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1560
APPLICATION FOR PLUMBING PEAMIT Pl) flt)). -1t.'·'-8
COUNTY~ OllAN0E
£MA - A£0UU.llOH
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~-PCSEO ____ ..... ·--·--·--- PRESENT CCRl,>,CAll()IHOI\REGUV.TIOH' ..,, ________ ,.
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CQNSTAUOTl◊N COST INDEX
1561
APPLIC"TION FOR PLUMBING PERMIT
COUNTY OF OAANOE
EMA--AtOIJlATIOH
ClNlllALOHICE ·:o· . ro t"H 4•>4ll • •
1/(iVtCCt~H.RP\Al.A. ~ '
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P(H TYi'( or fl)(Tl)l1( OR no.1 UNIT HE
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1563
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APPLICATION FOR PLUMBING PERMIT
COVNT'f ('IF OAAAOE
I 1'-'1 f ~tYill EMA - REO~TION
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1564
W/Off 7476
,.,,LICATION POR MICHANICA\. NRMl'f
COUNTY 0, 01\ANOI
lNYIRONlffNfAL MAHAOIIHM1 AlllMCY
lllOUUTIQN
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1565
MECHANICAL INSPECTION f'ECORO . . .
" .
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TRACT NO·---~----·--·-- . C -- .: -
LOT NOS. T __ H_R U ______ _
BUILDING PERMIT NO.________ ISSUED FOR LOT NO. _______ MECHANICAL. PERMIT NO.~..-,----,~- • LOT UN. GRD. DATE ROUGH DATE COMB. VENT DATE AIR CONO. DATE FINAL DAT!:
F--1~~17 ?f+✓ d4'.,,1~;,P-~~ ~ ~15 of. II'-- '11 t-d._,,_--4.. • • -ou dlcl{r:::~d. fv.~ ,(_,_t._-i'. __ - -...... ...-. ·--.. ~------
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w'iURKfflS COMPU.SAl!ON O(CLM<Al\011
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C)NSUIT IS tltH(OY GIVtN TO fHf COUNTY Of OnAN(\[ tr;: mf.(.UIS.
AGEll!S All[) tMPLO'rff'S TO [NIER liPOfl Ttff lANO fl)fl lH'. !'iJf\f'dl\!'S Qf t,U(HlNSr•e:ctrO'IS;lf<' ES ll•JATl()llf;. OflCOHfifCHV( ACliOII ~s Ttl( tl:}H.Q:N{; {)Ff IC',ll or Sl/ClfCOIJfllY CcU,IS Nrt.U,SAHY. • •
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VALI0ATJON
'Tiil'3 PFHMn SUPrRC!:C)E!i f. POHT!OI, /AIL or (,R,\OlNG PHH,ltr NO It/WIN(\ rtf: YARDAGE IN nu: A~\OUNl Of ...... , VO I ""> •: • ' :, ;, ,/• U- ,<." ' • ,.-:, ' • -t ~w a, ,, •--~ •_ : s ~ ,,,. ~¥ ,.,,.•, •-•.• ",_,.,• y,-5~• H•~;--14..:.,,;_r' r ~• S,~. _ , ~-, ~, '°'",7(' '":":" .. •~,I,. •;c J;,,>:,' "' S •,~• -~.".'," "0 +--:-,,_ • -~;v~~a•••cM "';\~, • 0.: •,,) ~';:;> - •; ~--, :~-• ...... • , ...... s~s .... :it• $$$$$$816.
1567
GRArnNGINSPECTIONSRECORD
PHE (,F\J\DiNG MEETING; •
PHEUMINAHY SOIUGEOl.OGY m.rom
EARHlWOHK·
!:XCAVAT!ON
FILLS
suonHAINS
OUTIRESSE~
OTHER .
ORI\IN.I\GE DEVICES
OHIER ..
HOUGH GHADING RELEI\St
CIVIL t,'i_.:_RTiFlCAflON .
!,OILS'GEOl.O(W nF.rORT
cmn nAc·rons ST A TEW NT or ( OMPU•\NC[
(HHFH .
PAVING
PflL-P1\VINC MLFTiNO
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SOILS•C,EOL HEPOIHS
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ASBUILTS
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A.f'PUCJ.Th)H fOR A 801LOIHG PERWT AHO A ctrnTIFtCAY'E Of USE & OCCUPANCY HI t,11)1,At.. Off-ICE
11'.Jl\ IHtH,NWAY
COUHTV OF ORAN:'if. 1 BOit.J)ING INSPECTOR
ENVIRONMENTAL MANAGE YE.NT AOl:.NCV 12 (?it 7,! ;i;':i ;:'._F,~ ),(i."11 i A \ /,r,tJfth HH l.S, CA 91~!!~1
'14 ~n 1019
RE0l;LA1't0H SI\N I /I AHA. C/\ \Ii fOJ
PO BOX 4048, SANlA Al'<A. Cl, !)2702 ·\(HO J i-1 8J4 262!; ~l~R~AC~,-------,""!0!"'L~OC~K------.,.l-(~)l~------...---;H-E_F_O~l~~-·11-,o-wo-r,-,i<.-. -,s-,.-llT-HORllEO IN rn,s ·;~,;.:;;;~---·-···--- ? ~~~-~:=~·==~~wa ~;~, Ml.~:•.:_~r:1~~·;:z~~- ~~~tg~v ~~~~ ~ ~~~J'•..L..:f+1--~~~~~~-r-'--+----+-----------'i
TYPE Of f'fl<>JEC. NEW l l Al.TEfl ! ] AOOIT i::!
AOD~f~ - __ V6M .. i . ' i ll(:PAIR i CONVEllT : l OEMO [ 1 OCCUPAN<;Y PMf PR .. cA.,.,-~,..,'Y ..... ,... ,,-,(;.,.', e01:rm, l"', NO ~~----W~~.rl/;$~/(J ;~~~-~~~~~~<"~ ~U~l"t '" ,.., ZONE 11 n.001) Sl'l PM·~-
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Ol\tl; EXPIRES __ _, _, __ , ...... __ ........
\IERtFIEO _____ .... ,-............ -.-· --'
Oate. ---------~IC,.iH ·-·-··-··-· -----.. ---·-- CtRT!flCAlE Of 0.EMPl~ I <t()M WOl\lf.RS CO~NSAIION IN!.IJRAI-ICE tl"'i -•on~t,¢t'!'.., ro.....,...~,-l 1>11•m<l tl.l<>! S100Q< '<'OI I ~"11-r di.al <fl lt>e f>tlio<'ll-•_ol ,,.... *OI\ lot ~ ~,,, P<)frm.1 "> ""'"" I V,.,I r,Q( .,,,pao,; 4ny j>f,WI II ¥"J ,,,_ W ,U I<) --t<,q«I IO_,. Wc;n(!<t C<,t_.w,, la..._ of Cai,q_r.a Oalfl ~-----'----APPI.ICANl ___ _
TIC!! lO APl'UC~-.'I .. II .i:.-, "'4""91M Ce,1#,:a ol E ••"'(11,0n Yo<, \Mv!d I)(,(()~ (11() hi WJll!Yt. Compe,,u<.,c-" Pl'QY>WI\S ol Ult l~bi;>I COOi!. "°" "~N lo<t'n,AA £0~ St.>dl r<OY<_,, 0< ll>tt 1"!<1"11""" bol ~ ,.,_,..,
RftfV !1141 ll~Vf; fd;AO l't<t$ Af>f'llCAT!ON A~STl,!li; TIIAl Wt:. AllOVf • COfUU.Ct • .¼RU tQC:(}t,'il'I..YW\ttt .\ll (;OUNtV111l.D>N,V,X:ESA Sf.l\UCT'°" l\~O ttEflE6Y AUftlOHIJC
• • •. '][;f I:: It. . -'.'. . • • .....
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REOOIRED • OAAOINO p. MT ~· '.'; ves
OOUGH ORAOIN<i ~ ..................... ...,_....;;..;_ _ _,;..,.0-AT_f. _______ __, Af>PROVEOBV
llf.'MRKS iNsms,
1569
PLUM81Ncl l}AlE
6Afll ·OISl. CERT REO'O
f>NAt PlUMUIIIO
MECIIANICAL DATE
VMll ll<)hOVllO
0011(111
INSPECTION RECORO$
AP1'~-t.8'mrs 110.bru<S
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REMAIIKS
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1570
APPLICATION FOA A 8Ulv.>tfl0 Pt:fUMT AHO A CEftTWt<:Aff OF USE l \')CCUPAHC\' t --· i3li!lDIN(\ lNSNiCiOR m r11<>'-AL orr ,ce ,i;,'#1 l l AITON W ,\ v OOUNl"'r Of ORANGE CENTll,\1 l'l'FICE ENVlROtdlENTAl IU.NAOt'!M~Nl' AGENCV 1;1 c1v1C ,;ttit q~ PL,\ZA l A(;Ut/A Hfl I.S, •,A 92&~3
714 472-1919 REGUL/\TION -, '.lll.NlAANi,,CA9:270l r O SCIX ,$0-ta_ SANT A ANA, CA 91702,4048 714 8:1•1 ,626 ffll ~S-":'j,f OUILOll+Q
AOOR
MlEA
ttwrlt!by ,~m tt .• 11 h,a,e • Cfr\if,(._t,otcoo.,l,,,t-nl \Q 1,#tii-ntu1&. o, ~ <•tV< •:lit"~~ ~,(tiff\ Con'•1"'<'1>:u1> ln1u••n.:e 01 • (eM,<><j<"l'Y 1><)1""' !'CO(,V NO --···-·---~-•"•·· _____ ., ___ ,. COMPANY __________ _ OAT( EXPIRES _
VlRIFIEO,
f c•1ty tt~at" lho i)frtOJ""'Arr• of. the t11i'01', hJf ~-t...-J'l lh,-$ ~nir .. , ,, 1\w"":t I v~.r ~ fn,tofQf a.01 ~•!,0,/\"' i,tlf 11'1¥.nef SOHl<>~Off\41 Suti,«1 l!:l ffl \l'IQr',e,t (°A)ttlPt•YN,,C.,, u .. iol C1>1,;,i,,1 3 USE,OCCUPANCV
I' /5-"-' -+---""5
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TOTAL VALUATION
ORA.OINO PMT.
REQUIRED AOUruf o'"'AA~o,=-.-,:,'---.i...;.;..;.;....:.c.::. __ ...,_O,..,A-TE.,._-----~ APPAOVto 8'(
REMARKS
IN$TN$1
1571
Ti''9: INSPECTIOH lr4UPiCTION A£COJlOS
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1580
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BA~ZUELO/RIERSON/~UFF 111111 & ASSOCIATES, INC
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Trf'tll SiiEET
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F'ri{s"r FLCfcfft
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PLXNs. & SECTIONS . fONI BLOW UP PLANS & ELEVATIONS
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ENTRY
mt!rW11s
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LOil!iY PAVING PLAN
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S7 DETAILS S'il DETAILS
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210 NORTH WINmA
fUU.U.TON, CA 92633
{714)-449-0698
, PROJECT DIIIECrciRY
PROJECT OWNER i----~----
1 AROONNE •
INTERNATIONAL
•IS AR60NMIT ~VE
Ml:;.s.lON Vl~.Jb. CA
PRO)ECI' ADDRESS
1·~1s ~NAUT-~i;;:,:,,r MISSION Vl~JO, CA
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Aeg,onal -- Office: 22921 Triton Way
COUNTY Of ORANGE
ENVIRONMENTAL MANAGEMENT AGENCY
REGULATION ' t I , c.i~,, CWio C,,,,,~im
Laguna Hills, CA 92653
(714) 472-7922/7923 APPLICATION FOR A GRADING PJtMIT
P.O. Box 4048
Santa Ana, CA 92702
(714) 834-2630/2631
A.P. NO. TOTAL NO. LOTS/UNITS
CROSS
o\-(a
.. o=w.,;..-NE:..;;R=.~s:;__-,.--'----'--'==-=---="-..:.....:.-=-1--..:...::=.:!....L-'-'-=-:....,;::=--------------__. _R_E_M_A_R_K_S_: ____________ ----1 4~
ADORE CITY ~ ZIP CODE
I-S-0-IL_S_=..:'-Ll:_.....:.L.......::...:.-=_:_.L..\--'=l.;,,..a..J.4..t,.a.:'-'--"=->~T~A1 =
1 ~~=1c.:; EN;::,S;;;E:.....:.;:-=-=..:..=....:,_;::.-=_:__P_H_ON~E-~-I -:-:-:-::---::-cr----r--n--:-,,-:---- ,.A- t?- -/- 3 --fJ-· ---t ----- -
ADDR ZIP CODE NAM DATE
0 NOT REQUIRED
PHONE f'IVS.W/l #te •..D1"--("'·
l-:--==='="'c:..._._~.U:--"-'--__.::c.=-=.::....::=--=---...J.;.e~---=",=1----------=-=c--c-~----1 BOND NO. --'-----''-'--=-'---"e,_ .;2_ 7.,__ _____ -1 ADDRESS C ..._ -- /J ZIP CODE BOND 00
t-,---,----'~-~r~,t.X---------------------11AMOUNT$~~'~ ':f,_o_ - ____ _, GRADING CONTRACTOR STATE LICENSE PHONE
ADDRESS CITY
CERTIFICATION FOR REGULATION PERMIT
Contractors
I certify that the following Contr. Lie No. _______ and Classification _______ is in full force and effect. Workmen's Compensation Insurance Certificate on file verified by ______________ Expiration date:
Other Applicants
I hereby certify I am exempt from Sec. 7031.5 of the Business and Professional Code, Div. ~hap. 9, Contractor's License Law under the following section:
O'Owner (Sect 7044), or
D Minor Work under $200 (Sect 7048), or
D Employee working for wages only (Sect 7053), or
OTHER: ---~-------------------
WORKERS COMPENSATION DECLARATION
Certification of Exemption from Sect 3800 of the California Labor Code, Article 3, Construction Permit: - - •
D The permit is for One Hundred Dollars ($100) or less. I certify that in the performance of the work for which the permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation laws of California.
If, after making such certification the applicant for this permit should become subject to the Workmen's Compensation provisions of the Labor Code, the applicant shall forthwith comply with the provisions of Sect 3700 or this permit shall be deemed revoked.
I hereby acknowledge and state that the information I have provided is correct both on the permit and this certificate and agree to comply with all County Ordinances and State laws regulating building construction.
t
FINAL APPROVED _______________ DATE _____ _
BOND RELEASED _______________ DATE _____ _
SURETY □ CASH □ BLANKET BONO D CERT OF DEPOSIT
ZIP CODE
0 LETTER OF CREDIT (Expiration date ___ )
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE INFORMATION I HAVE PROVIDED IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
CONSENT IS HEREBY GIVEN TO THE COUNTY OF ORANGE, ITS OFFICERS
AGENTS AND EMPLOYEES, TO ENTER UPON THE LAND FOR THE PURPOSES OF
SUCH INSPECTIONS, INVESTIGATIONS, OR CORRECTIVE ACTION AS THE BUILDING OFFICIAL OF SUCH COUNTY DEEMS NECESSARY.
I AM AWARE OF ORDINANCE NO. 2717 CONCERNING THE DISCLOSURE OF LOBBYIST. Jo (\ SIGNATURE p.
□ ELIMINARY
NO BUILDING PERMITS
TO BE ISSUED UNTIL THIS
PERMIT IS SUPERCEDED BY
A PRECISE GRADING PERMIT
BORROW FILL:
NATURAL FILL:
□ FEE YARDAGE: PRECISE •
BUILDING PERMITS
MAY BE ISSUED AFTER
ROUGH GRADING HAS BEEN
APROVED
VALUATION OF PROTECTIVE
DEVICES AND IMPROVEMENTS
$ ~ b-,'1- ~
GRADING FEES
PLAN CHECK: TOTAL P.C.
IMPROVEMENTS: (DIA 235)
GRADING (GRA 235) $ "3., e,4-
GRADING PERMIT TOTAL PERMIT
IMPROVEMENTS: (018 235) $ '2.4 / • 0'2-
GRADING (GRB 235) $ 2h3 ,'fO
$ b If, Z.6
THIS FORM WHEN PROPERLY VALIDATED !SA PERMIT
TO DO THE WORK DESCRIBED FOR A PERIOD OF 2
YEARS FROM DA TE OF ISSUANCE
VALIDATION
*THIS PERMIT SUPERCEDES A PORTION/ ALL OF GRADING PERMIT NO. ___ HAVING FEE YARDAGE IN THE AMOUNT OF ___ YD.3 4 12/22/88 212453 370.24 GRB235
204.87 DIA235
241.02 DIB235 $$$$$$816 . 13
CASHIER PERMIT NO. PERMIT FEE CODE PLAN CHECK TOTAL
1662
City of Aliso Viejo
Building and Safety Division
12 Journey
Aliso Viejo, CA 92656
(949) 425-2500
fax (949) 425-3899
APPLICATION FOR BUILDING
PERMIT
AND CERTIFICATE OF
OCCUPANCY
Inspection request line 949-425-2545
Building Address Penni! Number Plan Review No.:
St No. 15 Street :.:Ac_R_::_G_::_ON'-'A=-=-U-T ______ -t ___ ...:5:_7:_8=-1_:_4--.:._ __ ._l_ ___ 5_78_1_4 ___ --I APN Lot Tract Block
Applicant Centcenton On Electronics Inc
St No. 12 Street Argonaut
City Aliso Viejo Zip 92656 Phone 855-9111
~~ ~~
Arch
Owners namecENTCENTON ON 855-9111
15. ARGONAUT
Aliso Viejo 92656
on rac or Lie No.
Licensed Contractor's Declaration
I hereby affinn that I am licensed under the provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professions Code) and my license is in fu]l force and effect.
License Class
Date 6/18/2003
Address
Contractor
License Number
City and Zip Phone
Construction Lending Agency I hereby amrm that there is a constrnction lending agency for the performance oftJie work for which this permit is issue.d (Sec. 1097, Civ .. C)
Lender's Name _______________ _
Lender's Address
Owner.Builder Declaration
I hereby affirm that I am exempt from the Contractor's License Law for !he following reason [Sec.7031.5, Business and Professions Code: Any city or county which requires a permit to consttuct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursu·.mt to the provisions of the contractor's License Law(Chaptcr 9, commencing with Section 7000, of Division 3 ofthe 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 □
□
1, 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 Licensed Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are 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 the purpose of sale.)
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Sec.7044, Business and Professions Code·The Contractor's License Law does not apply to an The followin work is authorized b this ennit
□ Struct. □ Plumb. □ Mech. □ Elect.
Type of Project D New D Alter D Addition D Repair
D T errant Improvement
Project DescriRtion §g.Ft.
CERT OF OCCUP
Business Lie No
D Demo [g) Occupancy Permit
Remarks/Special Conditions/Project Description
THIS PERMIT IS FOR CERTIFICATE OF
OCCUPANCY. NO TENANT IMPROVEMENTS
ARE INVOLVED WITH THIS MOVE IN.
This permit shall expire if the building or work authorized by such permit is suspended or abandoned for a period of 180 All work shall conform to the 1997 U.B.C., ,
owner of property who builds or improves thereon, and contracts for such projects with contractor(s) 1997 U.M.C., 1997 U.P.C. and the 1996 N.E.C. licensed pursuant to the contractors License Law) □ I am exempt under Sec. __ , B&PC forth,s reason Group/Division/Type l--~____'.D:::•:::'~:!':~~/,=1/'l'::!/.'::'q3::::=:=--"'n'.'.'.it::i•l~AW7=:::::::::==--~-~~---J B !HR SPRINK High Fire Hazard
Yes No
Workers' Compensation Declaration
I hereby affirm under penally of perjury one of the following declarations:
□ a I have and will maimain a certilkale of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is Od:b. I have and will m:i~tain worker·:"co~pensati~·n, as'~equired by Section"j700 ofthe La~r Code, for the performance of the work fcir which this permit is issued. My worker's compensation Int~~~-~ carrier.and policy number are • ·, •
Policy No: __________________ _
Exp Date:-------------~----~
□ (This _section need not be completed if the permit i_s for one hundred dollars (S 100) or less) c. I certify that in the performance of the work forwh1ch. this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws ofCalifomia and agree that if! should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions Date.~------ Signature ______ ~----- waming· Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil lines up to one hundred thousand doll= ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest, and atlomey's fees
I certify that I have read this application and state that the above infonnation is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with al! city and state laws relating to building construction. I hereby authorize representatives of the City of Aliso Viejo to enter upon the above mentioned propc for inspc.cti~n p~
re of Applicant or Agent
Dat6 1
Valuation Fire Sprinklers
Yes No
Structural $40.00
Elect
Mech
Plumb
Plan check
Issuance $15.00
Microfiche
Soils/Geology
Total City Fee Due $55.00
Seismic Fee
Total Amount Paid $55.00
Issuance Approved Ty Hall
Date Issued Penni! Number
Wed, Jun 18, 2003 57814
Receipt# 2402
1663
CONSTRUCTION AND PLANNING POOL AND SPA
APPROVALS Permit# APPROVALS Permit #
Date lnsp. Date lnsp.
1. Temporary Electrical Service or Pole
,
2. Soil Pipe--Underground 1 . Pool & Equipment Location
3. Water Pipe--Underground / Underslab 2. Steel Reinforcement
4. Water Service 3. Electrical Bonding
5. Property Sewer/ House Connection 4. Rough Plumbing & Pressure Test
6. Electrical Conduit--Underground 5. APPROVAL TO COVER--GUNITE
7. Gas Line Underground & Test 6. Electrical Conduit--Underground ·•'"
8. Footings & Steel UferO 7. Gas Pipe, O Underground, Test
9. Foundation--Slab on Grade 8. Backwash Lines, P-Trap, OUnd.
10. Retaining Wall Footing 9. Backwash & Receptor--Final
11. Pre--Grout 0 Drainage 0 10. Fencing and Access Approval
12. Gas Pipe-Underground & Test 11. APPROVED FOR PLASTERING
13. Rough Plumbg./Top OuVShower Pan 12. Heater & Vent--Final
14. Roof Drains & Overflows 13. Plumbing System--Final
15. Rough Electrical--Conduit 14. Electricai--Final
16. Rough Electrical Wiring 15. Solar System--Final
17. Rough Heatin_g & Air Conditioning 16. POOL/ SPA SYSTEM FINAL
18. Rough Factory Fireplace FIRE DEPT. REQUIREMENT
APPROVALS Permit# Date lnsp.
19. Ducts, Ventilating
20. Fire Dampers 1. UNDERGROUND HYDRO
21. Floor Sheathing 2. PRODUCT PIPING OGAS 0 OIL
22. Roof Sheathing 3. UNDERGROUND FLUSH
23. Roof Framing 4. UNO. STAG. TANK OGAS 0 OIL
24. Approved to Cover Exterior 5. OVERHEAD HYDRO
25. Rough Frame and Flashing 6. DRY CHEMICAL
26. ''T" Bai Ceiling/Elect./Mechanical 7. DRY STANDPIPE
27. Insulation 8. FIXED SYSTEM FINAL
28. Lathing 0 Interior 0 Exterior 9. FIRE PREVENTION FINAL
29. Drywall Nailing NOTES:
30. Electric Power Meter Final I, AS THE CONTRACTOR, HEREBY AFFIRM UNDER PENALTY
31. Final Electric OF PERJURY THAT I AM A CERTIFIED HOME IMPROVEMENT CONTRACTOR UNDER THE PROVISIONS OF SECTIONS 7150
32. Final Sign AND 7151 OF THE STATE OF CALIFORNIA BUSINESS AND
33. Hood or Canopy Final
PROFESSIONS CODE.
34. Final Factory Fireplace DATE: C9,NTRACTOR: A , . -
35. Final Mechanical ,,,, •·,. /_j,,;_;,;--,4-~ // ~,1./, ff-~---:~//
36. Final Plumbing / . .,, \. -~A,,.,.- I 7 ,
37. Water Service Final/Release /J
38. Gas Final Including Connectors V ,
39. Solar Domestic--Final ,
40. Re-roof Final
41. Retaining Wall Final
42. Handicap Regulations
43. Landscape Final
44. Zoining--Final
45. Engineering--Final
46. Health--Final
47. Final Structure & Building
48. Gas Release ,
49. Electric Release
"'Inspector's Initials & Name I
1664
~·;.·-;-;,,• V' _:~~--'.' ~ ,,
,ft~
Olrrfifiratr of ®rrupanr~
CITY OF ALISO VIEJO
12 JOURNEY• ALISO VIEJO, CALIFORNIA 92656 • (949) 425-3800 This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use.
Address where Business
w;fl be conducted ____ _:_1_:5c_A=r'-'g.,_o=n:.:a::u=t:._ ______________________ _ Business
Name of Occupant/Owner -~C~e=n,..,t,,,o~n=--_,E"'l'"'e,..__,,c,..,t,,,r._o=n,..,iecC=S_,,~I'"'n=c'--'.'---- Phone 8 5 5-9111 Address of Home Office of Home Office
Occupant if different than above __________________ Phone _________ _ PermltNo. 5181 /I Occupancy Group _-JB~ No. of Units __ 1:.__Type of Construction .,,::,"/ Building Date 6 / 2 S / O
Division 3 Approved: _ _:_ _ _:_ ______ By: _ __::._::±.__..::.::=._=--=c., UseZone Business Park
Planning
Division
LIMITATIONS:
V NR SPRINKLERE
Date --"-6L/_,,,2.=<5L/_,,0c,3:...._ __ Buster Scholl " Building Official This Certificate shall be posted in a conspicuous place on the premises and shall not be removed except by the Building Official 1665
CENTON ELECTRONICS
M E M O R I E S T H A T L A S T F O R E V E R"'
Centon Electronics, Inc.
To: City of Aliso Viejo
Centon Electronics, Inc. is a leading worldwide designer, manufacturer and supplier of memory solutions. Centon's expansive product line includes state-of-the-art memory solutions for desktops, servers, notebooks, workstations, printers, motherboards, embedded systems and telecommunications devices. All products are either JEDEC compliant or engineered to meet or exceed OEM specifications to ensure reliability and 100% compatibility. Centon is ISO 9001 certified
Total Sq. Ft ofbuilding 37,724
Office aprox 12 k
Wharehouse /manf 25,724
Total number of employees 76
Men: 54
Women: 22
1666
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!S.8631
@cb(e.com
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-
KEITH BLACK
949.725.8633
[email protected]
.... ..,. ....
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-
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STEVE WAGNER
949.725.8616
[email protected]
t:. V .YCII .!CfJO/YI
SECOND FLOOR
,, .
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CB~ Richard Ellis
NAVi(iAflNG A NEW WC'JRlDH
1667
Building Address
St No. 15
---- APN
City o'Aliso Viejo
Building and Safety Division
12 Journey
Aliso Viejo, CA 92656
(949) 425-2500
fax (949) 425-3899
Street ARGONAUT
Lot Tract Block
Applicant Centcenton On Electronics Inc
St No. U Street Argonaut
City Aliso Viejo Zip 92656
Engr/ Cls Corp
Phone 855-9111
LicNo.
930
APPLICATION.R BUILDING
PERMIT
AND CERTIFICATE OF
OCCUPANCY
Inspection request line 949-425-2545
Permit Number Plan Review No.:
58110 58110
The followin work is authorized b this ermit
[g] Struct. □ Plumb. [g] Mech. [g] Elect.
Type of Project D New D Alter D Addition D Repair
['.2J Tenant Improvement D Demo [g] Occupancy Permit
Project Descrigtion ~.Ft.
Arch po Box 7318 ------jTENANT 8000
Fullerton 92834
Owners nameCENTCENTON ON
15 ARGONAUT
Aliso Viejo 92656
Gti Commerical Contractors
25801 Obero #5
Mission Viejo 92691
LicNo.
480519
583-9300
Licensed Contractor's Declaration
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professions Code) and my license is in full force and effect.
License Class
Date 9/8/2.QQ.'.i
Address 2580 I
0 License Number 480519
Comractor GT! COMMERICAL CONTRACTORS
OBERO #5
City and Zip MISSION VIEJO 92691
Construction Lending Agency I hereby amrm Ihm there is a construction lending agency for the performance of the work for which this pcnnil is issued (Sec. 1097, Ci11 .. C)
Lender's Name~-------------~
Lender's Address
Owner-Builder Declaration
l hereby anirm thal I am exempt from the Contrac!Or's License Law for the fbllowing reason [Scc.7031..5, Business and Professions Code: Any city or county which requires a permit IO const_ruct, altc,, impro11e, demolish, or repair any stmcturc, prior to iu; issuance, also requires the applicant for such pcnnit to file a sigued stalcmcnl !hat he is li,cnscd puri;uam to thi: pro11isions oflhc comrnccor·s License Law(Chaptcr 9, commencing with Section 7000, ofDivision 3 oflhe Business and professions Code) or thal he is cxempl therefrom. and the basis for the alleged exemption. Any violation of section 703 J.5 by any applicant for a permit subjects the applicant to a ci11il penally ofnm more than five D
D
I, as owner oft he 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 Con1mc1on Licensed Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided Ihm such improvement;; arc 1101 intended or offered for s.ilc. tr. howe11er, the building or improvement is sold within one year ofcomplelion, the oV.ner-buildcr will have the burden of proving that he did no! build or improve the purpose or sale.)
I, as owner oflhe property, am e~clusivcly contracting wilh lice,1sed contrJCI0rs to cons1ruct 1he projcci(Sec.7044, Business and Professions Code:The Contrnctor:s License Law does not apply to an owner of property who builds or improves !hereon, :ind contracts for such project;; with con1rnc10r{s) licensed pursuant to the contrac10rs License Law)
Business Lie No
Remarks/Special Conditions/Project Description
THIS PERMIT IS TO INSTALL TENANT
IMPROVEMENTS FOR 8000 SQFT
Expired
:-r6is~l)ermif~~:a[f;expire ·[fthe building or.work autlior(iecfby • ' : such'.permii'is•suspended or abandolied'for, a'period,of'180 ·, ' .,_ •~ > "-.~. ;~ > - ~ - " •• -• I ,_, • , All wor'k•sh'all conform to the 1997 U.B.C.,
1997 U.M.C., 1997 U.P.C. and the 1996 N.E.C.
D I am exempt under Sec. __ , B&PC for this reason Group/Division/Type ~--_::D::•:::••=====:..'.l'.'.ni:::ti:::al=====--------J B SPRINK High Fire Hazard
Yes No
Workers' Compepsat_i.2_n_.Decl.aration
I hereby amrm under penalty ofpcrjuiy one orthe following declarJtions □ a. 1 have and will maintain a ccrtiricatc ofcons~t 10 self-insure for workers' compensa1ion as ~
rovid.ed by Section3700 of the Labor Code, forthe p~formanceofthework for which this permil is b. I have and will maintain worker's compcnsat,on, 35 required by Section 3700 of the Labor de, for the performance of the work for~ t is pellTlil is is ued. My worker's compensation I nt~uEQ: canicr illld policy number arc:5 / ci..
Policy No: __ L.."-'>"½~~=-~=-------
Exp Date: -----'---"'--'---'-'L"'----------
□ (This section need not be completed iflhepermi1 is for one hundred dollars (SI00) or less) c. I cenify that in the performance of1he work for which this pcm1it is issued,[ shall not employ any person in a11y manni:r so 35 10 become subject to the W0rters· Compensation Laws of California and agree that irl should become subj~t to the \\:orters' i,,pmpcn's;!tion provisions ofScction 3700 of the Labor Code, ! shall forthwiLh comply wi1h those provisions. \\ • (" Date 'J-£".-O:, Signature:~_,,,~:::§!,==:::,,_':"l¥'==--- wam1ng: Failure 10 secure workers' compcnsa1ion covcrJge is unlawful, and sha ubjec1 an employer to criminal penalties and civil fine5 up to one hundred thousand dollars (S 100,000), in :iddition to the cost of compensation, damages as provided for in Section 3706 of the Labor Cod~. interest, and al\omcy's fees
I certify that I have read this application and state that the above infonnation is correct, and that lam the owner or the duly au1horized agent of the owner. I agree to comply with all city and state laws relating to building construction. l hereby authorize representatives oflhe City of Aliso Viejo to enter upon the above mentioned property for inspection purposes.
Signature of Applic nt av gent
G-ea-"/L-• kc Lt
Print Applicant's/Agent's Name Date
Valuation
$84,000.00
Structural
Elect
Mech
Plumb
Plan check
Issuance
Microfiche
Water Quality
Total City Fee Due
Seismic Fee
Total Amount Paid
Issuance Approved
Date Issued
Fire Sprinklers
Yes No
$849.90
$17.33
$9.00
$867.23
$876.23
Ty Hall
Mon, Sep 8, 2003
Permit Number
58110
receipt M_ .2646
1668
CONSTRUCTION AND PLANNING POOL AND SPA
APPROVALS Permit# APPROVALS Permit #
Date lnsp. Date lnsp.
1. Temporary Electrical Service or Pole
2. Soil Pipe--Underground I 1. Pool & Equipment Location
3. Water Pipe--Underground / Underslab 2. Steel Reinforcement
4. Water Service 3. Electrical Bonding
5. Property Sewer/ House Connection 4. Rough Plumbing & Pressure Test
6. Electrical Conduit--Underground 5. APPROVAL TO COVER--GUNITE
7. Gas Line Underground & Test 6. Electrical Conduit--Underground ·"
8. Footings & Steel UferO 7. Gas Pipe, O Underground, Test 9: Foundation--Slab on Grade 8. Backwash Lines, P-Trap, OUnd. 1 0. Retaining Wall Footing 9. Backwash & Receptor--Final
11. Pre--Grout 0 Drainage 0 10. Fencing and Access Approval
12. Gas Pipe-Underground & Test 11. APPROVED FOR PLASTERING
13. Rough Plumbg.frop Qui/Shower Pan 12. Heater & Vent--Final
14. Roof Drains & Overflows 13. Plumbing System--Final
15. Rough Electrical--Conduit 14. Electrical--Final
16. Rough Electrical Wiring 15. Solar System--Final
17. Rough Heatin_g & Air Conditioning 16. POOL/ SPA SYSTEM FINAL
18. Rough Factory Fireplace FIRE DEPT. REQUIREMENT
APPROVALS Permit #
Date fnsp.
19. Ducts, Ventilating
20. Fire Dampers 1. UNDERGROUND HYDRO
21. Floor Sheathing 2. PRODUCT PIPING OGAS 0 OIL
22. Roof Sheathing 3. UNDERGROUND FLUSH
23. Roof Framing 4. UNO. STRG. TANK OGAS 0 OIL
24. Approved to Cover Exterior 5. OVERHEAD HYDRO
25. Rough Frame and Flashing / 6. DRY CHEMICAL
26. ''T" Bar Ceiling/Elect./Mechanical _,/ -/- ./ 7. DRY STANDPIPE , . 27. Insulation 8. FIXED SYSTEM FINAL
28. Lathing 0 Interior □ Exterior / , 9. FIRE PREVENTION FINAL
29. Drywall Nailing 9f"/og .. -?ff' NOTES:
30. Electric Power Meter Final . (I I, AS THE CONTRACTOR, HEREBY AFFIRM UNDER PENALTY
31. Final Electric OF PERJURY THAT I AM A CERTIFIED HOME IMPROVEMENT CONTRACTOR UNDER THE PROVISIONS OF SECTIONS 7150
32. Final.Sign AND 7151 OF THE STATE OF CALIFORNIA BUSINESS AND PROFESSIONS CODE.
33. Hood or Canopy Final
34. Final Factory Fireplace DATE: CONTRACTOR:
35. Final Mechanical ,. ,., .. -: -._~._,,._
36. Final Plumbing . -
37. Water Service Final/Release
38. Gas Final Including Connectors
39. Solar Domestic--Final = . ff
40. Re-roof Final • JI' (;urea a
41. Retaining Wall Final
42. Handicap Regulations
43. Landscape Final
44. Zoining--Final
45. Engineering--Final
46. Health--Final
47. Final Structure & Building
48. Gas Release
49. Electric Release I
''.'Inspector's Initials & Name I -r.11 ~ /I 1:~,1 {/
V 1669
Building Address
City Viejo
Building arid Safety Division
12 Journey
Aliso Viejo, CA 92656
(949) 425-2500
fax (949) 425-3899
APPLICATIO.R BUILDING
PERMIT
AND CERTIFICATE OF
·OCCUPANCY
Inspection request line 949-425-2545
Pennit Number Pla~$evieW•N0.:
St No. 15 Street ARGONAUT 58113 53',M3
APN Lot ---T-ra~c_t ____ B_l_o_c_k-----i------T-h..:e_~.::_o_ll_o_w_i_n_w_o_r_k_i_s_aLu-th_o_r_iz_e_d_b_t_h-is-.-e-nn_i_t ____ , Applicant Centcenton On Electronics Inc D Struct. 0 Plumb. 0 Mech. 0 Elect.
St No. U Street Argonaut Type of Project D New D Alter D Addition D Repair City AliSo Viejo Zip 92656 Phone 855c9 l l l 0 Tenant Improvement D Demo D Occupancy Pennit Engr/ Cls Corp Lie No. Projie.Q_lj&~ption §£.Ft.
Arch po Box 7318 930
----J ELECT Tl
>---F_u_ll_ert_o_n _________ 9_28_3_4 ______ --l MECH Tl Owners namecENTCENTON'ON 855-9111 PLUMB Tl
15 ARGONAUT
Aliso Viejo
_ on rac or
92656
Lie No.
480519
:iGti· Corrimerical ,€0ntractors
25801 Obero #5
Mission Vie'jo 92691 583-9300
Licensed Contractor's Declaration
I heretiy.affirm:that I am licensed under the provisions of Chapter 9 (commericing with Section 7000·ofDivision 3 of the OusincSS and Pi'ofossions·Codc) and my licensg·iS in full force and-effect.
License Class
Date 9/8/2003
Address 2580 I
B
Contractor
OB ERO #5
License Number, 480519
GTICOMMERICAL CONTRACTORS
City and·'Zip MISSlON VIEJO 92691 Phone S_S3....:.2.3J)_Q Construction Lending•·Agen~y I hereby affinn that Lhere is a consmmion lending agency ror the po:rfOfTTlance of the work for which this pefTTlit is issued(Sec. l097,Civ .. C)
Lender's.Name ______________ _
Lcndcr_:S· Addr'ess
Ownci"~Buildcr Declaration
,f her1:by affirm that ( am exempt from the Contractor:s License Law for 1hc following reason {Sec.703 l.5. Business and Professions Code: Any city or counly_whi,ch rcquir1:s a 11c:rmit 10 ~onstruct, alter, iml)l'Ove, 4c_molish;or r1:pair any stmc"tur,:, prior to iLS iSSuancc, also requires the applicant for such pcm1i1 to file a signed statement that he is licensed pursuant to the provisions of the con tr.IC tor's Lic~nse L~w{Chapter 9, coriimencing with Sei:1iol\ 7000, ofDivisiOn 3 cifthc BUSiness and professions Cod,:) onhat he is e.xcnipt therefrom, and the basis forlhe alleged exemption. Any vioblion of section 7031.S hy any applicant for a pem1i1 subjecLS the applicant to a civil penalty ofnol more than five □ ~~~:;~~t~~~~:~~Y~:; i:1~~~~ ~~:~e~ r:;::e (sti;J:t~::~::::nP:1~1:~~e ~ode. The Co~_u:ictor:s Ucens,cd Law does nol_arply to an owner of property 1~ho builds or 1mp_mvcs thereon, amt who d_OCS s_uch wOrk himsdfor through his Own emp_loyees, proV1ded that Such improvcmcnls are not intended orolTered ior sale.'lf, however, t~e building or improvement is sol~_.within one ycilr of completion, the owiler-builder will h'avc thC burden of Proving· that he Business Lie No
Remarks/Special Conditions/Project Description
THIS PERMIT IS TO INST ALL ELECT, MECH, AND
PLUMB TENANT IMPROVEMENTS
REQUIREMENTS FOR 8000 SQFT
□
did no\ build 0/irrip'rove the purpose ofsak.)
!,asownerofthepmpeiiy,amexclusivelycontractiiigwi1hlicensedcontr.ictoJStocom;truclthe All, wor:k shafl confonn to·the 1997 U.B.C.,, projcct(SC:c. 70~4, ~w,incss and Pr<:>fcssions Code:The Contr.ICtor"s _License ),,aw ~oes nol ap_ply to an own.erofpropcrtywhob'uildsorimpi:ovcsthcreo~.andcontrJCLSforsuchprojecLSwi1hcon1raclor(s) 1997 U.M.·C., 1997 U.P.C. and the 1996 N.E.C~ licensed pursuant tothcconlrJctors license law) t--------------------~-----~-J ! am exempt under Sec. __ , B&PC for this n.:ason Date Initial
Workcrs'·COmpensation DeclarationI her1:by affimi under penalty of perjury one of the following dec!ar.itions:
□ a. I ha1·e and will maint.:1in a ccnilicatc of consent 10 self-insure for.workers' eoi:npensation as pJ?vidcd by Sccti0n}700 of the labor CodC, for thC "perfomlallce of the work for which this ·pennil is ad, b. ! have an.d will ma!main worker's COffiJK"nSalion, as m:iuircd by Section 3700 of the labor c, .•. ''.' fcir,~.e perfofTTI. anee of the work. "Shieh this pe1mit is issu~ My worker's compensation I n~.sue~~~c,,cr and policy number are. ~t:e. f._; r-J
P.oli~y,No: (1,'ciD:J6 --0L
1 EX(Datc: ~ r-n.,
'D (This section need not 'be completed iflhe pcfTTlit is fo~onc hundred dollan. ($100) ~rless} c. ! c"rnify that iil the perfofTTl:mce oflhe work for which this permit is issued,! shall not employ a_nype[jbi\ in any manner so as lo b.c~o~e. subject _Lo the Wo_!k_crs_· <;°OIT_lpensation t,.aws ofC~lifomia and_ asieflha,;if I ~hould become subj«L to th,: workeis' c_Dmpen • ion prov1Sioiis of Sec Lion 3700 Or the Labor Code, r'shall fonhwith comply.with those prov-fsions Bate 7-"/--oJ. SignJtufe':'.'..._/,_;;j-=-:-:=~:'..,-,--~-- warning: F;ii]ure 10 secure workeis' compensation trl'iv'er.igc s tmlawful, and Lo criminal.penal1ies and civil fines up _Lo one hundred thousand d_ollars {SI O , 0), in addition lo thC cost Of compensation, damai:CS as pri:wided for in Section 3706 of the Labor Code, interest. and anomey's recs
I ~crtify t_hat l'haye,rec!,d.this applicatio.l} <!nd.state-!hat the abov~.inforrnation1is correct, and that I an, the owner or the duly.authorized agent of the owner. I agree-to comply with all,city and:statC'laws relating to·building c0·nstruction. !·hereby authorize representatives.of the City of Aliso Viejo to enter upon·th_e above rm:ntiuncd property for in_sP,ec1ion.purposes.
_ _,_.,/\....,,____
s~"tf~i;;;;t;;t
.... 6~f'.cl',=' .. '+-t1-'--'-'-l"'--"' 0 IL"-1-F_
== ~ D1/ateq-c{•-rJ 3
<gr-int Applicant's/Agent's Name
Gfoup/Division/Type High Fire Hazard
B SPRINK Yes No
Valuation Fire:Sprinklers
Yes No'
Structural
Elect $106'.oo
Mech $48:?8
Plumb $23.10
Plan check $!,1L49,
Issuance. $1733:'_
Microfiche
Water Qual[ty
Total' G:ity Fee Due $:ioo:u,
Seismic Fee
Total Amount Paid $300,11
Issuance Approved Ty Hall
Date Issued Pennit Number
Mon,. Sep 8,. 2003 58113
Receipt# 2644
;,-
1670
·, . ' - •
CONSTRUCTION AND PLANNING POOL AND•SPA
APPROVALS Permit# APPROVALS Permit #
Date lnsp. . Date ., lnsp.
1. Temporary Electrical Service or·Pole,
2. Soil Pipe~Underground 1. Pool.&-Equipment Location
3. Water Pipe-0 l:Jnderground /'Underslab 2. Steel Reinforcement
4. Water Service 3. Electrical.Bonding
5. Property SewerIHouse Connection 4. Rough Plumbing & Pressure.Test 6- Electrical Condtiit--Underground 5. APPROVAL TO COVER--GUNITE 7, Gas Line Underground & Test 6. Electrical Conduit--Underground ·"
8. Footings & Steel Ufer □ 7. Gas Pip~, 'Underground, Test 9: Foulidation--Slab on Grade 8. Backwash Lines, P0
Trap, Sl:Jnd.
1 O. Retaining Wall Footing 9. Backwash & Receptor--F'inal
11. Pre--Grout □ Drainage □ 1 o. Fencing,and Ac_cess Approval '
12. GasPipe'Underground & Test 11. APPROVED FOR PLASTERING
13. Rough Plumbg./fop·Out/Shower Pan 12. Heater & Vent,-Final
14. Roof Drains & Overflows 13. Plumbing,System,-Final
15. Rough Electiical"Conduit ,:?M,rr.J~ .- /~/-· v-- 14. Electrical.°Final . 16. Rough Electrical Wiring 15. Solar Sysiem--Final
17., Rough Heatin_g·& Air-Conditioning 16. POOt/ SPA SYSliEM FINAL
18. Rough Factory fireplace FIRE'DEPT. REQUIREMENT
APPROVAtS.Permll # . Date lnsp .
19. Ducts, Ventilating
20. Fire Dampers 1. UNDERGR0l!JND HYDRO
2·1. Floor,Sheathing 2. PRODUCT PIPING. OGAS 0 OIL
'
22. RoofSheathing 3. UNDERGROUND FLUSH -·- 23. Roofframing 4. UND, Sl'RG. TANK O'GAS □ OIL .
24. Approved to Cover Exterior 5. OVERHEAD l;IYDRO
25. Rough l'rame and Flashing 6. DRY CHEMICAL
•26. 'T' Bar Ceiling/Elect/Mechanical 7. DRY STANDPIPE
27. Insulation 8. Fl)(_ED SYSliEM FINAL
28: Lathing, ,Interior D Exterior 9. FIREPREVENTION FINAL
29. Drywall Nailing NOTES:
30. Electric Power Meter Final l,.AS THE CONTRACTOR, HEREBY AFFIRM UNDER·PENALTY
31. Final Electric OF PERJURY THAT t 11.M.A_CERTIFIED HOME IMPROVEMENT CONTRACTOR UNDER'THE PROVISIONSOFSECTIONS 7150
32. Final.Sign AND 7151 OF THE STATE OF CALIFORNIA.BUSINESS AND . PROFESSIONS CODE . 33. Elood or Canopy F.inal
34. Final Facfoiy Fireplace DATE: CONTRACTOR: .
- 35. Final Mechanical .. J•·•--·--, \"·~·r,
36. Final Plumbing '
37. WaterService Final/Release
38: Gas Final Including Connectors .
39. Solar Domestic--Final .
40, Re-roof Final
41. Retaining Wall Final
42. Handicap Regulations
43. 'Landscape final
44. Zoining0 -Final
49· Engineering-°Final ~
46. Health-,fiinal '
47. 'FinalS_tructure·& Building q[1q/ol I,{~ ~~ 1;l,
48. Gas Release ' ::'-' ~
" 49. 'Electric Release
,, "'Inspector's Initials·& Name I .... 1671
il:~ ~r~·
~f.... e,<t~/l' t__A-(__
/~ e;--lti-f!:"6'~~
~... - 7/R£% <!J;(/,4v,-.. _
$'6/15
----------------
1673
il ~ fj:Jt t-r
t;.t-er:t1?l. ,t_A-(___
/~ e,#~~;g~
7/£<% C),,,t)~v-r--
#~~s 11~
1674
L I 1----JI
n I ~'
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'11
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<
-
1675
Building Address
StNo. 15
----
APN
City of Aliso Viejo
Building and Safety Division
12 Journey
Aliso Viejo, CA-92656
(949) 425-2500
fax (949) 425-3899
Street ARGONAUT
Lot Tract Block
Applicant Levey Roofing Services Inc
St No. 1220 Street S. Wright St
City Santa Ana Zip 92705 Phone 7149736233
APPLICATION FOR BUILDING
PERMIT
AND CERTIFICATE OF
OCCUPANCY
Inspection request line 949-425-2545
Permit Number Plan Review No.:
58959 58959
The followin work is authorized b this ermit
(gJ Struct. D Plumb. D Mech. D Elect.
Type of Project LJ New D Alter D Addition (gJ Repair
D Tenant Improvement D Demo D Occupancy Permit
Engr/
Arch
LicNo. Project Descrigtion §,g£l
----; REROOF
Owners namecENTCENTON ON 855-9111
15 ARGONAUT
Aliso Viejo
on rac or
Levey Roofing Services Inc
1220 S. Wright St
Santa Ana 92705
LicNo.
ill.ill
7149736233
Licensed Contractor's Declaration
I hereby affinn that I am licensed under the provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professions Code) and my license is in full force and effect.
License Class ______ License Number 811111
Date 5/14/2004 Contractor LEVEY ROOFING SERVICES INC
Address 1220 S. WRIGHT ST
City and Zip SANTA ANA 92705 Phone 714973J;23:l
Construction Lending Agency I hereby affimi that there is a consLTUction lending agency for the performance of the wori. for which this permit is issued(Scc. 1097, Civ .. C)
Lender's Name ______________ _
Lender's Address
Owner-Builder Declaration
I hereby affirm that I am exempt from the Contr.!Ctor's License Law for the following reason !Sec.703 J.5, Business and Professions Code: Any city or county which requires a permit to construct. alter, improve. demolish. or repair any structure, prior to its issuance, al~o requires the app!ie~nt for such permit to fi!e a signed statement that he is licensed pursuant to the provisions of the contractor's License Law{Chapler 9, commencing 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 10 a civil penally of not more than live D
D
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 Licensed Law docs not apply to an owner of property who builds or improves thereon, and who does such woric himself or through his own employees, provided that such improvements are not intended or offered for sale. Jf, however, the building or improvement is sold within one year of completion, the 01111er,builder will have the burden of proving that he did not build or impro'"e the purpose of sale.)
I, as owner of the property, am exclusively contructing with licensed contractors to const11.1c1 the projcct(Sec.7044, Business and Professions Code.The Contr.ictor's License Law does not apply to an 01111er of property who builds or improves thereon, and contracts for such projects with contractor(s) licensal pursuant to the conlr'.1Ctors License Law) I am exempt under Sec. __ , B&PC for this reason Date Initial
Workers' Compensation Declaration
I hereby affirm under penalty of perjury one of the following declarations:
D a. I have and will maintain a certificate of consent to selr-insurc for woricers' compensation as ~rovided by Secticn 3700 or the Labor Code, for the perfonnance of the wori. for which this permit is ~ b. I have and will mainu.in woricer'li compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation In~~u~~~ct;JJ1:t1i~tf:m;i:.A <- 464:S'<Af-TY CO,·
Policy !'lo:wc ,:J.?1 "" 1,;io;.
Exp Date: !2,_:__~!,~S".~· ---·~O~S~---------~---
D • • ' (This section need not be completed if the i>crmit is for one hllndrcd dol!afS ($100) or less) - c. l certify that in the perform'ance of the work for wh!ch thi/permit is issued,] shall n0t emp• :~ =ni~~ :~::"=o:e~u~j:c;:~om;;:~~~~. ~:m~:::~nc:::~:~:~~=~:o~f~~:tia· • the l..i!:iOr Code, I shall forthwith comply with those provisions / • Date.~---~~_ Signature_~--~~~~~----- waming: Failure to secure workers' compensation covcrdgc is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thoUS".md dollars {S 100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees
I certify that I have read this application and state that the above infonnation is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all city and state laws relating to building construction. I hereby authorize representatives of the City of Aliso Viejo to enter upon the above mentioned property for in ection purposes.
Print Applicant's/Agent's Name
Business Lie Nq
Remarks/Special Conditions/Project Description
THIS PERMIT IS TO TEAR OFF EXISTING
BUILT-UP ROOF AND REPLACE WITH 4PLY
BUILT UP ROOF
This permit shall expire if the building or work authorized by such permit is suspended or abandoned for a period of 180 All work shall conform to the 1997 U.B.C.,
1997 U.M.C., 1997 U.P.C. and the 1996 N.E.C,
Group/Division/Type
Valuation
$35,496.00
Structural
Elect
Mech
Plumb
Plan check
Issuance
Microfiche
Water Quality
Total City Fee Due
Seismic Fee
Total Amount Paid
Issuance Approved
Date Issued
High Fire Hazard
Yes No
Fire Sprinklers
Yes No
$483.16
$17.33
$500.49
$500.49
Ty Hall
Fri, May 14, 2004
Permit Number
58959
Rec;eipt "!I.;.•, 3451
1676
CONSTRUCTION AND PLANNING POOL AND SPA
APPROVALS Permit# APPROVALS Permit #
Date lnsp. Dale lnsp.
1. Temporary Electrical Service or Pole
2. Soil Pipe-Underground 1. Pool & Equipment Location
3. Water Pipe--Underground / Underslab 2. Steel Reinforcement
4. Water Service 3. Electrical Bonding
5. Property Sewer I House Connection 4. Rough Plumbing & Pressure Test
6. Electrical Conduit--Underground 5. APPROVAL TO COVER--GUNITE
7. Gas Line_ Underground & Test 6. Electrical Conduit--Underground .••
8. Footings & Steel UferO 7. Gas ~ipe, 0 Underground, Test
9. Foundation--Slab on Grade 8. Backwash Lines, P-Trap, OUnd.
10. Retaining Wall Footing 9. Backwash & Receptor--Final
11. Pre--Grout 0 Drainage 0 10. Fencing and Access Approval
12. Gas Pipe-Underground & Test 11. APPROVED FOR PLASTERING
13. Rough Plumbg./Top Out/Shower Pan 12. Heater & Vent--Final
14. Roof Drains & Overtlows 13. Plumbing System--Final
15. Rough Electrical--Conduit 14. Electrical--Final
16. Rough Electrical Wiring 15. Solar System--Final
17. Rough Heatin_g & Air Conditioning 16. POOL/ SPA SYSTEM FINAL
18. Rough Factory Fireplace FIRE DEPT. REQUIREMENT
APPROVALS Permit #
Date fnsp.
19. Ducts, Ventilating
20. Fire Dampers 1. UNDERGROUND HYDRO
21. Floor Sheathing /J . , 2. PRODUCT PIPING OGAS 0 OIL
22. Roof Sheathing /-/ 10~/4• ~--1~1 3. UNDERGROUND FLUSH
23. Roof Framing II I I 4. UNO. STRG. TANK OGAS 0 OIL
24. Approved to Cover Exterior V 5. OVERHEAD HYDRO .
25. Rough Frame and Flashing 6. DRY CHEMICAL
26. "T" Bar Ceiling/Elect./Mechanical 7. DRY STANDPIPE
' 27. Insulation 8. FIXED SYSTEM FINAL
28. Lathing O Interior o Exlerior 9. FIRE PREVENTION FINAL
29. Drywall Nailing NOTES:
30. Electric Power Meter Final I, AS THE CONTRACTOR, HEREBY AFFIRM UNDER PENALTY
31. Final Electric OF PERJURY THAT I AM A CERTIFIED HOME IMPROVEMENT CONTRACTOR UNDER THE PROVISIONS OF SECTIONS 7150
32. Final Sign_ AND 7151 OF THE STATE OF CALIFORNIA BUSINESS AND PROFESSIONS CODE.
33. Hood or Canopy Final
34. Final Factory Fireplace DATE: CONTRACTOR:
35. Final Mechanical .. ,_-.,_, ~-~~-,.- . -
36. Final Plumbing . A . - h - - q7_ -;?,,~;r.,-_.i,Z .
37. Water Service Final/Release L-~A .dU - . _ __, Ar/ ,,, - ~
38. Gas Final Including Connectors /2 . _._,, /. - . - r __/ A,u//
39. Solar Domestic--Final ,4 - .A J - / /
. .
Re-rool Final .,_ / / ~ I' / --✓ 40. , .
41. Retaining Wall Final .. -
42. Handicap Regulations .
43. Landscape Final
44. Zoining--Final
45. Engineering--Final
46. Health--Final ,
47. Final Structure & Building ~kl,1-/ V
48. Gas Release
49. Electric Release
'"Inspector's Initials & Name I ff IM·~ ',,;f7_ .
I' 1677
M8Y 14 '04 13:51 FR AIR INDUSTRIES 714 892 7904 TD 19494253899
AIR INDUSTRIES CORPORATION
12570 KNOTT ST. GARDEN GROVE, CA 92841
FROM: ROBERT REECE
Vice Pa wldmt, Director
PHONE 714-1192~1
EMAILbl'IEE O (',lu~
FAX 714-1192-7904
PAGES:L-__________ .:.1 __________ __,
FIRM:
ATTN:
FAX:
INCI.IIDBaMR
Aliso Viejo
Ty Hall
949-425-3899
DAlE: 5114/2004 0:00
Ty,
Aic lnvesiment Co. is roofing 15 argonaut for Cen10n Eiec1Jonic:
tenant -· city permit Is ls&ued 10 Lavey Roofing, Frmik Downing will pick up the permit.
Thank you,
SobReece
VloxPreslde11t
P.01/01
** TOTAL PAGE.01 ** 1678
05/14/04 11: 14 FAX 949 362 5899
■
Mem10
To: Ty Hall- City of Aliso Viejo
ALI SO VIEJO COMII
Aliso Viejo Community Association
81 Columbia, Suite 101
Aliso Viejo, CA 92656
(949) 362-5890
FAX (949) 362-5899
FAX: 949-425-3899
From: Deborah Baker, Assistant General Manager
Date, 5/14/2004
Re: 15 Argonau~ Aliso Viejo, CA 92656
.Mr. Hall,
Please allow this ;orrespondence to confirm that the re-roofing project planned for 15 Argonaut does not require review by the Aliso Viejo Community Association (AVCA) Master Architectural Committee (MAC) since it is Mplacing the original roof with the same color and type of roofing materials.
The MAC only re11iews plans for aesthetic purposes, and because this improvement will not affect the exterior appearan;e of the property there is no need for review or approval.
Should you have .3ny questions or concerns regarding this matter, please do not hesilate to contact me at (949) 262-589C ext 215.
14J 001/001
1679
City ~liso Viejo
Building and Safety Division
12 Journey, Suite 100
Aliso Viejo, CA 92656
P: (949) 425-2540
F: (949) 425-3899
Job Information
Street Address: 15 ARGONAUT
ApUSte: ____ _ Lot: APN: ______ _
Tract: Cross St:
Applicant: MARK GRISAFE
Street Address: 5618 ~E~. ~C~O~N~A~N_T_S~S~T _______ _
City: LONG BEACH
State:_gt_ Phone:_(562) 420-1035
Owner: AICI, LLC
Zio: __ ~9~0~8~0~8 __
Cell:
Street Address: 2321 ROSECRANS AVE
City: EL SEGUNDO Zio: __ .=.90"'2""4"'5 __
'
APPLICATIAFOR BUILDING PERMIT
AND CERTftATE OF OCCUPANCY
Inspection request line 949-425-2545
Permit Number
68254
Plan Review No.:
68254
The followinq work is authorized by this permit
~ Structural [;;<'] Plumbina ~ Electrical [;;<'] Mechanical Type of Project
D New D Addition D Occupancy Permit
D Alteration D Demolition
D Repair C8l Tenant Improvement
Sa.Ft.
1 ~T~I ______ 37406
MEP INCLUDED
State:__£L Phone:_(310) 725-0006 Cell: , _______ _
Ena/Arch: MARK GRISAFE
Phone: _(562) 420-1035 License#: C28845
LICENSED CONTRACTORS DECLARATION
I HEREBY CLAIM, UNDER PENALTY OF PERJURY, THE FOLLOWING \============--============j STATEMENT: THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 Zoning Approved By: LLOW COMMENCING WITH SECTION 7000 OF DIVISION 3 OF THE BUSINESS !-='.:'.:..'.'.'..'.:~!:'.!'.:'..:'...'..:'.'.~~....'.'..:::.'.:'.:::::'..'.::===========-1
AND PROFESSIONS CODE, AND AT THIS TIME MY CONTRACTORS
LICENSE IS CURRENT, ACTIVE AND IN FULL FORCE.
Contractor: RAND C ELECTRICAL CONTRACTORS
Street Address: • 21113 ~J~U~A~N~A_V_E~----------
City: HAWAIIAN GARDENS • Zic: ---=-90~7~1=6 __
State:__£L Phone: _(562) 860-3430 Cell: ______ _
Remarks/Special Conditions/Project Description
PERMIT TENANT IMPROVEMENT (PHASE 1) TO
EXISTING RESEARCH AND DEVELOPMENT BLDG.
WORK STARTED WITH OUT PERMITS.
TENANT: AMBRY GENETICS
LIC. #: 904308 Exe. Date: 10/31/2011 CLASS: B, C10
i..:::.:::::...::.:..::=C=O=N=TRA=C=T=O=R-T.:0.::P::.R.::O:.::V:::ID:;;E=A=C=C=ES=S=T=O=R=0=-0....:F::&:..:.::ATT.::.:.:IC====-l C&D APPROVED - COLLECTED $150REPOSIT I
FOJ-LOWING
HEREBY
WORKERS'
CLAIM,
STATEMENT:
UNDER
COMPENSATION
PENALTY OF
DECLARATION
PERJURY, ONE OF THE ~\''//
,_::f-_, ~
/...:,.
/
_
~ ~
g I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF '-..,
INSURE FOR WORKERS COMPENSATION, AS PROVIDED FOR BY
SECT N 3700 OF THE LABOR CODE FOR THE PERFORMANCE OF THE 0 FOR WHICH THIS PERMIT IS ISSUED.
I HAVE AND WILL MAINTAIN COMPENSATION INSURANCE AS
R UIRED BY SECTION 3700 OF THE LABOR CODE FOR THE
PERFORMANCE OF THE WORK WHICH THIS PERMIT IS ISSUED. 1--T-hi-s-.p-e-,-m-it_s_h_a_l_l e_x_p_i-re_i_f-th_e ___ li_u_ild_i_h_g_o_r_w~o-.r-k_a_u_t-hp_.r_iz_e_d_b_y __ --< Workers' Comoensation Carrier
SOUTHERN INS CO
Policy#
WSI0029363
Exp. Date
9/10/2011
such permit is suspended or abandoned for a period of 180 days.
CERTIFICATE OF WORKERS COMPENSATION EXEMPTION All work shall conform to the 2010 C.B.C., 2010 C.M.C., (TH1ssEcnoNNEEDNOTBECOMPLErE01FwoRK1S$soooRLESSJ 2010 C.P.C. and the 2010 C.E.C. q CERTIFY UNDER PENAL TY OF PERJURY THAT IN THE PERFORMANCE I------------------------I OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, THAT I SHALL NOT Grouo/DivisionrTvoe Hiah Fire Hazard EMPLOY ANY PERSON IN A MANNER so AS TO BECOME SUBJECT TO Bi$. IIIB □ Yes □ No THE WORKERS COMPENSATION LAWS OF CALIFORNIA, AND AGREE i--====':':::=========------------1 THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS Valuation Fire Sorinklers COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE __ $250,000.00 cgJ Yes O No THAT 1SHA11 FnRWITH r.nMPI vw1TH THOSF PRnv1s1nNs l-==:':::.:::::'::::':::::::=======----_.::::::..:.::.:_....:::::...:::::_-1 :~~~~~~~~~i!s ~i~~!~ tn~~~;· t~:r,~e~~~~~~ c;::i~~:~~di~~l~~~~$1 i cib,go"~ti1n
5 ~~~~~~~io8
~~l~~~i ~~ $3 7 43 86 compensation, damages as provided for in Section 3706 of the Labor Code. interest, and attorney's fees Structural ' ··' · ···--·
OWNER BUILDER DECLARATION
I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE
FOLLOWING REASON:
□ 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 FOR, OR OFFERED FOR SALE (SECTION 7044, OF THE BUSINESS AND PROFESSIONS CODE)
□ I, AS OWNER OF THE PROPERTY AM EXCLUSIVELY CONTRACTING
WITH LICENSED CONTRACTORS TO COMPLETE THE PERMITTED
PROJECT UNDER THE PROVISIONS OF SECTION 7044, OF THE BUSINESS & PROFESSIONS CODE.
Electrical __ $j_§ __ O_Jl.L_
Mechanical __ $47.3_$ __
Plumbina __ $.22~5 .. 3 __
Plan check
Issuance __ $69.32
Microfilm _$40.00 __
Water Quality
Total Citv Fee Due __ $.,4,064.00 _
Seismic Fee __ $52.50
I certify that I have read this application and state that the above information is SB 1473 __ $j_Q_,_O_Q __ correct, and that I am the owner or the duly authorized agent of the owner. I agree ta comply with all city and state laws relating to building construction. I I ____ T_o_ta_l_A_m_o_u_nt_P_a_id--'==$'-'4=·=1"'6'-'6=.5=0==---------J ~~':.?: ::~~.o~~~ :~~s:,~~at!~:: .... ~~/h: ~'.~ .... o:,,.~liso Viejo to enter upon the Issuance ApprovedJoan.na Stevens ~/4---
Signature of Applicant or Agent
Prinl Applicant's/Agent's Name Date
Date Issued
Iue ... J..\ua_9.-20-1 ..
Receipt Number
12971
Permit Number: _68254_ 1680
CONSTRUCTION AND PLANNING POOL AND SPA
APPROVALS Permit# APPROVALS Permit#
Date lnsp. Date lnsp.
1. Temporary Electrical Service or Pole ' .
2. Soil Pipe--Underground : /12/1 j (lt'.(_-) 1. Pool & Equipment Location :3. Water Pipe--Underground / Underslab 2. Steel Reinforcement
4. Water Service 3. Electrical Bonding
5. Property Sewer I House Connection 4. Rough Plumbing & Pressure Test
6. Electrical Conduit--Underground UJ-1/11 cc·~ 5. APPROVAL TO COVER--GUNITE -, -:;:c
7. Gas Line Underground & Test - 6. Electrical Conduit--Underground
8. Footings & Steel UferO - 7. Gas Pipe, 0 Underground, Test
9. Foundation--Slab on Grade Pr t)l/; / £1 8. Backwash Lines, P-Trap, OUnd. " 1 O. Retaining Wall Footing 9. Backwash & Receptor--Final
11. Pre--Grout 0 Drainage 0 10. Fencing and Access Approval .
12. Gas Pipe-Underground & Test , 11. APPROVED FOR PLASTERING
13. Rough Plumbg./Top OuVShower Pan 1!/s/?1 1cd 12. Heater & Vent--Final
14. Roof Drains & Overflows ' , 13. Plumbing System--Final
15. Rough Electrical--Conduit ,.,l,;7 ,\,\ i::5f.Us / "- 14. Electrlcal--Final
16. Rough Electrical Wiring \!'1 ''a, \-V:{ 4;?J 1n·~ L,,,,Jl 15. Solar System--Final
17. Rough Heatin_g & Air Conditioning I /!/3 / J,l ' if.el 16. POOL/ SPA SYSTEM FINAL
18. Rough Factory Fireplac() c) h] ' I FIRE DEPT. REQUIREMENT .
19. Ducts, Ventilating_u,-\e,J)clwf LdiJtJ APPROVALS Permit # Date lnsp.
20. Fire Dampers (j{'j 1. UNDERGROUND HYDRO
21. Floor Sheathing 2. PRODUCT PIPING OGAS 0 OIL
22. Roof Sheathing 3. UNDERGROUND FLUSH
23. Roof Framing 4. UND. STAG. TANK OGAS 0 OIL
24. Approved to Cover Exterior V 5. OVERHEAD HYDRO
25. Rough Frame and Flashing \\Jl\"U,$ br1~ I I'\ 1/44 l5 6. DRY CHEMICAL
26. "T" Bar Ceiling/Elect./Mechanical I 5ht ~ :l 7. DRY STANDPIPE ' 27. Insulation 8. FIXED SYSTEM FINAL
28. Lathing 0 Interior 0 Exterior 9. FIRE PREVENTION FINAL
29. Drywall Nailing 1l1f,z,C(/J, l"fiJJ./!< NOTES:
30. Electric Power Meter Final I, AS THE CONTRACTOR, HEREBY AFFIRM UNDER PENALTY
31. Final Electric OF PERJURY THAT I AM A CERTIFIED HOME IMPROVEMENT CONTRACTOR UNDER THE PROVISIONS OF SECTIONS 7150
32. Final Sign AND 7151 OF THE STATE OF CALIFORNIA BUSINESS AND PROFESSIONS CODE.
33. Hood or Canopy Final
34. Final Factory Fireplace DATE: CONTRACTOR:
35. Final Mechanical ' ... ,.
36. Final Plumbing
37. Water Service FinaVRelease
38. Gas Final Including Connectors
39. Solar Domestic--Final
40. Re-roof Final
41. Retaining Wall Final
42. Handicap Regulations
43. Landscape Final
44. Zoining--Final
45. Engineering--Final
46. Heallh--Final I ,
47. Final Structure & Building IY/?Jh, ({j
48. Gas Release -,
49. Electric Release
"'lnspe;:tor's Initials & Name f 1681
:fti1r
:i~)~i'.
CERTIFICATE OF USE AND OCCUPANCY
CITY OF ALISO VIEJO
12 Journey Suite 100 • Aliso Viejo, California 92656 • (949) 425-2540, www.cityofalisoviejo.com •. This Certificate issued pursuant to the requirements of Chapter 1, Section 111 of the 2010 California Building Code certifying that at the time of issuance this structure and use is in compliance with all the applicable ordinances of the City of Aliso Viejo including conditions of approval of the use regulating building construction or use for the following:
Business Name: Ambry Genetics
Business Address (Location): 15 Argonaut
Owner/Occupant: Ambry Genetics
Owner/Occupant Address: 15 Argonaut, Aliso Viejo, CA 92656 Occupancy Group: B, S Occupancy Load: 374 I . Type of Const: IIIB Phone: (949) 900-5518
Permit No: 68254
Occupancy/ Use Description: ___ .,_'R'-=e:.::s:.::e:.::ae.crc:,h"'-"&=-=Dc::ec:.v:::::e'-=lo2p,.,_m=e,.,_nt::....:Cc::o:.-____________ _ DatEHssued: 4/6/12 Sprinklers Yes
Pursuant to Appendix Chapter 1, Section 1 10.4 this Certificate may be revoked by the Building Official'_w.,.,,;,n~e~re,.,.v=e=r-m~e-- certificate is issued in error orin basis of incorrect information supplied or if it is in violation of any ordinance or r::~lation or any of thKJ.lsi&~ the code. Date Approved: 1-/ /f B /J L Albert Armijo,Diri,ctor of Planning Services 0/ 1/'I
By·. ~ ;t-f, Jf I Z • ✓ Date Approved: ---'--'----
al
Limitations: ----------1-+---------------------------
This Certificate shall be posted in a ~onspicu s place on the premises and shall not be removed except by the Building Official. 1682
CONDUCTED BY
MARGO BEAUCHAMP
CRIME PREVENTION THROUGH
ENVIRONMENTAL DESIGN
(CPTED)
CRIME PREVENTION SPECIALIST
(949) 425-2563 phone (949) 425-3899 facsimile
[email protected]
GENERAL INFORMATION
Project Name: /3f'A8:tllj 4 £/\.JET! cS
Proposal: New Addition Tenant Imp~ men!
Address: f 5' A12.ti o ,JAL,(,-T
Project Number:
Plan Check No.: {pf!2.S:L/
• Submittal Date:0,/..!>o/z.01 I
ReceiptNo.: 12.,&<:; I
Inspection Required: \/ ~ ,.S ·--,1,-..~---
PC Hours: ________ _
,..~----· ·~----~--~--~-----71
;: -··-·- . • __ _.,.... _____ .Status . •
7 c. Date ··--ii
:~ 1."_R:~~_J Approve_ or~ion _ _,7./i_1.,j'U) 1 /
c~: _R~"'.:_ I Approve /Corrections-, Jz:i/)!}} J
Ii 3rd Review : oved/Corrections I JI
6-----·' I =· = ~--I[
'tJJuJ N 1C.HT "EmO¾c~
L IC, T,,.,; 61_
o/-J S/-1,7:X £ - '-I r
e -~
Contact: /W)g k 6 R 1 5.Att Phone&0-i)'-f lD-/03S Fax/Email: _______ _
TYPE OF STRUCTURE
Commercial Building
D Open Space/Recreation
SITE INFORMATION
D
□
□
□
□
Lot Size
Dimensions
Lot Coverage
Landscape Coverage
Tenant Space Size
12/7/2010
Parking Structure Residential Building(s)
Other ___________ _
___ (width) ___ {depth)
----%
----%
□ Building Height
1683
m gRISAFE ARCHITECT
•
TO:
FROM:
DATE:
REGARDING:
VIA:
COPY:
Dear Jennifer
CITY OF ALISO VIEJO
12 Journey, Suite 100
Phone: 949-425-2526
Attn: Jennifer Lowe, Assoc. Planner
Mark Grisafe
July 26, 2011
15 Argonaut - CUP Description Letter
E-Mail
File
•
TRANSMITTAL
Ambry Genetics is a testing lab with offices, currently residing in the City of Aliso Viejo.
As their operations have expanded, they require additional space. They have agreed to relocate to 15 Argonaut - also in the City of Aliso Viejo.
This new, larger facility, previously occupied by a memory chip company, had a similar business model which allows Ambry a cost effective and relatively seamless expansion. It can also better accommodate their current and anticipated needs and it allows Ambry the chance to remain in the City of Aliso Viejo.
Reviewing City guidelines, we understand that Ambry is considered generally a dry lab with a minimal wet lab component.
Below is a description of the lab spaces of this project:
105 - R&D 2,954 s.f. (dry lab) - Use of small tubes and plates with micro~liter sized reactions. Various sequencing reactions and sample preps for next generation sequencing.
107 A,B,C- Test & Test Storage 1,092 s.f. & 491 s.f. (Future R&D dry lab)- for future expansion, no work going on in any of the 3 areas.
112- Sequence (dry lab) - 1,053 s.f.- Samples are loaded onto various sequencing platforms using either sequencing plates or flow-cells (microscope slide sized chips).
Very little to no bench work required. This room will house the sequencing equipment that will run either overnight or over several days.
113- PCR (dry lab) - 434 s.f. This room will house all of our PCR machines. Samples will be placed in these machines in either plates or tubes and be left to cycle through various temperatures for a number of cycles. Again this is very little to no bench work required.
114A - Dcode (dry lab) - 451 s.f. Being left empty at the moment for future growth. 561 8 E. CONANT STREET LONG BEACH. CA 90808 562.420. 1 035 1684
TRANSMITTAL
July 26, 2011
Page2
• •
114B - QA (wet lab) - 449 s.f. This room is what I would consider "wet" because this is where we do all of our electrophoresis which uses buffered T AE solution mixed in with de-ionized water. Techs will load acrylarnide gels with patient sample and let run for several hours as they gradually heat up and while constant voltage is being applied. 114C- Solutions (wet lab) - 329 s.f. - This is also what I would consider "wet" because this is where we use all of our chemicals in larger sized reactions. Usually in liters or in tens of liters. This is our reagent prep area.
The minimal amount of wet lab and the kinds and quantities of chemicals at this facility pose a minimal threat to public safety, yet Ambry is regulated by the following agencies: .
The Federal agencies are CUA = Clinical Laboratory Improvement Amendments and CAP = College of American Pathologists.
Federal License #
CUA 05D0981414
CAP LAP# 7154701
In addition, they are liscened in the following States:
State License #
California CLF11694
Florida 800016789
Rhode Island LCDO00439
Pennsylvania027832
Maryland 1052
New York PF!: 8160
Ambry Genetics also maintains a standard office emergency preparedness protocol.
Thank You,
Mark A. Grisafe, AJA
1685
July 13,201 I
City of Aliso Viejo
12 Journey, Suite 100
Aliso Viejo, CA 92656
Attention:
Regarding:
Joanna Stevens
Ambry Genetics
15 Argonaut
Dear Ms. Stevens:
Moulton Niguel Water
WATER QUALITY ANO SERVICE ARE #1
This letter serves as notice that the Moulton Niguel Water District (MNWD) will serve water and sanitary sewer to the above subject development. This project is completely within MNWD boundaries. MNWD staff has determined that there is no need for grease intercepting facilities.
This indication of MNWD's ability to serve the above-referenced project is conditioned upon the payment of all applicable fees.
The availability of water services is subject to the suppliers of water to MNWD continuing to honor their contractual obligation relative to the amount of water to be supplied. MNWD can make no representations as to the future intention of said suppliers in this regard.
Sincerely,
Mark H. Mountf rd, P.E.
Associate Engineer
MHM:jc
cc: Paul Schmidtbauer, SOCW A
TRICT
\\al l~s\ll"mc\j,;apenon\My Doc11mcmslDa1a\ WORD\ WILLS ER \'\will5ervcArnhryGcRCCb 7. 20 l l .<luc a public agency at:
27500 La Paz Road, Laguna Niguel, CA 92677-3489
Mailing Address: P.O. Box 30203, Laguna Niguel, CA 92607-0203 949/425-3532 FAX 949/643-2489 1686
• ~fj~ \~;,·:r;~i}.'.ti~'.;,;i~~ji
tf~k;!:"l' _-,, '.[-,, .. :._t1~,U:,
BUSINESS ADORES .
TVPE'OF BUSINESS:
BUSINESS DAYS/HOURS:
CHECK APPLICABLE BOXES:
D CHANGE OF OWNER
D CHANGE OF BUSINESS NAME
D TENANTIMPROVEMENTSPERFORMED
D.,NOTENANTIMPROVEMENTSPERFORMED
~NEW TENANT
•
EXISTING SQUARE FOOTAGE:
S~ RE; FOOTAGE BY USE: (EX. OFFIC / WAREHOUSE%, RETAIL%, STORAGE"/4) ., D - :y:::> ,&:,$ -z- - ~
NUMBER OF EMPLOYEES: NUMBER OF RESTROOMS: "'3
OCCUPANCY GROUP: OCCUPANCY LOAD: TYPE OF CONSTRUCTION: -P.:, DOES THIS BUILDING HAVE FIRE SPRINKLERS INSTALLED? S I NO .s,,
ilF.lYOUJ'AlliWE~!~T;p°JAf.!YlQ'Ul:00.Jil I:_ .. W:tftim;Qi(~P.IWN'!NTOSl'A &;~~ ~<!l~:e..VE$~;r, '-'"'7tl\lQ:,i : ·:
WILL ANY TOXIC, HAZARDOUS, FLAMMABLE LIQUIDS, CHEMICALS OR ANY V-- SOILD MATERIALS BE STORED AT THIS LOCATION?
WILL ANY MATERIALS OR CHEMICALS BE MANUFACTURED OR
FABRICATED AT THIS LOCATION? VEXPLAIN:----------------------~------- OWNER OF BUILDING OR MANAGEMENT COMPANY:
::~= =17:.,t;L ::: '°t:,,~ ' J . I CERTIFY THAT THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE:
BUSINESSOWNER'SNAME(PRINT) Dv.Jlof I :5Jlnc s: TITLE: /;J(J fl,,/>,A.lt'\,:- BUSINESS ONWER'S SIGNATURE: 9 :=::::;) /7 DATE: ~Irr, /1 I p 7 1687
,:1uuu1 vntngt: \..-ouncy .1:1.,nv1ronmenta1 Protection Permit Screening Form C
CA 1p;
I e:
ass:
Business Status: □ New □ Existing □ Change ofOwnmhip elocation Project Status: 0 New nterfor Alteration (TI) □ Minor Alteration Please review each category and Mark (EJ next to all that apply to your project. If none apply, Mark 1B] next to No. 97 and sign the declaration below.
Is ym11·/acili(l'
~
in" cutegmy be/~w?
□ Will facility occupant use, handle or
store hazardous materials in a
quantity that is;;:: 55 gallons of liquid,
500 lbs. of solids, or 200 cu. ft. of
compressed gas, at any time? (I)
□ Within 1,000 ft. of (K-12) school or
acute/Jong term health care facility (2)
□ Assembly (50 or more for drinking,
dining or education) (3)
□ Dry Cleaner (4)
□ Metal Finisher (5)
□ Plating Shop (6)
□ Photo Processor (7)
□ Print Shop (8)
□ Wood Stripping/Refinishing (9)
□ Circuit Board Manufacturer (IO)
□ Medical/Health Care/Dental Office (11)
0" Biomedical Operation (12)
□ Restaurant (13)
□ Food Preparation Facility (14)
□ Motel or Hotel (I 5)
□ Gasoline Station (16)
□ Automotive Body/Repair Shop (17)
□ Auto Wrecklng Yard (18)
□ Battery Storage, Use, Charging (19)
■ Tire/Rubber Storage (2,500 sq. ft.) (20)
E, 11i 1111e11t: Will 1111y oflhefol/owi11g
items he utilize,l ll1 yo111·fucili(11?
□ Fuel storage/dispensing equipment (2 I)
□ Above/below ground rtorage tanks (22)
□ Underground storage tank for
hazardous materials (23)
□ Above ground storage tank for
petroleum products (24)
□ Public swimming pool (25)
□ Refrigeration equipment (26)
□ Ovens, industrial baklng/drying (27)
· □ Cbarbroiler (28)
□ Spray booth (29)
□ Printing press (screen/lithographic/
flexographic) (30)
□ Abrasive blasting cabinet/room (3 I)
□ Grinder over 2 horsepower (32)
□ Dust collector, scrubber, or other air
pollution control equipment (33)
□ Elevators (34)
□ Tower Cranes, Scaffolding (35)
□ Boiler/Combustion (36)'
□ Steam boilers (volume> I 5 PSI) (37)
□ Internal combustion engine(> 50 HP,
excluding motor vehicles) (38)
□ Pressure vessels (volume> 1.5 cu. ft.
150 PSI of air) (39)
□ Retail stationary propane tanks (40)
0 Chemical coagulatfon/precipitation (41)
□ Cyanide destruction or chromium
reduction (42)
□ Air flotajion (43)
Mlltel'ittls: U1il/ ym1 11se, ,\-tore or
luuul/e /11r;,unlo11J material!,?
□ Hazardous materials (See Definitions) (64)
□ Extremely hazardous substances (List
Available) (65) •
□ Explosives, highly toxic material (See
Definitions) (66)
□ Combustible fiber (>100 cu. ft.) (67)
□ Combustible material (> 2 cu. ft.) (68)
□ Matches (storage >14;400 matches) (69)
□ Liquefied petroleum gas (70)
□ Medical gas installations (71)
□ Aerosol products (72)
□ Commercial grade pesticides,
fertilizers or radioactive isotopes (73)
□ Carcinogens (List Available) (74)
Will 1his.facili(1' use "''.J' 1if t/1e.f1Jl/111vi111: I W11.,1e/Diw·/1111•oe: JI ill yo11r/11cili(r pretre11t111e11t .'iJ'Slems.fm· wtutewuter? pnte11tiul(1· tli'ic/u11·ge 1/Jefollowi11g? □ Acid or base neutralization (44)
□ Interceptor, clarifier, sump, trap (45)
□ Screen, filter, or grit removal (46)
□ Solvent separation (47)
□ Centrifuge or cyclone (48)
Grease or oil removal (49)
S ill rotection (50)
■
■
■
■
■
Proce.fses: Will yo11 cm11/11c1 "'U'
o(t/fef1Jl/mvi11g pmce.sses 1111 .~ire?
Treating hazardous waste on-site (51)
High piled combustible storage (>12'
or 6' for palettes) (52)
Asbestos removal (53)
0 Producing dust (wood work, milling,
grinding), fumes, smoke, odors (54)
□ Etching/casting/melting metals (55)
□ Molding, extruding, curing plastics (56)
□ Mixing and blending or refining of
liquids and/or powders (57)
D Storage of acids, solvents, organic
liquids or fuels (58)
□ Application of paints/adhesives (59)
□ Spraying/dipping (60)
□ Welding and cutting (61)
□ Tr_enching and shoring (62)
□ Land disturbance/construction (63)
□
□
□
□
□
□
□
□
□
□
□
□
0 □
□
□
□
□
□
□
□
□
□
Generation of hazardous waste (75)
Toxic organic compounds, currently
on EPA, SCAQMD, or RCRA list (76)
Toxic/poisonous gases or wastes (77)
Flammable waste (78)
Radioactive materials (79)
Acid materials (pH< 6.0) (80)
Basic materials (pH> 11.0) (81)
Materials that could obstruct sewer (82)
Wastes > 3/8 inches in diameter (83)
Any Petroleum based oils (84)
Cyanide wastes (85)
Total dissolved solids >l000 MG/L (86)
Dissolved sulfides over 0.1 MG/L (87)
Discharge with temperature >140° F (88)
Highly colored wastes (89)
Highly odorous wastes (90)
Phenolic wastes (91)
Arsenic, boron, cadmium, chromium,
copper, lead, mercury (92)
Rainwater to sewer (Not allowed) (93)
Industrial storm water nm-off (94)
Discharge into surface waters (95)
Impacts to groundwater/changes in
abso!J2tiOn rates (96)
None of the Above Apply (97)
I understand that this fonn is provided to .assist pennit applicants· to detennine regulatory requirements and achieve compliance and that bold categories may require a permit prior to construction and operation. J certify that to the best of my knowledge the infonnation I provided on this fonn is ac urate.
For Office
Use Only
Revised 12:00 1/23/01
O R s □ Other:
FIRE
1688
ORANGE COUNTY • • FIRE AUTHORITY
Plan Submittal Criteria for COMMERCIAL projects, MULTIFAMILY RESIDENTIAL projects and RESIDENTIAL TRACT developments COM
INSTRUCTIONS: Fill in the project/business address and provide a brief description of the scope of work and type of operation that will take place. Answer questions I through 10, read and initial items 11 and 12, then complete and sign the certification section. If you answer "YES" to questions I through IO, submit the type of plan indicated in italics to the OCFA (see www.ocfa.org for submittal information and locations). In some cases, other plan types not indicated herein may also be necessary depending on specific conditions or business operations. If you need help completing this form or have questions regarding requirements for review, please contact the OCF A at 714-573-6108 or visit us at I Fire Authority Road in Irvine for assistance.
Address (street number/name, suite, city): IS: M::cJ~ 1 ~ V( RXJ ' Project Scope/Business Description: ~QPP:-+~~--~l~QF"'--' __ :r;..,.._.~I~, _________________ _ YES ~_,>re the following applicable to the proposed project or business?
1. 0 l.!:1 ~onstruction of a new building, a new story, or increase the footprint of an existing building? Changes to roadways, curbs, or parking lots? Addition, relocation, or modification of fire hydrants or fences/gates? Construction within 300 feet of an active or proposed oil well? Fire Master Plan
2. Q [12(" Property is adjacent to a wildland area or non-irrigated native vegetation? Fire Master Plan; a Fuel Modification Plan may also be required.
3. Q ~cated in or <100' from a Division of Oil, Gas, and Geothermal Resources (DOGGR) field boundary, <300' from an oil/gas seep, or <1000' from a landfill? Methane Work Plan.
4. Q e'installation/modification/repair of underground piping, backflow preventers, or fire department connections serving private fire hydrant/sprinkler/standpipe systems? Underground Plan.
5. Q ~rinking/dining/recreation/religious functions or other gatherings in a room > 750 sq.ft. or >49 people? Healthcare/outpatient services for >5 people who may be incapable of immediate evacuation without assistance? Daycare/education for children? Adult daycare? 24-hour care/supervision? Incarceration or restraint? Hotel/apartment/residential facility with 3+ units? Congregate housing/dormitories with 17+ people? A high-rise structure (55 feet)? Architectural Plan
6. Q ~~stallation or modification of electromechanical locks delaying/preventing egress from a room or building? Architectural, Sprinkler, and Alarm Plan.
7. Q (B'1.nstallation/modification/use of spray booths; dust collection; dry cleaning; industrial ovens/drying equipment; industrial/commercial refrigeration systems; compressed gasses; tanks for cryogenic or flammable/combustible liquids; vapor recovery; smoke control; battery back-up or charging systems; welding/brazing/soldering, open flame torches, cutting/grinding or other similar operations? Special Equipment Plan
8. Q [ZJ1torage, equipment, processes, or research involving flammable/combustible liquids or other chemicals? Motor vehicle or aircraft maintenance/repair facility? Cabinetry, woodworking, or finishing facility? Architectural Plan and Chemical Classification; Special Equipment Plans may also be necessary.
9. Q ~Storage or merchandizing areas in excess of 500 sq. ft. where items are located higher than 12' (6' for high- ,::::- ~ard commodities, plastic, rubber, foam, etc.)? High-piled Storage Plan
10.Q W':'-o,.'.'king under a Type I commercial hood; installation or modification of a fire extinguishing system located in a commercial cooking hood? Hood & Duct Extinguishing System, not just the hood mechanical plan.
Initial each of the following two Items indicating that you have read and understand the statement:
11. *Sprinkler/Alarm Requirements: Consult California Building and Fire Codes and local ordinances to determine sprinkler or alarm system requirements; if a system is required, plans shall be submitted to the OCFA. Existing buildings undergoing remodel must be evaluated by a licensed contractor to determine if modification_ ~d; if so,' the licensed contractor shall submit plans for approval prior to any changes taking place. (Initial here:-=-:--e--~-+-ar--)
12. Fire Hazard Severity Zone: Consult the maps available at the building department or on the OCFA website to determine if your site is located in a FHSZ. Buildings in a FHSZ may be subject to special constructioQ&rements detailed in CBC Chapter 7A-the building department will determine specific requirements. (Initial here: ) I certify under p~~alty of perjury und~r_th~Y= of the State of California that the above is :
Print name: w:,f<R ~ 0€::i s~ Signature:<;;_,:S:.,,,~=:ra'£:~~=~:;::JC=----- Phone Numbe:~~. +w- l~ s= Date _C,_,.' ~~o'-r-~·t ________ _ Building Department: If all of the questions have been answered "NO" and the project does not otherwise require OCF A review of sprinkler or alarm plans*, then you may accept this signed form as a written release that OCFA review is not required Should you still require that the applicant have plans approved by the OCFA please initial here ___ or allach an OCFA referral form and have the applicant submit the form along with the appropriate plans and fees for OCF A review. 1-6-2011 ee 1689
• •
CITY OF ALISO VIEJO
DISABLED ACCESS COMPLIANCE
THE ENTIRE TENANT SPACE, THE PRIMARY ENTRANCE TO THE BUILDING,
THE PRIMARY PATH OF TRAVEL FROM THE ACCESSIBLE PARKING SPACE(S)
TO THE TENANT SPACE, AND THE SANITARY FACILITIES (FOR BOTH SEXES),
DRINKING FOUNTAINS AND PUBLIC TELEPHONES SERVING THE TENANT
SPACE MUST BE ACCESSIBLE TO PEOPLE WITH DISABILITIES IN COMPLIANCE WITH STATE OF CALIFORNIA TITLE 24.
I HA VE READ, UNDERSTAND, AND ACCEPT RESPONISBILITY FOR
COMPLIANCE WITH THE REQUIREMENTS SET FORTH IN THE STATEMENT ABOVE.
Project Address
Sign&Date: ~~ ¼gi({
Applicant: NI Af2k- A-, bfi S~
Address:
L--(),-J.
5t:,{'.(J e3 g ~~
__'_J_~~
1690
' • City of Aliso Viejo •
SCAQMD RULE 1403 VERIFICATION FORM
INSTRUCTIONS: Complete section 1, read section 2, and complete and sign section 3.
SECTION 1
Job Address:_(i---;<:;-,,,,____,_Af6Pb(""_ '----=c=..+-"--'-/4:Ut:~..__--,--~~----------- t1, ,!.. :' Use of building to be demolished:~QFP=-+-+-~LC:ff~_-s_~t:::----.-~~k!. _____________ _ Building Size (ft): _____ x _____ No. of Stories: __ '2==----------- Property Owner: A:\Cj . LL, C
/
Address: 23--:2..,1 p,,o~,S ME-,, s;::J:F -Z.:ZTD
Phone No.: 3(0 , ---,:)...s- ~cx:::x:><,::,
Applicant's/Contractor Name: ~ <of:d ~
Company Name: . M @ SA'.P:e- fse.C1:h::(e:C?C
Address: % \e::::::i e. . c.-0 (---l~T ;:q-- - lprb- ,~ CA $Jj0'5 Phone No.: ~ ::i:2.0 • tOs~ State Lie No.: C. 2-'3~
SECTION 2
Under California Health and Safety Code regulations, applicants must file with the South Coast Air Quality Management Control District (SCAQMD) an Asbestos Demolition/Renovation Notification for every demolition EVEN WHERE NO ASBESTOS IS PRESENT and for each renovation operation where the amount of friable asbestos-containing material is greater than or equal to100 square or linear feet. NOTIFICATION MUST BE FILED 1 0 WORKING DAYS PRIOR TO COMMENCEMENT OF ANY WORK.
APPLICANTS ARE RESPONSIBLE for fully satisfying the provisions of these requirements and for obtaining the necessary approvals. For additional information contact:
SECTION 3
South Coast Air Quality Management District
21865 E. Copley Dr.
Diamond Bar, CA 91765-4182
(909) 396-2336
I certify I have read the above excerpt and the information I have provided on this form is true and correct, and I further certify the following: Please initial. ___ I certify that the amount of friable asbestos-containing material involved with this proposed / renovation operation does not equal or exceed 100 square or linear feet. ~V__ I declare that the written asbestos notification is not applicable ___ Attached are the copies of all written asbestos notifications and SCAQMD approvals regarding the above reference project.
Applicant's Signature:--<? CO c ?6S? Date:---'f:J."-. -1-P-'~==~""-l~/1-------- Print Name: /0AP ~ A- - 6f--,/S: f\ EE
CITY OF ALISO VIEJO, 12 JOURNEY, SUITE 100, ALISO VIEJO, CALIFORNIA 92656-5335 1691 I • Attachment C • City Tracking # __ _
South Coast
Air Quality Management District
21865 E. Copley Drive, Diamond Bar, CA 91765-4182
(909) 396-3529 • http://www.aqmd.gov
Air Quality Permit Checklist
California State Law Code 65850.2 prohibits cities from issuing an occupancy permit to a business without clearance from the local air quality agency. This checklist will determine if you need to obtain clearance from the South Coast Air Quality Management District (AQMD).
Company Name:
Property Address:
City:
Contact Person:
I 5 AP--Ec:Jt--JAu,
AlJ50 y ( 12"6cJ
~s t{;NLoP
Type of Business: R/Q M.(3:){CA--LApplicant (print name) JvYrfl:;. €:f-/SA-r----f:;. • Will the facility have any of the following equipment? Charbroiler
Dry cleaning machine
Spray booth
Printing press (screen/lithographic/flexographic)
Zip Code: -~~---------
Title: offi3'if!O>-JS: M-t-hf2-...
Telephone:~ qOO -$-S-)fo
Signature: ________ _
Yes [ ] No[~
Internal combustion engine (greater than 50 HP ( excluding motor vehicles) Boiler/combustion equipment (greater than 2 million BTU/hr. maximum input) Abrasive blasting cabinet/room
Baghouse/cartridge-type dust filter/scrubber
Motor fuel storage and dispensing equipment
• Will any of the following operations be performed?
Application of paints or adhesives
Etching, plating, casting, or melting of metals
Molding, extruding, or curing of plastics
Mixing and blending of liquids and/or powders
Storage of acids, solvents, organic liquids, or fuels
Production of fumes, dust, smoke, or strong odors
Yes [ ] No[~
If you answered "No" to both questions, this checklist is your clearance from AQMD. If you answered "Yes" to either question, you must contact AQMD to determine if air quality permits are required. If permits are needed, AQMD will assist you in submitting permit application(s) and then provide you with a clearance letter. You can call AQMD at their Small Business Assistance Office at (800) 388-2121.
Revised March 1999
1692
• City of Aliso Viejo •
Building and Safety Department
12 Journey
Aliso Viejo, CA 92656
PLAN CHECK
Submittal Date: .June JO, 2011
Applicant MARK GRISAEE
Plan Check # 68254 '------'---'-----'
Plan Check Fee: $1 216 75 '
Address -~5=6~1 B~- E CONANT SST
Zip 90808 City I ONG BEACH
Lot Apn
project Qescriotion
Tract
Contact: _______ _
Job Address:~-------
Job Street: ARGONAI JI
Telephone· (562) 420-1035
PLAN REVIEW TENANT IMPROVEMENT TO EXISTING RESEARCH AND DEVELOPMENT BLDG.
TENANT: AMBRY GENETICS
VALUATION:$250,000 00
Calculated by
Receipt# 12ss1
1693
DATE
INVOICE NO.
BILL OF LADING
CUSTOMER NO.
CUSTOMER P.O.
2/14/11
391973
12568
7670
L 28716 FF4
NUCOR-YAMATO STEEL CO.
P.O. BOX 1228 • BLYTHEVILLE,AR 72316
s
H
I
p
T
0 CCC STEEL, INC C/O
ANCON TRANS BNSF R/R
VERNON, CA FOR TRK DEL
TO COMPTON, CA
s
p
E
C
I
F
CERTIFIED MILL TEST REPORT
100% MEL TED AND MANUFACTURED IN U.S.A.
All shapes produced by Nucor-Yamato Steel are cast
and rolled to a fully killed and fine grain practice.
ASTM A992/A992M-06a A572/A572M GRS0-07
ASTM A709/A709M-09 GRSO {345)
ASTM A709/A709M-09 GR50S (3455)
ASTM A6/A6M-09
~-----------------~ I
IO
A
T
s
0 CCC STEEL, INC.
L
D
T
2576 E. VICTORIA ST.
~RANCHO DOMINGUEZ, CA 90220-0000
I
0 N
s a~ ______________________ _,
tTEM
NI·•• CHEMICAL PROPERTIES
VIELD TENSII.E ELONG CHARPY IMPACT
C Mn p Si Cu Ni Cr Mo V Cb CE ITEM YIELD STRENG Cl-I STRENOTH s ' DESCRIPTION QTY HEAT# TO "TEMP IM?ACT 'i;NERG
TENSIL PSI PSI % F FT-LBS
E "r Sn Pcm Cl
'" MP" MPs . JOULES
1 W21 - 62.0 3 360641 . 76 53000 70000 27 .OB . 90 .018 .030 .22 .31 .10 .12 .02 .00 .017 .29 40' . 76 54000 71000 28 .01 .16
W530 X 92 .0 365 483 27
12 .192 M 372 490 28
2 W21 - 62 .0 3 35828' . 76 53000 70000 24 .07 . 90 .008 .020 .26 .30 .12 .11 .03 .00 ,015 .28 SO' . 77 53000 69000 26 .01 .15
W53Q X 92.0 365 483 24
15.240 M 365 476 26
3 W21 - 62 .0 1 356007 . 77 55000 71000 26 .OB . 90 .022 .032 .23 .31 .13 .14 .04 .00 ,016 .30 60' .79 57000 72000 27 .01 .16
W530 X 92.0 31° 490 26
18.288 M 393 496 27
4 W21 - 62.0 2 360635 .77 55000 71000 25 .08 . 90 .015 .030 .25 .33 .11 .11 .03 .00 .016 .29 60' .75 52000 69000 26 .01 .16
W530 X 92. Q • 379 490 25
18.288 M 359 476 26
5 W21 - 83.0 3 309883 .77 55000 71000 26 .07 1.13 .016 .030 . 28 .30 .11 .10 .03 .00 ,019 .32 45' . 76 55000 72000 25 .01 .16
W530 x123.0 379 490 .26
13. 716 M 379 496 25
6 W21 - 83.0 3 360671 . 72 55000 76000 27 .OB 1.10 . 016 .023 .30 .30 .14 .16 .04 .00 .021 .33 SO' .72 55000 76000 27 .01 .18
W530 xl23 .0 379 524 27
15.240 M 379 524 27
7 W24 - 55 .0 1 360541 . 78 57000 73000 24 .OB . 91 .012 .027 .25 .32 .10 .08 .02 .00 .017 .28 30' .79 58000 73000 24 .01 .16
W610 x 82.0 393 503 24
9.144 M 400 503 24
8 W24 - 55.0 1 36054E .82 58000 71000 26 .08 . 90 .013 .024 .23 .36 .10 .09 .02 .00 .018 .28 30' .80 57000 71000 25 .01 .16
W610 X 82.Q 400 490 26
9.144 M 393 490 25
9 W24 - 55.0 1 360554 .81 58000 72000 26 ,07 . 90 .011 .024 .24 .27 .10 .09 .02 .00 .019 .26 30' .80 57000 71000 25 .01 .15
W610 X 82.0 400 496 26
9.144 M 393 490 25
!'cm-c d, • Mn•C~+ ~,+O • lo\o.+ ~ •I 6 a....,,.,.,_,,.,"~ CAI\W'.'l £.QU\V /\Lt,rr, Cf. ocl'f,ll_lW) = C + :,.Jnlb + (Cr-+7"1<>+\l J/5 + 1:>1, +Cu))lS I Co<n>sl<>o ln~o•c Cl:26.01(",Cul•l.88(,.._~ij+1.2C(%C,)+1.<i("'51)+17.2fl¾P 7,2Uj'l<.Cu)j.._,.,~i-10('t.Nl~¾PJ-33.lllo(%C:u) ' -:;;, ;;; ,.; Sn ;;; ~ 7,, \1er-eur ha< not h-<•• uS<d m tht dlrttl manufat!urln~ of !hi, m•1<rlal.
ELONGATION BASED ON 8.00 INCH GAUGE LENGTH
~
STATE OF ARKANSAS COUNTY OF MISS:~551 f,NE'~"l(.
SWORN TO AND SUBSCRIBED BEFORE M (
1 hereby certify that the contents of this report are (j MY {p accurate and correct. All test results and operations 14 02/1 Comm,e'.,.p performed by !his material manufacturer are in Day ot
l
compliance with ~OOTAJ!Y the requirements of the material QUALITY ASSURANCE CJ o,,,,b,.. W'a.tlw NOTARY ~~ 0 spec1tications listed in the Specifications Block above. s't CUSTOMER COPY MY COMMISSION EXPIRES l O / 21 / Pp,":': ,-p,-¢'" 1694 Steel Dynamics, Inc: Ship to:
CERTIFIED MILL TEST REPORT
Stniotural and Rail Division • Columbia Clly. lndlana CCC Steel, Inc. (260) 625-8100 (260) 625-8950 FAX
Quality Steel 100% EAF Melted
and Manufactured in the USA
Recycled content: PC= 84-75"/o, Pl= 15~10"/o
225 West Manville Street
UP Zone # 41, Track 728
Compton CA, 90220 US
Attn: Mark Ritchie
Customer# 000194 Bill to:
CCC Steel, Inc.
PO Box 5923
Compton CA, 90224 US
Attn: John Pyka
SHIPMENT DETAILS
Date:03 I 13 I 2010
GENERAL INFORMATION
Product Wide Flange Beam
Size. W21X44
SPECIFICATIONS
Standards
ASTM A6/A6M
Grades Bundle/ ASN #
021426067
Length
55'0"
BOL # 0000189003
pcs Customer PO
4 L28368pp
W 530x66
Heat Number A056794
Condition(s) As-Rolled
Fine Grained
Fully Killed
CHEMICAL ANALYSIS (weight percent)
C
.06
Mn
1.02 p
.021
s
.024
Si
.19
MECHANICAL TESTING
Yield (fy) Tensile (fu)
Strength Strength
Test ksi / MPa ksi / MPa
1 621431 74 / 513
2 63 1431 751515
3 4
5 6
7 Cu
.37
fy I fu
ratio
.84
.84
J) ASTM A992/A992M - 06a
ASTM A7091A709M - 06a
ASTM A572/A572M • 06
Ni
.10
CSA G40.21-04
Cr
.14
Mo
.044
Sn V
.013 .022
A992 / A992M
A709 g50S/g345S
A572 grS0/91345
50W/350W
Nb/Cb N B
.001 ,0116 .0003
*C1
.30
*C2
.33
% Elong.
Charpy Impact Tests • (available only when specified at time of order) Temp Absorbed Energy rtabfl J
*PC
.15
__@"._g~ FI C Specimen 1 Specimen 2 Specimen 3 Average Minimum 26 27
Notes: "Calculated Chemistry Values: Carbon Equivalents (C1, C2, PC), Corrosion Index (1) .,
5.95 Analysis Type
Heat
CE 1 {I lW}=C+Mn/6+(Cr+Mo+V)/5+(Ni+Cu)/15 C E2 {AWS}=C+(Mn+Si)/6+(Cr+Mo+V)/5+(Ni+Cu)/15 Pcm {AWS} = C+Si/30+Mn/20+Cu/20+Ni/60+Cr/20+mo/15+V/10+5B I (ASTM G 101 }= 26.01 (Cu)+3.88(Ni)+ 1.20(Cr)+1.49(Si}+17 .29(P)-7.29(Cu)(Ni}-9.1 O(Ni)(P)-33.39(Cu'} I hereby certify that the content of this report are accurate and correct. All tests and State of Indiana, County of Whitley Sworn to and subscribed before me operations performed by this material manufacturer are in compliance with the requirements of the material specifications and applicable purchaser designated requirements.
Signed: _________ ·Yiu-v ,1.·_ro {()'(} J'_.,__~_.,,_-_________ _ this ____ _ day of
Signed: __________ _ My commission expires:. _____ _
FormF-6100-002-os4 rev 1 • Manager of Technical Services Notary Public ASTM A6 - 14.6: A signature is not required on the test report; however, the document shall clearfy identify the organization submitting the report.
Notwilhstanding the absence of a signature, the organization submitting the report is responsible for the conterit of the report Page 13 of 21 1695
DATE
INVOICE NO.
BILL OF LADING
CUSTOMER NO.
CUSTOMER P.O.
2/21/11
393240
13456
7670
L 28728 FF4
s
NUCOR-YAMATO STEEL CO.
P.O. BOX 1228 • BLYTHEVILLE.AR 72316
s
H
I
p
T
0 CCC STEEL, INC. C/O
ANCON TRANS BNS~ R/R
VERNON, CA fOR TRK DEL
TO COMPTON, CA
0 CCC STEEL, INC.
L 2576 E. VICTORIA ST.
D
T
0 fANCHO DOMINGUEZ, CA
M
YIELD •=
~-
90220-0000
I"
ELONG CHARPY IMPACT
C Mn "" ITEM Sn>ENGT>< STilE>IOTH
DESCRIPTION QTY HEAT# TO TEMP . IMPACT ENERG
TENS IL PSI PSI % . ' FT-LBS
E "c "" MPa . JOULES '
1 Wl8 - 35.0 4 36110: .81 57000 70000 24 .08 . 90
30' .81 57000 70000 28
W460 X 52.0 393 483 24
9.144 M 393 483 28
2 Wl8 - 35.0 1 361111 .79 56000 71000 24 .08 .92
30' .80 56000 70000 24
W460 X 52.0 386 490 24
9.144 M 386 483 24
3 Wl8 - 35.0 1 36104E .83 59000 71000 24 .07 . 90
50' .80 57000 71000 24
W460 X 52.0 407 490 24
15.240 M 393 490 24
4 Wl8 - 35.0 1 361062 .83 59000 71000 24 .08 . 90
50' .83 59000 71000 26
W460 X 52.0 .. 407 490 24
15.240 M 407 490 26
5 Wl8 - 35.0 1 36108, .83 60000 72000 24 .07 .90
50' .81 58000 72000 25
W460 X 52.0 414 496 24
15. 240 M 400 496 25
6 Wl8 - 35.0 1 36108 . 81 56000 69000 25 .08 . 90
50' .80 56000 70000 26
W460 X 52.Q 386 476 25
15.240 M 386 483 26
7 Wl8 - 35. 0 1 36108E .82 58000 71000 22 .07 . 91
50' .81 58000 72000 23
W460 X 52 .0 400 490 22
15.240 M 400 496 23
8 Wl8 - 50 0 2 36122( ,77 56000 73000 26 .07 1.10
40' .76 55000 72000 25
W460 X 74.0 386 503 26
12.192 M 379 496 25
9 Wl8 - 50.0 1 361222 .79 59000 75000 24 .08 1.10
40' . 78 58000 74000 23
W460 X 74 .0 407 517 24
12.192 M 400 510 23
p
.017
.015
.013
.013
.012
.016
.023
.017
.020
CERTIFIED MILL TEST REPORT
100% MELTED AND MANUFACTURED IN U.S.A.
All shapes produced by Nucor-Yamato Steel are cast
and rolled to a fully killed and line grain practice.
s
p
ASTM A992/A992M-06a A572/A572M GRS0-07
ASTM A709/A709M-09 GRSO (345)
E
C
ASTM A709/A709M-09 GR50S (345S)
ASTM A6/A6M-09
F
I
G
A
T
I
0 N
s
s
.035
.030
.034
.023
.031
.032
.035
.028
.028
CHEMICAL PROPERTIES
Si Cu Ni
.23 .34 .13
.23 .30 .12
.22 .32 .15
.23 .35 .12
.20 .35 .13
.22 .34 .13
.22 .32 .14
.31 . 35 .12
.28 .35 .13
Cr Mo V Cb
Sn Pcm
.13 .03 .00 .016
.01 .16
.10 .03 .00 .016
.01 .16
.13 .04 .00 .016
. 01 .15
.12 .03 .01 .016
.01 .16
.12 .03 .00 .016
.01 .15
.10 .03 .00 .016
.01 .16
.16 .03 .DO .016
.01 .15
.10 .03 .00 .016
.01 .16
.12 .03 .DO .023
.01 .17
CE
Cl
.29
.29
.28
.29
.28
.29
.29
.31
.32
"'"'•<'•!!,•-~•':!_•:::!!,·'_!_' '.'!',·~···-•'""' ' CARBO~ EQU!VALE:"IT: CE •CE(IIW)mC •Mn/~• 1Cr>."1o+Y)JS • 1~1 +Cul/15 Corrool<>ft r,on, Cldl.Ol!~)•l.$111'!1.N1!>1 ~...C,i,u0l"-Sq,11 :l:ICM>)-1.:il(...CuM"""l-lJ. 'Dl""'MV)-~~"-Cu) VI ,., "' _,, "' I< 10 ."1utur• h•• n~ bffll uvd In lhf dlrH"I manurar111rin• oflhil m11uial.
ELONGATION BASED ON 8.00 INCH GAUGE LENGTH STATE OF ARKANSAS COUNTY OF MIS~~ISSI ENE~~ I hereby certify that the contents of this report are
~ SWORN TO ANO SUBSCRIBED BEFORE M /.
Ci MY iJl
accurate and correct. AU test results and operations 21 02/ c..rn.e,,, performed by th,s material manufacturer are in Day ot
:
~NOTAAY
I
compliance with the requirements of the material QUALITY ASSURANCE CJ~ Wl!lfu N(HARY 1~ 1 WC, specifications listed in the Specifications Block above. ,i' CUSTOMER COPY MY COMMISSION EXPIRES 10/21/ Pp,-- ~~'/J) 1696 1 JORGE DE ANDA
INSPECTION SERVICES
DEPT. OF BLDG. & SAFETY
CITY OF Ahiu V\PJ." <A ,1
o\Z......,y-. (..-+i
SPECIAL INSPECTION REPORT
BUILDING PERMIT NO c; '53 f{ JOB NO ___________ DATE _______ _ JOB IDENTIFICATION /ADDRESS Ac~ ... ..,...,f Is: A/,'r.! VIYj'o CA • or"'1'- t.,,..,,,.A..., GENERAL CONTRACTOR I ADDRESS e -( C f:::L, cd-,fcc I 6,,~r {h c:: , SUB-OCNTRACTOR I ADDRESS J,t D j:;J;?.....,_ L..J ... 1:. ,.- 'J;:'-. c • 5. t\_ ~ 0J G : : ' ! ..h..~--.~ C-u • STRUCTURAL ENGINEER I ADDREss __::::;f:it'.-. ~l''1c-l':____J_~JL.'::!l~'.'.:'.:.:__~:::_:;~='---i:+--.:._---------------.- TYPE OF WORK: -E(J,, ,.~ f7 t' ".,.c,1,,.1(
REINFORCED CONCRETE _______ MASONRY _________ HIGH - STRENGHT BOLTS-~_, __ _ Sb"'f _.-- ~ PRESTRESSED-CONCRETE ______ V\£LDING --'-°'<-'"""'"------- GYPSUM OCNCRETE _____ _ V\£LDER I V\tLDERS
,..,...
.,r:-
--Z.,,1-11 r \ '- ~y. ,·
V\£LDER (S)
1.0. NUMBER CITY
DESCRIPTION OF It.ORK INSPECTED
...,._Ll...,Q
7 ,,.,l.,J ..,,.u,,.J. ..f-o ... e~
... l""''' '-'"- • ,-1--', n·..k •.f (1,,.,, ~.Q ,.
RECEIPT
NUMBER
f I;, ..., A'-11 )
v,1.....-.
.-1u .1-1,.A-
·\1\,-v
(~ll \us IJ{~s" wL.,,,,,/ v--~ ..f .fv J, l ~-- ..,,('- ~~~ '\, !I-(.,,._ -t-1- ', L• , .. 4,·..,,. . ' ~O;H Jvf-r<' c: ... ~,- ,A-- <-\ I' ca---, .,,,;i.~ """.,;.1,~ b ,,
DATE OVERTIME TIME IN TIME OUT MILEAGE CODE
q / c,,, ,,... v1)
c&L ~ , ,,,.. .. ALL INSPECTION BASED ON MINIMUM OF ,t HOO RS & OVER 4 HOURS - e HOURS M1Ntt,UM. IN ADDITION. ANY NSPECT100 EXTENDt-lG PAST No<::t-1 HOOR WLL BE 8 HOURS MINIMUlr,I HAS BEEN FILED ANO IT STATES T n-lE ABOVE WORK HAS BEEN INSPECTED BY HIM ~O COMPLIES Wffii THE RESPEC~Tl LY SU D
APPROVED BY: __________________ BY: _ __._ "'-~-<-----"'~--------------
PROJECT SUPERNTENDENT JOROE OE ANDA
1697
JORGE DE ANDA
INSPECTION SERVICES
__ 01!) _]i'i -!~k
DEPT OF BLDG. & SAFETY
CITY OF Al, 'so V1 1 a C>4
0~µ_ {.,,,...,_J..,,, . I
SPECIAL INSPECTION REPORT
BUILDING PERMIT NO. & 83/ 8': JOB NO. ___________ DATE ______ _ JOB IDENTIFICATION I ADDRESS Aec,01v.Aq"' IS A L(,[C) v,·~i" () c.-1\- l '-'/V'IV¼.f.
GENERAL CONTRACTOR, ADDRESS f2 4 C &-1.,, <-f,1-,·, <- 1 C ""'TllA <-T10".1') c.. 0 • suB-CONTRACTOR, ADOREss C<. t J,A-cl n--, U,,,.r . ~
STRUCTURALENGINEER/ADDREss_SJ.uf~l~',Z,=(---~~+_,__,_~~~::::..r='--'=--~""--=~'VZ/=~/~,~•v,~F~,~-------------- TYPE oF woRK: L o-;,e-1 S:-_& x.f>
REINFORCED CONCRETE _______ MASONRY _________ HIGH~~RENGHT BOLrt,+--- PRESTRESSED CONCRETE ______ 'M=LDING _________ GYPSUM CONCRETE _____ _ V\£LDER / V\£LDERS V\£LDER (S) CITY RECEIPT
ID. NUMBER NUMBER
- - - --
DATE OF INSPECTION DESCRIPTION OF v\QRK INSPECTED
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- Le- \ \ l-.o\PJ ~rv'~ <!._ iQ\ou,"- \.,~~ .kfOY.-,' • - '--.~ .,.-1f:_ c;-i.--," < •"' , "'7 - .....,.D ,, HOURS DATE REG. OVERTIME- TIME IN TIME OUT MILEAGE CODE INITIALS 5 ...-'to\ \ r / ~:,r,. ... )','1.•,l"m / v-~1, I (... /1 D ' ~ ALL INSPECTION BASED ON MINIMUM OF 4 HOURS & OVER '4 HOURS- 8 HOURS MlNIWM. IN ADDITION, ANY INSPECTIOO EXTENONG PAST N<XlN HOUR 'NILL BE 8 HOURS MINIMUM.
ATTORNEY'S FEES- IF ANY ACTION AT LAW ORN EOJfTY IS BROUGHT TO ENFORCE OR tffERPRET THE TERMS OF THIS (X)NTRACT. THE PREVAILING PARTY SHALL BE ENTffiED TO REASO\IABLE ATTORNEY'S FEES. COSTS AND NECESSARY DISBURSEMENTS N AOOmON TC ANY OTHER REUEF WilCH SUCH PARTY MAY BE ENTITtEO.
CJ,( #ll'if REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFIED Sl~ED BY INSPECTOR ____ £_~,c::::;:z;,L_:f::'.::::-,.____ _____________ _ m NUMBER / Cc# 5DO"f} n - !S (' HAS BEEN FILED ANO IT STATES E ABOVE V\QRK HAS BEEN INSPECTED BY HIM ANO COMPLIES Wfl'r1 THE PROV1SK:iNS OF THE 5UILOING CODE APPLICABLE THERETO
APPROVED BY: ---__________________ BRYE:SPECTI~~LYSUD '-' _____ ~
PROJECT SUPER NTENOENT JORGE OE ANDA
11 ,
1698
.~
JORGE DE ANDA
INSPECTION SERVICES
DEPT OF BLDG. & SAFETY
CITY 0Fau'5t! l)1',:j v
SPECIAL INSPECTION REPORT
BUILDING PERMIT NO. ~l._.8: ....... 3~'~J--~-' --------- ____________ DATE-------- JOB IDENTIFICATION , AOORESS __c_/_::;cSc__-'---'-'-cf--'"-"-''--=--'--'-=-_,__--~-;-r--CA _ __,_,__~_2-'j,,;t;-c=S-6~ __ -;-_ ) l [ • I <, "--•-iv<s.cA-( C,. GENERAL CONTRACTOR/ADDRESS c. r-,re ,,.~, <H _,, • SUB-CONTRACTOR, ACORESs___,,..=qcc,· '--c=·'--"\-l_..,1',.,,.,,,"'+"--_..~~-~ .... 6-+=c~,-,=~~{___,C-.. ~~---r~.~-------- STRUCTURAL ENGINEER/ ADDRESS 5r YI' ;:-+r,,d,r, I ·"") ttw'i"S. II /fr"c,4, k.:t I /1,,.:ttr- A ('., r,i ... £<. ctl .4 TYPE OF WORK: .h-(7P>'-..f - .,,.._.;;,;~
REINFORCED CONCRETE ______ MASONRY ________ HIGH - STR,~BOLTS ~ J~r.
PRESTRESSEO CONCRETE ______ 'M:'LOING _________ GYPSUM CONCRETE _____ _ 'v\ELOER / 'v\ELOERS 'M:'LOER (S) CITY RECEIPT
1.0. NUMBER NUMBER
--- -·
--- DATE OF INSPECTION
I
I ~
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HOURS ,.,.,,, f""-
DATE REG. OVERTIME TIME IN TIMEOUT MILEAGE CODE INITIALS -fi-1.0,1 r: '-(1:. ID,' ( r;.' I{
ALL INSPECTION BASED ON MINIMUM OF 4 HOURS & OVER 4 HOURS- 8 HOURS MlNIWM. IN ADDITION, ANY INSPECT!~ EXTENONG PAST N~ HOJR 'Nill BE 8 HOURS MINIMUM.
ATTORNEY'S FEES. IF A1'N ACTION AT LAW ORN EOOITYIS BROUGHT TO ENFORCE OR INTERPRET TERM Tl-tlS CONTRACT. THE PREVAILING PARTY SHALL BE ENTITLED ro O,.s~Ae;;,,n/i~iFEES. COSTS ANO NECESSA~Y o,seuRsEMENTS N ADD c ANY~ T0'M-tlCH sucH PARTY MAY BE ENTmED.
REGISTERED DEPUTY BU~D'NG INS?ECT0R"S CERTIFIED SIGHED BY NSPECT0R -----'71;L,_ __________________ _
1.0. /NCLUMB..Jef 5'oo,1;, ~,.,,~ 'ffi -~~-~~--~?)_~_ ----HAS BEEN FILED AND IT STATES THATTl-fE A8CNE V-.ORK HAS BEEN INSPECTED BY HIM AAD COMPLIES Wtn-1 THE PRCNlSIONS OF THE BUILONG CODE APPLICABLE n-tERET0
D
APPROVED BY: __________________ BV: ___ 7 Y:=::c---------------- PROJECT SUPERV-.TENDENT JORGE DE AADA
1699
SP ItE
September 29, 2011
Mark Grisafe
5618 E. Conant St
Long Beach, CA 90808
STRUCTURAL
Subject: Drawing Clarification and Modification
Address: 15 Argonaut, Aliso Viejo, CA 92656
Dear Mark:
Item 1 : Shear walls
ENGINEERING
Memo 11.162.1
Per E-mail from Mark and Brian requesting additional holdown information: there are no holdowns required for 15 Argonaut. Per the plans (1/S210) the shear wall symbol will indicate if a holdown is required. See legend for more information. The symbol at the one wood shear wall indicates "NONE" for the holdown type. The Typical Structural Panel Shear wall Construction detail (3/S310) shows where holdowns would located if required.
Item 2: Rooftop Units
Two rooftop unit have been relocated moved per contractors request. Please see attached SK- 2 for partial plan. Similar detailing may be applied at the other units.
Please feel free to call with any questions or if we can be of additional assistance.
Sincerely,
Jeffrey M Roettele
23441 SoLih Poirie Drive, Slite 245, lagl.f'la Hills, Califonia 92653 Tel: 949.916.3440 Fax: 949.916.3445 www.spirestrucnres.com
1700
• •
Date Received:
REQUEST FOR BUILDING PERMIT ISSUANCE
HOLD HARMLESS AGREEMENT
TO: Building Department/ Engineering Department/ Planning Department APPLICANT:
PROJECT ADDRESS: PLAN CHECK#:
PROJECT DESCRIPTION: [eNfl:tVC 101p@vWENc 80t...1) OU1 EPB ) I
Building Permit Issuance. Following City of Aliso Viejo ("City") plan check review, the above listed project may be submitted to the Building Department/Engineering Department for issuance of a building permit. Applicant acknowledges no building permit final or Certificate of Occupancy shall be granted until all planning/zoning clearances have been obtained and all appeal periods exhausted. Applicant further acknowledges an appeal of planning/zoning approval may occur within ten (10) days of the date of planning discretionary approval determination and a public hearing may be required as part of the appeal process. Applicant acknowledges additional conditions or requirements may be placed on the project or planning/zoning approval may be overturned and the project denied. Applicant further acknowledges and agrees that in the event the approval is appealed and overturned or encumbered with additional conditions or requirements that may require additional building permit submittals, reviews, and issuances, that all plan check fees, building permit fees, and planning processing fees paid as part of the City's process are non-refundable and non-transferable.
Indemnification. Applicant shall defend, indemnify and hold City, its officials, officers, employees, volunteers and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful death, in any manner arising out of or incident to any alleged acts, omissions or willful misconduct of Applicant, its officials, officers, employees, agents, consultants, contractors and subcontractors arising out of or in connection with this Agreement, including but not limited to denial of the project and any changes that are required as a result of any pending discretionary actions and appeal periods.
Attorneys' Fees. If either Party commences an action against the other Party, either legal, administrative or otherwise, to enforce, interpret, rescind, or otherwise relating to this Agreement, the prevailing Party in such action shall be entitled to have and recover from the losing Party reasonable attorneys' fees and all other costs and expenses of such action.
Applicant:
Date:
Company: /ti C-i U.,,C J
AUG O 4 2011
PLANNING DEPARTMENT 1701
CITY OF ALISO-JO - PERMIT/ PLAN REVII APPLICATION
JOB ADDRESS: /S-~ APN#/TRACT#/LOT#:
ADDRESS: S~ 'O t,::;, GDN&K[ :Sf CITY: UW6 ~ ZIP CODE: 9q3(Jo PHONE NUMBER: fu-:;2. j'2o 70-?::,S;"
PROPERTY OWNER'S NAME: AJCI ~
ADDRESS: '21S2\ ~SA-\£ >'I? ?&iclTY: 8L SE<f:O...JPO ZIP CODE: Cf() .2.f\- PHONE NUMBER: s (0 -1 Z<;"" • oC:::X::X:i
NAME OF BUSINESS TO OCCUPY BUILDING/SPACE: f'rM'f!::f--1 0g:Ne{1C \ • ARCH./ENGINEER: M' ffi.S.~ A:1-C::ttiTECf'
ADDRESS: ~(<3 £=:::, COili:NJ: st"'. CITY: la{6 BC/± ZIP CODE: '(q,:::B LICENSE NUMBER: C. ~ :::f:';"" PHONE NUMBER: ey'.;,?)420 =fOs.c;;; '
CONTRACTOR'S NAME: f-.S:: C. Co~S PHONE NUMBER: U-gt[)-"'¥J-sCJ ADDRESS: t-111 ·s c.JU~ 1We . CITY:
CONT. LICENSE CLASS/ NUMBER: j3 fo ~ L
/IM'll!UAH Gf.J:NS ZIP CODE: 'jQ1/b
EXP. DATE: ID - 3 I- ),of!
WRITTEN DESCRIPTION OF WORK: SQUARE FOOTAGE:
() ~'f)S s( b g~ 3 S,F.
TYPE OF CONSTRUCTION: -
PUBLIC WORKS SCREENING QUESTIONS
LANDSCAPE PERMIT
DOES THIS PROJECT INCLUDE NEW LANDSCAPE OR LANDSCAPE RENOVATIONS FOR:
RESIDENTIAL PROJECTS - 5,000 SF AREA OR MORE?
COMMERCIAL/HONPROPERTY MGMT PROJECTS - 2,500 SF AREA OR MORE? IF YES TO EITHER QUESTION,. LANDSCAPE PERMIT IS REQUIRED
WATER QUALITY PERMIT
DOES THIS PROJECT REQUIRE ANY MOVEMENT OF SOIL?
DOES THIS PROJECT REQUIRE ANY OUTSIDE STORAGE OF MATERIALS?
IF YES TO EITHER QUESTION, WATER QUALITY PERMIT IS REQUIRED
CONSTRUCTION AND DEMOLITION C&D PERMIT
DOES THIS PROJECT INVOLVE MORE THAN 5,000 SF?
IS THE TOTAL VALUE OF THE PROJECT $50,000 OR MORE?
IF YES TO EITHER QUESTION, C&D PERMIT IS REQUIRED
WATER POLLUTION PREVENTION
[ DOES THIS PROJECT INCLUDE ONE ACRE OR MORE OF DISTURBED SOIL?
IF YES, STORM WATER POLLUTION PREVENTION PLAN (SWPPP, STATE) IS REQUIRED [ IS THIS A NON-RESIDENTIAL PROJECT THAT INCLUDES LESS THAN ONE ACRE OF DISTURBED SOIL? [
IF YES, WATER POLLUTION CONTROL PLAN (WPCP, CITY) IS REQUIRED ✓ SIGNATURE OF APPLICANT OR AGENT:-._G) CS>~
OFFICE USE ONLY DO NOT WRITE BELOW THIS LINE
Plan Check r2. H /l ice:, Plumbing
Building c-11- ~ 9. 7 I q?,, Electrical
Issuance I .v ' - . Mechanical
Scanning SMIP
General Plan Maintenance ,2,f} l)J SB 1473
Planning I CPTED
Other:
YES
YES NO
YES NO
YES NO
v:1
YE& NO
i7
APPROVED TO SUBMIT PER PLANNING: ________________ R.evised 01-03-11 1702
CITY OF ALISO VIEJO
MECHANICAL, ELECTRICAL. AND PLUMBING TAKE OFF SHEET
MECHANICAL UNIT FEE SCHEDULE
QTY ITEM FEE QTY ITEM FEE
FORCED AIR GRAVITY FAU DUCTS AIR HANDLING UNIT < = 5,000 CFM UP TO 100,000 BTUS AIR HANDLING UNIT> 5,000 CFM
OVER 100,000 BTUS INSTALLATION REPAIR ALTERATION
EVAPORATIVE COOLER RELOCATION OR ADD TO EA BOILER OR
COMMERCIAL VENTILATING FAN COMPRESSOR OR ABSORPTION SYSTEM COMMERCIAL VENTILATING SYSTEM < = HP OR 100,000 BTUS
EXHAUST HOOD W/ FANS/ DUCTS > 5 HP OR 100,000 BTUS
RES INCINERATOR NEW/ RELOCATE INSTALLATION/REPLACEMENT OF AIR
COMM INCINERATOR NEW/ RELOCATE CONDITIONING OF HEAT PUMPS REHEAT/COOLING COIUSTRIP HTR < = 5,000 TONS/HP
INCIDENTAL GAS PIPING > 5 TONS/HP
FLOOR WALL OR SUSPENDED HEATERS OTHER·
APPLIANCE VENTS
REPAIR/ ALT TO EA HTG APPLIANCE i
REFRIGERATION UNIT, COMFORT COOLING
UNIT, ABSORPTION UNIT, OR EA COMFORT
HTG / COOLING ABSORPTION OR EVAPORATIVE COOLING SYST. INCL. REGIST GRILLS
PLUMBING UNIT FEE SCHEDULE
QTY ITEM FEE QTY ITEM FEE
PER FIXTURE-SINK, TOILET, DISPOSAL < TEMPORARY SERVICE COMMERCIAL WTR HEATER, DISHWASHER, SOFTNER - GAS PIPING OUTLETS 1-5
RAINWATER SYSTEM (PER DRAIN) EACH ADDITIONAL
ALT OR REPAIR OF PIPING OR TREAT- CARBON DIOXIDE SYSTEM
MENT SYSTEM SPRINKLER SYSTEM (PER METER)
BUILDING SEWER RESIDENTIAL
PRE-INVESTIGATE PRIVATE SEWER COMMERCIAL
PRIVATE SEWER STANDPIPES (ANY COMBINATION)
SEEPAGE PIT.SEPTIC TANK.SEWER CAP SPRINKLER SYSTEM ALTERATION
OR DRAINAGE FIELD YARD PIPING, UNDER GROUND SPRINKLER
VACCUUM BREAKERS BACKFLOW OR YARD PIPING, ALTERATIONS ONLY, NOT
DEVICES OR FIXTURES ON TANKNATS COMPLETE SYSTEM COMPLETE 1-5 DEVICES DISTRIBUTION (PER 1,000)
EACH ADDITIONAL YARD GAS SYSTEM
INDUSTRIAL WASTE PRETREATMENT YARD WASTE SYSTEM
GAS REGULATOR (EACH\ YARD COLLECTION SYSTEM
TEMPORARY SERVICE RESIDENTIAL OTHER:
ELECTRICAL UNIT FEE SCHEDULE
QTY ITEM FEE QTY ITEM FEE
SERVICE METER SWITCHBOARD >600 VOLTS EACH ADDIT.
ANNUAL ELECTRICAL PERMIT SERVICE/SWITCHBOARD<=600 VOLTS SELF CONTAINED WIRED APPLIANCE 600 AMPS OR LESS
BUSWAYS FOR TROLLYS AND PLUGINS 601-1000 AMPS
TYPE BUSWAYS EA 100 OR FRACTION 1001- AND GREATER
POWER APPARATUS (HP,KW,KVA) OVER 600 VOL TS, ALL LAMPS
LESS THAN AND EQUAL TO 1 RELOCATION OF RESIDENTIAL SERVICE 1 UP TO AND EQUAL T 10 PRELOWERING
FROM 10 TO AND EQUAL TO 50 INSPECTION PER 10 SOFT
FROM 50 AND INCLUSIVE OF 100 GARAGE CARPORT PER 100 SOFT OVER 100 . PRELOWERING INSPEC. FOR COMMERCIAL
RADIANT CEILING HEAT PER ROOM ALL OTHER INSPECTION SEE TABLE
FIXTURES AND OUTLETS TEMPORARY POWER LIGHTING
FIRST 20 /EACH\ /QC.., SERVICE
ADDITIONAL (EACH\ RESIDENTIAL WORK SERVICE
5 OF MULTIPLE OUTLET STRIP /() COMMERCIAL WORK SERVICE
MULTIPLE APPLIANCE OUTLET ASSEMB. PEDESTALS, PIGGYBACK, POLES (EACH) POL MOUNTED VAPOR FIXTURE CONST. POLE (EACH NO POWER\
ADDITNL FIXTURES ON SINGLE POLE I ' CONST. LIGHTING <-500 LAMPS • LAMP HOLDING DEVICES 1 - 20 /EACH) CONST. LIGHTING >500 LAMPS NEXT 200 /EACH) SIGNAGE /INCLUDES GAS TUBE TYPE\
EACH ADDITIONAL ONE SIGN & TRANSFORMER
FLASHER/ TIME CLOCK EACH ADDITIONAL SAME BUILDING
SERVICES EA EXTRA TRANSFORMER FLASHER TIMER
PEDESTAL EA ADDIT. SIGNfrRANS SAME LOT
SUBPANEL I I MOVE EACH SIGNfrRANS
SWITCHBOARD<600 VOL TS FIRST SECTION ALTERING CHANGING LETTERING SWITCHBOARD <600 VOL TS EACH ADDIT CONVERTING SIGN OR DECORATVE TUBING ·SWITCHBOARD >600 VOLTS FIRST SECTION OTHER
• • 1703
LTG-2A
(Pa e 1 of3)
Enforcement Agency: Permit Number.
Note: Submit one certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance.
FIELD TECHNICIAN'S DECLARATION STATEMENT
• I certify tmder penalty of perjwy. under the laws of the State of CaJifomia, the information provided on this fonn is true and correct. • lam the person who perfonned the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I certify that the construction/installation identified on this form complies with the acceptance requirements indicared in the plans and specifications approved by the enforcement agency, and confonns to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7.
• I have confirmed that the lnstallatioo Certificate(s) for the oonsrruction/installation identified on this form has been completed and is posted or made available with the building permit(s) issued for the building. g___
Date Signed: 1de):
L___ _______ _l_ _____ .1-..!,='-'-'---· Tl l- r-of<'.EMA,V
RESPONSIBLE PERSON'S DECLARATION STATEMENT
• I certify under penalty of perjlll)'. under the laws of the State of California. that I am the Field Technician. or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this form. • I am a licensed contractor~ architect. or engineer. who is eligible under Division 3 of the Business and Professions Code. in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person).
• I certify that the information provided on this fonn substantiates that the constructionfmstal1ation identified on this form complies ·with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency~ and conforms co the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA 7. • I have confirmed that the Installation Certificate(s) for the construction/installation identified on this form has been completed and is posted or made available with the building pennit(s) issued for the building. • I will ensure that a completed. signed copy of this Certifican: of Acceptance shall be posted. or made available with the building pennit(s) issued for the bwlding. and made available to the enforcement agency for an applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the docwnentation the builder provides to the building owner at occupancy.
Company Name: fZ_:; (..,,, f-/ e cJ-r i CCI. I T VIC . Phone:
(5P-) s-w-3,no
Respo~ble Person's N
Occu=nt Sensor, Manual Davlil!btine Control. and Automatic Time Switch Control l11tent: I Lights are naned off when not needed per Section l 19(d) & 13 l(d).
Construction Inspection
I Instrumentation to perform test includes, but not limited to:
a. I Hand-held amnerai,e and voltoae meter
b. I Power meter
continued on next page
2008 Nonresidential Acceptance Forms August 2009
1704
ATE OF ACCEPTANCE LTG-2A
(Pa e 2 of3)
System location or Area Served:
2 Occupancy Sensor Construction Inspection
,~r Occupancy sensor has been located to minimize false signals □ Light meter
□ Ultrasonic occupancy sensors do not emit audible sound (1 J 9a) S feet fiom source 3 Manual Daylighting Controls Construction Inspection
□ If dimming ballasts are specified for light fixtures within the daylit area, make sure they meet all the Standards reauirements, includine "reduced flicker oneration" fur manual dimming control systems 4 Automatic Time Switch Controls Construction Inspection a. Automatic time switch control is programmed for (check all):
Weekdays
Weekend
. Holidays
b. Document for the owner automatic time switch programming ( check all):
Weekdays settings
Weekend settings
Holidays settings
Set-up settings
Preference program setting
Verify the correct time and date is properly set in the time switch □ Verify the battery is installed and energized
□ Override time limit is no more than 2 hours
Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in ~ accordance with the applicable provision in Section I I 9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Annliance and Control Devices A. Select Acceptance Test (Indicate lighting control systems Names/Designations by the applicable tests below) ~ 1 Occupancy Sensor
□ 2 Manual Daylighting Controls
3 Automatic Time Switch Controls
B. j Equipment Testing Requirements Applicable Lighting Check and verify those items applicable to selected system: Control Systems Occupancy Sensor - Step I: Simulate an unoccupied condition I 2 3 a. Lights controlled by occupancy sensors turn off within a maximum of 30 minutes from start of ao unoccuoied cohditioo oer Standard Section I 19(dl {pN YIN YIN b. The occupant sensor does not trigger a false "on" from movement in an area adjacent @N YIN YIN to the controlled space or from HV AC operation c. Signal sensitivity is adequate to achieve desired control ff,JN YIN YIN Occupant Sensor - Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly lYJN YIN YIN b. Lights controlled by occupancy sensors tum on when Immediately upon an occupied YIN YIN condition·OR (this requirement is mutually exclusive with Step 2.c.) . c. Sensor indicates space is "occupieda and lights tum on manuaJly {YYN YIN YIN continued on next page
1008 Nonresidential Acceptance Forms August 1009
1705
LTG-2A
Project Name/Address:
;r,_ tJ P. (}.
System Location or Area Served:
OCCUpant Sensor-Step 3: System returned to initial operating conditions &lfN YIN YIN Occupant Sensor - Step 4 - Sensor is also a multi-Level Occupant Sensor used to qualify 0@ for a Power Adjustment Factor in Section 146(a)2D of the Standards. If yes, then 'a,' ·b,' YIN YIN and 'c' must also be ves.
a. The first stage activates between 30 to 70% of the lighting either manually or &® YIN YIN automaticallv.
A reasonably uniform level of illuminance is achieved by dimming of all lamps or b. luminaires; or by switching alternate lamps in luminaires, alternate luminaires, or fjy@ YIN YIN alternate rows of luminaires.
After the first stage occurs, manual switches have been provided to activate the &8) C. alternate set oflights, activate 100% of the lighting power, and manually deactivate all YIN YIN of the li~hts.
Manual Daylighting Controls - Step 1: Manual switching control a. At least 50% of lighting power in daylit areas is separately controlled from other lights YI YIN YIN . b. The amount of light delivered to the space is uniformly reduced y YIN YIN Manual Daylighting Controls - Step 2: System returned to initial operating conditions YI YIN YiN Automatic Time Switch Controls - Step 1: Simulate occupied condition a. AU lights can be turned on and offby their respective area control switch YIN YIN YIN b. Verify tlte switch only operates lighting in the ceiling-height partitioned area in which YIN YIN YIN the switch is located Automatic rune Switch Controls - Step 2: Simulate unoccupied condition a. AU non-exempt lighting tum off per Section 13 l(d)l YIN YIN YIN Manual override switch allows only the lights in the selected ceiling height partitioned b. space where the override switch is located, to turn on or remain on until the next YIN YIN YIN scheduled shut off occurs
C. All non--exempt lighting turns off YIN YIN YIN
Automatic Time Switch Controls - Step 3: System returned to initial operating conditions YIN -Y/N YIN Note: ShaJled areas do not apply for particular test procedure I I I C. PASS I FAIL Evaluation (check one):
ti PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are oositive (Y - ves)
FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative (N- no) D responses in any applicable Equipment Testing Requirements section. Provide explanation below. Use and attach additional nages if nerP<mv.
1008 Nonresili£niiol Acceplance Forms Augusc2009
1706
LTG-2A
1 of3)
Prr"ject Name/Arirfrp,;;.,;;:
n "',.tff :p,.f~
Enforcement Agency: Permit Number:
Note: Submit one Certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance.
FIELD TECHNICIAN"S DECLARATION STATEMENT
• I certify under penalty of perjwy, under the laws of the State of California, the information provided on this form is true and correct. • I am the person who performed the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I certify that the construction/installation identified on this form complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA?.
• I have confinned that the Installation Certificate(s) for the construction/installation identified on this Fann has been completed and is posted or made available with the building pennit(s) issued for the building.
Com
Fi~hnician's Name:
c:l..X:l/v 4'-'D
RESPONSIBLE PERSON"S DECLARATION STATEMENT
Fiel
MAJJ
• I certify under penalty of perjury. under the laws of the State of California. that 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 infonnation provided on this foITD. • I am a licensed contractor. architect. or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person).
• [ certify that the information provided on this fonn substantiates that the construction/installation identified on this form complies v;ith the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA 7. • l have confirmed that the InstaJlation Certifica.te(s) for the oonstruction/installarion identified on this form has been complered and is posted or made available with the building pennit{s) issued for the building. • r will eosure that a completed., signed copy of this Certificate of Acceptance shall be po~ or made available with the building permir{s) issued for the building. and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy.
Company Name: ,Z 'i/ (._,, b /.R.e-h-i° C. o.__ Phone:
(5• z_) ',' {,0 - 3430
Respo
License: L;( - !i q3qos 1 I
Occunant Sensor, Manual Dav1iahtin2: Control. and Automatic Time Switch Control Intent: I Lights are turned off when not needed oer Section I 19(d) & 131(d), Construction Inspection
I Instrumentation to oerform test includes. but not limited to:
a, I Hand-held amperai,e and voltage meter
b, I Power meter
continued on next page
2008 Nonresidential Acceptance Forms August 2009
1707
LTG-2A
(Paae 2 of3)
Project Name/Address:
-rt ~ System Name or Identification/rag:
2 Occunahcy Sensor Construction Inspection
n/ Occupancy sensor has been located to minimize false signals D Light meter
D Ultrasonic occupancy sensors do not emit audible sound ( 119a) 5 feet from source 3 Manual Daylighting Controls Construction Inspection
D
If dimming ballasts are specified for light fixtures within the daylit area, make sure they meet all the Standards reauirements, including "reduced flicker ooeration1
' for manual dimming control systems
4 Automatic Time Switch Controls Construction Inspection a. Automatic time switch control is programmed for (check all):
D Weekdays
D Weekend
□ Holidays
b. Document for the owner automatic time switch programming (check all):
□ Weekdays settings
D Weekend settings
□ Holidays settings
□ Set-up settings
□ Preference program setting
□ Verify the correct time and date is properly set in the time switch □ Verify the battery is installed and energized
□ Override time limit is no more than 2 hours
Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in D accordance with the applicable provision in Section I 19 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Annliance and Control Devices A. ,,Select Acceptance Test (Indicate lighting control systems Names/Designations by the applicable tests below) at I Occupancy Sensor
□ 2 Manual Daylighting Controls
□ 3 Automatic Time Switch Controls
B. Equipment Testing Requirements Applicable Lighting
Check and verify those items applicable to selected system: Control Systems Occupancy Sensor - Step I: Simulate an unoccupied condition I 2 3 a. Lights controlled by occupancy sensors tum off within a maximum of 30 minutes from {1/N YIN YIN start ofan unoccupied condition per Standard Section l 19(d\ b. The occupant sensor does not trigger a false "on" fiom movement in an area adjacent {])N YIN YIN to the controlled space or from HY AC ooeration C. Signal sensitivity is adequate to achieve desired control /YJN YIN YIN Occupant Sensor - Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly {j)N YIN YIN b .• Lights controlled by occupancy sensors tum on when Immediately upon an occupied - condition OR (this reauirement is mutuallv exclusive with Sten 2.c.) YIN YIN c. Sensor indicates space is "occupied" and lights tum on manually (Y"}!N YIN YIN continued on next page
2008 Nonres,den/,a/ Acceptance Forms August 2009
1708
CERTIFICATEOFACCEPTANCE LTG-2A
tance Document (Paae 3 of3)
Project Name/ Address:
~,J • 'fi.
System Name or Identification/fag:
Occupant Sensor• Step 3: System returned to initial operating conditions (-Y}IN YIN YIN Occupant Sensor - Step 4 - Sensor is also a multi-Level Occupant Sensor used to qualify {)1N for a Power Adjustment Factor in Section 146{a)2D of the Standards. If yes, then ·a,' ·b,' YIN YIN and 'c' must also be ves.
a.
The first stage activates between 30 to 70% of the lighting either manually or (!j)N YIN YIN automaticallv.
A reasonably uniform level ofilluminance is achieved by dimming of all lamps or <!!JN b. luminaires; or by switching alternate lamps in luminaires, alternate lurninaires, or YIN YIN alternate rows of luminaires.
After the first stage occurs, manual switches have been provided to activate the (!)N c. alternate set of lights, activate 100% of the lighting power, and manually deactivate all YIN Y/N of the li~hts.
Manual Daylighting Controls - Step 1: Manual switching control a. At least 50% of lighting power in daylit areas is separately controlled from other lights YIN YIN YIN b. The amount oflight delivered to the space is uniformly reduced YIN YIN YIN Manual Daylighting Controls - Step 2: System returned to initial operating conditions YIN YIN YIN Automatic Time Switch Controls - Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch YIN YIN YIN b. Verify the switch only operates lighting in the ceiling-height partitioned area in which YIN YIN YIN the switch is located Automatic Time Switch Controls - Step 2: Simulate unoccupied condition a. All non-exempt lighting turn off per Section 13l{d)I YIN YIN YIN Manual override switch allows only the lights in the selected ceiling height partitioned b. space where the override switch is located. to tum on or remain on until the next YIN YIN YIN scheduled shut off occurs
C. All non-exempt lighting turns off YIN YIN YIN
Automatic Time Switch Controls - Step 3: System returned to initial operating conditions YIN YIN YIN Note: Shaded areos do not apply for particular test procedure I I I C. PASS I FAIL Evaluation {check one):
J PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - ves)
FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative (N - no) □ responses in any applicable Equipment Testing Requirements section. Provide explanation below. Use and attach additional oaees if necess:1rv.
1008 Nonresidential Acceptance Forms August 2009
1709
,,
LTG-2A
(Pa e 1 of3)
Enforcement Agency: Permit Number.
Note: Submit one Certificate of Acceptance fer each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance.
FIELD TECHNICIAN'S DECLARATION STATEMENT
• I certify under penalty of perjwy. under the laws of the State ofCaJifomia. the infonnation provided on this fonn is true and correct. • I am the person who perfonned the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I certify that the construction/installation identified on this form complies with the acceptance requiremenlS indicated in the plans and specifications approved by the enforcement agency, and confonns to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7.
• I have confirmed t:luu: the Installation Certificate{s) for the construction/installation identified on this form has been completed and is posted or made available with the building permit(s) issued for the building.
Date Signed: le):
L__ ______ __J _____ ~~.d....gTl '- r-oieeMAAJ
RESPONSIBLE PERSON'S DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California. that I am the Field Technician, or the Field Technician is: acting on my behalf as my employee or my agent and I have reviewed the information provided on this fonn. • I am a licensed contractor, architect. or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person).
• I certify that the information provided on this form substantiates that the constructionfmstallalion identified on this fonn complies ,vith the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA 7. • I have confirmed that the Installation Certificate(s) for the construction/installation identified on this form has been completed and is posted or made available with the building permit(s) issued for the building. • l will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy.
CompanyName: /25(.,, flRcJ,-ico..l I~. Phone:
(s1,z. si:0-3430
License'Lic. :11 q7q 0
Occunant Sensor, Manual Day1iahtin2 Control. and Automatic Time Switch Control Intent: I Lights are turned off when not needed oer Section 119(d) & 13 l(d).
Construction Inspection
I Instrumentation to perform test includes, but not limited to:
a. I Hand-held amn•=oe and voJtoae meter
b. I Power meter
continued on next page
2008 Nonresidential Acceptance Forms August2009
-J
1710
LTG-2A
tance Document (Pa e 2 of3)
2 Occupancy Sensor Construction Inspection
18' Occupancy sensor has been located to minimize false signals □ Light meter
D Ultrasonic occupancy sensors do not emit audible sound (II 9a) 5 feet from source 3 Manual Daylighting Controls Construction Inspection
□
If dimming ballasts are specified for light fixtures within the day lit area, make sure they meet all the Standards reauirements, including "reduced flicker ooeration" for manual dimming control svstems 4 Automatic Time Switch Controls Construction Inspection . a. Automatic time switch control is programmed for (check all):
Weekdays
Weekend
Holidays .
b. Document for the owner automatic time switch programming (check all):
Weekdays settings
Weekend settings
Holidays settings
Set-up settings
Preference program setting
Verify the correct time and date is properly set in the time switch □ Verify the battery is installed and energized
D Override time limit is no more than 2 hours
Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in J)( accordance with the applicable provision in Section 119 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Annliance and Control Devices A. Select Acceptance Test (Indicate lighting control systems Names/Designations by the applicable tests below) ~ 1 Occupancy Sensor
□ 2 Manual Daylighting Controls
3 Automatic Time Switch Controls
8. Equipment Testing Requirements Applicable Lighting
Check and verify those items applicable to selected system: Control Systems Occupancy Sensor - Step 1: Simulate an unoccupied condition I 2 3 a. Lights controlled by occupancy sensors tum off within a maximum of30 minutes from {pN YIN YIN start of an unoccuoied condition oer Standard Section 119/ dl b. The occupant sensor does not trigger a false "on" from movement in an area adjacent @N YIN YIN to the controlled space or from HY AC operation c. Signal sensitivity is adequate to achieve desired control f'ON YIN YIN Occupant Sensor - Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly lYJN YIN YIN b. Lights controlled by occupancy sensors tum on when Immediately upon an occupied YIN YIN condition OR (this reouirement is mutuallv exclusive with Step 7.c.) c. Sensor indicates space is "occupied" and lights tum on manually {YYN YIN YIN continued on next page
1008 Nonresident,a/ Acceptance Forms August 2009
1711
LTG-2A
Project Name/Address: /
;,._ N t>,
System Location or Area Served:
OcCupant Sensor - Step 3: System returned to initial operating conditions Ml!N YIN YIN Occupant Sensor - Step 4 - Sensor is also a multi-Level Occupant Sensor used to qualify 010 for a Power Adjustment Factor in Section l46(a)2D of the Standards. If yes, then •a,' ·b; YIN YIN and 'c' must also be ves.
a. The first stage activates between 30 to 70% of the lighting either manually or /t'/£j YIN YIN ·automaticallv.
A reasonably uniform level of illuminance is achieved by dimming of all lamps or b. &fj) luminaires; or by switching al~emate lamps in luminaires, alternate luminaires. or YIN YIN alternate rows of lwninaires.
After the first stage occurs, m.inual switches have been provided to activate the && C. alternate set of lights, activatej!OO% of the lighting power, and manually deactivate all YIN YIN of the li~hts. '
Manual Daylighting Controls - Step I: Manual switching control a. At least 50% of lighting power in daylit areas is separately controlled from other lights YI YIN YIN b. The amount of light delivered to the space is uniformly reduced y YIN YIN Manual Daylighting Controls - Step 2: System returned to initial operating conditions YI YIN YiN Automatic Time Switch Controls - Step I: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch YIN YIN YIN b. Verify the switch only operates lighting in the ceiling-height partitioned area in which YIN YIN YIN the switch is located Automatic Time Switch Controlt- Step 2: Simulate unoccupied condition a. All non-exempt lighting turn off per Section 13 l(d)l YIN YIN Y/N Manual override switch allows only the lights in the selected ceiling height partitioned b. space where the ovenide switch is located, to tum on or remain on until the next YIN YIN YIN scheduled shut off occurs
c. All non-exempt lighting turns off YIN YIN YIN
Automatic Time Switch Controls - Step 3: System returned to initial operating conditions YIN YIN YIN Note: Shaded areas do not apply for particular test procedure I I I C. PASS/ FAIL Evaluation (check one):
ti PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Reauirements resoonses are oositive (Y - ves)
FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative {1'J - no) D responses in any applicable Equipment Testing Requirements section. Provide explanation below. Use and attach additional cages ifnecessarv.
2008 Nonresidential Acceptance Forms August2009
1712
LTG-2A
Prnject Name/Arirlrp_c;,_:
-ri'NIWT ll>'IJ'~aY. /':''"'MT
Enforcement Agency: Permit Number:
Note: Submit one Certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance.
FIELD TECHNICIAN'S DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am the person who perfonned the acceptance requirements verification reported on this Certificate of Accepr.ance (Field Technician). • I certify that the construction/installation identified on this form complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA 7.
• I have confirmed that the Installation Certificate(s} for the construction/installation identified on this form has been completed and is posced or made available with the building permit(s) issued for the building.
Fiel
Date Signed:
MA.AJ.
RESPONSIBLE PERSON'S DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California, that I am the Field Technician,. or the Field Technician is acting on my behalf as my employee ormy agent and I have reviewed the information provided on this fonn. • I am a licensed contractor, architect, or engineer, who is eligible under Division 3 of the Business and Professions Code, in rhe applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person).
• I certify that the infonnarion provided on this form substantiates that the construction/installation identified on this form complies \\.ith the ac~ptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms ro the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. • I have confirmed that the Installation Certificate(s) for the construction/installation identified on this form has been completed and is posted or made available with the building pennit(s) issued for the building. • I will ensure that a completed. signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner ar occupancy.
Phone:
s,2-) 9'1,0 -,430
License: Lie_. l! q3qo5 7 I +--
Occunant Sensor, Manual Davlightin2 Control~ and Automatic Time Switch Control Intent: I Lights are turned off when not needed per Section I 19(d) & 13 l(d).
Construction Inspection
I Instrumentation to oerfonn test includes, but not limited to:
a. I Hand-held ampern~e and voltage meter
b. ] Power meter
continued on next page
2008 Nonresidential Acceptance Forms August 2009
1713
LTG-2A
tance Document (Pa e 2 of3)
2 Occuwmcy Sensor Construction Inspection
IY Occupancy sensor has been located to minimize false signals D Light meter
□ Ultrasonic occupancy sensors do not emit audible sound (119a) 5 feet from source 3 Manual Daylighting Controls Construction Inspection
D
If dimming ballasts are specified for light fixrures within the day lit area, make sure they meet all the Standards requirements, including "reduced flicker operation" for manual dimmin2 control systems 4 Automatic Time Switch Controls Construction Inspection a. Automatic time switch control is programmed for (check all):
D Weekdays
□ Weekend
D Holidays
b. Document for the owner automatic time switch programming (check all):
D Weekdays settings
D Weekend settings
□ Holidays settings
□ Set-up settings
□ Preference program setting
D Verify the correct time and date is properly set in the time switch D Verify the battery is installed and energized
D Override time limit is no more than 2 hours
Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in D accordance with the applicable provision in Section 119 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Annliance and Control Devices A. Select Acceptance Test (Indicate lighting control systems Names/Designations by the applicable tests below) ref 1 Occupancy Sensor
D 2 Manual Daylighting Controls
D 3 Automatic Time Switch Controls
B. Equipment Testing Requirements Applicable Lighting
Check and verify those items applicable to selected system: Control Systems Occupancy Sensor - Step 1: Simulate an unoccupied condition I 2 3 a. Lights controlled by occupancy sensors turn off within a maximum of 30 minutes from {VIN YIN YIN start of an unoccupied condition oer Standard Section 1 I 9(d) b. The occupant sensor does not trigger a false "on" from movement in an area adjacent {!JN YIN YIN to the controlled soace or from HY AC ooeration C. Signal sensitivity is adequate to achieve desired control (V)N YIN YIN Occupant Sensor - Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly 1.Y)N YIN YIN b. Lights controlled by occupancy sensors turn on when Immediately upon an occupied - condition OR (this reauirement is mutuallv exclusive with Step 2.c.) YIN YIN C. Sensor indicates space is "occupied" and lights tum on manually (YJIN YIN YIN continued on next page
2008 Nonresuient,a/ Acceptance Forms August 2009
1714
LTG-2A
tance Document (Pa e 3 of3)
Occupant Sensor - Step 3: System returned to initial operating conditions r:vJ1N YIN YIN Occupant Sensor - Step 4 - Sensor is also a multi-Level Occupant Sensor used to qualify for a Power Adjustment Factor in Section l46(a)2D of the Standards. lfyes, then ·a,' ·b,' ()1N YIN YIN and • c • must also be ves.
a. The first stage activates between 30 to 70% of the lighting either manually or ff)N YIN YIN automatically.
A reasonably uniform level of illuminance is achieved by dimming of all lamps or tJN b. luminaires; or by switching alternate lamps in luminaires, alternate luminaires, or YIN YIN alternate rOws of lurninaires.
After the first stage occurs, manual switches have been provided to activate the (!)N C. alternate set of lights, activate 100% of the lighting power, and manually deactivate all YIN YIN of the lights.
Manual Daylighting Controls - Step 1: Manual switching control a. At least 50% of lighting power in daylit areas is separately controlled from other lights YIN YIN YIN b. The amount oflight delivered to the space is uniformly reduced YIN YIN YIN Manual Daylighting Controls - Step 2: System returned to initial operating conditions YIN YIN YIN Automatic Time Switch Controls - Step 1: Simulate occupied condition . a. All lights can be turned on and off by their respective area control switch YIN YIN YIN b. Verify the switch only operates lighting in the ceiling-height partitioned area in which YIN YIN YIN the switch is located Automatic Time Switch Controls - Step 2: Simulate unoccupied condition a. All non-exempt lighting tum off per Section 13 I ( d) I YIN YIN YIN Manual override switch allows only the lights in the selected ceiling height partitioned b. space where the override switch is located, to tum on or remain on until the next YIN YIN YIN scheduled shut off occurs
c. All non-exempt lighting turns off YIN YIN YIN
Automatic Time Switch Controls - Step 3: System returned to initial operating conditions YIN YIN YIN Note: Shaded areas do not apply for particular test procedure I I C. 'PASS I FAIL Evaluation (check one):
J PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Reauirements resoonses are nositive (Y - ves l
FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative (N - no) D responses in any applicable Equipment Testing Requirements section. Provide explanation below. Use and attach additional pages ifnecessarv.
2008 Nonresidential Acceptance Forms August 2009
1715