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15060030150(, 0 C) a, c> STATE OF CALIFORNIA SIGN LIGHTING M ;EC-NRCC-LTS-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page I of 5) Project Name: Date Prepared: S, Project Address: . t6l`'t(-)�� :S- C)9- NN -7,,A F.LVP. Location of Sign Pq Outdoor Signs 11 Indoor Signs Phase of Sign Construction 1:1 New Signs 0 Sign Alterations Type*of Lighting Control 0 New Lighting Controls 0 Replaced Lighting Controls IX Not Installi g Lighting Controls This Certificate of Compliance includes the following components (check all that apply) 0 Mandatory Measures (Lighting Controls) 0 Maximum Allowed Lighting Power EI Specific Lighting Sources 1. Mandatory Sign Lighting Controls NOTES: 1. The same responsible person may install both the sign lighting power and the sign lighting controls, or a different responsible person may install the sign lighting controls than the responsible person installing the sign lighting power. 2. The Mandatory Measures (sign lighting controls) are required for compliance with the sign lighting Standards. If the person responsible for installing the sign lighting power is not also responsible for the sign lighting controls, then the owner of the sign, general contractor, or architect shall be responsible to have the sign lighting controls installed. 3. If more than one person has responsibility for compliance, each responsible person shall prepare and sign a Certificate of Compliance and an Installation Certificate applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign the Certificate of Compliance Declaration Statement for the entire construction. la. statements of Responsibility: Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E shall complete Part Ia. Check Yes or No for all of the following statements: 1 have responsibility for installing the sign lighting controls 11 Yes, complete parts Ia and Ib of this form 11 No, complete part Ia of this form 2 There are no existing sign lighting controls and I will be installing compliant sign lighting controls 11 Yes 0 No 3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls 11 Yes 11 No There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and I will be 4 installing compliant sign lighting controls 13 Yes 0 No There are existing sign lighting controls that do not comply with the applicable provision of §110.9 and §130.3 and someone 5 else will be responsible to install compliant sign lighting controls 11 Yes 11 No CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 2 of 5) Project Name: Date Prepared: 1 b. Mandatory Sign Lighting Controls If the person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E is responsible for complying with the sign lighting control requirements, that person shall answer all of the following questions: If there are construction documents, indicate where on the building plans the mandatory measures (sign lighting control) note block can be located: §130.3(a)l. All indoor sign lighting is controlled with an automatic time -switch control or astronomical time- Y N I NA switch control. 11 0 0 §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA 2 switch control, or an astronomical time -switch control. 0 0 0 EXCEPTION to Section 130.3(a)2A: Outdoor signs in tunnels, and signs in large permanently covered outdoor y NA areas that are intended to be continuously lit, 24 hours per day and 365 days per year. El 0 §130.3(a)2B. All outdoor sign lighting that is ON both day and night is controlled with a dimmer that provides the ability to automatically reduce sign lighting power by a minimum of 65 percent during nighttime hours. Y N NA 3 Signs that are illuminated at night and for more than I hour during daylight hours shall be considered ON both 11 0 0 day and night. EXCEPTION to Section 130.3(a)2B: Outdoor signs in tunnels and large covered areas that are intended to be Y NA illuminated both day and night. 11 E3 §130.3(a)36 Demand Responsive Electronic Message Center Control. An Electronic Message Center (EMC) having a new connected lighting power load greater than 15 kW has a control installed that is capable of Y N N/A 4 reducing the lighting power by a minimum of 30 percent when receiving a demand response signal. EXCEPTION to Section 130.3(a)3: Lighting for EMCs that is not permitted by a health or life safety statute, Y NA ordinance, or regulation to be reduced by 30 percent. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING A 11104 CEC-NRCC-LTS-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 3 of 5) Project Name: Cb L-0 Wi;L6 6A rq Date Prepared: 2 -.Maximum Allowed Lighting Power Method of Compliance Certificate of Compliance and Field Inspection Energy Checklist Complete this part if there are signs using the maximum allowed lighting power method of compliance. (Complete part 3 of this Certificate of Compliance if there are signs using the Specific lighting sources method of compliance) A B . C D E F G H I i Symbol OrCode Description of the Sign OPTIONAL — Energy Verified Label (see instructions below) Allotted Watts Design Watts Complies Y/N Filed Inspector Check that sign complies to Za E X LU -0 X N M 3: CU 0 Z_ LU < a) C) (D V] 4m cu 'a E 0 U El E] A Symbol or code used on the plans (when plans are required) and other documents. B A description ofthe sign, or location ofsign on the building; and the location ofsign on construction documents. C OPTIONAL- Check this box only ifthis sign has a permanent, pre-printed, factory -installed, ENERGYVERIFIED label, confirming that the sign complies with the Section 140.8 ofthe California 2013 Title 24, Part 6 Standards, usingthe Maximum Allowed Lighting Power method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories (UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/lEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISC/IEC 17020. For signs with such an ENERGY VERIFIED label, columns 'D'through 'I' are not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. D The sign area in square feet. E List "I" if the sign is internally illuminated. List "E" if the sign is externally illuminated. F Allowed watts per square foot. Enter 12 if the sign is listed as "I" in column E. Enter 2.3 if sign is listed as "E" in column E. G Multiply the square footage in column D times the allowed Lighting Power Density (LPD = watts) in column F. H Show the total installed watts in the sign, as determined according to the applicable provisions of §130(c). I Enter Y if the number in column H is less than or equal to the number in column G. Otherwise, the sign does not comply. i This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-01-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 4 of 5) Project Name: Cricow6u, Date Prepared: 3. Specific Lighting Source Method of Compliance Certificate of Compliance and Field Inspection Energy Checklist Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 2 of this Certificate of Compliance if there are signs using the maximum allowed lighting power method of compliance) A B C OPTIONAL Specific light source used for U Field,insp6ct r Symbol ENERGY VERIFIED compliance CheckthatSi in"I",_ or Description label Shall include only lighting ompl ies Code (see instructions technologies listed below below) List all that apply lit -AM (^I -ATC -0 1UQV�1A4C-,­IF (CL-A'MN'--,4'%T919 tAfM_ 5'(014 El n E] Z� A Symbol or code used on the plans (when plans are required) and other documents. B A narrative description of the sign, or location of sign on the building; and the location of sign on construction documents C OPTIONAL - Check this box only if this sign has a permanent, pre-printed, factory -installed ENERGY VERIFIED label, confirming that this sign complies with the Section 140.8 of the California 2013 Title 24, Part 6 Standards, using the Specific Lighting Source Method of Compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories [UL) or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/lEC 17011. Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body in accordance with ISO/IEC 17020. For signs with such an ENERGY VERIFIED label, column 'D' is not required to be filled out. Note: Using an ENERGY VERIFIED label is an optional method to validate compliance. An ENERGY VERIFIED label is not needed for compliance. Specific Light Source Compliance Method. The sign(s) identified above use only the following lighting technologies: List all applicable numbers (I through 9) that apply in column D above for each row. 1 High pressure sodium lamps Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or 2 greater. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested according to ANSI C82.6-2005. Metal halide lamps that are pulse start that are 320 watts or smaller, are not 250 watt or 175 watt lamps, and are served by 3 a ballast that has a minimum efficiency of 80 percent. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tesied according to ANSI C82.6-2005. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75 percent D 4 when the transformer or power supply rated output current is less than SO mA. The ratio of the output wattage to the input wattage is it 100 percent tubing load. Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent 5 when the transformer or power supply rated output current is 50 mA or greater. The ratio of the output wattage to the input wattage is at 100 percent tubing load. 6 Fluorescent lighting systems meeting one of the following requirements: A. Use only lamps with a minimum color rendering index [CRI) of 80; or B. Use only electronic ballasts with a fundamental output frequency not less than 20 kHz. 7 Light emitting diodes (LEDs) with a power supply having an efficiency of 80 percent or greater; Single voltage external power supplies that are designed to convert 120 volt AC input into lower voltage DC or AC output, and have a 8 nameplate output power less than or equal to 250 watts, shall comply with the applicable requirements of the Appliance Efficiency Regulations (Title 20). 9 Compact fluorescent lamps that do not contain a medium screw base sockets (E24/E26). E This page doubles as a field inspection checklist. Field Inspector Notes: CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014 STATE OF CALIFORNIA SIGN LIGHTING 'JEL L;E:U-NHL;(;-LTS-01-E(Rev1sed 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Proi-t Narre: Date Prepared: C 0 C-0 CV & 6M;�?ff, dZ- DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: �5(e 65CAM ( Documentation Auth gnatur 75� Company: 0 " "i X'g-r Signature Date: C dress: 5 42-9 HM(-rJWSF AqV (S-0 CEA/ HERS Certification identification (ifapplicable): City/State/Zip: P\ -1 %1 GC Q-,, CA C1 q q Phone: C(39 —qC77 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 building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Company: Date Signed: &6- d 2 -- Address: '3LI?-% 14U-cc.,�.rf A License: C —'(P 9 0 CN 6 �' -V1.9 FState/Zip: Ity, 1AAf_q.6cA , cA q4(T--e? Phone: q ?- T- cQ -? 7 7 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance June 2014