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BCOM2015-0019 Mechanical Doc's.0 STATE OF CALIFORNIA OUTDOOR LIGHTING CPf`_AIRCI_I Tri -M -F nci,c% CERTIFICATE OF INSTALLATION NRCI-LTO-01-E Outdoor Lighting (Page 1 of 2) Project Name�,r� Agency: Enforcement eOumber✓ �J Project Add r -611 ` Qf tY. GENERAL INFORMATION DATE OF BUILDING PERMIT PERMIT the specifications for the energy efficiency measures for the scope of responsibilityfor this C aoi BUILDING TYPE 10( Nonresidential Outdoor Lighting PHASE OF CONSTRUCTION New Construction ❑Addition ❑Alteration If more than one person has responsibility for building construction, each person shall prepare and sign an Installation Certificate document applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign the Installation Certificate document(s) for the entire construction. , SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibilityfor this / S Installation Certificate. /D In the table below, identify all construction documents that show that the outdoor lighting and controls were installed as it was proposed in the Certificates of Compliance. Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. Date Approved By the Enforcement Agency --s- - i �' a 9-/0 -� 4 A,_ CA Building'Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA OUTDOOR LIGHTING • CFC-NRCI-I TO -n1 -F IRPuiced n5N51 r'Ai Mr)PKuA rnirDnv rnnnnniecinni CERTIFICATE OF INSTALLATION NRCI-LTO-01-E Outdoor Lighting (Page 2 of 2) Project U Enforcement Agency: P k Nu Q/ S' Project—Add s 8 e Ci" zi P� S3 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documen i Author e: Docume uthorSignature: I A1.1Z Docum ntatjon Author Company Name: / ^r f ✓� to Signed: — r Address: C A Certification Identification (If applicable): / i9 6✓� 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a completed signed copy of this Certificate of Installation shall be posted, or 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 Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible'der/Instal Name: / �� Responsibl B' nstallerSignature: Company Name: (installing Subcontractor or General Contractor or Builder/Owner) Y16S 2- Pos' wn ith Co i ,pan tll I Q/ V - Address: CS /pc�ense: Ciry/State/' - Ph ne Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 v/6 S I A It: Uj- UALII-UHNIA INDOOR LIGHTING r:Fr:-NRCI-I TI.M.F IP—i—i n7Hd\ nAi MnonuA CKICOnV rnKeRniccinni :9 CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 1 of 2) Project Name✓� Liv ►v &•Jt Enforcement Agency: Petmit Numher: _ `s= 96 Project Address: lei I GENERAL INFORMATION DATE OF BUILDING PERMIT PERMIT # 1 /3 c lM aU s- 0012 BUILDING TYPE ['Nonresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION New Construction 11Addition 0 Alteration 11 unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. ' In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. Date Approved By the Enforcement Agency LonI B,.,J Lt rI J a 1-1ZV VJv! CA/ a- ay --7 e CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance July 2014 J 1 A I t Ur t.:ALIFUHNIA INDOOR LIGHTING CFC-NRCI-I TI -01-F /Revis.-d n7/1d1 rAi iGnenuA CAICDf`_V rnneReiecinni . CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 2 of 2) Project NNa�mee �aVN Enforcement Agency: ermit Number: �` - /101 -�p —60 Project Ijr • (/ Cj/y: $ Code;/1 AAn DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Docurne a 'on Autho ame: DocumentaY n Signature: Document A hciem any Name: Date ned. Address:�D/ f ��'Q CEA/ HERS Certification Identification (If applicable): Q y,,/ City/ in 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or 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 Installation is required to be included with the documentation the builder provides to the building owner at occupancy: Responsibl ilder//In Iler Name: Respons' /Installer Signature: �r /S��LIG Company Name: (installing Subcontractor or General Contractor or Builder/Owner) Po ion With C mpa y (Title): Address: CSL8 License:, e p City/State/Zip: t ,7j10 Pone �, d( Date ign `/6— CA Building Energy Efficiency Standards - 2013 Nonresidential Ccmpliance July 2014 b STATE OF CALIFORNIA OUTDOOR LIGHTING ACCEPTANCE TESTS CFC-NRCA-1 Tr] -1719-A (RAVIS?r1 n5H51 rAi iononuA CAICCr]V rrneeneiceinni CERTIFICATE OF ACCEPTANCE NRCA-LTO-02-A Outdoor Lighting Acceptance Tests (Page 1 of 3) Project Name: R AJ all-l"TCA Enforcement Agency: L 7�, 'T 1;� Permit Number: &P Project Addre s: 6� i- << 4 r r City: -AA Zip Code: i Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. NA7.8.1.2 Outdoor Motion Sensor Acceptance 01. Luminaires that can accept an incandescent lamp (for instance, screw -base fixtures) rated over 10OW are Intent: controlled with a motion sensor per Section 130.2(a). - Luminaires mounted 24 feet or below are controlled with a motion sensor per Section 130.2(c)3A A. Construction Inspection 01. Motion Sensor Construction Inspection ❑ Motion sensor has been located to minimize false signals ❑ 'Sensor is not triggered by motion outside of controlled area ❑ Desired motion sensor coverage is not blocked by obstruction that could adversely affect performance ❑ The lighting power of each luminaire is set to reduce by at least 40 percent but no more than 80 percent, in the unoccupied condition ❑ No more than 1,500 watts of lighting power is controlled together, by the same sensor or group of sensors B. Functional testing 01. Simulate motion of a pedestrian in area under lights controlled by the motion sensor. Verify and document the following: ❑ Status indicator operates correctly. ❑ Lights controlled by motion sensors turn on immediately upon entry into the area lit by the controlled lights near the motion sensor ❑ Signal sensitivity is adequate to achieve desired control 02. Simulate no motion in area with lighting controlled by the sensor but with pedestrian motion adjacent to this area. Verify and document the following: ❑ The occupant sensor does not trigger a false "on" from movement outside of the controlled area ❑ Signal sensitivity is adequate to achieve desired control. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA OUTDOOR LIGHTING ACCEPTANCE TESTS CEC-NRCA-LTO-02-A (Revised 05/15) i r:Al IFORNIA FNFRr.Y r:r1MMIRRIr1N CERTIFICATE OF ACCEPTANCE NRCA-LTO-02-A Outdoor Lighting Acceptance Tests (Page 2 of 3) Project Name: �) /- - fV- U 61,11 Enforcement Agency: l it Number: �r LU �,p Project Add r s:� - tl City: / �, L ' i ode: a NA7.8.2 Outdoor Lighting Automatic Shut-off Controls Acceptance 01. Outdoor Lighting Daytime Shut-off Controls All installed outdoor lighting shall be controlled by a photocontrol or outdoor astronomical time -switch control All outdoor lighting is controlled either by a photocontrol or outdoor astronomical time -switch control that automatically that automatically turns OFF the outdoor lighting when daylight is available, per Section 130.2(c)1. All outdoor Intent: lighting shall also be controlled by an automatic scheduling control that automatically turns OFF the lighting Astronomical time switch controls and photocontrols have been certified to the Energy Commission in accordance with the outside of business hours or occupied times. Certain types of outdoor lighting shall also be controlled by motion applicable provision in Standards Section 110.9. Verify that model numbers of all such controls are listed on the Energy sensor controls. Outdoor lighting shall be circuited separately from other electrical loads. C. Construction Inspection 01. Outdoor Lighting Daytime Shut-off Controls All outdoor lighting is controlled either by a photocontrol or outdoor astronomical time -switch control that automatically turns OFF the outdoor lighting when daylight is available Astronomical time switch controls and photocontrols have been certified to the Energy Commission in accordance with the applicable provision in Standards Section 110.9. Verify that model numbers of all such controls are listed on the Energy Commission database as "Certified Appliances & Control Devices." If an astronomical time switch is installed, the ON and OFF times should be within 99 minutes of sunrise and sunset. Verify ❑ that the controller is programmed with the location of the site, local date and time. Disconnect controller from power source, reconnect, and verify that all programmed settings are retained. 02. Outdoor Lighting Scheduling (Night -Time Shut Off) Controls All outdoor lighting is controlled by a scheduling control, which is either a time clock or astronomical time clock. . Controls are programmed with acceptable weekday, weekend, and holiday (if applicable) schedules Controls have been certified to the Energy Commission in accordance with the applicable provision in Standards Section 110.9. Verify that model numbers of all such controls are listed on the Energy Commission database as "Certified Appliances & Control Devices." Demonstrate and document for the owner time switch programming including weekday, weekend, holiday schedules as well as all set-up and preference program settings 03. Lighting systems that meet the criteria of Section 130.2(c)4 and 5 of the Standards shall have at least one of the following: ❑ I A part -night outdoor lighting control as defined in Section 100.1, which meets the functional requirements of NA7.7.1 ❑ Motion sensors capable of automatically reducing lighting power by at least 40 percent but not exceeding 80 percent, which have auto -ON functionality, and which meets the requirements of NA7.7.1 A centralized time -based zone lighting control capable of automatically reducing lighting power by at least ❑ 50 percent. This control shall be certified to the Commission in accordance with the applicable provision in Standards section 110.9. Verify that model numbers of all such controls are listed on the Energy Commission database as "Certified Appliances & Control Devices." D. Functional Testing 01. Outdoor Lighting Daytime Shut-off Controls Controlled lights are off during daylight hours. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA OUTDOOR LIGHTING ACCEPTANCE TESTS CEC-NRCA-LTO-02-A fReviser1 O5/151 r•ni icnonun :6 CERTIFICATE OF ACCEPTANCE NRCA-LTO-02-A Outdoor Lighting Acceptance Tests (Page 3 of 3) Project Name: Enforcement Age nry: Permit Number: tali n Author Company Na ' e: t CY; (.731 Projectdre 6( City: Zip Code: Phone: FIELD TECHNICIAN'S DECLARATION STATEMENT 3 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this C ficate of A eeptan a documentation is accurate and complete. Documentation Author Name: ` j � Documentation Author Signature: uI eF Docume tali n Author Company Na ' e: Date Signed: pI J Address: Po � CEA/ATT Certification Identification (If applicable): City/State/Zip:t / O60 Phone: FIELD TECHNICIAN'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 Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the u in permits issued for the ing. Field Technician Name: Field Technician Signature: Field Tech ni n C p ny Name: Position with ComMy (Title): Address: ATT Certification en Tication (if applicable): City/State/Zip: Pho e: Date Signed: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder providest he b ding owner at occupancy. Responsible Acceptance Person Name: Responsible Acceptance Person Signature: of G Respoible 'cceptance Person C pany Name: Position with Company (Title): to Address: (�O CSLBLicens : r Z City/State/Zip: � pp Phone' -- _ Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 51 A I L Ur GALWUHNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E (Revised 07/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION _ NRCI-LTI-02-E Energy Management Control System or Lighting Control (Page 1 of 6) System BUILDING TYPE Project Enforcement Agency: emit Number: / PHASE OF CONSTRUCTION New Construction p% •- �S Project Addre s: ff qty GENERAL INFORMATION DATE OF BUILDING PERMIT PERMIT # BUILDING TYPE Nonresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION New Construction ❑ Addition ❑ Alteration ❑ Unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. Requirements in the Standards: §130.4(b) Before an Energy Management Control System (EMCS), or Lighting Control System can be recognized for compliance with the lighting control requirements in Part 6 of Title 24, the person who is eligible under Division 3 of the Business and Professions Code to accept responsibility for the construction or installation of features, materials, components, or manufactured devices shall sign and submit this Installation Certificate. If any of the requirements in this Installation Certificate fail the Energy Management Control System or Lighting Control System installation requirements, these options for controlling lighting shall not be recognized for compliance with the Building Energy Efficiency Standards. Check all that apply: PART 1 What type of Lighting Control System has been installed? ❑ A. Energy Management Control System (EMCS) - Is a computerized control system designed to regulate the energy consumption of a building by controlling the operation of energy consuming systems, such as the heating, ventilation and air conditioning (HVAC), lighting, and water heating systems, and is capable of monitoring environmental and system loads, and adjusting HVAC operations in order to optimize energy usage and respond to demand response signals. lX The Energy Management Control System has been installed to function as a lighting control required by Part 6 and functionally meets all applicable requirements for each application for which it is installed, in accordance with Sections 110.9, 130.0 through 130.5, 140.6 through 150.0, and 150.2; and complies with Reference Nonresidential Appendix NA7.7.2. ❑ The EMCS has been separately tested for each respective lighting control system for which it is installed to function as. ❑ B. Lighting Control System - Requires two or more components to be installed in the building to provide all of the functionality required to make up a fully functional and compliant lighting control. The installed Lighting Control System complies with the requirements checked below; and all components of the system considered together as installed meet all applicable requirements for the application for which CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance July 2014 S I A I L UF (:ALIFUHNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CFC-NRCI-1 TI -09-F (Rcviscri 07/14) ` CGI IF()RNIA FNFRr.v C()MMIASI(1N CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control (Page 2 of 6) System , Enforcement Agency: Pro=, Pelm�'Na�mber:,, o(� Project Ad , cL/ity�� . T Zjp,Code u � 0 they are installed as required in Sections 130.0 through 130.5, Sections 140.6 through 140.8, Section 141.0, and Section 150.0(k). PART 2 Lighting Control Functional requirements: Check all that apply when verifying the installation of an EMCS or Lighting Control System. A- A. All lighting controls and equipment have been installed in accordance with the manufacturer's instructions. In B. The manufacturer has provided instructions for calibration. }� C. If indicator lights are integral to any components, such indicator lights consumes no more than 1 watt of \ power per indicator light. ❑, D. Components that are regulated by the Title 20 Appliance Efficiency Regulations have been certified to the Energy Commission. E. The EMCS or Lighting Control System functions as one or more of the Time -Switch Lighting Controls checked below, and complies with all of the following requirements: A1. Automatic Time -Switch Controls meeting all requirements for Automatic Time Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Residential automatic time -switch controls have program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 • hours if power is interrupted. b.' . Commercial automatic time -switch controls meet the following requirements: i. Has program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is interrupted; H. Is capable of providing manual override to each connected load and shall resume normally scheduled operation after manual override is initiated within 2 hours for each connected load; and iii. `' Incorporates an automatic holiday shutoff feature that turns off all connected loads for at least 24 hours and then resumes normally scheduled operation. 2. Astronomical Time -Switch Controls meeting all requirements for Astronomical Time -Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Meets the requirements of an automatic time -switch control; b. - Has sunrise and sunset prediction accuracy within plus -or -minus 15 minutes and timekeeping accuracy within 5 minutes per year; c. Is capable of displaying date, current time, sunrise time, sunset time, and switching times for each step during programming; d. Has an automatic daylight savings time adjustment; and e. Has the ability to independently offset the on and off for each channel by at least 99 minutes before and after sunrise or sunset. ( 3. Multi -Level Astronomical Time -Switch Controls, in addition to meeting all of the requirements for Astronomical Time -Switch Controls, includes at least 2 separately programmable steps per zone. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance July 2014 71TWU J 1 A I t OF UALWUHNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM in CFC-NRCI-1 Tl.n9-F [Pavi—rl n711d1 r+A1 inor.uA CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 3 of 6) Project arae: Enforcement Agency: it^NNu er: Project ddre l� Ci Zi v v F. The EMCS or Lighting Control System functions as one or more of the Daylighting Controls listed below: 1. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20 Appliance Efficiency Regulations, including the following: a. Is capable of reducing the power consumption in response to measured daylight either directly or by sending and receiving signals; b. If the system includes a dimmer, complies with the Dimmer Control device requirements in the Title 20 Appliance Efficiency Regulations. c. Automatically return to its most recent time delay settings within 60 minutes when put in calibration mode; d. Has a set point control that easily distinguishes settings to within 10 percent of full scale adjustment; e. Has a light sensor that has a linear response within 5 percent accuracy over the range of illuminance measured by the light sensor; f. - Has a light sensor that is physically separated from where the calibration adjustments are made, or is capable of being calibrated in a manner that the person initiating the calibration is remote from the sensor during calibration to avoid influencing calibration accuracy; and g. Complies with the Title 20 requirements for photo controls if the system contains a photo control component. [ 2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency ` Regulations,_ including the following that it does not have a mechanical device that permits disabling of the control. G. The EMCS or Lighting Control System functions as a Dimmer and meets all requirements for a Dimmer Control device in the Title 20 Appliance Efficiency Regulations, including the following: 1. Is capable of reducing power consumption by a minimum of 65 percent when the dimmer is at its lowest level; 2. Includes an off position which produces a zero lumen output; and 3. Does not consume more than 1 watt per lighting dimmer switch leg when in the off position. 4. Dimmer controls that can directly control lamps provide electrical outputs to lamps for reduced flicker 'operation through the dimming range so that the light output has an amplitude modulation of less than 30 percent for frequencies less than 200 Hz without causing premature lamp failure. 5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the ,dimmer if the lights are off. H. The EMCS or Lighting Control System meets the following requirements: 1. Is capable of automatically turning off controlled lights in the area no more than 30 minutes after the area has been vacated; 2. Allows all lights to be manually turned off regardless of the status of occupancy; and 3. . Has a visible status signal that indicates that the device is operating properly, or that it has failed or malfunctioned. The visible status signal may have an override switch that turns off the signal. 4. All occupant sensing devices that utilize ultrasonic radiation for detection of occupants meet the Ultrasound Maximum Decibel Values in the Title 20 Appliance Efficiency Regulations CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance July 2014 S I A I t OF UALIFUHNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM IS (:Fr-NRCI-I Tl -f)9 -F= (Pavicari 0711 A% r..AI IFr)RNIA FNFGAV Cr1MKAI4ZC10K] CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control (Page 4 of 6) System Project Enforcement Agency: ' it umbe_�/ v Project Addr Ziy��7� I 5. All occupant sensing devices that utilize microwave radiation for detection of occupants meet the radiation requirements in the Title 20 Appliance Efficiency Regulations 6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20 Appliance Efficiency Regulations 7. The EMCS or Lighting Control System functions as one or more of the Occupant Sensing Controls Checked Below: 0/% a. Occupant Sensors meeting all applicable requirements for Occupant Sensor Control devices in the Title 20 Appliance Efficiency Regulations b. Motion Sensors meeting all applicable requirements for Motion Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including that motion sensors are rated for outdoor use. C' c. Vacancy Sensors meeting all applicable requirements for Vacancy Sensor Controls devices in / \ the Title 20 Appliance Efficiency Regulations, including the following: i. Does not turn on lighting automatically and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; a ii. - Has a grace period of no more than 30 seconds and no less than 15 seconds to turn on _lighting automatically after the sensor has timed out; and iii. Does not have an override switch that disables the sensor. ❑ d. Partial -ON Sensors meeting all applicable requirements for partial on sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: r L Has two poles each with automatic -off functionality; ii. Has one pole that is manual -on and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; and iii. Has one pole that is automatic -on and is not be capable of conversion by the user to manual -on functionality. ❑ e. Partial -OFF Sensors meet all applicable requirements for partial off sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Has two poles; ii. Has one pole that is manual -on and manual off; and iii. Has one pole that is automatic -on and automatic -off and is not capable of conversion by the user to manual -on only functionality. ❑ f. Occupant Sensing Control systems consist of a combination of single or multi-level Occupant, Motion, or Vacancy Sensor Controls, and all components installed to comply with manual -on requirements are not capable of conversion by the user from manual -on to automatic -on functionality. PART 3 Requirements for which the control is being installed to complied with: Identify all requirements in the Standards for which the EMCS or Lighting Control System is installed to function as and complies with: Check all that are applicable �I A. Section 130.1(a) Area Controls. B. -Section 130.1(b) Multi -Level Lighting Controls C. Section 130.1 (c) Shut -OFF Controls D. Section 130.1(d) Automatic Daylighting Controls. - E. Section 130.1(e) Demand Responsive Controls. F. Section 130.5 (d) Circuit Controls for 120 -Volt Receptacles. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance July 2014 b I A I t UI- UALIrUHNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM IS CEC-NRCI-JI-02-E Revised 07/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 5 of 6) Proje e: Enforcement Agency: :t Nu1n Q14 J - Project / - t Zip S- If installed to qualify for a Power Adjustment Factor, submit this Installation Certificate in addition to the PAF J. Installation Certificate. G. To qualify for the PAF for a Partial -ON Occupant Sensing Control in TABLE 140.6-A H. To qualify for the PAF for an occupant sensing control controlling the general lighting in large open plan office areas above workstations, in accordance with TABLE 140.6-A L� I. To qualify for the PAF for a Manual Dimming System PAF or a Multiscene Programmable Dimming System PAF in TABLE 140.6-A J. To qualify for the PAF for a Demand Responsive Control in TABLE 140.6 -A l K. To qualify for the PAF for Combined Manual Dimming plus Partial -ON Occupant Sensing Control in TABLE 140.6-A y 4 CA Building Energy Efficiency Standards 2013 Nonresidential Compliance July 2014 61 A I L OF UALWUHNIA 4 ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E Revised 07/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 6 of 6) Project !` Enforcement Agency: P Project Address: —7,9611i Gty• CEA/ HERS Certification Identification (If applicable): 0 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complet . Documentatio uthor Na/ e: Document i or S' ture: FUi Documentati n Author C mpany Name:I- CCR- f8�/y-—I'�'✓L Date igngd: /d Addres VL11 CEA/ HERS Certification Identification (If applicable): 14-1 City/State?/ C 9hoe: rya P 3 ,S'"�l� 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or 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 Installation is required to be included with the documentation the builder provides to the building owner at occupancy. ResponsibleB ' der/lnsta r Name: Respo i 7 er/Installer Signature: Company ame: (Installing Subcontractor or General Contractor or Position With Comp ny itle): Builder/Owner) ` 6 t Address:/J/ CSL Li ense: �` O City/State 610e� �� / Phpne `, s g� Date Si ne • CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance July 2014 J/nIL VI Vf\LII Vr\rYII'\ LIGHTING CONTROL ACCEPTANCE DOCUMENT CFC_NRCA_I T1119A fRovie-4 nU1p Note: For more than 3 spaces attach additional sets of pages 2 Enforcement Agency Use: Checked by/Date through 5, as required. Automatic Shut-off Controls: Automatic Time Switch Control and Occupant Sensor Intent: Lights are turned off or set too lower level when not needed per Section 110.9(a) & 130.1(c). Guidance This acceptance test form must be filled out for all newly -installed lighting control systems of the following types: I. Automatic Time Switch Controls II. Occupancy Sensors III. Partial -OFF occupancy sensors IV. Partial -ON occupancy sensors (only if used to claim a Power Adiustment Factor) V. Occupancy Sensors serving small zones in large open plan offices (only if used to claim a Power Adiustment Factor) For automatic daylighting controls use acceptance test form NRCA-LTI-03-A; for demand responsive lighting controls, use acceptance test form NRCA-LTI-04-A. The tests on this certificate are required by Section 140.6(a)2 and 130.4(a) of the Building Energy Efficiency Standards 2013. The tests themselves are described in Sections 140.6(a)2 and in Reference Appendix NA7.6. A. Construction Inspection Fill out Section A to cover spaces 1 through 3 that are functionally tested under Section B. Make as many copies of pages 2-5 as are required to test all spaces in the building, and attach to page 1. Instruments needed to perform tests include, but are not limited to: hand-held amperage meter, power meter, or light meter f\VI VVIYmY11JJIVIY CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 1 of 5) Project Name: i' Enforcement Agency: Permit Number. rev T� v� -c.�l Project dress:,; Holidays f Zip fie, 119611 JU Weekdays settings 2Z5,3 Note: For more than 3 spaces attach additional sets of pages 2 Enforcement Agency Use: Checked by/Date through 5, as required. Automatic Shut-off Controls: Automatic Time Switch Control and Occupant Sensor Intent: Lights are turned off or set too lower level when not needed per Section 110.9(a) & 130.1(c). Guidance This acceptance test form must be filled out for all newly -installed lighting control systems of the following types: I. Automatic Time Switch Controls II. Occupancy Sensors III. Partial -OFF occupancy sensors IV. Partial -ON occupancy sensors (only if used to claim a Power Adiustment Factor) V. Occupancy Sensors serving small zones in large open plan offices (only if used to claim a Power Adiustment Factor) For automatic daylighting controls use acceptance test form NRCA-LTI-03-A; for demand responsive lighting controls, use acceptance test form NRCA-LTI-04-A. The tests on this certificate are required by Section 140.6(a)2 and 130.4(a) of the Building Energy Efficiency Standards 2013. The tests themselves are described in Sections 140.6(a)2 and in Reference Appendix NA7.6. A. Construction Inspection Fill out Section A to cover spaces 1 through 3 that are functionally tested under Section B. Make as many copies of pages 2-5 as are required to test all spaces in the building, and attach to page 1. Instruments needed to perform tests include, but are not limited to: hand-held amperage meter, power meter, or light meter 1 Automatic Time Switch Controls Construction Inspection—confirm for all listed in Section B a• All automatic time switch controls are programmed for (check all): Weekdays Weekend Holidays b. Document for the owner automatic time switch programming (check all): pZ Weekdays settings Weekend settings Holidays settings Set-up settings Preference program setting Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices 2 Occupancy Sensor Construction Inspection—confirm for all listed in Section B Occupancy sensors are not located within four feet of any HVAC diffuser Ultrasonic occupancy sensors do not emit audible sound 5 feet from source rn n..:i i:_ _ r----. rK:..:........ 1�-..J.. -.J.. �n.�f •r.. _...._:J.._a:..r i`.....�rt_...... • .. - c STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CFC-NRCA-1 TI -02-A (Revised 05/151 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 2 of 5) Project Name: �qqct r� 010 ( Enforcement Agency: j Ct i r Permit Number: OIrCG( Project a s' �// ,L City: Zip Code: B. Functional Testing of Lighting Controls 1 2 3 Step 1: Simulate an unoccupied condition Representative Spaces Selected Lights controlled by occupancy sensors turn off within a maximum of 30 minutes Y For every space in the building, conduct functional tests I through V below if applicable. If there are several geometrically similar spaces that use the same lighting controls, test only one space and list in the cells below which "untested spaces" are from start of an unoccupied condition per Standard Section 110.9(b) represented by that tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) The occupant sensor does not trigger a false "on" from movement in an area adjacent Y N Y N Tested space/ room name: lip Space Type (office, corridor, etc) PPIC ❑ 01 Untested areas/rooms �0�; 10PA, 101; Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctlyY Tested space/ room name: )'%_ Space Type (office, corridor, etc) Retf&-go&1 Y / N ❑ 02 Lights controlled by occupancy sensors turn on immediately upon -an occupied condition OR sensor indicates space is "occupied" and lights may be turned on N 9 N �/ N Untested areas/rooms /i,3 Step 3: System returned to initial operating conditions Tested space/ room name: 2-00 Space Type (office, corridor, etc) f DL4e ❑ 03 Untested areas/rooms Functional Tests Tested Space Number Confirm compliance (Y/N) for all control system types (I-V) present in each space: 01. Automatic Time Switch Controls 1 2 3 Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Y / N Y / N Y / N b Verify the switch only operates lighting in the ceiling -height partitioned area in which Y / N Y / N Y / N the switch is located Step 2: Simulate unoccupied condition a All lighting, including emergency and egress lighting, turns off. Exempt lighting may Y / N Y / N Y / N remain on per Section 130.1(c)1 and 130.1(a)1. Manual override switch allows only the lights in the selected ceiling height b. partitioned space where the override switch is located and remain on no longer than Y / N Y / N Y / N 2 hours (unless serving public areas and override switch is captive key type). Step 3: System returned to initial operating conditions Y / N Y / N Y / N 02. Occupancy Sensors 1 2 3 Step 1: Simulate an unoccupied condition a' Lights controlled by occupancy sensors turn off within a maximum of 30 minutes Y Y N Y N from start of an unoccupied condition per Standard Section 110.9(b) b' The occupant sensor does not trigger a false "on" from movement in an area adjacent Y N Y N Y N to the controlled space or from HVAC operation Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctlyY N Y / N Y N b. Lights controlled by occupancy sensors turn on immediately upon -an occupied condition OR sensor indicates space is "occupied" and lights may be turned on N 9 N �/ N manually Step 3: System returned to initial operating conditions CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 J 1/11L VI _---un LIGHTING CONTROL ACCEPTANCE DOCUMENT Wrlv CEC-NRCA-LTI-02-A Revised 05/15 - CALIFORNIA ENERGY COMMISSION -R1W- CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 3 of 5) Protect Name: Enforce merk Agency: PermitNumber: r(J- L u C -al ProJeet Address: atr nP code: `l A.112Z�3 3. Partial Off Occupancy Sensor 1 2 3 Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 30 minutes from start of an Y / N Y / N Y / N of the lighting automatically. unoccupied condition per Standard Section 110.9(a) a. Area served by controlled lighting (square feet) After the first stage occurs, manual switches allow an occupant to activate the The occupant sensor does not trigger a false "on" from movement in an area b Enter PAF corresponding to controlled area from line (a) above (<125sf for PAF --0.4, b. b adjacent to the controlled space or from HVAC operation. For library book stacks or Y / N Y / N Y / N all of the lights. warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in Enter PAF claimed for occupant sensor control in this space from the Certificate of Step 2. Simulate an unoccupied condition a' the aisle or stack. Y / N Y / N Y / N In the partial off state, lighting shall consume no more than 50% of installed lighting d The PAF corresponding to the controlled area (line b), is less than or equal to the PAF Y / N b power, or: Y / N Y / N Y / N • No more than 60% of installed lighting power for metal halide or high e Sensors shall not trigger in response to movement in adjacent walkways or Y / N C. pressure sodium lighting in warehouses. Y/N Y / N Y / N • No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80 percent or less of the value allowed under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken Step 2: Simulate an occupied condition a The occupant sensing controls shall turn lights fully ON in each separately controlled Y / N Y / N Y / N areas, Immediately upon an occupied condition 4. Partial On Occupancy Sensors 1 2 3 Step 1. -Simulate an occupied condition. Verify partial on operation. a Immediately upon an occupied condition, the first stage activates between 30 to 70% Y / N Y / N Y / N of the lighting automatically. Step 1. Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test II. a. Area served by controlled lighting (square feet) After the first stage occurs, manual switches allow an occupant to activate the b Enter PAF corresponding to controlled area from line (a) above (<125sf for PAF --0.4, b. alternate set of lights, activate 100% of the lighting power, and manually deactivate Y / N Y / N Y / N all of the lights. Enter PAF claimed for occupant sensor control in this space from the Certificate of Step 2. Simulate an unoccupied condition a' Both stages (automatic on and manual on) lights turn off within a maximum of 30 Y / N Y / N Y / N minutes from start of an unoccupied condition per Standard Section 110.9(a) d The PAF corresponding to the controlled area (line b), is less than or equal to the PAF Y / N b The occupant sensor does not trigger a false "on" from movement in an area adjacent Y / N Y / N Y / N to the controlled space or from HVAC operation e Sensors shall not trigger in response to movement in adjacent walkways or Y / N S. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger 1 2 3 than 250 Square Feet, to Qualify for a Power Adjustment Factor (PAF) First, complete Functional Test 2 (above) for each controlled zone Step 1. Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test II. a. Area served by controlled lighting (square feet) b Enter PAF corresponding to controlled area from line (a) above (<125sf for PAF --0.4, 126-250sf for PAF=0.3, 251-500sf for PAF --0.2). Enter PAF claimed for occupant sensor control in this space from the Certificate of C. Compliance d The PAF corresponding to the controlled area (line b), is less than or equal to the PAF Y / N Y / N Y / N claimed in the compliance documentation (line c) e Sensors shall not trigger in response to movement in adjacent walkways or Y / N Y / N Y / N workspaces. re n^4n k1.... -.. ..r r___I:---- •a.... nn+c STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CFC-IVRCA-I TI -M -A IP—A—i fKH I% CAI IFCIRNIA FNFRr;Y r.0MMISRIr1N CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 4 of 5) Project Name: 10 Enforcement Agency: Permit Number: Project Address: r •W city: - L6 Zip Cote:: 27 05. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger 1 2 3 than 250 Square Feet, to Qualify for a Power Adjustment Factor (PAF) FAIL FAIL FAIL First, complete Functional Test 2 (above) for each controlled zone Step 1. Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test II. a. Area served by controlled lighting (square feet) ' II Occupancy Sensor (On Off Control) (all answers must be Y). S Enter PAF corresponding to controlled area from line (a) above (<125sf for PAF=0.4, b' 126-250sf for PAF=0.3, 251-500sf for PAF=0.2). passing Test I or Test II. Enter PAF claimed for occupant sensor control in this space from the Certificate of IV Partial On Occupant Sensor for PAF (all answers must be Y). C. Compliance V Occupant Sensor serving small zones for PAF (all answers must be Y). Also must pass d The PAF corresponding to the controlled area (line b), is less than or equal to the PAF Y / N Y / N Y / N claimed in the compliance documentation (line c) e Sensors shall not trigger in response to movement in adjacent walkways or Y / N Y / N Y / N workspaces. f ' All steps are conducted in Functional Test 2 "Occupancy Sensor (On Off Control)" and, Y / N Y / N all answers are Yes (Y) C. Testing Results PASS / PASS / PASS / FAIL FAIL FAIL I Automatic Time Switch Controls (all answers must be Y). II Occupancy Sensor (On Off Control) (all answers must be Y). S III Partial Off Occupancy Sensor (all answers must be Y). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test I or Test II. IV Partial On Occupant Sensor for PAF (all answers must be Y). V Occupant Sensor serving small zones for PAF (all answers must be Y). Also must pass Test II D. Evaluation PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT rFr-NBCA-1 TI -02-A fRPvic d n5/151 rA1 iGnRuiA Giui=onv rnnnne1cc1nu CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 5 of 5) Project Name: N-- `' U l Enforcement Agency: Date Signed: Permit Number. -tel Project Address 60 City: Phone - Zip Code: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Ce 'ficate of Acce to a documentation is accurate and complete. Documentation Author Name: L% &e :E Documentation Author Signature: Docume atl9brA,urrthor Compa`n/y/��1ame:6. t✓� .Y �-C/ Date Signed: Address: Po CFA/ATT Certification Identification (If applicable): City/State/Zip: / le / ,o Phone - FIELD TECHNICIAN'S DECLARATIONSTATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permi ) issued for the KIlding. Field Technician Name: ® r7� Field Technician Signature: Field Technician Co an1V" me: Position with Compa (Title). Address: ATT Certification Identification (if applicable): Po Pe TL± a 3E City/State/Zip: �60 PhojZ' 7_5_y_ D Lr Date Signed: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides o the building owner at occupancy. Responsible Acceptance Person Name: ` Responsible Acceptance Person Sign tur • _ ulg oev e Responsib e Aceptance Perso ompany NNaame: t� Position with Company (Title): " ✓ Address: , CSLB License: City/State/Zip: Pito ��11 L Date Signed: ��lb CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA - AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT ��-NK( A-LTI-03-A (Revised 05/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 1 of 11) Project Name: Enforcement Agenc : Permit Number: u ~F /_e��4 P of _w Project Address: City: /�� Zip Code: Note: Submit one Certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance. Check boxes for all pages of this NRCA-LTI-03-A completed and included in this submittal N RCA-LTI-03-A ❑ Page 1 & 2 Construction Inspection. This page required for all submittals. N RCA-LTI-03-A 17 Continuous dimming control functional performance test — watt -meter or amp -meter measurement Page 3 & 4 NRCA-LTI-03-A 11 Stepped Switching/ Stepped Dimming functional performance test — watt -meter or amp -meter measurement Page 5 & 6 13 NRCA-LTI-03-A Continuous dimming control functional performance test — light meter power measurement, and default look -up Page 7 & 8 table of fraction of rated power versus fraction of rated light output. NRCA-LTI-03-A 0 Stepped Switching/ Stepped Dimming functional performance test — based on light output Page 10 & 11 A. Construction Inspection NA -7.6.1.1 01. Drawing of Daylit Zone(s) must be shown on plans or attached to this form. Select one or both of the following: ❑ Shown on plans page Ws 3 0 ❑ Daylit zones(s) drawn in on as -built plans (attached) page #'s Check box below if sampling method is used in accordance with NA7.6.1.2. If checked, attach a page with names of other controls in sample (only for buildings with > S daylight control systems, sample group glazing same orientation) Plans Page Check if Tested Control is Control System System Name (� a Number Representative of Sample Applicable Control System . B ❑ C ❑ A B C 02. System Information Zone Type: Skylit (Sky), Primary Sidelit (PS), or Secondary Sidelit (SS) Control Type: Continuous Dimming with more than 10 light levels (C), Stepped Dimming (SD), Switching (SW) G Design Footcandles: (enter number or "Unknown") CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA - AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-03-A (Revised 05/15) CALIFORNIA ENERGY COMMISSInN ERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A utomatic Daylighting Control Acceptance Document (Page 2 of 11) oject Name: Enforcement Agency: C, 1'/ J, -Z=4 a Permit Number: oject ddr :� � � � _ � (�41 City:� Zip Cade: 03. Sensor and Controls Daylighting control has been certified in accordance with §110.9: (Y/N) Control Loop Type: Open Loop (OL), Closed Loop (CL) Construction Inspection PASS/FAIL. If all responses on Construction Inspection pages 1 & 2are Sensor Location: Outside (0), Inside Skylight (IS), Near Windows facing out (NW), In Controlled Zone complete and all Yes/No questions have a Yes (Y) response, the tests PASS; If any responses on (CZ) this page are incomplete OR there are any no (N) responses, the tests FAIL Sensor Location is Appropriate to Control Loop Type: (Y/N) If control loop type is Open Loop (OL): Enter yes (Y) if location = Outside (0), Inside Skylight (IS), or Near Windows facing out (NW); otherwise, enter no (N). If Control loop type is Closed Loop (CL): Enter yes (Y) if location = In Controlled Zone (CZ); otherwise, enter no (N). Control Adjustments are in Appropriate Location (Y/N): Yes, If Readily Accessible or Yes if in Ceiling <_ 11 ft, No for all other. 04. Has documentation been provided by the installer: Installation Manuals and Calibration Instructions Provided to Building Owner: (Y/N) Location of Light Sensor on Plans: (Y/N) Location of Light Sensor on Plans: (Page Number) 3,10 05. Separate Controls of Luminaires in Daylit Zones: Are luminaires controlled by automatic daylighting controls only in daylit zones: (Y/N) Separately circuited for daylit zones by windows and daylit zones under skylights: (Y/N) 06. Daylighting control device certification Daylighting control has been certified in accordance with §110.9: (Y/N) Construction Inspection PASS/FAIL. If all responses on Construction Inspection pages 1 & 2are complete and all Yes/No questions have a Yes (Y) response, the tests PASS; If any responses on this page are incomplete OR there are any no (N) responses, the tests FAIL CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-03-A Revised 05/15 C A Pro P" Pr CALIFORNIA ENERGY COMMISSION ERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A utomatic Daylighting Control Acceptance Document (Page 6 of 11) ject Name: q r �_�JC / i.11Vl Enforcement envy: l� i � Permit Number: O� -001 le AddrQ4s: •� ��" City: � ., /'\ Zip e>� F. Functional Performance Testing — Continuous Dimming Systems NA -7.6.1.2.1 Power estimation using light meter measurement Complete all tests on page 7 & 8 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and Applicable Control System ill out Pass/Fail section on Page 8. A B C 01. System Information a. Control Loop Type: Open Loop or Closed Loop? (O or C) Indicate if Mandatory control - M (required for skylit zone or primary sidelit zone with b. installed general lighting power > 120 W); for Control Credit — CC; or Voluntary not for credit -V (M, CC, V) AA ` C. If automatic daylighting controls are mandatory, are all general lighting luminaires in daylight zones controlled by automatic daylight controls? (Y/N) d Documented general lighting design footcandles. If design footcandles not documented leave blank (enter fc) e. Power estimation method. (see line r) Default ratio of power to light (Dfc), cut -sheet ratio of power to light (CSfc) If CSFc — attach cut -sheet. Enter Dfc or CSfc, Step 1: Identify Reference Location (location where minimum daylight illuminance is measured in zone served by the controlled lighting.). f• I Method Used: Illuminance or Distance? (I or D) Override daylight control system and drive electric lights to full light output for highest light level c.: 9. Highest light level fc —enter measured controlled electric lighting footcandles (fc) h• Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TT) T� Step 2: No Daylight Test i. Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log), Cover Fenestration (CF), Cover Open Loop Photosensor (COLP) j. Reference Illuminance (footcandles) measured at Reference Location (Illuminance of , general lighting at the reference location) l I� . Enter Y if either of the following statements are true: k. If line h = FO; [Reference Illuminance (line j)] / [Full Output fc (line g)] > 70%? or iJ [Reference Illuminance (line j)] / [design footcandles (line d)] > 80%? (Y/ N) Step 3: Full Daylight Test conducted when daylight > reference illuminance (line j) Daylight illuminance (light level with electric lighting turned off) measured at Reference , Location (fc)3.� m. Daylight illuminance (line 1) greater than Reference Illuminance (line j) ? (Y/N) n . Fraction controlled wattage turned off. Enter %. [� o• Fraction of controlled wattage dimmed [1— (line n)] Enter %. 100 1 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA - AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT go CALIFORNIA ENERGY COMMISSION ERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A utomatic Daylighting Control Acceptance Document (Page 7 of 11) )ject Name: JA)B Enforcement Agency: �� ✓ Permit Number: lei -CQ )je Ad es : City: Zip Code: Fill out lines p through s only if fraction of controlled wattage turned off (line n) < 100%. P6 Total (daylight + electric light) illuminance measured at the Reference Location (fc) PASS: All applicable Construction Inspection responses on pages 1 & 2 are complete and all applicable Functional Performance Testing Requirements responses are positive (Y - yes) (applicable questions on pages 7 & 8 = c, k, m, u, v, w, Z, cc) FAIL: Any applicable Construction Inspection responses on pages 1 & 2 are incomplete OR there is one or more negative q. Electric lighting illuminance at the Reference Location (fc) [(line p) — (line 1)] pages 7 & 8= c, k, m, u, v, w, z, cc). System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10-103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and r• Electric lighting illuminance (line q) divided by Highest Light Level fc (line g). Enter % 17 S. Dimmed luminaire fraction of rated power. Attach manufacturer's cut -sheet or use default graph of rated power to light output on page 9. Label applicable control system (column A, B or C) on cut -sheet or graph. Enter fraction of rated power in %. ZQ t. System Power Reduction = [1— (line o) * (line s)] U. Is System Power Reduction (line t) > 65% when line h = FO, or > 56% when line h = TT (Y/N) V. With uncontrolled lights also on, no lamps dimmed outside of daylit zone by control (Y/N) w. Dimmed lamps have stable output, no perceptible flicker (Y/N) Applicable Control System A B C Step 4: Partial Daylight Test conducted when daylight between 60% and 95% of (line i) X. Daylight illuminance (light level without electric light) measured at Reference Location (fc) �] Y• Daylight illuminance divided by the Reference Illuminance = (line x)/ (line j). Enter % Z. Is Ratio of Daylight illuminance to Ref illuminance (line y) between 60% and 95%? (Y/N) aa. Total (daylight + electric light) illuminance measured at the Reference Location (fc) bb. Total illuminance divided by the Reference Illuminance = (line as )/ (line j). Enter % cc. Is Ratio of Total ilium. to Reference illum. (line bb) between 100% and 150%? (Y/N) G. PASS/FAIL Evaluation (check one): PASS: All applicable Construction Inspection responses on pages 1 & 2 are complete and all applicable Functional Performance Testing Requirements responses are positive (Y - yes) (applicable questions on pages 7 & 8 = c, k, m, u, v, w, Z, cc) FAIL: Any applicable Construction Inspection responses on pages 1 & 2 are incomplete OR there is one or more negative (N - no) responses in any applicable Functional Performance Testing Requirements section (applicable questions on pages 7 & 8= c, k, m, u, v, w, z, cc). System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10-103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and resubmitting NRCA-LTI-03-A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. CA Building Energy Efficiency Standards- 2013 Nonresidential Compliance May 2015 CEC•NRCA-LTI-03-A (Revised 05/15 CERTIFICATE OF ACCEPTANCE Automatic Daylighting Control Acceptance Document Project Name: Enfo Projectd 1 / City. Default fraction of rated power to fraction of light output (used on line r on page 7 of 10) 100% 90%------- ---i----------I ----- !---------- i- -------- - !-------- !---------' i IIID I i 80%---------i----------h---------r---------i----------F--------- ----- i ------ ;h ---------r--------- 70% ----- --- --I I I I I I 60% ------. a----------�--- ---I-- --FI .-ore- cen- ....... ea i i ,F 50% -------- !- i ---------. ---------i---------= i -- -----i -------- i i i i O 40% --------- i---------- i------- .-.i ------ j .......... i .......... i --------- J .......... L ......... I--------- � Oo .................. =--------- R20% ' ------- I.....-----'.------.. �........................... ..........!---------! p - I----- -I------u- 10°/-r---------i--------------------I-- — -----i•------h--------- I I00W 1--------- I I I I I I 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Fraction of rated light output (MISSION N RCA-LTI-03-A (Page 8 of 11) Vumber. ( z Z, STATE OF CALIFORNIA } AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CFC -NBCA -1 TI-r1Q-A 10—i—A ArJ1 S1 r`AI MnDAIIA CAICor_v r•- --lccln�i CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 11 of 11) Project Name: q i.!U. "C'�Ci� Enforcement Agency: % Address: Permit Number. fy.r CD C1/1�' CA Project ddr s' KJl r �l City: I IC4? Phone: - Z -5-y- Z_a Zip Code: C� DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Ceriltiicate of Accep ance d cumentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Documentati Au or Company ame: L eion 0 Date Signed: qa Address: CEA/ATT Certification Identification (If applicable): City/State/Zip: ��-Y-,ee Ci66 Phone: - Z -5-y- Z_a FIELD TECHNICIAN'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 Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the b ilding p rmit(s) issued for thqbqilding. Field Technician Name: Field Technician Signature: e Field Tech iciapI Company ame: Position with Company (Title): ` l ✓/ v e� Address: ATT Certification Id nt'fication (if applicable): City/State/Zp: �1/ Phon/R;; _ �� % Date Signed: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I underst nd that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to e Acting owner at occupancy. Responsible Acc p nce Person ame: Responsible Acceptance Person Signature: )rqut Owe' Responsible cc ance Person C mpany Name: Position with Company (Title):�'^ tl Address:�Q •__ _� S CSLB License: "2 11 city/state/Zip: � P e_ � Date Signed: l f �i f - r w CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALJFORNUI^^u- PLUMBING CERTIFICATE OF INSTALLATION - NRCI-PLB-01-E Plumbing( (Page 1 of 4) r'a"�"'m"r�• - U r.awm�me y.n�: rnw ro.see: 1 1 "' 1-01 omnTF4 CA PI.I A. GENERAL INFORMATION DATE OF BUILDING PERMIT BUILDING TYPE ion swig Ie, treryfas}rm{ w/onvo-ohm PHASE OF CONSTRUCTION If more than one person has responsibilityforbuilding constructfon, each person shall prepare and sign an Installation Certiflcate document applicable to the portion of construction for which they are responsible; alternatively, the person with chief respansibilityfor construction shag prepare and sign the Installation Certificate documentisjIfor the entire construction. B. SCOPE OF RESPONSIBILITY Date of approval by the enforcement agency of the CertlBcate of Compliance that provides the specWations for this Installation Certificate. In the table below identify all applicable construction documents that specify the features, materials, components, manufactured devlces, orsystem performance diagnostic results required for the scope of responsibility for this Installation Certificate. Document Title or Description Applicable Sleets or Pages, Tables, Schedules, etc Date Approved By the Enforcement Agency PPlumbin ochedules PI.I Neo erre "� PH bas fired w Neaten oemghL pl Plumbing �-evm eM PI. piping ma"AR PI. p �en�ra4jnolts pI. umm,+irujoLl r u ow-no.le motteltgx mtN-I coq aenWa" u -eo naks by S'Fb61 Ps >7 CA Building Energy Efficiency Standards- 2013 Nonresidential Compliance May 201S - I i 1 MISSION NRCI-PLB-01-E MR. 3 of 4) D. MANDATORY MEASURES FOR ALL SINGLE DWELLING NOT WATER DISTRIBUTION SYSTEMS Y STATE OF CALIFORNIA a PLUMBING CEC-MtC4Pl34)fE Revised 05h N !' CERTIFICATE OF INSTALLATION /1 Plumbing pipe that are subject to one of the exceptions below: (RA4.4.1) rawwa. FY to I 1 MISSION NRCI-PLB-01-E MR. 3 of 4) D. MANDATORY MEASURES FOR ALL SINGLE DWELLING NOT WATER DISTRIBUTION SYSTEMS 01 Equipment shall meet the applicable requirements of the Appliance Efficiency Regulations (Section 02 Unfired Storage Tanks are insulated with an external R-12 or combination of R-16 internal and external Insulation. (Section 110.3(cj4). The following pipes are insulated, to the thicknesses required by Table 120.3A, except for those sections of pipe that are subject to one of the exceptions below: (RA4.4.1) • The first 5 feet (1.5 meters) of hot and cold water pipes from the storage tank. • All piping with a nominal diameter of 3/4 inch (19 millimeter) or larger. • All piping associated with a domestic hot water redreulation system regardless of the pipe diameter, except when cold water return Is used in a demand system. • Piping from the heating source to storage tank or between tanks. • Piping buried below grade. 03 • All hot water pipes from the heating source to the kitchen fixtures. - The following sections of pipe do not have to be Insulated: (RA4.4.1) • Piping installed in interior or exterior walls that Is surrounded on all sides by at least 1 Inch of insulation. • Piping installed in attics with a minimum of 4 Inches (10 an) of attic insulation on top • Piping that penetrates framing members shall not be required to have pipe insulation for the distance of the framing penetration. Metal piping that penetrates metal framing shall use grommets, plugs, wrapping or other insulating material to assure that no contact is made with the metal framing. Insulation shall butt securely against all framing members 04 Piping buried below grade must be installed in a water proof and non -crushable casing or sleeve that allows for installation, removal, and replacement of the enclosed pipe and insulation. (Section 150.00)) 05 All elbows and tees shall be fully insulated. (RA4.4.1) 06 Where Insulation Is required, no piping shall be visible due to Insulation voids, and all Insulation shall fit tightly to the pipe. (RA4.4.1) For Gas or Propane Water Heaters: Ensure the following are installed (Section 150.0(n)) 1. A 120V electrical receptacle is within 3 feet from the water heater and accessible with no obstructions 07 2. A CatTry III or IV vent, or a Type B vent with straight pipe between outside and water heater 3. A condensate drain no more than 2 Inches higher than the base on water heater for natural draining Jk4. A gas supply line with capacity of at least 200,000 Btu/Hr The respomfble person's signature an this compliance doahment affirms that all applicable requirements In thts table have been met rIf . CA Building Energy Efficiency Standards - 2013 Nonresidential C.ompifance May 2015 6 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) Aft AIR CONDITIONER AND HEAT PUMP SYSTEMS CEGNRCA-MCH-03-A (Revised 051151 CALIFORNIA FNFRr;Y CnMMISSInN CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 4) fest Name:1&2—^ r1 `V' Enforc merit Agermy: Pemut Number. Prof �( ( � S3 System Name or ldents7imtion/rag;/t � � r/ System o®Bono BSe B. Functional Testing Requirements I Operating Modes Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Made Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 5 4 Step 2 —8: Check and verify the following for each simulation mode required a. Supply fan operates continually b. Supply fan turns off C. Supply fan cycles on and off d. System reverts to 'occupied" mode to satisfy any condition e. System turns off when manual override time period expires f. Gas-fired furnace, heat pump, or electric heater stages on g. No heating is provided by the unit h. No cooling is provided by the unit i. Compressor stages on j. Outside air damper Is open to minimum position k. Outside air damper closes completely Step 9: System returned to initial operating conditions after all tests have been completed: Y N C. Testing Results 87 6 5 a 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter rol PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 i STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 051151 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 4) 'ett N i Enforcement Agewr. Perm9 Number. system NameorldeMMCatbn/feg: !Svstemlocatronor a (Vote: Submit one Certificate of Acceptancefor each system that must ;;EriforcerrtentAgency tlse::Ceckedby demonstrate compliance. - A. Construction Inspection 1. Supporting documentation needed to perform test includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA75.2 Constant Volume, Single -zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At -A -Glance). b. 2013 Building Energy Efficiency Standards Manual. 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter 3. Ins ation (check if applies): IIF Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Pro i�amming (check all those that apply): Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual section 120.2(b). Mi um heating setpoint:°F. Maximum cooling setpoint F. Deadband: —Z--F.® 'Occupied, unoccupied, and holiday schedules have been programmed per the facility's schedule. ;-/Pre-occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: 0 Lesser of: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE ,,120.1-A or 15cfm per person times the expected number of occupants. IY 3 complete air changes. Notes: I ' CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CFGNRC.A-MrA4X0 A fRPvlcclt (L5f151 CAI IFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) eq Name: Enforcement Agenc r. Permit Number. PrqectAddr LSty: I S System ameor ldemifkatfon/rag: / Systemlrattanor aServed: ' DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certifi to of Acceptance documentation is accurate co fete. J)aeopfaMition Author Name: Docu on Author Si Do ntation Author Company Name: e ATrCertffication Idpifilficationyr applicable): .-. Ci Ta p: �r--a 4 Phone: 14, FIELD CHNICIAN'S DECLARATIO 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 Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has be ed or made avail le yv h the building permit(s) issued for the building. RqWJqphnrn Name: Fe Signature: o" Feld nician Company Name: Address: 41T Ce cation Identification (if applicable): p: Phone- DateSrgned: C:;)j&71 RESPO SIBLE PERSON'S OE TION STATEMENT wr I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Feld Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attestto the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified In Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy ofthis Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Accenceptance Person a espon ' Acce P re: R lble Acceptance Person parry Name: Company (Title r CSLB License: T� Cie,te/2ip: Date Signed: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE rFr.NRr&-"rxntn fp-lkm ;111% CALIFORNIA FNFRGY COMMISSION 16 CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) oleR Namr. ^ FnforcemerriAgency. Permit Number. ``=61 t // 0l z��d �S System Name m IdeMificatbnfreg4 1 ( �� System loraeron orArea Se S. Functional Testing Results Step 1: Disable demand control ventilation systems (if applicable) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open. Verify the following: a• Economizer damper modulates 100% open. ON b. Return air damper modulates 100% closed. N C. For systems that meet the criteria of 2013 Building Energy Efficiency Standards Section 140.4(e)1, verify that the economizer remains 100% open with the use of mechanical cooling. This occurs when the cooling demand can no longer be met by the economizer alone. O/ N d• All applicable fans and dampers operate as intended to maintain building pressure. N e. The unit heating is disabled (if applicable). Y N / NA Step 3: Disable the economizer and simulate a cooling demand. Verify the following: a• Economizer damper closes to its minimum position. N b. --All applicable fans and dampers operate as intended to maintain building pressure. N C. The unit heating is disabled (if applicable). ON/NA Step 4: If the unit is equipped with heating, simulate a heating demand and enable the economizer. Verify the following: a• Economizer damper closes to its minimum position. b. Return air damper opens. Y N / NA I (ON/NA Step 5: Turn off the unit and verify the following: a. Economizer damper closes completely. (9 14 Step 6: System returned to initial operating conditions UN C. Testing Results v FAIL. Step 2: Simulate cooling load and enable the economizer (all answers are Y). Step 3: Simulate cooling load and disable the economizer (all answers are Y). Step 4: Simulate heating demand and enable the economizer (all answers are Y). Step 5: Turn off the unit (all answers are Y). luation L9r PASS: All Construction inspection responses are complete and all Testing Results responses are "Pass" Notes. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE rFG.NRrA-UrJ4.n1.e r;?-A—A nANyl �wr �rnosuw cucory nnwaoc�nu CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) rolect Name: n EnforcementAgencr Permit Number. P � ew /It Q I Zip cu 5 system Name a Ifiwtian/r-M/,, Systemtocatimur ea Served: I DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate a mpl Author Name: Documents r at g'M DtuTntation Author Company ame: d /� d,AIT Certification Idepilification (Ira icable): CJ tatfop �7 Phone: , / 6 FIELD HNICIAN'S DECLARATION sT EMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. .I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. ' 4. 1 have confirmed that the Certiflcate(s) of installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been d or made available ith the building permit(s) issued for the building. Fi n =clan field Tech ' ' n lure: f' n clan Compa-i Name: Ith Company (Title): —% Add s: Certification Identification (inapplicable):a "2R 11WL 10T /s e/r, V d ! ^ UO e� 7 / oaten f� I h O RESPONSIBLE PERSON'S DE TION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certificate of Acceptance. ' 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the pians and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be induded documentation the b " er provides to the building owner at occupancy. Responsi nce Person Name:Res to ture: FE106mWe Acceptance Personp try me* ie r�r ); A(idpdr CsLBu rise: /^��.�^ ^.y [,,,f/ v tat P- 044 I / 794 b P l �i 9�Ape / Date Sl � : 0 �N CA Building Energy Efficiency Standards - 2413 Nonresidential Compliance May 2015 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE cFr_WPr, dr,.Wj C n r —A—A rx1191 flet Wnonue CUCor-v rnneRucc1nk1 CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 1 of 2) ect Name: O I Enforcement Agency. Permit Number. Pr7d( �7i 3 / rf System Ham o Jdentifcation/rag: &1CW System lontbnorMea Seryed:� / Note: Submit one Certificate ofAcceptancefareach system that .:Enforcement:Agency�l�e:;Cliecked�y/Dace:::,:,;;__;';.-:":;:=:':::;.::.::�: must demonstrate compliance. Intent: verify that systems required to employ demand Controlled ventilation (refer to §121(c)3) can vary outside ventilation flow rates ased on maintaining interior carbon dioxide (CO2) concentration setpoints A. Construction Inspection 1 . Instrumentation to perform test may include, but not limited to: O Step 2: Simulate a low CO2 load (check box complete) a. Calibrated hand-held CO2 analyzer b. Manufacturer's calibration kit c. Calibrated CO2/ai'r,mixtures 2 Insta tion The sensor is located in the high density space between aft and 6 ft above the floor or at the anticipated level of the occupants' heads:' 3 Documentation of all carbon dioxide control sensors includes (check one of the following): a.Callibb method Factory -calibration (certificate calibration cert must be attached) Field calibrated b. Senssoo accuracy tY' Certified by manufacturer to be no more than +/- 75 ppm calibration cert must be attached B. Functional Testing Resu a. Disable economizer controls b. Outside air CO2 concentration (measured dynamically using CO2 sensor) ppm c. Interior CO2 concentration setpoint (Outside CO2 concentration + 600 ppm) ppm Step 1• Simulate a signal at or slightly above the CO2 setpoirrt or follow manufacturers recommended testing procedures. For single zone units, outdoor' air damper modulates opens to satisfy the total ventilation air called for in the Certificate of Compliance. O For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone ventilation requirements. Step 2: Simulate signal well below the CO2 setpoint or follow manufacturers recommended procedures. For single zone units, outdoor air damper modulates to the design minimum value. ❑ For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone ventilation requirements. Step 3: System returned to initial operating conditions Y• N C. Testing Results P / FAIL ❑ Step 1: Simulate a high CO2 load (check box complete) O Step 2: Simulate a low CO2 load (check box complete) D: Evaluation. PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA AOL DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCXMCH-06-A (Revised 05t151 CALIFORNIA ENERGY COMMISSION AW CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control ventilation Systems Acceptance (Page 2 of 2) P Jeri NV Name: r^p V Enforcement Agency. Permit NumberM. ro dress -:7t3—All l z r System Name or Identification/rag: G 1[ S"em LowtioncrArea Semd: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is urate and co plete. ion Au Name: Doc�iatb� rCom rry i' : ed: O? / �` AddNA Certification lden cation(ifa cable): ( b VS G/?— r/T�FIHNICIAN'S DECLARATIO TATEMENT 1 certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builderIfinstaller an een posted or made avails le with the building permit(s) iss for the buitdin . ;rhpWan Name: ^ n (N w Field T n / ►y ` ci�p CAm`ny a e-" FieldT_1 Po mpany i ):.S 6 =Itf C11Add Ti Certificatbn Identification (if appliwblel: /Sta e/2ip 1 C yn6 � Date Signed aTa RESPO SIBLE PERSON'S DECIARAT N STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and 1 have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of, Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be induct h the documentati he builder provides to the building owne at occupancy. 1 Acceptarxe ersonNA01f. ( I� R leAcce rgnature: R A pts Person a pang Name: with Company (rme, MGLT- e CSLB license: 't I/ te/ziip: tj"� / /C P n��!1 Date `75,D Z J4 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 1 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEC-NRCA-Mf'.H-t2-A (Ravisaf tKH5) C.At IFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 1 of 3) pojedName: p o— — ® L .. Enforcement Agencr. Permit Number. j�d� t' i "P17 aA c7 em Name orl ar - � System Locatba orAm Servert Note: Submit one Ce lcote o Atte tante or each system that must :.En orceri7ent'..' e[iiji Use:; Checked tiy/Dale:;;:": _;::: ; _:=:?;= ._:'::;:: ; ::. `.. .. demonstrate compliance. A. Construction Inspection 1. Prior to fu ctional testing, verify and document the following: The Fault Detection and Diagnostics (FDD) hardware is installed on the unit. The FDD system is certified to the California Energy Commission. 2. The fall wing air temperature sensors are permanently installed: _,Outside Air Sensor upply Air Sensor Return Air sensor (applicable for differential economizer operation only) B. Functional Testing Air Temperature Sensor Failure/Fault Step 1: Verify the FDD system indicates normal operation Step 2: sconnect outside air temperature sensor from unit controller. Verify the following. FDD system reports a fault Step 3: CZ nett outside air temperature sensor to unit controller. Verify the following: FDD system indicates normal operation Excess Outside Air Step 1: Coordinate this test with NRC4-MCH-02A (NA 7.5.1 Outdoor Air), if NRCA-MCH-02-A indicates "pass' then verify the following:. FDD system indicates normal operation Economizer Operation Step 1: Coordinate this test with NRC4-MCH-05A (NA 7.5.4 Air Economizer Controls), and simulate failure by immobilizing the outdoor air economizer damper by disconnecting the control signal from the damper actuator (or another method specified by the manufacturer). Verify thefcllo g: FDD system reports a fault Step 2: Su ssfully complete and pass NRCA-MCH-05-A and verify the following: FDD system reports normal operation C. Testing Results P / FAII Test passes if all boxes are checked under Functional Testing ❑ I 1 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May2015 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS rt=4'-Wa1'e_aer4.1_49_e roe ._ . nares CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 2 of 3) Pr ject Name: �— En%rmwnt A,Ve y. Permk Number. Pr 'ect cess: !i //I r4 �� ZIP Code: 9 3 System Name w IderrtllicatbnJTag System La=Uw w Area Se D E aluation Ef PASS: All Construction Inspection responses are complete and Testing Results is "Pass" Notes: L CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May2015 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS Sk CEC-NRCA-MCH-12-A (Revised 051151 CALIFORNIA ENERAY COMMISSION ---- -------------- CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 3 of 3) Pr'A N'ame: Enforcement Agency. Permit Number. ATrCerf(if�icatiti'on eQntdkat (if applicable): CD T �'7 Ci /S /TP• � , �% cam— t)iu �i✓a- l T :O'�C'� / 6 / 7 FIELD CHNICIAN'S DECLARATIO STATEMENT System Name or ldeMtfication'T ,L System Location or Area Servcd: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 ce that this Certificat of Acceptance documentation is accurat oo lete. nAuthor me: Docu A or entation Author Company Name: to Signed l ! (' ATrCerf(if�icatiti'on eQntdkat (if applicable): CD T �'7 Ci /S /TP• � , �% cam— t)iu �i✓a- l T :O'�C'� / 6 / 7 FIELD CHNICIAN'S DECLARATIO 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 Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has b n sted or made ava' able with the building permit(s) Issued for the building. nician Name: Frel KV( ee Fiel Mcen Company Name: Posi Co pa ITdte (_4 (� e s:C J . J A �v�ATF Certification Identification (if applicable): Datesig6., RESPOIdSIBLE PERSON'S DECLARA-n N STATEMENT I certify the following under penalty of perjury, under the laws of the State of California. 1. 1 am the Field Technician, or the Feld Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. S. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. bleAcceptanee Res to re: ! L— R 'ble Acceptance Person C mpany Name: with Company (TiULK Z i9Qdr , CSiaLxetue �/�i/�y/ /5 teRP: ��11� t %long„ (')/ ) ^ 914 1((D // Date Signed: D r/0 / 1� 1 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May2015 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA- ICFs -02-A (Revised 05115) CALIFORNIA ENERGY rOMmisslnN - ---------------- — CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) mlect Name: i Enforcement Agenty. Pemdt Number Qu I Ova ZIP e: System Name w 1&ft1iat' ag: �V System location orruea Served: Note: Submit one Certificate o Acce tance or each system `Enfortemer ;Age _t1Se=`_eheclieirp'%oats-='. =_ - that must demonstrate compliance. -__- Intent:I Verify measured outside oirJfow reading is within t 10% of the total required outside airflow. Required for all newly installed HVAC I units. Reference MECH-3C (Column H or Column)) or Mechanical Equipment Schedules A. Construction Inspection Note: MCH -02 -A can be performed in conjunction with MCH -07 -A Supply Fan VFD Acceptance (if applicable) since testing activities overtop. 1. Supporting documentation needed to perform test includes: As -built and/or design documents (for domple, Mechanical Equipment Schedules, Equipment a. Start -Up Sheets or Balancing Reports). b. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At -A -Glance and NA7.S.1.2 Constant Volume Systems Outdoor Air Acceptance At A-Gionce). C. 2013 Building Energy Efficiency Standards. 2. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire ane ometer, velocity pressure probe, etc.). I. ' Method and equipment used: ii. Equipment calibration date (must be within one y ar): QW11/ J 3. System type (check either VAV or CAV): ❑ VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ❑ Check if factory calibrated and attach calibration certification. 0 Check if field calibrated and attach calibration results. ii. Damper. Cpntrol (must be checked): �nynamic damper control Is being used to control outside air. (This is NOT a fixed minimum position). iii. Une-of the following dynamic controls is being utilized to control outside air (check method used) 0 Outdoor Air CFM Compensation 0 Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking 0 Injection Fan Method 0 Dedicated Minimum Ventilation Damper with Pressure Control 0 -Other Active Control, Describe: b. Check if Constant Air Volume (CAV) and verify the following•. YF System is designed to provide a fixed minimum OSA when the unit is on. 4. Method of delivering outside air to the unit (check one of the following): 0 Outside air is ducted to the return air plenum. Confirm that outside air is ducted to either (check one of the following): 0 Within fire ft. of the unit. ❑ Within 15 ft of the unit, with the air directed substantially toward the unit. 63 Return air plenum is NOT used to distribute outside air to the unit. Le. outside air is ducted directly to the unit or outside air is provided independent of the unit. S. Pre -occupancy purge has been programmed for the 1 -hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less. b.' 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CFP^NRr.A-MrH.n9_A IR—A-4 Al1111 CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) reef Nam . r � Enforcement Age^q. � Permit Nmnber. 26-1D t5 Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a. cooling. Record VFD speed (Hz). b. Measured outdoor airflow reading (cfm) cfm System Name or lderrtEaatlan/iag: System timet serves B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing cAv 0 VAV Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit Is not in economizer mode during test (economizer disabled). 0 Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a. cooling. Record VFD speed (Hz). b. Measured outdoor airflow reading (cfm) cfm Hz cfm Required outdoor airflow (cfm) (from MECH-3C Column i, or C. Mechanical Equipment Schedules). cfm cfm d Time for outside air damper to stabilize after -full supply airflow is achieved minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) C. Required outdoor airflow (dm) (from MECH-3C, Column 1, or mechanical equipment schedules). d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): cfm cfm min Step S: Return to initial conditions (check) C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 2 a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow, (Step2b/Step2c) 2 % % b. %OAFA is within 10% of design Outside Air. (%OAFA 5110%) Y / N Y / N C. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) Y / N Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 3 (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading (Step3b/Step3c) b. %OARA is within 30% of design Outside Air. (OARA 5110%) C. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) % Y / N Y / N Note: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. D. Evaluation PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y - yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 V f�S STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CFC-NRCA.MC14112,A rRw's- A (15/151 CAL IFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) P Name: civ Enforcement Agency: Perms Number. l 7. 1 25 System Name or Identiflcation/rag:� System Location or Area Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Cert tate of Acceptance documentation is accurate a ete. 1-1 e ton Author Narne: me on Author, I rltation Author Comparty Name: Dat lgned: Q / An Certification Ide ' cation (If plicable): rIT P: ^ Phone G� (J FIELD CHNICIAN'S DECLARATION STA MENT OeT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has b ed or made available with the building permit(s) Issued r the building. Ae .17 F n cian Name: Fi Signature: Fie Tuan Com ny Name: r e i/V 1 a 0 QCertification Identification (if applicable): u 10 p S /ho . .— DateS RESPO SIBLE PERSON'S DE ON STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Feld Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement a envy foall applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be inclu w. he documentation he r provides to the building buil er owner at occupancy. Res eptancePersonN me•. R Acceptance re: es k Acceptance Person Company Name: m ny A 23 CSLB erase: /`tat /lip:a � v , A ,s / G _ ot Date SigrredO l // CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA MCH -03-A Revlsed 05115 CALIFORNIA ENERGY COMMISSION 16 CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 4) jest Neme: . E°fumement Ager. Permtz Number. Pmje d / l IIP C°dew I System Name w kkMff cvVw frag: 40 3 System loatian w Area Note: Submit one Certificate of AccePtoncefor each system that must 15-_�,n. _ 4-1k. ck demonstrate compliance. A. Construction Inspection 1. Supporting documentation needed to perform test includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.3.2 Constant Volume, Single -zone, 1. Unitary Air Conditioner and Heat Pumps Systems Acceptance At -A -Glance). b. 2013 Building Energy Efficiency Standards Manual. 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter 3. Ins lation (check if applies): Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Pro mming (check all those that apply): ; Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards Manual section 120.2(b). Mi um heating setpoint: °F. Maximum cooling setpoint!La°F. Deadband: ;?--2F. Q'Accupied, unoccupied, and holiday schedules have been programmed per the facility's schedule. Pre -occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: ❑ Lesser of: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 20.1-A or 15cfm per person times the expected number of occupants. complete air changes. Notes: A CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2025 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) Aftk AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCAWCH-03-A (Revised 051151 CALIFORNIA FNFRr.Y rnmmISSInN CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 4) jea Name: — O AJ —fJ Erdoro mem Agency: Permi[Number. Addrest T abr.4 Unoccupied Mode System Name or Identgiotion/rag System Location or Served: B. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 5 4 '.3;.:: ,.2::.. Step 2 —8: Check and verify the following for each simulation mode required a. Supply fan operates continually Vo b. Supply fan turns off C. Supply fan cycles on and off d. System reverts to 'occupied" mode to satisfy any condition e. System turns off when manual override time period expires f. Gas-fired furnace, heat pump, or electric heater stages on g. No heating is provided by the unit h. No cooling is provided by the unit i. Compressor stages on j. Outside air damper is open to minimum position k. Outside air damper closes completely Step 9: System returned to initial operating conditions after all tests have been completed: N C. Testing Results 8 1 7 1 6 I s 1 a 1 3 z Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter Q I Sr I PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 i STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AOL AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCHM A (Revised O5M51 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 4) ect Name: r r O Enfoioemem Agency: Permit Number. FIELD NICIAN'S DECLARATION "ENT � Zip co • s 3 System Name mDdentiliationfrag: Systemlaotronor Ned: wo DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate comp te. powilmlMn Author Nam Doatrne Author S Cation Author Company Name: OI Tr Certification Ide ficathon (I pplicable): Rcillot-0471P: o �, �4 Phone: r FIELD NICIAN'S DECLARATION "ENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has d or made available with the building permit(s) issued for the building. Fi an Name: Fi n clan Compai l`/ I IVC TT Certification Identification (if ap ghat ip:vF'� / FjtJ O (' Date S Q RESPON IBLE PERSON'S DECLARATI STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Feld Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be included with cumentation the builder provides to the building owner at occupancy. R ptance Person Na espons' eptance nature: Acceptance Personny Name: ): 7 CiUr CS LB License: tp: 6/-dyeDa 'ed: s CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 i STATE OF CAUFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A Revised 051151 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 1 of 3) Name: nit Ee(orrpman2 agenry: PermitNumber- d 1 zip System Name ortdemrT_1he/T0j - iYs[em Lotatcn ar a5ene6- ate: Su bmrt one Cert- mte of Acceptance for each system that must : Erifortement,fl�eneyUse::Ciietked?4y/Date;•:'::";=:::::_-::= :`; ;::'a.: demonstrate compliance. .. - .. = A. Construction Inspection 1. Supporting documentation needed to perform test includes: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.4 Air Economizer Controls Acceptance At A - Glance). b_ 2013 Building Energy Efficiency Standards. 2. Instrumentation to perform test includes: a. Hand-held temperature probe Calibration Date: (must be within last year) b. Device capable of calculating en al y Calibration Date: must be within last year) c. 1:2 k Ohm Resistor ( when specified by the manufacturer) 3• Installation: (all of the following boxes should be checked) W onEconomizer high limit shutoff control complies with Table 140.4-B found in the 2013 Building Energy Efficiency Standards Section 140-4(e)3. Economizer reliability features are present per 2013 Building Energy Efficiency Standards Section 140.4(e)4: a- 5 -year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product specification sheet proving compliance with AMCA Standard 500 damper leakage at 10 cfm/sf at 1.0 in w.g. A product specification sheet showing the manufacturer's results after following the testing procedures of AMCA Standard 500 or AMCA certification by a third party under AMCA Publication 511 can be used to satisfy this requirement (Class 1A, 1, and 2 are acceptable). d. If the high limit setpoint is fixed dry-bulb or fixed enthalpy +fixed dry-bulb then the control shall have an adjustable setpoint e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: i. Drybulb and wetbulb temperatures accurate to t2"F over the range of 407 to 80`F ii. Enthalpy accurate to ±3 Btu/Ib over the range of 20 Btu/Ib to 36 Btu/Ib iii. Relative humidity (RH) accurate to ±5% over the range of 20% to 80% RH f. Check that the sensor performance curve(s) is provided by the factory and sensor outputvalues measured during sensor calibration are plotted on the performance curve(s) g. Sensors used for high limit control shall be located to prevent false readings, including but not limited to being properly / shielded from direct sunlight W Unitary systems with an economizer have control systems, including two-stage or electronic thermostats, that cycle cgmpressors off when economizers can provide partial cooling V/ /System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. ❑ For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. 2 For systems with non -DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Efficiency Standards - 2013 Nonresidential Com pllance May 2015 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE r:Fr—N;?r:A-UrJd.ftSA M.0 -at M1 R1 CALIFORNIA FNFRr,Y r0UU1SSI0N 18 CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) Mect Na (1 FnforcementArmy. Pemnk Number. Pro , 6 3x/ �� iyna zip rod System Name or ldentiricutioNtrag System l.owtiun orAres Served: B. Functional Testing Results Step 1: Disable demand control ventilation systems Cif applicable) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open. Verify the following: a. Economizer damper modulates 100% open. ON b- • Return air damper modulates 100% closed. N C. For systems that meet the criteria of 2013 Building Energy Efficiency Standards Section 140.4(e)1, verify that the economizer remains 100% open with the use of mechanical cooling. This occurs when the cooling demand can no longer be met by the economizer alone. 0 N d.' All applicable fans and dampers operate as intended to maintain building pressure. N e. The unit heating is disabled (if applicable). (9N/NA Step 3: Disable the economizer and simulate a cooling demand. Verify the following: a. Economizer damper closes to its minimum position. Y N b. All applicable fans and dampers operate as intended to maintain building pressure. Y N C-' The unit heating is disabled (if applicable). Y N / NA Step 4: If the unit is equipped with heating, simulate a heating demand and enable the economizer. Verify the following: a. Economizer damper doses to its minimum position. &N/NA b. Return air damper opens. / N / NA Step 5: Turn off the unit and verify the following: a. Economizer damper doses completely. N Step 6: System returned to initial operating conditions I —O—N C. Testing Results P FAIL Step 2: Simulate cooling load and enable the economizer (all answers are Y). Step 3: Simulate cooling load and disable the economizer (all answers are Y).. Step 4: Simulate heating demand and enable the economizer (all answers are Y). Step 5: Turn off the unit (all answers are Y). D. E luation PASS: All Construction inspection responses are complete and all Testing Results responses are "Pass" Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE rFr_NRrAAArwlte 10.A—w ncMGt CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Pitied Name: ^ Ed6rwmeFd AgenW.. Pem*Number. FIELD HNICIAN'S DECLARATION STAT MENT I certify the following under penalty of perjury, under the laws of the State of California: ziP97 53 System Name wtderRyi[atia+/Tag: Systemtocationa ea Served ■ DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I. I certify that this Certificate of Acceptance documentation is accurate com ete. If 11-11 CpettqFn-fation Author NameV Documeoftr u - � C^ny Doc.. 7V—^\,/LNed D Address ,/ffcertification Idt_ ' ication applicaabblle): � Phone. / 2 c� FIELD HNICIAN'S DECLARATION STAT MENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. ' 4. 1 have confirmed that the Certificate(s) of installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and ha n po ed or made avails le with t e building permit(s) issued for the building. Fi n Name: FI igrature: f 11N\ Fief hn nCompanyName: pony Ne): C Adtfrgss t p�J_ CerGfiotion "f ' GGfate -Identificationi�icable): CY iP: I .� Phone* / I tl Date signed RESPON BLE PERSON'S DECLARATIONISTATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or 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 signed copy of this Certificate of Acceptance is required to be Inducted with documentation the builder provides to the building owner at occupancy. Resrroible4tMeptance Person Ne: Res Acceptance P tore: AJ R ctrl Acceptance Person arty Name: e I C' A �7 Q CSLB license: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE r'F.(_AIG/`A.ANLf M w /Gn.:nM KNC CERTIFICATE OF ACCEPTANCE -- - - v vNRCA MCH -06-A Demand Contra] Ventilation Systems Acceptance (Page 1 of 2) U3= ( I- r �1 2 r+opaaumerr L/I A, U Documentation of all carbon dio)dde control sensors includes (check one ofthe following): a. Calibration method 4i/Factoryr-calibration (oert]ftpte calibration cat must be attached) o Feld calibrated b. Se7 accuracy Certified by manufacturer to be no more Ulan +/- 75 ppm calibration cert must be attached 3 4-40 Note: Submit one C&V%coOe ofAcceptm m for each syserm that It tforc ilei t`Age fi 11 s e5lieti %�aCe ; :: _' ".; _:: ?' mtr demonstrate romplionch�T::?:::.:::.,•.:..::....::..::.:..:.:.....:- Interni e* thatsysterns required to employ demand Controped ventilation (referto §M(c)3)can vary outside ventifton flow rotes on maintaffibW interior corfm dioxide (CO2) concentration setpoints A. Canstructlo n trrspiNoon 1 Instrumentation to perform test may include, but not limited to: a. Calibrated hand-held CO2 analyzer Ix Manufacduees calibration kit c Calibrated CU=/air mixtures 2 Installation a✓The sensor is located in the high density space between aft and 6 It above the floor or at the anticipated level of the occupants' heads. 3 Documentation of all carbon dio)dde control sensors includes (check one ofthe following): a. Calibration method 4i/Factoryr-calibration (oert]ftpte calibration cat must be attached) o Feld calibrated b. Se7 accuracy Certified by manufacturer to be no more Ulan +/- 75 ppm calibration cert must be attached B. Functional Testing Results a. Disable economizer controls b. Outside air COz concentration (measured dynamically using CO2 sensor) ppm c. Interior CO2 concentration setpoint (Outside COz concentration + 690 ppm) 1 53-s— ppm Step 5hnulate a signal at orslightly above the COz se4wint or follow manufacturers recommended testing procedures. For single zone unnts, outdoor air damper modulates opens to satisfy the total ventilation air called for in the Certificate of Compliance 0 For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone ventilation requirements. step • Simulate signal well below the WJ setpoint or follow manufacturers recommended procedures. le For single zone units, outdoor air damper modulates to the design minimum value. l7 For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone ventilation requirements. Step 3: Systern Mored to WW operating con tions I Y / N C T sting Results P / FAIL a( Step 1 Simulate a high CO2 load (check box complete) Step 2. Simulate a low CO2 load (check box complete) D. E IuatZn ASS: All Construction hupection responses are complete and all Testing PAm is responses are "Pass" CA &nldbrg Energy tfficlency Standards -2023 Nonresidential GompUlm Z�}Q STOZ AeY4 aouelld—:) IeAuaPiswuoN ELoZ-sp,epugs Aauapgn A8,au3 2+IPIIng VD l J svulaowsnw vuvaauau iv i vaw I--- cu v'�lwfv-JnIV"JJJ 33NVld333V SW31SAS NOLLV'ILLN3A IOIUN09 dNvw3Q vlWdDAnVOa0RMS da I -v I I I tl uavad atl ?! =11 d ameldar,U AI uedmoo le sumo 1 n9 a4; o; sap;no-jd vo uaaap ayI nPul a9 0; pam�bau sl aoue;da�y}o a;vyy�a) snN}o Adm pauga padsw algHe ml AwmSe luawamWe aW of aig !m apew pue '8ulpimg ay3,ol panssi (s)Puuad e Qe43 Puetswpun I suor Su!Pllo9 alb yilnn a19epene spew jo'pa4sad aq IIS aoueld=V#o aie,ygla3 s!tp }o Adoopeufk paialdwm a ieyt alnsua 11m I 5 aql lol pans! 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(s)Mumd guippq a4l qW algeileAe apew,o palsod se ,alleml/aaKmq alglsuodsa, atp Aq pawls pue pagaidwm uaaq sey ammdaooy}o me3yg,ao sap uo payguapi uogeaielsuIMP A4 uagellelsul to (sPU=Jqm3 ayt le4l pauuyum aAe4 I 4 LVN xlpuaddV ieltuapp amoN awasla)j ul payizads swnpazo}d pue sluawalmbau aoueldame algeolidde atp of swjoluoo pue 'bu;&e wawao,o}ua ayl Aq pano,dde suoneoyuads pue sueld ayl ul pa;enpui swawa,lnba, ague;dame algeogdde ayt qpm saudwm--mmdamvp a%emylag slyl uo pag4wpl uogellgsul,o uogon4suao a4l •£ (ueaiuyoal Pear) aoueld=V to aQe:)UWa3 siyi uo pmjoda, uollmUuaA aouetdame atp pauuopad oym uossd alp we I 'Z ;oa,im pue ant; 5l aoueidaoob }o a;eoyq,ao s?43 uo papino,d uogeuuo}ul a<l1 T elu,a�JeJ to amS aW to smel ayz,apun 'Am(sd to Alleuad,apun luumnol ata Apzm I LN3WUV1S NOu 30 S&MO Oo m3m 7z ?...0 lltl J )o �,►ugit0 vtn�� 'a�idw a rme sl uogguawraop aougda�y }o al�a3 s!4t leiR Algso 1 'T MMUVJS NOLLVW030 s.HORUIV NOLLV1N NMG svulaowsnw vuvaauau iv i vaw I--- cu v'�lwfv-JnIV"JJJ 33NVld333V SW31SAS NOLLV'ILLN3A IOIUN09 dNvw3Q vlWdDAnVOa0RMS da I -v I I I Maqmmm.—d (Z 30 Z aSedj WUnda=V swaQsAS u04e1gWA IMWCO puewall V-90iOW-VJIIN 3:)NV1d37JV 3O 31Y)ULLa30 svulaowsnw vuvaauau iv i vaw I--- cu v'�lwfv-JnIV"JJJ 33NVld333V SW31SAS NOLLV'ILLN3A IOIUN09 dNvw3Q vlWdDAnVOa0RMS STATE OF CAUFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEC-01RCAMp+12-A Ubmised 851CALIFOMAE19MYCOMMISSION Sk CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 1 of 3) r eaa Pmrdtrrmaber / i oar 1khA zaccae Srstem Iftmor/rtV Note: Submit one Certifimte of Acepptowefor each system that must =; Erif9iriertt h�eglse-ced by/patie_ ?_ _ ' ......... '_ A. Construction inspection 1. Prior to functional testing, verify and document the following: The Fault Detection and Diagnostics (FDD) hardware is installed on the unit The FDD system is certified to the California Energy Commission. 2 The folio "ng air temperature sensors are permanently installed: Outside Air Sensor 21"tpply Air Sensor Return Air Sensor (applicable for differential economizer operation only) S. Functional Testing Air Temperature Sensor FaQure/FauR Step 1: Verify the FDD system Indicates normal operation Step 2: Disconnect outside air temperature sensor from unit controller. Verify the following: FDD system reports a fault Step 3: Connect outside air temperature sensor to unit controller. Verify the fogowing iroo'FDD system indicates normal operation Excess Outside Air Step 1: Coordinate this test with NRCA-MCN-02-A(NA 75.1 Outdoor Air), if NRCA-MCH-02-A indicates "pass" then verify the following: FOD system indicates normal operation Economizer Operation Step 1: Coordinate this test with NRC4-MCH-05A (NA 75.4 Air Economizer Controls), and simulate faflure by Immobilizing the outdoor air economizer damper by disconnecting the control signal from the damper actuator (or another method specified by the manufacturer). Verify the following: FDD system reports a fault Step 2: Successfully complete and pass h RCA -NIGH -)5-A and verify the following: FDD system reports normal operation C. Testing Results PADS / FAIL Test passes if all boxes are checked under Functional Testing. O CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May2015 9 STATE OFCAUFamiA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CE"RCA,ma-1-12-A CAI IFoRM1A=w=w-w f oQu"lS'mold CERTIFICATE OF ACCEPTANCE :3 ' NRC0k-MCH-12A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 2 of 3) MM V C' AV-W-� swtom tkm ar ideammotw0aw System LamUmorAMD Seroed L D Eva ion PASS: All Construction Inspection responses are complete and Testing Results is "Pass" Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May201S z STATE OFCALIFMIA Aft FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS 6010 CEC+RCAMC1+12-A osn cauFc)m Eht=r--rt-nmwcmnu VW CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Padcaged Direct Expansion Units (Page 3 of 3) /Name: neck Wry £idwoexntA�ogr PCMM mba h r L I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct Snam tao Neart0eiaVfag 9 Sy4nolWn aA�saar& DOCUMtNTABON AUTHORS DECLARATION STATEMENT L t caqffy that this Certificate of Acceptance documentation is acct comp ' n Au tiarn� lloannm - ( t�J rye /Name: neck Wry ATrcerWimtlmtkm appfiwWe]c 9 -- D RaqiliaiNICIANS DEaARATk6N sTATT]IIIw I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated In the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has sled or made avail ab the building permit(s) Lsgmjed for the building. Nam* Rdd 1 C��2( n Company Name ny i ATMenifkadmideri fImUon appUe6te): BRun6mmup °� tERSOWS DEMRA ON SYMMEN T I certify the following under penalty of perjury, under the Laws of the State of California: 1. 1 am the Field Technician, or the Feld Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Gude in the applicable classification to accept responsibility for the system design, construction or installation of features, materials components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that time construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permmi(s) issued for the building. S. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner_at occr e nm R Respoih A,.Aoo�tancePersonCompanyName Address: CSiB Lke se I CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May2015 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) Ask AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH4 3-A IReviwd OSM51 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 4) Name- .-- O N .� ,&_) Erdo�merrt Agerxy. Pemdt Number. Proi�y4ddr lcr FIELD CHNICIAN'S DECLARATION ATEMENT zip code +� S System Na—kientrficatioWar / ,� System location or Ama Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate andcoaWl9te. talion Author Na Author e DPmdno tation Author Compaq Name: ©t O k/7 C'0NJ TTCertiioti mifka (IfappEcable): • /S te/Zip: L7 Phone: FIELD CHNICIAN'S DECLARATION ATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and ha or made available with the building permit(s) issued for the building. FielEadan Name: J Tech ignature: ff niaan mpany Name: ny ►: N A rens: TTCeyffiationidentirication(ifappruable): CI /SP ne: / /G/o r 6 Date Signed: RESP SIB[E P RSON'S DEC TION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. l understand that a signed copy of this Certificate of Acceptance is required to be included a docu entation the builder provides to the building owner at occupancy. ptancePe N ,^^ Responsi eptancePerso - ►Y A1ce' tanc—epersoncompimyName: Com ny T CS license: to mp "Q1� 7fid 47 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 j STATE OF CALIFORNIA -OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A Revised 05115 CALIFORNIA ENERGY COMMISSION A* CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Protect Na 1 �^ V Enforcement Agency. Peffnft NNumber. System Name m ldeff"atimuMag: y I/� System taction orArea Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. - - _ - Intent•I Verify measured outside airflow reading is within t 10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MECH-3C(Column H or Column 1) or Mechanical Equipment Schedules A. Construction Inspection Note: MCH -02 -A can be performed in conjunction with MCH -07 -A Supply Fan VFD Acceptance (if opplicable) since testing activities overtop. 1. Supporting documentation needed to perform test Includes: As -built and/or design documents (for dkample, Mechanical Equipment Schedules, Equipment a" Start -Up Sheets or Balancing Reports). b. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems AtA-Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At A-Glonce). C. 2013 Building Energy Efficiency Standards. 2. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire ane mn r, velocit pressure probe, etc.). i. Method and equipment used: e V ii. Equipment calibration date (must be within one)ear): ®OCL /,'Sf 3. System type (check either VAV or CAV): ❑ VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. 0 Check if factory calibrated and attach calibration certification. 0 Check if field calibrated and attach calibration results. ii. Damper Control (must be checked): ❑ Dynamic damper control Is being used to control outside air. (This is NOT a fixed minimum position). Ill. One of the following dynamic controls is being utilized to control outside air (check method used) ❑ Outdoor Air CFM Compensation 0 Energy Balance Method ❑ Demand Control Ventilation 0 Return Fan Tracking ❑ Injection Fan Method 0 Dedicated Minimum Ventilation Damper with Pressure Control ❑ Other Active Control, Describe: b. Check if Co t Air Volume (CAV) and verify the following: 7SSystem is designed to provide a fixed minimum OSA when the unit is on. 4. Method of delivering outside air to the unit (check one of the following): ❑ Outside air is ducted to the return air plenum. Confirm that outside air is ducted to either (check one of the following): ❑ Within fire ft. of the unit. ❑ Within 15 ft. of the unit, with the air directed substantially toward the unit. Return air plenum is NOT used to distribute outside air to the unit. Le. outside air is ducted directly to the unit or outside air is provided independent of the unit. S. Pre -occupancy purge has been programmed for the 1 -hour period immediately beforethe building is normally occupied to provide (one of the following methods must be verified and checked): a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less. b• 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE r�r�arerurulto_e svma.� rx11=1 CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) rta�" 1 AJZ Fn[orameMegerxV: PermBN�anber. ed V OY'W r l Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a;- cooling. Record VFD speed (Hz). System Name or ldemEradon/Tag AIL / 2 system 11 se B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing IYKV O VAV Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit is not in economizer mode during test (economizer disabled). O Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a;- cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow, reading (cfm) cfm cfm C. Required outdoor airflow (cfm) (from MEGs -3C Column 1, or Mechanical Equipment Schedules). Soo cfm cfm d. Time for outside air damper to stabilize after -full supply airflow is achieved minutes): — min Step 4: VAV testing at reduced supply airflow, CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD s ed (Hz). Hz b. Measured outdoor airflow reading (cfm) C. Required outdoor airflow (cfm) (from MECH-3C, Column 1, or mechanical equipment schedules). d. • Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): cfm cfm In min Step 5: Return to initial conditions (check) ❑ C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow, (%OAFA) for Step 2 a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow (Step2b/Step2c) 17, % % b. %OAFA is within 10% of design Outside Air. (%OAFA 5110%) Y N Y / N C. Outside air damper position stabilizes within 5 minutes (Step 2d < 5 minutes) 1111110M Y / N Determine Percent Outside Air at reduced supply airflow, (%OARJ for Step 3 (VAV only) a. %OARA = Measured outdoor airflow, reading /Required outdoor airflow reading (Step3b/Step3c) b. %OAm is within 10% of design Outside Air. (OAAA 5110%) % MEY / N C. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) Y / N Note: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. D. Evaluation PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y - yes) CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE rFANRrA_Mr_WJW_A 117—A 4 rmnll CERTI FICATE OF ACCEPTANCE _ NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 1 of 3) .P ' Mame• EMorcemera Agency. Permit Number. etl l System ameor[ mdfiotionjra L Syftemtocetion a5erved: I Note: Submit one Cert tate f a tante Acce or each f p system that must EnfortOment.lgeriijiUse: _Ctieriietl;hy/Date .- : ;.' demonstrate compliance. -.:::: _.:,:::.-::_::.:.::::- ............ . A. Construction Inspection 1. Supporting documentation needed to perform test includes: a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NAZ5.4 Air Economizer Controls Acceptance At -A - Glance). b. 2013 Building Energy Efficiency Standards. 2. Instrumentation to perform test includes: a. Hand-held temperature probe Calibration Date: (must be within last year) b. Device capable of calculating enth py Calibration Date: /S (must be within last year) c. 1.2 k Ohm Resistor ( when specified by the manufacturer) 3• Installation: (all of the following boxes should be checked) al Economizer high limit shutoff control complies with Table 140.4-B found in the 2013 Building Energy Efficiency Standards /Section 140-4(e)3. Lel Economizer reliability features are present per 2013 Building Energy Efficiency Standards Section 140.4(e)4: a. 5 -year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product specification sheet proving compliance with AMCA Standard 500 damper leakage at 10 cfm/sf at 1.0 in w.g. A product specification sheet showing the manufacturer's results after following the testing procedures of AMCA Standard 500 or AMCA certification by a third party under AMCA Publication 511 can be used to satisfy this requirement (Class 1A, 1, and 2 are acceptable). d. If the high limit setpoint is fixed dry-bulb or fixed enthalpy +fixed dry-bulb then the control shall have an adjustable setpoint e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: i. Drybulb and wetbulb temperatures accurate to t2`F over the range of 40'F to 80'F ii. Enthalpy accurate to ±3 Btu/Ib over the range of 20 Btu/Ib to 36 Btu/Ib ili. Relative humidity (RH) accurate to ±5% over the range of 20% to 80% RH f. Check that the sensor performance curve(s) is provided by the factory and sensor output values measured during sensor calibration are plotted on the performance curve(s) g. Sensors used for high limit control shall be located to prevent false readings, including but not limited to being properly / shielded from direct sunlight - fa Unitary systems with an economizer have control systems, including two-stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling IX/System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. 0 For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. fly For systems with non -DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 11