HomeMy WebLinkAbout2791 LOKER AVE W; ; CBC2017-0140; PermitPrint Date: 05/04/2017
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
2791 Loker Ave W
BLDG-Commercial
2090814800
$20,092.32
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Commercial Permit
www.carlsbadca.gov
Work Class: Tenant Improvement
Lot#:
Reference#:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
Description: LG DISPLAY: 432 SF WAREHOUSE TO OFFICE Tl
Applicant: Owner:
MICHAEL KINOSHITA MC P SOCAL INDUSTRIAL-LOKER LLC
7510 Clairemont Mesa Blvd, Ste 207
San Diego, CA 92111-1539
858-268-8176
BUILDING PERMIT FEE $2000+
BUILDING PLAN CHECK FEE (BLDG)
Po Box 847
CARLSBAD, CA 92018
ELECTRICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
MECHANICAL BLDG COMMERCIAL NEW/ADDITION/REMODEL
PUBLIC FACILITIES FEES -outside CFD
581473 BUILDING STANDARDS FEE
SEWER BENEFIT AREA FEES -G
SEWER CONNECTION FEE (General Capacity all areas)
STRONG MOTION-COMMERCIAL
TRAFFIC IMPACT Commercial-Industrial Outside CFD
Total Fees: $1,874.12 Total Payments To Date: $1,874.12
Status:
Applied:
Issued:
Fina led:
Inspector:
Balance Due:
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
collectively referred to as "fees/exaction." 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/exactions 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/exactions of which you have previously been given a NOTICE similar to this, or as to which the
statute of limitation has previously otherwise expired.
Permit No: CBC2017-0140
Closed -Finaled
03/24/2017
04/17/2017
JWest
$0.00
$212.53
$148.77
$41.00
$39.00
$703.23
$1.00
$90.09
$116.87
$5.63
$516.00
TjlE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING D ENGINEERING QBUILDING OFIRE QHEALTH QHAZMAT/APCD
, (_ Cicyof
Carlsbad
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov
Plan Check No~Z.017-0 f 40
JOB ADDRESS
CT/PROJECT#
CITY
PHONE
EMAIL
ADDRESS
CITY
PHONE
EMAIL
STATE
FAX
# BEDROOMS
GARAGE (SF) -
ZIP
STAJF LIC, # , £ C.//.t/f;I' I
Est. Value 2D oq2_
Plan Ck. Deposit
Date ~z,....\-l-=J-SWPPP
SUITE#/SPACE#/UNIT# -· APNi 11 -/ju; -~
# BATHROOMS
PATIOS (SF)
~
DECKS (SF) _,., FIREPLACE
YESO
PROPERTYOWNER ~~ '::)'.:)
CITYr\~ _ ~~
'--<.)..I \totxld Lt-\
PHONE FAX
EMAIL
CONSTR. TYPE
V/.J
CITY BUS, LIC.# l"-'!> '1. ~ \') '1
-(J1
OCC. G OUP
~tr'
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair an~ structure, prior to 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 7000 of Division 3 of the Business and Professions Code} or that 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 penalty of not more than five hundred dollars {$500)).
Workers' Compensation Declaration: / hereby affirm under penally of perjury one of the following declarations: D I have and will maintain a certificate of consentto 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.
15{11 have and will maintain workers' compe,rsati~n, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, My workers' compensation i surance carrier and policy
number are: Insurance Co, ~'{,Iµ U l r,.. S C....,;::, Policy No, M It__ -JC.. 7 I C\ '1 J ') Expiration Date I
This section need not be completed if the permit is for one hundred dollars ($100) or less, D Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' co>,!!111-Ml!!!l!,!!ll~i!ffllge 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, damai!lllll~»fllm!!~iirl1f1Section 3706 of the Labor code, interest and attorney's fees.
·,g CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec, 7044, Business and Professions Code: The Contractor's
License Law does not apply to an owner of property who builds or improves thereon, and who does such work himse~ 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),
D
D
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),
I am exempt under Section _____ Business and Professions Code for this reason:
1, I personally plan to provide the major labor and materials for construction of the proposed property improvement OYes 0No
2, I (have/ have not) signed an application for a building permit for the proposed work,
3, I have contracted with the following person {firm) to provide the proposed construction (include name address /phone/ contractors' license number):
4. I 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, I will provide some of the work, but I have contracted {hired) the following persons to provide the work indicated (include name I address / phone/ type of work):
,I$ PROPERTY OWNER SIGNATURE OAGENT DATE
Is tile 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
Presley-Tanner Hazardous Substance Account Act? Cl Yes Cl No ·
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Cl Yes Cl No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Cl Yes Cl 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. .
I certify that I have read the application and slate that the above information is correct and that the information on the plans is accurate. I agree to comply with all Cify ordinances and State laws relating to building construction.
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CllY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CllY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. .
OSHA: An OSHA permit is required for excavations oVi 5'0' deep and demolition or construction of structures over 3 staies in height
EXPIRATION: Every permit issued by the Bulding · ajunder the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within
180 days fium the date of such permit or if the bui Q(work authorized by such 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).
,fl5 APPLICANT'S SIGNATURE DATE
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 building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
PHONE
r-51' '-111.. -~\..-~
EMAIL
~~rt'
DELIVERYO
Cl PICK UP:
FAX
o OCCUPANT (Listed above)
1' MAIL TO: o CONTACT (Listed above) ~OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
ZIP
D MAIL/ FAX TO OTHER: _______________ _
CO#: (Office Use Only)
OCCUPANT NAME J LG-i) cS t Lr'\'Y
BUILDING ADDRESS
'2-'7 9 ( L--~CC-(LJL f\-Jt!E-
CITY STATE
Carlsbad CA
OCCUPANT'S BUS. LIC. No.
l1 L rJ fl.._ \ L.-'\... \ 0-~
o ASSOCIATED CB#------------
0 NO CHANGE IN USE/ NO CONSTRUCTION
o CHANGE OF USE/ NO CONSTRUCTION
DATE
f (7 17
ZIP
M C P SOCAL INDUSTRIAL-LOKER
LLC
Work Tenant Improvement Date: 04/17/2017 Subdivision:
Status: Closed -Finaled Date: 10/23/2017 Address: 2791 Loker Avew
Carlsbad, CA 92010-6601
IVR Number: 2752
Scheduled Actual Inspection No. Inspection Status Primary Inspector Reinspection Complete Date Start Date Inspection Type
04/18/2017 04/18/2017 BLDG-14 020327-2017 Passed Jonathan West Complete
Frame/Steel/Bolting/
Welding (Decks)
Checklist item Passed
BLDG-Building Deficiency Yes
BLDG-31 020328-2017 Passed Jonathan West Complete
Underground/Condu
it-Wiring
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
04/20/2017 04/20/2017 BLDG-17 Interior 020583-2017 Passed Jonathan West Complete
Lath/Drywall
Checklist item COMMENTS Passed
BLDG-Building Deficiency Yes
04/26/2017 04/26/2017 BLDG-44 021195-2017 Passed Jonathan West Complete
Rough/Ducts/Dampe
rs
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Yes
05/04/2017 05/04/2017 BLDG-Final 022184-2017 Passed Jonathan West Complete
Inspection
Checklist Item Passed
BLDG-Building Deficiency Yes
BLDG-Plumbing Final Yes
BLDG-Mechanical Final Yes
BLDG-Structural Final Yes
BLDG-Electrical Final Yes
May 04, 2017 Page 1 of 1
EsGil Corporation
In (l'artnersliip witli qovernment for (}3ui{tfing Safety
DATE: 4/13/17
JURISDICTION: .,_lsbad t
PLAN CHECK NO.: CBC2017-0140
PROJECT ADDRESS: 2791 Loker Ave W.
SET: II
D APPLICANT
~JURIS.
D PLAN REVIEWER
D FILE
PROJECT NAME: Office TI within Existing Warehouse/ Production Area
~ The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
D 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.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
D The check list transmitted herewith is for your information. The plans are being held at EsGil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D 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: Michael Kinoshita Telephone#: In Person Walk In
Date contacted: 4/13/17 (by: CM) Email:
Mail Telephone Fax In Person
D REMARKS:
By: Chuck Mendenhall
EsGil Corporation
D GA D EJ D MB D PC walk In
Enclosures:
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576
. '
DATE: 4/4/17
JURISDICTION: Carlsbad
EsGil Corporation
In (partnersliip witli <jovernment for (8uifain9 Safety
PLAN CHECK NO.: CBC2017-0140
PROJECT ADDRESS: 2791 Loker Ave W.
SET: I
~PPLICANT
)'I JURIS.
CJ PLAN REVIEWER
CJ FILE
PROJECT NAME: Office TI within Existing Warehouse/ Production Area
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
D 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.
D 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.
D 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:
Michael Kinoshita
e-mail
D 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: Michael Kinoshita Telephone#: (858) 268-8176
/Date con~ted: tr(<; (by{'(...} Email: michaelk@mkainc.net
~ail T hone:-\ Fax In Person
D REMARK : < I
By: Chuck Mendenhall
EsGil Corporation
D GA D EJ D MB D PC
Enclosures:
3/28/17
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576
, . Carlsbad CBC2017-0140
4/4/17
PLAN REVIEW CORRECTION LIST
TENANT IMPROVEMENTS
PLAN CHECK NO.: CBC2017-0140
OCCUPANCY: B
TYPE OF CONSTRUCTION: II B
ALLOWABLE FLOOR AREA: no change
SPRINKLERS?: yes
REMARKS:
DATE PLANS RECEIVED BY
JURISDICTION:
DATE INITIAL PLAN REVIEW
COMPLETED: 4/4/ 17
FOREWORD (PLEASE READ):
JURISDICTION: Carlsbad
USE: office
ACTUAL AREA: 430 sf
STORIES: no change
HEIGHT: no change
OCCUPANTLOAD: 5
DATE PLANS RECEIVED BY
ESGIL CORPORATION: 3/28/17
PLAN REVIEWER: Chuck Mendenhall
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 2016 CBC, which adopts the 2015 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 2015 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 CBC2017-0140
4/4/17
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 TWO 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. Provide out-of-plane bracing between the walls ( all glass windows ) extending
from the suspended ceiling to the ceiling joists.
2. Show on the plans that the metal strapping over the CJ extends in 45 degrees in
both directions to provide lateral support of the structure. In lieu of this provide
plywood diaphragm decking screwed to the top of the ceiling joists to transfer
lateral loads to the side walls.
END OF PLAN REVIEW
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.
• · Carlsbad CBC2017-0140
4/4/17
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad
PREPARED BY: Chuck Mendenhall
BUILDING ADDRESS: 2791 Loker Ave W.
BUILDING OCCUPANCY: B
BUILDING AREA Valuation
PORTION ( Sq. Ft.) Multiplier
offie Tl 430 City Est
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb By Ordinance
Bldg. Permit Fee by Ordinance ;,·•;!
Plan Check Fee by Ordinance "lii'J
Type of Review: Complete Review
D Repetitive Fee ~~· ·~·;.j Repeats
D Other
0 Hourly
EsGil Fee
PLAN CHECK NO.: CBC2017-0140
DATE: 4/4/17
Reg. VALUE ($)
Mod.
20,092
20,092
$212.161
$137.901
D Structural Only
----IHr@• $118.81 I
Sheet 1 of 1
macvalue.doc +
BUILDING ENERGY ANALYSIS REPORT
PROJECT:
LG
2791 LOCKER AVE. WEST
CARLSBAD, CA 92010
Project Designer:
Report Prepared by:
HADI MAHZARI
ENERGY CONSUL TING GROUP
8015 BALBOA AVE.
SAN DIEGO, CA 92111
858-268-0660
Job Number:
Date:
3/8/2017
The EnergyPro computer program has been used to perfonn the calculations summarized in this compliance repor
authorized by the California Energy Commission for use with both the Residential and Nonresidential 2016 Build
This program developed by EnergySoft Software -www.energysoft.com.
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TABLE OF CONTENTS
Cover Page 1
Table of Contents 2
Form PRF-01-E Certificate of Compliance 3
Form ENV-MM Envelope Mandatory Measures 19
'
EnergyPro 7.1 by EnergySoft Job Number: ID: User Number. 2984
Project Name: LG NRCC-PRF-01-E Page 1 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
A. PROJECT GENERAL INFORMATION
1. Project Location (city) CARLSBAD 8. Standards Version Compliance2016
2. CA Zip Code 92010 9. Compliance Software (version) EnergyPro 7.1
3. Climate Zone 7 10. Building Orientation (deg) (N) Odeg
4. Total Conditioned Floor Area in Scope 438 ft2 11. Permitted Scope of Work NewEnvelopeAndMechanical
5. Total Unconditioned Floor Area 0 ft2 12. Building Type(s) Nonresidential
6. Total# of Stories (Habitable Above Grade) 1 13 Gas Type NaturalGas
7. Total # of dwelling units 0
B. COMPLIANCE RESULTS FOR PERFORMANCE COMPONENTS (Annual TDV Energy Use, kBtu/ft 2-yr) 1§ 140.1
BUILDING COMPLIES
1. EneliY Component 2. Standard Design (TDVI 3. Proposed Design (TDV) 4. compliance Margin (TDVI 5. Percent Better than Standard
Space Heating 10.92 12.74 -l.82 -16.7%
Space Cooling 43.46 29.49 13.97 32.1%
Indoor Fans 103.54 28.50 75.04 72.5%
Heat Rejection ------
Pumps & Misc. -------
Domestic Hot Water 14.13 14.13 -0.0%
Indoor Lighting 42.30 42.30 --0.0%
COMPLIANCE TOTAL 214.35 127.16 87.19 40.7%
Receptacle 109.37 109.37 0.0 0.0%
Process --------
Other Ltg --------
TOTAL 323.72 236.53 87.2 26.9%
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 2 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation 0ate/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
C. PRIORITY PLAN CHECK/ INSPECTION ITEMS (in order of highest to lowest TDV energy savings)
1st Indoor Fans: Check envelope and mechanical
2nd Space Cooling: Check envelope and mechanical
3rd Heat Rejection: Check envelope and mechanical
4th Pumps & Misc.: Check mechanical
5th Domestic Hot Water: Check mechanical
6th Indoor Lighting: Check lighting
7th Space Heating: Check envelope and mechanical
D. EXCEPTIONAL CONDITIONS
Compliance Margin By Energy Component (from Tobie B column 4}
Indoor Fans
Space Cooling
Heat Rejection
Pumps & Misc.
Domestic Hot Water
Indoor Lighting
Space Heating
The project shows partial compliance, either envelope only or mechanical only, excluding lighting systems. The building must show partial compliance including lighting or full new building
compliance or show prescriptive lighting compliance before operation
The building does not include service water heating. Verify that service water heating is not required and is not Included in the design.
E. HERS VERIFICATION
This Section Does Not Apply
F. ADDITIONAL REMARKS
Standard Building (Compliance)
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 3 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/rime: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input FIie Name: LG.cibd16x
G. COMPLIANCE PATii & CERTIFICATE OF COMPLIANCE SUMMARY
Identify which bw1ding components use the performance or prescriptive path for compliance. NNA "= not in project
For components that utilize the performance path, indicate the sheet number that includes mandatory notes on plans.
Building Component compliance Path compliance Forms (required Jar submittal) Location of Mandatory Notes on
Plans
181 Performance NRCC-PRF-ENV-DETAILS (section of the NRCC-PRF-01-E)
Envelope D Prescriptive NRCC-ENV-01 / 02 / 03 / 04 / 05 / 06-E
D NA
181 Performance NRCC-PRF-MCH-DETAILS (section of the NRCC-PRF-01-E)
Mechanical D Prescriptive NRCC-MCH-01 / 02 / 03 / 04 / 05 / 06 / 07-E
D NA
D Performance NRCC-PRF-PLB-DETAILS (section of the NRCC-PRF-01-E)
Domestic Hot Water D Prescriptive NRCC-PLB-01-E
181 NA
D Performance NRCC-PRF-LTI-DETAILS (section of the NRCC-PRF-01-E)
Lighting (Indoor Conditioned) D Prescriptive NRCC-LTl-01 / 02 / 03 / 04 / 05-E
181 NA
D Performance S2 (section of the NRCC-PRF-01-E)
Covered Process: D Prescriptive NRCC-PRC-01/ 03-E Commercial Kitchens
181 NA
D Performance 53 (section of the NRCC-PRF-01-E)
Covered Process: D Prescriptive NRCC-PRC-01/ 04-E Computer Rooms
181 NA
D Performance 54 (section of the NRCC-PRF-01-E)
Covered Process: D Prescriptive NRCC-PRC-01/ 09-E Laboratory Exhaust
181 NA
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 4 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/rime: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
G. COMPLIANCE PATH & CERTIFICATE OF COMPLIANCE SUMMARY
The following building components are only eligible for prescriptive compliance. Indicate which are The following building components may have mandatory requirements per Part 6. Indicate
relevant to the project. which are relevant to the project.
Yes NA Prescriptive Requirement Compliance Forms Yes NA Mandatory Requirement Compliance Forms
Lighting (Indoor Commissioning: §120.8
D 181 NRCC-LTl-01 / 02 / 03 / 04 / 05-E D 181 Simple Systems NRCC-CXR-01 / 02 / 03 / OS-E Unconditioned) §140.6 D 181 Complex Systems NRCC-CXR-01 / 02 / 04 / 05-E
D 181 Lighting (Outdoor) §140.7 NRCC-LT0-01 / 02 / 03-E D 181 Electrical: §130.5 NRCC-ELC-01-E
D 181 Lighting (Sign) §140.8 NRCC-LTS-01-E D 181 Solar Ready: §110.10 NRCC-SRA-01 / 02-E
Covered Process: §120.6 NRCC-PRC-01-E
D 181 Parking Garage NRCC-PRC-02-E
D 181 Solar Thermal Water NRCC-STH-01-E D 181 Commercial Refrigeration NRCC-PRC-05-E
Heating: §140.5 D 181 Warehouse Refrigeration NRCC-PRC-06/07 /08-E
D 181 Compressed Air NRCC-PRC-10-E
D 181 Process Boilers NRCC-PRC-11-E
CA Buildlng Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 5 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
H. CERTIFICATE OF INSTALLATION, CERTIFICATE OF ACCEPTANCE & CERTIFICATE OF VERIFICATION SUMMARY (NRCI/NRCA/NRCV) -
Documentation Author to indicate which Certificates must be submitted for the features to be recognized for compliance Confirmed (Retain copies and verify forms are completed and signed to post in field for Field Inspector to verify).
See Tables G. and H. in MCH and LTI Details Sections for Acceptance Tests and forms by equipment.
Buildina Component Compliance Forms (required for submittal) Pass Fall
Envelope
181 NRCI-ENV-01-E -For all buildings D D
181 NRCA-ENV-02-F-NFRC label verification for fenestration D D
181 NRCI-MCH-01-E -For all buildings with Mechanical Systems D D
181 NRCA-MCH-02-A-Outdoor Air D D
181 NRCA-MCH-03-A -Constant Volume Single Zone HVAC D D
D NRCA-MCH-04-H-Air Distribution Duct Leakage D D
D NRCA-MCH-05-A-Air Economizer Controls D D
181 NRCA-MCH-06-A-Demand Control Ventilation D D
D NRCA-MCH-07-A -Supply Fan Variable Flow Controls D D
D NRCA-MCH-08-A-Valve Leakage Test D D
D NRCA-MCH-09-A-Supply Water Temp Reset Controls D D
Mechanical D NRCA-MCH-10-A-Hydronlc System Variable Flow Controls D D
D NRCA-MCH-11-A -Auto Demand Shed Controls D D
D NRCA-MCH-12-A-Packaged Direct Expansion Units D D
D NRCA-MCH-13-A-Air Handling Units and Zone Terminal Units D D
D NRCA-MCH-14-A-Distributed Energy Storage D D
D NRCA-MCH-15-A-Thermal Energy Storage D D
D NRCA-MCH-16-A-Supply Air Temp Reset Controls D D
D NRCA-MCH-17-A-Condensate Water Temp Reset Controls D D
D NRCA-MCH-18-A-Energy Management Controls Systems D D
D NRCV-MCH-04-H-Duct Leakage Test D D
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:SS
Project Name: LG NRCC-PRF-01-E Page 6of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanlcal Input FIie Name: LG.cibd16x
H. CERTIFICATE OF INSTALLATION, CERTIFICATE OF ACCEPTANCE & CERTIFICATE OF VERIFICATION SUMMARY (NRCI/NRCA/NRCV) -
Documentation Author to indicate which Certificates must be submitted for the features to be recognized for compliance Confirmed (Retain copies and verify forms are completed and signed to post in field for Field Inspector to verify).
See Tables G. and H. in MCH and LTI Details Sections for Acceptance Tests and forms by equipment.
Buildin11 Component Compliance Forms (required for submittal) Pass Fail
D NRCI-PLB-01-E -For all buildings with Plumbing Systems D D
D NRCI-PLB-02-E -required on central systems In high-rise residential, hotel/motel application. D D
D NRCI-PLB-03-E -Single dwelling unit systems in high-rise residential, hotel/motel application. D D
D NRCI-PLB-21-E -HERS verified central systems in high-rise residential, hotel/motel application. D D Plumbing D D D NRCI-PLB-22-E -HERS verified single dwelling unit systems in high-rise residential, hotel/motel application.
D NRCV-PLB-21-H-HERS verified central systems in high-rise residential, hotel/motel application. D D
D NRCV-PLB-22-H -HERS verified single dwelling unit systems in high-rise residential, hotel/motel application. D D
D NRCI-STH-01-E -Any solar water heating D D
0 NRCI-LTl-01-E -For all buildings D D
D NRCI-LTl-02-E -Lighting control system, or for an Energy Management Control System (EMCS) D D
D NRCI-LTl-03-E -Line-voltage track lighting integral current limiter, or for a supplementary overcurrent protection panel used to D D energize only line-voltage track lighting
D NRCI-LTl-04-E -Two Interlocked systems serving an auditorium, a convention center, a conference room, or a theater D D
Indoor Lighting D NRCI-LTl-05-E -Lighting Control Credit Power Adjustment Factor (PAF) D D
D NRCI-LTl-06-E -Additional wattage Installed in a video conferencing studio D D
D NRCA-LTl-02-A-Occupancy sensors and automatic time switch controls. D D
D NRCA-LTl-03-A-Automatic daylighting controls D D
D NRCA-LTl-04-A-Demand responsive lighting controls D D
D NRCI-LT0-01-E -Outdoor Lighting D D
Outdoor Lighting D NRCI-LT0-02-E-EMCS Lighting Control System D D
D NRCA-LT0-02-A -Outdoor Lighting Control D D
Sign Lighting 0 NRCI-LTS-01-E-Sign Lighting D D
Electrical D NRCI-ELC-01-E -Electrical Power Distribution D D
Photovoltaic D NRCI-SPV-01-E Photovoltaic Systems D D
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 7 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
H. CERTIFICATE OF INSTALLATION, CERTIFICATE OF ACCEPTANCE & CERTIFICATE OF VERIFICATION SUMMARY (NRCI/NRCA/NRCV) -
Documentation Author to indicate which Certificates must be submitted for the features to be recognized for compliance Confirmed (Retain copies and verify forms are completed and signed to post in field for Field Inspector to verify).
See Tables G. and H. in MCH and LTI Details Sections for Acceptance Tests and forms by equipment.
Buildin11 component Compliance Forms (required for submittul) Pass Fall
D NRCI-PRC-01-E Refrigerated Warehouse D D
D NRCA-PRC-01-F-Compressed Air Systems D D
D NRCA-PRC-02-F-Kitchen Exhaust D D
D NRCA-PRC-03-F-Garage Exhaust D D
Covered Process D NRCA-PRC-04-F-Refrigerated Warehouse-Evaporator Fan Motor Controls D D
D NRCA-PRC-05-F-Refrigerated Warehouse-Evaporative Condenser Controls D D
D NRCA-PRC-06-F-Refrigerated Warehouse-Air Cooled Condenser Controls D D
D NRCA-PRC-07F-Refrigerated Warehouse-Variable Speed Compressor D D
D NRCA-PRC-08-F-Electrical Resistance Underslab Heating System D D
I. ENVELOPE GENERAL INFORMATION (See NRCC-PRF-ENV-DETAILS for more information)
1. Total Conditioned Floor Area 438 ft2 5. Number of Floors Above Grade 1 confirmed
z. Total Unconditioned Floor Area 0 ft2 6. Number of Floors Below Grade 0
3. Addition Conditioned Floor Area 0 ft2 .., 'lJ ..
4. Addition Unconditioned Floor Area 0 ft2 .. == ..
7. Opaque surfaces & Orientation 8. Total Gross Surface Area 9. Total Fenestration Area 10. Window to Wall Ratio
North Wall 920ft' 98 ft' 10.7% D D
East Wall 0 ft' 0 ft2 00.0% D D
South Wall 0 ft' 0 ft' 00.0% D D
West Wall 0 ft' 0 ft2 00.0% D D
Total 9ZOft2 98ft2 10.7% D D
Roof 438 ft' Oft' oo.or. D D
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 8 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibdl6x
J. FENESTRATION ASSEMBLY SUMMARY §110.6 Confirmed
1. 2. 3. 4. 5. 6. 7. 8. 9.
Fenestration Assembly Name/ Fenestration Type / Product Type i -: ..,
Overall overall Overall ..
Certification Method' Assembly Method Area ft' ill = Tagorl.D. / Frame Type U-factor SHGC VT C "t.
Vertical Fenestration
Single Mtl Clear Default FlxedWindow NFRC Rated Manufactured 98 1.10 0.80 a.so N D D
N/A
1 Newfy mstaffed fenestration shall hove a certified NFRC Lobel Certificate or use the CEC default tables found ,n Table 110.6-A and Table 110.6-8. Center of Glass (COG) values are fort he gfass-only, determined by the manufacturer, and are shown for ease
of verification. Site-built fenestmtion values are calculated per Nonresidential Appendix NA6 and are used in the analysis.
2 Status: N -New,A-Altered, £-Existing
Taking compliance credit for renestration shading devices? (If "Yes", see NRCC-PRF-ENV-DETAILS for more Information) No
K. OPAQUE SURFACE ASSEMBLY SUMMARY § 120.7/ § 140.3 Confirmed
1. 2. 3. 4. 5. 6. 7. 8.
Framing Cavity Continuous U-Factor / F-Factor ;:; i ~ surface Name Surface Type Area (ft') !I Type R·Value R·Value JC-Factor C "'~
2X4/R-134 ExteriorWall 920 Metal 13 6 U-Factor: 0.095 N D D
R-30Roof9 Roof 438 Wood 30 NA U-Factor: 0.035 N D D
Slab On Gradell UndergroundFloor 438 NA 0 NA F-Factor: 0. 730 N D D
1 Status: N-New, A -Altered, E-Existing
L. ROOFING PRODUCT SUMMARY I § 140.3 Confirmed
1. 2. 3. 4. 5. 6. 7.
Product Density Aged Solar Thermal Cool Roof Roofing Product l iii' Product Type SRI .. = (lb/ft2) Reflectance Emittance Credit Description
R-30Roof9 4.65104 0.08 0.75 NA No NA D D
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-Ol·E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page9of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/rime: 14:20, Wed, Mar OB, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
M. HVAC SYSTEM SUMMARY (see NRCC-PRF-MCH-DETAILS for more information) § 110.1 / § 110.2
Dry System Equipment 1 (Fan & Economizer info included below in Table N)
l. 2. 3. 4. 5. 6. 7. 8. 9. 10. ll.
System Type Total Heating Supp Heat Total COOiing Acceptance
IQ Supp Heat Efficiency Testing Equip Name Equip Type (Simple' or Qty Output Output Output ~ Source (Y/NI Required? (Y/NI C: Complex4J (kBtu/h) (kBtuh) (kBtu/h) Cooling Heating 5 ...
FC-1/CU-1 SZHP (Split3Phase) Simple 1 27 No 0 24 SEER-17.0 / HSPF-10.0 Yes N EER-12.0
Wet System Equipment 2 Pumps
12. 13. 14. 15. 16.
Equip Name Equip Type Qty Vol (gal) Rated Capacity
NonResBaseWaterHeater Storage 1 0
BaseResWtrHtr Storage 1 0
1 Dry System Equipment indudes fumams, a,r hand/mg units, heat pumps, etc.
2 K,wt System Equipment indudes boilers, chillers, cooling towen, water heaters, etc.
3 Simple Systems must complete NRCC-CXR-<J3-E commissioning design review form
4 Complec Systems must romplete NRCC-CXR-()4,-E commissioning design !lNiewform
5 A summary af which aa;eptonce tests are applicable is provided in NRCC-PRF-MCH-DETJJ./LS
6 Status: N -New, A -A ftered, E -EKisting
(kBtu/h)
0
17. 18. 19.
Tank
Efficiency Standby Loss Ext.R
Value
EF: 0.675 NA NA
EF: 0.820 NA 12.0
Discrepancy between modeled and designed equipment sizing? (If "Yes", see Table F. "Additional Remarks" for an explanation)
N. ECONOMIZER & FAN SYSTEMS SUMMARY1
1. 2. 3. 4.
Outside Supply Fan Return Fan Air
Equip Name TSP TSP
CFM CFM HP BHP (inch Control CFM HP BHP (Inch
WC) WC)
FC-1/CU-1 66 688 0.100 0.100 0.46 ConstantVolume NA NA NA NA
1 Mechanical ventilation calwlations and exhaust fans are included in the NRCC-PRF-MCH-DETAILS section
20. 21. 22. 23. 24.
l4
Qty GPM HP VSD ~ (Y/N) ,: ...
NA NA NA No N
NA NA (kW) NA N
No
§ 140.4
5.
Economizer Type
Control (ii present)
NA NoEconomizer
Confirmed
l il ., ==
D D
Confirmed
'JI i =
D D
D D
Confirmed
'JI ! .. .,
D D
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
,.----
Project Name: LG NRCC-PRF-01-E Page 10of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
0. EQUIPMENT CONTROLS l § 120.2 Confirmed
1. z. 3. ':I
Equip Name Equip Type Controls .. ! ..
No DCV Controls
No Economizer
FC-1/CU-1 SZHP No Supply Air Temp. Control D D
No Optimum Start
No Evaporative Cooler
NonResBaseSHWSystem Service Hot Water, Primary Only Fixed Temperature Control, No DDC D D
P. SYSTEM DISTRIBUTION SUMMARY § 120.4/ § 140.4(1)
Dry System Distribution Confirmed
L z. 3. 4. 5.
Duct Leakaae will be Ducts .., iii' Duct Lealrap and 5ealina Ill Equip Name Equip Type verified per NAl and .. = Required per 140.4(11 NAZ Insulation R-Value Location
FC-1/CU-1 SZHP No No 8 Unconditioned D D
Does the Project lndude Zonal Systems? (if "Yes", see NRCC-PRF-MCH-DETAILS for system informationl No
Does the Project lndude a Solar Hot water System? (if "Yes", see NRCC-PRF-MCH-DETAILS for system informatlonl No
Multifamily or Hotel/ Motel occupancy? (If "Yes", see NRCC-PRF-MCH-DETAILS for DHW system lnformationl No
Q. INDOOR CONDITIONED LIGHTING GENERAL INFO (see NRCC-PRF-LTI-DETAILS for more info)
This Section Does Not Apply
R. INDOOR CONDITIONED LIGHTING SCHEDULE (Adapted from NRCC-LTl-01-E)' § 130.0
This Section Does Not Apply
llf fightinr; power densities were used in the compliance model Buildinr, Departments will need to check prescriptive forms for luminaire Schedule details.
51. COVERED PROCESS SUMMARY -ENCLOSED PARKING GARAGES § 140.9
This Section Does Not Apply
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-D3-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 11 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
S2. COVERED PROCESS SUMMARY -COMMERCIAL KITCHENS § 140.9
This Section Does Not Apply
S3. COVERED PROCESS SUMMARY -COMPUTER ROOMS § 140.9
This Section Does Not Apply
S4. COVERED PROCESS SUMMARY -LABORATORY EXHAUSTS § 140.9
This Section Does Not Apply
T. UNMET LOAD HOURS
This Section Does Not Apply
U. ENERGY USE SUMMARY
Energy Component Standard Design Site Proposed Design Site Mafiin Standard Design Site Proposed Design Site Mafiin
(MWhl (MWhl (MWhl (MBtul (MBtul (MBtu)
Space Heating --0.3 -2.8 ---
Space Cooling 0.5 0.3 0.2 .. ---
Indoor Fans 2.0 0.6 1.4 .. ---
Heat Rejection -----· .. -· -
Pumps & Misc. ----.. .. ---
Domestic Hot Water ------4.3 4.3 0.0
Indoor Lighting 0.7 0.7 0.0 -----
COMPLIANCE TOTAL 3.2 1.9 1.3 7.1 4.3 2.8
Receptacle 1.9 1.9 0.0 -----
Process ---· --· ---
Other Ltg .. -------
TOTAL 5.1 3.8 1.3 7.1 4.3 2.8
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-Dl-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 12 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibdl6x
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I§ 10-103
I certify that this Certificate of Compliance documentation Is accurate and complete.
Documentation Author Name: HADI MAHZARI Signature: IIA0/ 11/AIIZIIRI Company: ENERGY CONSULTING GROUP
Address: 8015 BALBOA AVE. Signature Date: 3/20/2017
City/State/Zip: SAN DIEGO CA 92111 CEA Identification (If applicable): 2984
Phone: 858-268-0660
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
l 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.
2 I affirm that I am eligible under the provisions of Division 3 of the Business and Professions Code 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.
3 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.
Responsible Envelope Designer Name: ignature: /1~~8~ Company: National Air & Energy
Address: 2053 Kurtz Street Date Signed: 3/20/2W7
City/State/Zip: San Diego, CA 92110 Declaration Statement Type:
Phone: (619) 299-2500 Title: Engineer lucense #: 706889
Responsible Lighting Designer Name: ignature: NOT IN SCOPE
Company:
Address: Date Signed:
City/State/Zip: Declaration Statement Type:
Phone: Title: I license II:
Responsible Mechanical Designer Name: Tony Brunelle ignature: /1~~8~ Company: National Air & Energy
Address: 2053 Kurtz Street Date Signed: 3/20/ar,17
City/State/Zip: San Diego Ca 92110 Declaration Statement Type:
Phone: 619-299-2500 Title: I license#: 706889
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-Ol-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 13 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
NRCC-PRF-ENV-DETAILS ·SECTION START·
A. OPAQUE SURFACE ASSEMBLY DETAILS Confirmed
1. 2. 3. 4. i Surface Name surface Type Description of Assembly Layers Notes i
Stucco -7/8 in.
Vapor permeable felt -1/8 in.
2X4/R-134 ExteriorWall Metal framed wall, 16in. OC, 3.5in., R-13 D D Gypsum Board -1/2 in.
Cellular polyisocyanurate (unlaced) -1 in. RS.9
Asphalt shingles -1/4 in.
Vapor permeable felt -1/8 in.
R-30 Roof9 Roof Plywood -1/2 in. D D Air -Cavity-Wall Roof Celling -4 in. or more
Wood framed roof, 16in. OC, 9.25in., R-30
Gypsum Board -1/2 in.
Slab Type= UnheatedSlabOnGrade
Slab On Gradell Underground Floor Insulation Orientation= None D D
Insulation R-Value = RO
B. OVERHANG DETAILS (Adapted from NRCC-ENV-02-E)
This Section Does Not Apply
C. OPAQUE DOOR SUMMARY Confirmed
L 2. 3. 4. s. 6. 7.
Opaque Door Assembly Name Overall Pass Fail
/Tagorl.D. Door Type Certification Method Operation Area U-factor Status'
Wood Door? WoodGreaterThan0rEquaITo1.75inThickDoor DefaultPerformance Swinging 40 0.500 N D D
1 Status: N-New, A-Altered, E-fitisting
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Projec:t Name: LG NRCC-PRF-01-E Page 14of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanlcal Input File Name: LG.cibdl6x
NRCC-PRF-MCH-DETAILS -SECTION START-
A. MECHANICAL VENTILATION AND REHEAT (Adapted from 2013-NRCC-MCH-03-E} Confirmed
1. DESIGN AIR FLOWS 2. VENTILATION(§ 120.1)
:z: Cl Cl "' .. 0
8 m Cl 3: 3: 3: 8 Cl m 1il "' m 3: 0 Cl ~ iii iii "" i ~ ,. Cl z 3: "' z c m iii z z ,. z Si Cl ~ Cl z iii ~ z .,. 6 3: ... i: n 'n < < "' .e?. "Cl =~ z 3 'n ~ z m z ... iii' "' ~i 6 C: ~ C: 8 .,. m z m Cl 8 .. 0 z ,~ .. ..... < "' ~~ l CONDITIONED "i: 6 3: i:B ~ 3: ... 3: z ~ z ... z C: ,. nm ,. !2 -:
6~ .,, ,. ~~ -:Z: ~:,: .. m i! .. ~ ;; .,, z iii ~ :, ... ti = ZONE NAME ~:l! !;l si: el .. C 3: .. -o z -< !:I i: !:IE m ,. ;:r ~ 0 i!l :;: ... 1w,. 6 ~! G) ,. !;l 3: 3: :! I'" 3: "' !!::!:a .,, 6 ;; 3 -,. oz ~ ;; 3: -0"' -z ~ 6 m ,. "Cl ,a.; ~ .,, ~ 3i -~ Z< G) z G) ,. "' m ... 3 ;t ii: 0 6 n :,. 6 3: ~ ~ ,. "Cl 0 n ~ ... ~ m C: "' "' ;; ~ I'" z ... ~ 3: ~ 3: m ~ ,..
""
1-FC-1/CU-1 FC-1/CU-1 688 NA NA NA NA N FC-1/CU-1 438 NA 4 15.0 66 66 NA N NA D D
TOTAL 438 NA NA NA NA D D
8. ZONAL SYSTEM AND TERMINAL UNIT SUMMARY § 140.4
1. 2. 3. 4. 5. 6. 7. 8. confirmed
Rated Capacity Airflow(cfml Fan (kBtuhl Economizer "Cl -: System ID System Type Qty Zone Name Ill Min. ECM ., = Heating cooling Design Min. BHP Cycles Ratio Motor
1-FC-1/CU-1-Trm Uncontrolled l NA NA NA 1-FC-1/CU-1 688 NA NA NA NA D D D
C. EXHAUST FAN SUMMARY
This Section Does Not Apply
D. DHW EQUIPMENT SUMMARY-(Adapted from NRCC-PLB-01}
This Section Does Not Apply
E. MULTI-FAMILY CENTRAL DHW SYSTEM DETAILS
This Section Does Not Apply
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 15 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanical Input File Name: LG.cibd16x
F. SOLAR HOT WATER HEATING SUMMARY (Adapted from NRCC-STH-01)
This Section Does Not Apply
G. MECHANICAL HVAC ACCEPTANCE TESTS & FORMS (Adapted from 2013-NRCC-MCH--01-E} §RA4
Declaration of Required Acceptance Certificates (NRCA) -Acceptance Certificates that may be submitted. (Retain copies and verify forms are completed and signed to post in field for Field
Inspector to verify).
3: 3: 3: 3: 3: 3: 3: 3: 3: 3: 3: 3: 3: 3: 3: 3: 3:
Test Description n n n n n n n 2 ~ n n n n n n n n Confirmed ::c t ::c ::c ::c ::c t f f f ::c ::c f ::c f 0 0 0 0 0 5l .. .. .. .. ,:. ,:. .. ,:. .. N ~ t UI en ... ~ ~ !i: N ... t UI ~ ... ~ )> )> )> )> )> )> )> )> )>
~ "' "' "' I )> )> 0 C:
3' 0 "' C: C: 'TI ~-" () " i C: " "' )> :, C: ~ " 6' 0 6' -; < "' 0 0 ro =;· 0 " 0 ":, Equipment C: 3 " ~ < () ~ () 0 'TI n, rn ?;-~ a_
S' 0 Q 0:, "" Requiring #of a ;;;· ;;;· 0 < m'l ~ ~ 0 .. NO X !'l "' rl:, n, ..,
0 :, ,.. !'l ~ ol' iE :, 3 0 0 )> '?l! ';ji in' () ~ () II ~ Q " rl" 0 :, 0 " :s: Testing or units 0 () :, ~ ~ ~~ Q. 5.. X .. g' () "' Ii,' 3 :, ~ "' g: =
~ C C: 0 i,l" C ~ !:t:iE Verification :, a al ~ "' ~ 'TI "' ~ ?;-6' ,, 0 ., ~ < " 3 0 ::r al "' ii,i a :e " J10 "' " -< in ,, a_ " ~
NonResBase 1 -------------------D D ---------SHWSystem
FC-1/CU-1 1 X X --X -------------------D D
H. EVAPORATIVE COOLER SUMMARY
This Section Does Not Apply
NRCC-PRF-LTI-DETAILS -SECTION START-
A. INDOOR CONDITIONED LIGHTING CONTROL CREDITS (Adapted from NRCC-LTl-02-E) § 140.6
This Section Does Not Apply
B. INDOOR CONDITIONED LIGHTING MANDATORY LIGHTING CONTROLS (Adapted from NRCC-LTl-02-E) § 130.1
This Section Does Not Apply
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:55
Project Name: LG NRCC-PRF-01-E Page 16 of 16
Project Address: 2791 LOCKER AVE. WEST CARLSBAD 92010 Calculation Date/Time: 14:20, Wed, Mar 08, 2017
Compliance Scope: NewEnvelopeAndMechanlcal Input File Name: LG.cibd16x
C. TAILORED METHOD CONDITIONED LIGHTING POWER ALLOWANCE SUMMARY AND CHECKLIST (Adapted from NRCC-LTl-04-E) § 140.6
This Section Does Not Apply
D. GENERAL LIGHTING POWER (Adapted from NRCC-LTl-04-E) § 140.6-D
This Section Does Not Apply
E. GENERAL LIGHTING FROM SPECIAL FUNCTION AREAS (Adapted from NRCC-LTl-04-E) § 140.6(c) 3H
This Section Does Not Apply
F. ROOM CAVITY RATIO (Adapted from NRCC-LTl-04-E)
This Section Does Not Apply
G. ADDITIONAL "USE IT OR LOSE 1r• (Adapted from NRCC-LTl-04-E)
This Section Does Not Apply
H. INDOOR & OUTDOOR LIGHTING ACCEPTANCE TESTS & FORMS (Adapted from NRCC-LTl-01-E and NRCC-LT0-01-E) § 130.4
This Section Does Not Apply
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance Report Version: NRCC-PRF-01-E-12142016-4377 Report Generated at: 2017-03-08 14:21:SS
ENVELOPE MANDATORY MEASURES: NONRESIDENTIAL ENV-MM
Project Name I Date
LG 3/8/2017
DESCRIPTION
Building Envelope Measures:
§110.B(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.
§110.B(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.
§110.B(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.
§110.7(a): All Exterior Joints and openings in the building that are observable sources of air leakage shall be caulked, gasketed,
weatherstripped or otherwise sealed. ·
Manufactured fenestration products and exterior doors shall have air infiltration rates not exceeding 0.3 cfm/ft.2 of
§110.6(a): window area, 0.3 cfrn/ft.2 of door area for residential doors, 0.3 cfrn/ft.2 of door area for nonresidential single doors
(swinaina and slidina), and 1.0 cfm/ft.2 for nonresidential double doors (swinoina).
§110.6(a): Fenestration U-factor shall be rated in accordance with NFRC 100, or the applicable default Li-factor.
§110.6(a) : Fenestration SHGC shall be rated in accordance with NFRC 200, or NFRC 100 for site-built fenestration, or the
applicable default SHGC.
§110.6(b): Site 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).
EneravPro 7. 1 bv EneravSoft User Number: 2984 ID: Paae 19 of 19
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I ENERGY I CONSUL'.r ING I DESIGN I COMPLIANCE I
CALCTP A(:~CEPTANCE CERTIFICATION
FOR
27£11 Loker Avenue West
(":, .~, R'' c:·sAD CA 92010 ,., j"· !!-"-) ' .
PREPARED 05/2/2017
PROJECT: 170-1,9
!\I\
ELECTRICAL EF'PICACY CONSULTING, INC.
13100 KlRKI-fAM WAY, SUH'E 205, POWAY, CA 92064-7128
8,58/7 48-2060 858/748-6012-FAX
CLSB 1002594 A'TT CER'TIFICATION # ATE-0112
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IENERGYI
CALCTJl At\CCEPTANCE CERTIFICATION
CORJlECTION/DEFECIENTCIES/NOTES
PERMIT NUMBER: ,/, ,>.G : , i /~11 er: ENFORCEMENT AGENCY: C! TY OF C/.;,RLSBAD
lJectrical Efficacy Consulting, INC.
13100KIRKHAMvVAY,SUIIE 205,POWAY, CA 92064--7128
858/748-2060 858/7 48-6012-:FAX
-.,~"--~"" 1002594 AITCER'IIFICATION #TC-A813666
u NRCA-LTl-02-A
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lghting Control
roject Name: LG Display Enforcement Agency: CITY OF CARLSBAD ermit Number: CBC2017-0140
rojeol Address: 2791 Loker Avenue West City: Carlsbad ip Code: 92010
::nforcement Agency Use: Checked by/Date
LIGHTING CONTROL ENT
Automatic Shut-off Controls: ,t!,utomatic Time Switch Control and Occupant Sensor
Intent: Lights are turned off or set to a lower level when not needed per Section 110.9(a) & 130.l(c).
A. Construction Inspection
Fill out Section A to cover spaces l. througr 3 that are functionally tested under Section B.
Instruments needed to perform tests inclucie, but are not limited to: hand-held amperage meter, power meter, or light meter
1: Automatic Time Switch Controls Construct,,<on Inspection-confirm for all listed in Section B
a. All automatic time switch controls are p-ograrnmed for (check all):
r Weekdays r Weekend r Holidays
b. Document for the owner rutornalk time c;witch programming (check all):
r Weekday settim1s r \t\feekend S(~ttings r Holidays settings r Set-up settings
r Preference program setting r Verify the correct time and date is properly set in the time switch
r Verify the battery is installed and energized r Override time limit is no more than 2 hours
r Occupant Sensors and Automatic 7:irne Switch Controls have been certified to the Energy Commission in accordance with
the applicable prnvision in Section 110.~1 of the Standards, and model numbers for all sucil controls are listed on the Commission
database as Certified Appliance and Control Devices
2. Occupancy Sensor Construction Inspection-confirm for all listed in Section 8
F7 Occupancy sensors are not located within 4 feet of any HVAC diffuser
F7 Ultrasonic occupancy sensors do not e ·nit audible sound 5 feet from source
This is page 1 of
#,ting Control
oject Name: LG Display )!Enforcement Agency: CITY OF CARLSBAD
oject Address·. 2791 Loker Avenue West IICity: Carlsbad
frermitNumber: CBC2017-0140
I Zip Code: 92010
I B. functional Testing of Ughti1111g Controls
. or every space in the building, conduct functional tests 1 through 5 below if applicable. If there are severa: geometrically similar spaces
'that use the same lighting controls, test only one space and list in the cel!s below which "untested spaces" are represented by that
tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3)
Representative Spaces Selected
Tested space/room name:
Space Type (office, corridor, etc)
I Untested areas/rooms
Displ?.y Room OS 1
Open Office
Confirm compliance for all control system tyrccs (1-5) present in each space:
1. Automatic Time Switch Controls
Step 1: Simulate occupied condition
j
a. All lights can be turned on and off by th<:ir respective area control switch
b. Verify the switch only operates iightmg in the cei.'ing-height partitioned area in
which the switch is located.
Step 2: Simulate unoccupied condition
a. All lighting, including emen:iency and ew,:ss lighting, turns off. Exempt lighting may
remain on per Section J30,1:~c)1 .:::nd
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b. Manual override switch controls ,>nly th: li~1hts in the selected ceiling height
partitioned space where the over~·ide s itch is located and the lights i-emain on no
longer than 2 hours (unless serving public areas and override switch is captive key
type).
Step 3:
System returned to initiai operati,0 9 conclit. ons
2. Occupancy Sensors
Step 1: Simulate an unoccupied condition
a. Lights controlled by occupancy sensors ::urn off within a maximum of 20 minutes
from start of an unoccupied condition per Standard Section 110.9(b)
b. The occupant sensor does not tri~;ger il faise 'on' from movement in an area
adjacent to the cont~o!!cd spe;ce or frcrn HV/\C operation.
Step 2: Simulate an occupied condition
I
a. Status indicator or annunciato1-operates correctly
b. Lights controlled by occupancy sensors turn on immediately upon an occupied
condition OR sensor indicates s;121ce is occupied' and 1.igh~s may be turned on
manually
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'-"I .__ _____________________________________ J_ _ _J
This is page 2 of
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Project Addresf 2791 Loker Avenue West
I tntorcement Agency: CITY OF CARLSBAD
City: Carlsbad
kermit Number: CBC2017-0l 40
·pCode: 92010
SteP, 3:
System returned to initial operat1ng condi·,:ions ··"--...,,.-----------------------------------------------------.....l.--...J
3. Partial Off Occupancy Sens,o.,r
Step 1: Simulate an unoccupied condition
a. Lights go to partial off state within a m21)ci111um of 20 minutes from start of an
unoccupied condition per Standard Section 110.9(a)
b. The occupant sensor does not trigger a false 'on' from movement in an are21
adjacent to the controlled sp,ice or fro1°1 HVAC operation. For library book stacks or
warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in
the aisle or stack.
c. In the partial off state, lighting shall consume no more than 50% of installed lighting
power, or:
No more than 60% of installed Hghtinq power for metal halide or high pressure
sodium lighting in wa;·ehouses.
No more than 60% of installed lightinrJ power for corridors and stairwells in which
the installed lighting power is 80% ot· less of the value allowed under the Area
Category Method.
Light level may be used as a proxy for ligh\i:19 power when measurements are taken
Step 2: Simulate an occupied condition
I The occupant sensing controls shall turn liqhts fully ON in each separately controlled
areas, Immediately upon an occupied ccr,dition
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4. Partial On Occupancy Sensors
Step 1. -Simulate an occupied condition. Verify partial on operation.
a. Immediately upon an occupied c:)ndit:on, the first stcige activates between 50 to
70% of the lighting automatically,
b. After the first stage occurs, manual switches allow an occupant to activate the
alternate set of lights, activate 100% of t:1e lighting power·, and manually
deactivate all of the lights.
Step 2. Simulate an unoccupied condition
a. Both stages (automatic on and m,::'1ual on, iights turn off wil:hin a maximum of 20
minutes from start of an unoccupied con::lition per Standard Section 110. 9(a)
b. The occupant sensor does not trigger a fa:se 'on' from movement in an area
adjacent to the controlled space or from H\/AC operation.
~€$TP . . . . . . .
C!ilitornla Advam:ed Ughlin!J
Comrols Ti'aitiing Program
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This is page 3 of 11
~gluing Control
reject Name: LG Display Enforcement Agency: CITY OF CARLSBAD
'rojeet Address: 2791 Loker Avenue West City: Carlsbad
rermitNumber: CBC2017-0140
'p Code: 92010
5. Ad~tional test for Occupam:y Sensors Serving Small Zones in Office Spaces Larger than
150 ft , to Qualify for a Power Adjustment factor (PAF)
···'-.....dtep O: First, complete Functional Test 2 (ab<nm) for each controlled zone.
Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2.
a. Area served by controlled lighting ft.2
b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for
PAF=0.4, 126-250 ft2 fo: P)'._f~0.3, 251 · 500 for PAFcc0.2).
c. Enter PAF claimed for occu1:iant sensor control in this space from the Certificate of
Compliance.
d. The PAF corresponding to the controiiecl area (line b), is greater than or equal to
the PAF claimed in the compliance docu7lentation (line c).
e. Sensors shall not trigger in resoonse tc movement in adjacent walkways or
workspaces
f. All steps are conducted in Functional Te,,t 2 'Occupancy Sensor (On Off Control)'
and all answers are Yes.
Callfornla Atl\lariced L\gtrti11g
Ccllitro!s Training Program
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This is page 4 of
,tmg Control
ect Name: LG Display Enforcement Agency: CITY OF CARLSBAD
ect Address: 2791 Loker Avenue West City: Carlsbad
IC. Testing Results
1. Automatic Time Switch Contrnis (all answus must be Yes).
2. Occupancy Sensor (On Off Control) (ali arswers must be Yes).
3. Partial Off Occupancy Sensor (al! answers rnust be Yes). For warehouses, library
book stacks, corridors, stairwells in nonre,.ii.12ntiai t)uildings must also be
accompanied by passing Test 1 or Test 2.
4. Partial On Occupant Sensor for PAF (all a 1swers must be Yes).
5. Occupant Sensor serving s:nal/ zones for P.,\F (all answers must be Yes). /.\lso must
pass Test 2.
Representative Spaces Selected
Tested space/room name:
Space Type (office, corridor, etc)
! Untested areas/rooms
l)isplay Room OS 2
)pen Office
Permit Number: CBC2017-0140
Zip Code: 92010
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·-'--r··-· --------------------------------------------------------,
Confirm compliance for all control system typ,~s (:L-5) present in each space:
1. Automatic Time Switch Controls
Step 1: Simulate occupied condition
1
a. All lights can be turned on end off by their respective area control switch
b. Verify the switch only operates lighting n che ceiling-height partitioned area in
which the switch is located.
Step 2: Simulate unoccupied condition
a. All lighting, including emergency and eg1 ess lighting, turns off. Exempt lighting may
remain on per Section 130.l(c)l and i=,0.1:a)L
b. Manual override switch controls only th= lights 1n the selected ceiling height
partitioned space where the ovetTide si.vitch is located and the lights remain on no
longer than 2 hours (uniess serving puillic areas and override switch is captive key
type).
Step 3:
System returned to initial operatin9 condi:ions
··.........t. Occupancy Sensors
Step 1: Simulate an unoccupied condition
a. Lights controlled by occupancy sensors tum off within a maximum of 20 minutes
·c .. ··•.·.·.···' .. 'A ... ··.·<·.'.·.··.;;/'[_.· .·.~.-:;,.".::r··· .. •P· . Ca!iforn .. !~Atl .. ~anceil.lighting r°\i.l.i ~ ·· .·· · ·· ··· tont«lls 'fr&mmg Program
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This is page 5 of
•girting Control
oject Name: Li:, Display Enforcement Agency: CITY OF CARLSBAD
·ojecl Address: 2791 Loker Avenue West City: Carlsbad
from start of an unoccupied condition per Standard Section 110.9(b)
b. The occupant sensor does not trigger a i'i,lse 'on' frorn movement in an area
adjacent to the controlled space or from -NAC operation.
Step 2: Simulate an occupied condition
a. Status indicator or annunciator operates correctly
b. Lights controlled by occupancy sensors tl rn on immediately upon an occupied
condition OR SE:nsor indicates space ts 'occupied' and lights may be turned on
manually
Step 3:
System returned to initial operating c:onditic,<1.s
3. Partial Off Occupancy Sensor
Step 1: Simulate an unoccupied condition
I
I
a. Lights go to partial off state within a maximum of 20 minutes from start of an
unoccupied condition per Standard Section 110.9(a)
b. The occupant sensor cloec: not trigger a f3lse 'on' from movement in an area
adjacent to the controlled space or from H\/AC operation. For library book stacks or
warehouse aisle, activity beyond the s1:cck or aisle shall not activate the lighting in
the aisle or stack.
!Permit Number: CBC2017-0140
ip Code: 92010
P'
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c. In the partial off state, lighting shall con·,ume no more than 50% of installed lighting
power, or:
No more than 60% of installed lighting power fo•· metal halide or high pressure
sodium lighting i:1 watehouses.
No more than 60% of ir>stailed lightinr; power for c01Tidors and stairweHs in which
the installed lighting power B0°A1 o!· !ess of the value allowed under the Area
Category Method.
Light level may be used as a prnxy for lighl. ing power when measurements are taken
Step 2: Simulate an occupied condition
The occupant sensing controis shall turn ii Jhts fully ON in each separately controlled
areas, Immediately upon an occupied condition
4. Partial On Occupancy Sensors
Step 1. -Simulate an occupied condition. Verif\' partial on operation.
I
a. Immediately upon an occupied conditicn, the first stage activates between 50 to
70% of the lighting automatically.
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b. After the first stage occurs, rnanuai s1, itches aliow an occupant to activate the
alternate set of fights, activate lOO"li, of the !ightin;;! power, and rnanualiy
··~·1~ __ ct_e_a_c_t_iv_a_t_e_a_1_1_o_f_t_h_e_1_,9_,h_t_s_. ________________________________________ .._r _ __,
Step 2. Simulate an unoccupied condition
.. r-...... ' ... · ·/A· .. ··· .. , .. ·•.· .....•.. I':.. "·-..:.'•-::-.::.: •. · .. r· · .. ·P·· ·.· Cjjli.lo. rnia. Ad~ncerl.Ll9htlnt., '\..,if'''IJ,~,;;\;,I. . . Conirols trrumn~ Program This is page 6 of
.ting Controt
ect Name: LO Display Enforcement Agency: CITY OF CARLSBAD
ect t'tddress: 2791 Loker Avenue West City: Carlsbad
a. Both stages (automatic on and rnanual on) lights turn off within a maximum of 20
minutes from start of an unoccupied c:ondi1:ion per Standard Section 110.9(a)
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC: operation.
kermit Number: CBC2017-0140
· p Code: 92010
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This is page 7 oi
-~~--------------
.ting Control
ect Name: LG Display Enforcement Agency: CITY OF CARLSBAD
eel Address: 2791 Loker Avenue West City: Carlsbad
termit Number: CBC20l 7-0140
ip Code: 92010
5. Ad~tional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than
'150 ft , to Qualify for a Power .Adjustment factor (PAF)
-,_....,tep O: First, complete Functional Test 2 (above) for each controlled zone.
Step 1: Verify area served and compare actual PtJ' with claimed PAF. Refer to Functional Test 2.
a. Area served by controlled lighting ft2
b. Enter PAF correspondin~J to controlled are1: from line (a) above (<125 ft2 for
PAF==0.4, 126-250 ft2 for P/l.F=0.3, 251-SIJ0 ft2 for PAF=0.2).
c. Enter PAF claimed for occupant sensor co:1tro! in this space frorn the Certificate of
Compliance.
d. The PAF corresponding to the controlled crea (line b), is greater than o,· equal to
the PAF claimed in the compliance documentation (line c).
e. Sensors shall not trigger in response to n·ovement in adjacent wa!kways or
workspaces
f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Controi)'
and all answers are Yes,
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This is page 8 of
lllllgControf
;ect Name: LG Display nforcement Agency: CITY OF CARLSBAD
ject A3dress: 2791 Loker Avenue West ity: Carlsbad
IC. Testing Results
1. Automatic Time Switch Contr-o1s (a!/ answers must be Yes).
2. Occupancy Sensor (On Off Control) (all arswers rnust be Yes).
3. Partial Off Occupancy Sensor (al! ans,,:ers must be Yes). For warehouses, library
book stacks, corridors, stainNells in nonresidential buildings must also be
accompanied by passing Test 1 or Test 2
4. Partial On Occupant Sensor for P/!d= (ali a,1swers rnust be Yes).
5. Occupant Sensor serving small zones for ~/\F (all 2mswers must be Yes). Also must
pass Test 2.
D. Evaluation
P' PASS: All applicable Construction Inspectic n responses a1·e complete and all applicable
Equipment Testing Requirements response.•; are positive.
C.. ' .A_ .. ·_·. i. · .. · .. , ~ ··T .. · .. n · Callftlril.laMv __ a~ced Lighting ,...,,_\;J r · Cont!Ola Trai1111ig i'.';ogram
ermit Number: CBC2017-0140
ip Code: 92010
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This is page 9 of
htmg Control
ject Name: LG Display l!Enforcement Agency: CITY OF CARLSBAD
ject Aadress: 2791 Loker Avenue West IICity: Carlsbad
JkermitNumber: CBC2017..0140
ip C-0de: 92010
I ~~e~t~':~t~hT~!~~~e !~,!~t?n~'~c~~~~t1~~~!!,?a~ a~;!!P~~-ENT
tocumentation Author Company Dennis PhiH1ps ame
-;\ddress
Zip Code
13100 Ki1ki,arn Wc:y J,205
92064
City
Phone
Narne
CEA/ATT Certification
Identification (if TC-A813666 Author Signature '"''"""'~ \> ---~-='?""~---------.... _____ _
Date of Signatui-e: 05/01/2017
FIELD TECHNICIAN'S DECLARATION STATEMENT
I certify the following under pc,nalty of perjury, under !he laws of the State of California:
1. The information provided on this Certlflcate of ACCi'.ptance is true and correct.
Electrical Efficacy Ccnsultlnq, Inc.
Poway
(858)748-2060
2. I am the person who performed the-acceptance ve··if]cation reported on this Certificate of Acceptance (Field Technician).
3. The construction or installation iden~ifted on this Certific3te of Acceptance complies v·-litt·1 the applicable acceptance requirements ind1cated in the plans and
specifications approved by the enforcement agency, c1nd conforms to the applicable acceptance requirements and procedu ·es specified in Reference
Nonresidential Appendix NA 7.
4. I have confirmed that the Certificate(s) of InstaUa.:ion for the construction or installation identified on this Certificate of Acceptance has been completed and
signed by the respo11sible builde.r/instaiter and ha:; been posted 01 rnade available wit/, tile buiidlng permit(s) issued for the building.
Field Technician Name Company Marne Denr:is Phillips Electrfcal Efficacy r::onsulting, Inc.
Address:
Zip Code
ATT Certification
Identlfication
13100 Kirkham W,:1y #205
92064
TC-A813666
City
Phone
Position with Company
(Title)
Poway
(858)748-2060
Technician
.. ----------------------------.......
Date of Signature: 05/01/2017
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, unctei the laws of the State of California:
1. I am the Field Technician, or the Field ~lectrniciar is acting on my behalf as my employee ot· my a~Jent and I have reviewt:d the information provided on this
Certificate of ~.cceptance.
2. I am eligible under Division 3 CJf the Business and Professions Code in the applicable cl;Jssification to iJCC0.pt responsibi!ltv for the system design, construction
or installation of features, rnaterli:~!s, components I or rnanufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the
declarations in this statement (responsible accertance person).
3. The information provided on this Certificate of Accept!.rnce substantiates that the construction or installation identified on this Certificate of Acceptance complies
with the acceptance requirements indicated in th::: plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance
requirements and procedures specified in Ref ere ·ice Nonresidentia! Appendix NA7,
4. I have confirmed that the Certificc'te(s) of In.sta!iat!on for the construction or installation identified on this Certificate of 1\cceptance has been completed ancl is
posted or made r.1vailable with t(1e building pern1 t(s) Issued for the bullding.
5. 1 will ensure that a comp!et2d, slgne,J copy or th s C.ertlficau.~ of Acceptance shall be post.ed1 or rna<le avai!abie with the t:Ji!ding pennit(s) issued for the
building, and made available to the enforcement: a~1ency tor a!i applicable inspections. I understand that cl signed copy of this Certificate of Acceptance is
required to be included with the docurn(~ntation t 1e Dudder provides to the building owner at occupancy.
Responsibie Acceptance Company Name
Person Name Dennis Phd!ips
Address: 13100 Kirkha1n Way 1!205
Zip Code 92064
CSLB License 1002594
Responsib cceptance Pelon Signature
"Date of Signature:
)
05/01/2017
camomla t>;dvancect Ligrrtlnri
Controls Training -Pro9rmn
City
Phone
Position with Company
( Title)
ElEictr!cal Efficacv Consulting, ln-c.
Poway
(858)748-2060
President
This is page 10 of
jghting Controf'
roject Name: LG Display !Enforcement Agency: CITY OF CARLSBAD
'roject-Address: 2791 Loker Avenue West !City: Carlsbad
'!Permit Number: CBC2017-0l40 I Zip Code: 92010
CJAL~J':f) ~~!:t¢!~!~::r~::~~g "'---~-----'------"-----------'-~'--~ This is page 11 of
-NRCI-LTl-01-E
::ERTIFJ.CAJ'E OF JNSffALLATION IJNRCI-LTI-Ol-E
hdoorr.iglrting •
'roject Name: LO Display nforcement Agency: CITY OF CARLSBAD
'roject-Address: 2791 Loker Avenue West
termitNumber: CBC2017-0140
· p Code: 920! 0
leneral Information
Building Type: p r Nonresidential High-Rise Res (Common Area)
r Hotel/Motel (Curnrnon Area)
Phase of Construction: r New Construct on r Addition r,, Alteration
r Unconditioned
Scope of Responsibility
Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy
efficiency measures for the scope of responsil:ility for this Installation Certificate.
I Date: 3/20/2017 12:00:00 C\!'0
.
ARPllc;~1e· ,~·~ets or.f,lag;·s, 'Fables, Schedules, etc. ' Document Title or Description Date Approved ,BY the Enforcement Agency
'
Lighting Plan E2.2 3/20/2017 12:00:00 AM
Title 24 Sheets El.2 3/20/2017 12:00:00 AM
~.~~.:' .. ·T··· ... Q. v •. Cal. lforn(aMvan. . ·.··. ce.d l.1.ghti11g ~ : f"'." Controls TTlllµing Program
This is page 1 of:
foor Ligl\ting
oject Name: LG Display
oject kldress: 2791 Loker Avenue West
DOCUMENTATION AUTHOR'S DECL,f\RATION STATEMENT
I certify that this Certificate of Acceptance rjocument is accurate and complete.
"ocumentation Author
ame
/Address
Zip Code
CEA/ ATT Certification
Identification (if
applicable)
Date of Signature:
Manny Garcia
646 Gra11d Avenu,2,
91977
05/01/2017
Company Name
City
Phone
Author Signature
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of pequrv1 under t ·1e laws of the State of California:
UNRCI,LTI-01-E
Permit Number: CBC2017-0140
Merz Construction
Spring Vailey
(619)825·9105
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 informatlon provided on this
Certificate of Acceptance.
2. I am eligible under Divisior 3 of the Business ;:1n( Professions Code in the applicable classificatton to accept responsibility for the system design, construction
or installation of features, rnateria!s, components, or manufactured devices for the scope of work identlfied on this Certlfi:·ate of Acceptance and attest to the
declarations in this statement (1·~sponsib!e accep:rince person).
3. The information provided on this Certificate of /\c :eptance substantiates that the construction or in.s-tallation identified on 1:his Certificate of Acceptance
complies with the acceptance r·equin~n1ents 1'no'rc;; ted in the plans and specifications approved by the enforcement agency. and conforms to the appHcabte
acceptance requirements ~nd procedures specified in Reference Nonresidential Appendix NA7.
4. r have confirmed that the Certlf1cate(s) of Install<ttion for the construction or insta!!atton identified on this Certificate of Acceptance has been completed and
is posted or made cwailable. with the building per Tiit(s) lssued for the building.
5. I will ensure that a completed, signed copy of th,; Ce:·tificate of Acceptance shall be posted, or made available with the b, .. i\ding permit(s) issued for the
building1 and made available to the enforcement ::iye:ncy for at! applicable inspections, I understand that a signed copy of this Certificate of Acceptance is
required to be included with the documentation tre builder provides to the building owner at occupancy.
Responsible Acceptance Company Name Person Name Manny Garcia Merz Construction
Address:
Zip Code
.SLB License
Date of Signature:
',.....__....
646 Grand Avenue
91977
477564
05/01120 .\ l
ca11rorn1a MvancedL11illtin9
Gotttrols Tralnlng flrogram
City
Phone
Position with Company
(Title)
Sprin9 Valley
(619)8£.5-9105
Project Manager
This is page 2 of 2
Cj NRCI-LTl-02-E
Mes or Llgfiting Eoritrol'System
·oject Name: LG Display
·oject Asdress: 2791 Loker Avenue West
IIEnforcernent Agency: CITY OF CARLSBAD
j City: Carlsbad
'DOOR LIGHTIN
',-...._,,-
N RCI LTI 02 E
LG Display -
San Diego
General Information
Building Type:
li7 Nonresidential
r Hotel/Motel (Cornman Ar-ea)
Phase of Construction: r New Constructi,,n
r Unconditioned
Scope of Responsibility
r
r Addition
"Permit Nwnber: CBC2017-0I40
'p Code: 92010
High-Rise Res (Common Area)
f.il' Alteration
Enter the date of approval by enforcement age 1ey of the Certificate of Compliance that provides the specifications for the energy
efficiency measures for the scope of responsibilty for this Installation Certificate.
I Date: 3/20/2017 12:00:00 AM
§130.4(b) Before an Energy Management Con:rol System (EMCS), or Lighting Control System can be recog11ized for compliance with
. the lighting control requirements in Part 6 of·; it\e 24, the person who is eligible under Division 3 of the Business and Professions Code
to accept responsibility for the construction 01· installation of features, materials, components, or manufac".:ured devices shall sign and
submit this Installation Certificate.
If any of the requirements in this Installation 1:ertificate fail the Energy Management Control System or Lighting Control System
installation requirements, these options for co ,trolling lighting shall not be recognized for compliance with the Building Energy
Efficiency Standards.
Check all that apply
PART 1 What type of Lighting Control System has been installed?
r A. Energy Management Control System (EMCS) -Is a computerized control system designec to regulate the energy
consumption of a building by cc ntrolling the operation of energy consuming systems, such as the heating,
ventilation and air conditioning '.HVAC), lighting, and water heating systems, and is capable of monitoring
environmental and system load•;, and adjusting HVAC operations m order to optimize energy usage and respond to
demand response signals.
F The Energy Management Control System has been installed to function as a lighting control required by Part
6 and functionalfy meets all applicable requirements for each application for which it/'.,; installed, in
accordance with Section; 110.9, 130.0 through 130.5,. through 150.0, and· 150.2; and complies with
Reference Norn-esidentiai Appendix NA 7. 7 .2.
r The EMCS has ,)een separately tested for each respective lighting control system for which it is installed to
function as.
P' 8. Lighting Control System -Rc,Juircs twc or· more components to be installed in the building to provide all of the
functionality required to make up a fully functional and compliant lighting control.
I
.., A_. · .. I_ ... ''. , I:. __ ,~{. ,.._.P•-.. ~.UforniaMv_ an_ ced Ugh!lng .;~ \;;I l · · _Controls 'lralning,program This is pagl! 1 of 5
!11'HL1-Ll HJZ!-t.
MCJS or Lighting Controf System
roject Name: LG Display IIEnforcement Agency: CITY OF CARLSBAD RPermit Number: CBC20J 7-0140
roject .l!ddress: 2791 Loker Avenue West l!City: Carlsbad !IZip Code: 92010
II The installed Lighting C Jntrol System complies with the requirements checked below; and all components of
the system considered :ogether as installed meet all applicable requirements for the application for which
they are installed as required in Sections 130.0 through 130.5, Sections throuqh 140.8, Section 141.0,
and Section 150.0(k). '-') ;::==========================================================================:
PART 2 Lighting Control Functional requirements: Check all that apply when verifying
the installation of an EMCS or lighting Control System.
A. All lightH1g controls and eqi_ iprnent have been installed in accordance with the manufacturer's instructions.
B. The manufacture1· has prov1ded instructions for calibration.
C. If indicator lights are integrai to any cornponents, such indicator lights consumes no more than 1 watt of power
per indicator light.
D. Components that are regui3ted by the Title 20 Appliance Efficiency Regulations have been certified to the
Energy Commission.
r E. The EMCS or Lighting Control System functions as one or more of the Time-Switch Lightng Controls checked
below, and complies with alt oi the following requirements:
r 1. Automatic Time-Swi1 ch Controls meeting all requirements for Automatic Time Sw,tch Control devices in the
Title 20 f\ppli,rnce Effici '.'.ncy Regulations, including the requirements below:
a. Residential automatic time-switch controls have program backup capabilities that prevent the loss of the
device's schedule for a; least 7 days, and the device's date and time for at least 72 hours if power is
interrnr:ited.
b. Cornmercici autorn0lic tirne-svvitch controls meet the following requirements:
i. Has prograrn backup capabilities that prevent the loss of the device's schedule fo · at least 7 days, and the
device's datt:-~ tirne for at least 72. hours if power !s interrupted
ii. Is capable of providi119 1,1anudl over-ride to each connected load and shall resume 110rmally scheduled
operation after manual override is initiated within 2 hours for each connected load and
iii. Incorporates an automatic holiday shutoff feature that turns off all connected loads for at least 24 hours
and then 1·esurnes normally scheduled operation.
r 2. Astronornical Tirne-5witch Controls meeting ail requirements for Astronomical Time-Switch Control devices
in the Title 2\.l ,'-lppllance Efficiency Regulations, including the requirements below:
a. Meets the r,0,quirem,~nts of an automatic time-switch control
b. Has sunrise and sur;,et prediction accuracy within plus-or-minus 15 minutes and ,imekeeping accuracy
within 5 minutes per year
c. Is capable of displaying date, current time, sunrise time, sunset time, and switching times for each step
during programming
d. Has an automatic dayli,~ht savings time adjustment; and
e. Has the abiiity to independently offset the on and off for each channel by at least 99 minutes before and
after sunl~lse o: sunset
r 3, MuitH ... evc! Ast,-0110101ical Tirne-Switch Controls, in adciition to meeting all of the requirements for
Astronomical Time-Switch Contrnls, includes at least 2 separately progrnmmable steps per zone.
r F. The EMCS or Lightin9 Cont, ol System functions as one or more of the Daylighting Controls listed below:
I
I
I
California Advanceil Uglliing
Control$ Training Program This is page 2 of :
I CEHJIN;:u:.EU'10~
EMt,S or L1gl\bng Control System
?roject Name: Ld Display JIEnforcement Agency: CITY OF CARLSBAD JIPermitNumber: CBC2017-0l40
?roject Address: 2791 Loker Avenue West IICity: Carlsbad l!Zip Code: 92010
II r 1. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20
Appliance Efficiency Re9ulations, including the following:
a. Is capable of reducir1g the power consumption in response to measured daylight 0~ither directly or by
sending and receiving o ignals;
b. If the system inc!udc-s a dimmer, complies with the Dimmer Contra! device requirements in the Title 20
Appliance Efficiency ReJulations.
c. Automatically return l:o its most recent time delay settings within 60 minutes when put in calibration
mode;
d. Has a set point cont-al that easily distinguishes settings to within 10 percent of lull scale adjustment;
e. Has a light sensor tr at has a linear response within 5 percent accuracy over the range of i!luminance
measured by the light s.ensor;
f. Has a light sensor thdt is physically separated from where the calibration adjustments arc made, or is
capable of being caiibr,ited in a manner that the person initiating the calibration is remote from the sensor
during calibration to avoid influencing calibration accuracy; and
g. Complies with the Title .20 requirements for photo controls if the system contains a photo control
component.
r 2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency
Regulations, including lhe following that it does not have a mechanical device that permits disabling of the
contrni.
r G. The EMCS or Lighting Contni System functions as a Dirnmer and meets all requirements for a Dimmer Control
device in the Title 20 Appliance Efficiency Regulations, including the following:
1. Is capable of reducing powu consumption by a minimum of 65 percent when the dimme: is at its lowest level;
2. Includes an off position whi:h produces a zero lumen output; and
3. Does not consume more thm1 1 watt per lighting dimmer switch leg when in the off position.
4. Dimmer controls that can d rectly control lamps provide electrical outputs to lamps for r1cduced flicker operation
through the dimming 1·c:rge sc that the light output has an amplitude modulation of less than 30 percent for
frequencies less thar: 200 Hz V'ithout causing premature lamp failure.
5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the dimmer if the
lights are off.
W' H. The EMCS or Lighting Co11tnl System meets the following requirements:
1. Is capable of automatically :urning off controlled lights in the area no more than 30 minutes after the area has
been vacated;
2. Allows all lights to be manually turned off regardless of the status of occupancy; and
3. Has a visible status signal t·,at indicates t!,at the device :s operating properlv, or that it 1as failed or
malfunctioned. The visible sta1 us signal rnay have an override switch that turns off the signal.
4. All occupant sensing devices that utilize ultrasonlc radiation for detection of occupants n1eet the Ultrasound
Maximum Decibel Values in thE fitle 20 Appliance Efficiency Regulations
5. All occup,rnt sensinrJ device3 that utilize microwave radiation for detection of occupants meet the radiation
requirements in the Title 20 Ar.,pliance Efficiency Regulations
6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20
Appliance Efficiency Regu!atior s
7. The EMCS or Lighting Control System functions as one or more of the Occupant Sensing ::=ontrols Checked Below:
P' a. Occupant Sensors m,•eting all applicable requirements for Occupant Sensor Contrul devices in the Title 20
Appliance Efficiency Rec ulations
r
b. Motion Sensors meet ng all applicable requirements for Motion Sensor Controls devices in the Title 20
Appliance Efficiency Re~ ulations, including that motion sensors are rated for outdoor use.
c. Vacancy Sensors meeting all applicable requirements for Vacancy Sensor Controls devices in the Title 20
Appliance Efficiency Re(;ulations, i,:ciuding the following:
i. Does not turn on iight1119 automatically and does not incorporate DIP switches, or other manual means, for
conversion be~ween ma iual and automatic functionality;
ii. Has a gri.Ke pehod or no more than JO seconds and no less than 15 seconds to tum on lighting
automatically after the ,;en,;or has tirrit~d out; and
iii. Does not have an ov,crride switch that disables the sensor.
This is oa!!e 3 of 5
EMCS or Liglitin11 ControfSystem
Project Name: LO Display ffEnforcement Agency: CITY OF CARLSBAD IIPermitNumber: CBC2017-0140
Projectt,ddress: 2791 Loker Avenue West IICity: Carlsbad IIZip Code: 920 I 0
II r d. Partial-ON Sensors rneeting all applicable requirements for partial on sensing dev,ces in the Title 20
Appliance Efficiency Regulations, including the following:
i. Has two poles each with automatic-off functionality;
'~ ii. Has one pole that is manual-on and does not incorporate DIP switches, or other nianual means, for
conversion between milnuai and automatic functionality; and
iii. Has one pole that i'.; automatic-·on and is not be capable of conversion by the user to manual-on
functionality.
r e. Partial-OFF Sensors 111eet all applicable requirements for partial off sensing devices in the Title 20
Appliance Efficiency Re(Julations, including the following:
i. Has two poies;
i1. Has one pole that is ,nanual-on and manual off; and
iii. Has one pole that is automatic-on and automatic-off and is not capable of conve(sion by the user to
manual-on only functio11ality.
P' f. Occupant Sensing Co ·1trnl systems consist of a combination of single or multi-level Occupant, Motion, or
Vacancy Sensor Controis, and all components installed to comply with manual-on requirements are not
capable of conversion by the user from manual-on to automatic-on functionality.
PART 3 Requirements for which the control is being installed to complied with:
Identify all requirements in the Standards for which the EMCS or Lighting Control System is installed to function as and complies
with:
Check all that are applicable.
f,7 A. Section 130.1(2) /\tea Conttols.
f,7 B. Section 130. J.(b) Multi .. leve! Lighting Controls
"-f,7 C. Section 130.1 ( c) Shut-OFF Controls
P' D. Section 130.1 (d) Automatic Daylighting Controls.
r E. Section 130.1 ( e) Demand R,:sponsive Controls.
r F. Section 130.5 (d) Circuit Controls for 120-Volt Receptacles.
r G. To qualify for the PAF for a Fartiai-ON Occupant Sensing Control in TABLE 140.6-A
r H. To qualify for the f'AF for an occupant sensing control controlling the general lighting in large open plan office
areas above wo1kstc1tions, in accordance with TABLE 140.6-A
r I. To qualify for the PAF for a M, nual Dimming System PAF or a Multiscene Programmable Dimming System PAF in
TABLE 140.6-A
r J. To qualify fo, t;·;e PA.F for ,, D::mand ,'<.esponsive Control in TABLE 140.6-A
Ir" K. To qualify for the PAF for Combined Manual Dimming plus Partial-ON Occupant Sensing Control in TABLE 140.6-A
This is n:u•~ 4 nf .c;
EMt:S or Ligntini Controf System
Project Name: LG Display !IEnforcement Agency: CITY OF CARLSBAD
Project~ddress: 2791 Loker Avenue West UCity: Carlsbad
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I certify that this Certificate of Acceptance docurne11t is accurate and complete,
Jocumentation Author
;ame
Address
Zip Code
CEA/ ATT Certification
Identification (if
applicable)
Date of Signature:
Manny Garcia Company Name
646 Grand Avenue City
Phone 919"/7
Author Signature
05/01/20 i7
RESPONSIBLE PERSON'S DECLARATION STATEMENT
the laws of :he State of California:
!IPermitNurnber: CBC2017-0140
UZip Code: 92010
Merz Construction
Spring Valley
(619)825-9105
I certify the following under penatty of
1. I am the Field Technician, or the
Certificate of Acceptance.
31"1 1s actir,g on my behalf as my employee or my agent and I have reviewed the information µrovided on this
2. I am eliglble under Division 3 of the Business i:::nd Professi,Jns Code rn the applicable classlflcatlon to accept responsibd,ty for the system design1
construction or installation of features, rnatenals1 rnrmior1er1ts or manufactured devices for the scope of work identified on this Certificate of Acceptance and
attest to the decl.arations in this staternent acceptance person).
3. The information provided on this Certificate :.cceptance substantiates that the construction or installation Identified on this Certificate of Acceptance
complies with the acceptance requirements lndica:ed in the plans and specifications approved by the enforcement agency, and conforms to the applicable
acceptance reqt1irements and procedures specifier in Reference Nonresidential Appendix NA7.
4. I have confirmed that the Certlflcate(s) of Jnsti.: !IJtion for 1:he construction or installation identified on this Certificate of Acceptance has been completed and
is posted or made available wlth the building issued for the building.
5, I will ensure that a completed, signed copy of 1· ·iis of Acceptance shall be posted, or made available with the ::>uilding permit(s) issued for the
building, ond made .:wai!able to the enfo:·cernent for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is
required to be lnc!uded with the docu;Tct:>nt2:tion tfw provides to the building owner at occupancy.
Responsible Acceptance Manny Garcia Company Narne
Person Name
\ddress: 646 Grand Avenue.
,-Zip Code 91977
CSLB License 477564
Responsible Acceptance Person Signoture
Date of Signature: 05/01/2017
California Advanced Lighting
Controls Trainlngprogram
-
City
Phone
Position with Company
(Title)
Merz Construction
SµriCI\) Valley
(619)825-9105
Project Manager
This is page 5 of 5
OFFICE USE ONLY SAN DIEGO REGIONAL
HAZARDOUS MATERIALS
QUESTIONNAIRE
RECORD ID# ________________ _
PLAN CHECK# ________________ _
BP DATE
State
State
" Telephoni,. l_/4 'f n] b '><:/ I)
The following questions represent the facility's activities, NOT th specific project description.
PART I: FIRE DEPARTMENT -HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: {not required for projects within the City of San ~= Indicate by circling the item, whether your business. will use, process, or store any of the following hazardous materials. 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 ~one of These.
4. Flammable Solids 8. Unstable Reactives 12. Radioactives (_/
PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH -HAZARDOUS MATERIALS DIVISION {HMO): If the answer to any of the
questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue, Suite 110, San Diego, CA 92123.
Call (858) 505-6700 prior to the issuance of a building permit.
FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy:
Y
0
Es ~ (for new construction or remodeling projects)
1. JZ1 Is your business listed on the reverse side of this form? (check all that apply).
2. o
0
c;3: Will your business dispose of Hazardous Substances or Medical Waste in any amount?
3. [21' Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500
4.
5.
6.
7.
8.
D D
D
D D
pounds and/or 200 cubic feet? £( Will your business store or handle carcinogens/reproductive toxins in any quantity?
~' Will your business use an existing or install an underground storage tank? iz' Will your business store or handle Regulated Substances (CalARP)?
~, Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? er Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to
or reater than 1,320 allons? California's Above round Petroleum Stora e Act .
D CalARP Exempt
I
Date Initials
0 CalARP Required
I
Date Initials
0 CalARP Complete
I
Date Initials
PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT {APCD}: Any YES* answer requires a stamp from APCD 10124 Old Grove Road, San
Diego, CA 92131 apcdcomp@sdcounty.ca.gov (858) 586-2650). [*No stamp required if Q1 Yes and Q3 Yes aru;! Q4-Q6 No]. The following questions are intended
to identify the majority of air pollution issues at the planning stage. Projects may require additional measures not identified by these questions. For comprehensive
requirements contact APCD. Residences are typically exempt, except -those with more than one building· on the property; single buildings with more than four
dwelling units; townhomes; condos; mixed-commercial use; deliberate burns; residences forming part of a larger project. rExcludes garages & small outbuildings.]
YES NO
1. 0 r Will the project disturb 160 square feet or more of existing building materials?
2. D Will any load supporting structural members be removed? Notification may be required 10 working days prior to commencing demolition.
3. D (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed by a Certified Asbestos Consultant or Site Surveillance
Technician?
4. D D (ANSWER ONLY IF QUESTION 3 IS YES) Based on the survey results, will the project disturb any asbestos containing material? Notification
may be required 10 working days prior to commencing asbestos removal.
5. D JZ[ Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or APCD factsheet
(www.sdapcd.org/info/facts/permits.pdf) for typical equipment requiring an APCD permit.
6. D D (ANSWER ONLY IF QUESTION 5 IS YES) Will the project or associated construction equipment be located within 1,000 feet of a school
bounda
Date
FOR OFFICAL USE ONLY: FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ________________________________ _
BY· DATE· I I
EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY
COUNTY-HMO* APCD COUNTY-HMO APCD COUNTY-HMO APCD
. . *A stamp in this box only exempts businesses from completing or updating a Hazardous Matenals Business Plan. Other permitting requirements may still apply .
HM-9171 (08/15) County of San Diego -DEH -Hazardous Materials Division
INDUSTRIAL WASTEWATER DISCHARGE PERMIT
SCREENING SURVEY
Date~• 1,!, •11
Business Name LC::. P 1S P~+--f
Street Address '27-1) {A~~ .A,. V\15t
Email Address b')\C:,k\4~~ c. r.Jc.at,~, ~
PLEASE CHECK HERE IF YOUR BUSINESS IS EXEMPT: (ON. REVER,SE SJDE CH~CK TYPE OF BUSINESS) D
Check all below that are present at your facility:
Acid Cleaning Ink Manufacturing Nutritional Supplement/
Assembly laboratory Vitamin.Manufacturing
Automotive Repair Machining/ Milling Painting/ Finishing
Battery Manufacturing Manufacturing Paint Manufacturing
Bit:>fuel. Manufacturing Membrane Manu,facturing Pe.rsonal Care Products
Biotech Laboratory (i.e. water filter membranes) Manufacturing
Bulk Chemical Storage Metal Casting /Forming Pesticide Manufacturing I
CarWash Metal Failrication Packaging
Chemical Manufacturing Metal Finishing Pharmaceutical Manufacturing
Chemical Purification Electroplating (including precursors)
Dry Cleaning Efectroless plating Porcelain Enameling
Electrical Component Anodizing Power Generation
Manufacturing Coating (i.e. phosphating) Print Shop
Fertilizer Manufacturing Chemical Etching I Milling Research and Development
Film / X·ray Processing Printed Circuit Board Rubber Manufacturing
Food Processing Manufacturing Semiconductor Manufacturing
Glass Manufacturing Metal Powders Forming Soap I Detergent Manufacturing
lnqustrial Laundry Waste Treatment/ Storage
SIC Code(s) (if known): _____________________ _
Brief description of busrn~ activities (Production/ Manufacturing Operations): ____ _
)v
Description of operations generating wastewater {discharged to sewer, hauled or evaporated):
Estimated volume of industrial wastewater to be discharged (gal/ day): ---'~--ji=:::-----
List hazardous wastes generated (type/ volume): --l~I-"-"------------
Date operation began/or wilt begin at this location:------------~--
Have you ap 'ad for a Wastewater Discharge Permit from the Encina Wastewater Authority?
Yes N ff yes, when: ___________________ _
Site Contacu~~l\tl~~ti,U!iL-----TitJe ________ _,.... ____ _
Signature . . . . Phone Noj<JJ ({(L. (}( !J
ENC!NA WA EWATER AUTHORITY, 6200 Aven!da Encinas Carlsbad, CA 92011 (760) 438-3941
FAX: (760) 476-9852