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BCOM2020-0010 Title 24'"Air yr t'-kLWUKN1A ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LT1-02-E_(Remised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI 02-E Energy Management Control System or Lighting Control System (Page 1 of 6) Protect Name' Fnlorcement Nr^w i rrrlN D Protect Addreit.' q It.12 Li N4vK 111 S.t i>r Ian I Cdy I.A- I LO Code qi. 7-.^ GENERAL INFORMATION DATE OF BUILDING PERMIT PERMIT N �CuM-2o2o-- 0010 BUILDING TYPE Nonresidential ❑ High -Rise Res (Common Area) ❑ Ho Motel (Common Area) Alteration Elunconditioned PHASE OF CONSTRUCTION ❑ New Construction ❑ Addition SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. Requirements in the Standards: §130.4(b) Before an Energy Management Control System (EMCS), or Lighting Control System can be recognized for compliance with the lighting control requirements in Part 6 of Title 24, the person who is eligible under Division 3 of the Business and Professions Code to accept responsibility for the construction or installation of features, materials, components, or manufactured devices shall sign and submit this Installation Certificate. If any of the requirements in this Installation Certificate fail the Energy Management Control System or Lighting Control System installation requirements, these options for controlling lighting shall not be recognized for compliance with the Building Energy Efficiency Standards. Check all that apply: PART 1 What type of Lighting Control System has been installed? ❑ A. Energy Management Control System (EMCS) - Is a computerized control system designed to regulate the energy consumption of a building by controlling the operation of energy consuming systems, such as the heating, ventilation and air conditioning (HVAC), lighting, and water heating systems, and is capable of monitoring environmental and system loads, and adjusting HVAC operations in order to optimize energy usage and respond to demand response signals. ❑ The Energy Management Control System has been insta:led to function as a lighting control required by Part 6 and functionally meets all applicable requirements for each application for which it is installed, in accordance with Sections 110.9, 130.0 through 130.5, 140.6 through 150.0, and 150.2; and complies with Reference Nonresidential Appendix NA7.7.2. ❑ The EMCS has been separately tested for each respective lighting control system for which it is installed to function as. B. Lighting Control System - Requires two or more components to be installed in the building to provide all of the f ctionality required to make up a fully functional and compliant lighting control. The installed lighting Control System complies with the requirements checked below; and all components of the system considered together as installed meet all applicable requirements for the application for which they are installed as required in Sections 130.0 through 130.5, Sections 140.6 through 140.8, Section 141.0, and Section 150.0(k). CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 a i .v i t Vr l +�t it u try �N ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM Ink r;:r_nrori i rn —ell .,.CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 2 of 6) Drgect Namt. i^� o L T't? A ' f nlon emenl A(rnry / . 1 / . N V(Irr4 erma Nvnbrl to DrgM Addrrtt62'T f r 1 _ f r w' J �C O CM1y ^ u T,J rA ZIP PART 2 Lighting Control Functional requirements: Check all that apply when verifying the installation of an EMCS or Lighting Control System. �A. All lighting controls and equipment have been installed in accordance with the manufacturer's instructions. [: The manufacturer has provided instructions for calibration. C If indicator lights are integral to any components, such indicator lights consumes no more than 1 watt of wer per indicator light. Vou! . Components that are regulated by the Title 20 Appliance Efficiency Regulations have been certified to the ;/'E'nergy Commission. E. The EMCS or Lighting Control System functions as one or more of the Time Switch Lighting Controls checked below, and complies with all of the following requirements: Automatic Time -Switch Controls meeting all requirements for Automatic Time Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Residential automatic time -switch controls have program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is interrupted. b. Commercial automatic time -switch controls meet the following requirements: I. Has program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is interrupted; ii. Is capable of providing manual override to each connected load and shall resume normally scheduled operation after manual override is initiated within 2 hours for each connected load; and III. Incorporates an automatic holiday shutoff feature that turns off all connected loads for at least 24 hours and then resumes normally scheduled operation. /2Astronomical Time -Switch Controls meeting all requirements for Astronomical Time -Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Meets the requirements of an automatic time -switch control; b. Has sunrise and sunset prediction accuracy within plus -or -minus 15 minutes and timekeeping accuracy within 5 minutes per year; c. Is capable of displaying date, current time, sunrise time, sunset time, and switching times for each step during programming; d. Ilas an automatic daylight savings time adjustment; and e. Has the ability to independently offset the on and off for each channel by at least 99 minutes before and after sunrise or sunset. /3.Multi-Level Astronomical Time -Switch Controls, in addition to meeting all of the requirements for Astronomical Time -Switch Controls, includes at least 2 separately programmable steps per zone. FThe EMCS or Lighting Control System functions as one or more of the Daylighting Controls listed below: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January20=6 JINrt Vr l.hLrr VnrvrN ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI{Tt-02-E (Revised 01l+6) CAI IFORNIA FNFRGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 3 of 6) Protect Name. Fnrortemenl Aqgnwy Ninrrq �ipr>1 tivV�`t0 M Pm1AOCresa CRyU(Vt T'v + 19 CoA'n 12� V. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20 Appliance Efficiency Regulations, including the following: a. Is capable of reducing the power consumption in response to measured daylight either directly or by sending and receiving signals; b. If the system includes a dimmer, complies with the Dimmer Control device requirements in the Title 20 Appliance Efficiency Regulations. c. Automatically return to its most recent time delay settings within 60 minutes when put in calibration mode; d. Has a set point control that easily distinguishes settings to within 10% of full scale adjustment; e. Has a light sensor that has a linear response within 5% accuracy over the range of illuminance measured by the light sensor; f. Has a light sensor that is physically separated from where the calibration adjustments are made, or is capable of being calibrated in a manner that the person initiating the calibration is remote from the sensor during calibration to avoid influencing calibration accuracy; and g. Complies with the Title 20 requirements for photo controls if the system contains a photo control component. ❑ 2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency Regulations, including the following that it does not have a mechanical device that permits disabling of the control. G. The EMCS or Lighting Control System functions as a Dimmer and meets all requirements for a Dimmer Control device in the Title 20 Appliance Efficiency Regulations, including the following: 1. Is capable of reducing power consumption by a minimum of 65% when the dimmer is at its lowest level; 2. Includes an off position which produces a zero lumen output; and 3. Does not consume more than 1 watt per light ng dimmer switch leg when in the off position. 4. Dimmercontrols that can directly control lamps provide electrical outputs to lamps for reduced flicker operation through the dimming range so that the light output has an amplitude modulation of less than 30% for frequencies less than 200 Hz without causing premature lamp failure. 5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the dimmer if the lights are off. H. The EMCS or Lighting Control System meets the following requirements: 1. Is capable of automatically turning off controlled lights in the area no more than 30 minutes after the area has been vacated; 2. Allows all lights to be manually turned off regardless of the status of occupancy; and 3. Has a visible status signal that indicates that the device is operating properly, or that it has failed or malfunctioned. The visible status signal may have an override switch that turns off the signal. 4. All occupant sensing devices that utilize ultrasonic radiation for detection of occupants meet the Ultrasound Maximum Decibel Values in the Title 20 Appliance Efficiency Regulations 5. All occupant sensing devices that utilize microwave radiation for detection of occupants meet the radiation requirements in the Title 20 Appliance Efficiency Regulations 6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20 Appliance Efficiency Regulations CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 J IAIC Vr \.HLIYVIt141M ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM Zak CFC-NRr.l.l Tl-r') tD.,.de..A n11161 rAl Irr1RNIA FNFRRV rr1► Pjm<zl(NJ CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 4 of 6) 7rgrct Name r—o" , �������t I!',F,^-f M�wJ Fnlortt•.rrnl ARencY t A UG1rrjr4 �l rmnN ; �i (" .rrf PrgM AAAreil- -nq P11- �1/ Ed If1E �3 I ,I� �/11 / rrtr l//l ONiI•��C 7 Z9 Cod, r/ZZj7 7. The EMCS or Lighting Control System functions as one or more of the Occupant Sensing Controls Checked Below: L/ a• Occupant Sensors meeting all applicable requirements for Occupant Sensor Control devices in the Title 20 Appliance Efficiency Regulations. ❑ b. Motion Sensors meeting all applicable requirements for Motion Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including that motion sensors are rated for outdoor use. ❑ c. Vacancy Sensors meeting all applicable requirements for Vacancy Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Does not turn on lighting automatically and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; ii. Has a grace period of no more than 30 seconds and no less than 15 seconds to turn on lighting automatically after the sensor has timed out; and iii. Does not have an override switch that d sables the sensor. ❑ d. Partial -ON Sensors meeting all applicable requirements for partial on sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Has two poles each with automatic -off functionality; ii. Has one pole that is manual -on and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; and iii. Has one pole that is automatic -on and is not be capable of conversion by the user to manual -on functionality. ❑ e. Partial -OFF Sensors meet all applicable requirements for partial off sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Has two poles; ii. Has one pole that is manual -on and manual off; and iii. Has one pole that is automatic -on and automatic -off and is not capable of conversion by the user to manual -on only functionality. if - Occupant Sensing Control systems consist of a combination of single or multi -level Occupant, Motion, or Vacancy Sensor Controls, and all components installed to comply with manual -on requirements are not capable of conversion by the user from manual -on to automatic -on functionality. CA Building Energy Efficiency Standards - 2016 Nonres dential Compliance January 2016 5 t H I c Ul- %,ALtr VKr4IA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E {Revised 0V16) CALIFORNIA ENERGY COMMISSION CERTIFICAIE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System/oar lighting Control System (Page 5 of 6) "K.t Name. Enfwt meet Adoncv �� �l ��.L�"G� rmt Nwnbrr Jlil FC.J i (. UM�7o20-0 ZNSusTE /03 L)l ©o-- r447 L cod- q, 3 PART 3 Requirements for which the control is being Installed to compiled with: Identify all requirements in the Standards for which the EMCS or Lighting Control System is installed to function as and complies with: Check all that are applicable -12' A. Section 130.1(a) Area Controls. El"B. Section 130.1(b) Multi -Level Lighting Controls Dl C. Section 130.1 (c) Shut -OFF Controls 6/0. Section 130.1 (d) Automatic Daylighting Controls. ❑ E. Section 130.1 (e) Demand Responsive Controls. F. Section 130.5 (d) Circuit Controls for 120-Volt Receptacles. If ins tolled to qualify for a Power Adjustment Factor, submit this Installotion Certificate in addition to the PAF Installation Certificate. ❑ G. To qualify for the PAF for a Partial -ON Occupant Sensing Control in TABLE 140.6-A. ❑ H. To qualify for the PAF for an occupant sensing control controlling the general lighting in large open plan office areas above workstations, in accordance with TABLE 140.6-A ❑ I. To qualify for the PAF for a Manual Dimming System PAF or a Multiscene Programmable Dimming System PAF in TABLE 140.6-A ❑ 1. To qualify for the PAF for a Demand Responsive Control in TABLE 140.E-A ❑ K. To qualify for the PAF for Combined Manual Dimming plus Partial -ON Occupant Sensing Control in TABLE 140.6-A CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 a l H i c ter t,ruirvr<rviss ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM �EC-NRCI-LTI-02-E (Revised 01r16) CALIFORNIA ENERGY COMMISSION 'qr CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System c, . (Page 6 of 6) m Proleo Name. r � � _ - Fnlorceenl A1,rKV: `A �;0 y �A �( PrgM Add resitjJ2 i (t .�,;1� �s ercv: Lit Cfj- "t umber, zroec 3 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: T <J y1 _ \ 4\J Documentaton Autho, Signature: Documentation Author Company Name: �,,� �t�7z{,IJ Date Signed: Address: ^ ^ fk '� ^MV V` CEA Certification Identification ill applicable): Uty/State/tip: em f,,, ^ �� Phone; 6� ^� ?Z ` 7/� j RESPONSIBLE PERSON'S/DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of installation is true and correct. 2. 1 am eligible urder Division 3 of the Business and Professions Code in tree applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections_ I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name:Ann e r 00 /v Responsible Builder/Installer Signatu Compary Name! (Installing Subcontractor or Genera l ontractor Cr Builder/Owner) :;� Position With Company (Titl . Address. 2 l t^ 71 J CSLB Lcense: q ^ j L J City/state,/z p: ,r �- flop, Phone&, f S_�,Z C�� fL Date Signed: �• 1 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 Enforcement Agency Use: Checked by/Date LIGHTING CONTROL ACCEPTANCE DOCUMENT Automatic Shut-off Controls: Automatic Time Switch Control and Occupant Sensor Intent: Lights are turned off or set to a lower level when not needed per Section 110.9(a) & 130.1(c). A. Construction Inspection Fill out Section A to cover spaces 1 through 3 that are functionally tested under Section B. Instruments needed to perform tests include, but are not limited to: hand-held amperage meter, power meter, or light meter 1: Automatic Time Switch Controls Construction Inspection —confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): F Weekdays ® Weekend R Holidays b. Document for the owner automatic time switch programming (check all): P Weekday settings ® Weekend settings 0 Holidays settings Set-up settings Preference program setting ® Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized F Override time limit is no more than 2 hours P Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices 2. Occupancy Sensor Construction Inspection —confirm for all listed in Section B ® Occupancy sensors are not located within 4 feet of any HVAC diffuser ® Ultrasonic occupancy sensors do not emit audible sound 5 feet from source CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 B. Functional Testing of Lighting Controls For every space in the building, conduct functional tests 1 through 5 below if applicable. If there are several geometrically similar spaces that use the same lighting controls, test only one space and list in the cells below which "untested spaces" are represented by that tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Representative Spaces Selected Tested space/room name: Restroom Space Type (office, corridor, etc) Restroom Untested areas/rooms Confirm compliance for all control system types (1-5) present in each space: 1. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch I F b. Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located. Step 2: Simulate unoccupied condition F a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)1 and 130.1(a)1. F b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type). r Step 3: System returned to initial operating conditions I r 2. Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(b) P b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. P Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly I F b. Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually COAL TP California Advanced Lighting Controls Training Program This is page 2 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 Step 3: System returned to initial operating conditions N. 3. Partial Off Occupancy Sensor Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) f— b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack. c. In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80% or less of the value allowed under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled areas, Immediately upon an occupied condition f- 4. Partial On Occupancy Sensors Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to 70% of the lighting automatically. f— b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. f— Step 2. Simulate an unoccupied condition a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r COAL TP California Advanced Lighting Controls Training Program This is page 3 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 S. Add,itional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than 250 ft', to Qualify for a Power Adjustment Factor (PAF) Step 0: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c). r e. Sensors shall not trigger in response to movement in adjacent walkways or workspaces r f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)' and all answers are Yes. COAL TP California Advanced Lighting Controls Training Program This is page 4 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 C. Testing Results 1. Automatic Time Switch Controls (all answers must be Yes). r 2. Occupancy Sensor (On Off Control) (all answers must be Yes). P 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. r 4. Partial On Occupant Sensor for PAF (all answers must be Yes). F 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must pass Test 2. r Representative Spaces Selected Tested space/room name: Restroom Space Type (office, corridor, etc) Restroom Untested areas/rooms Confirm compliance for all control system types (1-5) present in each space: 1. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch F b. Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located. f— Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)1 and 130.1(a)1. f— b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type). Step 3: System returned to initial operating conditions r 2. Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes COAL TP California Advanced Lighting Controls Training Program :I _j This is page 5 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 from start of an unoccupied condition per Standard Section 110.9(b) I N. b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. 0 Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly N. b. Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually Step 3: System returned to initial operating conditions '; 3. Partial Off Occupancy Sensor Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack. r c. In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80% or less of the value allowed under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken r Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled areas, Immediately upon an occupied condition 4. Partial On Occupancy Sensors Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to 70% of the lighting automatically. b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. Step 2. Simulate an unoccupied condition COAL TP California Advanced Lighting Controls Training Program This is page 6 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) ro- b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r COAL TP California Advanced Lighting Controls Training Program This is page 7 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 S. Add,itional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than 250 ft', to Qualify for a Power Adjustment Factor (PAF) Step 0: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c). r e. Sensors shall not trigger in response to movement in adjacent walkways or workspaces r f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)' and all answers are Yes. COAL TP California Advanced Lighting Controls Training Program This is page 8 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 C. Testing Results 1. Automatic Time Switch Controls (all answers must be Yes). r 2. Occupancy Sensor (On Off Control) (all answers must be Yes). P 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. r 4. Partial On Occupant Sensor for PAF (all answers must be Yes). r 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must pass Test 2. r Representative Spaces Selected Tested space/room name: Sales Floor Space Type (office, corridor, etc) Open Untested areas/rooms Confirm compliance for all control system types (1-5) present in each space: 1. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch P b. Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located. Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)1 and 130.1(a)1. b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type). Step 3: System returned to initial operating conditions F 2. Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes COAL TP California Advanced Lighting Controls Training Program :I _j This is page 9 of 15 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 from start of an unoccupied condition per Standard Section 110.9(b) I IN b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly ro- b. Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually r Step 3: System returned to initial operating conditions r 3. Partial Off Occupancy Sensor Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack. r c. In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80% or less of the value allowed under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken r Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled areas, Immediately upon an occupied condition 4. Partial On Occupancy Sensors Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to 70% of the lighting automatically. b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. Step 2. Simulate an unoccupied condition COAL TP California Advanced Lighting Controls Training Program This is page 10 of CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) ro- b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r COAL TP California Advanced Lighting Controls Training Program This is page 11 of CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 S. Add,itional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than 250 ft', to Qualify for a Power Adjustment Factor (PAF) Step 0: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c). r e. Sensors shall not trigger in response to movement in adjacent walkways or workspaces r f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)' and all answers are Yes. COAL TP California Advanced Lighting Controls Training Program This is page 12 of CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 C. Testing Results 1. Automatic Time Switch Controls (all answers must be Yes). M. 2. Occupancy Sensor (On Off Control) (all answers must be Yes). r 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. r 4. Partial On Occupant Sensor for PAF (all answers must be Yes). r 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must pass Test 2. r D. Evaluation : ® PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive. COAL TP California Advanced Lighting Controls Training Program This is page 13 of CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Company Name Name Tristan Sears Accolade Electric, Inc. Address City 155 N LAKE AVE PASADENA Zip Code Phone 91101 (626)614-0000 CEA/ATT Certification Author Signature Identification (if ATE-0215 applicable) Date of Signature: 09/08/2020 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 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 builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name Company Name Tristan Sears Accolade Electric, Inc. Address: City 155 N LAKE AVE PASADENA Zip Code Phone 91101 (626)614-0000 ATT Certification Position with Company Identification TC-813899 (Title) PRESIDENT Field Technician Signature M"'rs Date of Signature: 09/08/2020 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 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. 2. 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). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 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. 5. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Company Name Person Name Tristan Sears Accolade Electric, Inc. Address: City 155 N LAKE AVE PASADENA Zip Code Phone 91101 (626)614-0000 CSLB License Position with Company 963036 (Title) PRESIDENT Responsible Acceptance Person Signature 7;�- Date of Signature: 09/08/2020 COAL TP California Advanced Lighting Controls Training Program This is page 14 of CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta Zip Code: 92253 This is page 15 of CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A Automatic Daylighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta JZip Code: 92253 AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT Check boxes for all pages of this NRCA-LTI-03-A completed and included in this submittal ❑ 1 & 2 NRCA-LTI-03-A Page Construction Inspection. This page required for all submittals. El3 NRCA-LTI-03-A Page & 4 Continuous dimming control functional performance test —watt-meter or amp -meter measurement ❑ NRCA-LTI-03-A Page Stepped Switching/ Stepped Dimming functional performance test — watt -meter or amp -meter measurement 5 & 6 O NRCA-LTI-03-A Page Continuous dimming control functional performance test — light meter power measurement, and default look -up 7 & 8 table of fraction of rated power versus fraction of rated light output. LNRCALI-1-03-A Page Stepped Switching/ Stepped Dimming functional performance test —based on light output 10 & 11 1. NA7.6.1.1 Construction Inspection: 1. Drawing of Daylit Zone(s) must be shown on plans or attached to this form. By checking this box, technician certifies that plans have been attached to thiswebform r Document Name and Page #'s Plans E Add Control Systems below if sampling method is used in accordance with NA7.6.1.2. If adding, attach a page with names of other controls in sample (only for buildings with > 5 daylight control systems, sample group glazing same orientation) Primary Daylight Zone Primary Daylight Zone L. bvstem IniormaEion Zone Type: Skylit (Sky), Primary Sidelit (PS), or Secondary Sidelit (SS) PS Control Type: Continuous Dimming with more than 10 light levels (C), Stepped Dimming (SD), Switching (SW) Design Footcandles: (enter number or leave blank): 3. Sensors and Controls Control Loop Type: Open Loop (OL), Closed Loop (CL) CL Sensor Location: Outside (0), Inside Skylight (IS), Near Windows facing out (NW), In Controlled Zone (CZ) CZ Sensor Location is Appropriate to Control Loop Type: (Y/N) If control loop type is Open Loop (OL): Enter yes (Y) if location = Yes Outside (0), Inside Skylight (IS), or Near Windows facing out (NW); otherwise, enter no (N). If Control loop type is Closed Loop (CL): Enter yes (Y) if location = In Controlled Zone (CZ); otherwise, enter no (N). Control Adjustments are in Appropriate Location (Y/N): Yes, If Readily Accessible or Yes if in Ceiling less than or equal to 11 ft, No Yes for all other. 4. Has documentation been provided by the installer: Installation Manuals and Calibration Instructions Provided to Building Owner: (Y/N) Location of Light Sensor on Plans: (Y/N) Yes Yes COAL TP California Advanced Lighting Controls Training Program 7= This is page 1 of 5 CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A Automatic Daylighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta jZip Code: 92253 Location of Light Sensor on Plans: (Page Number) I E S. Separate Controls of Luminaires in Daylit Zones: Are luminaires controlled by automatic daylighting controls only in daylit zones: (Y/N) Yes Separately circuited for daylit zones by windows and daylit zones under skylights: (Y/N) Yes 6. Daylighting control device certification Daylighting control has been certified in accordance with §110.9: (Y/N) Yes Construction Inspection PASS/FAIL. If all responses on Construction Inspection pages 1 & tare complete and all Yes/No questions Pass have a Yes (Y) response, the tests PASS; If any responses on this page are incomplete OR there are any no (N) responses, the tests FAIL II. PASS/FAIL Evaluation (check one):: PASS: If all responses on Construction Inspection pages 1 & 2 are complete and all Yes/No questions have a Yes (Y) response, the tests PASS FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative (N no)responses in any applicable Functional Performance Testing Requirements section. System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and resubmitting NRCA-LTI-03-A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. COAL TP California Advanced Lighting Controls Training Program This is page 2 of 5 CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A Automatic Daylighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta jZip Code: 92253 2. NA7.6.1.2.1 Functional Performance Testing - Continuous Dimming Systems: Power estimation using light meter measurement Complete all tests on page 3 & 4 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and fill out Pass/Fail section on Page 4. Primary Daylight Zone Svstem Information a. Control Loop Type: Open Loop or Closed Loop? (O or C) C b. Indicate if Mandatory control - M (required for skylit zone or primary sidelit zone with installed general lighting power > 120 W); M for Control Credit - CC; or Voluntary not for credit -V (M, CC, V) c. If automatic daylighting controls are mandatory, are all general lighting luminaires in daylit zones controlled by automatic daylight Yes controls? (Y/N) d. Documented general lighting design footcandles. If design footcandles not documented leave blank (enter fc) e. Power estimation method. (see line o) Default ratio of power to light (Dfc), cut -sheet ratio of power to light (CSfc) If CSFc - attach 1, cut -sheet. Enter Dfc or CSfc Step 1: Identify Reference Location (location where minimum daylight illuminance is measured in zone served by the controlled lighting.) f. Method Used: Illuminance or Distance? (I or D) I Override daylight control system and drive electric lights to highest light level for the following: g. Highest light level fc - enter measured controlled electric lighting footcandles (fc) 52 h. Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TT) FO step 2: No oayngnt Test Controls enabieo tk clayngnt less tnan 1 tc at reterence location i. Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log), Cover Fenestration (CF), Cover Open Loop Night Photosensor (COLP) J. Reference Illuminance (footcandles) as measured at Reference Location (see Step 1). Enter footcandles 52 k. Enter Y if either of the following statements are true: If line h = FO; [Reference Illuminance (line j)] / [Full Output fc (line g)] > 70%? or Yes [Reference Illuminance (line j)] / [design footcandles (line d)] > 80%? (Y/ N) Steb 3: Full Davliaht Test conducted when davliaht > reference illuminance (line i) I. Daylight illuminance (light level with electric lighting turned off) measured at Reference Location (fc) 81 m. Daylight illuminance (line 1) greater than Reference Illuminance (line j)? (Y/N) Yes n. Fraction controlled wattage turned off. Enter %. 100 o. Fraction of controlled wattage dimmed [1 - ( line n)] Enter%. 0 Fill out lines o throuah s only if fraction of controlled wattaae turned off (line n) < 100%. p. Total (daylight + electric light) illuminance measured at the Reference Location (fc) q. Electric lighting illuminance at the Reference Location (fc) [(line p) - (line 1)] 81 r. Electric lighting illuminance (line q) divided by Highest Light Level fc (line g). Enter % 77 155.76923076923 s. Dimmed Iuminaire fraction of rated power. Attach manufacturer's cut -sheet or use default graph of rated power to light output. Label applicable control system (column A, B or C) on cut -sheet or graph. Enter fraction of rated power in %. t. System Power Reduction = [1 - (line o) * (line s)] 100 COAL TP California Advanced Lighting Controls Training Program This is page 3 of 5 CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A Automatic Daylighting Control Project Name: Pieology Enforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta jZip Code: 92253 u. Is System Power Reduction (line t) > 65% when line h = FO, or > 56% when line h = TT (Y/N) v. With uncontrolled lights also on, no lamps dimmed outside of daylit zone by control (Y/N) w. Dimmed lamps have stable output, no perceptible flicker (Y/N) Step 4: Partial Daylight Test conducted when daylight between 60% and 95% of (line j) Yes Yes Yes x. Daylight illuminance (light level without electric light) measured at Reference Location (fc) 45 y. Daylight illuminance divided by the Reference Illuminance = (line x )/ (line j). Enter %. 86.5384615384615 z. Is Ratio of Daylight illuminance to Ref. illuminance (line y) between 60% and 95%? (Y/N) Yes aa. Total (daylight + electric light) illuminance measured at the Reference Location (fc) 68 bb. Total illuminance divided by the Reference Illuminance = (line as )/ (line j), Enter % 130.76923076923 77 cc. Is Total illuminance divided by the Reference illuminance (line bb) between 100% and 150%? (Y/N) Yes 3. PASS/FAIL Evaluation (check one): PASS: All applicable Construction Inspection responses are complete and all applicable Functional Performance Testing Requirements responses are positive (Y - yes) i7 FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative (N no)responses in any applicable Functional Performance Testing Requirements section. System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and resubmitting NRCA-LTI-03-A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. COAL TP California Advanced Lighting Controls Training Program This is page 4 of 5 CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A Automatic Daylighting Control Project Name: Pieology lEnforcement Agency: CITY OF LA QUINTA Permit Number: BCOM2020-0010 Project Address: 79024 CA -I I I Suite 103 City: La Quinta IZip Code: 92253 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name Company Name Tristan Sears Accolade Electric, Inc. Address city 155 N. Lake Ave. Pasadena Zip Code Phone 91101 (626)614-0000 CEA/ATT Certification Identification (if Author Signature applicable) ATE-oz Date of Signature: 09/08/2020 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 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 builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name Company Name Tristan Sears Accolade Electric, Inc. Address: City 155 N. Lake Ave. Pasadena Zip Code Phone 91101 (626)614-0000 ATT Certification Identification Position with Company (Title) TC-A813899 President Field Technician Signature Date of Signature: 09/08/2020 I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 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 permits) issued for the building. 5. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name Company Name Tristan Sears Accolade Electric, Inc. Address: 155 N. Lake Ave. Zip Code 91101 CSLB License 963036 Responsible Acceptance Person Signature Date of Signature: 09/08/2020 city Pasadena Phone (626)614-0000 Position with Company (Title) President COAL TP California Advanced Lighting Controls Training Program This is page 5 of 5 STATE OF CALIFORNIA INDOOR LIGHTING P-1 :EC-NRCI-LTI II-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 1 of 2) Pro,e l Name; A �/' ,. !� u rnlo� @e m Ag.r ' ��, IA 0/�LA 4 t.rM N r O Prolecl AdArcfs�29 074 (, q1� I It fI1E 03 Cny N �) Z,e Code 7—Z e Y GENERAL INFORMATION DATE OF BUILDING PERMIT: ERMIT # gCo►��20 , 00 lo• BUILDING TYPE Nonresidential ❑ High -Rise Res (Common Area ❑ Hotel/Motel (Common Area) PHASE OF ❑ New Construction ❑ Addition Alteration ❑ Unconditioned CONSTRUCTION SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. ! r In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. Date Approved By the Enforcement Agency L-rj_0Z-f � CBEs l-k. NR('A _L7 - OZ- 4 fs . tots I - // AlkGA - LIT- 0? - A CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCI-LTl-01-E (Revised 01116_ CERTIFICATE OF INSTALLATION Indoor Lightnings Project Na me. r r-eaoGm �/Pj Protect Add,— .I91ngfr - I GALIFU"NIA tNtHGY COMMISSION NRCI-LTI-01-E (Page 2 of 2) E nlorcement ,yrncy. MumOer I v "(PtAZN DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name---rh /nnyy Documentation Aut r Signature: Documentati n Author Comp Name'. P (14N -T tAC oil Co• Date Sign / 1 Address: 21^ , v[ CEA Certd¢atwnldenuhcat n (if applicable): Cry/State/2,p: Kos E�, p 12 C' I ? ?0 Phon 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 Installat on is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized rearesentative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installatio-i conforms to all appl cable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. 1 will ensure that a completed signed copy of this Certif cate 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 Budder/installer Name _ `i'o Respons ble Builder/Install signatt Company Name: (install ng Subcontractor or General Contractor pr Budder/Owner) � Position With ny (Title): Address: r�.7 � C �j�rnJl CSLB License: City/State/lip:,{ I� !� P b ca a r CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 0 w FAN NAMEPLATE DATA MANUFACTURER LENNOX TYPE PACKAGE AIC LOCATION ROOF HEATER LOCATION ROOF UNIT # 1 MODEL# ZHB060S4BN1Y SERIAL# 5620A10762 TEMPERATURE TEMPERATURE IN 90 TEMPERATURE OUT 118 SYSTEM DROP / Rise 28 1 2 DINING DINING S1 S CEILING CEILING 14 14 3 DINING R CEILING 14 4 DINING S CEILING 14 5 DINING S CEILING 14 6 7 8 9 10 11 12 13 14 15 161 17 18 19 1 his system is with n acceptable limits. +/_G% 0 2019 ARB/JK Air Balance CONTENTS SUPPLY AIR CFM 2000 1882 RETURN AIR CFM 1460 1382 FRESH AIR CFtd 480 500 STATIC PRESSURE • .5 WC .51 WC STATIC PRESSURE - 1.5 wC 1.55 WC TOTAL STATIC PRIES . 1.0 WC 1.06WC FILTER STATIC PRESS,0.03WC 10.032WC 230 1227 Restaurant 14 NIA NIA N/Al NIA 485 477 POS. 14 " " " " -. ,ED 485 481 ' 14 " 1460 1382 cvosEo 1460 1382 " 14 " Errosco 485 473 14 " 485 451 " REQUIRED SUPPLY 20001 I REQUIRED RETURN 1 1460 DATE September 4, 2020 ,cd 111 Ste 103& 104 La Qulnta, CA SYSTEM Heating & AIC 1 READINGS Jot;n Kwan- National Balanong IrsUtute S0 199-01 JOB NUMBER 20-89 7 0 all ;. FAN NAMEPLATE DATA MANUFACTURER LENNOX TYPE PACKAGE A/C LOCATION ROOF HEATER LOCATION ROOF UNIT # 2 MODEL# ZHB060S4BN1Y SERIAL# 5620A07943 MPERATURE MPERATURE MPERATURE STEM DROP IN 90 OUT 118 / Rise 28 1 DINING S1 CEILING 14 2 DINING S CEILING 14 3 DINING R CEILING 14 4 DINING S CEILING 14 5 DINING S CEILING 14 6 7 8 9 10 11 12 13 14 15 16 17 18 19 This system is within acceptaole limits. +/-8% 0 2019 ARB/JK Air Balance CONTENTS 0 SUP-LYAIR CFM 2000 1858 RETURN AIR CFM 1460 1344 FRFSH AIR CFM 480 514 STATIC PRESSURE + .5 WC .52 wC STATIC PRESSURE - .5 WC .56 wC TOTAL STATIC FIRES . 1.0 WC 1.08wc FILTER STATIC PRESSrO.03 we 10.031wc volts REQUIRED SUPPLY 230 1226 Restaurant !AMMO 4851 463 POS. E+ WD 485 456 ' " E.P SEO 1460 1344 " Eawnco 485 453 " t.�•. 485 486 " REQUIRED RETURN 1 1460 DATE September 4, 2020 ,4 �6 A 111 Ste 103 & 104 La Quinta, CA SYSTEM Heating & A/C 2 READINGS John Kwan- National Balancing Institute #0 199-31 JOB NUMBER 20-8970 EO FAN NAMEPLATE DATA MANUFACTURER LENNOX TYPE PACKAGE A.+C LOCATION ROOF HEATER LOCATION ROOF UNIT # 3 lwlODEL# ZHB048S4BN1Y SERIAL# 5620Al2121 EMPERATURE EMPERATURE IN 90 EMPERATURE OUT 118 YSTEM DROP / Rise 28 1 SERVICE S1 CEILING 14 2 SERVICE S CEILING 14 3 SERVICE R CEILING 14 4 SERVICE S CEILING 14 5 SERVICE S CEILING 14 6 7 8 9 10 11 12 13 14 15 16 17 18 19 s system is within acceptable limits. +1-8% (D 2019 ARB/JK Air Balance CONTENTS SUPPLY AIR CFM 1600 1521 RETURN AIR CAM 1180 1095 FRESH AIR CW 420 426 STATIC PRFSSIJRE - .5 WC .53 wC STATIC PRESSURE .5 wC .56 wC TOTAL STA- C PRIES 1.0 WC 1.09wc FILTER STATIC PRESSI10.03 wC 10.032 wC 230 1227 Restaurant 14 N/Al NIA NIA I NIA —0-11 400 391 POS. 14 11 rr EvnnsEr, 400 387 " 14 11801 1095 1180 1095 " " Errcimen 14 „I rr ENCLOSED 400 374 " 14 " ENCLOSED 400 369 " " REQUIRED SUPPLY 1 16001 1 REQUIRED RETURN 1 1180 DATE September 4, 2020 EX 111 Ste 103 & 104 La Quinta, CA SYSTEM Heating & A/C 3 READINGS ;onn Kwan- Natonal Balancing Institute #06 199-01 JOBNUMBER 20-8970 CL Q C M L) Y >` C m a.. al 0 0 0 FAN NAMEPLATE DATA MANUFACTURER LENNOX TYPE PACKAGE A/C LOCATION ROOF HEATER LOCATION ROOF UNIT # 4 MODEL# ZHB048S4BN1Y SERIAL# 5620A12121 :PERATURE PERATURE IN 90 PERATURE OUT 118 TEM DROP ! Rise 28 1 KITCHEN S1 CEILING 2 KITCHEN S CEILING 3 KITCHEN R CEILING 4 KITCHEN S CEILING 5 RESTROOM S CEILING 6 RESTROOM S CEILING 7 8 9 10 11 12 13 14 15 16 17 18 19 his system is within acceptable limits. +/-8% 0 2010 AR13/JK Air Balance CONTENTS SUPPLY AIR CFM 1600 1539 RETURN AIR '-FM 1180 1084 FRESH AIR CFM 420 455 STATIC PRESSURE + .5 WC .54 WC STATIC PRESSURE - .5 WC .54 we TOTAL STATIC PRES 1 A WG 1.08wc FILTER STATIC PRESS110.03 WC 10.031 WG volts 1230 1226 Restaurant 14 14 N/A N/Al NIA N/Al FWA0.11) 460 4531 POS. 14 14 fWLOW 460 447 " 14 14 " 1180 1084 FM 1.01ED 1180 1084 14 14 " F-SED 460 431 " 14 14 " " " EKLOSED 110 102 " 14 14 " EII LDSED 110 106 " REQUIRED SUPPLY 1 16001 1 REQUIRED RETURN 1 1180 DATE September 4, 2020 i d 111 Ste 103 & 104 La Quinta. CA SYSTEM Heating & A!C 4 READINGS Jcrn Khan- National 8alanurg Institute 906 199-01 JOB NUMBER 20-E970 Z4 N 0 EXHAUSTFAN MANUFACTURER CAPTIVE AIRE MODEL DU85HFA EXHAUST FAN MOTOR DATA MANUFACTURER TELCO VOLTS/PHASE 23011 HORSEPOWER 314 EXHAUST CFM MUA CFM 'OTHER MAKEUP AIR TOTAL MAKEUP AIR DIFFERENCE 1,320 N1A 1,320 HORSEPOWER 1 314 EXHAUST MOTOR PULLEY DATA FAN RPM DIAMETER DIRECT DIAMETER DIRECT TATIC N ADJ/FIXED ADJ. MUA FAN PULLEY DATA DIAMETER HVAC DIAMETER HVAC ADJ/FIXED ADJ. MAKE UP AIR UNIT MANUFACTURER LENNOX MODEL MULTI STYLE HVAC MUA MOTOR HORSE POWER MULTI TYPE HVAC PHASE 3 HORSE POWER MOTOR RPM 1725 E we MULTI MULTI STATIC PRESSURE !I nATF September 4, 2020 P�/ MEA 111 Ste 303 101% 103 & 104 395 106% La Quinta, CA NIA 395106% SYSTEM 92 Hood and MAU 314 1711 READINGS BY ;1.1 iiwe John Kwan MULTI PROJECT # MULTI 20-8970 1HOOD STYLE I Canopy I Canopy IHOOI7 TYPE (1 OR 2) 1 1 1 1 JAIR TEMPERATURE 1 118 1 ALTITUDE This is a Certified Type 1, 3 Canopy Hood, Central Custom Model. Testing and adjusting was done referencing the 2016 California Mechanical Code Sections 507, 508 & 509 - Commercial Hoods and Kitchen Ventilating Systems. e results of this diagnostic and air balance test are within acceptable limits. ID 2020 NCI, Inc. CO 2020 CONTENTS U �Co1 o rt VDU c co o (D a� U X WLU ''N� O �_ N O O 4t (D T i N ~ i Q N O � N � a) o y `7 �a U -i--+ Z • 0 KITCHEN L to R EXHAUST AND MAKEUP AIR REPORT (PAGE 2) FILTER MEASUREMENTS AND ••D AIRFLOW Required Test 1 Final CFM CFM CFM CFM OUTLETSTOTAL IMAKE UP AIR Area Outlet System Required Served Number CFM No. CFM Test 1 1 Final CFM CFM 0 Hs 0 • • s DATE September 4, 2020 9P,*Ed 111 Ste 103 & 104 La Quinta, CA SYSTEM Hood and MAU Heating & A/C READINGS John Kwan- National Balanong Insitute 906 199-01 JOB NUMBER 20-8970 AIR DATA METER STATIC PRESSURE KIT Optical Tachometer C 2020 ARB"J Air Balance CONTENTS STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE • 0 CEC-NRCA-%1C"2-A RevisM I2H51 _ _ t,Pt tr UMT4 Vt t- N t:" ki T t.Vrf MA JJrJn CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Croirtt Y.tmr rnlnrrrmrnl A/rnrq Orrnt HIn7 79024 CA 111 Ste 103 & 104 La Quint.), CA 0010 rm rrt A,Edntit Cry Lo CKr 79024 CA I11 Ste 103 & 104 La Quinta, CA 92253 I6rn;t1,141.0'. 111 Srsitm tocaUon v ltc i kNtd: ],z,3,a, 1,2,3,4, Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Verify measured outside airflow reading is within 10% of the total required outside airflow. Required for all newly installed HVAC Intent: units. Reference A4ECH-3C (Column H or Column 1) or Mechanical Equipment Schedules. J A. Construction Inspection Note: MCH-02-A can be performed in conjunction with MCH-07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. 1, Supporting documentation needed to perform test includes: a. As -built and/or design documents (for example, Mechanical Equipment Schedules, Equipment Start -Up Sheets or Balancing Reports). b. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Voriable Air Systems At -A -Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At -A -Glance). C. 2013 Building Energy Efficiency Standards. 2. Instrumentation needed to perform test Includes: a. Watch b. Calibrated means to measure airflow (i.e, hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: VELOCITY PRESSURE PROBE ii. Equipment calibration date (must be within one year): 9/2/2019--CAV 3. System type (check either VAV or CAV): ❑ VAV ❑✓ CAV a. Check if Variable Air Volume (VAV) and complete the following: L Outside airflow is either factory calibrated or field calibrated. ❑ Check if factory calibrated and attach calibration certification. (� Check J field calibrated and attach calibration results. H. Damper Control (must be checked): ❑✓ Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). iii. One of the following dynamic controls is being utilized to control outside air (check method used) ❑ Outdoor Air CFM Compensation (J Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking ❑ Injection Fan Method [] Dedicated Minimum Ventilation Damper with Pressure Control ❑ Other Active Control, Describe: b. Check if Constant Air Volume (CAV) and verify the following: ❑ System is designed to provide a fixed minimum OSA when the unit is on. 4. Method of delivering outside air to the unit (check one of the following): nt/ Outside air is ducted to the return air plenum- Confirm that outside air is ducted to either (check one of the following): ❑✓ Within five ft. of the unit. ❑ Within 1S ft. of the unit, with the air directed substantially toward the unit. ❑✓ Return air plenum is NOT used to distribute outside air to the unit. Le. outside air is ducted directly to the unit or outside air is provided independent of the unit. 5. Pre -occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): ❑✓ The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is less. ❑✓ 3 complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 121151 CAL IFnRNrA FNFRr1V r`nuuicanu S • • CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Namr 79024 CA 111 Ste 103 & 104 [nln•rnrrnl Mrnry La Quinta, CA Grrrn AunM-0010 Project Andmr % 79024 CA 111 Ste 103 & 104 cey La Quinta, CA Z,Pcxe 92253 Se+trm Namealdencdu arr�n Ise 1,2,3,4, Srstrm rocnrnnm Arei krvrd 1,2,3,4, B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing Q CAV ❑ vAv Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit is not in economizer mode during test (economizer disabled). �✓ ✓� Note: Shoded boxes do not opply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to acnieve design airflow or maximum airf ow at full a. cooling. Record VFD speed (Hz). Hz b. Measured outdoor air3low reading (cfm) Required outdoor airflow (cfm) (from MECH-3C, Column 1, or C. Mechanical Equipment Schedules). SEE REPORT rfm cfm SEE REPORT cfm cfm Time for outside air damper to stabilise after full supply airflow is achieved d' (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30%of the total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) cfm C. Required outdoor airflow (cfm) (from MECH-K, Column 1, or mechanical equipment schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step 5: Return to initial conditions (check) C. Testing Calculations & Results Determine Percent Outside Air at full supply a"rflow (%OAFA) for Step 3 a. %OArA = Measured outdoor airflow reading /Required outdoor airflow (Step3b/Step3c) NaN % % b. %OAIA is within 10% of design Outside Air. (%OA ;5 110%) Yes Q No C) Yes Q No Q C. Outside air damper position stabilizes within 5 minutes (Step 3d < 5 minutes) Yes p No Q Determine Percent Outside Air at reduced supply airflow (%OAAA) for Step 4 (VAV only) a. °oOAHA = Measured outdoor airf'ow reading /Required outdoor airflow reading (Step4b/Step4c) a� b. %OARA is within 10% of design Outside Air. (OARA 5 110%) Yes O No Q C. Outside air damper position stabdizes within 5 minutes (Step 4d < 5 minutes) Yes 0 No Note: I he intent of this test is to ensure that 1) all air handlers provide the minimum amoint of OSA and 21 VAV air handlers use dynamic controls to avoid over ventilation. D. Evaluation a PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y - yes) CA Building Energy Efficiency Stardards - 2013 NonresidAnt al Compliance December 2015 STATE OF CAL-1 FORMA OUTDOOR AIR ACCEPTANCE rrr-AlraraL61r4LM.A rraa,de d 191151 CALIF-0RNIAFNFRr:V rr)vL4 czi Q • CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Protect Vame, 79024 CA I11 Ste 103 & 104 nernrr. La Quinta, CA Per-irt tiirnbe�. 0010 Ao Cxe 92253 ►rvtetl Add,r,, 79024 CA I11 Ste 103 & 104 C'h La Quinta, CA systemNam* 0,IdcrRdrealro°!rag 1,2,3,4, Srstem Ia uo°a•Arc. 5--d 1,2,3,4, DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete. DOCJmentation Author Name; John Kwan Doc umentabon Aulli SRnature�. John Kwan Documentation Author company Namr: J Air Calanarg &Duct Testing Date Signed: September 4, 2020 Add•ess:9040 Telstar Ave. #137 ATT CerUficatioo Identificat.on I t applicablel: 06-199-01 phone: b2fi-274-0522 oty/State/z,p: El Monte, CA 91731 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following wider penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptarce is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. f he construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enfnrrement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidertial Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the respons ble builder/installer and has been posted or made available with the Cuilding permits) issued for the building. _ Field Technician Name: Field Technician Signature John Kwan John Kwan Field Techrician Company Name 1 Air Balancing & Duct Testing Position with Company (Titte)' Tecn. / Address: 904C Telstar Ave. #137 ATTCelification identification I f appl,cable):06-199-01 crty/State/zip: LI Monte, CA 91731 Phone.626-274-0522 Date Signed: September 4, 2020 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify t`1e following under penalty of perjury, under the laws of the State of Ca'ifornia: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on th s Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and corforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA/. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permits) issued for the building. 5. I will ensure that a competed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issuec for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Respors,b'e Acceptance Person Name: JACCB POON Responsible Acceptance Person Signature: JACOB POON Responsible Acceptance Pers. onCompany Name J P CONSTRUCTION CO Position with CompanyJJ1:rep Contractor Address:2714 STINGLE AVE U9 B ucense:642751 City/State/Zip', ROSEMEAD, CA 91770 Phone: 626) 572-9181 Date signed: September 4, 2020 CA Building Energy Efficiency Standards - 2013 Nonresidertial Compliance December 2015 is STATE OF CAL`FORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-RICH-03-A M@Osal 12A5 CALIFORNIA ENERGY COWASSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 3) Crgen Vame 79024 CA ill Ste 103 & 104 Inlnc•m.�r Aynry La Quetta, CA Ve•mrt rh.mp,c 0010 f rol-n AdArr.s 79024 CA 111 Ste 103 & 104 City La Quinta, CA92253 7-0 cod. syvcC Na nc o, IdcMi6cagwn Na 1,2,3,4, SV%I" Lwabm W Arta Sa ed' 1,23,4 Note: Submit one Certificate of Acceptonce for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Supportirg documentat'on needed to perform test includes, but not limited to: a. 2013 Building Energy Efficiency Standards Nonresidertial Compliance Manual (NA7.5.2 Constant Volume, Single -zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glonce). b. 2013 Building Erergy Efficiency Standards Manual, 2. Instrumentation to perform test includes, but not limited to: a. Temperature Meter b. Amp Meter 3. Installatinq (check if applies): ❑✓ Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Programming (check all those that apoly): 21 Thermostat meets the temperature adjustment and dead band requirements of 2013 Buildirg Energy Efficiency Standards Marual section 120.2(b). Minimum heating setpoint: 72 OF. Maximum cooling setpoint 78 OF. Deadband: 6 OF. Ev Occupied, unoccupied, and holiday schedules have been programmed per the facility's schedule. C Pre -occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: n Lesser ot: conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE 120.1-A or 15cfm per person times the expected number of occupants. (—✓] 3 complete air changes. Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 • • • STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS Ink CALIFORNIA ENERGY COMMISSION yCERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 3) iro ca Njmt 79024 CA 111 Ste 103 & 104 f nfnromrnt AA—y la Quetta, CA V-114 fk miler 0010 Prolei Address 79024 CA 111 Ste 103 R 104 CityLaQuints, CA 7i n ^ 92253 System NJ le ur W MIkil0", 149. 5y,tc^- LW.1 n a, Area S—d. 1,2,3,4, 1,2,3,4 B. Functional Testing Requirements I Operating Modes Step 1: Disable economizer control and demand -control ed ventilation (if applicable) to prevent unexpected interact ons. Occupied Mode Step 2: Heating load during occup ed condition Step 3: No-load during occupied condition Step 4: Coo ing load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating'oad during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 5 4 3 2 Step 2 — 8: Check and verify the following for each simulation mode required a. Supply fan operates continually ✓ ✓ ✓ ✓ b. Supply fan turns off ✓ e Supply fan cycles on and off ✓ ✓ d. System reverts to "occupied" mode to satisfy any condition ✓ e. System turns off wher. manual override time period expires ✓_ f. Gas -fired furnace, heat pump, or electric heater stages on ✓ ✓ g. No heating is provided by the unit ✓ ✓ ✓ ✓ h. No cooling is provided by the unit ✓ ✓ ✓ ✓ I. Compressor stages on _ ✓ ✓ ✓ ✓ J. Outside air damper is open to minimum pos.tion ✓ ✓ ✓ k. Outside air damper closes completely ✓ ✓ Step 9: System returned to initial operating conditions after all tests have been completed: yes o (, J C. Testing Results 8 7 6 5 4 3 7 Indica'e if Passed (P), Failed (F), or N/A (X), fi I in appropriate letter P P P ' P P P D. Evaluation P PASS: A I Construction Inspection responses are complete and all applicable Testing Results responses ore "Pass" (P) CA Building Energy Efficiency Stardards - 2013 Nonresidential Compliance December 2015 • STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CALIFORNIAENEF2GYCOfY1+AI5SION CEC-NRCA-MCI-03-A IRevised 121151 CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 3) e.oicd Name 79024 CA 111 Ste 103 & 104 ri,l..a.me�. Aa.�.v La Quinta, CA o..Te rn,...e.r 0010 P.rect Addreu 79024 CA 111 Ste 103 R 104 city la Quints, CA 7'P cod' 92253 5„lt•m Na Tc o- 1,7,3,d, 5/,tern Lixot-�J w Area St'vtd 1,2,3,4 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature. :ohn Kwan John Kwan D:KLnWt.tdtionAuthor Company NameJAir Balancing &Duct Testing Date Sig.ned:September 4,2020 Address 9040 Telstar Ave. g137 ATT Certification Identification (if appllcabel 06-199-01 City/S1ate'1z.p El Monte, CA 91731 Phone: 626-274-0522 FIELD TECHNICIAN'S DECLARATION STATEMENT certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies w-th the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) Issued for the ouild,ng. I Held Technician Name: Field Technician Signature* ; F`,•.. �-' John Kwan John Kwan Field Terhninan Company Name' J Air Balancing & Duct Testing Positron with Compary (True): Tech. f fcww!Jv �� `\\ Address:9040 Telstar Ave. Jf137 ATTCertRication Identification (if applicable): 06-199-01 cihistate/Zo: E' Monte, CA 91731 Phone: 626-274-0522 Date Signed September 4, 2020 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following undr - penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician s acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured dev ces for the scope of work identified on this Certificate of Acceptance and attest to the declarations in th s statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 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. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be incluaed with the documentation the builder provides to the building owner a- occupancy. Responsible Acceptance Person Name: JACOB POON Responsible Acceptance Person 5ignatu-e: JACOB POON Responsible Acceptance Person Company Name: J P CONSTRUCTION CO Position with Company (title): Contractor Address: 2714 STINGLE AVE C5L5 License 642751 Phone:626) 572-9181 Date signed: September 4, 2020 crylStale17ip: ROSEMEAD, CA 91770 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 .. � � � ( ,��-� J _ ► '. Wit) c � i �'r'��� ` ' ' �' � •� �� � . CIT. I t 1'1 `iI t i11 ril 411113H113111MICyl r� ki Has 5uc<tully (oniple-led the required tr�iinlri(I and l),V,%1-d �•� ,t't lt• JI tiwlit1011 exam by tlw � rp "' 'q. I1i11 fIUl it, o. , to per((�1 nt I iV/1( (ulttlit(•tO - systen) balanc-in(4 uF-) to 1_, Io' h, aCcor(titt(,l to N( 1 pi.ictict-il standards rind procedurl•s. ti° < l Citified Since �Iti ,Ic.iltln1%11-rL•c1 d11d recOi�tlllt:'�f try yp �p Lertified �;. \ 1 ` 1• � Air Balancer Cult N. 06 199.01 1Vt11 a� 1 IVn�f�nnJ CumfivrT lnstl[art��, Ins -Hob }1fCSIC�('lll , f C lc i 1 v }