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BMCH2019-007278-495 CALLE TAMPICO T-i D "i- Q � VOICE (760) 777-7 FAX (760) 777-7011011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/19/2019 Permit Type/Subtype: MECHANICAL/ Owner: Application Number: BMCH2O19-0072 REALTY TRUST GROUP INC Property Address: 47900 WASH INGTON ST ST 300 WILMOT RD APN: 643200037 DEERFIELD, IL 92253 Application Description: WALGREENS / CHANGE OUT (6) HVAC PACKAGE UNITS Property Zoning: Application Valuation: $15,000.00 Applicant: Contractor: P2EG ARTIC MECHANICAL INC 1390 W 6TH ST D 10440 TRADEMARK STREET CORONA, CA 92882 MAR 19 2019 RANCHO CUCAMONGA, CA 91730 (909)980-2539 my OFLAQUINTA Llc. No.:806737 DESIGN & DVELDPMENT DEPARTMENT LICENSED CONTRACTOR'S DECLARATIO I hereby affirm under penalty of perjury that I am license under rovisivns of Chapter 9 (commencing with Section 7000) of Division 3 QaProfessions Code, and my License is in full force and effect.License Class: C20, C38 CIQ License No. D4f`e. __ �,lR AI Contractor: OWNER -BUILDER DEC ON ,I hereby affirm under penalty of perjury that I am exempt m L Contractor's State 'License Law for the following reason (Sec. 7031.5, Business a d4PIessrons Code: Any city or county that requires a permit to construct, alterimpromulish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. . B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C,). Lender's Name: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance oft ork for which this permit is issued. +I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: IRAYLLERS PRQPERTY CASUALTY COMPANY OF AMERICA Policy Number: 9C577941 I certify that in the performance of th4for this permit is issued, I shall not employ any person in any manner so act to the workers' compensation laws of California, and agree thame subject to the workers' compensation provisions of Section 37ode, I shall forthwith comply with those provisions. Date:. q ZA Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENS ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN A DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECT N 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance ofthis permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. J r I certify that I have read this application and state that theVY,3ut anoniscorrect. I agree to comply with all city and county ordinances and ingtobuilding construction, and hereby authorize representatives of thipon the above - mentioned property for inspection purposes. Lender's Address: Ilpate� �1/ I n I (4 ^ Signature (Applicant or Agent): Date: 3119/-.3019 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: P2EG 1390 W 6TH ST CORONA, CA 92882 BMCH2019-0072 47900 WASHINGTON ST ST 643200037 WALGREENS / CHANGE OUT (6) HVAC PACKAGE UNITS $15,000.00 Owner: REALTY TRUST GROUP INC 300 WILMOT RD DEERFIELD, IL 92253 Contractor: ARTIC MECHANICAL INC 10440 TRADEMARK STREET RANCHO CUCAMONGA, CA 91730 (909)980-2539 Llc. No.: 806737 Detail: HVAC CHANGE OUT - SIX (6) PACKAGE UNITS [ENGINEERED) THIS PERMIT DOES NOT INCLUDE NEW ROOF PENETRATIONS OR CURB INSTALLATIONS. 2016 CALIFORNIA BUILDING CODES. yid DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT CITY AMOUNT HVAC CHANGEOUT - PACKAGED UNIT 101-0000-42402 0 $240.12 DESCRIPTION ACCOUNT CITY AMOUNT HVAC CHANGEOUT- PACKAGED UNIT PC 101-0000-42600 0 $160.08 Total Paid for CHANGEOUT: $400.20 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT CITY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 i I (� iLLILiV{J — (;I. .M ,j ,i,, ur-tea r — Project Address: i0 Vuna1n M1d,1 5% APN #: Applicant Name: ill t,4 Address: l 34 0 W 44, {— City, ST, Zip:, Telephone: � 5-1 Email Arch/Eng Name: Address: 6 1rJ 4 City, St, Zip Telephone: Email: O �� State Lic: 2 City Bus Lic: Property Owner's Name: �a Address: A-7ao VJ4 City, ST, Zip Let �� CJ+ q2� Telephone: Email: PERMIT # z m cg 2Q n PLAN LOCATION: Project Desc+i6n,::V'bol, i ZnhAel, Acf'dr}r,; %% tt, *,mb, Mech ,i dl r Mee- Wt7v110-. IAI LL Ylo rlo-91.^AA n Valuation of Project $ 9 lJ &UQ Construction Type: Grading: Bedrooms: I Stories: Occupancy: # Units: 5' New Commercial / Tenant Improvements: Total Building SF Construction Type: Occupancy: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 �c Ni2C c� - MGN - 02 3 crr�r� BUILDING ENERGY ANALYSIS REPORT PROJECT: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) 47900 Washington St. La Quinta, CA 92253 Project Designer: Proscap Engineering & Energy Group 1390 W 6th Street, Suite 106 Corona, CA 92882 9512837085 Report Prepared by: ProsCap Engineering & Energy Group P289 Proscap Engineering & Energy Group Job Number: P2EG-28219 Date: 2/8/2019 CITY M LA QUIIVTA BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE I �l BY —(&— MAR 1 1 CD-Y OF LA QUINTA 'OMMUNITY DEVELOPMENT The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2016 Building Energy Efficiency Standards. This program developed by EnergySoft Software — www.energysoft.com. TABLE OF CONTENTS I Cover Page 1 Table of Contents 2 Form MCH-01-E Prescriptive - Mechanical Systems 3 Form MCH-02-E Prescriptive - HVAC System Requirements 7 Form MCH-03-E Prescriptive - Mechanical Ventilation and Reheat 11 Form MCH-04-E Prescriptive - Required Acceptance Tests 14 Form MCH-05-E Prescriptive - Requirements for Packaged Single Zo 17 . • e EnergyPro 7.2 by EnergySoft Job Number: ID: P2EG-28219 User Number: 8088 1 STATE OF CALIFORNIA MECHANICAL SYSTEMS r-1-1 CEC-NRCC-MCH-01-E (Revised 01116) CALIFORNIA ENERGY COMMISSION r CERTIFICATE OF COMPLIANCE NRCC-MCH-01-E Mechanical Systems (Page 1 of 4) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 A. MECHANICAL COMPLIANCE DOCUMENTS & WORKSHEETS (check box if worksheet is included) For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2016 Nonresidential Manual Note: The Enforcement Agency may require all forms to be incorporated onto the building plans. YES NO JComp. Doc./Worksheet # Title in ❑ NRCC-MCH-01-E (Part 1 of 3) Certificate of Compliance, Declaration. Required on plans for all submittals. ❑ ❑ NRCC-MCH-01-E (Part 2 of 3) Certificate of Compliance, Required Acceptance Tests (MCH-02-A to 11-A). Required on plans for all submittals. ❑ ❑ NRCC-MCH-01-E (Part 3 of 3) Certificate of Compliance, Required Acceptance Tests (MCH-12-A to 18-A). Required on plans where applicable. ❑ ❑ NRCC-MCH-02-E (Part 1 of 2) Mechanical Dry Equipment Summary is required for all submittals with Central Air Systems. It is optional on plans. ❑ NRCC-MCH-02-E (Part 2 of 2) Mechanical Wet Equipment Summary is required for all submittals with chilled water, hot water or condenser water systems. It is optional on plans. Mechanical Ventilation and Reheat is required for all submittals with multiple zone heating and cooling systems. It is optional on plans. ❑ NRCC-MCH-03-E ❑ 0 NRCC-MCH-07-E (Part 1 of 2) Power Consumption of Fans. Required on plans where applicable ❑ 0 NRCC-MCH-07-E (Part 2 of 2) Power Consumption of Fans, Declaration. Required on plans where applicable CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA MECHANICAL SYSTEMS "P. CEC-NRCC-MCH-01-E (Revised 01116) CALIFORNIA ENERGY COMMISSION r CERTIFICATE OF COMPLIANCE NRCC-MCH-01-E Mechanical Systems (Page 2 of 4) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 B. MECHANICAL HVAC ACCEPTANCE FORMS (check box for required compliance documents) Test Performed By: Designer: This compliance document is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for HVAC systems. The designer is required to check the applicable boxes for all acceptance tests that apply and list all equipment that requires an acceptance test. All equipment of the same type that requires a test, list the equipment description and the number of systems. Installing Contractor: The contractor who installed the equipment is responsible to either conduct the acceptance test themselves or have a qualified entity run the test for them. If more than one person has responsibility for the acceptance testing, each person shall sign and submit the Certificate of Acceptance applicable to the portion of the construction or installation for which they are responsible. Enforcement Agency: Plancheck—The NRCC-MCH-01-E compliance document is not considered a completed document and is not to be accepted by the building department unless the correct boxes are checked. Inspector - Before occupancy permit is granted all newly installed process systems must be tested to ensure proper operations. Test Description MCH-02-A MCH-03-A MCH-04-A MCH-05-A MCH-06-A MCH-07-A MCH-08-A MCH-09-A MCH-10-A MCH-11-A Equipment Air Demand Hydronic Automatic Requiring Testing # of Outdoor Single Zone Distribution Economizer Control Supply Fan Valve Leakage Supply Water System Demand Shed or Verification Units Air Unitary Ducts Controls Ventilation VAV Test Temp. Reset Variable Flow Control (DCV) ❑ ❑ Control ❑ ❑ ZR090E09R2B! 1 0 0 ❑ 0 p ❑ XP078COOR2B! 3 0 p ❑ 0 0 ❑ ❑ ❑ ❑ ❑ XYE06A2C1AB 1 0 0 ❑ 0 0 ❑ ❑ ❑ ❑ ❑ XYE05A2C1AB 1 0 0 ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA MECHANICAL SYSTEMS CEC-NRCC-MCH-01-E (Revised 01116) CERTIFICATE OF COMPLIANCE Mechanical Systems Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) C. MECHANICAL HVAC ACCEPTANCE FORMS (check box for required compliance docume Test Performed CALIFORNIA ENERGY COMMISSION NRCC-MCH-01-E (Page 3 of 4) Date Prepared: 2/8/201 9 I Designer: This compliance document is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for HVAC systems. The designer is required to check the applicable boxes for all acceptance tests that apply and list all equipment that requires an acceptance test. All equipment of the same type that requires a test, list the equipment description and the number of systems. Installing Contractor: The contractor who installed the equipment is responsible to either conduct the acceptance test themselves or have a qualified entity run the test for them. If more than one person has responsibility for the acceptance testing, each person shall sign and submit the Certificate of Acceptance applicable to the portion of the construction or installation for which they are responsible. Enforcement Agency: Plancheck — The NRCC-MCH-01-E compliance document is not considered a completed document and is not to be accepted by the building department unless the correct boxes are checked. Inspector - Before occupancy permit is granted all newly installed process systems must be tested to ensure proper operations. Test Description �l MCH-12-A MCH-13-A MCH-14-A MCH-15-A ._ MCH-16-A MCH-17-A _ MCH-18-A Equipment # of Fault Detection & Automatic Fault Detection & Distributed Energy Thermal Energy Supply Air Condenser Water Requiring Testing Units Diagnostics for DX Diagnostics for Air & Storage DX AC Storage (TES) Temperature Reset ECMS Reset Controls or Verification Units Systems Systems Controls Zone ZR090E09R2B° 1 ❑ ❑ 1 ❑ ❑ ❑ ❑ ❑ XP078COOR213', 3 ❑ ❑ ❑ ❑ ❑ ❑ ❑ I XYE06A2C1AB; 1 ❑ ❑ ❑ ❑ ❑ ❑ ❑ XYE05A2C1AB 1 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ j ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA MECHANICAL SYSTEMS is CEC-NRCC-MCH-01-E [Revised 01116) CALIFORNIA ENERGY COMMISSION � CERTIFICATE OF COMPLIANCE NRCC-MCH-01-E Mechanical Systems (Page 4 of 4) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. o Documentation Author Name: Documentation Author Signature: Company: ProsCap Engineering & Energy Group Signature Date: 2/8/2019 Address: CEA/ HERS Certification Identification (if applicable): City/State/Zip: Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT' I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 .and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: r Bernard Adebayo-Ige, P.E. Responsible Designer Signature: I _ _ p0.aFCSS1O Company: Date Signed: �4 E Proscap Engineering &Energy Group 2/8/2019 AD �- �. Address: License: 1390 W 6th Street, Suite 106ul City/State/Zip: Phone: V �� 30 in Corona, CA 92882 9512837085 M 'n CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA HVAC DRY & WET SYSTEM REQUIREMENTS C E C -N R CC- MCH -02- E (Revised 01A6) CALIFORNIA ENERGY COMMISSION -qW- CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Dry & Wet System Requirements (Page 1 of 3) Project Name: Walgreens No. 776 (installation of Heat Pumps & HVAC Unit) Date Prepared: A. Equipment Tags and System Description'- Dry Systems ZR090E09R2B5C XP078C00R2135C XYE06A2C1AB3E MANDATORY MEASURES T-24 Sections Reference to the Requirements in the Contract Documents Heating Equipment Efficiency 110.1 or 110.2(a) Cooling Equipment Efficiency 110.1 or 110.2(a) HVAC or Heat Pump Thermostats 110.2(b), 110.2(c) Furnace Standby Loss Control 110.2(d) Low Leakage AHUs 110.2(f) Ventilation 120.1(b) Demand Control Ventilation 120.1(c)4 Occupant Sensor Ventilation Control 120.1(c)5, 120.2(e)3 Shutoff and Reset Controls 120.2(e) Outdoor Air and Exhaust Damper Control 120.2(f) Isolation Zones 120.2(g) Automatic Demand Shed Controls 120.2(h) Economizer FDD 120.2(i) Duct Insulation 120.4 PRESCRIPTIVE MEASURES Equipment is sized in conformance with 140.4(a & b) Y Y/N Y Y/N Y Y/N 140.4(a & b) Supply Fan Pressure Control 140.4(c) 140.4(d) Simultaneous Heat/Cool Economizer 140.4(e) Heat and Cool Air Supply Reset 140.4(f) Electric Resistance Heating 140.4(g) Duct Leakage Sealing and Testing 140.4(I) Notes: 1. Provide equipment tags (e.g. AHU 1 to 10) and system description (e.g. Single Duct VAV reheat) as appropriate. Multiple units with common requirements can be grouped together. 2. Provide references to plans (i.e. Drawing Sheet Numbers) and/or specifications (including Section name/number and relevant paragraphs) where each requirement is specified. Enter "N/A" if the requirement is not applicable to this system. 3. The referenced plans and specifications must include all of the following information: equipment tag, equipment nominal capacity, Title 24 minimum efficiency requirements, and actual rated equipment efficiencies. Where multiple efficiency requirements are applicable (e.g. full- and part -load) include all. Where appliance standards apply (110.1), identify where equipment is required to be listed per Title 20 1601 et seq. 4. Identify where the ventilation requirements are documented for each central HVAC system. Include references to both central unit schedules and sequences of operation. If one or more spaces is naturally ventilated identify where this is documented in the plans and specifications. Multiple zone central air systems must also provide a MCH-03-E compliance document. 5. If one or more spaces has demand controlled ventilation identify where it is specified including the sensor specifications and the sequence of operation. 6. If one or more space has occupant sensor ventilation control identify where it is specified including the sensor specifications and the sequence of operation 7. If the system is DDC identify the sequences for the system start/stop, optimal start, setback (if required) and setup (if required). For all systems identify the specification for the thermostats and time clocks (if applicable). S. Identify where the heating, cooling and deadband airflows are scheduled for this system. Include a reference to the specification of the zone controls. Provide a MCH-03-E compliance document. 9. Enter N/A if there is no electric heating. If the system has electric heating indicate which exception to 140.4(g) applies. 10. If duct leakage sealing and testing is required, a MCH-04-A compliance document must be submitted. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA HVAC DRY & WET SYSTEM REQUIREMENTS rd-, - 14, CEC-NRCC-MCH-02-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Dry & Wet System Requirements (Page 1 of 3) Project Name: Wa greens No. 7765 (Installation of Heat Pumps & HVAC nit Date Prepared: A. Equipment Tags and System Description' - Dry Systems XYE05A2C1 AB1 E MANDATORY MEASURES T-24 Sections Reference to the Requirements in the Contract Documents2 Heating Equipment Efficiency 110.1 or 110.2(a) Cooling E uipment Efficiency110.1 or 110.2(a) HVAC or Heat Pump Thermostats 110.2(b), 110.2(c) Furnace Standby Loss Control 110.2(d) Low Leakage AHUs 110.2(f) Ventilation 120.1(b) Demand Control Ventilation 120.1(c)4 ULLUpant Sensor Ventllatlon CU-1-1tr Vl 12U. 1(c)7� 120.2(e)3 Shutoff and Reset Controls 120.2(e) Outdoor Air and Exhaust Damper Control 120.2(f) Isolation Zones 120.2(g) Automatic Demand Shed Controls 120.2(h) Economizer FDD 120.2(i) Duct Insulation 120.4 PRESCRIPTIVE MEASURES Equipment is sized in conformance with 140.4(a & b) Y Y/N Y/N Y/N 140.4(a & b Supply Fan Pressure Control 140.4(c) Simultaneous Heat/Cool 140.4(d) Economizer 140.4(e) Heat and Cool Air Supply Reset 140.4(f) Electric Resistance Heating k 140.4(g) Duct Leakage Sealing and Testing 140.4(I) Notes: 1. Provide equipment tags (e.g. AHU 1 to 10) and system description (e.g. Single Duct VAV reheat) as appropriate. Multiple units with common requirements can be grouped together. 2. Provide references to plans (i.e. Drawing Sheet Numbers) and/or specifications (including Section name/number and relevant paragraphs) where each requirement is specified. Enter "N/A" if the requirement is not applicable to this system. 3. The referenced plans and specifications must include all of the following information: equipment tag, equipment nominal capacity, Title 24 minimum efficiency requirements, and actual rated equipment efficiencies. Where multiple efficiency requirements are applicable (e.g. full- and part -load) include all. Where appliance standards apply (110.1), identify where equipment is required to be listed per Title 20 1601 et seq. 4. Identify where the ventilation requirements are documented for each central HVAC system. Include references to both central unit schedules and sequences of operation. If one or more spaces is naturally ventilated identify where this is documented in the plans and specifications. Multiple zone central air systems must also provide a MCH-03-E compliance document. 5. If one or more spaces has demand controlled ventilation identify where it is specified including the sensor specifications and the sequence of operation. 6. If one or more space has occupant sensor ventilation control identify where it is specified including the sensor specifications and the sequence of operation 7. If the system is DDC identify the sequences for the system start/stop, optimal start, setback (if required) and setup (if required). For all systems identify the specification for the thermostats and time clocks (if applicable). 8. Identify where the heating, cooling and deadband airflows are scheduled for this system. Include a reference to the specification of the zone controls. Provide a MCH-03-E compliance document. 9. Enter N/A if there is no electric heating. If the system has electric heating indicate which exception to 140.4(g) applies. 10. If duct leakage sealing and testing is required, a MCH-04-A compliance document must be submitted. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA HVAC DRY & WET SYSTEM REQUIREMENTS r_ CEC-NRCC-MCH-02-E (ReWwd 01/16) CALIFORNIA ENERGY COMMISSION r CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Dry & Wet System Requirements (Page 2 of 3) Project Name: Walgreens No. 7765 (Installation of Heat_Pumps & HVAC Unit) Date Prepared: 2/8/2019 B. Equipment Tags and System Description' — Wet Systems MANDATORY MEASURES T-24 Sections Reference to the Requirements in the Contract DocumentS2 Heating Hot Water Equipment Efficiency 110.1 Cooling Chilled and Condenser Water 110.1, 140.4(i) Equipment Efficiency3 Open and Closed Circuit Cooling Towers 110.2(e) 1 conductivity or flow -based controls Open and Closed Circuit Cooling Towers Maximum Achievable Cycles of 110.2(e) 2 Concentration (LSI)6 110.2(e) 3 Open and Closed Circuit Cooling Towers Flow Meter with analog output Open and Closed Circuit Cooling Towers 110.2(e) 4 Overflow Alarm 110.2(e) 5 Open and Closed Circuit Cooling Towers Efficient Drift Eliminators 120.3 Pipe Insulation PRESCRIPTIVE MEASURES Cooling Tower Fan Controls 140.4(h)2, 140.4(h)5 Y/N Y/N Y/N Cooling Tower Flow Controls 140.4(h)3 Centrifugal Fan Cooling Towers 140.4(h)4 Air -Cooled Chiller Limitation 140.46) Variable Flow System Design 140.4(k) Chiller and Boiler Isolation 140.4(k) CHW and HHW Reset Controls 140.4(k) WLHP Isolation Valves 140.4(k) VSD on CHW, CW & WLHP Pumps >5HP 140.4(k) DP Sensor Location 140.4(k) 1 Notes: 1. Provide equipment tags (e.g. CH 1 to 3) or system description (e.g. CHW loop) as appropriate. Multiple units with common requirements can be grouped together. 2. Provide references to plans (i.e. Drawing Sheet Numbers) and/or specifications (including Section name/number and relevant paragraphs) where each requirement is specified. Enter "N/A" if the requirement is not applicable to this system. 3. The referenced plans and specifications must include all of the following information: equipment tag, equipment nominal capacity, Title 24 minimum efficiency requirements, and actual rated equipment efficiencies. Where multiple efficiency requirements are applicable (e.g. full- and part -load) include all. For chillers operating at non-standard efficiencies provide the Kadj values. For chillers also note whether the efficiencies are Path A or Path B. 4. Identify if cooling towers have propeller fans. If towers use centrifugal fans document which exception is used. 5. If air-cooled chillers are used, document which exceptions have been used to comply with 140.40) and the total installed design capacity of the air-cooled chillers in the chilled water plant. 6. Identify the existence of a completed MCH-06-E when open or closed circuit cooling towers are specified to be installed, otherwise enter "N/A". CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA HVAC SYSTEM REQUIREMENTS r'Eifll CEC-NRCC-MCH-02-E (Revised 06114) CALIFORNIA ENERGY COMMISSION -qW` CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Wet System Requirements (Page 3 of 3) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: company. ProsCap Engineering & Energy Group Signature Date: 2/8/2019 Address: CEA/ HERS Certification Identification (if applicable): City/State/Zip: I Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Bernard Adebayo-Ige, P.E. h��QFtss%t. Company! Proscap Engineering & Energy Group I Date Signed: 2/8/2019 Address` 1390 W 6th Street, Suite 106 License: City/State/Zip: Corona, CA 92882 Phone: 9512837085 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA MECHANICAL VENTILATION AND REHEAT We CEGNRCC-MCH-03-E (Revised 05/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-03-E Mechanical Ventilation & Reheat (Page 1 of 2) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 A. Mechanical Ventilation and Reheat ROOM VAV Reheated Primary VAV Deadband ACTUAL DESIGN INFO (FROM EQUIPMENT SCHEDULES, ETC) AREA BASIS OCCUPANCY BASIS BASIS MINIMUM Air CFM Primary Air CFM 01 02 03 1 04 05 j 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 Q C O a 1' S ❑ CC O Q LL U 3 ❑ O ❑ LL ❑ w w K Q Q w J a z r F r. l7 Z w w cc < ❑ w > X lJi < d 2 3 m �_ 55_ x Q w z LL Z ¢ z O w« J w I ii Q m a a m z a m O w 3 > O Q w 0 ~ OU �_ ❑ 2 cc w w z ❑ O m 3 p O w ..-. V1 m w> l7 LL l7 Z U LL❑ LL LL U cai U a [7 z U D_ LL 2 w U F $' Z Q .... I LL O cc a U 7 Z_ U U Z 6 ❑ LL w � K U d 2 LL U it Q U ¢ C w 7 U D- ❑ OU V Q LL 6 U d Z¢ (] > W ❑ Q W F ilN1 Z Z U Z Z_ O w Q 1' O win S Q X O U Q> m XQ` Q O U N O U ❑ ❑ U r z U m a < )� Pass Pass Sales Floor 0 0 0 Y 502 2,509 0.20 502 21.0 15.0 316 502 1ffi Pass 0 502 ElFail 0 502 ❑ Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass Total 502 ❑ Pass ❑ Fail El Fail ❑ Fail ❑ N/A ❑ N/A �I Pass Pass Sales Floor 0 0 0 Y 1,305 6,523 0.20 1,305 55.0 15.0 825 1,305 x Pass 0 1 305 El Fail 0 1,305 ❑Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass ❑ Pass Total 1,305 ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A Pass N Pass Pass Sales Floor 0 0 0 Y 334 1,672 0.20 334 14.0 15.0 210 334 0 334 ❑ Fail 0 334 ❑ Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass Total 334 ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A �I Pass X Pass Sales Floor 0 0 0 Y 268 1,338 0.20 268 11.0 15.0 165 268 ) Pass 0 268 ❑ Fail 0 268 ElFail ❑ Fail ❑ N/A ❑ N/A CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance May 2016 STATE OF CALIFORNIA MECHANICAL VENTILATION AND REHEAT 1i I r ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-03-E Mechanical Ventilation & Reheat (Page 1 of 2) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 A. Mechanical Ventilation and Reheat ROOM VAV Reheated Primary VAV Deadband ACTUAL DESIGN INFO (FROM EQUIPMENT SCHEDULES, ETC) AREA BASIS OCCUPANCY BASIS BASIS MINIMUM Air CFM Primary Air CFM 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 Oac 0 3 O W w Cr w Cr Z O M1. ~Q = f�• 0 M1 W Q cac ❑ Z C_ cQ C W _ a} 2 Z ❑ Q Q W d W m H Z d m W > O� W .-1 Q VI ❑ tj W Vf W V1 ❑ Q in OJ w i X tr! ❑ m R Q a lJ x m 0 a 0 W W FE R 0. W i_7 Z is Q z 11 CJ W y = 2 w �- 1 m W ❑ a K U 7 O V❑ U J a Z Z7 K W 0 �' a V 7 lJ Ca p� n 0 U 4 v+ W U W' Z U Z $ �. U [7 Q ...- Z U ...� > K W yWj V O Q Z LL U W U Z U Z K S Q 0 U 5 w W Q c C V C ❑ a T V K x Q ❑ ❑> wo n Q v.d Z z o Z Z Ca C 20 2 U a Q� x mg a N 0 OU ij O Z U ii ii 2 ❑ Pass ❑ Pass ❑ Pass Total 268 ❑ Fail ❑Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ N/A ❑ N/A CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance May 2016 STATE OF CALIFORNIA MECHANICAL VENTILATION AND REHEAT J1 T GEC-NRCC-MCH-03-E (Revised 05116) CALIFORNIA ENERGY COMMISSION rr CERTIFICATE OF COMPLIANCE NRCC-MCH-03-E Mechanical Ventilation & Reheat (Page 2 of 2) Project Name: Walgreens No. 7765 (installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: I company: ProsCap Engineering & Energy Group Signature Date: 2/8/2019 Address: HERS Certification Identification (if applicable): Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Bernard Adeba o-i e, P.E. Responsible Designer Signature: Y 9 company: Proscap Engineering & Energy Group ' Date Signed: 2/8/2019 Address: 1390 W 6th Street, Suite 106 City/State/Zip: Corona, CA 92882 License: 9512837085 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance May 2016 STATE OF CALIFORNIA REQUIRED ACCEPTANCE TESTS CEC-NRCC-MCH-04-E Revised 01/16) CERTIFICATE OF COMPLIANCE Required Acceptance Tests CALIFORNIA I Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) f Date Prepared: 2/8 /2019 )MISSION 0 NRCC-MCH-04-E (Page 1 of 3) A. MECHANICAL COMPLIANCE FORMS & WORKSHEETS (indicate if worksheet is included) For detailed instructions on the use of this anal all Energy Standards compliance documents, refer to the 2016 Nonresidential Manual Note: The Enforcement Agency may require all compliance documents to be incorporated onto the building plans. The NRCC-MCH-04-E and NRCC-MECH-05-E are alternative compliance documents to NRCC-MCH-01-E, NRCC-MCH-02-E and NRCC-MCH-03-E for projects using only single zone packaged HVAC systems. YES NO Form Title ✓ NRCC-MCH-04-E (1 of 2) Certificate of Compliance. Required on plans when used. ✓ NRCC-MCH-04-E (2 of 2) Mechanical Acceptance Tests. Required on plans when used. ✓ NRCC-MCH-05-E (1 of 2) HVAC Prescriptive Requirements. It is required on plans when used. ✓ NRCC-MCH-05-E (2 of 2) Mechanical SWH Equipment Summary is required for all submittals with service water heating, pools or spas. It is required on plans where applicable. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA REQUIRED ACCEPTANCE TESTS CEC-NRCC_MICH-04-E (Revised 01/16) CERTIFICATE OF COMPLIANCE Required Acceptance Tests Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) � CALIFORNIA ENERGY COMMISSION NRCC-MCH-04-E (Page 2 of 3) Date Prepared: 2/8/201 9 Designer: This compliance document is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for mechanical systems. The designer is required to check the applicable boxes by all acceptance tests that apply and list all equipment that require an acceptance test. If all equipment of a certain type requires a test, list the equipment description and the number of systems. The NA number designates the Section in the Appendix of the Nonresidential Reference Appendices Manual that describes the test. Since this compliance document will be part of the plans, completion of this section will allow the responsible party to budget for the scope of work appropriately. Enforcement Agency: Systems Acceptance. Before occupancy permit is granted for a newly constructed building or space, or a new space -conditioning system serving a building or space is operated for normal use, all control devices serving the building or space shall be certified as meeting the Acceptance Requirements for Code Compliance. Systems Acceptance. Before occupancy permit is granted. All newly installed HVAC equipment must be tested using the Acceptance Requirements. The NRCC-MCH-04-E compliance document is not considered a completed document and is not to be accepted by the building department unless the correct boxes are checked. The equipment requiring testing, person performing the test (Example: HVAC installer, TAB contractor, controls contractor, PE in charge of project) and what Acceptance test must be conducted. The following checked -off forms are required for ALL newly installed and replaced equipment. In addition a Certificate of Acceptance documents shall be submitted to the building department that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of Section tn-inRfh] and TitIP 74 part 6_ The huildine inspector must receive the Drooerlv filled out and signed compliance documents before the building can receive final occupancy. Test Description MCH-02-A MCH-03-A MCH-04-A MCH-05-A MCH-06-A MCH-07-A MCH-11-A MCH-12-A MCH-14-A MCH-18-A Test Performed By: Equipment Requiring Testing or Verification # of Units Outdoor Air Single Zone Unitary Air Distribution Ducts Economizer Controls Demand Control Ventilation (DCV) Supply Fan VAV Automatic Demand Shed Control FDD for Packaged DX Units Distributed Energy Storage DX AC Systems Energy Management Control System ZR090E09R 1 ✓ ✓ ✓ ✓ XP078COOR 3 ✓ ✓ ✓ ✓ XYE06A2C1 1 ✓ ✓ ✓ ✓ XYE05A2C1 1 ✓ ✓ ✓ CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA REQUIRED ACCEPTANCE TESTS CEGNRCC-MCH-04-E JaEisecl D1116 CALIFORNIA ENERGY COMMISSION "1W CERTIFICATE OF COMPLIANCE NRCC-MCH-04-E Required Acceptance Tests (Page 3 of 3) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared: 2/8/2019 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Company: ProsCap Engineering & Energy Group signature Date: 2/8/2019 Address: CEA/ HERS Certification Identification {if applirabtel: City/State/Zip: Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. I will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Bernard Adebayo-Ige, P.E. qCp��gS� Company: Date Signed: 2�8�2019 t4 ,a�� E� Proscap Engineering &Energy Group � L 1390 W 6th Street, Suite 106 Corona, CA 92882 License: Phone: 9512837085 3505z rn Icy r:,. 1 rin .% CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA REQUIREMENTS FOR PACKAGED SINGLE ZONE UNITS "Col CEC-NRCC-MCH-05-E (Revised 01/1e] CALIFORNIA ENERGY COMMISSION -MOP' CERTIFICATE OF COMPLIANCE NRCC-MCH-05-E Requirements for Packaged Single -Zone Units (Page 1 of 2) Project Name: Walgreens No. 7765 (Installation of Heat Pumps 8r HVAC Unit) Date Prepared: 2/8/2019 EquipmentTag(s) ZR090E09R2B5GCA2R1 XP078C00U85GCA2R1 XYE06A2C1AB3B223A2 T-24 Sections Requirement As Scheduled Requiremene As Scheduled Requirernent5 As Schedule MANDATORY MEASURES Heating Equipment Efficiency 110.1 or 110.2(a) n/a n/a 3.30 COP 3.40 COP 7.70 FIPF 8.20 HSPF Cooling Equipment Efficiency 110.1 or 110.2(a) 11.0 EER 11.2 EER 11.0 EER 12.0 EER 13 SEER 15.0 SEER / 12.: Thermostats-'110.2(b),110.2(c) Setback Setback Setback Setback Setback etback Furnace Standby Loss Control 110.2(d) Low Leakage AHU 110.2(f) NR none NR none NR none Ventilation 7 120.1(b) 502 316 1305 825 334 210 Demand Control Ventilation 120.1(c)4 NR Yes NR Yes NR Yes Occupant Sensor Ventilation Control 120.1(c)5, 120.2(e)3 Shutoff and Reset Controls 120.2(e) Reg i Programmable Reg Programmable.' Reg Pro rammable S Outdoor Air and Exhaust Damper Control 120.2(f) Req Auto R ecl Auto Req Auto Automatic Demand Shed Controls 120.2(h) NR none NR none R i none Economizer FDD 120.2(i) Req Yes Req Yes NR No Duct Insulation 120.4 R-8 R-8.0 R-8 R-8.0 R-8 R-8.0 PRESCRIPTIVE MEASURES Equipment is sized in conformance with 140.4(a & b) 74,551 Btu/hr 30,700 Btu/hr 93,231 Btuthr 140,529 Btu/hr 42,883 Btu/hr 34,352 Btu/hr 140.4 (a & b) 90,475 Btu/hr 57,444 Btu/hr 162,427 Btuft 172,371 Btu/hr 55,079 Btu/hr 45,560 Btu/hr Economizer 140.4(e) Reg Fixed Temp (Ir Req Fixed Temp I t NR Fixed Temp Inte Electric Resistance Heating 140.4(g) No NO No No NO No Duct Leakage Sealing and Testing. 140.4(1) NR No NR No NR No Notes: 1. Provide equipment tags (e.g. ACl or AC1 to 10). Multiple units of the same make and model with the same application and accessories can be grouped together. 2. Enter the following information as appropriate: Unit Manufacturer; Unit Model Number (including all accessories); Description of the unit (e.g. gas -pack or heat pump; rated heating capacity (enter "N/A" if no heating); and, rated cooling capacity (enter "N/A" if no cooling). For unit capacities include the units (e.g. kBtuh or tons). 3. For each requirement, enter the minimum requirement from the Standard In the left column (under 'Standard Requirement"). In the right column (under "As Scheduled') enter the value for the units as specified. 4. Where there is more than one requirement (e.g. full and part load efficiency) enter both with the appropriate labels (e.g. COP and IEER). 5. In the left column identify the thermostatic requirements from the standard (e.g. programmable setback thermostat or heat pump with electric heat), . In the right column indicate the capabilities of the thermostat as scheduled. 6. If the unit has a furnace which is rated at>225,000 Btuh of capacity, indicate the rated standby loss and ignition source (e.g. IID). If there is no furnace or the unit is rated for <225,000 Btuh indicate "N/A". 7. In the left column, enter both the required ventilation value from Table 120.1A and for the number of occupants times 15 cfm/person. In the right column enter the actual minimum ventilation as scheduled. If the space is naturally ventilated enter "N/A" in the left column and "the space is naturally ventilated" in the right column. 8. If the space is required to have either DCV or Occupant Sensor Ventilation Control indicate "required" in the left column (otherwise indicate "N/A" in the left column). If either DCV or Occupant Sensor Ventilation Control is provided indicate "provided" in the right column (otherwise indicate "N/A" in the right column) 9. In the left column indicate the required time controls from the standard. In the right column identify the device that provides this functionality (e.g. EMCS or programmable timeclock). 10. Enter N/A if there is no electric heating. If the system has electric heating indicate which exception to 140.4(g) applies. 11. If duct leakage sealing and testing is required, a MCH-04-A compliance document must be submitted. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA REQUIREMENTS FOR PACKAGED SINGLE ZONE UNITS 0 CEC-NRCC-MCH-05-E Revised 01/16 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-05-E Requirements for Packaged Single -Zone Units (Page 1 of 2) Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) Date Prepared:2/8/2019 Equipment Tag(s) XYE05A2C 1 AB1 B223A2 MANDATORY MEASURES T-24 Sections i Requiremene As Scheduled'Requirement As Scheduled'Requirement As Schedule Heating Equipment Efficiency 110.1 or 110.2(a) 17.70 HSPF 8.20 HSPF Cooling Equipment Efficiency 110.1 or 110.2(a) 13 SEER 15.0 SEER / 1, Thermostats' 110.2(b), 110.2(c) Setback Setback Furnace Standby Loss Control 110.2(d) Low Leakage AHU 110.2(f) none Ventilation 120.1(b) 268 165 Demand Control Ventilation 120.1(c)4 NR No Occupant Sensor Ventilation Control 120.1(c)5, 120.2(e)3 Shutoff and Reset Controls 120.2(e) Reg Pro rammable Outdoor Air and Exhaust Damper Control 120.2(f) Req Auto Automatic Demand Shed Controls 120.2(h) none Economizer FDD 120.2(i) O Duct Insulation 120.4 R-8 R-8.0 PRESCRIPTIVE MEASURES Equipment is sized in conformance with 140.4(a & b) 39,242 Btu/hr 28,730 Btu/hr 140.4 (a & b) 47,956 Btu/hr 38,085 Btu/hr Economizer 140.4(e) NR Fixed Tern(I Electric Resistance Heating 140.4(g) NO No Duct Leakage Sealing and Testing. 140.4(I) NR No Notes: 1. Provide equipment tags (e.g. AC1 or ACI to 10). Multiple units of the same make and model with the some application and accessories can be grouped together. 2. Enter the following information as appropriate: Unit Manufacturer; Unit Model Number (including all accessories); Description of the unit (e.g. gas -pack or heat pump; rated heating capacity (enter "N/A" if no heating); and, rated cooling capacity (enter "N/A" if no cooling). For unit capacities include the units (e.g. kBtuh or tons). 3. For each requirement enter the minimum requirement from the Standard In the left column (under "Standard Requirement"). In the right column (under "As Scheduled") enter the value for the units as specified. 4. Where there is more than one requirement (e.g. full and part load efficiency) enter both with the appropriate labels (e.g. COP and IEER). 5. In the left column identify the thermostatic requirements from the standard (e.g. programmable setback thermostat or heat pump with electric heat), . In the right column indicate the capabilities of the thermostat as scheduled. 6. If the unit has a furnace which is rated at>225,000 Btuh of capacity, indicate the rated standby loss and ignition source (e.g. 11D). If there is no furnace or the unit is rated for <225,000 Btuh indicate "N/A". 7. In the left column, enter both the required ventilation value from Table 120.IA and for the number of occupants times 15 cfm/person. In the right column enter the actual minimum ventilation as scheduled. If the space is naturally ventilated enter "N/A" in the left column and "the space is naturally ventilated" in the right column. 8. If the space is required to have either DCV or Occupant Sensor Ventilation Control indicate "required" in the left column (otherwise indicate "N/A" in the left column). If either DCV or Occupant Sensor Ventilation Control is provided indicate "provided" in the right column (otherwise indicate "N/A" in the right column) 9. In the left column indicate the required time controls from the standard. In the right column identify the device that provides this functionality (e.g. EMCS or programmable timeclock). 10. Enter N/A if there is no electric heating. If the system has electric heating indicate which exception to 140.4(g) applies. 11. If duct leakage sealing and testing is required, a MCH-04-A compliance document must be submitted. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA REQUIREMENTS FOR PACKAGED SINGLE ZONE UNITS CEC-NRCC-MCH-05-E Revised 01116 CERTIFICATE OF COMPLIANCE Requirements for Packaged Single -Zone Units Project Name: Walgreens No. 7765 (Installation of Heat Pumps & HVAC Unit) DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and com lete. Documentation Author Name: I Documentation Author Signature: Company: ProsCap Engineering & Energy Group Address: RESPONSIBLE PERSON'S DECLARATION STATEMENT Signature Date: 2/8/2019 Phone: Certification Identification (if app@ca Date Prepared: 2/8/201 9 N RCC-MCH-05-E (Page 2 of 2) I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Bernard Adebayo-Ige, P.E. F� Company: Proscap Engineering & Energy Group Address: 1390 W 6th Street, Suite 106 City/State/Zip: Corona, CA 92882 Date Signed: 2/8/2019 License: Phone: 9512837085 O?KO 0 1 �P �0 4� ul 0 M 35035 m m EXP. 6,130FQ av 0 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016