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BCOM2022-0025 Energy DocsSTATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: La Quinta Zip Code: 92253 System Name or Identification/Tag: ERV 1-1 System Location or Area Served: 1st Floor "South" Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent: Verify measured outside airflow reading is within 10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MCH-03 (Column 14) or Mechanical Equipment Schedules. A. Construction Inspection Note: MCH-02-A can be performed in conjunction with MCH-07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. Supporting documentation needed to perform test includes: As -built and/or design documents (for example, Mechanical Equipment Schedules, Equipment a' Start -Up Sheets or Balancing Reports). b. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At -A -Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At -A -Glance). C. 2016 Building Energy Efficiency Standards. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: Manometer ii. Equipment calibration date (must be within ^ne year, 5�2� 22 System type (check either VAV or CAV): VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: L Outs rflow is either factory calibrated or field calibrated. Check if factory calibrated and attach calibration certification. F9Check if field calibrated and attach calibration results. ii. Dam ontrol (must be checked): Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). iii. One following dynamic controls is being utilized to control outside air (check method used) Outdoor Air CFM Compensation Energy Balance Method Demand Control Ventilation Return Fan Tracking Injection Fan Method �Dedicated Minimum Ventilation Damper with Pressure Control OtherActive Control, Describe: b. Check if Co t Air Volume (CAV) and verify the following: �ystem is designed to provide a fixed minimum OSA when the unit is on. MetOdelivering outside air to the unit (check one of the following): utsid ducted to the return air plenum. Confirm that outside air is ducted to within (check one of the following): ft. of the unit. 915 ft. of the unit, with the air directed substantially toward the unit. Return air plenum is NOT used to distribute outside air to the unit. (i.e. outside air is ducted directly to the unit, outside air is provided independent of the unit, or economizer) Pre -occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): Dhe conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm Der person times the expected number of occupants, whichever is greater. omplete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: La Quinta Zip Code: 92253 System Name or Identification/Tag: ERV 1-1 System Location or Area Served: 1st Floor "South" B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing Ate VA11 Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit is not in economizer mode during test (economizer disabled) Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a' cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) 1142 cfm cfm Required outdoor airflow (cfm) (from MCH-03, Column 14, or C. Mechanical Equipment Schedules). 1160 cfm cfm d Time for outside air damper to stabilize after full supply airflow is achieved (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow (cfm) (from MCH-03, Column 14, or Mechanical Equipment Schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step 5: Return to initial conditions (check) C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 3. a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow. (Step3b/Step3c) 8 0 Yes No ° Yes No b. %OAFA is within 10% of design Outside Air. (90% <_ %OAFA <_ 110%) C. Outside air damper position stabilizes within 5 minutes. (Step 3d < 5 minutes) Yes UNo Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 4. (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading. (Step4b/Step4c) ° b. %OARA is within 10% of design Outside Air. (90% <_ %OARA <_ 110%) Yes No C. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) Yes No Note: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. D. Evaluation: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: La Quinta Zip Code: 92253 System Name or Identification/Tag: ERV 1-1 System Location or Area Served: 1st Floor "South" DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ts1 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd ATT Certification Identification (If applicable): City/State/zip: Harbor City CA Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT isl I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G Field Technician Signature: AQ Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City, CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: Zip Code: System Name or Identification/Tag: ERV 1-2 System Location or Area Served: 1 St Floor "North" Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent: Verify measured outside airflow reading is within 10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MCH-03 (Column 14) or Mechanical Equipment Schedules. A. Construction Inspection Note: MCH-02-A can be performed in conjunction with MCH-07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. Supporting documentation needed to perform test includes: As -built and/or design documents (for example, Mechanical Equipment Schedules, Equipment a' Start -Up Sheets or Balancing Reports). b. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At -A -Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At -A -Glance). C. 2016 Building Energy Efficiency Standards. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: Manometer ii. Equipment calibration date (must be within ^ne year, 5�2� 22 System type (check either VAV or CAV): VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: L Outs rflow is either factory calibrated or field calibrated. Check if factory calibrated and attach calibration certification. F9Check if field calibrated and attach calibration results. ii. Dam ontrol (must be checked): Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). iii. One following dynamic controls is being utilized to control outside air (check method used) Outdoor Air CFM Compensation Energy Balance Method Demand Control Ventilation Return Fan Tracking Injection Fan Method �Dedicated Minimum Ventilation Damper with Pressure Control OtherActive Control, Describe: b. Check if Co t Air Volume (CAV) and verify the following: �ystem is designed to provide a fixed minimum OSA when the unit is on. MetOdelivering outside air to the unit (check one of the following): utsid ducted to the return air plenum. Confirm that outside air is ducted to within (check one of the following): ft. of the unit. 915 ft. of the unit, with the air directed substantially toward the unit. Return air plenum is NOT used to distribute outside air to the unit. (i.e. outside air is ducted directly to the unit, outside air is provided independent of the unit, or economizer) Pre -occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): Dhe conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm Der person times the expected number of occupants, whichever is greater. omplete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: Zip Code: System Name or Identification/Tag: ERV 1-2 System Location or Area Served: 1 St Floor "North" B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing Ate VA11 Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit is not in economizer mode during test (economizer disabled) Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a' cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) 596 cfm cfm C. Required outdoor airflow (cfm) (from MCH-03, Column 14, or Mechanical Equipment Schedules). 585 cfm cfm d Time for outside air damper to stabilize after full supply airflow is achieved (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow (cfm) (from MCH-03, Column 14, or Mechanical Equipment Schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step 5: Return to initial conditions (check) C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 3. a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow. (Step3b/Step3c) 2 0 Yes No ° Yes No b. %OAFA is within 10% of design Outside Air. (90% <_ %OAFA <_ 110%) C. Outside air damper position stabilizes within 5 minutes. (Step 3d < 5 minutes) Yes UNo Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 4. (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading. (Step4b/Step4c) ° b. %OARA is within 10% of design Outside Air. (90% <_ %OARA <_ 110%) Yes No C. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) Yes No Note: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. D. Evaluation: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: Zip Code: System Name or Identification/Tag: ERV 1-2 System Location or Area Served: 1 St Floor "North" DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ts1 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT isl I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: Jay Field Technician Signature: Jay Field Technician Company Name: LA Air Balance Company Position with Company (Title): Technician Address: 1848 W. 11th Street Suite N ATT Certification Identification (if applicable): City/State/Zip: Upland, CA91786 Phone: 800-429-6880 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City, CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: La Quinta Zip Code: 92253 System Name or Identification/Tag: ERV 1-3 System Location or Area Served: 1st Floor "East" Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent: Verify measured outside airflow reading is within 10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MCH-03 (Column 14) or Mechanical Equipment Schedules. A. Construction Inspection Note: MCH-02-A can be performed in conjunction with MCH-07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. Supporting documentation needed to perform test includes: As -built and/or design documents (for example, Mechanical Equipment Schedules, Equipment a' Start -Up Sheets or Balancing Reports). b. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At -A -Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At -A -Glance). C. 2016 Building Energy Efficiency Standards. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: Manometer ii. Equipment calibration date (must be within ^ne year, 5�2� 22 System type (check either VAV or CAV): VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: L Outs rflow is either factory calibrated or field calibrated. Check if factory calibrated and attach calibration certification. F9Check if field calibrated and attach calibration results. ii. Dam ontrol (must be checked): Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). iii. One following dynamic controls is being utilized to control outside air (check method used) Outdoor Air CFM Compensation Energy Balance Method Demand Control Ventilation Return Fan Tracking Injection Fan Method �Dedicated Minimum Ventilation Damper with Pressure Control OtherActive Control, Describe: b. Check if Co t Air Volume (CAV) and verify the following: �ystem is designed to provide a fixed minimum OSA when the unit is on. MetOdelivering outside air to the unit (check one of the following): utsid ducted to the return air plenum. Confirm that outside air is ducted to within (check one of the following): ft. of the unit. 915 ft. of the unit, with the air directed substantially toward the unit. Return air plenum is NOT used to distribute outside air to the unit. (i.e. outside air is ducted directly to the unit, outside air is provided independent of the unit, or economizer) Pre -occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): Dhe conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm Der person times the expected number of occupants, whichever is greater. omplete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: La Quinta Zip Code: 92253 System Name or Identification/Tag: ERV 1-3 System Location or Area Served: 1st Floor "East" B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing Ate VA11 Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit is not in economizer mode during test (economizer disabled) Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a' cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) 523 cfm cfm C. Required outdoor airflow (cfm) (from MCH-03, Column 14, or Mechanical Equipment Schedules). 520 cfm cfm d Time for outside air damper to stabilize after full supply airflow is achieved (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow (cfm) (from MCH-03, Column 14, or Mechanical Equipment Schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step 5: Return to initial conditions (check) C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 3. a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow. (Step3b/Step3c) 1 0 Yes No ° Yes No b. %OAFA is within 10% of design Outside Air. (90% <_ %OAFA <_ 110%) C. Outside air damper position stabilizes within 5 minutes. (Step 3d < 5 minutes) Yes UNo Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 4. (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading. (Step4b/Step4c) ° b. %OARA is within 10% of design Outside Air. (90% <_ %OARA <_ 110%) Yes No C. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) Yes No Note: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. D. Evaluation: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: La Quinta Zip Code: 92253 System Name or Identification/Tag: ERV 1-3 System Location or Area Served: 1st Floor "East" DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ts1 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT isl I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: Jay Field Technician Signature: A Field Technician Company Name: LA Air Balance Company Position with Company (Title): Technician Address: 1848 W. 11th Street Sutie N ATT Certification Identification (if applicable): City/State/Zip: Upland, CA91786 Phone: 800-429-6880 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: Zip Code: System Name or Identification/Tag: ERV 2-1 System Location or Area Served: 2nd Floor Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent: Verify measured outside airflow reading is within 10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MCH-03 (Column 14) or Mechanical Equipment Schedules. A. Construction Inspection Note: MCH-02-A can be performed in conjunction with MCH-07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. Supporting documentation needed to perform test includes: As -built and/or design documents (for example, Mechanical Equipment Schedules, Equipment a' Start -Up Sheets or Balancing Reports). b. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.1.1 Ventilation Systems: Variable Air Systems At -A -Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At -A -Glance). C. 2016 Building Energy Efficiency Standards. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: Manometer ii. Equipment calibration date (must be within ^ne year, 5�2� 22 System type (check either VAV or CAV): VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: L Outs rflow is either factory calibrated or field calibrated. Check if factory calibrated and attach calibration certification. F9Check if field calibrated and attach calibration results. ii. Dam ontrol (must be checked): Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). iii. One following dynamic controls is being utilized to control outside air (check method used) Outdoor Air CFM Compensation Energy Balance Method Demand Control Ventilation Return Fan Tracking Injection Fan Method �Dedicated Minimum Ventilation Damper with Pressure Control OtherActive Control, Describe: b. Check if Co t Air Volume (CAV) and verify the following: �ystem is designed to provide a fixed minimum OSA when the unit is on. MetOdelivering outside air to the unit (check one of the following): utsid ducted to the return air plenum. Confirm that outside air is ducted to within (check one of the following): ft. of the unit. 915 ft. of the unit, with the air directed substantially toward the unit. Return air plenum is NOT used to distribute outside air to the unit. (i.e. outside air is ducted directly to the unit, outside air is provided independent of the unit, or economizer) Pre -occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): Dhe conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm Der person times the expected number of occupants, whichever is greater. omplete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: Zip Code: System Name or Identification/Tag: ERV 2-1 System Location or Area Served: 2nd Floor B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing Ate VA11 Step 1: Disable demand control ventilation (if applicable) Step 2: Verify unit is not in economizer mode during test (economizer disabled) Note: Shaded boxes do not apply for CAV systems Step 3: CAV and VAV testing at full supply airflow Adjust supply air to achieve design airflow or maximum airflow at full a' cooling. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm) 1010 cfm cfm C. Required outdoor airflow (cfm) (from MCH-03, Column 14, or Mechanical Equipment Schedules). 1015 cfm cfm d Time for outside air damper to stabilize after full supply airflow is achieved (minutes): min Step 4: VAV testing at reduced supply airflow CAV VAV a. Adjust supply airflow to either the sum of the minimum zone airflows, full heating, or 30% of the total design airflow. Record VFD speed (Hz). Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow (cfm) (from MCH-03, Column 14, or Mechanical Equipment Schedules). cfm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step 5: Return to initial conditions (check) C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OAFA) for Step 3. a. %OAFA = Measured outdoor airflow reading /Required outdoor airflow. (Step3b/Step3c) 0 0 Yes No ° Yes No b. %OAFA is within 10% of design Outside Air. (90% <_ %OAFA <_ 110%) C. Outside air damper position stabilizes within 5 minutes. (Step 3d < 5 minutes) Yes UNo Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 4. (VAV only) a. %OARA = Measured outdoor airflow reading /Required outdoor airflow reading. (Step4b/Step4c) ° b. %OARA is within 10% of design Outside Air. (90% <_ %OARA <_ 110%) Yes No C. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) Yes No Note: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and 2) VAV air handlers use dynamic controls to avoid over ventilation. D. Evaluation: PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Name: WelBe - Laquinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Rd City: Zip Code: System Name or Identification/Tag: ERV 2-1 System Location or Area Served: 2nd Floor DOCUMENTATION AUTHOR'S DECLARATION STATEMENT ts1 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern-AirConductloning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT isl I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: Jay Field Technician Signature: f Field Technician Company Name: LA Air Balance Company Inc. Position with Company (Title): Technitlon Address: 1848 W. 11th Street Suite N ATT Certification Identification (if applicable): City/State/Zip: Upland, CA91786 Phone: 800-429-6880 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 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: Alex GrabOW Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA AUTOMATIC DEMAND SHED CONTROL ACCEPTANCE CEC-NRCA-MCH-11-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-11-A Automatic Demand Shed Control Acceptance (Page 1 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or Identification/Tag: Trane VRF System System Location or Area Served: Entire Site Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent: I Ensure that the central demand shed sequences have been properly programmed into the DDC system A. Construction Inspection 1. Instrumentation to perform test includes, but not limited to: a. None 2.In tion: The EMCS front end interface enables activation of the central demand shed controls. B. Functional Testing a j Results Step 1: Engage the demand shed controls a• Engage the central demand shed control signal. Yes ko b• Verify that the current operating temperature set point in a sample of non -critical spaces increases by the proper amount. Yes (�)o C. Verify that the current operating temperature set point in a sample of critical spaces does not change. Yes 0 No Step 2: Disengage the demand shed controls a• Disengage the central demand shed control signal. Yes ko b• Verify that the current operating temperature set point in the sample of non -critical spaces returns to their original value. Yes c• Verify that the current operating temperature set point in the sample of critical spaces does not change. Yes o Step 3: System returned to initial operating conditions Yes o C. Testing Results PASS / FAIL Test passes if all answers are yes in Step 1 and Step 2. valuation : PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass". Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AUTOMATIC DEMAND SHED CONTROL ACCEPTANCE CEC-NRCA-MCH-11-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-11-A Automatic Demand Shed Control Acceptance (Page 2 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or Identification/Tag: Trane VRF System System Location or Area Served: Entire Site DOCUMENTATION AUTHOR'S DECLARATION STATEMENT f1 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Grabow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT t I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David Glick Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 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: Alex Gra bow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 CALIFORNIA ENERGY COMMISSION FENESTRATION ACCEPTANCE 2022-CEC-NRCA-ENV-02-F Pro'ect Name and Address Authority Having Jurisdiction Name: V,101hpEnforcement Agency: City of La Quinta Address: Lib Jut-,' L,o d Permit Number: BCOM2022-0225 City,Zip: ,•, QL,' r-cj q -3 Permit Application Date: 9/19/2023 Building: X I Floor: I Room: Control to 060 Construction inspection complies Date Submitted to AH7:10/18/20 2 Does not comply Intent: Each fenestration product must provide an NFRC Label Certificate or the California Energy Commission's Fenestration Certificate to identify the thermal performance of each fenestration product being installed (NA7.4.1) and §10- I11. The labels must be located at the job site for verification by the enforcement agency. In addition, the responsible party must fill out the Fenestration Acceptance Certificate. The responsible party must verify the thermal performance of each spedfied fenestration product being installed matches the label certificate, energy compliance documentation and building plans. A copy of the certificate and any associated documentation must be given to the building owner and the enforcement agency for their records. Responsible The responsible party must verify the following (NA7.4.1.1 and §10-103(a)): Party a) Verify that the Fenestration Certificate of Compliance (NRCC-ENV-E) and Certificate of Installation (NRCI-ENV-01-E) are completed and approved by the enforcement agency; and b) For non -rated fenestration, record the U-factor, solar heat gain coefficient (R)SHGC, and visible light transmitted (VT) for the installed fenestration product(s); and c) For rated fenestration, record the installed fenestration product(s) NFRC's Certified Product Directory (CPD) number or Certificate Number when the Component Modeling Approach Label is submitted; and d) Verify that the delivery receipt, purchase order, or detailed receipt matches the delivered fenestration product(s); and e) Verify that the thermal performance (U-Factor, (R)SHGC, VT) for the fenestration product(s) matches the building plans, energy compliance documentation (NRCC-ENV-E or NRCI-ENV-01-E), and the label certificate (b or c above); and f) Verify that the Certificate of Acceptance (this form) is completed and signed. The Certificate of Acceptance form is limited to seven (7) fenestration types, use as many forms as needed to document all fenestrations. California Energy Commission Page i of 3 January 1, 2023 0 uuvoaxu casacv c... I-ioa FENESTRATION ACCEPTANCE 2022{EC-NRCA-ENV-02-F Table A. Required Docurimmentation NA7.4.1.2 Fenestration Rated Cross Reference NRCA-ENV-E, Design -Plans Nonrated Fenestration Cross Reference Section Kor Ideri fkation Fenestration NFRC label ID RecelPt NRCI-ENV-01-E fl'l O� \# V b L - _ rJ - Matches Delivery Reoeipt(s) C 7 - aaSU`I6 ��nn 001�03' 0� W ( Matches Purchase Order tches Detailed Receipt Matches Designs Fails to match P Fails to match Matches Delivery Receipt(s) Matches Purchase Order Matches Designs Matches Detailed Receipt Falls to match Falls to match Matches Delivery Receipts) MaWm Purchase Order ❑ Matches Designs Matches Detailed Receipt ❑ Fails to match Fails to match Matches Delivery Receipt(s) Matches Purchase Order 8 Matches Designs Matches Detailed Receipt Fails to match Fails to match Matches Delivery Receipt(s) Matches Purchase Order Matches Designs Matches Detailed Receipt Fails to match Fails to match Matches Delivery Receipt(s) Matches Purchase Order ❑ Matches Designs Matches Detailed Receipt ❑ Fails to match Fails to match Matches Delivery Receipts) Matches Purchase Order ❑Matches Designs Matches Detailed Receipt ❑ Fails to match Fails to rrhatch California Energy Commission Page 2 of 3 January 1, 2023 e -1--l- --- <o h soy FENESTRATION ACCEPTANCE 2022-MC-NRCA-ENV-02-F Declaration Statement Signatory Document Author I assert that this Certificate of Acceptance documentation is accurate and complete. Feld Technkfan I certify the following under penalty of perjury, under the laws of the State of California: The information provided on this Certificate of Acceptance is true and correct I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). The construction or installation identified on this Certificate of Acceptance complies with the applicable: acceptance requirements indicated in the plans and specifications approved by the enforcement agency and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builderinstaller and has been posted or made available with the building s Issued for the buldinq. Responsible Person I assert the following under penalty of perjury, under the laws of the State of California: I am the Feld Technician, or the Reid Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations In this statement (responsible acceptance person). The information provided on this Certificate of Acceptance substantiates that the construction or installation Identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency v OI I °' and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. I have confirmed that the Certificate(s) of Installation for the construction or installation Identified on this Certificate of Acceptance has been completed and Is posted or made available with the building permit(s) issued for the building. I understand 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, and I will take the necessary steps to ensure this requirement is accomplished. 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, and I will take the necessary steps to ensure this requirement is accomplished. California Energy Commission Page 3 of 3 January 1, 2023 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CEC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Supporting documentation needed to perform test includes, but not limited to: a. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.2 Constant Volume, Single -zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At -A -Glance). b. 2016 Building Energy Efficiency Standards Manual. 2. Instrumentation to perform test may include: a. Temperature Meter b. Amp Meter 3. ❑llation (check if applies): Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. ramming (check all those that apply): Lljhermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120.2(b). heating setpoint: 68 OF. Maximum cooling setpoint 72 0F. Deadband: 4 OF. 5rcumupied, unoccupied, and holiday schedules have been programmed per the schedule provided. e-occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Che Osser hod used to determine pre -occupancy purge: of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 13 20.1-A or 15cfm per person times the expected number of occupants. complete air changes. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CEC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom B. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 5 4 3 2 Step 2 — 8: Check and verify the following for each simulation mode required a. Supply fan operates continually V/ V V V b. Supply fan turns off V C. Supply fan cycles on and off V V d. System reverts to "occupied" mode to satisfy any condition V/ e. System turns off when manual override time period expires f. Gas -fired furnace, heat pump, or electric heater stages on I/ g. No heating is provided by the unit V V/ V V h. No cooling is provided by the unit V i. Compressor stages on V j. Outside air damper is open to minimum position k. Outside air damper closes completely Yes No Step 9: System returned to initial operating conditions after all tests have been completed: C. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter P P P P P P P luation PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P). CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CFC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom DOCUMENTATION AUTHOR'S DECLARATION STATEMENT a 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT G 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern Air Cond Co Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA Phone: 310-235-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CEC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Supporting documentation needed to perform test includes, but not limited to: a. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.2 Constant Volume, Single -zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At -A -Glance). b. 2016 Building Energy Efficiency Standards Manual. 2. Instrumentation to perform test may include: a. Temperature Meter b. Amp Meter 3. ❑llation (check if applies): Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. ramming (check all those that apply): Lljhermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120.2(b). heating setpoint: 68 OF. Maximum cooling setpoint 72 0F. Deadband: 4 OF. 5rcumupied, unoccupied, and holiday schedules have been programmed per the schedule provided. e-occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Che Osser hod used to determine pre -occupancy purge: of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 13 20.1-A or 15cfm per person times the expected number of occupants. complete air changes. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CEC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South B. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 5 4 3 2 Step 2 — 8: Check and verify the following for each simulation mode required a. Supply fan operates continually V/ V V V b. Supply fan turns off V C. Supply fan cycles on and off V V d. System reverts to "occupied" mode to satisfy any condition V/ e. System turns off when manual override time period expires f. Gas -fired furnace, heat pump, or electric heater stages on I/ g. No heating is provided by the unit V V/ V V h. No cooling is provided by the unit V i. Compressor stages on V j. Outside air damper is open to minimum position k. Outside air damper closes completely Yes No Step 9: System returned to initial operating conditions after all tests have been completed: C. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter P P P P P P P luation PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P). CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CFC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City, CA Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Uaw Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title . Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City, CA Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT L 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond Co Position with Company (Title): Project Manager Address: 1086 Lomita Blvd CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone: 310-325-37-12 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CEC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Supporting documentation needed to perform test includes, but not limited to: a. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.2 Constant Volume, Single -zone, Unitary Air Conditioner and Heat Pumps Systems Acceptance At -A -Glance). b. 2016 Building Energy Efficiency Standards Manual. 2. Instrumentation to perform test may include: a. Temperature Meter b. Amp Meter 3. ❑llation (check if applies): Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. ramming (check all those that apply): Lljhermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120.2(b). heating setpoint: 68 OF. Maximum cooling setpoint 72 0F. Deadband: 4 OF. 5rcumupied, unoccupied, and holiday schedules have been programmed per the schedule provided. e-occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Che Osser hod used to determine pre -occupancy purge: of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 13 20.1-A or 15cfm per person times the expected number of occupants. complete air changes. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CEC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North B. Functional Testing Requirements Operating Modes Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpected interactions. Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupied Mode Step 5: No-load during unoccupied condition Step 6: Heating load during unoccupied condition Step 7: Cooling load during unoccupied condition Step 8: Manual override 8 7 6 5 4 3 2 Step 2 — 8: Check and verify the following for each simulation mode required a. Supply fan operates continually V/ V V V b. Supply fan turns off V C. Supply fan cycles on and off V V d. System reverts to "occupied" mode to satisfy any condition V/ e. System turns off when manual override time period expires f. Gas -fired furnace, heat pump, or electric heater stages on I/ g. No heating is provided by the unit V V/ V V h. No cooling is provided by the unit V i. Compressor stages on V j. Outside air damper is open to minimum position k. Outside air damper closes completely Yes No Step 9: System returned to initial operating conditions after all tests have been completed: C. Testing Results 8 7 6 5 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter P P P P P P P luation PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P). CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) loftkk AIR CONDITIONER AND HEAT PUMP SYSTEMS 1911 CFC-NRCA-MCH-03-A (Revised 07/16) 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 3 Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North DOCUMENTATION AUTHOR'S DECLARATION STATEMENT a 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT G 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond Co Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 1 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Supporting documentation needed to perform test includes: a. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.4 Air Economizer Controls Acceptance At -A - Glance). b. 2016 Building Energy Efficiency Standards. 2. Instrumentation to perform test includes: a. Hand-held temperature probe Calibration Date: 1/23 (must be within last year) b. Device capable of calculating enthalpy (i.e. psychrometer) Calibration Date: 1/23 (must be within last year) c. 1.2 k Ohm Resistor ( when specified by the manufacturer) 3. Installation: (all of the following boxes should be checked) Oconomizer high limit shutoff control complies with Table 140.4-B found in the 2016 Building Energy Efficiency Standards Section 140.4(e)3. Oconomizer reliability features are present per 2016 Building Energy Efficiency Standards Section 140.4(e)4: a. 5-year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product specification sheet proving compliance with AMCA Standard 500-D damper leakage at 10 cfm/ftz at 250 Pascals (1.0 in w.g). A product specification sheet showing the manufacturer's results after following the testing procedures of AMCA Standard 500-D. A product specification sheet showing the economizer outside air and return air damper leakage rates have been certified to the Energy Commission in accordance with Section 110. d. If the high limit setpoint is fixed dry-bulb or fixed enthalpy +fixed dry-bulb then the control shall have an adjustable setpoint. e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: i. Dry-bulb and wet -bulb temperatures accurate to ±2°F over the range of 40oF to 80oF ii. Enthalpy accurate to ±3 Btu/Ib over the range of 20 Btu/Ib to 36 Btu/Ib iii. Relative humidity (RH) accurate to ±5% over the range of 20% to 80% RH f. Check that the sensor performance curve(s) is provided by the factory and sensor output values measured during sensor calibration are plotted on the performance curve(s). g. Sensors used for high limit control shall be located to prevent false readings, including but not limited to being properly shielded from direct sunlight. Unitary systems with an economizer have control systems, including two -stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling. System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom B. Functional Testing Is the economizer listed in the CEC equipment certification directory? (if yes, proceed to Section D.) Yes Its No Step 1: Disable demand control ventilation systems (if applicable) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open. Verify the followin a Economizer damper modulates 100% open. Yes No b. Return air damper modulates 100% closed. Yes No C. For systems that meet the criteria of 2016 Building Energy Efficiency Standards Section 140.4(e)1, verify that the economizer remains 100% open with the use of mechanical cooling. This occurs when the cooling demand can no longer be met by the economizer alone. Yes No d. All applicable fans and dampers operate as intended to maintain building pressure. Yes 0 No e• The unit heating is disabled (if applicable). Yes ® No ® NA Step 3: Disable the economizer and simulate a cooling demand. Verify the following: a• Economizer damper closes to its minimum position. Yes No b. All applicable fans and dampers operate as intended to maintain building pressure. Yes 0 No C. The unit heating is disabled (if applicable). Yes ® No ® NA Step 4: If the unit is equipped with heating, simulate a heating demand and enable the economizer. Verify the following: a• Economizer damper closes to its minimum position. Yes 00 A b. Return air damper opens. Yes 00 A Step 5: Turn off the unit and verify the following: a. Economizer damper closes completely. Yes No Step 6: System returned to initial operating conditions Yes No C. Testing Results P S / FAIL Step 2: Simulate cooling load and enable the economizer (all answers are Y and/or NA). CO Step 3: Simulate cooling load and disable the economizer (all answers are Y and/or NA). Step 4: Simulate heating demand and enable the economizer (all answers are Y and/or NA). Step 5: Turn off the unit (all answers are Y). 8 valuation U IF PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" or the economizer is listed in the CEC equipment cerification directory. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom DOCUMENTATION AUTHOR'S DECLARATION STATEMENT i ;s 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd ATT Certification Identification (If applicable): City/State/Zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT qi I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modenr-Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT k sl 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: Alex Gra bow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone: 310-235-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 1 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Supporting documentation needed to perform test includes: a. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.4 Air Economizer Controls Acceptance At -A - Glance). b. 2016 Building Energy Efficiency Standards. 2. Instrumentation to perform test includes: a. Hand-held temperature probe Calibration Date: 1/23 (must be within last year) b. Device capable of calculating enthalpy (i.e. psychrometer) Calibration Date: 1/23 (must be within last year) c. 1.2 k Ohm Resistor ( when specified by the manufacturer) 3. Installation: (all of the following boxes should be checked) Oconomizer high limit shutoff control complies with Table 140.4-B found in the 2016 Building Energy Efficiency Standards Section 140.4(e)3. Oconomizer reliability features are present per 2016 Building Energy Efficiency Standards Section 140.4(e)4: a. 5-year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product specification sheet proving compliance with AMCA Standard 500-D damper leakage at 10 cfm/ftz at 250 Pascals (1.0 in w.g). A product specification sheet showing the manufacturer's results after following the testing procedures of AMCA Standard 500-D. A product specification sheet showing the economizer outside air and return air damper leakage rates have been certified to the Energy Commission in accordance with Section 110. d. If the high limit setpoint is fixed dry-bulb or fixed enthalpy +fixed dry-bulb then the control shall have an adjustable setpoint. e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: i. Dry-bulb and wet -bulb temperatures accurate to ±2°F over the range of 40oF to 80oF ii. Enthalpy accurate to ±3 Btu/Ib over the range of 20 Btu/Ib to 36 Btu/Ib iii. Relative humidity (RH) accurate to ±5% over the range of 20% to 80% RH f. Check that the sensor performance curve(s) is provided by the factory and sensor output values measured during sensor calibration are plotted on the performance curve(s). g. Sensors used for high limit control shall be located to prevent false readings, including but not limited to being properly shielded from direct sunlight. Unitary systems with an economizer have control systems, including two -stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling. System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South B. Functional Testing Is the economizer listed in the CEC equipment certification directory? (if yes, proceed to Section D.) Yes Its No Step 1: Disable demand control ventilation systems (if applicable) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open. Verify the followin a Economizer damper modulates 100% open. Yes No b. Return air damper modulates 100% closed. Yes No C. For systems that meet the criteria of 2016 Building Energy Efficiency Standards Section 140.4(e)1, verify that the economizer remains 100% open with the use of mechanical cooling. This occurs when the cooling demand can no longer be met by the economizer alone. Yes No d. All applicable fans and dampers operate as intended to maintain building pressure. Yes 0 No e• The unit heating is disabled (if applicable). Yes ® No ® NA Step 3: Disable the economizer and simulate a cooling demand. Verify the following: a• Economizer damper closes to its minimum position. Yes No b. All applicable fans and dampers operate as intended to maintain building pressure. Yes 0 No C. The unit heating is disabled (if applicable). Yes ® No ® NA Step 4: If the unit is equipped with heating, simulate a heating demand and enable the economizer. Verify the following: a• Economizer damper closes to its minimum position. Yes 00 A b. Return air damper opens. Yes 00 A Step 5: Turn off the unit and verify the following: a. Economizer damper closes completely. Yes No Step 6: System returned to initial operating conditions Yes No C. Testing Results P S / FAIL Step 2: Simulate cooling load and enable the economizer (all answers are Y and/or NA). CO Step 3: Simulate cooling load and disable the economizer (all answers are Y and/or NA). Step 4: Simulate heating demand and enable the economizer (all answers are Y and/or NA). Step 5: Turn off the unit (all answers are Y). 8 valuation U IF PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" or the economizer is listed in the CEC equipment cerification directory. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South DOCUMENTATION AUTHOR'S DECLARATION STATEMENT i ;s 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd ATT Certification Identification (If applicable): City/State/Zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT qi I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modenr-Air Conditioning Company Position with Company (Title)! --'Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT k sl 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: Alex Gra bow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/zip: Harbor City CA 90710 Phone:310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 1 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Supporting documentation needed to perform test includes: a. 2016 Building Energy Efficiency Standards Nonresidential Compliance Manual (NA7.5.4 Air Economizer Controls Acceptance At -A - Glance). b. 2016 Building Energy Efficiency Standards. 2. Instrumentation to perform test includes: a. Hand-held temperature probe Calibration Date: 1/23 (must be within last year) b. Device capable of calculating enthalpy (i.e. psychrometer) Calibration Date: 1/23 (must be within last year) c. 1.2 k Ohm Resistor ( when specified by the manufacturer) 3. Installation: (all of the following boxes should be checked) Oconomizer high limit shutoff control complies with Table 140.4-B found in the 2016 Building Energy Efficiency Standards Section 140.4(e)3. Oconomizer reliability features are present per 2016 Building Energy Efficiency Standards Section 140.4(e)4: a. 5-year manufacturer warranty of economizer assembly b. Provide a product specification sheet proving capability of at least 60,000 actuations c. Provide a product specification sheet proving compliance with AMCA Standard 500-D damper leakage at 10 cfm/ftz at 250 Pascals (1.0 in w.g). A product specification sheet showing the manufacturer's results after following the testing procedures of AMCA Standard 500-D. A product specification sheet showing the economizer outside air and return air damper leakage rates have been certified to the Energy Commission in accordance with Section 110. d. If the high limit setpoint is fixed dry-bulb or fixed enthalpy +fixed dry-bulb then the control shall have an adjustable setpoint. e. Outdoor air, return air, mixed air, and supply air sensors shall be calibrated as follows: i. Dry-bulb and wet -bulb temperatures accurate to ±2°F over the range of 40oF to 80oF ii. Enthalpy accurate to ±3 Btu/Ib over the range of 20 Btu/Ib to 36 Btu/Ib iii. Relative humidity (RH) accurate to ±5% over the range of 20% to 80% RH f. Check that the sensor performance curve(s) is provided by the factory and sensor output values measured during sensor calibration are plotted on the performance curve(s). g. Sensors used for high limit control shall be located to prevent false readings, including but not limited to being properly shielded from direct sunlight. Unitary systems with an economizer have control systems, including two -stage or electronic thermostats, that cycle compressors off when economizers can provide partial cooling. System has return fan speed control, relief dampers, or dedicated relief fans to prevent building over pressurization in full economizer mode. For systems with DDC controls, sensor used for economizer lockout has been factory or field calibrated. For systems with non-DDC controls, manufacturer's startup and testing procedures have been applied. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 2 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North B. Functional Testing Is the economizer listed in the CEC equipment certification directory? (if yes, proceed to Section D.) Yes Its No Step 1: Disable demand control ventilation systems (if applicable) Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open. Verify the followin a Economizer damper modulates 100% open. Yes No b. Return air damper modulates 100% closed. Yes No C. For systems that meet the criteria of 2016 Building Energy Efficiency Standards Section 140.4(e)1, verify that the economizer remains 100% open with the use of mechanical cooling. This occurs when the cooling demand can no longer be met by the economizer alone. Yes No d. All applicable fans and dampers operate as intended to maintain building pressure. Yes 0 No e• The unit heating is disabled (if applicable). Yes ® No ® NA Step 3: Disable the economizer and simulate a cooling demand. Verify the following: a• Economizer damper closes to its minimum position. Yes No b. All applicable fans and dampers operate as intended to maintain building pressure. Yes 0 No C. The unit heating is disabled (if applicable). Yes ® No ® NA Step 4: If the unit is equipped with heating, simulate a heating demand and enable the economizer. Verify the following: a• Economizer damper closes to its minimum position. Yes 00 A b. Return air damper opens. Yes 00 A Step 5: Turn off the unit and verify the following: a. Economizer damper closes completely. Yes No Step 6: System returned to initial operating conditions Yes No C. Testing Results P S / FAIL Step 2: Simulate cooling load and enable the economizer (all answers are Y and/or NA). CO Step 3: Simulate cooling load and disable the economizer (all answers are Y and/or NA). Step 4: Simulate heating demand and enable the economizer (all answers are Y and/or NA). Step 5: Turn off the unit (all answers are Y). 8 valuation U IF PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" or the economizer is listed in the CEC equipment cerification directory. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AIR ECONOMIZER CONTROLS ACCEPTANCE CEC-NRCA-MCH-05-A (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A Air Economizer Controls Acceptance (Page 3 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North DOCUMENTATION AUTHOR'S DECLARATION STATEMENT i ;s 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd ATT Certification Identification (If applicable): City/State/Zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT qi I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modenr-Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT k sl 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: Alex Gra bow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone: 310-325-7312 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEC-NRCA-MCH-12-A (Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 1 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Prior to functional testing, verify and document: The Fault Detection and Diagnostics (FDD) hardware is installed on the unit. The FDD system is certified to the California Energy Commission. 2. The following air temperature sensors are permanently installed: Outside Air Sensor kvl Supply Air Sensor Return Air Sensor (Applicable for differential economizer operation only) 14 B. Functional Testing Li Air Temperature Sensor Failure/Fault Step 1: Verify the FDD system indicates normal operation. Step 2: Disconnect outside air temperature sensor from unit controller. Verify the FDD system reports a fault. Step 3: Connect outside air temperature sensor to unit controller. Verify the FDD system indicates normal operation. Excess Outside Air Step 1: Coordinate this test with NRCA-MCH-02-A (NA 7.5.1 Outdoor Air), if NRCA-MCH-02-A indicates "pass" then verify the FDD ✓ system indicated normal operation. Economizer Operation Step 1: Coordinate this test with NRCA-MCH-05-A (NA 7.5.4 Air Economizer Controls). Simulate failure by immobilizing the outdoor air economizer damper according to the manufacturer's instructions. Verify the FDD system reports a fault. ✓ Step 2: Successfully complete and pass NRCA-MCH-05-A and verify the FDD system reports normal operation. C. Testing Results SS Test passes if all boxes are checked under Functional Testing. D. Evaluation YJPASS: All Construction Inspection responses are complete and Testing Results is "Pass". Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEO-NRCA-MCH-12-A (Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 2 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom DOCUMENTATION AUTHOR'S DECLARATION STATEMENT F 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd ATT Certification Identification (if applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone:310-325-3712 Date signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEC-NRCA-MCH-12-A (Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 1 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South Note: Submit one Certificate of Acceptance for each system that must Tnforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Prior to functional testing, verify and document: The Fault Detection and Diagnostics (FDD) hardware is installed on the unit. The FDD system is certified to the California Energy Commission. 2. The following air temperature sensors are permanently installed: Outside Air Sensor kvl Supply Air Sensor Return Air Sensor (Applicable for differential economizer operation only) 14 B. Functional Testing Li Air Temperature Sensor Failure/Fault Step 1: Verify the FDD system indicates normal operation. Step 2: Disconnect outside air temperature sensor from unit controller. Verify the FDD system reports a fault. Step 3: Connect outside air temperature sensor to unit controller. Verify the FDD system indicates normal operation. Excess Outside Air Step 1: Coordinate this test with NRCA-MCH-02-A (NA 7.5.1 Outdoor Air), if NRCA-MCH-02-A indicates "pass" then verify the FDD ✓ system indicated normal operation. Economizer Operation Step 1: Coordinate this test with NRCA-MCH-05-A (NA 7.5.4 Air Economizer Controls). Simulate failure by immobilizing the outdoor air economizer damper according to the manufacturer's instructions. Verify the FDD system reports a fault. ✓ Step 2: Successfully complete and pass NRCA-MCH-05-A and verify the FDD system reports normal operation. C. Testing Results SS Test passes if all boxes are checked under Functional Testing. D. Evaluation YJPASS: All Construction Inspection responses are complete and Testing Results is "Pass". Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEO-NRCA-MCH-12-A (Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 2 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor South DOCUMENTATION AUTHOR'S DECLARATION STATEMENT F 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd ATT Certification Identification (if applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA 90710 Phone:310-325-3712 Date signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEC-NRCA-MCH-12-A (Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 1 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North Note: Submit one Certificate of Acceptance for each system that must Tnforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection 1. Prior to functional testing, verify and document: The Fault Detection and Diagnostics (FDD) hardware is installed on the unit. The FDD system is certified to the California Energy Commission. 2. The following air temperature sensors are permanently installed: Outside Air Sensor kvl Supply Air Sensor Return Air Sensor (Applicable for differential economizer operation only) 14 B. Functional Testing Li Air Temperature Sensor Failure/Fault Step 1: Verify the FDD system indicates normal operation. Step 2: Disconnect outside air temperature sensor from unit controller. Verify the FDD system reports a fault. Step 3: Connect outside air temperature sensor to unit controller. Verify the FDD system indicates normal operation. Excess Outside Air Step 1: Coordinate this test with NRCA-MCH-02-A (NA 7.5.1 Outdoor Air), if NRCA-MCH-02-A indicates "pass" then verify the FDD ✓ system indicated normal operation. Economizer Operation Step 1: Coordinate this test with NRCA-MCH-05-A (NA 7.5.4 Air Economizer Controls). Simulate failure by immobilizing the outdoor air economizer damper according to the manufacturer's instructions. Verify the FDD system reports a fault. ✓ Step 2: Successfully complete and pass NRCA-MCH-05-A and verify the FDD system reports normal operation. C. Testing Results SS Test passes if all boxes are checked under Functional Testing. D. Evaluation YJPASS: All Construction Inspection responses are complete and Testing Results is "Pass". Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016 STATE OF CALIFORNIA FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS CEO-NRCA-MCH-12-A (Revised 08/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A Fault Detection and Diagnostics (FDD) for Packaged Direct Expansion Units (Page 2 of 2) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: LA Quinta, CA Zip Code: 92253 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor North DOCUMENTATION AUTHOR'S DECLARATION STATEMENT F 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G. Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Tits K Technician Address: 1086 Lomita Blvd ATT Certification Identification (if applicable): City/State/zip: Harbor City, CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City, CA 90710 Phone:310-325-3712 Date signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance August 2016 "' CALIFORNIA ENERGY COMMISSION FENESTRATION ACCEPTANCE 2022-CEC-NRCA-ENV-02-F Project Name and Address Authority Having Jurisdiction Name: WelbeHealth La Quinta Enforcement Agency: City of La Quinta Address: 46805 Dune Palms Road Permit Number: BCOM2022-0025 City,Zip: La Quinta, CA 92253 Permit Application Date: 9/19/2023 Building: X I Floor: I Room: I Control/tag: ❑ Construction inspection complies Date Submitted to AHJ:10/18/202 ❑ Does not comply Intent: Each fenestration product must provide an NFRC Label Certificate or the California Energy Commission's Fenestration Certificate to identify the thermal performance of each fenestration product being installed (NA7.4.1) and §10- 111. The labels must be located at the job site for verification by the enforcement agency. In addition, the responsible party must fill out the Fenestration Acceptance Certificate. The responsible party must verify the thermal performance of each specified fenestration product being installed matches the label certificate, energy compliance documentation and building plans. A copy of the certificate and any associated documentation must be given to the building owner and the enforcement agency for their records. Responsible The responsible party must verify the following (NA7.4.1.1 and §10-103(a)): Party a) Verify that the Fenestration Certificate of Compliance (NRCC-ENV-E) and Certificate of Installation (NRCI-ENV-01-E) are completed and approved by the enforcement agency; and b) For non -rated fenestration, record the U-factor, solar heat gain coefficient (R)SHGC, and visible light transmitted (VT) for the installed fenestration product(s); and c) For rated fenestration, record the installed fenestration product(s) NFRC's Certified Product Directory (CPD) number or Certificate Number when the Component Modeling Approach Label is submitted; and d) Verify that the delivery receipt, purchase order, or detailed receipt matches the delivered fenestration product(s); and e) Verify that the thermal performance (U-Factor, (R)SHGC, VT) for the fenestration product(s) matches the building plans, energy compliance documentation (NRCC-ENV-E or NRCI-ENV-01-E), and the label certificate (b or c above); and f) Verify that the Certificate of Acceptance (this form) is completed and signed. 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V c -p n N V O N p +' � L -p V Q cn V }, C ) � E cB �' O O p C C N �, O C V L 0"= C O U N (n L cn �, (n 6 tB �C p"Oa�^ N�Ln fa'-^ a)0 L_4�Q � O N C NV> U QC (1C0) fo ro CU -0fzfu Q-0o� c6 c'�c�o—C: a wQv-a���>�c� i�' O t= `� c E N v fo N� U C N Q a In .0 v o C Q N ate+ Q Q p O O Q N Z +� .6 +�•+ a=.+ cn m 0 C� i C O Q C d 0 cn �O Q-0 0 Q V ra C V a-J • V 0 O N O Cr N p N N 4- i u+'i (Cn (a C � o+J Q � o M ate..+ L (Cn (a C +' '� o o Q� o i Q V cn 0 +y v ����o�ocin ���Vo��Uco�a�`���'?O(n co p V C m O c a� ra c— o— pi ro v, — (n 'Q 0 cn L ra 0 ra � ra •vj Q- cn a"1 -� •cv .� u .� o a� o � °u� � o �� o �'� 0CL- (n C a�'i ca �=� cn L a� u �� u c o " >= G C LL H Q V ra ro z -0 CC '—' '—' '—' o -0 cn " aJ M ro z o M a✓ -0 C V -0 ra M N O N C C rn r1 M 4-- 0 M O 0) ro a C 0 E U R O C W c� •C L 0 V 2022 Building Energy Efficiency Standards Page 139 TABLE 110.E-A DEFAULT FENESTRATION PRODUCT U-FACTORS Frame Product Type Single Pane 3.4 U-Factor Double Pane 1,1,4 U-Factor Glass Block z,s U-Factor Metal Operable 1.28 0.79 0.87 Metal Fixed 1.19 0.71 0.72 Metal Greenhouse/Garden Window 2.26 1.40 N.A. Metal Glazed Doors 1.25 0.77 N.A. Metal Skylight 1.98 1.30 N.A. Metal, Thermal Break Operable N.A. 0.66 N.A. Metal, Thermal Break Fixed N.A. 0.55 N.A. Metal, Thermal Break Greenhouse/Garden Window N.A. 1.12 N.A. Metal, Thermal Break Glazed Doors N.A. 0.59 N.A. Metal, Thermal Break Skylight N.A. 1.11 N.A. Nonmetal Operable 0.99 0.58 0.60 Nonmetal Fixed 1.04 0.55 0.57 Nonmetal Glazed Doors 0.99 0.53 N.A. Nonmetal Greenhouse/Garden Windows 1.94 1.06 N.A. Nonmetal Skylight 1.47 0.84 N.A. 1. For all dual -glazed fenestration products, adjust the listed U-factors as follows: a. Add 0.05 for products with dividers between panes if spacer is less than 7/16 inch wide. b. Add 0.05 to any product with true divided lite (dividers through the panes). 2. Translucent or transparent panels shall use glass block values when not rated by NFRC 100. 3. Visible Transmittance (VT) shall be calculated by using Reference Nonresidential Appendix NA6. 4. Windows with window film applied that is not rated by NFRC 100 shall use the default values from this table. SECTION 110.6 - MANDATORY REQUIREMENTS FOR FENESTRATION PRODUCTS AND EXTERIOR DOORS Page140 2022 Building Energy Efficiency Standards TABLE 110.E-B DEFAULT SOLAR HEAT GAIN COEFFICIENT (SHGC) FRAME TYPE PRODUCT GLAZING FENESTRATION PRODUCTSHGC Single Pane2,3 SHGC FENESTRATION PRODUCTSHGC Double Pane2-3 SHGC FENESTRATION PRODUCTSHGC Glass Block' z SHGC Metal Operable Clear 0.80 0.70 0.70 Metal Fixed Clear 0.83 0.73 0.73 Metal Operable Tinted 0.67 0.59 N.A. Metal Fixed Tinted 0.68 0.60 N.A. Metal, Thermal Break Operable Clear N.A. 0.63 N.A. Metal, Thermal Break Fixed Clear N.A. 0.69 N.A. Metal, Thermal Break Operable Tinted N.A. 0.53 N.A. Metal, Thermal Break Fixed Tinted N.A. 0.57 N.A. Nonmetal Operable Clear 0.74 0.65 0.70 Nonmetal Fixed Clear 0.76 0.67 0.67 Nonmetal Operable Tinted 0.60 0.53 N.A. Nonmetal Fixed Tinted 0.63 0.55 N.A. 1. Translucent or transparent panels shall use glass block values when not rated by NFRC 200. 2. Visible Transmittance (VT) shall be calculated by using Reference Nonresidential Appendix NA6. 3. Windows with window film applied that is not rated by NFRC 200 shall use the default values from this table. SECTION 110.6 — MANDATORY REQUIREMENTS FOR FENESTRATION PRODUCTS AND EXTERIOR DOORS 2019 Nonresidential Appendices Appendix NA6-3 NA6.3 Default Solar Heat Gain Coefficient, SHGC The SHGC of the fenestration product shall be calculated using the following equation: Equation NA6-2 Where: SHGCT = 0.08 + (0.86 x SHGCT) SHGCT = SHGC Is the Total Performance of the fenestration including glass and frame SHGCc = Center of glass SHGC calculated in accordance with NFRC 200 Section 4.5.1.1 http://www.nfrc.org/software.aspx NA6.4 Default Visible Transmittance, VT (a) Equation NA6-3 - VT of Center of Glass (COG) calculation Where: VTT = VTF x VTc VTT = Is the Total Performance of the fenestration including glass and frame VTF = 0.53 for projecting windows, such as casement and awning windows VTF = 0.67 for operable or sliding windows VTF = 0.77 for fixed or non -operable windows VTF= 0.88 for curtain wall/storefront, Site -built and manufactured non -curb mounted skylights VTF = 1.0 for Curb Mounted manufactured Skylights VTc = Center of glass VT is calculated in accordance with NFRC 200 Section 4.5.1.1 or NFRC 202 for Translucent Products or NFRC 203 for Tubular Daylighting Devices and Hybrid Tubular Daylighting Devices or ASTM E972 http://www.nfrc.org/software.aspx NA6.5 Responsibilities for Compliance This section describes the responsibilities of energy consultants, designers, architects, builders, installers, and enforcement agencies when using the procedures of this appendix. NA6.5.1 Energy Consultants, Designers, Architects The person with responsibility for preparing the compliance documentation shall establish the inputs from the following: (a) The center of glass U-factor, SHGC and VT shall be taken from manufacturers' literature and determined using methods consistent with NFRC 100, NFRC 200, NFRC 202 and NFRC 203 procedures. (b) The frame type (Metal, Metal Thermal Break, Non-metal) shall be verified from manufacturers' literature and through observations of frame sections provided by the manufacturer. For the Prescriptive Overall Compliance Method, the calculated values shall be entered on the prescriptive Certificate of Compliance form. In addition the Fenestration Certificate of Compliance Label Certificate must be also filled and located at the project site location in according to Reference Nonresidential Appendix NA7. Appendix NA6— Alternate Default Fenestration Procedure to Calculate Thermal Performance N N O N 0 T M � v otko F v o m f6 d O C) U) E H a) W @ ci p OO C LL o Y d @ U � U c.> Z U x M � Ln N 0 N 72 m u .c c C W � ~I -6 ate+ O O CC iY N V E J � a C � � p 2 -0 o m U) M U) iri N E E z Z Q _v U U LL 0) cu a a � rnstatus' z z 00 i N O V1 O C)O U d m W Ln a OH O O ` +QU+ a) LO t0 N f6 c-I O OCD Ln i+ m L Ln 1.0 0 m a 0 O 0) � i1 N ++ 3 O u v > m w E In C: N cc� G a" G u Ecu O M = O i v � � U u a cr w O Z a u p Gl Q H u 7 c O OL N i O O a a E N N 4) O LL A E L_L 'O m v y -le 'O L v C LL U X CCO LL C X LL O i U) L > d Ca C � N LL H D J m � O Y N W LA m Z m M N a E T O 4) H Ln Q O x v W z f�6 ; c W LL N C in LA N LL O IR v O 0 v v V ad IL 0 v Q 0 Status' z z z z z z z _ F iJ m m m N_ E N_ E W i i i O O Q Q a -I N N p p p O O O O Z Z E L Q CL U) X U! X UJ X OW W W O Z O Z W Ln O O T u C O O N N N r� Ln O 0) `� `� `� Ln V) CJ0 0 C) W Ln V V c r o W s W W i cc crW W W O1 Q (,J C W W W W cr cc W W W W N W W W W W Ln W tn W tn WO ++ L f6 C co N 00 0 m Ol n Ln -ii u O Y u rl O O O Q Q O m O m 'u co co 00 Z Z m rn W L u Q Q Q z z U U N W O C m v j N 2 L r' r Q LL N Q O CO CD O O C:)Q Z Z a E 7 C Q. m } L ya = r ,\3 C) C:) O -4 0000 L _ 3 co f6 O Y N 1-1 r C F 3 tw T � M � a -I ri a-i ci ci r-I ci a C m t V1 N N m cu a) a) Q L d L d L d n f6 n (6 m C N C 4! U1 w U) b U) w m m LL LL L Q Y Y Y O- O- i i U V VIU N a W a a a Ui Ln Ln C N N Ln W cr v W N E Q m W z N m U U N Nci rl d U U U m v H E Q Q Q Q 2 2 Z EL LL z W O r.j o rn Ln ci 00 O O LA N N O N f�6 l�6 Ul d/ lD O O_ O) ivaiwans MIA C 2 Z 3SVHd ---------- Mill E LET] J o 111 URI If 1 A r Elid !nil AL 11H 11 11 1HH HE HUI 11 (h 1" M MR, . M1 lull Uh HIM H H ;HUI nj il Elul 21 01 in 1, S S / \ \/§� 0 ,| | ! ■ _ . g � Z & K Z & / § §| \ @ � .. 2 3 \ j z / / 3 s / � 4 z / u / m / |m us \ - I I n k - \ 2 4 / - ) }� 2 / _ \ $ _ » Gr s2 § \ ) !Iz - 10 /as w_ \ � / ! \ , w PC) �, /!G : \ # 2 : /�r § Ld G q/ Pn �Ln !l;nae 2G/o �_] � ®® ♦ STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 1 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-1 System Location or Area Served: Great Room Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. Intent: Verify that the system detects common faults in air handling units and zone terminal units. A. Construction Inspection . 1. Instrumentation to perform test includes, but not limited to: a. No instrumentation is required — changes are implemented at the building automation system control station. 2. Installation: a. The functional testing verifies proper installation of the controls for FDD for air handling units and zone terminal units. No additional installation checks are required. B. Functional Testing for Air Handling Units Testing of each AHU with FDD controls shall include the following tests: Results Step 1: Sensor drift/failure a. Disconnect outside air temperature sensor from unit controller. Yes (!) No b. Verify that the FDD system reports a fault. Yes(!) No C. Connect OAT sensor to the unit controller. Yes E) No d. Verify that FDD indicates normal system operation. Yes Q No Step 2: Damper/actuator fault a. From the control system workstation, command the mixing box dampers to full open (100% outdoor air). Yes Q No b. Disconnect power to the actuator and verify that a fault is reported at the control workstation. Yes No C. Reconnect power to the actuator and command the mixing box dampers to full open. Yes No d. Verify that the control system does not report a fault. Yes 8 No e. From the control system workstation, command the mixing box dampers to a full -closed position (0% outdoor air). Yes Q No f. Disconnect power to the actuator and verify that a fault is reported at the control workstation. Yes 8 No g. Reconnect power to the actuator and command the dampers closed. Yes (F) No h. Verify that the control system does not report a fault during normal operation. Yes 8 No Q CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 2 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-1 System Location or Area Served: Great Room Step 3: Valve/actuator fault a. From the control system workstation, command the heating coil valves to full open. N/A Yes Uo b. Disconnect power to the actuator and verify that a fault is reported. N/A Yes o c. Reconnect power to the actuator and command the heating coil valve to full open. N/A Yes o d. Verify that the control system does not report a fault. N/A Yes ® No E) e. From the control system workstation, command the cooling coil valve to the full open position. N/A Yes Co f. Disconnect power to the actuator and verify that a fault is reported. N/A YesRoE) 9, Reconnect power to the actuator and command the cooling coil valve to full open. N/A Yes'® h. Verify that the control system does not report a fault. N/A Yes o 6) Step 4: Inappropriate simultaneous heating, mechanical cooling, and/or economizing a. From the control system workstation, override the heating coil valve and verify that a fault is reported at the control workstation. N/A Yes 00 • b. From the control system workstation, override the cooling coil valve and verify that a fault is reported at the control workstation. N/A Yes 00 • C. From the control system workstation, override the mixing box dampers and verify that a fault is reported at the control workstation. N/A Yes o CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) r.Al iFnRNIA FNFR(v cnnnnnlSSinN CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 3 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-1 System Location or Area Served: Great Room C. Functional Testing for Zone Terminal Units Testing shall be performed on one of each type of terminal unit (VAV box) in the project. A minimum of 5% of the terminal boxes shall be tested. Results Step 1: Sensor drift/failure a. Disconnect the tubing to the differential pressure sensor of the VAV box. N/A b. Verify that control system detects and reports the fault. N/A tYeso C. Reconnect the sensor and verify proper sensor operation. N/A d. Verify that the control system does not report a fault. N/A Step 2: Damper/actuator fault — damper stuck open a. Command the damper to be fully open. N/A Yes b. Disconnect the actuator to the damper. N/A Yes 0 C. Adjust the cooling set point so that the room temperature is below the cooling setpoint to command the damper to the minimum position. Verify that the control system reports a fault. N/A Yes U0 d. Reconnect the actuator and restore to normal operation. N/A Yes Step 3: Damper/actuator fault — damper stuck closed a. Set the damper to the minimum position. N/A Yes o b. Disconnect the actuator to the damper. N/A Yes o Set the cooling set point below the room temperature to simulate a call for cooling. Verify that the control system reports IVJA C. fault. Yes UO d. Reconnect the actuator and restore to normal operation. N/A Yes o Step 4: Valve/actuator fault (For systems with hydronic reheat) a. Command the reheat coil valve to (full) open. N/A Yes O No Disconnect power to the actuator. Set the heating set point temperature to be lower than the current space temperatur /A b' to command the valve closed. Verify that the fault is reported at the control workstation. Yes ®No C. Reconnect the actuator and restore normal operation. N/A Yes O No Step 5: Feedback loop tuning fault (unstable airflow) a. Set the integral coefficient of the box controller to a value 50 times the current value. Lower the space cooling setpoint to simulate a call for cooling. N/A Yes O No O b• The damper cycles continuously and airflow is unstable. Verify that the control system detects and reports the fault. N/A YeskONo C. Reset the integral coefficient of the controller to the original value to restore normal operation. N/A Yes O No Step 6: Disconnected inlet duct a' From the control system workstation, command the damper to minimum position. N/A Yes O No b. Disconnect power to the actuator and verify that a fault is reported at the control workstation. N/A Yes O No C. Reset the space temperature setpoint back to its original value. N/A Yes O No 8 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 4 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-1 System Location or Area Served: Great Room Step 7: Discharge air temperature sensor a• Adjust zone setpoints to drive the box from dead band to full heating. N/A Yes ® No (F) b Verify that in heating, the supply air temperature resets up to the maximum setpoint while the airflow is maintained at N/A Yes ® No Q the dead band flow rate. Verify that after the supply air temperature is reset up to the maximum setpoint, the airflow rate then increases up to theFc -- Yes ®No heating maximum flow rate in order to meet the heating load. D. Testing Results PASS / FAIL Test passes if all applicable answers are yes under Functional Testing Sections. 0 E. Evaluation ✓ PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass". CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 5 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-1 System Location or Area Served: Great Room DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 61 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLs License: 472651 City/State/Zip: Harbor City CA 90710 Phone:310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 1 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-2 System Location or Area Served: 1st Floor Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. Intent: Verify that the system detects common faults in air handling units and zone terminal units. A. Construction Inspection . 1. Instrumentation to perform test includes, but not limited to: a. No instrumentation is required — changes are implemented at the building automation system control station. 2. Installation: a. The functional testing verifies proper installation of the controls for FDD for air handling units and zone terminal units. No additional installation checks are required. B. Functional Testing for Air Handling Units Testing of each AHU with FDD controls shall include the following tests: Results Step 1: Sensor drift/failure a. Disconnect outside air temperature sensor from unit controller. Yes (!) No b. Verify that the FDD system reports a fault. Yes(!) No C. Connect OAT sensor to the unit controller. Yes E) No d. Verify that FDD indicates normal system operation. Yes Q No Step 2: Damper/actuator fault a. From the control system workstation, command the mixing box dampers to full open (100% outdoor air). Yes Q No b. Disconnect power to the actuator and verify that a fault is reported at the control workstation. Yes No C. Reconnect power to the actuator and command the mixing box dampers to full open. Yes No d. Verify that the control system does not report a fault. Yes 8 No e. From the control system workstation, command the mixing box dampers to a full -closed position (0% outdoor air). Yes Q No f. Disconnect power to the actuator and verify that a fault is reported at the control workstation. Yes 8 No g. Reconnect power to the actuator and command the dampers closed. Yes (F) No h. Verify that the control system does not report a fault during normal operation. Yes 8 No Q CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 2 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-2 System Location or Area Served: 1st Floor Step 3: Valve/actuator fault a. From the control system workstation, command the heating coil valves to full open. N/A Yes Uo b. Disconnect power to the actuator and verify that a fault is reported. N/A Yes o c. Reconnect power to the actuator and command the heating coil valve to full open. N/A Yes o d. Verify that the control system does not report a fault. N/A Yes ® No E) e. From the control system workstation, command the cooling coil valve to the full open position. N/A Yes Co f. Disconnect power to the actuator and verify that a fault is reported. N/A YesRoE) 9, Reconnect power to the actuator and command the cooling coil valve to full open. N/A Yes'® h. Verify that the control system does not report a fault. N/A Yes o 6) Step 4: Inappropriate simultaneous heating, mechanical cooling, and/or economizing a. From the control system workstation, override the heating coil valve and verify that a fault is reported at the control workstation. N/A Yes 00 • b. From the control system workstation, override the cooling coil valve and verify that a fault is reported at the control workstation. N/A Yes 00 • C. From the control system workstation, override the mixing box dampers and verify that a fault is reported at the control workstation. N/A Yes o CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) r.Al iFnRNIA FNFR(v cnnnnnlSSinN CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 3 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-2 System Location or Area Served: 1st Floor C. Functional Testing for Zone Terminal Units Testing shall be performed on one of each type of terminal unit (VAV box) in the project. A minimum of 5% of the terminal boxes shall be tested. Results Step 1: Sensor drift/failure a. Disconnect the tubing to the differential pressure sensor of the VAV box. N/A b. Verify that control system detects and reports the fault. N/A tYeso C. Reconnect the sensor and verify proper sensor operation. N/A d. Verify that the control system does not report a fault. N/A Step 2: Damper/actuator fault — damper stuck open a. Command the damper to be fully open. N/A Yes b. Disconnect the actuator to the damper. N/A Yes 0 C. Adjust the cooling set point so that the room temperature is below the cooling setpoint to command the damper to the minimum position. Verify that the control system reports a fault. N/A Yes U0 d. Reconnect the actuator and restore to normal operation. N/A Yes Step 3: Damper/actuator fault — damper stuck closed a. Set the damper to the minimum position. N/A Yes o b. Disconnect the actuator to the damper. N/A Yes o Set the cooling set point below the room temperature to simulate a call for cooling. Verify that the control system reports IVJA C. fault. Yes UO d. Reconnect the actuator and restore to normal operation. N/A Yes o Step 4: Valve/actuator fault (For systems with hydronic reheat) a. Command the reheat coil valve to (full) open. N/A Yes O No Disconnect power to the actuator. Set the heating set point temperature to be lower than the current space temperatur /A b' to command the valve closed. Verify that the fault is reported at the control workstation. Yes ®No C. Reconnect the actuator and restore normal operation. N/A Yes O No Step 5: Feedback loop tuning fault (unstable airflow) a. Set the integral coefficient of the box controller to a value 50 times the current value. Lower the space cooling setpoint to simulate a call for cooling. N/A Yes O No O b• The damper cycles continuously and airflow is unstable. Verify that the control system detects and reports the fault. N/A YeskONo C. Reset the integral coefficient of the controller to the original value to restore normal operation. N/A Yes O No Step 6: Disconnected inlet duct a' From the control system workstation, command the damper to minimum position. N/A Yes O No b. Disconnect power to the actuator and verify that a fault is reported at the control workstation. N/A Yes O No C. Reset the space temperature setpoint back to its original value. N/A Yes O No 8 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 4 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-2 System Location or Area Served: 1st Floor Step 7: Discharge air temperature sensor a• Adjust zone setpoints to drive the box from dead band to full heating. N/A Yes ® No (F) b Verify that in heating, the supply air temperature resets up to the maximum setpoint while the airflow is maintained at N/A Yes ® No Q the dead band flow rate. Verify that after the supply air temperature is reset up to the maximum setpoint, the airflow rate then increases up to theFc -- Yes ®No heating maximum flow rate in order to meet the heating load. D. Testing Results PASS / FAIL Test passes if all applicable answers are yes under Functional Testing Sections. 0 E. Evaluation ✓ PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass". CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 5 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-2 System Location or Area Served: 1st Floor DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 6 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT 6d I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G Field Technician Signature: Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLs License: 472651 City/State/Zip: Harbor City CA 90710 Phone:310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 1 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-3 System Location or Area Served: 1st Floor Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. Intent: Verify that the system detects common faults in air handling units and zone terminal units. A. Construction Inspection . 1. Instrumentation to perform test includes, but not limited to: a. No instrumentation is required — changes are implemented at the building automation system control station. 2. Installation: a. The functional testing verifies proper installation of the controls for FDD for air handling units and zone terminal units. No additional installation checks are required. B. Functional Testing for Air Handling Units Testing of each AHU with FDD controls shall include the following tests: Results Step 1: Sensor drift/failure a. Disconnect outside air temperature sensor from unit controller. Yes (!) No b. Verify that the FDD system reports a fault. Yes(!) No C. Connect OAT sensor to the unit controller. Yes E) No d. Verify that FDD indicates normal system operation. Yes Q No Step 2: Damper/actuator fault a. From the control system workstation, command the mixing box dampers to full open (100% outdoor air). Yes Q No b. Disconnect power to the actuator and verify that a fault is reported at the control workstation. Yes No C. Reconnect power to the actuator and command the mixing box dampers to full open. Yes No d. Verify that the control system does not report a fault. Yes 8 No e. From the control system workstation, command the mixing box dampers to a full -closed position (0% outdoor air). Yes Q No f. Disconnect power to the actuator and verify that a fault is reported at the control workstation. Yes 8 No g. Reconnect power to the actuator and command the dampers closed. Yes (F) No h. Verify that the control system does not report a fault during normal operation. Yes 8 No Q CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 2 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-3 System Location or Area Served: 1st Floor Step 3: Valve/actuator fault a. From the control system workstation, command the heating coil valves to full open. N/A Yes Uo b. Disconnect power to the actuator and verify that a fault is reported. N/A Yes o c. Reconnect power to the actuator and command the heating coil valve to full open. N/A Yes o d. Verify that the control system does not report a fault. N/A Yes ® No E) e. From the control system workstation, command the cooling coil valve to the full open position. N/A Yes Co f. Disconnect power to the actuator and verify that a fault is reported. N/A YesRoE) 9, Reconnect power to the actuator and command the cooling coil valve to full open. N/A Yes'® h. Verify that the control system does not report a fault. N/A Yes o 6) Step 4: Inappropriate simultaneous heating, mechanical cooling, and/or economizing a. From the control system workstation, override the heating coil valve and verify that a fault is reported at the control workstation. N/A Yes 00 • b. From the control system workstation, override the cooling coil valve and verify that a fault is reported at the control workstation. N/A Yes 00 • C. From the control system workstation, override the mixing box dampers and verify that a fault is reported at the control workstation. N/A Yes o CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) r.Al iFnRNIA FNFR(v cnnnnnlSSinN CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 3 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-3 System Location or Area Served: 1st Floor C. Functional Testing for Zone Terminal Units Testing shall be performed on one of each type of terminal unit (VAV box) in the project. A minimum of 5% of the terminal boxes shall be tested. Results Step 1: Sensor drift/failure a. Disconnect the tubing to the differential pressure sensor of the VAV box. N/A b. Verify that control system detects and reports the fault. N/A tYeso C. Reconnect the sensor and verify proper sensor operation. N/A d. Verify that the control system does not report a fault. N/A Step 2: Damper/actuator fault — damper stuck open a. Command the damper to be fully open. N/A Yes b. Disconnect the actuator to the damper. N/A Yes 0 C. Adjust the cooling set point so that the room temperature is below the cooling setpoint to command the damper to the minimum position. Verify that the control system reports a fault. N/A Yes U0 d. Reconnect the actuator and restore to normal operation. N/A Yes Step 3: Damper/actuator fault — damper stuck closed a. Set the damper to the minimum position. N/A Yes o b. Disconnect the actuator to the damper. N/A Yes o Set the cooling set point below the room temperature to simulate a call for cooling. Verify that the control system reports IVJA C. fault. Yes UO d. Reconnect the actuator and restore to normal operation. N/A Yes o Step 4: Valve/actuator fault (For systems with hydronic reheat) a. Command the reheat coil valve to (full) open. N/A Yes O No Disconnect power to the actuator. Set the heating set point temperature to be lower than the current space temperatur /A b' to command the valve closed. Verify that the fault is reported at the control workstation. Yes ®No C. Reconnect the actuator and restore normal operation. N/A Yes O No Step 5: Feedback loop tuning fault (unstable airflow) a. Set the integral coefficient of the box controller to a value 50 times the current value. Lower the space cooling setpoint to simulate a call for cooling. N/A Yes O No O b• The damper cycles continuously and airflow is unstable. Verify that the control system detects and reports the fault. N/A YeskONo C. Reset the integral coefficient of the controller to the original value to restore normal operation. N/A Yes O No Step 6: Disconnected inlet duct a' From the control system workstation, command the damper to minimum position. N/A Yes O No b. Disconnect power to the actuator and verify that a fault is reported at the control workstation. N/A Yes O No C. Reset the space temperature setpoint back to its original value. N/A Yes O No 8 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 4 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-3 System Location or Area Served: 1st Floor Step 7: Discharge air temperature sensor a• Adjust zone setpoints to drive the box from dead band to full heating. N/A Yes ® No (F) b Verify that in heating, the supply air temperature resets up to the maximum setpoint while the airflow is maintained at N/A Yes ® No Q the dead band flow rate. Verify that after the supply air temperature is reset up to the maximum setpoint, the airflow rate then increases up to theFc -- Yes ®No heating maximum flow rate in order to meet the heating load. D. Testing Results PASS / FAIL Test passes if all applicable answers are yes under Functional Testing Sections. 0 E. Evaluation ✓ PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass". CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA AUTOMATIC FAULT DETECTION AND DIAGNOSTICS FOR AIR HANDLING UNITS AND ZONE TERMINAL UNITS ACCEPTANCE CEC-NRCA-MCH-13-A (Revised 06/17) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-13-A Automatic Fault Detection and Diagnostics (FDD) for Air Handling Units and Zone Terminal Units Acceptance (Page 5 of 5) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: Project Address: 46-805 Dune Palms Road City: La Quinta Zip Code: 92253 System Name or dentification/Tag: AC-3 System Location or Area Served: 1st Floor DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 6 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Conditioning Company Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David G Field Technician Signature: 1/0 Ill Field Technician Company Name: Modern -Air Conditioning Company Position with Company (Title • Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/Zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 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: Alex Grabow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLs License: 472651 City/State/Zip: Harbor City CA 90710 Phone:310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June 2017 STATE OF CALIFORNIA ENVELOPE 'EC-NRCI-ENV-01-E (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-ENV-01-E Envelope (Page 1 of 2) Pr°'en Name. Welbe Health Care Phase 4 TI - la Quinta ° A8`"`9 Permit Number °r"'ectAdd- 46-805 Dune Palms Rd. "9 La Quinta `'P`°de. 92253 GENERAL INFORMATION DATE OF BUILDING PERMIT: PERMIT # 09/19/23 BCOM2022-0025 BUILDING TYPE ® Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room PHASE OF CONSTRUCTION ❑ New Construction ❑ Addition ® Alteration ❑ Unconditioned If more than one person has responsibility for building construction, each person shall prepare and sign an Installation Certificate applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign the Installation Certificate document(s) for the entire construction. SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. 10/18/22 In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility for this Installation Certificate. Date Approved By Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. the Enforcement City Approved Agency Drawings Architecturals 10/18/22 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA ENVELOPE CEC-NRCI-ENV-ol-F IP—A > 4 nt nm - CERTIFICATE OF INSTALLATION �'aurvKNw trvtKGY GVMMISSION �' NRCI-ENV-01-E Envelope (Page 2 of 2) Pru;ect Name. We] be Health Care Phase 4 TI - La Quints Enforcement Agency: Address: 805 Dune Paims Rd. `"y La Quints ���Perm,teroject -002546 3 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I. I certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Jessica Renteria Documentation Author Signature Documentation Author Company Name:OJ Insulation, LP. Date signed: 08/01/2023 Ir Address: 2061 d r rove Ave. CEA/HERS Certification Identification (If applicable): City/State/Zip: Escondido, CA 92029 Phone: 760-839-3200 I RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder to provides the building owner at occupancy. Responsible Builder/Installer Name: Jessica RenteriaCompanyName: Responsible Builder/Installer (Installing Subcontractor or General Contractor or Builder/Owner) OJ Insulation LP. Position with Company (Title�sinaum Address: ------ Administrative Assistant 2061 Aldergrove Ave. CstB License: 888804 Phone 760-839-3200 Date signed: 08/01/2023 City/state/ziP: Escondido, CA 92029 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 CERTIFICATE OF INSTALLATION —USER INSTRUCTIONS NRCI-ENV-01-E Envelope (Page 1 of 1) CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA MECHANICAL CEC-NRCI-MCH-01-E (Revised 01120) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-MCH-01-E Mechanical (Page 1 of 2) Project Name: Welbe La Qulnta Enforcement Agency: Permit Number: Project Address: 48-805 Dune Palms Road `'ty:La Quinta, CA Zip Code: 92253 I A. GENERAL INFORMATION DATE OF BUILDING PERMIT: 09/19/23 BUILDING TYPE ® Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel PHASE OF ElCONSTRUCTION New Construction ❑ Addition ® Alteration If more than one person has responsibility for building construction, each person shall prepare and sign an Installation Certificate document applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign the Installation Certificate document(s) for the entire construction. 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: 7/31/23 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 Mechanical Construction Drawings Mechanical Schedule page M1.0 T-24 Page G4-012 10/18/22 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA MECHANICAL CEC-NRCI-MCH-01-E (Revised 01120) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-MCH-01-E Mechanical (Page 2 of 2) Project Name: Welbe La QUlnta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address:48-805 Dune Palms Road city: La Quinta, CA "P`o 72253 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Alex Grabow Documentation Author Signature: Documentation Author Company Name: Modern -Air Cond. Co. Date Signed: 7/31/23 Address: 1086 Lomita Blvd. CEA/ HERS Certification Identification (If applicable): N/A City/State/Zip: Harbor City CA Phone: 310-325-3712 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/installerName: Alex Grabow Responsible Builder/installerSignature: Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Modern -Air Cond. Co. Position With Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLBLicense: 472651 city/state/zip: Harbor City CA Phone: 310-325-3712 Date signed: 7/31/23 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 6.02 04. As needed, this row shall be filled according to the instructions for row B.02 05. As needed, this row shall be filled according to the instructions for row B.02 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA PLUMBING C -C-NRCI-PLB-01-E (Revised 01/20) CALIFORNIA ENERGY COMMISSION -'W' CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing (Page 1 of 4) Project Name: �o Enforcement Agency: / . ��w Permit Number: "x_ 1BCOM2022-0025 Project Address:4(0 -6,05 bl u- N4.) — city: / v` L Zip Code: .Z?_.3 A. GENERAL INFORMATION DATE OF BUILDING PERMIT: 9/19/2023 BUILDING TYPE Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel PHASE OF CONSTRUCTIO ❑ New Construction ❑ Addition VAlteration N 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 documents) for the entire construction. B. SCOPE OF RESPONSIBILITY Date of approval by the enforcement agency of the Certificate of Compliance that Date: provides the specifications for this Installation Certificate. 10/18/2022 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 eU,u/i s P - 10/18/2022 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA PLUMBING CEC-NRCI-PLB-01-E (Revised 01/20) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing (Page 2 of 4) Project Name: Enforcement Agency: Permit Number: BCOM2022-0025 Project Add ess: b 12A Ci[y: V"Mc Zip Code: q z75 C. MANDATORY REQUIREMENTS FOR ALL CENTRAL DOMESTIC HOT WATER RECIRCULATION SYSTEMS On systems that have a total capacity greater than 167,000 Btu/hr, outlets that require higher than service water 01 temperatures as listed in the ASHRAE Handbook have separate remote heaters, heat exchangers, or boosters to supply the outlet with the higher temperature. (Section 110.3 (c)1) 02 Systems with circulating pumps or with electrical heat trace systems shall be capable of automatically turning off the system. (Section 110.3(c)2). Unfired storage tanks are insulated with an external R-12 or combination of R-16 internal and external Insulation. 05 Alternatively, the heat loss of the tank surface based on an 80°F water -air temperature difference shall be less than 6.5 Btu per hour per square foot. (Section 110.3(c)4). All sections of the recirculation loop, and the first 5 feet of all branches off the loop are insulated, to the thicknesses required by Table 120.3A, except for the following: (RA4.4.1) • Piping installed in interior or exterior walls that is surrounded on all sides by at least linch of insulation. • Piping installed in attics with a minimum of 4 inches (10 cm) of attic insulation on top. 06 • Piping that penetrates framing members shall not be required to have pipe insulation for the distance of the framing penetration. Metal piping that penetrates metal framing shall use grommets, plugs, wrapping or other insulating material to assure that no contact is made with the metal framing. Insulation shall butt securely against all framing members. • Insulation is not required on the cold water line when it is used as the return. Hot water pipes that are buried below grade are installed in a water proof and non -crushable casing or sleeve that allows for 07 installation, removal, and replacement of the enclosed pipe and insulation. (RA4.4.1) Insulation outside conditioned space is protected from damage, including that due to sunlight, moisture, equipment 08 maintenance, and wind. (RA4.4.1) 09 Pipe insulation fits tightly to the pipe. (RA4.4.1) On insulated sections of pipe, no piping is visible due to insulation voids, and all elbows and tees are fully insulated. 10 (RA4.4.1) The recirculation pump is mounted on a vertical section of the return line, OR an automatic air release valve is installed on a 11 riser at least 12 inches in length, on the inlet side of the recirculation pump, no more than 4 feet from the pump. (Section 110.3(c)5A). 12 A check valve is located between the recirculation pump and the water heater. (Section 110.3(c)5B). A hose bibb is installed between the pump and the water heating equipment with an isolation valve between the hose bibb 13 and the water heating equipment. (Section 110.3(c)5C). 14 Isolation valves are installed on both sides of the pump. One of the isolation valves may be the same isolation valve as in item 12 above. (Section 110.3(c)5D). The cold water supply piping and the recirculation loop piping is not connected to the hot water storage tank drain port. 15 (Section 110.3(c)5E). 16 A check valve is installed on the cold water supply line between the hot water system and the next closest tee on the cold water supply. (Section 110.3(c)5F). The hot water distribution system piping from the water heater(s) to the fixtures and appliances takes the most direct path. 17 (RA 4.4.7.1) 18 Installation and operation instructions that provide details of the operation of the pump and controls are available at the jobsite for inspection. (RA 4.4.7.1) 19 More than one circulation loop may be installed. Each loop shall have its own pump and controls. (RA4.4.8, RA 4.4.9, RA 4.4.10) The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA PLUMBING CEC-NRCI-PLB-01-E Revised 01/20 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing (Page 3 of 4) Project Name: olft Enforcement Agency: Permit Number: BCOM2022-0025 Project Address- _ 05 Vt1is City: 0- u` _„ ( Zip Code: ,0?CC E. Mandatory Measures for all Domestic Hot Water Distribution Systems 01 Equipment shall meet the applicable requirements of the Appliance Efficiency Regulations (Section 110.3(b)1). 02 Unfired Storage Tanks are insulated with an external R-12 or combination of R-16 internal and external Insulation. (Section 110.3(c)4). • All domestic hot water piping shall be insulated as specified in Section 609.11 of the California Plumbing Code. In addition, the following piping conditions shall have a minimum insulation wall thickness of 1 inch or a minimum insulation R-value of 7.7: • The first 5 feet (1.5 meters) of cold water pipes from the storage tank. • All piping with a nominal diameter of 3/4 inch (19 millimeter) and less than 1 inch. • All hot water with a nominal diameter less than % inch that is:. o Associated with a domestic hot water recirculation system. o From the heating source to the kitchen fixtures. 03 o From the heating source to storage tank or between tanks. o Buried below grade. • Piping that penetrates framing members shall not be required to have pipe insulation for the distance of the framing penetration. Piping that penetrates metal framing shall use grommets, plugs, wrapping or other insulating material to assure that no contact is made with the metal framing. Insulation shall butt securely against all framing members. • Piping installed in interior or exterior walls that is surrounded on all sides by at least 1 inch of insulation. • Piping installed in crawlspace with a minimum of 2 inches (5 cm) of crawlspace insulation above and below. • Piping installed in attics with a minimum of 4 inches (10 cm) of attic insulation on top • Pipe insulation shall meet the insulation protection requirements of Section 120.3(b) 04 o Insulation exposed to weather shall be shielded from solar radiation. o Insulation on peps buried below grade must be installed in a water proof and non -crushable casing or sleeve. 05 All elbows and tees shall be fully insulated. (RA4.4.1) 06 Where insulation is required, no piping shall be visible due to insulation voids, and all insulation shall fit tightly to the pipe. (RA4.4.1) For Gas or Propane Water Heaters: Ensure the following are installed (Section 150.0(n)) 1. A dedicated 125V, 20A electrical receptacle connected to the electric panel with a 120/240V 3 conductor, 10 AWG copper branch circuit, within 3 feet from the water heater and accessible with no obstructions; 07 a. The conductor shall be labeled with the work "Spare" on both ends; and b. A reserved single pole circuit breaker space next to the circuit breaker next to the branch circuit in A labeled "Future" 240V shall be provided. 2. A Category III or IV vent, or a Type B vent with straight pipe between outside and water heater 3. A condensate drain no more than 2 inches higher than the base on water heater for natural draining 4. A gas supply line with capacity of at least 200,000 Btu/hr The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA PLUMBING CEC-NRCI-PLB-01-E Revised 01/20 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing (Page 4 of 4) Project Name: Wkg Enforcement Agency: Permit Number: BCOM2022-0025 Project Addre4_ City: VL /,Al Zip Co : -25-3 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Allison Mercado Documentation Author Signature: Affison �b[ercado Documentation Author Company Name: Golden Construction, Inc. Date Si ned: 8/1�23 Address: 7271 Mars Drive CEA/ HERS Certification Identification (If applicable): City/State/Zip: Huntington Beach CA 92647 Phone: 714 847-8080 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. 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: I ^ �� Responsible Builder/Installer Signature. Corn any Name: (Inst Iling Subcontractor or General Contractor or Builder/Owner) P�Iuw�bi ,ems Position With Company (Title): r��s t Y f Addy; qqkw 0 CSLB License: '? O City/State/Zi :� S 0 Pho e: -79 4( .3& 23 Date Signed;.., , 3 (,�� CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 1 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom Note: Submit one Certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance. Verify that systems required to employ demand Controlled ventilation (refer to §121(c)3) can vary outside ventilation flow rates Intent: based on maintaining interior carbon dioxide (CO2) concentration setpoints A. Construction Inspection 1 Instrumentation to perform test may include, but not limited to: a. Calibrated hand-held CO2 analyzer b. Manufacturer's calibration kit c. Calibrated CO2/air mixtures 2 Installation: ❑✓ The sensor is located in the high density space between 3 ft and 6 ft above the floor or at the anticipated level of the occupants' heads. 3 Documentation of all carbon dioxide control sensors includes: a. Calibration method (check one of the following) ❑ Factory -calibration (certificate calibration cert must be attached) ✓❑ Field calibrated b. Sensor accuracy ✓❑ Certified by manufacturer to be no more than +/- 75 ppm calibration cert must be attached B. Functional Testing 61 Results Step 1: Prepare for Functional Testing a. Disable economizer controls b. Outside air CO2 concentration (measured dynamically using CO2 sensor) 419 ppm c. Interior CO2 concentration setpoint (Outside CO2 concentration + 600 ppm) 1019 pprn Step 2: Simulate a signal at or slightly above the CO2 setpoint or follow manufacturers recommended testing procedures. a. For single zone units, outdoor air damper modulates opens to satisfy the total ventilation air called for in the Yes No Certificate of Compliance. b. For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone Yes No ventilation requirements. Step 3: Simulate signal well below the CO2 setpoint or follow manufacturers recommended procedures. a• For single zone units, outdoor air damper modulates to the design minimum value. Yes No b. For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone Yes 0 No ventilation requirements. Step 4: System returned to initial operating conditions Yes No Step 5: With all controls restored, apply CO2 calibration gas at a concentration slightly above the setpoint to the sensor. Verify that the outdoor air damper modulates open to satisfy the total ventilation air called for in the Certificate of Compliance. C. Testing Results PASS / FAIL Step 2: Simulate a high CO2 load (check box complete) Q Step 3: Simulate a low CO2 load (check box complete) 0 Q CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 2 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom D. Evaluation of 0 PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 3 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-1 System Location or Area Served: Greatroom DOCUMENTATION AUTHOR'S DECLARATION STATEMENT LJI 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Cond. Co. Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David Glick Field Technician Signature: Field Technician Company Name: Modern -Air Cond. Co. Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT L 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: Alex Gra bow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 1 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor Note: Submit one Certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance. Verify that systems required to employ demand Controlled ventilation (refer to §121(c)3) can vary outside ventilation flow rates Intent: based on maintaining interior carbon dioxide (CO2) concentration setpoints A. Construction Inspection 1 Instrumentation to perform test may include, but not limited to: a. Calibrated hand-held CO2 analyzer b. Manufacturer's calibration kit c. Calibrated CO2/air mixtures 2 Installation: ❑✓ The sensor is located in the high density space between 3 ft and 6 ft above the floor or at the anticipated level of the occupants' heads. 3 Documentation of all carbon dioxide control sensors includes: a. Calibration method (check one of the following) ❑ Factory -calibration (certificate calibration cert must be attached) ✓❑ Field calibrated b. Sensor accuracy ✓❑ Certified by manufacturer to be no more than +/- 75 ppm calibration cert must be attached B. Functional Testing 61 Results Step 1: Prepare for Functional Testing a. Disable economizer controls b. Outside air CO2 concentration (measured dynamically using CO2 sensor) 419 ppm c. Interior CO2 concentration setpoint (Outside CO2 concentration + 600 ppm) 1019 pprn Step 2: Simulate a signal at or slightly above the CO2 setpoint or follow manufacturers recommended testing procedures. a. For single zone units, outdoor air damper modulates opens to satisfy the total ventilation air called for in the Yes No Certificate of Compliance. b. For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone Yes No ventilation requirements. Step 3: Simulate signal well below the CO2 setpoint or follow manufacturers recommended procedures. a• For single zone units, outdoor air damper modulates to the design minimum value. Yes No b. For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone Yes 0 No ventilation requirements. Step 4: System returned to initial operating conditions Yes No Step 5: With all controls restored, apply CO2 calibration gas at a concentration slightly above the setpoint to the sensor. Verify that the outdoor air damper modulates open to satisfy the total ventilation air called for in the Certificate of Compliance. C. Testing Results PASS / FAIL Step 2: Simulate a high CO2 load (check box complete) Q Step 3: Simulate a low CO2 load (check box complete) 0 Q CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 2 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor D. Evaluation of 0 PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 3 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-2 System Location or Area Served: 1st Floor DOCUMENTATION AUTHOR'S DECLARATION STATEMENT LJI 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Cond. Co. Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David Glick Field Technician Signature: Field Technician Company Name: Modern -Air Cond. Co. Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT L 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: Alex Gra bow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 1 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor Note: Submit one Certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance. Verify that systems required to employ demand Controlled ventilation (refer to §121(c)3) can vary outside ventilation flow rates Intent: based on maintaining interior carbon dioxide (CO2) concentration setpoints A. Construction Inspection 1 Instrumentation to perform test may include, but not limited to: a. Calibrated hand-held CO2 analyzer b. Manufacturer's calibration kit c. Calibrated CO2/air mixtures 2 Installation: ❑✓ The sensor is located in the high density space between 3 ft and 6 ft above the floor or at the anticipated level of the occupants' heads. 3 Documentation of all carbon dioxide control sensors includes: a. Calibration method (check one of the following) ❑ Factory -calibration (certificate calibration cert must be attached) ✓❑ Field calibrated b. Sensor accuracy ✓❑ Certified by manufacturer to be no more than +/- 75 ppm calibration cert must be attached B. Functional Testing 61 Results Step 1: Prepare for Functional Testing a. Disable economizer controls b. Outside air CO2 concentration (measured dynamically using CO2 sensor) 419 ppm c. Interior CO2 concentration setpoint (Outside CO2 concentration + 600 ppm) 1019 pprn Step 2: Simulate a signal at or slightly above the CO2 setpoint or follow manufacturers recommended testing procedures. a. For single zone units, outdoor air damper modulates opens to satisfy the total ventilation air called for in the Yes No Certificate of Compliance. b. For multiple zone units, either outdoor air damper or zone damper modulate open to satisfy the zone Yes No ventilation requirements. Step 3: Simulate signal well below the CO2 setpoint or follow manufacturers recommended procedures. a• For single zone units, outdoor air damper modulates to the design minimum value. Yes No b. For multiple zone units, either outdoor air damper or zone damper modulate to satisfy the reduced zone Yes 0 No ventilation requirements. Step 4: System returned to initial operating conditions Yes No Step 5: With all controls restored, apply CO2 calibration gas at a concentration slightly above the setpoint to the sensor. Verify that the outdoor air damper modulates open to satisfy the total ventilation air called for in the Certificate of Compliance. C. Testing Results PASS / FAIL Step 2: Simulate a high CO2 load (check box complete) Q Step 3: Simulate a low CO2 load (check box complete) 0 Q CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 2 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: BCOM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor D. Evaluation of 0 PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017 STATE OF CALIFORNIA DEMAND CONTROL VENTILATION SYSTEMS ACCEPTANCE CEC-NRCA-MCH-06-A (Revised 07/17) CALIFORNIA ENERGY COMMISSION 4W CERTIFICATE OF ACCEPTANCE NRCA-MCH-06-A Demand Control Ventilation Systems Acceptance (Page 3 of 3) Project Name: Welbe La Quinta Enforcement Agency: Permit Number: 13COM2022-0025 Project Address: 48-805 Dune Palms Road City: LA Quinta CA Zip Code: 90710 System Name or Identification/Tag: AC-3 System Location or Area Served: 1st Floor DOCUMENTATION AUTHOR'S DECLARATION STATEMENT LJI 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Alex Gra bow Documentation Author Signature: Documentation Author Company Name: Modern -Air Cond. Co. Date Signed: 7/31/23 Address: 1086 Lomita Blvd. ATT Certification Identification (If applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: David Glick Field Technician Signature: Field Technician Company Name: Modern -Air Cond. Co. Position with Company (Title): Technician Address: 1086 Lomita Blvd. ATT Certification Identification (if applicable): City/State/zip: Harbor City CA 90710 Phone: 310-325-3712 Date Signed: 7/31/23 RESPONSIBLE PERSON'S DECLARATION STATEMENT L 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: Alex Gra bow Responsible Acceptance Person Signature: Responsible Acceptance Person Company Name: Modern -Air Cond. Co. Position with Company (Title): Project Manager Address: 1086 Lomita Blvd. CSLB License: 472651 City/State/Zip: Harbor City CA Phone: 310-325-3712 Date Signed: 7/31/23 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2017