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B22-1524 - 32301 CAMINO CAPISTRANO11/21/2024 Letter of Transmittal 3707 W Garden Grove Blvd. Suite 100, Orange, CA 92868 phone 714.568.1010 fax 714.568.1028 www.csgengr.com ORA – BPR - 160801 To: City of San Juan Capistrano Date Completed: 2/7/2023 Review #:PC02 32400 Paseo Adelanto Date Received: San Juan Capistrano, CA 92675 CSG #: 4216923 Attn: Building & Safety Division Agency Plan Check #: B22-1524 Job Address: 32301 A Camino Capistrano Job Description: Install of EVCS associated equipment to (1) utility transformer (1) light mode, (1) Light pole, (4)175 KW dispensers (4) 175KW power units & switch board assembly. 470 SF open to air enclosure and (1) power pole for site light Status: Hours: (By Rate) X Plan is approved. 3.0 1st Plan Check Plan is approved with conditions. See remarks. 1.0 2nd Plan Check Plan is approved with redlines. See remarks. 3rd Plan Check Plan is approved with redlines and conditions. See remarks. 4th Plan Check Plan requires corrections. See attached list. Total Hours We have reviewed the following documents ( X Digital only): X Plans Truss Calculations X Structural Calculations 2 Energy Calculations Soil Report Specifications Geotechnical Review Letter Special Inspection Form(s) Other: Special items to note: X Plan has been stamped and signed by CSG Environmental Health Services approval required Special inspection required for Hardship Form included Remarks: Recommend for approval From: Jensen Ku S.E. (ginsun@csgengr.com) CSG Consultants Inc. GREG NAUFAUL 310-625-4595 26111 Antonio Parkway ENCROACHMENT PERMIT No. ______________ Rancho Santa Margarita, Ca 92688 Applicants Please Complete Items 1-7, Read and Initial at the Bottom of Page 2 1.Location of work: _________________________________________________________City:____________ Tract: __________Lot: _______Est. Start Date: ______________Est. Completion Date: ________________ 2.Property Owner: _________________________ Address: __________________________ City: _________ 3.Applicant: ______________________________ Address: __________________________ City: _________ Contact: _________________________ Phone: ____________________Email: _______________________ 4.Required Documents 5.This work effects: (Choose All Applicable) Domestic Water Non-Domestic Sewer SMWD Easement _______________ 1 Set of Plans & Paving Schedule Copy of Liability Insurance Certificate $320 Fee 6. Description Of Work:______________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Permittee shall contact SMWD Inspection @ 949/459-6503 and DigAlert @ 811 at least 2 days prior to commencing any work. Failure to obtain proper inspection may cause permit rejection. This permit and approved plans must be on the job and available to District representatives at all times. In consideration of granting this permit the applicant acknowledges that he has read and agrees to all the terms and conditions attached to this form. 7.____________________________________Date: ___________ Applicant’s Signature SMWD Use: Permit Fee $_________ Issue Date: __________ Expires: ________CE Approval: _________ 8.Special Conditions of Approval: SANTA MARGARITA WATER DISTRICT Inspection Assigned to Date Remarks Certificate of Inspection: I hereby certify that the work allowed by this permit has been constructed according to the plans and specifications and I hereby accept the work in this manner. By:_____________Date:_________ ____ Submit Application to: Engcounter@smwd.com or call 949.459.6505 32301 Camino Capistrano San Juan Capistrano Westwood Financial 32301 Camino Capistrano San Juan Capistrano Dene Pfeiffer Geiser for Electrify America 2301 246th Street Lomita Dene Pfeiffer Geiser (949) 471-3877 pfeifferd@bv.com x Installation of Electric Vehicle Charging Stations with associated equipment. Construction includes routing of conduit over water line along Camino Capistrano to access power. Dene Pfeiffer Geiser 1/31/2023 TBD TBD By Catherine Aamodt at 1:43 pm, Feb 15, 2023 Refer to attached Special Conditions. This EP applies only to the design of the attached plans. Another EP application will need to be submitted by the contractor doing the work. No fee 02/16/23 08/16/23 23-006 ENCROACHMENT PERMIT SPECIAL CONDITIONS 1.Maintain 3’-0” minimum horizontal clearance from water pipeline (except for perpendicular crossings) unless otherwise approved by the District inspector. 1’-0” minimum vertical clearance must be maintained when crossing over a domestic water pipeline. 2.This EP is being issued only for the design shown on plan E-1 dated 01/10/2023. The contractor that installs the work shown on these plans must request another EP from SMWD and reference EP 23-006. 3.All water must be metered through the set SMWD construction meter. Any violations will be subject to fines per the SMWD Board Ordinance 2020 -06- 02, attached to this permit. 4.False bottom systems shall be in place in any impacted manholes as directed or required by the SMWD Inspector. The type of false bottom system must be approved by the SMWD Inspector and cannot be placed or removed until the Inspector is made aware. As a licensed contractor, at a minimum the contractor is required to follow SSPWC (Greenbook). See attached applicable SSPWC sections. If any manholes need adjusting all existing mortar and the entire concrete frame/ring must be removed, a new ring or rings (however many necessary) set and ½-inch of new cement mortar and a new concrete frame placed. Work on manholes shall be in accordance with SMWD Standard Plan S1. Upon the completion of work, the false bottom placed in any manholes and all debris and foreign material collected in the manholes shall be completely removed by the permittee under the supervision of the SMWD Inspector. 5.Valves needing adjustment shall have the existing riser and cover and the entire concrete ring removed. A new riser and cover shall be set and a new concrete ring placed. Work on valves shall be done per SMWD Standard Plan W9. Valves shall not be inaccessible for more than 48 hours and manholes shall not be inaccessible for more than 5 working days to allow for District access in the event of an emergency. 6.Manhole lids and valve covers must be protected during all work and cleaned to the satisfaction of the SMWD Inspector once work has been completed. Any sewer manholes or water valves that have not been previously tied off at the curb face by SMWD staff are the responsibility of the contractor. All tie-ing off of existing facilities needs to be done prior to the start of work. 7.The permittee shall examine the existing manhole structure, frames and covers or inlets, and piping and connections for damage or defects that would affect adjustment to grade. Report such damage or defects to the SMWD Inspector before beginning work. 8.If the SMWD Inspector determines the existing manhole frames, covers, or grade rings to be in an unacceptable condition, the permittee shall remove and replace them with new frames, covers, or grade rings. The new frames and covers will be provided to the permittee. 9.The permittee shall take all necessary measures to prevent damage to existing or new frames, covers, grade rings, or cones from equipment and materials used in, or taken through, the work area. If an item is damaged resulting from the permittee’s operations, it shall be replaced as directed by the SMWD Inspector and at no additional cost to the District. 10. The permittee shall install 3/8” minimum thick plywood covers over all the sewer and shelf areas to prevent surface materials such as asphalt, rocks, dirt, and debris from entering the sewer or storm drain lines. The permittee is responsible for removing all debris and foreign matter of any kind from the manhole and manhole frame and cover that resulted from his/her operations. 11.A pre-construction meeting must be scheduled with the property owner's representative, contractor, and Inspector before installation of the meters and prior to start of construction. All terms discussed in the pre -con meeting with the SMWD Inspector and those of this permit shall be complied with by the applicant. All work is to be done to the satisfaction of the District Inspector. Work shall not commence until the EP has been approved and a District inspector has been assigned to the permit. 12.Permittee or their construction contractor shall have applicable SMWD standards onsite by the time the pre-con meeting is held. 13.Striping shall be replaced in kind with the approval of the appropriate jurisdiction (e.g. City of San Juan Capistrano). 14.Refer to attached Inspection checklist for additional requirements. Encroachment Permit Terms and Conditions 1.By acceptance of this permit, permittee acknowledges and assumes all responsibility for compliance with requirements of other regulatory governing agencies including but not limited to zoning regulations, applicable ordinances and laws, etc. of the County of Orange, the State of California, or others having regulatory control over the use granted herein. 2.Should any damage or injury to District facilities occur, either through the acts of agents, servants or employees of Permittee or by any independent contractor of Permittee in the exercise of the rights herein granted, Permittee shall immediately, upon the written demand of District, restore such works to the condition of same on the date of the occurrence of said damage or injury at Permittee’s cost or expense. Any questions as to whether or not any such damage or injury has been caused to District Facilities shall be determined by the Chief Engineer of the District and the determination shall be final. 3.District reserves the right unto itself to perform any work upon any portion or all of the area covered by this permit, or to do any other work necessary at any time. Such work may be performed without incurring any liability of any nature whatsoever to the Permittee. It is further understood and agreed that District reserves unto itself the right of ingress over any or all portions of the subject area. 4.Permittee further agrees that all operations within District Property and/or easements shall be subject to inspection and/or review at any time by District personnel and/or or any other authorized persons under District control. All work is to be done to the satisfaction of the District Inspector. 5.This permit may be immediately revoked for reasons in the best interest of the District including violation of permit provisions or other applicable rules and regulations or for the creation of a nuisance upon notice given by the Chief Engineer of the District or authorized representative. In the event of such revocation, Permittee shall immediately cease all operations and restore District Property and/or easements as directed by assigned inspector. 6.Permittee agrees to perform all work in accordance with the Standard Specifications for Public Works Construction (latest edition); Standard Special Provisions and Standard Drawings of the District; special provisions; and all applicable laws and ordinances. 7.Permittee agrees that the work site shall be kept clean and free of rubbish, debris and dust throughout all phases of construction. 8.District will provide inspection during normal working hours only (7:00 a.m. - 3:30 p.m., Monday – Friday). 9.Trenches exceeding five (5) feet in depth require a permit from the Divisions of Industrial Safety, State of California. 10.Permittee shall pay for all Structural Engineer compaction and materials tests deemed necessary by the District. 11.Access to fire hydrants shall be maintained at all times. 12.Permittee agrees to save District, including its officers, agents or employees, harmless from any and all penalties, liabilities or loss resulting from claims or court actions, arising directly or indirectly out of any damage or injury to person or property by reason of the acts or omissions of Permittee, its agents, employees or independent contractors, in exercising any of the privileges herein granted or in consequence thereof. 13.Permittee shall contact the District’s inspector for final inspection prior to the finalization of the permit and /or release for occupancy. Applicant Initials: __________ July 2021 DPG ORIGINAL:SMWD Permit; ELECTRONIC COPY: Contractor & Property Owner Print Name Signature Print Name and Title Signature Print Name and Title (if applicable) Signature Company (if applicable) Company PRE-CON CHECKLIST – SMWD Permit No: _________ AC WORK REPAIR/GRIND, OVERLAY AND/OR SEAL COAT Meeting Location:__________________________________________________ Date:_________ Time:_________ Inspector to Check Off Items as Discussed Sewer manholes and water valves must be tied off at the curb face prior to the start of work. The contractor must tie off any missed manhole covers or water valve lids. All water used by the contractor must be metered through the set SMWD construction meter. False bottom systems shall be in place in all impacted manholes as directed by the SMWD Inspector. Coordinate installation and removal with SMWD Inspector. Manhole lids and water valve covers must be protected during all work and cleaned to the satisfaction of the SMWD Inspector at the completion of all work. All manholes shall be adjusted in accordance with SMWD Standard Plan S1. All water valves shall be adjusted per SMWD Standard Plan W9. Provide SMWD Inspector with current schedule and any schedule changes. Additional Items: Meeting Attendees: SMWD Inspector: _______________________________ __________________________________ Contractor: _______________________________ __________________________________ _______________________________ Property Owner: _______________________________ __________________________________ _______________________________ 202300138 VD 03/02/2023 No equipment Van Doan, 03/02/2023 2023000138 www.hilti.us Company: Specifier: Black & Veatch Corp. L. Thapakorn I:11S-'i Profis Anchor 2.8.6 Page: 4 Project: Address: Sub-Project I Pos. No.: ELECTRIFY AMERICA GENERIC Phone I Fax: E-Mail: 4 Shear load Steel Strength* Steel failure (with lever arm)* Pryout Strength** Load Vua [lb] 308 N/A 4,637 Concrete edge failure in direction x+** 4,637 Date: Capacity lj, Vn [lb] 4,472 N/A 76,342 11,584 *anchor having the highest loading **anchor group (relevant anchors) 4.1 Steel Strength Vsa ,eq = ESR value cl> Vs1ee1 2: Vue refer to ICC-ES ESR-1917 ACI 318-14 Table 17.3.1.1 Variables As..v [in.2] 0.10 Calculations Vsa ,eq [lb] 6,880 Results Vsa ,eq [lb] 6,880 4.2 Pryout Strength futa [psi] a.v,seis 115,000 1.000 cl> steel cl> nonductile 0.650 1.000 Vcpg = kcp [ {:::) ljl ec,N ljl ed,N ljl c ,N ljl cp,N Nb] cl> Vcpg 2:Vua ANc see ACI 318-14, Section 17.4.2.1, Fig. R 17.4.2.1(b) ANc0 = 9 h�f ljl ac,N = ( 1 + � eN) S 1.0 3her 'I' ed.N = o. 1 + o.3 U."sh:) s 1.0 = MAX{Ca,m l n , i.Sh•r) S 1_0 ljl cp,N Cac C•< Nb = kc A. a --J?.; h!l Variables lj/ c,N 1.000 Calculations �c [in.2] 1,315.67 Results Vcpg [lb] 109,060 he r [in.] 3.250 C8c [in.] 6.000 A Nc0 [in.2] 95.06 4> concrete 0.700 ec 1,N [in.] 1.875 kc 17 'If ac1,N 0.722 cf, seismic 1.000 cl> V .. [lb] Vua [lb] 4,472 308 ACI 318-14 Eq. (17.5.3.1b) ACI 318-14 Table 17.3.1.1 ACI 318-14 Eq. (17.4.2.1c) ACI 318-14 Eq. (17.4.2.4) ACI 318-14 Eq. (17.4.2.5b) ACI 318-14 Eq. (17.4.2.7b) ACI 318-14 Eq. (17.4.2.2a) ec2,N [in.] Ca,min [in.] 0.000 10.500 (C [psi] 1.000 3,000 ljl ec2,N lj/ ed,N 1.000 1.000 <J, nonductile cl> Vcpg [lb] 1.000 76,342 Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor ( c ) 2003-2009 Hilti AG, FL-9494 Schaan Hilli is a nagistered Trademark of Hilti AG, Schaan 1/15/2020 Utilization JJv = V u.14> V n Status 7 OK N/A N/A 7 OK 41 OK ljl cp,N Nb [lb] 1.000 5,455 Vua [lb] 4,637 www.hilti.us Company: Specifier: Black & Veatch Corp. L. Thapakorn Page: Project: Address: Sub-Project I Pos. No.: Phone I Fax: E-Mail: 4.3 Concrete edge failure in direction x+ -(A"c) V cbg -Avc0 lj/ ec,\/ lj/ od,\/ lj/ c ,\/ lj/ h,\/ lj/ para llel,\/ v b 4, Vcbg ?:. Vua Ave see ACI 318-14, Section 17.5.2.1, Fig. R 17.5.2.1(b) Avc0 = 4.5 C�1 lj/e c,\/ ={1+12e�)s1.o 3c a , 1J1 od,\/ = 0.7 + 0.3( 1.';�J s 1.0 = -M.5hc.,,?:. 1.0 lj/h,\/ '/� vb = ( 7 G:) 0\1cr.) ,-a '#c cl1 5 Variables C.1 [in.) 9.587 10 [in.] 3.250 Calculations Ave [in.2] 398.08 Results Vct,g [lb] 16,549 c.2 [in.] 10.500 '-• 1.000 Avc0 [in.2] 413.57 4i concrele 0.700 ecv [in.] 0.091 d8 pn.] 0.500 lj/ ec,\/ 0.994 4i seJsmJc 1.000 5 Combined tension and shear loads 13v 0.619 0.400 5/3 /3NV = 13� + /3� <= 1 Date: ACI 318-14 Eq. (17.5.2.1b) ACI 318-14 Table 17.3.1.1 ACI 318-14 Eq. (17.5.2.1c) ACI 318-14 Eq. (17.5.2.5) ACI 318-14 Eq. (17.5.2.6b) ACI 318-14 Eq. (17.5.2.8) ACI 318-14 Eq. (17.5.2.2a) lj/ c.V ha [in.] 1.200 8.000 f0 (psi] lj/ parallel,\/ 3,000 1.000 lj/ ed,V lj/ h,\/ 0.919 1.341 4, nonductile 4, Vcbq [lb] 1.000 11,584 Utilization 13N.v [%] Status 67 OK Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor ( c) 2003-2009 Hilti AG, FL-9494 Schaan Hilli is a registered Trademar1< of Hilti AG, Schaan Vb [lb] 11,701 Vua [lb] 4,637 1: ii s- 1 Profis Anchor 2.8.6 5 ELECTRIFY AMERICA GENERIC 1/15/2020 www.hilti.us Company: Specifier: Address: Phone I Fax: E-Mail: 6 Warnings Black & Veatch Corp. L. Thapakorn Page: Project: Sub-Project I Pos. No.: Date: I:11S • Profis Anchor 2.8.6 6 ELECTRIFY AMERICA GENERIC 1/15/2020 •The anchor design methods in PROFIS Anchor require rigid anchor plates per current regulations (ETAG 001/Annex C, EOTA TR029, etc.). This means load re-distribution on the anchors due to elastic deformations of the anchor plate are not considered -the anchor plate is assumed to be sufficiently stiff, in order not to be deformed when subjected to the design loading. PROFIS Anchor calculates the minimum required anchor plate thickness with FEM to limit the stress of the anchor plate based on the assumptions explained above. The proof if the rigid anchor plate assumption is valid is not carried out by PROFIS Anchor. Input data and results must be checked for agreement with the existing conditions and for plausibility! •Condition A applies when supplementary reinforcement is used. The <I> factor is increased for non-steel Design Strengths except Pullout Strength and Pryout strength. Condition B applies when supplementary reinforcement is not used and for Pullout Strength and Pryout Strength. Refer to your local standard. •Refer to the manufacturer's product literature for cleaning and installation instructions. •Checking the transfer of loads into the base material and the shear resistance are required in accordance with ACI 318 or the relevant standard! •An anchor design approach for structures assigned to Seismic Design Category C, D, E or Fis given in ACI 318-14, Chapter 17, Section 17.2.3.4.3 (a) that requires the governing design strength of an anchor or group of anchors be limited by ductile steel failure. If this is NOT the case, the connection design (tension) shall satisfy the provisions of Section 17.2.3.4.3 (b), Section 17.2.3.4.3 (c), or Section 17.2.3.4.3 (d). The connection design (shear) shall satisfy the provisions of Section 17.2.3.5.3 (a), Section 17.2.3.5.3 (b), or Section 17.2.3.5.3 (c). •Section 17.2.3.4.3 (b) / Section 17.2.3.5.3 (a) require the attachment the anchors are connecting to the structure be designed to undergo ductile yielding at a load level corresponding to anchor forces no greater than the controlling design strength. Section 17.2.3.4.3 (c) / Section 17.2.3.5.3 (b) waive the ductility requirements and require the anchors to be designed for the maximum tension I shear that can be transmitted to the anchors by a non-yielding attachment. Section 17.2.3.4.3 (d) / Section 17.2.3.5.3 (c) waive the ductility requirements and require the design strength of the anchors to equal or exceed the maximum tension / shear obtained from design load combinations that include E, with E increased byroo- •Hilti post-installed anchors shall be installed in accordance with the Hilti Manufacturer's Printed Installation Instructions (MPII). Reference ACI 318-14, Section 17.8.1. •The characteristic bond resistances depend on the return period (service life in years): 50 Fastening meets the design criteria! Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor ( c ) 2003-2009 Hilti AG, FL-9494 Schaan Hilti is a registered Trademari< of Hilti AG, Schaan