HomeMy WebLinkAboutTI-20-1416 ,,_.. City of Arcadia, CA Permit NO.T1-20-1416
Development Services Department Permit Type:Tenant Improvement
240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 Work Classification:Tenant Improvement
(626)574-5416
Permit Status:Issued
ARCADIA IssueDate:10/19/2020 Expiration: 10/19/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
308 S First AVE B Arcadia,CA 91006-7345 5779002094
Contacts
SUN HOMELAND INC Owner JIMMY ZHONG Applicant
308 S 1ST AVE UNIT F,ARCADIA,CA 91006
(626)310-2160 (626)327-4505 ZH123ONG@YAHOO.COM
Description:INTERIOR TI FOR HAIR SALON INCLUDES MEP Valuation: $ 25,000.00 Tenant HAZEL SOLA SALON
(HAZEL SOLA SALON)
Total Sq Feet: 0.00 Plan Check#20-1416 Plan#345
Fees Amount Payments Amount Paid
220-240 Volt Outlet $6.60 Total Fees $1,984.69
Accessibility Plan Check $47.56 Cash/Receipt#REC-05427-20 $773.86
Accessiblity Building Permit $48.78 Cash/Receipt#REC-05790-20 $1,210.83
Add/Alter Ducts $9.94
Building Issuing Fee $47.01 Amount Due: $0.00
Building Permit Fees $487.75
Building Plan Review Fee $317.04
Cal Green Plan Check $31.71
Clothes Washer $13.21
Commercial T.I.Fire Plan Chk. $280.00
Electrical Permit Issuance Fee $47.01 CALLS FOR INSPECTIONS
Energy Plan Review Fee $97.55 Request for inspection by telephone at 626-574-5450. Leave a message
Fire Final Occupancy Fee $200.00 requesting the address,timeframe and what inspection item is needed.
Green Building Standard $1.00
Lavatories $105.68
Light Fixtures $32.60 This permit/plan review expires by time limitation and becomes null and
Mechanical Permit Issuance Fee $47.01 void if the work authorized by the permit is not commenced within 180 days
Outlets-Receptacles&Switches $62.28 from the date of issuance or if the permit is not obtained within 180 days
Plumbing Permit Issuance Fee $47.01 from the date of plan submittal.This permit expires and becomes null and
Solid Waste Management Fee $6.25 void if any work authorized by this permit is suspended or abandoned for 180
consecutive days or if no progressive work has been verified by a City of
Solid Waste Management Fee 2 $1.00 Arcadia building inspector for a period of 180 consecutive days.
Total: $1,984.69
C COMPLETED
October 19, 2020
Issued By: Date
October 19,2020 Page 1 of 1
`*ytYORV��
4 PERMIT/PLAN REVIEW APPLICATION
* t+
_ 4410,, Development Services Department, 240 West Huntington Drive, Post Office Box 60021
Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Signature of Contractor
NER-BUILDER DECLARATION ❑ 1 have and will maintain workers'compensation insurance,as required by Section
�' 3700 of the Labor Code,for the performance of the work for which this permit
I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve, Carrier
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number
for such permit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of MI certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of the Labor Code,I shall
0 I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for
sale(Section 7044,Business and Professions Code:The Contractors License Date /9- -f
-1 4,-- Signature 4/.--0. I!
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). _.. -------_-_, damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
I, as o wte he property, am exclusively co•• ratting with licensed
contractors to c struct the project(Section 7044, Busily :•t•. .. • io
Code:The Contractors License Law does not apply to an owner of property9CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
i I am exem t under SeAiop 7044,Business and Professions Code,for this reason:
Of
cL) 1 WS— Lender's Name
)(Date 110-11 -20-1/0 Signature k1!4.., 7 Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO T , BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for
further information.
Name , ' a'.. Title
PRINT it E
I certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner.
I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upon the above-mentioned property for inspection purposes.
Sipatured)Li_ _ Date /O- 7
— 24.)
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp. 30g- C�(� . , igs I V
, 4$,Q
100. Setbacks 210. Under flr./bldg.drain
101. Rough grade 211. Copper underslab 77- 20 --1416
102. Figs.&forms 212. Rough plumbing 1.2-2-2b
103. Pre-slab 213. Rough gas
104. Floor joists 214. Shower pan
105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer
108. Diaph nailing 218. Water service
109. Roof nailing 219. Final gas
110. Framing 12.2.2b ti-s, 220. Fixtures }
111. Occ./Area Sept.Wall 221. Final plumbing 2S 21
112. Sound walls 222. Sewer cap/demo. t
113. T-bar.rid 2 , xj
114. Insulation-Flr. Pool Inspections Date Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing
117. Drywall nailing 12-7:10 4-'J 242. Light shell/bonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grader 245. Gas line&test
121. Final building j.7 11- 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Final.lumbin. -
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Underground conduit
153. Underslab conduit Reroof Inspections Date I Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical 12-2-2.6 •"c! 272. Sheathing nailing
157. Fixtures (07.331-� 1 273. Final reroof
158. G.F.C.I. '�+
159. Eqpt.bonding Sign Inspections Date Insp. -
160. Service panel 280. Setback/overhang
161. Final electric 1.-)...1,74 (1 1.6 281. Footing
282. Conduit/wirin.
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC Miscellaneous Insp. I Date Insp.
183. Fire dampers 290. Fire alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fire sprinklers
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Hood dry chem.
188. Compressor setback 295. Final
189. Commercial hood
190. Duct shaft Sewers&Offsite Insp. Date Insp.
191. Final mechanical 300. Lateral(main to P/L)
301. Saddle/Y
Block Wall Inspections Date Insp. 302. Cess...I filled --
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
City of Arcadia, CA Permit NO. FIRE-20-1853
Development Services Department Permit Type:Fire
240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 Work Classification:Fire Sprinkler
(626)574-5416
Permit Status:Issued
ARCADIA Issue Date: 11/24/2020 Expiration: 11/24/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
308 S FIRST AVE B Arcadia,CA 91006-7341 5779002095
Contacts
Chung Lai Owner UNITED FIRE&SAFETY CO.* Contractor
308 S 1st 2318 CHICO AVE,SOUTH EL MONTE,CA
(951)279-8208 621096
Description:FIRE SPRINKS FOR TI 3 HEADS Valuation: $2,200.00 Tenant
Total Sq Feet: 0.00 Plan Check#20-1853 Plan#
•
Fees Amount Payments Amount Paid
Fire Issuance $47.01 Total Fees $448.36
Fire Permit Fees $120.35 Cash/Receipt#REC-06129-20 $448.36
Solid Waste Management Fee 2 $1.00
Sprinkler Heads $280.00 Amount Due: $0.00
Total: $448.36
CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
This permit/plan review expires by time limitation and becomes null and
void if the work authorized by the permit is not commenced within 180 days
from the date of issuance or if the permit is not obtained within 180 days
from the date of plan submittal.This permit expires and becomes null and
void if any work authorized by this permit is suspended or abandoned for 180
consecutive days or if no progressive work has been verified by a City of
Arcadia building inspector for a period of 180 consecutive days.
COMDLE?ED
November 24, 2020
Issued By: Date
November 25,2020 Page 1 of 1
OF A'
01411 PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Signature of Contractor
❑ I have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DECLARATION
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number
for such permit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
❑I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for
further information.
Name Title
PRINT NAME
I certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner.
I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upon the above-mentioned property for inspection purposes.
Signature Date
Aft
%4.1
4 oFF ci,,
C.) illillA 7
Avry� , 9
�`n'`y°`�`� MEMORANDUM
Fire Department
DATE: January 19, 2021
TO: BUILDING DEPARTMENT
INSPECTOR Jeff Wang
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 308 S. First Avenue, Suite B
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS (PC# 20-1853) 1-19-2021 Jill Perumean
FIRE ALARMS
HOOD & DUCT
KNOX BOX
OCCUPANCY (PC# 20-1416) 1-19-2021 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 1-19-2021 Rita
STATE OF CALIFORNIA
SHUT-OFF LIGHTING CONTROL ACCEPTANCE DOCUMENT
CEC-NRCA-LTI-02-A(Revised 01/19) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A
Shut-Off Lighting Control Acceptance Document (Page 1 of 3)
Project Name: Up H Enforcement Agency: Permit Number: /�
H07/11 e G+/t// /ny/JC ///] !A1/ ZOf 4
Project Address: O v' r S V / G City: / `yc ad t.V Zip Code:P°v
Compliance Results: Enforcement Agency Use:Checked by/Date
[COMPLIES or DOES NOT COMPLY]
This document is used to demonstrate compliance with acceptance requirements in§130.4(a)4 and Reference Nonresidential
Intent: Appendix NA7.6.2 for shut-off lighting controls.Attach additional sets of pages 1 through 2,as required,for all controls that must
be tested.
Indicate all types of shut-off controls tested for this project:
D§ Automatic time switch lighting controls(Sections A-1 and B-1 of this document should be completed)
Occupant sensing lighting controls(including occupant sensors,partial-ON occupant sensors,partial-OFF occupant sensors,and/or
13 vacancy sensors)(Sections A-2 and B-2 of this document should be completed)
Automatic Time Switch Lighting Controls
Building: Floor: Room: Control:
A-1.Automatic Time Switch Lighting Control Construction Inspection(NA7.6.2.4)
Automatic time switch controls are programmed with acceptable weekday,weekend,and holiday(if applicable)schedules.
o a. (NA7.6.2.4(a),§110.9(b)1Aii,§130.1(c)1A,§130.1(c)4)
Document for the owner weekday,weekend,and holidays schedules,as well as all set-up and preference program settings.
❑ b. (NA7.6.2.4jb))
c. The correct time and date are properly set in the time switch.(NA7.6.2.4(c))
p d. The battery backup(if applicable)is installed and energized.(NA7.6.2.4(d),§110.9(b)1)
Override time limit is no more than 2 hours.(NA7.6.2.4(e),§110.9(b)1Ai,§130.1(c)3B)OR The automatic time switch control's
❑ e. override time is exempt from the 2-hour limit.(EXCEPTION to§130.1(c)3B)
Override switches remote from area with controlled luminaires have annunciator lights.(NA7.6.2.4(f),§130.1(c)3A,§130.1(a))
❑ f. OR The manual override switch is exempt from being in the same enclosed area with the lighting it controls.(EXCEPTION 1 to
§130.1(a)2)
Construction Inspection Compliance: 0 Complies 0 Does Not Comply
B-1.Automatic Time Switch Lighting Control Functional Testing(NA7.6.2.5)
Confirm compliance(Y-yes/N-no)for the control being tested.
Step 1:Simulate occupied condition.(NA 7.6.2.5(a))
a. All lights can be turned on and off by their respective area control switch.(NA7.6.2.5(a)1)
b The switch only operates lighting in the enclosed space(ceiling-height partitioned area)in which the switch is located. /v
(NA7.6.2.5(a)2,§130.1(c)1C)
For the area controlled by an automatic time switch control with a time override located in and for the area,the
lighting can be turned on manually by initiating the time override.The lighting is configured to remain on for no more
c. A/(?
than 2 hours,unless the area is exempt from the 2-hour time override limit.(NA7.6.2.5(a)3,§110.9(b)1Ai,5130.1(c)38
EXCEPTION to§130.1(c)3B)
For the area controlled by an automatic time switch control with an automatic holiday shut-off feature,the lighting in
d the area can be turned off automatically by initiating the holiday shut-off.(NA7.6.2.5(a)4,5110.9(b)1Aii,§130.1(c)4)OR (170
The automatic time switch control is exempt from incorporating an automatic holiday shut-off feature.(EXCEPTION to
§130.1(c)4)
For the area controlled by an automatic time switch control with manual-on mode configured,the lighting in the area
e. can be turned on manually when it is manually activated.(NA7.6.2.5(a)5,§130.1(c)1E)OR The automatic time switch /
control does not include or utilize a manual-on mode.(§130.1(c)1E)
Step 2:Simulate unoccupied condition.(NA7.6.2.5(b))
a All non-exempt lighting turns off in accordance with the programmed time switch schedules.(NA7.6.2.5(b)1, �(�
§130.1(c)1A)
Manual override switch allows only the lights in the enclosed space(ceiling height partitioned)where the override
b. switch is located to turn on or remain on until the next scheduled shut off occurs.(NA7.6.2.5(b)2,§130.1(c)1C, 442
5130.1(c)3)
Functional Testing Compliance: Complies 0 Does Not Comply
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2019
STATE OF CALIFORNIA o
SHUT-OFF LIGHTING CONTROL ACCEPTANCE DOCUMENT
CEC-NRCA-LTI-02-A(Revised 01/19) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A
Shut-Off Lighting Control Acceptance Document (Page 2 of 3)
Project Name: 7 Enforcement Agency: Permit N mber:
Sup IfO7T- G� fAC' l / -/o-i't
Project Address: City: Zip Code:
5�s ISS S� >CGi 6d( 7/006
Occupant Sensing Lighting Controls
Building: Floor: Room: Control:
S, Control is representative of sample.(NA7.6.2.3)If sampling method is used,attach a page listing untested controls in sample.
A-2.Occupant Sensing Lighting Control Construction Inspection(NA7.6.2.2)
4 a. Occupant sensors have been located to minimize false signals.(NA7.6.2.2(a))
❑ b. Occupant sensors are located no closer than four(4)feet from any HVAC diffuser.(NA7.6.2.2(b))
❑ c. Passive infrared sensor pattern does not enter into adjacent zones. (NA7.6.2.2(c))
❑ d. Occupant sensors do not encounter any obstructions that could adversely affect desired performance.(NA7.6.2.2(d))
❑ e. Ultrasonic occupant sensors do not emit audible sound.(NA7.6.2.2(e),§110.9(b)6Bii)
Construction Inspection Compliance: . Complies 0 Does Not Comply
gl
B-2.Occupant Sensing Lighting Control unctional Testing(NA7.6.2.3)
Confirm compliance(Y-yes/N-no)for the control being tested.
Step 1:Simulate an unoccupied condition.(NA7.6.2.3(a))
Lights controlled by occupant sensing control turn off or partially off,if applicable,within a maximum of 20 minutes
from start of an unoccupied condition.(NA7.6.2.3(a)1,§110.9(b)4A)
In the partial off state,partial-OFF occupant sensors automatically reduce lighting power by at least 50%(§130.1(c)6A-
C§130.1(c)7A),OR:
• For metal halide or high pressure sodium lighting in warehouses,automatically reduce lighting power by at
least 40%(EXCEPTION 2 to§130.1(c)6A).
• In aisle ways and open areas in warehouses in which the installed lighting power is 80%or less of the value
a.
allowed under the Area Category Method,automatically reduce lighting power by at least 40%(EXCEPTION 1
to§130.1(c)6A).
• In corridors and stairwells in which the installed lighting power is 80%or less of the value allowed under the f)
Area Category Method,automatically reduce lighting power by at least 40%(EXCEPTION to§130.1(c)7A).
Occupant sensing controls in parking garages,parking areas,and loading and unloading areas have at least one control
step between 20 to 50%of design lighting power(§130.1(c)7B).OR Occupant sensing controls for metal halide
luminaires with a lamp plus ballast mean system efficacy of 75 lumens per watt in parking garages,parking areas,and
loading and unloading areas have at least one control step between 20 to 60%of design lighting power(EXCEPTION to
§130.1(c)7B).
The occupant sensing control does not trigger a false"on"from movement in an area adjacent to the controlled space
b. or from HVAC operation.(NA7.6.2.3(a)2)
Signal sensitivity is adequate to achieve desired control.(NA7.6.2.3(a)3)For library book stacks or warehouse aisles, /`✓�
c. I ,
activity beyond the stack or aisle shall not activate the lighting in the stack or aisle.(§130.1(c)6A §130.1(c)6B)
Step 2:Simulate an occupied condition.(NA7.6.2.3(b))
a. Status indicator or annunciator operates correctly.(NA7.6.2.3(b)1,§110.9(b)4C) Y
Immediately upon an occupied condition(NA7.6.2.3(b)2): I
• Lights controlled by an occupant sensor or a partial-OFF occupant sensor turn on;OR
• A vacancy sensor indicates a space is"occupied"and lights may be turned on manually;OR
b • The first stage of a partial-ON occupant sensor automatically activates between 50 to 70%of the lighting. \r.
(§130.1(c)5A)
After the first stage occurs for partial-ON occupant sensors,manual switches allow an occupant to activate the
alternate set of lights,activate 100%of the lighting power,and manually deactivate all of the lights.
Functional Testing Compliance: 0 Complies 0 Does Not Comply
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2019
STATE OF CALIFORNIA
SHUT-OFF LIGHTING CONTROL ACCEPTANCE DOCUMENT
CEC-NRCA-LTI-02-A(Revised 01/19) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A
Shut-Off Lighting Control Acceptance Document (Page 3 of 3)
Project Name: / ' �� / / Enforcement Agency: Permit Number:
)Uf /((i and/1 �/-ZO
Project Address: 3t Z j City: /�ra4� Zip Code: � e-n.
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name:/ -j Documentation Author Signature: /�„) n
l l ��Vi��y�J r l� 1
Documentation Author Company Name: Date Signed: / / _
Address: 2/2
1.,
/'_a ( ! CEA/ATT Certification Identification(If applicable):
City/State/Zip: - / Phone:
s Ph
.y� �t 6. 10-- 2'16 L2
FIELD TECHNICIAN'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Acceptance is true and correct.
2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance(Field Technician).
3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements
indicated in the plans and specifications approved by the enforcement agency,and conforms to the applicable acceptance
requirements and procedures specified in Reference Nonresidential Appendix NA7.
4. I have confirmed that the Certificate(s)of Installation for the construction or installation identified on this Certificate of Acceptance
has been completed and signed by the responsible builder/installer and has been posted or made available with the building
permit(s)issued for the building.
Field Technician Name: Field Technician Signature:
(') I. 9 ZA4 4/(17
Field Technician Company Name: I Position with Company(Title):
i)&) HOME ) /vl)
Address: ATT Certification Identification(If applicable):
30S IS - s+
City/State/Zip: Phone: Date
(`, Cz1g
I6- 2 2_
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. I am the Field Technician,or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the
information provided on this Certificate of Acceptance.
2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the
system design,construction or installation of features,materials,components,or manufactured devices for the scope of work
identified on this Certificate of Acceptance and attest to the declarations in this statement(responsible acceptance person).
3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this
Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the
enforcement agency,and conforms to the applicable acceptance requirements and procedures specified in Reference
Nonresidential Appendix NA7.
4. 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.
5. I will ensure that a completed,signed copy of this Certificate of Acceptance shall be posted,or made available with the building
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a
signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building
owner at occupancy.
Responsible Person Name: „:.,A—/
` —' c{ n^ Responsible Person Signature: /j��XN �.
Responsible Person Company Name: if 'f J /'l / Position with Company(Title):
Address: r[,b �, � c 1 a CSLB License:
City/State/Zip: C,,,,-I"[,(7 h Phone: Date Signed:
—i(�u i- /<fi k>-d
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2019
STATE OF CALIFORNIA
ELECTRICAL POWER DISTRIBUTION
CEC-NRCI-ELC-01-E(Created 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-ELC-01-E
Electrical Power Distribution (Page 1 of 5)
Project Name: -- Enforcement Agency: Permit Number•T _26C.�
/
11V1 i1,✓1(��( I �l
Ho'd)N
Project Address: ""'t City: Zip Code:
›L} 6 Flr ' /, <"1 /
GENERAL INFORMATION
DATE OF BUILDING PERMIT: I I /`(')PERMIT# I w
/41
BUILDING TYPE Io Nonresidential 0 High-Rise Residential(Common Area) ElHotel/Motel(Common Area)
PHASE OF
CONSTRUCTION
0 New Construction 0 Addition ( Alteration
SCOPE OF RESPONSIBILITY
Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the Date:
specifications for the energy efficiency measures for the scope of responsibility for this 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
•
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA
ELECTRICAL POWER DISTRIBUTION r :
CEC-NRCI-ELC-01-E(Created 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-ELC-01-E
Electrical Power Distribution (Page 2 of 5)
Project Name: Enforcement Agency: Permit Number:.
'� j,..- i' HCAP cm"6 I ►'1(, 4 vi, ` TI —2 .— (
Project Address: ,.. City: Zip Code: i
A.Service Electrical Metering
Indicate by checking one of the three boxes below if the electrical power distribution system is in compliance with Section 130.5(a).
❑ For newly installed electrical service in newly constructed buildings,Service Electrical Metering is required according to Section 130.5(a).Fill out
Column 1 thru 6 of table below.
❑ For new or replacement electrical service equipment in existing buildings,Service Electrical Metering is required according to Section 141.0(b)2Pi.
Fill out Column 1 thru 6 of table below.
❑ EXCEPTION to requirements of the Electrical Service Metering:Service or feeder for which the utility company provides a metering system that
indicates instantaneous kW demand and kWh for a utility-defined period. Fill out Column 1,3,6 and 7 of table below with the compliance
information.
❑EXCEPTION to requirements of the Electrical Service Metering:Electrical power distribution systems subject to California Electrical Code Article
517.Not required to fill out.
Fill out a separate line for each electrical service that is connected to the building.If additional table space is needed for electrical service information,
submit additional page with the information.
Electrical Service Schedule Electrical Service Rating Metering Capabilities Exception to 130.5(a)
(check all that are present)
01 02 03 04 05 06 07
,,, Y b0
f0
03L N C
N ' ai
u, E fl- Y N U ,_ -0 i)
+
' ) bn3 co 'o
C � �, o v
Y
.toaY O `"' a E -'
N 0 O N U. L Q Nn i
N ;
STATE OF CALIFORNIA
ELECTRICAL POWER DISTRIBUTION
CEC-NRCI-ELC-01-E(Created 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-ELC-01-E
Electrical Power Distribution��'/// (Page 3 of 5)
Project Name: yJ Enforcement Agency: Permit Number. / 7O- lull
/
lC' G4? 11t r (� r(f 4L
�Af Zip Code:
Project Address: /!�r„,�/a t.D
B.Separation of Electrical Circuits for Electrical Energy Monitoring �1 L//j[v��' l I/V
Check all boxes below if the electrical power distribution system is in compliance with Section 130.5(b).
O The electrical power distribution system meets the separation of electrical circuits for electrical energy monitoring requirement of Section
130.5(b).The electrical power distribution systems is designed so that measurement devices can monitor the electrical energy usage of load
types according to TABLE 130.5-B.
O Describe the electrical power distribution system installed and the compliance method chosen in meeting the requirement of Section 130.5(b).
Use the space below to include the information.Examples of compliance methods are detailed in Nonresidential Compliance Manual
Chapter 8.
❑ EXCEPTION to requirements of the Separation of Electrical Circuits for Electrical Energy Monitoring:Electrical power distribution systems
subject to California Electrical Code Article 517.Not required to fill out.
Fill out Column 1 thru 3 with the compliance information.
General Information Electrical Power Distribution System Information and Method of Electrical Service Rating
Compliance
01 02 03
Electrical Service Describe the electrical power distribution system installed and the kVA
Designation/Location/Description compliance method used.
Field Inspector Notes:
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA j" t
ELECTRICAL POWER DISTRIBUTION
CEC-NRCI-ELC-01-E(Created 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-ELC-01-E
Electrical Power Distribution (Page 4 of 5)
Project Name: pft J tJ !A�`� jn%, Enforcement Agency: Permit Number. Z0_/ //
Project Address: 01
),{K'LVVV ( l City: rin-a Aa Zip Code: f�/ h
ed
C.Voltage Drop
Check all boxes below if the electrical power distribution system is in compliance with Section 130.5(c).
0 The electrical power distribution system meets the voltage drop requirement of Section 130.5(c).The maximum combined voltage drop on
feeder conductors and branch circuit conductors to the farthest connected load or outlet does not exceed 5%.
❑ Voltage drop calculation documents showing compliance to Section 130.5(c)are submitted as part of the compliance document submittal.
D.Circuit Controls for 120-Volt Receptacles and Controlled Receptacles
Check one or more boxes below for applicable requirements of Section 130.5(d)for the electrical power distribution system.
❑ The control is capable of automatically shutting OFF the controlled receptacles when the space is typically unoccupied,either at the
receptacle or circuit level.For the automatic time switch control,it incorporates an override control that allows the controlled receptacle to
remain ON for no more than 2 hours when an override is initiated and an automatic holiday"shut-OFF"feature that turns OFF all loads for
at least 24 hours and then resumes the normally scheduled operation.Countdown timer switches are not to be used to comply with the
automatic time switch control requirements.The controls meet the requirement of Section 130.5(d)1.
44 There is at least one controlled receptacle within 6 feet from each uncontrolled receptacle.Where receptacles are installed in modular
furniture in open office area,at least one controlled receptacle is installed at each workstation.The receptacles meet the requirement of
Section 130.5(d)2.
❑ There are installed split wired receptacles with at least one controlled and one uncontrolled receptacle.Where receptacles are installed in
modular furniture in open office area,at least one controlled receptacle is installed at each workstation.The receptacles meet the
requirement of Section 130.5(d)2.
❑ Permanent and durable marking for controlled receptacles or circuits to differentiate them from uncontrolled receptacles or circuits is
provided.The markings meet the requirement of Section 130.5(d)3.
❑ For hotel and motel guest rooms,there are controlled receptacles for at least one-half of the 120-volt receptacle in each guest room.Electric
circuits serving controlled receptacles in guestrooms are installed to have captive key controls,occupancy sensing controls,or automatic
controls so the power is switched off no longer than 30 minutes after the guest room has been vacated.The receptacles meet the
requirement of Section 130.5(d)4.
Receptacles that are only for the following purposes are excepted from Section 130.5(d):
-Receptacles specifically for refrigerators and water dispensers in kitchen areas.
-Receptacles located a minimum of six feet above the floor that are specifically for clocks.
-Receptacles for network copiers,fax machines,A/V and data equipment other than personal computers in copy rooms.
-Receptacles on circuits rated more than 20 amperes.
-Receptacles connected to an uninterruptible power supply(UPS)that are intended to be in continuous use,24 hours per day/365 days per
year,and are marked to differentiate them from other uncontrolled receptacles or circuits.
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA
ELECTRICAL POWER DISTRIBUTION
CEC-NRCI-ELC-01-E(Created 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-ELC-01-E
Electrical Power Distribution J (Page 5 of 5)
Project Name: '„/ //'L • Enforcement Agency: Permit Number: .
Project Address: / City:
y „J4 Zip Code: f jm 6"
3D s rt G� `
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Documentation Author Company Name: yt Date Signed:
Address: CEA/HERS Certification Identification(If applicable):
21524- crweeil
City/State/Zip: l)k1 , Phone: ` 9 17
RESPONSIBLE PERSON'S DECLARATION STATEMENT VKlvh
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,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. I 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. I will ensure that a completed signed copy of this Certificate of Installation shall be posted,or made available with the building permit(s)
issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a completed signed
copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at
occupancy.
Responsible Builder/Installer Name: Ai
-( Responsible Builder/Installer Signature:
Company Name: (Installing Subcontractor or General Contractor or udder/Owner) Position With Company(Title):
Address: 24 C-ia CSLB License:
)1 C L
City/State ZI F'v l Phone: Date Signed:
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA
AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT
CALIFORNIA ENERGY COMMISSION e
CEC-NRCA-LTI-03-A(Revised 01/20)
CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A
Automatic Daylighting Control Acceptance Document (Page 1 of 6)
/// Enforcement Agency: Permit Number:
Project Name: /f n `/ I� n T1-
/ -/tH�
S!!f9 / OYl c'� A �( l C ZipCo1—
de:41/ 7
Project Address: City.
?oF (si s/ /irri i 4 .?/er
Compliance Results: Enforcement Agency Use:Checked by/Date
[COMPLIES or DOES NOT COMPLY]
This document is used to demonstrate compliance with acceptance requirements in§130.4(a)3 and Reference Nonresidential
Intent: Appendix NA7.6.1 for automatic daylighting controls.Attach additional sets of pages 2 through 5,as required,for all controls that
must be tested.
Indicate all control methods used for this project:
❑ Continuous dimming controls(Sections A and 8-1 of this document should be completed)
Stepped switching/stepped dimming controls(Sections A and 8-2 of this document should be completed)
A.Construction Inspection(NA7.6.1.1)
The general lighting in skylit and primary sidelit daylit zones,or the general lighting in the combined primary and secondary
❑ a. sidelit daylit zones in parking garages,is controlled by automatic daylighting controls.(§130.1(d))
The daylit zones are shown on page(s) of plans;
❑ b. OR
The daylit zones are drawn in on page(s) of as-built plans(attached).(5130.1(d)1)
❑ c.
The automatic daylighting controls provide separate control for luminaires in each type of daylit zone.Luminaires that fall in
both a skylit and primary sidelit daylit zone are controlled as part of the skylit zone.(§130.1(d)2
)
For photosensors located within a daylit zone,at least one photosensor is not readily accessible to unauthorized personnel.
d' (§130.1(d)4)
The location where calibration adjustments are made to the automatic daylighting controls is readily accessible to authorized
❑ e.
personnel,including inside a locked case or under a cover that requires a tool for access.(§130.1(d)5
i Construction Inspection Compliance: , Complies 0 Does Not Comply
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance
January 2020
STATE OF CALIFORNIA
AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT
CEC-NRCA-LTI-03-A(Revised 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A
Automatic Daylighting Control Acceptance Document (Page 2 of 6)
• Enforcement Agency: Permit Number:
Project Name: /.
� {/1 l'
et,///76,-,
TT-2a—/lf/‘
307 S / City:
f/ 1
� �/� Zip Code: 'kw
Project Address: [
B-1.Continuous Dimming Control Systems Functional Testing(NA7.6.1.2.1)
Building: Floor: Room: Control:
❑ Control is representative of sample.(NA7.6.1.2)If sampling method is used,attach a page listing untested controls in sample.
Step 1:Identify the reference location(the minimum daylighting location in the controlled zone).(NA7.6.1.2.1(a))For parking garages,
illuminance levels should be measured at the farthest edge of the secondary sidelit zone away from the glazing or opening.(§130.1(d)3D)
Specify the power estimation method to be used:default ratio of power to light(Dfc),cut sheet ratio of power to light /1
a.
(CSfc)–cut sheet must be attached,measured Amps multiplied by Volts(VA),or measured watts(W).
Step 2:No daylight test.Simulate or provide conditions without daylight.(NA7.6.1.2.1(d))
b.
Indicate the method used to simulate or provide conditions without daylight:night time manual measurement(Night), /V
night time illuminance logging(Log),cover fenestration(CF),or cover photosensor(CP).
Enter the reference illuminance value in footcandles(fc),as measured at the reference location.(NA7.6.1.2.1(d)2)This
c' is the electric lighting illuminance without any daylight.
d Enter the measured full load power in Volt-Amps(VA)if power estimation method(line a)=VA or in watts(W)if power /Y
estimation method=W.OR Indicate not applicable(N/A)if power estimation method(line a)=Dfc or CSfc. —
Automatic daylight control system provides appropriate control so that the electric lighting system is providing full light •
e.
output unless otherwise specified by design documents.(NA7.6.1.2.1(d)1)Enter yes(Y)or no(N).
f. Light output is stable with no discernable flicker.(NA7.6.1.2.1(d)3)Enter yes(Y)or no(N).
Step 3:Full daylight test.Simulate or provide bright conditions where the daylight illuminance is greater than 150%of the reference
illuminance measured in Step 2.(NA7.6.1.2.1(e),§130.1(d)3C,§130.1(d)3D)
Enter the daylight illuminance(light level with the electric lighting turned off)value in footcandles(fc)measured at the
g. reference location. n/
h. Calculate the ratio of daylight illuminance to the reference illuminance in%.([line g/line c]x 100)
The ratio of daylight illuminance to the reference illuminance(line h)is greater than 150%.(§130.1(d)3C,§130.1(d)3D) /�,(
r. V
Enter yes(Y)or no(N).
Enter the total illuminance(combined daylight and electric light illuminance)in footcandles(fc)measured at the n /
j. reference location if power estimation method(line a)=Dfc or CSfc.OR Enter the measured power in Volt-Amps(VA)if
power estimation method(line a)=VA,or in watts(W)if power estimation method(line a)=W.
Calculate the electric lighting illuminance in footcandles(fc)at the reference location if power estimation method(line
k. / V
a)=Dfc or CSfc.(line j–line g)OR indicate not applicable(N/A)if power estimation method(line a)=VA or W.
I.
Calculate the fraction of rated light output in%if power estimation method(line a)=Dfc or CSfc.([line k/line c]x 100) ( V
OR Indicate not applicable(N/A)if power estimation method(line a)=VA or W.
Enter the dimmed luminaire fraction of rated power in%if power estimation method(line a)=Dfc or CSfc,and label n/
m. the control system being tested on the manufacturer's cut sheet or the default graph on page 3.OR Indicate not
applicable(N/A)if power estimation method(line a)=VA or W.
Calculate the system power reduction in%.
If power estimation method(line a)=Dfc or CSfc,system power reduction=[1-dimmed luminaire fraction of rated
n. power(line m)).OR /
If power estimation method(line a)=VA or W,system power reduction=[1-measured power(line j)/full load power
(line d)].
For areas other than parking garages,the system lighting power reduction of controlled luminaires(line o)is at least /]
o. 65%.(NA7.6.1.2.1(e)1,§130.1(d)3C)OR For parking garages,the controlled lighting power consumption is zero.
(§130.1(d)3D)Enter yes(Y)or no(N).
p. Dimmed lamps are stable with no discernable flicker.(NA7.6.1.2.1(e)1)Enter yes(Y)or no(N).
q. Only the luminaires in the daylit zones are affected by daylight control.(NA7.6.1.2.1(e)2)Enter yes(Y)or no(N).
If a PAF is claimed for daylight dimming plus OFF controls,the system automatically turns off the luminaires that are
r.
receiving this credit.(NA7.6.1.2.1(e)3,§140.6(a)2H)Enter yes(Y),no(N),or not applicable(N/A).
Step 4:Partial daylight test.Simulate or provide daylight conditions where illuminance(fc)from daylight only at the reference location is
between 60 and 95%of the reference illuminance measured in Step 2.(NA7.6.1.2.1(f)) _
❑ There are 0 control steps between ON and OFF.(Indicate not applicable(N/A)for lines s through aa.)
Indicate method used to simulate or provide conditions with partial daylight:natural daylight manual measurement /V
s' (ND),light logging(Log),partially cover fenestration(PCF),open loop setpoint adjustment(OLSA).
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA f ti
AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT
CEC-NRCA-LTI-03-A(Revised 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A
Automatic Daylighting Control Acceptance Document (Page 3 of 6)
Project Name: �y (Id
, Enforcement Agency: Permit Number.
5 /V/�� (Id Ac Zip Code _" a-/1/4
Project Address: ?&4 ,4/ C / City: A�a ���/
B-1.Continuous Dimming Control Systems Functional Testing(NA7.6.1.2.1)
Building:
Floor: Room: Control:
t. Enter the daylight illuminance(light level without electric light)in footcandles(fc)measured at the reference location. 1
u. Calculate the ratio of daylight illuminance to the reference illuminance in%.([line t/line c]x 100) /1/1
The ratio of daylight illuminance to the reference illuminance(line u)is between 60 and 95%.(NA7.6.1.2.1(f))Enter yes /�
v' (Y)or no(N). f �/
Enter the total illuminance(combined daylight and electric light illuminance)in footcandles(fc)measured at the / `
w' reference location. / ?/
The total illuminance(line w)is greater than or equal to the reference illuminance(line c).(NA7.6.1.2.1(f)1, 71.7
x' 130.1(d)3B)Enter yes(Y)or no(N).
y. Calculate the ratio of total illuminance to the reference illuminance in%.([line w/line c]x 100) /17
The ratio of total illuminance to the reference illuminance(line y)is less than or equal to 150%.(NA7.6.1.2.1(f)2)Enter /
z. � V
yes(Y)or no(N). n/
aa. The light output is stable with no discernable flicker.(NA7.6.1.2.1(f)3)Enter yes(Y)or no(N). ' V
Functional Testing Compliance: 0 Complies Q Does Not Comply
Default fraction of rated power to fraction of light output
(used on line m on page 2)
100% , 1 T 1 ni r '
p/ r I r
3 80/O a
HID r a 1.r.- 1- u
'
a 70% 1 a �/�- '•-�'-
4., , i , • •
r
E50%
fluorescent y '
46 40% t i ---I•-b---f�D i i i- t i
a iI I
c 309'0 — ,i/ ,Y f
al 20% -...---;10.!.- 4.10e--- :
LL 10% --- je:
0o 1
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Fraction of rated light output
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA
AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT -A
CEC-NRCA-LTI-03-A(Revised 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A
Automatic Daylighting Control Acceptance Document (Page 4 of 6)
Project Name: � Enforcement Agency: Permit Number:
5l.!/1 1076 e OP�t 17( 7� _z7p-Is-/6
d
Cae:
Project Address: 4 % / City: 7( J� Zip yreiri
50 4
8-2.Stepped Switching or Stepped Dimming Control Systems Functional Testing(NA7.6.1.2.2)
Building:
Floor: Room: Control:
p Control is representative of sample.(NA7.6.1.2)If sampling method is used,attach a page listing untested controls in sample.
Step 1:Identify the reference location(the minimum daylighting location in the controlled zone).(NA7.6.1.2.2(a))For parking garages,
illuminance levels should be measured at the farthest edge of the secondary sidelit zone away from the glazing or opening.(§130.1(d)3D)
a. Specify the control type:stepped dimming(SD)or stepped switching(SW). 4/
Specify the power estimation method to be used:counting(C)—only for stepped switching,cut sheet(CS)—ballast cut
b. sheet with steps of power and light must be attached,measured Amps multiplied by Volts(VA),or measured watts
(W).
Step 2:No daylight test.Simulate or provide conditions without daylight.(NA7.6.1.2.2(b))
Indicate the method used to simulate or provide conditions without daylight:night time manual measurement
c. (Night),night time illuminance logging(Log)—attach plot of illuminance or power,cover fenestration(CF),or cover
photosensor(CP).
d Enter the reference illuminance value in footcandles(fc),as measured at the reference location.This is the electric
lighting illuminance level without any daylight.(NA7.6.1.2.2(b)4)
Enter the measured Amps multiplied by Volts in Volt-Amps(VA)if power estimation method(line b)=VA.OR Enter
e. the measured watts(W)if power estimation method(line b)=W.OR Indicate not applicable(N/A)if power
estimation method(line b)=C or CS.
Automatic daylight control system turns on all stages of controlled lights unless it is documented that multi-level
f. luminaires have been tuned to less than full output and the design illuminance levels are provided.(NA7.6.1.2.2(b)2)
Enter yes(Y)or no(N).
The stepped dimming control system provides reduced flicker over the entire operating range as specified by§110.9.
B. (NA7.6.1.2.2(b)3)Enter yes(Y)or no(N).OR Indicate not applicable(N/A)if control type(line a)=SW. / v
Step 3:Full daylight test.Simulate or provide bright conditions where the daylight illuminance is greater than 150%of the reference
illuminance measured in Step 2.(NA7.6.1.2.2(c),§130.1(d)3C,§130.1(d)3D)
Enter the daylight illuminance(light level with the electric lighting turned off)value in footcandles(fc)measured at
h' the reference location. n/
i. Calculate the ratio of daylight illuminance to the reference illuminance in%.([line h/line d]x 100) /U
The ratio of daylight illuminance to the reference illuminance(line i)is greater than 150%.(§130.1(d)3C,§130.1(d)3D) �I✓
j' Enter yes(Y)or no(N).
Enter the measured system power in Volt-Amps(VA)or watts(W)if power estimation method(line b)=VA or W.OR n
k. /V
Indicate not applicable(N/A)if power estimation method(line b)=Cor CS.
Enter the fraction of system wattage turned off in%if the power estimation method(line b)=C.OR Indicate not
applicable(N/A)if the power estimation method(line b)=CS,VA,or W.
Enter the power reduction of dimmed lamps calculated from the manufacturer's cut sheet if the power estimation /t i
m.
method(line b)=CS.OR Indicate not applicable(N/A)if the power estimation method(line =C,VA,or W.
Calculate the system power reduction in%.
If power estimation method(line b)=C,system power reduction=fraction of system wattage turned off(line I).OR
n. If power estimation method(line b)=CS,system power reduction=power reduction of dimmed lamps(line m).OR
If power estimation method(line b)=VA or W,system power reduction=[1-measured system power at dimmed
stage(line k)/full load system power(line e)].
For areas other than parking garages,the system lighting power reduction of the controlled luminaires(line n)is at
o. least 65%.(NA7.6.1.2.2(c)1,§130.1(d)3C)OR For parking garages,the controlled lighting power consumption is zero. N
(§130.1(d)3D)Enter yes(Y)or no(N).
p. Only the luminaires in the daylit zones are affected by daylight control.(NA7.6.1.2.2(c)2)Enter yes(Y)or no(N).
If a PAF is claimed for daylight dimming plus OFF controls,the system automatically turns off the luminaires that are n/
q. receiving this credit.(§140.6(a)2H)Enter yes(Y),no(N),or not applicable(N/A). / V
Step 4:Partial daylight test.For each control stage tested in this step,the control stages with lower setpoints than the staged tested are left
on and those stages of control with higher setpoints are dimmed or controlled off.Simulate or provide conditions so that each control stage
turns on and off or dims.(NA7.6.1.2.2(d))
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA t .
AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT
CEC-NRCA-LTI-03-A(Revised 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A
Automatic Daylighting Control Acceptance Document (Page 5 of 6)
Project Name: Enforcement Agency: Permit Number:
' 5U4 'me' 47/, /4C T/ -Z0-/4d
Project Address: { City: Zip Code: I
;as si s YC O �lo�
B-2.Stepped Switching or Stepped Dimming Control Systems Functional Testing(NA7.6.1.2.2)
Building:
Floor: Room: Control:
Enter the number of control steps between ON and OFF.If the control has 1 to 3 steps,all control stages must be
r. tested.If the control has more than 3 steps,testing 3 control stages is sufficient for showing compliance.(NA7.6.1.2.2) �v
If the control has 0 steps between ON and OFF,the partial daylight test is not necessary.
❑ There are 0 control steps between ON and OFF.(Indicate not applicable(N/A)for lines s through kk.)
Indicate method used to simulate or provide conditions with partial daylight:natural daylight manual measurement 4/
s.
(ND),light logging(Log),partially cover fenestration(PCF),open loop setpoint adjustment(DESA .
First stage of control(partial daylight test)
Enter the total illuminance(combined daylight and electric light illuminance)in footcandles(fc)measured at the /J/
t. / v
reference location just after the first stage of control dims or shuts off a stage of lighting.(NA7.6.1.2.2(d)1
The total illuminance(line t)is greater than or equal to the reference illuminance(line d).(NA7.6.1.2.2(d)1A,
u' §130.1(d)3B)Enter yes(Y)or no(N).
v. Calculate the ratio of total illuminance to the reference illuminance in%.([line t/line d]x 100) 47
The ratio of total illuminance to the reference illuminance(line v)is less than or equal to 150%.(NA7.6.1.2.2(d)1B)
w' Enter yes(Y)or no(N). \Cr
The control stage does not cycle on and off between dim and undimmed while daylight illuminance remains constant.
x' (NA7.6.1.2.2(d)2)Enter yes(Y)or no(N).
y. Only the luminaires in the daylit zones are affected by daylight control.(NA7.6.1.2.2(d)3)Enter yes(Y)or no(N).
Second stage of control(partial daylight test) /
LI There is only 1 control step between ON and OFF.(Indicate not applicable(N/A)for lines z through kk.) 4�
Enter the total illuminance(combined daylight and electric light illuminance)in footcandles(fc)measured at the /l/
z. /
reference location just after the second stage of control dims or shuts off a stage of lighting.(NA7.6.1.2.2(d)1
The total illuminance(line z)is greater than or equal to the reference illuminance(line d).(NA7.6.1.2.2(d)1A,
aa. 1
§130.1(d)3B)Enter yes(Y)or no(N).
bb. Calculate the ratio of total illuminance to the reference illuminance in%.([line z/line d]x 100) /Y
The ratio of total illuminance to the reference illuminance(line bb)is less than or equal to 150%.(NA7.6.1.2.2(d)1B) 47
cc' Enter yes(Y)or no(N).
dd. The control stage does not cycle on and off between dim and undimmed while daylight illuminance remains constant. /17
(NA7.6.1.2.2(d)2)Enter yes(Y)or no(N).
ee. Only the luminaires in the daylit zones are affected by daylight control.(NA7.6.1.2.2(d)3)Enter yes(Y)or no(N). 4"
Third stage of control(partial daylight test)
❑ There are only 2 control steps between ON and OFF.(Indicate not applicable(N/A)for lines ff through kk.)
ff. Enter the total illuminance(combined daylight and electric light illuminance)in footcandles(fc)measured at the
reference location just after the third stage of control dims or shuts off a stage of lighting.(NA7.6.1.2.2(d)1) 4/
The total illuminance(line ff)is greater than or equal to the reference illuminance(line d).(NA7.6.1.2.2(d)1A,
gg' §130.1(d)3B)Enter yes(Y)or no(N).
hh. Calculate the ratio of total illuminance to the reference illuminance in%.([line ff/line d]x 100)
The ratio of total illuminance to the reference illuminance(line hh)is less than or equal to 150%.(NA7.6.1.2.2(d)1B)
ii. /J/
Enter yes(Y)or no(N).
The control stage does not cycle on and off between dim and undimmed while daylight illuminance remains constant.
ii• (NA7.6.1.2.2(d)2)Enter yes(Y)or no(N).
kk. Only the luminaires in the daylit zones are affected by daylight control.(NA7.6.1.2.2(d)3)Enter yes(Y)or no(N).
/17
Step S:Verify time delay.(NA7.6.1.2.2(e))
V
II The time delay automatically resets to normal mode within 60 minutes.(NA7.6.1.2.2(e)1,§110.9(b)2A)Enter yes(Y)or (,�
no(N).
mm. Set the normal mode time delay to at least 3 minutes.(NA7.6.1.2.2(e)2)
There is at least a 3-minute time delay between when illuminance exceeds the setpoint for a given dimming stage and
nn. when the control dims or switches off the controlled lights.(NA7.6.1.2.2(e)3)Enter yes(Y)or no(N).
Functional Testing Compliance: O Complies 0 Does Not Comply
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA se/
AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT
CEC-NRCA-LTI-03-A(Revised 01/20) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-LTI-03-A
Automatic Daylighting Control Acceptance Document (Page 6 of 6)
Project Name: Enforcement Agency: Permit Number:
SGi!N, Aiii �J 7/-1.0-7 /1(
Project Address: 30 �/3 City. 47-cetii-L Zip Code:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name: / V)teal /, Documentation Author Signature:,, ) _ 4t 1
/-�
Documentation Author Company Name: ( Date Signed: y_' 4 2.4
Address: CEA/ATT Certification Identification(If applicable):
Z ZZ GTw47 S�
City/State/Zip: Phone: 6-/1 10— 2.,60
FIELD TECHNICIAN'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Acceptance is true and correct.
2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance(Field Technician).
3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements
indicated in the plans and specifications approved by the enforcement agency,and conforms to the applicable acceptance
requirements and procedures specified in Reference Nonresidential Appendix NA7.
4. I have confirmed that the Certificate(s)of Installation for the construction or installation identified on this Certificate of Acceptance
has been completed and signed by the responsible builder/installer and has been posted or made available with the building
permit(s)issued for the building.
Field Technician Name: AiA4 00A4Field Technician Signature:
Field Technician Company Name,, Position with Company(Title):
Address: L,/r ATT Certification Identification(if applicable):
CRy/State/Zlp: v 1 J l r' one: Date Signed:
0) MownPh6 - 2- 1- GLS
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. I am the Field Technician,or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the
information provided on this Certificate of Acceptance.
2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the
system design,construction or installation of features,materials,components,or manufactured devices for the scope of work
identified on this Certificate of Acceptance and attest to the declarations in this statement(responsible acceptance person).
3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this
Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the
enforcement agency,and conforms to the applicable acceptance requirements and procedures specified in Reference
Nonresidential Appendix NA7.
4. 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.
5. I will ensure that a completed,signed copy of this Certificate of Acceptance shall be posted,or made available with the building
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a
signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building
owner at occupancy.
Responsible Person Name: , G Responsible Person Signature: )ISM
Responsible Person Company Name: C Position with Company(Title): l
Address: Z/L1 (4 Ord' O-
( CSLB License:
City/State/Zip: Q l/ Phone: Date Signed:
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020