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B-2016-2073CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10080 N WOLFE RD CUPERTINO, CA 95014 16 20 086) CONTRACTOR: PERMIT NO: B-2016-2073 (3 T F MCGUCKIN INC MILPITAS, CA 95035 OWNER'S NAME: I&G DIRECT REAL ESTATE 27 LP DATE ISSUED: 08/15/2016 OWNER'S PHONE: PHONE NO: (408) 263-5614 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. #654239 Contractor T F MCGUCKIN INC Date 09/30/2016 X BLDG — ELECT PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — MECH — RESIDENTIAL X COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: I hereby affirm under penalty of perjury one of the following two declarations: SUITE:SW3-250; T.I. - OFFICE AREA (16,714) - SUGARCRM 1.. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3 700 of the Labor Code, for the performance of the work for which this permit is issued. i 2. I have and will maintain Worker's Compensation insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $460749.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 316 20 086 A (Tenant Improvements),B (Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the this permit. Additionally, the applicant understands and will comply with all non -point comply with all WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.1 S. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date Issued by: Kim Dunbar Date: 08/15/2016 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (See.7044, Business & Professions Code) 2. 1, as owner of the property, arm exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this Hermit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation_ Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health &z Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the peifortiiance of the work for which this permit is issued, I Health &a Safety Code, Section 25532(a) should I store or handle hazardous shall not employ airy person in any manlier so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption,1 become subject to the Worker's Compensation provisions of the the Health &s Safety Code, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICAT-10 Date: I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9,18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE.AiIENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FA(408) 777-3333 ® buildincii2cupertino.ora NEW CONSTa.0 ADDITION _XATER A-1I0-.q/—jI D REVISION/ DEFERRED ORIGINAL PERMIT O PROJECTADDRESS 106t E4. vw& APN# r*0 V0 OWNER NAME —iftw"r— e4k PHONE F E-MAIL STREET ADDRESS 10 65D N. CITY, STATE, ZIP FAX ®moi CONTACT NkMF PHONE U, STREET -ADDRESS I I a' CITY, STATE, ZIP ❑ OWNER. 0 QW-NER-BUILD- 13 OWNERAGENT EJ CONTRACTOR El CONTRACTORAGENT 1:1 ARC111TECT 171 ENGINEER 1:1 DEVELOPER ❑ TENANT CONTPACTORNAME -14f:MCHNSENUMBER I r LICENSE TYPE BUS. LIC 1) COMPANYNAMF "16riqq fE-MAIL Nil e. 0P C I LLGi°Ih . CO& rax STREETADDRESSfb"#�A C! TYSTATEZIP "11414$ U- 1055- PHONE ARCHITECTIENGINEER NAME LICENSE NUMBER RUS. Lie # COMPANY NAME E-MAILFAX IlKh"fe-1 4e,51- STREET ADDRESS < CITY, STATE, ZIPow, CA -43 PHONE TION OF OM11, DFSCWW )A mw fto qwsw P" - �Opr- iK644w-? mopt&*(w-S -1d U 9"'-.E .E. tl 3 P-t-POW044-TA —77-0771-7—pv0 EXISTING USE 11,0POS00 USE 1 4 STORIES USE TYPE OCC, SQ.FT. VALUATION =AiEVJ rLOOR A..A AREA DEMO AREA NRF AREA BATHROOM OTHBP, REMODELAREA REMODEL AREA r,2Y-ODE-7 AREA PORCH AREA I DECK AREAAREGARAGEAREA: D DETACH I I 0 ATTACH DWELLING UNITS- ISAS33CONDUMIT [3vFS Sr -,d D91'ORY —ffY--ES I BEINUADDED? 0,1,0 ADDITION? ©NO PRF -APPLICATION []YIIS IF YES, PROVIDE COPY OF PLAWNQAPPL# nNO, PLAMWINCAPPROVALLEITLM ISTIMBLI)GAN 0 YES RICHLER HGAINI? 0 ON 17 ... ... ...... PT "IALTJAI'10 1 By nay signattri-e below, I certify to each offthe follmving. I ain tbc, property owner or authorized agento act o I the, property owner's behalf. I have read this application and the infornrationIStave provided is correCL I have read the Description of Work and verify it is accurate. I agree to comply wink all applicable local ordinances and state laws relating to building construction, 1 authorize represent itivos of Cupertino to enter theabove-identified property for inspection purposes. Signature ofApphcant/Agent: Date: h, OV, l -- SUPP1:JEMENTAdTW-Tt&AT-10-N RBQTJlRE-D --,'—��---ROIJT G. New SFD or Multifamily dwellings. A-Pply for demolition pernift for -Y. ... . .... —:BIJnM1NGPL existingbuilding(s). Demolition permit is required prior to issuance of building . ..... . .... pen -nit for new building.FXPR, SS 'I TLANNN IG -YL Commercial Bldgs: Providea completed Hazardous Materials Disclosure U ij B ... To—rin if any Hazardous Materials are being used as part of this project, LARGE.-- ...... F BpEpr: Copy ofPlanning Approval 'L. t'LotorPAectLqgwifliPlaimi-tigl3riorto ... .. T SANITARY ofBuilding Permit apDECV6013. .. ... ....... ...... ..STAITRDISTRICT'�. :BNAWWAIENT EA TH-.� BIdgApp_2011.doc revised 06121111 "013 SIVIX*n INSPECTION8,160. CONSTRUCTION INSPECTION SPECIALISTS City of Cupertino Building Department 10300 Torre A. Cupertino, Subject, Final Project )A-f:M-fi Specipl 1nsppectio �a A Testing S 100ANWolfe ad,SW3-250 Dear irs, FILE 0-1 - October 13,,20t6------ Zi" HPI Pro'. bt No.: SCRM- permit o: 20l6--2020 73 This Project Affidavit is submitted in accordance with the requirements of CBC Section 1704 and certifies that HP Inspections has provided special inspection and testing services for the following work at the above -referenced project: Torque load testing of 1/2" diameter expansion anchors to a load of 40 ft -lbs located on the existing concrete slab for Server Room 222. Based on our observations, testing and to the best of our knowledge, the work observed was performed in accordance with the approved project plans, specifications and with the applicable workmanship provisions of the California Building Code. sincerely, HP Inspection$, Inc. Basil A. Amso, CE 49998 cc: T F McGuckin 0 A. A A No. 49998 M EXP. (a acs ( C, OFCA."V3, .4... "Af -1) 600 SUNOL STREET, BUILDING H 0 SAN JOSE, CA 96126 * (408) 288-8460 * Fax: (408) 271-0902 - 5 X66 � ')07-� CERTIFICATE OF ACCEPTANCE- DATA FIELD DEFINITIONS AND CALCULATIONS Automatic Daylighting Control Acceptance Document NRCA-LTI-03-A (Page 1 of 9) i Note: Submit one Certificate of Acceptance for each system thatI Enforcement Agency Use; Checke y a e f Imust demonstrate compliance. 11 Check boxes for all pages of this LTG -3A completed and included in this submittal ®' LTG -3A Page 2 Construction Inspection. This page required for all submittals. FN LTG -3A Page 3 & 4 Continuous dimming control functional performance test — watt -meter or amp -meter measurement 0' LTG -3A Page 5 & 6 Stepped Switching/ Stepped Dimming functional performance test —watt -meter or amp -meter measurement Rr LTG -3A Page 7 & 8 Continuous dimming control functional performance test — light meter power measurement, and default look -up table of fraction of rated power versus fraction of rated light output. 0 LTG -3A Page 9 & 10 Stepped Switching/ Stepped Dimming functional performance test — based on light output 1. Construction Inspection NA -7.6.2.1 1 Drawing of Daylit Zone(s) must be shown on plans or attached to this form. Select one or both of the following: Shown on plans page #'s 0 Daylit zones(s) drawn in on as -built plans (attached) page #`s Check box below if sampling method is used in accordance with NA7.6.2.1. If checked, attach a page with names of other controls in sample (only for buildings with > 5 daylight control systems, sample group glazing some orientation) Sys Zor Cot Swi De! Ser Cor Set Zor Set If c Ne If C Ott Co Ye: 4 Plans Page Check if Tested Control is Control System System Name �9 Number Representative of Sample A W A- Jrr f es° 0 Applicable Control System B 0 C ❑ A B C tem Information e Type: Skylit (Sky), Primary Sidelit (PS), or Secondary Sidelit (SS) itrol Type: Continuous Dimming with more than 10 light levels (C), Stepped Dimming (SD), tching (SW) ;ign Footcandles: (enter number or "Unknown") sor and Controls 0 I° itrol Loop Type: Open Loop (OL), Closed Loop (CL) isor Location: Outside (0), Inside Skylight (IS), Near Windows facing out (NW), In Controlled e (CZ) isor Location is Appropriate to Control Loop Type: (Y/N) :)ntroi loop type is Open Loop (OL): Enter yes (Y) if location = Outside (0), Inside Skylight (IS), or it Windows facing out (NW); otherwise, enter no (N). ontrol loop.type is Closed Loop (CL): Enter yes (Y) if location = In Controlled Zone (CZ); erwise, enter no (N). f itrol Adjustments are in Appropriate Location (Y/N): Yes, If Readily Accessible or if in Ceiling <-11 ft, No for all other. Has documentation been provided by the installer: Installation Manuals and Calibration Instructions Provided to Building Owner: (Y/N) Location of Light Sensor on Plans: (Y/N) IR14 Location of Light Sensor on Plans: (Page Number) CERTIFICATE OF ACCEPTANCE— DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A' Automatic Daylighting Control Acceptance Document (Page 2 of 5 Separate Controls of Luminaires in Daylit Zones: Are luminaires controlled by automatic daylighting controls only in daylit zones: (YIN) Separately circuited for daylit zones by windows and daylit zones under skylights: (Y/N) 6 Daylighting control device certification Daylighting control has been certified in accordance with §110.9: (YIN) Construction Inspection PASS/FAIL. If all responses on this Construction Inspection page are complete and all Yes/No questions have a Yes (Y) response, the tests PASS; If any responses on this page are incomplete OR there are any no (N) responses, the tests FAIL v C 11. Functional Performance Testing — Continuous Dimming Systems NA -7.6.2.2 Power estimation using amp -meter measurement, or alternate option — watt -meter measurement Complete all tests on page 3 of 10 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and fill out Pass/Fail section on Page 4 of 10. Applicable Control System A B C System Information a. Control Loop Type: Open Loop or Closed Loop? (0 or C) b. Indicate if Mandatory control - M (required for skylit zone or primary sidelit zone with installed general lighting power> 120 W); or Voluntary -V (M, V) tA C. If automatic daylighting controls are mandatory, are all general lighting luminaires in daylit zones controlled by automatic daylight controls? (YIN) d. Documented general lighting design footcandles. (Enter footcandle value or "Unknown" (U)) o e• Power estimation method. Measured Amps Multiplied by Volts, Volt -Amps (VA), alternate option is Measured Watts (W) ` t u�l Step 1: Identify Reference Location (location where minimum daylight illuminance is measured in zone served by the controlled lighting.) f. Method Used: Illuminance or Distance? (1 or D) Override daylight control system and drive electric lights to highest light level for the following: 9. Highest light level fc — enter measured footcandles (fc) from controlled electric lighting (does not include daylight illuminance) h Full load Highest light level power. Enter measured Amps times Volts, Volt -Amps (VA) or measured Watts. i Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TC) FU Step 2: No Daylight Test controls enabled & daylight less than 1 fc at reference location j• Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log), Cover Fenestration (CF), Cover Open Loop Photosensor (COLD) /V Ph k. Reference Illuminance (footcandles) as measured at Reference Location (see Step 1). Enter footcandles L Enter Y if either of the following statements are true: [Reference Illuminance (line j)] /[Highest light level fc (line g)] > 70% when line I = FO?90%? or [Reference Illuminance (line j)] / [design footcandles (line d)] > 80%? (Y/ N) Step 3: Full Daylight Test conducted when daylight greater than reference illuminance (line j) m- Enter measured Amps Multiplied by Volts, Volt -Amps (VA) or measured Watts (W). n• System power reduction enter [1— (line m)/(line h)] enter as percent. ®� o- Is System Power Reduction (line m) > 65% when line i = FO, or > 56% when line i = TT (Y/N) P- With uncontrolled lights also on, no lamps are dimmed outside of daylit zone by same control mechanism or formula (Y/N) q. Dimmed lamps have stable output (no perceptible visual flicker) (Y/N) li, CERTIFICATE OF ACCEPTANCE— DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 3 of 9) Step 4: Partial Daylight Test conducted when daylight between 60% and 95% of (line k) Applicable Control System r Daylight illuminance (light level without electric light) measured at Reference Location (fc) s• Daylight illuminance divided by the Reference Illuminance = (line r )/ (line k). Enter %.o �? t• Is Ratio of Daylight illuminance to Ref. illuminance (lines) between 60% and 95%? (Y/N) A eV `� u• Total (daylight + electric light) illuminance measured at the Reference Location (fc) (p`, V. Total illuminance divided by the Reference Illuminance = (line u )/ (line k), Enter w• Is Total illuminance divided by the Reference illuminance (line u) between 100% and 150%7 (X/N) e. Method Used: Illuminance or Distance? (I or D) It. Evaluation ; PASS: All applicable Construction Inspection responses on page 2 of 10 are complete and all applicable Functional Performance Testing Requirements responses are positive (Y - yes) (applicable questions on page 3 of 10 = c, k, n, o, p, s, v) Step 2: No Daylight Test (daylight less than 1 fc at reference location) f- Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log) attach plot of fc or power, Cover Fenestration (CF), Cover Photosensor (CP) H. NA7.6Z.2 Functional Performance Testing — Stepped Switching/ Stepped Dimming Systems Power estimation using watt -meter or amp -meter measurement Complete all tests on pages 3 & 4 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and fill out Pass/Fail section on Page 6 of 10. Applicable Control System A R C System Information a- Control Loop Type. Open Loop or Closed Loop? (O or C) �? b. f Indicate if Mandatory control - M (required for skylit zone or primary sidelit zone with installed general lighting power > 120 W); or Voluntary -V (M, V) A eV `� C. If automatic daylighting controls are mandatory, are all general lighting luminaires in daylight zones controlled by automatic daylight controls? (Y/N) d Power estimation method. Measured Watts (W), Measured Amps Multiplied by Volts, Volt - Amps (VA), Step 1: Identify Reference Location (location where minimum daylight illuminance is measured in zone served by the controlled lighting.) e. Method Used: Illuminance or Distance? (I or D) Step 2: No Daylight Test (daylight less than 1 fc at reference location) f- Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log) attach plot of fc or power, Cover Fenestration (CF), Cover Photosensor (CP) 1- Reference Illuminance (foot-candles) measured at Reference Location h- Enter measured Watts (W), or Amps Multiplied by Volts, Volt -Amps (VA) i Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TT) Step 3: Full Daylight Test conducted when daylight > 150% of reference illuminance (line g) J• Measured Watts of Volt -Amps - record system power k• System fraction of power reduction = [1 -(line k) / (line h)), L Is System Power Reduction (k) > 65% when line i = FO or >56% when line i = TT (Y/N) Step 4: Partial Daylight Test rn- Method Used: Light Logging (Log), Partially Cover Fenestration (PCF), Open Loop Setpoint Adjustment (OLSA) 1�1 CERTIFICATE OF ACCEPTANCE— DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 4 of 9) n. If the control has three steps of control or less, all steps of control are tested. If the control has more than three steps, testing three steps of control is sufficient for showing compliance Tests have been conducted at various daylight levels that correspond to steps of electric lighting control. (Y/N) II.NA7.6.2.2 Functional Performance Testing— Stepped Switching/ Stepped Dimming Systems (continued) Applicable Control System A B C First Stage of Control F1 Total (daylight+electric light) illuminance measured at the Reference Location (foot-candles when stage turns off or dims F2 Is the measured total illuminance between 100% and 150% of the Reference Illuminance (line g)? (Y/N) F3 With time delay disabled, control stage does not cycle (i.e. deadband is sufficient)? (Y/N) Second Stage of Control F4 Total (daylight + electric tight) illuminance measured at the Reference Location (foot-candles) when stage turns off or dims F5 Is the measured total illuminance between 100% and 150% of the Reference Illuminance (line g)? (Y/N) F6 With time delay disabled, control stage does not cycle (i.e. deadband is sufficient)? (Y/N) Third Stage of Control F7 Total (daylight + electric light) illuminance measured at the Reference Location (foot-candles when stage turns off or dims F8 Is the measured total illuminance between 100% and 150% of the Reference Illuminance (line g)? (Y/N) F9 With time delay disabled, control stage does not cycle (i.e. deadband is sufficient)? (Y/N) Step 5; Time Delay Test (conduct at least 60 minutes after overriding time delay) r. After change of state from little daylight to full daylight, time in minutes before light output is reduced S. Is the measured time delay (line r) greater than or equal to 3 minutes? (VN) Ill. PASS/FAIL Evaluation (check one): E] PASS: All applicable Construction Inspection responses on page 2 of 10 are complete and all applicable Functional Performance Testing Requirements responses are positive (Y - yes) (applicable questions on pages 5 & 6 of 10 are on lines c, i, I, m, n, F2, F3, F5, F6, F8, F9, s) FAIL: Any applicable Construction Inspection responses on Page 2 are incomplete OR there is one or more negative (N - no) responses in any applicable Functional Performance Testing Requirements section (applicable questions on pages 5 & 6 of 10 are on lines c, i,1, m, n, F2, F3, FS, F6, F8, F9, s). System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10-103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and resubmitting LTG -3A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. CERTIFICATE OF ACCEPTANCE— DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 5 of 9) Rfl. Functional Performance Testing — Continuous Dimming Systems NA -7.6.2.2 Power estimation using light meter measurement Complete all tests on page 7 & 8 of 10 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and fill out Pass/Fail section on Page 8 of 10. Applicable Control System A B C System Information a. Control Loop Type: Open Loop or Closed Loop? (O or C) b, Indicate if Mandatory control - M (required for skylit zone or primary sidelit zone with installed general lighting power > 120 W); for Control Credit — CC; or Voluntary not for credit -V (M, CC, V)C. j� q ' "" 6 If automatic daylighting controls are mandatory, are all general lighting luminaires in daylight zones controlled by automatic daylight controls? (Y/N) d Documented general lighting design footcandles. If design footcandles not documented leave blank (enter fc) e. Power estimation method. (see line r) Default ratio of power to light (Dfc), cut -sheet ratio of power to light (CSfc) If CSFs — attach cut -sheet. Enter Dfc or CSfc, D Step 1: Identify Reference Location (location where minimum daylight illuminance is measured in zone served by the controlled lighting.)., f• Method Used: Illuminance or Distance? (I or D) Override daylight control system and drive electric lights to full light output for highest light level fc.: Q , g• Highest light level fc — enter measured controlled electric lighting footcandles (fc) h. Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TT) FO. Step 2: No Daylight Test i- Method Used: Nighttime manual measurement (Night), Night Time Illuminance togging (Log), Cover Fenestration (CF), Cover Open Loop Photosensor (COLD) j• Reference Illuminance (footcandles) measured at Reference Location (illuminance of general lighting at the reference location) O 'J k- Enter Y if either of the following statements are true: If line h = FO; [Reference Illuminance (line i)] / [Full Output fc (line g)) > 70%? or [Reference Illuminance (line i)] / [design footcandles (line d)] > 80%? (Y/ N) Step 3: Full Daylight Test conducted when daylight > reference illuminance (line i) L Daylight illuminance (light level with electric lighting turned off) measured at Reference Location (fc) 30- m. Daylight illuminance (line[) greater than Reference Illuminance (line j) ? (Y/N) - n. Fraction controlled wattage turned off. Enter %. `6 o• Fraction of controlled wattage dimmed [1- ( line n)] Enter %. 177 Fill out lines p through s only if fraction of controlled wattage turned off_(1*e n) < 100%. p• Total (daylight + electric light) illuminance measured at the Reference Location ft) q- Electric lighting illuminance at the Reference Location (fc) [(fine p) — (line 1)] r. Electric lighting illuminance (line q) divided by Highest Light Level fc (line g). Enter % s• Dimmed luminaire fraction of rated power. Attach manufacturer's cut -sheet or use default graph of rated power to light output on bottom of page 8 of 10. Label applicable control system (column A, B or C) on cut -sheet or graph. Enter fraction of rated power in %. t- System Power Reduction = [1— (line o) * (line s)] U. Is System Power Reduction (line t) > 65% when line h = FO, or > 56% when line h = TT (Y/N) v With uncontrolled lights also on, no lamps dimmed outside of daylit zone by control (Y/N) w- Dimmed lamps have stable output, no perceptible flicker (Y/N) CERTIFICATE OF ACCEPTANCE DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 6 of 9) 11. Functional Performance Testing— Continuous Dimming Systems NA -7.6.2.2 (continued) PASS/FAIL Evaluation (check one): Applicable Control System A B C Step 4: Partial Daylight Test conducted when daylight between 601 and 95% of (line i) FAIL: Any applicable Construction Inspection responses on page 2 of 10 are incomplete OR there is one or more negative (N - no) responses in any applicable Functional Performance Testing Requirements section (applicable questions on page 7 of 10 = c, k, m, u, v, w, z, cc). System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10-103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and - resubmitting LTG -3A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. X. Daylight illuminance (light level without electric light) measured at Reference Location (fe) 3.0 Y- Daylight illuminance divided by the Reference Illuminance = (line x)/ (line j). Enter 1o� Z. Is Ratio of Daylight illuminance to Ref illuminance (line y) between 601 and 951? (Y/N) aa. Total (daylight + electric light) illuminance measured at the Reference Location (fc) AFL bb. Total illuminance divided by the Reference Illuminance = (line as )/ (line j). Enter 1 I a ;� cc. Is Ratio of Total ilium. to Reference ilium. (line bb) between 100% and 1501? (Y/N) III. PASS/FAIL Evaluation (check one): PASS: All applicable Construction Inspection responses on page 2 of 10 are complete and all applicable Functional Performance Testing Requirements responses are positive (Y - yes) (applicable questions on page 7 of 10 = c, k, m, u, v, W, z, cc) FAIL: Any applicable Construction Inspection responses on page 2 of 10 are incomplete OR there is one or more negative (N - no) responses in any applicable Functional Performance Testing Requirements section (applicable questions on page 7 of 10 = c, k, m, u, v, w, z, cc). System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10-103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and - resubmitting LTG -3A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. Default fraction of rated power to fraction of light output (used on line r on page 7 of 10) 100% L 90%-----i------r-----r--- r-----��D -7--- 0 80%° -----I-----+---------- ----- ----- --- ----------- 70% ----------i ----'- - -- ------------ -------------------- So 60%------ -----More cent''----- 50%-----I-----------I----- --------1----------� ---- ---- 0 40% ---- --------'-----------'----- -----'------'---- 0 30%----------I----I----------�-----I----------�---------- L20% ----t---- -----1 ----- r ----- I-----fi-----r----7----- L- LL 10% ------------------------------------------------------------ 0% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90.% 100% Fraction of rated light output ll. NA7.6.2.2 Functional Performance Testing — Stepped Switching/ Stepped Dimming Systems CERTIFICATE OF ACCEPTANCE— DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 7 of 9) Power estimation based on light output Complete all tests on page 9 & 10 of 10 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and fill out Pass/Fail section on Page 10 of 10. Applicable Control System A B C I.Systern information a- Open Loop or Closed Loop? (O or C) b- Indicate if Mandatory control - M (skylit zone or primary sidelit zone with installed general lighting power > 120 W)); for Control Credit — CC; or Voluntary not for credit -V (M, CC, V) C. If automatic daylighting controls are mandatory, are all general lighting luminaires in daylight zones controlled by automatic daylight controls? (Y/N) d Power estimation method. Counting (C) — not allowed for step dimming, Counting plus Cut Sheet (C+CS) attach ballast cut sheet with steps of power and light. Step 1: Identify Reference Location (location where minimum daylight illuminance is measured in zone served by the controlled lighting.) e. Method Used: Illuminance or Distance? (I or D) Step 2: No Daylight Test f- Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log) attach plot of fc or power, Cover Fenestration (CF), Cover Photosensor (CP) 9- Reference Illuminance (foot -candies) measured at Reference Location h. Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TT) Step 3: Full Daylight Test conducted when daylight > 150 percent of reference illuminance (line g) i. Fraction system wattage turned off J- Fraction of system wattage dimmed k- Step dimming level as a fraction of rated light output if applicable I. Dimmed ballast fraction of rated power from cut -sheet m. System Power Reduction = [1— (line j)*(fine 1)] n. Is System Power Reduction (line m) > 65% when line f = FO or >56% when line i = TT (Y/N) o• With uncontrolled lights also on, no lamps controlled outside of daylit zone (Y/N) p• Dimmed lamps have stable output, no perceptible visual flicker (Y/N) Step 4: Partial Daylight Test q- Method Used: Light Logging (Log), Partially Cover Fenestration (PCF), Open Loop Setpoint Adjustment (OLSA) r. If the control has three steps of control or less, all steps of control are tested. If the control has more than three steps, testing three steps of control is sufficient for showing compliance. Tests have been conducted at various daylight levels that correspond to steps of electric lighting control. (Y/N) II.NA7.6.1.2Functional Performance Testing — Stepped Switching/ Stepped Dimming Systems Applicable Control System A 1 B 1 C First Stage of Control F1 Total (daylight + electric light) illuminance measured at the Reference Location (foot- candles) when stage turns off or dims F7- Is the measured total illuminance between 100% and 150% of the Reference Illuminance (line A? (Y/N) CERTIFICATE OF ACCEPTANCE— DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 8 of 9) F3 With time delay disabled, control stage does not cycle (i.e. deadband is sufficient)? (Y/N) Second Stage of Control F4 Total (daylight + electric light) illuminance measured at the Reference Location (foot= candies) when stage turns off or dims F5 Is the measured total illuminance between 1009/6 and 150% of the Reference Illuminance ' (line g)? (Y/N) F6 With time delay disabled, control stage does not cycle (i.e. deadband is sufficient)? (Y/N) Third Stage of Control F7 Total (daylight + electric light) illuminance measured at the Reference Location (foot- candles) when stage turns off or dims F8 Is the measured total illuminance between 100% and 150% of the Reference Illuminance (line g)? (Y/N) F9 With time delay disabled, control stage does not cycle (i.e. deadband is sufficient)? (Y/N) Step 5: Time Delay Test (conduct at least 60 minutes after overriding time delay) s• After change of state from little daylight to full daylight, time in minutes before light output is reduced t• Is the measured time delay (fine s) greater than or equal to 3 minutes? (Y/N) Ill. PASS/FAIL Evaluation (check one): PASS: All applicable Construction Inspection responses on page 2 of 10 are complete and all applicable Functional Performance Testing Requirements responses are positive (Y - yes) (applicable questions on pages 9 & 10 of 10 are on lines c, h, n, o, p, r, F2, F3, FS, F6, F8, F9, t) FAIL: Any applicable Construction Inspection responses on page 2 of 10 are incomplete OR there is one or more negative (N - no) responses in any applicable Functional Performance Testing Requirements section (applicable questions on pages 9 & 10 of 10 are on lines c, h, h, o, p, r, F2, F3, F5, F6, F8, F9, t). System does not pass and is NOT eligible for Certificate of Occupancy according to Section 10-103(a)3B. Fix problem(s) and retest until the system(s) passes all portions of this test before retesting and resubmitting LTO -3A with PASSED test to the enforcement agency. Describe below the failure mode and corrective action needed. CERTIFICATE OF ACCEPTANCE— DATA FIELD DEFINITIONS AND CALCULATIONS NRCA-LTI-03-A Automatic Daylighting Control Acceptance Document (Page 9 of 9) DOCUMENTATION AUTHOR'S DECLARATION STATEMENT • 1 certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Documentation Author Company Name: y Date Signed: IF Address: CEA/HERS/ATT Certification Identification (If applicable): City/State/Zip: � s" Phone: .SIC �� 7 �® FIELD TECHNICI 'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 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 the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 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 signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: f Field Technician Signature: Field Technician Company Name:Position r* with Company (Title); aw e ® do dAW 'Oe- �r A !se_ Address: ? L/ ATT Certification Identification (if applicable): City/State/Zip: e„ Phone:Date _ Signed: RESPONSIBLE P RSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement (responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 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 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 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 Person Name: Responsible Acceptance Person Signature: a_._ 77 Responsible Acceptance Person Company Name: ` J= Position with Company (Title): Address: CSLB License: City[State/Zip: 7 Phone: Date Signed: F STATE OF CALIFORNIA DEMAND RESPONSIVE CE6NRCA M -04-A (Remi%[ MUM LIGHTING CONTROL ACCEPTANCE DOCUMENT ` f At 1FA01,111\ CPIC®f_V MnARRICC/tIAI `I''" CERTIFICATE OF ACCEPTANCE NRCA LT1-04-A D mand Responsive Lighting Control Acceptance Document (Page S of 5) Pro ectNamet p 1 u �— �i�sv® �GSi3 iinforcementAgencir /� _ C! D� L&Ipve %/! Penn Number O g k1 ZD/& GAO �g "Irr- �jCWT Cp�! �LF-.l /'�$%� C4_ SPL 9-TO/6 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT •` I certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Documentation Authorsignature: Do umentationAuthorCompanyName: a�o Date Signed: 1g9 Address: LF2_ e� fes® I/State%Zip: CEA/HERSfATrCertificationidentificaVoon (if applicable)- pplicable):Ci tit t� � 0 Phone: FIELD TECHNiCI S DECLARATION STATEMENT I certify the following under penalty of perjury, under the taws of the State of California: 1. The 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 the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NAT. 4 I have confirmed that the Certificate(s) of installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Fild Techniclum Name: Reld recimician Signature: Fd1clTechnicianCompany Name:gP ® Position withCompany(TWe): Address- ® 37 ATT Certification identification lif applicable): C 1r/SfatejZip: _ �ef Phone: -1� 55-3;, / 5000p��40 DateSigned: /,0// c��✓ RESPONSIBLE AER N'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1 I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and i have reviewed the information provided on this Certificate of Acceptance. 2 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 NA7. 4. i have confirmed that the Certificate(s) of installation forthe construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s) issued for the building. 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. onsible Acceptance Person Name:, Responsible Acceptance Person Signature: esponsible Acceptance Person Company Name: Position with company (Title): ddress,- I W d e � E C5u3 License.®Azr V?_ /stateop: 1/0 Bate Stgned:�� ® C� Phone: 7 1/1/0 Building Energy Efficiency Standards- 2013 Nonresidential Compliance June 2013 h- I ' STATE OF CALIFORNIA DEMAND RESPONSIVE cF-6NRcA.L-n-a&A (Revised ()Fill141 LIGHTING CONTROL ACCEPTANCE DOCUMENT C�RTIFiCATE OF ACCEPTANCE NRCA-LTI-04-A Demand Responsive Lighting Control Acceptance Document (Page 1 of 5) Pro act Name: r� % . e C✓ -)e /ill ,,. A (-,. �(/( Enforcement ABe Y- - - P',}er�mk Num/ 7— /�®� �® / Project Address: Gd ®� ®0 �+ry ��,gg G4' b. Power meter Zip Code: ;�o fid NI te: Submit one Certificate of Acceptance for each system shot Enforcement Agency Use: Checked by/Date m st demonstrate compliance i) mand Responsive lighting Control Intent: Test the reduction in lighting power due to the demand responsive lighting control as per Sections 1103(a), ' 130.1(e) and 130.5(e). N 7.6.7 Acceptance tests for Demand Responsive Lighting Controls in accordance with Section 130.1(e) Instrumentation to perform test includes, but not limited to. a. Hand-held amperage and voltage meter b. Power meter c. Light meter Construction Inspection Verify the demand responsive control is capable of receiving a demand response signal directly or indirectly through another device and that it complies with the requirements in Section 130.5(e). " Demand responsive controls and equipment shall be capable of receiving and automatically 130.5(e) responding to at least one standards based messaging protocol which enables demand response after receiving a demand response signal. DEMAND RESPONSE SIGNAL is a signal sent by the local utility, Independent System i3perator (ISO), �( Definition or designated curtailment service provider or aggregator, to a customer, indicating a price or a (i request to modify electricity consumption, for a limited time period. if the demand response signal is received from another device (such as an EMCS), that system must itself be capable of receiving a demand response signal from a utility meter or other external source. i NA7.6.7.2 Functional Test Use either Method 1(illuminance measurement) or Method 2 (power input measurement) to perform the functional test. Test building -wide reduction in lighting power to at least 15% below the maximum total lighting power, as calculated 2-, on an area -weighted basis (measured in illuminance or power). However, any single space must not reduce the combined illuminance from daylight and electric light to less than 501% of the design illuminance. 3 For buildings with up to seven (7) enclosed spaces requiring demand responsive lighting controls, all spaces shall be tested. For buildings with more than seven (7) enclosed spaces requiring demand responsive lighting controls, sampling may be done on additional spaces with similar lighting systems. If the first enclosed space with a demand responsive 4 lighting control in the sample group passes the acceptance test, the remaining building spaces in the sample group also pass. If the first enclosed space with a demand responsive lighting control in the sample group falls the acceptance test the rest of the enclosed spaces in that group must be tested. If any tested demand responsive lighting control system fails it shall be repaired, replaced or adjusted until it passes S the test. Method 1: Illuminance Measurement, in each space, select one location for illuminance.measurement. The chosen location must not be in a primary or secondary skylit or sidelit area, and when placed at the location, the illuminance meter must not have a direct view of a window or skylight. If this is not possible, perform the test at a time and location at which daylight illuminance provides less than half of the design illuminance. Mark each location to ensure that the illuminance meter can be accurately located. itep 1; Full output test Space number 1 2 3 4 5 6 7. Using the manual switches/dimmers in each 5 91F18d d®A), 018 hL �� 1 space, set the lighting system to design full Q�►C� ;raF� oFr�f-' output. Kate that the lighting in areas with photocontrols or occupancy/vacancy sensors Building Energy Efficiency Standards - 2013 Nonresidential Compliance lune 2013 ° STA TE OF CALIFORNIA DEMAND RESPONSIVE CEC-NBCA-LTI-04-A (Revised 061131 LIGHTING CONTROL. ACCEPTANCE DOCUMENT rrnr enoetrn �t•®cv nna,aamcan.. _x _ CORTiFICATE OF ACCEPTANCE NRCA-LTi-04-A Demand Responsive Lighting Control Acceptance Document (Page 2 of 5) Pro ect Name:y ,, - Fnfor4emem -- g ,J p ..meg zo/ Pro ectAddress: yy 6y. /00 8� ®v 0! /� % Gty: Q. (®P,� P � l F /BJH £pfode: Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2013 may be at less than full output, or may be off. Z q 5 - Take one illuminance measurement at a b, representative location in each space, using an 0 -fc —50 fe 0 fc fc 50 fc SO fcfc illuminance meter. C. Simulate a demand response condition using the demand responsive control. d Take one illuminance measurement at the same locations as above, with the electric lighting q3 fc, 43 fc151c fc fcIt 5fcIY3fc system in the demand response condition. e Turn off the electric lighting and measure the fc b fc Q fc fc 0 fc < fc fc daylighting at the same location (if present) Calculate the reduction in illuminance in the f. demand response condition, compared with the F, � 157 % L % ) �/ l design full output condition. f ({line b - line (line d — line e)) /(line b - line e)j g Note the area of each controlled space 21S& sf jelMsf 276 sf 279$7 sf 600 sf. 6 sf (v4&7 sf The area -weighted reduction must be at least 0.15 (15916) but must not reduce the combined (ft x g1) + (f2 x g2) + (f3 x g3) h illuminance from electric light and daylight to [gt + g2 + g3 .... j less than 50% of the design illuminance in any individual space. i. The demand response signal must not reduce the power input of any individual circuit by (�y N 5/ N Y N N / N f N / N more than 50%. f continued on next page Step 2: Minimum output test Using the manual switches/dimmers in each space, set the lighting system to minimum Output (but not off). Note that the lighting in areas with photocontrois or occupancy/vacancy sensors may be at more than minimum output or may be off. Take one illuminance measurement at each OZ fc - fc 3fc fc fc 3 fc 3 fc location, using an illuminance meter. Simulate a demand response condition using Y i y y the demand responsive control, Take one illuminance measurement at each location with the electric lighting system in the Z fc 2 fc Z fc 2 fc fc Z fc —L-fc demand response condition. in each space, the illuminance in the demand response condition must not be less than the YIN YIN YIN YIN YIN YIN YIN illuminance in the minimum output condition or 50% of the design illuminance, whichever is less. EXCEPTION: in daytit spaces, the illuminance in the demand response condition maybe below the minimum output setting, but in fhe demand response condition the combined illuminance from daylight and electric light must be at least 50% of the design illuminance. Method 2: Power Input Measurement. At the lighting circuit panel, select at least one lighting circuit that serves spaces required to meet Section 130.1(b) to Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2013 STATE OF CAUFORNIA DFtMAND RESPONSIVE CEdrNikcA-LTi-44-A fRevised 06/131 LIGHTING CONTROL ACCEPTANCE DOCUMENT CALIFORNIA FNERQV COMM4SSION CkRTiFICATE OF ACCEPTANCE NRCA LT1-04-A Demand Responsive Lighting Control Acceptance Document (Page 3 of 5) Prejeallame:. - _ EnFacement Agency.Peprmiftt ft r Pro ect AddressQtr- 110® A) eliKe / 3 , �� `® r _. �F� 501 CA Building Energy Efficiency Standards- 2013 Nonresidential Compliance lune 2013 measure the reduction in electrical current. Alternatively, employ the power monitoring capabilities of the DR controls system to monitor the circuits in the tests below. The testing process is constant with either approach. Circuit number Step 1: Full output test 1 2 3 4 5 6 7 Using the manual switchesjdimmersin each Z & d0 " 12 /1 space, set the lighting system to full output. a Note that the lighting in areas with photocontrols or occupancylvacancy sensors may be at less than full output, or may be off. Take one electric power measurement for each selected circuit, VAZyA U$2 --VA //LVA /®/bVAl� VA VA c Simulate a demand response condition using the demand responsive control. c1. Take one electric power measurement at each circuit location with the electric lighting system 1 � jVA l �' VA % jq VA kOVA _ ��`TUA 6 1� `f VA 700 VA in the demand response condition. ! Calculate the reduction in lighting power in the demandresponse condition; compared with the d C % ! 5" 9a 1-5' % 1$` !a °la /,� t .� full output condition [(b-d)Ib] Note the area of each controlled space sf Z6 vsf Zzoosf /3r{i{sf 7-33(.sf 760 sf /Z/VO sf Calculate the area -weighted average reduction in electric power in the demand response 1-{((elx€i)+(e2xf2)+(e3xf3)... ]f[f1+f2+f3...]I condition, compared with the full output Y / N , condition. The area -weighted reduction must be at least 15/ G i The demand response signal must not reduce the power input of any individual circuit by N y N N Y N N Y J N Y N more than SB%. Step 2: Minimum output test Using the manual switches/dimmers in each space, set the lighting system to minimum output (but not off). Note that the lighting in areas with photocontrols or occupancy/vacancy v sensors may be at more than minimum output, or may be off. continued on next page b Take one electric power measurement for each /- VA l� lZ VA l SV A i' pz VA VA 1®2" VA ? Z VA VA Z_ selected circuit location. Simulate a demand response condition using the demand responsive control. j Take one electric power measurement at each Cd. circuit with the electric lighting system in the /0 YVA i 15 VA to VAgq VA 7FVA VA 7 C/VA i demand response condition. in each space, the electric power input in the demand response condition must not be less le. than the power input in the minimum light (,; 1 N N N N / N N Y N output condition or 5076 of the design V * illuminance power input condition, whichever is less. CA Building Energy Efficiency Standards- 2013 Nonresidential Compliance lune 2013 870ATE OF CALIFORNIA AOTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CECI-NRCA-LTI-03-A (Revised 06/131 C FICATE OF ACCEPTANCE i:AGrt UKN11k NtRGY COMMISSION NRCA-LTi-02-A f.ijhti Control Acceptance Document (Page 1 of 6) PrajedName; f.6' - Enforcem e nt Age "'e_L7�y �� g �q Pyeerrmi�tpNuumpbe� r� Pro ecE Address100be sj ®°°® �f ewPIA 794) 0 Zip Code. 119N 41 Note: For more than 3 spaces attach additional sets of pages 2 Enforcement Agency Use: Checked by/Date thLough 5, as required Automatic Shut-off Controls: Automatic Time Switch Control and Occupant Sensor intent: tights are turned off or set to a lower level when not needed per Section 110.9(x) & 130.1(c). Guidance Tliis acceptance test form must be filled out for all newly -installed lighting control systems of the following types: f I. Auto® Time Switch Controls T : 0 upancy Sensors 1 Partial -OFF occupancy sensors Partial -ON occupancy sensors (only if used to claim a Power Adjustment Factor} Occupancy Sensors serving small zones in large open plan offices (only if used to claim a Power Adjustment Factor) automatic daylighting controls use acceptance test form NRCA-LTI-03-A; for demand responsive lighting controls, use =.ptance test form NBCA-LTI-04-A. tests on this certificate are required by Section 140.6(a)2 and 130.4(x) of the Building Energy Efficiency Standards 2013. The s themselves are described in Sections 140.6(a)2 and in Reference Appendix NA7.6. Al Construction Inspection Fill out Section A to coyer spaces 1 through 3 that are functionally tested under Section B_ Make as many copies of pages 2-5 as are required to test all spaces in the building, and attach to page 1. Instruments needed to perform tests include, but are not limited to: hand-held amperage meter, power meter, or light meter Automatic Time Switch Controls Construction Inspection—confirm for all fisted in Section 8 i a. All automatic time switch controls are programmed for (check all): N- A Weekdays Weekend A... Holidays b.; Document for the owner automatic time switch programming (check all): )VIV Weekdays settings Weekend settings f I Holidays settings 4 10 Set-up settings j # Preference program setting o � Verify the correct time and date is properly set in the time switch A)IaA- Verify the battery is installed and energized WS Override time limit is no more than 2 hours j !, Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards, and model numbers for alt such controls are listed on the Commission database as Certified Appliance and Control Devices Occupancy Sensor Construction inspection—confirm for all listed in Section 8 Building Energy Efficiency, Standards - 2013 Nonresidential Compliance June 2013 OF CALIFORNIA ygda OMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT 0, tCA-LTI-03-A (Revism natini Wil— 'ATE OF ACCEPTANCE Control Acceptance Document NRCA-LTi-02-A Errf-cementftenw- (Page 2 of 6) 6-A /c'7- ^4 U-9 Permit Number A), 1()CIFC- cir. Zip Code 6-014/— Occupancy sensors are not located within four feet of any HVAC diffuser Ultrasonic occupancy sensors do not emit audible sound 5 feet from source % Functional Testing of Lighting Controls 116resentative Spaces Selected Fc r every space in the building, conduct functional tests I through V below if applicable- If there are several geometrically similar spaces that use the same lighting controls, test only one space and list in the cells below which "untested spaces' are represented by that tested space. -EICEPTION: For buildings With up to seven (7) occupancy sensors, All occupancy sensors shall be tested. (NA7.6.2.3) T Testedd space/ room name: --9441 f— 2S 0 Space Type (office, corridor, etc)_. Untested ntested areas/rooms Lights controlled by occupancy sensors tum off within a maximum of 30 minutes 5)1 N Tested space/ room name: Space Type (office, corridor, etc), Y/N 2 from start of an unoccupied condition per Standard Section 110.9(a) (9N Untested areas/rooms The occupant sensor does not trigger a false "on" from movement in an area 0/ N Tested space/ room name: Space Type (office, corridor, etc)_ 3 adjacent to the controlled space or from HVAC operation Untested areas/rooms Functional Tests Tested Space Number �Confirm compliance (Y/N) for all control system types (I-V) present in each space: N 11 Automatic Time Switch Controls T 2 3 Sep 1: Simulate occupied condition a. All lights can be turned on and off by their respective area control switch N I rYIN --F Y/N Verify the switch only operates lighting in the ceiling -height partitioned area in which the switch is located N I NN Y/N j Si ep : Simulate unoccupied condition All lighting, including emergency and egress lighting, turns off. Exempt lighting may NY/N remain on per Section 130.1(c)1 and 130,1(a)1. Manual override switch allows only the lights in the selected ceiling height partitioned space where the override switch is located and remain on no longer Y N (914 Y/N than 2 hours (unless serving public areas and override switch is captive key type). Lp,3: System returned to initial operating conditions si 4&1 N Y N 21 Occupancy Sensors j 3 Sep -2 1: Simulate an unoccupied condition 3. Lights controlled by occupancy sensors tum off within a maximum of 30 minutes 5)1 N Y/N from start of an unoccupied condition per Standard Section 110.9(a) (9N The occupant sensor does not trigger a false "on" from movement in an area 0/ N ON adjacent to the controlled space or from HVAC operation Y/N I Sep 2: Simulate an occupied condition I a. 0 Status indicator or annunciator operates correctly . ...... ... N Y/N Building Energy Etticiency Standards - 2013 Nonresidential Compliance June 2013 OF CALIFORNIA 0MATIC"DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT ICA -LB -03-A (Revised 061131 CALIFt?F2tw11 I IFICATE OF ACCEPTANCE ing Control Acceptance Document lame: r �GP t9'vf-l?-- C ent ftency. address: �L�6�`0 ��t 10 0 00 A) CtM / �- A -D S4t,,, OWNER IMISSION NRCA-LTI-02-A (Page 3 of 6) lumber: 7f6p 7 ;tea /L Lights controlled by occupancy sensors turn on immediately upon an occupied k . condition OR sensor indicates space is "occupied" and lights may be turned on N Y / y J N { manually Step 3: System returned to initial operating conditions y N Y N y / N Building Energy Efficiency Standards- 2013 Nonresidential compliance lune 2013 STATE OF OAUFORNiA t AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT GEC NBCA -LTi -03-A /Ra%AgP i ARMA) CERTIFICATE OF ACCEPTANCE uf9LjP'wmxlt =INMM%�T 4ummi;b6icN NRCA-LTI-02-A Lighting Control Acceptance Document (Page 4 of 6) P�- 4 :5 °'� � Enforcement en d.f %rte Pe itN�u�mb/ear. 20 ^� <z✓/(® Pro{edAddress: S42 3 �g �' Cz-el -A ZIPCode: 3.1 Partial Off Occupancy Sensor 2 3 Step 1; Simulate an unoccupied condition ` Lights go to partial off state within a maximum of 30 minutes from start of an N N Y I N of the lighting automatically. unoccupied condition per Standard Section-110.9ta) l:R Area served by controlled lighting (square feet) After the first stage occurs, manual switches allow an occupant to activate the The occupant sensor does not trigger a false "on" from movement in an area b. Enter PAF corresponding to controlled area from line (a) above (<125sf for PAF=0.4, 1. ` adjacent to the controlled space or from HVAC operation. For library book stacks or warehouse beyond � Y N N Y / N all of the lights. aisle, activity the stack or aisle shall not activate the lighting in L L%' Step 2. Simulate an unoccupied condition s the aisle or stack. f.` N N Y / N In the partial off state, lighting shall consume no more. than S01/ of installed. lighting ' The PAF corresponding to the controlled area (line b), is less than or equal to the FAF Y N- Y J N power, or: N N Y J N ! • No more than 6094 of installed lighting power for metal halide or high e. Sensors shall not trigger in response to movement in adjacent walkways or Y J N I pressure sodium lighting in warehouses. YJ Y N Y J N • No more than 60% of installed lighting power for corridors and stairwells in which the installed lighting power is 80 percent or less of the value allowed i under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken S#ep 2: Simulate an occupied condition 1 j` The occupant sensing controls shall turn lights fully ON in each separately controlled Y N Y N Y j N areas, Immediately upon an occupied condition 41 Partial on occupancy sensors 1 2 3 Step 1. -Simulate an occupied condition. Verify partial on operation, j Immediately upon an occupied condition, the first stage activates between 30 to 70% NYIN i of the lighting automatically. Step 1. Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test It. l:R Area served by controlled lighting (square feet) After the first stage occurs, manual switches allow an occupant to activate the b. Enter PAF corresponding to controlled area from line (a) above (<125sf for PAF=0.4, 1. alternate set of lights, activate 100% of the lighting power, and manually deactivateN N Y J N all of the lights. Enter PAF claimed for occupant sensor control in this space from the Certificate of Step 2. Simulate an unoccupied condition s Both stages (automatic on and manual on) lights turn off within a maximum of 30 f.` N N Y / N minutes from start of an unoccupied condition per Standard Section 110.9(a) ' The PAF corresponding to the controlled area (line b), is less than or equal to the FAF Y N- Y J N The occupant sensor does not trigger a false "on" from movement in an area adjacentIYY N N Y J N to the controlled space or from HVAC operation e. Sensors shall not trigger in response to movement in adjacent walkways or Y J N 5. Additional test for Occupancy Sensors Serving Small Zones in Office spaces larger1 2 3 than 250 Square Feet, to Qualify for a Power Adjustment Factor (PAP) First, complete Functional Test 2 (above) for each controlled zone Step 1. Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test It. a. Area served by controlled lighting (square feet) b. Enter PAF corresponding to controlled area from line (a) above (<125sf for PAF=0.4, 126-250sf for PAF=0.3, 251-500sf for RAE=0.2). Enter PAF claimed for occupant sensor control in this space from the Certificate of C. Compliance ' The PAF corresponding to the controlled area (line b), is less than or equal to the FAF Y N- Y J N YIN claimed in the compliance documentation (fine c) e. Sensors shall not trigger in response to movement in adjacent walkways or Y J N Y J N Y / N workspaces. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance lune 2013 STAGE; OF CALIFORNIA �r F AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LM-03-A (Revised 061131 f -A1 lrA K {A =k—ftl V f�AY Aao[ MAa. CERTIFICATE OF ACCEPTANCE NBCA-LTI-02-A Lighting Control Acceptance Document -..... (Page 5 of 6) ProiectName: �� d"+ OC- rd' t LTJ a Enfo cemeh4A8en 4 P � C ®tf /'�� Permit Number ..82®!% Ze73 ProjectAddress: /J) a ��1 g'' �� /L�• P�SO��i" �� ci" Cs-zf �6��d<aJp ZrpCode: f. All steps are conducted in Functional Test 2 "Occupancy Sensor (On Off Controi)" andON PAS PASS PASS! all answers are Yes Y FAIL l_ J FAIL C 1. Testing Results PAS PASS PASS! FAIL FAIL FAIL I Automatic Time Switch Controls tali answers must bey). YS5 110 ic:upancy Sensor (On Off Control) (all answers must be Y). ' III Partial Off Occupancy Sensor (all answers must be Y). For warehouses, library book stacks, corridors, stairwells in nonresidential buildings must also be accompanied by passing Test I or Test ll. IV Partial On Occupant Sensor for PAF tall answers must be Y). V Occupant Sensor serving small zones for PAF (all answers must be Y). Also must pass \/t ! Test II D. Evaluation 2 i PASS: All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive (Y - yes) Building Energy Efficiency Standards - 2013 Nonresidential Compliance lune 2013 WXSTATE of CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CALIFORNIA ENERGY COMMISSION CEC.NkCA.LTI_03-A Re-Ased 01113NRCA LTi -02-A CERTIFICATE OF ACCEPTANCE (Page 6 of 6) fighting Control Acceptance Document s T PermitPtamher. ProlectName: EnfarcemecrFAilency: e_1 g7 -. 7' /_" � /1 / 1 —0 82116 GCS7-3 Zip Code: f Prole"Address-Pn COY' { I®gig® /0,. W'Ol2F Documentation author's Declaration Statement 1. `l certify that this Certificate of Acceptance documentation is accurate and complete. i ocumentation Author Company Name':CEAIHERS/ATr ate Signed: A %�� ,ddress Certification identification (if ap�icabte}: � _ Phone: f aty/statethp: cam" / 6 537 'YeIG FIELD TECHNICIAN'S DECLARATiON STATEMENT 1 certify the following under penalty of perjury, under the laws of the State of California-. 1 The information provided on this Certificate of Acceptance is true and correct. 2 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 pians 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 Certificates) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Technician Name: Field Technician Signature: J� Field Technician Company Name: Position with Company (rd, ATT Certification identification Iif applicable): Address: / Phone: Date Signed cifir/state/Zip: c�JAY %� % % l W RESPONSIBLE RSON'S DECLARATION STATEMENT i certify the following under penalty of perjury, under the laws of the state of California: 1 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. 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). 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. 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 permit(s) issued for the building. , I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) 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. i !Responsible Acceptance Person Name/,°� nA_ % ResponsibieacceptancePerson Signature Responsible Acceptance Person Company Name- y Positibn with Company lritle): s �O License: CALCREEN SIGNATURE DECLARAATION$ ✓✓ Project Name Tenant Improvements for Sugar CRM' Project Address: 10080 North Wolfe Road, Suite SW3-250, Cupertino, CA Project Description* Tenant improvement for approx. 16,714 sf space in existing 3 story bldg. I — DESIGN VERIFICATION Complete all lines of Section 1 � "Design verification" and submit the completed checklist (Columns 1 and 2) with the plans`and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with fhe`requirements set forth in the 2013 California Green Building Standards Code as adopted; iy the Clt t&t ,upertino. j Ow is Signature Date N Signature Design p' fessional's Na a (- eas Print) a Sign4FI, License rofessional responsible for CalGreen compliance Date a IAL— 04 Name of License Professional responsible for CalGreen compliance (Please Print) Phone t4e-etlz LA s� Email AAds' for License Professional re onsible for C reen compliance SECTION 2 ® IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, togetherwith all original signatures on Section 2 to the Building Department prior to Building Department final inspection. t have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 25P California Green Building Standards Code as adopted by the City of Cupertino. Sign responsible for CalGreen compliance Name of License Professional responsible for CalGreen compliance (Please Print) _.. ..... 1 r (t"&MA A mlA1 G v 1)i_ A-voo- ei I% ^ %A /'4 ri !A r u. 1 Date (ow. w • iVie. Phone Page 9 of 9 CalGreen Non Res Checklist -doe revised 01/23/14 IX VAV SYSTEM f Y SYSTEms ... Building Confadencer AIR BALANCE REPORT 1300 Galaxy Way #9 • Concord, California 94520 (925) 356-3000 • Fax: (925) 356-3004 License # 450929 Project: Sugar CRM Job No. 81602 Date: 10/13/16 Location: 10050 Wolfe Rd. Cupertino, Ca System: Instruments Used: Alnor Balometer Tested by: Justin Haines ROOM AREA SERVED No. Size (duct) REQUIRED PRELIMINARY FINAL Min. CFM (VAV) Heating CFM Cooling CFM Cooling CFM Cooling CFM Cooling CFM Min. CFM (VAV only) Heating CFM Cooling CFM VAV 3201 12 167 n/a 650 170 226 1 8 190 70 175 175 226 2 8 190 170 190 190 201 3 8 190 390 190 190 224 4 6 40 25 41 223 5 6 40 225 40 41 TOTALS 167 0 650 -880 636 0 170" 40 0 325 636 280 VAV 3202 10 170 325 825 170 243 1 12 275 65 200 230 244 2 12 275 110 290 230 280 245 3 12 275 70 190 1 245 275 TOTALS 170 325 825 245 680 705 170 325 835 VAV 3203 12 150 325 600 150 325 201 1 10 200 180 210 210 202 2 10 200 240 220 220 203 3 10 200 260 220 220 TOTALS 150 325 600 680 650 0 150 325 650 VAV 3204 8 150 155 310 150 155 204 1 8 155 200 180 204 2 8 155 190 170 TOTALS 350 I 155 310 390 0 0 150 155 350 VAV 3205 12 130 325 650 130 325 205 1 12 325 110 220 325 205 2 12 325 115 230 340 TOTALS Ramnrke 1 AH --A;--- .. 130 . c_ 325 650 225 450 0 130 325 665 —Min. CFM =15 CFM per person/seat or .15 per sq. ft. whichever is greater. —Heat CFM =35 CFM per sq. ft. (typical) Cool CFM =1.5 CFM per sq. ft. interior, 2.5 CFM per sq. ft. exterior (typical) e oaf � d?e Ysm©. .BuddingConfdence�& 1300 Galway Way ##9 Concord, California 94520 (926)356-3040 + Fax:{925}356-3004 License#450929 Project: Location: Instruments Used: VAV SYSTEM AIR BALANCE REPORT Sugar CRM Job No. B1602 Date: 10/13/16 10050 Wolfe Rd. Cupertino, Ca System: Alnor Balometer Tested by: Justin Haines ROOM AREA SERVED No. Size (duct) REQUIRED PRELIMINARY FINAL Min. CFM (VAV) Heating CFM Cooling CFM Cooling CFM Cooling CFM Cooling CFM Min. CFM i VAV only) Heating CFM Cooling CFM VAV 3206 12 235 580 1160 235 580 220 1 12 280 175 120 280 220 2 12 280 53 126 295 206 3 6 40 25 35 207 4 12 280 120 120 45 207 5 12 280 125 125 275 TOTALS 235 580 1160 498 526 0 235 290 580 1200 1185' 2400 VAV 3207 14 480 1200 2400 480 216 1 12 300 83 122 300 215 2 12 300 127 130 295 214 3 12 300 135 120 300 213 4 12 300 100 127 300 212 5 12 300 137 125 305 211 6 12 300 75 125_ 300 207 7 12 300 151 125 300 207 8 14 300 1 150 120 300 TOTALS 480 1200 2400 958 994 0 480 1200 4800 VAV 3208 10 125 310 615 125 310 217 1 12 615 313 625 TOTALS 125 310 615 313 0 0 125 310 625 VAV 3209 14 325 815 1620 325 815 218 1 12 405 245 160 440 218 2 12 405 78 155 410 218 3 12 405 164 158 405 218 4 12 405 110 155 405 TOTALS 325 815 1620 597 628 0- 325 815 1660- VAV 3210 14 195 450 900 195 450 232 1 14 440 125 400 1 440 LOBBY 2 12 230 80 195 215 LOBBY 3 12 230 80 200 230 TOTALS Rom.A4 - All A7.. A.. :.ti. ;9757 L_ 450 900 285 795 0 195 450 885 •••b� —v 1011 aL iVUZO k11114# d11U viAv 51uV%open. -Min. CFM =15 CFM per person/seat or .15 per sq. ft. whichever is greater. -Heat CFM =35 CFM per sq. ft. (typical) -Cool CFM =1.5 CFM per sq. ft. interior, 2.5 CFM per sq. ft. exterior (typical) ,, L3 Ar,-- sYsfiEMS ...Building Confidences: 1300 Galaxy Way #9 Concord, California 94520 (925) 356-3000 + Fax: (925) 356-3004 License # 450929 Project: Location: Instruments Used: VAV SYSTEM AIR BALANCE REPORT Sugar CRM Job No. B1602 Date: 10/13/16 10050 Wolfe Rd. Cupertino, Ca System: Alnor Balometer Tested by: Justin Haines ROOM AREA SERVED No. Size (duct) REQUIRED PRELIMINARY FINAL Min. CFM (VAV) Heating CFM Cooling CFM Cooling CFM Cooling CFM Cooling CFM Min. CFM (VAV only) Heating CFM Cooling CFM VAV 3211 14 300 700 1400 300 700 340 233 1 14 350 210 230 233 233 2 3 14 14 350 350 170 250 250 250 370 365 233 4 14 350 320 250 360 TOTALS 300 1 700 1400 950 980 0 300 700 1435 VAV 3212 12 130 325 650 130 320 234 1 12 325 90 120 330 234 1 12 325 140 120 320 TOTALS 130 1 325 650 230 240 0 130 320 650 VAV 3213 16 295 735 1465 295 740 235 1 14 490 386 390 500 235 2 14 490 390 390 510 235 3 14 490 360 370 490 TOTALS 295 735 1470 1136 1150 0 295 740 1500 VAV 3214 8 95 235 470 95 235 236 1 10 235 150 175 240 236 2 10 235 210 180 230 TOTALS 95 235 470 360 355 0 95 235 470 VAV 3215 8 100 250 500 100 250 237 1 10 250 100 220 220 238 2 10 250 105 230 230 TOTALS RemI— All 100 250 1 Soo 205 450 0 100 250 450 ar readings done with AM fan at 100% (77hz) and VAV's 100% open. -Min. CFM =15 CFM per person/seat or .15 per sq. ft. whichever is greater. -Heat CFM =35 CFM per sq. ft. (typical) Cool CFM = 1.5 CFM per sq. ft. interior, 2.5 CFM per sq. ft. exterior (typical) `` A—'f l o SYSTEMS .. Building Confidenceg 1300 Galaxy Way #9 Concord, California 94520 (925} 356-3000 Fax: (925) 356-3004 License # 450929 Project:, Location: Instruments Used: Sugar CRM Job No. B1602 10050 Wolfe Rd. Cupertino, Ca System: Alnor Balometer VAV SYSTEM AIR BALANCE REPORT Date: Tested by: Justin Haines 10/13/16 ROOM AREA SERVED No. Size (duct] REQUIRED PRELIMINARY FINAL Min. CFM (VAV) Heating CFM Cooling CFM Cooling CFM Cooling CFM Cooling CFM Min. CFM (VAV only) Heating CFM Cooling CFM VAV 3216 12 130 325 650 132 325 240 1 10 325 420 270 320 241 2 10 325 135 260 325 TOTALS 130 325 650 555 530 0 132 325 645 VAV 3217 10 100 250 500 1 100 250 242 1 12 250 315 260 242 2 12 250 340 265 TOTALS 100 250 Soo 655 0 0 100 250 525 VAV 3218 14 210 525 1050 210 525 235 1 12 350 280 350 235 2 12 350 260 345 235 3 12 350 280 350 TOTALS 210 525 1050 820 0 0- 210 525 1045 VAV 3220 14 225 550 1100 225 550 235 1 10 255 250 230 270 235 2 10 255 112 130 250 235 3 10 255 190 230 265 235 4 10 255 220 250 275 227 5 6 40 85 40 40 228 6 6 40 90 42 42 TOTALS 225 550 1100 947 922 0 225 550 1142 VAV 3221 14 450 735 1470 450 735 235 1 12 1 240 240 235 1 370 235 2 12 240 265 245 255 235 3 12 240 190 200 240 235 4 12 240 250 1 240 240 235 5 12 240 160 170 239 235 6 12 240 80 120 215 231 1 7 6 40 35 37 37 TOTALS 1 450 735 1480 1 1220 1 1247 0 450 735 1 1596 nemaMb. Au feadings gone witn AHU Tan at iW% (77hZ) and VAV"s 1UU% open. -Min. CFM =15 CFM per person/seat or .15 per sq. ft. whichever is greater. -Heat CFM = .75 CFM per sq. ft. (typical) -Cool CFM =1.5 CFM per sq. ft. interior, 2.5 CFM per sq. ft. exterior (typical) 'A VAV SYSTEM aCIP? it ' ,r � ? r [ il�,e SYSTUMS ... BUildingConficleneea AIR BALANCE REPORT 1300 Galaxy Way #9 Concord, California 94520 (925) 356-3000 • Fax: (925) 356-3004 License # 450929 Project: Sugar CRM Job No. B1602 Date: 10/13/16 Locations 10050 Wolfe Rd. Cupertino, Ca System: Instruments Used: Alnor Balometer Tested by: Justin Haines ROOM AREA SERVED w. No. Size (duct) REQUIRED PRELIMINARY FINAL Min. CFM (VAV) Heating CFM Cooling CFM Cooling CFM 1 .Cooling CFM Cooling CFM . MinCFM (VAV only) Heating CFM Cooling CFM VAV 3222 1 14 240 n/a 1150 240 220 1 10 250 290 215 260 220 2 10 250 130 220 270 220 3 10 250 240 216 250 221 4 8 150 130 125 165 220 5 10 250 100 208 255 TOTALS 240 0 1150 890 984 0240 0 1200 VAV 3223 16 570 n/a 1670 570 220 1 12 335 270 280 335 220 2 12 335 245 285 350 220 3 12 335 210 278 335 208 4 6 30 45 28 35 209 51 6. 30 35 30 30 210 6 10 270 80 150 270 TOTALS 570 0 1335 88S 1051 0 570 0 1355 VAV 3224 10 150 300 600 150 300 219 1 10 210 160 192 220 219 2 10 1 210 220 188 215 TOTALS 150 300 420 380 380 0 150 300 435 FCU 1275 MDF 1 12 425 425 MDF 2 12 425 425 MDF 3 12 425 425 TOTALS 0 0 1275 0 0 0 0 0, 1275 TOTALS 0 0 0 0 0 0 0 0 0 An +eadmga dune w¢n AHU ran at lu07o(//nz) and vAv's 1UUYo open. `Min. CFM =15 CFM per person/seat or .15 per sq. ft. whichever is greater. Heat CFM =.75 CFM per sq. ft. (typical) Cool CFM =1.5 CFM per sq. ft. interior, 2.5 CFM per sq. ft. exterior (typical) CERTIFICATE OF ACCEPTANCE ae (PageI ofA NA7.5.1 Outdoor Air Acte tauce e of 3 Project Name/Address: Sugar CRM 10050 N. Wolfe Rd. Ctzpert:ino, CA 95014 System Name or Identiiication/Tag: system Location or Area Served: FIELD TECHNICIAN'S DECLARATION STATEMENT s 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 the person who performed the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I certify that the construction/installation identified on this form 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 NAT • I have confirmed that the Installation Certificate(s) for the constructiontinstallation identified on this form has been completed and is °.-._:,_Lt .."a. It t' ;1.4; � � -littcw iced fir the building. postcu of Inaurz aV al — P — .. u- vu..u...t, 1.........1.., _._.._ _ _-- .---- _. r Company Name: Bay Air Systetns, Inc- FieW echnician' e: Fiel chnic'an's Si a re Date Signed: Position With Company RESPONSIBLE PERSON'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, that 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 form. 0 I aun a licensed contractor, architect, or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for lire scope of work specified on this document and attest to the declarations in this statement (responsible person). • I certify that the information provided on this form substantiates that die construction/installation identified on this form 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. • I have confirmed that the Installation Certificate(s) for the constructionlinstallation identified on this form has been completed and is posted or made available with tfre building permit(s) issued for the building. I will ensure that a Fompleted, 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 —nCR._.. - -r A. n..erJ — :c --;—A tn he inchaded with the documentation the builder provides to the building owner at occupancy. 2008 NonresidentialAcceptance Forms August 2009 CERTIFICATE OF ACCEPTANCE MECH-2A NA7.5.1 Outdoor Air Acceptance (Page 2 of 3 Project Name/Address: Sugar CRM 10050 N. Wolfe Rd. Cupertino, CA 95014 System Name or Identification/Tag: System Location or Area Served: Intent: Verify measured outside air, floiv reading is within f 10% of the total required outside airflow value found in the Standards Mechanical Plan MECH--3C, Column H or Column 1, per NA7.5.1. 1 Instrumentation to perform test includes, but not limited to: a. Watch b. Calibrated means to measure airflow 2 Chec one of the following: Variable Air Volume (VAV) - Check as appropriate: a• Sensor used to control outdoor air flow must have calibration certificate or be field calibrated Calibration certificate (attach calibration certification) ❑ Field calibration (attach results) p Constant Air Volume (CAV) - Check as appropriate: ❑ System is designed to provide a fixed minimum OSA when the unit is on NA7.5.1.1 Outdoor Air Acceptance A. Functional Testing (Check appropriate column) CAV VAV a. Verify unit is not in economizer mode during test - check appropriate column Step 1: CAV and VAV testing at full supply airflow a. Adjust supply to achieve design airflow b. Measured outdoor airflow reading (cfm) c. Required outdoor airflow (cfm) (from MECH--3C, Column 1) d. Time for outside air damper to stabilize after VAV boxes open (minutes) e. Return to initial conditions (check) Step 2: VAV testing at reduced supply airflow a. Adjust supply airflow to either the sum of the. minimum zone airflows or 30% of the total design airflow b. Measured outdoor airflow reading (cfm) I c. Required outdoor airflow (cfm) (forn MECH-3C Column 1) d. Time for outside air damper to stabilize after VAV boxes open and minimum air flow achieved (minutes) e Cil ► e. Return to initial conditions (check:) B. Testing Calculations & Results CAV VAV Percent OSA at full supply airflow(%aOAFA for Step 1) a. %OAFA = Measured outside air reading /Required outside air (Step) b/Step 1c) % q4 % b. 90% <%OAFA < 110% Y I N N c. Outside air damper position stabilizes within 15 minutes (Step Id < 15 minutes) Y 1 N Y 1 N Percent OSA at reduced supply airflow (%OARA for Step 2) - a. %OARA =Measured outside air reading /Required outside air (Step2b/Step2c) % % b. 90% _< %OARA !� 110% N c. Outside air damper position stabilizes within 15 minutes (Step 2d < 15 minutes) I N Note: Shaded boxes do not apply for CAV systems 2008 Nonresidential Acceptance Forms August 2009 CERTIFICATE OF ACCEPTANCE IYIECH-2A NA7.5.1 Outdoor Air Acceptance Pa e 3 of 3 Project Name/Address: Sugar CRM 10054 N. Wolfe Rd. Cupertino, CA 95014 System Name or Identification/Tag: System Location or Area Served: C. PASS / FAIL Evaluation (check one): PASS: All Construction Inspection responses are complete and Testing Calculations & Results responses are positive (Y - yes) p - FAIL:. Any Construction Inspection responses are incomplete OR there is one or more negative (N - no) responses in Testing Calculations & Results section. Provide explanation below. Use and attach additional pages if necessary. 2008 Nonresidential Acceptance Forms Augnst 2009 CERTIFICATE OF ACCEPTANCE MECH-7A NA7.5.6 Supgly Fan VFD Acce tance a e 1 of 2 Project Name/Address: Sugar CRM 10050 N. Wolfe Rd. Cupertino, CA 95014 System Name or Identification/Tag; System Location or Area Served: Enforcement Agency: Permit Number: Note: Submit one Certificate of Acceptance for each system that must demonstrate compliance. Enforcement Agency Use! Checked by/Date FIELD TECHNICIAN'S 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 the person who performed the acceptance requirements verification reported on this Certificate of Acceptance (Field Technician). • I certify that the construction/installation identified on this form 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. • I,have confirmed that the Installation Certificate(s) for the construction/installation' identified on this form has been completed and is posted or made available with the building permit(s) issued for the building. Company Name: Bay Air Systems, Inc. Field Tec i ian's Name:Field -'-2b e ician's S' e: Kr) -P --j Mon I License: Date Signed: Po " ' n With Company (Title) - -- - -- ) - l- - , RESPONSIBLE PERSON'S DECLARATION STATEMENT • I certify under penalty of perjury, under the laws of the State of California, that 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 form. • I am a licensed contractor, architect, or engineer, who is eligible under Division 3 of the Business and Professions Code, in the applicable classification, to take responsibility for the scope of work specified on this document and attest to the declarations in this statement (responsible person). • I certify that the information provided on this form substantiates that the construction/installation identified on this form 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. • I have confirmed that the Installation Certificate(s) for the construction/installation identified on this form has been completed and is posted or made available with the building perinit(s) issued for the building. • 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. Company Name: hone: Bay Air Systems., Inc. Resp 'ble Person's t�pn MUM Resp s' le Person's Sign License: to Signed: —� In Pos' ' �iththCompan (Title): Trvo o 2008 Nonresidential Acceptance Forms August 2009 i CERTIFICATE OF ACCEPTANCE MECH-7A NA7.5.6 Sue& Fan WD Acce tance (Page 2 of 2 Project Name/Address: Sugar CRM 10450 N. Wolfe Rd. Cupertino, CA.95014 System Name or Identification/Tag: System Location or Area Served: Intent Verb that the supply fan in a variable air volume application modulates to meet system abyfow demand Construction Inspection 1 Instrumentation to perform test includes, but not limited to: a. Calibrated differential pressure gauge 2 Installation �( Discharge static pressure sensors are either factory^calibrated or field -calibrated. The static pressure location, setpoint, and reset control meets the requirements of Standards section 144(c)2C 3 Documentation of all discharge static pressure sensors including (check one of the following): Flibrated 7Idzlibration complete, all pressure sensors within 10% of calibrated reference sensor A. Functional Testing Results Step 1: Drive all VAV boxes to achieve design airflow a. Supply fan controls modulate to increase capacity Y / N b. Supply fan maintains discharge static pressure within +/-10% of the current operating set point. Y N c. Supply fan controls stabilize within a 5 minute period. Y N Step 2: Drive all VAV boxes to minimum flaw a. Supply fan controls modulate to decrease capacity.Y N b. Current operating setpoint has decreased (for systems with DDC to the zone level). Q Y)/ N c. Supply fan maintains discharge static pressure within -t/-10% of the current operating setpoint. _ f N d. Supply fan controls stabilize within a 5 minute period. Y 'N Ste 3: System returned to initial operating conditions Y B. Testing Results PASS / FAIL Step 1; Drive all VAV boxes to achieve design airflow Step 2: Drive all UAV boxes to minimum flow C. PASS / FAIL Evaluation (check one): PASS: All Construction Inspection responses are complete and all Testing Results responses are "Pass" Ej FAIL: Any Construction Inspection responses are incomplete OR there is one or more "Fail' responses in Testing Results section. Provide explanation below. Use and attach additional pMes if necessary. 2008 Nonresidential Acceptance Forms xlugztst 2009