HomeMy WebLinkAboutH2022-0539 - MiscS7:ATE OF CAUFORNIA
MECHANICAL
GEC-NRCI-MCH-01-E (Revised 01120)
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION
NRCI-MCH-01-E
Mechanical
(Page 1 of 2)
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CITY (5 AA ENPORT BEACH
92022-0539
655'
NEWPORT CENTER DRIVE
`�EWPORT BEACH
9�2660
A. GENERAL INFORMATION
DATE OF BUILDING PERMIT:
10/04/2022
BUILDING TYPE
0 Nonresidential 13 High -Rise Residential 13 Hotel/Motel
PHASE OF
13 New Construction 0 Addition ®Alteration
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 responsibilityfor construction shall prepare and sign the Installation Certificate document(s) 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,
Date:
10/4/2022
In the table below identify all applicable construction documents that specify the features, materials, components,
manufactured devices, or system performance diagnostic results required for the scope of responsibilityfor this Installation
Certificate.
Document Title or Description
Applicable Sheets or Pages, Tables, Schedules, etc.
Date Approved By
the Enforcement
Agency
TITLE-24
M
10/04/22
CA Building Energy Efficiency Standards-2019 Nonresidential Compliance January 2020
STATE OF CALIFORNIA
MECHANICAL
CEC-NRCI-MCH-01-E (Revised 01/20)
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION
NRCI-MCH-01-E
Mechanical
(Page 2 of 2)
4 76" am us WSHP replace
I FS� VVPORT BEACH
F12022-0939
PraecLAddress:
65i0 NEWPORT CENTER DRIVE
ry,,
tWPORT BEACH
I Cade:
9f2660
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Philip Scholnick
Aieliy k-;W u
Documentation Author Com an Name:
SYSTEMS
Date Signed:
ACCO ENGINEERED
11/12/2023
Address:
CW HERS Certification Identification (if applicable):
265 MCCORMICK AVE
N/A
CRY/State/Zip:
Phone:
COSTA MESA, CA, 92626
71Z52-2226
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the
system design, construction, 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 tothe requirements
given on the plans and specifications approved by the enforcement agency.
4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements
for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements
that apply to the construction or installation have been met.
5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted, or made available with the building
permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a
completed signed copy of this Certificate of Installation is required to be included with the documentation the builder provides to
the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Eric Berman
Eric Berman
Company Name:
(Instal ling Subcontractor or General Contractor or Builder/Owner)
Position with company(Title):
ACCO ENGINEERED
SYSTEMS
PROJECT MANAGER
Address:
CSLB License:
2201 PARK PLACE, STE. 400
#120696
Ci y/state/Zip:
Phone:
Date Signed:
EL SEGUNDO, CA 90245
818-244-6571
11/22/2023
CA Building Energy Efficiency Standards - 2019 Nonresidential Compliance January 2020