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HomeMy WebLinkAboutBCOM2023-1030 Energy DocsSTATE OF CALIFORNIA Indoor Lighting rAI ILnDnuA CUCOGV CERTIFICATEINSTALLATION ,V I .-V IYIIVIIJJIV IY NRCI-11I-01-E This Certificate of Installation documents the installation of indoor lighting features, materials, components, and manufactured devices required to demonstrate compliance with Title 24, Part 6 per 10.103(a)3 for low-rise residential and low-rise mixed -use occupancies. Project Name: Walmart La Quints lReport Page: (Page 1 of 10) Project Address: 79295 Hwy 111, La Quints, CA 92253 JDate Prepared: 2024-12-SST15:37:55-05:00 A. GENERAL INFORMATION 01 Project Location (city) La Quints 1 04 JAuthority Having Jurisdiction City of La Quinta 02 Zip Code 92253 OS JBuilding Permit # BCOM2023-1030 03 Date of Permit Set used for construction 2024-06-12 06 1 Date of As -built Set 2024-06-12 B. INSTALLER SCOPE This table indicates the construction systems and materials documented on this Certificate of Installation. 01 02 03 Luminaires Space Types Controlsl ❑ General Lighting g 8 ® Conditioned ® Time -switch ® Occupant Sensors ® Dimmers ❑ Daylighting ❑ Interlocked Systems ❑ Shut-off ❑ Decorative/Accent ❑ Unconditioned ® Area Controls ® Demand Response El Video Conferencing Studio Controls ❑ Multi -Level ❑ Institutional Tuning 'FOOTNOTES: If an Energy Managment Control System (EMCS) or Lighting Contol System is installed to function as another type of lighting control, the type of lighting control for which it functions is indicated. Example: if the EMCS is acting as a time -switch control, "Time -switch " is checked here. C. COMPLIANCE RESULTS This table indicates whether the as -built conditions documented in this form are equal or better than what was documented on the permitted Certificate of Compliance. If the installation is not equal or better, Section 10-103(a)28 requires the Certificate of Compliance form to be revised accordingly to demonstrate compliance. 01 INSTALLED FEATURES EXACTLY MATCH DESIGN ON PERMITTED CERTIFICATE OF COMPLIANCE Documented as -built conditions should be verified by inspector from Authority Having Jurisdiction to comply. D. EXCEPTIONAL CONDITIONS This table is auto filled with uneditable comments because of field conditions noted by the installer that may impact requirements documented on the Certificate of Compliance. A iuminaire was selected as Not in Scope in the Indoor Lighting Fixture Schedule Table. Please ensure that this luminaire was claimed as in scope on anoher another Certificate of Installation CI-LTI Indoor Lighting form Generated Date/Time: CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 o-tia,.,� ve..Io.,• .o., im?non, Documentation Software: Energy Code Ace Compliance ID: 154166-0124-0003 STATE OF CALIFORNIA Indoor Lighting 'LiFURMA ENERGT LUIVIIVIDJIVIN CERTI FICATEINSTALLATI ON NRCI-LTI-01-E Project Name: Walmart La Quinta Report Page: (Page 2 of 10) Date Prepared: 2024-12-11T15:37:55-05:00 E.INSTALLER NOTES This table includes remarks made by the installer to the Authority Having Jurisdiction. F. INSTALLATION DETAILS The following tables indicate performance requirements as documented on the permitted Certificate of Compliance for all systems and components included in Table B. Installer Scope. Also included are the as -built conditions documented by the installer/documentation author Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-0003 7n„nam Ro.,.,.rau. ,rnn_,, ,, ,,.,,,. STATE OF CALIFORNIA Indoor Lighting IHLIrUMINIA CIVCnIJT L.UMMI»IUN CERTI FIGATEI NSTALLATI ON NRCI-LTI-01-E Project Name: Walmart La Quinta Report Page: (Page 3 of 10) Date Prepared: 2024-12-11T15:37:55-05:00 Indoor Lighting Controls O1 02 03 04 05 06 07 08 09 10 Area Description Primary Demand Manual Area Multi -Level Shut -Off Primary/Skylit Secondary Interlocked Function Area Response Controls Controls Controls Daylighting Daylighting Systems Controls compliance Required >_ Required Per C of C subject Readily NA: Restrooms Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Restrooms Restroom to multilevel Accessible Sensor zone zone EXACTLY MATCH As -built Required >_ DESIGN ON PERMITTED Conditions 4,000W subject Readily NA: Restrooms Occupancy NA: Not daylit NA: Not daylit No CERTIFICATE OF to multilevel Accessible Sensor zone zone COMPLIANCE Required >_ Per C of C 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Alcove Corridor to multilevel Accessible Sensor zone zone EXACTLY MATCH As -built Required >_ DESIGN ON PERMITTED Conditions 4subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No CERTIFICATE OF tomultilevel to multilevel Accessible Sensor zone zone COMPLIANCE Required >_ Per C of C 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Mother's Room All Other Space to multilevel Accessible Sensor zone zone EXACTLY MATCH As -built Types DESIGN ON PERMITTED Required >= Conditions 4,OOOW subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No CERTIFICATE OF to multilevel Accessible Sensor zone zone COMPLIANCE Required >_ Per C of C 4,OOOW subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Managers Office Office ( <=250 square feet) to multilevel Accessible Sensor zone zone EXACTLY MATCH DESIGN ON PERMITTED As -built Required >= Conditions 4,000W sub ect Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No CERTIFICATE OF to multilevel Accessible Sensor zone zone COMPLIANCE Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-0003 c�hP,n� \1 r6n ro„ TNln0nl aonnrrr ..e. -d. Intl 11 11 STATE OF CALIFORNIA Indoor Lighting rAl IMOKIIA CAICDIv rnnnen¢mnra CERTIFICATEINSTALLATION `NRCI-LTI-01--E Project Name: Walmart La Quinta Report Page: (Page 4 of 10) Date Prepared: 2024-12-11T15:37:55-05:00 Indoor Lighting Controls Required >_ Per C of C 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit ry0 INSTALLED FEATURES to multilevel Accessible Sensor zone zone EXACTLY MATCH Breakroom Lounge DESIGN ON PERMITTED Required >_ As -built 4,ODOW subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions to multilevel Accessible Sensor zone zone No COMPLIANCE Required >_ Per C of C 4,000W subject Readily Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Assistant Office (<=250 to multilevel Accessible Sensor ensor zone zone EXACTLY MATCH Managers Office square feet) DESIGN ON PERMITTED As -built Required >_ Conditions 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit N0 CERTIFICATE OF to multilevel Accessible Sensor zone zone COMPLIANCE Required >_ Per C of C Retail 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Merchandise to multilevel Accessible Sensor zone zone EXACTLY MATCH Game Play Sales DESIGN ON PERMITTED Required>= As -built Wholesale 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions Showroom to multilevel Accessible Sensor zone zone No COMPLIANCE Required >_ Per C of C Retail 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit ry° INSTALLED FEATURES Merchandise to multileveld Accessible Sensor zone zone EXACTLY MATCH Auto Center Sales DESIGN ON PERMITTED Required As -built Wholesale OOOW 4,omultilevel subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions Showroom to multilevel Accessible Sensor zone zone No COMPLIANCE Required >_ Per C of C 4,000W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Customer Service Grocery Sales to multilevel Required >_ Accessible Sensor zone zone EXACTLY MATCH DESIGN ON PERMITTED As -built 4,000W subject Readily Dimmer Occupancy NA: Not daylit I Not daylit CERTIFICATE OF Conditions to multilevel accessible Sensor zone zone N0 COMPLIANCE Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-0003 Gnc�mo vPr��.,n ro„im1nam Rannrt r.nootcd- in'IA-1)1111.]7.CO STATE OF CALIFORNIA Indoor Lighting rai IFr1RNm vmpry rnmuir inN CERTIFICATEINSTALLATION NRCI-L7I-01-E Project Name: Waimart La Quinta Report Page: (Page 5 of 10) Date Prepared: 2024-12-11T15:37:55-05:00 Indoor Lighting Controls Required >_ Per C of C 4,000W subject Readily Multilevel Auto. Time NA: Sidelit NA: Sidelit No INSTALLED FEATURES Vestibules Grocery Sales to multilevel Accessible Switch Switch retail sales area retail sales area EXACTLY MATCH DESIGN ON PERMITTED As -built Required >_ 4,000W subject Readily Multilevel Auto. Time NA: Sidelit NA: Sidelit CERTIFICATE OF Conditions to multilevel Accessible Switch Switch retail sales area retail sales area N° COMPLIANCE Required >_ Per C of C subject 4to Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES multilevel to multilevel Accessible Sensor zone zone EXACTLY MATCH Pharmacy Pharmacy DESIGN ON PERMITTED As -built Required ect 4,000W subje Readily Dimmer Occupancy NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions to multilevel Accessible Sensor zone zone No COMPLIANCE Required >_ Per C of C Retail 4to Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Merchandise to multilevel multilevel Accessible Sensor zone zone EXACTLY MATCH Vision Center Sales DESIGN ON PERMITTED As -built Wholesale Required >= 4,Oo0W subject Readily Dimmer Occupancy NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions Showroom I to multilevel Accessible Sensor zone zone No COMPLIANCE Required >_ Per C of C 4,000W subject Authorized Multilevel Auto. Time NA: Nat daylit NA: Not daylit No INSTALLED FEATURES Produce Sales Grocery Sales to multilevel Personnel Switch Switch zone zone EXACTLY MATCH DESIGN ON PERMITTED Required >= 4,000W subject I Authorized Multilevel Auto. Time NA: Not daylit NA: Not daylit As -built CERTIFICATE OF Conditions to multilevel Personnel Switch Switch zone zone No COMPLIANCE Required >= Per C of C 4,000W subject Readily Y Dimmer Occupancy NA: Not daylit NA: Not daylit No INSTALLED FEATURES Bakery/Produc a Prep Kitchen/ Food Preparation to multilevel Accessible Sensor zone zone EXACTLY MATCH DESIGN ON PERMITTED As -built Required >= Conditions 4000W sub ect , Readily Dimmer Occupancy NA: Not daylit NA: Not daylit No CERTIFICATE OF to multilevel Accessible Sensor zone zone COMPLIANCE Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-0003 CY6a.na uarcinn r.,, zmzngnl Rannrl ronnn+ad- IAIA_19_11 1 V.RI.CR STATE OF CALIFORNIA Indoor Lighting rAl IMRNIA FNFR(,v rnKAuKCIr)N CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Walmart La Ciuinta Report Page: (Page 6 of 10) Date Prepared: 2024-12-11T15:37:55-05:00 Indoor Lighting Controls Required >_ Per C of C Retail 4,000W subject Annunciated NA: General Ltg Auto. Time NA: Not daylit NA: Not daylit No INSTALLED FEATURES Merchandise to multilevel <=O.SW/SF Switch zone zone EXACTLY MATCH Garden Center Sales DESIGN ON PERMITTED As -built Wholesale Required>= 4,000W subject Annunciated NA: General Ltg Auto. Time NA: Not daylit NA: Not daylit CERTIFICATE OF Conditions Showroom to multilevel <=0.5W/SF Switch zone zone No COMPLIANCE Required >_ Per C of C 4,000W subject Readily NA: General Ltg Auto. Time NA: Not daylit NA: Not daylit No NSTALLED FEATURES Storage -MF to multilevel Accessible <=0.5W/SF Switch zone zone EXACTLY MATCH Storage common areas DESIGN ON PERMITTED Required >_ As -built 4,000W subject Readily NA: General Ltg Auto. Time NA: Not day NA: Not daylit CERTIFICATE OF Conditions to multilevel Accessible <=0.5W/SF Switch zone zone No COMPLIANCE Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-OW3 Crhoma \/orcinm ruy zminnnt Rnnnn rrn.r t.,i• in?�i i-1 i i 7.x7.cs STATE OF CALIFORNIA Indoor Lighting l.MurUMMIA CIVLRUI I.VNIIVIIJJIVn CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Walmart La quints Report Page: (Page 7 of 10) Date Prepared: 2024-1241T15:37:55-05:00 Lighting Controls Functionality Functionality listed for all lighting control systems must be installed and programmed Time -switch Controls Installed controls that provide time -switch functionality, including automatic & astronomical controls: A. Have program backup capabilities to prevent the loss of schedule for at least 7 days & the date and time for at lest 72 hours If power is interrupted; B. Are capable of providing manual override to each connected load and of resuming normally scheduled operations within 2 hours after manual override is initiated (nonresidential buildings only); C. Provide automatic holiday shutoff that turns off all connected loads for at least 24 hours and then resumes normally scheduled operation (nonresidential buildings only); D. Have sunrise and sunset prediction accuracy within +/-15 minutes and timekeeping accuracy withing 5 min per year (astronomical only); E. Are capable of displaying date, current time, sunrise time, and switching times for each step during programming and automatically adjusting for daylight savings time (astronomical only); F. Have ability to independently offset the on and off for each channel by at least 90 minutes before and after sunrise & sunset (astronomical only); G. Include at least 2 separately programmable steps per zone (multilevel only); H. Indicator lights integral to lighting controls shall consume no more than one watt of per indicator light. Dimmers Installed controls that provide dimmer functionality: A. Are capable of reducing lighting power consumption be a minimum of 65%when at its lowest setting; B. ; Provide reduced flicker operation, meaning that directly controlled light sources shall be provided electrical power such that the light output has an amplitude modulation of less than 30% for frequencies less than 200 Hz without causing premature lamp failure; C. Provide an off setting that produces a zero lumen output; D. For wall box dimmers and associated switches designed for use in three way circuit, be capable of turning lights off, and on to the level set by the dimmer if the lights are off; E. Indicator lights integral to lighting controls shall consume no more than one watt of per indicator light. Occupant Sensing Controls Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards -2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124.0003 Crhum> Vnrcinn- rov JM�nRr[t Runnrt fnnnorud'lmn_� �_� � � �a-ero STATE OF CALIFORNIA Indoor Lighting rAl IFr)RNIA FNFRr y rrimmirc Ir)N CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Walmart La Quinta Report Page: (Page B of 10) Date Prepared: 2024-12-11T15:37:55-05:00 Lighting Controls Functionality functionality listed for all lighting control systems must be installed and programmed Installed occupant sensing controls include occupant sensors, motion sensors, and vacancy sensors, including those with a Partial -ON or Partial -OFF function: A. Are capable of automatically turning the controlled lights In the area either off or down no more than 20 minutes after the area has been vacated; B. ; For manual -on controls, have a grace period of no less than 15 seconds and no more than 30 seconds to turn on lighting automatically after the sensor has timed out; C. Provide a visible status signal that indicates that the device is operating properly, or that it has failed or malfunctioned. The visible status may have an override that turns off the signal. D. Indicator lights integral to lighting controls shall consume no more than one watt of per indicator light. E. NOTE: Occupant Sensing Control systems may consist of a combination of single or multilevel Occupant, Motion, or Vacancy Sensor Controls, provided that components installed to comply with manual -on requirements shall not be capable of conversion by occupants from manual -on to automatic -on functionality. F. Sensors that are used by occupant sensing controls to detect occupants shall meet all of the following requirements: I. Shall not incorporate switches or mechanical devices that allow the sensor to be disabled without changing the settings of the control. ii. Sensors that utilize ultrasonic radiation for detection of occupants shall comply with 21 C.F.R. part 1002.12, not emit audible sound and not emit ultrasound in excess of the decibel levels shown in Table 110.9-A measured no more than five feet from the source, on axis. Ill. Sensors that utilize microwave radiation for detection of occupants shall comply with 47 C.F.R. parts 2 and 15 and not emit radiation in excess of 1 milliwatt per square centimeter measured at no more than 5 centimeters from the emission surface of the device. TABLE 110.9-A - ULTRASOUND MAXIMUM DECIBEL VALUES Mid -frequency of Sound Pressure Third -Octave Band (in dB reference 20 Third -Octave Band (in kHz) micropascals) Less than 20 80 20 or more to less than 25 105 25 or more to less than 31.5 110 31.5 or more 31.5 or more Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-0003 trhnma l/nrcinn- r.,, )n,)?ngnl Rann" rnnoremd- 1n7n_11.11 11a7.cR STATE OF CALIFORNIA Indoor Lighting rei IMPKILA rNrary rnnnnA1Cann1 CERTIFICATEINSTALLATION NRCI-LTt-01-E Project Name: Walmart La Quinta Report Page: (Page 9 of 10) Date Prepared: 2024-12-11T15:37:5S-OS:00, G. ACCEPTANCE TESTS & FIELD VERIFICATION The following Acceptance Tests related to the systems or materials documented on this NRCI have been indicated on the permitted Certificate of Compliance (NRCC) as being required to comply with Title 24, Part 6. Form/Title Systems To Be Field Verified Certificates of Acceptance Lighting Acceptance Tests must be completed by a certified Acceptance Testing Technician and NRCA forms completed through an approved Acceptance Test Technician Certification Provider database. The Certificate of Acceptance (NRCA) forms indicated below will be required by the Authority Having Jurisdiction to demonstrate compliance. Restrooms; Alcove; Mother's Room; Managers Office; Breakroom; Assistant Managers Office; Game NRCA-LTI-02-A - Must be submitted for all new, added or altered shut-off lighting controls Play; Auto Center; Customer Service; Vestibules; Pharmacy; Vision Center; Produce Sales; Bakery/Produce Prep; Garden Center; Storage Restrooms; Alcove; Mother's Room; Managers Office; Breakroom; Assistant Managers Office; Game NRCA-LTI-04-A -Must be submitted for all new, added or altered demand responsive lighting controls. Play; Auto Center; Customer Service; Vestibules; Pharmacy; Vision Center; Produce Sales; Bakery/Produce Prep; Garden Center; Storage A copy of this Certificate of Installation should be distributed to the certified Acceptance Test Technician(s) who will perform the acceptance testis). Title 24, Part 6 Section 10-103(a)3F also requires this Certificate of Installation be posted or made available to the Authority Having Jurisdiction for all applicable inspections. Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-0003 grhom� Vo,inn ro„ 7m7nom co.,,... r .,n. ,A. inIA_ll.,, ,,.,,Co STATE OF CALIFORNIA Indoor Lighting rA1 IFnp NIA FNFpr v rnKAKAI Zr Ir1N CERTIFICATEINSTALLATION NRCI-LTI-01-E Project Name: Walmart La Quinta Repot (Page 10 of 10) ProjectAddress: 79295 Flwy 111, La Ouirda, CA 92253 Date Prepared: 2024-12-11T15:37:55-05:00 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Company: Signature Date: Address: CEA/ HERS Certification Identification (if applicable): City/State/Zip: Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the. State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or Installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installar), otherwise I am an authorized representative of the responsible builder/installer. I The constructed or installed features, materials, components or manufactured devices (the installation) Identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of constructions or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentatio a builder vides to the building owner at occupancy. Responsible Builder/Installer Name: C� Responsible Builder/Installer Signature: Company Name: (Installing Subcontractor or General Contractor Builder/Owner)Esce-AVJ t(EZ„yid ' . Position With Company (Title): Address:27z S*7ueF S79,e` 6(M7-A CSLB License: City/State/Zip: Phone: Date Signed: s�w e4 9Z97/ 7/y-8y-E71- �Z ,Z �z Generated Date/Time: Documentation Software: Energy Code Ace CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance Report Version: 2022.0.000 Compliance ID: 154166-0124-0003 crhnmo vor<inn• .,, om7nonl R.,,,,,.r r noorod- oma-1 7-11 1 J.i7.cp 2111% DOMESTIC WATER HEATING SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-PLB-E CERTIFICATE OF INSTALLATION This Certificate of Installation documents the installation of service water heating features, materials, components, and manufactured devices required to demonstrate compliance with Title 24, Part 6 per §10-103(a)3 for nonresidential, hotel/motel and high-rise residential occupancies. Project Name: Walmart 1805 La Quinta Enforcement Agency: City of La Quinta Building Division Dwelling Address: 79295 Us Hwy 111 Permit Number: BCOM2023-1030 City and Zip Code: La Quinta, California 92253 Permit Application Date: A. GENERAL INFORMATION 01 Project Location (city): La Quinta 05 Authority Having Jurisdiction: City of La Quinta Building Division 02 Zip Code: 92253 06 Building Permit #: BCOM2023-1030 03 Date of Permit Set used for construction: Approval Date: 05.14.24 07 Date of As -built Set: 10.30.24 04 Name of Permit Set used for construction: W18054 Approved Permit Set 08 Name of As -built Set: W18054 Plumbing As-builts (10.30.24) B. INSTALLER SCOPE This table indicates construction systems and materials documented on this Certificate of Installation. 01 02 03 Water Heating Equipment ❑ Distribution (piping, valves, insulation, etc.) ❑ Controls CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 DOMESTIC WATER HEATING SYSTEMS =1 CALIFORNIA ENERGY COMMISSION CEC-NRCI-PLB-E C. COMPLIANCE RESULTS This table indicates whether the as -built conditions documented in this form are equal or better than what was documented on the permitted Certificate of Compliance. If the installation is not equal or better, Section 10-103(o)2B requires the Certificate of Compliance to be revised accordingly to demonstrate compliance. 01 INSTALLED FEATURES EXACTLY MATCH DESIGN ON PERMITTED CERTIFICATE OF COMPLIANCE Documented as -built conditions should be verified by inspector from Authority Having Jurisdiction to comply. The Certificate of Compliance should be revised to confirm as -built conditions comply and this Certificate of Installation updated accordingly. D. EXCEPTIONAL CONDITIONS This table is auto filled with uneditable comments because of field conditions noted by the installer that may impact requirements documented on the Certificate of Compliance. E. INSTALLER NOTES This table includes remarks made by the installer to the Authority Having Jurisdiction. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 DOMESTIC WATER HEATING SYSTEMS S CALIFORNIA ENERGY COMMISSION CEC-NRCI-PLB-E F. INSTALLATION DETAILS The following tables indicate performance requirements as documented on the permitted Certificate of Compliance for all systems and components included in Table B. Installer Scope. Also indicated are the as -built conditions documented by the installer/ documentation author. DOMESTIC HOT WATER EQUIPMENT EFFICIENCY 01 02 03 04 05 06 07 08 09 10 11 Individual Rated Input DHW Equipment Volume Capacity Rated Efficiency Standby Name or Item Tag Model # or Central Type (gal) Capacity Unit Efficiency Unit Loss Equipment System (Btu/h) Compliance Per CofC As -built Conditions CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 DOMESTIC WATER HEATING SYSTEMS ts CALIFORNIA ENERGY COMMISSION r DOMESTIC HOT WATER EQUIPMENT ADDITIONAL REQUIREMENTS CEC-NRCI-PLB-E The following requirements have been included on the permitted Certificate of Compliance (NRCC) to comply with Title 24, Part 6. Installed equipment shall meet these requirements or the Certificate of Compliance shall be modified to demonstrate compliance. (Applies to New Construction only) For gas or propane water heaters serving individual dwelling units, the follow components are included in the installation per Title 24, Part 6 §150.0(n)1: - Dedicated 125V, 20 amp electrical receptacle that is connected to the panel with a 120/240V 3 conductor, 10 AWG copper branch circuit within 3 ft from the water heater that's accessible and with both ends of the unused conductor labeled with the word "spare" and be electrically isolated. A single pole circuit breaker space in the panel adjacent to the circuit breaker for the branch circuit is provided labeled with the word "future 240V use"; and - Category III or IV vent, or Type B vent with straight pipe between the outside termination and where the water heater is installed; and - Condensate drain that is no more than 2in higher than the base of the water heater and drains without pump assistance; and - Gas supply line with a capacity of at least 200,000 BTUH Unfired storage tank insulation shall have Internal + External >_ R-16 OR External >_ R-12. Label required per Title 24, Part 6 §110.3(c)3 (Applies to new state buildings only) 60% of energy for service water heating is from site solar energy or recovered energy per Title 24, Part 6 §110.3(c)5 Isolation valves installed for instantaneous water heater with input rating > 6.8 kBTUH or 2 kW per Title 24, Part 6 §110.3(c)6. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 DOMESTIC WATER HEATING SYSTEMS CALIFORNIA ENERGY COMMISSION DOMESTIC HOT WATER DISTRIBUTION REQUIREMENTS CEC-NRCI-PLB-E The following requirements have been included on the permitted Certificate of Compliance to comply with Title 24, Part 6. Installed equipment shall meet these requirements or the Certificate of Compliance shall be modified to demonstrate compliance. Recirculation Loops in Central Systems Serving Dwelling Units or Nonresidential Spaces Automatic air release valve no more than 4 feet from pump or vertical pump installation Check valve or similar located between recirculation pump and water heating equipment to prevent backflow Hose bibb installed between pump and equipment and isolation valve between hose bibb and equipment Isolation valves on both sides of the pump Cold water and recirculation loop piping is not connected to the hot water storage tank drain port Check valve is installed on cold water supply between hot water system and next closest tee on cold water supply DWELLING UNITS ONLY: For central systems serving multiple dwelling units, design includes a recirculation system serving separate dwelling units per §170.2(d) unless building has < 8 dwelling units. DWELLING UNITS ONLY: For heat pump water heating systems, the hot water return from the recirculation loop shall connect to a recirculation loop tank and shall not directly connect to the primary heat pump water heater inlet or the primary thermal storage tanks per §170.2(d)2A. DWELLING UNITS ONLY: For heat pump water heating systems, the fuel source for the recirculation loop tank shall be electricity if auxiliary heating is needed. The recirculation loop heater shall be capable of multi -pass water heating operation per §170.2(d)2B. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 DOMESTIC WATER HEATING SYSTEMS CALIFORNIA ENERGY COMMISSION Distribution of Individual System(s) serving Dwelling Units CEC-NRCI-PLB-E Single 240 volt heat pump water heaters serving dwelling units must also include systems with: - Compact hot water distribution system as specified in Reference Appendix RA4.4.16 in climate zone 1 & 16; AND - A drain water heat recovery system that is field verified by a HERS Rater per Reference Appendix RA3.6.9 in climate zone 16. A drain water heat recovery system that is field verified by a HERS Rater per Reference Appendix RA3.6.9 in climate zone 16. For recirculation distribution systems serving individual dwelling units, only Demand Recirculation Systems with manual on/off control as specified in the Reference Appendix RA4.4.9 shall be used. Mandatory Pipe Insulation Requirements For systems serving dwelling units and common areas, pipe insulation must meet the minimum insulation requirements in Table 160.4-A (see below) except: - 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 abut securely against all framing members. - Piping installed in interior or exterior walls shall not be required to have pipe insulation if all of the requirements are met for compliance with Quality Insulation Installation (QII) as specified in the Reference Residential Appendix RA3.5. - Piping surrounded with a minimum of 1 inch of wall insulation, 2 inches of crawlspace insulation, or 4 inches of attic insulation, shall not be required to have pipe insulation. For systems serving nonresidential spaces, pipe insulation for the following applications must comply with the following: - Recirculating system piping, including supply and return piping of the water heater - The first 8 ft of hot and cold outlet piping, including between storage tank and heat trap, for a nonrecirculating storage system - Pipes that are externally heated Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Insulation exposed to weather shall be installed with a cover suitable for outdoor service per §120.3(b)/ §160.4(f). Pipe insulation buried below grade must be installed in a water proof and non - crushable casing or sleeve. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 DOMESTIC WATER HEATING SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-PLB-E DOMESTIC HOT WATER SYSTEM CONTROLS The following requirements have been included on the permitted Certificate of Compliance to comply with Title 24, Part 6. Installed equipment shall meet these requirements or the Certificate of Compliance shall be modified to demonstrate compliance. Manufacturers must certify that service water -heating systems shall be equipped with automatic temperature controls capable of adjustment from the lowest to the highest acceptable temperature settings for the intended use as listed in Table 3, Chapter 50 of the ASHRAE Handbook, HVAC Applications Volume or Table 613.1 of the California Plumbing Code for healthcare facilities. On systems that have a total capacity greater than 167,000 Btu/hr, outlets that require higher than service water temperatures as listed- in the ASHRAE Handbook, Applications Volume, shall have separate remote heaters, heat exchangers, or boosters to supply the outlet with the higher temperature unless covered by California Plumbing Code Section 613.0. Controls for circulating pumps or electrical heat trace systems are capable of automatically turning off the system unless system serves healthcare facility. For recirculation systems serving multiple dwelling units, design includes automatic pump controls per §170.2(d), or §180.1(b)3 for additions or alterations. For recirculation systems serving individual dwelling units, design includes manual on/off controls as specified in Reference Appendix RA 4.4.9 per §150.1(c)8 §170.2(d). Combustion air positive shut-off shall be provided per §160.4(e) on all newly installed commercial boilers as follows: - Boiler with input capacity >= 2.5 MMBtu/h, in which the boiler is designed to operate with a nonpositive vent static pressure - Boilers where one stack serves two or more boilers with a total combined input capacity per stack of 2.5 MMBtu/h. Boiler combustion air fans with motors >= 10 hp shall meet one of the following for newly installed boilers: - The fan motor shall be driven by a variable speed drive OR - The fan motor shall include controls that limit the fan motor demand to <= 30% of the total design wattage at 50% of the design air volume. Newly installed boilers with an input capacity >= 5 MMbtu/h and a steady state full -load combustion efficiency < 90% shall maintain excess (stack -gas) oxygen concentrations <= 5% by volume on a dry basis over firing rates of 20-100%. Combustion air volume shall be controlled with respect to firing rate or flue gas oxygen concentration. Use of a common gas and combustion air control linkage or jack shaft is prohibited. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 DOMESTIC WATER HEATING SYSTEMS CALIFORNIA ENERGY COMMISSION DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. CEC-NRCI-PLB-E Documentation Author Name: Mark Hellmuth Documentation Author Signature: Documentation Author Company Name:MJ Hellmuth Plumbing Inc Date Signed: 3/7/25 Address: 16835 Sierra Highway CEA/HERS Certification Identification (If applicable): City/State/Zip: Canyon Country, CA 91351 Phone: 661-252-771 RESPONSIBLE PERSON'S DECLARATION STATEMENT 2. 1 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 understand 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, and I will take the necessary steps to accomplish this requirement. 6. 1 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, and I will take the necessary steps to accomplish this requirement. Responsible Builder/Installer Name: Responsible Builder/Installer Signatufe: Mark Hellmuth (� Company Name: (Installing Subcontractor or General Contractor or Builder/owner) P6sition Wiih Company (Title): Owner MJ Hellmuth Plumbing Inc Address: CSLB License: 16835 Sierra Highway 486785 City/State/Zip: Canyon Country, CA 91351 Phone: Date Signed: 661-252-771 3/7/25 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300 CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-PLB-E Domestic Water Heating System (Page 1 of 2) A. General Information 1. This field is filled out automatically with data from the NRCC. 2. This field is filled out automatically with data from the NRCC. 3. Enter the Date of Permit Set used for construction. 4. Enter the Name of Permit Set used for construction. 5. Enter the Authority Having Jurisdiction. 6. Enter the Building Permit #. 7. Enter the Date of As -Built Set. 8. Enter the Name of As -Built Set. B. Project Scope 1. Select water heating equipment if applicable. 2. Select distribution (piping, valves, insulation, etc.) if applicable. 3. Select controls if applicable. C. Compliance Results 1. This table is automatically filled with uneditable comments based on data entered in Section F. D. Exceptional Conditions 1. This table is automatically filled with uneditable comments because of selections made or data entered in tables throughout the form. E. Additional Remarks 1. Enter any notes or comments for the AHJ. F. Installation Details Domestic Hot Water Equipment Efficiency 1. This field is filled out automatically. 2. Enter the Model # of the equipment installed. 3. Individual or Central System: Select from dropdown. 4. Equipment Type: Select from dropdown. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-PLB-E Domestic Water Heating System (Page 2 of 2) 5. Enter the Volume (gal) of the equipment installed. 6. Enter the Rated Input Capacity (Btu/h) of the equipment installed. 7. Enter the Capacity Unit of the equipment installed. 8. Enter the Rated Efficiency of the equipment installed. 9. This field is filled out automatically. 10. This field is automatically calculated. 11. This field is filled out automatically. Domestic Hot Water Equipment Additional Requirements 1. This table covers the additional requirements for domestic hot water equipment. Domestic Hot Water Distribution Requirements 1. This table covers the additional requirements for domestic hot water distribution. Domestic Hot Water System Controls 1. This table covers the additional requirements for domestic hot water system controls. Documentation Declaration Statements 1. The person who prepared the NRCI will sign and complete the fields for their name, company (if applicable), address, phone number, certification information (if applicable), date and signature. 2. The person who is assuming responsibility for the project being built to comply with Title 24, Part 6, will complete the fields for their name, company (if applicable), address, phone number, license number (if applicable), date and signature. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION CEC-NRCI-MCH-E This Certificate of Installation documents the installation of mechanical features, materials, components, and manufactured devices required to demonstrate compliance with Title 24, Part 6 per §10-103(a)3 for nonresidential, hotel/motel and high-rise residential occupancies. Project Name: WALMART 1805-243 Enforcement Agency: Dwelling Address: 79295 US HWY 111 Permit Number: BCOM2023-1030 City and Zip Code: LA QUINTA, CA Permit Application Date: A. GENERAL INFORMATION 01 Project Location (city): LA QUINTA, CA 02 Zip Code: 92253 03 Date of Permit Set Approval Date: 05.14.24 04 Name of Permit Set used for construction: W18054 Approved Permit SE used for construction: 05 Authority Having City of La Quinta Building Division 06 Building Permit #: BCOM2023-1030 Jurisdiction: 07 Date of As -built Set: 10.30.24 08 Name of As -built Set: W18054 Mechanical As-builts (10." B. INSTALLER SCOPE This table indicates construction systems and materials documented on this Certificate of Installation 01 ❑ Dry System (Airside) Equipment ❑ Ventilation ❑ System Controls Ductwork ❑ Boiler ❑ Pumps ❑ Terminal Box Controls ❑ Piping ❑ Chiller ❑ Fans and Air Economizers ❑ Heat Rejection Equipment (cooling towers, condensers, waterside economizers) ❑ Electric Resistance Heating 10.24) CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS =1 CALIFORNIA ENERGY COMMISSION CEC-NRCI-MCH-E C. COMPLIANCE RESULTS This table indicates whether the as -built conditions documented in this form are equal or better than what was documented on the permitted Certificate of Compliance. If the installation is not equal or better, Section 10-103(o)2B requires the Certificate of Compliance to be revised accordingly to demonstrate compliance. 1 1 INSTALLED FEATURES EXACTLY MATCH DESIGN ON PERMITTED CERTIFICATE OF COMPLIANCE Documented as -built conditions should be verified by inspector from Authority Having Jurisdiction to comply. The Certificate of Compliance should be revised to confirm as -built conditions comply and this Certificate of Installation updated accordingly. D. EXCEPTIONAL CONDITIONS This table is auto filled with uneditable comments because of field conditions noted by the installer that may impact requirements documented on the Certificate of Compliance. E. INSTALLER NOTES This table includes remarks made by the installer to the Authority Having Jurisdiction. F. INSTALLATION DETAILS The following tables indicate performance requirements as documented on the permitted Certificate of Compliance for all systems and components included in Table B. Installer Scope. Also indicated are the as -built conditions documented by the installer/ documentation author. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Dry System Equipment Schedule 01 02 03 04 05 06 07 08 09 10 11 12 13 Heating Mode Cooling Mode Equip Rated Supplemental Rated Name or Item Model Equipment ment Tag # Type Output Heating Output Efficiency Efficiency Output Efficiency Efficiency Efficiency Efficiency Compli (kBtu/h) (kBtu/h) Unit (kBtu/h) Unit Unit ance Per CofC As -built Conditions Heat Pump Equipment Schedule 01 02 03 04 05 06 07 08 09 10 11 12 13 Heating Mode Cooling Mode Name or Item Model Size Size Equipment Tag # System Category Efficiency Efficiency System Category Efficiency Efficiency Efficiency Efficiency Compliance Category (Btu/h) Unit Category (Btu/h) Unit Unit Per CofC As -built Conditions DX DOAS Schedule 01 02 03 04 05 06 07 08 09 10 Name or Item Model # Equipment Type Energy Recovery Rating Efficiency Efficiency Efficiency Efficiency Equipment Tag Condition Unit Unit Compliance Per CofC ISMRE ISCOP As -built Conditions CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Boiler Efficiency and Controls 01 02 03 04 05 06 07 08 09 10 Controls Tag/Plan Detail ID Model # Equipment Type Quantity Rated Input (Btu/h) Rated Efficiency Efficiency Unit Equipment Compliance Isolation Temperature Valve Reset PerCofC As -built Conditions Chiller Efficiency and Controls 01 02 03 04 05 06 07 08 09 10 11 12 Rated Rated Controls Tag/Plan Detail ID Model# Equipment Type Quantity Size Efficiency Efficiency Efficiency Efficiency Equipment Isolation (tons) #1 Unit #1 #2 Unit #2 Valve Temperature Reset Compliance Per CofC As -built Conditions Heat Rejection Equipment (Cooling Towers, Condensers, Waterside Economizers) Efficiency and Controls 01 02 03 04 05 06 07 08 09 10 11 12 Controls Tag/Plan Detail ID Model Equipment Quantity Rated Performance Equipment Fan Tower Fan Control in Economizer Condenser # Type Yp performance Unit Speed Flow Multiple Cell Water Compliance Control Control Turndown Equipment Temp. Reset Per CofC As -built Conditions CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Electric Resistance Heating 01 02 03 04 05 Name or Tag ID Model # Equipment Description Output Capacity Equipment (kW) Compliance Per CofC As -built Conditions Pumps 01 02 03 04 05 06 07 08 09 Controls Name or Tag ID Type Quantity Horsepower BHP) Equipment Compliance Variable Flow Hydronic Heat VSD on Differential Controls Pump Isolation Pumps > 5HP Pressure Sensor Per CofC As -built Conditions Fans and Air Economizers 01 02 03 04 05 06 Fan Electrical Input Power Name or Tag ID Quantity Fan Function Economizer System Compliance Per CofC As -built Conditions CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Dedicated Outdoor Air System (DOAS) 01 02 03 04 05 06 07 System Name Quantity Delivered Directly DOAS Fan Control Multi -Zone DOAS with Multifamily DOAS System Compliance To The Space Cooling Per CofC As -built Conditions H. Fan Energy Index (FEI) 01 02 03 04 Fan System Name or Item Tag Name or Item Tag FEI Exception FEI Per CofC As -built Conditions Exhaust Air Heat Recovery 01 02 03 04 05 06 07 Fan System Name y Required? q Type of Heat Recover Rating yp y g Required Installed EnergyRecover Bypass y yp System Compliance y p Recovery Ratio Recovery Ratio Per C of C NA As -built Conditions CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Dwelling Unit Fan Efficacy & Energy/Heat Recovery 01 02 03 04 05 06 07 Fan System Name System Airflow Input Power Watts/CFM Energy/Heat Recovery Ventilation Sensible Recovery/Effectiveness System Compliance or Item Tag (cfm) (kW) Per CofC As -built Conditions System Controls 01 02 03 04 05 06 07 08 09 Shut -Off Isolation Zone Demand Supply Air Direct Digital Control System Name Thermostats Window Interlocks System Compliance Controls Controls Response Temp. Reset (DDC) Per CofC As -built Conditions Nonresidential, Hotel/Motel and Multifamily Common Use Ventilation Systems 01 02 03 04 System Name System Design CA CFM Airflow System Design Transfer Air CFM Air Filtration 05 06 07 08 09 Space Name Exhaust Ventilation Occupant Sensor Controls Demand Control Ventilation System Compliance Per CofC As -built Conditions CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Multifamily Dwelling Unit Ventilation Systems 01 02 03 04 05 06 07 Outside Air Supply Air Exhaust Space Name Local Exhaust Air Filtration Space Compliance CFM CFM CFM Per CofC As -built Conditions Terminal Box Controls 01 02 03 04 05 06 07 08 09 Design Reheated, Recooled, Mixed Air Compliance Zone/System/VAV Box Name Item Zonal Control Zone/ Box/ System peak Primary Primary Air in Reheated Retooled 1st Stage Modulates 2nd Stage or Strategy Airflow Deadband Mixed Airflow Outside Air <95°F and Modulates from DB Compliance P Tag CFM Flow to Heating CFM CFM CFM Maintains DB Rate? Max Flow? Per CofC As -built Conditions CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Ducts The following duct systems require duct leakage testing by a certified Mechanical Acceptance Test Technician or a HERS Rater. Learn more about the Acceptance Testing Program on the Energy Commission website here: https://www.energy.ca.gov/programs-and- topics/programs/acceptance-test-technician-certification-provider-program Learn more about the HERS Program on the Energy Commission website here: https://www.energy.ca.gov/programs-and-topics/programs/home- energy-rating-system-hers-program CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-NRCI-MCH-E Pipe Insulation Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Insulation exposed to weather shall be installed with a cover suitable for outdoor service. Insulation covering chilled water piping and refrigerant suction piping located outside the conditioned space shall have a Class I or Class II vapor retarder. All penetrations and joints of which shall be sealed. Insulation thickness (in) or R-value shall be per the following Title 24, Part 6 Table 120.3-A/ 160.3-D. Fluid Operating Temperature Range (,F) Insulation Conductivity Nominal Pipe Diameter (in inches) Conductivity (in Btu•in/h•ft2• •F) Mean Rating Temperature VF) < 1 1 to <1.S 1.S to < 4 4 to < 8 8 and larger Space heating and Service Water Heating Systems (Steam, Steam Condensate, Refrigerant, Space Heating, Service Hot Water) Minimum Pipe Insulation Required (Thickness in inches or R-value) Above 350 0.32-0.34 250 Inches 4.5 5.0 5.0 5.0 5.0 R-value R 37 R 41 R 37 R 27 R 23 251-350 0.29-0.32 2nn Inches 3.0 4.0 4.5 4.5 4.5 R-value R 24 R 34 R 35 R 26 R 22 201-250 0.27-0.30 150 Inches 2.5 2.5 2.5 3.0 3.0 R-value R 21 R 20 R 17.5 R 17 R 14.5 141-200 0.25-0.29 125 Inches 1.5 1.5 2.0 2.0 2.0 R-value R11.5 R11 R14 R11 R10 105-140 0.22-0.28 100 Inches 1.0 1.5 1.5 1.5 1.5 R-value R7.7 R12.5 1111 R9 R8 CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-NRCI-MCH-E Fluid operating Insulation Conductivity Nominal Pipe Diameter (in inches) Temperature Conductivity Mean Rating < 1 1 to <1.S 1.S to < 4 4 to < 8 8 and Range (°F) (in Btu-in/h•ft2- 'F) Temperature ('F) larger Space cooling systems (chilled water, refrigerant and brine) Minimum Pipe Insulation Required (Thickness in inches or R-value)' 40-60 0.21-0.27 75 Inches Nonres Res Nonres Res 1.0 1.0 1.0 0.5 0.75 0.5 0.75 R-value Nonres Res Nonres Res R 7 R o R 5 R3 R6 R3 RS Below 40 0.20-0.26 50 I r C h 1.0 1. 5 1.5 R-v-;l.ie R 8.5 R 1.4 R 12 R 10 y G. ACCEPTANCE TESTS & FIELD VERIFICATION The following Acceptance Tests and HERS Verifications related to the systems or materials documented on this Certificate of Installation have been indicated on the permitted Certificate of Compliance as being required to comply with Title 24, Part 6. Certificates of Acceptance Mechanical Acceptance Tests must be completed by a certified Acceptance Testing Technician and Certificate of Acceptance forms completed through an approved Acceptance Test Technician Certification Provider database. The Certificate of Acceptance forms indicated below will be required by the Authority Having Jurisdiction to demonstrate compliance. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION CEC-N RCI-MCH-E Form/Title Systems to be Field Verified NRCA-MCH-02-A Outdoor Air must be submitted for all newly installed HVAC units. Note: MCH-02-A can be performed in conjunction with MCH-07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. NRCA-MCH-03-A - Must be submitted for Constant Volume Single Zone HVAC. NRCA-MCH-04b-A - Must be submitted for Air Distribution Duct Leakage. NRCA-MCH-05-A - Must be submitted for Air Economizer Controls. NRCA-MCH-06-A - Must be submitted for Demand Control Ventilation. NRCA-MCH-07-A - Must be submitted for Supply Fan Variable Flow Controls. NRCA-MCH-08-A - Must be submitted for Valve Leakage Test. NRCA-MCH-09-A - Must be submitted for Supply Water Temperature Reset Controls. NRCA-MCH-10-A - Must be submitted for Hydronic System Variable Flow Controls. NRCA-MCH-11-A - Must be submitted for Automatic Demand Shed Controls. NRCA-MCH-12-A-FDD-F - Must be submitted for Packaged Direct Expansion Units. NRCA-MCH-13-A-FDD - Must be submitted for Air Handling Units and Zone Terminal Units. NRCA-MCH-14-A - Must be submitted for Distributed Energy Storage DX -AC Systems. NRCA-MCH-15-A - Must be submitted for Thermal Energy Storage. NRCA-MCH-16-A - Must be submitted for Supply Air Temperature Reset Controls. NRCA-MCH-17-A - Must be submitted for Condenser Water. NRCA-MCH-18-A - Must be submitted for Energy Management Control Systems. NRCA-MCH-19-A - Must be submitted for Occupancy Sensor Controls. NRCA-MCH-20-H - Must be submitted for Multifamily Ventilation. NRCA-MCH-21-H - Must be submitted for Multifamily Envelope. NRCA-MCH-22-A - Must be submitted for Multifamily Duct Leakage. NRCA-MCH-23-A - Must be submitted for Multifamily HRV/ERV Verification. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS =1 CALIFORNIA ENERGY COMMISSION CEC-NRCI-MCH-E Certificates of Verification HERS verifications must be completed by a HERS Rater and NRCV forms completed through an approved HERS Provider database. The Certificate of Verification forms indicated below will be required by the Authority Having Jurisdiction to demonstrate compliance. NRCA-MCH-04a-H - Must be completed by installer and submitted for Air Distribution Duct Leakage. NRCV-MCH-04-H Duct Leakage Test NRCV-MCH-24 Enclosure Air Leakage Worksheet NRCV-MCH-27 High-rise Residential NRCV-MCH-32 Local Mechanical Exhaust There are no Acceptance Tests or HERS verifications indicated on the permitted Certificate of Compliance related to the systems or materials documented on this Certificate of Installation. A copy of this Certificate of Installation should be distributed to the certified Acceptance Test Technician(s) who will perform the acceptance test(s). Title 24, Part 6 Section 10-103(a)3F also requires this Certificate of Installation be posted or made available to the Authority Having Jurisdiction for all applicable inspections. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 MECHANICAL SYSTEMS CALIFORNIA ENERGY COMMISSION DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. i—\kA CEC-NRCI-MCH-E Documentation Author Name: Randy Kashou Documentation Author Signature: Documentation Author Company Name: Kashou Climate Control Inc Date Signed: 3/11/25 Address: 1240 E. Ontario Ave, Suite 102-179 CEA/HERS Certification Identification (If applicable): City/State/Zip: Corona, CA 92881 Phone: 951-270-2600 RESPONSIBLE PERSON'S DECLARATION STATEMENT 2. 1 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 understand 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, and I will take the necessary steps to accomplish this requirement. 6. 1 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, and I will take the necessary steps to accom li h this requirement. Responsible Builder/Installer Name: Responsible Builder/Installer Signature: Randy Kashou Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position With Company (Title): Kashou Climate Control Inc PROJECT MANAGMENT Address: CSLB License: 1240 E. Ontario Ave., Suite 102-179, 813791 City/State/Zip: Phone: Date Signed: Corona, CA 92881 951/270/2600 03/11/2025 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300 CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-MCH-E Mechanical Systems (Page 1 of 7) A. General Information 1. This field is filled out automatically. 2. Enter the zip code of the construction project. 3. Enter the Date of Permit Set used for construction. 4. Enter the Name of Permit Set used for construction. 5. Enter the Authority Having Jurisdiction. 6. Enter the Building Permit #. 7. Enter the Date of As -Built Set. 8. Enter the Name of As -Built Set. B. Project Scope 1. Select all applicable equipment, systems and materials documented. C. Compliance Results Results in this table are automatically calculated from data input and calculations in Tables F. D. Exceptional Conditions 1. This table is auto filled with uneditable comments because of selections made or data entered in tables throughout the form. E. Installer Notes 1. Enter any notes or comments for the AHJ. Dry System Equipment Schedule 1. This field is filled out automatically. 2. Enter the model # of the equipment being installed. 3. Select: True or False. 4. Enter the heating mode Rated Output of the equipment in kBtu/h. 5. Enter the Supplemental Heating Output of the equipment in kBtu/h. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-MCH-E Mechanical Systems (Page 2 of 7) 6. Enter the efficiency of the equipment while in heating mode. 7. This field is filled out automatically. 8. Enter the cooling mode Rated Output of the equipment in kBtu/h. 9. Enter the efficiency of the equipment while in cooling mode. 10. This field is filled out automatically. 11. If a second efficiency is required, enter the efficiency of the equipment while in cooling mode. 12. This field is filled out automatically. 13. This field is calculated automatically. Heat Pump Equipment Schedule 1. This field is filled out automatically. 2. Enter the model # of the equipment being installed. 3. Select: True or False. 4. Select: True or False. 5. Enter the efficiency of the heat pump while in heating mode. 6. This field is filled out automatically. 7. Select: True or False. 8. Select: True or False. 9. Enter the efficiency of the heat pump while in cooling mode. 10. This field is filled out automatically. 11. If a second efficiency is required, enter the efficiency of the heat pump while in cooling mode. 12. This field is filled out automatically. 13. This field is calculated automatically. DX DOAS Schedule 1. This field is filled out automatically. 2. Enter the model # of the equipment being installed. 3. Select: True or False. 4. Select: True or False. 5. Select: True or False. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-MCH-E Mechanical Systems (Page 3 of 7) 6. Enter the ISM RE efficiency of the DOAS equipment. 7. This field is static text showing the efficiency unit is ISMRE. 8. Enter the ISCOP efficiency of the DOAS equipment. 9. This field is static text showing the efficiency unit is ISCOP. 10. This field is calculated automatically. Boiler 1. This field is filled out automatically. 2. Enter the model # of the equipment being installed. 3. Select: True or False. 4. Enter the quantity of identical equipment being installed. 5. Enter the Rated Input of the boiler in Btu/h. 6. Enter the Rated Efficiency of the equipment. 7. This field is automatically filled out. 8. Isolation Valve: Select from Dropdown. 9. Temperature Reset Controls: Select from Dropdown. 10. This field is calculated automatically. Chiller 1. This field is filled out automatically. 2. Enter the model # of the equipment being installed. 3. Select: True or False. 4. Enter the quantity of identical equipment being installed. 5. Select: True or False. 6. Enter the efficiency while in cooling mode. 7. This field is filled out automatically. 8. If a second efficiency is required, enter the efficiency while in cooling mode. 9. This field is filled out automatically. 10. Isolation Valve: Select from Dropdown. 11. Temperature Reset Controls: Select from Dropdown. 12. This field is calculated automatically. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-MCH-E Mechanical Systems (Page 4 of 7) Heat Rejection Equipment (Cooling Towers, Condensers, Waterside Economizers) Efficiency and Controls 1. This field is filled out automatically. 2. Enter the model # of the equipment being installed. 3. Select: True or False 4. Enter the quantity of identical equipment being installed. 5. Enter the Rated Performance of the equipment being installed. 6. This field is filled out automatically. 7. Fan Speed Control: Select from Dropdown. 8. Tower Flow Turndown: Select from Dropdown. 9. Fan Control in Multiple Cell Equipment: Select from Dropdown. 10. Economizer Control: Select from Dropdown. 11. Condenser Water Temperature Reset: Select from Dropdown. 12. This field is calculated automatically. Electric Resistance Heating 1. This field is filled out automatically. 2. Enter the model # of the equipment being installed. 3. This field is filled out automatically. 4. Enter the Output Capacity in kW. 5. This field is calculated automatically. Pumps 1. This field is filled out automatically. 2. This field is filled out automatically. 3. Enter the quantity of identical equipment being installed. 4. Enter the Horsepower of the pump. 5. Variable Flow Controls: Select from Dropdown. 6. Hydronic Heat Pump Isolation Control: Select from Dropdown. 7. Variable Speed Drive on pumps greater than 5 horsepower: Select from Dropdown. 8. Differential Pressure Sensor Control: Select from Dropdown. 9. This field is calculated automatically. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-MCH-E Mechanical Systems (Page 5 of 7) Fans and Air Economizers 1. This field is filled out automatically. 2. Enter the quantity of identical equipment being installed. 3. Fan Function: Select from Dropdown. 4. Economizer: Select from Dropdown. 5. Enter the Electrical Input Power of the fan in Watts. 6. This field is calculated automatically. Dedicated Outdoor Air Systems (DOAS) 1. This field is filled out automatically. 2. Enter the quantity of identical equipment being installed. 3. Delivered Directly to the Space: Select from Dropdown. 4. Enter the fan system power in kilowatts. 5. Enter the fan system airflow in cubic feet per minute. 6. This field is calculated automatically. 7. This field is static text that says less than or equal to 3 speeds. 8. Multizone DOAS with cooling: Select from Dropdown. 9. Select: Yes or No. 10. Multifamily DOAS: Select from Dropdown. 11. This field is calculated automatically. System Controls 1. This field is filled out automatically. 2. Thermostat Controls: Select from Dropdown. 3. Shut-off Controls: Select from Dropdown. 4. Isolation Zone Controls: Select from Dropdown. 5. Demand Response Controls: Select from Dropdown. 6. Supply Air Temperature Reset Controls: Select from Dropdown. 7. Window Interlock Controls: Select from Dropdown. 8. Direct Digital Controls: Select from Dropdown. 9. This field is calculated automatically. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-MCH-E Mechanical Systems (Page 6 of 7) Nonresidential, Hotel/Motel and Multifamily Common User Ventilation Systems 1. This field is filled out automatically. 2. Enter System Designed Outside Air Airflow in cubic feet per minute. 3. Enter System Designed Transfer Air Airflow in cubic feet per minute. 4. Air Filtration: Select from Dropdown. 5. This field is filled out automatically. 6. Enter Exhaust Ventilation for the space. 7. Occupant Sensor Controls: Select from Dropdown. 8. Demand Control Ventilation: Select from Dropdown. 9. This field is calculated automatically. Multifamily Dwelling Unit Ventilation Systems 1. This field is filled out automatically. 2. Enter System Designed Outside Air Airflow in cubic feet per minute. 3. Enter System Designed Supply Air Airflow in cubic feet per minute. 4. Enter Exhaust Air Airflow in cubic feet per minute. 5. Local Exhaust: Select from Dropdown. 6. Air Filtration: Select from Dropdown. 7. This field is calculated automatically. Terminal Box Controls 1. This field is filled out automatically. 2. Zonal Control Strategy: Select from Dropdown. 3. Enter the Peak Primary Airflow for the zone or system in cubic feet per minute. 4. Enter the Primary Air in Deadband Airflow for the zone or system in cubic feet per minute. 5. Enter the Reheated, Recooled or Mixed Airflow for the zone or system in cubic feet per minute. 6. Enter the Outside Air Airflow for the zone or system in cubic feet per minute. 7. Confirm the first stage modulates and maintains the drybulb rate. 8. Confirm the second stage modulates from drybulb flow to heating max flow. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 CERTIFICATE OF INSTALLATION — USER INSTRUCTIONS NRCI-MCH-E Mechanical Systems (Page 7 of 7) 9. This field is calculated automatically. Ducts 1. This field is filled out automatically. Pipe Insulation 1. This table includes required pipe insulation values from Part 6 and does not require user entry. G. Acceptance Tests and Field Verification 1. This field is filled out automatically. Documentation Declaration Statements 1. The person who prepared the NRCI will sign and complete the fields for their name, company (if applicable), address, phone number, certification information (if applicable), date and signature. 2. The person who is assuming responsibility for the project being built to comply with Title 24, Part 6, will complete the fields for their name, company (if applicable), address, phone number, license number (if applicable), date and signature. CA Building Energy Efficiency Standards - 2022 Nonresidential Compliance January 2022 Project Status Report — Lighting Controls Acceptance Testing National Lighting Contractors Association of America (Revised 02/2021) COMPLETED Code Cycle: Project Name: NLCAA Project Number: Project Address: Permit Number: Enforcement Agency: Acceptance Test Employer: Acceptance Test Technician: FORMS INCLUDED 91 2022 Energy Code Walmart - La Quinta 2411-00016 79295 Hwy 111, La Quinta, CA, 92253-2060 BCOM2023-1030 City of La Quinta Kevin White - ATE-1412-00008 Kevin White - ATT-1501-00024 AA National Lighting Contracto, Association of America MQ. STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America Q CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Time Switch Lighting Controls Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Storage Automatic Time Switch Lighting Controls A-1. Automatic Time Switch Lighting Controls Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America MM CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Time Switch Lighting Controls Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Garden Center Automatic Time Switch Lighting Controls A-1. Automatic Time Switch Lighting Controls Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Ly iL,1, L,iii.ici Association of America CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Bakery / Produce Prep Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America MM CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Time Switch Lighting Controls Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Produce Automatic Time Switch Lighting Controls A-1. Automatic Time Switch Lighting Controls Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Ly iL,1, L,iii.ici Association of America CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Vision Center Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America MM CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Pharmacy Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America ro Q. CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Time Switch Lighting Controls Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Vestibule Automatic Time Switch Lighting Controls A-1. Automatic Time Switch Lighting Controls Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America ro Q. CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Customer Service Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contractor Association of America �%o CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Auto Center Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America MM CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Game Play Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Ly iL,1, L,iii.ici Association of America CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Breakroom Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America Em CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Manager's Office Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) nn r- National Lighting Contracto, ■ Association of America ❑ - CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Asst. Managers Office Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA ri National Lighting Contractor Association of America FEE CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Mother's Room Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA ri National Lighting Contractor Association of America FEE CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Alcove Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Ly iL,1, L,iii.ici Association of America CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Front Restroom Men's Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America MM CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Front Restroom Women's Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America Em CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Back Restroom Men's Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Ly iL,1, L,iii.ici Association of America CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Back Restroom Women's Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA National Lighting Contracto, Association of America MM CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Automatic Shut -Off Occupant Sensing Lighting Control Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Building: 1 Floor: 1 Room: Back Restroom Family Occupant Sensing Lighting Controls A-2. Occupant Sensing Lighting Control Construction Inspection Step Entry Item Code Reference 1 STATE OF CALIFORNIA SHUT-OFF LIGHTING CONTROLS CEC-NRCA-LTI-02-A (Revised 12/24) AA 0� CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Shut -Off Lighting Controls Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Declaration Statement Signatory Document Author Name: Kevin White I assert that this Certificate of Acceptance documentation is accurate and complete. Company Name: Emmaus Electric Author Signature: Date Signed: December 13, 2024 Field Technician Name: Kevin White I certify the following under penalty of perjury, under the laws of the State of California: The Company Name: Emmaus Electric information provided on this Certificate of Acceptance is true and correct. I am the person who ATT No.: ATT-1501-00024 performed the acceptance verification reported on this Certificate of Acceptance (Field Title: Technician). The construction or installation identified on this Certificate of Acceptance complies Phone: with the applicable acceptance requirements indicated in the plans and specifications approved by Signature: the enforcement agency and conforms to the applicable acceptance requirements and procedures Date Signed: December 13, 2024 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 builder/installer and has been posted or made available J4- with the building permit(s) issued for the building. �_ Responsible Person Name: Kevin White I assert the following under penalty of perjury, under the laws of the State of California: I am the Company Name: Emmaus Electric Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I Lic. No.: 991307 have reviewed the information provided on this Certificate of Acceptance. I am eligible under ATE No., (If applicable): Division 3 of the Business and Professions Code in the applicable classification to accept Title: President responsibility for the system design, construction or installation of features, materials, components, Phone: 714-853-3744 or manufactured devices for the scope of work identified on this Certificate of Acceptance and Signature: attest to the declarations in this statement (responsible acceptance person). The information Date Signed: December 13, 2024 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. 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 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 Page 21 of 21 STATE OF CALIFORNIA DEMAND RESPONSIVE CONTROLS CEC-NRCA-LTI-04-A (Revised 12/24) AA National Lly!llll i_i L,t—toi�Association of America CERTIFICATE OF ACCEPTANCE NRCA-LTI-04-A Demand Responsive Illuminance Measurement Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 A-1. Demand Responsive Lighting Control Construction Inspection (NA7.6.3.1) Step Entry Item Code Reference 1 STATE OF CALIFORNIA DEMAND RESPONSIVE CONTROLS CEC-NRCA-LTI-04-A (Revised 12124) AA National L..... Association of America B-1. Functional Testing Method 1: Illuminance Measurement (NA7.6.3.2) Step Entry (#1) Functional Testing Code Reference N/A STATE OF CALIFORNIA DEMAND RESPONSIVE CONTROLS CEC-NRCA-LTI-04-A (Revised 12/24) CERTIFICATE OF ACCEPTANCE NRCA-LTI-04-A Demand Responsive Controls Project Name: Walmart - La Quinta Project Address: 79295 Hwy 111 City, Zip Code: La Quinta, 92253-2060 Enforcement Agency: City of La Quinta Permit Number: BCOM2023-1030 Permit Application Date: 06-12-2024 Declaration Statement Signatory Document Author Name: Kevin White I assert that this Certificate of Acceptance documentation is accurate and complete. Company Name: Emmaus Electric Author Signature: Date Signed: December 13, 2024 Field Technician Name: Kevin White I certify the following under penalty of perjury, under the laws of the State of California: The Company Name: Emmaus Electric information provided on this Certificate of Acceptance is true and correct. I am the person who ATT No.: ATT-1501-00024 performed the acceptance verification reported on this Certificate of Acceptance (Field Title: Technician). The construction or installation identified on this Certificate of Acceptance complies Phone: with the applicable acceptance requirements indicated in the plans and specifications approved by Signature: the enforcement agency and conforms to the applicable acceptance requirements and procedures Date Signed: December 13, 2024 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 builder/installer and has been posted or made available with the building permit(s) issued for the building. Responsible Person Name: Kevin White I assert the following under penalty of perjury, under the laws of the State of California: I am the Company Name: Emmaus Electric Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I Lic. No.: 991307 have reviewed the information provided on this Certificate of Acceptance. I am eligible under ATE No., (If applicable): Division 3 of the Business and Professions Code in the applicable classification to accept Title: President responsibility for the system design, construction or installation of features, materials, components, Phone: 714-853-3744 or manufactured devices for the scope of work identified on this Certificate of Acceptance and Signature: attest to the declarations in this statement (responsible acceptance person). The information Date Signed: December 13, 2024 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. 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 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 Page 3 of 3