HomeMy WebLinkAboutX2019-2139 - MiscControl Air
Conditioning
Corporation
5200 E La Palma Avenue, Anaheim, CA 92807
Phone (714)777-8600 Fax (714) 777-3293
License Number 369439: C-20, C-36, C-38
CACC Job #: 102-19-0084
1(2019 -2139
660 Newpor6 Cenkf Dr-
Control
r
Test and Balance Report
Project Name: MOBILTE #200
Address: 660 NEWPORT CENTER DRIVE
Suite/Floor: 200
City: NEWPORT BEACH
Date: 12/13/2019
Technician: CARTER SNOWDEN
Control
Conditioning
Corporation AIR BALANCE REPORT
5200 E . Palma Avenue, Anaheim, CA 92807
,Phone (714) :.,1 Fax (714) 777-3293
.,
..• ,.
STATE OF CALIFORNIA
MECHANICAL
CEG-NRCI-MCH-01-E (Revised 01116)
f k
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-MCH-01-E
Mechanical (Page 2 of 2)
Project Name:
Mobilitie #200 @ 660 NCD
Enforcement Agency:
Permit Number:
Address:
660 Newport Center Drive 200
City
Newport Beach
Zip Code:
92660
Document Title or Description
Applicable Sheets or Pages, Tables, Schedules, etc.
Date Approved By
the Enforcement
Agency
Doc�entation Author Signature:
l/J`i'yrf'IrSrnl �J
Documentation Author Company Name: -
Date Signed:
Control Air Conditioning Corporation
8/16/19
Address:
CEA/ HERS Certification Identification (If applicable):
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
DocyOnentation Au or Nme'
Doc�entation Author Signature:
l/J`i'yrf'IrSrnl �J
Documentation Author Company Name: -
Date Signed:
Control Air Conditioning Corporation
8/16/19
Address:
CEA/ HERS Certification Identification (If applicable):
5200 E. La Palma Avenue
Not Applicable
City/State/Zip:
Phone:
Anaheim, CA 92807
(714) 777-8600
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify that this Certificate of Installation documentation is accurate and complete.
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 forthe
system design, construction, or installation of features, materials, components, or manufactured devices forthe 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.
S. 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/Installer Name:
Responsible Builde staller Signature:
Company Name: (Installing Subcontractor or General Contractor or
Position With Company I e :
Builder/Owner) Control Air ConditioningCorporation
Foreman
Address:
CSLB License:
5200 E. La Palma Avenue
369439
City/State/Zip:
Phone:
Date Signed:
Anaheim, CA 92807
(714)777-8600
8/16/19
CA Building Energy Efficiency Standards- 2016 Nonresidential Compliance June January 2016
STATE OF CALIFORNIA
MECHANICAL
CEC-NRCI-MCH-W-E (Revised 01116)
�y
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-MCH-01-E
Mechanical (Page 1 of 2)
Project Name:
Mobilitie #200 @ 660 NCD
Enforcement Agency:
Permit Number:
Address:
660 Newport Center Drive 200
City
Newport Beach
Zip Code:
92660
A. GENERAL INFORMATION
DATE OF BUILDING PERMIT
In the table below identify all applicable construction documents that specify the features, materials, components,
manufactured devices, or system performance diagn ostic results required for the scope of responsibility for this Installation
Certificate.
BUILDING TYPE
Applicable Sheets or Pages, Tables, Schedules, etc.
PHASE OF CONSTRUCTION
If more than one person has responsibility for building construction, each person shall prepare and sign an Installation Certificate
document applicable to the portion of construction for which they are responsible; alternatively, the person with chief
responsibility for construction shall prepare and sign the Installation Certificate documents) for the entire construction.
B. SCOPE OF RESPONSIBILITY
Date of approval by the enforcement agency of the Certificate of Compliance that provides the specifications for this Installation
Certificate.
In the table below identify all applicable construction documents that specify the features, materials, components,
manufactured devices, or system performance diagn ostic results required for the scope of responsibility for this Installation
Certificate.
Document Title or Description
Applicable Sheets or Pages, Tables, Schedules, etc.
Date Approved By
the Enforcement
Agency
No Mechanical Acceptance Forms Required
CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance June January 2016