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BCOM2022-0060DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type: Permit Number Property Address APN: Legal Description Property Zoning: Valuation: BUILDING PERMIT eca Qa�&a CALIFORNIA Building Commercial BCOM2022-0060 46480 WASHINGTON ST STE 3 643020068 Parcel 2 PM 213/19 TR 32683 CR, 2 $50,000.00 Owner: Applicant PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 10/26/2022 ISSUED DATE: 05/05/2023 WASHINGTON 111 LTD 80618 DECLARATION AVE, INDIO, CA 92253 David Solomon 11331 E. 183rd St. #367, Cerritos, CA, CA 90703 Contractor: PALM CAPITAL GROUP LLC dba PALM CONSTRUCTION GROUP 205 E AVENIDA SAN JUAN, SAN CLEMENTE, CA 92672 PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE FOLLOWING: LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2) 1) They are licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and the referenced License is in full force and effect, or; 2) That they are exempt from the Contractors' State License Law for the reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or she is exempt from licensure by a valid exemption. [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code] Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).) a) As owner of the property, or my employees with wages as their sole compensation, will do all of or portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). b) As owner of the property, will be exclusively contracting with licensed c) Are exempt from licensure under the Contractors' State License Law. As an Owner -Builder, they acknowledge that, except for their personal residence in which they must have resided in for at least one year prior to completion of the improvements covered by this permit, they cannot legally sell a structure built as an owner -builder if it has not been constructed in its entirety by licensed contractors. It is understood that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application was submitted at the following Web site: http://www.leginfo.ca.gov/calaw.html. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If applicable) A construction lender will be used for completion of the improvements covered by this permit and the name and information of which is on file for public inspection during the regular business hours of the public entity. Failure of the applicant to indicate the construction lender on the WORKERS' COMPENSATION DECLARATION (1, 2 or 3) WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1) Has and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2) Has and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3) Certifies that, in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. NOTICE TO APPLICANT (1, 2 and 3) 1) Each person upon whose behalf this application was made, each person at whose request and for whose benefit work is being performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2) Any permit issued as a result of this application becomes null and void if work is not commenced within 360 days from date of issuance of such permit, or if cessation of work for 180 days will subject permit to cancellation. On or after January 1, 2019, every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 12 months after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 12 months after the time the work is commenced. 3) Certified that they read the application and state that the information provided is correct. Agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspection purposes. IMPORTANT: An Application for Permit was made to the Building Official, subject to the conditions and restrictions set forth at the time of application, which is now hereby an Issued Permit. If any part of the information being supplied on this permit is inaccurate or untrue, please contact the City of La Quinta at (760) 777-7125 immediately for correction. Printed: 11/20/24 4:33 pm Page 1 of 6 1-311111]1Z"a4 NV,IkI Permit Type: Building Commercial Permit Number: BCOM2022-0060 Property Address: 46480 WASHINGTON ST STE 3 application does not relieve that person of the n construction lender preliminary notice from that duty. Printed: 11/20/24 4:33 pm Page 2 of 6 1-3111101Z"a4NJilkI Permit Type: Building Commercial Permit Number: BCOM2022-0060 Property Address: 46480 WASHINGTON ST STE 3 SALON CENTRIC / 2,530SF RETAIL TI/VB/M-OCC/34-OL/SPRINKLED *** 2,530SF RETAIL BEAUTY SHOP TI/VB/M-OCC/34-OL/SPRINKLED [SALON CENTRIC] THIS PERMIT DOES NOT INCLUDE ALTERATION TO EXISTING LOAD BEARING OF LATERAL RESISTING CONSTRUCTION. NO TUMF OR DIF ASSESSMENT BASED ON PREVIOUSLY APPROVED SHOPPING CENTER. INTERIOR ONLY PATH OF TRAVEL IMPROVEMENTS, EXTERIOR NOT REQUIRED BASED ON AGREEMENT BETWEEN DEVELOPMEW AND CITY. 2019 CALIFORNIA BUILDING CODES. instruction Dpt;. Commercial Work Type Remodel Building/Unit M: Stores, Markets, Gas Gross Square Footage 2530 Occupancy Station Classification(s) Conditioned Square 2530 Fire Sprinkler Square 2530 Number of Floors 1 Footage Footage Occupant Load 34 Construction Type V-B Code Edition 2019 Remodel Area Square 2530 Footage Number of Plumbing 2 Fixtures/Traps Number of Dispensing 1 Units - Gas (TUMF) Zoning CR Subdivision Name TR 32683 Legal Description Parcel 2 PM 213/19 TR 32683 New Electrical Square 2530 Footage Water System Install Yes or Alteration? City Development No Impact Fee Applicable General Plan CG Lot Number 2 Miscellaneous Mechanical Transportation Uniform No Mitigation Fee Applicable Art in Public Places No Fund Exempt City Limits Within La Quinta Limits Lot Size 3676.29 I Type Group Sq Ft Value I Printed: 11/20/24 4:33 pm Page 3 of 6 1-311111]1Z"a4 N IT, IkI Permit Type: Building Commercial Permit Number: BCOM2022-0060 Property Address: 46480 WASHINGTON ST STE 3 Invoice No. Fee PERMIT-BCOM2022-00( REMODEL, EA ADDITIONAL 500SF PC 0 REMODEL, FIRST 100SF PC WATER SYSTEM INST/ALT/REP PC OTHER MECHANICAL EQUIPMENT FIXTURE/TRAP NON-RESIDENTIAL, FIRST 2,000SF PC FIRE COMMERCIAL TI WATER SYSTEM INST/ALT/REP TECHNOLOGY ENHANCEMENT FEE SMI - COMMERCIAL OTHER MECHANICAL EQUIPMENT PC NON-RESIDENTIAL, EA ADDITIONAL 2,000SF PC REMODEL, FIRST 100SF BSAS SB1473 FEE REMODEL, EA ADDITIONAL 500SF FIRE COMMERCIAL TI PC NON-RESIDENTIAL, FIRST 2,000SF RECORDS MANAGEMENT FEE - MAJOR HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW FIXTURE/TRAP PC NON-RESIDENTIAL, EA ADDITIONAL 2,000SF Total for Invoice PERMIT-BCOM2022-0060 Grand Total for Permit Fee Amount Amount Paid $105.05 $105.05 $162.81 $162.81 $14.59 $14.59 $43.77 $43.77 $29.18 $29.18 $101.54 $101.54 $175.00 $175.00 $14.59 $14.59 $8.00 $8.00 $14.00 $14.00 $43.77 $43.77 $11.67 $11.67 $59.52 $59.52 $2.00 $2.00 $131.30 $131.30 $263.00 $263.00 $131.30 $131.30 $22.00 $22.00 $312.50 $312.50 $29.18 $29.18 $43.77 $43.77 $1,718.54 $1,718.54 $1,718.54 $1,718.54 Workflow Step / Action Name Action Type Start Date End Date Inspections v.1 10/26/2022 0:00 FINAL INSPECTION v.1 Inspection FINAL** v.2 Inspection FINAL** v.1 Inspection T-BAR/OVERHEAD v.2 Inspection T-BAR/OVERHEAD v.1 Inspection DRYWALL NAIL v.1 Inspection UNDERGROUND PLBG v.2 Inspection ROUGH ELEC v.1 Inspection FRAMING v.1 Inspection ROUGH PLBG v.1 Inspection UNDERGROUND PLBG v.1 Inspection Application Completeness Check v.1 Submittal Document Verification v.1 Generic Action Confirm Fees Paid v.1 Generic Action Plan Check v.1 Building M 1 Receive Submittal Printed: 11/20/24 4:33 pm Page 4 of 6 Permit Type: Building Commercial 11111141110Ma4MYi1111 Permit Number: BCOM2022-0060 Property Address: 46480 WASHINGTON ST STE 3 Permit Issuance v.1 Contractor / Owner -Builder Information v.1 ................................................................................................................................................................ Verify & Invoice Fees v.1 ................................................................................................................................................................ Ready to Issue v.1 ................................................................................................................................................................ Verify Fee Payment & Issue Permit v.1 ................................................................................................................................................................ Print, Attach, and Email Building Permit v.1 Generic Action ....................................................... Generic Action ....................................................... Generic Action ....................................................... Generic Action ....................................................... Create Report 111.71./wl uvl I* - VVvwl 19v —vin VI IIII MF plvvCv V.1 Roof Nail v.1 Inspection Okay to Wrap v.1 Inspection Rough Fire Clearance v.1 Generic Action Framing v.1 Inspection Rough Electrical v.1 Inspection Rough Mechanical v.1 Inspection Rough Plumbing v.1 Inspection Shower Pan v.1 Inspection Insulation v.1 Inspection Drywall Nail v.1 Inspection T-Bar/Overhead v.1 Inspection Exterior Lath v.1 Inspection Gas Test v.1 Inspection Sewer Connection v.1 Inspection Temporary Power v.1 Inspection p Y p TempUse of Permanent Power v.1 Inspection p IN I01JOULIVI10 - VIIIaI V.1 VV/G I/GVLJ (— Final Fire v.1 Inspection Final Building v.1 Inspection 08/21/2023 14:59 08/21/2023 15:07 Final Building v.2 Inspection 08/29/2023 8:07 08/29/2023 8:07 VCI II1 CLU VI WUi FJG11 Y V.1 Iccl to (`ohifin�fo of (lnnl In�nry v 1 Printed: 11/20/24 4:33 pm Page 5 of 6 1-31111111]1Z"a4 N IT, IkI Permit Type: Building Commercial Permit Number: BCOM2022-0060 Property Address: 46480 WASHINGTON ST STE 3 Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of any material required to allow inspection. It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this code. A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the iurisdiction shall not be valid. A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by the building official. Printed: 11/20/24 4:33 pm Page 6 of 6 CERTIFICATE OF OCCUPANCY DESIGN AND DEVELOPMENT DEPARTMENT This Certificate is issued pursuant to the requirements of Chapter 1 Section 111 of the California Building Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 46480 WASHINGTON ST STE 3 Use Classification: Occupancy Group: M: Stores, Markets, Type of Construction: V-B Gas Station Code Edition: 2019 By: Jake Fuson Date: 8/29/2023 12: OO:OOAM Building Official: AJ ORTEGA ta Qa�&cu — GEM of the DESERT — Sprinkler Installed: YES Permit No.: BCOM2022-0060 Land Use Zone: CR Occupant Load: 34 Owner of Building: WASHINGTON 111 LTD Address: 80618 DECLARATION AVE City, ST, ZIP: INDIO, CA 92253 POST IN A CONSPICUOUS PLACE ffi IDSam I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable try. 1.1 I � es, iptr ; z,� Control Valves.— Identification Sign N ��Ae�Da Refe[e�Rcs 13.3.1 �17"t1aYe p6/30123$ P i �T r 1.2 1 Control Valves — Inspection 13.3.2 P 1.3 1 Waterflow Alarm Devices 5.2.5 P 1.4 1 Supervisory Devices 5.2.5 P 1.5 1 Gauges (Wet Pipe Systems) 5.2.4.1 P 1.6 1 Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 1 Enter Water Supply Pressure Above Riser Check 5.2.4.1 95 psi psi psi psi 1.8 1 Pressure Readings Acceptable 5.2.4.1 P 1.9 1 Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 P 1.10 I General Information Sign (not required for system prior to 2007 edition of NFPA 13) 5.2.8 N/A 1.11 I Heat Tape 5.2.7 N/A 1.12 1 Spare Sprinklers 5.2.1.4 P 1.13 1 Fire Department Connections 13.7 P 1.14 1 Alarm Valves — Exterior Inspection 13.4A N/A 1.15 1 Pressure Reducing Valves 13.5.1.1 N/A 1.16 I Backflow Preventers 13.6.1 P 1.17 1 Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 N/A 1.18 I PRV — Fire Sprinkler Systems 13.5.1.1 N/A * Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, 11, or III standpipe systems. Form AES 2.1 Sept. 3, 2013 = Inspection. T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable NJxk A... k't 'TMA,a'ir1s v.„,x z�,.4a.."P,,. :a°Descr..ed:Date�,..Gomrnents�O �p#��".,. 1P F"NIA _•a wa..,, a. fin ca,m+�wa ,;f2ference i �,�,, u, �i 1 A 9 1 Sprinklers 5.2.1 06/30/23 P 1.20 1 Buildings (Freeze Protection) 4.1.1.1 Owner's Responsibility N/A 1.21 1 I Pipe and Fittings 5.2.2 06/30/23 P 1.22 1 Hangers 5.2.3 06/30/23 P 1.23 1 Seismic Braces 5.2.3 06/30/23 P 2.1 T Field Service Test Required 5.3.1 If REQUIRED, Enter'F' until N/A (Send Report to Fire Code Official) results are returned from Lab 2.2 T Recalled Sprinklers Title 19 06/30/23 P If not present= Pass;. If eresent = Fail 904.1 c 2.3 T Water Flow Alarm Devices 5.3.3 06/30/23 40 sec. P 90 sec: maximum - Enter Time 13.2.6 2.4 T . Main Drain Test: 13.2.5 06/30/23 P (Enter data on Page 1 of this form) 13.3.3.4 2.5 T Control Valve -Position 13.3.3.2 06/30/23 P 2.6 T Control Valve - Operation 13.3.3.1 06/30/23 P 2.7 T Supervisory Devices 13.3.3.5 06/30/23 P 2.8 T Backflow Preventer Assemblies 13.6.2 N/A 2 9 T Small Hose Connections* 13.5.2.3 N/A w/PRV Hose Valves — Partial Flow Test 13.5.3.3 2.10 T PRV — Fire Sprinkler Systems 13.5.1.3 N/A 3.13 11 M Control Valves 13.3.4 06/30/23 P 3.2 M Small Hose Connections* 13.5.6.3 N/A Obstruction Investigation required Yes 3.3 M (if "Yes', see Deficiencies and Comments Section 14.3 06/30/23 No P for Results.) 3.4 M System Returned to Service 4.5.3 06/30123 Nos P * Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, 11, or III standpipe systems. Form AES 2.1 Sept. 3, 2013 I hereby certifythat the.fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the "Deficiencies and Comments" section of this form. Check boz.ifAnnual Inspection, Testing & Maintenance Items are Completed in the Indicated Quarter Date 0630 _Print�_Name_ 3 Nick Co___..�_._._.... Signature " Form AES 2.1 Sept. 3, 2013 12iser Nox T d1 fx sF k r 2 4 ,„Locatlop d D ameter pa€etrae€r ' to€ttat Stat<c - PressureFressurg� Resadpaf rFina) Static Pressure ;, v 1 Outside of Suite 1 inside access panel 3" 1 1/4" 85 75 80 P This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached: 1 I = Inspection .. T =.Test • M = Maintenance IEe'm �� 1s zM, LS x`y , x Descnptron ed'.; Reference P = Pass F = Fail N/A = NotApplicable Date, k'Comments�rrly PF N/A� r 1.1 I Control, Valves — Identification Sign 13.3.1 12/01/22 P 1.2 1 Control Valves — Inspection 13.3.2 12/01/22 P 1.3 1 Waterfiow Alarm Devices 5.2.5 12/01/22 P 1.4 1 Supervisory Devices 5.2.5 12/01/22 P 1.5 1 Gauges (Wet Pipe Systems) 52.4.1 12/01/22 P 1.6 1 Hydraulic Design Information Sign (For hydraulically designed systems) 5_2,6 12/01/22 P 1.7 1 Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi NA 1.8 1 Enter Water Supply Pressure Above Riser Check 5.2.4.1 12/01/22 85 psi P 1.9 1 Pressure Readings Acceptable 5.2.4.1 12/01/22 P 1.10 I General Information Sign (not required for system prior to 2007 Edition NFPA 13) 5 2 8 NA 1.11 1 Heat Tape 5.2.7 NA 1.12 1 Spare Sprinklers 52.1.4 12/01/22 P 1.13 1 Fire Department Connections 13.7 12/01/22 P 1.14 1 Alarm Valves —Exterior Inspection 13.4.1 NA 1.15 1 Pressure Reducing Valves 13.5.1.1 NA 1.16 1 Backfiow Preventers 13.6.1 NA Form AES 2.2 Sept_ 3, 2013 Contractor or Licensed Owner Information Building Name Washington 111. LLC {v Name Desert Fire Extinguisher CO., INC Address 46480 Washington St ' Job # 5 Year Inspection 27491504 CityLa Quinta, Ca. 92253 INA i Inspection T Test M Maintenance P = Pass F = Fail N/A = Not Applicable s �r DeIte m scnpt�on NFPA 25 CA=ed . €?ate '' Comrinents fJnlyP F;hllAp"s :Reference 1.17 1 Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 NIA 1.18 1 RRV — Fire Sprinkler Systems 13.5.1.1 N/A 1.19 I Buildings (Freeze Protection) 4.1.1.1 Owner's Responsibility NIA 1.20 1 Sprinklers 5.2.1 12/01/22 p 1.21 1 Sprinklers --Accessible Concealed Space 5.2.1.1.6 12/Q1/22 p 1.22 1 1 Pipe and Fittings 5.2.2 12/01/22 p 123 1 Pipe and Fittings -Accessible Concealed Space 5.2.2.3 12/01/22 P 1.24 i Hangers 5.2.3 12/01/22 p 1.25 1 Hangers- Accessible Concealed Space 5.2.3.3 12/01/22 P 1.26 1 Seismic Braces 5.2.3 12/01/22 p 1.27 1 Seismic. Braces -Accessible Concealed Space 5.2.3.3 12/01/22 P 1.28 1 Unsprinklered Areas CFC 901.4 12/01/22 ElYes V No 2.1 T Field Service Test Required If REQUIRED, Enter'F' until Send Report to Fire Code Official5.3.1 results are returned from Lab NIA 22 T Recalled Sprinklers Title 19 /f not present = Pass; if present = Fait 904.1(c) 12101 /22 p 2.3 T Water Flow Alarm Devices 5.3.3 90 secs max. Enter lime 13.2.6 12/01/22 35 sec. P 2A T Main Drain Test 13-2.5 (Enter data on Page 9 of this form) 13.3.3.4 12/01/22 P 2.5 T Control Valve -'Position 13.3.3.2 12/01/22 P 2.6 T Control Valye — Operation 13.3.3.1 12/01/22 p 2.7 T Supervisory Devices 13.3.3.5 12/01/22 p 2.8 T BackfI6vv Preventer Assemblies 13-6.2 N/A 2 9 T Small Hose.Connections* 13.5.2.3 w/PRV Hose. Valves — Partial Flow Test 13.5.3.3 N/A 2.10 T PRV— Fire Sprinkler Systems 13.5.1.3 N/A 2.11 T: ISmalf-H.ose Pressure Gauges - Calibration 5.3-2 12/01/22 p 2.12 T Connections* 13.5.6.2.2 NIA * Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class 1, 11, or III standpipe systems_ Form AES 2.2 Sept. 3, 2013 Property Information Building Name g } Washin ton 111 1_LC Address 46480 Washington St 9 City La Quinta, Ca: 92253 -mn� Form AES 2.2 Contractor or Licensed Owner Information rvarne Desert Fire Extinguisher CO_ INC Job # 5 Year Inspection 27491504 Sept. 3, 2013 � STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Project Name and Address Authority Having Jurisdiction Salon Centric TI CITY OF LA QUINTA 46480 Washington St., #3 BCOM2022-0060 La Quinta 92253 Permit Iss. Date: 5/5/2023 ■❑Construction inspection and functional testing comply Date Submitted 7/26/23 ❑Does not comply �to AHJ: This document is used to demonstrate compliance with acceptance requirements in Intent: §130.4(a)4, §160.5(e)1D and Reference Nonresidential Appendix NA7.6.2 for shut-off lighting controls. Attach additional sets of pages 1 through 8, as required, for all controls that must be tested. Indicate all types of shut-off controls tested for this project ❑ Automatic time switch lighting controls (Tables A-1 and B-1 of this document should be completed) Occupant sensing lighting controls (including occupant sensors, partial -ON occupant ❑■ sensors, partial -OFF occupant sensors, and/or vacancy sensors) (Tables A-2 and B-2 of this document should be completed) ❑ Multi zone occupant sensing lighting controls in office spaces larger than 250 square feet Tables A-2 and B-3 of this document should be completed) Automatic Time Switch Lighting Controls Table A-1. Automatic Time Switch Lighting Controls Construction Ins ection Code Step Entry Item Reference 1 ❑ The automatic time switch controls are shown on NA7.6.2.5(a) Ian documents and are installed. NA7.6.2.5(b) Automatic time switch controls are programmed §110.9(b)1Aii §130.1(c)1A 2 ❑ with acceptable weekday, weekend, and holiday §130.1(c)4 (if applicable) schedules. §160.5(b)4Cia §160.5(b)4Civ Document weekday, weekend, and holidays 3 ❑ schedules, as well as all set-up and preference NA7.6.2.5(c) program settings. 4 ❑ The correct time and date are properly set in the NA7.6.2.5(d) automatic time switch controls. 5 ❑ The battery backup (if applicable) is installed and NA7.6.2.5(e) energized. §110.9 b 1 Manual override time limit is set to no more than 2 NA7.6.2.5(f) 6 ❑ hours, OR §110.9(b)1Ai The automatic time switch control's manual §130.1(c)3B override time is exempt from the 2-hour limit. §160.5 b 4Ciiib `' TP CardoCaxrnislalnog axKed MIng Page 1 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Item Code Reference Manual override switches located remotely from NA7.6.2.5(g) area with controlled luminaires allow the user to §130.1(c)3A 7 ❑ see the controlled luminaires or have a visual §130.1(a) signal or display showing the current state of the §160.5(b)4Ciiia controlled luminaires. §160.5 b 4A ❑ Pass N/A ❑ Fail Construction Inspection Compliance. N/A Table B-1: Automatic Time Switch Lighting Controls Functional Testing Buildinq: Back Stock Floor:l 1 Room: Storaae Control: Occ Sensor Code Step Entry Functional Test Reference 1 No Entry Occupied Test. Simulate occupied condition in NA7.6.2.6(a) the controlled space. 1.1 ❑ Yes The automatic time switch control turns on the NA7.6.2.6(a)1 ❑ No controlled lighting. 2 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.6(b) condition in the controlled space. 2.1 ❑ Yes The automatic time switch control turns off all NA7.6.2.6(b)1 §130.1(c)1A ❑ No controlled lighting. § 160.5 b 4Cia For the area controlled by an automatic time switch control with a configured automatic holiday NA7.6.2.6(b)2 2.2 ❑ Yes shut-off, the controlled lighting can be turned off §110.9(b)1Aii ❑ No automatically by the holiday shut-off, OR the §130.1(c)4 automatic time switch control is exempt from §160.5(b)4Civ incor orating an automatic holiday shut-off. For the area controlled by an automatic time switch control with a time override located in and NA7.6.2.6(b)3 ❑ Yes for the area, the lighting can be turned on §110.9(b)1Ai 2.3 ❑ No manually by initiating the time override. The §130.1(c)3B lighting is configured to remain on for no more §160.5(b)4Ciiib than 2 hours OR the area is exempt from the 2- hour time override limit. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A &TP CaFbrmAMMMW`"I" Page 2 of 9 January 1, 2023 cALCmtrnN halting Pr rm 4 '� �� STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Occupant Sensing Lighting Controls Table A-2: Occupant Sensina Liahtina Control Construction Inspection Code Step Entry Item Reference 1 ❑E The occupant sensing lighting controls are shown NA7.6.2.1(a) on plan documents and are installed. Occupant sensing lighting control is installed per manufacturer's instructions to minimize false 2 ❑■ triggering — such as to install an occupancy sensor NA7.6.2.1(c) away from HVAC diffusers to avoid probable false triggerin . N/A 0 Pass ❑ Fail Construction Inspection Compliance. N/A Table 13-2: Occupant Sensing Lighting Control Functional Testing Buildina: Back Stock I Floor:1 I Room:Storaae I Control:Occ Sensor Step Entry Functional Test Code Reference ❑ Yes Control is representative of sample. If sampling N/A❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. 1 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.3(a) condition in the controlled space. `' TP CardoCaxrnislalnog axKed MIng Page 3 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference The occupant sensing control turn the controlled lighting off or partially off, if applicable, in 20 minutes or less from start of an unoccupied condition. In addition: For partial -on occupant sensing controls, 1 occupant sensing controls and vacancy sensing §110.9(b)4A §110. (b)4 controls, the controlled lighting is turned off in unoccupied condition. In the partial off state, partial OFF occupant sensing controls automatically reduce lighting power by at least 50 percent, OR: • For warehouses with metal halide or high pressure sodium lighting, automatically §130.1(c)6A-C reduce lighting power by at least 40 §130.1(c)7A percent. • For aisle ways and open areas in §160.5(b)4Cvia warehouses in which the installed lighting ❑■ Yes power is 80 percent or less of the value 1.1 ❑ No allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. • In corridors and stairwells that provide access to guestrooms in hotel/motels in which the installed lighting power is 80 percent or less of the value allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. For parking garages, parking areas, and loading and unloading areas, occupant sensing controls §130.1(c)7B have at least one control step between 20 to 50 §160.5(b)4Cviib percent of design lighting power, OR Occupant sensing controls for metal halide luminaires with a lamp plus ballast mean system efficacy of 75 lumens per watt, in parking garages, parking areas, and loading and unloading areas, have at least one control step between 20 to 60 percent of design lighting power. 2 No Entry Occupied Test. Simulate an occupied condition in NA7.6.2.3(b) the controlled space. 2.1 ❑■ Yes No ❑ Status indicator or annunciator operates correctly. NA7.6.2.3(b)1 §110.9b4C `' TP CardornislalnaxKed ogMIng Page 4 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Immediately upon an occupied condition: NA7.6.2.3(b)2 • The occupant sensing control or partial off occupant sensing control turns on controlled lighting; OR • The vacancy sensing control indicate a space is occupied and the controlled 2.2 0 Yes lighting can be turned on manually; OR ❑ No • The partial -on occupant sensing controls automatically turns on the controlled §130.1(c)5A lighting at between 50 to 70 percent of §160.5(b)4Cva controlled lighting power. After the partial - on stage, manual switches can be activated to turn on the controlled lighting at full controlled lighting ower. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A Table B-3: Multi -Zone Occupant Sensing Lighting Controls Functional Testing Buildinq: Back Stock Floor:1 Room: Storage Control: Occ Sensor Code Step Entry Functional Test Reference ❑ Yes Control is representative of sample. If sampling N/A ❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. Occupied Control Zone Test. Simulate an 1 No Entry occupied condition in the control zone controlled NA7.6.2.4(a) by the occupant sensor. 1.1 Yes Immediately upon occupancy of the control zone, NA7.6.2.4(a)1 ❑ No the occupant sensors turn on controlled lighting. Enter the illuminance value in footcandles (fc) measured at a location in the control zone where the controlled lighting is at full light output or designed light output if it has been documented that dimming luminaires have been intentionally 1.2 Enter Value tuned to less than full output and the design NA7.6.2.4(a)2 illuminance levels are provided. Informational note: Automatic daylighting controls may need to be temporarily overridden to achieve full or designed light output for the test. 1.3 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(a)3 ❑ No control. 1.4 ❑ Yes ❑No Status indicator or annunciator operates properly. NA7.6.2.4(a)4 §110.9b4C �, QrUprnlBhdwu.Koo lghting Page 5 of 9 January 1, 2023 C, L&TP GONnIS arammp Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Unoccupied Control Zone Test. Simulate an unoccupied condition in the control zone 2 No Entry controlled by the occupant sensor. Confirm that at NA7.6.2.4(b) least one other control zone within the office space is occupied. The occupant sensor uniformly reduces light NA7.6.2.4(b)1 2.1 ❑ Yes output of the controlled lighting in 20 minutes or §130.1(c)6Dii ❑ No less from the start of the unoccupied condition in §160.5(b)4CvibII the control zone. Enter the illuminance value during unoccupancy in 2.2 Enter Value footcandles (fc) measured at the same location as NA7.6.2.4(b)2 in Step 1.2. Calculate the ratio of the illuminance during 2.3 NaN unoccupancy to the illuminance at full or designed NA7.6.2.4(b)2 light output in %. ([Step 2.2 / Step 1.2] x 100 2.4 ❑ Yes The ratio of illuminance from Step 2.3 is no more NA7.6.2.4(b)2 §130.1(c)6Dii ❑ No than 20%. §160.5 b 4CvibII The occupant sensing control does not trigger a false on from movement outside of the control zone or from HVAC operation. ❑ Yes Informational note: The field of view of occupant 2.5 ❑ No sensors in the adjacent control zones in office NA7.6.2.4(b)3 spaces larger than 250 square feet may overlap, but the field of view should stay away from an adjacent enclosed space that is not part of the office space, like conference rooms, and private offices. 2.6 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(b)4 ❑ No control. Control Zone Size Test. Follow the procedures 3 No Entry described in either Method 1 (Steps 3.1 — 3.1.3) NA7.6.2.4(c) OR Method 2 (Steps 3.2 — 3.2.4 `� TP CaFbrm�`"I" Page 6 of 9 January 1, 2023 cALCmtrn. halting Pr rm STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Method 1: Simulate an unoccupied condition in the control zone controlled by the occupant sensor while standing in an adjacent control zone. Determine the "edge" of the control zone controlled by the occupant sensor by moving toward the occupant sensor until the lights 3.1 No Entry controlled by the occupant sensor turn on to NA7.6.2.4(c) simulate an occupied condition for that control Method 1 zone. Informational note: While moving toward the occupant sensor, making additional movements, motions, or sounds may be necessary to trigger the occupant sensor. Enter the distance in feet (ft) measured from the 3.1.1 "edge" of the control zone to the spot that is NA7.6.2.4(c) directly below the occupant sensor. This is the Method 1 radius of the control zone. 3.1.2 Calculate the area (in ftz) of the control zone by NA7.6.2.4(c) using the formula: Area = 3.14*radius2. Method 1 NA7.6.2.4(c) 3.1.3 ❑ Yes The area of the control zone (Step 3.1.2) is less Method 1 ❑ No than or equal to 600 square feet. §130.1(c)6Di §160.5 b 4CvibI 3.2 No Entry Method 2: Simulate an unoccupied condition for NA7.6.2.4(c) the entire offices ace. Method 2 Walk through the space and count the number of NA7.6.2.4(c) 3.2.1 zones of lighting that turn on automatically. Enter Method 2 the number of zones that turn on automatically. Enter the area of the office space (in ftz) from construction plans or from other information NA7.6.2.4(c)2 3.2.2 source such as construction documents or Method 2 Nonresidential Certificates of Compliance N RCCs . Divide the area of the office by the number of NA7.6.2.4(c)3 3.2.3 NaN zones. Enter the value in square feet. This Method 2 calculated value is the assessed control zone size. NA7.6.2.4(c)4 3.2.4 ❑ Yes The area of the control zone is less than or equal Method 2 ❑ No to 600 square feet. §130.1(c)6Di 160.5 b 4CvibI corlrprnl0Adv�ooUghting Page 7 of 9 January 1, 2023 cAL&TP Gas= lfalmng Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Unoccupied Office Test. Simulate an unoccupied condition in all control zones NA7.6.2.4(d) ❑Yes controlled by all occupant sensors in the office. §130.1(c)6Diii§1 4 ❑ No In 20 minutes or less from the start of the 60.5(b)4CvibIII unoccupied condition of the entire office, all controlled lighting in the office is turned off. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A `' TP CardoCaxrnislalnog axKed MIng Page 8 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Declaration Statement Signatory Document Author 07/26/2023 I assert that this Certificate of Acceptance documentation is accurate and complete. Sign Here: Field Technician Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting, Inc. , TC A813601 ,ATT/RP, (951)270-0575 The information provided on this Certificate of Acceptance is true and correct. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference J�__ Nonresidential Appendix NA7. I 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 Select Date 07/26/2023 builder/installer and has been posted or made available with the building ermit s issued for the building. Signed: Responsible Person Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting Inc, 993105, ATT/RP, (951) 270-0575 I 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. I 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). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference J Nonresidential Appendix NA7. I 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. 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 Select Date building, and made available to the enforcement agency for all applicable inspections. I understand that a Signed: 07/26/2023 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. CarlrQmla AdvaKed llgMing cAL �\ TP Lontn lialmngPrDgram Page 3 of 3 January 1, 2023 � STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Project Name and Address Authority Having Jurisdiction Salon Centric TI CITY OF LA QUINTA 46480 Washington St., #3 BCOM2022-0060 La Quinta 92253 Permit Iss. Date: 5/5/2023 ■❑Construction inspection and functional testing comply Date Submitted 7/26/23 ❑Does not comply �to AHJ: This document is used to demonstrate compliance with acceptance requirements in Intent: §130.4(a)4, §160.5(e)1D and Reference Nonresidential Appendix NA7.6.2 for shut-off lighting controls. Attach additional sets of pages 1 through 8, as required, for all controls that must be tested. Indicate all types of shut-off controls tested for this project ❑ Automatic time switch lighting controls (Tables A-1 and B-1 of this document should be completed) Occupant sensing lighting controls (including occupant sensors, partial -ON occupant ❑■ sensors, partial -OFF occupant sensors, and/or vacancy sensors) (Tables A-2 and B-2 of this document should be completed) ❑ Multi zone occupant sensing lighting controls in office spaces larger than 250 square feet Tables A-2 and B-3 of this document should be completed) Automatic Time Switch Lighting Controls Table A-1. Automatic Time Switch Lighting Controls Construction Ins ection Code Step Entry Item Reference 1 ❑ The automatic time switch controls are shown on NA7.6.2.5(a) Ian documents and are installed. NA7.6.2.5(b) Automatic time switch controls are programmed §110.9(b)1Aii §130.1(c)1A 2 ❑ with acceptable weekday, weekend, and holiday §130.1(c)4 (if applicable) schedules. §160.5(b)4Cia §160.5(b)4Civ Document weekday, weekend, and holidays 3 ❑ schedules, as well as all set-up and preference NA7.6.2.5(c) program settings. 4 ❑ The correct time and date are properly set in the NA7.6.2.5(d) automatic time switch controls. 5 ❑ The battery backup (if applicable) is installed and NA7.6.2.5(e) energized. §110.9 b 1 Manual override time limit is set to no more than 2 NA7.6.2.5(f) 6 ❑ hours, OR §110.9(b)1Ai The automatic time switch control's manual §130.1(c)3B override time is exempt from the 2-hour limit. §160.5 b 4Ciiib `' TP CardoCaxrnislalnog axKed MIng Page 1 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Item Code Reference Manual override switches located remotely from NA7.6.2.5(g) area with controlled luminaires allow the user to §130.1(c)3A 7 ❑ see the controlled luminaires or have a visual §130.1(a) signal or display showing the current state of the §160.5(b)4Ciiia controlled luminaires. §160.5 b 4A ❑ Pass N/A ❑ Fail Construction Inspection Compliance. N/A Table B-1: Automatic Time Switch Lighting Controls Functional Testing Buildinq: Retail / Cashi i Floor:l 1 Room: Retail / Cashier Control: Occ Sensor Code Step Entry Functional Test Reference 1 No Entry Occupied Test. Simulate occupied condition in NA7.6.2.6(a) the controlled space. 1.1 ❑ Yes The automatic time switch control turns on the NA7.6.2.6(a)1 ❑ No controlled lighting. 2 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.6(b) condition in the controlled space. 2.1 ❑ Yes The automatic time switch control turns off all NA7.6.2.6(b)1 §130.1(c)1A ❑ No controlled lighting. § 160.5 b 4Cia For the area controlled by an automatic time switch control with a configured automatic holiday NA7.6.2.6(b)2 2.2 ❑ Yes shut-off, the controlled lighting can be turned off §110.9(b)1Aii ❑ No automatically by the holiday shut-off, OR the §130.1(c)4 automatic time switch control is exempt from §160.5(b)4Civ incor orating an automatic holiday shut-off. For the area controlled by an automatic time switch control with a time override located in and NA7.6.2.6(b)3 ❑ Yes for the area, the lighting can be turned on §110.9(b)1Ai 2.3 ❑ No manually by initiating the time override. The §130.1(c)3B lighting is configured to remain on for no more §160.5(b)4Ciiib than 2 hours OR the area is exempt from the 2- hour time override limit. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A &TP CaFbrmAMMMW`"I" Page 2 of 9 January 1, 2023 cALCmtrnN halting Pr rm 4 '� �� STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Occupant Sensing Lighting Controls Table A-2: Occupant Sensina Liahtina Control Construction Inspection Code Step Entry Item Reference 1 ❑E The occupant sensing lighting controls are shown NA7.6.2.1(a) on plan documents and are installed. Occupant sensing lighting control is installed per manufacturer's instructions to minimize false 2 ❑■ triggering — such as to install an occupancy sensor NA7.6.2.1(c) away from HVAC diffusers to avoid probable false triggerin . N/A 0 Pass ❑ Fail Construction Inspection Compliance. N/A Table B-2: Occupant Sensing Lighting Control Functional Testing Buildina: Retail / Cashie Floor:1 I Room: Retail / Cashier I Control: Occ Sensor Step Entry Functional Test Code Reference ❑ Yes Control is representative of sample. If sampling N/A❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. 1 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.3(a) condition in the controlled space. `' TP CardoCaxrnislalnog axKed MIng Page 3 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference The occupant sensing control turn the controlled lighting off or partially off, if applicable, in 20 minutes or less from start of an unoccupied condition. In addition: For partial -on occupant sensing controls, 1 occupant sensing controls and vacancy sensing §110.9(b)4A §110. (b)4 controls, the controlled lighting is turned off in unoccupied condition. In the partial off state, partial OFF occupant sensing controls automatically reduce lighting power by at least 50 percent, OR: • For warehouses with metal halide or high pressure sodium lighting, automatically §130.1(c)6A-C reduce lighting power by at least 40 §130.1(c)7A percent. • For aisle ways and open areas in §160.5(b)4Cvia warehouses in which the installed lighting ❑■ Yes power is 80 percent or less of the value 1.1 ❑ No allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. • In corridors and stairwells that provide access to guestrooms in hotel/motels in which the installed lighting power is 80 percent or less of the value allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. For parking garages, parking areas, and loading and unloading areas, occupant sensing controls §130.1(c)7B have at least one control step between 20 to 50 §160.5(b)4Cviib percent of design lighting power, OR Occupant sensing controls for metal halide luminaires with a lamp plus ballast mean system efficacy of 75 lumens per watt, in parking garages, parking areas, and loading and unloading areas, have at least one control step between 20 to 60 percent of design lighting power. 2 No Entry Occupied Test. Simulate an occupied condition in NA7.6.2.3(b) the controlled space. 2.1 ❑■ Yes No ❑ Status indicator or annunciator operates correctly. NA7.6.2.3(b)1 §110.9b4C `' TP CardornislalnaxKed ogMIng Page 4 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Immediately upon an occupied condition: NA7.6.2.3(b)2 • The occupant sensing control or partial off occupant sensing control turns on controlled lighting; OR • The vacancy sensing control indicate a space is occupied and the controlled 2.2 0 Yes lighting can be turned on manually; OR ❑ No • The partial -on occupant sensing controls automatically turns on the controlled §130.1(c)5A lighting at between 50 to 70 percent of §160.5(b)4Cva controlled lighting power. After the partial - on stage, manual switches can be activated to turn on the controlled lighting at full controlled lighting ower. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A Table B-3: Multi -Zone Occupant Sensing Lighting Controls Functional Testing Buildinq: Retail / Cashi i Floor:1 1 Room: Retail / Cashier Control: Occ Sensor Code Step Entry Functional Test Reference ❑ Yes Control is representative of sample. If sampling N/A ❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. Occupied Control Zone Test. Simulate an 1 No Entry occupied condition in the control zone controlled NA7.6.2.4(a) by the occupant sensor. 1.1 Yes Immediately upon occupancy of the control zone, NA7.6.2.4(a)1 ❑ No the occupant sensors turn on controlled lighting. Enter the illuminance value in footcandles (fc) measured at a location in the control zone where the controlled lighting is at full light output or designed light output if it has been documented that dimming luminaires have been intentionally 1.2 Enter Value tuned to less than full output and the design NA7.6.2.4(a)2 illuminance levels are provided. Informational note: Automatic daylighting controls may need to be temporarily overridden to achieve full or designed light output for the test. 1.3 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(a)3 ❑ No control. 1.4 ❑ Yes ❑No Status indicator or annunciator operates properly. NA7.6.2.4(a)4 §110.9b4C �, QrUprnlBhdwu.Koo lghting Page 5 of 9 January 1, 2023 C, L&TP GONnIS arammp Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Unoccupied Control Zone Test. Simulate an unoccupied condition in the control zone 2 No Entry controlled by the occupant sensor. Confirm that at NA7.6.2.4(b) least one other control zone within the office space is occupied. The occupant sensor uniformly reduces light NA7.6.2.4(b)1 2.1 ❑ Yes output of the controlled lighting in 20 minutes or §130.1(c)6Dii ❑ No less from the start of the unoccupied condition in §160.5(b)4CvibII the control zone. Enter the illuminance value during unoccupancy in 2.2 Enter Value footcandles (fc) measured at the same location as NA7.6.2.4(b)2 in Step 1.2. Calculate the ratio of the illuminance during 2.3 NaN unoccupancy to the illuminance at full or designed NA7.6.2.4(b)2 light output in %. ([Step 2.2 / Step 1.2] x 100 2.4 ❑ Yes The ratio of illuminance from Step 2.3 is no more NA7.6.2.4(b)2 §130.1(c)6Dii ❑ No than 20%. §160.5 b 4CvibII The occupant sensing control does not trigger a false on from movement outside of the control zone or from HVAC operation. ❑ Yes Informational note: The field of view of occupant 2.5 ❑ No sensors in the adjacent control zones in office NA7.6.2.4(b)3 spaces larger than 250 square feet may overlap, but the field of view should stay away from an adjacent enclosed space that is not part of the office space, like conference rooms, and private offices. 2.6 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(b)4 ❑ No control. Control Zone Size Test. Follow the procedures 3 No Entry described in either Method 1 (Steps 3.1 — 3.1.3) NA7.6.2.4(c) OR Method 2 (Steps 3.2 — 3.2.4 `� TP CaFbrm�`"I" Page 6 of 9 January 1, 2023 cALCmtrn. halting Pr rm STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Method 1: Simulate an unoccupied condition in the control zone controlled by the occupant sensor while standing in an adjacent control zone. Determine the "edge" of the control zone controlled by the occupant sensor by moving toward the occupant sensor until the lights 3.1 No Entry controlled by the occupant sensor turn on to NA7.6.2.4(c) simulate an occupied condition for that control Method 1 zone. Informational note: While moving toward the occupant sensor, making additional movements, motions, or sounds may be necessary to trigger the occupant sensor. Enter the distance in feet (ft) measured from the 3.1.1 "edge" of the control zone to the spot that is NA7.6.2.4(c) directly below the occupant sensor. This is the Method 1 radius of the control zone. 3.1.2 Calculate the area (in ftz) of the control zone by NA7.6.2.4(c) using the formula: Area = 3.14*radius2. Method 1 NA7.6.2.4(c) 3.1.3 ❑ Yes The area of the control zone (Step 3.1.2) is less Method 1 ❑ No than or equal to 600 square feet. §130.1(c)6Di §160.5 b 4CvibI 3.2 No Entry Method 2: Simulate an unoccupied condition for NA7.6.2.4(c) the entire offices ace. Method 2 Walk through the space and count the number of NA7.6.2.4(c) 3.2.1 zones of lighting that turn on automatically. Enter Method 2 the number of zones that turn on automatically. Enter the area of the office space (in ftz) from construction plans or from other information NA7.6.2.4(c)2 3.2.2 source such as construction documents or Method 2 Nonresidential Certificates of Compliance N RCCs . Divide the area of the office by the number of NA7.6.2.4(c)3 3.2.3 NaN zones. Enter the value in square feet. This Method 2 calculated value is the assessed control zone size. NA7.6.2.4(c)4 3.2.4 ❑ Yes The area of the control zone is less than or equal Method 2 ❑ No to 600 square feet. §130.1(c)6Di 160.5 b 4CvibI corlrprnl0Adv�ooUghting Page 7 of 9 January 1, 2023 cAL&TP Gas= lfalmng Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Unoccupied Office Test. Simulate an unoccupied condition in all control zones NA7.6.2.4(d) ❑Yes controlled by all occupant sensors in the office. §130.1(c)6Diii§1 4 ❑ No In 20 minutes or less from the start of the 60.5(b)4CvibIII unoccupied condition of the entire office, all controlled lighting in the office is turned off. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A `' TP CardoCaxrnislalnog axKed MIng Page 8 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Declaration Statement Signatory Document Author 07/26/2023 I assert that this Certificate of Acceptance documentation is accurate and complete. Sign Here: Field Technician Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting, Inc. , TC-A813601 ,ATT/RP, (951)270-0575 The information provided on this Certificate of Acceptance is true and correct. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference J Nonresidential Appendix NA7. I 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 Select Date 07/26/2023 builder/installer and has been posted or made available with the building permit(s) issued for the building. Signed: Responsible Person Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting Inc, 993105, ATT/RP, (951) 270-0575 I 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. I 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). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I 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. 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 Select Date building, and made available to the enforcement agency for all applicable inspections. I understand that a Signed: 07/26/2023 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. C cAL % TP D �Islralning gProgramPage 3 of 3 January 1, 2023 � STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Project Name and Address Authority Having Jurisdiction Salon Centric TI CITY OF LA QUINTA 46480 Washington St., #3 BCOM2022-0060 La Quinta 92253 Permit Iss. Date: 5/5/2023 ■❑Construction inspection and functional testing comply Date Submitted 7/26/23 ❑Does not comply �to AHJ: This document is used to demonstrate compliance with acceptance requirements in Intent: §130.4(a)4, §160.5(e)1D and Reference Nonresidential Appendix NA7.6.2 for shut-off lighting controls. Attach additional sets of pages 1 through 8, as required, for all controls that must be tested. Indicate all types of shut-off controls tested for this project ❑ Automatic time switch lighting controls (Tables A-1 and B-1 of this document should be completed) Occupant sensing lighting controls (including occupant sensors, partial -ON occupant ❑■ sensors, partial -OFF occupant sensors, and/or vacancy sensors) (Tables A-2 and B-2 of this document should be completed) ❑ Multi zone occupant sensing lighting controls in office spaces larger than 250 square feet Tables A-2 and B-3 of this document should be completed) Automatic Time Switch Lighting Controls Table A-1. Automatic Time Switch Lighting Controls Construction Ins ection Code Step Entry Item Reference 1 ❑ The automatic time switch controls are shown on NA7.6.2.5(a) Ian documents and are installed. NA7.6.2.5(b) Automatic time switch controls are programmed §110.9(b)1Aii §130.1(c)1A 2 ❑ with acceptable weekday, weekend, and holiday §130.1(c)4 (if applicable) schedules. §160.5(b)4Cia §160.5(b)4Civ Document weekday, weekend, and holidays 3 ❑ schedules, as well as all set-up and preference NA7.6.2.5(c) program settings. 4 ❑ The correct time and date are properly set in the NA7.6.2.5(d) automatic time switch controls. 5 ❑ The battery backup (if applicable) is installed and NA7.6.2.5(e) energized. §110.9 b 1 Manual override time limit is set to no more than 2 NA7.6.2.5(f) 6 ❑ hours, OR §110.9(b)1Ai The automatic time switch control's manual §130.1(c)3B override time is exempt from the 2-hour limit. §160.5 b 4Ciiib `' TP CardoCaxrnislalnog axKed MIng Page 1 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Item Code Reference Manual override switches located remotely from NA7.6.2.5(g) area with controlled luminaires allow the user to §130.1(c)3A 7 ❑ see the controlled luminaires or have a visual §130.1(a) signal or display showing the current state of the §160.5(b)4Ciiia controlled luminaires. §160.5 b 4A ❑ Pass N/A ❑ Fail Construction Inspection Compliance. N/A Table B-1: Automatic Time Switch Lighting Controls Functional Testing Buildinq: Office Floor:l 1 Room: Office < 250 sf Control: Occ Sensor Code Step Entry Functional Test Reference 1 No Entry Occupied Test. Simulate occupied condition in NA7.6.2.6(a) the controlled space. 1.1 ❑ Yes The automatic time switch control turns on the NA7.6.2.6(a)1 ❑ No controlled lighting. 2 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.6(b) condition in the controlled space. 2.1 ❑ Yes The automatic time switch control turns off all NA7.6.2.6(b)1 §130.1(c)1A ❑ No controlled lighting. § 160.5 b 4Cia For the area controlled by an automatic time switch control with a configured automatic holiday NA7.6.2.6(b)2 2.2 ❑ Yes shut-off, the controlled lighting can be turned off §110.9(b)1Aii ❑ No automatically by the holiday shut-off, OR the §130.1(c)4 automatic time switch control is exempt from §160.5(b)4Civ incor orating an automatic holiday shut-off. For the area controlled by an automatic time switch control with a time override located in and NA7.6.2.6(b)3 ❑ Yes for the area, the lighting can be turned on §110.9(b)1Ai 2.3 ❑ No manually by initiating the time override. The §130.1(c)3B lighting is configured to remain on for no more §160.5(b)4Ciiib than 2 hours OR the area is exempt from the 2- hour time override limit. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A &TP CaFbrmAMMMW`"I" Page 2 of 9 January 1, 2023 cALCmtrnN halting Pr rm 4 '� �� STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Occupant Sensing Lighting Controls Table A-2: Occupant Sensina Liahtina Control Construction Inspection Code Step Entry Item Reference 1 ❑E The occupant sensing lighting controls are shown NA7.6.2.1(a) on plan documents and are installed. Occupant sensing lighting control is installed per manufacturer's instructions to minimize false 2 ❑■ triggering — such as to install an occupancy sensor NA7.6.2.1(c) away from HVAC diffusers to avoid probable false triggerin . N/A 0 Pass ❑ Fail Construction Inspection Compliance. N/A Table B-2: Occupant Sensing Lighting Control Functional Testing Buildina: Office I Floor:1 I Room: Office < 250 sf I Control: Occ Sensor Step Entry Functional Test Code Reference ❑ Yes Control is representative of sample. If sampling N/A❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. 1 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.3(a) condition in the controlled space. `' TP CardoCaxrnislalnog axKed MIng Page 3 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference The occupant sensing control turn the controlled lighting off or partially off, if applicable, in 20 minutes or less from start of an unoccupied condition. In addition: For partial -on occupant sensing controls, 1 occupant sensing controls and vacancy sensing §110.9(b)4A §110. (b)4 controls, the controlled lighting is turned off in unoccupied condition. In the partial off state, partial OFF occupant sensing controls automatically reduce lighting power by at least 50 percent, OR: • For warehouses with metal halide or high pressure sodium lighting, automatically §130.1(c)6A-C reduce lighting power by at least 40 §130.1(c)7A percent. • For aisle ways and open areas in §160.5(b)4Cvia warehouses in which the installed lighting ❑■ Yes power is 80 percent or less of the value 1.1 ❑ No allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. • In corridors and stairwells that provide access to guestrooms in hotel/motels in which the installed lighting power is 80 percent or less of the value allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. For parking garages, parking areas, and loading and unloading areas, occupant sensing controls §130.1(c)7B have at least one control step between 20 to 50 §160.5(b)4Cviib percent of design lighting power, OR Occupant sensing controls for metal halide luminaires with a lamp plus ballast mean system efficacy of 75 lumens per watt, in parking garages, parking areas, and loading and unloading areas, have at least one control step between 20 to 60 percent of design lighting power. 2 No Entry Occupied Test. Simulate an occupied condition in NA7.6.2.3(b) the controlled space. 2.1 ❑■ Yes No ❑ Status indicator or annunciator operates correctly. NA7.6.2.3(b)1 §110.9b4C `' TP CardornislalnaxKed ogMIng Page 4 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Immediately upon an occupied condition: NA7.6.2.3(b)2 • The occupant sensing control or partial off occupant sensing control turns on controlled lighting; OR • The vacancy sensing control indicate a space is occupied and the controlled 2.2 ❑■ Yes lighting can be turned on manually; OR ❑ No • The partial -on occupant sensing controls automatically turns on the controlled §130.1(c)5A lighting at between 50 to 70 percent of §160.5(b)4Cva controlled lighting power. After the partial - on stage, manual switches can be activated to turn on the controlled lighting at full controlled lighting ower. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A Table B-3: Multi -Zone Occuuant Sensin Controls Functional Testin Buildinq: Office I Floor:1 I Room: Office < 250 sf I Control: Occ Sensor Code Step Entry Functional Test Reference ❑ Yes Control is representative of sample. If sampling N/A ❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. Occupied Control Zone Test. Simulate an 1 No Entry occupied condition in the control zone controlled NA7.6.2.4(a) b the occu ant sensor. 1.1 Yes Immediately upon occupancy of the control zone, NA7.6.2.4(a)1 ❑ No the occupant sensors turn on controlled lighting. Enter the illuminance value in footcandles (fc) measured at a location in the control zone where the controlled lighting is at full light output or designed light output if it has been documented that dimming luminaires have been intentionally 1.2 Enter Value tuned to less than full output and the design NA7.6.2.4(a)2 illuminance levels are provided. Informational note: Automatic daylighting controls may need to be temporarily overridden to achieve full or designed light output for the test. 1.3 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(a)3 ❑ No control. 1.4 ❑ Yes ❑No Status indicator or annunciator operates properly. NA7.6.2.4(a)4 §110.9b4C �, QrUprnlBhdwu.Koo lghting Page 5 of 9 January 1, 2023 C, L&TP GONnIS arammp Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Unoccupied Control Zone Test. Simulate an unoccupied condition in the control zone 2 No Entry controlled by the occupant sensor. Confirm that at NA7.6.2.4(b) least one other control zone within the office space is occupied. The occupant sensor uniformly reduces light NA7.6.2.4(b)1 2.1 ❑ Yes output of the controlled lighting in 20 minutes or §130.1(c)6Dii ❑ No less from the start of the unoccupied condition in §160.5(b)4CvibII the control zone. Enter the illuminance value during unoccupancy in 2.2 Enter Value footcandles (fc) measured at the same location as NA7.6.2.4(b)2 in Step 1.2. Calculate the ratio of the illuminance during 2.3 NaN unoccupancy to the illuminance at full or designed NA7.6.2.4(b)2 light output in %. ([Step 2.2 / Step 1.2] x 100 2.4 ❑ Yes The ratio of illuminance from Step 2.3 is no more NA7.6.2.4(b)2 §130.1(c)6Dii ❑ No than 20%. §160.5 b 4CvibII The occupant sensing control does not trigger a false on from movement outside of the control zone or from HVAC operation. ❑ Yes Informational note: The field of view of occupant 2.5 ❑ No sensors in the adjacent control zones in office NA7.6.2.4(b)3 spaces larger than 250 square feet may overlap, but the field of view should stay away from an adjacent enclosed space that is not part of the office space, like conference rooms, and private offices. 2.6 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(b)4 ❑ No control. Control Zone Size Test. Follow the procedures 3 No Entry described in either Method 1 (Steps 3.1 — 3.1.3) NA7.6.2.4(c) OR Method 2 (Steps 3.2 — 3.2.4 `� TP CaFbrm�`"I" Page 6 of 9 January 1, 2023 cALCmtrn. halting Pr rm STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Method 1: Simulate an unoccupied condition in the control zone controlled by the occupant sensor while standing in an adjacent control zone. Determine the "edge" of the control zone controlled by the occupant sensor by moving toward the occupant sensor until the lights 3.1 No Entry controlled by the occupant sensor turn on to NA7.6.2.4(c) simulate an occupied condition for that control Method 1 zone. Informational note: While moving toward the occupant sensor, making additional movements, motions, or sounds may be necessary to trigger the occupant sensor. Enter the distance in feet (ft) measured from the 3.1.1 "edge" of the control zone to the spot that is NA7.6.2.4(c) directly below the occupant sensor. This is the Method 1 radius of the control zone. 3.1.2 Calculate the area (in ftz) of the control zone by NA7.6.2.4(c) using the formula: Area = 3.14*radius2. Method 1 NA7.6.2.4(c) 3.1.3 ❑ Yes The area of the control zone (Step 3.1.2) is less Method 1 ❑ No than or equal to 600 square feet. §130.1(c)6Di §160.5 b 4CvibI 3.2 No Entry Method 2: Simulate an unoccupied condition for NA7.6.2.4(c) the entire offices ace. Method 2 Walk through the space and count the number of NA7.6.2.4(c) 3.2.1 zones of lighting that turn on automatically. Enter Method 2 the number of zones that turn on automatically. Enter the area of the office space (in ftz) from construction plans or from other information NA7.6.2.4(c)2 3.2.2 source such as construction documents or Method 2 Nonresidential Certificates of Compliance N RCCs . Divide the area of the office by the number of NA7.6.2.4(c)3 3.2.3 NaN zones. Enter the value in square feet. This Method 2 calculated value is the assessed control zone size. NA7.6.2.4(c)4 3.2.4 ❑ Yes The area of the control zone is less than or equal Method 2 ❑ No to 600 square feet. §130.1(c)6Di 160.5 b 4CvibI corlrprnl0Adv�ooUghting Page 7 of 9 January 1, 2023 cAL&TP Gas= lfalmng Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Unoccupied Office Test. Simulate an unoccupied condition in all control zones NA7.6.2.4(d) ❑Yes controlled by all occupant sensors in the office. §130.1(c)6Diii§1 4 ❑ No In 20 minutes or less from the start of the 60.5(b)4CvibIII unoccupied condition of the entire office, all controlled lighting in the office is turned off. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A `' TP CardoCaxrnislalnog axKed MIng Page 8 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Declaration Statement Signatory Document Author 07/26/2023 I assert that this Certificate of Acceptance documentation is accurate and complete. Sign Here: J�_ Field Technician Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting, Inc. , TC-A813601 ,ATT/RP, (951)270-0575 The information provided on this Certificate of Acceptance is true and correct. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference t Nonresidential Appendix NA7. I 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 Select Date 07/26/2023 builder/installer and has been posted or made available with the building permit(s) issued for the building. Signed: Responsible Person Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting Inc, 993105, ATT/RP, (951) 270-0575 I 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. I 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). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I 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. 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 Select Date building, and made available to the enforcement agency for all applicable inspections. I understand that a Signed: 07/26/2023 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. C cAL % TP D �Islralning gProgramPage 3 of 3 January 1, 2023 � STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Project Name and Address Authority Having Jurisdiction Salon Centric TI CITY OF LA QUINTA 46480 Washington St., #3 BCOM2022-0060 La Quinta 92253 Permit Iss. Date: 5/5/2023 ■❑Construction inspection and functional testing comply Date Submitted 7/26/23 ❑Does not comply �to AHJ: This document is used to demonstrate compliance with acceptance requirements in Intent: §130.4(a)4, §160.5(e)1D and Reference Nonresidential Appendix NA7.6.2 for shut-off lighting controls. Attach additional sets of pages 1 through 8, as required, for all controls that must be tested. Indicate all types of shut-off controls tested for this project ❑ Automatic time switch lighting controls (Tables A-1 and B-1 of this document should be completed) Occupant sensing lighting controls (including occupant sensors, partial -ON occupant ❑■ sensors, partial -OFF occupant sensors, and/or vacancy sensors) (Tables A-2 and B-2 of this document should be completed) ❑ Multi zone occupant sensing lighting controls in office spaces larger than 250 square feet Tables A-2 and B-3 of this document should be completed) Automatic Time Switch Lighting Controls Table A-1. Automatic Time Switch Lighting Controls Construction Ins ection Code Step Entry Item Reference 1 ❑ The automatic time switch controls are shown on NA7.6.2.5(a) Ian documents and are installed. NA7.6.2.5(b) Automatic time switch controls are programmed §110.9(b)1Aii §130.1(c)1A 2 ❑ with acceptable weekday, weekend, and holiday §130.1(c)4 (if applicable) schedules. §160.5(b)4Cia §160.5(b)4Civ Document weekday, weekend, and holidays 3 ❑ schedules, as well as all set-up and preference NA7.6.2.5(c) program settings. 4 ❑ The correct time and date are properly set in the NA7.6.2.5(d) automatic time switch controls. 5 ❑ The battery backup (if applicable) is installed and NA7.6.2.5(e) energized. §110.9 b 1 Manual override time limit is set to no more than 2 NA7.6.2.5(f) 6 ❑ hours, OR §110.9(b)1Ai The automatic time switch control's manual §130.1(c)3B override time is exempt from the 2-hour limit. §160.5 b 4Ciiib `' TP CardoCaxrnislalnog axKed MIng Page 1 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Item Code Reference Manual override switches located remotely from NA7.6.2.5(g) area with controlled luminaires allow the user to §130.1(c)3A 7 ❑ see the controlled luminaires or have a visual §130.1(a) signal or display showing the current state of the §160.5(b)4Ciiia controlled luminaires. §160.5 b 4A ❑ Pass N/A ❑ Fail Construction Inspection Compliance. N/A Table B-1: Automatic Time Switch Lighting Controls Functional Testing Buildinq: Restroom Floor:l 1 Room: Restroom Control: Occ Sensor Code Step Entry Functional Test Reference 1 No Entry Occupied Test. Simulate occupied condition in NA7.6.2.6(a) the controlled space. 1.1 ❑ Yes The automatic time switch control turns on the NA7.6.2.6(a)1 ❑ No controlled lighting. 2 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.6(b) condition in the controlled space. 2.1 ❑ Yes The automatic time switch control turns off all NA7.6.2.6(b)1 §130.1(c)1A ❑ No controlled lighting. § 160.5 b 4Cia For the area controlled by an automatic time switch control with a configured automatic holiday NA7.6.2.6(b)2 2.2 ❑ Yes shut-off, the controlled lighting can be turned off §110.9(b)1Aii ❑ No automatically by the holiday shut-off, OR the §130.1(c)4 automatic time switch control is exempt from §160.5(b)4Civ incor orating an automatic holiday shut-off. For the area controlled by an automatic time switch control with a time override located in and NA7.6.2.6(b)3 ❑ Yes for the area, the lighting can be turned on §110.9(b)1Ai 2.3 ❑ No manually by initiating the time override. The §130.1(c)3B lighting is configured to remain on for no more §160.5(b)4Ciiib than 2 hours OR the area is exempt from the 2- hour time override limit. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A &TP CaFbrmAMMMW`"I" Page 2 of 9 January 1, 2023 cALCmtrnN halting Pr rm 4 '� �� STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Occupant Sensing Lighting Controls Table A-2: Occupant Sensina Liahtina Control Construction Inspection Code Step Entry Item Reference 1 ❑E The occupant sensing lighting controls are shown NA7.6.2.1(a) on plan documents and are installed. Occupant sensing lighting control is installed per manufacturer's instructions to minimize false 2 ❑■ triggering — such as to install an occupancy sensor NA7.6.2.1(c) away from HVAC diffusers to avoid probable false triggerin . N/A 0 Pass ❑ Fail Construction Inspection Compliance. N/A Table B-2: Occupant Sensing Lighting Control Functional Testing Buildina: Restroom I Floor:1 I Room: Restroom I Control: Occ Sensor Step Entry Functional Test Code Reference ❑ Yes Control is representative of sample. If sampling N/A❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. 1 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.3(a) condition in the controlled space. `' TP CardoCaxrnislalnog axKed MIng Page 3 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference The occupant sensing control turn the controlled lighting off or partially off, if applicable, in 20 minutes or less from start of an unoccupied condition. In addition: For partial -on occupant sensing controls, 1 occupant sensing controls and vacancy sensing §110.9(b)4A §110. (b)4 controls, the controlled lighting is turned off in unoccupied condition. In the partial off state, partial OFF occupant sensing controls automatically reduce lighting power by at least 50 percent, OR: • For warehouses with metal halide or high pressure sodium lighting, automatically §130.1(c)6A-C reduce lighting power by at least 40 §130.1(c)7A percent. • For aisle ways and open areas in §160.5(b)4Cvia warehouses in which the installed lighting ❑■ Yes power is 80 percent or less of the value 1.1 ❑ No allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. • In corridors and stairwells that provide access to guestrooms in hotel/motels in which the installed lighting power is 80 percent or less of the value allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. For parking garages, parking areas, and loading and unloading areas, occupant sensing controls §130.1(c)7B have at least one control step between 20 to 50 §160.5(b)4Cviib percent of design lighting power, OR Occupant sensing controls for metal halide luminaires with a lamp plus ballast mean system efficacy of 75 lumens per watt, in parking garages, parking areas, and loading and unloading areas, have at least one control step between 20 to 60 percent of design lighting power. 2 No Entry Occupied Test. Simulate an occupied condition in NA7.6.2.3(b) the controlled space. 2.1 ❑■ Yes No ❑ Status indicator or annunciator operates correctly. NA7.6.2.3(b)1 §110.9b4C `' TP CardornislalnaxKed ogMIng Page 4 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Immediately upon an occupied condition: NA7.6.2.3(b)2 • The occupant sensing control or partial off occupant sensing control turns on controlled lighting; OR • The vacancy sensing control indicate a space is occupied and the controlled 2.2 0 Yes lighting can be turned on manually; OR ❑ No • The partial -on occupant sensing controls automatically turns on the controlled §130.1(c)5A lighting at between 50 to 70 percent of §160.5(b)4Cva controlled lighting power. After the partial - on stage, manual switches can be activated to turn on the controlled lighting at full controlled lighting ower. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A Table B-3: Multi -Zone Occupant Sensing Lighting Controls Functional Testing Buildinq: Restroom I Floor:1 1 Room: Restroom Control: Occ Sensor Code Step Entry Functional Test Reference ❑ Yes Control is representative of sample. If sampling N/A ❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. Occupied Control Zone Test. Simulate an 1 No Entry occupied condition in the control zone controlled NA7.6.2.4(a) b the occu ant sensor. 1.1 Yes Immediately upon occupancy of the control zone, NA7.6.2.4(a)1 ❑ No the occupant sensors turn on controlled lighting. Enter the illuminance value in footcandles (fc) measured at a location in the control zone where the controlled lighting is at full light output or designed light output if it has been documented that dimming luminaires have been intentionally 1.2 Enter Value tuned to less than full output and the design NA7.6.2.4(a)2 illuminance levels are provided. Informational note: Automatic daylighting controls may need to be temporarily overridden to achieve full or designed light output for the test. 1.3 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(a)3 ❑ No control. 1.4 ❑ Yes ❑No Status indicator or annunciator operates properly. NA7.6.2.4(a)4 §110.9b4C �, QrUprnlBhdwu.Koo lghting Page 5 of 9 January 1, 2023 C, L&TP GONnIS arammp Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Unoccupied Control Zone Test. Simulate an unoccupied condition in the control zone 2 No Entry controlled by the occupant sensor. Confirm that at NA7.6.2.4(b) least one other control zone within the office space is occupied. The occupant sensor uniformly reduces light NA7.6.2.4(b)1 2.1 ❑ Yes output of the controlled lighting in 20 minutes or §130.1(c)6Dii ❑ No less from the start of the unoccupied condition in §160.5(b)4CvibII the control zone. Enter the illuminance value during unoccupancy in 2.2 Enter Value footcandles (fc) measured at the same location as NA7.6.2.4(b)2 in Step 1.2. Calculate the ratio of the illuminance during 2.3 NaN unoccupancy to the illuminance at full or designed NA7.6.2.4(b)2 light output in %. ([Step 2.2 / Step 1.2] x 100 2.4 ❑ Yes The ratio of illuminance from Step 2.3 is no more NA7.6.2.4(b)2 §130.1(c)6Dii ❑ No than 20%. §160.5 b 4CvibII The occupant sensing control does not trigger a false on from movement outside of the control zone or from HVAC operation. ❑ Yes Informational note: The field of view of occupant 2.5 ❑ No sensors in the adjacent control zones in office NA7.6.2.4(b)3 spaces larger than 250 square feet may overlap, but the field of view should stay away from an adjacent enclosed space that is not part of the office space, like conference rooms, and private offices. 2.6 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(b)4 ❑ No control. Control Zone Size Test. Follow the procedures 3 No Entry described in either Method 1 (Steps 3.1 — 3.1.3) NA7.6.2.4(c) OR Method 2 (Steps 3.2 — 3.2.4 `� TP CaFbrm�`"I" Page 6 of 9 January 1, 2023 cALCmtrn. halting Pr rm STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Method 1: Simulate an unoccupied condition in the control zone controlled by the occupant sensor while standing in an adjacent control zone. Determine the "edge" of the control zone controlled by the occupant sensor by moving toward the occupant sensor until the lights 3.1 No Entry controlled by the occupant sensor turn on to NA7.6.2.4(c) simulate an occupied condition for that control Method 1 zone. Informational note: While moving toward the occupant sensor, making additional movements, motions, or sounds may be necessary to trigger the occupant sensor. Enter the distance in feet (ft) measured from the 3.1.1 "edge" of the control zone to the spot that is NA7.6.2.4(c) directly below the occupant sensor. This is the Method 1 radius of the control zone. 3.1.2 Calculate the area (in ftz) of the control zone by NA7.6.2.4(c) using the formula: Area = 3.14*radius2. Method 1 NA7.6.2.4(c) 3.1.3 ❑ Yes The area of the control zone (Step 3.1.2) is less Method 1 ❑ No than or equal to 600 square feet. §130.1(c)6Di §160.5 b 4CvibI 3.2 No Entry Method 2: Simulate an unoccupied condition for NA7.6.2.4(c) the entire offices ace. Method 2 Walk through the space and count the number of NA7.6.2.4(c) 3.2.1 zones of lighting that turn on automatically. Enter Method 2 the number of zones that turn on automatically. Enter the area of the office space (in ftz) from construction plans or from other information NA7.6.2.4(c)2 3.2.2 source such as construction documents or Method 2 Nonresidential Certificates of Compliance N RCCs . Divide the area of the office by the number of NA7.6.2.4(c)3 3.2.3 NaN zones. Enter the value in square feet. This Method 2 calculated value is the assessed control zone size. NA7.6.2.4(c)4 3.2.4 ❑ Yes The area of the control zone is less than or equal Method 2 ❑ No to 600 square feet. §130.1(c)6Di 160.5 b 4CvibI corlrprnl0Adv�ooUghting Page 7 of 9 January 1, 2023 cAL&TP Gas= lfalmng Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Unoccupied Office Test. Simulate an unoccupied condition in all control zones NA7.6.2.4(d) ❑Yes controlled by all occupant sensors in the office. §130.1(c)6Diii§1 4 ❑ No In 20 minutes or less from the start of the 60.5(b)4CvibIII unoccupied condition of the entire office, all controlled lighting in the office is turned off. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A `' TP CardoCaxrnislalnog axKed MIng Page 8 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Declaration Statement Signatory Document Author Jeff Bernardino, Integrated Power & I assert that this Certificate of Acceptance documentation is accurate and complete. Lighting,07/26/2023 Sign Here: Field Technician Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting, Inc. , TC-A813601 ,ATT/RP, (951)270-0575 The information provided on this Certificate of Acceptance is true and correct. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference J Nonresidential Appendix NA7. I 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 Select Date 07/26/2023 builder/installer and has been posted or made available with the building permit(s) issued for the building. Signed: Responsible Person Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting Inc, 993105, ATT/RP, (951) 270-0575 I 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. I 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). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference 1 Nonresidential Appendix NA7. I have confirmed that the Certificate(s) of Installation for the construction �J 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. 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 Select Date building, and made available to the enforcement agency for all applicable inspections. I understand that a Signed: 07/26/2023 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. C cAL % TP D �Islralning gProgramPage 3 of 3 January 1, 2023 � STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Project Name and Address Authority Having Jurisdiction Salon Centric TI CITY OF LA QUINTA 46480 Washington St., #3 BCOM2022-0060 La Quinta 92253 Permit Iss. Date: 5/5/2023 ■❑Construction inspection and functional testing comply Date Submitted 7/26/23 ❑Does not comply �to AHJ: This document is used to demonstrate compliance with acceptance requirements in Intent: §130.4(a)4, §160.5(e)1D and Reference Nonresidential Appendix NA7.6.2 for shut-off lighting controls. Attach additional sets of pages 1 through 8, as required, for all controls that must be tested. Indicate all types of shut-off controls tested for this project ❑ Automatic time switch lighting controls (Tables A-1 and B-1 of this document should be completed) Occupant sensing lighting controls (including occupant sensors, partial -ON occupant ❑■ sensors, partial -OFF occupant sensors, and/or vacancy sensors) (Tables A-2 and B-2 of this document should be completed) ❑ Multi zone occupant sensing lighting controls in office spaces larger than 250 square feet Tables A-2 and B-3 of this document should be completed) Automatic Time Switch Lighting Controls Table A-1. Automatic Time Switch Lighting Controls Construction Ins ection Code Step Entry Item Reference 1 ❑ The automatic time switch controls are shown on NA7.6.2.5(a) Ian documents and are installed. NA7.6.2.5(b) Automatic time switch controls are programmed §110.9(b)1Aii §130.1(c)1A 2 ❑ with acceptable weekday, weekend, and holiday §130.1(c)4 (if applicable) schedules. §160.5(b)4Cia §160.5(b)4Civ Document weekday, weekend, and holidays 3 ❑ schedules, as well as all set-up and preference NA7.6.2.5(c) program settings. 4 ❑ The correct time and date are properly set in the NA7.6.2.5(d) automatic time switch controls. 5 ❑ The battery backup (if applicable) is installed and NA7.6.2.5(e) energized. §110.9 b 1 Manual override time limit is set to no more than 2 NA7.6.2.5(f) 6 ❑ hours, OR §110.9(b)1Ai The automatic time switch control's manual §130.1(c)3B override time is exempt from the 2-hour limit. §160.5 b 4Ciiib `' TP CardoCaxrnislalnog axKed MIng Page 1 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Item Code Reference Manual override switches located remotely from NA7.6.2.5(g) area with controlled luminaires allow the user to §130.1(c)3A 7 ❑ see the controlled luminaires or have a visual §130.1(a) signal or display showing the current state of the §160.5(b)4Ciiia controlled luminaires. §160.5 b 4A ❑ Pass N/A ❑ Fail Construction Inspection Compliance. N/A Table B-1: Automatic Time Switch Lighting Controls Functional Testing Buildinq: Hallwav Floor:l 1 Room: Hallwav Control: Occ Sensor Code Step Entry Functional Test Reference 1 No Entry Occupied Test. Simulate occupied condition in NA7.6.2.6(a) the controlled space. 1.1 ❑ Yes The automatic time switch control turns on the NA7.6.2.6(a)1 ❑ No controlled lighting. 2 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.6(b) condition in the controlled space. 2.1 ❑ Yes The automatic time switch control turns off all NA7.6.2.6(b)1 §130.1(c)1A ❑ No controlled lighting. § 160.5 b 4Cia For the area controlled by an automatic time switch control with a configured automatic holiday NA7.6.2.6(b)2 2.2 ❑ Yes shut-off, the controlled lighting can be turned off §110.9(b)1Aii ❑ No automatically by the holiday shut-off, OR the §130.1(c)4 automatic time switch control is exempt from §160.5(b)4Civ incor orating an automatic holiday shut-off. For the area controlled by an automatic time switch control with a time override located in and NA7.6.2.6(b)3 ❑ Yes for the area, the lighting can be turned on §110.9(b)1Ai 2.3 ❑ No manually by initiating the time override. The §130.1(c)3B lighting is configured to remain on for no more §160.5(b)4Ciiib than 2 hours OR the area is exempt from the 2- hour time override limit. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A &TP CaFbrmAMMMW`"I" Page 2 of 9 January 1, 2023 cALCmtrnN halting Pr rm 4 '� �� STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Occupant Sensing Lighting Controls Table A-2: Occupant Sensina Liahtina Control Construction Inspection Code Step Entry Item Reference 1 ❑E The occupant sensing lighting controls are shown NA7.6.2.1(a) on plan documents and are installed. Occupant sensing lighting control is installed per manufacturer's instructions to minimize false 2 ❑■ triggering — such as to install an occupancy sensor NA7.6.2.1(c) away from HVAC diffusers to avoid probable false triggerin . N/A 0 Pass ❑ Fail Construction Inspection Compliance. N/A Table B-2: Occupant Sensing Lighting Control Functional Testing Buildina: Hallwav I Floor:1 I Room: Hallwav I Control: Occ Sensor Step Entry Functional Test Code Reference ❑ Yes Control is representative of sample. If sampling N/A❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. 1 No Entry Unoccupied Test. Simulate an unoccupied NA7.6.2.3(a) condition in the controlled space. `' TP CardoCaxrnislalnog axKed MIng Page 3 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference The occupant sensing control turn the controlled lighting off or partially off, if applicable, in 20 minutes or less from start of an unoccupied condition. In addition: For partial -on occupant sensing controls, 1 occupant sensing controls and vacancy sensing §110.9(b)4A §110. (b)4 controls, the controlled lighting is turned off in unoccupied condition. In the partial off state, partial OFF occupant sensing controls automatically reduce lighting power by at least 50 percent, OR: • For warehouses with metal halide or high pressure sodium lighting, automatically §130.1(c)6A-C reduce lighting power by at least 40 §130.1(c)7A percent. • For aisle ways and open areas in §160.5(b)4Cvia warehouses in which the installed lighting ❑■ Yes power is 80 percent or less of the value 1.1 ❑ No allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. • In corridors and stairwells that provide access to guestrooms in hotel/motels in which the installed lighting power is 80 percent or less of the value allowed under the Area Category Method, automatically reduce lighting power by at least 40 percent. For parking garages, parking areas, and loading and unloading areas, occupant sensing controls §130.1(c)7B have at least one control step between 20 to 50 §160.5(b)4Cviib percent of design lighting power, OR Occupant sensing controls for metal halide luminaires with a lamp plus ballast mean system efficacy of 75 lumens per watt, in parking garages, parking areas, and loading and unloading areas, have at least one control step between 20 to 60 percent of design lighting power. 2 No Entry Occupied Test. Simulate an occupied condition in NA7.6.2.3(b) the controlled space. 2.1 ❑■ Yes No ❑ Status indicator or annunciator operates correctly. NA7.6.2.3(b)1 §110.9b4C `' TP CardornislalnaxKed ogMIng Page 4 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Immediately upon an occupied condition: NA7.6.2.3(b)2 • The occupant sensing control or partial off occupant sensing control turns on controlled lighting; OR • The vacancy sensing control indicate a space is occupied and the controlled 2.2 0 Yes lighting can be turned on manually; OR ❑ No • The partial -on occupant sensing controls automatically turns on the controlled §130.1(c)5A lighting at between 50 to 70 percent of §160.5(b)4Cva controlled lighting power. After the partial - on stage, manual switches can be activated to turn on the controlled lighting at full controlled lighting ower. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A Table B-3: Multi -Zone Occupant Sensing Lighting Controls Functional Testing Buildinq: Hallway I Floor:1 Room: Hallway Control: Occ Sensor Code Step Entry Functional Test Reference ❑ Yes Control is representative of sample. If sampling N/A ❑ No method is used, attach a page listing untested NA7.6.2.2 controls in sample. Occupied Control Zone Test. Simulate an 1 No Entry occupied condition in the control zone controlled NA7.6.2.4(a) by the occupant sensor. 1.1 Yes Immediately upon occupancy of the control zone, NA7.6.2.4(a)1 ❑ No the occupant sensors turn on controlled lighting. Enter the illuminance value in footcandles (fc) measured at a location in the control zone where the controlled lighting is at full light output or designed light output if it has been documented that dimming luminaires have been intentionally 1.2 Enter Value tuned to less than full output and the design NA7.6.2.4(a)2 illuminance levels are provided. Informational note: Automatic daylighting controls may need to be temporarily overridden to achieve full or designed light output for the test. 1.3 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(a)3 ❑ No control. 1.4 ❑ Yes ❑No Status indicator or annunciator operates properly. NA7.6.2.4(a)4 §110.9b4C �, QrUprnlBhdwu.Koo lghting Page 5 of 9 January 1, 2023 C, L&TP GONnIS arammp Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Unoccupied Control Zone Test. Simulate an unoccupied condition in the control zone 2 No Entry controlled by the occupant sensor. Confirm that at NA7.6.2.4(b) least one other control zone within the office space is occupied. The occupant sensor uniformly reduces light NA7.6.2.4(b)1 2.1 ❑ Yes output of the controlled lighting in 20 minutes or §130.1(c)6Dii ❑ No less from the start of the unoccupied condition in §160.5(b)4CvibII the control zone. Enter the illuminance value during unoccupancy in 2.2 Enter Value footcandles (fc) measured at the same location as NA7.6.2.4(b)2 in Step 1.2. Calculate the ratio of the illuminance during 2.3 NaN unoccupancy to the illuminance at full or designed NA7.6.2.4(b)2 light output in %. ([Step 2.2 / Step 1.2] x 100 2.4 ❑ Yes The ratio of illuminance from Step 2.3 is no more NA7.6.2.4(b)2 §130.1(c)6Dii ❑ No than 20%. §160.5 b 4CvibII The occupant sensing control does not trigger a false on from movement outside of the control zone or from HVAC operation. ❑ Yes Informational note: The field of view of occupant 2.5 ❑ No sensors in the adjacent control zones in office NA7.6.2.4(b)3 spaces larger than 250 square feet may overlap, but the field of view should stay away from an adjacent enclosed space that is not part of the office space, like conference rooms, and private offices. 2.6 ❑ Yes Signal sensitivity is adequate to achieve desired NA7.6.2.4(b)4 ❑ No control. Control Zone Size Test. Follow the procedures 3 No Entry described in either Method 1 (Steps 3.1 — 3.1.3) NA7.6.2.4(c) OR Method 2 (Steps 3.2 — 3.2.4 `� TP CaFbrm�`"I" Page 6 of 9 January 1, 2023 cALCmtrn. halting Pr rm STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Code Step Entry Functional Test Reference Method 1: Simulate an unoccupied condition in the control zone controlled by the occupant sensor while standing in an adjacent control zone. Determine the "edge" of the control zone controlled by the occupant sensor by moving toward the occupant sensor until the lights 3.1 No Entry controlled by the occupant sensor turn on to NA7.6.2.4(c) simulate an occupied condition for that control Method 1 zone. Informational note: While moving toward the occupant sensor, making additional movements, motions, or sounds may be necessary to trigger the occupant sensor. Enter the distance in feet (ft) measured from the 3.1.1 "edge" of the control zone to the spot that is NA7.6.2.4(c) directly below the occupant sensor. This is the Method 1 radius of the control zone. 3.1.2 Calculate the area (in ftz) of the control zone by NA7.6.2.4(c) using the formula: Area = 3.14*radius2. Method 1 NA7.6.2.4(c) 3.1.3 ❑ Yes The area of the control zone (Step 3.1.2) is less Method 1 ❑ No than or equal to 600 square feet. §130.1(c)6Di §160.5 b 4CvibI 3.2 No Entry Method 2: Simulate an unoccupied condition for NA7.6.2.4(c) the entire offices ace. Method 2 Walk through the space and count the number of NA7.6.2.4(c) 3.2.1 zones of lighting that turn on automatically. Enter Method 2 the number of zones that turn on automatically. Enter the area of the office space (in ftz) from construction plans or from other information NA7.6.2.4(c)2 3.2.2 source such as construction documents or Method 2 Nonresidential Certificates of Compliance N RCCs . Divide the area of the office by the number of NA7.6.2.4(c)3 3.2.3 NaN zones. Enter the value in square feet. This Method 2 calculated value is the assessed control zone size. NA7.6.2.4(c)4 3.2.4 ❑ Yes The area of the control zone is less than or equal Method 2 ❑ No to 600 square feet. §130.1(c)6Di 160.5 b 4CvibI corlrprnl0Adv�ooUghting Page 7 of 9 January 1, 2023 cAL&TP Gas= lfalmng Program STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Step Entry Functional Test Code Reference Unoccupied Office Test. Simulate an unoccupied condition in all control zones NA7.6.2.4(d) ❑Yes controlled by all occupant sensors in the office. §130.1(c)6Diii§1 4 ❑ No In 20 minutes or less from the start of the 60.5(b)4CvibIII unoccupied condition of the entire office, all controlled lighting in the office is turned off. N/A 0 Pass ❑ Fail Functional Testing Compliance. N/A `' TP CardoCaxrnislalnog axKed MIng Page 8 of 9 January 1, 2023 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROL 2022-CEC-NRCA-LTI-02-A Declaration Statement Signatory Document Author 07/26/2023 I assert that this Certificate of Acceptance documentation is accurate and complete. Sign Here: Field Technician Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting, Inc. , TC-A813601 ,ATT/RP, (951)270-0575 The information provided on this Certificate of Acceptance is true and correct. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference J Nonresidential Appendix NA7. I 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 Select Date 07/26/2023 builder/installer and has been posted or made available with the building permit(s) issued for the building. Signed: Responsible Person Jeff Bernardino, Integrated Power & I certify the following under penalty of perjury, under the laws of the State of California: Lighting Inc, 993105, ATT/RP, (951) 270-0575 I 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. I 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). 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, Sign Below: and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I 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. 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 Select Date building, and made available to the enforcement agency for all applicable inspections. I understand that a Signed: 07/26/2023 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. C cAL % TP D �Islralning gProgramPage 3 of 3 January 1, 2023 STATE OF CALIFORNIA Indoor Lighting CALIFORNIA ENERGY COMMISSION CERTIFICATEINSTALLATION NRCI-LTI-01-E This Certificate of Installation documents the installation of indoor lighting features, materials, components, and manufactured devices required to demonstrate compliance with Title 24, Part 6 per 10.103(a)3 for low-rise residential and low-rise mixed -use occupancies. Project Name: Salon Centric TI Report Page: (Page 1 of 7) Project Address: Date Prepared: 2023-07-26T13:33:51-04:00 A. GENERAL INFORMATION 01 Project Location (city) La Quinta 04 Authority Having Jurisdiction City of La Quinta 02 Zip Code 92253 05 Building Permit # BCOM2022-0060 03 Date of Permit Set used for construction 2023-04-17 06 Date of As -built Set 2023-05-04 B. INSTALLER SCOPE This table indicates the construction systems and materials documented on this Certificate of Installation. 01 02 03 Luminaires Space Types Controls' El General Lighting ® Conditioned ❑ Time -switch ® Occupant Sensors ® Dimmers ❑ Daylighting ❑ Interlocked Systems ® Shut-off El Decorative/ Accent El Unconditioned Area Controls El Demand Response El® Video Conferencing Studio Controls ® Multi -Level ❑ Institutional Tuning FOTNOTES: If an Energy Managment Control System (EMCS) or Lighting Contol System is installed to function as another type of lighting control, the type oflighting controlfor which nctions is indicated. Example: if the EMCS is acting as a time -switch control, "Time -switch" is checked here. C. COMPLIANCE RESULTS This table indicates whether the as -built conditions documented in this form are equal or better than what was documented on the permitted Certificate of Compliance. If the installation is not equal or better, Section 10-103(a)28 requires the Certificate of Compliance form to be revised accordingly to demonstrate compliance. 01 INSTALLED FEATURES EXACTLY MATCH DESIGN ON PERMITTED CERTIFICATE OF COMPLIANCE Documented as -built conditions should be verified by inspector from Authority Having Jurisdiction to comply. Registration Number: Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 83253-0123-0006 Schema Version: rev 20220901 Report Generated: 2023-07-26 10:33:55 STATE OF CALIFORNIA Indoor Lighting CALIFORNIA ENERGY COMMISSION CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Salon Centric TI Report Page: (Page 2 of 7) Date Prepared: 2023-07-26T13:33:51-04:00 D. EXCEPTIONAL CONDITIONS This table is auto filled with uneditable comments because of field conditions noted by the installer that may impact requirements documented on the Certificate of Compliance. A luminaire was selected as Not in Scope in the Indoor Lighting Fixture Schedule Table. Please ensure that this luminaire was claimed as in scope on anoher another Certificate of Installation CI-LTI Indoor Lighting form Selections made in CA Certificate Table have been changed by the permit applicant. See Table E. Additional Remarks for permit applicant's explanation. E. INSTALLER NOTES This table includes remarks made by the installer to the Authority Having Jurisdiction. {NRCA-LTI-03-A Explanation} Not Required < 120 Watts in zone F. INSTALLATION DETAILS The following tables indicate performance requirements as documented on the permitted Certificate of Compliance for all systems and components included in Table B. Installer Scope. Also included are the as -built conditions documented by the installer/documentation author. Registration Number: Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 83253-0123-0006 Schema Version: rev 20220901 Report Generated: 2023-07-26 10:33:55 STATE OF CALIFORNIA Indoor Lighting CALIFORNIA ENERGY COMMISSION CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Salon Centric TI Report Page: (Page 3 of 7) Date Prepared: 2023-07-26T13:33:51-04:00 Indoor Lighting Controls 01 02 03 04 05 06 07 08 09 10 Primary Demand Manual Area Multi -Level Shut -Off Primary/Skylit Secondary Interlocked Area Description Controls compliance Function Area Response Controls Controls Controls Daylighting Daylighting Systems NA < 4,000W Per C of C subject to Annunciated NA: Restrooms Occupancy p y NA: Not dya lit NA: Not dya lit No INSTALLED FEATURES multilevel Sensor zone zone EXACTLY MATCH RESTROOM Restroom DESIGN ON PERMITTED CERTIFICATE OF As -built NA < 4,000W Occupancy NA: Not daylit NA: Not daylit Conditions subject to Annunciated NA: Restrooms Sensor zone zone No COMPLIANCE multilevel NA < 4,000W Per C of C subject to Annunciated NA: Enclosed Occupancy p Y NA: Not da lit Y NA: Not da lit Y No INSTALLED FEATURES Commercial multilevel area <100SF Sensor zone zone EXACTLY MATCH BACK STOCK Industrial Storage Area DESIGN ON PERMITTED CERTIFICATE OF As -built NA < 4OOOW NA: Enclosed Occupancy NA: Not daylit NA: Not daylit Conditions subject to Annunciated area <100SF Sensor zone zone No COMPLIANCE multilevel NA < 4,000W Per C of C subject to Annunciated NA: Enclosed Occupancy p y NA: Not dya lit NA: Not dya lit No INSTALLED FEATURES OFFICE Office (<-250 square feet q multilevel area <100SF Sensor zone zone EXACTLY MATCH DESIGN ON PERMITTED NA < 4,000W As -built NA: Enclosed Occupancy NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions subject to Annunciated area <100SF Sensor zone zone No COMPLIANCE multilevel NA < 4,000W Per C of C subject to Annunciated NA: Enclosed Occupancy p y NA: Not dya lit NA: Not dya lit No INSTALLED FEATURES multilevel area <100SF Sensor zone zone EXACTLY MATCH HALL Corridor DESIGN ON PERMITTED CERTIFICATE OF As -built NA < 4 OOOW NA: Enclosed Occupancy NA: Not daylit NA: Not daylit Conditions subject to Annunciated area <100SF Sensor zone zone No COMPLIANCE multilevel Registration Number: Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 83253-0123-0006 Schema Version: rev 20220901 Report Generated: 2023-07-26 10:33:55 STATE OF CALIFORNIA Indoor Lighting CALIFORNIA ENERGY COMMISSION CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Salon Centric TI Report Page: (Page 4 of 7) Date Prepared: 2023-07-26T13:33:51-04:00 Indoor Lighting Controls NA < 4,000W Per C of C subject to Annunciated Dimmer Occupancy Included Included No INSTALLED FEATURES multilevel Sensor EQUAL OR BETTER BACK ROOM Lounge THAN PERMITTED As -built NA < 4 OOOW Occupancy NA: General Ltg NA: General Ltg CERTIFICATE OF Conditions subject to Annunciated Dimmer Sensor < 120W < 120W No COMPLIANCE multilevel NA < 4,000W NA: Enclosed Occupancy p Y NA: Not daylit Y NA: Not daylit Y INSTALLED FEATURES Per C of C Electrical subject to Annunciated No DATA Mechancial Telephone multilevel area <100SF Sensor zone zone EXACTLY MATCH DESIGN ON PERMITTED NA < 4,000W As -built Room NA: Enclosed Occupancy NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions subject to Annunciated area <100SF Sensor zone zone No COMPLIANCE multilevel NA < 4,000W Per C of C subject to Annunciated NA: <= 80 % LP Occupancy p Y NA: <= 80 % LP NA: <= 80 % LP No INSTALLED FEATURES multilevel (alt only) Sensor (alt only) (alt only) EXACTLY MATCH RETAIL SPACE Grocery Sales DESIGN ON PERMITTED CERTIFICATE OF As -built NA < 4 OOOW NA: <= 80 % LP Occupancy NA: <= 80 % LP NA: <= 80 % LP Conditions subject to Annunciated (alt only) Sensor (alt only) (alt only) No COMPLIANCE multilevel NA < 4,000W NA: General Ltg Occupancy NA: Not daylit NA: Not daylit INSTALLED FEATURES Per C of C subject to Annunciated <_ 0.5W/SF Sensor zone zone No EXACTLY MATCH CASHIER All Other Space Types multilevel DESIGN ON PERMITTED CERTIFICATE OF As -built NA < 4,000W NA: General Ltg Occupancy NA: Not daylit NA: Not daylit Conditions subject to Annunciated <= 0.5W/SF Sensor zone zone No COMPLIANCE multilevel Registration Number: Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 83253-0123-0006 Schema Version: rev 20220901 Report Generated: 2023-07-26 10:33:55 STATE OF CALIFORNIA Indoor Lighting CALIFORNIA ENERGY COMMISSION CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Salon Centric TI Report Page: (Page 5 of 7) Date Prepared: 2023-07-26T13:33:51-04:00 Lighting Controls Functionality Functionality listed for all lighting control systems must be installed and programmed Dimmers Installed controls that provide dimmer functionality: A. Are capable of reducing lighting power consumption be a minimum of 65% when at its lowest setting; B. ; Provide reduced flicker operation, meaning that directly controlled light sources shall be provided electrical power such that the light output has an amplitude modulation of less than 30% for frequencies less than 200 Hz without causing premature lamp failure; C. Provide an off setting that produces a zero lumen output; D. For wall box dimmers and associated switches designed for use in three way circuit, be capable of turning lights off, and on to the level set by the dimmer if the lights are off; E. Indicator lights integral to lighting controls shall consume no more than one watt of per indicator light. Occupant Sensing Controls Installed occupant sensing controls include occupant sensors, motion sensors, and vacancy sensors, including those with a Partial -ON or Partial -OFF function: A. Are capable of automatically turning the controlled lights in the area either off or down no more than 20 minutes after the area has been vacated; B. ; For manual -on controls, have a grace period of no less than 15 seconds and no more than 30 seconds to turn on lighting automatically after the sensor has timed out; C. Provide a visible status signal that indicates that the device is operating properly, or that it has failed or malfunctioned. The visible status may have an override that turns off the signal. D. Indicator lights integral to lighting controls shall consume no more than one watt of per indicator light. E. NOTE: Occupant Sensing Control systems may consist of a combination of single or multilevel Occupant, Motion, or Vacancy Sensor Controls, provided that components installed to comply with manual -on requirements shall not be capable of conversion by occupants from manual -on to automatic -on functionality. F. Sensors that are used by occupant sensing controls to detect occupants shall meet all of the following requirements: i. Shall not incorporate switches or mechanical devices that allow the sensor to be disabled without changing the settings of the control. ii. Sensors that utilize ultrasonic radiation for detection of occupants shall comply with 21 C.F.R. part 1002.12, not emit audible sound and not emit ultrasound in excess of the decibel levels shown in Table 110.9-A measured no more than five feet from the source, on axis. iii. Sensors that utilize microwave radiation for detection of occupants shall comply with 47 C.F.R. parts 2 and 15 and not emit radiation in excess of 1 milliwatt per square centimeter measured at no more than 5 centimeters from the emission surface of the device. Registration Number: Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 83253-0123-0006 Schema Version: rev 20220901 Report Generated: 2023-07-26 10:33:55 STATE OF CALIFORNIA Indoor Lighting CALIFORNIA ENERGY COMMISSION CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Salon Centric TI Report Page: (Page 6 of 7) Date Prepared: 2023-07-26T13:33:51-04:00 Lighting Controls Functionality Functionality listed for all lighting control systems must be installed and programmed TABLE 110.9-A - ULTRASOUND MAXIMUM DECIBEL VALUES Mid -frequency of Sound Pressure Third -Octave Band (in kHz) Third -Octave Band (in dB reference 20 micropascals) Less than 20 80 20 or more to less than 25 105 25 or more to less than 31.5 110 31.5 or more 31.5 or more G. ACCEPTANCE TESTS & FIELD VERIFICATION The following Acceptance Tests related to the systems or materials documented on this NRCI have been indicated on the permitted Certificate of Compliance (NRCC) as being required to comply with Title 24, Part 6. Form/Title Systems To Be Field Verified Certificates of Acceptance Lighting Acceptance Tests must be completed by a certified Acceptance Testing Technician and NRCA forms completed through an approved Acceptance Test Technician Certification Provider database. The Certificate of Acceptance (NRCA) forms indicated below will be required by the Authority Having Jurisdiction to demonstrate compliance. NRCA-LTI-02-A - Must be submitted for all new, added or altered shut-off lighting controls RESTROOM; BACK STOCK; OFFICE; HALL; BACK ROOM; DATA; RETAIL SPACE; CASHIER NRCA-LTI-03-A - Must be submitted for all new, added or altered automatic daylight controls. NRCA-LTI-04-A -Must be submitted for all new, added or altered demand responsive lighting controls. NRCA-LTI-05-A. - Must be submitted for Institutional Tuning Power Adjustment Factor (PAF) A copy of this Certificate of Installation should be distributed to the certified Acceptance Test Technician(s) who will perform the acceptance test(s). Title 24, Part 6 Section 10-103(a)3F also requires this Certificate of Installation be posted or made available to the Authority Having Jurisdiction for all applicable inspections. Registration Number: Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 83253-0123-0006 Schema Version: rev 20220901 Report Generated: 2023-07-26 10:33:55 STATE OF CALIFORNIA Indoor Lighting CALIFORNIA ENERGY COMMISSION CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Salon Centric TI Report Page: (Page 7 of 7) Project Address: IDate Prepared: 2023-07-26T13:33:51-04:00 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Jeff Bernardino Company: Signature Date: Integrated Power & Lighting, Inc. Address: CEA/ HERS Certification Identification (if applicable): City/State/Zip: Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code 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/installar), 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 constructions 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. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Company Name: (Installing Subcontractor or General Contractor Builder/Owner) Position With Company (Title): Address: CSLB License: City/State/Zip: Phone: Date Signed: 12023-07-26 Registration Number: Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 83253-0123-0006 Schema Version: rev 20220901 Report Generated: 2023-07-26 10:33:55 es1'. zax� DEN & BURROW LLC. Project: Salon Centric, BCOM2022-0060 By Alec Calzada PATH OF TRAVEL UPGRADE DETERMINATION In accordance with the 2019 California Building Code (CBC) Section 1113-202.4, exception 8, the cost of compliance with Section 1113-202.4 is allowed to be limited to 20% of the adjusted construction cost of the alterations, structural repairs or additions when the adjusted construction cost does not exceed the current valuation threshold. Construction cost for proposed project (not including costs of improvements to the path of travel to the area of alteration): $ 80,000 (A) Cost of alterations to areas on this path of travel undertaken during the preceding three-year period which did not provide an accessible path of travel to the area of alteration (as applicable): $ 0 (B) Adjusted construction cost (C) = (A) + (B) $ 80,000 (C) PATH OF TRAVEL CONSTRUCTION COSTS: Elements serving the area of alteration Is element in If not, will element be Proposed cost of based on priority compliance with upgraded to current compliance with current Chapter Chapter 1113? (Y/N) current 1113?(Y/N) Chapter11B 1. An accessible entrance Y $ 2. An accessible route (interior and $ exterior) to the Y altered area 3. At least one accessible restroom for $ each gender or a single accessible unisex, N Y 15,000 single user or family restroom 4. Accessible public telephones N/A $ 5. Accessible drinking fountains N/A $ 6. When possible, additional accessible elements such as: a. Parking N/A $ b.Storage N/A $ c. Signs N/A $ d. Alarms N/A $ e. Other $ Total cost of providing compliant path of $ 15,000 (D) travel elements: COST OF PATH OF TRAVEL UPGRADES AS PERCENTAGE OF ADJUSTED CONSTRUCTION COST: Compliance of path of travel upgrades as % of adjusted construction cost: (E)% = 18.75 % (E) (D) / (C) Note: This may not be less than 20% CAL FIRE - RIVERSIDE UNIT RIVERSIDE COUNTY FIRE DEPARTMENT OFFICE OF THE FIRE MARSHAL — LA QUINTA c,,LIFoRMA 78495 Calle Tampico, La Quinta, CA 92253 • Phone (760) 777-7074 • www.rvcfire.org March 22, 2023 David Solomon 11331 E 183rd Street #367 Cerritos, CA 90703 Re: Tenant Improvement Construction - Fire Plan Review — SALON CENTRIC BCOM2022-0060 / 46480 WASHINGTON STREET #3, LA QUINTA, CA 92253 The building plans you submitted for the above referenced project have been reviewed by Riverside County Fire Department - Office of the Fire Marshal personnel and are approved with the following conditions. Fire Department approval is based upon the 2022 CBC requirements for M occupancies. It is prohibited to use, process or store any materials in the occupancy that would classify it as a Group H occupancy, without further review and approval. DEFERRED SUBMITTALS REQUIRED 1) FIRE SPRINKLER SYSTEM - Tenant Improvement plans must be submitted and reference the installing contractor performing the work. Permit fees will be required. PRIOR TO FINAL 1) Minimum 6" tall suite addressing shall be provided to both the front and rear entrances. All addressing must be legible and of a contrasting color with the background to be visible from the street at all hours. 2) Provide keys to the tenant space (all tenants), utility rooms and elevator services for inclusion in the main building Knox Box. Key(s) shall have durable and legible tags affixed for identification of the correlating tenant space. 3) Install portable fire extinguishers per Title 19, but not less than 2AIOBC in rating. Contact a certified extinguisher company for proper placement and spacing of equipment. 4) A durable sign stating: "THIS DOOR TO REMAIN UNLOCKED WHEN THIS SPACE IS OCCUPIED" shall be placed on or adjacent to the front exit doors. The sign shall be in letters not less than one inch high on a contrasting background (A <300, B, F, M and S). 5) Illuminated Exit Signage and Egress Illumination placement and functional test will be witnessed by OFM Fire Inspector at time of final inspection. The Fire Department approved plans and conditions letter must be at the job site. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 48 hours in advance and may be arranged by calling (760)777-7131. IqIIIIIiiiIj!!!!! E5T. ;oa[ DEN & BURROW LLC. Project: Salon Centric, BCOM2022-0060 46480 Washington St. La Quinta, CA Field Change Letter 08/17/2023 By Alec Calzada DESCRIPTION: After review of the existing HVAC equipment and system installed at the subject project location it has been determined that it is unnecessary to replace or upgrade the existing HVAC system. Therefore, the declarations of acceptance noted under section "O" within the MCH Report on sheet T24.2 are not required for this project. Please contact me for any questions or concerns. 1 , 7 Alec Calzada� alec@denandburrow.com 1 (909)754-0209 1 denandburrow.com Page 1 of 1 All questions regarding the meaning of these conditions should be referred to the Office of the Fire Marshal staff at (760)777-7074. Kohl Hetrick - Fire Safety Specialist Gmail George Fancher <george@paimconstructiongrp.com> RE: URGENTM Building TI final Conditions of Approval Rojas, Leilani@CALFIRE <Leilani.Rojas@fire.ca.gov> Tue, Aug 29, 2023 at 6:14 AM To: George Fancher <george@palmconstructiongrp.com> Cc: HUHN Jeff <JHuhn@saloncentric.com>, andrew lujan <andrew@palmconstructiongrp.com>, Daniel Moreno <daniel@palmconstructiongrp.com> George, Looks good, you are all clear to open. Thanks, Leilani Rojas Fire Systems Inspector / Office of the Fire Marshal Cal Fire/Riverside County Fire Department City of La Quinta Desk: 760-777-7158 1 Mobile: 760-218-8125 Inspection Hotline: 760-777-7131 78495 Calle Tampico, La Quinta, CA 92253 leilani.rojas@fire.ca.gov I www.rvcfire.org Sch: Tues-Fri Leadership, Competence, Integrity, Safety, Customer Service The Office of the County Fire Marshal is committed to facilitating fire and life safety solutions by empowering its employees to serve our community through innovation and partnership. From: George Fancher <george@palmconstructiongrp.com> Sent: Monday, August 28, 2023 3:34 PM To: Rojas, Leilani@CALFIRE <Leilani.Rojas@fire.ca.gov> Cc: HUHN Jeff <JHuhn@saloncentric.com>; andrew lujan <andrew@pal mconstructiongrp.com>; Daniel Moreno <daniel@palmconstructiongrp.com> Subject: Fwd: URGENT!!! Building TI final Conditions of Approval Warning: this message is from an external user and should be treated with caution. Hello Leilani, Please see the passing Fire Alarm Inspection report attached. Best regards, George Fancher Project Manager Palm Construction Group 949.507.7901 George@PalmConstructionGrp.com Pal mConstructionGrp.com ---------- Forwarded message --------- From: Martha Inga <marthainga@jacktarrdc.com> Date: Mon, Aug 28, 2023 at 3:29 PM Subject: URGENT!!! Building TI final Conditions of Approval To: HUHN Jeff <JHuhn@saloncentric.com>, George Fancher<george@palmconstructiongrp.com> Jeff: We finally obtained the inspection report attached hereto for your perusal. Thank you, Martha Inga Assistant to Jack Tarr Washington 111, Ltd. 30240 Rancho Viejo Road, Suite B San Juan Capistrano, CA 92675 (949) 443-1234 Ext. 131 (714) 609-2500 Cell (949) 443-1233 Fax marthainga@iacktarrdc.com From: Service <service@comtronl.com> Sent: Monday, August 28, 2023 3:04 PM To: Martha Inga <marthainga@jacktarrdc.com> Subject: RE: URGENT!!! Building TI final Conditions of Approval Here it is thank you. From: Martha Inga[maiIto: marthainga@jacktarrdc.com] Sent: Monday, August 28, 2023 2:56 PM To: Service Subject: RE: URGENT!!! Building TI final Conditions of Approval Brandi: We are still waiting for the report. Thank you, Martha Inga Assistant to Jack Tarr Washington 111, Ltd. 30240 Rancho Viejo Road, Suite B San Juan Capistrano, CA 92675 (949) 443-1234 Ext. 131 (714) 609-2500 Cell (949) 443-1233 Fax marthainga@iacktarrdc.com