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HomeMy WebLinkAboutX2019-0083 - MisctINl W Newporf ENJ }( oA-0083 Enforcement Agency Use: Checked by/Date LIGHTING CONTROL ACCEPTANCE DOCUMENT Automatic Shut-off Controls: Automatic Time Switch Control and Occupant Sensor Intent: Lights are turned off or set to a lower level when not needed per Section 110.9(a) & 130.1(c). A. Construction Inspection Fill out Section A to cover spaces I through 3 that are functionally tested under Section B. Instruments needed to perform tests include, but are not limited to: hand-held amperage meter, power meter, or light meter 1: Automatic Time Switch Controls Construction Inspection—confirm for all listed in Section B a. All automatic time switch controls are programmed for (check all): i' Weekdays r Weekend r Holidays b. Document for the owner automatic time switch programming (check all): F Weekday settings r Weekend settings I— Holidays settings Set-up settings F Preference program setting F Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized r- 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 110.9 of the Standards, and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices 2. Occupancy Sensor Construction Inspection—confirm for all listed in Section B P7 Occupancy sensors are not located within 4 feet of any HVAC diffuser lu Ultrasonic occupancy sensors do not emit audible sound 5 feet from source This is page 1 of 23 cxr•Yxa.r�tvzncy�axcxu B. Functional Testing of Lighting Controls For every space in the building, conduct functional tests 1 through 5 below if applicable. If there are several geometrically similar spaces that use the same lighting controls, test only one space and list in the cells below which "untested spaces" are represented by that tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3) Representative Spaces Selected Tested space/room name: Esthetician #3 Space Type (office, corridor, etc) Medical Office Untested areas/rooms Confirm compliance for all control system types (1-5) present in each space: 2. Automatic Time Switch Controls Step 1: Simulate occupied condition a, All lights can be turned on and off by their respective area control switch r b. Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located. r - Step 2: Simulate unoccupied condition a. All lighting, Including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)l and 130.1(a)i, r b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type) r _, Step 3: System returned to initial operating conditions T 2. Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(b) b. The occupant sensor does not trigger a false 'onfrom movement in an area adjacent to the controlled space or from HVAC operation. r. Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly r b. Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually r This is page 2 of 23 Step 3: System returned to initial operating conditions _ r. gffmmva, Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack. r c. In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80% or less of the value allowed under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken r Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled areas, Immediately upon an occupied condition r Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to 70% of the lighting automatically. F b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. r Step 2. Simulate an unoccupied condition a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. This is page 3 of 23 5 Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than 250 ft , to Qualify for a Dower Adjustment Factor (PAF) Step 0: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed RAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c). r e. Sensors shall not trigger in response to movement in adjacent walkways or workspaces r f. All steps are conducted in Functional Test 2'Occupancy Sensor (On Off Control)' and all answers are Yes. r This is page 4 of 23 1. Automatic Time Switch Controls (all answers must be Yes). r 2. Occupancy Sensor (On Off Control) (all answers must be Yes). r- 3. 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. r 4. Partial On Occupant Sensor for PAF (all answers must be Yes). 17- 5. 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must r pass Test 2. Representative Spaces Selected Tested space/room name: Office 2 Space Type (office, corridor, etc) Office Untested areas/rooms Confirm compliance for all control system types (1-5) present in each space: 1. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch r b. Verify the switch only operates lighting in the ceiling -height partitioned area in r which the switch is located. Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)l. and 130.1(a)1. r b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type). r Step 3: System returned to initial operating conditions r 2, Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes This is page 5 of 23 _16. from start of an unoccupied condition per Standard Section 110.9(b) b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. F Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly r b. Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually Step 3: System returned to initial operating conditions Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack. 17- c. In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80% or less of the value allowed under the Area Category Method. r, Light level may be used as a proxy for lighting power when measurements are taken Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled areas, Immediately upon an occupied condition Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to r 70°% of the lighting automatically. b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually i deactivate all of the lights. Step 2. simulate an unoccupied condition This is page 6 of 23 OFACCEPTANCE At. a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) N h. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r This is page 7 of 23 %Adqtional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than P 1M, Qualify forPower Adjustment Factor't Step O: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF -0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c). r- e. e. Sensors shall not trigger in response to movement in adjacent walkways or workspaces r f. All steps are conducted in Functional Test 2'Occupancy Sensor (On Off Control)' and all answers are Yes. r This is page 8 of 23 ACCEPTANCE N.. skin RIBTMZ,I� 1. Automatic Time Switch Controls (all answers must be Yes). r 2. Occupancy Sensor (On Off Control) (ail answers must be Yes). 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. 4. Partial On Occupant Sensor for PAF (all answers must be Yes). r 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must pass Test 2. r Representative Spaces Selected "rested space/room name: Esthetician #2 Space Type (office, corridor, etc) Medical Office Untested areas/rooms Confirm compliance for all control system types (1-5) present in each space: t r t a Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch r b. Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located. r Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)1 and 130.1(a)l, r b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type). r Step 3: System returned to initial operating conditions r- 2. 2. Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes This is page 9 of 23 ACCEPTANCE ;NY�YNyJ4l'11NtiYn9SN;.l from start of an unoccupied condition per Standard Section 110.9(b) b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly r b. Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually Step 3: System returned to initial operating conditions l '+' MM ' .r ��, Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r J. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack. c. In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80% or less of the value allowed under the Area Category Method. f„ Light level may be used as a proxy for lighting power when measurements are taken Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled areas, Immediately upon an occupied condition r� Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between SO to r 70% of the lighting automatically. b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. r7 - Step Step 2. Simulate an unoccupied condition This is page 10 of 23 CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Project Name: skin Bo huge Enforcement Agency: CITY OF NEWPORT BEACH N.RNumber: X2019-0083 Project Address: 449 Newpurt Blvd. City: Newport Beam IZi, Code: 92663 a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r This is page 11 of 23 d..r .�a s i;: w,.moi .':• � �:'r. ♦- 1t�0 Step 0: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 17 b. Enter PAF corresponding to controlled area from line (a) above (<12S ft2 for PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c). r- e. Sensors shall not trigger in response to movement in adjacent walkways or workspaces r - f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)' and all answers are Yes. f - This is page 12 of 23 1. Automatic Time Switch Controls (all answers must be Yes), f.- 2. Occupancy Sensor (On Off Control) (all answers must be Yes). r 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. r 4. Partial On Occupant Sensor for PAF (all answers must be Yes). r 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must pass Test 2. r Representative Spaces Selected Tested space/room name: Reception Space Type (office, corridor, etc) Medical Office Untested areas/rooms Treatment Rm. 1, 2, 3, 4, Kitchen , Office Confirm compliance for ail control system types (1-5) present in each space: 1. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch It. Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located. r Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)1 and 130.1(a)1. F - b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type). r Step 3: System returned to initial operating conditions r 2. Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes r This is page 13 of 23 b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly r_ b. Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually r Step 3: System returned to initial operating conditions r Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack. c. In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells In which the installed lighting power is 80% or less of the value allowed under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled r - Step Immediately upon an occupied condition J r r r Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to 70% of the lighting automatically. b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. r Step 2. Simulate an unoccupied condition This is page 14 of 23 166WA Code: 92663 a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(x) A b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. F This is page 15 of 23 Ad(:qtional test for•: ♦.. .. as � • . • Spaces 1 • !1 • .: I• • Adjustment ,,. Step 0: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 b. Enter PAF corresponding to controlled area from fine (a) above (<125 ft2 for PAF -0.4, 126-250 ft2 for PAF= 0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c). e. Sensors shall not trigger in response to movement in adjacent walkways of workspaces 1•- f. All steps are conducted in Functional Test 2'Occupancy Sensor (On Off Control)' and all answers are Yes. This is page 16 of 23 OFACCEPTANCE C. Testing Results 1. Automatic Time Switch Controls (all answers must be Yes). r 2. Occupancy Sensor (On Off Control) (all answers must be Yes). r 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. r 4. Partial On Occupant Sensor for PAF (all answers must be Yes). r 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must pass Test 2. r Representative Spaces Selected Tested space/room name: Esthetician #1 Space Type (office, corridor, etc) Medical Office Untested areas/rooms Confirm compliance for ail control system types (1-5) present in each space: 1. Automatic Time Switch Controls Step 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch r b. Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located. r Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may remain on per Section 130.1(c)1 and 130.1(a)1, r b. Manual override switch controls only the lights in the selected ceiling height partitioned space where the override switch is located and the lights remain on no longer than 2 hours (unless serving public areas and override switch is captive key type). r Step 3: System returned to initial operating conditions r 2. Occupancy Sensors Step 1: Simulate an unoccupied condition a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes This is page 17 of 23 b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. P Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly r b, Lights controlled by occupancy sensors turn on immediately upon an occupied condition OR sensor indicates space is 'occupied' and lights may be turned on manually 7r - Step 3: System returned to initial operating conditions I Step 1: Simulate an unoccupied condition a. Lights go to partial off state within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in the aisle or stack, r c In the partial off state, lighting shall consume no more than 50% of installed lighting power, or: No more than 60% of installed lighting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80% or less of the value allowed under the Area Category Method. rLight level may be used as a proxy for lighting power when measurements are taken Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately controlled areas, Immediately upon an occupied condition Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to 70% of the lighting automatically. F b. After the first stage occurs, manual switches allow an occupant to activate the alternate set of lights, activate 100% of the lighting power, and manually r, deactivate all of the lights, Step 2. Simulate an unoccupied condition This is page 18 of 23 a. Both stages (automatic on and manual on) lights turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section 110.9(a) r b. The occupant sensor does not trigger a false 'on' from movement in an area adjacent to the controlled space or from HVAC operation. r This is page 19 of 23 AdVional test forOccupancy Sensorsr. Small Zones Office Spaces ( to Qualify forPower Adjustment Factor• t Step 0: First, complete Functional Test 2 (above) for each controlled zone. Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2. a. Area served by controlled lighting ft2 b. Enter PAP corresponding to controlled area from line (a) above (<125 ft2 for PAF=0.4, 126-250 ft2 for PAF -0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor control in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than or equal to the PAF claimed in the compliance documentation (line c), r- e. e. Sensors shall not trigger in response to movement in adjacent walkways or workspaces f. All steps are conducted in Functional Test 2'Occupancy Sensor (On Off Control)' and all answers are Yes. r This is page 20 of 23 Y 1. Automatic Time Switch Controls (all answers must be Yes). T- 2. 2. Occupancy Sensor (On Off Control) (all answers must be Yes). r 3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test 1 or Test 2. 4. Partial On Occupant Sensor for PAF (all answers must be Yes). 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must pass Test 2. ®. Evaluation P- PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive. This is page 21 of 23 BEACH DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Acceptance doelimentation Is good, ste and complete. Documentation Author Tom Blanchard Company Name Name Address 2546 N Berkeley St City Zip Code 92665 CEA/ATT Certification TC -A819250 Id entifica ti a pplicab e ( /�►���\\ V r 1 Date of Signature: 03/15/2919 Phone Author Signature 1st l'itle 24 Testing Orange (714)334-3383 WIELD 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. 0. 1 have confirmed that the Cat tlficate(s) of Installation for [he construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible build,/installer and has been posted or made available with the building permit(,) issued for the building. Rend Ischnnclan Name Company Name "fom Blanchard list Title 24 Testing Address: 2546 N Berkeley St City Orange Zip Code 92865 Phone (714)334-3383 ATT Certification Position with Company Identification T— A81;210 (Title, C' Field Tech n ignatu Date of Signature: 93/15/2919 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 resign, c.O t, O,tion 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 infornatlon provided on this Certificate of Acceptance subOtantlatas that the construction or Installation Identified on this Certiflcate 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(,) of Installation far the construction or Installation identified on this Certificate of Aeceptance has been completed and e posted or made available with the building permits) 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 permlt(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 Company Name Tom Blanchard 1st Title 24 Testing Person Name Address: City 2546 N Berkeley St Orange Zip Code 92865 Phone (714)334-3383 CSLB License Position with Company 822811 (Title) Owner Responsl n Signature Date ofSIgnatu e. 03/t5/2019 This is page 22 of 23 This is page 23 of 23