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HomeMy WebLinkAboutX2019-1076 - Misc)(2ol •9076 1103 Quo S4 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E Maylaed 01120 CERTIFICATE OF INSTALLATION CALIFORNIAENERGV COMMISSION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page4 of 4) Profetl NameVC` /q t `4 EntorI,r-1 My ,T_ 10 S ParmN Number PmpRAdtlresr. /t03 ev ew 0-7 13 Cats% Code: 16 0 For common areas equals 20 percent or less of the total building floor area, the installed lighting must be controlled by occupant sensors. ❑ For common areas is greater than 20 percent of the total building floor area, the Installed lighting control must comply with the applicable nonresidential lighting control requirements. Corridor and stairwell lightingmust be controlled by occupant sensors. ❑ D. High -Rise Residential Building Indoor Lighting. ❑ All indoor lighting controls of the dwelling units must comply with Section 150.0(k)2. ❑ Garages with less than 8 vehicles per site: The lighting control must comply with nonresidential indoor lightingcontrol requirements in Section 130.1. a.•+ nauu... a mw,gy tmaency manoa ros - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI.nF.F IR.,,neve mrvn, CERTIFICATE OF INSTALLATION cnurunnw ENERGY COMMISSION RIIIIIIIIIIIIIIIIF NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 2 of 4) PraleaE Namc° Enley5emypg . i.c-. n L7�-s(. eF� ParmlE Nu Mr: cLU%d.Ce1103 a�jcJ etr'�i�f- .. it Ga e: PART 2 Lighting Control Functional requirements: Check aft that apply when verifying the installation of On EMCS or Ing Control System. Ll� A. All lighting controls and equipment have been installedin accordance with the manufacturer's instructions. B. All installed EMCS systems meet each respective lighting control for which it is installed for meeting C.requirementsin Section 110.9, 130.1, 130.4, 150.0(k), and 150.2. Components of all installed lighting control systems meet applicable requirements In Section 110.9, 130.2, -130.4,150.0(k), and 150.2. D. The. EMCS or the lighting control system. functions as time -switch lighting control. checked below, and complies with all of the following requirements: 1. The EMCS or the lighting control system functions as a time -switch control meets the requirements below: a. has program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is Interrupted. b. Automatic time -switch controls installed in nonresidential buildings meet the following requirements: I. Is capable of providing manual override to each connected load and shall resume normally scheduled operation after manual override is initiated within 2 hours for each connected load; and if. Incorporates an automatic holiday shutoff feature that turns off all connected loads for at _J least 24 hours and then resumes normally scheduled operation. yry 2. The EMCS or the lighting control system functions as an astronomical time -switch control meets the I/ requirements below: a. Meets the requirements of an automatic time -switch control; b. Has sunrise and sunset prediction accuracy within plus -or -minus 15 minutes and timekeeping accuracy within 5 minutes per year; c. is capable of displaying date, currenttime, sunrise time, sunset time, and switching timesfor each step during programming; d. Has an automatic daylight savings time adjustment; and e. Has the ability to independently offset the on and off for each channel by at least 99 minutes before and after sunrise or sunset. Multi -Level Astronomical Time -Switch Controls, in addition to meeting all of the requirements for Astronomical Time -Switch Controls, includes at least 2 separately programmable steps per zone. E. The EMCS or the lighting control system functions as an automatic daylighting control meets the requirements below: 1. Automatically return to its most recent time delay settings within 60 minutes of the last received input when put in calibration mode; 2. Has a set point control that easily distinguishes settings to within 10% of full scale adjustment; 3. Provide a linear response within 5% accuracy over the range of illuminance measured by the light sensor; 4. Be capable of being calibrated in a manner that the person initiating the calibration is remote from the sensor during calibration to avoid influencing calibration accuracy; and — ouuun,g u,ergy crr¢lency ntanoaras - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E(Revise 01@a1 _..___.. __.._____.__. CERTIFICATE OF INSTALLATION CrvtttWT UUMM15bION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 3 of 4) Pmled Nome: F lor[ement Apea y= ,:V4. ��� , P_, b Proles Pddr¢ea 0 - CiN f -r— Qt? Ao tl Co e 0 ❑ F. The EMCS or Lighting Control System functions as a dimming control and meet all of the requirements below: 1. is capable of reducing power consumption by a minimum of 65% when the dimming is at its lowest level; 2. provides an off setting which produces a zero lumen output; and 3. Reduce flicker operation through the dimming range so that the light output has an amplitude modulation of less than 30% for frequencies less than 200 Hz without causing premature lamp failure. 4., (For system designed for use in three way circuits:) be capable of turning lights off, and to the level set by the dimming controls if the lights are off. G. The EMCS or the lighting control system functions as an occupant sensing control and meets all of the following requirements: 1. Is capable of automatically turning the controlled lights in the area either off or down no more than 20 minutes after the area has been vacated. 2. (for system with manually -on control features:) have a grace period of no less than 15 seconds and no more than 30 seconds to turn on lighting automatically afterthe sensor has timed out; and 3. Provides a visible status signal that indicates that the control is operating properly, or that it has failed or malfunctioned. The visible status signal may have an override switch that turns off the signal. PART 3 Requirements for which the control is being installed to complied with: Identify all requirements in the Standards for which the EMCS or Lighting Control System is installed to function as and complies with: Check all that are In compliance with the Standards, Section 130.1: ❑ A. Section 130.1(a) Area Controls ❑ B. Section 130.1(b) Multi -Level Lighting Controls ❑ C. Section 130.1(c) Shut -OFF Controls ❑ D. Section 130.1 (d) Automatic Daylighting Controls ❑ E. Section 130.1(e). Demand Responsive Controls ❑ F. Section 130.5 (d). Circuit Controls for 120 -Volt Receptacles Check all that are applicable and in compliance with the Standards: ❑ A. Residential garages with 8 vehicles or more per site: All lighting controls must comply with nonresidential indoor Alit hong control requirements in Section 130.1. ,y B:.Singl mily Building Indoor Lighting. �// All in lighting controls must comply with Section 150.0(k)2. ❑ Garages with less than 8 vehicles per site: The lighting control must comply with Residential indoor lighting control requirements in Section 150.0(k)21. ❑ C. Low -Rise Residential Building Indoor Lighting. ❑ All indoor lighting controls of the dwelling units must comply with Section 150.0(k)2. ❑ Garages with less than 8vehicles per site: The lighting control must comply with one of the following: ❑ Residential indoor lighting control requirements in Section 150.0(k)21; ❑ Nonresidential indoor lighting control requirements in Section 130.1. Interior Common Area Lighting: CA Building. Energy Efficiency Standards- 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL CERTIFICATE OF INSTALLATION Energy Management Control System or Lighting Control System �r1 NRCI•LTI-02-E (Page 5 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Nam Documentation A hot re: Documen orlon Author Compan Name: �: SC4 Wc, .' Z �(@�C Date Signed: e Atldress: J-(n.� Q 1s"� ` CEA Certification Identification (If appllcable): City/ t0✓a *1110, C -r Q). 1 4 Phone: 4 0 3% U 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. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, orinstallation of features,. materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the Installation conforms to the requirements. given on the plans and Specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that Identifies the specific requirements for the scope of construction or installation identified. on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or Installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable Inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides tothe building owner at occupancy. Responsibleauiider/Installer Name: Responsible aui er/In Ilex Signature: Company Name: (installing Subcontrac0 tor or General Co tractor or Builder/Owner) , i1 Position With C pany(Tlde): /��,, 4 / -' Adtlress: /l /'e/� � V tJC.gv, CSLB License: - 9v3-5 CIN/ tateRip: A x -1.0 C -i'' "ln �y "�.� Phonjj/ / +9 ('� G V f ` 6 /-2-3 ! 01 cl 44 Date sign 20 CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance JanuarV2020 large.png (PNG Image, 770 x 1024 pixels) STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT Cec.narIAlTI.ns.0 tmc i.ea n5 v to hitps://www.pdffiller.com/preview/6/963/6963413/targe.png CERTIFICATE OF ACCEPTANCE ntn crvcnul cpMM 56gn •� NRCA.LTIA2•A — Lighting Control Acceptance Document _ _ ._.. (Page I of 5) Fgen t+em,.f fnlp[omMi O�ryKl t� Porgy (3 ti� w hMRMenbt: tts 1 � 4 Weekdays settings i Weekend settings Lightsare turned off of set too iower level when not needed perSettlan 220.91a) & 130.1(c). Guidance This acceptance test form must be filled out for all newly -Installed fighting control systems of the following types: I. Automatic Time Switch Controls 11, Occupancy Sensors III. Partial -OFF occupancy sensors IV, Partial -ON occupancy sensors (only. if used to claim a Power Adlustment Factors V. Occupancy Sensors serving small zones in large open plan offices (only if used to claim a Power Adjustment Factnrl For automatic daylightlng controls use acceptance test form NBCA -LTi -03-A; for demand responsive lighting controls, use acceptance test form NRCA-LTI-04-A. The tests on this certificate are required. by Section 140:6(0)2 and 230.41a) of the Building Energy Efficiency Standards 2013. The A. Construction Inspection Fill out Section A to cover spaces I through 3 that are functionally tested under Section B. Make as many copies of pages 2.5 as are required to test all spaces In the building, and attach to page 1 Instruments needed W.perlorm tests include but are not limited to hand held ampeiail meter sower meter or I0tmeter 03 Automatic Time Switch Controls construction Inspection—confirm for all Iltted In section B 4 a All time switch controls are programmed for (check all) - rautomatic f9 Weekdays L _._ 4 I Weekend � _�.--i Holidays b. Document for the Owner automatic time switch programming (check alQ_. Weekdays settings i Weekend settings L Holidays settings set-up settings preference program setting Verify the correct time and date is properlv set in the time switch Verify the battery is installed and energized i I 02 1 of ._J Occupancy C9• Override time limit Is. no more Shan 2 hours 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 Sensor Construction Ins action B Dccupancy sensorsare not loraedwi hon four feet of any HVpp�_`-�~^�� y AC diffuser Ultrasonic occupancy sensors do emit audible sound 5 feet from source nergy Efficiency Standards- 2013 Nonresidential Compliance _ May 2015 CA BulldingrE 1 of 2 u VI 2, w N N m Ci 3 6 a n O R 3~ n n 3 m 3 c' a m C5,' Z Z fl w a 3 » EL H w O O m ie w y o m '^ O A C 2 i m ro ry D C Z ° m Z F ° w 2 Q f1 m y�' ❑y ao a c "2 m^3'm"'m v� rn c rn L vga SOS❑ N Z = m rA m N Z m Z a ui D m N m m m n 7, w °_' a n D 0 m n o O m a N a m o n ry ZmZ 7r T 3 n » s n n c o. nc 0 ° 6 m m O On d G 0 0 d n O vmO�R°= n 0 a =n m � n❑ m n 1° O 6 yq a a' 3. ° N a 3.0 3 c ^ o T m d ry s o. s 9 v o s a � a a = � s m a s m m Q o S m w� [y a a a n O N A a Er v PN '-o N �y n go c Z H oQo c33 n� E.q. �' N J 3 c a. M O jm Z w a D A c ? < .Je 09 N N O. ry Q c O j µ J .4 m ➢ A m z o O � m m W N N mL. � cw�ac n yi'o m�w'o v n m m o 3» a �'-'<,am E m r z c oa w'v N o s n 5 Z n Z m Q °3 ^ m m n 3 m 0 n n 0 w 0 ^. c C 7 J -1 f-�t ry O d Z On y N m a F » r G = N » N N h nwT n m 3o m m Sr Si n a N Tm a Q N.MJ m o o a 3° o 3 d N n on w g n (° 3 p m n R '� W' O SO •n y y� p p � m n N MI. T IJ pYj f0 V ¢ pYj a s � .o• � N i W m Q m q m=5.o m' m - N C tlJC 3 O J a na o < s v a p v J ? N y T p n m o J p J N [y a a a 6 3 a a N d eTM 3 C �. 5 O m�� W a Y .SNo m Z Z n0 bo m m .arfAA A y m p 20 mm m mw ? [Ai m m o 3 N 6 M `.�' N. a� m w m m M< � O Oi 2 P a_ a m y n v n n S n y a= m m m z a 5 N z m o o^ N ac 0` wJa D n A ga 0 w D » a o O �m iiO o' m n n O 2 A o 3 Y O rbT .0 a m n m m m H a m: m 3 -1 O m 5 ? o v o T J J ^.^ae °1 °. a J r n mC- m R A,n � ^ N 2. m 3 c a N ^' N N^ vJi iii M N Er o o y m - o o 3 a N D 2 nm 0 m 3 o n a m n A 0, m '^ a c 3 m u w P 'm a o 9 P m H n m z? o e o � w.. 3 N m f° d• � _ J P 3 F 3 Q nv a a o v m � n 3. 0 3 ^ o m a a m n 9. i m o S a o^ o J J nw m = o m = m a m T a a J 0 J m a P M o=. s m J b J m m o m m J A STATE OF CALIFORNIA INDOOR LIGHTING CERTIFICATE OF INSTALLATION CALIFORNIA ENERGY COMMISSION' Indoor Lighting #RCI-LTI-O3-E P�olual Nam¢ �.� Of'.�'^�L� Pilled (Page 1 of 2) E�/Orcement ABeuy: 1 �{ 'L F r" PA+s. U(Z'[ G rtC Derml �b� Y. � O,, ` Ad Ee}r. V[t� �O rV "'I.J I�OAi.N 2ioEpde: f00 GENERAL INFORMATION DATE OF BUILDING. PERMIT: PERMIT# BUILDING TYPE onresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION - New Construction 13 Addition ❑Alteration 13Unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this/ Installation Certificate, 0 3 /'Z)/ ZO lq In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Date Approyed By Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. the Enforcement A enc SPP raved �r eunomg tnergy tmclency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCI-LTI.01-E /Revised 01/20) - CERTIFICATE OF INSTALLATION VnurunNlNtNLRGY COMMISSION �� NRCI•LTI-03-E Indoor Lighting (Page 2 of 2) Iaaiea Nam.: Enfe �'t Kament Pgenry; fMai Ua¢:T' (] P It Nu .c � / I 4� aD Propq Atltlrea: a.1 �: 2t % o r1 P� -A u LP eetl 6 DOCUMENTATION AUTHOR'S DEC LARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name:!� -�+a-vc'. C—I- S CIA YI—t Documentation Authal 51 a: lyy p e Dpcum¢Aus ti p Date Signed: �l v Address: CEA Ceitificeims ldentifica n(if applicablel: U /State ()Gr Phone; (l ! 46,7 `} —z5-7 V 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 an 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 an this Certificate of Installation and attest to the declarations in this statement (responsible builder/Installer), otherwise Iaman authorized representative of the responsible builder/Installer. 3. The constructed or Installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or Installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the. construction or Installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) Issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this. Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/insla (er Name: 'i'8V t'3 CC•f OW - Responsible Builder/Installer slgnatu company Name: (Installing hcontractlwor or General Contract r or BuilJer/0w eq 11 �IOw Zi _ 43 Position wit mpany (ilei: . Address: I lle k , _ /s _ u CSIs License2 City/Sate/ZIP: t0 CAG1�'Ib2 Phone 7 Date Slgn CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL CERTIfICATEOF INSTALLATION NRCI-LTI-02-E EnergyManagement Control System or Lighting Control System (Page.1 of 1) GENERAL INFORMATION DATE OF BUILDING PERMIT: PERMIT# BUILDING TYPE ❑ High -Rise Res (Common onresidential ❑.Hotel/Motel Area) Installation Certificate. Area) .(Common PHASE OF CONSTRUCTION ❑ New. Construction ❑ Addition Alteration ❑Unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. Requirements in the Standards: 4130.4(b) Before an Energy Management Control System (EMCS), or Lighting Control System can be recognized for compliance with the lighting control requirements in Part 6 of Title 24, the person who is under Division 3 of the Business and Professions Code to accept responsibility for the construction or installation of features, materials, components, or manufactured devices shall sign and submitthis Installation Certificate. If any of the requirements in this Installation Certificate fail the Energy Management Control System or Lighting Control System Installation requirements, these options for controlling lighting shall not be recognized for compliance with the Building Energy Efficiency Standards. Check all that apply: PART 1 What type of Lighting Control System has been installed? ❑ A. Energy Management Control System (EMCS) - Is an automated control system that regulates the energy consumption of a building by controlling the operation of energy consuming systems, and is capable of monitoring loads, and adjusting operations in order to optimize energy usage and respond to demand response signals. ❑ The Energy Management Control System is installed to function as a lighting control required by Part 6 and Its functionally meets all applicable requirements for each application for which It is installed, In accordance with Section 110.9, 130.1, 130.4, 130.5, 150.0(k), and 150.2, and complies with Nonresidential Appendix NA7.7.2. ❑ B. Lighting Control System - Requires two or more components to be installed in the building to provide all of the functionality required to make up a fully functional and compliant lighting control. ❑ The installed Lighting Control System is installed to comply with applicable requirements in Section 110.9, 130.2, 130.4, 150.0(k), and 150.2, and complies with Reference Nonresidential Appendix NA7.7.2. CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020 HILLSIDE HEATING AND AIR CONDITIONING INC JOB NAME: ENGINEER: ARCHITECT: NO. OF COPIES: TECHNICIAN: HILLSIDE JOB# COMPLETION DATE: LICENSE# 579091 OCBS OLFATI DESIGN GROUP PARLADH SINGH GREWAL 1 GREG HELBERG 3869 8/27/2019 UNLESS OTHERWISE NOTED, INDICATED C.F.M. IS AT STANDARD CONDITIONS. FLOW HOOD USED ON ALL CEILING SUPPLY AND RETURN TERMINAL UNITS, ALL SIDEWALL REGISTERS AND GRILLES WHERE APPLICABLE. CERTIFIED Cemmerdal Air 1311wcing Tmwcian Greg Heiberg # IzZDAn dl.,.. -..,. 1 9304 Magnolia Ave RIv rllde Ca 92503 WWW.HILLSIDEAIR.NET PHONE(951)737-1241 FAN NAMEPLATE MFG DAY&NIGHT Model PHD46000HOOF Serial C191040781 Type PACK Size 5 TON _ocation ROOF FAN MOTOR VIFG CENTURY vlodel FD6000A MOTOR PULLEY )iameter N/A ;haft N/A =ixed/ADJ N/A 3elt/Size N/A FAN PULLEY Nameter N/A ;haft N/A ixed/ADJ N/A Supply Register Airflow 2010 1926 Return Grille Airfow 1510 1600 Outside Air CFM 260 260 NA NA smNA 75 -. 55 Total External Static Pressure 0.5 0.4 Coil Pressure Drop 0.2 0.2 Filter Pressure Droo 0.2 0.1 Fan Motor RF Fan Motor Vo Fan Motor An Fan Service F Fan RPM Entering Air T Exiting Air Tei REGISTERS AND GRILLES DATE08/2712019 OCBS 1003 QUAIL ST NEWPORT CA 0.50 0.5 SYSTEM ACI 1303 1302 208 212 1.9 1.6 1.25 1.25 AREA SERVED OFFICE NA NA smNA 75 NA 55 READINGS BY GH NA 20 NA 75 3 150 200 OFFICE 1 200 100 175 185 92% OFFICE 2 150 100 120 120 80% OFFICE 3 150 200 135 135 90% OPEN AREA 4 200 250 185 185 92% OFFICE 5 150 150 140 120 89% OFFICE 6 150 200 145 145 96% OFFICE 7 100 95 110 99 99% OFFICE 8 100 125 120 100 100% OFFICE 9 120 100 98 97 80% OFFICE 10 120 99 90 100 94% OFFICE 11 130 150 100 100 90% ELEC CLOSET 12 60 85 80 70 101% OPEN AREA 13 200 300 250 200 100% OPEN AREA 14 150 200 199 145 95% OPEN AREA 15 1 NA 1 100 1 125 1 125 1 100% w O w N rn � U Q �v N 2� � U� i R * LO m a0 d mr- yl c .c d o 0 X7099-9076 9803 Goo; 1 Si CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 SMOKE DETECTOR AND CARBON MONOXIDE SELF -CERTIFICATION (this certification is to be filled out by the permittee or homeowner) Project Address: 1 5-0 ( PF-A4k n 2i�• Permit Number: PV 201 9 —00 -7 Property Owner: P € Z_P0N'TE.. Gr 1 C FFCLI E Licensed Contractor: Pik PowEX 5ow-riorls Lic #: 11-7325 3 The State of California now requires that smoke and carbon monoxide detectors must be installed in all residential buildings California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors. CRC Section R314.3, CRC R315.3 defines required locations. Both boxes below must be checked: do Carbon Monoxide Alarm: On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms or in each hallway outside of the rooms, and each level of the dwelling. Detectors are also required in bedrooms with gas fired appliances 00 Smoke Alarms: Installed in each room used for sleeping purposes, outside each sleeping area, and on each level of the dwelling unit. Retrofitted detectors may be battery operated for buildings where no alterations are performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke alarms) shall comply with all applicable standards and must be approved by the State Fire Marshall. The devices must be installed per manufacturer's specifications. I, the undersigned, hereby certify that I am the permittee or homeowner of the project. I further certify that smoke alarms and carbon monoxide alarms are present and teste a nctional in all the following locations:: Signature: Date: NOTE: This self -certification is only used for projects to the exterior of the structure where access to the interior of the dwelling by the City of Newport Beach Building Inspector is not achieved during the course of construction. Forms\SmokeDetectorandCarbonMonozideSelfCert 08/12/16