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BCOM2019-0051 Title 24STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 1 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 2 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 3 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 4 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 3 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 5 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 3 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 6 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 2 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 7 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 2 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 8 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 1 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 9 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Office 1 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 10 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA r- ❑� �r CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam 5 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 11 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam 5 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 12 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam 4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 13 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam 4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 14 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Hallway 2-4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 15 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Hallway 2-4 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 16 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Patient Restroom Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 17 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Lab Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 18 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Lab Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 19 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA r- ❑� �r CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Staff Restroom Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 20 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Staff Break Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 21 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA r- ❑� �r CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Staff Break Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 22 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Storage #2 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 23 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Storage #2 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 24 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #8 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 25 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #8 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 26 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #7 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 27 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA r- ❑� �r CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #7 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 28 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: IT RM/Storage Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 29 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: IT RM/Storage Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 30 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Nurse Station Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 31 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Nurse Station Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 32 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Hallway #1 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 33 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Hallway #1 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 34 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Vital Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 35 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Vital Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 36 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #6 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 37 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #6 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 38 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #3 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 39 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA r, CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #3 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 40 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #2 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 41 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA r- ❑� �r CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #2 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 42 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #1 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 43 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Exam #1 Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 44 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Reception Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 45 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Reception Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 46 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Automatic Time Switch Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Waiting Room Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A.- Construction Inspection 01 Automatic Time Switch Controls Construction Inspection - confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): 0 Weekdays Weekend O✓ Holidays b. Document for the owner automatic time switch programming (check all): Weekday settings Weekend settings Holidays settings Set-up settings Preference program settings Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices B. Functional Testing of Lighting Controls Confirm compliance (Yes/No). 01. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Yes b. I Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located Yes 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 Yes b. Manual override switch controls only 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). Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 1 Automatic Time Switch Controls (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 47 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission ❑� M AA CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Occupancy Sensor Acceptance Test Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 Building: 1 Floor: 1 Room: Waiting Room Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use.: Checked by/Date: A. Construction Inspection 02 Occupancy Sensor Construction Inspection — confirm for all listed in Section B 0 Occupancy sensors are not located within 4 feet of any HVAC diffuser 0 Ultrasonic occupancy sensors do not emit audible sound 5 feet from source ✓O 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 B. Functional Testing of Lighting Controls If there are several geometrically similar spaces that use the same lighting controls, test only one space and provide an attached page listing "untested areas" which are represented by the tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Confirm compliance (Yes/No). 02. 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) Yes b. The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Yes Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly Yes 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 Yes Step 3: System returned to initial operating conditions Yes C. Testing Results PASS / FAIL 2 Occupancy Sensor (On Off Control) (all answers must be Y). Pass D. Evaluation Pass PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes). Page 48 of 49 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A (Revised 04/17) California Energy Commission CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Lighting Control Acceptance Document Project Name: Family Medicine and Sports Medicine / CMR Construction #001 Enforcement Agency: City of La Quinta Permit Number: BCOM2019-0051 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: James Stackhouse Documentation Author Company Name: Date Signed: March 05 2020 Stackhouse Electric Inc. Address: 29796 Circinus Street CEA/ATT Certification Identification (If applicable): City/State/Zip: Murrieta, California 92563 Phone: 1 (951) 440-6640 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1.The information provided on this Certificate of Acceptance is true and correct. 2.1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3.The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4.1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or m e ailable with the building permit(s) issued for the building. Field Technician Name: Field Technician Signature James Stackhouse Field Technician Company Name: Position with Company (Title): Stackhouse Electric Inc. Acceptance Test Technician Address: 29796 Circinus Street ATT Certification Identification (if applicable): ATT-1503-00003 City/State/Zip: Murrieta, CA, 92563-2784 Phone: 1 (951) 440-6640 Date Signed: March 05 2020 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1.1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2.1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3.The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4.1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5.1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspectionsk I up4erstand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to tRV uilding owner at occupancy. Responsible Acceptance Person Name: Responsible Acceptance Person Signature: James Stackhouse Responsible Acceptance Person Company Position with Company (Title): Name: Stackhouse Electric Inc. Acceptance Test Employer Address: 29796 Circinus Street CSLB License: City/State/Zip: Murrieta, CA, 92563-2784 Phone: 1 (951) 440-6640 Date Signed: March 05 2020 Page 49 of 49 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCI-LTI-01-E (Revised 01/20) �MLIrvrcrviri C111CKbT t UMM16b1UN CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 1 of 2) Project Name: C i/ `AM, ` /fC/ -1 { � Aov,45 Mir(ji x(t r N Enforcement Agenry: C` p Lh' Q /kf Permit Number: ,t0�f�- Project Address` qZ t` �A e '1 ��r City: Cft 42 V I& Af Zip Code: : GENERAL INFORMATION DATE OF BUILDING PERMIT: PERMIT# I G - xo;'o 1 i c15ro AD(C(-ooS( BUILDING TYPE J4 Nonresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION ❑ New Construction ❑Addition ,Alteration ❑ Unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. 3 — I O - A0A p In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Date Approved By Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. I the Enforcement 'Et-1 1 3 - 10-'X0xo CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCI-LTI-01-F (RevisPrt nl/9nt __ __ �.r� !Vvr[imuw CIVCRU T "'OMM66iUN CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 2 of 2) Project Name: I AMQf rat s 6,, �edleI { Enforcement Agency- Vf rm P it Number: Project Address: I C t't City: C� tic f-ff Zip Code: v x 6-3 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Documentation Author Company Name: Date Signed: Address: CEA 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: l Responsible Builder/Installer Signature: G c.LL Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position With Company (Title): c co e-co -r e Aesrd Address: ?% 3 G *34) Vt A 10AI CSLB License: ` )"( 0'�-6 City/State/Zip: V/%-1, oietrr , 1 �—� 7 Phone 1 Q^ U7o� 6O O G Date Signed: —10—%Id�o %-M DUHUMg tnergy tmciency btanoaras - ZU19 Nonresidential Compliance January 2020