Form DSA 140: Application for Approval of Construction ...

6
140 APPLICATION FOR APPROVAL OF CONSTRUCTION CHANGE DOCUMENT – CCD CATEGORY A/B This application is for construction changes, as defined in IR A-6, to approved contract documents. This form shall be completed by the Design Professional in General Responsible Charge of the project, in accordance with California Code of Regulations, Title 24, Part 1, Section 4-338 (c) and in compliance with DSA IR A-6. School District/Owner: DSA File #: - Project Name/School: DSA App. #: - APPLICANT CCD Cat. A / B, #: Date Submitted: Attached Pages?: No Yes (_____pages) For CCD Cat. B, this is a voluntary submittal, DSA required submittal (attach DSA notification requiring submission). Firm Name: Contact Name: Email: Phone Number: Address: City: State: Zip: A DSA 301-N, DSA 301-P, or 90-Day Letter has been issued for this project. For project currently under construction. To obtain DSA approval of existing uncertified building(s). DESIGN PROFESSIONAL IN GENERAL RESPONSIBLE CHARGE Name of Design Professional in General Responsible Charge: Professional License #: Discipline: Design Professional in General Responsible Charge Statement: The attached Construction Change Documents have been examined by me for design intent and appear to meet the appropriate requirements of Title 24, California Code of Regulations and the project specifications. They are acceptable for incorporation into the construction of the project. Signature: _______________________________________________________________________________________ DESIGN PROFESSIONAL IN GENERAL RESPONSIBLE CHARGE CHECK THIS BOX: To confirm that all CCD drawings and, when applicable, first sheet or index of calculations and specifications have been stamped and signed by the Responsible Design Professional listed on DSA 1 for this this project. Brief description of construction change (attach additional sheets if needed): List of DSA approved drawings affected by this CCD: DSA USE ONLY For business office use only Date Sent Return By Delivery Method DSA Stamp SSS Date Approved / Disapproved / Not Req’d FLS Date Approved / Disapproved / Not Req’d ACS Date Approved / Disapproved / Not Req’d Remarks DSA 140 (rev 12-16-16) Page 1 of 1 DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

Transcript of Form DSA 140: Application for Approval of Construction ...

Page 1: Form DSA 140: Application for Approval of Construction ...

140 APPLICATION FOR APPROVAL OF CONSTRUCTION CHANGE DOCUMENT – CCD CATEGORY A/B This application is for construction changes, as defined in IR A-6, to approved contract documents. This form shall be completed by the Design Professional in General Responsible Charge of the project, in accordance with California Code of Regulations, Title 24, Part 1, Section 4-338 (c) and in compliance with DSA IR A-6.

School District/Owner: DSA File #:

-

Project Name/School: DSA App. #:

-

APPLICANT CCD Cat. A / B, #: Date Submitted: Attached Pages?: No Yes (_____pages)

For CCD Cat. B, this is a voluntary submittal, DSA required submittal (attach DSA notification requiring submission).

Firm Name: Contact Name:

Email: Phone Number: Address: City: State: Zip:

A DSA 301-N, DSA 301-P, or 90-Day Letter has been issued for this project.

For project currently under construction.

To obtain DSA approval of existing uncertified building(s).

DESIGN PROFESSIONAL IN GENERAL RESPONSIBLE CHARGE Name of Design Professional in General Responsible Charge: Professional License #: Discipline:

Design Professional in General Responsible Charge Statement: The attached Construction Change Documents have been examined by me for design intent and appear to meet the appropriate requirements of Title 24, California Code of Regulations and the project specifications. They are acceptable for incorporation into the construction of the project. Signature: _______________________________________________________________________________________ DESIGN PROFESSIONAL IN GENERAL RESPONSIBLE CHARGE

CHECK THIS BOX: To confirm that all CCD drawings and, when applicable, first sheet or index of calculations and specifications have been stamped and signed by the Responsible Design Professional listed on DSA 1 for this this project. Brief description of construction change (attach additional sheets if needed):

List of DSA approved drawings affected by this CCD:

DSA USE ONLY For business office use only

Date Sent Return By Delivery Method

DSA Stamp

SSS Date Approved / Disapproved / Not Req’d

FLS Date Approved / Disapproved / Not Req’d

ACS Date Approved / Disapproved / Not Req’d

Remarks

DSA 140 (rev 12-16-16) Page 1 of 1 DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

Page 2: Form DSA 140: Application for Approval of Construction ...

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FLAG POLE

VISITOR/STAFFPARKING

74 STALLS

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SERVICEYARD

AC PAVING& STRIPING,

TYP.

AC PAVING,TYP.

AC PAVING,TYP.

CONC. WALK

CONC.HARDSCAPE

PLANTER

NOTE:ALL OFFSITE IMPROVEMENTS BY OTHERS.DRAWING SHALL BE REVISED UPON RECEIPTOF UPDATED OFF-SITE PLANS

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INCREMENT 2FDC

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KEYPAD OPERATEDACCESS GATE W/ KNOX BOX

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KEYPAD/CAR READERw/ MOUNTING POST

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6"

20' -0" CLEAR

SEE /55 AS9.3

KEYPAD & CARD READERW/ MOUNTING POST

KEYPAD & CARD READERW/ MOUNTING POST

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LOCATE LOOP DETECTORPER MANUFACTURERINSTALLATIONREQUIREMENTS.

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1 CONTROLLED ACCESS GATE

ACCESS CONTROL SYSTEM

1. ONE (1) 1838-081 MULTI-DOOR ACCESS CONTROLLER2. TWO (2) 1815-250 KEYPAD AND DK PROX CARD READER3. ONE (1) 1830-185 NETWEOK ADAPTER4. TWO (2) HEAVY DUTY MOUNTING POST PAD MOUNT

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STANDARD MOUNTING DETAILS, PERMANUFACTURER.

4"1'

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"

CONCRETE PAD

FINISHED GRADE

#4 T & B

3" M

IN. C

LR.

3" MIN. CLR.

1' - 6"

KEY SWITCH FOR FIRE DEPTKNOXBOX #3502 SINGLE SWITCH WITHPLATE MOUNTED ONTO POST.

INSTALLATION AND WIRING PERMANUFACTURER INSTALLATIONINSTRUCTIONS.

DIGITAL KEYPAD CARD READER

MOUNTING POST BASE PLATE

MOUNTING POST GOOSENECK

PLAN AXON

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1 KEYPAD FOOTING DETAIL

SCALE: 1" = 1'-0"SKA-3

2 FIRE DEPT KEY SWITCH INSTALLATION LOCATION

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DOORKING1838­081ACCESS

CONTROLLER

DOORKING1815­250

CARDREADER/KEYPAD

COMBO

2-22 GA 6-CONDUCTORSTRANDED SHIELDED

IN 0.75"C. UG

2-22 GA 6-CONDUCTORSTRANDED SHIELDEDIN 0.75"C. UG

18 GA 2-CONDUCTORSTRANDED SHIELDED IN

0.75"C. UG GATECONTROLLER

DOORKING1800­080

CELLULARNETWORKADAPTER 18GA. 8-CONDUCTOR STRANDED,

SHIELDED NON-TWISTED (DATA)18GA. 3-CONDUCTOR (12V POWER)IN 0.75"C.DOORKING

1200­080TRANSFORMER

BOX

DOORKING1815­250

CARDREADER/KEYPAD

COMBO

PROVIDE 2 EXTRA 16V ACTRANSFORMERS, INSTALL

ONLY IF NEEDED FORKEYPADS/CARD READERS,

DOOR KING 1804-060

INSTALL ACCESS CONTROLLER, CELLULARNETWORK ADAPTER, AND TRANSFORMERBOX ON A POST OR BRACKET TO KEEPTHE EQUIPMENT ABOVE THE SNOW LINE,POSSIBLY NEAR (OR ON) THE GATECONTROLLER

ROUTE DC POWER CABLESPROVIDED WITH ACCESS

CONTROLLER IN 0.5"C.

TRUCKEE HIGH SCHOOL CARD READER /KEYPAD / GATE CONTROLLER WIRING

DIAGRAM

120V PER PLANS

120V PER PLANS

KNOX KEYSWITCH

1-18 GA 2-CONDUCTORSTRANDED SHIELDEDIN 0.75"C. UG

SKE­1

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Keypad

Gate Swing

KnoxboxAccess

1. KEYS ARE IN OFF POSITIONSTATUS: GATE IS CLOSED

Keypad

NORMAL ACCESS

Gate Swing

KnoxboxAccess

Keypad

EMERGENCYACCESS

Gate Swing

KnoxboxAccess

LOOP DETECTOR SEQUENCE OF OPERATION

2. KEYPAD IS IN ON POSITIONSTATUS: GATE IS OPEN

3. KNOXBOX IS IN ON POSITIONSTATUS: GATE IS OPEN

LEGEND:

KEY IN OFF POSITION

KEY IN ON POSITION

SIGNAL INDICATING CLOSED

SIGNAL INDICATING OPEN

BYPASSED SIGNAL

ENGAGED SIGNAL