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HomeMy WebLinkAbout2540 EL CAMINO REAL; B; CB152392; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 09-09-2015 Commercial/Industrial Permit Permit No: CB152392 Building Inspection Request Line (760) 602-2725 Job Address: 2540 EL CAMINO REAL CBADSt: B Permit Type: TI Sub Type: COMM Status: ISSUED Parcel No: 1610304800 Lot #: 0 Applied: 07/28/2015 Valuation: $76,243.00 Construction Type: 5B Entered By: LSM Occupancy Group: Reference # Plan Approved': 09/09/2015 Issued: 09/09/2015 Inspect Area Plan Check #: Project Title: DAVID STEMLEY= INCORPORATE 1,760 SF SUITE C INTO SUITE B TO INCLUDE REMOVAL OF INTERIOR DEMISING WALLH NEW PARTITIONS, P/M/E- Applicant: Owner: LAUREN D'AGOSTINI AZALEA INC <LF> A A E PACIFIC PARK ASSCS L L C C/O HUGHES INVESTMENTS -MANAGER 2272 FIRST AV P O BOX 8100 SAN DIEGO CA 92101 NEWPORT BEACH CA 92658 619-744-5884 Building Permit $525.17 Meter Size Add'I Building Permit Fee $0.00 Add'I Recl. Water Con. -Fee $0.00 Plan Check $367.62 Meter Fee $0.00 Add'I'Building Permit Fee $0.00 SDCWA Fee $0.00 Plan Check Discount $0.00 CFD Payoff Fee $0.00 Strong Motion'Fee $21.35 PFF (3105540) $0.00 Park Fee $0.00 PFF (4305540) $0.00 LFM Fee $0.00 License Tax (31041-93) $0.00 Bridge Fee $0.00 License Tax (4304193)' $0.00 BTD #2 Fee $0.00 Traffic Impact Fee (3105541) $0.00 BTD #3 Fee $0.00 Traffic Impact Fee (4305541) $0.00 Renewal Fee $0.00 PLUMBING TOTAL $0.00 Add'I Renewal Fee $0.00 ELECTRICAL TOTAL $46.00 Other Building Fee $0.00 MECHANICAL TOTAL $0.00 Pot. Water Con. Fee $0.00 Master Drainage Fee $0.00 Meter Size Sewer Fee $0.00 Add'I Pot. Water Con. Fee $0.00 Redev Parking Fee $0.00 Red. Water Con. Fee $0.00 Additional Fees $0.00 Green Bldg Stands (SB.1473) Fee $4.00 HMP Fee ?? Fire Expedidted Plan Review $0.00 Green Bldg Standards Plan Chk ?? TOTAL PERMIT FEES $964.14 Total Fees: $964.14 Total Payments To Date: $964.14 Balance Due: $0.00 FINAL AP ROYAL Inspector: Date: << Z''�5� Clearance: NanCE Pleasetalcs CEthatappuvdcfyourprojectirxludesthe"inpositicrf' fees,deda#jas,reservations,orotterexactionsNyeaftercdledivdy referred to as "teeslexactions." You have 90 days from the date this pern it vas issued to protest inposition of these fees/exactions. If you protest them you mst fdiwvthe protest procedures set forth in Gmerrrrent Code Section fflWa), and file the protest and any other required Irfarrslien with the aty VwW for pDoessirig in accadanee Wth Cartsbad M.xidpai Code Section 3.32030. Failure to tirrelyfdlowthat prooed<re will bar any subsaW legal action to attack, review, set aside, void, or mU their inposition. You are hereby RRr ER NOTI RED that your right to protest the spedfied fees(000tic s DOES NOT APPLY to wafer and saner correction fees and capadty dvrges, nor plaming, acing, grading or other sin ilar applicafion prooessirg or service fees in omiedion Wth this paject. NCR DOES ITAPPLY to any fees/exactions of v�hich)o have previously been dven a NOTICE sirrilar to this or as to W ich the statute of limitations has orejudy off-oWse red. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: E313LANNING LIENGINEERING OBUILDING AFIRE [:]HEALTH E]HAZMAT/APCD �� Building Permit Application Cj r of 1635 Faraday Ave., Carlsbad, CA 92008 Carlsbad Ph.email6bui ding@ca Isbad a.yov558 www.carisbadca.gov Plan Check No. C6 i s-as 9, 2 Est. Value 7 a y plan Ck. Deposit 31a7. (O� Date � a—S� J SWPPP JOB ADDRESS Z��o �MtNO RL SUITE#/SPACE#/UNIT# Slk) ►T APN - CT/PROJECT # LOT # PHASE # # OF UNITS # BEDROOMS # BATHROOMS -pa,�ibS1`�1�lUiG TENANTt,BUSINEESSS NAMES ` v•�• CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(S) �oN►N�� �N'(�0�- I GZi- ot >� ems_ ,y PL�c►.�,�P EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES❑ R NOD AIR CONDITIONING YES NO ❑ ❑ IFIRESPRINKLERS ❑� YESNO APPUCANT Primary Contact AME ��A�'� PROPERTY OWNER NAME, ` ' �� / S ADDRESS zz-m ADDRESSvO CITY STATE � ZIP w^ (O l CITY N��V STATE � ZIP f! f�r,r•+—�� PHONEif . � . ` /� w ((//1�1` ( T�r FAX PHONE A FAX � � • EMAIL OL EMAIL . DESIGN PROFESSIONALr .{' (.y -L' ` . CONTRACTOR BUS. NAME ep 7 ADDRESS 22 Z ����%• "ADDRESS ��3 V1�1���C'� CITY STATE ZIP � a2�o� CITY. STATE ZIP �N �» cap �►�► PHONE�'�•� FAX PHONEhw - ``77 N' FAX EMAIL V V dcjT�lti��t'S� i1 d� _`!AlY�- EMAIL 1 ► 1r O��jIGIV�}-�ot�hOtdi��tl�j GYIGI�OI.� `GDi� -41, . STA E LIC. # - STATE LIC.# #0 155Z CLASS $ CITY BUS. LIC.# 12 (Sec; 7031.5 Business and Professions -Code: Any City or County which requires a permit to, construct, alter, improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a siggned statement that he is licensed pursuant to the provisions of the Contractor's License Law ((Chapter 9, commending with Section 7000 of Division 3 of the .Business and Professions Code) ortllat he is exempt therefrom, and the basis for the alleged exemption. Any violation of.Section 7031.5 by any applicant for a permit subjects the applicant to a civil nannity of not mnm Than five h(inrlmd dnllars MS001). Workers' Compensation Declaration: ) hereby affirm under penallyofpeduryone ofthe following declaration's., ❑ 1 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 permit is issued. ❑ 1 have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance -of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. Policy No. Expiration Date Thi section need not be completed if the permit is for one hundred dollars ($100) or less. Certificate of Exemption:'I certify that in the performance of the work for which this permit is issued, I shall notemploy any person in any manner so as to become subject to the Workers' 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'attomey's fees. RE CONTRACTOR SIGNATURE AGENT DATE 1 hereby affirm that 1 am exempt from Contractor's License Law for the following reason: El ],as owner of the property or my employees with wages as,theirsole compensation, will do the work and the structure is not intended oroffered-for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are notintended or offered for sale. If, however,'the building or improvement is sold within one yeanof 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 w110 builds or improves thereon, -and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). .I am exempt under Section Business and Professions Code for this reason: 1.1 personally -plan to provide the major labor and materials for construction of the proposed property improvement. QYes ❑No 2.1(have I have not) signed an application for a building permit for the proposed Work. 3.1 have contracted with the fallowing person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and-provide.the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone [type of work): &E PROPERTY OWNER SIGNATURE []AGENT DATE s;3'+as'r.LUt:Y",7� L!"�✓ ' ' a - • • • D D L`l,, Lm'�LV SiAJ�S'EJ +% �+s./ve++i.: t° - - Is the applicant or future•buildmg 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 Presley -Tanner Hazardous Substance Account Act? Yes No Is the.applicant or future building occupant required to obtain a permit from -the air pollution control district or air quality management district? - Yes No Is the facility to be constructed 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. WOMe e D ',7, I hereby affirm that 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 I c e tifythatl have read the appication and statethatthe above i-iinformation is correctand thatthe information on the plans is accurate.I agreeto comply Wth all City ordf nances and State laws relatingto builcingconstruc Lion. I hereby authorize representative ofthe Cily of Carlsbad to enteruponthe above mentioned property for inspection purposes. I ALSO -AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINSTALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH'MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permitis required for excavations over 60' deep and demdibon or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the 'Iding Official under the priovisionj ofthis Code shall expire by limitation and become null and void Ithe building brwork authorized by such permit is not commenced within 180 days from the dab ofsuch permitor' build' or work authorized by uch permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ,eAPPLICANT'SSIGNATURE DATE 0% . STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Only)CERTIFICATE OF OCCUPANCY (Commercial Projects Fax"(760) 602-8560, Email building carlsbadca.goV or Mail the completed forth to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACTNAME OCCUPANT NAME ADDRESS BUILDING -ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA " PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg.:L) ASSOCIATED CB# MAIL TO: CONTACT"(Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg.1) NO CHANGE IN USE / NO CONSTRUCTION MAIL/ FAX TO OTHER:, CHANGE OF USE/ NO CONSTRUCTION .!SAPPLICANPS SIGNATURE DATE Inspection,_ List Permit#: CB152392 Type: TI COMM DAVID STEMLEY= INCORPORATE 1,760 SF SUITE C INTO SUITE B TO INCL Date Inspection Item 11/20/2015 89 Final Combo 11/20/2015 89 Final Combo 10/29/2015 85 T-Bar 10/07/2015 17 Interior Lath/Drywall 09/18/201514 Frame/Steel/Bolting/Weldin 09/18/201.5 21 Underground/Under Floor Inspector Act Comments - RI, COF/ FIRST APPT PLEASE PY AP PY AP . PY AP PY AP PY AP Monday, November 23, 2015 Page 1 of 1 EsGil Corporation In (Partnership with Government for Building Safety DATE: 09/02/2015 JURISDICTION: Carlsbad PLAN CHECK NO.: 15-2392 PROJECT ADDRESS: 2540 El Camino Real SET:1i PROJECT NAME:, David Stemley optometrist TI ❑ .6PPLICANT ❑ JURIS. 0 PLAN REVIEWER ❑ FILE Z The pla,ls transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. ❑ 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. ❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. ❑ The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. ❑ 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. ❑ EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Date contacted: (by: ) Mail Telephone Fax In Person ❑ REMARKS: By: John Le Vey EsGil Corporation ❑GA ❑EJ ❑MB El PC Telephone #: Email: Enclosures: 08/31 /2015 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 EsGil Corporation In (Partnership with Government for Building Safety DATE: 08/07/2015 JURISDICTION: Carlsbad PLAN CHECK NO.: 15-2392 SET: I PROJECT ADDRESS: 2540 El Camino Real PROJECT NAME: David Stemley optometrist TI ❑ A PLICANT JURIS. ❑ PLAN REVIEWER ❑ FILE ❑ 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 codes when minor deficiencies identified below are resolved and checked by building department staff. ❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. ® The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. ❑ 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. ® EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Lauren Augostini J-4 Date contacted: (5 ail e e'phonJ Fax In Person ❑ REMAR By: John Le Vey EsGil Corporation ❑GA EJ. ❑ M B ❑PC Telephone #: 619-744-5884 Email: Lauren@augstinedesigngroup.com Enclosures: 07/31 /2015 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 Carlsbad 15-2392 08/07/2015 PLAN REVIEW CORRECTION LIST - TENANT IMPROVEMENTS PLAN CHECK NO.: 15-2392 OCCUPANCY: B TYPE OF CONSTRUCTION: VB (ALLOWABLE FLOOR AREA: SPRINKLERS?: No REMARKS: DATE PLANS RECEIVED BY JURISDICTION: 07/28/2015 DATE INITIAL PLAN REVIEW COMPLETED: 08/07/2015 FOREWORD (PLEASE READ): JURISDICTION: Carlsbad USE: optometrist ACTUAL AREA: 1,760 STORIES: 1 HEIGHT, unknown OCCUPANT LOAD: 45 DATE PLANS RECEIVED BY ESGIL CORPORATION: 07/31/2015 PLAN REVIEWER: John Le Vey This plan review is limited to the technical requirements contained in the California version of 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 2013 CBC, which adopts the 2012 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 2012 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 15-2392 08/07/2015 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. Each sheet of the plans must be signed by the person responsible for their preparation, even though there are no structural changes. California State Law. 2. Provide a note on the site plan indicating the previous use of the tenant space or building being remodeled. Section 107.2. 3. Please show GFCI protection of the receptacles within 6 feet of the any waters edge 4. Please clarify if the electrical panels are new or existing sheets A2.1 and E2.0 are conflicting 5. Roof mounted equipment must be screened and roof penetrations should be minimized (city Policy 80-6). This form can be found on the city web site attach to the plans 6. Please provide plans and calculations signed -by the California State licensed engineer or architect for the structural support of the 1000# rooftop air handler unit. Include all calculations and finding on the plans. Please include the California license number, seal, date of license expiration and date plans are signed. Business and Professions Code. 7. Please provide a service receptacle located less than 25' from the new equipment and GFCI protected. CIVIC 310.1 Advisory Note : When alterations, structural repairs or additions are made to an existing building, that building, or portion of the building affected, is required to comply with all of the following requirements, per Section 11 B-202.4: • The area of specific alteration, repair or addition must comply as "new" construction. • A primary entrance to the building and the primary path of travel to the altered area, must be shown to comply with all accessibility features. The path of travel shall include the existing parking. Carlsbad 15-2392 08/O7/2O15 • Existing toilet and bathing facilities that serve the remodeled area must be shown to comply with all accessibility features. • Please address the following comments that are the result of the alterations. 8. Show or note that the lower 10" of all doors comply with Section 11 B-404.2.10, as follows: a) To be smooth and uninterrupted, to allow the door to be opened by a wheelchair footrest, without creating a trap or hazardous condition. b) Narrow frame doors may use a 10" high smooth panel on the push side of the door. 9. Show, or note, that there is a level floor or landing on each side of all doors. The floor or landing is to be 5Y2' lower than the doorway threshold, per Section 11 B- 404.2.5. 10. Show on the site plan the complying disabled accessible path of travel from the disabled accessible parking spaces to the primary entrance of the tenant space. Please provide detailed plans of the path of travel, indicate slope and width, any pedestrian ramps, curb ramps, walks, handrails, provide dimensioned parking stall details etc. 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. Please indicate here if any changes have been made to the plans that are not a result of corrections from, this list. If there are other changes, please briefly describe them and where they are located in the plans. Have changes been made to the plans not resulting from this correction list? Please indicate: ❑ Yes ❑ No 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 John Le Vey at Esgil Corporation. Thank you. Carlsbad 15-2392 08/07/2015 ADO NOT PAY- THIS IS NOT AN INVOICE] VALUATION AND PLAN CHECK FEE JURISDICTION: Carlsbad PLAN CHECK NO.: 15-2392 PREPARED BY: John Le Vey DATE: 08/07/2015 BUILDING ADDRESS: 2540 El Camino Real BUILDING OCCUPANCY: B BUILDING PORTION AREA ( Sq. Ft.) Valuation Multiplier Reg. Mod. VALUE ($) TI 1760 per citv 76,243 Air Conditioning Fire Sprinklers TOTAL VALUE 76,243 Jurisdiction Code Icb IBy Ordinance I Bldg. Permit Fee by Ordinance W Plan Check Fee by Ordinance Type of Review: 0 Complete Review ❑ Structural Only ElRepetitive Fee ❑ Other Repeats ❑ Hourly Hr. @ EsGil Fee Comments: Sheet of $520.71 $338.46 $291.60 macvalue.doc + s CITY OF C& PLAN CHECK REVIEW TRANSMITTAL Community & Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carlsbadca.gov DATE:07/29/2015 PROJECT NAME: TI PROJECT ID: CB152392 PLAN CHECK NO. 1 SET#: 1 ADDRESS: 2540 EL CAMINO REAL STE B APN- 1670304300 VALUATION: $ 76243 This plan check review is complete and has been APPROVED by the ENGINEERING Division. By: VALRAY NELSON A Final Inspection by the ENGINEERING 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: LAUREN@AUGUSTINEDESIGNGROUP.COM 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 of a building 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 ENGINEERING FIRE.PR.EVENTI.ON _ ', 760-6024610 760-602-2750 . 7..60=602-4665 Chris Sexton Kathleen Lawrence Greg Ryan 760-602-4624 760-602-2741 760-602-4663 Chris.Sexton@carlsbadca..gov Kathleen.Lawrence@carlsbadca.eov Gregory. Ryan@carlsbadca.eov Gina -Ruiz Linda Ontiveros Cindy Wong 760-602-4675 760-602-2773 760-602-4662 Gina.Ruiz@carisbadca.gov Linda.OntiVeros@carlsbadca.gov ynthia.Wong@carlsbadca.eov ValRay Nelson Dominic Fieri 1� 760-602-2741 760-602-44664 Va1Ray.Nelson@carisbadca.gov Dominic.Fieri@carisbadca.gov Remarks: 4. BUILDING PLANCHECK Development services I�.,� - Land Development Engineering V CITY OF CHECKLIST 1635 Faraday Avenue g�,p QUICK-CHECK/APPROVAL 760-602-2750 www,carlsbadca.gov ENGINEERING Plan Check for CB152392 Date:0712912015 Project Address: 2540 EL CAMINO REAL STE B APN:1670304800 Project Description: TI REMOVING WALL BETWEEN STE B AND C Valuation: $ 76243 ENGINEERING Contact: VALRAY NELSON Email: VALRAY.NELSON@CARLSBADCA.GOV Phone: 760-602-2741 0 RESIDENTIAL INTERIOR El RESIDENTIAL ADDITION MINOR (<$20,000.00) El CARLSBAD PREMIER OUTLETS [:1 OTHER: GYM Fax: 760-602-1052 WJENANT IMPROVEMENT PLAZA CAMINO REAL [l COMPLETE OFFICE BUILDING r.._.._.._.._.._.._.._.. OFFICIAL USE .ONLY .._.._.._.._... .._...I i ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT i i BY: VALRAY NELSON- DATE:07/2912015 i REMARKS: I Notification of Engineering APPROVAL has been senf to..LAUREN@AUGUSTINEDESIGNGROUP.COM.- �_ via VALRAY.NELSON@CARLSBADCA.GOV, on. 07/29/2015_ . , _ .. _ .. _ • , _ .'� E-36 Page 1 of 1 REV 4/30/11 t Fee Calculation Worksheet ENGINEERING DIVISION Prepared by: Date: 07/2912015 GEO DATA: LFMZ: / B&T: Address: 2540 EL CAMINO REAL STE B Bldg. Permit #: CB152392' .Fees Update by: Date: 07/29/2015 Fees Update by: Date: 07/291201d EDU CALCULATIONS: List types and square footages for all uses. Types of Use: Sq.Ft./Units EDU's: Types of Use: Sq.Ft./Units EDU's: Types of Use: Sq.Ft./Units- EDU's: Types of Use: Sq.Ft./Units EDU's: ADT CALCULATIONS: List types and square footages for all uses. Types of Use: Sq.Ft./Units ADT's: Types of Use: Sq.Ft./Units ADT's: Types of Use: Sq.Ft./Units ADT's: Types of Use: Sq.Ft./Units ADT's: FEES REQUIRED: Within CFD:❑YES (no bridge & thoroughfare fee in-District.#1, reduces Traffic Impact Fee) ❑NO 1. PARK-IWLIEU FEE:[❑NW QUADRANT ZNE QUADRANT ❑SE QUADARANT ❑SW QUADRANT ADT'S/UNITS: I X FEE/ADT: I =$ ❑ 2.TRAFFIC IMPACT FEE: ❑ ADT'S/UNITS: I X FEE/ADT: =$ .3, BRIDGE & THOROUGHFARE FEE: ❑ DIST. #1 ❑ DIST,#2 I { DIST.#3 ADT'S/UNITS: FEE/ADT: I=$ ❑ 4. FACILITIES MANAGEMENT FEE ZONE: - ADT'S/UNITS: I X FEE/SQ.FT./UNIT: I _$ ❑', 5. SEWER FEE EDU's I X FEE/EDU: I =$ ❑ BENEFIT AREA: EDU's I X FEE/EDU: I =$ ❑ 6. DRAINAGE FEES: PLDA: OHIGH ❑❑MEDIUM GLOW ACRES: I X FEE/AC: I =$ ❑ 7. POTABLE WATER FEES: UNITS I CODE CONN. FEE I METER FEE SDCWA FEE I TOTAL 4- PLANNING DIVISION pevelopment Services BUILDING PLAN CHECK Planning Division / C I T Y O F APPROVAL 1635 Faraday Avenue CARL.SBAD P-29 (760) 10 www.carlsbadca.2dca.eov DATE: 7-28-15 PROJECT NAME: PROJECT ID: PLAN CHECK NO: CB 15-2392 SET#: 1 ADDRESS: 2540 El Camino Real APN: 167-030-48-00 ® This plan check review is complete and has been APPROVED by the Planning Division. By: Chris Sexton A Final Inspection by the Planning Division is required F� Yes ® No 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 of a building permit. Resubmitted plans should include corrections from all divisions. 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 APPROVAL has been sent to: For questions or clarifications on the attached checklist please contact the following reviewer as marked: PLANNING 760=6024610 ENGINEERING 760-602-2750. F1RE:PREVENTION' .' ` 766-6024665.', ' ® Chris Sexton 760-602-4624 Chris.Sexton@carisbadca.gov F Chris Glassen 760-602-2784 Christopher.Glassen@carisbadca.gov Greg Ryan 760-602-4663 Gregoa.Ryan@carisbadca.gov [-] Gina Ruiz 760-602-4675 Gina.Ruiz@carisbadca.gov F] Val,Ray Marshall 760-602-2741 Val Ray.Marshall@carisbadca.gov F-] Cindy Wong 760-602-4662 Cynthia.Wong@carlsbadca.gov Linda Ontiveros 760-602-2773 Linda.Ontiveros@carisbadca.gov F I Dominic Fier! 760-602-4664 Dominic.Fieri@carlsbadca.gov Remarks: $* CITY OF C,S ,D PLAN CHECK REVIEW TRANSMITTAL PAT9: 09/4/15 PROJECT NAME; david otemley 0^ PROJECTIIOKP'�' PLAN CHECK NO; 010=92 $ET#,- If ADDRESS: 2440 eor �PN-. This plan check review Is complete and has been APPROVED @fie We Division, By: 0wong A Final Inspection by the Divisimi Is. required Z yos [ No This plan chock review Is NOT COMPLETE, Items missing or incorrect are listed on the attached checklist, Please resubmit amended plans as required. Plan Check Comments have been sent to octavio o2arch.com &USPS 1635 Faraday Avenue CarlsbaO CA 92008 You may also have corrections from one or more of the divisions listed below. Approval from these divisions may be required prior to the Issuance of a building permit.. PesuOmitted plans should Include corrections from a// divisions. For questions or Plarifloptions on the attached checklist plow contact the following reylower as marked: P34 � �^ti- ' . . . . . . . . ... r` Y �zfc^ .� S 'z", -' 'S .}} ;"T«4+'z - 'f a. '.[jam '',,�=,'y.F+'y.+i Y� . � Be Chris Sexion Kathleen Lawrence Greg Ryan- 700-602-46024 760�02,274 700,602-4063 Chrl§, a1magmt 9"i1qM14wan car ov 0 Gino. Ruiz Linda Ontiveros Cindy Wong 760,402-4676 760-602,2773 760-602-4662 nda.Ontivero Wthi8.W0jV@0 Dominic Merl 760-602-4004 Remarks: 9/4/1.5 **APPIROW D: P400 -1 oft THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSU ANCE CP A BUILDING PERMIT, THIS APPROVAL IS SUBJECT TO FIELD INSPECTIM, ANY REQUIRED TESTS, FIRE DEPART M ENT N OTATIC N$t CONDITIONS IN CORRESPONDENCE AND COMPLIANCE ALL APPLICABLE CODES AND QULATIONS1 THIS APPROVAL- SHALL NOT BE :FOLD TO PERMIT OR APPROVE ANY VIOLATION OF THE LAW. ***BoOle All Changes*** I.Shect TS; Vicinity map is incorrect. Confirm bonding data too e.g. parpe€ nurn0er 2.Providc A4L co0e references to reflect current edition years and Carl.0ad Municipal code Ad -option, P4ge 2 of :p1re D Plwl- Reviow Roquipamonts CatagorX TI, COMM Date ofRepoit 09,044015 Nanw: Addyew. Pomit #-, C3 1 $2392 LAUREN MOWN 2272 FIR$T AV SAS' DIEGO CA 92101 job Nanw: DAVID S`DEMUY-- INCORPORATE Job Addros, 2540 EL CAMINO n--AL CBAV St:. Roviewed bly: INCOMPLA"1AIN1ed , omp ote, t .1$141M e, t1lis office emlot 1A40—-4-o-, adequately P(MOUCt 4 MViOW to dleepte anep', it I 1+**Wapodes and/or standiards. Please roview (Irefully all Comments attach ease resubmit thp necessary plans aid/ors 1; 1! 1 10ith changos "clouded", W to -this! office fQr roview apprpval. I C Cl fi "'a Co- 4� CON0008500, [NR MET] 1, Sheet TS: Vicinity Map is moor --rent, Confirm building data corrw, 0Q. o,g, pac@l numbor. 2. Provide ALL code reforcilge's t6 ketlect rourren mid Carlsbad Munipipal, Code t edition years adqption, _3,14aw lioensqd professional sign all sheets the 4rP submitting. Entry: 08/11/2015 By: wons Action: CO Cond., CQN00081$7 [MET] THIS PROJKT HAS BEEN MVIE -B MED ANI) APPROVED FORTH PT,.T.TPOSES. OF ISSUBANCE Qr A 13UILDING PERMIT. THIS APPROVAL IS SUBJECT TO FIELD INSPECTIQNS, A -NY REQUIRED TESTS, FIRE, I)FPAwrMF'NT NOTATIONS, CONDITIONS IN CQRR ENCE AND CQMPLIANCFE WITH ALL APPLICABLE CQDES AND ESPOND 9ROULATIONS. THIS APPROVAL ALL NOT BE HELD TO PF3RM IT OR APPROVE ANY VIOLATION OF THE LAW, Etitry: 09/04/2915 $y- qvwns Action: AP 121, , A 0> <K1 I CITY OF LBA CARSD PLAN CHECK REVIEW TRANSMITTAL Community & Economic Development Department 1635 Faraday Avenue Carlsbad CA 92008 www.carisbadca.gov DATE: 08/A/15 PROJECT NAME:david stemley d.o. PROJECT I " PLAN CHECK NO: cb152392 SET#: I ADDRESS: 2540 ecr APN: 10 ❑ This plan check review is complete and has been APPROVED by the fire Division. By: cwong A Final Inspection by the 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 Lauren@augustinedesigngroup.com &USPS 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 of a building 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 7604502-2750 FIRE PREVENTION: 760-602-4665' ❑ Chris Sexton 160-602-4624 Chris.Sexton@carlsbadca.gov ❑ Kathleen Lawrence 760-602-2741 Kathleen.Lawrence@carlsbadca.gov ❑ Greg Ryan 760-602-4663 Gregory.Ryan@carisbadca.gov ❑ Gina Ruiz 760-602-4675 Gina:Ruiz@carlsbadca.gov ❑ Linda Ontiveros 760-602-2773 Linda.Ontiveros@carlsbadca.eov ® Cindy Wong 760-602-4662 Cynthia.Wong@carlsbadca.gov ❑ ❑ ❑ Dominic Fieri 760-602-4664 Dom inic.Fieri@carlsbadca.gov Remarks: 8/11/15 Page 1 of 2 ***Bubble All Changes*** 1. Add under required deferred submittals: hydrant installation per-NFPA 24, 2013, standards. 2. Begin labeling on plans fire access roads not maintenance roads. 3. -Provide tank capacities and chemical MSDS and amounts. Indicate use. e.g. storage, use or dispensing if applicable. Does an application need to be filed for any hazardous chemical storage? Page 2 of 2 Carlsbad Fire 'Department Plan Review 1?equlrepients Category,, TI, COMM D* of RopQrt; 013-11--2015 Name: Address: Pormit #: QB 152392 LAUREN DIA00STINI 2272 FIRST AV $AN DIROO CA 92101 Job Name: r)AVTD STEMLEYm INCORPORATF, Job Address: 2540 EL CAMINO REAL CBAD St: B Reviowod by e LNG MPI;E— l kze item you haw submitted for review is incomplete. A! this time, this office cminQt a equately conduct a review to determine compliance with the applicable codes mid/or standards. Please. review carefully all comments attached, Please resubmit the Accessary plans and/or speWfIcAtions, with changes "clouded", to, this office for review and approval. C2Udjj1oT_as: Cmd: CON000000 [NOT MET] L 14b 5 A, L �hango Sheet 'TS: Vicinity -map is ind.orrect, Confirm building data oorreet too, e,g. pacel nwober, 2. Provido ALL code referen"s to'refleqt current edition years ond Carlsbad, Municipa.l. Code Adoption. ..................... 3 Entry; 08/11/2015 By: cwong Action-, CQ BUILDING ENERGY ANALYSIS. REPORT PROJECT: Dr. Stemley 2540 El -Camino Real Suite B Carlsbad, CA 02008 Project Designer: Augustine Design Group 2272 First Avenue San Diego, CA 92101 (619) 744-5884 Report Prepared by Engineering Resources Mechanical RECEIVED JUL 2 8 2015 CITY OF CARLSBAD -BUILDING DIVISION Job Number: 15067 Date: 7/27/2015 The EnergyPro computer program -has been used'to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2013 Building Energy Efficiency Standards. This,program developed by EnergySoft, LLC — www.energysoft.com. Ener' Pro 6.4 by EnergyS6ft User Number: 5328 ID: 15067 cf3 15 23°I2 Y I TABLE OF CONTENTS I Cover Page 1 Table of Contents 2 Form MCH-01-E Mechanical Systems 3 Form MCH-02-E HVAC System Requirements 6 Form MCH-03-E Mechanical Ventilation and Reheat 8 Form MCH=04-E .Required Acceptance Tests 10 Form MCH-05-E- Requirements for Packaged Single Zone Units 13 Form MCH-07-E Fan Power Consumption 15 EnergyPro 6 4 by EnergySoft Job Number ID: 15067 User Number: 5328 STATE OF CALIFORNIA MECHANICAL SYSTEMS CERTIFICATE OF COMPLIANCE NRCC-MCH-01-E Mechanical Systems (Page 1 of 3) Project Name: Dr. 5temley Date Prepared: 7/27/2015 MECHANICAL COMPLIANCE FORMS & WORKSHEETS (check box if wo'rksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2013 Nonresidential Manual Nate: The Enforcement Agency may require all forms to be incorporated onto ,the building plans. _ YES NO Form/Worksheet # Title Ei ❑ NRCC-MCH-01-E (Part 1 of 3) Certificate of Compliance,,Declaration. Required on plans for all submittals. E] 1 NRCC-MCH-01-E (Part 2 of 3) Certificate of Compliance, Required Acceptance Tests (MCH-02A to 11A). Required -on plans for all submittals. ❑ ❑ NRCC-MCW01-E (Part 3 of 3) Certificate of Compliance, ,Required Acceptance Tests (MCH-12A to 18A). Required on plans where applicable. M ❑ NRCC-MCH-02-E (Part 1 of 2) Mechanical •Dry Equipment Summary is required for all submittals with Central Air Systems. It is optional on plans. El ❑ NRCC-MCH-02-E (Part 2 of 2) Mechanical Wet Equipment Summary is required for all submittals with chilled water, hot water or condenser water systems. Itis optional on plans. El- ❑ NRCC-MCH-03-E Mechanical Ventilation and •Reheat is required for all submittals with multiple zone heating and cooling systems. It is optional on plans. MECHANICAL HVAC ACCEPTANCE FORMS (check'box for required forms) Designer: This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for HVAC systems. The designer is required to check the applicable boxes for all acceptance tests that apply and list all equipment that requires an acceptance test. All equipment of the same type that requires a test, list the equipment description and the number of systems. Installing Contractor: The contractor who installed the equipment -is responsible to either conduct the acceptance test them self or have a qualified entity run the test for them. If more than one person has responsibility for the acceptance testing, each person shall sign and submit the Certificate of Acceptance applicable to the portion of the -construction or installationforwhich they are responsible. Enforcement Agency: Plancheck — The NRCC-MCH-01-E form is not considered a completed form and is not to be accepted by the building department unless the correct boxes are checked. Inspector- Before occupancy permit is granted all.newly installed process systems must be tested to ensure proper operations. Test Description MCH-02A MCH-03A MCH-04A MCH-05A MCH-06A MCH-07A MCH-08A MCH-09A MCH-10A MCH-11A Equipment # of Outdoor Single Zone Air Economizer Demand Supply Fan Valve Leakage Supply Water Hydronic Automatic Requiring Testing units Air Unitary Distribution Controls Control VAV Test Temp. Reset System Demand Shed or Verification Ducts Ventilation Variable Flow Control (DCV) Control Carrier 50TCW 1 0 E1 ❑ ® ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ [3 - ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MECHANICAL SYSTEMS CEC-NRCC=MCH-01-E Revised'06114 CALIFORNIA ENERGY COMMISSIOt•'k4W' CERTIFICATE OF COMPLIANCE NRCC-MCH-01-E Mechanical Systems (Page 2 of 3) ProjectName: Dr. Stemley "Date Prepared: 7/27/2015 MECHANICAL HVAC ACCEPTANCE FORMS (check box for required forms) Designer: This form is to be used by the designer and attached to the plans. Listed below -are all the acceptance tests for HVAC systems. The designer is required to check the applicable- boxes for all acceptance tests that -apply and list all equipment that requires an acceptance test. All equipment of the same type that requires a, test, list the equipment description and the number of systems. dnstalling Contractor: The contractor who installed the equipment is responsible to eitherconduct the acceptance test -them self or have a qualified entity run the test_for them. If more than one person has responsibility for the acceptance testing, each person shall sign and submit the Certificate of Acceptance applicable to the portion of the construction or installation'for which they are responsible. The following tests require a Enforcement Agency: Plancheck— The NRCC-MCH-01-E form is not considered a completed form and -is not to be accepted by the building department unless the correct boxes are checked. Inspector - Before occupancy permit is granted all newly installed process, systems must be tested to ensure proper operations. Test Description MCH-12A , _ MCH-13A MCH-14A MCH-15A MCH-16A MCH-17A MCH-18A Lquipment # of Fault Detection•& Automatic Fault Distributed Energy Thermal Energy Supply Air Condenser Water ECMS RequiringTesting units, Diagnostics for DX Detection & Storage DX•AC Storage (TES) Temperature Reset Reset Controls or Verification Units Diagnostics for Air & Systems Systems Controls Zone Carrier 50TCOP 1 .0 ❑ ❑ ❑ E3 ❑ ❑ ❑ o ❑ o ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑. ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o ❑ ❑ ❑ ❑ CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MECHANICAL SYSTEMS CERTIFICATE OF COMPLIANCE NRCC-MCH-01=E Mechanical Systems y (Page 3 of 3) Project Name: Dr. Stemlev - Date Prepared: 7/27/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Compliannce documentation is accurate and complete. Documentation Author Name: Tim Imhoff Documentation Author Signature: Company: Engineering Resources Mechanical signature Date: 7/27/2015 Address: 27 Mauchly, Suite 209 CEA/ HERS certification Identification (if applicable): City/state/Zip: Irvine, CA 92618 Phone: 949.450.0431 RESPONSIBLE PERSON'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 Compliance is true and' correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance Specifications, materials, components, and manufactured devices for the -building design or system design identified on this Certificate of Compliance conform to the requirements of Title-24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with.the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. I will ensure that a completed signed copy of this Certificate of Compliance shall•be made available with the building permit(s) issued,for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance'is required to be -included with the documentation the builder provides to the building owner -at occupancy. Responsible Designer Name: TIM-IMHOFF Responsible Designer Signature: company: Engineering Resources Mechancial Date Signed: 7/27/2015 Address: 27 Mauchly, Ste 209 License: M27832 City/State/Zip: Irvine, 'CA 92618 Phorle: 949-450-0431 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 x STATE OF CALIFORNIA HVAC SYSTEM REQUIREMENTS CEC NRCC MCH 02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION - CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Dry System Requirements (Page 1 of 3) ProjectName: Dr. Stemley Date Prepared: 7/2V2015 Equipment Tags and System Description" HP.-1.„ , MANDATORY MEASURES Heating Equipment Efficiency3 Cooling Equipment Efficiency3 HVAC or Heat Pump Thermostats Furnace Standby Loss Control Low leakage AHUs Ventilation Demand Control Ventilations Occupant Sensor Ventilation C6ntrol6 Shutoff and Reset Controls -Outdoor Air and Exhaust Damper Control Isolation Zones Automatic Demand Shed Controls Economizer FDD Duct -1 nsu lation, PRESCRIPTIVE MEASURES Equipment is sized in conformance with 140.4(a&b) Supply Fan Pressure Control Simultaneous Heat/Cool$ Economizer Heat and Cool'AirSupply Reset Electric Resistance Heating9 Duct Leakage Sealing and Testing.10 T-24 Sections Reference to the Requirements in the Contract Documents2 110.1 or 110.2(a) M=1' 110.1 or 110.2(a) M-1' 110.2(b),110.2(c) M-1 11U(d) M-1- 110.2(f) M-1 120.1(b) M-1 120.1(cj4 M-1 _ 120.1(c)S, 120.2(e)3 M-1 120.2(e), •M-1 _ 120.2(f) M- I 120.2(g) M-1 120.2(h) M-1 120.4 M-1' 140.4(a & b) 140.4(c) M-1 140.4(d) M-1 140.4(e) 1404(f) M-1 140.4(g) M-1 , 140.4(I) M4 Notes: 1. Provide equipment tags (e.g. AHU Ito 10)•and system description (e.g. Single Duct VAV reheat) as appropriate. Multiple units with common requirements can be grouped together. 2. Provide references to plans (i.e. Drawing Sheet Numbers) and/or specifications (including Section name/number and relevant paragraphs) where each requirement is specified. Enter "NIA" if the requirement is not applicable to this system. 3. The referenced plans and specifications must include all of the following,informati6n: equipment tag, equipment nominal capacity, Title 24 minimum efficiency requirements, and actual rated equipment efficiencies. Where multiple efficiency requirements are applicable (e.g. full- and part4oad)'include all. Where appliance standards apply (110.1), identify where equipment is required to be listed per Title 201601 et seq. 4. Identify, where the ventilation,requir-ements are documented for each central HVAC system. Include references to both central unit schedules and sequences of operation. If one or more, space is naturally ventilated identify where this is documented in the plans and specifications. Multiple zone central air systems must also provide a MCH-03-E form: 5. If one or more space has demand controlled ventilation identify where it is specified including the sensor specifications and the sequence ofoperation. 6. if one or more space has occupantsensor ventilation control identify where it is specified including the sensor specifications and the sequence of operation Z If the system is DDC identify the sequences for the system start/stop, optimal start, setback (if required) and setup (if required). For all systems identify the specification for the thermostats and time clocks ,(if applicable). 8. identify where the heating, cooling and deadband airflows are scheduled for this.system. Include a reference to the specification of the zone controls. Provide d MCH-03-E form. 9_ Enter N/A if there is no electric heating. If the system has electric heating indicate which exception to 140.4(g) applies. 10. If duct leakage sealing, and testing is required, a MCH-04-A form must be submitted. CA Building Energy Efficiency Standards _ 2013 Nonresidential Compliance June 2014 x STATE OF CALIFORNIA 14VAr. SYSTEM REQUIREMENTS CEC NRCC MCH-02-E (Revised 06113) CALIFORNIA ENERGY COMMISSION W" CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Wet System Requirements (Page 3 of 3) PiojectName: Dr. Stenl-ley Date Prepared: 7/27/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name; Tim Imhoff Documentation Author Signature: Company: Engineering Resources Mechanical signature Date` 7/27/2015 Address: 27 MaUChy, Suite 209 CEA/ HERS Certification Identification (if applicable): City/State/Zip: Irvine,CA,92618 phone: 949-450-0431 RESPONSIBLE PERSONS DECLARATION STATEMENT - I certify the following under penalty of perjury, underthe laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer.). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements -of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance -are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the. enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: TIM IMHOFF Responsible Designer Signature: Z—�� Company: Engineering Resources Mechancial Date signed` 7/27/2015 Address: 27 Mauchly, Ste 209 License: M27$32 City/state/Zip: Irvine, CA 92618 Phone: 949-450-0431 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STAT.E.OF CALIFORNIA MECHANICAL VENTILATION AND REHEAT CERTIFICATE OF COMPLIANCE Mechanical Ventilation & Reheat -' Project Name: Dr. $temley I Date Prepared: 7/27/2015 NRCC-MCH-03-E (Page 1 of 2). ACTUAL DESIGN INFO (FROM'EQUIPMENT VAV Reheated PrimaryAir VAV Deadband SCHEDULES, ETC) AREA BASIS OCCUPANCY BASIS MINIMUM CFM Primary"AirCFM A B C D E F 6 H I 1 K L M N O P. Q R S T DZ. Ory zmy �.tmn Z-I Dom, Z n -" n 3 n it OZ� y �3 O - ZO o . D N O, W N, 0X '� Z 'n i Z T D O O Z �D� Z f') ,� Z T m :� \ z Cl .n T Z D ei' A *�+p 3. �+ O m %� v D 3 �� n z p T O -n 0 n Z A 1 O D K 3 pvOpO O" C A 3 y OX�. m l') Z p �•O 0 0 3 n yM 3�'a T� nZ3 3Dm VT3 Z 30rT :E Z m• D < D m O m. y O 3"CC)< ��Z m n�o 0r �'2 y n Z Z r Oo ,N rD 3vD OD O 70 .7J Whole; ,'676 `0'.15 251 " 20.1 15.0 301 301 Y Total 301 Yellow shaded cells require user input. Remaining cells are protected and automatic B. The largest amount of primary air supplied by the terminal unit when it's operating in the cooling mode. C. The smallest amount of primary air supplied by the terminal unit in the deadband mode. D. The largest amount of primary air supplied by the terminal -unit when it's operating in the heating mode. E. A terminal unit can be controlled with; DDC controls, or non-DDC controls. Each control category has different reheat limitations in code. F. Transfer Air must be provided where Required Ventilation Airflow"(Column M) is greater than the Design Primary Deadband Airflow (Column C). H. Minimum ventilation rate per Section §120.1. Table 120.1-A. J. Based on number of fixed seats where applicable or the greater of the expected number of occupants and,50% of the CBC occupant load for egress purposes for spaces without fixed seating. M. Required Ventilation Airflow (Req'd Ventilation Airflow) is the larger of the ventilation rates calculated on an AREA BASIS or OCCUPANCY BASIS (Column I or L) N. This column identifies whether or not the Design Primary Deadband Airflow• complies or not. It compares the value in column M to the value in column C and column F. 0. Design Primary Cooling Airflow * 0.50 for DDC, Design Primary Cooling Airflow * 0.30 for Non-DDC. If the Design Primary Cooling Airflow is less than 300 cfm, then this is not applicable. P. Maximum of Column M and Column 0. If the Design Primary Cooling Airflow is 300 cfm or less, then this is not applicable. Q. This column identifies whether or not the Design Primary Reheat Airflow at the zone level, complies or not. It compares the value in column P to the value in column D. R. Design Primary Cooling Airflow * 0.20 for DDC. Not applicable for Non-DDC zones or zones where Design Primary Cooling Airflow is is 300 cfm or less. S. Maximum of Column M and Column R. Not applicable if the Design Primary Cooling Airflow is 300 cfm or less. T. This column identifies whether or not the Design Primary Deadband Airflow at the zone level, complies or not. It compares the value in column S to the value in column C. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA MECHANICAL VENTILATION AND REHEAT CEC-NRCC-MCH-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION .. F - CERTIFICATE OF COMPLIANCE NRCC-MCH-03-E Mechanical Ventilation & Reheat (Page 2 of 2) Project Name: Dr. Stemley Date Prepared: 7/27/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT, 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. t if Documentation Author Name: 1'Tim ICnh011 Documentation Author Signature: Company: Engineering Resources Mechanical Signature Date` 7/27/2015 Address: ' 27, Mauchy, Suite 209 CEA/ HERS Certification Identification (if applicable): City/State/Zip: Irvine CA, 92618 Phone: 949-450-0431 RESPONSIBLE PERSON'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 Compliance is true and correct. 2: 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performarice, specifications, materials, components, and manufactured devices for the building design or system design identified -on this Certificate of.Compliance conform to the requirements of Title,,24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the infor'mation.,provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this Uilding-permit application. 5. 1 will ensure that a completed signed copy of this,Certificate of Compliance shall be made,available with the building permit(s) issued for the building, and made available to -the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentatiomthe builder provides to the building,owner at occupancy. . Responsible Designer Name: TIM IMHOFF Responsible'DesignerSignature:�` aj l Company:' Engineering Resources Mechancial Datesignea: 7/27/2015 Address: 27 Mauchly, Ste 209 License: M27832 City/State/zip: Irvine, CA 92618 Phone: 949-450-0431 CA Building Energy Efficiency -Standards - 2013 Nonresidential Compliance June 2014 STATE OF CAALIFORNIA REQUIRED ACCEPTANCE TESTS CEC-NRCC-MCH-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE — NRCC-MCH-04-E Required Acceptance Tests (Page 1 of 3) Project Name: Dr. Stemley Date Prepared: 7/27/2015 MECHANICAL COMPLIANCE FORMS.& WORKSHEETS -(indicate if•worksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2013 Nonresidential Manual Note: The Enforcement Agency may require all forms to be incorporated onto the building plans. Forms, N9CGMCH-04=E and NRCC-MECH-05-E are alternative forms to NRCGMCH-01-E, 1VRCC-A4CH-02-E and NRCC- MCH-03-E for projects using only single zone packaged HVA,C systems. YES NO Form Title ✓ NRCC-MCH-04-E (1 of 2) Certificate of Compliance: Required on plans when used. ✓ 14RCC-MCH-04-E (2 of 2) Mechanical Acceptance Tests. Required on plans when used. ✓ NRCC-MCH-05-E (1 of 2) HVAC-Prescriptive Requirements. It is required on plans when used. ✓ NRCC-MCH-65-E (2 of 2)' Mechanical SWH Equipment Summary is required for all.submittals with service water heating, pools or spas. It is required on plans where applicable. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA REQUIRED ACCEPTANCE TESTS CALIFORNIA ENERGY COMMISSION vCERTIFICATE OF COMPLIANCE NRCC-MCH-04-E Required Acceptance Tests (Page 2 of 3) Project Name: Dr. Stemley Date Prepared: 7/27/2015 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 list all equipment that requires an, acceptance test. If alLequipment 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 partof 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 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 NRCC-MCH-04-E 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 and replaced 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 Section 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 MCH-02-A MCH-03-A MCH-04-A MCH-05-A MCH-06-A MCH-07-A MCH-11-A MCH-12-A MCH-14-A MCH-18-A Test Performed By: Equipment Requiring Testing or Verification # of units Outdoor Air Single Zone Unitary Air Distribution Ducts Economizer Controls Demand Control Ventilation (DCV) Supply Fan VAV Automatic Demand Shed Control FDD for Packaged DX Units Distribute d Energy Storage DX AC Systems Energy Managem ent Control System Carrier 50T 1 ✓ ✓ ✓ ✓ CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA REQUIRED ACCEPTANCE TESTS' CEC-NRCC-MCH-04-E Revised 06/14 CALIFORNIA ENERGY. COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-'04-E, Required Acceptance Tests 15 (Page 3 of 3) Project Name: Dr. Stemley Date Prepared: 7/27/20 DOCUMENTATION.AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate oft. Compliance documentation is accurate and complete. Documentation Author Name: Tim Imhoff Documentation Author Signature: Company: Engineering Resources Mechanical Signature Date:7/27/2015 Address: 24 Mauchy , Suite 209 CEA/ HERS Certification Identification (if applicable): City/State/Zip: Irving C'A, 92618 Phone: 949-450-0431 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The informationprovided on this Certificate of Compliance.is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to.accept responsibility for the building design or system design identified on this Certificate.of Compliance (responsible designer). 3. The energy-features-and'performance specifications, materials, components, and manufactured devices for the building clesign or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The'building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval -with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(t) issued for the.building, and made availableto the enforcement agency for all applicable inspections'. I understand that a completed signed copy of this Certificate of Compliance is required to be included -with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: TIM IMHOFF Responsible Designer Signature: s� Company,: Engineering Resources Mechancial Date Signed: 7/27/201 5 Address: 27 Mauchly, Ste 209 License: M27832 City/State/Zip: Irvine, CA 92618 Phone: 949-450-0431 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNI4 REQUIREMENTS FOR PACKAGED SINGLE ZONE UNITS CEC-NRCC-MCH-05-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-05-E x Requirements for Packaged Single -Zone Units (Page 1 of 2) Project Name: Dr. Stemley Date Pre pared: 7/27/2015 Equipment Tag(s)l -HP-1 MANDATORY MEASURES T-24 Sections . Requirement's As Scheduled? Requirement? As Scheduled Requirement? As Scheduled? Heating'Equipment Efficiency4 110.1 or 110.2(a) 3.30 COP 2:25 COP Cooling Equipment Efficiency4 110.1 or 110.2(a) 11.0.EER 11.1' EER' Thermostats5 110.2(b),1101(c) -Setback Setback Furnace Standby Loss Control6 110.2(d) n/a . Low Leakage AHU 110.2(f) . NR none Ventilation? 120.1(b) 301 301 Demand Control Ventilation$ 120.1(c)4 NR No Occupant Sensor Ventilation Control$ 120.1(c)5, 120.2(e)3 Shutoff and Reset Controls9 120.2(e) Req Programmable Outdoor Air and Exhaust Damper Control 120.2(.f) Req Auto Automatic Demand'Shed Controls 120.2(h) NR none Economizer FDD 120.2(i) _ Req Duct Insulation 120.4 R-8 R-4.2 PRESCRIPTIVE MEASURES Equipment is sized in conformance with 140.4(a & b) 38,373 Btu/hr 22,934 Btu/lir 140.4. (a & b) 83,532 Btu/hr 49,014 Btu/hr Economizer 140.4(e) Fkeg Diff. Temp Inte Electric Resistance Heating10 140.4(g) No No Duct Leakage Sealing.and Testing.j- 1, 14o.4(1) I NR lNo Notes: 1. Provide equipment tags (e.g. AC1 orAC1 to 10). Multipleunits of•the some make and model with the same application and accessories.con be grouped together. 2. Enter the following information as.appropriate: Unit Manufacturer; Unit Model Number (including all accessories); Description.of the unit (e.g. gas -pack or heat pump; rated heating capacity (enter "N/A" if no heating); and, rated cooling capacity (enter "N/A" if no cooling). For unit capacities include the units (e.g. kBtuh or tons). 3. For each requirement enter the minimum requirement from the Standard In the,left column (under "Standard Requirement"). In the right column,(under "As Scheduled") enter the value for the units as specified. 4. Where there is more than one requirement (e.g. full and part load efficiency) enter both with the appropriate labels (e.g. COP and IEER). 5. In the left column identify the thermostatic requirements from the standard (e.g. programmable setback thermostat or heatpump with electric heat), . In the right column indicate the capabilities of the thermostat as scheduled. 6. If the unit has a furnace which is rated at>=225,000 Btuh of capacity, indicate the rated standby loss and ignition source (e.g. IID). If there is no furnace or the unit is rated for <225,000 Btuh indicate "N/A". Z In the left column, enter both the required ventilation value from Table 120.1A and for the number of occupants times 15 cfm/person. In the right column enter the actual minimum ventilation as scheduled. If the space is naturally ventilated enter "N/A" in the left column and "the space is naturally ventilated" in the right column. 8. If the space is required to have either DCV or Occupant Sensor Ventilation Control indicate "required" in the. left column (otherwise indicate "N/A" in the left column). if either DCV or Occupant Sensor Ventilation Control is provided indicate "provided" in the right column (otherwise indicate "NIA" in the right column) 9. In the left column indicate the required time controls from the standard. in the right column identify the device that providgs this functionality (e.g. EMCS or programmable timeclock). 10. Enter N/A if there is no electric heating. If the system has electric heating indicate which exception to 140.4(g) applies. 11. If duct leakage sealing and testing is required, a MCH-04-A form must be submitted. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA REQUIREMENTS FOR PACKAGED SINGLE ZONE:UNITS_ CEC-NRCC-MCH-05-E Revised 66/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-05-E Requirements for Packaged Single -Zone Units (Page 2 of 2) PrbJectName: Dr. Steinley Date Prepared: 7/27/2015 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. [Certify that this Certificate.of Compliance documentation is accurate and complete. Documentation Author Name: Tim Imhoff Documentation'Author5ignature: Company: Engineering Resources Mechanical signature Date` 7/27/2015 Address: 24 Mauchy,Suite 209 CEA/-HERS Certification Identification (if applicable): City/State/Zip: Irvine, CA,.92618 Phone: 949-450-0431 RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 certify the following under penalty of perjury,.underthe_laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions, Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured .devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, •Part 1 and Part 6 of the California Code=of Regulations. 4. The building design features or system design features identified on -this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with -this building permit application. 5. 1 will ensure that a completedsigned copy of this Certificate of Compliance shall be made available with -the -building permit(s) issued for the -building, and Blade available to the enforcement agency for all applicable inspections. I understand that a completed signedcopy.of this Certificate of Compliance is,required to be included.with the documentation the builder provides to the building owner at occupancy. ResponsiblepesignerNamei TIM IMHOFF Responsible Designer Signature: Company: Engineering Resources Mechancial Date Signed: 7/27/2015 Address: 27 Mauchly, Ste'209 License: M27832 City/State/Zip: Irvine, CA 92618 Phone: 949-460=0431 x CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE AF CALIFORNIA FAN POWER CONSUMPTION MR CEC-NRCC-MCH=07-E Revised 07/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-07-E Power Consumption of Fans Requirements (Page 1 of 2) Project Name: Dr. ptemley Date Prepared: 7/j7/2015 Constant Volume_ Fans -Systems NOTE: Provide one copy of this worksheetfor each fan -system with -a total fan system horsepower greater than 25 hp of Constant Volume Fan Systems when using the Prescriptive Approach. See Power Consumption of fans §140:4(c). A B C D E F FAN DESCRIPTION DESIGN BRAKE HP EFFICIENCY NUMBER OF FANS PEAK WATTS B x E x 746 / (C x D) MOTOR DRIVE HP-TSupply Fin 1.650 86.5 %. 97.0 % 1.0 1,467 Exhaust Fan 0.060 85.5 % 100.0 % 1.0 75 Variable Air Volume Fans Systems NOTE: Provide one copy of this worksheet for each fan system with a total fan system horsepower greater than 25 hp. of Variable Air Volume (VAV) Systems when using the Prescriptive Approach. See Power Consumption,of fans §140.4(c). A B C D E F i - FAN -DESCRIPTION DESIGN BRAKE HP EFFICIENCY NUMBER OF FANS PEAK WATTS B x E x 746 / (C x D) MOTOR DRIVE Totals and Adjustments FILTER PRESSURE ADJUSTMENT Equation 140.4-A 1) TOTAL FAN SYSTEM POWER, (WATTS, SUM 1,542 W, in §140.4(c) of the Building Energy Efficiency COLUMN F) 2) SUPPLY DESIGN AIRFLOW 2100 CFM Standards. A) If filter pressure drop�(SPJ is greater than 1 inch 3) TOTAL FAN SYSTEM POWER INDEX (Row 1/ Row 2)1 W/CFM W. C. or 245-Pascal then enter SPa on line 4. Enter in W.0 Total Fan pressure drop across the fan (SPf) on Line 5. 4) SP. or Pa in W.0 B) Calculate Fan Adjustment and enter on line 6. 5) SPf or Pa 6) Fan Adjustment- 1-(SPZ, — I-)/S-Pf C) Calculate Adjusted Fan Power Index and enter 7) ADJUSTED FAN POWER INDEX (Line-3 x.Line 6)1 0.734 W/CFM on Row 7 1. TOTAL FAN SYSTEM POWER INDEX orADIUSTED FAN"POWER INDEX must -not exceed 0.8 w/cfm for Constant Volume systems or 1.25 w/cfm for VAV systems. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance July 2014 STATE OF CALIFORNIA FAN POWER CONSUMPTION "4 CEC-NRCC-MCH-07-E Revised 07114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-07-E Power Consumption of Fans Requirements (Page 2 of 2) Pro)ectName: Dr. Stemley Date Prepared: 7/27/2015 DOCUMENTATION AUTHOR'S DECLARATION'STATEMENT - 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Th Imhoff Documentation Author Signature: Company: Engineering Resources Mechanical Signature Date: 7/27/2015 Address: 24 Mauchy, SUlte 92618 CEA/ HERS Certification Identification (if applicable): City/State/Zip: Irvine, CA, 92618 Phone: 949-450=0431 RESPONSIBLE PERSON'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 Compliance is true an&correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for -the building design or system design identified'lon this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design.identified on this Certificate of Compliance conform to the- requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and -specifications submitted to the enforcement agency for approval with this building permitapplication. 5. 1 will -ensure that a completed signed copy of this Certificate of Compliance shall'be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: TIM IMHOFF Responsible Designer Signature: I Company: Engineering Resources'Mechancial Date signed' 7/27/2015 Address: 27 Mauchly, Ste 209 License: M27832 City/State/Zip: Irvine, CA 92618 Phone: 949450-0431 CA Building Energylfficiency Standards -2013 Nonresidential -Compliance July 2014 (LENCINAINDUSTRIAL WASTEWATER DISCHARGE PERMIT Mowty SCREENING SURVEY Date D% S Business Name Street Address���i�d./ Email Address�(�/�q� tiC4a416 1aln (j.M,1t2- 61941n �---�/ PLEASE CHECK HEREIF YOUR BUSINESS IS EXEMPT: (ON REVERSE SIOE CHECK TYPE OF BUSINESS) Check all below that are present at your facility: II II Acid Cleaning Ink Manufacturing Nutritional Supplement/ Assembly Laboratory Vitamin Manufacturing Automotive Repair Machining :/ Milling Painting 1 Finishing Battery Manufacturing Manufacturing Paint Manufacturing Biofuel Manufacturing Membrane Manufacturing Personal Care Products Biotech Laboratory- (i.e. water -filter membranes). Manufacturing Bulk Chemical Storage Metal Casting / Forming Pesticide Manufacturing / Car Wash Metal Fabrication Packaging Chemical Manufacturing Metal Finishing Pharmaceutical Manufacturing Chemical Purification Electroplating (including precursors) Dry Cleaning Electroless plating Porcelain Enameling Electrical Component Anodizing Power Generation Manufacturing Coating (i.e. phosphating) Print Shop Fertilizer Manufacturing Chemical Etching / Milling Research and Development Film/ X-ray Processing Printed Circuit Board Rubber Manufacturing Food Processing Manufacturing Semiconductor Manufacturing 'Glass Manufacturing Metal Powders Forming Soap / Detergent Manufacturing Industrial Laundry Waste Treatment / Storage SIC Code(s) (if known): Brief description of business activities (Production / Manufacturing Operations): Description of operations generating wastewater (discharged• to sewer, hauled or evaporated): Estimated, volume of industrial wastewater to be discharged (gal / day): List hazardous wastes generated (type / volume): Date operation began/or will begin at this location: Have you applied for a Wastewater Discharge Permit from the Encina Wastewater Authority? Yes No If yes, when: Site Contac LW?V*R N I Title _'ita of - �13 P_V.&— Signatur Phone No. (1 1 44.0e4- ENCIN _ A AT UTHORITY, µ6200 Avenida. Encinas Carlsbad, CA 92bi 1 (760) 4 8-3941 FAX: (760) 476-9852 vy��OjIVE! Th�,AGe a n O more" Z o "y o Mo ccc��� OFFICE USE ONLY RECORD ID # SAN DIEGO REGIONAL-HHMBP# HAZARDOUS, MATERIALS QUESTIONNAIRE .. BP DATE I. / Business Name V IV 5'n�✓ WA Business Contact Telephone # S I 74W . -tl �i5 Project Address 2y' MO Pity State State Zi Code i." !,� Cry 2olo 1U#T 0-37 Mailing Address City State Zip Code Plan File# Project Contact �R] G Telephone # The following questions represent the facility's activities,.NOT the spgcitic project description. PART 1• FIRE DEPARTMENT — HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: (not required for projects within the City of San Diego): Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materi als. If any of the Items are circled, applicant must contact.the Fire Protection Agency with jurisdiction prior to plan submittal. Occupancy Rating: Facility's Square Footage (including, proposed project): 1. Explosive or Blasting Agents 5. Organic Peroxides .9. Water Reactives 13. Corrosives 2. Compressed Gases 6. Oxidizers 10. Cryogenics 14. Other Health Hazards 3. Flammable/Combustible Liquids. 7. Pyrophorics 11. Highly Toxic or Toxic Materials 15. None of These. 4. Flammable Solids 8. Unstable Reactives 12. Radioactives it the answer to any Diego, CA 92123. prior to.the-issuance of a building permit. FEES ARE REQUIRED. Project Completion -Date: Expected Date of Occupancy: YES NO (for new, construction- or remodeling projects) 1. ❑ Is your business listed on the reverse side of this form? (check all -that apply). 2. [:1�` Will your business dispose of Hazardous Substances or Medical Waste -in any amount? 3. El� Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 pounds and/or-200 cubic feet? handle toxins in any 4. ❑ Will your business store or carcinogens/reproductive quantity? - 5. ❑ ,r Will your business use an existing or install an underground storage tank? 6. ❑ Will your business store or handle Regulated Substances (CaIARP)? 7. ElWill your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? 8. ❑ Will your business store petroleum in tanks or containers at your facility with -a total facility storage capacity equal to orgreaterthan 1,320 gallons? (California's Aboveground Petroleum Storage Act). ❑ CalARP Exempt Date Initials ❑ CaIARP Required Date Initials ❑ CalARP Complete Date Initials PART III: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT (APCD): If the answer to Question #1 below is no or the answer to any of the Questions #2-5 is yes, applicant must contact the APCD at 10124 Old Grove Road, San Diego, CA 92131-1649 or telephone (858) 586-2600 prior to the issuance of a building or demolition permit. If the answer to questions #4 or #5 is yes, applicant must also submit an asbestos notification form to the APCD at least 10 working days prior to commencing demolition or renovation. (Some residential projects may be-exerhpt from the notification requirements. Contact the APCD for more information.) YES NO 1. Z ❑ Has a survey been performed to determine the presence of Asbestos Containing Materials? 2. Will the -subject facility or construction.activities include operations or equipmentthat emit or are capable of emitting an air contaminant? (See the APCD factsheet at http://www.sdapcd.org/info/facts/permits.pdf, and the list of typical equipment requiring an APCD permit on the reverse side of this from. Contact APCD if you have any questions). 3. ❑ ,0' (ANSWER ONLY IF QUESTION 1 IS YES) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12)? (Search the California School Directory at http://www.cde.ca.-gov/re/sd/ for public and private schools or contact the appropriate school district). 4. ❑ ET Will there be -renovation that involves handling of any friable asbestos materials, or disturbing any material that contains non -friable asbestos? 5. -❑ Will there be demolition involving the removal of a load supporting structural member? Briefly describe business activities: Briefly describe proposed project: O b I declare uunnddeer. penalty of perjury that to tC best of my knowledge and Of onse made herein.are true and correct.Name of Owner or Authorized Agent �f er A horized- gent Date FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: BY: DATE: EXEMPT OR NO FURTHER INFORMATION_ REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY COUNTY=HMD* APCD COUNTY=HMD APCD COUNTY-HMD APCD *A stamp in this.box only exempts businesses from completing or updating a Hazardous Materials Business Plan. other permitting requirements may still appy. HM-9171 (03/14) County of San Diego — DEH —Hazardous Materials Division .I C8152392 2540 EL CAMINO REAL B DAVID STEMLEY= INCORPORATE 1 7Rn CF CI IITI= n IArfn CI IITG R Tn INIrl-I In= oClnCly Al .1-2-b - tS7 D\,4n_t r J-D � �� Vv/-Q - xCJ`A aC� o b-L Plan -1-ZCI-IL5 vc- k a sl Final Inspection required by. ❑ flan ❑ CM&I ❑ Fire ❑ SW DISSUED ❑CV. Approved Date By BUILDING Z r ✓Ll/ PLANNING ENGINEERING �( 'Z,G, — `s v FIRE Expedite? Y N & DIGITAL FILES Required? Y N HazMat APCD Health Forms/Fees Sent Rec'd Due? By Encina (_ Y N Fire Y N HazHealthAPCD 71 Y N PE&M rJ Y N School Y N Sewer Y N Stormwater Y N Special inspection Y N CFD: Y N LandUse: Density: ImpArea: :FY. Annex: Factor: PFF: Y N Comments 'Date Date Date Date Building Planning Engineering Fire Need? T ❑ Done ❑ Done ❑ Done ❑ Done