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HomeMy WebLinkAboutX2021-0686 - Misc2T39 a>olfW6VI{+ "Dr CERTIFIED TEST, ADJUST, AND BALANCE REPORT DATE November 24, 2021 PROJECT WESTCLIFF MEDICAL CENTER BUILDING 3, SUITE 202 ADDRESS 2131 WESTCLIFF DRIVE, #202 NEWPORT BEACH, CA 92660 ARCHITECT LPA DESIGN STUDIOS ADDRESS 5301 CALIFORNIA AVENUE, SUITE 100 IRVINE, CA 92617 PHONE/FAX 949-261-1001 / 949-260-1190 ENGINEER LSA ASSOCIATES ADDRESS 83 WINDSWEPT WAY MISSION VIEJO, CA 92692 PHONE/FAX 949-830-4746 HVAC CONTRACTOR KNIGHT MECHANICAL SERVICES ADDRESS 22967 LA CADENA DRIVE LAGUNA HILLS, CA 92653 PHONE/FAX 949-716-2868 / 949-916-8158 TAB FIRM HARTMANAIRE ADDRESS 12 GARDENA LAKE FOREST, CA 92630 PHONE/FAX 951-479-6855 / 949-215-1001 c!", MC lan.M1en MCClanahanlaGDMHenmanal,e TAN Cow , BT60590817C CERTIFICATION PROJECT WESTCLIFF MEDICAL CENTER, BUILDING 3 ADDRESS 2131 WESTCLIFF DRIVE. #202 NEWPORT BEACH, CA THE DATA PRESENTED IN THIS REPORT IS AN EXACT RECORD OF SYSTEM PERFORMANCE AND WAS OBTAINED IN ACCORDANCE WITH TABB - ICB STANDARD PROCEDURES. ANY VARIANCES FROM DESIGN QUANTITIES WHICH EXCEED TABB TOLERANCES ARE NOTED THROUGHOUT THIS REPORT. THE AIR DISTRIBUTION SYSTEMS HAVE BEEN TESTED & BALANCED AND FINAL ADJUSTMENTS HAVE BEEN MADE IN ACCORDANCE WITH TABB - ICB PROCEDURAL STANDARDS FOR TESTING, ADJUSTING BALANCING OF ENVIRONMENTAL SYSTEMS AND THE PROJECT SPECIFICATIONS. TABB TAB FIRM REG. NO. TB0690817C CERTIFIED BY Mario Covarrubias DATE 11/24/2021 (Air Tab Supemscr) THE HYDRONIC DISTRIBUTION SYSTEMS HAVE BEEN TESTED & BALANCED AND FINAL ADJUSTMENTS HAVE BEEN MADE IN ACCORDANCE WITH TABB - ICB PROCEDURAL STANDARDS FOR TESTING, ADJUSTING BALANCING OF ENVIRONMENTAL SYSTEMS AND THE PROJECT SPECIFICATIONS. TABB TAB FIRM REG. NO. TB0690817C CERTIFIED BY SUBMITTED & CERTIFIED BY: TABB TAB FIRM TAB SUPERVISOR (Hydronic Tab Supervisor) HARTMANAIRE Mario Covarrubias SIGNATURE 1 DATE Marl. Co ermblas McClanahan Inc. BBA Harlmenabe TA., CnnelaL nr NTBW6T]6S H TABLE OF CONTENTS SECTION I - PROJECT INFORMATION CERTIFICATES WARRANTY CALIBRATION ABBREVIATIONS SECTION II - UNIT REPORTS AIR MOVING EQUIPMENT DATA -AC-1 DIFFUSER AND GRILLE TEST DATA - AC-1 AND EF-1 SECTION III - OTHER DATA MECHANICAL PLAN 10 R N w �.. 19 I A r� N O N i z� u� LL U IN u R ti �i o- w 1 e m 0 d. a h +p N � C nU o W y OU t0 y c Lo N IL R •� E �_q Q9 +c O u N V PO U 0 �7 O O N O N N t y^ � � b Q V•C N .�. E E m 0 a 00 N r C �UE o C v ou y � _ c 0 d IL E u U v n°10 m n 09 tZ01 U tZ) u v b R \ O U AR 1 cz t7 12 Gardenia Lake Forest, CA 92630 951-479-6855 Warranty Warranty of Services Hartmanaire warranties the TAB work for one year from the date of this report. Hartmanaire reserves the right to correct errors or omissions in the collection of data. The Warranty covers Balancing Issues. Off Season Testing: Typical balance report covens testing and balancing of all scheduled equipment, regardless of the outside air temperature. An Off Season test will generally cover temperature measurements Balancing Issues: Any balancing issues or concerns that arise, Hartmanaire will return to the site any time during the warranty period. Systems will be rechecked and verified that tested items adhere with the reported test date, AT NO CHARGE. Warranty Procedures For all warranty items Balancing Issues, Hartmanaire requires a written request. The written request should be specific on the areas of concern, such rooms, or equipment, and the type of issue the occupants are having. Once written notification is received Hartmanaire will schedule a Technician. It is recommended that an Owner, or Architect, or Engineer be on site at that time. Voided Warranty and Additional Charges If a complaint issue is due to a mechanical equipment failure, control or maintenance related, the return trip maybe subject to a service charge, not covered under warranty. Hartmanaire reserves the right to resolve any TAB issues. If a third party or competing Test & BalancelCommissioning firm test or adjust any equipment, all project warranty is voided. (This is typical standard for the Mechanical industry, as Manufacture, Mechanical and Control Contractor voids all warranty when a competing firm test or manipulates their systems.) Any return trip to the job site is subject to a service charge and a purchase order will be required before returning to the job site. Document Archiving An electric file of all test documents will be kept on file until the end of the Warranty period. During that time an electronic copy of the test date will be provided a no charge. Any additional hard bound copies requested will be subject to a fee. Building owner should retain all documentation for future reference. All documentation pertaining to this project will be destroyed in accordance with our record retention schedule. a a ry 0 o m o p o O o m N o m o p o 0 0 Emo ioQmo�oo �o o `ioo ,.: �oQmo mo o lma io$�oQ mQ a` yQj m m Q Q Q n O n m N h m m Q Z rr N Q r N Z z z Z z Z z z Z z Z z z Z UI Vl UI N l9 '. _ h Ol OJ fn ,f%j N 41 Ol y 2 Q v •'•�•� N a N y N np • M .1 h N OJ p N �'. v O f SI v N N 5 N ICY (� .�y.. W t7 N rtl tll O ,E¢2' (b V� m [O ��..�o N h m N. EoE zc oNoM ON Q 0 n :(7x X v EO E '�Oa �� ? O 2 1 F :m i v N .� .� m m:>ato j Q [ 0 2 �6 L �❑ O o y :aul [ wo y N F a` O z E o a s a aoa u a U ? s a�a "va v C o.o v @ @ v �' n L .'n@ -¢�' �' @ n@ �. �' @ tin@ ¢@ k a, >.o >.o �- Ti �- o, o 3 a z C E u E a., v a E p5 e' N N N Ci p O • h O O C iF H p N O N p O K .,00 Nr IZ Go p � Q � p Q\ `o `o o `o o `o o`o \\ o 'o a n ': `o `o "a:'o 'o a z E LL a LL U n j 3 4 n E' z p Y Y Y 0o p o o $ o o m y o o o g N E EE ry v E m ' v Ozv v vvv.o LL N v N N C N YU ¢ y; o o f a ` s E v S a v 'Q, m W> Q_/aQ?2 H 12 Gardenia Lake Forest, CA 92630 951-479-6855 ABBREVIATIONS ACT - Actual AK - Free Area Factor AHU - Air Handling Unit CD - Ceiling Diffuser CER - Ceiling Exhaust Register CFM - Cubic Feet per Minute CR - Ceiling Return Register D.B. - Dry Bulb DD - Direct Drive DDC - Direct Digital Controls: EMS Control System for the HVAC DL - Drum Louver DNL - Data Not Listed EF - Exhaust Fan EMS - Energy Management System ERU - Energy Recovery Unit ENT - Entering FH - Flowhood (Measures CFM Directly SO FPM and AK factors are not required). FPM - Feet per Minute GPM - Gallons per Minute H.P. - Horsepower LVG - Leaving MBH - 1,000 BTUH NA - Not Available / No Access NVL - No Valid Location O.S.A. - Outside Air P.D. - Pressure Drop R.A. - Return Air REQ - Required RPM - Revolutions per Minute RTU - Roof Top Unit S.A. - Supply Air S.F. - Service Factor S.P. - Static Pressure SWS - Side Wall Supply SWR - Side Wall Return TAB - Test, Adjust, and Balance TSP - Total Static Pressure Traverse - CFM readings take in at a point in the ductwork VAV - Variable Air Volume; box that contains a motorized damper that modulates airflow W.B. - Wet Bulb W.G. - Water Gauge ,A . J PROJECT WESTCLIFF MEDICAL CENTER, BUILDING 3 LOCATION 2131 WESTCLIFF DRIVE, STE 202, NEWPORT AIR MOVING EQUIPMENT DATA CA 92660 FAN NAME AC-1 SERVICE SUITE 202 LOCATION ROOF MANUFACTURER ICP MODEL # RHV060ADF SERIAL # C211279690 CFM DESIGN1387 UAL DESIGN ACTUAL DESIGN ACTUAL DESIGN ACTUAL TOTAL FAN 185005 RETURN AIR 145018 OUTSIDE AIR 400 STAT PRES DISCHARGE .22" SUCTION - 32" ESP .50 .54" MOTOR FAN MANUFACTURER X-VANE HORSEPOWER 1 VOLTAGE 208 208 AMPERAGE 8.6 7.3 PHASE 1 RPM/SPEED IRECT DRIV VARI SPD SERVICE FACTOR (A) DRIVE MOTOR SHEAVE SIZE DIRECT DRIVE % CLOSED DIRECT DRIVE - FAN SHEAVE SIZE DIRECT DRIVE FAN RPM DIRECT DRIVE BELT SIZE / # OF DIRECT DRIVE CENTER TO CENTER DIRECT DRIVE DIFFUSER & GRILLE TEST SHEET PROJECT WESTCLIFF MEDICAL CENTER, BUILDING 3 AREA NO. KIND SIZE AK DESIGN PRELIM FINAL FPM I % I REMARKS AC-1 SA TREATMENT #103 1 CD 24 X 24 1.0 150 162 108% APOTHECARY #104 2 CD 24 X 24 1.0 150 143 95% IV #105 3 CD 24 X 24 1.0 150 158 105% TREATMENT #108 4 CD 24 X 24 1.0 150 160 107% STERILIZATION #107 5 Cu 24 X 24 1.0 150 138 92% BACK AREA #106 6 CD 24 X 24 1.0 150 155 103% ROOM #109 7 CD 24 X 24 1.0 150 160 107% WAITING ROOM #100 8 SWS 20 X 6 1.0 120 118 98% WAITING ROOM #100 9 SWS 20 X 6 1.0 120 120 100% WAITING ROOM #100 10 SWS 20 X 6 1.0 120 130 108% WAITING ROOM #100 11 SWS 20 X 6 1.0 120 127 106% ROOM #101 12 CD 24 X 24 1.0 200 202 101% WAITING ROOM #100 13 SWS 20 X 6 1.0 120 132 110% T= 1850 1905 103% AC-1 RA TREATMENT #103 1 CRR 24 X 24 1.0 130 133 102% HALLWAY 2 CRR 16 X 16 1 1.0 1 510 562 110% TREATMENT #108 3 CRR 24 X 24 1.0 130 119 92% APOTHECARY #104 4 CRR 24 X 24 1.0 130 131 101 % STERILIZATION #107 5 CRR 24 X 24 1.0 130 130 100% IV #105 6 CRR 24 X 24 1.0 130 134 103% ROOM #109 7 CRR 24 X 24 1.0 130 133 102% ROOM #101 8 CRR 24 X 24 1.0 160 176 110% T= 1450 1518 105% OSA _ 400 387 97% EF-1 - -- RESTROOM KIM— in%=r 1 CER 1 12 X 12 1.00 100 1 108 108% (A) �F-i DrtUrJV IVIUVGL LIU UIKr-Ul UKIVE, SINGLE SPEED CEILING EXHAUST FAN. vive� by LUTRON Operation & Maintenance Report November 12, 2021 Dr Lu Newport Beach, California, United States 7 Lutron Electronics Co., Inc. Page 1 of '12 Vive O&M Report created on November 12, 2021 Dr Lu Table of Contents ProjectSummary .................................................................................................................... 3 DevicesSummary ................................................................................................................... 4 ProjectHubs........................................................................................................................... 5 " Vive-dr lu ......... Devices summary per room ........ 5 r Lutron Customer Assistance Details..................................................................................... 11 U Lutron Electronics Co., Inc. Page 2 of 12 Vive O&M Report created on November 12, 2021 Dr Lu Project Summary Project Name Dr Lu Project ID VI131 DC51 Project building type Healthcare Project Location Newport Beach, California, United States Project Creation November 12, 2021 Extended Warranty Yes, 5-Years extended warranty activated Hubs & Devices Hubs 1 Total Devices 41 Rooms Total Rooms 9 Handoff Handoff Date November 12, 2021 Sender/Installer William Plowman Sender Primary Contact William Plowman 9092080991 bjll@rileyelectricinc.com Recipients Bill Plowman 9092080991 bill@rileyelectricinc.com Details listed above are from the last cloud backups of the project hubs. © Lutron Electronics Co., Inc. Page 3 of 12 Vive O&M Report created on November 12. 2021 Dr Lu Devices Summary Device Type Model No. Description oty Hub HJS-2-XX Vive Wireless Hub 1 Pico PJ2-2BRL-GXX-X01 Pico Wireless Control with 2 10 Button Raise/Lower �, PowPak RMJS-8T PowPak 0-10V Dimming 14 a Module FCJS-010 PowPak 0-10V Fixture 4 Control with sensor XRMJS-20R-DV-B PowPak 20A Receptacle 1 Control j Occupancy Sensor LRF2-XXXXB-P-XX Radio Powr Savr Wireless 11 OccupancyNacancy Sensor Daylight Sensor LRF2-DCRB Wireless Daylight Sensor 1 Details listed above are from the last cloud backups of the project hubs. Lutron Electronics Co., Inc. Page 4 of 12 Vive 0&M Report created on November 12. 2021 Dr Lu Project Hubs Vive-dr lu Details listed below are from the last cloud backup date of Nov 12, 2021 Hub Name Vive-dr lu Hub Password Not set Serial ID 017D9AA2 Model Number HJS-2-XX Software Version 01.12.10 Wi-Fi Settings Wi-Fi Name Vive-dr lu Wi-Fi Password Is set' Admin1234! Status Enabled Visibility On Ethernet Settings Status Disconnected DHCP Enabled Passwords are not shared for security reasons. Total Rooms 9 Total Devices 41 J Lutron Electronics Co., Inc. Page 5 of 12 Vive O&M Report created on November 12, 2021 Dr Lu Project Hubs Vive-dr lu Details listed below are from the last cloud backup date of Nov 12, 2021 Waiting room 100 Device Type Model No. Description Serial No. Qty Pico PJ2-2BRL- Pico Wireless 02E57CF9, 02CFOB9C 2 GXX-X01 Control with 2 Button Raise/Lower PowPak RMJS-8T PowPak 0-10V 03D1 DBOE, 04865F59, 4 FCJS-010 Dimming Module 04978E1A, 037E6006 1 PowPak 0-10V 03775F63 Fixture Control with sensor Occupancy Sensor LRF2-XXXXB- Radio PowrSavr 035BEFFF,0358EFF3 2 P-XX Wireless OccupancyNacancy Sensor Daylight Sensor LRF2-DCRB Wireless Daylight OOD18B3B 1 Sensor Room 101 Device Type Model No. Description Serial No. Qty Pico PJ2-2BRL- Pico Wireless 02E3E9BC 1 GXX-X01 Control with 2 Button Raise/Lower © Lutron Electronics Co., Inc. Page 6 of 12 Vive O&M Report created on November 12, 2021 Dr Lu Room 101 Device Type Model No. Description Serial No. Qty PowPak RMJS-8T PowPak 0-10V 03D1 DAA9 1 FCJS-010 Dimming Module 048FF591 1 PowPak 0-10V Fixture Control with sensor Occupancy Sensor LRF2-XXXXB- Radio Powr Savr 035BEFB6 1 P-XX Wireless Occupancy/Vacancy Sensor 0-u 1 Device Type Model No, Description Serial No, Qty Pico PJ2-2BRL- Pico Wireless 02E57C7E 1 GXX-X01 Control with 2 Button Raise/Lower PowPak RMJS-8T PowPak 0-10V 04865F5B 1 XRMJS-20R- Dimming Module 048586138 1 DV-B PowPak 20A Receptacle Control Occupancy Sensor LRF2-XXXXB- Radio Powr Savr 035BF139 1 P-XX Wireless Occupancy/Vacancy Sensor © Lutron Electronics Co., Inc. Page 7 of 12 Vive 0&M Report created on November 12, 2021 Or Lu ZT-MISTIF Device Type Model No. Description Serial No, Qty Pico PJ2-2BRL- Pico Wireless 02E57C92 1 GXX-X01 Control with 2 Button Raise/Lower PowPak RMJS-8T PowPak 0-1 OV 03D1 DBOA, 02FC560B 2 Dimming Module Occupancy Sensor LRF2-XXXXB- Radio PowrSavr 035BEFB3 1 P-XX Wireless Occupancy/Vacancy Sensor Room 107 Device Type Model No. Description Serial No. Qty Pico PJ2-2BRL- Pico Wireless 02E3E9FA 1 GXX-X01 Control with 2 Button Raise/Lower PowPak FCJS-010 PowPak 0-10V 03775D81 1 Fixture Control with sensor Occupancy Sensor LRF2-XXXXB- Radio Powr Savr 035BF104 1 P-XX Wireless Occupancy/Vacancy Sensor t0 Lutron Electronics Co., Inc. Page 8 of 12 Vive O&M Report created on November 12, 2021 Dr Lu Back area Device Type Model No, Description Serial No, City Pico PJ2-2BRL- Pico Wireless 02E57D05 1 GXX-X01 Control with 2 Button Raise/Lower PowPak RMJS-8T PowPak 0-10V 04978E27, 03D1 DB34 2 Dimming Module Occupancy Sensor LRF2-XXXXB- Radio PowrSavr 035BEFE9,035BEFA7 2 P-XX Wireless Occupancy/Vacancy Sensor Room 105 Device Type Model No. Description Pico PJ2-2BRL- Pico Wireless GXX-X01 Control with 2 Button Raise/Lower PowPak RMJS-8T PowPak 0-10V Dimming Module Serial No, 02E57D26 Qty 1 03D1DAA4 1 Occupancy Sensor LRF2-XXXXB- Radio Powr Savr 035BEFE8 1 P-XX Wireless Occupancy/Vacancy Sensor © Lutron Electronics Co., Inc. Page 9 of 12 Vive O&M Report created on November 12, 2021 Dr Lu Room 104 Device Type Model No, Description Serial No. city Pico PJ2-2BRL- Pico Wireless 02E2F46D 1 GXX-X01 Control with 2 Button Raise/Lower PowPak RMJS-8T PowPak 0-10V 02FC55FC 1 FCJS-010 Dimming Module 048FF5A3 1 PowPak 0-10V Fixture Control with sensor Occupancy Sensor LRF2-XXXXB- Radio Powr Savr 035BFOEB 1 P-XX Wireless OccupancyNacancy Sensor Room 103 Device Type Model No. Description Pico PJ2-2BRL- Pico Wireless GXX-X01 Control with 2 Button Raise/Lower PowPak RMJS-8T PowPak 0-10V - Dimming Module Occupancy Sensor LRF2-XXXXB- Radio Powr Savr P-XX Wireless OccupancyNacancy Sensor Lutron Electronics Co., Inc. Serial No, Qty 02E3E9D5 1 03D33CC7, 04978E24 2 035BF16B 1 Page 10 or 12 Vive O&M Report created on November 12. 2021 Dr Lu Lutron Customer Assistance Details Visit www.lutron.com/vive for a wide range of tutorials, videos, FAQs, and forums Forum httos://lutron com/vive/forum USA/Canada Web Email Hotline Latin America/Mexico Web Email Mexico Hotline Latin America Hotline UK/Europe Web Email UK Hotline China Web Email China Hotline Hong Kong SAR, China Hotline www.lutron.com/supp systemsupport@lutron.com +1.844.588.7661 www.lutron.com/es-la latechsupport@lutron.com +1.614.481.1300 +1,610.282.6701 www.lutron.com/europ eatechnicalsupport@lutron.com +44.207.702.0657 www.lutron.com/asia glts@lutron.com +86.400.046.3600 +85.280.090.8673 © Lutron Electronics Co., Inc. Page 11 of 12 Vide C&NI Report created on November 12, 2021 Dr Lu India Web Lt-to:ZJu1ron.com/suiDr)ort Email a3etechsupport@lutron.com India Hotline 1800-102-0093 Others Web www,lutron.com/stApport Email systemsupport@lutron.com Hotline +1.610.282.3800 ,0 Lutron Electronics Co., Inc. Page 12 of 12 Compliance Results: COMPLIES AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT Intent: This document is used to demonstrate compliance with acceptance requirements in §130.4(a)3 and Reference Nonresidential Appendix NA7.6.1 for automatic daylighting controls. Attach additional sets of pages 2 through 5, as required, to, all controls that must he tested. Indicate all control methods used for this project: r Continuous dimming controls (Sections A and 13-1 of tills document should he completed) r Stepped Switching / stepped dimming controls (Sections A and B-2 of this document should be completed) A-1. Automatic Time Switch Lighting Control Construction Inspection (NA7.6.2.4) r a. The general lighting in skylit and primary sidelit daylit zones, or the general lighting in the combined primary and secondary sidelit daylit zones in parking garages, is controlled by automatic daylighting controls. (§130.1(d)) r b. The daylit zones are shown on page(s) __ E2.1_ _. of plans; OR-1-he daylit zones are drawn in oilpage(b)- 2.1 of as - built plans (attached). (§130,1(<I)'1) P C. The automatic dayligh ,mg controls provide separate control for . luminaires m 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) `r d. For photosensors located within a daylit zone, at least one photosensor is not readily accessible to unauthorized personnel. (§130.1((l)4) r e. The location where calibration adjustments are made to the automatic daylighting controls is readily accessible to authorized Personnel, including inside a locked case or under a cover that requires a tool for access. (§130.1(d)S) Construction Inspection Compliance: f: Complies C Does Not Comply QA/� 44,, �ilellro{ttiiigpupgPealUlaMirfa :� LQTP pan4ial§Tra�rilpiAlPfopleM This is page 1 of 5 crarr, nicwrr OF ACCEPTANCE NRCA-Cl'1-03-A Automatic Daylighting Control Protect Name: Dr I. Mart EN'umemem Agency: MY OF NLWPOR'1➢EACH Pemrit Nmnba, M021-0686 &ojed Address: 2131 WESTCLIPP DR SID'1L 202 City: NEWPORT BEACH Zip Cade: 92660 B-1. Continuous Dimming Control Systems Functional Testing (NA7.6.1.2.1) Building: BUI LUING 3 Floor: 2nd STE 201 Room: 200 Control: CEILING DAYLIGHT SENSOR G 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 sideht zone away from the glazing or opening. (§130,1(ci)3D) a. Specify the power estimation method to be used: default ratio of power to light (Dfc), cut sheer ratio of power to light (CSfc) - cut DFC sheet must be attached, measured Amps multiplied by Volts (I or measured watts (W). Step 2: No daylight test. Simulate or provide conditions without daylight. (NA7.6.1.2.1(d)) L. Indicate the method used to arnulate or provide conditions without daylight: night time manual measurement (Night), night time CP illuminance logging (Log), cover fenestration (CF), or cover photosensor (CP). c. Enter the reference illuminance value in footcandles (fc), as measured at the reference location. (NA7.6.1.2.1(d)2) This is the electric 98,2 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 estimation (N/A) method = W. OR Indicate not applicable (N/A) if power estimation method (line a) = Dfc or CSfc. e. Automatic daylight controls stern provides a Y p pproprlate control so that the electric lighting system Is providing full light output unless Y otherwise specified by design dOCUrnert5. (NA7.6.1,2.1(d)l) Enter yes (Y) or no (N). I. Light output is stable with no discernable flicker. (NA7.6.1.2.1(d)3) Enter yes (Y) or no (N). Y 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) g. Enter the daylight Illuminance (light level with the electric Ilghting turned off) value In footcandles (fc) measured at the reference 153 location. Of. Calculate the ratio of daylight illuminance to the reference illuminance in %. line ([ g /line c] x 100) '155.8 1. The ratio of daylight illuminance to the reference illuminance (line h) is greater than 1500/u. (§130.1(d)3C, §730.1 (d)3 D) Enter yes Y (Y) or no (N). I. Enter the total Illuminance ((ombined daylight and electric light illuminance) in footcandles (fc) measured at the reference location if 118.5 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. k. Calculate the elech is lighting Illuminance in footcandles (fc) at the reference location if power estimation method (line a) = Dfc or -34.5 CSfc. (line ) - line g) OR indicate not applicable (N/A) if power estimation method (fine a) = VA or W. I. Calculate the fraction of rated light output In % if power estimation method Ilne a ( ) =Dfc or CSfc. ([line k /line c] x 100) OR Indicate -35.13 not applicable (N/A) If power estimation method (line a) = VA or W. In. Enter the dimmed Iuminane fraction of rated power in % If power estimation method Tine a ( ) =Dfc or CSfc, and label the control 30 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 of W. A L `�` TP a�Ilrorgi3AduenPed'elaryt�nq 4efi'� 1'— aoni;=Ols�reihLnelpraatam -. This is page 2 of 5 BEACH IlPenuii Nwnben =1-0696 n. ICalculate the system power reduction In %. If power estimationmethod (line a) = Ufc or CSfc, system power reduction = [1 - churned 0 lurnmaire fraction of rated 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)], o. IFor areas other than parking garages, the system lighting power reduction of controlled luminaires (line o) is at least 65%. (NA7.6.1.2.1(e)1, 4130.1(d)3C) OR For parking garages, the controlled lighting power consumption is zero. (§130.1(d)3D) Enter yes (Y) or no (N). p. I Dimmed lamps are stable with no discernable flicker. (NA7.6.1.2.1(e)1) Enter yes (Y) of no (N). q. I Only the luminaires in the daylit zones are affected by daylight control. (NA7.6.1.2.1(e)2) Enter yes (Y) of no (N). r. If a PAF is claimed for daylight dimming plus OFF controls, the system automatically turns off the luminaires that are receiving this N/A credit. (NA7.6.1..2.1(e)3, §140.6(a)2H) Enter yes (Y), no (N), or not applicable (N/A). Sep 4: Partial daylight test. Simulate of provide daylight conditions where illuminance (to) from daylight only at the reference location is ietween 60 and 95-% of the reference illuminance measured in Step 2. (NA7.6.1_2.1(f)) r I There are 0 control steps between ON and OFF. (Indicate not applicable (N/A) for lines s through aa,) S. Indicate method used to simulate or provide conditions with partial daylight: natural daylight manual measurement (ND), light PCF logging (Log), partially cover fenestration (PCF), open loop setpoint adjustment (OLSA). I. I Enter the daylight illwnlnance (light level without electric IighC) in footcandles (fc) measured at the reference location. 1 76.2 U. Calculate the ratio of daylight illuminance to the reference Illuminance in % . ([line C /line c] x 100) 1 77.6 v. IThe ratio of daylight illuminance to the reference illuminance (Ilne u) is between 60 and 95%. (NA7.6.1.2.1(f)) Enter yes (Y) or no (N). W. Enter the total illuminance (combined daylight and electric light illuminance) in footcandles (fc) measured at the reference location. 1 98.2 x. IThe total illuminance (line w) is greater than or equal to the reference illuminance (line c). (NA7.6.1.2.1(f)1, §130.1(d)38) Enter yes (Y)or no (N). Y. I Calculate the ratio of total Illuminance to the reference Illuminance in % . ([line w / line c] x 100) 100 Z. I The ratio of total illuminance to the reference illuminance line %. Y ( y) is less than or equal to 150 / (NA7.6.1.2.1 (f)2) Enter yes (Y) or no (N). aa. I The light output Is stable with no discernable flicker. (NA7.6.1.2.1(f)3) Enter yes (Y) of no (N), Functional Testing Compliance: IT Complies r Does Not Comply gdllf0mikiAdyentledidi;htlhg iJ Oanttols'jreCninglNfagfam ". This is page 3 of 5 ACCEPTANCE 2131 Default fraction of rated power to fraction of light output (used on line m on page 2) 100% .-- - ---- --- r------ E ,-- I---- r----- 4 9 oWOW- 8 J, - I T `L HID a 70% 1 1 •° u I I v 7p di 60% 1 ------.' ,. 4 `- wSrry e_ ___ _ Fluorescent �° 40% ------I -i 4-------- ---- -- : ' :LED ; 30% ------ ----• -• y -- - 2 o ;_____ LL __ _ _ _ __ _ u W W I I I , I I 0% , , 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Fraction of rated light output G+AL', A L �� 7^P cagto�iaAduagaad a Ahg, d� V aoni}ai�ire��ifr'elhroaram < This is page 4 of 5 OF ACCEl'1'ANCE 92660 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Acceptance docu menotban Is accurate and complete. Docrmentatlon Author Name V,, IIam Plowman Company Name Riley Electric Inc Address 1800 W IITH ST UNIT C, Unit C ❑ly/State/Zip UPLAND, CA 91786 Plane (909)981-6110 CEP/ATT Certification Iden Uflcation (If applicable) TC-A814190 Arbor Signature Data of Signature: 11/12/2021 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty cf perjury, under the laws of the state of Callfomla: 1. The Information provided on fills Certificate of Acceptance Is true and co rest. 2. I am the person who performed the acceptance verlficaton reported an this Certificate of Acceptance (Field Tedmloan). 3 The construction nstallatio n identified -11 this Clanfliatily of Accapld Ke counties with the applicable aCceptance requirements indicated in the plans and specifications approved by Oil V 'e net seems', W conforms to the applicable Acceptanceq eve is .,to of.cashme, specified in Refe'erce Nonresidential A,,oed x NA2. 4 1 have confirmed that tile Certificate(,) of Installation for theconstruction stall [ n identified this Certificate of Acceptance has been rmplated and sgned by the espon ble binder/ n,taller and has been posted or made available wTh Me building permit(,) issued for lice building. Field Tecnnician Name Company Name W llliam Plowman Rgey Electric Inc Address- City/State/Zip 1800 W 11TH ST UNIT C, Unit C UPLAND, CA 91786 Phone ATT Car litration (909)981-6110 Identification IC-A814190 Position with company (Title) Feld Techmda,. Slgnature SERVICE MANAGER -A, l Date of signature', 1111212021 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following rude, penalty of perjury, under 111, laws of the State of California: I. I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have revlewed the Information provided on this Certificate of Acceptance. 2. 1 am eligible under Dnvlslt, 3 of the But mess and Professions Code in the applicable classification to accept V"ourcholf, for the system design, construction or installation of features, materials, components, or manrfacmred devices far the scope of dark Identified on this Certificate of Acceptance and attest to the declarations In this statement (responsible acceptance person). 3, The matron poinsettias this Cank Fcate of Acceptance substantiates that the coultrtcto 't llidid. identified on ths, Certificate of Accepts,,e compfe, with the acceptance cImmurement,-'indicated the Plato and specifications approved by the enforcement agency, and conforms to the applcable acceptance requirements and procedures specified In Reference No tires dental Appendix Not. 4. 1 have Confirmed that the CeRlficata(s) of Installation for the construction m Installation identified on this Certificate of Acceptance has been completed and Is posted or made vallable wil'h the It hug Far fully) for the bullding. 5. 1 will ensure that a mlmpleted, signed copy of tins Certificate of Acceptance shall be posted, or made avallabie wltln the bullding permit(,) Issued for the building, anti ,site violable to the enforcement agency for all applicable inspections. I understand that a argued copy of this Certificate of Acceptance Is required to be Included with the documentation the builder provides to the bullding owner at occupancy. Responsible Acceptance Company Name Person Name RICK CLARK Riley Electric In, Address. Cly/State/ZIp 1800 W 11TH ST UNfI' C, Unll C UPLAND, CA 91786 Phone CSLB License (9 d9)9Ul-fitlg 393866 C-30 Position with Company (Title) PROTECT MANAGERResponsible Acceptance Person Slgnature Date of Slgnature_ 11/12/2021 GAL �•;TP aemnmteAduagv@01-tra l f CoM�l9 Tra�il�g�Plfia[nm .'. This is page 5 of 5 un 92660 General Information Building Type: Nonresidential r High -Rise Res (Common Area) r 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: 5/17/2021 12:00:00 AM Document APPROVED Title or Desci iption• BLUEPRINTS or Pages, Tables, SchedUles, _ tc. E0.1 ELECTRICAL GENERAL NOTES Date Approved 5/17/2021 12:00:00 By the Enfoicernent Agency AM APPROVED BLUEPRINTS E0.2 SINGLE LINE DIAGRAM, PANEL SCHEDULES 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E2.2 EGRESS PHOTOMETRIC PLAN 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E2.0 POWER PLAN 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E0.3 INTERIOR TITLE 24 FORMS 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E1.0 SECOND FLOOR PLAN 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E2.1 LIGHTING PLAN 5/17/2021 12:00:00 AM C�� ��, �� aellMp(IaAHuennegiplahtlna oog�ui§/Rglnif�!f7oeram ± This is page 1 of 2 - --- ---- --- -- --- -- lemorcement agency: ull x UY NE WPOKF BEACII Wrranu Nwnber: X2021-0686 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Ce ILI fl ca to of Acceptance document Is accurate and complete. Documentation Author Company Name Name William Plowman Address City 1800 W 11TH ST UNIT C, Unit C Zip Code 91/Bti CEA/ATT CertiflCation Identification (if TC-AB14190 applicable) Date of Signature: 11/12/2021 Phone Author Signature Riley Electric Inc UPLAND (909)981-5110 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under file laws of the State of California 1. I am the Field TechnlCmL, or the Field Technician is acting on my behalf as my employee or cry 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 NAJ. 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 permits) issued for the building. 5. 1 add ensure that a completed, signed copy of this Certifiate 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 RICK CLAIiK Company Name Person Name Riley Electric Inc Address: City 1800 W 11TH AT UNiI' C UPLAND Zip Code Phone 919E6 (909)981-6310 CSLB license PosRlon whir Company 393&tib C-10 p y PROJECT MANAGER file) Responsible Acceptance Person Signature k4� C,k&�5 Date of Signature: 11/12/2U21 This is page 2 of 2 202 Compliance Results: COMPLIES Enforcement Agency Use: Checked by/Date SHUT-OFF LIGHTING CONTROL ACCEPTANCE DOCUMENT Intent: This d0Cnment is used to demonstrate compliance with acceptance requirements in §130.4(a)4 and Reference Nonresidential Appendix NA7.6.2 for shut-off lighting controls. Attach additional sets of pages 1 through 2, as required, for all controls that roust be tested. Indicate all types of shut-off controls tested for this project: r Automatic time switch lighting controls (Sections A-1 and B-i of this document should be completed) fJ Occupant sensing lighting controls (including occupant sensors, partial -ON occupant sensors, partial -OFF occupant sensors, and/or vacancy sensors) (Sections A-2 and B-2 of this document should be completed) A-1. Automatic Time Switch Lighting Control Construction Inspection (NA7.6.2.4) r a. Automatic time switch controls are programmed with acceptable weekday, weekend, and holiday (if applicable) schedules. (NA7.6.2.4(a), §110.9(b)lAii, §130.1(c)IA, §130.1(c)4) r It. Document for the owner weekday, weekend, and holidays schedules, as well as all set-up and preference program settings. (NA7.6.2.4(b)) r c. The correct time and date are properly set in the time switch. (NA7.6.2.4(c)) r d. The battery backup (if applicable) is installed and energized. (NA7.6.2.4(d), §110.9(b)l) r e. Override time limit is no more than 2 hours. (NA7.6.2.4(e), §110.9(b)lAi, §130.1(c)3B) OR The automatic time switch control's override time is exempt from the 2-1101Ar limit. (EXCEPTION to §130.1(c)38) r f. Override switches remote from area with controlled luminaires have annunciator lights. (NA7.6.2.4(f), §130.1(c)3A, §130.1(a)) 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: L Complies (? Does Not Comply iL7 (``t .I>'1 COuhibl9'191�B�fajiYd4(R�t �; This is page 1 of 13 OPACCEFPANU 92660 B-1. Automatic Time Switch Lighting Control Functional Testing (NA7.6.2.5) Confirm compliance (Y - yes / N - no) for the control being tested. � /�,� fir' a�lifn I>Iaauapaadl4f�hfCaa ��� ongh,n�inlK�krQdram .' , This is page 2 of 13 Ion Code A-2. Occupant Sensing Lighting Control Construction Inspection (NA7.6.2.2)) r a. Occupant sensors have been located to minimize false signals. (NA7.6.2.2(a)) r 6. Occupant sensors are located no closer than four (4) feet from any HVAC diffuser. (NA7.6.2.2(b)) r c. Passive infrared sensor pattern does not enter into adjacent zones. (NA7.6.2.2(c)) r d. Occupant sensors do not encounter any obstructions that could adversely affect desired performance. (NA7.6.2.2(d)) f✓ e. Ultrasonic occupant sensors do not emit audible sound. (NA7.6.2.2(e), §110.9(b)6Bii) Construction Inspection Compliance: r Complies r Does Not Comply B-2. Occupant Sensing Lighting Control Functional Testing (NA7.6.2.3) Confirm compliance (Y - yes / N - no) for the control being tested. Building: BUILDING 3 Floor: 2nd STE 201 Room: 209 Control: CEILING OS r- Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unocaipled condition, (NA7.6.2.3(a)) a. Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from start of r an unoccupied condition. (NA7.6.2.3(a)l, §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 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 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). b. The occupant sensing control does not trigger p 9 gger a false "on" from movement in an area adjacent to the controlled space or from r I1VAC operation. (NA7.6.23(a)2) c. Signal sensitivity is adequate to achieve desired control (NA7.6.2.3(a)3) For library book stacks or warehouse aisles, activity r 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. (NA7.6,23(b)1, §110.9(b)4C) r b. Immediately upon an occupied condition (NA7.6,2.3(b)2): r • Lights controlled by an occupant sensor or a partial -OFF occupant sensor turn on; OR: • A vacancy sensor indicates a space is "occupiecl" and lights may be turned on manually; OR: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70 % of the lighting. (§130.1(c)SA)OR: 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: /► �� T f gdllk, 1'ntl9enged f 14(��hA OPhjlkftgl( [f9iPla9�dn ., This is page 3 of 13 Dr L. f3 Complies C Does Not Comply Building: BUILDING 3 Floor. 2nd STE 201 Room: 203 Control: CEILING OS G Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) a. Lights controlled by occupant sensing control for off or partially off, if applicable, within a maximum of 20 minutes from start of r an unoccupied condition. (NA7.6.2,3(a)l, §1109(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 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 uncler the 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). b. The occupant sensing control does not trigger P g gger a false "on" from movement in an area adjacent to the controlled space or from r HVAC operation. (NA7.6.2.3(a)2) c. Signal sensitivity is adequate to achieve desired control (NA7.6.2.3(a)3) Tel library book stacks or warehouse aisles, activity r beyond the stack or aisle shall not activate the lighting in the stack m 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 correct) p y. (NA7.6.2.3(b)1, §110.9(b)4C) r b. Immediately upon an occupied condition (NA7.6.23(b)2): • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§130.1(c)5A)OR: 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: ro Complies r Does Not Comply Building: BUILDING 3 Floor: 2nd STE 201 Room: 204 Control: CEILING OS x.. q, �p ael�Mlf�idd}tluIh�aed�IJd�1to, IN[ ' 1:5 1 gonlaTrglhlllpikroafem...' This is page 4 of 13 OEACCEIPFANOE r Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) a. Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from start of r an unoccupied condition. (NA7.6.2.3(a)i, §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 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 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). b. The occupant sensing control does not trigger p 9 gger a false "on" from movement in an area adjacent to the controlled space or from Ck HVAC operation. (NA7.6.2.3(a)2) c. Signal sensitivity is adequate to achieve desired control. (NA7.6.2.3(a)3) For library book stacks or warehouse aisles, activity WV 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) ro- b. Immediately upon an occupied condition (NA7.6.2.3(b)2): • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§130.1(c)5A)OR: 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: r Complies r7 Does Not Comply Building: BUILDING 3 Floor: 2nd STE 201 Room: 205 Control: CEILING OS ��n ♦` ealgn I�dtlVA,H,allPLlahtlhet,-' gdn�Isnelhlelroliram This is page 5 of 13 r- Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) 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 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 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), b. The occupant sensing control does not trigger P g gger a false "on" from movement in an area adjacent to the controlled space or from r HVAC operation. (NA7.6.2.3(a)2) c. Signal sensitivity is adequate to achieve desired control. (NA7.6.2.3(a)3) Ent library book stacks or warehouse aisles, activity W 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) r b. Immediately upon an occupied condition (NA7,6.2.3(b)2): r • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§ 130.1(c) 5A)OR: 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: 6 Complies r Does Not Comply Building: BUILDING 3 Floor: 2nd STE 201 Room: 207 Control: CEILING OS CA��j�jo1( s ( O4�Ii0 l�` .i4)IRsd klilMi Ig&: goni a)6� :I,Ui41PgYa�} This is page 6 of 13 OFACCEPI'ANCL • �+_� •, -•�••_� _ Ilenmrcement Agency: Cr1'Y OF N6WPOWrBE.ACH Wend Nwnber X2021-0686 r Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) a, Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from start of r an unoccupied condition, (NA7.6.2.3(a)i, §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% m less of the value 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 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), b. The occupant sensing control does not trigger p g gger a false "on" from movement in an area adjacent to the controlled space or from r HVAC operation. (NA7.6.2.3(a)2) c. Signal sensitivity is adequate to achieve desired control (NA7.6.2.3(a)3) For library book stacks or warehouse aisles, activity r 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)i, §110.9(b)4C) r b. Immediately upon an occupied condition (NA7.6.2.3(b)2): (? • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§130.1(c)5A)OR. 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: fe' Complies Q Does Not Comply Building: BUILDING 3 Floor: 2nd STE 201 Room: 208 Control: CEILING OS � ¢Onr), Is��Tra)61fi�dl�Ilgral�aF ' This is page 7 of 13 CERTIFICATE OFACCEI-FANCE Lighting Convol NRcn-cn-o2-A Praj eel Name or Lu Office En(orcemenl Agency: CI'PY OY NEWI'OR'I' REACH YmJect Address: 2131 WL'S'rCLIPP DR SOII'E 202 Permit Nwrben X2021-0686 City: NEWPOR'IEEACH Zip Cade:92660 r Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2,3(a)) a. Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from r 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 of 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 80e/ or less of the value 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 is 80% less power or of the value allowed under the 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 in per watt parking garages, parking areas, and loading and unloading areas have ne control step between 20 to 60% design of lighting power (EXCEPTION to §130,1(c)7B). ant sensing control does not trigger a false "on" from movement in anEareaadjacent to the controlled space or from (NA7.6.2,3(a)Z)sitivity ESimulll'pate rration. is adequate to achieve desired control. (NA7.6.2.3(a)3) For libtacks or re warehouse aisles, activity stack or aisle shall not activate the lighting in the stack or aisle. (§1§130.1(c)6B) te an occupied condition. (NA7.6.2.3(b)) dicator or annunciator operates correctly. (NA7.6.2.3(b)1, §110.9(b)4C) r tely upon an occupied condition (NA7.6.2.3(b)2); r s controlled by an occupant sensor of a partial -OFF occupant sensor turn on; OR: r(§13O.1(c)5A)OR; cancy sensor indicates a space is 'Occupied" and lights may be turned on manually; OR: irst stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. 130.1(c)5A)OR: first stage occurs for partial -ON occupant sensors, manual switches allow an occupant to activate the alternate set of tivate 100% of the lighting power, and manually deactivate all of the lights, Functional Testing Compliance: t„ Complies r Does Not Comply Building: BUILDING 3 Floor: 21nd STE 201 Room: 211 Control: CEILING OS Paelliaml��d#p" ad1,10h4he 1- : goh l�ltdl{II�rMBfem This is page 8 of 13 r Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) a. Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from start of r 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 2to §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 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 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). b. The occupant sensing control does not trigger a false "on" from movement in an area adjacent to the controlled space or from ry HVAC operation. (NA7.6.2.3(a)2) c. Signal sensitivity is adequate to achieve desired control. (NA7,6.2.3(a)3) For library book stacks or warehouse aisles, activity P 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 correct) p y. (NA7.6.L3(b)1, §110.9(b)4C) r b. Immediately upon an occupied condition (NA7.6.2.3(b)2): r • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§130.1(c)SA)OR: 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: P Complies r Does Not Comply Building: BUILDING 3 Floor: 2nd STE 201 Room: 212 Control: CEILING OS ('� 1' r� 8411(O i&7AiIVG7Asd p�ting-,`' ' I aani lsbm`i3O*0roaiam _. This is page 9 of 13 202 f' Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) a. Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from start of TV an Unoccupied condition. (NA7.6.2.3(a)l, §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 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 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). b. The occupant sensing control does not trigger p 9 gger a false "on" from movement in an area adjacent to the controlled space or hom r HVAC operation. (NA7.6.2.3(a)2) c. Signal sensitivity g y is adequate to achieve desired control (NA7.6.23(a)3) For library book stacks or warehouse aisles, activity r 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 correct) p y. (NA7.6.23(b)1, §110.9(b)4C) r b. Immediately upon an occupied condition (NA7.6.2.3(b)2): • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§130.1(c)5A)OR. 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: fn Complies G.S Does Not Comply Building: BUILDING 3 Floor: 2nd STE 201 Room: 206 Control: CEILING OS 1,.r�', ��i`�1" Uoryf}irl9lYglhl�ig'�PYaBfa�(•; This is page 10 of 13 r Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) a. Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 20 minutes from start of r an unoccupied condition. (NA7.6.2.3(a)l, §1109(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 2to §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 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 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). r b. The occupant sensing control does not tri I g gger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation. (NA7.6.2.3(a)2) c, Signal sensitivity Is adequate to achieve desired control. (NA7.6.2.3(a)3) For library book stacks or warehouse aisles, 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)) r a. Status indicator or annunciator operates correct) p y. (NA7.6.2.3(b)1, §110.9(b)4C) b. Immediately upon an occupied condition (NA7,6.23(b)2): • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§ 1301(c)5A) OR: 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: f. Complies r Does Not Comply Building: BUILDING 3 Floor: 2nd Room: 200 Control: CEILING OS p aalllorlfifi d�atIt� -A ah4he, gah}�Ik,�Ygldlff�lR%918m . This is page I 1 of 13 r Control is representative of sample. (NA7.6.2.3) If sampling method is used, attach a page listing untested controls in sample. Step 1: Simulate an unoccupied condition. (NA7.6.2.3(a)) a. Lights controlled by occupant sensing control turn off or partially off, if applicable, within a maximum of 2U minutes from start of r 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 500% (§130.1(c)6A-C, §130.1(c)7A), OR: • For metal halide or high pressure sodium lighting in warehouses, autornatically 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 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 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 509/6 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). b. The occupant sensing control does not h i i J gger a false "on" from movement in an area adjacent to the controlled space or from HVAC operation. (NA7.6.2.3(a)2) c. Signal sensitivity is adequate to achieve desired control. (NA7.6.2.3(a)3) For library book stacks or warehouse aisles, activity r beyond the stack or aisle shall not activate the lighting in the stack or aisle. (§13( 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) r b. Immediately upon an occupied condition (NA7.6.23(b)2): r • 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: • The first stage of a partial -ON occupant sensor automatically activates between 50 to 70% of the lighting. (§130.1(c)5A)OR: 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: (: Complies P, Does Not Comply Q fit' p Ua�lh IdA e�llleh(Ih 1 9ogf le7teljl}ih(Fa roaram c This is page 12 of 13 ACCEPTANCE ONNIYNYOINPIQ:]010el:F[N:I DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Company Name Flame William Plowman Riley Electric lnc Address 1800 W 1ITH ST UNIT C, Unit C City/State/Zip UPLAND, CA 91786 Phone CEA/ATI Certification (909)981-61to Identification fit TC-A814191) applicable) Author Signature Date of Signature: 11/12/2U21 FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1'tie 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 tire applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAJ. 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 perm R(s) issued for the building. Field Technician Name Company Name William Plowman 12iley Elecmc L¢ Address Phone Position with Company (Title) Date of Signature 1900 W 11TH S1UNIT C, Unit C (909)981-6110 SERVICE PIANACER 11/12/2021 City/State/Zip UPLAND, CA 91786 AFT Certification Identification TC-A814190 Field Technician Signature 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. 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 req Wrements and procedures specified in Reference Nonresidential Appendix NAJ. 4. 1 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 permits) 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 Acceptance Company Name Person Nor,. RICK CIARK Riley Electric Inc Address: 1800 W IITH ST UNI"r C, Unit C Clfy/StatC City/State/Zip UPLAND, CA 91786 Phone CSLB License (909)981-6110 393865 C-10 Position With Company V201ECT MANAGERResponsibleAcceptance Person Signature C /�-- Date of Signature: 1111212021 Gdllfn0 441�aed noryig?rylnlniProaPnm i This is page 13 of 13 General Information Building Type: W Nonresidential r High -Rise Res (Common Area) r 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: 5/17/2021 12:00:00 AM Document APPROVED Title or Desci iption BLUEPRINTS Applicable Sheets or Pages, Tables, Schedules, etc. E0.1 ELEC'rRiCAL GENERAL NOTES Date Approved 5/17/2021 12:00:00 By the Enforcement Agency AM APPROVED BLUEPRINTS E0.2 SINGLE LINE DIAGRAM, PANEL SCHEDULES 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E2.2 EGRESS PHOTOMETRIC PLAN 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E2.0 POWER PLAN 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E0.3 INTERIOR TITLE 24 FORMS 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS E1.0 SECOND FLOOR PLAN 5/17/2021 12:00:00 AM APPROVED BLUEPRINTS I E2.1 LIGHTING PLAN 5/17/2021 12:00:00 AM Cpps ,vr pall taMlGgyva�g60,04004 L��P Quh[�I�hdlil119�PCP.9ian! This is page 1 of 2 or INSTALIATION DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1 rertify that this Certificate of Acceptance document is accurate and complete. Documentation Author Company Name Name William Plowman Riley Electric Inc Address City 1800 W 11TH ST UNIT C, Unit C UPLAND Zip Code Phone 91786 (909)981-6110 CEA/ATT Certification Author Signature Identification (if IC-AB14190 applicable) Date of Signature: 11/12/2021 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the fallowing under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Hold 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 tiered ations 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 Ca Tiflcate(s) of Installation for the construction or installation Identified on this Certificate of Acceptance has been cumlpleted 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 penmit(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 pravides to the holding owner at occupancy. Responsible Acceptance Company Name Person Name RICK CLARK Riley Electric Inc Address: City 1000 W lITH ST ITCH C UPLAND Zip Code 91786 Phone (909)981-6110 CSL6 License 393666 C-10 Position with Company itle) PROJECT MANAGER Responsible Acceptance Person Signature Rk4/V-.. Cko�"X Date of Signature: 11/12/2021 It p cell f�Aay�nQatliG�aJHiha' �.IP` Oory1�iV`ei{IlfldiProppem This is page 2 of 2