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HomeMy WebLinkAboutX2012-1236 - MiscX,Zo v- IZ3& 31J� Daiwa prvd w Certificate of Com Hance (Sign Lighting) (Page I of 4) SLTG-IC Project Name: VI. 0 A�W 6 ' Date, Project Address: 613 \N Location of Sign y, Qutdoor Signs ❑ Indoor Signs Phase of Sign Construction "' ❑ New Signs ❑ Sign Alterations TX2e of Lighting Control ❑ New Lighting Controls ❑ Replaced Lighting Controls ❑ Not Installing Lighting Controls This Certificate of Compliance includes the following components (check all that apply) 11 Mandatory Measures (Lighting Controls) ❑ Maximum Allowed Lighting Power ❑ Specific Lighting Sources I. Certificate of Compliance Declaration Statement (this maybe a CIO, C45 or other eligible person) © I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. ® 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the fighting design. ® This Certificate of Compliance identifies the lighting features and performance specifications required for compliance with Title 24, Parts 1 and 6 of the California Code of Regulations. a The design features represented on this Certificate of Compliance are consistent with the information provided to document this design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit app,lication. Name: ho rklbaffc, Signature Company:; 1. Phone - 6 Z`r b-7 Address: g License number (may be contractor's lie #) City/State/zi , °1 'I Z'aN/A .elf " � 9a i ' Date ." B Z 2. Installation Certificate (to be signed by responsible person after installation) Permit number Checked by/Date (Enfosemeat Ageoc Use (Enforcemem Agency Use Installation Declaration statement • I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized representative of the person responsible for construction. • 1 certify that the installed features, materials, components, or manufactured devices identified on this certificate conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the enforcement agency. ® 1 certify that the requirements detailed on this Certificate of Compliance have been met. 0 1 will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. 1 understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name; ssrr vo Responsible Person's Name:p,^'`V An g L('C. '3,,�u-a Tra7"s Res ry¢ si a so ' ignature: f.. p' .4,�.Cr! t..Y 0. � License number (may be contractor's lie #) Date Signed: Position With Company: 2 2008 Nonresidential Compliance Forms October 2010 Certificate of Compliance (Sign Lighting) (Page 2 of 4) SLTG®AC Project Name: 'CV __V�� Date: 3. Mandatory Sin Limliting Controls NOTES. 1. The same responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible person may install the sign lighting controls than the responsible person installing the sign lighting power, - 2. The Mandatory Aeasures (,sign lightingcontrols)are required forcompliance-with the sign -lighting -Standards. If the person- responsible for installing the sign lighting power is not also responsible for the sign lighting controls, then the owner of the sign, general contractor, or architect shall be responsible to have the sign lighting controls installed. 3. If more than one person has responsibilityfor compliance, each responsible person shall prepare and sign a Certificate of Compliance and an Installation Certificate applicable to the portion of construction for which they are responsible, alternatively, the person with chief responsibility for constmction shall prepae and sign the Certificate of Compliance Declaration Staternen! for the entire construction. 321< Statenxents of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on page I of 4 on this SLTG-1C shall complete Part 3a. Check Yes or No for all of the following statements: 1 I have responsibility for installing the sign lighting coot ols ❑ Yes, complete arts 3a and 3b of this form No complete part 3a of this form 2 There are no existing sign lighting controls and I will befunstalling compliant sign lighting controls ❑ Yes 121 No 3 There are no existing sign lighting controls and someoneelse will be responsible to install compliant sign lighting controls ❑ Yes 9fNo There are existing sign lighting controls that do not comply with the applicable provision of § 119 and §133 and I will be 4 installing compliant sign lighting controls I ❑ Yes 16 No There are existing sign lighting controls that do not compl With the applicable provision of §119 and §133 and someone else 5 will be responsible to install compliant sign lighting co ols ❑ Yes No 3b. Mandatory Sign Lighting Controls If the person signing the Certificate of Compliance Declaration Statement on page 1 of 4 of this SLTG-IC is responsible for complying with the sign lighting control requirements, that person shall answer all of the following questions: If there are construction documents, indicate where on the building plans the mandatoa measures sio li htin control) note block can be located: 1 §133(a)l. All indoor sign lighting is controlled with an automatic time switch control that complies with the Y N NA applicable requirements of §119. ❑ ❑ ` §133(a)l and 2. All outdoor sign lighting is controlled with an automatic time switch control plus a photo YJ N NA control, or an outdoor astronomical time switch, that comply with the applicable requirement s of 119. ❑ 2 Exception to §133(a)2. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ §133(a)3. All outdoor signs are controlled with a dimmer that provides the ability to automatically reduce Y N NA sin power by a minimum of 65 percent during nighttime hours. ❑ X ❑ Exception 1 to §133(a)3. Signs illuminated for less than one hour per day during daylight hours. y NA ❑ 3 Exception 2 to §133(a)3. Outdoor signs in tunnels or large covered areas that require illumination during Y NA daylight hours. ❑ Exception 3 to §133(a)3. Only metal halide, high pressure sodium, cold cathode, or neon lamps used for Y NA illuminating signs or parts of signs. ❑ §133(a)4. An Electronic Message Center (EMC) having a new connected lighting power load greater than 15 kW has a control installed capable of reducing the lighting power by a minimum of 30 percent when Y ❑ N ❑ N/A 4 receivinga demand response signal that is sent out b the local utility, Exception to §133(a)4. EMC required by a health or life safety statue, ordinance, or regulation, including Y NA but not limited to exit signs and traffic signs. ❑� Field Inspector Notes: 2008 Nonresidential Compliance Forms October 2010 Certificate of Coinita2ce (Sign Li ht6n (Pa e 3 ®9 4) SL i G-iC Project Name: n. - � � y �, Date: rjrar� 4. Maximum Allowed Lighting P®aver ]Method of Compliance Certificate of Compliance and Field Inspection Energy Checklist Complete this part if there are signs using the maximum allowed lighting power method of compliance. (Complete part 5 of this Certificate of Compliance if there are si ns usin the S ecific li In sources method of com Hance --A E C D E F G o Allowed Watts Design Complies? Watts Y/N w Field U A _ O p aN+ C Inspector }) u V ti >, °� '� ro 3 3 Check that o ? 3 x •o ❑ w Sign Complies a. w `� .s `" ✓ C A ® .V O Description ✓ F y� j LL ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ A Symbol or code used on thwen plans are required) and other documents. R A. narrative description of the sign, or location of sign on the building; and the location of sign on construction documents. OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed, ENERGY VERIFIED label, confirming that the sign complies with the Section 148 of the California 2005 Title 24, Part 6 Standards, using the Maximum Allowed Lighting Power method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized C by Urdenvriters Laboratories (LIL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the Arnerican National - Standards Institute in accordance with ISO/IEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with iSO/IEC 17020. For signs with such an ENERGY VERIFIED label, columns `D' through `I' are not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. D The sign area in square feel. E List "I" if the sign is intcmally illuminated. List "E" if the sign is oxtemalll illuminated. - F Allowed watts 2er square fool. Enter 12 if the sign is listed as "I" in column E. Enter 2.3 if sign is listed as "E" in column E. G Multiply the square foots a in column D times the allowed Li hlin Power Densi (LPD =watts in column F. F! Show the total installed watts in the sign, as determined according to the applicable provisions of §130(d ore). I Enter Y if the number in column H is less than ore ual to the number in column G. Otherwise, the sign does not com. I . 3 This page doubles as a field inspection checklist. Field Inspector Notes: 2008 Nonresidential Compliance Fornes October 2010 Certificate of Compliance (Pa e 4 of 4) SLTG-iC Project Name: C, /"y Date: i �� 5. Specific ghtitag Source Method of Compliance Certificate of Compliance and Field Inspection Energy Checklist Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 4 of this Certificate of Com fiance if there are sign s usin the maximum allowed li hung power method of com liance A _l3_ C - - D - - - E-- _ OPTIONAL Specific light source used for Field ENERGY Symbol VERIFIED compliance Inspector or Description P label Shall include only lighting Check that Code (see instructions technologies listed below n Sign below) List all that apply Complies \'I A ® '� ❑ ❑ ❑ ❑ ❑ A Symbol or code used on the tans (when tans are re aired) and other documents. B A narrative descri lion oC [he si , or location of si on the buildin ;and the location of si ton construction documents C OPTIONAL -Check this box only if this sign has a permanent, pre-printed, factory -installed ENEgGY irERIFTED label, confirming that this sign complies with the Section 148 of the California 2008 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. Tate only labels tttPai will be reougtized 'Far ibis purpose ara f`;T+LGR(SF VER3FIED Certification Marks authorized by LSrdar-writes Laberaiories (tIL) or other I'roducl Certilicaiion Lady acorediied io ISO/lEC Guide, GS by Gte American National Standards Inatiauie in aaeordanre wiah lS0/IEC 1701 1. Snrveillanee by she Acrredite.f Cert#$cation Eody ;hall bo an ongoing annual inspection prograns carried out by a'rytre A inspection body in accordance wiah 35O/3EC ] 7D'20. For signs with such an ENERGY VERIFIED label, column 'D' is not required to be filled ou(. Note: Using an ENERGY VERIFIED Zabel is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for com Rance. Specific Light Source Compliance Method. The sign(s) identified above use only the following lighting technologies: List all a licable numbers ] [hrou h ] 0) that ap2ly in column Dabove for each row. 1 Hi It ressure sodium lamps 2 Pulse start or ceramic metal halide lams served by a ballast with > 88% efficient 3 Pulse start metal halide lamps that are < 320 watts, are not 250 watt or 175 watt lamps, and are served by a ballast with > 80% efficient 4 Neon or cold cathode lams with transformer or ower supply efficiency > 75% with rated output current < 50 mA D 5 Neon or cold cathode lams with transformer or power supply efficient > 68% with rated output current > 50 mA 6 Fluorescent lamps with a minimum color rendering index (CRI) of 80 Note: when using electronic ballasts for compliance, lamps with a CRI < 80 may be used 7 Light emitting diodes LEDs with a power sup2ly with > 80% efficient Single voltage LED external power supplies designed to convert 120 volt AC input into lower voltage DC or AC 8 output, having a nameplate output power less than or equal to 250 watts, and certified to the Energy Commission as complying with the applicable requirements of the Appliance Efficiency Regulations (Title 20 9 1 Com act fluorescent lams that do not contain a medium screw base sockets (E24/E26 10 1 Electronic ballasts with a fundamental ou ut frequency > 20 kHz E This page doubles as a field ins ection checklist. Field Inspector Notes: 2008 Nonresidential Comphdnce Forms October 2010