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X2019-3606 - Misc
X2019-3606 941 Newport Cenier ®r 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 TEMPORARY CERTIFICATE OF OCCUPANCY APPLICATION 1. Obtain approval from the Chief Building Official 2. Pay $216.00 processing fee. 3. Obtain Electrical Inspector approval or final inspection. (Insp. Initials) 4. Obtain Fire Department's approval or final inspection. (Insp. Initials) 5. Obtain Structural Inspector approval. (Insp. Initials) NOTE: If a Temporary Certificate of Occupancy expires and additional time is granted (by the Chief Building Official) an extension fee of $115.00 will be charged. TO BE COMPLETED BY APPLICANT To: Chief Building Official City of Newport Beach 100 Civic Center Drive, P.O. Box 1768 Newport Beach, CA 92658-8915 j� Job Address: �9 4 f klE�A9 POR'T Ce 1� 6� E fZ bk( Building Permit Number: X zo m� 36()G State reason for requesting the Temporary Certificate of Occupancy: 'rI'bpvR.,qAy leo n4), S-re1zC- How much time will you need to complete the project: 30° �6 A4 Y4 Who will take responsibility to handle this matter to conclusion and will call for the final inspection? Te,f! (nneGLEA SUPER (Name of Responsible Party) (Job Title) (Telephone Number) ® (S"n lure of person who c pl ted this form) (Date) Fotms\Temporary Certificate of Occupancy Application 0826/2019 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E Revised 01/16 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 1 of 6) Pr°Ject Na / Enforcemen[Agenry: 017Y OF JJ. Q 1f/— p �rryit {V be�bob Protect Add ,.� r NSJ Port,-( cu�7J'I�JL- (1,1)- . "" N 2T rj�c zipV GENERAL INFORMATION Enter the date of approval by enforcement agency of the Certificate of Compliance that provides DATE OF BUILDING PERMIT If. 17-- Z PERMIT 11 BUILDING TYPE BUILDING l Nonresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION ❑New Construction ❑ Addition] Alteration EI 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 eligible 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 submit this 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 a computerized control system designed to regulate the energy consumption of a building by controlling the operation of energy consuming systems, such as the heating, ventilation and air conditioning (HVAC), lighting, and water heating systems, and is capable of monitoring environmental and system loads, and adjusting HVAC operations in order to optimize energy usage and respond to demand response signals. ❑ The Energy Management Control System has been installed to function as a lighting control required by Part 6 and functionally meets all applicable requirements for each application for which it is installed, in accordance with Sections 110.9, 130.0 through 130.5, 140.6 through 150.0, and 150.2; and complies with Reference Nonresidential Appendix NA7.7.2. ❑ The EMCS has been separately tested for each respective lighting control system for which it is installed to function as. ❑ 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 complies with the requirements checked below; and all components of the system considered together as installed meet all applicable requirements for the application for which they are installed as required in Sections 130.0 through 130.5, Sections 140.6 through 140.8, Section 141.0, and Section 150.0(k). CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA 'ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E (Revised 01116) CALIFORNIA ENFRr Y COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 2 of 6) Project Name: ( �] J ( _1pew Entarcement ABencY: f * F �r - !V/NCIr. eOif lmbe{;_ ye Proiect Atldr :f ( 9N-T Ceoyam D0 "y: ijew Z)R�-T a Z ,be PART 2 Lighting Control Functional requirements: Check all that apply when verifying the installation of an EMCS or Lighting Control System. ❑ A. All lighting controls and equipment have been installed in accordance with the manufacturer's instructions. ❑ B. The manufacturer has provided instructions for calibration. ❑ C. If indicator lights are integral to any components, such indicator lights consumes no more than 1 watt of power per indicator light. ❑ D. Components that are regulated by the Title 20 Appliance Efficiency Regulations have been certified to the Energy Commission. ❑ E. The EMCS or Lighting Control System functions as one or more of the Time -Switch Lighting Controls checked below, and complies with all of the following requirements: ❑ 1. Automatic Time -Switch Controls meeting all requirements for Automatic Time Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the requirements below: a. Residential automatic time -switch controls have program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the devices date and time for at least 72 hours if power is interrupted. b. Commercial automatic time -switch controls meet the following requirements: I. 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; ii. 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 iii. Incorporates an automatic holiday shutoff feature that turns off all connected loads for at least 24 hours and then resumes normally scheduled operation. © 2. Astronomical Time -Switch Controls meeting all requirements for Astronomical Time -Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the 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, current time, sunrise time, sunset time, and switching times for 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. ❑ 3. 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. ( ❑ F. The EMCS or Lighting Control System functions as one or more of the Daylighting Controls listed below: CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E (Revised 01116) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 3 of 6) Protect Name: .F I q Enforcement Agenry: �r (J .�9�0��'+L .1 .n FP}[n{iq[Npr r: r Protect Address: PLi N 191Ne *whir Gv� ba "`°' Okav PD2'rI geproR 'V {i �ZlDL�f0d1`fV bd ❑ 1. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20 Appliance Efficiency Regulations, including the following: a. Is capable of reducing the power consumption in response to measured daylight either directly or by sending and receiving signals; b. If the system includes a dimmer, complies with the Dimmer Control device requirements in the Title 20 Appliance Efficiency Regulations. c. Automatically return to its most recent time delay settings within 60 minutes when put in calibration mode; d. Has a set point control that easily distinguishes settings to within 10% of full scale adjustment; e. Has a light sensor that has a linear response within 5% accuracy over the range of illuminance measured by the light sensor; f. Has a light sensor that is physically separated from where the calibration adjustments are made, or is 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 g. Complies with the Title 20 requirements for photo controls if the system contains a photo control component. ❑ 2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency Regulations, including the following that it does not have a mechanical device that permits disabling of the control. ❑ G. The EMCS or Lighting Control System functions as a Dimmer and meets all requirements for a Dimmer Control device in the Title 20 Appliance Efficiency Regulations, including the following: 1. Is capable of reducing power consumption by a minimum of 65% when the dimmer is at its lowest level; 2. Includes an off position which produces a zero lumen output; and 3. Does not consume more than 1 watt per lighting dimmer switch leg when in the off position. 4. Dimmer controls that can directly control lamps provide electrical outputs to lamps for reduced 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. 5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the dimmer if the lights are off. ❑ H. The EMCS or Lighting Control System meets the following requirements: 1. Is capable of automatically turning off controlled lights in the area no more than 30 minutes after the area has been vacated; 2. Allows all lights to be manually turned off regardless of the status of occupancy; and 3. Has a visible status signal that indicates that the device is operating properly, or that it has failed or malfunctioned. The visible status signal may have an override switch that turns off the signal. 4. All occupant sensing devices that utilize ultrasonic radiation for detection of occupants meet the Ultrasound Maximum Decibel Values in the Title 20 Appliance Efficiency Regulations 5. All occupant sensing devices that utilize microwave radiation for detection of occupants meet the radiation requirements in the Title 20 Appliance Efficiency Regulations �i 6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20 Appliance Efficiency Regulations CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E (Revised 01/16) rAi icnawA vnivor_v rnnnnmemnni CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 4 of 6) Project Name: U(q I —7--i-Add— EnforcementAgency: rojectAdd—qql " oi7/V� A.a f'0(,/ n� qq Cil4:�....5 y�(LI Q_.k!/rL The EMCS or Lighting Control System functions as one or more of the Occupant Sensing Controls Checked Below: ❑ a. Occupant Sensors meeting all applicable requirements for Occupant Sensor Control devices in the Title 2.0 Appliance Efficiency Regulations. ❑ b. Motion Sensors meeting all applicable requirements for Motion Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including that motion sensors are rated for outdoor use. ❑ c. Vacancy Sensors meeting all applicable requirements for Vacancy Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Does not turn on lighting automatically and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; ii. Has a grace period of no more than 30 seconds and no less than 15 seconds to turn on lighting automatically after the sensor has timed out; and iii. Does not have an override switch that disables the sensor. ❑ d. Partial -ON Sensors meeting all applicable requirements for partial on sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Has two poles each with automatic -off functionality; ii. Has one pole that is manual -on and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; and iii. Has one pole that is automatic -on and is not be capable of conversion by the user to manual -on functionality. ❑ e. Partial -OFF Sensors meet all applicable requirements for partial off sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: I. Has two poles; ii. Has one pole that is manual -on and manual off, and iii. Has one pole that is automatic -on and automatic -off and is not capable of conversion by the user to manual -on only functionality. ❑ f. Occupant Sensing Control systems consist of a combination of single or multi-level Occupant, Motion, or Vacancy Sensor Controls, and all components installed to comply with manual -on requirements are not capable of conversion by the user from manual -on to automatic -on functionality. CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance January 2016 M STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LT(-02-E (Revised 01/16) CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page S of 6) Project Name: r� CIq ( r -1 -1 Enforcementpcenry: ^ty„� . rV ber b O G 1 "„ � 6,4 ProiecI Adl res q 4 _ 1 N(L Ciry: I!V ,S 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 applicable ❑ 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. If installed to qualify fora Power Adjustment Factor, submit this Installation Certificate in addition to the PAF Installation Certificate. ❑ G. To qualify for the PAF for a Partial -ON Occupant Sensing Control in TABLE 140.6-A. ❑ H. To qualify for the PAF for an occupant sensing control controlling the general lighting in large open plan office areas above workstations, in accordance with TABLE 140.6-A ❑ I. To qualify for the PAF for a Manual Dimming System PAF or a Multiscene Programmable Dimming System PAF in TABLE 140.6-A ❑ J. To qualify for the PAF for a Demand Responsive Control in TABLE 140.6-A ❑ K. To qualify for the PAF for Combined Manual Dimming plus Partial -ON Occupant Sensing Control in TABLE 140.6-A CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA ENERGY MANAGEMENT CONTROL SYSTEM OR LIGHTING CONTROL SYSTEM CEC-NRCI-LTI-02-E (Revised 01/16) CALIFORNIA FNFRGV (IOMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-02-E Energy Management Control System or Lighting Control System (Page 6 of 6) Project Name: ..1. qI EnforcemjnA'envy: oy �B• GGA a.{ r/ .3 (� b Protect AddreM , , I,;j fVp /A TtI City: I lam. 1 Ao nT n_ 1� Z' l DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documen [i nAuth rName: Documentation rSi 0.� b ✓� Ca G We me ation Author Company N'm aN lo� 0(T' cP4 Date Signeda t Address: &�y-, 2n ** v O E. IN1.Qp/�//1'C. ClW L(/ �'72 CEA Certificate Iden istion llfapplicablel: AWState/Zip: CW q ` S ` Phon%.7fr' .,J n� �7O C' "�!r b�f RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/I st er Na e: 45r� Responsa e: Company Name: Installing Subcontractor or General Contractor. Builder/Owner) �S Position With rrpany(Tita): mot rlu Adtyesp.o 'E. .MP�t, ,'J � L- O r fwd CSLIB License: C�D. 7- 9 C State/ ip: ��A�W' Phon / O �Je� Datesign.d: CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance January 2016 Of STATE OF CALIFORNIA LIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-02-A laertam (14117) CALIFORNIA ENERGY COMMISSION f o 0 NLCAA National ughNnp Coot"Itore Assofmtmn or Ammo o. CERTIFICATE OF ACCEPTANCE - NRCA-LTI-02-A Lighting Control Acceptance Document Project Name: F.I. LL IMPROVEMENTS #941 Enforcement Agency: CITY OF NEWPORT 1 BEACH Permit Number: X2019-3606 Project Address: 941 NEWPORT CENTER DRIVE City: NEWPORT BEACH Zip Code: 92660 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Gary Ducros--� Documentation Author Signature: �-- Documentation Author Company Name: Date Signed: November 14 2019 Ducros Electrical Contracting & Design Inc. Address: 2500 E. Imperial Hwy. 201-520 CEA/ATT Certification Identification (If applicable): ATT -1706-00001 City/State/Zip: Brea, CA 92821 Phone: 714-688-7000 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the Slate 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 Cer ificate(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: Field Technician Signature Gary Ducros Field Technician Company Name: Position with Company (Title): Ducros Electrical Contracting & Design Inc. Acceptance Test Technician Address: 2500 E. Imperial Hwy. 201-520 ATT Certification Identification (if applicable): ATT -1706-00001 City/State/Zip: Brea, CA 92821 Phone: 714-688-7000 Date Signed: November 14 2019 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. 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: Responsible Acceptance Person Signatu_er= �s-.7 — Gary Ducros Responsible Acceptance Person Company Position with Company (Title): Name: Ducros Electrical Contracting & Acceptance Test Employer Design Inc.. Page 2 of 2 Address: 2500E. Imperial Hwy. 201-520 �CSLB License: C10 #750903 C i t y /StatelZip: Brea, CA 92821 Phone: 714-688-7000 Date Signed: November 14 2019 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCI-LTI-01-E (Revised 01/16) r.AI IFnRNIA FNFRr Y MIWIMI.RRInN CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 1 of 2) Projea Name:Q qLfI Enf--e n[Agenry: C1 0 l I r f3 . RNu r �e�'o / 3 G o f Pm eRAddl:HI OeWejWl MJTEk 9R. `"`U 6.)Po vT atwc+1 zP eibb o GENERAL INFORMATION DATE OF BUILDING PERMIT: PERMIT# X2-0 ( 3 6 O 6 BUILDING TYPE Nonresidential ❑ High -Rise Res (Common Area) ❑ Hotel/Motel (Common Area) PHASE OF ❑New Construction Addition Alteration ❑ Unconditioned CONSTRUCTION U-Iff t c4 L 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 1 l V , l q 7 _' Installation Certificate. In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. Date Approved By the Enforcement Agency -I-�7 /� 1 I Lt L �opT U-Iff t c4 L CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA INDOOR LIGHTING is CEC-NRCI-LTI-01-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 2 of 2) Project Name: IN -ILf) Enforcem1ent Agq t __ll ,n,.Cl or- N1 EL. IPref hN7b :_ 36ob dre Project ss:( r t-fe papa hep f v EG. a . of': M eW POA,7154BVC, N'lGV, Code:O 2-,&b 0 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Document ti Author Name: Documen i azure: cS ljguGn�o�Author Co mpany NpCme:L hof Date Signed: :iei IrA (b -L AWN Znf —pd P1Phone: CEA Certifi tion ld lification(if applicable): CiZip: �A- 9Z'�ZI 1I1 70oo RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Buil r/I taller ame: Responstaller Signat -Company Name: Ilnrtall�ng�5ub apt General Contractor r�u d /�r_ ( G 1V�cc (,JK Posilior-, ompa��ny (� TitT Atldress: 0o L. INP 6X I nr&_ HW 17.0/. 52a fSLB License: Cj o . 7 so 9 ciN/Statg* I's 8z-' Ph ['J -&9j3- 9j3- 70DO Date Signed: CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance January 2016 STATE OF CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMEN CEC-NRCA-LTI-03-A (Re J.wm) CALIFORNIA ENERGY COMMISSION f NLCAA ra,uowi usnun� comracwrs Association of America CERTIFICATE OF ACCEPTANCE - NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document Project Name: F.I. LL IMPROVEMENTS #941 Enforcement Agency: CITY OF NEWPORT BEACH Permit Number: X2019-3606 Project Address: 941 NEWPORT CENTER DRIVE City: NEWPORT BEACH Zip Code: 92660 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Gary Ducros Documentation Author Company Name: Date Signed: November 14 2019 Ducros Electrical Contracting & Design Inc. Address: 2500 E. Imperial Hwy. 201-520 CEA/ATT Certification Identification (If applicable): ATT -1706-00001 City/State/Zip: Brea, CA 92621 Phone: 714-688-7000 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: Field Technician Signature Gary Ducros h Field Technician Company Name: Position with Company (Title): Ducros Electrical Contracting & Design Inc. Acceptance Test Technician Address: 2500 E. Imperial Hwy. 201-520 ATT Certification Identification (if applicable): ATT -1706-00001 City/State/Zip: Brea, CA 92821 Phone: 714-688-7000 Date Signed: November 14 2019 RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 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. 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: Responsible Acceptance Person Signalur . J Gary Ducros Responsible Acceptance Person Company Position with Company (Title): Name: Ducros Electrical Contracting & Acceptance Test Employer Design Inc. Page 4 of 4 I T Address: 2500 E. Imperial Hwy. 201-520 CSLB License: C10#750903 CitylStatelZip: Brea, CA 92821 Phone: 714-688-7000 Date Signed: November 14 2019 O m x O O m A S O V M NfR OA N N N n N A N.Q J P Z O 0 Z 0 Z G1 N y C3 N M 9 O wC D o ODC fD F N N O R � D a a r +.n A 0 N O o O A V A O O O O OO O O O O oo 0000 00 M MMZZDD010 v DD. T k 0 r0- ¢°. 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DEL u12Ld :aonl 5 nejl CxTT) jU` IV I G EQUIPMENT (LTxTT) AW)l :azlS b kejl Date: 10/31/2019 Page: 1 CA.92625 0 0 0 0 sauolplW g61H (;IsuaO jolo0 ks: OA E TOR TAG. 0£8[03 MoLd ga0jaseT joLOJ dH aweudOLN uo npojd saigef aelog Lura}sng 610nn1111GJ a QQ!Aa(1 L��I jl� -• �. -e • • SYSTEM 9) jaggal K.Ls £ R'ejl uie ad kej HP-1Ar Equipment Loca ii`669 8 jaggal KLS z ejl ROOF s10 :saoLnJBS Im ROOF OM dH dH Area Served x ja a azr CH OFFICE RM # 101 # 1 ajn51 uo :00dg E u merftlWrWf960fdr:azls .a ed gLnejaa CARRIER - PtAMIE{QN :aLgel JO LOO L04Sno Model suol;d0 pue ejl jaded 50HCQA04A2A5 VR -C30- 0 :'eMa 2 g}6L0 dVal Serial Number 2119054050 3510468540 dews :AW42 d1WS UL '0810 MM�ML Pagw3 jeH guasajd jegSajnS dH a eu dap ified A 0W 00 ZT "figlo pecified a u3 : sl@ l: s10 0120 uL5u3 u2H dei Total CFM -f®figeu3 : el Pue l esn � 0 u3 u3 3s10 Total CFM - W : joMsse ue of 0 6 990 POW R/A CFM (agljMja14150 10 850 lb£0dnI6Qg(pgwnw L2 j@s u ua SLsja :aaua srS a PIP 0 0 150 14 UJ �ddIl Static PWd3 Tbi kt Igd�j u3 egp750C S 0. 0.60" ESP 0062dOZ 31 vdOMd Inlet Pressure 43" 0. dJLV j:Jad 3001 isc arge ressure 0.54" z[O[3We 1dIa Slsod Fan RPM 1051 NS HI W)d lid .61W1 e;sul 00'£T'T£ Zbbs p§ Actual Specifieduvvj 3 Actual goN.� Motor cturer sa at jaw MARATHON I(1 a uI as jgje3 Motor H.P. :sal e3a oW DNL NS dd0I Lod a p j4ae3 3 1 sa , auL6u g e3 joLOD Voltage 8 206 / 205 / 205 208 66206xsa LOBO a I6u3 Amperage 2 4.7 / 4.6 / 4.7 4.1 2M Sd njaS motor 5 1780 2 SPD a1-Le4suH1GH:uolsln a DA Motor Servi or 1.15 n3 dH Wj L3 MotorWi@dam 0e/L/1T 3Le 0/xeWO Ise] 70% OPEN SOT000 6b£/W :uolslnay @J1MWLJ MWj L3 9�S Motor Sheave ' h 8a x au16 d gseg 1VL34 X 5/8" DIRECT ja wnN jag ewjo3 Fan heave Shaft AFD44 X 5/8" Di IyR1 nN Le LAS g npojd Belts (1 OF) AX38 R ue o3 LPW ks: OA E TOR TAG. 0£8[03 MoLd ga0jaseT joLOJ dH aweudOLN uo npojd saigef aelog Lura}sng 610nn1111GJ a QQ!Aa(1 L��I jl� -• �. -e • • (sems PIamun) 4sou3 AIR BALANCE CO., INC. DATE: PAGE: SYSTEM #: PROJECT: FIRST REPUBLIC BANK DEL MAR 2800 EAST COAST HIGHWAY BLVD. DEL MAR, CA. 92625 AIR DISTRIBUTION Wd S4 WZG 6WIVAoN 10/31/2019 2 HP -1 ROOM NO. CODE SIZE AK FACTOR REQUIRED F.P.M. REQUIRED C.F.M. ACTUAL F.P.M. ACTUAL C.F.Ml SUPPLY AIR SYSTEM 101 1 CD 2408 1.00 200 200 101 2 CD 2408 1.00 200 198 101 101 3 4 CD CD 2408 2408 1.00 1.00 200 200 002MOOJJ j 00800 000060Z0 000 000 000 eal eai 101 5 CD 2408 1.00 * 200 XMISION, Ilk 197sed 101 6 CD 2408 1.00 pa n60 oN 213 :SuoLSL Loo 7Lws TOTAL n (1226) ; L Un 2JJ d 0H0 Ogb9 L :Pa17Lwsus.al aMaed l 101 qT @nLwa Sl ae Se Peg Luo RETURN AIR SYSTEP50) 9690 OZ :P nL@aWb ached 1101 106 1 CR 18X18 1.00 gOga:Ob ON 1070 :aPOW 100gWd SNO P@I9 aLL SEE d (1070) :1ua6y uawaaun dIj uuV -- -------- --- nd paL; 1Lne as S 1oN a0/p@LdLaadS 1 :p N:@weN Mssed uwPV w0 109 aaV WNS OUTSIDE ;99 qa��Qq'pq34 aweN OLAJ@S ano.fuog Pa, 01n O:TZ 80 -60 -VZ w SIInIQ'4 w 1a5 S@iLdx3 WNS WNS aa0 ROOF 1 DO 8.5 W 250 TOTAL (RoopuOO 1247 pa [d oadS(JN80) :XT OaS sdI Zog 0 '9Z LT :ssa.:PPV dI C8 BVOE ZZ8LL3 Id VTJ set JOIOj dH p@j@'sLI5@N 10KIu� no d09 Dog F as :sn1e1S a eaLlddV 1oN -- ----- - a e dd o .ew3 a Dauuo dH a@ OLZ :1 oawLl @LPI d01 6T07. P.0 Eli e nue SM 1e0 P@LdLOa S 1ON M-** x000T6SOT69 :OI Lun1Oe; ueW T woe ZL :.aan,aa (9Adf)sI;l8 SND �-le uoaa5 we 1pnj 1000T :6L uO0 1nV JOd 061 IV 0B eL :.aan 11 aS SNO .aewLud 902V b9T99b0p; :b"dl REMARKS: Spe LS :aweN uLewog bndI 900vot9199b0 :ssaappV a.aeMp.aeH POW paLgeu3 :9ndI PaLquul :tAdl APP@d I e1S ---------------- dT/w---------------------- --- uoi,ewao uTieaauan--------- LL �►TbII�FraMPtl iaONATION.AL ENVIRONMELV , I CIfVGptpp a LU3 �7j • AIR BALANCE CO., INC. DATE: 10/31/2019 PAGE: 3 SYSTEM #: HP -2 PROJECT: FIRST REPUBLIC BANK DEL MAR 2800 EAST COAST HIGHWAY BLVD. DEL MAR, CA. 92625 AIR DISTRIBUTION 4 CERTIFIED MEMBER - NATIONAL ENVIRONMENTAL BALANCING BUREAU SK e� � � AIR BALANCE CO., INC. Project Name: FIRST REPUBLIC BANK DEL MAR 2800 EAST COAST HIGHWAY BLVD. DEL MAR, CA. 92625 AIR MOVING EQUIPMENT TEST SHEET Date: 10/31/2019 Page: 4 SYSTEM HP -3 I" HP -4 Equipment Location ROOF ROOF Area Served BRANCH OFFICE RM # 101 Y / OFFICE Equipment Manufacturer CARRIER CARRIER Model 50VR-C30-50 R-C24-30TP Serial Number 3519F49554 0719C35133 Motor Sheave & Shaft Size DIRECT DRIVE DIRECT DRIVE Fan Sheave & Shaft Size DIRECT DRIVE DIRECT DRIVE Belts DIRECT DRIVE DIRECT DRIVE Remarks: (!)NO ACCES5 TO MOTOR TAG CERTIFIED MEMBER - NATIONAL ENVIRONMENTAL BALANCING BUREAU 0 1,81 ,• - m♦ -=m_MEMO --- �OmM©® z ; m♦_ MMM10mm" © 1000101000 MISS �mm������ 000100 000001=100 MISS ISSIPS -�m-MEMO - _-____ MISS _ • hOMMAMMOSEll 1000 10011000 mm MOMEMOMMEW _-_ 1000000110000001 • . ® '... - MISS 10001000 mm EMS SOMME 1000 �mmNEW SOMME10 00010001 MISS WIN 1000001 00010001 1000001 00010001 000010=1010 1000001 10000001 �MISS 3, 1000001 1000001 1000000011 1000001 10000001� 000001 ISO .h M 1000001 00111000 MEME 1000001 00011001 MISS 100101000001 10IMME1 000010mam10MEMS1 1000001��■ A;--IIRR BALANCE CO., INC. Project Name: FIRST REPUBLIC BANK DEL MAR 2800 EAST COAST HIGHWAY BLVD. DEL MAR, CA. 92625 AIR MOVING EQUIPMENT TEST SHEET Date: 10/31/2019 Page: 7 SYSTEM FC -1 Equipment Location IDF ROOM # 111 Area Served IDF ROOM # 111 Equipment Manufacturer DAIKIN Model FTK24NMVJU Serial Number G014200 Specified A pecified Actual Total CFM fan - 700 Total CFM - Outlet 700 R/A CFM 700 7 O/A CFM -0- Static Pressure (Total/Ext NS Inlet Pressure NA Discharge Pressure NA Fan RPM 4, NS MED pec Actual Motor Manufacturer Specified Actual 1 1) Motor H.P. S Phase 1 1 Volta a 1W 208 / 230 206 Am era a 0.30 0,2 Motor RP 5 SPD MED Motor Servi or 1 Motor Sheave h Motor Sheave & Shaft Size DIRECT DRIVE Fan Sheave & Shaft Size DIRECT DRIVE Belts DIRECT DRIVE Re narKs: (!)NO ACCESS TO MOTOR TAG 446 CERTIFIED MEMBER - NATIONAL ENVIRONMENTAL BALANCING BUREAU General Information Building Type: F Nonresidential r High -Rise Res (Common,Area) r Hotel/Motel (Common Area) Phase of Construction: r New Construction r Addition fv. Alteration r Unconditioned Scope of Responsibility Enter the date of approval by enforcement agency of the Certificate of compliance that provides the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. Date: 7/8/2019 12:00:00 AM Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc, Date Approved By I the Enforcement Agency PLANSET EI -- E9 7/8/2019 9:00:00 PM This is page 1 of 2 f DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1 certify that this Certificate of Acceptance document Is accurate and complete. Documentation Author Company Name Name paul bussell 21st Century Electrics AddressCity Encinitas 270 N EI Camino Real F201 Zip Code Phone 92024 7608098285". CEA/ATF Certification Author Signature Identification (if ATC 813002 applicable) i Date of Signature: 11/01/2019'. RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 certify the following underpenalty ofperjury, 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 1 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 NA]. 4. I 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 permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. 1 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 DAP Electric Inc Person Name Fernando Sanchez Adtlress:city Chino 14175 TELEPHONE AVENUE UNIT G Zip Code 91710 Phone 9095916900 -\I CSL8 License Position with Company PM 790439 (Title) Responsible Acceptance Person Signature (1r Date of Signature: 11/01/2019 This is page 2 of 2 r'INDOOR LIGHTING NRCI_LTI_02_E istRepublicBank CDM Orange General Information Building Type: F Nonresidential r High -Rise Res (Common Area) F Hotel/Motel (Common Area) Phase of Construction: r New Construction r Addition r Alteration r Unconditioned Scope of Responsibility Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. Date: 7/8/2019 12:00:00 AM §130.4(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 eligible 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 submit this 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 a computerized control system designed to regulate the energy con ,on of a building by controlling the operation of energy consuming systems, such as the heating, ventilation an conditioning (HVAC), lighting, and water heating systems, and is capable of monitoring environmental and sys ads, and adjusting HVAC operations in order to optimize energy usage and respond to demand response signals. r The Energy Management Control System ha Installed to function as a lighting control required by Part 6 and functionally meets all applicable requirements h application for which it is installed, in accordance with Sections 110.9, 130.0 through 130.5, 140.6 t 150.0, and 150.2; and complies with Reference Nonresidential Appendix NA7.7.2. r The EMCS has been separately tested for each respective lighting control system for whit nstalled to function as. r 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. This is page 1 of 5 The Installed Lighting Control System complies with the requirements checked below; and all components of the system considered together as installed meet all applicable requirements for the application for which they are installed as required in Sections 130.0 through 130.5, Sections 140.6 through 140.8, Section 141.0, and Section 150.0(k). PART 2 Lighting Control Functional requirements: Check all that apply when verifying the installation of an EMCS or Lighting Control System. fs A, All lighting controls and equipment have been installed in accordance with the manufacturer's instructions. P B. The manufacturer has provided instructions for calibration. r C. If indicator lights are integral to any components, such indicator lights consumes no more than 1 watt of power per Indicator light. P D. Components that are regulated by the Title 20 Appliance Efficiency Regulations have been certified to the Energy Commission. P E. The EMCS or Lighting Control System functions as one or more of the Time -Switch Lighting Controls checked below, and complies with all of the following requirements: r 1. Automatic Time -Switch Controls meeting all requirements for Automatic Time Switch Control devices in the Title 20 Appliance Efficiency Regulations, Including the requirements below: a. Residential automatic time -switch controls have 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. Commercial automatic time -switch controls meet the following requirements: I. 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 ii. 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 iii. Incorporates an automatic holiday shutoff feature that turns off all connected loads for at least 24 hours and then resumes normally scheduled operation. 17 2. Astronomical Time -Switch Controls meeting all requirements for Astronomical Time -Switch Control devices in the Title 20 Appliance Efficiency Regulations, including the 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, current time, sunrise time, sunset time, and switching times for 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. F 3. 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. r F. The EMCS or Lighting Control System functions as one or more of the Daylighting Controls listed below: This is page 2 of 5 I� 1. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20 Appliance Efficiency Regulations, including the following: a. Is capable of reducing the power consumption in response to measured daylight either directly or by sending and receiving signals; b. If the system includes a dimmer, complies with the Dimmer Control device requirements in the Title 20 Appliance Efficiency Regulations. c. Automatically return to Its most recent time delay settings within 60 minutes when put in calibration mode; d. Has a set point control that easily distinguishes settings to within 10 percent of full scale adjustment; e. Has a light sensor that has a linear response within 5 percent accuracy over the range of illuminance measured by the light sensor; f. Has a light sensor that is physically separated from where the calibration adjustments are made, or is 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 g. Complies with the Title 20 requirements for photo controls if the system contains a photo control component. r 2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency Regulations, Including the following that it does not have a mechanical device that permits disabling of the control. F G. The EMCS or Lighting Control System functions as a Dimmer and meets all requirements for a Dimmer Control device in the Title 20 Appliance Efficiency Regulations, including the following: 1. Is capable of reducing power consumption by a minimum of 65 percent when the dimmer is at its lowest level; 2. Includes an off position which produces a zero lumen output; and 3. Does not consume more than 1 watt per lighting dimmer switch leg when in the off position. 4. Dimmer controls that can directly control lamps provide electrical outputs to lamps for reduced flicker operation through the dimming range so that the light output has an amplitude modulation of less than 30 percent for frequencies less than 200 Hz without causing premature lamp failure. 5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the dimmer if the j lights are off. P H. The EMCS or Lighting Control System meets the following requirements: 1. Is capable of automatically turning off controlled lights in the area no more than 30 minutes after the area has been vacated; 2. Allows all lights to be manually turned off regardless of the status of occupancy; and 3. Has a visible status signal that indicates that the device is operating properly, or that It has failed or malfunctioned. The visible status signal may have an override switch that turns off the signal. 4. All occupant sensing devices that utilize ultrasonic radiation for detection of occupants meet the Ultrasound Maximum Decibel Values in the Title 20 Appliance Efficiency Regulations 5. All occupant sensing devices that utilize microwave radiation for detection of occupants meet the radiation requirements in the Title 20 Appliance Efficiency Regulations 6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20 Appliance Efficiency Regulations 7. The EMCS or Lighting Control System functions as one or more of the Occupant Sensing Controls Checked Below: la a. Occupant Sensors meeting all applicable requirements for Occupant Sensor Control devices in the Title 20 Appliance Efficiency Regulations F b. Motion Sensors meeting all applicable requirements for Motion Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including that motion sensors are rated for outdoor use. r c. Vacancy Sensors meeting all applicable requirements for Vacancy Sensor Controls devices in the Title 20 Appliance Efficiency Regulations, including the following: i. Does not turn on lighting automatically and does not incorporate DIP switches, or other manual means, for conversion between manual and automatic functionality; H. Has a grace period of no more than 30 seconds and no less than 15 seconds to turn on lighting automatically after the sensor has timed out; and ill. Does not have an override switch that disables the sensor. This is page 3 of 5 d. Partial -ON Sensors meeting all applicable requirements for partial on sensing devices in the Title 20 Appliance Efficiency Regulations, including the following: two poles each with automatic -off functionality; ii. Has o ole that is manual -on and does not Incorporate DIP switches, or other manual means, for conversion be manual and automatic functionality; and iii. Has one pole that tomatic-on and is not be capable of conversion by the user to manual -on functionality. F e. Partial -OFF Sensors meet all applicable irements for partial off sensing devices in the Title 20 Appliance Efficiency Regulations, including the fo 'ng: I. Has two poles; ii. Has one pole that Is manual -on and manual off; and M. Has one pole that is automatic -on and automatic -off and is not ca a of conversion by the user to manual -on only functionality. r f. Occupant Sensing Control systems consist of a combination of single or multi-level OcEtroazt, Motion, or Vacancy Sensor Controls, and all components installed to comply with manual -on requirements a of capable of conversion by the user from manual -on to automatic -on functionality. 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 applicable. P A. Section 130.1(a) Area Controls. W B. Section 130.1(b) Multi -Level Lighting Controls WR C. Section 130.1 (c) Shut -OFF Controls F D. Section 130.1 (d) Automatic Daylighting Controls. F E. Section 130.1 (e) Demand Responsive Controls. r F. Section 130.5 (d) Circuit Controls for 120 -Volt Receptacles. . To qualify for the PAF for a Partial -ON Occupant Sensing Control in TABLE 140.6-A r H. To qualify for F for an occupant sensing control controlling the general lighting in large open plan office areas above workstations, i ante with TABLE 140.6-A r I. To qualify for the PAF for a Manual Dimming Sys ora Multiscene Programmabfe Dimming System PAF in TABLE 140.6-A r J. To qualify for the PAF for a Demand Responsive Control in TABLE 140.6-A r K. To qualify for the PAF for Combined Manual Dimming plus Partial -ON Occupant Sensing Control in TABL - This is page 4 of 5 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1 certify that this Certificate of Acceptance document is accurate and complete. Documentation Author Company Name Name paul bussell 21st Century Electrics Address 270 N EI Camino Real F201 city Encinitas Zip Code Phone 92024 7606098285 CEA/ATT Certification Author Signature Identification (if ATC 813002 applicable) Date of Signature: 11/01/2019 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 acing 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 compiles 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. 9, 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($) 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 Person Name Fernando Sanchez DAP Electric Inc Address; 1417S TELEPHONE AVENUE UNIT G City Chino Zip Code Phone 91710 9095916900 CSLB License Position with Company 790439 (Title) PM Responsible Acceptance Person Signature Date of Signature: 11/01/2019 This is page 5 of 5 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 1 through 3 that are functionally tested under Section a. 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): F Weekdays r Weekend r Holidays b. Document for the owner automatic time switch programming (check all): P Weekday settings r Weekend settings r Holidays settings r Set-up settings r Preference program setting F Verify the correct time and date is properly set in the time switch r 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 6 r Occupancy sensors are not located within 4 feet of any HVAC diffuser r Ultrasonic occupancy sensors do not emit audible sound 5 feet from source U This is page 1 of 15 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: 101 Space Type (office, corridor, etc) FINANCIAL INSTITUTION 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 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)1. (a 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 from start of an unoccupied condition per Standard Section 110.9(b) 17 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 Yep 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 F This is page 2 of 15 Step 3: System returned to initial operating conditions r 3. Partial Off Occupancy Sensor Step 1: Simulate an unoccupied condition Lights go to partial off state within a maximum of 20 minutes from start of an noccupied condition per Standard Section 110.9(a) I r b. The occant sensor does not trigger a false 'on' from movement in an area adjacent to a controlled space or from HVAC operation. For library book stacks or warehouse ais activity beyond the stack or aisle shall not activate the lighting in r the aisle or stack. c. In the partial off state, ligh shall consume no more than 50% of installed lighting power, or: No more than 60% of installed ting power for metal halide or high pressure sodium lighting in warehouses. No more than 60% of Installed lightin ower for corridors and stairwells in which the installed lighting power is 80% or s of the value allowed under the Area Category Method. r Light level may be used as a proxy for lighting po r when measurements are taken Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each s arately controlled areas, Immediately upon an occupied condition r 4. Partial On Occupancy Sensors 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. Aker 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 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 I Nadjacent to the controlled space or from HVAC operation. This is page 3 of 15 S. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than 250 ft , to Qualify for a Power 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 PAF. Refer to Functional Test 2. a.. ea served by controlled lighting R` b. Enter PAF corresp mg to controlled area from line (a) above 0125 R2 for PAF=0.4, 126-250 ft o F=0.3, 251-500 fit for PAF=0.2). c. Enter PAF claimed for occupant sensor con in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than. equal to the PAF claimed in the compliance documentation (line c). r e. Sensors shafl 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 0 This is page 4 of 15 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 r pass Test 2. Representative Spaces Selected Tested space/room name: 102-105 Space Type (office, corridor, etc) OFFICE IT 250, CONFERENCE 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. hts can be turned on and off by their respective area control switch r b. Verify the switch on =rates lighting in the ceiling -height partitioned area in r which the switch is locate . Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, s off. Exempt lighting may r remain on per Section 130.1(c)1 and 130.1(a)1. 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 2. Occupancy Sensors Step 1: Simulate an unoccupied condition This is page 5 of 15 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 'on' from movement in an area adjacent to the controlled space or from HVAC operation. Step 2: Simulate an occupied condition P 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 3. Partial Off Occupancy Sensor Step 1: Simulate an unoccupied condition Lights go to partial off state within a maximum of 20 minutes from start of an I r occupied condition per Standard Section 110.9(a) b. The occupa ensor does not trigger a false 'on' from movement in an area adjacent to the ntmiled space or from HVAC operation. For library book stacks or warehouse aisle, ac ity beyond the stack or aisle shall not activate the lighting in r the aisle or stack. c. In the partial off state, lighting shal nsume no more than 50% of installed lighting power, or: No more than 60% of installed lighting po r for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for ridors and stairwells in which the installed lighting power Is 80%1 or less of the v e allowed under the Area Category Method. Light level maybe used as a proxy for lighting power when mea rements are taken r Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately contrON areas, Immediately upon an occupied condition \ r 4. Partial On Occupancy Sensors 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. I r b. After the first stage occurs, manual switches allow aoccupant to activate the alternate set of lights, activate 100% of the lighting poo wer, and manually deactivate all of the lights. This is page 6 of 15 Step 2, Simulate an unoccupied condition U This is page 7 of 15 5. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than ' 250 ft , to Qualify for a Power 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 PAF. Refer to Functional Test 2. served by controlled lighting b. Enter PAFcomes ing to controlled area from line (a) above (<125 ft` for PAF=0.4, 126-250 ft4 f0KQAF=0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor con in this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater tha equal to i the PAF claimed in the compliance documentation (line c). 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)' �r and all answers are Yes. This is page 8 of 15 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. 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: 106-108 Space Type (office, corridor, etc) SUPPORT/STORAGE/RESTROOM 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. A is can be turned on and off by their respective area control switch r b. Verify the switch only rates lighting in the ceiling -height partitioned area In r which the switch is locate . Step 2: Simulate unoccupied condition a. All lighting, including emergency and egress lighting, off. Exempt lighting may I r remain on per Section 130.1(c)1 and 130.1(1 b. Manual override switch controls only the lights in the selected ceilingheight 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 r type). Step 3: System returned to initial operating conditions 2. Occupancy Sensors Step 1: Simulate an unoccupied condition U This is page 9 of 15 CERTMCATE OF ACCEPTANCE CA-LUa A Pght�CmhoI jWNeme: WRe.M.Bmk COM iHnfb..t Ag q:= OF NEWPORT BEACH I ' N.ber.x20191182 JPwjet Addsms: 280 East coot krghwy Ciry:Newpo Bach Zip Cade; 92625 a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes from start of an unoccupied condition per Standard Section I10.9(b) I 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 Step 2: Simulate an occupied condition a. Status indicator or annunciator operates correctly yr 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 Pr 3. Partial Off Occupancy Sensor Step 1: Simulate an unoccupied condition . Lights go to partial off state within a maximum of 20 minutes from start of an occupied condition per Standard Section 110.9(a) r b. The occupa sensor does not trigger a false 'on' from movement In an area adjacent to the ntrolled space or from HVAC operation. For library book stacks or warehouse aisle, a Ity beyond the stack or aisle shall not activate the lighting in the aisle or stack. r c. In the partial off state, lighting she nsume no more than 50% of installed lighting power, or: No more than 60% of Installed lighting po r for metal halide or high pressure sodium lighting in warehouses. No more than 60% of installed lighting power for rridors and stairwells in which the installed lighting power is 80% or less of the a allowed under the Area Category Method. Light level may be used as a proxy for lighting power when me rements are taken r Step 2: Simulate an occupied condition The occupant sensing controls shall turn lights fully ON in each separately cont`3 1 1 areas, Immediately upon an occupied condition \ r 4. Partial On Occupancy Sensors Step 1. -Simulate an occupied condition. Verify partial on operation. a. Immediately upon an occupied condition, the first stage activates between 50 to \ I r 70% of the lighting automatically. b. After the first stage occurs, manual switches allow an occupant to activate the \ I alternate set of lights, activate 100% of the lighting power, and manually deactivate all of the lights. This is page 10 of 15 Step 2. Simulate an unoccupied condition This is page I 1 of IS 5. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than 250 ft , to Qualify for a Power 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 PAF. Refer to Functional Test 2. served by controlled lighting ft2 b. Enter PAF corres0bPAQg to controlled area from line (a) above (<125 ft` for PAF=0.4, 126-250 ft F=0.3, 251-500 ft2 for PAF=0.2). c. Enter PAF claimed for occupant sensor con 'n this space from the Certificate of Compliance. d. The PAF corresponding to the controlled area (line b), is greater than qual to the PAF claimed in the compliance documentation (line c). I 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. I This is page 12 of 15 1. Automatic Time Switch Controls (all answers must be Yes). r- 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. r 4. Partial On Occupant Sensor for PAF (all answers must be Yes). r- 5. 5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must r pass Test 2. D. Evaluation : P PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive. This is page 13 of 15 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Acceptance documentation Is accurate and complete. Documentation Author Paul bussell Company Name Name 21st Century Electrics Address 270 N EI Camino Real F201 City Encinitas Zip Code 92024 Phone 7608098285 CEA/ATT Certification ATC 813002 Author Signature Identification (if applicable) Date of Signature: 11/01/2019 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty ofperjury, 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. t 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 bullderlinstaller and has been posted or made avallable with the building Permit(s) Issued for the building, Field Technician Name Paul bussell Company Name 21st Century Electrics Address: 270 N EI Camino Real F201 Zip Code 92024 ATT Certification PTC 813002 Identification Field Technician Signature Date of Signature: 11/01/2019 City Encinitas Phone ]608098285 Position with Company (Title) Owner 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 1 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 Certlficate of Acceptance substantiates that the construction or Installation Identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the pians and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA]. 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 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. 1 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 Paul bussell Company Name 21st Century Electrics Person Name P rY Address: 270 N EI Camino Real F201 City Encinitas Zip Code 92024 ISLE License 633743 Responsible Acceptance Person Signature Date of Signature: 11/01/2019 Phone ]608098285 Position with Company (Title) Owner This is page 14 of 15 u This is page 15 of 15 AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT Enforcement Agency use: Checked by/Date Check boxes for all pages of this NRCA-LTI-03-A completed and included in this submittal ¢[ NBCA-LTI-03-A Page 1&2 Construction Inspection. This page required for all submittals. NRCA-M-03-A Page 3&4 Continuous dimming control functional performance test -watt -meter or amp -meter measurement NRCA-LTl-03-A Page Stepped Switching/SteppedDimmingfunctionalperformancetest-watt-meter or amp -meter measurement 5&6 NRCA-LTI-03-A Page Continuous dimming control functional performance test- light meter power measurement, and default look -up 7&8 table of fraction of rated power versus fraction of rated light output. NRCA-LTI-03-A Page Stepped Switching/ Stepped Dimming functional performance test - based on light output 9&10 1. NA7.6.1.1 Construction Inspection: 1. Drawing of Daylit Zone(s) must be shown an plans or attached to this compliance document. By checking this box, technician certifies that plans have been attached to this webform r Document Name and Page #'s PLANSET E2 Add Control Systems below. If sampling method is used in accordance with NA7.6.1.2. If adding, attach a page with names of other controls in sample (only for buildings with > 5 daylight control systems, sample group glazing same orientation) nLight PSS Plans Page Number Check If Tested Control is Representative of Sample Zone Type: Skylit (Sky), Primary Sldelit (PS), or Secondary Sidellt (SS) Control Type: Continuous Dimming with more than 10 light levels (C), Stepped Dimming (SD), Switching (SW) Design Footcandles: (Enter footcandle (fc) value or "U" if unknown): Control Loop Type: Open Loop (OL), Closed Loop (CL) Sensor Location: Outside (0), Inside Skylight (IS), Near Windows facing out (NW), In Controlled Zane (CZ) Sensor Location is Appropriate to Control Loop Type: (Yes/No) If control loop type Is Open Loop (OL): Enter yes (Y) if location = Outside (0), Inside Skylight (IS), or Near Windows facing out (NW); otherwise, enter no (N). If Control loop type Is Closed Loop (CL): Enter yes (Y) if location = In Controlled Zone (CZ); otherwise, enter no (N). �. I Control Adjustments are in Appropriate Location (Yes/No): Yes, If Readily Accessible or Yes If In Ceiling less than or equal to 11 ft, nLight PSS E2 F Yes This is page 1 of 5 No for all other. 4. Has Documentation Been Provided by the Installer: Installation Manuals and Calibration Instructions Provided to Building owner: (Yes/No) ves Location of Light Sensor on Plans: (Yes/No) Yes Location of Light Sensor on Plans: (Page Number) E2 S. Separate Controls of Luminaires in Da lit Zones: Are luminaires controlled by automatic dayllghting controls only in daylit zones: (Yes/No) Ves Separately circulted for daylit zones by windows and daylit zones under skylights: (Yes/No) Ves 6. Davilghting Control Device Certification Daylighting control has been certified In accordance with §110.9:-(Yes/No) Construction Inspection PASS/FAIL. If all responses on Construction Inspection pages I & 2 are complete and all Yes/No questions Pass have a Yes response, the tests PASS; If any responses on this page are Incomplete OR there are any No responses, the tests FAIL PASS/FAIL Evaluation (check one): (° PASS: If all responses on Construction Inspection pages 1 & 2 are complete and all yes/No questions have a Yes (V) response, the tests PASS r FAIL: Any applicable Construction Inspection responses are incomplete OR there Is one or more negative IN - no) responses in any applicable Functional Performance Testing Requirements section. System does not pass and Is NOT eligible for Certificate of Occupancy according to Section 10- 103(a)3B. FIX problem(s) and retest until the systems) passes all portions of this test before retesting and resubmitting NRCA-LTI-03-A with PASSED test to the enforcement agency. Describe below the failure made and corrective action needed. C-1 This is page 2 of 5 L 2. NA7.6.1.2.1 Functional Performance Testing - Continuous Dimming Systems: Power estimation using amp -meter measurement, or alternate option - watt -meter measurement Complete all tests on page 3 & 4 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and fill out Pass/Fail section on Page 4. rUght PSS Svstem Information a. Control Loop Type: Open Loop or Closed Loop? (0 or C) I It. Indicate If Mandatory control - M (required for skyllt zone or primary sidelit zone with installed general lighting power > 120 W); for Control Credit - CC; or Voluntary -V (M, CC, V) c. If automatic daylighting controls are mandatory, are all general lighting luminaires in dayllt zones controlled by automatic daylight controls? (Yes/No) Eyes J. General lighting design footcandles. (Enter footcandle (fc) value or "U" If Unknown) 102 e. Power estimation method. Meas. red Amps Multiplied by Volts, Volt -Amps (VA), alternate option is Measured Watts (W) VA Step 1: Identify Reference Location (location where minimum daylight Illuminance is measured in zone served by the controlled lighting.) f. Method Used: Illuminance or Distance? (1 or D) Override daylight control system and drive electric lights to highest light level for the following: g. Highest light level fc: Enter measured footcandles (fc) from controlled electric lighting (does not include daylight illuminance) IS In. Full load Highest light level power: Enter measured Amps times Volts, Volt -Amps (VA) or measured Watts (W). 102 I. Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TT) FO Ste 2: No Daylight Test controls enabled & daylight less than 1 fc at reference location j. Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log), Cover Fenestration (CF), Cover Night Open Loop Photosensor(COLP) k. Reference Illuminance (footcandles) as measured at Reference Location (see Step 1). Enter footcandles SS 1. Enter Y If either of the following statements are true: [Reference Illuminance (line k)] /[Highest light level fc (line g)] > 70% Ves when line I = FO or [Reference Illuminance (line k)) / [design footcandles (line d)] > 80%7 (Yes/No) Ste 3: Full Daylight Test conducted when daylight > 150% of reference illuminance line k m. Enter measured Amps Multiplied by Volts, Volt -Amps (VA) or measured Watts (W). 22 n. System power reduction enter 13 - (line m)/(line h)], Enter %. 78.431372549019 1 o. Is System Power Reduction (line n) > 65% when line I = FO, or > 56% when line I = TT (Yes/No) Yes p. With uncontrolled lights also on, no lamps are dimmed outside of dayllt zone by same control mechanism or formula (Yes/No) Yes q. Dimmed lamps have stable output (no perceptible visual flicker) (Yes/No) Ves r. Daylight Dimming plus OFF Controls PAF No (This portion of the full daylight test applies to lighting systems that are claiming a PAF for daylight dimming plus OFF controls. This portion of the full daylight test shall be conducted instead of steps m. thru q.) Does the system automatically turn OFF the luminaires when full daylight Is available? (Yes/No) s. Daylight Illuminance (light level without electric light) measured at Reference Location (fc) 1q This is page 3 of 5 CERTMICATE OFACCEPTANCE CA-LTt-g3-A ubmYicDavlodibm Coeaol 'ea Noma: IsMapubliasol CDM eforcemmt Ag®ry: CITY OFNBWPORTBBACB emit Nimbe,8201?1162 oject Addri 2600%t CoastRighway City: Newynrtli pcode 92623 t. Daylight Illuminance divided by the Reference Illuminance = (line s )/ (line k). Enter %. I 93.3333333333333 u. Is Ratio of Daylight illuminance to Ref. illuminance (line t) between 60% and 95%i (Yes/No) Ves v. Total (daylight + electric light) Illuminance measured at the Reference Location (fc) 22 w. Total Illuminance divided by the Reference Illuminance = (Ilne v )/ (line k), Enter %. 346.66666666666 6 x. Is Total illuminance divided by the Reference illuminance (line w) between 100% and 150%7 (Yes/No) Ves PASS/FAIL Evaluation (check one): r PASS: All applicable Construction Inspection responses are complete and all applicable Functional Performance Testing Requirements responses are positive (V - yes) r FAIL: Any applicable Construction Inspection responses are incomplete OR there Is one or more negative IN - no) responses in any applicable Functional Performance Testing Requirements section. System does not pass and Is NOT eligible for Certificate of Occupancy according to Section 10- 103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and resubmitting NRCA-LTI-03-A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. U This is page 4 of 5 OOCUMENTATION AUTHOR'S DECLARATION STATEMENT I cerclrr be Mls Ce. to Of AcapMnce daeumenp0on Is accu2@and mmplate. Oemmemmdnn AUMm Name pain bussell Adamson 270 N EI Qmino Real MD1 Zip Code 92024 CWATTC oatlon Identification Of applicable) /1[813002 Date of Signature: W01/2019 FIELD TI I eamly Me 1. Me 2.1an 3. The mmosms m the Sufferable a¢eptanre requirements and perwdures spetlfle 4.1 base ronflrmad Mat Me CerEflmM(s) of Imdlkryon for Me mnsbuctior Flea Teposted tlmtl o made avallablewIM Me building Perri Issuedfor Me bulNing. ame Paul bussell Mess: 270 N EI Camino Rawl E201 Zip Oude 92024 ATT CeiVlkatpn (dentlflcaden ATC 813002 Said Tshnldan SlgnaMre company Name 21s1, Century Hord¢ ally Endimen Phone 715080911205 AUNor Signature aemamnre managements mmraded In Ne plana and speGnreVons approved by the enNrtement a0enry, and Appendix NAT Is Ratlfisabs of Asceptana has been mradehtl and signed by Me responsible bulaeOfalaller and has been Company Name 21st CenWry Elsomm city, Enclnfda Phone ]608090266 RetlNen with company MO.) Manor 3ann9 on my ..a.,,r as my employee or my agent eSendI base revlewed Me Infmmallon psovaed on this C¢Mflcete of Acceplan¢. 2.1emcuunder Orissa theBusiness and Pmfeaslons title In Me appllgble dasa0mdon so accept responslblllry ,the cyatem mNon range, nrtryor Imdma ll.dan of features, terials, cemfonents, or anufactumdred devices for [M1e scopSpe of wod Weighted an MIs Oa to of Acuptance and a. to Me detlaradens In MR statement (responsible arsepbnce person). 3. The Inlormetlon pmvWed an Me 4rtlflate of agency, and subatanaallo MM Me able aSNon or Insta item nts and d onedu CeKlnmle of Refornim wmplls aMl Me Appendix a reOUlmmenls Indlw[etl In Me plain aM hawaperoftlom d Met tl by Me enforcement a9eircy, and a minab to Me r Installation on Identified rry this Cnb and prf Acceptance specified in n mandet Non d Isposte or mad W. 4. I M1ave c e build Met Me Cestlflrate(s) of Installation for Me ransta[tlon or InspllaVan Wen[Ifletl on this Certifla[e of Acrephnce Ms leen completed and Is posted or made avalleble wttM1 Me building Pa`mlt(s) 5. 1.11Ssad for Me Maing. a5.1willensure Mata aunderstasi Met ropy of Mis Y Of MIS Certificate i ehallm ..'ad, or Includhle with Me building penn Me issued for Me bulltling, and madeavailable N[he enfortemen[agenry lar all Responsible Aaeptan a Person Namee rand Mata 519nM mpY of MIS CeNflate of Arup[ana Is required to he Ind .P.wIM Me tlocumenM[lon Me bu21st gravida to Me buiWing owner .1 ..pan,. and bussell Company Name 21st @nary EIeMo Address: 270 N EI Gmino Road s2D1 alty En<Inhas Zip Code phone 92024 76ve090205 MW Meanse Posl[lon with Company (Title) 1533]93 Owner Responsible Aaepance Person Slpnalure nam .1 sipnatum: 11/01/2019 0 This is page 5 of 5 u a e� i till,pp�4a I CIO ANN uj CL W: ui ca .�.► /��♦♦ p V ? C ro s N w 5 a Lm CN V 2 J� tsy u