SFPD 4.08 (Rev. 06/16/03) PLAN SUBMITTAL REQUIREMENTS FOR SCHOOL MODERNIZATION PROJECTS

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SFPD 4.08 (Rev. 06/16/03) PLAN SUBMITTAL REQUIREMENTS FOR SCHOOL MODERNIZATION PROJECTS Education Code 17070.50 requires that all modernization plans to be funded by the State Allocation Board (SAB) be approved by the California Department of Education (CDE). Districts not requesting state funding may also request CDE review and approval of modernization plans. This packet contains the required forms and information necessary for submitting modernization plans to the CDE for review. The various components are listed in the following Table of Contents. Table of Contents I. CDE Plan Review Requirements for Modernization Plans p.2 II. Checklist for Modernization Plan Submittal p.2 III. Project Information for Modernization SFPD Form 4.08A p.3 IV. District Certifications for Modernization SFPD Form 4.08B p.4 V. Summary of Educational Specifications for Modernization SFPD Form 4.08C p.6 Part One-Summary of Educational Specifications Part Two-Space Conversions Submit plans and the required documents to the following address: California Department of Education School Facilities Planning Division 1430 N Street, Suite 3207 Sacramento, CA 95814 For more information, visit the SFPD website at www.cde.ca.gov/facilities or call (916) 322-2470. SFPD Form 4.08 Series (Rev. 06/16/03) Page 1 of 8

SFPD FORM 4.08 (Rev. 06/16/03) CDE PLAN REVIEW REQUIREMENTS FOR MODERNIZATION Educational Specifications: California Code of Regulations (CCR) Title 5, Section 14010, and good planning practice, requires the preparation of educational specifications for school plans. As an alternative to a comprehensive educational specifications, a summary of the scope of the project may be submitted on the form 4.08C. Preliminary and Final Plans: The submittal of schematic or preliminary plans is recommended strongly as the California Department of Education (CDE) may recommend or require changes prior to final plan approval. For final approval, CDE reviews the working drawings. It is not necessary to submit construction specifications. If no changes are made from the preliminary plan submittal, districts need not submit a second Form 4.08C with the final plans. Indicate in writing that no changes were made when submitting the final plans and submit updated Forms 4.08A and 4.08B. Do not include drawings, calculations, or plans for buildings not included in the modernization project. Reduced Size Plans: 2A and 3A diagrams are not required. Scaled or dimensioned plans on 11 X 17 paper may be submitted in place of 2A or 3A diagrams. Project Tracking Number: The project tracking number (PTN) is a unique identifier that will link application data utilized by the School Facilities Planning Division, the Division of the State Architect, and the Office of Public School Construction. Plans without a PTN will not be approved by the SFPD. A PTN can be issued for a project by accessing the PTN web page via the SFPD web page at: www.cde.ca.gov/facilities. Existing School Safety Certification: The district s review and certification of the Title 5 California Code of Regulations for school sites must be completed for all modernization projects on existing schools. These standards are listed on Part 2 of the form SFPD 4.08B. CHECKLIST FOR MODERNIZATION PLANS SUBMITTAL PRELIMINARY PLANS SUBMITTAL 1. SFPD Form 4.08A Project Information for Modernization including the Project Tracking Number 2. Educational Specifications: The district s Educational Specification document or SFPD Form 4.08C Summary of Educational Specifications 3. Preliminary or Schematic Construction Plans: Site Plan with street designations, parking areas, and topography Floor Plans with dimensions and spaces labeled consistent with 2A s Elevations typical interior and exterior elevations 4. Reduced Size Plans (see Plan Review Requirements for Modernization): Site Plan with street designations and parking areas Floor Plans with dimensions and spaces labeled consistent with plans Dimensions and area calculations FINAL PLANS SUBMITTAL 1. SFPD Form 4.08A Project Information for Modernization (updated) including the Project Tracking Number and the Construction Cost Estimate that the district will submit to the Office of Public School Construction 2. SFPD Form 4.08B District Certifications for Modernization (signed and dated) 3. SFPD Form 4.07/4.08D Existing School Site Certification 4. Educational Specifications Updated Educational Specifications document, or updated SFPD Form 4.08C, or a letter indicating that no changes have been made to educational specifications since the preliminary plan submittal 5. Final Construction Plans (Working Drawings): Site Plan with street designations, parking areas, and topography Floor Plans with dimensions and spaces labeled consistent with 3A s Elevations A full set of interior and exterior elevations 6. Reduced Size Plans (see Plan Review Requirements for Modernization): Site Plan with street designations and parking areas Floor Plans with dimensions and spaces labeled consistent with plans Dimensions and area calculations 7. A Diagrams SFPD Form 4.08 Series (Rev. 06/16/03) Page 2 of 8

SFPD FORM 4.08A (Rev. 06/16/03) PROJECT INFORMATION FOR MODERNIZATION Submit request sheet to Rodrigo Rodriquez of FGF Project Tracking # 6 DISTRICT INFORMATION 4 7 3 3 - PROJECT INFORMATION Plans are submitted for Preliminary Review Final Approval District School Name Los Angeles Unified School District Grade Level MANAGERS Grades in Class Size Reduction N/A Name Mark DeMan DISTRICT CONTACT Master Plan Site Capacity FGF Project Capacity (This Phase) N/A LD Project Total Number of Teaching Stations to be Modernized: Mangers Total Project Area (sq. ft.) LD Project Manager (This Phase) Phone 213-633-8084 Fax 213-633-8195 E-mail mark.deman@lausd.net Gross MANAGERS Net SITE ACREAGE MANAGERS Additional Joint-Use Acres N/A Contact Name Firm Name Mailing Address ARCHITECT CONTACT Does the district plan to operate the school on an MTYRE schedule? Yes No Type of MTYRE Calendar MANAGERS Phone Construction Cost Estimate MANAGERS Fax E-mail *Due to scope of the work to be performed for this project, teaching stations and square footage are not applicable. SFPD Form 4.08 Series (Rev. 06/16/03) Page 3 of 8

SFPD FORM 4.08B (Rev. 06/16/03) DISTRICT CERTIFICATIONS FOR MODERNIZATION (For Final Plans Only) Submit request sheet to Rodrigo Rodriquez of FGF District Los Angeles Unified School District County Los Angeles School Project Tracking Number 6 4 7 3 3 1. California Environmental Quality Act (CEQA) Compliance: Per Public Resource Code 21000 et. seq. and CEQA Guidelines Section 15000 et. seq. (Check one and fill in dates as applicable) The Local Educational Agency (LEA) certifies that it has completed for this project all actions required pursuant to CEQA and determined this project to be A. not a project for purposes of CEQA and that no CEQA action is required; or B. completely exempt from preparation of CEQA environmental documents either by statutory, categorical, or general rule exemption; or To be completed by C. fully covered in a Negative Declaration/Initial Study adopted by the LEA; or Local District D. fully covered in a Final Environmental Impact Report (EIR) adopted and certified by the LEA; Project or Manger E. fully covered within another lead agency s adopted CEQA document, and if necessary, the LEA has adopted a finding of no new impact. Date the Final EIR or Negative Declaration was adopted: Date the project was approved by the LEA governing board: Date the Notice of Exemption or Notice of Determination was filed with the County Clerk: MANAGERS 2. Existing School Safety Certification For districts modernizing an existing school site, the district must certify the district's review of the following Title 5 standards for this school modernization project and that the project will not create any new significant, or exacerbate any existing, safety hazards to students. California Code of Regulations (CCR), Title 5, Section 14010: (http://www.cde.ca.gov/facilities/field/codes/title5regs.htm) (c) Powerlines/Electromagnetic fields (d) Within 1,500 feet of a railroad (e) Traffic noise (f) Active fault or fault trace (g) Flood or inundation area (h) Near an above ground water or fuel storage tank or within 1,500 feet of a pipeline which can pose a safety hazard (i) Liquefaction/Landslides (l) Traffic/Pedestrian safety (m) Compatible existing and proposed surrounding land uses (q) Exposure to adverse light, wind and air pollution (r) Easements restricting access or building placement (t) Within 2,000 feet of a significant disposal of hazardous waste 3. Classroom Telephones and Public Safety: Per Education Code Section 17077.10. For permanent or portable classrooms in this project, the district has complied with Education Code Section 17077.10 by providing a telephone in each classroom that is a hard-wired or wireless connection to a public-switched telephone network. (Check one) Yes No Local District Project Manager. SFPD Form 4.08 Series (Rev. 06/16/03) Page 4 of 8

Not applicable, since there are no classrooms in the project. SFPD FORM 4.08B (Rev. 06/16/03) 4. Urban/Security/Impacted Site: For districts requesting additional funding pursuant to SAB regulation 1859.83(d), the CDE must certify to the SAB that the site size is 60% or less of the CDE recommended site size for the current CBEDS enrollment of the site. To request this increase, please complete Sections A and B below, and the CDE will compute the percent of the CDE recommended site size and report this figure in the Final Plan Approval letter for the project. A. Usable Site Acres (is the sum of the following): 1) Usable acres of existing school site. Exclude any portion of the project site which CDE has found to LDPM be unusable for school purposes, including but not limited to easements, steep terrain, and designated wetlands. 2) N/A Joint-use acres if the district has title to the property or signed a joint-use agreement with another public agency. Net Acres from page 3 must match total usable LDPM TOTAL USABLE ACRES acres B. Site Capacity: Does the school operate on a multi-track year round education calendar? Yes No If yes, enter the maximum enrollment on the site at one time (SAB Regulation 1859.2)*. Does the school operate single or double session kindergarten classes? Single Double For middle schools, does the educational program require football and track facilities? Yes No For high schools, does the educational program require: 1) Swimming pool? Yes No 2) Diving pool? Yes No 3) Baseball field including bleachers and dugouts? Yes No 4) Football field and track including a stadium? Yes No (district completion) FGF TO COMPLETE Section B to be completed by Local District Project Manager. Grades Kinder. 1 3 4 6 7 8 9 12 Non-Severe Severe TOTAL *Current CBEDS Enrollment of School (as adjusted for MTYRE if applicable) FGF FGF FGF FGF FGF FGF FGF FGF Non-Severe Special Education/ Severe Special Education Students (CDE use only) TOTAL ENROLLMENT OF SCHOOL **CDE Recommended Acres **Based on Guide to School Site Analysis and DeveloLD Project Managersent, 2000 Edition Net Usable Acres As A Percent of CDE Recommended Acres I certify, as the District Representative, that the information reported on this form is true and correct and that the above named school district has reviewed the Title 5 standards, cited in Section 2 herein, for this school modernization project and has determined that the project will not create any new significant, or exacerbate any existing, safety hazards to students. If a different CEQA process is pursued subsequent to this certification, the district shall notify immediately the School Facilities Planning Division and Office of Public School Construction. Beth Hamby Name of Authorized District Representative Director, Facilities Grants and Funding Title Signature of Authorized District Representative Date SFPD Form 4.08 Series (Rev. 06/16/03) Page 5 of 8

SFPD FORM 4.08C, PART ONE (Rev. 06/16/03) SUMMARY OF DISTRICT MODERNIZATION EDUCATIONAL SPECIFICATIONS (Submit with preliminary and final modernization plans) This Section to Be Completed By LD Project Managers Summary of how the project supports the district s educational program: The information placed in these sections describes the scope of work and building ID s. It should include the appropriate Building Names, corresponding DSA/Insurance Numbers from the drawings, and SP1 A Building Numbers. Please see section C for an actual project example Description of scope of work in the following areas: A. Technology ( Centralized Tech Lab Dispersed Technology Both None) B. Science (indicate if project includes science laboratories and if caustic and/or corrosive materials will be used) C. Heating, Ventilation, Air Conditioning Project includes HVAC service to the Administration Building, Cafeteria Kitchen, Kindergarten, and 17 classrooms 2096-003DAN CLASSROOM BLDG. 1 (SP1A Bldg. # 1) 2096-X0789M RELOCATABLE BUILDING (SP1A Bldg. # 7) 2096-X0663L RELOCATABLE BUILDING (SP1A Bldg. # 6) 2096-X1257M RELOCATABLE BUILDING (SP1A Bldg. # 10) 2096-X0852M RELOCATABLE BUILDING (SP1A Bldg. # 11) 2096-005DAN KINDERGARTEN BUILDING (SP1A Bldg. # 5) 2096-001DAL ADMINISTRATIVE BUILDING (SP1A Bldg. # 4) 2096-002DAN ASSEMBLY/CAFETERIA BUILDING (SP1A Bldg. # 3) 2096-X0492L RELOCATABLE BUILDING (SP1A Bldg. # 9) D. Plumbing E. Lighting, Ceilings, Electrical SFPD Form 4.08 Series (Rev. 06/16/03) Page 6 of 8

SFPD FORM 4.08C, PART ONE (Rev. 06/16/03) F. Floors, Doors, Walls, Windows G. Cabinetry H. Handicapped Accessibility I. Other SFPD Form 4.08 Series (Rev. 06/16/03) Page 7 of 8

SFPD FORM 4.08C, PART TWO (Rev. 06/16/03) SPACE CONVERSIONS (Complete only for spaces that will be altered in size or purpose) Some modernization projects may include a change in the purpose and/or size of a particular space to provide for an environment suitable to the current and future educational program. If a space is altered significantly, it is necessary to complete the 4.08C Part Two, Space Conversions. Removing a wall to make one large classroom out of two current classrooms would be considered significant. For instance, removing a stall in a restroom to make it handicapped accessible would not be considered significant and need not be included in this section. NOTE: Do not complete this section if teaching stations and support spaces are not being altered in size or purpose. Column A Column B Column C BUILDING IDENTIFICATION: Indicate the building identification by letter, number, or name. TYPE OF SPACE AND EDUCTIONAL PROGRAM: Label the type of space provided in each building under the column labeled "current." Indicate under the column labeled "planned" the type of space after modernization. SQUARE FEET PER SPACE AND NUMBER OF SPACES: Provide the current number of square feet per type of space to be converted and the number of spaces under the two columns under "current." Provide the square feet for the newly planned space and number of spaces under the planned column. For example: Current Planned Square Feet No. of Spaces Square Feet No. of Spaces 780 2 1,560 1 Column D PURPOSES: Provide a brief explanation of the educational purpose for the conversion. Example: Metal shop converted to simulation technology laboratory to provide students with exposure to various skills in operating robotics equild Project Managersent and related computer programming. A Building Identification B C D Type of Space and Educational Program Current Planned Square Feet Square Feet per Space and Number of Spaces Current Planned No. of Spaces Square Feet No. of Spaces Purposes Attach additional sheets if necessary SFPD Form 4.08 Series (Rev. 06/16/03) Page 8 of 8