HomeMy WebLinkAboutCBPR-05-2016-23923.TIF T \ii, \ tisi Catawba County Public Health
COUNTY . . . www.catawbacountync.gov/environmentalhealth
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.' a _ Environmental Health
North Garouno
P.O. Box 389, 100-A South West Blvd., Newton, NC 28658
Phone (828) 465-8270. Fax (828) 465-8276
Case#
Property Location
Street Address 1 `r 10 AT covri-+h2.k D2 . 6w or nta fltN)
City NEUT-oKi , }4 c...
Zip 28(7S8
Business Name: Levees 7FAvEL S-rnPs
Mailing Address Io&ol M. PgNN57LVAr444- AVE
Address 2
City *LA Ham crrr , oJk
Zip '7312.o
Phone l- goo -(ass• 6e37
Operator Name
E mail address
Mailing Address
City
Zip
Phone
Architect (if applicable) ?As cal ,vvl•h�.Y 4 Assoc.
E mail address Pa5CAL t. PAccALAg-ot+. Co&t
Contact Address 131 13P-fl hN RA.
Address 2
City okttlNoMa cArr , ok
Zip 73111-
Phone 4o5- +6o3 • 3414
Contractor (if applicable) N/A. .
Contact Address
Address 2
City
Zip
Phone
Water Supply Type ❑ Individual Well 0 Community Well (` Public Water Unknown
Sewer Supply Type H Individual Septic NI Public Sewer ❑ Unknown
All applicable information must be provided prior to submission
Contact Environmental Health r a slicable fees
Applicant Signature till, a ____- Date 5'/AL
g T \ \ it Catawba County Public Health
COUNTY www.catawbacountync.gov/environmentalhealth\
"y""�°I No th C;roicnc Environmental Health
P.O. Box 389, 100-A South West Blvd., Newton, NC 28658
Phone (828) 465-8270. Fax (828) 465-8276
Food Establishment Plan Review Application
Type of Construction: NEW 15d. REMODEL ❑ EXISTING
Name of Establishment: LOVES TRANeL S'NP
If existing, please give name of old establishment if known:
Address: 1-Lutr Ifl AT SovTi-hWolzV DR. . ( t.,1 of NiEsvrvN)
City: _ 1-IEt.,Tfl1J I NC-. Zip Code: Zt498
Phone (if available): N/s. - Fax: - -
Owner or Owner's Representative: 19YEg 712AvE.t. STOPS
Address: locsol • • PEMNSYLVAi4 LA AVE.
City & State: dfe.LAt4oM4 cirri' , ok Zip Code: 7x17.-0
Telephone: 900 - (&CS - 0837 Fax: -
E-mail Address: CoM,✓weN-ts cc, lows . taM
Submitter: tZKab 6ALLA6.14£R.•
Company: PASCAL A-t2t.FLY 4" ASsoc.
Contact Person: F3RA2 CALLAGI-ltP-
Address: q31 E. 15RITVDN Lb.
City & State ok-LALIGMf4 GATT , o k Zip Code: 731141-
Telephone: 405 -4(03 - 31-.4I4 Fax: -
E-mail Address: $RAD (0_ PAscs;LARCN . G.oltti
Title(owner, manager, architect, etc.): ARt4N-1-Mc- 'r
I certify that the information in this application is correct, and I understand that any deviation without
prior approval from this Health Regulatory Office may nullify plan approval.
r
Signature:
(Owner ory„ -spc7r;;Thie Representative)
Hours of Operation:
Sun x Mon X Tue x Wed x Thu X Fri X Sat .)C
Projected number of meals served between product deliveries:
Breakfast: Ba Lunch: 129' Dinner: 140
Number of seats: COD Facility total square feet: 2, i nc.6 C-W RoeES
Projected start date of construction: Projected completion date: Nor 1eNOwn1 .
TYPE OF FOOD SERVICE: CHECK ALL THAT APPLY
r/Restaurant Sit-down meals
Food Stand _Take-out meals
Drink Stand Catering
I I Commissary Single-sew c(disposa e):
Plates MGlassware Silverware
n Meat Market
Multi-use (reusable):
n Other (explain): (Plates I 'Glassware nSilverware
Indicate any specialized processes that will take place:
Curing n Acidification (sushi, etc.) n Reduced Oxygen Packaging (eg: Vacuum)
Smoking n Sprouting Beans I Other
Explain checked processes:
Indicate any of the following highly susceptible populations that will be catered to or served:
Nursing Home I Child Care Center Health Care Facility
ssisted Living Center School with pre-school aged children
MINA
Please Enclose the Following Documents
• Proposed menu items (including seasonal variations in the menu). ✓
• Manufacturer specification sheets for each piece of equipment shown on plans. I/
• Site plan showing location of business in building, location of building on site including alleys, streets
and location of any outside facility (dumpster, walk-ins, etc.). ✓
• Plan of facility drawn to scale showing location of equipment, plump ng, electrical service and
mechanical ventilation, including location of all electrical panels.
Contents and Format of Plans and Specifications
I. The plans should be a minimum of I I X 14 inches in size and the layout of the floor plan accurately drawn to a
minimum scale of 1/4 inches = I foot. This is to allow for ease in reading.
2. Information accompanying the plans should include; the proposed menu, seating capacity, projected daily meal
volume for food service operation.
3. The plans should show the location and when requested elevated drawing of all food service equipment. Each
piece of equipment shall be clearly labeled on the plan with its common name.
4. Adequate rapid cooling including ice baths and refrigeration, and hot-holding facilities for potentially hazardous
food (PHF) should be clearly designated on the plan.
5. When menu dictates, separate food preparation sinks should be labeled and located to preclude contamination
and cross-contamination ofraw and ready to cat foods.
6. Adequate hand washing facilities used for no other purpose should be designated for each toilet facility and in
the immediate area of food preparation and dishwashing area.
7. The plan layout should contain room size, aisle space, space between and behind equipment, and the placement
of the equipment on the floor.
8. Auxiliary areas such as storage rooms, garbage rooms, toilets, basements and/or cellars used for storage or food
preparation should be represented on the plan and all features of these rooms shown as required by the
standards.
9. The plans and specifications should also include:
A. Entrances, exits, loading/unloading areas and docks;
B. Completed finish schedules for each room to include floors, walls, ceilings and coved juncture bases;
approved materials for food preparation, handling and storage areas include quarry tile, ceramic tile, sealed
concrete, commercial linoleum, fiberglass reinforced panels, stainless steel, wall board painted with
washable, nonabsorbent paint, vinyl coated ceiling tiles, and brick, cinder blocks, slag blocks, or concrete
blocks, if glazed, tiled, plastered or filled so as to provide a smooth surface. If specifying the use ofa
material not on this list, include a sample of the material for evaluation.
C. Plumbing schedule to include location of the floor drains, floor sinks and water supply lines, overhead
waste water lines, hot water lines, hot water generating equipment with capacity and recovery rate,
backflow prevention, waste water line connections. Electrical layout, electrical panels and disconnects.
10. Lighting Requirements;
A. Surfaces where a food employee is working with food or working with utensils or equipment such as
knives, slicers, grinders or saws where employee safety is a factor at those levels: 50 foot candles (540 lux)
B. In walk-in refrigeration units and dry food storage areas and in other areas and rooms during periods of
cleaning at a distance of 30 inches (75 cm) above the floor: 10 foot candles (108 lux)
C. Lighting in utensil washing area and on food contact surfaces shall be measured at 30 inches (75 cm) above
the floor and/or at the work levels and equipment and utensil storage and toilet rooms: 20 foot candles (215
lux)
D. At surfaces where food is provided for consumer self-service such as buffets and salad bars or where fresh
produce or packaged foods are sold or offered for consumption, inside equipment such as a reach-in and
under-counter refrigerators: 20 foot candles (2151ux)
E. Light bulbs in food preparation, storage, and display areas shall be shatter-proof or shielded so as to
preclude the possibility of broken bulbs or lamps falling into food. Shatter-proof or shielded bulbs need not
be used in food storage areas where the integrity of the unopened packages will not be affected by broken
glass falling onto them and the packages, prior to being opened, are capable of being cleaned. Heat lamps
shall be protected against breakage by a shield surrounding and extending beyond the bulb; leaving only the
face of the bulb exposed in food preparation area.
11. Insure that all food service/kitchen equipment is NSF International (NSF) listed, Underwriters
Laboratories Inc., Classified for Sanitation or if not NSF or UL listed/classified, be constructed to meet NSF
standards as specified according to 15A NCAC I 8A .2600, Rule .2617 paragraph (d).
12. Source of water supply and method of sewage disposal. The location of these facilities should be shown and
evidence submitted that state and local regulations are to be complied with.
13. As specified according to 15A NCAC 18A .2600, Rule .2632 "Storage Spaces". All items stored in rooms
where food or single-service items are stored shall be at least 12 in. (30.48 cm.) above the floor when placed on
stationary storage units or 6 in. (15.24 cm.) above the floor when placed on portable storage units or otherwise
arranged so as to permit thorough cleaning.
14. Ventilation schedule for each room.
15. A mop sink with facilities for hanging wet mops and storage of mop buckets. As specified according to 15A
NCAC I8A .2600, Rule.2626, "Disposal Of Waste". Facilities shall be provided for the washing and storage of
all garbage cans and mops. These facilities can be incorporated into ajanitor closet.
16. Garbage can washing area/facility. As specified according to 15A NCAC 18A .2600, 2009 NC Food Code
Manual 5-203.13, "Plumbing Systems". Adequate facilities shall be provided for the washing and storage of all
garbage cans. The cleaning facilities shall include a combination faucet, hot and cold water, a threaded nozzle
and a curbed impervious pad,a minimum recommended size of 36" x 36" x 4" with walls finished being easily
cleanable and nonabsorbent to a height of 48 inches. A shelf may also be provided for the storage of cleaning
supplies and/or chemicals. If the unit is utilized as a combination can wash/mop sink than the minimum
recommended size for this unit is 36"by 36".
17. Dumpster pad and location as specified according to 15A NCAC 18A .2600, 2009 NC Food Code Manual 5-5
Refuse, Recyclables and Returnables".
18. Grease traps and/or grease interceptor location.
19. Grease storage containers and storage location.
20. Cabinets/shelves for storing toxic chemicals.
21. Dressing rooms, locker area, employee rest area, and/or coat rack as required.
22. Completed checklist.
23. Site plan (plot plan)
COLD STORAGE
Method used to determine cold storage requirements:
Cubic-feet of reach-in cold storage: 31.1 c-C'. Cubic-feet of walk-in cold storage: 2,0175 0) .4.
Reach-in refrigerator storage: 11.5 ft3 Walk-in refrigerator storage: 12Z* ft3
Reach-in freezer storage: 29.2 ft3 Walk-in freezer storage: 1151 ft3
Number of reach-in refrigerators: 2 MiN•
Number of reach-in freezers:
HOT HOLDING
Food that will be held hot:
.‹..4NDW1cH ES . FRIES , ETG. S E E. A T r A a r e b / ENJ
COLD HOLDING
Food that will he held cold:
SEE A-ITAUFED /WEtai
COOLING
Indicate by checking the appropriate boxes how cooked food will be cooled to 45°F (7°C) within 6 hours.
If"Other" is checked indicate type of food:
Cooling Process Meat Seafood Poultry Other
Shallow Pans ❑ 1 f ❑
Ice Baths I I ❑ ❑
Rapid Chill
THAWING
Indicate by checking the appropriate boxes how food in each category will be thawed.
If"Other" is checked indicate type of food: ro-r -rves (F-REn,Lcµ FP tES)
Thawing Process Meat Seafood Poultry Other
Refrigeration ❑ ❑
Running Water less than 70°F (21°C) ❑ ❑ n
Cooked Frozen
Microwave V �✓�
FOOD HANDLING PROCEDURES
Explain the following with as much detail as possible. Provide descriptions of the specific areas of the
kitchen and corresponding items on the plan where food will be handled.
Explain the handling procedures for the following categories of food. Describe the process from receiving to
service including:
• How the food will arrive (frozen, fresh, packaged, etc.)
• Where the food will be stored
• Where (specific pieces of equipment with their corresponding equipment schedule numbers) and how
the food will be handled (washed, cut, marinated, breaded, cooked, etc.)
• When (time of day and frequency/day) food will be handled
1. READY-TO-EAT FOOD HANDLING (edible without additional preparation necessary, e.g.,
salads, cold sandwiches, raw molluscan shellfish)
SYDREb IN ek-1N coot g. art 2E.FR..6E@+T612. PEI2. PP,cD Jett 114nifeR42N5
012- tzEt0A%wvG NOAc-rLONS,
2. PRODUCE HANDLING
a. Will produce be washed or rinsed prior to use? Yes / No
b. Is there an approved location used for washing or rinsing produce? Yes ✓ No
c. Will it be used for other operations? Yes No ✓
Please indicate location of produce washing equipment and describe the procedures. Include time of day and
frequency for washing or rinsing the produce at this location:
SEPERA"re PREP LIME VSED Fop.. Foot USED 1.-11-1-0,-N NFECet> D✓RIg1. 'RIc UAY.
3. POULTRY HANDLING
a. Will poultry be washed or rinsed prior to use? Yes No V.
b. Is there an approved location used for washing or rinsing poultry? Yes No ✓
c. Will it be used for other operations? Yes No ✓
Please indicate location of poultry washing equipment and describe the procedures. Include time of day and
frequency for washing or rinsing the poultry at this location:
l'OVlnt LIIL(. LIkeor Ba cooIdED FROM FRa2Eu +- gar 1,171/4c14 ED,
4. MEAT HANDLING
a. Will pork and red meats be washed or rinsed prior to use? Yes No
b. Is there an approved location used for washing or rinsing pork and red meats? Yes No ✓
c. Will it be used for other operations? Yes No ✓
Please indicate location of meat washing equipment and describe the procedures. Include time of day and
frequency for washing or rinsing the meat at this location:
&NEAt LOLL LI Ice LY Be. Look E.b PWoAA P9.OZ.EN t Alar L J SN-EA.
5. SEAFOOD HANDLING
a. Will seafood be washed or rinsed prior to use? 1J/Q. • Yes No ✓
b. Is there an approved location used for washing or rinsing seafood? Yes No ✓
c. Will it be used for other operations? Yes No V
Please indicate location of seafood washing equipment and describe the procedures. Include time of day and
frequency for washing or rinsing the seafood at this location:
N/A, .
DRY STORAGE
Provide information on the frequency of deliveries and the expected gross volume that is to be delivered each
time:
Square feet of dry storage shelf space: 1+3 1ft2 CACmAL SH ELF SPaoe'
Where will dry goods be stored? 11-fEwiM14, i RACKS IN PAOk of 1+ayse 5113 e ASEAS.
FINISH SCHEDULE
Indicate floor, wall and ceiling finishes (e.g., quarry tile, stainless steel, vinyl coated acoustic tile)
Area Floor Base Walls Ceiling
A
Kitchen ct 5415 P
11 LE COVED TLE FRP/S.S. WA TILES
Bar N/A
Ace— Susf
Food Storage '1LE £PveA ice Fiz.F L✓ADf TILES
Dry Storage AGE. Sul p
y b "TILE I�VED TLE 1•'K.lo L■z,5 H. TILES
Love GTLE) (LO46� m.e)
Toilet Rooms N 4 N/A. LE 'tlL8
Dressing Rooms
Garbage & Refuse
Storage 1.4,/A
Service Sink Gave-D
Pi
(mop/trash can wash) 'Tl.!` 'TILE t?
Other
Other
WATER SUPPLY-SEWAGE
1. Is water supply: Municipal VWcllf i Is sewer: MunicipalVSepticfl
2. Will ice: be made on premisesf�or purchased
3. Water healer:
• Tank type:
a. Manufacturer and model: BRaoFolti% (A4Ih Er- loot — IS a E - 3t4
b. Storage capacity: &c gallons
• Electric water heater: kilowatts (kW)
• Gas water heater:I S o k BTU's
c. Water heater recovery rate(gallons per hour at 80°F temperature rise): ill GPH
(See Water Heater Calculator on the Plan Review Unit website to calculate recovery rate needed)
• Tankless:
a. Manufacturer and model: N/Ar
b. Quantity of tankless water heaters: 0
4. Check the appropriate box indicating equipment drains:
Indirect Waste Direct Waste
Plumbing Fixtures Floor sink Hub Drain Floor Drain
Warewashing Sink U✓/si ❑ ❑ V
Prep Sinks 'U✓ ❑ ❑ V
Handwashing Sinks V ❑ ❑ Er
Warewashing Machine ❑ ❑ ❑ ❑
Ice Machine ❑ ❑ ❑
Garbage Disposal ❑ ❑ ❑ ❑
Dipper Well ❑ ❑ ❑ ❑
Refrigeration ❑ ❑ ❑ ❑
Steam Table ❑ ❑ ❑ ❑
Other ❑ ❑ ❑ ❑
Other ❑ ❑ ❑ ❑
WAREWASHING EQUIPMENT
a. Manual Warewashing
1 . Size of sink compartments (inches): Length: 2tr Width: ¶S' Depth: ft--
2. What type of sanitizer will be used?
Chlorine: Iodine: n Quaternary Ammonium: n Hot Water: V] Other(specify): 1
b. Mechanical Warewashing
Will a warewashing machine be used? Yesn NoV
Warewashing machine manufacturer and model:
2. Type of sanitization: Hot water(I80°F)1f Chemical
c. General
1. Describe how cooking equipment, cutting boards, slicers, counter tops and other food contact surfaces
that cannot be submerged in sinks or put through a dishwasher will be cleaned and sanitized:
L4? D CA.EaN LJ\Th- SAUr TM.PAL
2. Describe location and type(drainboards, wall-mounted or overhead shelves, stationary or portable
racks) of air drying space:
Square feet of air drying space: ft2
HANDWASHING
Indicate number and location of handwashing sinks:
14A40 $INKS (oNE AT LrARe t.1 s-fgr , AREA, °NE AT Fool) ?)z€P ot4e Ar DLit - 77+(29)
EMPLOYEE ACCOMMODATIONS
Indicate location for storing employees' personal items:
OFFic- AP-EAr ciTh+ $PIa vas •
REFUSE AND RECYCLABLES /
Will refuse be stored inside? Yes No N./
If yes, where
2. Provision for refuse disposal: Dumpster n Compactor V
3. Provision for cleaning dumpster/compactor: On-site I Off-site V
If off-site cleaning, provide name of cleaning contractor: O fl4ap_ PR.ov IDc�
4. Describe location for storage of recyclables: (cooking grease, cardboard, glass, etc.):
IF ILEo-cc asues LMLL SE STORED IY W1LL,13E OVt'IOE We.4R. CCJWPAc-Telt
ENGLo5(.72E-- •
SERVICE SINK
1. Location and size of service (mop) sink/can wash: 2.'t w3(,
2. Is a separate mop storage area provided? Yes No If yes, describe type and location:
NLof FAO GIt-
INSECT AND RODENT CONTROL
1. How is protection prided on all outside doors?
Self-closing door Fly Fan fl Screen Door
2. How is protectio provided on windows?
Self-closing Fly Fan Screening
LINEN
1. Indicate location of clean and dirty linen storage:
STORED IN bK.Y AREA
POISONOUS OR TOXIC MATERIALS
1. Indicate location of poisonous and/or toxic materials (chemicals, sanitizers, etc.) storage:
S1btEO OFF Flood IN l'eniPERji1VRE [ urito -es) AR.eo
Catawba County Environmental Health
P.O. Box 389, 100-A South West Blvd., Newton, NC 28658
Phone (828) 465-8270. Fax (828) 465-8276
www.catawbacountync.gov/environmentalhealth
AT-
-
Hazard Analysis Critical Control Plan
A 's r- Dan
All Company & Franchise Restaurants
f A ' ` Hazard
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; , Analysis
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Key Contacts:
Title Name Phone #
Hardee's Quality Assurance Angela Sanchez 714-254-4556
Franchisee:
FBC:
Other Contact:
L r ont;,. , Assessment Information
Menu
Hardee's Food Systems (Hardee's/Red Burrito) is a quick service restaurant chain (1935
restaurants in 31 states domestically and 12 countries) owned, operated and franchised by CKE
Restaurants Inc. serving breakfast (made from scratch biscuits/breakfast sandwiches and platters,
lunch and dinner (burgers, sandwiches, chicken). Restaurants dual branded with Red Burrito
serve quick service Mexican Fare (tacos, burritos). Complete menu can be accessed at:
http://www.hardees.com/menu/nutritional calculator landing
Food Preparation/ Service Systems
✓ Process 1-Receive-Store-Prepare-Hold-Serve
✓ Process 2-Receive-Store-Prepare-Cook-Hold-Serve
✓ Process 3-Receive-Store-Prepare-Heat-Cool-Reheat-Hot Hold-Serve
Measures taken to reduce risks include:
Ingredients
• Pasteurized Liquid Eggs
➢ Fully Cooked Animal Products
• Hamburger- (Little Thickburgers (1/4 Ib)., 1/3 pound & $6 Angus Thickburger),
• Chicken (BBQ fillet)
Turkey Burger
RTE prepared sauces or mix with water sauces
• Non-PHF sauces & cheese
Product Specific SOPs (Details regarding Hardee's Policies/Procedures can be found in the
Operations Procedures Manual (OPM); SOPs are HACCP based with CCPs/Corrective Actions
identified.)
Menu Standards to Reduce Risks include:
Cook to order
• Prohibited emergency thaw procedures for high risk foods (raw meat/chicken)
• Discard end of day (leftover procedures only allowed for small number of items)
• Timing systems for quality control / shelf life controls more stringent than Food Code
requirements
Equipment Specifications/Settinqs
Equipment specifications/settings (ex. Chain speed on Charbroiler, Fryer & microwave
settings). Verification Studies to determine compliance with CCPs
✓ Color coded utensils and wiping cloths
➢ Automated/metered Sanitizer Dispenser
Population Served
General Public (not designated as a facility serving highly susceptible populations as defined in
FDA Model Food Code)
2
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General Food Handling
lnfor ration & Procedures
Approved Source
CKE has a robust Quality Assurance Department that sources approved vendors using a farm to fork, HACCP
based approach. The Quality Assurance (QA) Department has continuous feedback systems in place to monitor
vendor compliance to CKE's strict food safety and quality criteria" All restaurants are required to source products
from approved vendors using MBM (food, paper goods, chemicals, smallwares) and HED (equipment) distribution.
Supply chain data base and management teams provide feedback to ensure compliance with vendor source
requirements.
Preventing Cross Contamination from Raw to Cooked/RTE foods
Hardee's Operations Procedures Manual (OPM) Section 401 outlines systems in place to prevent cross
contamination from Raw to Cooked/RTE foods (color coded utensils, designated prep areas (kitchen layout),
separation of prep steps by daypart, use of fully cooked products when possible, etc.). QA reviews all proposed
food preparation procedures to ensure compliance with Food Safety requirements to prevent cross contamination"
Changes in operations procedure to improve food safety concerns are also vetted through Corporate support
departments (QA, Operations, Training, Product Development. etc)"
Thawing Procedures
Hardee's Operations Procedures Manual Section 600 outlines thawing guidelines. As a general practice all foods
are thawed under refrigeration. Emergency thaw procedures are only allowed for specified menu items (no raw
animal products). Raw hamburger patties are cooked from a frozen state. Approved Hierarchy on thaw racks/walk-
in shelving is designated in OPM to prevent cross contamination during thaw steps.
Cooling Procedures
Hardee's Operations Procedures Manual Section 401 outlines 2-stage cooling. Products are placed into shallow
pans and placed in the walk in freezer for 30 minutes to rapidly reduce temperatures. Product is then transferred to
walk-in cooler to ensure cooling to 70"F within 2 hours and 41°F within 4 hours (6 hrs total). This procedure has
undergone verification study (results available upon request).
Prepared PHF Foods with hold time/opened shelf life greater than 12 hrs
Hardee's Operations Procedures Manual Section 200 outlines shelf life for all items. Hardee's uses designated
timing systems to monitor hold times/shelf life"
Delivery/Catering Services
Hardee's does not deliver prepared foods. Red Burrito Catering is for pick up by guest only.
Frozen Foods (storage < 41'F)
Hardee's OPM Section outlines requirements for frozen storage (maintain all freezers at 0°F). Daily Temperature
Tracking Form (DTTF) is completed by PIC and verifies product is hard frozen. OPM Section 405 provides
guidelines/criteria for disposition of foods during power/equipment failure"
On-site ROP Processes
Hardee's does not do any onsite ROP.
Time as a Public Health Control (TILT)
Hardee's uses Time as a Public Health Control for cut PHF produce (sliced tomatoes/lettuce) and sliced processed
cheese at the dress table. Other timing systems are in place for quality" Written procedures can be found in OPM
section 701 and complies with Time Control Requirements set forth in FDA Food Code (4 hrs only).
3
Process Approach HACCP
irWeiiitagnelLitzt
Com tedri t- 9-4cre ige -1.", 4
tc 136,F � p' V- -
gisSCre ss eon ZpiAAklAiV-,YAZ xS',
141=F��O � Ns"" n�,
;. No Cook Same De Y� COmPlez't§V
, , Danger Zone Diagram' e
Process #1 , Food Preparation with no Cook Step
Menu items: Cut Tomatoes, Cut Lettuce, Milkshakes, Red Burrito Fresh Cut Salsa, Deli
Meats
CCP Procedures Monitoring Corrective Action Verification
Cool in walk-in refrigerator Check internal product Relocate foods <41°F for Manager review of Daily
to or below 41 T with in 4 temperature at 3 day parts less than 2 hrs to alternate Temperature Tracking
hrs, keep in cold storage refrigeration unit. Discard Form. 3rd party audit verity
at 41'F until service or foods that have been completion of Daily
held under Time as a >41'F for longer than 2 Temperature Tracking
Public Health Control hours or time could not be Logs.
(make line sandwich verified.
produce-4hrs)
Process #2, Food Preparation Same Day Service
Food Preparation for Same Day Service (Refrigerated storage per Process#1)
Menu items: Breakfast Biscuit Sandwiches, Sandwiches & Burgers, Hand Breaded Chicken
Tenders/Bone-in Fried Chicken, Roast Beef, Fried Meat Patties/Sides
CCP Procedures Monitoring Corrective Action Verification
Cook/Heat (grill-top, Crew member takes Continue cooking until Manager review of Daily
oven/AltoSham, fryer) to: random internal cook final required cook Temperature Tracking
Raw Ground Beef Patty temperatures temperature is achieved. Form. 31d party audit verify
(9:1): 160"F completion of Daily
Fully Cooked (1/31b, 1/41b, Crew and PIC take Product not maintained at Temperature Tracking
Angus Beef) Patties: 140T temperature readings at 140T must be discarded. Logs.
Raw Chicken: 165°F specified time intervals
Fully Cooked Chicken: and record on Daily
140"F Temperature Tracking
Fish:155°F Logs.
PotatoesNeg etables: 140°F
Red Burrito Beans, Rice,
Steak, Chicken, Taco Beef
(fully cooked): 145°F
Hot Hold (steam table,
overshelf): 165T
4
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'r®case Approach HACC (tont). :t
Process #3, Complex Food Preparation
Preparation (Cold store per Process #1, cook and hot hold per Process#2)
Menu items: Breakfast Sausage for Sausage Gravy, Chili, Mushroom Sauce, Red Burrito
Beans, Red Burrito Rice
CCP Procedures Monitoring Corrective Action Verification
Place unused product in Temperature decent for If product is not at 41F. Manager review of Daily
shallow Y size pans. With Cooling process has been discard. Temperature Tracking
product thickness no more verified with Lab Study for Form. 3rd party audit verify
than 2"thick. Cool each process 3 food item completion of Daily
product in walk-in freezer Temperature Tracking
for 30 minutes. After 30 Breakfast Sausage is Logs.
minutes, transfer to walk- cooled during normal
in cooler on upper shelves business hours and
(make sure sufficient decent is monitored by
airflow to facilitate crew members.
cooling). Cool from 135°F
to 70'F with-in 2 hours Crew member takes
and from 70°F to 41'F temperature prior to
within an additional 4 reheating.
hours.
Reheat food in microwave Check internal Continue to reheat until Manager review of Daily
to 165'F and hot hold on temperature product reaches 165°F. Temperature Tracking
steam table. Form &Waste Logs.
5
kN a y * , C '. f F lf W t �a-11° ti /
Equipment List
Equipment Specification Sheets available upon request
Cold Holding
* Walk-in Freezer
* Walk-in Cooler
* Reach-in Coolers/Freezers (in prep areas)
Food Preparation
* Commercial food preparation equipment (tables, work surfaces) (ANSI certified for
sanitation)
• Food preparation sink_
Cooking
* Chain Driven Charbroiler
* Fryer
Flat Grill
Convection Oven
* Alto-Shaam
Barbeque King Cooking Oven
Hot Holding
Steam Table
* Warming Drawers
Alto-Shaam
Cooling
Walk-in Freezer
Walk-in Cooler
Handwashinq
Hand wash sink located proximal to food preparation areas; equipped with hot and cold
running water to ensure 100T water and stocked with antibacterial soap, paper towels &
hand sanitizer
Cleaning & Sanitizing Food Contact Surfaces
* 3-compartment Sink-manual sanitization
• Dishmachine (not in all restaurants)
6
^+ r .. + guci._H�y: ..sa+ c' m: E y, , a^.,;y�r..$ e2� a+i t vt cg >.
� '��:�. .� F '}� .r u�r,�:?9� �atMla'h'r M'�'*.'`f•x �� s��'s
ti
Training Standards
New Crew Member Orientation
Upon hire, all Employees will be trained to use the approved HACCP plan and annually
thereafter. The approved HACCP plan will be available to the PIC at all times. Additionally,
before actually beginning to work in production, all employees are required to watch our Food
Safety DVD during orientation. Food Safety Orientation includes Handwashing procedures,
cleaning & sanitizing utensils, equipment & food preparation surfaces. All employees are trained
to calibrate a metal stem thermometer and calibration of the thermocouple is done daily; prior to
logging any temperatures.
Employees are then trained one-on-one with a trainer on actual work stations to learn our food
safety procedures per our OPM standards (as summarized in our HACCP plan). In addition, all
employees are taught to maintain daily temperature tracking logs (kept on file) involving several
of our products to insure the safety of food that is served to our guests at all times.
At least one person per restaurant has taken an approved Food Manager Certification Training
Course and completed an ANSI accredited Food Manager Certification Exam
Coaching, Refresher Training & Third Party Oversight
Management (PIC) routinely "paths" the restaurant to monitor and ensure that Hardee's
procedures are being implemented and executed. If issues are observed, the PIC takes
immediate steps to initiate the necessary immediate corrective action. The PIC also conducts
crew member coaching and review of proper Hardee's. Operations Procedures (applicable OPM
section) as part of their on-going corrective action. The PIC makes management aware of
trends to ensure the all necessary steps are taken to address and correct the issues. These may
include initiating special "Refresher Training courses" with Hardee's Training Materials/
Personnel and or initiating necessary disciplinary action.
Daily Temperature Tracking Forms (DTTF) are kept on file in the restaurant and available for
inspection. DTTF is reviewed by General Manager and Upper Management to ensure
completion and appropriate corrective action is taken when CCP is not achieved.
As an added oversight, we have a third party unannounced Food Safety Audit Program. This
helps reinforce that employees are systematically and properly following all food safety
procedures and standards and makes management aware of any trending operational
deficiencies. Our audit provider, conducts these audits three times every year during various
restaurant hours of operation.
New Menu Item Training
Whenever Hardee's introduces a new menu item, all employees are required to get properly
trained/certified by our management staff/Regional Training Managers regarding the food safety
procedures of that menu item. New Menu Items SOPs are HACCP based. A copy of the
Resource Guide is available for inspection. Any additional questions/documentation regarding
SOP/food items can be obtained from the Quality Assurance Department.
7
Training Certification
t° — tt0
HACCP - Hazard Analysis Critical Control Point
*` Post this Certification Roster on the bulletin board **
Crew Training
Crew Person's Name Date Trainer's Person's
Initials nest
Please Complete and Maintain available for Inspection. Training must be completed upon hire/annually
Restaurant Training has been completed on all above Crew Persons: Date
GM Signature
District Manager/Franchise Business Consultant Follow-up completed: Date
DM/FBC Signature
8
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2012 APPENDIX B
BUILDING CODE SUMMARY
FOR ALL COMMERCIAL PROJECTS
.(EXCEPT 1 AND 2-FAMILY DWELLINGS AND TOWNHOUSES)
• (Reproduce the following data on the building plans sheet 1 or 2)
(101\i/V A1C-G S'T>7.7RE
•
Name of Project: vTo ty Mc t-o V F S ItiV'FL_ slap.
Address: 1-1/4 4aY 110 AT SoV17-lreRk DR.. of Nea,.rm p Code Z$(r 5
Proposed Use: Co M.I✓-E Itcl A l..
Owner/Authorized Agent:PASCAL, Atfbl{IRYPhone# ( 4o5 ) 4 3 - 34g4 E-Mail ?ASCAL f pASCALA P-c4--Les
Owned By: ❑ City/County Private ❑ State •
Code Enforcement Jurisdiction: ❑ City County ❑ State
LEAD DESIGN PROFESSIONAL: - 'PAS CAL_ AtZl-t i KY 1" ASSoL
DESIGNER FIRM NAME LICENSE# TELEPHONE# E-MAIL
. Architectural _r±401,&.. d1,24TR-Y PA cC4L ALR MT t (t2 1L(03 34-14 PAS C4L0 PAS CAI-Afzcx
Civil bMP 5K144. LES1....r.YEN4644D (3 } 886- 9792.1 DMr- IN46,.M .cJrv�
Electrical M-fr X1.16, 5c.w Lfz.JMLEY (417C) 24'C 28-((e Sc�„yi -CV M TFF.NGINt
Fire Alarm ( ) EFINb, toAA
Plumbing MTF Et3{a Sear ccNMLEY (1-0'>) 744' PACK" scaiM.L£rcI Nt7Ffu6!14
Mechanical M-fF EI4 ScaTFGCPMLEY CI-K (0c 781 t r £e,e-INc.40s+-
Sprinkler-Standpipe ( )
Structural 1„JILLFT El . 444“-- ( RLt--T- (77 o) 27D -94Q4- Mwiu-ereLALLErtialN
Retaining Walls>5'High (- ) ££WIN6-�6
Other ( )
2012 EDITION OF NC CODE FOR: 1Rew Construction ❑ Addition ❑ Upfit
EXISTING: ❑ Reconstruction ❑ Alteration ❑ Repair ❑ Renovation
CONSTRUCTED:(date) IJ ORIGINAL USE(S) (Ch. 3):
RENOVATED: (date) CURRENT USE(S) (Ch. 3):
PROPOSED USE(S) (Ch. 3):
BASIC BUILDING DATA
Construction Type: ❑I-A ❑ A ❑ III-A ❑ IV ❑ V-A
(check all that apply) ❑ I-B II-B ❑ III-B ❑ V-B
Sprinklers: � 10 Partial ❑ Yes ❑ NFPA 13 ❑NFPA 13R ❑ NFPA 13D
F
Standpipes: No ,0/Yes Class ❑ I ❑ II ❑ m Wet ❑ Dry
Fire District: ❑No Imo'Yes (Primary) Flood Hazard Area: ❑No ❑ Yes
Building Height: (feet) n,2$ C0
Gross Building Area:
FLOOR EXISTING (SQ FT) NEW (SQ FT) SUB-TOTAL
6`°Floor •
5`° Floor
4th Floor
3rd Floor
2' Floor
Mezzanine
1st Floor J 1,B/o • 1-S SAC
Basement
TOTAL
2012 NC Administrative Code and Policies
ALLOWABLE AREA
Occupancy:
Assembly ❑ 1 c -2 ❑ A-3 ❑ A-4 ❑ A-5
Business
Educational ❑
Factory ❑F-I Moderate ❑F-2 Low
Hazardous ❑ H-I Detonate ❑ H-2 Deflagrate ❑ H-3 Combust ❑ H-4 Health ❑H-5 1-PM
Institutional ❑I-I ❑ I-2 ❑ I-3 ❑ 1-4
1-3Candiyon ❑ 1 D ❑ 3 E 0
Mercantile �/
Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4
Storage ❑ S-I Moderate ❑ S-2 Low ❑ High-piled
❑ Parking Garage ❑ Open ❑ Enclosed ❑ Repair Garage
Utility and Miscellaneous ❑
Accessory Occupancies: , •
�
Assembly ❑ )J/1 A-2 ❑ A-3 ❑ A-4 ❑ A-5
Business
Educational ❑
Factory ❑ F-1 Moderate ❑ F-2 Low
Hazardous ❑ 1-1-1 Detonate ❑ H-2 Deflagrate ❑ H-3 Combust ❑ H-4 Health ❑ H-5 RPM
Institutional ❑ I-I ❑I-2 ❑ 1-3 ❑ I-4
I-3 Condih.on ❑ 1 102 ❑ 3 ❑ 4 ❑ 5
Mercantile �7
Residential -1 ❑ R-2 ❑ R-3 ❑ R-4
Storage S-1 Moderate ❑ S-2 Low ❑ High-piled
❑ Parking Garage ❑ Open ❑ Enclosed ❑ Repair Garage
Utility and Miscellaneous ❑
incidental Uses (Table 508.2.5):
❑ Furnace room where any piece of equipment is over 400,000 Btu per hour input
❑ Rooms with boilers where the largest piece of equipment is over 15 psi and 10 horsepower
❑ Refrigerant machine room
❑ Hydrogen cutoff rooms, not classified as Group H
❑ Incinerator rooms
Paint shops,not classified as Group H,located in occupancies other than Group F
❑ Laboratories and vocational shops,not classified as Group H. located in a Group E or I-2 occupancy
❑ Laundry rooms over 100 square feet
❑ Group 1-3 cells equipped with padded surfaces
❑ Group I-2 waste and linen collection rooms
❑ Waste and linen collection rooms over 100 square feet
❑ Stationary storage battery systems having a liquid electrolyte capacity of more than 50 gallons, or a lithium-
ion capacity of 1,000 pounds used for facility standby power, emergency power or uninterrupted power
supplies
❑ Rooms containing fire pumps
❑ Group I-2 storage rooms over 100 square feet
❑ Group 1-2 commercial kitchens
❑ Group 1-2 laundries equal to or less than 100 square feet
❑ Group I-2 rooms or spaces that contain fuel-fired heating equipment
Special Uses: ❑ 402 ❑ 403 ❑ 404 ❑ 405 ❑ 406 ❑ 407 ❑ 408 ❑ 409 ❑ 410 ❑ 411❑ 412
❑ 413 ❑ 414 ❑ 415 ❑ 416 ❑ 417 ❑ 418 ❑ 419 ❑ 420 ❑ 421 ❑ 422 04230424
❑ 425 ❑ 426 ❑ 427
Special Provisions: ❑ 509.2 ❑ 509.3 ❑ 509.4 ❑ 509.5 ❑ 509.6 ❑ 509.7 ❑ 509.8 ❑ 509.9
Mixed Occupancy: ❑ No 2' Yes Separation: 2- Hr. Exception:
❑ Incidental Use Separation (508.2.5)
2012 NC Administrative Code and Policies
This separation is not exempt as a Non-Separated Use (see exceptions).
❑Non-Separated Use (508.3)
The required type of construction for the MI—dingg shall-be-determined by applyingthe height and
limitations for each of the applicable occupancies to the entire building. The most restrictive type of
'instruction, so determined, shall apply to the entire building.
Separated Use (508.4) - See below for area calculations
For each story, the area of the occupancy shall be such that the sum of the ratios of the actual floor area of
each use divided by the allowable floor area for each use shall not exceed 1.
Actual Area of Occupancy A + Actual Area of Occupancy B < 1
Allowable Area of Occupancy A Allowable Area of Occupancy B —
(o) 14z .SS + 2 67 o. 6 Si - ...... = < 1.00
Zr500 S 9, s0o S �
STOAY NO 'DESCRIETION (A) " (H) (C) (D) (E) (F)
AND USE - -BLDG AREA TABLE-5035 AREA FOR - -AREA FOR -" ALLOWABLE MAXIMUM
PER STORY' _AREA ' FRONTAGE SPRINKLER;'' AREA OR BUILDING:_'
lCpNVEMIdu I0,67S.fff lz,Soo ,Nor cCSED u I LZ, 0eV SY r
`S'1D2e q rod 2.2,00ast
RES7at-t4W .
Frontage area increases from Section 506.2 are computed thus:
a. Perimeter which fronts a public way or open space having 20 feet minimum width= (F)
b. Total Building Perimeter = (P)
c. Ratio(F/P) _ (F/P)
d. W=Minimum width of public way = (W)
e. Percent of frontage increase It= 100 [F/P -0,25] x W/30 = (%)
2 The sprinkler increase per Section 506.3 is as follows:
a. Multi-story building I,=200 percent 'EJ/Pe
b. Single story building I,=300 percent
Unlimited area applicable under conditions of Section 507. N aT U$E D)
4 Maximum Building Area=total number of stories in the building x E (506.4).
5 The maximum area of open parking garages must comply with Table 406.3.5. The maximum area of air traffic
control towers must comply with Table 412.1.2.
ALLOWABLE HEIGHT
ALLOWABLE INCREASE FOR SPRINKLERS SHOWN ON PLANS CODE
(TABLE 503) .. _ . - -.REFERENCE. .
Type of Construction Type I I - B Type '1 - B//
Building Height in Feet Ss -0 Feet=H+20'= St- 91bz
Building Height in Stories 2 Stories+ 1=
•
2012 NC Administrative Code and Policies
•
❑ Exterior wall opening area with respect to distance to assumed property lines (705.8)
�V�7('i�.'Existing structures within 30' of the proposed building
NJ Occupancy types for each area as it relates to occupant load calculation (Table 1004.1.1) T
ccupant loads for each area
� ,Exit access travel distances (1016)
U,Common path of travel distances (1014.3 & 1028.8)
14 Dead end lengths (1018.4)
l g, Clear exit widths for each exit door
Maximum calculated occupant load capacity each exit door can accommodate based on egress width(1005.1)
❑ Actual occupant load for each exit door
❑ A separate schematic plan indicating where fire rated floor/ceiling and/or roof structure is provided for
purposes of occupancy separation
•
❑ Location of doors with panic hardware(1008.1.10)
❑ Location of doors with delayed egress locks and the amount of delay (1008.1.9.7)
❑ Location of doors with electromagnetic egress locks (1008.1.9.8)
❑ Location of doors equipped with hold-open devices
0/Loc❑ Location of emergency escape windows (1029)
ation
• square footage of each fire area (902)
❑ The square footage of each smoke compartment(407.4)
❑ Note any code exceptions or table notes that may have been utilized regarding the items above
ACCESSIBLE DWELLING UNITS
(SECTION 1107)
TOTAL ACCESSIBLE ACCESSIBLE TIPS A TYPE A' TYPE B TrPP B 'TOTAL^r F
nz '
UNTTS UNITS UNITS UNITS UMTS UNITS UMTS � AC_CESSIBLEUMTS
REQUIRED PROVIDED REQUIRED ' PROVIDED REQUIRED,. PROVIDED ' PROVIDED-. . .
W/.4I I I I I
ACCESSIBLE PARKING
(SECTION 1106)
L211-OR PARKING TOTAL 4 OF PARKING SPACES •#OF ACCESSIBLE SPACES PROVIDED . , . . .TOTAL#
AREA REQUIRED PROVIDED REGULAR WITH VAN SPACES I WITH , _ ACCESSIBLE .
132"ACCESS -.81 ACCESS
S1 ACCESS PROVIDED'•
AISLE AISLE _ AISLE
TR.vUc 10 3 I I
cAg_ 3 64 3 I — — I 3
TOTAL I I I
STRUCTURAL DESIGN
DESIGN LOADS:
Importance Factors: Wind (Iv,) 1.b Flo WIN.
Snow (Is) 1.0 15 s PSF
Seismic (IE) l• o CD)
Live Loads: Roof 2 o psf
Mezzanine psf
Floor psf
Ground Snow Load: IC. 0 psf
2012 NC Administrative Code and Policies
FIRE PROTECTION REQUIREMENTS
BUILDING ELEMENT{, FIRE. .-. RATING DETAH.# DESIGN# DESIGN#FOR DESIGN#.;
'SEP 9RA7709 R}',Q'D PROVIDED AND IOR RATED FOR
' DISTANCE (WI SHEET# RATED PENETRATION RATED
Structural Frame, rr11 I
including columns,girders, X ) 3�PT' okes
trusses
Beating Walls I l p �Srj
Exterior 0 In
North
East
West
South
Interior o intr5
Nonbearing Walls and
Partitions I I O
Exterior walls
North
East
West
South
Interior walls and partitions O lew8
Floor Construction I
Including supporting beams I I o IAfS
and joists
Roof Construction
II
Including supporting beams 0 hr.(
and joists
Shaft Enclosures-Exit
Shaft Enclosures-Other
Corridor Separation
Occupancy Separation
Parry/Fire Wall Separation
Smoke Bather Separation
Tenant Separation
Incidental Use Separation
* Indicate section number permitting reduction
LIFE SAFETY SYSTEM REQUIREMENTS
Emergency Lighting: ❑ No Yes
Exit Signs: ❑ No ,__,/Yes
Fire Alarm: ❑ No L✓J es
Smoke Detection Systems: ❑ No ,Vyes ❑ Partial
Panic Hardware: ❑ No d'Yes
LIFE SAFETY PLAN REQUIREMENTS
Life Safety Plan Sheet#,: LF5
Fire and/or smoke rated wall locations (Chapter 7)
V�Assumed and real property line locations
2012 NC Administrative Code and Policies
Wind Load: Basic Wind Speed q 0 mph (ASCE-7)
- ---- Exposure Category — e — —"—
Wind Base Shears (for MWFRS) Vx= Vy= •
SEISMIC DESIGN CATEGORY: ❑ A ❑ B ❑ C gip
Provide the following Seismic Design Parameters:
Occupancy Category(Table 1604.5) ❑I XII ❑ III ❑ iv
Spectral Response Acceleration SS .233 %g SI . 15z- %g
Site Classification (Table 1613.5.2) ❑A ❑ B ❑ C ' D ❑ E ❑F
Data Source: - ❑ Field Test ❑ Presumptive ❑ Historical Data
Basic structural system (check one)
❑ Bearing Wall ❑ Dual w/Special Moment Frame
❑ Building Frame ❑ Dual w/Intermediate R/C or Special Steel
❑ Moment Frame ❑ Inverted Pendulum
Seismic base shear: Vx = 21k Vy = 2_2 k
Analysis Procedure: ❑ Simplified ❑ Equivalent Lateral Force ❑ Dynamic
Architectural,Mechanical, Components anchored? ❑ Yes ❑No
LATERAL DESIGN CONTROL: Earthquake ❑ Wind ❑
SOIL BEARING CAPACITIES:
Field Test(provide copy of test report) (SE E R.E.Po R-r) psf
Presumptive Bearing capacity '3 0 00 psf
Pile size,type, and capacity (30 ;ACk -404-M - 3 o 0 0 p 5c.
SPECIAL INSPECTIONS REQUIRED: [' Yes ❑ No
PLUMBING FIXTURE REQUIREMENTS
(TABLE 2902.1)
• - USE SNATERCLOSETS _., URINALS LAVATORIES SHOWERS/ it DRINIGNG FOUNTAINS
- ' ..
MALE { .,FEiN_4LE : :;'MALE : FEMALE TUBS; ,,,REGUEAR 'ACCESSIBLE`-,
SPACE EXISTING — -- I — — I —
NEW Co, 7 1- 4+Z 4+31 5 — —
REQUIRED I I I I 1 I I -- I
SPECIAL APPROVALS
•
Special approval: (Local Jurisdiction, Department of Insurance; OSC, DPI, DHHS, ICC, etc., describe below)
2012 NC Administrative Code and Policies
•
ENERGY SUMMARY
ENERGY REQUFREMENTS:
—The-following data shall-be-considered minimum-and-any special-attribute-required-to meet-the-energy-code-shall
also be provided. Each Designer shall furnish the required portions of the project information for the plan data sheet.
If performance method, state the annual energy cost for the standard reference design vs annual energy cost for the
proposed design.
Climate Zone: ❑ 3 '4 ❑ 5
Method of Compliance:
❑ Prescriptive (Energy Code)
❑ Performance (Energy Code)
❑ Prescriptive (ASHRAE 90.1)
❑ Performance (ASHRAE 90.1)
THERMAL ENVELOPE
Roof/ceiling Assembly(each assembly)
Description of assembly: RIWID INSt.2 . 04 M-n-RoaF Eck lam+ Sl146t-E. rL (ooM (i.00FAATL.
U-Value of total assembly: MIN. Ig.bi)
R-Value of insulation: ( M.IM .'2-c)
Skylights in each assembly: N/,4
U-Value of skylight: N/A,
total square footage of skylights in each assembly: N�Pc
Exterior Walls (each assembly)
Description of assembly: -1. 57195 Ia Wtn- air.. n'ISv1A7t N +- 3R'ck e1lrEaios.
U-Value of total assembly: _MN . ti•Z8)
R-Value of insulation: R— 1�
Openings (windows or doors with glazing)
U-Value of assembly: AVERAGE V-FAcrop- No mom eTi-AN . 69 3-Ev/St chrd F
Solar heat gain coefficient:
projection factor:
Door A-Values: Nor LESS-1114m4 1-.o 445 F x (5rEC5EG-ltaN 9
allO)
Walls below grade(each assembly)
Description of assembly: N/ft
U-Value of total assembly:
R-Value of insulation:
Floors over unconditioned space (each assembly)
Description of assembly: NA
U-Value of total assembly:
R-Value of insulation:
Floors slab on grade
Description of assembly: M I N. 4'- Lion . _s/VA.fox BA RR1Ete—
U-Value of total assembly: K_ I.SS (esr.)
R-Value of insulation: NvrJE
Horizontal/vertical requirement: 144 •
slab heated: No
2012 NC Administrative Code and Policies
•
MECHANICAL SUMMARY
MECHANICAL SYSTEMS, SERVICE_SYSTEMS_AND_EQUIPMENT
Thermal Zone
winter dry bulb: 21 ° F
summer dry bulb: 94'F
Interior design conditions
winter dry bulb: to° F
summer dry bulb: 1 3°F
relative humidity: 55° SoMN%€ . /3s°
Building heating load:
SEA MEGLI-4NICAL SIFT M -4.1
Building cooling load: Fop_ &Db. IoAC INFO,
Mechanical Spacing Conditioning System
Unitary
description of unit:
heating efficiency:
cooling efficiency:
size category of unit:
Boiler
Size category. If oversized, state reason.: N/,4 -
Chiller
Size category. If oversized,state reason.:
List equipment efficiencies:
ELECTRICAL SUMMARY
ELECTRICAL SYSTEM AND EQUIPMENT
Method of Compliance:
Energy Code: ❑ Prescriptive ❑ Performance
ASHRAE 90.1: ❑Prescriptive ❑ Performance
Lighting schedule(each fixture type) (✓g Et.Ec-J(ALSitE,re.i6 Fo(z LI&I4'I1N&Sci+EpVVE.)
lamp type required in fixture
number of lamps in fixture
ballast type used in the fixture .
number of ballasts in fixture
total wattage per fixture
total interior wattage specified vs. allowed (whole building or space by space)
total exterior wattage specified vs. allowed
Additional Prescriptive Compliance
❑
506.2.1 More Efficient Mechanical Equipment
❑ 506.2.2 Reduced Lighting Power Density
❑ 506.2.3 Energy Recovery Ventilation Systems
❑ 506.2.4 Higher Efficiency Service Water Heating
•
❑ 506.2.5 On-Site Supply of Renewable Energy
❑ 506.2.6 Automatic Daylighting Control Systems
2012 NC Administrative Code and Policies
•
2012 APPENDIX B
BUILDING CODE SUMMARY
FOR ALL COMMERCLAL PROJECTS
(EXCEPT 1 AND 2-FAMILY DWELLINGS AND TOWNHOUSES)
(Reproduce the following data on the building plans sheet 1 or 2)
—Cl Re S'14-e7P .
Name of Project NEL.)TDN , Kg. La ES ITAVEL STOP
Address: N/A. 41.-3Y Iv At Tovtkh flIG 1ZD (u OF Net,rmu)Zip Code 28 658
Proposed Use: InMM.Eg,CI A L
Owner/Authorized Agent:PASCAL A✓eHt iPhone 4 (+0$ ) 4(o? - 3914- E-Mail PA5(�IL PASL4Lax.ell, 6,41
Owned By: ❑ City/County Private ❑ State
Code Enforcement Jurisdiction: ❑ City E County ❑ State
LEAD DESIGN PROFESSIONAL: PASCAL AUA- 11Zt + ASSOC
DESIGNER FIRM NAME LICENSE# TELEPHONE# E-MAIL
Architectural PA5C4L AliZe441 )( PA5C4L AtIL, 1iph (4oc) 4-&3 3414 r45CAL PA SCAL AP-c44: .
Civil DM p ENG. LESLEY EN4tAND (-;-1/4;) SE" 4'82.4 PAW - LNG. LaM
Electrical (y,7 F ENG. Sccrr CAW/VIL.EY (4n5 )WS 2:6-7& 5CaJMate MTF ENGINEER
Fire Alarm ( ) MIL' COAL
Plumbing MIT ENC.,, . 56,0-rr&1,IMLEY (4oS ) 2105 237(6 StWMLEte. M-1FEN61x4t
Mechanical NIT E N6, l I ( tt ) I( t( 1144•A>M
Sprinkler-Standpipe ( )
Structural WILLET t.r.lG, MAC. RJRI-Er (—no) 2.10 gQ-61- Ail Lit us-re LJtlt'Er�NLIN
Retaining Walls>5'High ( ) EERPN6.Len.
Other ( )
2012 EDITION OF NC CODE FOR: N<ew Construction ❑ Addition ❑ Upfit
EXISTING: ❑ Reconstruction ❑Alteration ❑ Repair ❑ Renovation
CONSTRUCTED:(date) N/4 _ ORIGINAL USE(S) (CE 3):
RENOVATED: (date) _ CURRENT USE(S) (Ch. 3):
PROPOSED USE(S) (Ch. 3):
BASIC BUILDING DATA
Construction Type: ❑ I-A ❑II-A ❑ III-A ❑ IV ❑ A
(check all that app1ly) ❑I-B ❑11-B ❑ 111-B V-B
Sprinklers: ❑ Partial ❑ Yes ❑ NFPA 13 ❑NFPA 13R ❑NFPA I3D
Standpipes: Fr No ❑yes Class ❑ I ❑II ❑ III ❑ Wet ❑Dry
Fire District: ❑No Yes (Primary) Flood Hazard Arca: • No ❑Yes
Building Height: (feet) `z- 22=
Gross Building Area:
FLOOR EXISTING (SQ FT) NEW (SQ PT) SUB-TOTAL
6th Floor
5th Floor
4th Floor
3`d Floor
2' Floor
Mezzanine
le Floor 5, I18 . 4 5.r.
Basement
TOTAL
2012 NC Administrative Code and Policies
ALLOWABLE AREA
Occupancy:
Assembly ❑ A-1 ❑A-2 ❑ A-3 ❑ A-4 ❑ A-5
Business ❑
Educational ❑
Factory ❑ F-I Moderate ❑ F-2 Low
Hazardous ❑ H-1 Detonate ❑ H-2 Deflagrate ❑ 1-1-3 Combust ❑ H-4 Health ❑ H-5 HPM
Institutional ❑I-1 ❑1-2 ❑I-3 ❑I-4
I-3Condi on ❑ 1 El E 0 D
Mercantile
Residential ❑ -1 ❑ R-2 ❑ R-3 ❑ R-4
Storage S-1 Moderate ❑ S-2 Low ❑ High-piled
❑Parking Garage ❑ Open ❑ Enclosed ❑ Repair Garage
Utility and Miscellaneous ❑
Accessory Occupancies:
Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ A-4 ❑ A-5
Business ❑
Educational ❑
Factory ❑F-1 Moderate ❑F-2 Low
Hazardous ❑ H-1 Detonate ❑ H-2 Deflagrate ❑ H-3 Combust ❑ H-4 Health ❑ H-5 HPM
Institutional ❑ I-1 ❑ I-2 ❑I-3 ❑ I-4
I-3 Condition ❑ 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5
Mercantile ❑
Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ R-4
Storage ❑ S-1 Moderate ❑ S-2 Low ❑ High-piled
❑ Parking Garage ❑ Open ❑ Enclosed ❑ Repair Garage
Utility and Miscellaneous ❑
Incidental Uses (Table 508.2.5):
❑ Furnace room where any piece of equipment is over 400,000 Btu per hour input
❑ Rooms with boilers where the largest piece of equipment is over 15 psi and 10 horsepower
❑ Refrigerant machine room
❑ Hydrogen cutoff rooms,not classified as Group H
❑ Incinerator rooms
❑Paint shops, not classified as Group H,located in occupancies other than Group F
❑Laboratories and vocational shops,not classified as Group H. located in a Group E or I-2 occupancy
❑ Laundry rooms over 100 square feet
❑ Group 1-3 cells equipped with padded surfaces
❑Group I-2 waste and linen collection rooms
❑ Waste and linen collection rooms over 100 square feet
❑ Stationary storage battery systems having a liquid electrolyte capacity of more than 50 gallons, or a lithium-
ion capacity of 1,000 pounds used for facility standby power,emergency power or uninterrupted power
supplies
❑ Rooms containing fire pumps
❑ Group 1-2 storage rooms over 100 square feet
❑ Group 1-2 commercial kitchens
❑ Group 1-2 laundries equal to or less than 100 square feet
❑ Group I-2 rooms or spaces that contain fuel-fired heating equipment
Special Uses: ❑402 ❑ 403 ❑ 404 ❑ 405 ❑ 406 ❑ 407 ❑ 408 ❑ 409 ❑ 410 ❑ 411❑ 412
❑ 413 ❑414 ❑ 415 ❑ 416 ❑ 417 ❑ 418 ❑ 419 ❑ 420 ❑ 421 ❑ 422 ❑ 4230 424
❑425 ❑ 426 ❑ 427
Special Provisions: ❑ 509.2 ❑ 509..33 ❑ 509.4 ❑ 509.5 ❑ 509.6 ❑ 509.7 ❑ 509.8 ❑ 509.9
Mixed Occupancy: ❑ No Mil Yes Separation: Hr. Exception:
❑ Incidental Use Separation (508.2.5)
2012 NC Administrative Code and Policies
his separation is not exempt as a Non-Separated Use(see exceptions).
,This
Use (508.3)
The required-type of construction-for the-building shall-be
for each of the applicable occupancies to the entire building. The most restrictive type of
construction, so determined,shall apply to the entire building.
❑ Separated Use (508.4) - See below for area calculations
For each story,the area of the occupancy shall be such that the sum of the ratios of the actual floor area of
each use divided by the allowable floor area for each use shall not exceed 1.
Actual Area of Occupancy A Actual Area of Occupancy B < 1
Allowable Area of Occupancy A Allowable Area of Occupancy B —
+ + ...... = < 1.00
sroRVNO nascRIPTIO A) B)Y (c)''' _---. LL' (f)
s ...
AND USE:. `,BLDG 503 ^AREA)OR ALLOWABLE MAXIMUM_
PER STORY AREA ' FRONTAGE .SPRI■KLER AREA'OR BUILDING-,`:
- , L (ACTUAL):, _ WCREASEI . I ..-INCREASE .1... UNLEWTED3 :„°'AREA4>,.
mRESior 5110•45.f. 'j000 Nor USED a g000S.g
,- S-rvlrad.E 9foao S.0
t Frontage area increases from Section 506.2 are computed thus:
a. Perimeter which fronts a public way or open space having 20 feet minimum width= (F)
b. Total Building Perimeter = (P)
c. Ratio (F/P) = (F/P)
d. W=Minimum width of public way = (W)
e. Percent of frontage increase Ir= 100 [F/P -0.25] x W/30 = (%)
2 The sprinkler increase per Section 506.3 is as follows: N /
a. Multi-story building I,=200 percent
NA-
b. Single story building I,=300 percent or USE.D)
3 Unlimited area applicable under conditions of Section 507.
4 Maximum Building Area=total number of stories in the building x E (506.4).
5 The maximum area of open parking garages must comply with Table 406.3.5. The maximum area of air traffic
control towers must comply with Table 412.1.2.
ALLOWABLE HEIGHT
ALLOWABLE INCREASE FOR SPRINKLERS ,'SHOWN ON PLANS CODE ,
__ (TABLE 5113) - ' .. -. REFERENCE.:
Type of Construction Type V- d Type V -
Building Height in Feet 1-o - d' Feet=H+20'= .y 'ZZ=a
Building Height in Stories . `L Stories+ 1 = 1
2012 NC Administrative Code and Policies
FIRE PROTECTION REQUIREMENTS
BUILDING ELEMENT. ' FIRE .RATING DETAIL# DESIGN# DESIGN#FOR DESIGN#
SEPARATION REQ D PROLRDE'0 AND FOR RATED ••
• DISTANOE • (WV -p1 SHEET# RATED PENETRATION RATED.'
- (FEET•). �:.: RCDUCTIO\).... ,. ASSEMBLY. JOINTS...
Structural Frame. r
including columns,girders, X L1 36 i'Y O lirS.
trusses
Bearing Walls I/ 0 krt.
Exterior
North
East
West
South
interior It Okn.
Nonbearing Walls and
Partitions
Exterior walls If O Arc.
North
East
West
South
Interior walls and partitions I I O lnrC•
Floor Construction
Including supporting beams II
and joists tt OVA
Roof Construction
Including supporting beams Ii 01 -
and joists
VMS
Shaft Enclosures-Exit
Shaft Enclosures-Other
Corridor Separation
Occupancy Separation
Parry/Fire Wall Separation _
Smoke Barrier Separation
Tenant Separation
Incidental Use Separation
* Indicate section number permitting reduction
LIFE SAFETY SYSTEM REQUIREMENTS
Emergency Lighting: ❑ No Yes
Exit Signs: ❑ No In Yes
Fire Alarm: ❑ No Yes
Smoke Detection Systems: ❑ No Yes ❑ Partial
Panic Hardware: ❑ No Yes
LIFE SAFETY PLAN REQUIREMENTS
Life Safety Plan Sheet#: A 1.4 r - 2
❑ Fire and/or smoke rated wall locations (Chapter 7) N/de •
❑ Assumed and real property line locations
2012 NC Administrative Code and Policies
•
❑ Exterior wall opening area with respect to distance to assumed property lines (705.8)
❑H Existing structures within 3W of the proposed building
Q Occupancy types for each area as it relates to occupant load calculation (Table 1004.1.1)
ccupant loads for each area
Cxit access travel distances (1016)
ommon path of travel distances (1014.3 R. 1028.8)
Dead end lengths (1018.4)
,/Clear exit widths for each exit door
M/ Maximum calculated occupant load capacity each exit door can accommodate based on egress width(1005.1)
zu Actual occupant load for each exit door
❑ A separate schematic plan indicating where fire rated floor/ceiling and/or roof structure is provided for
purposes of occupancy separation
/purposes
of doors with panic hardware (1008.1.10)
❑ Location of doors with delayed egress locks and the amount of delay (1008.1.9.7)
❑ Location of doors with electromagnetic egress locks(1008.1.9.8)
❑ Location of doors equipped with hold-open devices
❑ Location of emergency escape windows (1029)
/Location
square footage of each fire area (902)
❑ The square footage of each smoke compartment(407.4)
❑ Note any code exceptions or table notes that may have been utilized regarding the items above
ACCESSIBLE DWELLING UNITS
(SECTION 1107)•
TOTAL ACCESSIBLE ACCESSIBLE TITER 7YPEA TYPE II IITEB TOTAL;'?
UNITS , UNrrs UNrrS UNITS' UNITS UNITS UNITS , 'ACCESSIBLE UNITS:-. REQUIRED PROVIDED REQUIRED PROVIDED. . : - PROVIDED,
. RE REQUIRED_ _PRO
Q \7I1ED y.
W/I+ . I I I I
ACCESSIBLE PARKING
(SECTION 1106)
LOT OR PARKING TOTAL#.OF PARKING SPACES. #OF ACCESSIBLE SPACES PROVIDED ;r. TOTAL#•AREA • REQUIRED PROVIDED REGULAR WITH VAN SPACES WITH ACCE.-. „.
5'ACCESS • 132"ACCESS 8 8'.ACCESS PROVIDED
• AISLE AISLE AISLE
NA- .
TOTAL
STRUCTURAL DESIGN
DESIGN LOADS:
•
Importance Factors: Wind (IN.) 1.o Iv n vt(^ C4pkF_ F9-oAA ail-I-ali..
Snow (Is) t .o 15. 5 ps.C: 1301.-DING,)
Seismic (IE) 1. o D
Live Loads: Roof psf (6VION& MA)44.3?-.)
Mezzanine psf (8kaus,IU4 mil)4 uF•)
Floor psf ( 13 ult-D1146I. M4uwF)
Ground Snow Load: psf
2012 NC Administrative Code and Policies
Wind Load: Basic Wind Speed mph (ASCE-7)
Exposure Category
Wind Base Shears(for MWFRS) Vx= Vy=
SEISMIC DESIGN CATEGORY: ❑ A ❑ B ❑ C ND
Provide the following Seismic Design Parameters:
Occupancy Category(Table 16045) ❑ I II ❑ III ❑TV (-1,c FgoM
Spectral Response Acceleration SS •'9;43 %g SI . IC2- %g (21}F6(L SVILDIM61)
Site Classification (Table 1613.5.2) ❑ A ❑B ❑ C D ❑E ❑F
Data Source: ❑ Field Test ❑ Presumptive ❑Historical Data
Basic structural system (check one) -
❑ Bearing Wall ❑ Dual w/Special Moment Frame
❑ Building Frame ❑ Dual w/Interniediate R/C or Special Steel
❑ Moment Frame ❑ nverted Pendulum
Seismic base shear: Vx = 22 t4 Vv = Z2.JC •
Analysis Procedure: ❑ Simplified ❑ Equivalent Lateral Force ❑ Dynamic
Architectural,Mechanical,Components anchored? ❑ Yes ❑No
LATERAL DESIGN CONTROL: Earthquake ❑ Wind ❑ -
SOIL BEARING CAPACITIES: (SSE Am .C1+eD 50IL5 Lst'o RT 7
Field Test(provide copy of test report) psf
Presumptive Bearing capacity '3 0oo psf
Pile size, type, and capacity 3 t' MIN . ' roo pa.
SPECIAL INSPECTIONS REQUIRED: ❑Yes ❑No
PLUMBING FIXTURE REQUIREMENTS
(TABLE 2902.1)
USE WATERCLOSETS ' : URINALS LAVATORIES I SHO ■ERS/ DRINKING FOUNTAINS .
;. � ., ,. -MALE .FEMALE =; .MAtE: ,:FEMALE TUBS;;'�., ��, REGULAR _.ACCESSIBLE
SPACE EXISTING - '-
NEW 0 0
REQUIRED
SPECIAL APPROVALS
Special approval: (Local Jurisdiction, Department of Insurance, OSC, DPI,DHHS,ICC, etc., describe below)
•
2012 NC Administrative Code and Policies
ENERGY SUMMARY
ENERGY REQUIREMENTS:
The-following-data-shall-be considered-minimum-and-any-speci al.attribute_required.to.meet the energy_code_shall
also be provided. Each Designer shall furnish the required portions of the project information for the plan data sheet.
If performance method, state the annual energy cost for the standard reference design vs annual energy cost for the
proposed design.
Climate Zone: ❑ 3 X4 ❑ 5
Method of Compliance:
❑ Prescriptive (Energy Code)
❑ Performance (Energy Code)
❑ Prescriptive (ASHRAE 90.1)
❑Performance (ASHRAE 90.1)
THERMAL ENVELOPE
Roof/ceiling Assembly (each assembly) (�4L.VSLvMe "R. A'tt.-rAt, Root PAMEI.5 oN
Description of.assembly: METAL 13VIw1N4 Woo; PV1t41u5 AND VINYL- -FSACkE INSQL •
U-Value of total assembly:
R-Value of insulation:
Skylights in each assembly: N/A•
U-Value of skylight: N/A
total square footage of skylights in each assembly: N/q .
Exterior Walls(each assembly)
Description of assembly: Mg7p,l 1$v1LDIN4 1.•rAk PANreLS ON blP3 t ' VINY1--F54cj et)
U-Value of total assembly: 14•1 5uti N•
R-Value of insulation:
Openings (windows or doors with glazing) J
U-Value of assembly: N/A"'
Solar heat gain coefficient: N/4
projection factor: N /4
Door R-Values: Nor LESS THAN 4.o doi FY u 5.C, /t-to (sr c sec-nom
glto )
Walls below grade(each assembly)
Description of assembly: N/A-.
U-Value of total assembly:
R.-Value of insulation:
Floors over unconditioned space(each assembly)
Description of assembly: 474-
4-
U-Value of total assembly:
R-Value of insulation:
Floors slab on grade
Description of assembly: Io • M1N• CONC. 5L4' U,VAPoR PAR12-IR-•
U-Value of total assembly:
R-Value of insulation: N/4,
Horizontal/vertical requirement: N/A. •
slab heated: hlo
2012 NC Administrative Code and Policies
MECHANICAL SUMMARY
MECHANICAL SYSTEMS, SERVICE SYSTEMS,AND EQUIPMENT
Thermal Zone
winter dry bulb: 7-1 ° F.
summer dry bulb: 14° F
Interior design conditions
•
winter dry bulb: 10° F
summer dry bulb: 12,° p
relative humidity: 55° 44,.NImsR/35.° I,.ni,l .ls-.
Building heating load:
See rweu44.• ICAL SHr. YM - 4. 1
Building cooling load: CF+,, gwG LOAD INFO.
Mechanical Spacing Conditioning System
Unitary
description of unit:
heating efficiency:
cooling efficiency:
size category of unit:
Boiler
Size category. If oversized, state reason.: IZ1/41/4-
Chiller
Size category. If oversized, state reason.: N jjer.
List equipment efficiencies:
ELECTRICAL SUMMARY
•
ELECTRICAL SYSTEM AND EQUIPMENT
Method of Compliance:
Energy Code: ❑ Prescriptive ❑Performance
ASHRAE 90.1: ❑ Prescriptive ❑Performance
Lighting schedule (each fixture type) SEE €LEC. 514e?✓fl Fop- LI&4+T1PtL Sct+etUt.,E ,
lamp type required in fixture
number of lamps in fixture
ballast type used in the fixture
number of ballasts in fixture
total wattage per fixture
total interior wattage specified vs. allowed (whole building or space by space)
total exterior wattage specified vs. allowed
Additional Prescriptive Compliance
❑ 506.2.1 More Efficient Mechanical Equipment
❑ 506.2.2 Reduced Lighting Power Density
❑ 506.2.3 Energy Recovery Ventilation Systems
❑ 506.2.4 Higher Efficiency Service Water Heating
❑ 506.2.5 On-Site Supply of Renewable Energy
❑ 506.2.6 Automatic Daylighting Control Systems
2012 NC Administrative Code and Policies