _ . _ System location or Area Served: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use; Checked by/Date intent: Verify that systems required to employ demand Controlled ventilation (refer to §121(c)3) can vary outside ventilation fiow rates based on maintaining Interior carbon dioxide (COJ concentration setpoints Constructton Inspection 1 instrumentation to perform test may Include, but not limited to; a. Calibrated hand-held CO^ analyzer b. Manufacturer's calibration kit ^^tallbrated COVair mixtures Installation o The sensor is located in the high density space between 3ft and 6 ft above the fioor or at the anticipated level of the occupants' heads. Documentation of all carbon dioxide control sensors indudes (check one of the following); a. Calibration method Factory-calibration (certificate calibration cert must be attached) ° Field calibrated b. Sensor accuracy • Certified by manufacturer to be no more than +/• 75 ppm calibration cert must be attached A. Functional Testing Results a. Disable economizer controls b. Outside air CO^ concenti-ation (measured dynamically using Co' sensor) Dom c. Interior CO^ concentration setpoint (Outside CO^ concentration + 600 ppm) ppm Step 1: Simulate a signal at or slightly above the CO' setpoint or follow manufacturers recommended testing procedures. • For single zone units, outdoor air damper modulates opens to satisfy the total ventilation air called for In the Certjflcate of Compliance. • For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone ventilation requirements. Step 2: Simulate signal well below the CO^ setpoint or follow manufacturers recommended procedures. • For single zone units, outdoor air damper modulates to the design minimum value. • For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone ventilation requirements. Step 3: System returned to Initial operating conditions C£»N B. Testing Results PASi FAIL • Step 1: Simulate a high CO^ load (check box complete) • Step 2: Simulate a low CO^ load (check box complete) C. Evaluation: PASS; All Construction Inspection responses are complete and all Testing Results responses are "Pass" CA Bullding Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAUFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 2 of 2) ProjectNarj^^^ Enforcement AgerKy: Permit Number: ProjectAddress: ;— . " Vh*y6 "PzPl/l4y5bTA \yAAAJj P^^AiP\ Zip Code: SwteniNameorldenfaf[cBtIan/Tag: . ^ System Location or Area Sen/ed; DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. Icertlfythat this Certificata ofAcceptance documentation is accurate and comptete. y^ y^y^D Documentation Author NatnetV i I Documentation Author slgnaturi; /// ^--^ y''Jt' / :^Ay >Cr^ DocumentatiDn Author Companv NBT^^I^ / *^L^ ^ ^DateSigned: ^.^^f^^ Cf ^ ATT Certification ld<ntificat^n(ifapplicable): *— FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the fotlowing under penalty of perjury, under the laws of the State of California: The Information provided on this Certlflcate ofAcceptance Is true and correct. I am the person who performed the acceptance veriflcation reported on this Certlflcate of Acceptance (Field Technician). The construction or installation identified on this Certificate ofAcceptance 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 spedfled in Reference Nonresidential Appendix NA7, I have conflrmed that the Certificate(s) of Installation for the construction or Installation klentified 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 permlt(s) issued forthe bulldlng. Fieid Technician Name; Field Technician Signature:' Field Technician Company Name: Position with Company (Titlo); Address: ATT Certification Identification (if applicable); City/state/zip; Date Signed' RESPONSIBU PERSON'S DECURATION STATEMENT I certify the following under penalty of perjury, under the laws ofthe State of California: 1 am the Fteld Technician, or the Field Technidan is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certificate ofAcceptance. 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). The information provided on this CerUficate of Acceptance substantiates that the construction or Installation identified on this Certificate of Acceptance complies wtth the acceptance requirements indicated in the plans and spedfications approved by the enforcement agency, and conforms to the applicabte acceptance requtrements and procedures specifled in Reference Nonresidential Appendix NA7. I have confirmed that the Certiflcate(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 forthe building; I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) Issued for the building, and made avaitable to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be induded with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Slgnatuii: Responsible Acceptance Person Name; \tuit r Responsible Acceptar\ca Person£ PosiUon with Company fTitle); CSIB Ucense: Cfty/State/Tip: Date Signed; CA Building Energy Effidency Standards - 2013 Nonresidential Compliance June 2014 beatilaiDr Thefirst name in fireplaces Model(s): NDV3630, NDV3933, NDV4236, NDV4842, NDV3630I, NDV3933I, NDV4236I, NDV4842I, NDV3630L, NDV3933L, NDV4236L, NDV4842L, NDV3630iL, NDV3933IL, NDV4236IL, NDV4842IL Owner's Manual Installation and Operation GAS-FIRED cy^us LISTED NOTICE DO NOT DISCARD THIS MANUAL Important operating and maintenance instructions included. Read, understand and follow these instructions for safe installation and operation. Leave this manual with party responsible for use and operation. A WARNING: If the information in these instructions is not followed exactly, a fire or explosion may result causing property damage, personal injury, or death. DO NOT store or use gasoline or other flam- mable vapors and liquids in the vicinity ofthis or any other appliance. What to do if you smell gas - DO NOT try to light any appliance. - DO NOT touch any electrical switch. DO NOT use any phone in your building. - Immediately call your gas supplier from a neighbor's phone. Follow the gas suppli- er's instructions. - If you cannot reach your gas supplier, call the fire department. Installation and service must be performed by a qualified installer, service agency, orthe gas supplier. A WARNING HOT SURFACES! Glass and other surfaces are hot during operation AND cool down. Hot glass will cause burns. • DO NOT touch glass until it is cooled NEVER allow children to touch glass • Keep children away • CAREFULLY SUPERVISE children in same room as fireplace. Alert children and adults to hazards of high temperatures. High temperatures may ignite clothing or other flammable materials. • Keep clothing, furniture, draperies and other flammable materials away. This appliance has been supplied with an integral barrier to prevent direct contact with the fixed glass panel. DO NOT operate the appliance with the barrier removed. Contact your dealer or Hearth & Home Technologies if the barrier is not present or help is needed to properiy install one. This appliance may be installed as an OEM installation in manufactured home (USA only) or mobile home and must be installed in accordance with the manufacturer's instructions and the manufactured home construction and safety standard, Title 24 CFR, Part 3280 or Standard for installation in Mobile Homes, CAN/CSA Z240MH, in Canada . Tills appliance is oniy for use with the type(s) of gas indicated on the rating plate. In the Commonwealth of Massachusetts installation must be performed by a licensed plumber or gas fitter. See Table of Contents for location of additional Commonwealth of Massachusetts requirements. Installation and service of this appliance should be performed by qualified personnel. Hearth & Home Technologies suggests NFI certified or factory trained professionals, or technicians supervised by an NFI certified professional. Heatilator • Novus NDV Series • 4055-187 Rev. T • 5/11 D. Optional Components (continued) Model # Description NDV4236 Top/rear direct vent standing pilot, natural gas, 42' framing width, 36" viewing glass NDV4236L Top/rear direct vent standing pilot, L.P. gas, 42" framing width, 36" viewing glass NDV42361 Top/rear direct vent, natural gas, Intellifire ignition system, 42" framing width, 36" viewing glass NDV4236IL Top/rear direct vent, LP gas, Intellifire ignition system, 42" framing width, 36" viewing glass Optional Accessories (shipped separately) WTB36 Traditional brick pattern refractory WHB36 Herringbone brick pattern refractory BC10 Fan motor rheostat control, wall mounted GFK4B Transaxial fan kit GFK4MB Multi-pak of 12 GFK4B transaxial fan kits RCTS-MLT-HTL Remote Controi Kit (SiT valve only) WSK-MLT-HTL Multi-function wall switch (standing pilot or Intellifire ignition, Robertshaw valve only) RC-BATT-HTL Battery operated remote control (standing pilot or Intellfire ignition) RC-SMART-HTL Remote control (requires llOv or prewiring) RCT-MLT-HTL Multi-functional remote: On/Off, high/low flame, room temp., fan speed (standing pilot or Intellifire ignition, Robertshaw valve only) SMART-STAT-HTL Multi-functional remote: On/Off, room temp., thermostat temp., timer (standing pilot or Intellifire ignition) SMART-BATT-HTL Multi-functional remote: On/Off, thermostat temp., timer (standing pilot or Intellfire ignition) DF-DEMI36 Operable Square Decorative Front DF-TRES36 Operable Arch Decorative Front FFDEMI36 Non-operable Decorative Front DFNMESH36 Mesh Front DFNMESH36M Multi Pack of 4 Mesh Fronts Model # Description NDV4842 Top/rear direct vent standing pilot, natural gas, 48" framing width, 42" viewing glass NDV4842L Top/rear direct vent standing pilot L.P. gas, 48" traming width, 42" viewing glass NDV4842I Top/rear direct vent, natural gas, Intellifire ignition system, 48" framing width, 42" viewing glass NDV4842IL Top/rear direct vent, LP gas, Intellifire ignition system, 48" framing width, 42" viewing glass Optional Accessories (shipped separately) WTB42 Traditional brick pattern refractory WHB42 Herringbone brick pattern refractory BC10 Fan motor rheostat control, wall mounted GFK4B Transaxial fan kit GFK4MB Multi-pak of 12 GFK4B transaxial fan kits RCTS-MLT-HTL Remote Control Kit (SIT valve only) WSK-MLT-HTL Multi-function wall switch (standing pilot or Intellifire ignition, Robertshaw valve only) RC-BATT-HTL Battery operated remote control (standing pilot or Intellfire Ignition) RC-SMART-HTL Remote control (requires 110v or prewiring) RCT-MLT-HTL Multi-functional remote: On/Off, high/low flame, room temp., fan speed (standing pilot or Intellifire ignition, Robertshaw valve only) SMART-STAT-HTL Multi-functional remote: On/Off, room temp., thermostat temp., timer (standing pilot or Intellifire ignition) SMART-BATT-HTL Multi-functional remote: On/Off, thermostat temp., timer (standing pilot or Intellfire ignition) DF-DEMI42 Operable Square Decorative Front DF-TRES42 Operable Arch Decorative Front FFDEMI42 Non-operable Decorative Front DFNMESH42 Mesh Front DFNMESH42M Multi Pack of 4 Mesh Fronts 84 Heatilator • Novus NDV Series • 4055-187 Rev. T • 5/11 D. Optional Components (continued) LDS33/LDS46 Decorative Shroud Catalog # A B c D Catalog # in. mm in. mm in. mm in. mm LDS33 36 914 36 914 8.5 216 11 279 LDS46 48 1219 72 1829 8.5 216 11 279 17 in. (432 mm] TCG375 Terra Cotta Cap LDSCP-M Shroud Leg Multipack (not shown) LDS-BV Decorative Shroud Catalog # A B C E E LDS-BV in. 26 12.5 15.5 22 23 LDS-BV mm 660 318 394 533 584 See your Heatilator dealer for a complete listing of optional components. Heatilator • Novus NDV Series • 4055-187 Rev. T • 5/11 85 E. Contact Information beotiiator The first name in fireplaces Please contact your Heatilator dealer with any questions or concerns. For the location of your nearest Heatilator dealer, please visit wvvw.heatilator.com. Heatilator, a brand of Hearth & Home Technologies Inc. 7571 215"^ Street West, Lakeville, MN 55044 vvww.heatilator.com NOTES - NOTICE DO NOT DISCARD THIS MANUAL Important operating • Read, understand and follow • Leave this manual with and maintenance these instructions for safe party responsible for use instructions included. installation and operation. and operalion. This product may be covered by one or more of the following patents: (United States) 5328356, 5601073, 5613487, 5647340, 5890485, 5941237, 5947112, 5996575, 6006743, 6019099, 6053165, 6145502, 6170481, 6374822, 6484712, 6601579, 6769426, 6863064, 7077122, 7098269, 7258116, 7470729 orother U.S. and foreign patents pending. 2000-945 Printed in U.S.A. - Copyright 2011 86 Heatilator • Novus NDV Series • 4055-187 Rev. T • 5/11 heati Convenience and Value Combined Heatilator gas inserts feature advanced technology with the IntelliFire ignition system and controls. The unique front and finish options highlight the realistic and beautiful fire with large flames. These airtight and energy efficient gas metal inserts offer comfort and convenience along with a level of value not offered by wood burning fireplaces. These gas metal inserts are an excellent addition to any home. A new fireplace in four easy steps 1) Measure your existing fireplace 2) Choose your insert 3) Choose your surround 4) Finish with a front Step 1 Measure your existing fireplace We'll need the height, width and depth of the existing fireplace opening to ensure that the proper-sized insert is selected. Distance from Firebox to Mantel N 1 11/ ]\ \ X 1 1 1 Back Width \ Xy " Depth from fronf\l. to back Height from hearth to top of the opening Front Width step 2 Choose your insert There are two main factors to consider when selecting an insert. First consider the height of your existing fireplace opening. You'll want to choose the tallest insert that will fit into your existing fireplace. Second consider how the insert will be used. Do you have a large room, do you want a lot of heat or a little, and how long do you plan to run the fireplace? These answers will direct you to the insert that is ideal for you and your home. NDI30 • Min. fireplace opening: 19-1/8" high • Ideal size for smaller firebox openings • 32,000 Btu/Hr input (NG) • 6 oak-style logs NDi35 • Min. fireplace opening: 22-3/4" high • Ideal size for larger firebox openings • 35,000 Btu/Hr Input (NG) • 6 oak-style logs Step 3 Choose your surround To bring a finished and polished look to your new insert, you need a matching metal surround to cover the gap between the insert and your existing fireplace opening. Offered in three fixed, non-adjustable sizes and two color options including black and bronze you're sure to find the perfect fit for your space. SURROUND NDI35 NDI30 Small 42- X 29" 40- X 27" Medium 44" x32" 42" X 30" Large 48" X 32" 44" X 32" I Small r-t Medium r-i Large Surround Sunound Sunound Step 4 Finish with a front Complete your insert with a stylish front, available in two finishes. Front Finishes Firescreen i f>J?4T<rr,l>vi I • Bronze Cabinet Optional Refractory Upgrade steel Refractory Kit Our exclusive, state-of-the-art IntelliFire ignition system reduces gas consumption and thermogenerator wear by providing a pilot flame only when needed. It also supplies a back-up battery system to run the fireplace during a power outage. IntelliFir^^ TotalRemote This remote control effortlessly manages heat output and comfort level. For fireplaces and Inserts. Models: RCTS-MLT-HTL Features: Hardwired Receiver, Timer Mode, Thermostat Mode, Room Temperature Readout, Flame Higli/Low, Fan Speed, On/Oft SmartRemote An added level of function and convenience in a remote control. For fireplaces, stoves, inserts, and gas logs with or without line power. Models: SMART-BATT-HTL, SMART-STAT-HTL Features: Battery-Powered or Hardwired Receiver, Timer Mode, Thermostat Mode, Room Temperature Readout, On/Off E-x(:P|)li(jn<sl Vnluo L3c'pr;nclnljility Mosl Fi('c:ocjnize(l Brnnd Technical Specifications FRONT WIDTH BACK WIDTH BTU/HR INPUT UNIT MINIMUM MINIMUM MINIMUM MINIMUM VIEWING AREA FIREBOX OPENING FIREBOX OPENING FIREBOX OPENING FIREBOX OPENING NDI35 34-5/8 33-1/4 23-1/2 24 24 22-3/4 15-1/8 15-1/8 31-5/8x15-3/4 35,000 - 26,000 NDI30 30-1/2 29-1/4 20-1/4 20-1/2 20-1/2 19-1/8 14-5/8 13-7/8 27-1/2x12-7/8 32,000 - 25,000 Minimum firebox openings are for D surrounds. For all other surrounds, add 1 -3/8" to the minimum height and width and 7/8" to the depth. Top View 7 E Side View MODEL A B C D E F G NDI35 23-1/2 34-5/8 31-5/8 15-3/4 24 21-1/8 15-7/8 NDi30 20-1/4 30-1/2 27-1/2 12-7/8 20-1/2 17-5/8 14-5/8 Models Available MODI 1 B'lU'l IF^ INPUFiNCi Ol'l NINf. r.i/t Vl NTINCl K'iNirioN SY;;i[ M 1 UFl NDI35 35,000 - 26,000 33-1/4 X 22-3/4 Direct Vent IntelliFire or standing Pilot NG (standard) / LP* NDI30 32,000 - 25,000 29-1/4 X 19-1/8 Direct Vent IntelliFire or Standing Pilot NG (standard) / LP* 'Order a conversion Iclt when using LP U.S. Efficiencies steady State - Since most homeowners use their fireplaces for an extended time while they are in the room, Steady State measures how efficiently your fireplace converts fuel to heat once it is warmed up and running in a "steady state". AFUE - AFUE rating is more typically used with appliances, like your furnace, that continually cycle on and off to maintain a constant temperature. Canada Efficiencies EnerGuide (CSA P.4.1-02) - EnerGuide is a rating used in Canada to measure annual fireplace efficiency Rating NDI30 NDI35 Steady State 84.1% 78.5% AFUE 73.2% 73.5% Rating NDI30 NDI35 EnerGuide (CSA P.4.1-02) 72.7% 72.2% Available From heatilator Limited Lifetime Warranty' Tl'.c '.Ironqr-.t TI VM: uKlustry, HiMiilatcii -yiVJ'dr', J I'lnitcd hii-lmir vj.iiuiiily on q<i:-,-lHirIIKHI piddUf Is ol lh Pi^i' .t i'iv,)(Ml,tiM ,pi'l.l •• 'iirliox aiKl \ iviiiqi'f //'';•;"'." s / / 'l'l '\ -I I ' ' I 111 • intuMii.ilinii [noviilrd in Ul!'-. Iiti'i. ill i'i> IS lor [)l:ui[inicj |>iii [)o;-.i'S oiiiy ,iM J MiL'N •< 1 tn < \i,.ini]r PU\iM • ( oii^iult 1915 West S,.tuncl(MS Sttoc-t '"M.-ilkitiofi ir.,uui.ii tor .Klual •iisl.ilialinn Arln,il Mt. Ploasnnt. Iowa 52641 ''^'^"'"•^ appo,it,iM< r- -n.iy d,it,T f-om produci mi.Kirs ,i ., . r'.)[ tiili'.v.iri.uitv ilf'l.irK. (]<; In tio.itil,il(ir i,(Mii 800-927-6841 ho.itilator.com ' ENERGIUIDE HIL I()6l!U 0910 CV VLVUS LISTED Stainless Steel Natural Gas Grill | Caster l^ounted Series i Barbeque Grills I Belson Outdoors 5/3/13 3:44 PM - 'Your "Outdoor Superitore 1 -800-323-5664 CUTD SfWn S M-F 8:00am - 4:30pm CST Home I Free Catalog | About Us i Contact Us | FAQs | Site Map I Natural Gas Fired Grill Our Stainless Steel PORTA-GRILL® represents a first in state of the art design and technology. It was the first grill of its kind to be both UL Design Certified to ANSI Z83.11-2002 Standard for Gas Food Service Equipnnent and Certified by NSF to ANSI/NSF Standard 4. In addition, its handling weight is only 176 pounds. It folds up in minutes and stacks 4 high for easy storage and transport. Patent# 6,655,374 Features & Specifications Overall Size: 67-5/8"L x 32-5/8"W x 36"h. Folded Height: 17-13/10" Cooking Area: 24" x 60" Shipping Weight: 241 Ibs. Handling Weight: 176 Ibs. NSF Certified. UL Design Certified. 304 Stainless Steel Grill Construction. Powder-Coated Aluminum Frame. Unique Folding Leg System. Stackable - Up To 4 High. 5" Locking Casters with Brakes. Heavy-Duty Nickel-Plated or Stainless Steel Cooking Grates (V4" Round Bars) Stainless Steel Radiant Guards (No Lava Rock Needed) 8 Heavy Wall Stainless Steel Burners. 164,000 BTU's. Air Mixers with Debris Guards. Dual Ignition System (No Matches Needed) Convenient 7-5^" Service Shelf. Propane Gas Fired Grill also available. Model PG-SNGX ® PORTA-GRILL® provides the kind of safety and peace of mind that only a gas grill manufactured to the highest known safety standards can offer! PROFITABILITY CHART! Browse I Weekly Specials Featured Products Buying Guides Barbecue Grills Barbecue Smoker Grills Banquet Tables Benches Bike Racks Bleachers | Grandstands Bus Stop Shelters Canopy Tents Cigarette Receptacles Dimensional Lumber Drinking Fountains Exercise Equipment Fire Rings Flags Floor Matting Food Service Equipment Message Centers Park Benches Park Grills | Camp Stoves Parking Lot Equipment Patio I Cafe Fumiture Pet Products Picnic Tables [Food Quantity Cooking Time Temp 1 Planters Steak, 1" thick 35 8 min. ' H Playground Equipment Steak, 1" thick Pool Furniture 1/2 Chickens 24 40 min. M Sanitation Equipment Burgers, 1/4 Ib. 60 8 min. H Security Sports Equipment Franks 150 5 min. H : Tables Brats 120 12 min. H ; Trash Receptacles Note: All figures are based on a gas grill. Counts and times can vary with size. Umbrellas Universal Access • Brow«»^ Material Concrete http://www.belson.com/pgssng60.htm Page 1 of 2 Stainless Steel Natural Gas Grill | Caster Mounted Series | Barbeque Grills I Belson Outdoors 5/3/13 3:44 PM Fiberglass Thermoplastic Coated Metal I Aluminum | Steel Recycled Plastic Stack Up To 4 Units High 1. Unfold Legs 2. Stand Grill Upright 3. Install Shelf and Tanks T Item Specific Details Available on Linked Model Numbers Below Jl^^lMJ ^Tweet PG-SNG Nickel Plated Cooking Grates PG-SNGX Stainless Steel Cooking Grates Caster Natural Gas (342 Ibs) $3,700.00 Caster Natural Gas (342 Ibs) $3,900.00 PG-SHD 30" Stainless Steel Hood PG ST 30" Steamer Support PG-SPS 30" Steamer Pan Set - 6 Piece (58 Ibs) $575.00 (15 Ibs) $Qrm (17 Ibs) $228.00 (Prices F.O.B. Origin) Some Assembly Required Bulk Inquiry ( Add to Cart } Related Products Super PORTA-GRILL® Barbecue Grills Mesquite / Charcoal Grill Accessories for PORTA-GRILL® Commercial Barbecue Grills PORTA-GRILL® Stainless Steel Trailer Mounted LP Barbecue Grills Pnvtous Produa Copyright and Disclaimer© 1993-2013, Belson Outdoors, Inc. PORTA-GRILL® Barbeque Pit Grill Wood / Charcoal Grill Nva ITOCHJCx Home I Free Catalog | About Us | Contact Us | FAQs | Site Map | Shop Cart 111 North River Road | North Aurora, IL 60542 | (800) 323-5664 | Fax: (630) 897-0573 | sales@belson.com r.'J ET.J. -SS ^tl JiJlu. a«2 t l / f 1 Free Catalog AC,^FTJi-rr.. B LN L J http://www.belson.com/pgssng60.htm Page 2 of 2 Belson Outcioors, Inc. Ill North River Road, North Aurora, IL 60542 Tel 1-800-323-5664 Fax 1-630-897-0573 www.belson.com MANUAL for the ASSEMBLY, INSTALLATION AND OPERATION Of Foodservice Type OUTDOOR GAS GRILL/STEAIVI TABLE/FOOD WARMER IVIODEL NOS. PG-SLP, PG-SLPX, PG-SNG and PG-SNGX GAS-FIRED LISTED NSF FOR YOUR SAFETY If you smell gas: 1. Shut off gas to grill 2. Extinguish any open flames 3. Open hood 4. If odor continues call gas supplier or fire department FOR YOUR SAFETY Do not store or use gasoline or other flammable vapors or liquids in the vicinity of this or any other appliance. An LP cylinder not connected for use shall not be stored in the vicinity of this or any other appliance. A copy of these boxed instructions is to be posted in a prominent location and the instructions are to be followed in the event the grill user or area occupant detects gas odors. ASSEMBLER / INSTALLER: Leave these instructions with the grill. OPERATOR / USER: Read these instructions and keep them accessible for future reference. [MANUAL PART NUMBER 600031] TABLE OF CONTENTS SECTION SUBJECT I GENERAL SAFETY INFORMATION II ASSEMBLY INSTRUCTIONS III CONNECTING LP FUEL CYLINDERS IV SETTING UP STORED UNIT FOR OPERATION V FUEL TYPES VI COOKING CONFIGURATIONS VII LIGHTING INSTRUCTIONS VIII SHUT DOWN INSTRUCTIONS IX USE AND CARE INSTRUCTIONS X COOKING HINTS XI KNOCK DOWN FOR EXTENDED STORAGE XII STORAGE OF LP FUEL CYLINDERS XIII PARTS LIST XIV EXPANDED VIEW XV TROUBLE SHOOTING GUIDE XVI WARRANTY INFORMATION SECTION I - GENERAL SAFETY INFORMATION 1 This section of the manual contains important safety information. Please read the entire manual and follow all pertinent instructions when assembling, installing and operating this appliance. The manual should be retained for future reference. WARNING: Improper installation, adjustment, alteration, service or maintenance can cause property damage, injury or death. Read the installation, operation, and maintenance instructions thoroughly before installing or servicing the equipment. Appliance installation sites should be provided with safety instructions based on information supplied by local fiael suppliers. These instructions are to be posted in a prominent area near the appliance. All installations are to conform to local codes. In the absence of local codes, installation should conform to the National Fuel Gas Code, ANSI Z223.1/NFPA 54, and in Canada the National Gas fnstallation Code, CAN/CGA-B 149.1 or the Propane fnstallation Code, CAN/CGA-BB 149.2. The appliance and its individual shutoff valve must be disconnected from the gas supply piping system during any pressure testing of that system at pressures in excess of Vi psi (3.45 kPa). The appliance must be isolated from the gas supply piping system by closing its individual manual shutoff valve during any pressure testing of the gas supply piping system at test pressures equal to or less than Vi psi (3.45 kPa). Appliances connected to fixed fuel supply piping and provided with casters shall utilize: - gas connectors that comply with the provisions of the Standard for Connectors for Movable Gas Appliances, ANSI Z2I.69 or Connectors for Moveable Gas Appliances, CAN/CGA-6.16 - quick-disconnect devices used must comply with the provisions of the Standard for Quick- disconnect Devices for Use With Gas Fuels, ANSI Z21.4I, or Quick-disconnect Devices for Use With Gas Fuel, CANI-6.9 This appliance is designed for use in a well-ventilated outdoor area only! It is not to be operated inside a building, garage or any other enclosed area. Units with self-contained LP ftiel tanks and caster wheels are intended to be portable for mobile installation. • LP gas cylinders are not to be stored in any parts on the appliance that are not intended for such cylinder storage. Improper storage of cylinders could lead to an explosion, fire and/or personal injury. • LP gasses are heavier than air, tend to pool and collect in low-lying areas, are easily ignited and are highly flammable. Proper care and caution should be employed when dealing with any such fuels. • With the exception of trailer moimted units, do not operate imit with legs or casters removed. Use only casters or legs supplied with appliance. Replacement casters have to be obtained from the manufacturer. • Installations must provide adequate clearance for service and ventilation and combustion air supplies. Do not locate grill closer than 12 inches to non- combustible construction. • Wheels are to be locked to prevent movement of the appliance after positioning for use. Caster wheels are equipped with locking bars. Depressing the locking bars sets the wheel brakes. • The location of the unit and the surrounding area should be kept clear of combustible materials. • Operate the unit only in a ventilated area. Do not obstruct the flow of combustion and ventilation air supplies to the appliance and the fiiel tanks. Do not store or locate items by leaning them against the grill surfaces or on the fiiel tanks. • The appliance should be shut off and all supply valves (on piping or on fiiel cylinders) should be closed in the event that the odor of unbumed gas is detected. Do not attempt to use the unit until any gas leaks are fixed and/or the source of the unbumed gas odor is accounted for. The grease screen trays must be properly installed when operating this unit. In the event of rain or storage of the unit outdoors without optional hoods, remove the grease screen trays and place them on top of the cooking grates. The minimum environmental temperature for safe operation of this appliance is 0, "zero" degrees F, (-18 degrees C). Do not use the grill if the cross over bumers or main bumers fail to light or fail to remain lit. Under such conditions, gas should be shut off. If self-contained fiiel cylinders are involved, they should be disconnected. Do not touch or allow contact with appliance sides after lighting. Unit rear and side surfaces, and all surfaces above bumers are hot during operation and take some time to cool down following use. Allow grill components to cool down before conducting any routine service or maintenance. Use under high wind conditions that result in poor bumer operation such as blowing out and flaring should be avoided. If repositioning the unit does not improve operation under such wind conditions, the unit should be shut off. When unit is in operation, maintain a minimum 12 inches clearance from grill to any non-combustible surfaces and constmction. SECTION II - ASSEMBLY INSTRUCTIONS Congratulations, and thank you for your purchase of this appliance. We are pleased that you have recognized the advantages and value built into this unit. Since we believe that the assembly of this product should not be a chore, this grill has been engineered for easy assembly. We have taken every effort to insure that the instructions for use of this product are easy to follow. Please follow all of the instructions in this manual in order to insure thatyour grill is properly assembled and also to insure that the grill will operate safely. For your convenience we have simplified assembly and setup of this grill to few essential steps by shipping the grill in an almost fiilly assembled state. Please keep in mind that the grill is a commercial foodservice unit and as such was built to last and to be durable. In meeting these design objectives we had to utilize the most suitable materials. As a result, the grill weight is considerable. While weighing less than most similar units, during assembly the grill still requires at least two individuals to uncrate, assemble, set up and handle. Parts Identification And Lavout 1. Each mobile unit consists of a total of (4) cartons. Verify that all components are included. Notify the Customer Service Department at 1-800-323-5664 if it is determined that any components are missing. Carton 1&2 - Horizontal LP Propane Cylinders Carton 3 - Tank Shelf & Brackets Carton 4 - Stainless Steel Grill 2. Remove components from cartons and set parts aside allowing easy access during assembly. Unfold the top and bottom cartons and use as a drop cloth and staging area during assembly to prevent scratching of components. A. Grill - The grill consists of a completely assembled grill body, (2) female quick- disconnects, (2) 30" hoses, (2) regulators, (1) tank shelf, (4) brackets, and (2) horizontal propane cylinders. (See Fig. 1). B. Hood - Optional items provided only if ordered. The hood consists of (1) outer hood half, (1) inner hood half, (2) stanchions (handle ends), (1) handle, (1) clevis pin and (2) hairpins. (See Fig. 2). C. Steamer Pan Support & Pan Set - Optional items provided only if ordered. The steamer pan support consists of (1) support, (1) clevis pin and (2) hairpins. The pan set consists of (2) 4" deep ftill size pans, (2) 2 Vi" deep fiill size pans and (2) flat lids. (See Fig. 3). FIG. 1 FIG. 3 FIG. 4c FIG. 4d GRILL ASSEMBLY 1. To set up grill, lay unit on its backside. Fold legs open to full vertical position. Legs are provided with an integral locking device that will lock legs in place. Lock engagement can be determined by pronounced mechanical click when legs are moved to the proper locked position. Verify that legs are properly positioned and stand grill upright. 2. Insure that main bumers were not dislodged and that they are properly located and pinned on positioning pins at rear end. (See Fig. 4e). Look under control panel. The cross over bumers and main bumers mixer face ends should engage over the orifice hoods. (See Fig. 4d). 3. Insure that radiant guards and cooking grates are properly positioned by verifying that the mounting pins in the rear of the unit are fiilly engaged with hairpins. (See Fig. 4e). 4. Insure that grease screen trays are placed into position. They are properly positioned when the mounting pins in the front of the unit are fully engaged with hairpins. 5. Install (optional) steamer pan support, pans, and cooking hoods if so equipped. Remove cooking grate and install attachment. Re-install cooking grates under hoods only. Use clevis pins and hairpins to properly locate and secure these items. (See Fig. 4a & 4f). Note: Hoods should be locked in place and steamer pans removed prior to transporting unit. 6. For LP units with self-contained fuel cylinders - Have fiiel cylinders filled by a qualified facility. Assemble cylinder shelf by attaching the small brackets to one side of the shelf and the larger brackets to the other side. Set shelf in place between legs with the larger brackets toward the front of the grill (control panel side). Slide filled fuel cylinders onto shelf and fasten to front and back cylinder mounting brackets using steel bolts and wing nuts supplied. (See Fig. 4c). Also see Section III for instmctions regarding handling of fiiel cylinders. Be sure that fuel tanks are properly positioned, oriented, and secured as shown on diagrams. Attach regulator P.O.L. fittings (bull nosed male end with left-handed threads) to the service valves on the cylinders. Flared brass fittings do not require pipe dope on threads. Important: Regulators must be oriented with the breather screen vents pointing downward. Attach female brass socket located at end of flexible gas connector hose over brass quick- disconnect mating plug (located undemeath control panel on either side of the grill). Pull down on socket ring to allow parts to engage. (See Fig. 4b). Test connection by pulling down on it to verify good connection. Unless connection is properly made, there will be no gas flow through the fitting. 7. For units designed to operate on either natural gas or propane gas supplied from fixed fuel supplies - Grills without self-contained grill mounted fuel cylinders. A. Verify that fiiel supply matches type of fiiel indicated on data plate. Gas is to be delivered to the appliance by fuel hoses terminating at a fiiel outlet pipe. Installing a "T" fitting at the outlet is recommended. This will simplify the installation and will require only one supply pipe to fiiel the grill. Providing the fiiel line is an installer responsibility. The manufacturer does not supply ftiel lines as part of the unit. B. Grill is provided with two appliance regulators. These regulators are to be installed on the supply lines on each side of the grill in accordance with the National Fuel Gas Code. C. Any fiiel connection to fixed fiiel supplies shall be made with a connector that complies with the standard for Connectors for Moveable Appliances, ANSI Z2I.69 or Connectors for Moveable Appliances, CAN/CGA-6.16. D. Any fiiel connection to fixed fiiel supplies shall also be made with a quick-disconnect device that complies with the standard for Quick-Disconnect Devices for Use with Gas Fuels, ANSI Z21.41, or Quick-Disconnect Devices for Use with Gas Fuels, CAN-6.9 E. Installer supplies fiiel hoses for connection to fixed fiiel supplies. One end of the hose is connected to the threaded end of the quick-disconnect device socket. The other end is to terminate at the gas supply outlet pipe. Be sure to use thread joint compound in making these thread connections. (The female end of the quick-disconnect device should be the hose termination from the wall gas supply since it incorporates a gas shutoff device.) Gas hose should be routed under the cylinder shelf rack between the unit legs. Gas hose should be routed so as to allow no contact with any hot grill surfaces. F. To get gas to the grill, the quick-disconnect device sockets should be mated with the quick-disconnect device plugs attached to the underside of the grill control panel. Push back on socket ring to allow parts to engage. Test quick-disconnect connection by pulling on it to verify a good connection. (See Fig. 4b). Please note that the socket type end fitting has an integral flow valve. This valve is automatically closed unless the plug is inserted into the socket. This feature prevents gas flow when the fuel hose is not connected to the appliance. Even though the quick-disconnect device has an integral valve, it should not be relied on as a stand-alone valve. This valve feature is intended only as a backup to the regular valve. To be in compliance with most local codes, a listed wall mounted shutoff valve has to be installed at the gas supply outlet pipe. G. Appliance movement shall be limited by use of adequate restraint devices. These devices limit movement of the appliance without depending on the quick-disconnect device or its associated piping. A restraint cable anchor loop is attached to the underside of these units. The other end of the restraint device has to be mechanically attached to a suitable load bearing structure. H. In addition to the restraint devices, the grills are provided with four lockable caster wheels. All wheels should be locked when the unit is connected to fiiel or in place for cooking. Following any relocation of the grill, restraint devices if disconnected, will have to be re-attached and wheel caster locks engaged. I. After all connections are completed and with all valves closed, apply leak check solution (soapy water) to all gas carrying connections and fittings. Open the tank valve. Presence of bubbles at areas of wet solution indicates a gas leak. If leaks are detected or you smell gas, shut off valve and repair leak or replace defective part. Do not use grill until leaks are corrected. THIS SECTION APPLIES ONLY TO LP UNITS FACTORY SUPPLIED WITH PORTABLE LP FUEL CYLINDERS (SELF-CONTAINED LP GAS SUPPLY SYSTEM) 1. Any fuel supply cylinder used must be constmcted and marked in accordance with specifications for propane cylinders of the U.S. Department of Transportation (DOT), or CAN/CSA B339. The appliances variation with self-contained LP gas supply system is to be used only with the 40 pound horizontally mounted vapor withdrawal type cylinder supplied by the manufacturer. Cylinder Model No. PI-40HB (30 inches length, 12 inches diameter). 2. WARNING! The instructions stated on tanks have to be followed when filling or transporting tanks. Failure to do so could result in problems relating to overfilling, excessive venting release of gas and regulator freezing. 3. Do not allow dirt or foreign material to get into P.O.L. connection when it is not attached to the fiiel supply system. 4. Only empty fiiel cylinders are shipped from the factory. Cylinders must be purged of air and filled with propane before initial use. All handling, transport, filling and storage of LP gas cylinders must be in accordance with NFPA 58 Storage and Handling of Liquid Petroleum Gases, or CAN/CGA bl49.2 Propane Installation Code. Cylinders must be suitably tied down during transport. Do not place any other items on top of cylinders at any time. Cylinders are not to be exposed to excessive temperatures or high heat. 5. Propane fiiel cylinders must be securely mounted to tank rack by use of bolts and wing nuts provided by manufacturer. (See Fig. 4c). When installed, outlet end of cylinders is to face the front of the grill (control panel side). The cylinder surface identified by label and marking as "Top" is to be positioned to correspond with the marking. 6. The pressure regulator and hose assemblies supplied by the manufacturer with the appliance by must be used. Replacement pressure regulator and hose assemblies must be those specified by the appliance manufacturer. 7. The regulator/hose assembly should be handled carefully to prevent contamination by foreign objects and dirt. The assembly should be inspected before use and any dirt or contamination should be wiped off. The P.O.L. swivel nut fitting on the regulator/hose assembly is tightened into the corresponding fitting on the tank valve outlet. For safety related reasons the threads on the P.O.L. fitting are left-handed. When properly installed, the regulator vent opening is facing downward. This orientation prevents the entry of any rain into the regulator vent opening. (See Fig. 4c). In order to insure proper operation, any replacement of the fiiel tank regulator assembly has to be done with parts provided by the grill manufacturer. 10 8. Connect the female brass quick-disconnect device located on the other end of the gas hose portion of the assembly into the corresponding male brass receiving part located under the control panel. (See Fig. 4b). The connection is made by pulling down on the brass ring lock on the female end while simultaneously pushing up on the quick-disconnect until the two parts are fiilly engaged. A proper connection will allow the locking ring to click up into position while at the same time opening the valve portion of the connecting device. A bad connection would not allow the valve to open and therefore would result in no gas flow. 9. When all fuel connections are completed, check for leaks. With all valves closed, apply leak check solution (soapy water) to all gas carrying connections and fittings. Open tank valve. Presence of bubbles on wetted surfaces indicates a gas leak. If leaks are detected or you smell gas, shut off fiiel valve and repair leak or replace defective part. Do not use grill until leaks are corrected. 10. If this appliance is to be utilized with a non-self-contained LP-gas supply system, any temporary gas system must be installed in accordance with local codes. In the absence of local codes, the piping system must conform to requirements of ANSI/NFPA 58, Storage and Handling of Liquid Petroleum Gases, or CAN/CGA B 149.2, Propane Installation Code. CAUTION: Pressure regulators are factory set to the correct operating pressures. No attempts should be made by unqualified persons to adjust these settings! SECTION IV - SETTING UP STORED UNIT FOR OPERATION 1 When setting up a unit that was stored in a folded up configuration, follow instmctions as outlined in SECTION II - ASSEMBLY INSTRUCTIONS under steps 1 through 7. For units operating from fixed fiiel systems, it is best to place hoses away from any traffic. If the fiiel supply hose lays on the ground, care should be taken to protect the fiiel supply hose from damage by either foot or vehicle traffic. Protection can be provided to fiiel hoses by lowering them in open trenches or placing them between two boards, which would bear any traffic contact load. Any hose trench should be cleared of sharp edged objects, which could damage the fiiel hose. The boards should be higher than the outside diameter of the ftiel hose. If hoses need to be located behind the grill, they should be routed under the lower leg brace bar in order to prevent possible contact with the hot grill parts. Restraint devices have to be attached to the unit under the grill. SECTION V - FUEL TYPES There are two variations for this product as determined by fiiel usage, LP (liquid propane) and NG (natural gas). The grills are set up and factory configured for either one fiiel or the other. 1. LP fueled version for propane fuel in either: A. Self-contained LP fuel version - stores its own LP fiiel supply in cylinders mounted right under the grill. Designated by the suffix letters LP in the Model No. B. LP version intended to operate from LP supplies piped from a remote source to the grill through regular or temporary piping. See Section II, Item 7. This version does not have self-contained LP fuel cylinders but is equipped with two quick-disconnect devices for attaching fiiel lines from on site LP supplies. Grills equipped for this fiieling option are also designated by the suffix letters LP in the Model No. 2. NG fiieled version designed to operate from a natural gas fiiel supply - designated by the suffix letters NG in the Model No. Grills are equipped with two quick-disconnect devices for attaching fiiel lines to on site natural gas supplies. See Section II, Item 7. Determine the type of fiiel required by checking the Model No. suffix letters on the data plate. Units are factory equipped for use with only one type of fuel and are built to one of the configurations previously identified. These units cannot and should not be used with other fiiel types. Doing so can cause severe damage to the unit, installation area and subjects personnel to the risk of serious injury. Any attempt to operate these units on fuels other than what they were intended immediately voids the manufacturer's warranty. SECTION VI - COOKING CONFIGURATIONS Your grill is available with three different optional cooking configurations: 1. Open top, without cooking hoods or food warmers. 2. With optional cooking hoods that can be attached when needed. (See Fig. 2). 3. With food warmer/steam table option - this feature allows preparation/holding of side dishes at serving temperatures. (See Fig. 3). Any combination of the above options is acceptable. Switching between any of the configurations is simple and requires limited tool usage since the grill has been engineered to allow configuration changes by use of easily removable clevis pins and hairpins. 12 SECTION VII - LIGHTING INSTRUCTIONS 1 1. Before starting grills for use with self-contained LP tanks, check to make sure both tanks are tumed off. For natural gas and LP units operating from a fixed fiiel supply, tum off any gas valves supplying the appliance. Check that all bumer valves are in the off position. 2. Insure that the grill is not located on combustible flooring and is located away from combustible constmction. Keep leaves, grass and other combustible material from the area below the appliance. 3. Insure that the minimum clearance of 12 inches is maintained between unit and non- combustible constmction (side walls and back wall). 4. Inspect unit for any visible damage to grill or fuel piping system. Make sure fiiel lines and any quick-disconnect devices are properly connected. 5. Inspect all fiiel hoses before each use. On evidence of excessive abrasion or wear, these items must be replaced prior to putting the appliance in operation. Any replacement of fiiel hoses will only be done with parts identical to the original equipment provided by the manufacturer. 6. If unit is equipped with hoods, fiilly open hoods before lighting. 7. Make sure that the grease screen trays are properly installed. 8. On LP units with self-contained fuel cylinders, open propane cylinder service valve on first side to be lit. For the first 1/6* of a turn, open service valve very slowly until you hear the manifold pressurize. Once you hear the "pst", you may open the valve as quickly as you like. Opening the valve to quickly during the first 1/6* of a turn will result in the activation of the excess flow limiter in the P.O.L. fitting. This partially restricts the flow of gas and leads to improper grill operation. To reset the safety device (excess flow limiter in P.O.L. fltting), shut off the service valve on the cylinder. Disconnect the regulator and tap the P.O.L. fitting in your hand until the spring loaded translucent ball returns to its proper position against the silver six prong star washer in the end of the fitting. It is common for the safety device to reset itself while disconnecting the regulator. On units operating from fixed fuel supplies open supply valve. 9. Push in and tum on carry over bumer gas supply valve (RED knob) for the side being lit. 10. Push the ignitor (RED) button to activate the piezo electronic spark ignitor. Repeat pushing the (RED) button of the piezo electronic spark ignitor until the carry over bumer is lit. To verify, look through pilot observation hole located near center of each side of the control panel. 13 11. To light individual main bumers; push in and tum on the bumer valve (BLACK) knob for the desired bumer to the high flame position. After main bumer is lit, the flame can be adjusted to desired level by changing position of the bumer valve knob. 12. In the event the appliance fails to light, all valves are to be closed for five (5) minutes in order to vent any accumulated gas. After a five-minute wait, repeat the above lighting procedures. 13. In the event that the piezo elecfronic spark ignitor is damaged, the carry over bumer can be match lit through the observation hole. 14. The match holder provided with this manual should be employed to reach the appliance carry over bumer through the observation hole. 15. If the main bumer flames lift off or float away from bumer surface, if bumers flash-back, or if bumers bum with bright yellow flame of undefined pattem, the main bumer air shutters should be adjusted. (See Fig. 4d). To adjust main burner air shutters remove control panel and disconnect ignitor lead wires. Loosen air shutter adjustment screw on air shutter at bumer end, and with bumers on "HIGH" or fiill flow, slowly close (make opening smaller) air shutters by tuming until yellow tipped flame is observed. Back off air shutters slightly from yellow tipped flame setting, re-tighten air shutter set screw. Repeat this process for all bumers. 14 Individual bumers can be shut off by rotation of the "BLACK" bumer control knob to the off position whenever main bumer use is not required. The small hole above the knob indicates the "Off position. To temporarily shut off the grill's main burners - rotate all bumer controls to the "Off position. In this configuration the bumers re-light on demand since the carry over pilot/bumer will continue to bum. To completely shutoff the grill - for LP units with self-contained tanks - shut off the fiael at the tanks by fully closing the service valve hand wheels on each cylinder. This will allow all gas in the piping system and manifolds to bum off. Insuring that there are no open flames present, remove P.O.L. fittings from tanks. Note: P.O.L. fittings have reverse (left hand) threads. Tum fitting clockwise to disconnect. Install plastic plugs in each service valve to prevent debris entry. To completely shutoff the grill - for units operating from a fixed fiiel supply source - shut off the fuel supply valve. Note: The carry over pilot/bumer may continue to bum for a limited time following fiiel supply shutoff due to bum off of gas accumulated in the gas lines. For all units - after bumers go out, close all main bumer confrol valves and the carry over pilotl5umer valves. WARNING! The quick-disconnect device is not designed to be a substitute for a shutoff valve! For open top models, when grill is shut down but left in place for the next anticipated use, the grease screen trays, #608003 (See Fig. 5) should be placed on top of cooking grates. When grill is in use, this part and the hairpins should be properly installed in the front of the grill. While unit is in storage or during use mode, the grease screen trays are to be secured in place with hairpins provided. Grills equipped with food warmer option and/or hoods do not need to use the grease screen trays as rain shields. 15 • Verify that the grill has been assembled and set up according to instmctions contained in this manual. • Locate the grill on a level installation site that conforms to clearance requirements and to other requirements as indicated throughout this manual and on the appliance markings. • Wheels are to be locked to prevent movement of the grill after positioning for use. Depressing the locking bars down sets the wheel brakes. • Follow lighting and shut down instmctions as contained in this manual and labeled on the front control panel. IMPORTANT! - While operating the grill, periodically inspect the grease collection tray for grease build up. Empty the grease collection tray as needed to avoid any grease spills. • After each use, any accumulated cooking process residue, dirt and soil should be cleaned from grill surfaces, grease screen trays, side deflectors and radiant guards. Grease should be emptied from grease collection trays. • Cleaning hints: 1. Remove optional hoods and/or steam pan assemblies. 2. Remove cooking grates and clean with warm water and detergent by bmshing or scouring with plastic pads. Rinse with clean water and dry. 3. Bumer radiant guards, frame, food warmer trays, and hoods can all be cleaned with warm water and detergent by bmshing or scouring with plastic pads. Rinse with clean water and dry. 4. Bumers and carry over pilot/bumers should not be removed for cleaning by unfrained operators. If cleaning is required, these items can be bmshed to remove dry baked on deposits. • Any grill service, maintenance, or repair must be conducted by the manufacturer, factory authorized representatives, or a qualified local service company. Warranty issue related work can only be conducted by a factory authorized agency. • Any damage to working parts such as bumers, controls, and fuel distribution system should be repaired by authorized and qualified factory representatives before grill is retumed to operation. 16 ^^^^^^^^^^ECTIO^^OOKIN^INT^^^^^^^J The grill can be pre-heated prior to use. Following pre-heat, tum down bumers to lower settings once pre-heat temperatures are reached. For buming sear marks on meat, preheat one or two sections (adjacent bumers) on high setting and use this area for searing and fast grilling. After a short time tum over meat and lay on other side choosing a new area since original area might have cooled down and not leave sear marks. If simuhaneously cooking different types of product, e.g. different thickness cuts, meat with a lot of fat and drippings, vegetables, and lean cuts without fat drippings, designate an area for each type of product. This will give you more consistent results and help to eliminate effects of unexpected grease fire flare-up and the resultant increase in cooking temperatures. Be sure to keep water in food warmer outer (steamer pans) pots. For many foods, there will not be a need to operate main bumers when utilizing food warmers since carry over bumer output can generate adequate heat to maintain food temperature. On grill configurations with one side used as a steam table/food warmer, arrange steamer pans to have the food item with the least heat requirement at the outside since the area nearest the grilling side will be the warmest. In certain outdoor settings, if wind becomes a problem due to velocity, re-position the appliance to minimize the effect of wind and/or take advantage of on site natural windbreaks such as walls, and barriers nearby stmctures. 17 1. Follow shut down instmctions in Section VIII to tum off grill. 2. On grills equipped with self-contained fuel cylinders, remove cylinders. Remove tank shelf / rack for fuel cylinders. 3. Do not store used propane cylinders inside. 4. If multiple units are to be stored or nested together (one on top of the other) food warmer frame and grill hoods need to be removed. It is recommended to stack units a maximum of four high. To prevent loosing small items such as cotter and clevis pins, reinsert them into grill body with hairpins. 5. With proper assistance, place grill on backside. Release leg catches and fold legs. Engage spring latches located undemeath grill body, to hold legs in place. 6. Empty cylinder racks can be set on each other or the grills. Racks with empty fiiel cylinders, if properly secured, or additional grills, can be placed on each other for storage or transport. No more than four units or tank racks should be stored on top of each other at any time. SECTION XII - STORAGE OF LP FUEL CYLINDERS • Insure that grill was shut down and properly configured to the storage configuration. • Propane cylinder valves are to be shut off and the cylinder disconnected when not in use. • Propane cylinders should not be allowed to remain in a high heat area such as a closed car, tmnk, or direct sunlight. • Indoor storage of the appliance is permitted only if the cylinders are disconnected and removed from the appliance. • Cylinders must be stored outdoors in a well-ventilated area and be kept out of the reach of children. • Disconnected cylinders must not be stored in a building, garage, shed, or any other enclosed area. • Protective plastic caps must be installed on the cylinder's valves when storing the cylinders. • See other pertinent instmctions under safety, connecting cylinders, handling of and transport of LP cylinders and grill shut down procedures as stated throughout these instmctions. 18 SECTION XIII - PARTS LIST The manufacturer, or a qualified local service company must conduct Service or repair to the grill. Replacement parts and components should be obtained only from the manufacturer to insure continued safe and proper operation of the grill. For parts replacement, contact the customer service department by telephone at 1-800-323-5664 PARTS LIST PG-SLP/PG-SLPX/PG-SNG/PG-SNGX See FIG. 5 1 Item Part No. Qty. Description 1 600031 1 Instruction Manual 2 PI-40HB 2 Fuel Cylinders - Only With LP Units Utilizing Self-contained Fuel 3A PI-260-00 2 Regulator Assembly 2-Stage, LP Grills Only 3B 602069 2 RV48T-4 Regulator, Natural Gas Grills Only 4 602029 2 Hose, LP Gas - Male 30" x 3/8" 5 602012 2 Quick-disconnect (Socket) 6 602011 2 Quick-disconnect Gas Hose Assembly (Plug) 7 602014 2 Nipple, Black Iron Pipe, x 3" NPT 8 602015 2 Elbow, 'A" NPT, 90 Degree 9 606003 1 Manifold, Right Hand 10 606004 1 Manifold, Left Hand 11 602013 2 End Cap, Ya" NPT 12A 602008 2 Manual Valve, Cross Over Burner, LP (Liquid Propane) Grills Only 12B 602062 2 Manual Valve, Cross Over Burner, NG (Natural Gas) Grills Only 13 602016 2 Red Knob Cross Over Burner 14A 602009 2 Hood Orifice, Propane (Cross Over Tube) 14B 602063 2 Hood Orifice, Natural Gas (Cross Over Tube) 15 600002 2 Cross Over Burner Tube (Runner Arm Burner) 16 PI-211GN 2 Piezo Ignitor Push Button (Red) 17 602002 2 Electrode Assembly 18 600033 1 Match Wand 19A 606011 8 Main Burner Valve - Includes Orifice Hood (Propane) 198 602061 8 Main Burner Valve - Includes Orifice Hood (Natural Gas) 20 602017 8 Burner Knob, Main Burner (Black) 21 602002 8 Bug Guard 22 600001 8 Main Burners, Stainless Steel 23 608025 2 Radiant Guard 24A 600030 2 Cooking Grate, Nickel Plated Steel 248 600029 2 Cooking Grate, Stainless Steel 25 608003 2 Grease Screen Tray 26 608014 2 Deflector Shelf, Side 27 608011 2 Deflector Shelf, Center 28 608018 1 Firebox 29 608013 1 Control Panel 30 600017 4 Control Panel Mounting Bracket 19 Item Part No. Qty. Description 31 600023 2 Wind Guard 32 602003 1 Grease Collection Pan 33 602026 4 Chrome End Stanchion 34 602024 2 Handle, Grill 35 600026 2 Leg Assembly 36 602004 4 Rubber Bumper (1 x 1") 37 602023 4 Casters, 5" With Locks 38 600027 1 Tank Shelf (Optional) 39 600009 2 Cylinder Support Bracket, Rear, LP Grills Only 40 600008 2 Cylinder Support Bracket, Front, LP Grills Only HARDWARE LIST - PG-SLP/PG-SLPX/PG-SNG/PG-SNGX Item Part No. Qty. Description 41 602019 50 Machine Screw Stainless Steel Pan Head, Phillips Vi-20 X .50 42 602020 8 Machine Screw Stainless Steel Pan Head, Phillips %-20 X .625 43 602018 58 Nut-Stainless Steel, Hex Serrated Flange 74-20 44 602022 18 Hairpin, Stainless Steel PARTS LIST PG-SPS & PG-ST - OPTIONAL STEAMER PANS & SUPPORT KIT Item Part No. Qty. Description 45 602082 2 Full Size Lid 46 602003 2 2 y/ Super Pan 47 602083 2 4" Super Pan 48 600060 1 Steamer Pan Support 49 602021 1 Clevis Pin % x 5/8 50 602022 2 Hairpin, Stainless Steel PARTS LIST PG-SHD - OPTIONAL HOOD KIT Item Part No. Qty. Description 51 602076 1 Hood Handle 52 602026 2 Stanchion 53 602019 4 !^-20 x Pan Head Screw 54 602018 4 14-20 Hex Serrated Flange Nut 55 608028 1 Front Hood 56 608029 1 Rear Hood 57 602021 1 Clevis Pin V* x 5/8 58 602022 2 Hairpin Stainless Steel 20 [ SECTION XIV - EXPANDED VIEW 1 21 i: SECTION XV - TROUBLE SHOOTING GUIDE 1 PROBLEM SYMPTOMS POSSIBLE CAUSES SOLUTIONS CROSS OVER BURNER WILL NOT LIGHT NO FLAME ON CROSS OVER BURNER 1. OUT OF FUEL 2. CROSS OVER BURNER NOT LIT 3. WIND TOO STRONG 4. ELECTRODE BROKEN ELECTRODE LEAD BROKEN OR NOT CONNECTED 5. FLAME CARRY OVER BURNER BLOCKED BY DIRT OR DEBRIS 6. CROSS OVER BURNER WARPED 1. FILL TANKS 2. TURN ON SUPPLY VALVE, TRY TO RECONNECT QUICK- DISCONNECT DEVICE WHICH COULD BE ATTACHED INCORRECTLY 3. REPOSITION GRILL 4. REPLACE IGNITOR, ATTACH IGNITOR LEAD 5. USE PRESSURIZED AIR TO BLOW OFF RUNNER ARM, CLEAN BLOCKED PORTS, BRUSH OFF DIRT, OR USE FINE WIRE TO CLEAN PORTS 6. REPLACE WARPED CROSS OVER BURNER MAIN BURNER WILL NOT LIGHT NO FLAME ON MAIN BURNER 1. BLOCKED CROSS OVER BURNER 2. WARPED CROSS OVER BURNER 3. IMPROPER AIR SHUTTER ADJUSTMENT 4. LOW FUEL LEVEL IN TANKS OR TANKS ALMOST EMPTY 1. CLEAN CROSS OVER BURNER 2. REALIGN CROSS OVER BURNER 3. ADJUST AIR SHUTTERS 4. FILL FUEL CYLINDER FLAME ON MAIN BURNER IS NOT CONSISTENT LIFTING AND FLOATING OF FLAME 1. DIRT ON BURNER PORTS 2. AIR SHUTTER S NOT ADJUSTED 1. CLEAN OFF DIRT FROM BURNER PORTS 2. ADJUST EACH AIR SHUTTER. FLAME FLAREUP DURING COOKING LARGE FLAMES AND/OR SMOKE GREASE BUILD UP ON FLAME SHIELDS, BURNERS, OR GRATES EXCESSIVE GREASE ON SCREEN DRIP TRAYS CLEAN OFF GREASE BUILDUP CLEAN GREASE SCREEN TRAYS 22 ^^^^^SECTIO^V^WARRANI^NFO^^ Claims Poiicv The manufacturer of this equipment has taken extreme care to ensure that your shipment arrives in acceptable condition. When your shipment arrives, the carrier will provide you with a delivery receipt. It is vital that you count the number of pieces being delivered and inspect for damage prior to signing that document. No claims for damaged or missing merchandise can be made unless it is recorded on this delivery receipt. Claims for hidden damage must be reported within 15 calendar days of receipt of delivery. Should you have any questions or encounter any difficulty, please call our Customer Service Department at 1-800-323-5664 Warrantv Poiicv Every Belson product is warranted against defects in material and workmanship for one full year from the date of shipment Misuse, neglect or alteration of product is not covered under this warranty. 23 ^ outdoor <^ lifestyles Owner's Manual Installation and Operation Models: Outdoor Woodburning Castlewood 42 LISTED CAUTION DO NOT DISCARD THIS MANUAL Important operating and maintenance instructions included. Read, understand and follow these instructions for safe installation and operation. Leave this manual with party responsible for use and operation. AWARNING Ifthe Information in these instruc- tions is not followed exactly, a flre may result causing property damage, personal injury, or death, Do not store or use gasoline or other flam- mable vapors and liquids in the vicinity of this or any other appliance. Do not overfire. Overfiring will void your warranty. Comply with all minimum clearances to combustibles as specified. Failure to comply may cause house fire. A WARNING HOT SURFACES! Glass and other surfaces are hot during operation and cool down. Hot glass will cause burns. • Do not touch glass until it is cooled • NEVER allow children to touch glass • Keep children away • CAREFULLY SUPERVISE children in same room as appliance. • Alert children and adults to hazards of high temperatures. High temperatures may ignite clothing or other flammable materials. • Keep clothing, furniture, draperies and other combustibles away. Installation and service ofthis fireplace should be performed by qualified personnel. Hearth & Home Technologies suggests NFI certified or factory-trained professionals, or technicians supervised by an NFI certified professional. w. \l/tfoed Entrgjr Ttehnkel Trplning 1^ AWARNING Fire Risk • For use with solid wood fuel or decorative gas appliance only. • Do not install unvented gas logs. Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 Read this manual before installing or operating this fireplace. Please retain this owner's manual for future reference. Congratulations' Congratulations on selecting a Outdoor Lifestyles wood buming fireplace. The Outdoor Lifestyles fireplace you have selected is designed to provide the utmost in safety, reliability and efficiency. As the owner of a new fireplace, you'll want to read and carefully follow ali ofthe instructions contained in this owner's manual. Pay special attention to all cautions and warnings. This owner's manual should be retained for future reference. We suggest you keep it with your other important documents and product manuals. The information contained in this owner's manual unless noted otherwise, applies to all models and gas control systems. Your new Outdoor Lifestyles wood buming fireplace will give you years of durable use and trouble-free enjoyment. Welcome to the Outdoor Lifestyles family of fireplace products! Homeowner Reference Information Model Name: Serial Number:. Dealership purchased from:, Notes: We recommend that you record the following pertinent information about your fireplace: Date purchased/installed:. Location on fireplace: Dealer phone: Listing Label Information/Location The model information regarding your specific fireplace can be found on the rating plate located on the smoke shield ofthe fireplace. Serial Number Grate Fireplace_ Model FIREPCACE NO. USTED XXXXXX WARNING: RISK OF FIRE DAMAGE. REPLACE GRATE WITH HEARTH t HOME TECHNOLOGIES INC. MODELl MODEL NO.' MFG. DATE GR29 ODCASTLEWD-42 XXXXXX OUTDOOR FIREPLACE INTENDED FOR USE WITH HEARTH & HOME TECHNOLOGIES INC. LISTED FIREPLACE PARTS. SEE INSTALUTION AND OPERATING INSTRUCTIONS FOR THIS MODEL ONLY HEARTH & HOME TECHNOLOGIES INC. GLASS DOOR KITS CAN BE INSTALLED ON THIS UNIT. FIREPLACE ALSO FOR USE IN MANUFACTURED HOMES DO NOT OVERFIRE. USE ONLY: SOLID WOOD FUEL OR LISTED DECORATIVE GAS APPLIANCE. DO NOT USE A FIREPLACE INSERT OR OTHER PRODUCTS NOT SPECIFIED FOR USE WITH THIS PRODUCT. IF DOORS ARE USED OPERATE FIREPLACE WITH DOORS FULLY OPEN OR CLOSED ONLY. WHEN BURNING A DECORATIVE GAS APPLIANCE IN THE FIREPLACE, ADJUST DAMPER TO THE FULLY OPEN POSITION. WARNING! THIS FIREPLACE HAS NOT BEEN TESTED WITH AN UNVENTED GAS LOG SET. TO REDUCE THE RISK OF FIRE OR INJURY, DO NOT INSTALL AN UNVENTED GAS LOG SET INTO FIREPLACE. WARNINGl TO AVOID THE RISK OF DAMAGING FIREPLACE MATERIALS AND INCREASING THE RISK OF SPREADING A FIRE DO NOT USE THE FIREPLACE TO COOK OR WARM FOOD. IF INSTALLATION OR OPERATING INSTRUCTIONS ARE MISSING CONTACT: HEARTH & HOME TECHNOLOGIES INC., 1915 W. SAUNDERS ST., MT. PLEASANT, IA 52641. PIIVI. 4021-723A Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev B • 8/10 Framing and Clearances A. Selecting Fireplace Location 7 B. Clearances 9 C. SIdewalls/Surrounds 10 D. Frame the Fireplace 10 E. Chimney Requirements 11 Installation of Fireplace A. Secure the Fireplace 12 B. Install Cooling Air Hoods 13 Chimney Assembly A. Chimney Requirements 14 B. Assemble the Chimney Sections 15 C. Using Offsets/Returns 16 Complete the Enclosure A. Chimney Termination 17 B. Chase Top 17 C. Install the Termination Cap 17 Installation of Molded Brick Panel A. Install Hearth Molded Brick Panel 19 B. Install Back Molded Brick Panel 19 C. Install side Molded Brick Panel 19 D. Install Screens 20 E. Mortar (Optional) 20 11 12 Table of Contents Listing and Code Approvals A. Appliance Certification 4 Getting Started A. Design and Installation Considerations 5 B. Non-Combustible Materials 5 C. Combustible Materials 5 D. Tools and Supplies Needed 5 E. Inspect Fireplace and Components 6 R Grate 6 G. Firescreen 6 H. Cooling Air 6 I. Molded Brick Panel 6 B. C. D. E. 13 Troubleshooting A. Diagnostics and Problem Solving Maintenance and Servicing the Fireplace A. Disposal of Ashes Chimney Inspection/Cleaning Firebox Refractory Maintenance Task List Chimney Fire Reference Materials A. Fireplace Dimensions B. Optional Components C. Chimney Components D. Termination caps E. Sen/ice Parts List F. Limited Warranty G. Contact Information .31 .32 .32 .32 .33 .33 .34 .35 .36 .38 .39 .41 .43 8 Accessories A. Gas Log/Lighter Provisions 21 9 Finishing A. Non-combustlble Materials 22 B. Combustible Materials 22 C. Hearth Extension 22 D. Raised Hearth Extension Framing 23 E. Non-combustible Sealant 24 F. Finishing Material 25 G. Mantel 26 10 Operating Instructions A. Generalinformation 27 B. Grate 27 C. Clear Space Near the Fireplace 28 D. Firescreen 28 E. Glass Doors 28 R Wood Fuel 29 G. Starting a Fire 30 Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev B • 8/10 1 Listing and Code Approvals A. Appliance Certification This fireplace system has been tested and listed in accor- dance with UL 127 standard by Underwriters Laboratories Inc. for installation and operation in the United States. This fireplace has been tested and listed for use with the optional components specified in this manual. These optional com- ponents may be purchased separately and installed at a later date. Outdoor Lifestyles is a registered trademark of Hearth & Home Technologies Inc. A WARNING Improper installation, adjustment, alteration, service or maintenance can cause injury or property damage. Refer to the owner's information manual provided with this fireplace. For assistance or additional information consult a qualified installer, service agency or your dealer. Not intended for use as a primary heat source. This fireplace is tested and approved as a decorative fireplace. It should not be factored as a primary heat source in residential heating calculations. A WARNING Fire Risk • Do not install or operate damaged fireplace. • Do not modify fireplace. • Installation other than as instructed by Hearth & Home Technologies Inc. is strictly prohibited. • Do not operate the fireplace without fully assembling ali components. • Do not overfire. • THIS FIREPLACE HAS NOT BEEN TESTED FOR USE WITH UNVENTED GAS LOGS. TO REDUCE RISK OF FIRE OR INJURY, DO NO INSTALL AN UNVENTED GAS LOG SET INTO THIS FIREPLACE Installation and/or use of any component part not approved by Hearth & Home Technologies. Hearth & Home Technologies disclaims any responsibility for, and the warranty and agency listing will be voided by the above actions. A WARNING Fire Risk WARNING! TO AVOID THE RISK OF DAMAGING FIREPLACE MATERIALS AND INCREASING THE RISK OF SPREADING A FIRE, DO NOT USE THE FIREPLACE TO COOK OR WARM FOOD. Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 2 Getting Started A. Design and Installation Considerations CAUTION Check building codes prior to installation. • Installation MUST comply with local, regional, state and national codes and regulations. * Consult insurance canier, local building inspector, fire officials or authorities having jurisdiction about restrictions, installation inspection, and permits. When planning a fireplace installation, it is necessary to de- termine the following information before installing: • Where the fireplace is to be installed. See Sections 3 and 4. • The vent system configuration to be used. See Sections 5 and 6. • Framing and finishing details. See Sections 3, 6 and 8. • Whether optional accessories are desired. See Section 12. Moisture Resistance: This outdoor fireplace will shed moderate amounts of water, but is not waterproof Water and condensing water vapor may enter the chase under certain conditions. The fireplace will not perform as an exterior wall. Moisture penetration must be considered for construction that places the fireplace in structure walls or on moisture sensitive sur- faces. When installed on exterior walls: Hearth & Home Tech- nologies recommends that the fireplace chase be con- structed outside the structure's weather envelope. Where the platform meets the wall, use a flashing detail similar to that required for attached decks. Chase platforms, including hearths should slope away from the structure at 1/8 in. to 1/4 in. perfoot. The fireplace can be shimmed level. When installed on surfaces where water may collect or cause damage: Hearth & Home Technologies recommends that a drainage pan be placed under the unit. This can be constructed of metal, adhesive polymer membrane (such as ice and water shield) or other suitable materials. A means of drainage out ofthe pan such as tubes or weep holes should be provided. A slope of 1/8 in. to 1/4 in. per foot towards the drain port is suggested. The fireplace can be shimmed level. Hearths should slope away from the front of the fireplace and chase at 1/8 in. to 1/4 in. per foot. Spark strips must be on top ofany combustible hearth materials used for moisture management. B. Non-Combustible Materials Materials which will not ignite and burn, composed of any combination of the following: - Steel -Iron - Brick -Tile -Concrete -Slate -Glass -Plasters Materials reported as passing ASTM R 136, Standard Test Method for Behavior of Metals, in a Vertical Tube Furnance aat 750° C C. Combustible Materials Materials made of or surfaced with any of the following materials: -Wood -Compressed paper -Plant fibers -Plastic Any material that can ignite and burn; flame proofed or not, plastered or un-plastered. D. Tools and Supplies Needed Before beginning the installation be sure the following tools and building supplies are available: Reciprocating Saw Framing material Pliers High temp caulking material Hammer Gloves Phillips screwdriver Framing square Flat blade screwdriver Electric drill and bits Plumb line Safety glasses Level Tape measure 1/2-3/4 in. lenght, #6 or #8 self-drilling screws Misc. screws and nails Read all the instructions before starting the installation. Follow these instructions carefully during the installation to ensure maximum safety and benifit. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 E. Inspect Fireplace and Components A WARNING Fire Risk Explosion Risk Inspect fireplace and components for damage. Damaged parts may impair safe operation. * Do NOT install damaged components. * Do NOT install incomplete components. * Do NOT install substitute components • Carefully remove the fireplace and components from the packaging. The fireplace system consists of the following: * Fireplace / Integral grate/dual cooling air inlet hoods, firescreen, and hearth refractory. F. Grate This fireplace is designed to be used with the grate sup- plied with this unit or one approved by HHT. The grate will deteriorate over time and will need occasional replace- ment. Warning! Risk of Fire! Use only the factory-supplied intergral grate. Keep logs in place. Allows proper air circulation around the fire. G. Firescreen The firescreen is provided to control sparks. Keep it closed when the fireplace is in use. WARNING! Risk of Fire or Burns! Screen will not prevent burning materials from falling out, Screen pulls or handles may be hot. H. Cooling Air Cooling air is necessary to install the fireplace on a com- bustible surface and in a combustilbe enclosure. Two inlet hoods are provided and must be installled. The complete structure must be noncombustible if the hoods are not installed. I. Molded Brick Panel • The molded brick panels are shipped separately, but required to contain heat and provide an attractive interior. They will deteriorate over time and will need occa- sional replacement. Small hairiine cracks and discol- oration are normal and do not affect safety. Mortar is not necessary but can be used to enhance the appearance. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 3 Framing and Clearances A WARNING Fire Risk Provide adequate clearances. • Around air openings • To combustibles • For service access. Locate fireplace away from traffic areas. Note: Illustrations and photos reflect typical installations and are FOR DESIGN PURPOSES ONLY Illustrations/diagrams are not drawn to scale. Actual installation/appearance may vary due to individual design preference. Hearth & Home Technologies reserves the right to alter its products. A. Selecting Fireplace Location This outdoor fireplace will shed moderate amounts of water, but is not waterproof Water and condensing water vapor may enter the chase under certain conditions. The fireplace will not perform as an exterior wall. Moisture penetration must be considered for construction that places the fireplace against structure walls or on moisture sensitive surfaces. • Exterior Walls (see Figure 3.1) Hearth & Home Technologies recommends that the fireplace chase be constructed outside the structure's weather envelope. Where the platform meets the wall, use a flashing detail similar to that required for attached decks. Chase platforms, including hearths, should slope away from the stmcture at 1/8 in. to 1/4 in. perfoot. The fireplace can be shimmed level. Build the outside enclosure out of standard building materials, being careful to maintain the minimum air clearances specified in these installation instructions. Freestanding Installations (see Figure 3.2) When installing this fireplace as a freestanding fireplace on your porch, patio or in your yard, it must be enclosed to prevent impact damage to the fireplace. The cooling air hoods MUST be used if installing in a combustible enclosure. If unit is installed on cement and totally enclosed with non combustilbe materials (i.e. metal studs, cement board, etc.) the cooling air hoods do not need to be installed. When Installed on Surfaces Where Water May Collect or Cause Damage: Hearth & Home Technologies recommends that a drainage pan be placed under the unit. This can be constructed of metal, adhesive polymer membrane (such as ice and water shield) or other suitable materials. A means of drainage out of the pan such as tubes or weep holes should be provided. A slope of 1/8 in. to 1/4 in. per foot towards the drain port is suggested. The fireplace can be shimmed level. Hearths should slope away from the front of the fireplace and chase at 1/8 in. to 1/4 in. per foot. Spark strips must be used on top ofany combustible hearth materials used for moisture management. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 Note: If this surface Is inside the building's warm air enevelope... r^i ...then this surface must be an exterior wall system. l/J - 1131 -B 11344 1 -54 113« 1 1/2 1131 1-1/J 138] S4 [1372 1 -9M/2 12424 Figure 3.1 Fireplace Locations © -—10ft—• Min. (Enclosed Fireplace) FREESTANDING INSTALLATION Figure 3.2 (Combustib Freestandinq Fireoiace Locations e Structure) Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 B. Clearances ilk" A WARNING Fire Risk • Comply with all minimum clearances to combustibles as specified. • Framing or finishing material used on the front of, or in front of, the appliance closer than the minimums listed, must be constructed entirely of noncombustible materials (i.e., steel studs, concrete board, etc.). Failure to comply may cause fire. 0 in. to level of standoffs Figure 3.3 Clearance to Combustible _ 1-1/2 to side and back unit angled (isometric) 0 inches. H~1/2 in to framing Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8 * 8/10 C. SIdewalls/Surrounds * Locate adjacent combustible sidewalls a minimum of 24 in. (610 mm) from fireplace opening. • Mantle leg, surround, stub wall, whether combustible or non-combustible, may be constructed as shown in Figure 3.4. Note: Grid depicts 1 inch squares. 22 3/8 in. [568 mm] 18 1/2 in. [470 mm] I— 24 in. — [610 mm] BRICK FRONT 4 in. [102 mm] 42 in. [1067 mm] 52-7/8 in. - (1343 mm) •24 in. [610 mm] Figure 3.4 Mantel Leg, Surround or Wall Projection (acceptable on both sides of opening) D. Frame the Fireplace Figure 3.4 shows typical framing using combustible materials (2x4 lumber shown). Cooling air hoods required If total struc- ture is non-combustible, cooling air hoods are not necessary. * Observe all required air space clearances to combustible materials as shown in Figure 3.5. 2 in./51 mm minimum air space clearance to the enclosure. Use only noncombustible material below the top of the top standoffs. Figure 3.5 28-3/8 in. 721 cm - i_ 74.1/2 jn. 1892 cm Framing the Fireplace 10 Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 E. Chimney Requirements When planning your fireplace location, the chimney construc- tion and necessary clearances must be considered. The fire- place system and chimney components have been tested to provide flexibility in construction. The following figures are the minimum distances from the base of the fireplace. • Minimum overall straight height is 10 ft If the fireplace is freestanding and a minimum of 10 ft from a combustible structure. See Figure 3.2. * Chimney must extend 2 ft (.6 m) above any portion of the roof within 10 ft (3048 mm) of the chimney. Refer to Figure 6.2. ft m Minimum height (Structure Height 9 1/2 fl) 10* 3 Maximum height 90 27.43 Maximum chimney length between an offset and return 20 6.1 Maximum distance between chimney stabilizers 35 10.67 Double offset/return minimum height 24 7.32 Maximum unsupported chimney length between the offset and return 6 1.83 Maximum unsupported chimney height above the fireplace 35 10.67 " Transition section standard with unit and 1 toot section required in addtion as minimum. 91/2 ft Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 11 ^ Installation of Fireplace A. Secure the Fireplace Position the Fireplace This fireplace may be placed on either a combustible or noncombustible continouous flat surface. Follow the instructions for framing in Section 3.0. Slide the fireplace into position. Be sure to provide the minimum air clear- ance at the sides and back of the fireplace assembly. See Section 3.8. A WARNING Flre Risk! Prevent contact with sagging, loose insulation. Do NOT instal against vapor barriers or exposed insulation. Cooling Air Hoods must be installed if instaling on a combusfible surface. Level the Fireplace Level the fireplace side-to-side and front-to-back. Shim with noncombusfible material, such as sheet metal, as neces- sary. Secure the fireplace (using the nailing fianges located on either side of the fireplace) to the vertical framing. Note: When elevating the fireplace above the hearth extension the front of the elevated platform must be protected with a protective metal hearth strip. Important: To ensure proper fit of the glass doors, check the fireplace opening for square. Measure diagonal distances of the opening to make sure they are equal. If they are not, confinue to shim the fireplace until those diagonals are equal. Top piece must overlap bottom piece 2 in (51 mm)^"C^ " '^^l in. (25 mm) min. overlap ^2 in (51 mm) Figure 4.2 Protect the Front of an Elevated Platform Place the Protective Metal Hearth Strips fvl 1 in. (25 mm) Jf^' overlap Protective metal strips are placed 2 in. (51 mm) under the front of the fireplace and must extend beyond the front and sides of fireplace opening by 2 in. (51 mm). Figure 4.1 Position the Protective IMetal Klearth Strips Included with yourfireplace you will find two metal hearth strips measuring approximately 26 in. x 4 in. (660 mm x 102 mm). These strips are used to provide added protection where the fireplace and the hearth extension meet when installed on a combusfible service. Slide each metal strip 2 in. (51 mm) under the front edge of the fireplace. The individual pieces must overiap each other by 1 in. (25 mm) minimum in the middle of the fireplace to provide confinuous coverage of the fioor See Figure 4.1. These metal strips should extend from the front and sides of the fireplace opening by 2 in. (51 mm). A WARNING Fire Risk! * Metal hearth strips MUST be installed. Sparks or embers may ignite flooring. 12 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev B • 8/10 B. Install Cooling Air Hoods WARNING! Cooling air must be provided when install- ing in combustible enclosure or on combusfible surface. • Locate cooling air hoods to prevent blockage from leaves, snow/ice, or other debris. Blockages could cause the unit to overheat. • Recommended bottom of a 7-3/4" X 7-3/4" or 7-3/4" diameter hole 12" above bottom of unit • Do Not place cooling air hood close to exhaust vent. • The outside air hood can be painted to match/accent the color of the structure. Caution! Risk of Fire or Asphyxiation! Do not draw outside air from wall, floor, or ceiling cavity, or enclosed spaces such as an attic or garage. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 13 ^ Chimney Assembly A. Chimney Requirements Vertical distances are measured from the base of the fire- place. * Minimum overall straight height is 10 ft. if the fireplace is freestanding and a minimum of 10 ft from a combustible structure. * Chimney must extend 2 ft (.6 m) above any portion of the roof within 10 ft (3 m) of the chimney. To determine the chimney components needed to complete your particular installafion, follow the steps below: * Determine the total vertical height of the fireplace installation. This dimension is measured from the base of the fireplace assembly to the point where the smoke exits the terminafion cap. * Subtract the effective height ofthe fireplace assembly from the overall height of the fireplace installafion (measured from the base of the fireplace to the bottom of the termination cap). * Refer to Table 5.1 to determine what components must be selected to complete the fireplace installafion. * Determine the number of ceiling firestops, stabilizers, roof flashing, etc. required to complete the fireplace installafion. ft m Minimum height * 10 3 Maximum height 90 27.43 Maximum chimney length between an offset and return 20 6.1 Maximum distance between chimney stabilizers 35 10.67 Double offset/return minimum height 24 7.32 Maximum unsupported chimney length between the offset and return 6 1.83 Maximum unsupported chimney height above the fireplace 35 10.67 ' 1 ransition section standard with unit and 1 foot section required in addtion as minimum. Note: A maximum of two pairs of offsets and returns may be used. WARNING Fire Risk Must maintain 2 in. (51 mm) air clearance to insulation and other combusfible materials. * Warning: DO NOT PACK REQUIRED AIR SPACES WITH INSULATION OR OTHER MATERIALS. A CAUTION Do NOT connect this fireplace to a chimney flue servicing another appliance. Do NOT connect to any air distribution duct or system. Table 5.1 HEIGHT OF CHIMNEY COMPONENTS in. mm US Canada ONLY Chimney Stabilizer SL11 SL4 4-3/4 121 Ceiling Firestops FS538 FS538 0 0 FS540 FS540 0 0 Offsets/Returns SL1130 SL430 14-1/2 368 Chimney Sections* 81.1106 SL406 4-3/4 121 SL1112 SL412 10-3/4 273 SL1118 SL418 16-3/4 425 SL1136 SL436 34-3/4 883 SL1148 SL448 46-3/4 1187 n/a SLA10 16-3/4 425 * Dimensions reflect effective height. 14 Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 B. Assemble the Chimney Sections WARNING! Risk of Fire! DO NOT install substitute or dam- aged chimney components. Use only those components described in this manual. Substitute or damaged chimney components could impair safe operafion and cause overheafing and fire. * Support the pipe during construcfion and check to be sure inadvertent loading has not dislodged the chimney secfion from the fireplace or at any chimney joint. * Attach the transifion secfion to the top of the fireplace. * Place inner flue to the inside ofthe chimney secfion below it. Place the outer casing outside the outer casing of the chimney secfion below it. Refer to Figure 5.1. NOTICE: CHmNEY SECTIONS CANNOT BE DISASSEMBLED ONCE LOCKED TOGETHER. PLAN AHEAD! * Lock chimney sections and/or ofl'sets/returns together by pushing downward unfil the top section meets the stop bead on the lower section. * Pull on the top secfion to make sure it is fully engaged and will not separate. * You may use #6 or #8 sheet metal screws no longer than 1/2 in. (13 mm) to fasten chimney secfions together. Do NOT penetrate inner flue. * Fasten ofFset/retums to chimney sections. Insert the screws (provided) through the predrilled holes. Do NOT penetrate inner flue. * Secure chimney returns with hanger straps (provided); fasten to studs or joists. * Vertical straight runs of chimney must be supported every 35 ft (10.7 m). Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev B * 8/10 15 C. Using Offsets/Returns To bypass any overhead obstrucfions, the chimney may be offset using an offset/return. An offset and return may be attached together or a chimney section(s) may be used between an offset and return. Perform the following steps to determine the correct chim- ney component combinafion for your particular installafion: A WARNING Fire Risk • Draft will be restricted if offsets/returns greater than 30° are used. Table 5.2 Measure how far the chimney needs to be shifted to enable it to avoid the overhead obstacle. See Figure 5.1. Use dimension "A" to determine chimney secfion required to achieve the needed shift. After determining the offset dimension, refer to Table 5.2 and find the "A" dimension closest to but not less than the distance of shift needed for your installafion. The "8" dimension that coincides with the "A" dimension represents the required vertical clearance that is needed to complete the offset and return. Read across the chart and find the number of chimney secfions required and the model numberof those particular chimney parts. Whenever the chimney penetrates a fioor/ceiling, a ceiling firestop must be installed. The effecfive height ofthe fireplace assembly is measured from the base of the fireplace to the top of the starter collar. See Dimensions in Secfion 12. A B SL1106 SL1112 SL1118 SL1136 SL1148 in. mm in. mm SL406 SL412 SL418 SL436 SL448 4 7/8 124 17 7/8 454 ----- 7 1/4 184 22 559 1 ---- 9 3/4 248 26 1/8 664 2 ---- 10 1/4 260 27 1/4 692 -1 --- 12 3/4 324 31 3/8 797 1 1 --- 13 1/4 337 32 3/8 822 --1 -- 15 3/4 400 36 5/8 930 -2 --- 18 1/8 460 40 3/4 1035 1 2 --- 18 3/4 476 41 3/4 1060 -1 1 -- 21 3/4 552 47 1194 --2 -- 22 1/4 565 48 1219 ---1 - 24 3/4 629 52 1/8 1324 1 --1 - 27 3/4 705 57 3/8 1457 -1 -1 - 28 1/4 718 58 3/8 1483 ----1 30 3/4 781 62 1/2 1588 1 ---1 33 3/4 857 67 3/4 1721 -1 --1 36 3/4 933 73 1854 --1 -1 39 3/4 1010 78 1/8 1984 ---2 - 41 1/8 1045 82 3/8 2092 1 --2 - 45 3/4 1162 88 1/2 2248 ---1 1 48 1/8 1222 92 3/4 2356 1 --1 1 51 3/4 1314 98 7/8 2511 ----2 Proper assembly of air cooled chimney parts results in an overlap of chimney joints of 1-1/4 in. (32 mm). Effective length is built into this table. 1-1/4 in. (32 mm) OVERLAP Figure 5.2 Example: Your "A" dimension from Figure 5.2 is 14 1/2 in. (368 mm). Using Table 5.2 the dimension closest to, but not less than 14 1/2 in. (368 mm) is 15 3/4 in. (400 mm) using a 30° offset/return. It is then determined from the table that you would need 36 5/8 in. (930 mm) (Dimension "B") between the offset and return. The chimney components that best fit your applicafion are two SL1112s or SL412s. 16 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 6 Complete the Enclosure A. Chimney Termination Chimney Termination Requirements (see Fig- ure 6.1) Must have a cap approved and listed for this fireplace system Must not be located where it will become plugged by snow or other material Must terminate at least 3ft (914 mm) about the roof and at least 2 ft (610mm) above any portion of the roof within 10ft. (305mm) Must be located away from trees or other structures A WARNING Fire Risk * Must maintain 2 in. (51 mm) air clearance to insulation and other combustible materials. B. Chase Top A metal chase top is required to seal the top of the chase around the chimney pipe. The top should include a turn- down and drip edge to prevent water from seeping into the chase. Provide a 1/8 in. (3 mm) gap around the flue pipe and slope the top downward away from the penetration. C. Install the Termination Cap Note: To protect against the effect of corrosion on those parts exposed to the weather, the terminafion cap can be painted with a rust-resistant paint. A WARNING Fire Risk * The minimum overiap of cap to pipe MUST be met or chimney may separate from cap. Separafion allows sparks, heat and embers to escape. Install the chimney secfions up through the chase enclosure and refer to terminafion cap instrucfions. NOTE: TR11/TR444 Round Termination Cap and TRI IT/ TR442 Round Telescoping Terminafion Cap not recom- mended for Installations less than 20 feet. ST1175/ST475 Square Termination Cap All seams must be caulked to prevent leaks. A chase installafion must use a chase top. Chase tops are available from your HHT dealer or may be field constructed. Attach the chase top to the top of the chase. c 2 in. (51 mm) Collar on Chase Top Slope Downward i-Turn-down X Drip Edge .018 (26 ga) min. Galvanized Chase Top Figure 6.1 Field Constructed Chase Top Specification Flange Collar 2 in. (51 mm) Minimum Height Place waterproof caulk or sealer under each flange of the termination cap and on top of each screw to help prevent leaks The last section of pipe must stop between 2 in. (51 mm) above the top of the chase and 4 3/4 in. (121 mm) below the top of the chase.- 4 3/4 in. (121 mm) i maximum Termination cap pipe and chimney section must overlap 1-1/2 in. (38 mm) Figure 6.2 Installing an ST1175/ST475 Sguare Termination Cap Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8 • 8/10 17 TCT1175 Terra Cotta Cap Remove 2 screws from front & back to lift the top off Place waterproof sealer under each flange of the termination cap and on top of each screw to help prevent leaks. Collar 2 in. (51 mm) Minimum Height The last section of pipe must stop between 2 In. (51 mm) above top of chase and 7 in. (178 mm) below top of chase 2 in. (51 mm) 7 in. (178 mm) Chimney} Chase 1S£ Termination cap pipe and chimney section must overlap 1-1/2 In. (38 mm) Figure 6.3 Installing a TCT1175 Sguare Termination Cap 18 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 7 Installation of Molded Brick Panel A. Install Hearth Molded Brick Panel 1. Put a level on fireplace to verify it is level side to side and front to back. 2. While the hearth is removed from the fireplace, measure all 4 corrners to determine the variance from corner to corner. See Figure 7.1. 3. Shim the low corners ofthe hearth refractory by installing the metal pieces provided on the fireplace bottom. See Figure 7.2. 4. Put a level on the top flange ofthe refractory and shim as necessary from side to side or front to back. See Figure 7.3. Note: The top flange of the hearth should be level to allow the sides and back to be installed with minimal gaps. The hearth slopes towards the front of the unit approximately B. Install Back Molded Brick Panel Refer to Figure 7.4. Set the grate retainer in place, in the notch in the hearth. Install the back panel. Center from side to side. Install rear refractory retainer 1/4". igure 7.1 Sida Rsfractoiy Retainer Bach Refractory ftetalnsr Left Side Molded Brick Panel Figure 7.4 /side Refractory Retainer Right Side Molded Brick Panel C. Install Side Molded Brick Panel Remove screen rods. • Remove smoke shield Install side panel by lifting up, setfing on top flange of hearth and slide towards back of unit unfil it meets up with back panel. Install refractory retainer Install second side panel following the steps above. Replace the smoke shield. Install refractory retainer. Figure 7.3. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 19 D. Install Screens F. Grate Lay one screen panel flat and slide the round end of the rod through the rings starting at the handle side of the screen. Leave the last ring off the rod. Insert the rod through the hole in the bracket. Slip the last ring over the rod on the other side of the bracket. Fasten the flat end of the screen rod back in place us- ing the screw removed eariier Repeat for the other screen panel E. Mortar (Optional) The brick panels have been designed for installafion without the use of mortar being necessary. If the look of mortar is preferred, it is available and can be installed. Follow the direcfions on the container for mixing. The mortar can be applied with a mortar bag or trowled on. Install the grate If a gas log set is not going to be installed. Posifion the rear grate bar in the Grate Retainer Position the top of the grate retainer over the rear grate bar and fasten in place with screw provided. VERY IIVIPORTANT: Allow the mortar 72 hours to cure before operating the ^replace. Mortar should be applied after finishing material is installed. Mortar will be applied between finishing materials and molded brick edges, bottom and sides. The seam between finishing materials and firebox top must be sealed with non-combustible sealant. n The non-combusfible finishing material across the top of fireplace opening will be even with lower edge of metal face. Non-combusfible finishing materials MUST overiap side faces by 1 1/4 in. (32 mm) to cover the edges of the panels. Finished opening -should be 38 x 42 in. (965 x 1067 mm) to allow for door installafion. The surface of the finished hearth extension and the surface of the hearth panel should be level. Figure 7.5 Facing Materials and Mortar 20 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 8 Accessories A. Gas Log/Lighter Provisions A certified gas log lighter or decorative gas log set can be installed in this fireplace. This fireplace was not tested and listed for use with an un- vented gas log heater. Do not install an unvented gas log heater in this fireplace and operate it with the flue damper in the closed position unless the unvented gas log heater has been specifically tested and listed for use in this fireplace by Unden/vriters Laboratories Inc. Use of an unvented gas log heater in this factory built fireplace may create a fire hazard that can result in a structure fire. * Maximum input is 100,000 BTU/hr. * Decorafive gas appliance must be certified to ANSI Z21.60 "Standard for Decorafive Gas Appliances for Installafion in Vented Fireplaces". * Must be installed in accordance with the National Fuel Gas Code, ANSI Z223.1. * A log set must incorporate a gas shutoff. * Log set requires the damper to be locked fully open. Knockouts are provided on both sides of the fireplace and in refractories for 1/2 in. (13 mm) iron pipe. * We recommend you seal refractory around pipe with fireplace mortar or high temperature, noncombusfible sealant. * Repack insulafion from the knockout around the pipe. * Maintain 1-1/2 in. (38 mm) air space around the pipe for 4 in. (102 mm) beyond the fireplace. * See Figure 8.1. Firebox Outer shell of fireplace Refractory- Seal with fireplace mortar or non-combust ible sealant Gas line Repack insulation knockout Maintain air clearance to combustibles. Combustible materials 1 1/2 in. (38 mm) air space around pipe 4 in. (102 mm) Combustible materials may be located at zero clearance to gas line beyond 4 in. (102 mm) from fireplace side. Figure 8.1 Gas Line Installation A WARNING /\ Asphyxiation Risk • Damper must be locked open when gas logs • • installed. Gas fire generates fumes. A WARNING Fire Risk • For use with solid wood fuel or decorative gas appliance only. * DO NOT install unvented gas logs. A WARNING Fire Risk Explosion Risk Inspect appliance and components for damage. Damaged parts may impair safe operafion. * Do NOT install damaged components. * Do NOT install incomplete components. * Do NOT install subsfitute components Report damaged parts to dealer. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 21 9 Finishing A. Non-combustible Materials * Materials which will not ignite and burn, composed of any combinafion of the following: - Steel - Iron - Brick - Tile - Concrete - Slate - Glass - Plasters * Materials reported as passing ASTM E 136, Standard Test Method for Behavior of Metals, in a Vertical Tube Furnace at 750° C B. Combustible Materials * Materials made of or surfaced with any of the following materials: - Wood - Compressed paper - Plant fibers - Plasfic * Any material that can ignite and burn; fiame proofed or not, plastered or un-plastered C. Hearth Extension WARNING! Risk of flre! High temperatures, sparks, em- bers or other burning material falling from the fireplace may ignite flooring or concealed combustible surfaces. * Metal hearth strips MUST be installed (Section 7.C.). * Inearth extensions MUST be installed exactly as specified. Table 12.1 R = 1/k X inches of thickness You MUST use a hearth extension with this fireplace. This fireplace has been tested and approved for use with a hearth extension insulated to a minimum R value of 2.32. The hearth extension material MUST be covered with file, stone or other non-combusfible material. Manufactured hearth materials will usually have a published R value (resistance to heat) or k value (conducfivity of heat). Refer to the formula in Table 12.1 to convert a k value to an R value. Refer to Table 12.2 for hearth extension insulafion alternatives. Table 12.2 Raised Platform 20 in. (508 mm) Minimum Flush Hearth 30 in. (762 mm) Minimum Hearth Extension Insulation Alternatives-Total minimum R Value must equal 2.32 Material k per inch thick R per inch thick Minimum thickness required Hearth & Home HX3, HX4 (Micore 300™) 0.49 2.06 1 in. (25.4 mm) USG Micore 160™ 0.39 2.54 1 in.(25.4 mm) USG Durock™ Cement Board 1.92 0.52 4 in. (101.6 mm) Cement Mortar 5.0 0.20 10 in. (254 mm) Common Brick 5.0 0.20 10 in. (254 mm) Ceramic Tile 12.50 0.08 25-3/4 in. (654 mm) Armstrong™ Privacy Guard Plus 0.46 2.18 1 in. (25.4 mm) Marble 14.3 to 20.0 0.07 to 0.05 29-1/2 to 41 in. (749.3 to 1041.4 mm) 22 Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 D. Raised Hearth Extension Framing The hearth framing must be constructed of non-combustible materials (Figure 12.2) and placed on 1/2 in. Durock and 1 in. Micore (or equivalent material) (Figure 12.4). When cre- afing the platform, allow for the thickness of the non-com- bustible finishing materials (Figure 12.5). IMPORTANT! Hearth extension design must be determined before installafion of fireplace. Durock 1 in. Micore or equivalent insulation (see Tatjie) Continuous, non-combustible sealant Tile, stone or other non-combustible material ~ Protective Metal Hearth strip Floor constructed of wood or other combustible material ' 2 in. (51 mm) Figure 12.2 Non-combustlble Framing Material 1 in. Micore or equivalent insulafion & 1/2 in. Durock Figure 12.4 Raised Platform Hearth Extension-Framing Materials Note: The bottom of the fireplace opening is 3-3/4 in. (95.3mm) above the bottom of the fireplace. Finished hearth must NOT extend above this level. 20 in. Min. Hearth Extension Bottom of fireplace opening Non-combustible Finishing l\/1aterial Platform must be built to raise the bottom of the fireplace opening to the level of the desired hearth height. 1 in. IVIicore or equivalent insulation & 1/2 in. Durock - Non-combustible Framing Material Figure 12.3 Raised Platform Hearth Extension Detail Non-combusfible Finishing Materials Figure 12.5 Raised Platform Hearth Extension-Finishing Materials Hearths should slope away from the front ofthe fireplace and chase at 1/8 in. to 1/4 in. per foot. Spark strips must be on top of any combusfible hearth materials used for moisture management. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 23 E. Non-combustible Sealant After complefing the framing and applying the facing ma- terials over the framing, a bead of 300° F minimum non- combusfible sealant or motar must be used to close off any gaps at the top and sides between the fireplace and hearth. Figure 12.6 Place Non-combustible Sealant Flush Hearth Extension Framing • Fireplace must be recessed 3 3/4 in. (95.3 mm) below the finished floor. 24 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 F. Finishing Material Refer to Secfions 9.A. and Secfions 9.8. for combusfible/ non-combusfible materials. Refer to Figure 9.2 for non-com- busfible zone if cooling air hoods are installed. WARNING! Risk of Fire! You must maintain clearances. • Use only non-combustible framing material below standoffs. • Sheetrock, wood or other combustibles must NOT be used as sheathing or facing in the non-combustible zone. • DO NOT cover metal fireplace front with combustible materials. • Install combustible materials only to specified clearances on top front and side edges. • Complete framing and apply facing material (drywall) over framing. • A bead of 300-deg F minimum non-combusfible sealant must be used to close off any gaps at the top and sides between the fireplace and facing to prevent cold air leaks. • Large gaps can be bridged with fiberglass rope gasket. • Only non-combusfible materials may be used to cover the metal fireplace front. WARNING! Risk of Fire! Use only non combusfible material when cooling hoods are not installed. These surfaces must be covered with non-combusfible material. Non-combusfible sealant. Figure 9.1 Non-combustible Facing Note: We recommend mortar be applied after facing materials are installed. Refer to Sec- tion 7.E Finished combustible wall Non-Combustible materiaU Non-combustible decorative facing (up to full brick depth) Continuous, non-combustible sealant - Tile, stone or other non-combustible material 1 in. Micore — or equivilent insulation & 1/2 in. Durock -•-I— 2x^ 9x4 2x4 stud wall 2x4 header, flush with front of stand-offs Bottom of fireplace opening and finished hearth may be 'the same height Metal strips are placed 2 in. (51 mm) under the front of the fireplace and must extend beyond the front and sides of fireplace opening by 2 in. (51 mm) Floor constructed of wood or other combustible material Figure 9.2 Decorative Facing Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 25 G. Mantel Use Non combusfible mantel only. CombustibleWall NoiKiombustible Decorative Fadng suchas jtee^nivDnci^ tll6;ooracl^SBti^ glassy piasteis. ^^-Combustible A Deoon Decorative Fadng Sedjofeitwllh noiHombuslible sealant Figure 9.3 Clearance to Mantel or other non-combustilbes above fireplace Tit (2134mm) minimum baseofliieplaoe toodng 26 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 Operating Instructions A WARNING Fire Risk * Do not operate fireplace before reading and understanding operafing instrucfions. Failure to operate fireplace properiy may cause fire. A. General Information Fireplaces, as well as other woodburning appliances, have been used safely for many years. It has been our experience that most problems are caused by improper installafion and operafion of the fireplace. Make certain that installafion and operafion ofthe fireplace system is in accordance with these instrucfions. It is extremely important that the fire be supervised when- ever the fireplace is in use. It is also recommended that an annual inspection be performed on the fireplace system to determine if the flue system needs to be cleaned, or as in the case of any appliance, if minor repairs are required to maintain the system in top operafing condition. B. Grate The factory installed integral grate must be used to hold the logs from falling out of an open fireplace and to allow air to pass between the burning logs, ft is important to keep the fire off the hearth and to allow the ashes to collect beneath the fire, thereby forming a layer of addifional heat protecfion. A WARNING Fire Risk • Use only factory installed integral grate. May cause overfire. A WARNING HOT SURFACES! Glass and other surfaces are hot during operafion and cool down. Hot glass will cause burns. * Do not touch glass unfil it is cooled * NEVER allow children to touch glass * Keep children away • CAREFULLY SUPERVISE children in same room as appliance. • Alert children and adults to hazards of high temperatures. High temperatures may ignite clothing or other flammable materials. • Keep clothing, fumiture, draperies and other combusfibles away. A WARNING Fire Risk • For use with solid wood fuel or decorative gas appliance only. * Do not install unvented gas logs. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 27 C. Clear Space Near the Fireplace Combustible materials must not be stored on the hearth ex- tension. Outdoor room furnishings such as chairs or other combusfibles must be at least 4 ft (1.22 m) from the open front of the fireplace. THERE IS NOT A FLUE DAMPER, THEREFORE UNIT CANNOT BE INSTALLED INDOORS. D. Firescreen A firescreen is always provided to control sparks. It must be closed whenever the fireplace is in use. Glass doors or fire- screens must not be used to hold burning material inside the fireplace. Only those glass doors specifically tested and list- ed for use with the specific fireplace model should be used. Screens should be closed when the glass doors are closed. A WARNING Fire Risk • Close firescreen when burning fireplace. • Do not use firescreen or glass doors to hold burning material in fireplace. Firescreen controls sparks. Glass may break or burning material may roll out. E. Glass Doors Most efficient fireplace operafion using glass doors is with the doors open. When the doors are open the screen must be closed. Only Hearth & Home Technologies glass doors may be used. See Figure 10.1 for proper glass door opera- fion. FULLY OPEN CORRECT PARTLY OPEN INCORRECT o o FULLY CLOSED PARTLY CLOSED CORRECT INCORRECT o Figure 10.1 Proper Operating Positions of Bi-fold Doors A WARNING Fire Risk Smoke Risk • Doors must be fully opened or fully closed when operafing fireplace. Partially opened doors may draw fiame, smoke or heat from fireplace. 28 Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev B * 8/10 F. Wood Fuel Firewood Yourfireplace performance depends on the quality ofthe firewood you use. All seasoned wood, regardless of spe- cies, contains about 8,000 BTU's per pound, and hard- woods have a greater density than soft woods. A piece of hardwood will contain about 60% more BTU's than an equal size piece of soft wood. Firewood is commonly sold by the cord (128 cu. ft.). A cord of seasoned oak (hardwood) would contain about 60% more potenfial en- ergy than a cord of seasoned pine (soft wood). Examples of soft wood trees are Douglas fir, pine, spruce, and cedar, poplar, aspen and alder Soft woods require less fime to dry, burn faster and are easier to ignite than hardwoods. Examples of hardwood trees are oak, maple, apple, and birch. Hardwoods require more fime to season, burn slower and are usually harder to ignite than soft woods. The best wood fuel is a combinafion of soft wood and hardwood. Start the fire with soft wood; the fire will give off quick heat to bring the fireplace up to operating tem- perature, and then the hardwood can be added for slow, even heat and longer burn fime. Moisture Regardless ofwhich species of wood you burn, the single most important factor that effects the way your fireplace operates is the amount of moisture in the wood. The ma- jority of the problems fireplace owners experience are caused by trying to burn wet, unseasoned wood. Freshly cut wood can be as much water as it is wood, having a moisture content of around 50%. Imagine a wooden bucket that weighs about eight pounds. Fill it with a gallon of water, put it in the fireplace and try to burn it. This sounds ridiculous but that is exacfiy what you are doing ifyou burn unseasoned wood. Seasoning Seasoned firewood is nothing more than wood that is cut to size, split and air dried to a moisture content of around 20%. The fime it takes to season wood varies from around nine months for soft woods to as long as eighteen months for hardwoods. The key to seasoning wood is to be sure it has been split, exposing the wet interior and increasing the surface area of each piece. A tree that was cut down a year ago and not split is likely to have almost as high a moisture content now as it did when it was cut. The following guideline will ensure properiy seasoned wood: * Stack the wood to allow air to circulate freely around and through the woodpile. * Elevate the woodpile off the ground to allow air circulafion underneath. * The smaller the pieces, the faster the drying process. Any piece over 6 in. (152 mm) in diameter should be split. * Cover the top of the woodpile for protection from rain and snow. Avoid covering the sides and ends completely. Doing so may trap moisture from the ground and impede air circulafion. The problems with burning wet, unseasoned wood are twofold: First, you will receive less heat output from wet wood because it requires energy in the form of heat to evaporate the water trapped inside. This is wasted ener- gy that should be used for heafing your home. Secondly, this moisture evaporates in the form of steam which has a cooling effect in your fireplace and chimney system. When combined with tar and other organic vapors from burning wood it will form creosote which condenses in the relatively cool fireplace and chimney. A WARNING Fire Risk • Do NOT burn wet or green wood. • Store wood in dry locafion. • Stack wood so both ends are exposed to air. Wet, unseasoned wood can cause accumulafion of creosote. A WARNING Fire Risk Do NOT store wood: * Closer than required clearances to combusfibles to fireplace. * Within space required for loading or ash removal. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8 * 8/10 29 G. Starting a Fire Place crumpled or twisted paper under the fireplace grate. Loosely arrange kindling or small pieces of wood to form a layer above the paper. The fires must be built on the fireplace grate, without danger ofthe burning fuel falling out ofthe fireplace opening. Light the paper and add small pieces of wood unfil a hot bed of embers has been established. After establishing the fire bed, and the small firewood is burning briskly, add a minimum ofthree average sized piec- es of split firewood, place the wood in such a manner to al- low combusfion air and flames between them. Note: When first lighfing your fireplace, it may be necessary to pre-warm the flue to establish a draft. This is done by holding a rolled up piece of burning newspaper under the flue damper for a few moments. This will help reduce smoke spillage during start-up. Note: The flrst three or four fires should be of moderate size to allow the oils and binders to be burned from the fireplace and the refractory and paint to cure. You may notice an industrial odor the first few fires. This is considered normal. CAUTION Odors and vapors released during inifial operafion. * Curing of high temperature paint. • Open windows for air circulafion. Odors may be irritafing to sensifive individuals. A WARNING Fire Risk Keep combusfible materials, gasoline and other flammable vapors and liquids clear of fireplace. * Do NOT store flammable materials close to the flreplace. * Do NOT use gasoline, lantern fuel, kerosene, charcoal lighter fluid or similar liquids to start or "freshen up" a fire in this fireplace. * Keep all such liquids well away from the fireplace while it is in use. Combusfible materials may ignite. 30 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 11 Troubleshooting A. Diagnostics and Problem Solving I can't get a good fire going. What am I doing wrong? Diagnostic Questions Possible Causes of Condition Solutions Is the damper open? • No draft Open damper. Is there enough paper/starter? • Insufficient heat to ignite kindling Use more paper/starter. Is there enough kindling? Is the kindling dry? • Insufficient heat to ignite fuel • Insufficient heat to establish draft Use more dry kindling. Is there enough or too much wood? Is it too large? Is it dry enough? • Insufficient heat to ignite fuel • Insufficient heat to establish draft Use small split wood that is well seasoned (split, covered on top at least 6 months, preferably a year). Is there enough or too much wood? Is it too large? Is it dry enough? • Insufficient air passage Use small split wood that is well seasoned (split, covered on top at least 6 months, preferably a year). Is there enough or too much wood? Is it too large? Is it dry enough? • Insufficient surface area Use small split wood that is well seasoned (split, covered on top at least 6 months, preferably a year). Is there enough or too much wood? Is it too large? Is it dry enough? • Ignition temperature high due to moisture Use small split wood that is well seasoned (split, covered on top at least 6 months, preferably a year). Are there adequate air spaces between fuel pieces? • Insufficient combustion air and exposed surface area Arrange kindling and wood for air movement. Is the chimney pre-warmed? • Exposed, cold chimney down drafting Use lighted rolled newspaper at throat or flue opening to start upward movement. Does the kindling, wood not ignite? • Condition, amount, arrangement of kindling and fuel Use more, drier, well-spaced kindling and fuel. Does the kindling ignite, but the fuel doesn't? • Amount of kindling • Condition of fuel Use more kindling; use smaller, dry wood. Does the fuel ignite, but not burn well? • Condition of fuel • Draft problem Use well-seasoned wood and sufficient amount; tum exhaust fans off; open window slightly. Perform Simplified House Pressure Test. 1 don't get enough/any heat from the fireplace. What can 1 do about it? Diagnostic Questions Possible Causes of Condition Solutions How much wood is used for fire? • Insufficient fuel Make larger fires. How well seasoned is the wood? • Condition of fuel Burn seasoned wood: covered on top, split and stacked for 9 months to 2 years. How much heat output do you expect? • Unrealistic expectations Explanation of decorative nature of fireplace; suggestion of approved fireplace insert. The fireplace burns the wood too fast. What can 1 do? Diagnostic Questions Possible Causes of Condition Solutions Do you have glass doors? • Need to slow air intake Add glass doors. What is the condition of the wood? • Extremely dry wood Mix in less seasoned wood after fire established. Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 31 12 Maintenance and Servicing the Fireplace A. Disposal of Ashes Ashes should be placed in a metal container with a tight- fitting lid. The closed container of ashes should be placed on a noncombustible floor or on the ground, well away from all combusfible materials, pending final disposal. If the ash- es are disposed of by burial in soil or othenwise locally dis- persed, they should be retained in the closed container unfil all embers have thoroughly cooled. A WARNING Fire Risk Disposal of ashes Ashes should be placed in metal container with fight fitting lid. Do not place metal container on combustible surface. Ashes should be retained in closed container until all embers have thoroughly cooled. A WARNING Fire Risk Prevent creosote buildup Inspect chimney once every two months during heafing season. Remove creosote to reduce risk of chimney fire. Ignited creosote is extremely HOT. B. Chimney Inspection/Cleaning Inspect the chimney internally for obstructions and construc- fion damage. Flue pipe joints and seams must be continu- ous and mechanically fight. The chimney should be inspected once every two months during the heafing season. If creosote has accumulated, it should be removed to reduce the risk of a chimney fire. Referto Figure 12.1 to remove/reinstall terminafion caps. C. Firebox Refractory Check firebox refractory for excessive cracks or gaps. If cracks exceed 1/4 in. (6 mm) in width the refractory should be replaced. See Secfion 12 for replacement informafion. A WARNING Fire Risk • Inspect fireplace refractory annually. Crumbling, deteriorated refractory can allow overheafing of surrounding materials. Note: As you use the fireplace, expansion and contracfion will cause minor cracking of the refractory. This is normal, unavoidable, and will not affect the performance of the fireplace. Ifthe cracks become large enough thatthe metal behind the refractory is exposed or large pieces fall out, the panels should be replaced. 1. REMOVE (8) SCREWS 2. LIFT TOP Remove screws, lift top cover. Top Cover i-O I ~Cap Remove 4 screws and lift top pan off. Chimney TR11/TR11T TR444/TR442 Round Termination Cap Figure 12.1 Chimney cleaning Section ST1175 ST475 Square Termination Cap Remove 2 screws from the front and back and lift the top off. SCREW TCT1175 Terra Cotta Termination Cap Available US only TOP -TOP LLJJ SCREW DT SERIES 32 Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 4 CAUTION Handle glass assembly with care. When cleaning glass door: * Avoid striking, scratching or slamming glass. * Do NOT use abrasive cleaners. * Use a hard water deposit glass cleaner on white film. * Do NOT clean glass when it is hot. A WARNING Fire Risk * Do not use chimney cleaners or fiame colorants in your fireplace. Will corrode chimney. A WARNING Asphyxiation Risk Fire Risk Annual inspecfion by qualified technician recommended. Check: Condition of doors, surrounds and fronts Condifion of glass and glass assembly Obstructions of combustion and ventilation air Gas connecfions and fittings (if present) Obstrucfions of terminafion cap Refractory panels Clean: Glass Air passageways, grilles D. Maintenance Task List Inspect Maintenance Tasks Screens 1 Assess condition of screen and replace as necessary. Screens are required. Screens 2 Verify maintenance of proper clearance to combustible household objects. Glass Doors 1 Inspect glass panels for cracks. Replace if this condition is present. Glass Doors 2 Confirm there is no damage to glass or glass frame. Replace as necessary. Glass Doors 3 Clean glass using a non-abrasive cleaner such as Brasso©. Circulation Compartment 1 Remove any foreign objects. Circulation Compartment 2 Verify unobstructed air circulation. Firebox 1 Inspect condition of refractory. Replace if crumbly, deteriorated, or if cracks exceed 1/4 in. (6 mm). Chimney 1 Inspect for blockage or obstruction such as bird nests, leaves, etc. Chimney 2 Confirm that termination cap remains clear and unobstructed by plants, etc. Chimney 3 Verify that termination cap clearance to subsequent construction (building additions) has been maintained. Chimney 4 Inspect for corrosion or separation. Chimney 5 Verify weather stripping, sealing and flashing remain intact. Chimney 6 Inspect for creosote and remove as needed. (See Sections 10 and 11) Grate 1 If grate burns out, it should be replaced only with the grate specified on the rating plate and in the replacement parts list for this fireplace. E. Chimney Fire In the event of a chimney fire: * Have the chimney and adjacent structure inspected by qualified professionals. Hearth & Home Technologies recommends that NFI or CSIAcertified professionals, or technicians under the direcfion of certified professionals, conduct a minimum of an NFPA 211 Level 2 inspecfion of the chimney. • Replace components of the chimney and fireplace as specified by the professionals. * Ensure all joints are properiy engaged and the chimney is properiy secured. A chimney fire can permanenfiy damage your chimney sys- tem. Failure to replace damaged components and make proper repairs creates risk of fire. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 33 13 Reference Materials A. Fireplace Dimensions 11-1/8 [281] fl29l|^ 16-1/8 [408] 74-1/8 [1883] 52-7/8 [1343] 16-1/8 [408] _[ fl29] 1 34 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 B. Optional Components 0DGF42-BZ Glass Doors (optional) See your Hearth & Home dealer for a complete list of optional components. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 35 C. Chimney Components The following pictures show only those chimney components which may be safely used with this fireplace. Catalog # Description SL1106 Chimney Section - 6 in. (152 mm) long SL1112 Chimney Section -12 in. (305 mm) long SL1118 Chimney Section -18 in. (457 mm) long SL1136 Chimney Section - 36 in. (914 mm) long SL1148 Chimney Section - 48 in. (1219 mm) long SL11 Chimney Stabilizer SLI130 Chimney Offset/Return - 30 deg FS538 Ceiling Firestop - Straight FS540 Ceiling Firestop - 30 deg JB577 Chimney Joint Band CB576 Chimney Bracket TRII Round Termination Cap TRI IT Round Telescoping Termination Cap TRI ITV Round Telescoping Termination Cap-Top Vent TCT1175 Terra Cotta Tennination Cap ST1175 Square Termination Cap CT56 Chase Top DT0134 Short Octagon Decroative Cap DT0146 Tall Octagon Decroative Cap DTS134 Short Square Decoratvie Cap DTS146 Tall Square Decorative Cap LDS33 Decorative Shroud - 3 ft x 3 ft (.91 m x .91 m) LDS46 Decorative Shroud - 4 ft x 6 ft (1.22 m x 1.83 m) LDS-BV Decorative Shroud - 26 in. x 26 in. (660 mm x 660 mm) Field Constructed Shrouds (See "Woodburning Termination Cap") CT-11A Adapter-May be used with the following copper caps CT-Series DT-Series 11 in. (279 mm) 13 in. (330 mm) Chimney Sections Catalog # A B Catalog # in mm in mm SL1106 6 152 4-3/4 121 SL1112 12 305 10-3/4 273 SL1118 18 457 16-3/4 425 SL1136 36 914 34-3/4 883 SLI148 48 1219 46-3/4 1187 A = Actual Length B = Effective Length (length of chimney part after it has been snapped to another) 20-3/4 in. (527 mm) Inside Diameter 11 in. (279 mm) Putside Diameter 13 in. (330 mm) SL11 Vent Stabilizer 36 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 C. Chimney Components Continued The following pictures show only those chimney components which may be safely used with this fireplace. Inside Diameter 11 in. (279 mm) 17 in. (432 mm) 21 in. (533 mm Outside Diameter 13 in. (330 mm) SL1130 Offset/Return 13 in. (330 mm) Catalog # A B FS538 0-deg. 17 in. 432 mm FS540 30-deg. 26 in. 660 mm JB577 Chimney Joint Band -13 in.- (330 mm)' CB576 Chimney Joint Band Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 37 D. Termination caps 15-3/4 in. (400 mm) TR11 - Round Termination Cap TR-TVK , 10 3/4 in. , K H 34-3/8 in. (873 mm) 31-3/4 in. (806 mm) 34-5/8 in. (879 mm) TR11-TV - Round Termination Cap 26 in. CT11-A Adapter TR11T - Round Telescoping Termination Cap 15-5/8 in. (397 mm) ST1175 - Square Termination Cap . 20 in. (508 mm) V<1 DTS134/DTS146 17 in. (432 mm) • i~( * 1111 ttt )'(> »') ttt I t ttt I t I I lilt ttlIttt 1111111111111 fI •llltlllltlltlltlttlttttitt itlllltlltl*tlttltlttltt(l> litIttttIttIt I Itltl 11 tttitt III ItIttit tttItt Ititt Itttt' r 9-3/8 in. {238^m) •TO134/0TO146 Decorative Caps DT0134 A B C in 34 20 24 mm 864 508 610 DT0146 in 46 22.7 26 mm 1168 576 660 DTS134 in 34 21.18 24 mm 864 538 610 DTS146 in 46 21.18 26 mm 1168 538 660 TCT1175 - Terra Cotta Cap 38 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 E. Service Parts List outdoor <iil!> lifestyles by hearth S home technologies* Service Parts ODCASTLEWD-42 42 in. Woodburning Fireplace Beginning IVIanufacturing Date: July 2010 Ending Manufacturing Date: Active Part numbers on following page. Traditional Molded Brick Panel Herringbone Molded Brick Panel 13 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 39 ^ outdoor <ii>. lifestyles by hearth & home technologies* Service Parts List ODCASTLEWD-42 Service Parts List IMPORTANT: THIS IS DATED INFORMATION. When requesfing service or replacement m^^^f^ parts for your appliance please provide model number and serial number. All parts listed ifP^VI in this manual may be ordered from an authorized dealer. W Stocked atDepol Stocked atDepol 1 Transifion Assembly 4059-044 2 Outer Transiton Assembly 24377 3 Inner Transiton Collar 4059-148 4 Grate Assembly GR29 5 Screen Rod Qty 2 req 4070-301 Y Screen Rod Clips Qty 2 req 4059-111 6 Firescreen Assembly Qty 2 req 4070-015 Y 7 Hearth Molded Brick Panel 4070-130 Traditional Molded Brick Panel 8 Left Panel 4070-131 9 Rear Panel 4070-133 10 Right Panel 4070-132 11 Side Refractory Retainer Qty 2 req 4070-108 12 Rear Reractory Retainer 4070-106 Herringbone Molded Brick Panel 11 Side Refractory Retainer Qty 2 req 4070-108 12 Rear Reractory Retainer 4070-106 13 Left Panel 4070-134 14 Rear Panel 4070-136 15 Right Panel 4070-135 Refractory Fastener Pack 8 #8 Screws 4025-026 Mortar 10L8 Bucket MMMORTR Outside Air Hood Qty 2 req 4070-019 40 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 F. Limited Warranty Outdoor Lifestyles by Hearth & Home Technologies, Inc.™ Limited Warranty Hearth & Home Technologies, Inc. ("HHT") extends the following warranty for all Outdoor Lifestyles by HHT™ brand products ("Products") that are purchased from an HHT authorized dealer. WARRANTY COVERAGE: HHT warrants to the original owner of the Product at the site of installafion, and to any transferee taking ownership of the Product at the site of installafion within one year following the date of original purchase, that the Product will be free from defects in materials and workmanship at the time of manufacture. After installation, if covered components manufactured by HHT are found to be defecfive in materials or workmanship during the applicable warranty period, HHT will, at its option, repair or replace the covered components. This warranty is subject to condifions, exclusions and limitafions as described below. WARRANTY PERIOD: The warranty period runs for one year, beginning on the eariier of: (i) the date of invoice for the Product; (ii) in the case of new home construcfion, the date of first occupancy of the residence or six months after the date of sale of the Product by an HHT authorized dealer, whichever occurs first; or (iii) the date 24 months following the date of Product shipment from HHT, regardless of the invoice or occupancy date. WARRANTY CONDITIONS; • This warranty only covers Products that are purchased through an HHT authorized dealer or distributor A list of HHT authorized dealers is available on the HHT branded websites. This warranty is only valid while the Product remains at the site of original installafion. Contact your installing dealer for warranty service. If the installing dealer is unable to provide necessary parts, contact the nearest HHT authorized dealer or supplier. Addifional service fees may apply if you are seeking warranty service from a dealer other than the dealer from whom you originally purchased the Product. Check with your dealer in advance for any costs to you when arranging a warranty call. Travel and shipping charges for parts are not covered by this warranty. WARRANTY EXCLUSIONS: This warranty does not cover the following: Changes in surface finishes as a result of normal use. As a heating appliance, some changes in color of interior and exterior surface finishes may occur; this is not a flaw and not covered under warranty. Damage to printed, plated, or enameled surfaces caused by fingerprints, accidents, misuse, scratches, melted items, or other external sources and residues left on surfaces from the use of abrasive cleaners or polishes. Repair or replacement of parts that are subject to normal wear and tear during the warranty period. These parts include: paint, firebricks, grates, flame guides and the discoloration of glass. Minor expansion, contracfion, or movement of certain parts causing noise. These condifions are normal and complaints related to this noise are not covered by this warranty. Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 41 Limited Warranty (continued) Damages resulfing from: (1) failure to install, operate, or maintain the Product in accordance with the installafion instrucfions, operafing instrucfions, and lisfing agent identificafion label furnished with the Product; (2) failure to install the Product in accordance with local building codes; (3) shipping or improper handling; (4) improper operafion, abuse, misuse, continued operafion with damaged, corroded or failed components, accident, or incorrectly performed repairs; (5) inad- equate venfilafion, negafive pressure or environmental condifions, including, without limitafion: hail, snow, ice, fallen branches, flooding, water damage and fading of color; (6) use of fuels other than those specified in the operafing instrucfions; (7) installafion or use of components not supplied with the Product or any other components not expressly authorized and approved by HHT; (8) modificafion of the Product not expressly authorized and approved by HHT in wrifing; and/or (9) interrupfions or fluctuations of electrical power supply to the Product. Non-HHT venfing components, hearth components or other accessories used in conjuncfion with the Product. Any part of a pre-exisfing fireplace system in which an insert or a decorafive gas appliance is installed. The Product's capability to heat the desired space. Informafion is provided to assist the consumer and the dealer in selecfing the proper appliance for the applicafion. Considerafion must be given to the Product's location and configurafion and environmental condifions. This warranty is void if: The Product has been over-fired or operated in atmospheres contaminated by chlorine, fluorine, or other damaging chemicals. Over-firing can be identified by, but not limited to, warped plates or tubes, rust colored cast iron, bubbling, cracking and discoloration of steel or enamel finishes and cracking or spalling of refractory or cementitious materials. The Product is subjected to prolonged periods of dampness, condensation, ice or snow. There is any damage to the Product or other components due to water or weather damage which is the result of, but not limited to, improper chimney or venting installation. UMITATIONS OF LIABILITY; Repair or replacement in accordance with the provisions of this warranty will be the owner's exclusive remedy for and will consfitute HHT's sole obligation under this warranty, under any other warranty (express or implied), or in contract, tort or othenwise; provided, however, that if HHT is unable to provide repair or replacement in an expedient and cost effective manner, HHT may discharge all such obligations by refunding the purchase price ofthe Product. No employee, agent, dealer, or other person is authorized to give any warranty on behalf of HHT. TO THE EXTENT ALLOWED BY LAW, HHT MAKES NO OTHER WARRANTY, EXPRESS OR IMPLIED, INCLUDING ANY WAR- RANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. HHT WILL NOT BE LIABLE FOR ANY CONSEQUENTIAL OR INCIDENTAL DAMAGES ARISING OUT OF DEFECTS IN OR USE OF THE PROD- UCTS. Some states do not allow exclusions or limitafion of incidental or consequential damages, so these limitations may not apply to you. This warranty gives you specific rights; you also may have other rights, which vary from state to state. The duration of any implied warranty is limited to the duration of the warranty period specified herein. 42 Outdoor Lifestyles by Hearth & Home Technologies Inc. * 4070-300 Rev 8*8/10 G. Contact Information out(door lifestyles by hearth & home technologies* Please contact your Outdoor Lifestyles dealer with any questions or concerns. For the number of your nearest Outdoor Lifestyles dealer, please visit www.hearthnhome.com. - NOTES - CAUTION DO NOT DISCARD THIS MANUAL Important operating and maintenance instructions included. Read, understand and follow these instructions for safe installation and operation. Leave this manual with party responsible for use and operafion. Outdoor Lifestyles by Hearth & Home Technologies Inc. • 4070-300 Rev 8*8/10 43 ^ COMMUNITY y/y cA/^ii ixicc Development Services ^> FACILITIES Building Division ^ CITY OF DISTRICTNO. 1 CARLSBAD NONRESIDENTIAL Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov NON-RESIDENTIAL CERTIFICATE: Non-Residential land owner, please read this option carefully and be sure you thoroughly understand before signing. The option you chose will affect your payment of the developed Special Tax assessed on your property. This option is available only at the time of the first building permit issuance. Property owner signature is required before signing. Your signature is confirming the accuracy of all information shown. NORTH COAST CALVARY CHAPEL 760 929-0029 Name of Owner Telephone 1350 POINSETTIA LN 1350 POINSETTIA LN Address Project Address CARLSBAD CA Carisbad, CA 920 City, State Zip City, State Zip 215-070-49-00 Assessor Parcel Number(s) or APN(s) and Lot Numbers(s) if not yet subdivided by County Assessor CB102519 Building Permit Number(s) As cited by Ordinance No. NS-155 and adopted by the City of Carisbad, California, the City is authorized to levy a Special Tax in Community Facilifies District No. 1. All non-residenfial property, upon the issuance ofa building pemiit, shall have the opfion to (1) pay the SPECIAL DEVELOPMENT TAX ONE TIME or (2) assume the ANNUAL SPECIAL TAX - DEVELOPED PROPERTY for a period not to exceed twenty-five (25) years. Please indicate your choice by initializing the appropriate line below: OPTION (1): I elect to pay the SPECIAL TAX - ONE TIME now, as a one-time payment. Amount of One-Time Special Tax: $ 17,477.77 Owner's Inifials^ OPTION (2): I elect to pay the SPECIAL DEVELOPMENT TAX ANNUALLY for 3 period not to exc^ejKwenty-five (25) years. Maximum annual Special Tax: $ 2,413.68 Owner's Initials . I DO HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE UNDERSIGNED IS THE PROPERTY OWNER OF THE SUBJECT PROPERTY AND THAT I UNDERSTAND AND VVILL COMPLY WITH THE PROVISION AS STATED ABOVE. PERTY AND THAT I UNDERSTV\ND ANDWILL COMPLY V Property Owner-^ Title me J Date Print Name The City of Carlsbad has not independently verified the information shown above. Therefore, we accept no responsibility as to the accuracy or completeness of this information. LandUse CHURCH Imp.Area 1 FY 2012/2013 Annex date 5/7/92 Factor .9725 X Square Ft. 17,972 = $17,477.77 B-32 Page 1 of 1 Rev. 07/09 CITY OF CARLSBAD CERTIFICATION OF SCHOOL FEES PAID B-34 Development Services Building Department 1635 FaradayAvenue 760-602-2719 www.carlsbadca.gov This form must be completed by the City, the applicant, and the appropriate school districts and returned to the City prior to issuing a building permit. The City will not issue any building permit without a completed school fee form. Project Name Building Permit Plan Check Number: Project Address: A.P.N Project Applicant (Owner Name): Project Description: Building Type Residential: Second Dwelling Unit: Residential Additions: NORTH COAST CALVARY CHAPEL Project ID: CT/MS: CUP04005 CB102519 1350 POINSETTIA LN 215-070-49-00 NORTH COAST CALVARY CHAPEL NEW CHAPEL. BOOKSTORE. MULTI-PURPOSE ROOM CHURCH NEW DWELLING UNIT(S) Square Feet of Living Area in New Dwelling/s Square Feet of Living Area in SDU Net Square Feet New Area Commercial/Industrial: 17,972 SF Net Square Feet New Area City Certification of Applicant Information.- (f^ganaHm (fihh^ nate 7/?4/?ni3 SCHOOL DISTRICTS WITHIN THE CITY OF CARLSBAD Carlsbad Unified School District 6225 El Camino Real Carisbad CA 92009 (760-331-5000) • Vista Unified School District 1234 Arcadia Drive Vista CA 92083 (760-726-2170) 1 1 San Marcos Unified School District 255 Pico Ave Ste. 100 San Marcos, CA 92069 (760-290-2649) Contact: Nancy Dolce (By Appt. Only) 1 1 Encinitas Union School District 101 South Rancho Santa Fe Rd Encinitas, CA 92024 (760-944-4300 xll66) 1 1 San Dieguito Union High School District-By Appointment Only 684 Requeza Dr. Encinitas, CA 92024 (760-753-6491 x5514) Certification of Applicant/Owners. The person executing this declarafion ("Owner") certifies under penalty of perjury that (1) the information provided above is correct and true to the best ofthe Owner's knowledge, and that the Owner will file an amended certification of payment and pay the additional fee if Owner requests an increase in the number of dwelling units or square footage after the building permit is issued or if the initial determination of units or square footage is found to be incorrect, and that (2) the Owner is the owner/developer ofthe above described project(s), or that the person executing this declaration is authorized to sign on behalfofthe Owner. Signature: B-34 Page 1 of 2 Date: Rev. 03/09 SCHOOL DISTRICT SCHOOL FEE CERTIFICATION (To be completed by the school district(s)) **************************************************** THIS FORM INDICATES THAT THE SCHOOL DISTRICT REQUIREMENTS FOR THE PROJECT HAVE BEEN OR WILL BE SATISFIED. SCHOOL DISTRICT: The undersigned, being duly authorized by the applicable School District, certifies that the developer, builder, or owner has satisfied the obligation for school facilities. This is to certify that the applicant listed on page 1 has paid all amounts or completed other applicable school mitigation determined by the School District. The City may issue building permits for this project. SIGNATURE OF AUTHORIZED SCHOOL DISTRICT OFFICIAL TITLE NAME OF SCHOOL DISTRICT DATE CARLSBAD UNIFIED SCHOOL DISTRICT 6225 EL CAMINO REAL CARLSBAD, CA 92009 7' 1 3 PHONE NUMBER B-34 Page 2 of 2 Rev. 03/09 SDGl A ^^Sempra Energy uiniiy" Project No. 354440-010 Mays, 2013 9891 In/ine Center Drive, Suite 140 In/ine, Ca. 92618 Dear Jim Thayer: SUBJECT: 1330 Poinsettia Lane, Carlsbad, Ca Hello Jim, I have reviewed your plans for Calvary Chapel, 1330 Poinsettia Lane in Carlsbad. SDG&E is proposing no changes to your existing gas meter and/or service at this time. SDG&E's calculations for meters and services do not change when piping lengths change beyond our meter. Should you increase your gas loads beyond what has previously been designed for or need a gas meter or service relocation, please contact me. The gas meter may need upsized and work orders may need to be generated. Sincerely, lifer Pric stomer Prtsject Planner Telephone: (760) 480-7727 ^ PLUMBING, Development Services <^ (•X ELECTRICAL, Building Department ^ CITY OF MECHANICAL I635 Faraday Avenue r^Ani CD Am WORKSHEET 75^6022719 L-AKLbbAU B 18 www carisbadca gov ProjectAddress: /330 PaU^^^/A PermitNo.: Information provided bek>u; refen to worb being done on the above mentioned permit only. This form must be completed and returned to the Buildinq Department before the permit can be issued. Building Dept. Fax: (760) 602-8558 Number of new or relocated fixtures, traps, or floor drains 32- New building sewer line? Ves No ^£»r/»J 6 Number of new roof drains? 23 Install/alter water line? ^ Number of new water heaters? ^ Number of new, relocated or replaced gas outlets? S' Number of new hose bibs? (t^ Upgrade existing panel? Ves No ^ From ^Amps to ^Amps Number of new paneb or subpanels? 8 Single Phase Number of new amperes Three Phase. .(.?..Q/^..'^.{5^.....^C«lLt4r Number of new amperes ^QO Three Phase 480.. .....v.c2y:. Number of new amperes. Remodel (relocate existing outlets/switches or add outlets/switches)? Yes No )( Number of new fumaces, A/C or heat pumps? ' New or relocated duct worh? . Ves No Number of new fireplaces? ^Z- Number of new exhaust fans? . .3 Relocate/install vent? '^2— Number of new exhaust hoods? Q Number of new boilers or compressors? Number of HP ^ B-18 Page 1 of 1 Rev. 03/09 City of Carlsbad Permit No: Address VALUATION WORKSHEET Assessor Parcel No. Date By- Building Division TypeofWork Area of Work Multiplier VALUE SFD and Duplexes $110.17 $0.00 Residential Additions $131.73 $0.00 Remodels / Lofts $57.48 $0.00 Apartrnents & Multi-family $98.20 $0.00 Garages/Sunrooms/Solariums $28.74 $0.00 Patio/Porch/Carport 1284 $9.58 $12,300.72 Enclosed Patio $15.51 $0.00 Decks/Ba 1 co ni es/Sta i rs 3895 $15.57 $60,645.15 Retaining Walls, concrete,masonry $19.16 $0.00 Pools/Spas-Gunite $40.72 $0.00 Tl/Stores, Offices $37.12 $0.00 Tl/Medical, restaurant, H occupancies $50.30 $0.00 Photovoltaic Systems/ # of panels $400.00 $0.00 CHURCH IIIA 17,972 $97.00 $1,743,284.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fire Sprinkler System 17,972 $3.11 $55,892.92 Air Conditioning - commercial 17,972 $5.03 $90,399.16 Air Conditioning - residential $4.19 $0.00 Fireplace/ concrete, masonry $3,855.98 $0.00 Fireplace/ prefabricated Metal $2,621.34 $0.00 $0.00 $0.00 TOTAL Valuation: $1,962,522 Comm/Res (C/R): 0 Building Fee $6,044.72 Plan Check Fee $4,231.30 Strong Motion Fee $412.00 Green Bldg. Stand. Fee $76.00 Green Bldg PC Fee $150.00 License Tax/PFF $68,688.27 License Tax/PFF (in CFD) $35,717.90 CFD Isthourof Plan CheckFire Expedite Plumbing TBD Mechanical TBD Electrical TBD $1,962,521.95 CFD 0 Yes (PFF= 1.82%) M No (PFF = 3.5%) Land Use: Density: Improve. Area: Fiscal Year: Annex. Year: Factor: CREDITS PFF and/orCFD Explanation: & 1 H.S P*'""^''"*"' orih« Treasury !n(«rn»l R*v«nu* Service P.O. Box 2508 Cincinnati OH <^SZQ1 In reply refer to: 0248367572 Oct. 09, 2013 LTR <tl68C 0 95-3063132 OOOOOO 00 00017535 BODCt TE 003540 CALVARY CHAPEL NORTH COAST 1330 POINSETTIA LN CARLSBAD CA 92011 Employer Identification Number: Person to Contact: Toll Free Telephone Number: Dear Taxpayer: 95-5063132 Ms. Mueller 1-877-829-5500 This is in response to your Sep. 30i 2015» request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in February 1982. Our records also indicate that you are not a private foundation within the meaning of section 509Ca) of the Code because you are described in section(s) 509(a)(1) and 170 (t>) ( 1) (A) (i) . Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. Please refer to our website www.irs.gov/eo for infarmation regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011. Inlernal Revenue Servjce District Director Department of the Treasury Date: Calvery Chapel - North Coast i> 237 North El Camlno Real Encim'tas, CA 92024 Employer Identificatiort Number: 95-3063132 Accounting Periotl Ending: December 31 Form 990 Required: • Yes Q No Person to Contact: B. Brewer Contact Telephone Number: (213) 688-4553 Dear Applicant: Based on information supplied, and assuming your operations will be as stated tn your application for recognition of exemption, we have determined you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. We have further determined that you are not a private foundation within the meaning of section 509(a) of the Code, because you are an organisation described in section 170(b)(T)(A)(i) & 509(a)(1). If your sources of support, or your purposes, character, or method of operation change, please let us know so we can consider the effect of the change on your exempt status and foundation status. Also, you should inform us of all changes in your name or address. Generally, you are not liable for social security (PICA) taxes unless you file a waiver of exemption certificate as provided in the Federal Insurance Contributions Act. If you have paid FICA taxes without filing the waiver, you should contact us. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA). • Since you are not a private foundation, you are not subject to the excise taxes under Chapter 42 of the Code. However, you are not automatically exempt from other Federal excise taxes. If you have any questions about excise, employment, or other Federal taxes, please let us know. Donors may deduct -contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. The box checked in the heading of this letter shows whether you raust file Form 990, Return of Organization Exempt from Income tax. If Yes is checked, you are required to file Form 990 only if your gross receipts each year are normally more than $10,000. If a return is requirad. it must be filed by the 15th day of of the fifth month after the end of your annual accounting period. The law imposes a penalty of $10 a day, up to a maximum of $5,000, when a return is filed late, unless there is reasonable cause for the delay. P.O. Box 2350. Los Angeles, Calif. 90053 {ovtri Letter 947(DO) (5-77) ro M^tiVi 1350 POINSEHIALN ^LVARY CHAPEL MAPEL,-COFFEE/BOOKSTORE ' Approved , Pa^e By //V/ p.. •id iL- ''^l r-f'^ r^AOtr-jo^i^ ^. Planning Approved BUIUJING lAjj/^JiyVt^aJi^ PUWNING ENGINEERING ExpedKe? IE HazMat APCD Health , Pal 'llh/l^ Forms/Fees Sent Reed Due? By Encina Rre HazHealthAPCD PE&M school Sewer Stormwater Special Inspection \jsnMse:Cfjt(rctt DensXy. (mpArea f Ff /'jZf jjrinex: fj'^l Factor^ ll^S PFF: Commeni CD bate Date/ Date -.5^ Builciing Engineering Fire ffio/fi <P/K#/< SIAJ l ot) ^50{ ssued ,tV'H/'-i <ar^ y-^/ O Corporate Express- A Bi^wmni Compmy CEB03408 Made In aie USA