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B-2017-0554
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0554 20745 STEVENS CREEK BLVD CUPERTINO, CA 95014 (326 32 055) METRO TECH SERVICE CORP SCHAUMBURG, IL 60173 OWNER'S NAME: PCG CUPERTINO LLC 100% DATE ISSUED: 04/10/2017 OWNER'S PHONE: 408-725-2651 PHONE NO: (800) 886-7667 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class 1224 Lic. #739184 Contractor METRO TECH SERVICE CORP Date 08/31/2017 X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing X MECH _ RESIDENTIAL X COMMERCL4,L with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: TARGET - T.I. - REPLACE ROOFTOP HVAC UNIT I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the 'performance of the work for which this permit is issued. 2. -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 Sq. Ft Floor Area: Valuation: $15000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 326 32 055 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 granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 4/10/2017 Issued by: AbbyAyende OWNER -BUILDER DECLARATION Date: 04/10/2017 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. 1, 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 (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 4/10/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOYCOVERINGS TO BE CLASS "A" OR BETTER 1. 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit 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 & 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 performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Co e, 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: e v APPLICANT CERTIFICATION Date: 4/10/2017 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws 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. be used a public I understand my plans shall be used as public records. Licensed Signature Date 4/1.0/2017 professional '-zo1`�-ussq GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINOg MPLUMBING I yIMECFIANICAL nFT.F('.TRTCAT, MK( -PTT AM-PnTTc (408) ?77-3228 •FAX (408) 777-3333 • buildina(a�cupertino.ar PROJECT ADDRESS �� l �� f' 9� g \ eVea7 ((fJ APN # L):.E� OWNER NAME ,p��cAe� v' Y� PHOT L'r__ ^/ �G� J4_AL ( G ' STREET ADDRESS � SF��&-)� g CITY, S Tj, ZIP,, FAX CONTACT N PHONE�j ^ j ^� � E-MAIL STREET ADDRESS CITY, STATE, ZIP ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME a P1^ LIC ENSE NRI �t ` l ( LICENSE TYPEs�!a (�J BUS. LIC # , (h� 1\ 0 COMPANY NAME E-MAIL FAX STREET ADDRESS ��s yp�, `t✓i L1 iV CITY, STA&ZpIP a l✓�CiU°+�/�+�d V PHONE ARCHITECT/ENGINEER NAME LIC SE NUMBER BUS. LIC a COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, 'LIP PHO NE USE OF ❑ sFD or DUPLEX ❑ MULTI -FAMILY BUILDING: OMMERCIAL PROJECT IN WIL.DLAND ❑ YES URBAN INTERFACE AREA NO PROJECT IN 171 YES FLOOD ZONE ' NO IS THE BLDG AN ❑ 77ES EICHLER HOME? K NO DESCRIPTION OF WORK TOTAL VALUATION: C� RECEIVEDBY:. By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behal I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rela � > uilding cons tion. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicanbAgent: Date: I-� lti t i SUPPLEMENTAL INTFO ATION REQUIRED a'® - _ ,`1 `+3""ve,D Y OFFICE vsE ONLY ❑ OVER-THE-COUNTER __ ❑_ EXPRESS ❑ STANDARD - ❑ °LARGE ❑ *j6R MEPMiscApp_201 1. doc revised 06/21/11 lL pJYlryli The Roof Reinforcer TITLE 24 REPORT for HVAC REPLACEMENT Target 323 20745 Stevens Creek Blvd, Cupertino, CA 95014 Prepared for Brie Baltes MetroTech HVAC www.TheRoofReinforcer.comIII°°) E 11 11140 434 B. Main StreetB, Ventura, CA 9300 �IIqI) e p a r'I:IllameIn'i' ILEIUUEU':'.':U:) F U'3 CODE CONA[I[JANCE Date� 04110117 Main (805) 648-8949 I TABLE OF CONTENTS I Cover Page 1 Table of Contents 2 Form CXR -01-E Cx Design Review Kickoff 3 Form CXR -03-E Cx Construction Documents -Simple HVAC Systems 5 Form CXR -05-E Cx Design Review Signature Page 7 Form MCH -01-E Prescriptive - Mechanical Systems 9 Form MCH -02-E Prescriptive - HVAC System Requirements 13 Form MCH -03-E Prescriptive - Mechanical Ventilation and Reheat 16 Form MCH -04-E Prescriptive - Required Acceptance Tests 18 Form MCH -05-E Prescriptive - Requirements for Packaged Single Zo 21 Zone Load Summary 23 CUI�IEI�I 11140 1I°°I3Uii III Iihn I1'° III rfi n nt � EnergyPro 7.1 by EnergySoft Fi EWEMI � �P � V � � ..� � � .w.� User Number: 5308 evuewed ByAAird L........ oliei STATE OF CALIFORNIA DESIGN REVIEW KICKOFF rll' CEC-NRCC-CXR-01-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-CXR-01-E Design Review Kickoff (Page 1 of 2) Project Name: Target 323 Date Prepared: 17 -Mar -1 7 A. GENERAL INFORMATION Climate Zone: Building Type: Conditioned Floor Area (ft): Reviewer's Name: Reviewer's Agency: Enforcement Agency: Permit Number: Enforcement Agency Use: Checked by Enforcement Agency Use: Date B. DATE OF DESIGN REVIEW KICKOFF C. DESIGN REVIEW CHECKLISTS PROVIDED TO DESIGN TEAM YES p NO 0 D. DESIGN REVIEWER QUALIFICATIONS: 10,000 ft2: design engineer or architect 10,000 ft2 and <50,000ft2: in-house engineer or architect with no other project involvement or a third party engineer, architect, or contractor oaS0,000 ft2 or complex mechanical system serving > 10,000 ft2: third -party engineer, architect, or contractor E. LIST OF MEETING ATTENDEES: ❑Owner: ❑ ❑ Design Reviewer: ❑Project Manager: o❑Design Architect/Engineer(s): F. DOCUMENTS RECEIVED BY DESIGN REVIEWER FOR DESIGN REVIEW KICKOFF: ❑Owner's Project Requirements O Basis of Design or Narrative ❑Drawing Set (issue & date): _ o❑Specifications: ❑ Other: _ G. DESIGN REVIEW MEETING TOPICS: PROJECT SCOPE: DESIGN ELEMENTS AND ASSUMPTIONS: HVAC SYSTEM SELECTION: LIGHTING SYSTEM SELECTION: RECOMMENDED ENERGY EFFICIENCY MEASURES: OTHER COMMENTS: IIEIIl 11140 H. •••D • TARGET CONSTRUCTION DOCUMENT REVIEW DAT TARGET PERMIT SUBMITTAL DATE: -LLCLLILIL IL ILLV I LlIL ILLLILLLIL .1 CA Building Energy Efficiency Standards - 2016 Non reaiwarrOi° T oIIT111111777-- January 2016 DatEb; ,i./'fin/1 STATE OF CALIFORNIA DESIGN REVIEW KICKOFF ri CEG-NRCC-CXR-01-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-CXR-01-E Design Review Kickoff (Page 2 of 2) Project Name: Target 323 Date Prepared: 17 -Mar -17 DOCUMENTATION AUTHOR/RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. S. I will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Person Name: Gabrielle Baltes Responsible Person Signature: 1 L (1 „, � Company. Metro Tech Service Corp Date Signed: 4/4/2017 Address: 1827 Walden Office Walden #304 License: 739184 City/State/Zip: Schaumburg, IL 60173 Phone. 855-344-7515 ext. 763 CUI�'El�l 11140 1I°°I° Iii III Iii u1i I1 e 111 e v'fiir ree ISA VIIII.1 11•IID I•LIIE CODE COCA IIII2II.II II CIIIw. CA Building Energy Efficiency Standards Nonre January 2016 �9 eMIaMl"fd I"""""If1i DatEg: 0,i./I n/I STATE OF CALIFORNIA CONSTRUCTION DOCUMENTS M CEC-NRCC-CXR-03-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-CXR-03-E Construction Documents (Page 1 of 2) Project Name: Target 323 Date Prepared: 17 -Mar -17 A. General Information Climate Zone: Building Type: Conditioned Area (ft): Reviewer's Name: Reviewer's Agency: Note: Design Review for each system/subsystem must be submitted Enforcement Agency: Permit Number: Enforcement Agency Use: Checked by Enforcement Agency Use: Date B. Design Review Checklist Design Reviewer Designer Response z a C° `—' a, a, 3 O 3 m Code Measure Section c U � OO M i E 2 C X O y vi p v rn d U Z 0 ?j Z H SIMPLE HVAC SYSTEMS DESIGN - FAN SYSTEMS Measured outdoor air rates of constant volume mechanical 120.1(e)3 ventilation and space conditioning systems shall be within 10% of required outside air rate. Fan power index at design conditions meets the following: 0.8 W/cfm 140.4(c)1 supply air for constant volume fan systems with total horsepower over 25 hp. Best Fans appear to be correctly sized for application, accounting for a Practices factor of safety, diversity and redundancy issues. CONTROLS 110.2(c) Controls for unitary single zone, air conditioners, heat pumps and furnaces must have a setback thermostat. Cooling systems identified in Table 140.4-D have fan controls to vary the indoor fan airflow as a function of load: 1. DX and chilled water cooling systems that control capacity based on occupied space temperature have a minimum of 2 stages of control with no more than 66% speed operating at stage 1 and 140.4(m) draw no more than 40% of fan power at full fan speed when operating at 66% speed. 2. Systems that control space temperature by modulating airflow to the space have proportional fan control such that at 50% air flow the power draw is no more than 30% of fan power at full fan speed. 3. Systems with air side economizer have a minimum of 2 speeds of fan control during economizer NOTES elll 1 elllaartijI"eiee . u•^G t. L/ II II • -VY II'.'. 1112 II L..) IIS L... L II L II'. 6... L LILV II°' V... I LL IILV L..II'.'. CA Building Energy Efficiency Standards - 2016 Nonre e�rILS?Iia l"") """"""s""II January 2016 I/ atEb; ,i./'fin/l 7 STATE OF CALIFORNIA CONSTRUCTION DOCUMENTS M CEC-NRCC-CXR-03-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-CXR-03-E Construction Documents (Page 2 of 2) Project Name: Target 323 Date Prepared: 17 -Mar -17 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Tailored Energy and Testing Services Lb Documentation Author Signature: ' Company: Kevin Laughton Signature Date: 17 -Mar -17 Address: PO BOX 7775 #30051 CEA/ HERS Certification Identification (if applicable): City/state/zip: San Francisco, CA 94120-7775 Phone Toll Free (888) 310 0808 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. S. I will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Person Name: Gabrielle BalteS Responsible Person Sinature: .. Company: Metro Tech Service Corp Date Signed. 4/4/2017 Address. 1827 Walden Office Sq #304 License: 739184 City/State/Zip:' Schaumburg, IL 60173 Phone 855-344-7515 ext. 763 CUI�'El�l 11140 1I°°Iteliilllr Iijlji I13ellyavtijjirieet ISA VIIII.1 11•IID I•LIIE CODE C01I1IM112l1I All CIIIw. CA Building Energy Efficiency Standards Nonre January 2016 /9I/e ?iMlifd I"""""If1i D a tEg: 0, i./'I 0/'I STATE OF CALIFORNIA COMMISSIONING - DESIGN REVIEW SIGNATURE PAGE R-0-01, CEC-NRCC-CXR-05-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-CXR-05-E Commissioning - Design Review Signature Page (Page 1 of 2) Project Name: Target 323 Date Prepared: 17 -Mar -17 A. General Information Climate Zone: Building Type: Conditioned Floor Area (ft2): Reviewer's Name: Reviewer's Agency: Enforcement Agency: Permit Number: Enforcement Agency Use: Checked by Enforcement Agency Use: Date 120.8(d): DESIGN REVIEW B. Date of Design Review Kickoff Owner/Owner's Representative (Print Name): Signature: Date: Design Architect/Engineer (Print Name): Signature: Date: Design Reviewer (Print Name): Signature: Date: C. Date of Construction Document Checklist Checklists Completed: General Checklist - Completed by all Buildings 13 HVAC Simple 13 HVAC Complex p Owner/Owner's Representative (Print Name): Signature: Date: Design Architect/Engineer (Print Name): Signature: Date: Design Reviewer (Print Name): Signature: Date: IIEIIl 11140 1I°°I° e lii lldI ijja I1'° e llya r ui ee t 112EVIIII.1 11•IID I•LIIE CODE C01II II2II.II II CIIIw. CA Building Energy Efficiency Standards - 2016 Nonre ILS?Iw"f) """""f1""II January 2016 DatEb; ,I./'i /'i STATE OF CALIFORNIA COMMISSIONING — DESIGN REVIEW SIGNATURE PAGE R-0-01, CEC-NRCC-CXR-05-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-CXR-05-E Commissioning - Design Review Signature Page (Page 2 of 2) Project Name: Target 323 Date Prepared: 17 -Mar -17 DOCUMENTATION AUTHOR/RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be 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 complel Df this Certificate of Compliance is required to be included with the documentation the builder provides to the building o icy. Responsible Person Name: Tailored Energy and Testing Services Lt'Responsible Person Signature: company : Date Signed: Kevin Laughton 17 -Mar -17 Address: PO BOX 7775 #30051 License: city/State/zip:San Francisco, CA 94120-7775 Phone: Toll Free (888) 310 0808 CUI�'El�l 11140 1l°°Iteliilllr Iijla I13ellyartuieeet 112EVIIII.WII IID I•LIIE CODE C01II II2II.II II CIIIw. CA Building Energy Efficiency Standards Nonre January 2016 Ie ? w "fd I"""""If1i DatEb; ,i./'i /'i \ u \ / � \ k \ ( \ \ k \ \ / \ _ _ « 8 \ / ®/ 0 » 8 < a a / \ \ \ \ c = = s = 2 a a a/ \ \ 2 \ \ § \ $ 3 ® 2 \ 2 0 a® ra u t< < \ % § \ t \ —/ z u $ \ \ E 7a \ N k \ \ \ 2 c u u •§ k 7 s rara 7 E _ ® _ J } § e / ( ( ( u < u < ' 7 \ \ \C.0? % 7 7 / u E \ k\ j JV)( J # _ i/ § 2 § / & & u u ° E § 5 J J o ( ( ( \: — / % % / \ ® . - . - . - , - _ _ \ . 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H O c L v a c o - O - a2 E -i U N Z O v v .� 5 *' a C: -0 N U /6 N Z+ Z c O 7 aJ r-+ U+ a Z � O 0 W O aJ � O W N v r6 2r -W r 5 W O E '� on *'' aJ N O O 2 m 00 aj .� Ln Zw a CO aJ c c aJ u o Q Q H na aJ o Y —_ c iv aiLU U c > Y Z aJ E N aJ c aJ aJ L l6 aJ LO t O W m ? \ v V— E o a o v �n \ "� d H LU v O fl a E i \ 0 c 0 u Q U = -i N M u'1 z U Q U 1 0 N L ro7 ro c E O v STATE OF CALIFORNIA HVAC DRY & WET SYSTEM REQUIREMENTS ri CEC-NRCC-MCH-02-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Dry & Wet System Requirements (Page 1 of 3) Project Name: Target 323 Date Prepared: 17 -Mar -17 A. - ar- A. Equipment Tags and System Description' - Dry Systems HVAC new MANDATORY MEASURES T-24 Sections Reference to the Requirements in the Contract Documentsz Heating Equipment Efficiency3 110.1 or 110.2(a) Cooling Equipment Efficiency3 110.1 or 110.2(a) HVAC or Heat Pump Thermostats 110.2(b), 110.2(c) Furnace Standby Loss Control 110.2(d) Low Leakage AHUs 110.2(f) Ventilation 120.1(b) Demand Control Ventilations 120.1(c)4 Occupant Sensor Ventilation Contro16 120.1(c)5, 120.2(e)3 Shutoff and Reset Controls' 120.2(e) Outdoor Air and Exhaust Damper Control 120.2(f) Isolation Zones 120.2(g) Automatic Demand Shed Controls 120.2(h) Economizer FDD 120.2(i) Duct Insulation 120.4 PRESCRIPTIVE MEASURES Equipment is sized in conformance with 140.4(a & b) Y Y/N Y/N Y/N 140.4(a & b) Supply Fan Pressure Control 140.4(c) Simultaneous Heat/Cool 140.4(d) Economizer 140.4(e) Heat and Cool Air Supply Reset 140.4(f) Electric Resistance Heating9 140.4(g) Duct Leakage Sealing and Testing10 140.4(1) Notes: 1. Provide equipment tags (e.g. AHU 1 to 10) and system description (e.g. Single Duct VAV reheat) as appropriate. Multiple units with common requirements can be grouped together. 2. Provide references to plans (i.e. Drawing Sheet Numbers) and/or specifications (including Section name/number and relevant paragraphs) where each requirement is specified. Enter "N/A" if the requirement is not applicable to this system. 3. The referenced plans and specifications must include all of the following information: equipment tag, equipment nominal capacity, Title 24 minimum efficiency requirements, and actual rated equipment efficiencies. Where multiple efficiency requirements are applicable (e.g. full- and part -load) include all. Where appliance standards apply (110.1), identify where equipment is required to be listed per Title 20 1601 et seq. 4. Identify where the ventilation requirements are documented for each central HVAC system. Include references to both central unit schedules and sequences of operation. If one or more spaces is naturally ventilated identify where this is documented in the plans and specifications. Multiple zone central air systems must also provide a MCH -03-E compliance document. 5. If one or more spaces has demand controlled ventilation identify where it is specified including the sensor specifications and the sequence of operation. 6. If one or more space has occupant sensor ventilation control identify where it is specified including the sensor specifications and the sequence of operation 7. If the system is DDC identify the sequences for the system start/stop, optimal start, setback (if required) and setup (if required). For all systems identify the specification for the thermostats and time clocks (if applicable). 8. Identify where the heating, cooling and deadband airflows are scheduled for this system. Include a reference to the specification of the zone controls. Provide a MCH -03-E compliance document. 9. Enter N/A if there is no electric heating. Im has electric heating indicate which exception to 140.4(g) applies. 10. If duct leakage sealing and testing is requ H-0 aE, ment must be submitted. 1°113eliilldhjja I1'° ellyartijj eet CA Building Energy Efficiency Standards - 2016onresiden ial i January 2016 Newewe I/ atEg; ,i./I /I STATE OF CALIFORNIA HVAC DRY & WET SYSTEM REQUIREMENTS ri CEC-NRCC-MCH-02-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Dry & Wet System Requirements (Page 2 of 3) Project Name: Target 323 Date Prepared: 17 -Mar -17 B. Equipment Tags and System Description' — Wet Systems MANDATORY MEASURES T-24 Sections Reference to the Requirements in the Contract Documentsz Heating Hot Water Equipment Efficiency3 110.1 Cooling Chilled and Condenser Water 110.1, 140.4(i) Equipment Efficiency3 Open and Closed Circuit Cooling Towers 110.2(e) 1 conductivity or flow -based controls Open and Closed Circuit Cooling Towers Maximum Achievable Cycles of 110.2(e) 2 Concentration (LSI )6 Open and Closed Circuit Cooling Towers 110.2(e) 3 Flow Meter with analog output Open and Closed Circuit Cooling Towers 110.2(e) 4 Overflow Alarm Open and Closed Circuit Cooling Towers 110.2(e) 5 Efficient Drift Eliminators Pipe Insulation 120.3 PRESCRIPTIVE MEASURES Cooling Tower Fan Controls 140.4(h)2, 140.4(h)5 Y/N Y/N Y/N Cooling Tower Flow Controls 140.4(h)3 Centrifugal Fan Cooling Towers4 140.4(h)4 Air -Cooled Chiller Limitations 140.4(j) Variable Flow System Design 140.4(k) Chiller and Boiler Isolation 140.4(k) CHW and HHW Reset Controls 140.4(k) WLHP Isolation Valves 140.4(k) VSD on CHW, CW & WLHP Pumps >5HP 140.4(k) DP Sensor Location 140.4(k) Notes: 1. Provide equipment tags (e.g. CH 1 to 3) or system description (e.g. CHW loop) as appropriate. Multiple units with common requirements can be grouped together. 2. Provide references to plans (i.e. Drawing Sheet Numbers) and/or specifications (including Section name/number and relevant paragraphs) where each requirement is specified. Enter "N/A" if the requirement is not applicable to this system. 3. The referenced plans and specifications must include all of the following information: equipment tag, equipment nominal capacity, Title 24 minimum efficiency requirements, and actual rated equipment efficiencies. Where multiple efficiency requirements are applicable (e.g. full- and part -load) include all. For chillers operating at non-standard efficiencies provide the Kadj values. For chillers also note whether the efficiencies are Path A or Path B. 4. Identify if cooling towers have propeller fans. If towers use centrifugal fans document which exception is used. 5. If air-cooled chillers are used, document which exceptions have been used to comply with 140.4(j) and the total installed design capacity of the air-cooled chillers in the chilled water plant. 6. Identify the existence of a completed MCH -06-E when open or closed circuit cooling towers are specified to be installed, otherwise enter "N/A". CUI°IEIIl 11140 1I'°°I° eliilldhjja I1'° ellyarfi eet CA Building Energy Efficiency Standards - 2016 onresi en January 2016 ewewa^ I/ atEg: ,i./I /I STATE OF CALIFORNIA HVAC SYSTEM REQUIREMENTS CEC-NRCC-MCH-02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-MCH-02-E HVAC Wet System Requirements (Page 3 of 3) Project Name: Target 323 Date Prepared: 17 -Mar -1 7 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Tailored Energy and Testing Services L Documentation Author Signature: Company: Kevin Laughton Signature Date: 17 -Mar -17 Address: PO BOX 7775 #30051 CEA/ HERS Certification Identification (if applicable): City/State/Zip: San Francisco, CA 94120-7775 Phone. Toll Free (888) 310 0808 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the buildi g owner at occupancy. Responsible Designer Name: Gabrielle Baltes Responsible Designer Signature: Company. Metro Tech Service Corp Date signed: 4/4/2017 Address: 1827 Walden Office Sq #304 License: 739184 City/State/Zip: Schaumburg, IL 60173 Phone. 855-344-7515 ext. 763 CUI�IEI�l 11140 1l°°I1 e Iii III Iii uin I1'° e llya v,fi ern t ra�IL.• UP 1. vie e � CA Building Energy Efficiency Standards - 2016 onresid n ial � i nlc„� Iln""II January 2016 DatEg: 0,i./I n/I N tSTIdW00 LL LL Z LL LL Z LL LL Z LL LL Z LL LL Z LL LL Z LL LL Z MOIJUIV u m ONV9-OV30 XVW o (Wj0) > UIV 9NIOOD AVAUd a NDIS30 03SV9 tSTIdW00 LL LL Z LL LL Z LL LL Z LL LL Z LL LL Z LL LL Z LL LL Z a 1V3H3U Wf1WIXVW m u (Wj0) s ¢ UIV v 9NnoO0AUVWlad � N91S30 03SV9 39V1N3DU3d tSTIdW00 LL LL LL LL LL LL LL LL ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ z (Wj0) N N N MOIJUIV O p 1N3A O,03'd 0 ^W0ou p �n o m m A9 WjONIW 1NVdnDDo I� N A9 WjONIW I� r m - NOSU3d U3d AD u p N 31d03dj0,LNnN C0 N O N O O C) O o V3UVA9 WjDNIW I� N ¢ LO LO ¢ o V3UV U3d WjD NIVA N N z O O (z;}) O O V3UV O O o O O 03NOLI0NOD N r (Wj0) o MOIJUIV U3JSNVUi u w N (N/A) '^ w o D00 3dAl lUiND 7 w (WjD) u o MOIJUIV 9NliV3H z AUVWRld NDIS30 N (Wj0) L N a MOIJUIV j 0 m O ONV90V30 'a w C AUVWRld NDIS30 m C z T (Wj0) ++ O ^' o MOIJUIV 9NIIOOD *'' AUVWRld NDIS30 c z � m o O U v ¢ U m r, o 9V1 X09 AVA Q Q ¢ /W31SAS/3NOZ fn d � � O O d 3 � 1 a, N a a v : Q Q a c.o a v v a, Cl - 0 O o u - 7 - U fl_ aJ � Q F= -0 a1 E O o s Oa u — c v v ai ° c c U O Q £ aJ U a L O c a �� a, t c J c as v - M v a .5 a, _ > . t £ a c . v ,. ai Q .a a ai 3 N O00 9 O 110 f6 CL N a Q 00 Oo . 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