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BMCH2022-0248
BUILDING PERMIT DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type: Mechanical Permit Number: BMCH2O22-0248 Property Address: 47647 CALEO BAY APN: 643200004 Legal Description Property Zoning: Valuation: $16,200.00 PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 05/09/2022 ISSUED DATE: 11/02/2022 CALIFORNIA Owner: Ruth Vanderplas 47647 Caleo Bay Dr. Ste 250, La Quinta, CA 92353 Applicant: BURGESONS HEATING AND AIR CONDITIONING P O BOX 7310, REDLANDS, CA 923750310 Contractor: BURGESONS HEATING AND AIR CONDITIONING P O BOX 7310, REDLANDS, CA 92375-0310 PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE FOLLOWING: LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2) 1) They are licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and the referenced License is in full force and effect, or; 2) That they are exempt from the Contractors' State License Law for the reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or she is exempt from licensure by a valid exemption. [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code] Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).) a) As owner of the property, or my employees with wages as their sole compensation, will do all of or portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). b) As owner of the property, will be exclusively contracting with licensed c) Are exempt from licensure under the Contractors' State License Law. As an Owner -Builder, they acknowledge that, except for their personal residence in which they must have resided in for at least one year prior to completion of the improvements covered by this permit, they cannot legally sell a structure built as an owner -builder if it has not been constructed in its entirety by licensed contractors. It is understood that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application was submitted at the following Web site: http://www.leginfo.ca.gov/calaw.html. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If applicable) A construction lender will be used for completion of the improvements covered by this permit and the name and information of which is on file for public inspection during the regular business hours of the public entity. Failure of the applicant to indicate the construction lender on the application does not relieve that person of the requirement to give the construction lender preliminary notice from that duty. WORKERS' COMPENSATION DECLARATION (1, 2 or 3) WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1) Has and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2) Has and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3) Certifies that, in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. NOTICE TO APPLICANT (1, 2 and 3) 1) Each person upon whose behalf this application was made, each person at whose request and for whose benefit work is being performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2) Any permit issued as a result of this application becomes null and void if work is not commenced within 360 days from date of issuance of such permit, or if cessation of work for 180 days will subject permit to cancellation. On or after January 1, 2019, every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 12 months after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 12 months after the time the work is commenced. 3) Certified that they read the application and state that the information provided is correct. Agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspection purposes. IMPORTANT: An Application for Permit was made to the Building Official, subject to the conditions and restrictions set forth at the time of application, which is now hereby an Issued Permit. If any part of the information being supplied on this permit is inaccurate or untrue, please contact the City of La Quinta at (760) 777-7125 immediately for correction. Printed: 6/12/25 8:28 am Page 1 of 3 Permit Type Mechanical BUILDING PERMIT Permit Number: Property Address BMCH2O22-0248 47647 CALEO BAY LQ MEDICAL CENTER/HVAC CHANGE OUT - 5 TON ROOF TOP PACKAGE *** HVAC CHANGE OUT - LLQ MEDICAL CENTER/HVAC CHANGE OUT - 5 TON ROOF TOP PACKAGE UNITS LIKE FOR LIKE NO CHANGE OF LOCATION. CARBON MONOXIDE ALARM(S) TO B INSTALLED PRIOR TO FINAL INSPECTION. PER 2019 CALIFORNIA BUILDING CODES. Amount of Packaged 1 unit(s) Type Group Sq Ft Value Invoice No. Fee PERM IT-BMCH2O22-02z RECORDS MANAGEMENT FEE 8 HVAC CHANGEOUT - PACKAGED UNIT BSAS SB1473 FEE HVAC CHANGEOUT - PACKAGED UNIT PC TECHNOLOGY ENHANCEMENT FEE PERMIT ISSUANCE Total for Invoice PERMIT-BMCH2O22-0248 Fee Amount Amount Paid $11.00 $11.00 $41.68 $41.68 $1.00 $1.00 $27.79 $27.79 $5.00 $5.00 $105.60 $105.60 $192.07 $192.07 Grand Total for Permit $192.07 $192.07 Workflow Step / Action Name Action Type Stan. Date End Date Inspections v.1 05/09/2022 0:00 -- -- -- -- -.. .. .. .. ..................................................................................................... MECHANICAL FINAL v.2 Inspection ---------------------------- - - ---- MECHANICAL FINAL** v.1 Inspection Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of any material required to allow inspection. It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this code. Printed: 6/12/25 8:28 am Page 2 of 3 BUILDING PERMIT Permit Type: Mechanical Permit Number: BMCH2022-0248 Property Address: 47647 CALEO BAY A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the iurisdiction shall not be valid. A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by the buildina official. Printed: 6/12/25 8:28 am Page 3 of 3 BMCH2022-0248 CITY OF LA QUINTA BUILDING DIVISION REVIEWED FOR CODE COM PLIANCE er J.ANAYA DATE 1110212022 LQ MEDICAL CENTER/HVAC CHANGE OUT - 5 TON ROOF TOP PACKAGE UNITS LIKE FOR LIKE. 2019 CALIFORNIA BUILDING CODES. �( SITE ADDRESS � � L( � � A L- p o- -)S A, ASSESSORS PARCEL NUMBER I I FRONT PROPERTY Ll N2 I L I N E Is-mm 2B4-199 (Rev, 06/2009) Ea:rr��ie:r:) 50GCQ 3 TO 5 TON PHYSICAL DATA 50GCQ UNIT 50GCQM04 50GCOM05 50GCQM06 NOMINAL TONS 3 4 5 BASE UNIT OPERATING WT (lb)' 475 590 596 REFRIGERATION SYSTEM No. Circuits/No. Compressors/Type 1 / 1 / 2-Stage Scroll 1 / 1 / 2-Stage Scroll 1 / 1 / 2-Stage Scroll Puron® (R-410A) Charge (lbs-oz) 10-3 11-3 15-0 Metering Device TXV TXV TXV High -Pressure Trip/Reset (psig) 630/505 630/505 630/605 Low -Pressure Trip/Reset (psig) 54/117 54/117 54/117 EVAPORATOR COIL (Indoor) Material (Tube/Fin) Cu/AI Cu/AI Cu/AI Coil Type 3/8-in. RTPF 3/8-in. RTPF 3/8-in. RTPF Rows/FPI 3/15 3/15 4/15 Total Face Area (ft2) 5.5 7.3 7.3 Condensate Drain Connection Size 3/4-in. 3/4-1n. 3/4-in. CONDENSER COIL (Outdoor) Material Cu/AI Cu/AI Cu/AI Call Type 5/16-in. RTPF 5/16-in. RTPF 5/15-in. RTPF Rows/FPI 2/18 2/18 2/18 Total Face Area (ft2) 14.6 15.0 18.8 EVAPORATOR FAN AND MOTOR (Indoor) Standard Static 1 Phase Motor Qty/Drive Type 1/Direct 1/Direct 1/Direct Max Cont BHP 0.44 0.72 1.06 RPM Range 189-1890 190-1900 215-2150 Fan Qty/Type 1Nane Axial iNan e Axial 1/Vane Axial Fan Diameter (in.) 16.6 16.6 16.6 Medium Static 1 Phase Motor Qty/Drive Type 1/Direct 1/Direct 1/Direct Max Cont BHP 0.71 1.06 1.44 RPM Range 219-2190 217-2170 239-2390 Fan Qty/Type Wane AAal iNan e Axial 1/Vane Axial Fan Diameter (in.) 16.6 16.6 16.6 High Static 1 Phase Motor Qty/Drive Type 1/Direct 1/Direct 1/Direct Max Cont BHP 1.07 1.53 1.96 RPM Range 249-2490 246-2460 266-2600 Fan Qty/Type Wane Axial iNane Axial 1Nane Axial Fan Diameter (in.) 16.6 16.6 16.6 Standard Static 3 Phase Motor Qty/Drive Type 1/Direct i/Direct 1/Direct Max Cont BHP 0.44 0.72 1.06 RPM Range 189-1890 190-1900 215-2150 Fan Qty/Type iNane Axial 1Nane Axial 1/Vane Axial Fan Diameter (in.) 16.6 16.6 11 16.6 Medium Static 3 Phase Motor Qty/Drive Type 1/Direct 1/Direct 1/Direct Max Cont BHP 0.71 1.06 1.44 RPM Range 219-2190 217-2170 239-2390 Fan Qtyfrype iNane Axial iNan e Axial 1/Vane Axial Fan Diameter (in.) 16.6 16.6 16.6 High Static 3 Phase Motor Qty/Drive Type 1/Direct 1/Direct 1/Direct Max Cont BHP 1.07 1.96 2.43 RPM Range 249-2490 266-2660 284-2836 Fan Qty/Type iNane Axial 1 /Vane Axial iNane Axial Fan Diameter (in.) 16.6 16.6 16.6 E��a—rrier `.• 50GCQ 3 TO 5 TON PHYSICAL DATA (cont) 50GCQ UNIT 50GCQM04 50GCQM05 CONDENSER FAN AND MOTOR (Outdoor) Qty / Motor Drive Type 1 / Direct 1 / Direct Motor HP/RPM 7/6 / 825/675 1/4 / 100/900 Fan Diameter (in.) 23 23 FILTERS RA Filter City / Size (in.) 2 / 16x25x2 4 / 16x16x2 OA Inlet Screen Qty / Size (in.) 1 / 20x24x1 1 / 20x24xl LEGEND * Base unit operating weight does BHP — Break Horsepower FPI — Fins Per Inch OA — Outdoor Air RA — Return Air STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E This document is used to demonstrate compliance for mechanical systems that are within the scope of the permit application and are demonstrating compliance using the prescriptive path outlined in 140.4 or 1141.0(b)2 for alterations. Project Name: Vanderplas Report Page: (Page 1 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 A. GENERAL INFORMATION 01 Project Location (city) La Quinta 04 Total Conditioned Floor Area 2000 02 Climate Zone 9 05 Total Unconditioned Floor Area 0 03 Occupancy Types Within Project: 06 # of Stories (Habitable Above Grade) 1 ® Office (B) ❑ Retail (M) ❑ Non -refrigerated Warehouse (S) ❑ Hotel/ Motel Guest Rooms (R-1) ❑ School (E) ❑ Healthcare Facility (1) ❑ High -Rise Residential (R-2/11-3) ❑ Relocatable Class Bldg (E) ❑ Other (write in) B. PROJECT SCOPE This table Includes mechanical systems or components that are within the scope of the permit application and are demonstrating compliance using the prescriptive path outlined in 140.4 or §141.0(b)2 for alterations. 01 02 03 Air System(s) Wet System Components Dry System Components ® Heating Air System ❑ Water Economizer ❑ Air Economizer ® Cooling Air System ❑ Pumps ❑ Electric Resistance Heat Mechanical Controls ❑ System Piping ❑ Fan Systems Mechanical Controls (existing to remain, altered ❑ or new) ❑ Cooling Towers ❑ Ductwork (existing to remain, altered or new) ❑ Chillers ❑ Ventilation ❑ Boilers ❑ Zonal Systems/Terminal Boxes Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 2 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 C. COMPLIANCE RESULTS Table C will indicate if the project data input into the compliance document is compliant with mechanical requirements. This table is not editable by the user. If this table says "DOES NOT COMPLY" or "COMPLIES with Exceptional Conditions" refer to Table D., or the table indicated as not compliant for guidance. 01 AND 02 AND 03 AND 04 AND 05 AND 06 AND 07 AND 08 09 System Summary 110.1 110.2 140.4 Pumps 140.4 k Fans/ Economizers 140.4 c , System Controls 110.2 120 2' 140.4 f Ventilation 120.1 (See Table J) Terminal Box Controls 140.4 d Distribution 120.3 140.4 I (See Table L) Cooling Towers §110.2(e)2 (See Table M) Compliance Results 140.4 e (See Table K) (See Table F) (See Table G) (See Table H) (See Table 1) Yes AND AND I I AND Yes AND AND AND AND COMPLIES Mandatory Measures Compliance (See Table Qfor Details) COMPLIES D. EXCEPTIONAL CONDITIONS This table is auto filled with uneditable comments because of selections made or data entered in tables throughout the form. E. ADDITIONAL REMARKS This table includes remarks made by the permit applicant to the Authority Having Jurisdiction. Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 3 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 F. HVAC SYSTEM SUMMARY (DRY & WET SYSTEMS) This table is used to demonstrate compliance for mechanical equipment with mandatory requirements found in 110.1 and 110.2 a and prescriptive requirements found in 140.4 a §140.4(bl and 140.4Lkj or 1141.0(bj2 for alterations. Dry System Equipment Sizing (includes air conditioners, condensers, heat pumps, VRF, furnaces and unit heaters) 01 02 03 04 05 06 07 08 09 10 11 Equipment Sizing per Mechanical Schedule (kBtu/h) 140.4 (a&b) Smallest Size Heating Output2,3 Cooling Output2-3 Load Calculations3,4 Name or Item Equipment Category per Equipment Type per Tables 110.2 /Title Available' Total Tag Tables 110.2 20 140.4 a Supp. Sensible Total Sensible Per Design Rated Heating Per Design Rated Heating Cooling (kBtu/h) (kBtu/h) Output (kBtu/h) (kBtu/h) Load Load (kBtu/h) (kBtu/h) (kBtu/h) Duo Pac PTAC/ PTHP PTHP replacements Yes 90000 1 87000 1 0 1 60000 1 60000 1 70000 150000 'FOOTNOTES: Equipment shall be the smallest size, within the available options of the desired equipment line, necessary to meet the design heating and cooling loads of the building per 140.4 a . Healthcare facilities are excepted. 21t is common practice to show rated output capacity on the equipment schedule. Sensible cooling output comes from specification sheet tables. I If equipment is heating only, leave cooling output and load blank. If equipment is cooling only, leave heating output and load blank. 4 Authority Having Jurisdiction may ask for load calculations used for compliance per 114Q.4Lb J. Dry system Equipment Efficiency (Package Terminal Air Conditioners (PTAC) and Package Terminal Heat Pumps (PTHP) only) 01 02 03 04 05 06 07 Heating Mode Cooling Mode Minimum Name or Item Tag COP Rated Output Minimum EER Rated Output Capacity (kBtu/h) Required Design COP Capacity (kBtu/h) Required per Tables Design EER per Table 110.2-E 110.2-E Duo Pac 87000 2.5 3.5 60000 7.6 16 G. PUMPS This section does not apply to this project. Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Schema Version: rev 20200601 Report Generated: 2022-05-25 11:53:42 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 4 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 H. FAN SYSTEMS & AIR ECONOMIZERS This section does not apply to this project. I. SYSTEM CONTROLS This table is used to demonstrate compliance with mandatory controls in 110.2 and 120.2 and prescriptive controls in 140.4 and (n) or requirements in §141.0(b)2E for altered space conditioning systems. 01 02 03 04 05 06 07 08 09 Conditioned Thermostats Shut -Off Isolation Supply Air System Name System Floor Area 110.2 b & (c)1, Controls Zone Demand Response Temp. Reset Window Interlocks per Zoning Being Served §120.2(a)or §141.0(b)2E 120.2 e Controls 110.12 and 120.2 b 140.4 f 140.4 n (ftz) 120 2 Duo Pac Multi -zone <= 25,000 ftz Setback Occ. Sensor Occ. Sensor NA: PTAC, PTHP, Rm AC, HP NA. Alteration NA: Alteration Project 'FOOTNOTES: Gravity gas wall heaters, gravity floor heaters, gravity room heaters, non -central electric heaters, fireplaces or decorative gas appliances, wood stoves are not required to have setback thermostats. *Notes: Controls with a * require a note in the space below explaining how compliance is achieved. EX: system 1: SA Temp Reset: Exempt because zones compliant with 140.4 d ; EXCEPTION 1 to 140.4 f J. VENTILATION AND INDOOR AIR QUALITY This section does not apply to this project. K. TERMINAL BOX CONTROLS This section does not apply to this project. L. DISTRIBUTION (DUCTWORK and PIPING) This section does not apply to this project. M. COOLING TOWERS This section does not apply to this project. Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 5 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 N. DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION Selections have been made based on information provided in previous tables of this document. If any selection needs to be changed, please explain why in Table E Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at https://www.energy.ca.gov/title24/2019standards/2019 compliance documents/Nonresidential Documents/NRCl/ Form/Title Field Inspector Pass Fail NRCI-MCH-01-E - Must be submitted for all buildings ❑ ❑ O. DECLARATION OF REQUIRED CERTIFICATES OF ACCEPTANCE Selections have been made based on information provided in previous tables of this document. If any selection needs to be changed, please explain why in Table E Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at https://www. energy.ca.gov/title24/2019standards/2019 compliance-documents/Nonresidential Documents/NRCA/ Form/Title Systems/Spaces To Be Field Verified Field Inspector Pass =ail NRCA-MCH-19-A Occupancy Sensor Controls Duo Pac ❑ ❑ P. DECLARATION OF REQUIRED CERTIFICATES OF VERIFICATION There are no NRCV forms required for this project. Q. MANDATORY MEASURES DOCUMENTATION LOCATION This table is used to indicate where mandatory measures are documented in the plan set or construction documentation. 01 02 Compliance with Mandatory Measures documented through MCH Mandatory Measures Note Block Yes N/A Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 6 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Hannah Kendrick Company: Signature Date: Address: CEA/ HERS Certification Identification (if applicable): City/State/Zip: Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer) 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Company: Date Signed: Address: License: City/State/Zip: Phone: Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E This document is used to demonstrate compliance for mechanical systems that are within the scope of the permit application and are demonstrating compliance using the prescriptive path outlined in 140.4 or 1141.0(b)2 for alterations. Project Name: Vanderplas Report Page: (Page 1 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 A. GENERAL INFORMATION 01 Project Location (city) La Quinta 04 Total Conditioned Floor Area 2000 02 Climate Zone 9 05 Total Unconditioned Floor Area 0 03 Occupancy Types Within Project: 06 # of Stories (Habitable Above Grade) 1 ® Office (B) ❑ Retail (M) ❑ Non -refrigerated Warehouse (S) ❑ Hotel/ Motel Guest Rooms (R-1) ❑ School (E) ❑ Healthcare Facility (1) ❑ High -Rise Residential (R-2/11-3) ❑ Relocatable Class Bldg (E) ❑ Other (write in) B. PROJECT SCOPE This table Includes mechanical systems or components that are within the scope of the permit application and are demonstrating compliance using the prescriptive path outlined in 140.4 or §141.0(b)2 for alterations. 01 02 03 Air System(s) Wet System Components Dry System Components ® Heating Air System ❑ Water Economizer ❑ Air Economizer ® Cooling Air System ❑ Pumps ❑ Electric Resistance Heat Mechanical Controls ❑ System Piping ❑ Fan Systems Mechanical Controls (existing to remain, altered ❑ or new) ❑ Cooling Towers ❑ Ductwork (existing to remain, altered or new) ❑ Chillers ❑ Ventilation ❑ Boilers ❑ Zonal Systems/Terminal Boxes Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 2 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 C. COMPLIANCE RESULTS Table C will indicate if the project data input into the compliance document is compliant with mechanical requirements. This table is not editable by the user. If this table says "DOES NOT COMPLY" or "COMPLIES with Exceptional Conditions" refer to Table D., or the table indicated as not compliant for guidance. 01 AND 02 AND 03 AND 04 AND 05 AND 06 AND 07 AND 08 09 System Summary 110.1 110.2 140.4 Pumps 140.4 k Fans/ Economizers 140.4 c , System Controls 110.2 120 2' 140.4 f Ventilation 120.1 (See Table J) Terminal Box Controls 140.4 d Distribution 120.3 140.4 I (See Table L) Cooling Towers §110.2(e)2 (See Table M) Compliance Results 140.4 e (See Table K) (See Table F) (See Table G) (See Table H) (See Table 1) Yes AND AND I I AND Yes AND AND AND AND COMPLIES Mandatory Measures Compliance (See Table Qfor Details) COMPLIES D. EXCEPTIONAL CONDITIONS This table is auto filled with uneditable comments because of selections made or data entered in tables throughout the form. E. ADDITIONAL REMARKS This table includes remarks made by the permit applicant to the Authority Having Jurisdiction. Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 3 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 F. HVAC SYSTEM SUMMARY (DRY & WET SYSTEMS) This table is used to demonstrate compliance for mechanical equipment with mandatory requirements found in 110.1 and 110.2 a and prescriptive requirements found in 140.4 a §140.4(bl and 140.4Lkj or 1141.0(bj2 for alterations. Dry System Equipment Sizing (includes air conditioners, condensers, heat pumps, VRF, furnaces and unit heaters) 01 02 03 04 05 06 07 08 09 10 11 Equipment Sizing per Mechanical Schedule (kBtu/h) 140.4 (a&b) Smallest Size Heating Output2,3 Cooling Output2-3 Load Calculations3,4 Name or Item Equipment Category per Equipment Type per Tables 110.2 /Title Available' Total Tag Tables 110.2 20 140.4 a Supp. Sensible Total Sensible Per Design Rated Heating Per Design Rated Heating Cooling (kBtu/h) (kBtu/h) Output (kBtu/h) (kBtu/h) Load Load (kBtu/h) (kBtu/h) (kBtu/h) Duo Pac PTAC/ PTHP PTHP replacements Yes 90000 1 87000 1 0 1 60000 1 60000 1 70000 150000 'FOOTNOTES: Equipment shall be the smallest size, within the available options of the desired equipment line, necessary to meet the design heating and cooling loads of the building per 140.4 a . Healthcare facilities are excepted. 21t is common practice to show rated output capacity on the equipment schedule. Sensible cooling output comes from specification sheet tables. I If equipment is heating only, leave cooling output and load blank. If equipment is cooling only, leave heating output and load blank. 4 Authority Having Jurisdiction may ask for load calculations used for compliance per 114Q.4Lb J. Dry system Equipment Efficiency (Package Terminal Air Conditioners (PTAC) and Package Terminal Heat Pumps (PTHP) only) 01 02 03 04 05 06 07 Heating Mode Cooling Mode Minimum Name or Item Tag COP Rated Output Minimum EER Rated Output Capacity (kBtu/h) Required Design COP Capacity (kBtu/h) Required per Tables Design EER per Table 110.2-E 110.2-E Duo Pac 87000 2.5 3.5 60000 7.6 16 G. PUMPS This section does not apply to this project. Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Schema Version: rev 20200601 Report Generated: 2022-05-25 11:53:42 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 4 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 H. FAN SYSTEMS & AIR ECONOMIZERS This section does not apply to this project. I. SYSTEM CONTROLS This table is used to demonstrate compliance with mandatory controls in 110.2 and 120.2 and prescriptive controls in 140.4 and (n) or requirements in §141.0(b)2E for altered space conditioning systems. 01 02 03 04 05 06 07 08 09 Conditioned Thermostats Shut -Off Isolation Supply Air System Name System Floor Area 110.2 b & (c)1, Controls Zone Demand Response Temp. Reset Window Interlocks per Zoning Being Served §120.2(a)or §141.0(b)2E 120.2 e Controls 110.12 and 120.2 b 140.4 f 140.4 n (ftz) 120 2 Duo Pac Multi -zone <= 25,000 ftz Setback Occ. Sensor Occ. Sensor NA: PTAC, PTHP, Rm AC, HP NA. Alteration NA: Alteration Project 'FOOTNOTES: Gravity gas wall heaters, gravity floor heaters, gravity room heaters, non -central electric heaters, fireplaces or decorative gas appliances, wood stoves are not required to have setback thermostats. *Notes: Controls with a * require a note in the space below explaining how compliance is achieved. EX: system 1: SA Temp Reset: Exempt because zones compliant with 140.4 d ; EXCEPTION 1 to 140.4 f J. VENTILATION AND INDOOR AIR QUALITY This section does not apply to this project. K. TERMINAL BOX CONTROLS This section does not apply to this project. L. DISTRIBUTION (DUCTWORK and PIPING) This section does not apply to this project. M. COOLING TOWERS This section does not apply to this project. Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 5 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 N. DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION Selections have been made based on information provided in previous tables of this document. If any selection needs to be changed, please explain why in Table E Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at https://www.energy.ca.gov/title24/2019standards/2019 compliance documents/Nonresidential Documents/NRCl/ Form/Title Field Inspector Pass Fail NRCI-MCH-01-E - Must be submitted for all buildings ❑ ❑ O. DECLARATION OF REQUIRED CERTIFICATES OF ACCEPTANCE Selections have been made based on information provided in previous tables of this document. If any selection needs to be changed, please explain why in Table E Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at https://www. energy.ca.gov/title24/2019standards/2019 compliance-documents/Nonresidential Documents/NRCA/ Form/Title Systems/Spaces To Be Field Verified Field Inspector Pass =ail NRCA-MCH-19-A Occupancy Sensor Controls Duo Pac ❑ ❑ P. DECLARATION OF REQUIRED CERTIFICATES OF VERIFICATION There are no NRCV forms required for this project. Q. MANDATORY MEASURES DOCUMENTATION LOCATION This table is used to indicate where mandatory measures are documented in the plan set or construction documentation. 01 02 Compliance with Mandatory Measures documented through MCH Mandatory Measures Note Block Yes N/A Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 STATE OF CALIFORNIA Mechanical Systems NRCC-MCH-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-E Project Name: Vanderplas Report Page: (Page 6 of 6) Project Address: Date Prepared: 2022-05-25T14:53:28-04:00 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Hannah Kendrick Company: Signature Date: Address: CEA/ HERS Certification Identification (if applicable): City/State/Zip: Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer) 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Company: Date Signed: Address: License: City/State/Zip: Phone: Registration Number: Registration Date/Time: Registration Provider: Energy Code Ace CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance Report Version: 2019.1.003 Report Generated: 2022-05-25 11:53:42 Schema Version: rev 20200601 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC) Project Name: CF1R-ALT-02-E (Page 1 of 3) Ruth Vanderplas I Date Prepared: 2022-05-06 A. General Information CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CF111-ALT-02 document for each dwelling unit. 01 Project Name Ruth Vanderplas 02 Date Prepared 2022-05-06 03 Project Location 47647 Caleo Bay #250 04 Building Type Single family 05 CA City La Quinta 06 Dwelling Unit Name Ruth Vanderplas Dwelling Unit Conditioned Floor 07 Zip Code 92253 08 Area (ft2) 1000 Number of Space Conditioning LO9 Climate Zone 15 10 (SC) Systems in this Dwelling 1 1 Unit: B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 SC System ID or SC System CFA served by this Is the SC system a Installing a refrigerant Installing new SC Installing more Installing entirely Installing entirely Name Location or Area SC System (ft2) ducted system? d containing system than 40 feet of new duct system? new SC system? Alteration Type Served component? components? ducts? Altered space System 1 Location 1 1000 Yes Yes Yes No No No conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. Registration Number: 422-A020066663A-000-000-0000000-0000 Registration Date/Time: 2022-05-06 10:30:38 HERS Provider: CHEERS NOTICE: This document has been generated by ConSol Home Energy Efficiency Rating System Services, Inc. (CHEERS) using information uploaded by third parties not affiliated with or related to CHEERS. Therefore, CHEERS is not responsible for, and cannot guarantee, the accuracy or completeness of the information contained in this document. CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.006 Report Generated: 2022-05-06 10:39:05 Schema Version: rev 20210501 CERTIFICATE OF COMPLIANCE CF111-ALT-02-E Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC) (Page 2 of 3) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) 01 02 03 04 05 06 07 08 09 10 11 12 13 SC System Heating Cooling Description Altered Heating Minimum Altered Cooling Minimum Required New or System ID/ of Area Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct Name Served System Type Components Type Value System Type Components Type Value Type Duct Length R-Value Central All new Central All new N/A- no System 1 Location 1 packaged HP heating AFUE 0.8 packaged AC cooling SEER 16 Setback ducts n/a components components replaced. Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems - Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16) CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced -Leakage rate compliance: <= 15 percent or <= 10 percent leakage to outside, or seal all accessible leaks. CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH-25 is required. Exceptions: Duct systems registered with HERS provider as previously sealed are exempt from MCH-20 Duct Leakage Testing requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH-23, or Refrigerant Charge MCH-25. Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH-20 Duct Leakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 422-A020066663A-000-000-0000000-0000 Registration Date/Time: 2022-05-06 10:30:38 HERS Provider: CHEERS NOTICE: This document has been generated by ConSol Home Energy Efficiency Rating System Services, Inc. (CHEERS) using information uploaded by third parties not affiliated with or related to CHEERS. Therefore, CHEERS is not responsible for, and cannot guarantee, the accuracy or completeness of the information contained in this document. CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.006 Report Generated: 2022-05-06 10:39:05 Schema Version: rev 20210501 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF-IR-ALT HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Kevin Burgeson K." Yv 3 Lw Company: Signature Date: Burgesons Heating & Air Conditioning 2022-05-06 Address: CEA/ HERS Certification Identification (if applicable): 620 Tennessee Street City/State/Zip: Phone: Redlands CA 92374 909-792-2222 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Kevin Burgeson K.evi Yv 3 Lw Company: Date Signed: Burgesons Heating & Air Conditioning 2022-05-06 Address: License: 620 Tennessee Street 263871 City/State/Zip: Phone: Redlands CA 92374 909-792-2222 Digitally signed by ConSol Home Energy Efficiency Rating System Services, Inc. (CHEERS). This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 422-A020066663A-000-000-0000000-0000 Registration Date/Time: 2022-05-06 10:30:38 HERS Provider: CHEERS NOTICE: This document has been generated by ConSol Home Energy Efficiency Rating System Services, Inc. (CHEERS) using information uploaded by third parties not affiliated with or related to CHEERS. Therefore, CHEERS is not responsible for, and cannot guarantee, the accuracy or completeness of the information contained in this document. CA Building Energy Efficiency Standards - 2019 Residential Compliance Report Version: 2019.1.006 Report Generated: 2022-05-06 10:39:05 Schema Version: rev 20210501 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 01/20) ASIll CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: Vanderplas La Quinta Enforcement Agency: Permit Number: BMCH2022-0248 Project Address:47647 Caleo Bay City La Quinta Zip Code: 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste. 250 Compliance Results: Enforcement Agency Use:Initial/Date Complies () Does NOT Comply Verify measured outside airflow sensor reading is within 10% of the total required outside airflow. Required for all newly installed HVAC units. Reference NRCC-MCH-E. Intent: Submit one Certificate of Acceptance for each system that must demonstrate compliance. NRCA-MCH-02-A can be performed in conjunction with NRCA-MCH-07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. A. Construction Inspection Building: Floor: 1st Room/Area/Zone: Ste. 250 Control/System: 5t RTU Prior to Functional Testing, verify and document all of the following 1. Required Documentation (all must be checked). R1 a. I NRCC-MCH-E as approved by the authority having jurisdiction. (§10-103(a)2A) 2. System type —Select either Constant Air Volume (CAV) or Variable Air Volume (VAV) below: 0 a. VAV only: i. I Outside airflow is either factory calibrated or field calibrated (check one of the following). ® A factory calibrated. (NA 7.5.1.1.1 (a)) ® B field calibrated. (NA 7.5.1.1.1(b)) ii. Damper Control (check all of the following): ❑ A Dynamic damper control is being used to control outside air. (NA 7.5.1.1.1 (c)) ❑ B Dynamic damper is NOT a fixed minimum damper. (NA 7.5.1.1.1, §120.1(f12) iii. Identify the dynamic control being utilized to control outside air. (NA 7.5.1.1.1 (d)) ❑ Describe control: b. CAV only (check all of the following): ❑✓ i. System is designed to provide a fixed minimum outside air when the unit is on. (NA 7.5.1.2.1 (a)) ❑✓ ii. Minimum position is marked on the outside air damper. (NA 7.5.1.2.1 (d)) ❑✓ iii. The system has means of maintaining the minimum outdoor air damper position. (NA 7.5.1.2.1 (e)) 3. Method of delivering outside air to the heating or cooling unit (select one of the following): (NA 7.5.1.1.1 (e), NA 7.5.1.2.1 (b)) a' Return Plenum Ducted: Confirm that outside air is ducted to within 5 or 15 ft. (with direction and velocity requirement) of the heating or cooling unit as specified by NRCC-MCH-E, Section H. (§120.1(e)1 &2) ® b' Direct Unit Ducted. Return air plenum is NOT used to distribute outside air to the heating or cooling unit. (i.e. outside air is ducted directly to the unit, outside air is provided independent of the unit, or economizer). 4. Pre -occupancy Purge a'I Verify that the pre -occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide ventilation as indicated on NRCC-MCH-E. (VAV - NA 7.5.1.1.1 (f) , CAV - NA 7.5.1.2.1 (c), §120.1(c1 2) Construction Inspection Compliance Results: G Complies © Does NOT Comply CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA ASIll OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Name: Vanderplas La Quinta Enforcement Agency: Permit Number: BMCH2022-0248 Project Address:47647 Caleo Bay City La Quinta Zip Code: 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste. 250 B. Functional Testing Building: Floor: Room/Area/Zone: Control/System: 1 St Ste. 250 5t RTU Steps: CAV VAV 1 Disable demand control ventilation (if applicable) ❑✓ Check if NA ❑ ❑ Verify unit is not in economizer mode during test 2 (economizer disabled) ❑ Check if NA ❑✓ ❑ (VAV - NA 7.5.1.1.2 Step 1, CAV — NA 7.5.1.2.2 Step 1) 3 CAV and VAV testing at full supply airflow a' Adjust supply air to achieve design airflow or maximum airflow at full cooling. El (NA 7.5.1.1.2 Step 21 Measured outdoor airflow reading (cfm) b' (VAV - NA 7.5.1.1.2 Step 2a, CAV — NA 7.5.1.2.2 Step 2a) 261 cfm cfm C. Required outdoor airflow (cfm) 250 (refer to NRCC-MCH-E, Section J). cfm cfm Time for outside air damper to stabilize after full supply airflow is achieved (minutes): d (NA 7.5.1.1.2 Step 2b) min 4 VAV testing at reduced supply airflow a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or ❑ 30% of the total design airflow. (NA 7.5.1.1.2 Step 3) b. Measured outdoor airflow reading (cfm). [NA 7.5.1.1.2 Step 3a] cfm Required outdoor airflow (cfm) C. (refer to NRCC-MCH-E, Section J). cfm Time for outside air damper to stabilize after reduced supply airflow is achieved d. (minutes): (NA 7.5.1.1.2 Step 3b) min 5 Return to initial conditions (NA 7.5.1.1.2 Step 4) ❑✓ ❑ 6 Calculations Determine Percent Outside Air at full supply airflow (%OAFA) for Step 3. (§120.1(fl1) %OAFA = Measured outdoor airflow reading /Required outdoor airflow. 104.4 % % a 100 x (Step3b/Step3c) b. %OAFA is within 10% of design Outside Air. (90% <_ %OAFA <_ 110%) Q P / F Q ® P / F O C. Outside air damper position stabilizes within 5 minutes. (Step 3d < 5 minutes) O P / F VAV only: Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 4. (§120.1(fl21 %OARA = Measured outdoor airflow reading /Required outdoor airflow reading. a 100 x (Step4b/Step4c) % b. %OARA is within 10% of design Outside Air. (90% <_ %OARA <_ 110%) © P / F C. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) P / F Functional Testing Compliance Results: Q Complies () Does NOT Comply CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Name: Vanderplas La Quinta Enforcement Agency: Permit Number: BMCH2022-0248 Project Address:47647 Caleo Bay City La Quinta Zip Code: 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste. 250 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Petra SOUCkova Documentation Author Signature: 10eft b S'oawkova Documentation Author Company Name: AH P TESTING Date Signed: 04/1 2/23 Address:74801 Hovley Ln. East, Unit #12732 ATT Certification Identification (If applicable): City/State/Zip: PALM DESERT, CA 92260 Phone:760-895-9434 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 NAT 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made av/aifable ith the building permit(s) issued for the building. Field Technician Name: ROBERTBACHUS Field Technician Signature: Field Technician Company Name:AHP TESTING Position with Company (Title): FIELD TECHNICIAN Address:74801 Hovley Ln. East, Unit #12732 ATT Certification Identification (if applicable): City/State/Zip: PALM DESERT, CA 92260 Phone:760-702-4772 Date Signed:04/12/23 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 NAT 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Dustin Coon Responsible Acceptance Person Signature: DU, &'t Cooa Responsible Acceptance Person Company Name:Burgeson's Heating tic AC II Position with Company (Title): Sales Address:620 Tennessee St. CSLB License: 263871 City/State/Zip: Redlands, CA 92374 Phone:909-792-2222 Date Signed: 04/12/23 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 1 of 4) Project Name Vanderplas Enforcement Agency' La Qulnta Permit Number:BMCH2O22-0248 Project Address 47647 Caleo Bay City La Quinta Zip Code 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste. 250 Compliance Results: Enforcement Agency Use: Checked by/Date Complies ® Does NOT Comply Submit one Certificate of Acceptance for each room, area, or zone that is directly or indirectly served by a thermostatic controls Intent: system. Includes construction inspection for an optional economizer that has been certified to the Energy Commission. A. Construction Inspection Building: 47647 Caleo Bay Floor: 1 St Room/Area/Zone: Ste. 250 Control/System 5t RTU Prior to Functional Testing, verify and document all of the following 1. Required Documentation (check all of the following): ❑✓ a. NRCC-MCH-E as approved by the authority having jurisdiction is available for reference. (§10-103(a)2A) A printed copy of the OpenADR 2.Oa or OpenADR 2.Ob Virtual End Node (VEN) certificate for the demand response control system (§110.12(a)1A); OR ❑✓ b. A certificate from the manufacturer stating that the demand response control system is capable of responding to a demand response signal from a certified OpenADR 2.Ob Virtual End Node by automatically implementing the control functions requested by the Virtual End Node for the equipment it controls. (§110.12(a)1B) Note: Demand responsive controls may incorporate and use protocols in addition to (not instead of) the protocols listed above. (§110.12(a)3) 2. Thermostatic controls for each zone served by the system (check one of the following): Q a. Thermostat is located within the space -conditioning zone that is served by the HVAC system (NA 7.5.2.1(a), §120.2(a)). b' An Energy Management Control system is installed to comply with the requirement of one or more thermostatic controls. (§120.2(a)) Q C. An independent perimeter heating or cooling system that serves more than one zone without individual thermostatic controls is installed (check all of the following): (Exception to §120.2(a)) ❑ I i All zones served by the perimeter system are also served by an interior cooling system; and ❑ li The perimeter system is designed solely to offset envelope heat losses or gains; and ❑ lii The perimeter system has at least one thermostatic control for each building orientation of 50 feet or more; and ❑ Iv The perimeter system is controlled by at least one thermostat located in one of the zones served by the system. 3. Criteria for Thermostatic zone controls (check all of the following): a. Set Points and Dead -band (check one of the following): ® The thermostatic control is used to control comfort heating only and is capable of being set, locally or remotely, down to 55°F or lower. (§120.2(b)11 © ii The thermostatic control is used to control comfort cooling only and is capable of being set, locally or remotely, up to 85°F or higher. (§120.2(b)2) • ® iii The thermostatic control is used to control both comfort heating and comfort cooling and requires manual changeover between heating and cooling modes. (Exception to §120.2(b)3) © iv The thermostatic control is used to control both comfort heating and comfort cooling and does NOT require manual changeover between heating and cooling modes and is capable of all of the following: (§120.2(b)3) ✓❑ A A minimum heating setpoint of 55°F or lower; and ✓❑ B A maximum cooling setpoint of 857 or higher; and C A temperature range or dead band of at least 57 within which the supply of heating and cooling energy to the zone is shut off or reduced to a minimum. b. ADDITIONAL THERMOSTATIC CONTROLS (check one of the following): Q i The heating or cooling systems is NOT a heat pump system and is NOT controlled by an Energy Management Control System, and has a clock mechanism that allows the building occupant to program the temperature setpoints for at least four periods within 24 hours (a setback thermostat). (§120.2(b)4, §110.2(c)1) C) ii Thermostatic control NOT required. The heating or cooling system is NOT a heat pump system and is NOT controlled by an Energy Management Control System, and is one of the following (check one of the following): (Exception to §110.2(c)) ❑ A Gravity gas wall heater CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 2 of 4) Project Name: VanderplaS Enforcement Agency: La Quinta Permit Number: BMCH2O22-0248 Project Address: 47647 Caleo Bay City La Quinta Zip Code 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste. 250 A. Construction Inspection Building: Floor: Room/Area/Zone Control/System 47647 Caleo Bay 1 St Ste. 250 5t RTU Prior to Functional Testing, verify and document all of the following ❑ B Gravity floor heater ❑ C Gravity room heater ❑ D Non -central electric heater, fireplace or decorative gas appliance, wood stove, room air conditioner, or room air - conditioner heat pump. • O iii The heating or cooling system is a heat pump with supplementary electric resistance heaters and has all of the following controls (check all of the following): The cut -on temperature for compression heating is higher than the cut -on temperature for supplementary ❑✓ A heating, and the cut-off temperature for compression heating is higher than the cut-off temperature for supplementary heating. 1110.2(b)21 Verify that supplementary heater operation is prevented when the heating load can be met by the heat pump alone (§110.2(b)1), UNLESS the thermostatic controls provide preferential rate control, intelligent recovery, ❑ B staging, ramping or another control mechanism designed to preclude the unnecessary operation of supplementary heating; supplementary heater operation is limited the following conditions: • Defrost • Transient Periods (i.e., start-ups or following thermostat setpoint advance) (Exception to §110.2(b)1) 4. Demand Response Controls & Demand Responsive Zonal HVAC Controls (check all of the following) a. Verify that the demand responsive controls are capable of communicating using one or more of the following for communications that occur within the building: Wi-Fi, ZigBee, BACnet, Ethernet, or hard -wiring. (§110.12(a)2) b Verify that when the demand responsive control communications are disabled or unavailable, all demand responsive controls continue to perform all other control functions provided by the control. (§110.12(a)4) Verify that the demand response control system has been certified to the Energy Commission as meeting all of the ❑✓ c. requirements in Joint Appendix 5 (Occupant Controlled Smart Thermostat). (§110.12(a)5) https://ww2.energy.ca.gov/title24/equipment cert/ocst/index.html d Verify that the controls are programmed to provide an adjustable rate of change for the temperature setup increase, decrease, and reset. (§110.12(b)4) e. Verify that the controls have the following features: (check all of the following) (§110.12(b)5) ❑✓ i. Disabled. Disabled by authorized facility operators; (§110.12(a)5A) ❑✓ ii. Manual control. Manual control by authorized facility operators to allow adjustment of heating and cooling set points globally from a single point in the EMCS. (§110.12(a)5B) Automatic Demand Shed Control. Upon receipt of a demand response signal, the space conditioning systems conduct a ❑✓ iii. centralized demand shed for non -critical zones during the demand response period. (§110.12(b)1, §110.12(b)2, and §110.12(a)5C) 5. OCCUPANCY AND PRE -OCCUPANCY PROGRAMMING (check all of the following) ❑✓ a. Occupied, unoccupied, and holiday schedules have been programmed per the schedule provided. (NA7.5.2.1(c)) ❑✓ b Pre -occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide ventilation by (check one of the following). (NA7.5.2.1(d), §120.1(d)2) i The minimum CFM specified by design for the heating or cooling unit; reference NRCC-MCH-E, Section J. (§120.1(d)2) 0 ii Three complete air changes to the zone served by the heating or cooling unit as specified by design; reference NRCC-MCH-E, Section J (§120.2(d)2) 6. If an economizer is installed that is certified to the Energy Commission (check all of the following): (NA7.5.4.1) ❑✓ a. Verify that the economizer has been certified to the Energy Commission at the Energy Commission website: (NA7.5.4.1(a)-(e),(h),&(I), §140.4(e)2) http://www.energy.ca.gov/title24/equipment cert/ae/index.html ❑✓ b. Economizer damper moves freely without binding. (NA7.5.4.1(f)) Unitary systems with an economizer have control systems, including two -stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling (NA7.5.4.1(g)) ❑✓ d System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. (NA7.5.4.1(i)) ❑✓ e. I For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. (NA7.5.4.1(i)) CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) 4ia AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 3 of 4) Project Name. Vanderplas Enforcement Agency: La Quinta Permit Number. BMCH2O22-0248 Project Address. 47647 Caleo Bay City. La Quinta Zip Code. 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste. 250 A. Construction Inspection Building: 47647 Caleo Bay Floor: 1 St Room/Area/Zone: Ste. 250 Control/System 5t RTU Prior to Functional Testing, verify and document all of the following ❑ I f. I For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. (NA7.5.4.1(k)) Construction Inspection Compliance Results: (i) Complies O Does NOT Comply B. Functional Testing Building: 47647 Caleo Bay Floor: 1st Room/Area: Ste. 250 Control/System: 5t RTU Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpected interactions. (NA7.5.2.2 Step 1) Occupied Mode Step 2: Heating load during occupied condition (NA7.5.2.2 Step 21 Step 3: No-load during occupied condition (NA7.5.2.2 Step 31 Step 4: Cooling load during occupied condition (NA7.5.2.2 Step 41 Unoccupied Mode Step 5: No-load during unoccupied condition (NA7.5.2.2 Step 5) Step 6: Heating load during unoccupied condition (NA7.5.2.2 Step 0 Step 7: Cooling load during unoccupied condition (NA7.5.2.2 Step 7) Step 8: Manual override (NA7.5.2.2 Step 8) As each test applies, enter in the box either Pass (P), Fail (F), or Does Not Apply (X) 8 7 6 5 4 3 2 a. Supply fan operates continuously (NA7.5.2.2 Step 2(a), Step 3(e), Step 4(h)) X X X b. Supply fan turns off (NA7.5.2.2 Step 5(I)) X C. Supply fan cycles on and off (NA7.5.2.2 Step 6(o), Step 7(s)) X X d. System operates in "occupied" mode (NA7.5.2.2 Step %w)) X e System reverts back to "unoccupied" mode when manual override time period expires (NA7.5.2.2 Step 8(x)) X f. The unit provides heating (NA7.5.2.2 Step 2(b), Step 6(p)) X X g. No heating is provided by the unit (NA7.5.2.2 Step 3(f), Step 4(Il, Step 5(n), Step 7(u)) X X X X h. No cooling is provided by the unit (NA7.5.2.2 Step 2(c), Step 3(f), Step 5(n), Step 6(g)) X X X X i. Cooling is provided by the unit (NA7.5.2.2 Step 4(i), Step 7(t)) X X j. Outside air damper is at minimum position (NA7.5.2.2 Step 2(d), Step 3(g), Step 4(k)) X X X k. Outside air damper closes completely (NA7.5.2.2 Step 5(m)) X I. Outside air damper is either closed or at minimum position (NA7.5.2.2 Step 6(r), Step 7(v)) X X Step 9: Functional Testing Results (NA7.5.2.2 Step 9) Enter: P/F/X P P P P P P P Step 10: System returned to initial operating conditions after all tests have been completed. Functional Test Compliance Results: O Complies © Does NOT Comply CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems (Page 4 of 4) Project Name: Vanderplas Enforcement Agency: La Qulnta Permit Number: BMCH2O22-0248 Project Address: 47647 Caleo Bay City La Quinta Zip Code 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste. 250 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Petra SOUCkova Documentation Author Signature: AeftaS'owkwa Documentation Author Company Name:AHP TESTING Date Signed: 4/12/23 Address:74801 Hovley Ln. East, Unit #12732 ATT Certification Identification (If applicable): City/State/Zip: PALM DESERT, CA 92260 Phone:760-895-9434 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available th building permit(s) issued for the building. Field Technician Name: Robert BaChus Field Technician Signature: Field Technician Company Name:AHP TESTING Position with Company (Title): FIELD TECHNICIAN Address:74801 Hovley Ln. East, Unit #12732 ATT Certification Identification (if applicable): City/State/Zip: PALM DESERT, CA 92260 Phone:760-702-4772 Date Signed: 4/12/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Dustin Coon Responsible Acceptance Person Signature: oad&t COW Responsible Acceptance Person Company Name: Position with Company (Title): Sales Burgeson's Heatinq & AC Inc Address:620 Tennessee St. CSLB License:263871 City/State/zip: Redlands, CA 92374 Phone: 909-792-2222 Date Signed: 4/12/23 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised: 01/20) CALIFORNIA ENERGY COMMISSION 0 CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 1 of 3) Project Name:Vanderplas Enforcement Agency: La Quinta Permit Number:BMCH2O22-0248 Project Address:47647 Caleo Bay City: La Quinta Zip Code: 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste.250 Compliance Results: Enforcement Agency Use: Checked by/Date 0 Complies Q Does NOT Comply Construction inspection and functional testing for an air economizer to verify that the HVAC system can use outdoor air to satisfy Intent: space -cooling loads. Intended for air economizers that are NOT already certified to the Energy Commission. Submit one Certificate of Acceptance for each system that must demonstrate compliance. (NA7.5.4, §140.4(e)) A. Construction Inspection Building: Floor: Room/Area/Zone: Control/System: 47647 Caleo Bay 1st Ste. 250 5t RTU Prior to Functional Testing, verify and document all of the following 1. Required documentation must be available for review (check all of the following). ❑✓ a. All documentation shipped with the economizer including manuals and performance curves. 2' Verify the economizer is set to the Required High Limit setting according to the economizer Device Type and Climate Zone where installed (check one compliance path and all applicable NOTES). (Table 140.4-E, NA7.5.4.1(a), §140.4(e)2C) Required High Limit Setting (Economizer off when :) Equation Description Device Type Climate Zone ❑ 1, 3, 5, 11-16 ToA > 75°F Outdoor air temperature exceeds 75°F. ❑ 2, 4, 10 ToA > 73°F Outdoor air temperature exceeds 73°F. 4 ✓❑ Fixed Dry Bulb ✓❑ 6, 8, 9 ToA 71°F Outdoor temperature 71°F. o > air exceeds v El7 ToA > 69°F Outdoor air temperature exceeds 69°F. ro V ❑ 1, 3, 5, 11-16 ToA > TRA Outdoor air temperature exceeds return air temperature. ❑ 2, 4, 10 ToA > TRA- 2°F Outdoor air temperature exceeds return air E ❑ Differential Dry Bulb temperature minus 2°F. El 6, 8, 9 ToA > TRA - 4°F Outdoor air temperature exceeds return air 00 _ temperature minus 4°F. ❑ 7 ToA > TRA 6°F Outdoor air temperature exceeds return air Cr W temperature minus 6°F. °C ❑ Fixed Enthalpy and All hoA > 28 Btu/lb or Outdoor air enthalpy exceeds 28 Btu/Ib of dry air or ° L Fixed Dry-bulb ToA > 75°F Outdoor air temperature exceeds 75°F. aOthers such as Dew Point, Fixed Enthalpy, May not be used in any Climate Zone in California unless approval for use ❑ Electronic Enthalpy, and Differential Enthalpy is provided by the Energy Commission Executive Director. u c m Controls APPROVAL MUST BE ATTACHED. c- E ❑ NOTE: Devices with selectable (rather than adjustable) setpoints must be set to within 2°F and 2 Btu/lb of the setpoint listed. u NOTE for Fixed Enthalpy At altitudes substantially different than sea level, the Fixed Enthalpy limit value must be set to the ❑ and Fixed Dry-bulb devices o enthalpy value at 75°F and 50% relative humidity. As an example, at approximately 6,000 foot elevation, the fixed enthalpy limit is approximately 30.7 Btu/lb. 3. Economizer reliability features are present as specified in the Energy Code (check all of the following): (NA 7.5.4.1(h), §140.4(e)2D) 0 a. 5-year manufacturer warranty of economizer assembly (§140.4(e)2Di) The economizer assembly (including but not limited to outdoor air damper, return air damper, drive linkage, and actuator) 0 b. have been tested and are able to open and close against the rated airflow and pressure of the system for 60,000 damper opening and closing cycles. (§140.4(e)2Dii) C. The outdoor air and return air dampers have a maximum leakage rate of 10 cfm/sf at 250 Pascals (1.0 inch of water) when tested in compliance with AMCA Standard 500-D. (§140.4(e)2Diii) d If the high -limit control is fixed dry-bulb or fixed enthalpy + fixed dry-bulb, then it must have an adjustable setpoint. (NA7.5.4.1(b), §140.4(e)2Div) CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised: 01/20) CALIFORNIA ENERGY COMMISSION 0 CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) Project Name:Vanderplas Enforcement Agency: La QUlnta Permit Number:BMCH2O22-0248 Project Address: 47647 Caleo Bay City: La Quinta Zip Code: 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste.250 A. Construction Inspection Building: 47647 Caleo Bay Floor: 1st Room/Area/Zone: Control/System: Ste. 250 5t RTU e' Outdoor air, return air, mixed air, and supply air sensors must be calibrated as follows (check all of the following): (140.4(e)2Dv) ❑✓ i. Dry-bulb and wet -bulb temperatures accurate to ±2°F over the range of 40°F to 80°F ❑✓ ii. Enthalpy accurate to ±3 Btu/Ib over the range of 20 Btu/Ib to 36 Btu/Ib ❑✓ iii. I Relative humidity (RH) accurate to ±5% over the range of 20%to 80% RH f Sensor performance curve(s) is provided with the economizer instruction materials that plotted data used for economizer control as well as plotted sensor output value measurements during calibration. (NA7.5.4.1(d) & (e), §140.4(e)2Dvi) g' Sensors used for high limit control shall be located to prevent false readings, including but not limited to being properly shielded from direct sunlight. (NA7.5.4.1(c), §140.4(e)2Dvii) 4. Economizer additional features (check all of the following): ❑✓ a. Economizer damper moves freely without binding. (NA7.5.4.1(f)) ❑✓ b Unitary systems with an economizer have control systems, including two -stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling (NA7.5.4.1(g)) c' System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. (NA7.5.4.1(i)) (Check one of the following): d. For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. (NA7.5.4.1(i)) Q e. For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. (N67.5.4.1(k)) Construction Inspection Compliance Results: ®' Complies 0 Does NOT Comply B. Functional Testing Building: 47647 Caleo Bay Floor: 1 St Room/Area/Zone: Ste. 250 Control/System: 5t RTU Step 1: Disable demand control ventilation systems (if applicable) (NA7.5.4.2 Step 1) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open (record all of the following): (NA7.5.4.2 Step 21 a' Economizer damper modulates 100% open and that the return air damper modulates 100% closed. (NA7.5.4.2 Step 2a) • P O /F O b. All applicable fans and dampers operate as intended to maintain building pressure. (NA7.5.4.2 Step 2b) Q P / F Q C. The unit heating is disabled (if applicable). (NA7.5.4.2 Step 2c) O P / F 0 Step 3: Disable the economizer and simulate a cooling demand (record all of the following): (NA7.5.4.2 Step 31 a. Economizer damper closes to its minimum position. (NA7.5.4.2 Step 3d) Q P / F 0 b• All applicable fans and dampers operate as intended to maintain building pressure. (NA7.5.4.2 Step 3e) Q P / F o C. The unit heating is disabled (if unit has heating capability). (NA7.5.4.2 Step 3f) Q P / F Q Step 4: If unit has heating capability, simulate a heating demand and set economizer so that it is capable of operating (i.e., actual outdoor air conditions are below lockout setpoint). (record all of the following): (NA7.5.4.2 Step 41 a. Economizer is at minimum position. (NA7.5.4.2 Step 4g) (�)POF DNA b. Return air damper opens. (NA7.5.4.2 Step 4h) (�)POF ON Step 5: Turn off the unit. (NA7.5.4.2 Step 51 Record if the Economizer damper closes completely. (NA7.5.4.2 Step 5i) (�) P / F O Step 6: Restore demand control ventilation systems (if applicable) and remove all system overrides initiated. (NA7.5.4.2 Step 6) Functional Test Compliance Results: O Complies O Does NOT Comply CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised: 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Project Name: Vanderplas Enforcement Agency: La Qulnta Permit Number:BMCH2O22-0248 Project Address 47647 Caleo Bay city La Quinta Zip Code 92253 System Name or Identification/Tag: 5t RTU System Location or Area Served: Ste.250 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Petra SOUCKOVa Documentation Author Signature: PMia S'oaa6va Documentation Author Company Name: AHP TESTING Date Signed:04/12/23 Address:74801 HOVIey Ln. East, Unit #12732 ATT Certification Identification (If applicable): City/state/zip:PALM DESERT, CA 92260 Phone:760-895-9434 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 madeavail le with the building permit(s) issued for the building. Field Technician Name: Robert BaChus Field Technician Signature: Field Technician Company Name:AHP TESTING Position with Company (Title): FIELD TECHNICIAN Address:4801 HOVIey Ln. East, Unit #12732 ATT Certification Identification (if applicable): City/state/zip:PALM DESERT, CA 92260 Phone:760-702-4772 Date Signed: 04/12/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Dustin Coon Responsible Acceptance Person Signature: i%lM&Z Coon Responsible Acceptance Person Company Name:Burgeson's Heating & AC II Position with Company (Title): Sales Address:620 Tennessee St. CSLB License: 263871 City/state/zip Redlands, CA 92374 Phone:909-792-2222 Date Signed:04/12/23 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA MECHANICAL CEC-NRCI-MCH-01-E (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-MCH-01-E Mechanical (Page 1 of 2) Project Name: Vanderpla$ Enforcement Agency: La QUlnta p �t��y1 I3I�'t%HL n_'n48 Project Address :47647 Caleo Bay `'ty La Quinta Zip Code:92253 A. GENERAL INFORMATION DATE OF BUILDING PERMIT: 11-2-2022 BUILDING TYPE >❑ Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel PHASE OF ❑ New Construction ❑ Addition Alteration CONSTRUCTION If more than one person has responsibility for building construction, each person shall prepare and sign an Installation Certificate document applicable to the portion of construction for which they are responsible, alternatively, the person with chief responsibility for construction shall prepare and sign the Installation Certificate document(s) for the entire construction. B. SCOPE OF RESPONSIBILITY Date of approval by the enforcement agency of the Certificate of Compliance that provides the specifications for this Installation Certificate. Date: 04/17/2023 In the table below identify all applicable construction documents that specify the features, materials, components, manufactured devices, or system performance diagnostic results required for the scope of responsibility for this Installation Certificate. Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. Date Approved By the Enforcement Agency City Approved Plan Set All Pages 11 /02/2022 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA MECHANICAL CEC-NRCI-MCH-01-E (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-MCH-01-E Mechanical (Page 2 of 2) Project Name: Vanderpla$ Enforcement Agency: La QUlnta BrMCH2O22-0248 Project Address:47647 Caleo Bay C'ty:La Quinta Zip Code: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Dustin Coon Documentation Author Signature: T� erL Documentation Author Company Name: p /� � oo Heat U " C In Date Date Signed: 04/17/2023 Address: 620 Tennessee St CEA/ HERS Certification Identification (If applicable): na City/State/ZiP: Redlands, Ca 92374 Phone: 909-793-3685 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: Dustin Coon Responsible Builder/Installer Signature: T� erL Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position With Company (Title): Burgesons Heat & A/C Inc Sales Address. 620 Tennessee St CSLB License: 263871 City/state/Zip:Redlands, Ca 92374 Phone:909-793-3685 Date Signed 04/17/2023 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 CERTIFICATE OF INSTALLATION —USER INSTRUCTIONS NRCI-MCH-01-E Mechanical (Page 1 of 1) NRCI-MCH-01 User Instructions Section A. General Information 01. Enter the date on the building permit. 02. Indicate the appropriate building type. 03. Indicate the appropriate phase of construction. Section B. Scope of Responsibility 01. Enter the date the enforcement agency approved the Certificate of Compliance (NRCC-MCH-XX) that is used as the basis of the specifications used to demonstrate compliance. 02. Enter the construction document that specifies the installed feature, material, component, manufactured device or system performance diagnostic results required for compliance as specified on the certificate of compliance. 03. As needed, this row shall be filled according to the instructions for row B.02 04. As needed, this row shall be filled according to the instructions for row 6.02 05. As needed, this row shall be filled according to the instructions for row 6.02 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020