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HomeMy WebLinkAboutX2018-3734 - MiscSTATE OF CALIFORNIA 6880 63 50r) X2013- 913y LIGHTING CONTROL ACCEPTANCE DOCUMENT CALIFORNIA ENERGY COMMISSION CEC-LTG-2A (Revised 08/09) LTG -2A CERTIFICATE OF AUChrIAINUE, (Pae I of 4) Li hting Control Acceptance Document Field Technician's Signature: Pro)ect Name/Address: /S system Name or Jdentification/Tag: system Location or AreaServed: Date Signed: Position With Company (Title): Enforcement: Agency: 6e Permit Number: ><2— t71 � � 3-1 3 ` r Note: submit one Certificate of Acceptance for each system that Enforcement Agency Use: Checked by/Date must demonstrate compliance. FIELD TECHNICIAN'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is nue and correct. • I am the person who performed the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I certify that the construction/installation identified on this form 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 Installation Certificates) for the construction/installation identified on this form has been completed and is ..,.ated er Wade avanaliln adth the hnildinn nermitisl issued for the building. RESPONSIBLE PERSON'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, that I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this form. • I am a licensed contractor, architect, or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person). • I certify that the information provided on this form substantiates that the construction/installation identified on this form 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 Installation Certificate(s) for the construction/installation identified on this form has been completed and is posted or made available with the building permit(s) issued for the building. • I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: „t� Company Name: _ Field Techn/iiciiaan'§ Name:. �sy Field Technician's Signature: License: gI93it Date Signed: Position With Company (Title): 5— 2.9-- let ® LP, aL e� RESPONSIBLE PERSON'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, that I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this form. • I am a licensed contractor, architect, or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person). • I certify that the information provided on this form substantiates that the construction/installation identified on this form 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 Installation Certificate(s) for the construction/installation identified on this form has been completed and is posted or made available with the building permit(s) issued for the building. • I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: „t� Pphonppe�:: , @ q Responsible P rson's Name: Responsible Person's Signature: License: gI93it Date Signed: ISI Position With Company (Title): $_2-S-_ tWr%_e.f- Occu ant Sensor, Manual Da lightin Control, and Automatic Time Switch Control Intent: Li hts are turned off when not needed per Section 119 d & 131 d . Construction Inspection 1 Instrumentation to Perforin test includes, but not limited to: a. Hand-held am era a and voltage meter 2008 Nonresidential Acceptance Forms August 2009 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-LTG-2A (Revised 08/08) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE LTG -2A Lighting Control Acceptance Document (Page 2 of 4 Prot Name/Address: /i1'�t / l'+�ilG 2 U .�iSca.� .f�+'� -��/S ,/�2v� or � � �✓-�_ System Name or Identification/Tag: _ Location or Area Served: y b. I Power meter continued on next page 2 Occupancy Sensor Construction Inspection fT' Occupancy sensor has been located to minimize false signals X Light meter $ Ultrasonic occupancy sensors do not emit audible sound (119a) 5 feet from source 3 Manual Daylighting Controls Construction Inspection If dimming ballasts are specified for light fixtures within the daylit area, make sure they meet all the Standards requirements, including "reduced flicker operation" for manual dimming controls stems 4 Automatic Time Switch Controls Construction Inspection a. Automatic time switch control is programmed for (check all): .Er' Weekdays Weekend ,pT' Holidays b. Document for the owner automatic time switch programming (check all): ff- Weekdays settings Weekend settings ,gr Holidays settings ,8' Set-up settings 4�T Preference program setting ,n- Verify the correct time and date is properly set in the time switch ,gam Verify the battery is installed and energized ,a Override time limit is no more than 2 hours ,r Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 119 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices A. Select Acceptance Test (Indicate lighting control systems Names/Designations by the applicable tests below) .®' I Occupancy Sensor R' 2 Manual Daylighting Controls p- 3 Automatic Time Switch Controls B. Equipment Testing Requirements Check and verify those items applicable to selected system: Applicable Lighting Control Systems Occupancy Sensor - Step 1: Simulate an unoccupied condition 1 2 3 a' Lights controlled by occupancy sensors turnoff within a maximum of 30 minutes from start of an unoccupied condition per Standard Section 119 d XI N `Q/ N Yl N b The occupant sensor does not trigger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation Y-/ N -T/ N A`/ N c. Signal sensitivity is adequate to achieve desired controlJf / N Jt / N ,IL9 N Occupant Sensor - Step 2: Simulate an occupied condition 2008 tvonrestaentiat Acceptance Forms August 2009 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT eFc_I T(:_9A IRuvlxed na/n91 CALIFORNIA ENERGY COMMISSION ` CERTIFICATE OF ACCEPTANCE LTG -2A Lighting Control Acceptance Document (Page 3 of 4 ProjectName/Addres: O-VCt l W 6\Z- G�� SPA- v'e- Mil Dv t System 1V 101ne or Identification/rag: — YIN System Location or Area Served:( a. Status indicator or annunciator operates correctly YIN / N YIN b Lights controlled by occupancy sensors tum on when Immediately upon an occupied condition OR this requirement is mutually exclusive with Step 2.c. }y / N YIN YIN C. Sensor indicates space is "occupied" and lights turn on manually /(11 N YIN / N continued on next page Occupant Sensor - Step 3: System returned to initial operating conditions XIN V�/ N Y / N Occupant Sensor - Step 4 - Sensor is also a multi -Level Occupant Sensor used to qualify for a Power Adjustment Factor in Section 146(a)2D of the Standards. If yes, then `a,' `b,' and `c' must also be yes. Y / N YIN It / N a' The first stage activates between 30 to 70% of the lighting either manually or automatically. / N / N / N b. A reasonably uniform level of illuminance is achieved by dimming of all lamps or luminaires; or by switching alternate lamps in luminaires, alternate luminaires, or alternate rows of luminaires. Y / N YIN X / N c. After the fust stage occurs, manual switches have been provided to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the li hts. / N YIN YIN Manual Daylighting Controls - Step 1: Manual switching control a. At least 50% of lighting power in daylit areas is separately controlled from other lights Y / N Y / N Y / N b. I The amount of light delivered to the space is uniformly reduced X / N X / N X / N Manual Daylighting Controls - Step 2: System returned to initial operating conditions Yl N I h / N JY / N Automatic Time Switch Controls - Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Jf / N Y1 N Y / N b Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located /* / N W / N ,,Y / N Automatic Time Switch Controls - Step 2: Simulate unoccupied condition a. All non-exempt lighting tum off per Section 131(d)1 YIN Jf / N Y1 N b, Manual override switch allows only the lights in the selected ceiling height partitioned space where the override switch is located, to tum on or remain on until the next scheduled shut off occurs }r/ N Y / N Yl N c. All non-exempt lighting turns off Y/ N YIN Y1 N Automatic Time Switch Controls -Step 3: System returned to initial operating conditions 7P / N IN Y®/ N Note. Shaded areas do not apply for particular test procedure C. PASS / FAIL Evaluation (check one): IRK PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive Y - es ❑ FAIL: Any applicable Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in any applicable Equipment Testing Requirements section. Provide explanation below. Use and attach additional pages if necessary. -­ ....... ws rgufus nwUyturtce r arms August 2009 STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-LTG-2A (Revised 08/09) CERTIFICATE OF ACCEPTANCE VI VVIVIIVIIJJIUIY LTG -2A Lighting Control Acceptance Document Pae 4 of 4 ProjeZt Name/Address: a 4 t 12 -ft a - % e: S7 - 0 e,4.. - us -1 (� r_ • ti.(� /�' System Name or Identificgtion/Tag: System Locationj or Area Se ed: 2008 Nonresidential Acceptance Forms August 2009 STATE OF CALIFORNIA MECHANICAL CEC-NRCWCH-01.E /R9VI.d WPOI CERTIFICATE OF INSTALLATION V V NRCI-MCH-01-E Mechanical (Page 1 of 2) "r°"cttiam Total Wine, Newport Beach EnPorcemen[Agenry; F rip, j✓ -'to 3 "r°'edAdd".:1280 Bison Ave, Ste B15 ""'Newport Beach r"`°""92660 A. GENERAL INFORMATION DATE OF BUILDING PERMIT: BUILDING TYPE ® Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel PHASE CONSTRUCTION ❑ New Construction 13Addition ❑ 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 documents) for the entire construction. 8. SLOPE OF RESPONSIBILITY Date of approval by the enforcement agency of the Certificate of Compliance that provides the Date: specifications for this Installation Certificate. 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 Date Approved By Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. I the Enforcement IN bunting energy ert¢lency btandaras - 2u19 Nonresidential Compliance January 2020 STATE OF CALIFORNIA MECHANICAL CEC•NRCI-MCH-01{ (Revised 01120 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-MCH-01-E Mechanical (Page 2 of 2) °roleC°"am"Total Wine, Newport Beach Erf nern.rtA8e",' f� "" 7 Project Addmse: City: 1280 Bison Ave, Ste B15 Newport Beach p ua" 92660 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Max Wilkie no "nta"nA thor qre; Documentat oA C. hyN a i�Iri�Paxi C06 & Air Conditioning, Inc. Date31 ed: ,7-s / Address: 336.00 Buckwheat Road CEA/HERS CeolEcationl entificatien(if applicable): `"/state/zlptMenifee, CA 92584 Phone: 951.672.1221 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 attestto the declarations in this statement (responsible builder/installer), otherwise 1 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 agencythat identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) Issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be Included with the documentation the builder provides to the building owner at occupancy.. Responsible Builder/Installer Name: Max Wilkie Resp. - Tale lid Ins I Ignerur.; Company Name: (installing subcontractor or General Contractor or Builder/owner) Position ith Compo nylffilel: Air Max Heating & Air Conditioning, Inc. Technician/President Address: 33600 Buckwheat Road CSLBLicense: 691077 "/sttazlp.Menifee, CA 92584 Ph°°`'951.672.1221 Oa[e5ignp CA Building Energy Efficiency Standards -2019 Nonresidential Compliance January 2020 -..._ _. - _.1..... CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Reviged07/tat ORNIA ENERGY COiKilivii iI'lIV 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: Total Wine, Newport Beach Enforcement Agency: Permit Number: ? -37 3V Pns1.d Address: 1280 Bison Ave Ste B15 Ciry: Newport Beach iip Code: 92660 System Name or Identification/Tag: RTU -1 System Location or Area Served: Cep' 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. Installation (check if applies): ®"Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): Thermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120:2(b). Minimum heating setpoint:°F. Maximum cooling setpointF. Deadband:°F. Zn Occupled, unoccupied, and holiday schedules have been programmed per the schedule provided. (Pre -occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: ❑ Lesser of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 120.1-A or 15cfm per person times the expected number of occupants. V 3 complete air changes. Notes: CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A IRavicad n911a1 CERTIFICATE OF ACCEPTANCE V NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems Page 2 of 3 Pmjec[ Name: Total Wine, Newport Beach Enforcement Agency: Pamtt Num Step 3: No-load during occupied condition .-7. Projec[Fdtlress: 1280 Bison Ave Ste B35 ON: Newport Beach Zip Code 9266 60 System Name., ddrrt1ft.tr../Trg: RTU -1 System Location or Area Served 2 werS Ltl�/ B. Functional Testing Requirements I 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; x �� b. Supply fan turns off C. Supply fan cycles on and offs d. System reverts to "occupied" mode to satisfy any condition e. System turns off when manual override time period expires s F�4 f. Gas-fired furnace, heat pump, orelectric heaterstages on w, a41" 0" g. No heating is provided by the unit ',N h. No cooling is provided by the unit i `' # ", I/ 1. Compressor stages on ,- .t 1. Outside air damper is open to minimum position k. Outside air damper closes completely I, rl Step 9: System returned to initial operating conditions after all tests have been completed: Ves No (� C. Testing Results 6 1 7 1 6 I s 1 4 3 z Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter 71 L tY l PASS: All Construction Inspection responses are complete and all applicable Testing Results responses are "Pass" (P). 1 CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-M-A (Revised D711AI lo, cc�c,ana 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: Total Wine, Newport Beach Card rcement Agency: rmi Pet Number: y 373Y mo-1 Address; 1280 Bison Ave Ste BIS Clty:zip Newport Beach code: 92660 system Name or identification/Tag: RTU -1 System Location or Area Served: a� rr,e.S Ryg,1 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie Documentation Author Signature: ), Documentation Author Company Name: Air Max Heating& Air Conditioning, Inc. Date Signed: Address: 33600 Buckwheat Road AT -Certification l antificati n (Ifap icable): City/state/Zip: Menifee, CA 92584 Phone: 951.672.1221 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 instal lation 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 forthe building. Field Technician Name: Max Wilkie Field Technician Signature: l Fiedd Technician Company Name: Air Max Heating & Air Conditioning, Inc. Position with Company (Title): Technician/President Address: 33600 Buckwheat Road ATT Certification Identification (if applicable): clry/state/Zip: Menifee, CA 92584 Phone:Date 951.672.1221 Ogn Z `!r 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 Certificates) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permits) issued for the building. S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Max Wilkie Responsible Acceptance Persia S afore: Responsible Acceptance Persian Company Name: Air Max Heating& Air Condltlonir Position with Company (Title): Technlchlan/President Address: 33600 Buckwheat Road Cyte License: 691077 city/state/Zip: Menifiee, CA 92584 Phone: 951.672.1221 Date Signed: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NBCA-MCH-03-A Revised 07/16 CAUFO NIA ENE Y C R RG OMMISSION 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: Total Wine, Newport Beach Enforcement Agency: Permit Number Pmiectaddmss: 1280 Bison Ave Ste BSS city: Newport Beach ziP code: 92660 System Name or ldendfcal1on/7ag: RTU -2 system Loatlon or Area Served �Cj 00/ Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date demonstrate compliance. A. Construction Inspection I. 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. Inst ation:(check if applies): LK Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): ®/thermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120.2(b). Ir Minimum heating setpoint: °F. Maximum cooling setpoint °F. Deadband:.�°F. fn Occupied, unoccupied, and holiday schedules have been programer the schedule provided. (Pre -occupancy purge has been programmed. to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: ❑ Lesser of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 1}•0.1-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 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A M.,ei.rd n]H A% B. Functional Testing Requirements I Operating Modes 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: Total Wine, Newport Beach Enroreement Agency: Permit Number: Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter Unoccupied Mode IrIPIFIf Project Address: 1260 Bison Ave Ste B15 cit Newport Beachy: 2iP Code: 92660 System Name or Identification/Tag: RTU -2 System Locati"n or Area Served 8 7 6 5 1 4 B. Functional Testing Requirements I 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 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter Unoccupied Mode IrIPIFIf 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 1 4 3 2 Step 2 —8: Check and verify the following for each simulation mode required ' + l�".' a. Supply fan operates continually ti (j .V b. Supply fan turns off 4!. C. Supply fan cycles on and off d. System reverts to "occupied" mode to satisfy any condition e. System turns off when manual override time period expires 7's� f. Gas-fired furnace, heat pump, or electric heater stages on g. No heating is provided by the unit � h. No cooling is provided by the unit iii a I. Compressor stages on j. Outside air damper is open to minimum position rs k. Outside air damper closes completely, s. Step 9: System returned to initial operating conditions after all tests have been completed: Yes No O C. Testing Results 8 1 7 6 1 s 1 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter it" IrIPIFIf Evaluation W 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 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03.A mevfced n)H n . ..,......__._.. V 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: Total Wine, Newport Beach Enforcement Agency: Permit Number: Address: 33600 Buckwheat Road ATT Certification Identific tion (If plicabl ): ; Project Address: 1280 Bison Ave Ste 815 City: Newport Beach IP Code: 92660 System Name oNdentieaadon/Tag: RTU -2 System Location or Area Served: 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements 3& r� DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie Documentation Author Signature: Documentation Author Company Name: Air Max Heating& Air Conditioning, Inc. Date Signed: 2S Address: 33600 Buckwheat Road ATT Certification Identific tion (If plicabl ): city/state/zip: Menifee, CA 92584 Phone: 951.672.1221 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building, Field Technician Name: Max Wilkie Field Technician Signature: J Field Technician Company Name: Air Max Heating & Air Conditioning, Inc. Position with Company (Title): Technician/President Address: 33600 Buckwheat Road ATT Certification identification (if applicable): City/State/zip: Menifee, CA 92584 Phone: 951.672.1221 Date Ig , 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 offeatures, 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. S. 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: Max Wilkie Responsible Acceptance Person Signature: + Responsible Acceptance Person Company Name: Air Max Heating&Air Conditionir Position with Company (Title): Technichian/ resident Address: 33600 Buckwheat Road CSLa License: 691077 city/state/zip: Menifiee, CA 92584 Phone: 951.672.1221 Date 5i n CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC.NRCA-MCH-03-AYRAvN.d niltn) SPLIT) 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. Installation (check if applies): [V Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): [j'7hermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120.2(b). MVmum heating setpoint: F. Maximum cooling setpoint:�°F. Deadband:,5°F. [1� Occupied, unoccupied, and oliday schedules have been programme per the schedule provided. lvpre-occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: ❑ Lesser of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 20.1-A or 15cfm per person times the expected number of occupants. 3 complete air changes. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 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. Total Wine, Newport Beach Enfomement Agency: Permit Number. Profecl Addreszu 1280 Bison Ave Ste BIS Ci ty: Newport Beach Zip Code: 92660 System Name or identifimtiontrag: RTU -3 System location pr Area Served: � ✓r� �� 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. Installation (check if applies): [V Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): [j'7hermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120.2(b). MVmum heating setpoint: F. Maximum cooling setpoint:�°F. Deadband:,5°F. [1� Occupied, unoccupied, and oliday schedules have been programme per the schedule provided. lvpre-occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: ❑ Lesser of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 20.1-A or 15cfm per person times the expected number of occupants. 3 complete air changes. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, AIR CONDITIONER AND HEAT PUMP CEC-NRCA-101311-03-A Mai 071161 UNITARY (PACKAGED AND SPLIT) SYSTEMS GAL mnoui 0 CERTIFICATE OF ACCEPTANCE V NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems Page 2 of 3 Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: 3 73YProject edd,ess: 1280 Bison Ave Ste B15 cry: Newport Beach mP cede: 92660 System Name or Identification/tag: RTU -3 System Location or Area Served: B. Functional Testing Requirements I 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 R Arll el a. Supply fan operates continually art ,js, Y b. Supply fan turns off T ; A C. Supply fan cycles on and off =''t ✓' f d. System reverts to "on cupied" mode to satisfy any conditionV, e. System turns off when manual override time period expires` f. Gas-fired furnace, heat pump, or electric heater stages on _u g. No heating is provided by the unit ✓ h. No cooling is provided by the unit n ` ' i. Compressor stages on 1. Outside air damper is open to minimum position k. Outside air damper closes completely Step 9: System returned to initial operating conditions after all tests have been completed: Yes No Q C. Testing Results 1 8 1 7 1 6 s 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter D. LVI 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 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A (Revised 07/161 SPLIT) nn, icnonnn c E CERTIFICATE OF ACCEPTANCE V NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems Page 3 of 3 Project Name', Total Wine, Newport Beach Enforcement Agency: Oem —3 3 It No � Pfpject dddresi: 1280 Bison Ave Ste 815 Ciry: Newport Beach 2ip Cotle: 92660 System Name or Idenlification/rag: RTU -3 system System Lamport or area Sawed: FLOII Ciry/state/zip: Menifee, CA 92584 Phone: 951.672.1221 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie Documentation Author Signature: Documentation Author Company Name! Air Max Heating& Air Conditioning, Inc. Date Signed: 2 ! Address: 33600 Buckwheat Road ATT Certification Identification (If aplilicabley. Ciry/state/zip: Menifee, CA 92584 Phone: 951.672.1221 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. I have confirmed that the Certificate(s) of Installation for the construction or installation Identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: Max Wilkie Field Technician Signature: Field Technician Company Name: Air Max Heating &AIr Conditioning, Inc. Position with Company (Title): echnician/President Address: 33600 Buckwheat Road ATT Certification Identification (if applicable): City/State/Zip: Menifee, CA 92584 Phone: 951.672.1221 Dates - Z 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 offeatures, 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: Max Wilkie Responsible Acceptance Person Signature: t v Responsible Acceptance Person Company Name: Air Max Heating & Air Condltlonlr Position with Company (Title): Technlchia President Address: 33600 Buckwheat Road CSLB License: 691077 city/State/zip: Menifiee, CA 92584 Phone: 951.672.1221 Datesign 2 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC,NRCA-MCH-03-A Revised 07116 CALIFORNIA ENERGY COMMISSION As 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: Total Wine, Newport Beach Enforcement Agency: Perm it Number. �7r 3.. Pm1rd Address: 1280 Bison Ave Ste 815 City: Newport Beach Zi, Code; 92660 System Name or Identitication/rag: RTU -4 System LOW Ilan or Area Served. F1101 Note: Submit one Certificate of Acceptance for each system that must Enforcement Agency Use: Checked by/Date - 1 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 (NA7.5.1 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. Instal ation (check if applies): Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. Programming (check all those that apply): QVIhermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 120'2(b). 111 Minimum heating setpoint: 4T F. Maximum cooling setpoint&°F. Deadband: I or. ,(.,? �"Dtcupled, unoccupied, and holiday schedules have been programmed per the schedulee provided. grre-occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: ❑ Lesser of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 120.1-A or 15cfm per person times the expected number of occupants. 3 complete air changes. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEG-NRCA-MCH-03-A iRevised 07/161 re} mnonne _7 CERTIFICATE OF ACCEPTANCE I Operating Modes NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems Page 2 of 3 Pmjed Name: Total Wine, Newport Beach Enfbrceme tAgency: —7p—it Number 1 -373. Project Address: 1280 Bison Ave Ste 815 Oty: Newport Beach Zip�otle: 92660 Step 6: Heating load during unoccupied condition System Name or Identif etion/rag: RTU -4 ca System Lotion or area 5erved: 8 7 6 5 4 s /10/// Step 2-8: Check and verify the following for each simulation mode required `` `' B. Functional Testing Requirements I 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 `` `' �' E ` `' a. Supply fan operates continually b. Supply fan turns off C. Supply fan cycles on and off s;le V Rnt d. System reverts to "occupied" mode to satisfy any condition' AE ^N ? it e. System turns off when manual override time period expires' f. Gas-fired furnace, heat pump, or electric heater stages on g. No heating is provided by the unit I r -, L) Nrj^ r/ h. No cooling is provided by the unit i. Compressor stages on E` ,� tsv „rs t afl j. Outside air damper is open to minimum position V r - <oh; k. Outside air damper closes completely ;«i r- V s+, ,t .,� Step 9: System returned to initial operating conditions after all tests have been completed: Yes No Q C. Testing Results 8_I 7 1 6 1 s 1 a 1 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter 103 Lk'I 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 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A IRwainnd n7Nna — In—s— —11— CERTIFICATE .11...... CERTIFICATE OF ACCEPTANCE 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. V NRCA-MCH-03-A Constant Volume, Single Zone, Unitary (Packaged and Split) Air Conditioner and Heat Pump Systems Page 3 of 3 Project Name Total Wine, Newport Beach Enforcement Agency: Pcrmlt ry��ms r, X �f L^r� �./ 1/l/ PmleeAddresz: 1280 Bison Ave Ste 615 City: Newport Beach Zip code: 92660 1. The information provided on this Certificate of Acceptance is true and correct. System Name or Idcotificatlonfrag: RTU -4 System Location or Area Served: 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. ZS .C1 -0d% been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie DocumenttiAth aon uor Ignatu e: / Documentation Author Company Name: Air Max Heating& Air Conditioning, Inc. Date Signed: y� Address: 33600 Buckwheat Road ATTCertificatiou dentifica ion (If a plicable): city/state/zip: Menifee, CA 92584 Phone: 951.672.1221 FIELD TECHNICIAN'S DECLARATION STATEMENT 1 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: Max Wilkie Field Technician signature: 2 Iv /Lex Field Technician Company Name: Air Max Heating & Air Conditioning, Inc. Position with Company (Title): Technician/President Address; 33600 Buckwheat Road ATT Certification Identification (if applicable): City/State/Zip: Menifee, CA 92584 Phone: 951.672.1221 Date Sign ,'6 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: Max Wilkie Responsible Acceptance Personjign� ur Responsible Acceptance Person Company Name:Air Max Heating &Air Condtionir Position with Compan Title): Technichian/President Address: 33600 Buckwheat Road CSLa License: 691077 City/state/Zip: Menifiee, CA 92584 Phone: 951.672.1221 Date 49 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NBCA-MCH-03-AIRBvised 071161 CAI IFr1RUlA FNFR('V Cl1MMICFIrIN 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: Total Wine, Newport Beach Enforcement Agency: permit Number: lye 73 Project Address : 1280 Bison Ave Ste 615 City: Newport Beach Zip Code: 92660 System Name or Identipcationinag: RTU -S System Location or Area Served: S LWa y a6 //" Note: Submit one Certificate ofAcceptancefor 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. Installation (check if applies): (Thermostat is located within the space -conditioning zone that is served by the HVAC system. 4. (check all those that apply): rPProogramming i hermostat meets the temperature adjustment and dead band requirements of 2016 Building Energy Efficiency Standards Manual Section 1202(b). Minimum heating setpoint: 120.2(b). Minimum Maximum' cooling setpoint 60°F. Deadband:�nF. gKoccupled, unoccupied, and oliday schedules have been programmed per the schedule provided. Vere -occupancy purge has been programmed to meet the requirements of 2016 Building Energy Efficiency Standards Manual Section 120.1(c)2. 1. Check method used to determine pre -occupancy purge: ❑ Lesser of: conditioned floor area times ventilation rate from 2016 Building Energy Efficiency Standards TABLE 130.1-A or 15cfm per person times the expected number of occupants. Lge�3 complete air changes. Notes: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2015 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS GEC-NRCA-MCH-03-A Revised 07116 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: Total Wine, Newport Beach Enfaraement Agency: Permit Numbn+: % 3 7.3 Project AddrZ. 1280 Bison Ave Ste BSS City: Newport Beach Zip Cotle: 92660 Syctem Name or Identification/Tag; System location or Area Served: RTU -5 S F�-Or✓ ,SAL r� B. Functional Testing Requirements I Operating Modes Step 1: Disable economizer control and demand -controlled ventilation (if applicable) to prevent unexpected interactions. Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter Occupied Mode Step 2: Heating load during occupied condition Step 3: No-load during occupied condition Step 4: Cooling load during occupied condition Unoccupled 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 I c . , '-0 a�_� , a. Supplyfan operates continually 3z _�..-.. _.._a .,.:. b. Supply fan turns off i, R u= ,t„l ..:w C. Supply fan cycles on and off '$ t sem, d. System reverts to "occupied” mode to satisfy any condition ILI j, .OR .n.;. e. System turns off when manual override time period expires f. Gas-fired furnace, heat pump, or electric heater stages onR4 yd V g. No heating is provided by the unit ''i G,k' ✓ fru rv.cx: h. No cooling is provided by the unit I. Compressor stages on j. Outside air damper is open to minimum position '13 tirj k. Outside air damper closes completelyit + N Step 9: System returned to initial operating conditions after all tests have been completed: Yes No Q C. Testing Results B 1 7 1 6 1 5 1 4 3 2 Indicate if Passed (P), Failed (F), or N/A (X), fill in appropriate letter n 1. [Q I 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 CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT) AIR CONDITIONER AND HEAT PUMP SYSTEMS CEC-NRCA-MCH-03-A Revised 07/16 CALIFDRNIA 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 Nandi Total Wine, Newport Beach Enforcement Agency: Permit Number: Pmiectaaara:.:1280 Bison Ave Ste BIS city Newport Beach zip Codi 92660 system Name or identification/Tag: RTU -5 sy4remtnvtlan orArao xrved: �n7 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie Dacumentattan Author gignatu e:� Documentation Author Company Name; Air Max Heating& Air Conditioning, Inc. Data Signed: z Address: 33600 Buckwheat Road ATr Certcation Identcat on (If ap Ilcable): city/state/tip: Menifee, CA 92584 Phone: 951.672.1221 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or Installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permits) issued for the building. Field Technician Name: Max Wilkie Field Technician Signature: -N Field Technician Company Name: Air Max Heating &Air Conditioning, Inc. Position with company (Ti le) Technician/President Address: 33600 Buckwheat Road ATT Certification Identification (if applicable): city/state/Zip: Menifee, CA 92584 Phone: 951.672.1221 Date stye_, 4f RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work Identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificates) 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. S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable Inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Max Wilkie Responsible Acca tan arson Signature: Responsible Acceptance Person Company Name: Air Max Heating& A Condltlonlr Position 61th Company (Title): Technichia n/President Address: 33600 Buckwheat Road CSLB license: 691077 City/state/Zlp: Menifiee, CA 92584 Phone: 951.672.1221 Date S�gfi Z CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (ReVised 07/16) CALIFORNIA ENERGYCOMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: -W0 -3 73 Y Projett Adtlress: 1280 Bison Ave, Ste B15 qty: Newport Beach Z p Cade: 92660 System Name or ldentiflenkm/P., RTU -1 Systemyl [alien ar Area Served J ¢101// 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. 1. 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. 2. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow, (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: 0_0^1 ,c,L 4'/fa' 0 ii. Equipment calibration date (must be within one year):, 30 % 3. System type (check either VAV or CAV): ❑ VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ❑ Check if factory calibrated and attach calibration certification. ❑ Check if field calibrated and attach calibration results. ii. Damper Control (must be checked): JK Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). ill. One of the following dynamic controls is being utilized to control outside air (check method used) Ne' Outdoor Air CFM Compensation ❑ Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking ❑ Injection Fan Method Dedicated Minimum Ventilation Dam er with Pressure Control bi"' Other Active Control, Describes ✓GOhDMi2. 4/ b. Check if Constant Air Volume (CAV) and verify the following: ❑ System is designed to provide a fixed minimum OSA when the unit is on. 4. Method of delivering outside air to the unit (check one of the following): 5;-6utside119/5 _aiir is ducted to the return air plenum. Confirm that outside air is ducted to within (check one of the following): + tom 5ft.ofthe unit. ❑ 15 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) 5. Pre -occupancy purge has been programmed for the 1 -hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): ❑ The conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm ,per person times the expected number of occupants, whichever is greater. .0 Complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards -2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE CAV NRCA-MCH-02-A Outdoor Air Acceptance Step 1: Disable demand control ventilation (if applicable) (Page 2 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: Project Address 1280 Bison Ave, Ste BIS city Newport Beach Zip Code: 92660 System Name or Identification/rag: RTU -1 System Location.,A,.a Served: L o✓ Adjust supply air to achieve design airflow or maximum airflow at full a- cooling. Record VFD speed (Hz). B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV VAV 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) ,j cfm cfm Required outdoor airflow (cfm) (from MCH -03, Column 14, or C. Mechanical Equipment Schedules). F3 ✓ b 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). x '' cfm C. Required outdoor airflow (cfm) (from MCH -03, Column 14, or Mechanical Equipment Schedules) vs 3 } ,yi cfm d. Time for outside air damper to stabilize after reduced supply airflow is -achieved (minutes): min Step 5: Return to initial conditions (check) El C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OA,) for Step 3. a. %OA, = Measured outdoor airflow reading /Required outdoor airflow. (Step3b/Step3c) G % % It. %OA, is within 10% of design Outside Air. (90% <%OA, < 110%) Yes No Q Yes Q No p C. Outside air damper position stabilizes within 5 minutes. (Step 3d <5 minutes) ",r`='5 Yes Q No O Determine Percent Outside Air at reduced supply airflow (%OAaA) for Step 4. (VAV only) a. %OAaA cc Measured outdoor airflow reading /Required outdoor airflow reading. (Step4b/Step4c) b. %OAm is within 10% of design Outside Air. (90%<_ %OAp, < 110%) c. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) 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 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07116) CERTIFICATE OF ACCEPTANCE 1. I certify that this Certificate of Acceptance documentation is accurate and complete. NRCA-MCH-02-A Outdoor Air Acceptance Documentation Author Company Name: Air Max Heating& Air Conditioning, Inc. (Page 3 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: %b Project Address: 1280 Bison Ave, Ste 815 City: Newport Beach Zip Code: 92660 System Name or lom irimnion/rag: RTU -1 System Location or Area served: d✓ 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie Documentation Author Signature: a Documentation Author Company Name: Air Max Heating& Air Conditioning, Inc. Date Signed: z t Address: 33600 Buckwheat Road ATT Certification Iden dation (If applicable): City/state/Zip: Menifee, CA 92584 Phone: 95 1.672.1221 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permits) issued for the building. Field Technician Name: Max Wilkie Field Technician signature Field Technician Company Name: Air Max Heating & Air Conditioning, Inc. Position with Compan iTitle): Technician/President Address: 33600 Buckwheat Road ATT Certification Identification (if applicable): City/State/21P:Menifee, CA 92584 Phone: 951.672.1221 Date SV e : J � f RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or Installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements Indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT. 4. 1 have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and Is posted or made available with the building permit(s) issued for the building. 5. 1 will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Max Wilkie Responsible Acceptance Yson Signature: Responsible Acceptance Person Company Na me: Air Max Heating& Air Conditlonir Position vAth Company(Tltle): Technician/President Address: 33600 Buckwheat Road CSLB License: 691077 City/state/zip: Menifee, CA 92584 Phone: 951.672.1221 Date Signed:� CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: 3 Project Address: 1280 Bison Ave, Ste 815 City: Newport Beach Zip Code'. 92660 System Name or Identification/Tag: RTU -2 sme. tonFlon orAre;p /So"ad.r,1 / be /�V4✓ Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent:I 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 141 or Mechnnical Fnuinment irhadulac. A. Construction Inspection Note: MCH -01-A can be performed in conjunction with MCH -07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. 1. Supporting documentation needed to perform test includes: 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. 2. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anneemometer, velocity pressure probe, etc.). I. Method and equipment used:_Apm Plots/ yelel I. Equipment calibration date (must be within one year): R / G 3. System type (check either VAV or CAV): ID VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ❑ Check if factory calibrated and attach calibration certification. ❑ Check if field calibrated and attach calibration results. ii. DamperControl (must be checked): [Er Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). iii. One of the following dynamic controls is being utilized to control outside air (check method used) Outdoor Air CFM Compensation ❑ Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking ❑ Injection Fan Method ❑ Dedicated Minimum Ventilation Damper with Pressure Control �Other Active Control, Describe: gaZA0M17-ver b. Check if Constant Air Volume (CAV) and verify the following: ❑ System is designed to provide a fixed minimum OSA when the unit is on. 4. Method delivering outside air to the unit (check one of the following): Outside alrJs ducted to the return air plenum. Confirm that outside air is ducted to within (check one of the following): 5 ft. of the unit. ❑ 15 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) 5. Pre -occupancy purge has been programmed for the 1 -hour period immediately before the building is normally occupied to provide (one ofthe following methods must be verified and checked): he conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm [P/er person times the expected number of occupants, whichever is greater. Complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE CAV NRCA-MCH-02-A Outdoor Air Acceptance Q� (Page 2 of 3) Project Name: Total Wine, Newport Beach Enforcement Agenor: Permit Numbed xZp/y-373 Project Address: 1280 Bison Ave, Ste B15 city: Newport Beach Zip code: 92660 System Name or Identi(ica tion/rag: RTU -2 J! 5ystem Location or Area Served'. B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV VAV Step 1: Disable demand control ventilation (if applicable) Q� ❑ Step 2: verify unit is not in economizer mode during test (economizer disabled) ❑ Note: Shaded boxes do not applyfor CAVsystems 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) 517 cfm cfm Required outdoor airflow (cfm) (from MCH -03, Column 14, or C. Mechanical Equipment Schedules). S3� 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). s ." Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow (cfm) (from MCH -03, Column 14, or Mechanical Equipment Schedules) , ;, Y""" 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 (%DA,) for Step 3. a. %OA,= Measured outdoor airflow reading /Required outdoor airflow.(Step3b/Step3c) ,�' % % b. %OA, is within 10% of design Outside Air. (90% 5 %OA, 5110%) Yes (y No Q Yes Q No Q C. Outside air damper position stabilizes within 5 minutes. (Step 3d <5 minutes) f "` '" Yes Q No Q Determine Percent Outside Air at reduced supply airflow (%OAPA) for Step 4. (VAV only) a. %OARA= Measured outdoor airflow reading /Required outdoor airflow reading.(Step4b/Step4c) b. %OAPA is within 0% of design Outside Air. (90%< %OARA < 110%) ° x : Yes Q No Q c. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) `� '"` =' r Yes Q No Q 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 OUTDOOR AIR ACCEPTANCE CEC-NBCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. NRCA-MCH-02-A Outdoor Air Acceptance Documentation Author Compa ny Name: Air Max Heating &Air Conditioning, Inc. (Page 3 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: 19-Y% Project Address: 1280 Bison Ave, Ste B15 City: Newport Beach Zip race: 92660 System Name or Identlflcation/rag: RTU -2 System Laratlon a'Area Sorvatl: S' �'Gi F�Jza✓ 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: MaxWilkie Documentation Author Signature: / _ Documentation Author Compa ny Name: Air Max Heating &Air Conditioning, Inc. Date Signed:V nr / RJ Address: 33600 Buckwheat Road ATT certificatidIn Identification (If applicable): City/State/zip: Menifee, CA 92584 Phone: 951.672.1221 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: Max W llkle Field Technician Signature: Field Technician Company Name: Air Max Heating &Air Conditioning, Inc. Position with Company(Titl 'Technician/President Address: 33600 Buckwheat Road ATr Certification Identification (if applicable): city/stats/zip:Menlfee, CA 92584 Phone: 951.672.1221 Date I fid: , 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 Peron Name: Max Wilkie Responsible Acceptance Peron St natula Responsible Acceptance Person company Name: Air Max Heating & Air Condltlonlr Position with Company (Title)- TFech�nician/President Address: 33600 Buckwheat Road CSLIB ucense: 691077 cry/state/zip: Menifee, CA 92584 Phone: 951.672.1221 Date 5J4{k .17 J CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance July 2016 _...._.. _.._.... OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) lect Name: Project Wine, Newport Beach Enforcement Agency: Permit Number: AW `3 �3• Project Address: 1280 Bison Ave, Ste B15 city: Newport Beach Lp Code. 92660 System Name orldoniricationfrag: RTU -3 System ,leoc,/ation or Area Se ed: .5zge Z7yl Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent: =Reference outside airflow reading is within 10% of the total required outside airflow. Required forall 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. 1. 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. 2. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). i. Method and equipment used: A AO'ii' "ii Lt/ HerIA ii. Equipment calibration date (must be within one year): 30 3. System type (check either VAV or CAV): ❑ VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ❑ Check if factory calibrated and attach calibration certification. ❑ Check if field calibrated and attach calibration results. ii. Damper Mrol (must be checked): [V Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). Iii. One of the following dynamic controls is being utilized to control outside air (check method used) Outdoor Air CFM Compensation ❑ Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking ❑ Injection Fan Method Dedicated Minimum Ventilation Dam,ver with Pressure Control � Other Active Control, Describe: 4," CPA 0 Ai t Z b. Check if Constant Air Volume (CAV) and verify the following: ❑ System is designed to provide a fixed minimum OSA when the unit is on. 4. Method f delivering outside air to the unit (check one of the following): Outside air 1 ducted to the return air plenum. Confirm that outside air Is ducted to within (check one of the following): 5 ft, of the unit. ❑ 15 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) 5. Pre -occupancy purge has been programmed for the 1 -hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): ❑ The conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 chat ,—,/per person times the expected number of occupants, whichever is greater. ye Complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE CAV NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Name: Total Wine, Newport Beach Enforcement Agenq: mit rvum er: Apl f , 3 PF°ject Address: 1280 Bison Ave, Ste B15 Qty: Newport Beach Zip Code: 92660 5,te. Name or Nentiii t,.nfr., RTU -3 system Lv<°lipn° A'e seined: J!�lGJY �pd� B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV VAV Step 1: Disable demand control ventilation (if applicable) ❑ Step 2: Verify unit is not in economizer mode during test (economizer disabled) LV ❑ Note: Shaded boxes do not apply for CAI/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) cfm �i.� cfm cfm Required outdoor airflow (cfm) (from MCH -03, Column 14, or C. Mechanical Equipment Schedules). 53 cfm cfm Time for outside air damper to stabilize after full supply airflow is achieved d. (minutes): ilr1411 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).; -` `. N {'Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow (cfm) (from MCH -03, Column 14, or Mechanical Equipment Schedules).u'"3 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 (%OA,) for Step 3. a. %OA, = Measured outdoor airflow reading /Required outdoor airflow. (Step3b/Step3c) rdJ % % b. %OA, is within 10% of design Outside Air. (90%55 %OA, s 110%) Yes No Q Yes Q No Q C. Outside air damper position stabilizes within 5 minutes. (Step 3d <5 minutes) Yes Q No Q Determine Percent Outside Air at reduced supply airflow (%OApA) for Step 4. (VAV only) a. %OARA= Measured outdoor airflow reading /Required outdoor airflow reading. (Step4b/Step4c) , , s441 b. %OApA is within 10%P of design Outside Air. (90%<_ %OApA < 110%) , tfi', , Yes Q No Q c. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) r �'" 7 s Yes Q No Q Note: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and controls to avoid overventilation. 2) VAV air handlers use dynamic 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 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 3 of 3) Project Name: Total Wine, Newport Beach Enforcement Agenry: Permit Number: Project Address: 1280 Bison Ave, Ste BIS City: Newport Beach Zip Code: 92660 System Name or Id.rrt flcation/Tag: RTU -3 System Loation or Area Served: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie Doc n tion uth r nature: Documentation Author Compa ny Name: Air Max Heating & Air Conditioning, Inc. Date Signed: V2. - Address: 33600 Buckwheat Road ATr Certificatlo Identifi ation (lf pplicable): city/state/ziP: Menifee, CA 92584 Phone: 951.672.1221 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws ofthe 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: Max Wilkie Field Technician Signature! Field Technician Company Name: Air Max Heating St Air Conditioning, Inc. Position with ompany e): Technician/President Address: 33600 Buckwheat Road ATT Certification Identification (if applicable): city/state/zlp:Menifee, CA 92584 Phone: 951.672.1221 Date ed: 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 an 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. S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Max Wilkie Re onsibl Accepts Personsignature: Responsible Acceptance Person Company Name: Air Max Heating& Air Condltlonlr Poi with Company (Title): Technician/President Address: 33600 Buckwheat Road CSLB License: 691077 City/state/zip: Menifee, CA 92584 Phone: 951 672 1221 Datn,.yg `8 2 CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 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) Pmir& Name: Total Wine, Newport Beach Enforcement Agency Permit Number. x7sx-37334 Project Address: 1280 Bison Ave, Ste B15 City: Newport Beach Zip Code: 92660 System Name or Identiflcaticn/rag: RTU -4 System Location or Area Servde Y _f"vZ Note: Submit one Certificate of Acceptance for each system Enforcement Agency Use: Checked by/Date that must demonstrate compliance. Intent: =Reference outside airflow reading is within 10% of the total required outside airflow. Required for all newly installed HVAC units. Reference MCH -03 (Column 141 or Mechanical Equipment Schedules. A. Construction Note: MCH -02-A can be performed in conjunction with MCH -07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. 1: Supporting documentation needed to perform test includes: 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. 2. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (i.e. hot-wire anemometer, velocity pressure probe, etc.). IT I. Method and equipment used: L M 6441 12L-9QJ ii. Equipment calibration date (must be within one year): b 3 v 3. System type (check either VAV or CAV): ❑ VAV gK CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ❑ Check if factory calibrated and attach calibration certification. ❑ Check if field calibrated and attach calibration results. Ii. Damper Control (must be checked): VDynamic damper control Is being used to control outside air. (This Is NOT a fixed minimum position). iii. One of the following dynamic controls is being utilized to control outside air (check method used) [P/Outdoor Air CFM Compensation ❑ Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking ❑ Injection Fan Method ❑ Dedicated Minimum Ventilation Oa per with Pressure Control VOther Active Control, Describe: 7GGA6vh17-te b. Check if Constant Air Volume (CAV) and verify the following: ❑ System is designed to provide a fixed minimum OSA when the unit is on. 4. Method of delivering outside air to the unit (check one of the following): Outside air is ducted to the return air plenum. Confirm that outside air is ducted to within (check one of the following): (/ 5 ft. of the unit. ❑ 15 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) S. Pre -occupancy purge has been programmed for the 1 -hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): ❑ The conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm er person times the expected number of occupants, whichever is greater. Tr/complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION 4Q CERTIFICATE OF ACCEPTANCE CAV NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project Name: Total Wine, Newport Beach Womement Agency: Permit Number: Proica Adarets: 1280 Bison Ave, Ste 815 city Newport Beach zP coda; 92660 5ystem Name or lde bfica[idn/rag: RTU -4 5ystem Lccmom or Arca Served: ,5r Y LGG✓ B. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV vav 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 CAI/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) ,S.Z cfm cfm Required outdoor airflow (cfm) (from MCH -03, Column 14, or c Mechanical Equipment Schedules). 53& cfm cfm d Time for outside ai r da mper to stabilize after full supply airflow is achieved (minutes): 1 7— - __..F,. 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). f ,: „��: Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow (cfm) (from MCH -03, Column 14, or Mechanical Equipment Schedules) fi'.. 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 (%OA,) for Step 3. a. %OA,= Measured outdoor airflow reading /Required outdoor airflow.(Step3b/Step3c) 01 17W % 1 % b. %OA, is within 10% of design Outside Air. (90%15 %OA, 5 110%) Yes 0 No Q Yes Q No Q C. Outside air damper position stabilizes within 5 minutes. (Step 3d <5 minutes) tai _ w " x '! Yes Q No Q Determine Percent Outside Air at reduced supply airflow (%OARA) for Step 4. (VAV only) a. %OAAA= Mea sured outdoor airflow reading/Required outdoor airflow reading. (Step46/Step4c) ._- 4Q44 % b. %OAeA is within 10% of design Outside Air. (90%<%0ARA < 110%) i` a �,�,r Yes Q No Q c. Outside air damper position stabilizes within 5 minutes. (Step 4d < 5 minutes) ' °=` ``z Yes Q No Q Nate: The intent of this test is to ensure that 1) all air handlers provide the minimum amount of OSA and controls to avoid over ventilation. 2)VAV air handlers use dynamic 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 OUTDOOR AIR ACCEPTANCE CEC-NBCA-MCH-02-A (Revised 07/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. NRCA-MCH-02-A Outdoor Air Acceptance Documentation Author Company Name: Air Max Heating& Air Conditioning, Inc. (Page 3 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: Project adar[s::1280 Bison Ave, Ste B15 city Newport Beach ZIP Code: 92660 System Name or ldenducatlon/rag: RTU -4 S t System la[aHon orAma aewed: D� 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: MaxWilkie Documentation Authot Signature: Documentation Author Company Name: Air Max Heating& Air Conditioning, Inc. Date 51gn d: Address: 33600 Buckwheat Road ATTcertlflcation Identification inapplicable): CRy/state/zlp: Menifee, CA 92584 Phone: 951.672.1221 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance (Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 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: MaxWilkie Field Technician 5i cure Field Technician company Name: Air Max Heating & Air Conditioning, Inc. Position with Company (Title): Technician/President Address: 33600 Buckwheat Road ATT Certification Identification (if applicable): ciry/State/zip:Menifee, CA 92584 Phone: 951.672.1221 Datesi ne ' 2 / 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, S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance Person Name: Max Wllkle Responsible Acceptance Persnature: Responsible Acceptance Person Company Name: Air Max Heating& Air Condltionlr Position with Company (Title): Technician/President Address: 33600 Buckwheat Road CSLR License` 691077 city/spoe/z"c Menifee, CA 92584 Phone: 951.672.1221 Date slgn�. 2s -_ oi CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/76) cal Icnatdla rnicar_v rnnnnalcmnnl CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A Outdoor Air Acceptance (Page 1 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Num2aiY- 3'ber: X Projec[Adtlress: 1280 Bison Ave, Ste 815 qty: Newport Beach Zip Code: 92660 system Name or Identificationirag: RTU -5 System Lotmn or area served: n IZZS a/�' 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 Note: MCH -02-A can be performed in conjunction with MCH -07-A Supply Fan VFD Acceptance (if applicable) since testing activities overlap. 1. Supporting documentation needed to perform test includes: 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. 2. Instrumentation needed to perform test includes: a. Watch b. Calibrated means to measure airflow (ie. hot-wire anemometer, velocity pressure probe, etc.). I. Method and equipment used: A'0M "C�Ow ,1orled ii. Equipment calibration date (must be within one year): 3. System type (check either VAV or CAV): ❑ VAV CAV a. Check if Variable Air Volume (VAV) and complete the following: I. Outside airflow is either factory calibrated or field calibrated. ❑ Check if factory calibrated and attach calibration certification. ❑ Check if field calibrated and attach calibration results. ii. Damper Control (must be checked): V Dynamic damper control is being used to control outside air. (This is NOT a fixed minimum position). Ili. One of the following dynamic controls is being utilized to control outside air (check method used) U2' Outdoor Air CFM Compensation ❑ Energy Balance Method ❑ Demand Control Ventilation ❑ Return Fan Tracking ❑ Injection Fan Method ❑ Dedicated Minimum Ventilation Dam,J�erwith Pressure Control Other Active Control, Describe: t QL24 c 1 j7. * S b. Check if Constant Air Volume (CAV) and verify the following: ❑ System is designed to provide a fixed minimum OSA when the unit is on. 1. Method of delivering outside air to the unit (check one of the following):. ff Outsideairy I ducted to the return air plenum. Confirm that outside air Is ducted to within (check one of the following): Q 5 ft. of the unit. ❑ 15 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) 5.. Pre -occupancy purge has been programmed for the 1 -hour period immediately before the building is normally occupied to provide (one of the following methods must be verified and checked): ❑ The conditioned floor area times the ventilation rate from the 2016 Building Energy Efficiency Standards TABLE 120.1-A, or 15 cfm per person times the expected number of occupants, whichever is greater, Complete air changes to the zone served by the air handler. CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE CAV NRCA-MCH-02-A Outdoor Air Acceptance (Page 2 of 3) Project inside: Total Wine, Newport Beach Enforcement Agency: Permit Number: 1 i//q_ 73 Project Address: 1280 Bison Ave, Ste B15 City: Newport Beach Zip Code: 92660 5ystem Name or ldentirication/rag: RTU -5 System L°�gIon� or Area ServeA �`T3't aw B. NA7.5.1.1 Outdoor Air Acceptance Functionai Testing CAV VAV 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) cfm cfm Required outdoor airflow (cfm) (from MCH -03, Column 14, or C. Mechanical Equipment Schedules). ,.1 /+(/ V cfm cfm clTime 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). r' 3 Hz b. Measured outdoor airflow reading (cfm). cfm C. Required outdoor airflow, (cfm) (from MCH -03, Column 14, or Mechanical Equipment Schedules) iY dm d. Time for outside air damper to stabilize after reduced supply airflow is achieved (minutes): min Step 5: Return to initial conditions (check) EV ❑ C. Testing Calculations & Results Determine Percent Outside Air at full supply airflow (%OArA) for Step 3. a. %OA,00 Measured outdoor airflow reading /Required outdoor airflow.(Step3b/Step3c) /�� % % b. %OAEA is within 10% of design Outside Air. (90% 9 %OA, < 110%) IYes V No Q Yes Q No Q C. Outside air damper position stabilizes within 5 minutes. (Step 3d e 5 minutes) `�IljgA Yes Q No Q Determine Percent Outside Air at reduced supply airflow (%OAPA) for Step 4. (VAV only) a. %OApA= Measured outdoor airflow, reading /Required outdoor airflow reading.(Step4b/Step4c) "�_-�% % b.%OAflA is within 10%of design Outside Air. (90% <_ %OAaA <_ 110%) `-�' "`'m rs n, Yes Q No Q c. Outside air damper position stabilizes within 5 minutes. (Step 4d c 5 minutes) a r Yes Q No Q 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 OUTDOOR AIR ACCEPTANCE CEC-NRCA-MCH-02-A (Revised 07/16) CAI IFrIRNtAFNFRr;Y CfaMMIFAll1N CERTIFICATE OF ACCEPTANCE 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. NRCA-MCH-02-A Outdoor Air Acceptance Documentation Author Company No me: Air Max Heating& Air Conditioning, Inc. (Page 3 of 3) Project Name: Total Wine, Newport Beach Enforcement Agency: Permit Number: Project Atldress:City: 1280 Bison Ave, Ste B15 Newport Beach zip Code: 92660 System Name or Identification/rag: RTU -5 System Lydd or Am., Seryedf AG'LS�'i p'Om 3. The construction or installation Identified on this Certificate of Acceptance complies with the applicable acceptance requirements DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Max Wilkie Docu ent I�=nature: Documentation Author Company No me: Air Max Heating& Air Conditioning, Inc. Date Signed: 2 Address: 33600 Buckwheat Road ATT certificaticiii Identi icatio (If applicable): City/State/Zip: Menifee, CA 92584 Phone: 951.672.1221 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: Max Wilkie Field Techniclan Signal r L Field Technician Company Name: Air Max Heating& Air Conditioning, Inc. Position VAh Company(itleP Technician/President Address: 33600 Buckwheat Road ATT Certification Identification (if applicable): oty/state/zip:Menifee, CA 92584 Phone: 951.672.1221 Oatg3t Z -S `1� 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: Max Wilkie Responsible Acce��p�tsemunSignature: ALJ mu Responsible Acceptance Person Company Name: Air Max Heating& Air Conditionlr Position 411irldo Company (Title): Technician/President Address: 33600 Buckwheat Road CSLa license: 691077 City/State/Zip: Menifee, CA 92584 Phone: 951.672.1221 Date signed: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance July 2016 2 PROJECT LOCATION PACKAGE ROOFTOP I HEATPUMP I AC UNIT REPORT FAN NAME , SERVICE LOCATION MANUFACTURER MODEL O -- SERIAL # CFM DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL .TOTALFAN `�s 4- 1� RETURN AIR 3 3-�2 3. OUTSIDEAIR DAMPER POS OSA % STAT PRE$ G✓ DISCHARGE SUCTION ®� ESPN ;MOTOR FAN MANUFACTURER - HORSEPOWER /Z VgLTAGE AMPERAGE PHASE RPM/SPEED 70-5 f SERVICE FACTOR DRIVE MOTOR SHEAVE SIZE L O % CLOSED SIZE 767' FAN SHEAVE FAN RPM BELT SIZE /#OF CENTER TO CENTER /" PROJECT LOCATION /b, PACKAGE ROOFTOP / HEATPUMP / AC UNIT REPORT FAN NAME SERVICE LOCATION MANUFACTURER - MODEL # m �� SERIAL#_ CFM DESIGN ACTIIAL DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL TOTAL FAN RETURN AIRS ` OUTSIDEAIR 2/ DAMPER POS OSA % STAT PRES DISCHARGE �l J SUCTION ESP MOTOR FAN MANUFACTURER HORSEPOWER 2 - U VOLTAGE AMPERAGE PHASE 7 RPMISPEED SERVICE FACTOR o DRIVE MOTOR SHEAVE SIZE % CLOSED ' FAN SHEAVE SIZE LJ FAN RPM BELT SIZE ! # OF CENTER TO CENTER J� ij Haertrnanalre PROJECT ---ee;4 FAN DATA Mfr. H.P. .L. Amps I S.F. _ lotor Sheave Diam x o Closed _ 'an Sheave DAM x B TEST DATA Motor RPM E.S.P. m NUMBER— ? FAN NUMBER DESIGN I ACTUAL I DESIGN EXHAUST FAN REPORT NUMBER ACTUAL I DESIGN I ACTUAL PROJECT 7c:/7,Z1`4L J• ! bA��:1►� PROJECT , 7 INOUT REPORT PROJECT ISM ME PROJECT o -' INOUT REPORT �©R� � r`ssC�il►��� lwh yr/pp xaols-37s� evE'WPORj. 090 8;wAve u Iz e.. c�ciFae�N�� Report of Special Inspection Permit Number 2�4$ — 7.3 A . _. ,. Inspection Type(s) Inspection Date(s)" Describe I it lr%IA List Tests Made: Made, Total Inspection Time Each Day: ] Periodic ( X ] Continuous Hours .� Requiring Correction, include uncorrected items previously listed Comments: To the best of my knowledge, the work inspected was in accordance with the Building Department approved design drawings, specifications and applicable workmanship provisions of the U.B.C. except as notedAabo�,�q�� Signed: #t �XJ i GQ'' Date ��itfli`►-"FR.1�111i�Llll%.G9�brf"�! 21< FORM SI -02,90 Report of Special Inspection Inspection Type(s) r' Inspection Date(s) 1 1 j J Periodic J Continuous Des ribs 14spection Made, inclu ing Locations: t /x'06 S� p !! c� V ' 22�p v S G cvS 5f 09- — List Tests Made:TQft� 7-0 `�Rg Total Inspection Time Each Day: Date $ f (g Hours —� Requiring Correction, include uncorrected items previously listed Comments: To the best of my knowledge, the work inspected was in accordance with the Building Department approved design drawings, specifications and applicable workmanship provisions of the U.B.C. except as noted aboveq FORM SI -02,90 216 Report of Special Inspection Permit Number, jS .GLI>t?5 - Ort) -T- - Inspection Type(s) &" Inspection Date(s) 71x4 To j ] Periodic [,>< j Continuous u .. E+�: D � o ' �M_ � � � i��: I �i►�?��> :. is Total Inspection Time Each Day: List Items Requiring Correction, include uncorrected items previously listed To the best of my knowledge, the work inspected was in accordance with the Building Department approved design drawings, specifications and applicable workmanship provisions of the U.B.C. except as notecabove, -7 �} Signed: --��--�-+�,��.�— Date ` a'S 1 Print Full e: Jl (:100�S Registration No. FORM S[-02,90 00 Report of Special.Inspection �� .... .. '� Air - �✓� � ,•. r. i. Divi �.�>� Permit Number �!�{=37-3� InspectionType(s) Inspection Date(s) Periodic [ X )Continuous Inspection List Tests Made: Total Inspection Time Each Day: Date 7 L_2-2 Hours List Items Requiring Correction, include uncorrected items previously listed Comments: To the best of my knowledge, the work inspected was in accordance with the Building Department approved design drawings, specifications and applicable workmanship provisions of the U.B.C. except as notefi abov Signed:/ Date Print Full Name: Registration No.'A—�6G FORM S[-02,90 2S� BUILDING DEPARTMENT SPECIAL INSPECTOR'S REPORT City of Newport Beach 3300 Newport Blvd. Newport Beach, CA 92659-1768 Attention: Final Project Report Project Name: I 'UL hi to i Permit Number: X D11J Q — • • • rSi�3�i1Fi�� 2 This is to ceritfy that I performed special inspection on the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect: 14 Based upon my personal observation and written reports of this work, it is my judgement that the inspected work was performed, to the best of my knowledge, in accordance with the approved plans, specificVons, a d the applicable workmanship provisions of the Uniformed Building Code. (Sp J 1 In pecctttoor's Signature) IAA l_ lM4Nol �ttC Date Print Full Name Registration No. 20-7 FORM Sf-04/90 Report of Special Inspection Permit Number 1, oVIp 3 -:D I nIF Inspection Type(s) K� t.. U tSl II.U- W WM V Inspection Date(s)" j ]Periodic [ ] Continuous List Tests Made:1wcftpuc(� jap— Eg*1c Total Inspection Time Each Day: tems Requiring Correction, include uncorrected items previously listed Comments:�� To the best of my knowledge, the work inspected was in accordance with the Building Department approved design drawings, specifications and applicable workmanship provisions of the U.B.C. except as noted,,abov5,A Signed: 91,/�`�_��r% Date Print Full N e: 511' Registration No �L = FO R M S 1-02, 90 Af�