Submitted Application for a 2019 CIP Project

AppID19054
I. Administrative Section 
1. Project Name: Repair 2nd level concrete structure at DMV CC west wing
2. Project Description (One Sentence): Repair failing exterior concrete structure on the upper level of the west wing.
3a. Project Location: County: Carson City
3b. Project Location: City: Carson City
4. Department (department requesting project): Administration
5. Division (division requesting project): Buildings & Grounds
6. Agency (agency requesting project): N/A
7. Agency contact person: Michael L Johnson
8. Contact phone: 775-684-1816
9. Contact email: mljohnson@admin.nv.gov
The Department ranking of this project:
10. The Department will rank their projects 1 through the lowest ranked project (e.g., If 5 projects were submitted by the Department a ranking of 1 would be assigned to the most important or most needed project and a ranking of 5 would be the least needed project). 1
11. Has this project been previously requested in a prior CIP? No
12. SPWD 4 digit Building No. (for existing buildings) 0209
13. Facility Condition Analysis Project No. (if recommended)
14. Is the property State Owned? Yes
15. If the facility is existing, is it State owned? Yes
II. Narrative Section 
16. Project Description: Repair failing exterior concrete structure on the upper level of the west wing and repaint all exterior finishes.
17. Project Justification: The upper concrete structure of the building is failing - pieces of concrete have separated from the exterior structure exposing the underlying steel (re-bar) to the elements. The concrete is cracking/breaking away on the north, east and south sections of the building.
18. Project Background Information: The upper concrete structure of the building is failing - pieces of concrete have separated from the exterior structure exposing the underlying steel (re-bar) to the elements. The concrete is cracking/breaking away on the north, east and south sections of the building.
19. Mechanical and/or Electrical Equipment Replacement Projects:
19a. Type of equipment to be replaced:
19b. Year existing equipment was installed:
19c. Manufacturer of existing equipment:
19d. Model of existing equipment:
19e. Are there any known hazardous materials? No
Environmental Considerations
20a. Hazardous Materials (Asbestos, Lead Paint, etc.):
20b. Will the site require any hazardous material abatement? No
21. Ramifications if the Project is not Approved (short essay): This is a serious issue affecting both the integrity of the building structure as well as exposing employees to the risk of falling objects (concrete).
Health, Life Safety, and/or Legal Issues
22. Please describe any health, life safety, and/or legal issues that will be resolved by completing this project (Short Essay): This is a serious issue affecting the safety of employees. Completion of this project will eliminate eposing employees to the risk of falling objects (concrete).
23. Proposed Project Schedule Impacts/Issues
23a. Will this project require relocating personnel or vacating the building for any period of time? No
23b. Explain:
23c. Has any design work been completed on the proposed project? No
23d. What is the latest date this project could be completed without disrupting your program?
23e. What is the driving proposed completion date?
III. Preliminary Construction Cost Estimate and Funding Sources Section 
Preliminary Construction Cost Estimate and Funding Sources (The SPWD will prepare all final cost estimates. This schedule is for preliminary purposes only.)
24. Land (if land must be purchased):
25. Offsite construction:
26. On-site Development:
27. Utility connection fees:
28. Water rights deeded:
29. Furniture, Fixtures and Equipment:
30. Specialty equipment:
31. Data and network equipment:
32. Telephone equipment costs:
33. Moving:
34. Renovation of vacated space:
35a. Correction of known deficiencies:
35b. (describe deficiencies)
36a. Any known commitments:
36b. (describe commitments)
37a. Known hazardous material abatement:
37b. (describe hazardous materials)
38. Total project costs: 225,000
NOTE: COSTS FOR EXTENDED LEASE AGREEMENTS MUST BE INCLUDED IN YOUR OPERATING BUDGET
39. Proposed funding of total project cost:
39a. Agency:
39b. Federal
39c. State
39d. Other/Donor
39e. (describe source of 'Other/ Donor' funding): Possible Highway Funds
39f. Total: 225,000
40. Agency point of contact for outisde funding if 39a, 39b, or 39c funding sources are providing funds.
40a. Name
40b. Phone Number
40c. Email Address
IV. Site Analysis Section 
Site Analysis (New construction only)
41. Estimated land area to be acquired (acres) 0
42. Will this project require new parking spaces? No
43. Are utilities available to site? Yes
44. Will project require relocation of existing utilities? No
45. Are there any required offsite improvements (or right-of-way dedications)? No
46. Is the site in a flood plain? Yes
47. Is the site in an airport impact zone? No
48. Does the site contain any underground storage tanks? Unknown
49. Does the site contain any adverse soil conditions? Unknown
50. Will the site require an environmental assessment? No
51. Will rezoning or a special use permit be required? No
52. Will any Utility connection fees need to be paid? No
53. Will any water rights need to be deeded? No
54. Will construction traffic degrade existing access or facilities? No
55. Will the site require any hazardous material abatement? No
56a. Other site considerations affecting cost? (describe): No
56b. Describe Site Considerations:
V. Programming Section 
Programming (New construction, building remodels, and building additions only)
57. Has any architectural programming occurred?
(Programming is an architectural definition of the needs/problems that must be addressed by the project)
58. Has any advanced planning occurred in previous CIPs? No
59. Usable Square footage required (including storage space)
59a. New Construction SF:
59b. Remodel/Renovation SF:
59c. Addition SF
59d.Total project SF:
60. Occupancy type (Assembly, business, educational, factory/industrial, high hazard, institutional, mercantile, residential, storage, utility/miscellaneous) : Business
61. Approximate number of staff to occupy facility: 125
62. Approximate number of visitors per day: 40
63. Will this project require funding for any furnishings, fixtures and equipment? No
64. For existing facilities, are there any known hazardous materials? (e.g., Asbestos, lead paint or underground storage tanks): No
65. How many years of future growth will this project accommodate? 25
66. List of required facilites (laboratory space, classroom space, office space, conference rooms, cafeterias, maintenance shops, garages) and any unusual related equipment required for your project:

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NOTE:  IF YOU ARE THE “AGENCY CONTACT PERSON”, AND HAVE NOT BEEN CONTACTED BY THE ASSIGNED PROJECT MANAGER BY APRIL 16, 2018, PLEASE CONTACT THEM.