|
STATE OF CALIFORNIA
<br />INDOOR LIGHTING
<br />SEC-NRCC-LTI-01-E ,'Revised 44117]-- CALIFORNIA ENERGY COMMISSION
<br />CERTIFICATE OF COMPLIANCE _ NRCC-LTI-01-E
<br />indoor Lighting -�- - Page I of 5
<br />Project Name: �^ � Date Prepared:
<br />A. General Information
<br />For detailed Instructions on the use of this and oll Energy Efficiency Standards compliance documents, refer to the Nonresidential Manual published by the California Energy Commission.
<br />YES
<br />NO FORM
<br />TiTtE
<br />Climate zone:
<br />Conditioned Floor Area
<br />Certificate of Compliance All Pages required on plans for all submittals,
<br />—
<br />NRCC-LTI-02-E
<br />Lighting Controls, Certificate of Compliance, and PAF Calculation. All Pages required on plans for all submittals.
<br />(,
<br />Unconditioned Floor Area :
<br />Indoor lighting Power Allowance
<br />c�
<br />t NRCC-LTI-04-F.
<br />Tailored Method Worksheets
<br />BuildingType:
<br />❑ Nonresidential
<br />❑
<br />High -Rise Residential
<br />❑
<br />Hotel/Motel
<br />❑ schools
<br />❑ Relocatable Public Schools
<br />❑
<br />Conditioned Spaces
<br />❑
<br />Unconditioned Spaces
<br />Phase of Construction:
<br />❑ New Construction
<br />❑
<br />Addition
<br />❑
<br />Alteration
<br />Method of Compliance:
<br />❑ Complete Building
<br />❑
<br />Area Category
<br />❑
<br />Tailored
<br />Project Address:
<br />m m
<br />sa c
<br />0
<br />NRCC LTI 02 E
<br />square foot
<br />4
<br />-
<br />B. Lighting Compliance Documents (select yes for each document included)
<br />For detailed Instructions on the use of this and oll Energy Efficiency Standards compliance documents, refer to the Nonresidential Manual published by the California Energy Commission.
<br />YES
<br />NO FORM
<br />TiTtE
<br />NRCA-LTI-02-A - Must be submitted for occupancy sensors and automatic time switch controls.
<br />NRCC-LTI-01-E
<br />Certificate of Compliance All Pages required on plans for all submittals,
<br />Watts
<br />NRCC-LTI-02-E
<br />Lighting Controls, Certificate of Compliance, and PAF Calculation. All Pages required on plans for all submittals.
<br />(,
<br />NRCC-1_11-034
<br />Indoor lighting Power Allowance
<br />c�
<br />t NRCC-LTI-04-F.
<br />Tailored Method Worksheets
<br />NRCC-LTI-01-E, Table Id
<br />C" NRCC-LTi-05-E
<br />Line Voltage Track Lighting Worksheets
<br />(
<br />f NRCC-LT1-0i
<br />Indoor Lighting Existing Conditions _—
<br />STATE OF CALIFORNIA
<br />INDOOR LIGHTING
<br />:EC-NRCC-LTi-01�E (Revised 04117) CALIFORNIA ENERGY COMMISSION
<br />CERTIFICATE OF COMPLIANCE NRCC-LTI-01--E
<br />Indoor Lighting -- -�� Page 2 of 51
<br />Project Name: Date Prepared: —
<br />Adt! T FJles fvr Uoconr tlydPied 5p ces.
<br />C. Summary of Allowed Lighting Power
<br />Conditioned and Unconditioned space Lighting must not be combined for compliance_-
<br />�-
<br />Indoor Lighting Power for Conditioned Spaces
<br />Indoor Lighting Power for Unconditioned Spaces
<br />Form/Title�
<br />NRCA-LTI-02-A - Must be submitted for occupancy sensors and automatic time switch controls.
<br />Watts
<br />----v
<br />Page 4 of 5
<br />Watts
<br />❑ Field Inspector
<br />Installed LightinInstalled
<br />Lighting
<br />NRCI-LTI-02-E - Must be submitted for a lighting control system, or for an Energy Management Control System (FMCS),
<br />❑ Field Inspector
<br />c�
<br />❑Field inspector
<br />1,
<br />NRCC-LTI-01-E, Table Id
<br />+
<br />0
<br />NRCC-LTI-01-E, Table H
<br />+
<br />Respansibie Designer Name:
<br />Responsible oesignersignature: --"-
<br />Portable Only for Offices
<br />El Field Inspector
<br />Address:
<br />tlCeir S£: --
<br />2
<br />NRCC-LTi 01 E
<br />_
<br />+
<br />0
<br />conference room, a multipurpose room, or a theater to be recognized for compliance.
<br />3
<br />Minus Lighting Control Credits
<br />(._
<br />NRCI-LTI-05-E - Must be submitted for a Power Adjustment Factor (PAF) to be recognized for compliance.
<br />Minus Lighting Control Credits
<br />NRCI-LTI-06-E - Must be submitted for additional wattage installed in a video conferencing studio to be recognized for
<br />NRCC-LTI-02-E
<br />m m
<br />sa c
<br />0
<br />NRCC LTI 02 E
<br />square foot
<br />4
<br />Number of
<br />4
<br />Adjusted Installed Lighting Power
<br />Pass
<br />Faif
<br />Adjusted Installed Lighting Power
<br />luminaire
<br />E -
<br />watts in this
<br />(row 1 plus row 2 minus raw 3)
<br />(G04 / 505)
<br />0
<br />(row 1 minus row 3)
<br />Pass
<br />Fail
<br />Complies ONLY if Installed 5 Allowed (Box 04< Box 05)
<br />Complies ONLY if Installed <_ Allowed (Sox 04< Box 05l i
<br />$
<br />Allowed Lighting Power
<br />cr
<br />o
<br />Allowed Lighting Power
<br />(G06 - 0.3)
<br />Conditioned NRCC-LTI-03-E
<br />Unconditioned NRCC-LTI-03-E
<br />Alterations with replacement luminaires that have at least 50/3S% lower
<br />x G03)
<br />Alterations with replacement luminaires that have at least
<br />power compared to the original existing luminaires, may instead use the
<br />INSTALLED WATTS PAGE TOTAL:
<br />50/35% lower power compared to the original existing luminaires,
<br />-
<br />Arid i'fbut
<br />allowed wattage from NRCC-LTI-06, page 2
<br />-
<br />may instead use the allowed wattage from NRCC-LTI-prs, page 2
<br />D. Declaration of Required Certificates of Installation
<br />Declare by selecting yes for all of the Certificates that will be submitted. (Retain copies and verify forms are completed and signed,)
<br />YES
<br />NO
<br />Form/Title�
<br />NRCA-LTI-02-A - Must be submitted for occupancy sensors and automatic time switch controls.
<br />[] Field Inspector
<br />----v
<br />Page 4 of 5
<br />NRCI-LTI-01-E - Must be submitted for all buildings
<br />❑ Field Inspector
<br />W (
<br />NRCA-LTI-04-A - Must be submitted for demand responsive lighting controls.
<br />NRCI-LTI-02-E - Must be submitted for a lighting control system, or for an Energy Management Control System (FMCS),
<br />❑ Field Inspector
<br />c�
<br />❑Field inspector
<br />to be recognized for compliance.
<br />11
<br />documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building, permit application,
<br />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
<br />NR I -LTi -03-E - Must be submitted for aline -voltage track lighting iri current limiter, or for a supplementary
<br />Installed
<br />Respansibie Designer Name:
<br />Responsible oesignersignature: --"-
<br />overcurrent protection panel used to energize only line -voltage track lighting, to be recognized for compliance.
<br />El Field Inspector
<br />Address:
<br />tlCeir S£: --
<br />NRCI-LTI.04-E - Must be submitted for two interlocked systems serving an auditorium, a convention center, a
<br />❑Field Inspector
<br />o �,
<br />conference room, a multipurpose room, or a theater to be recognized for compliance.
<br />v
<br />a W
<br />W
<br />Watts per
<br />(._
<br />NRCI-LTI-05-E - Must be submitted for a Power Adjustment Factor (PAF) to be recognized for compliance.
<br />[] Field Inspector
<br />NRCI-LTI-06-E - Must be submitted for additional wattage installed in a video conferencing studio to be recognized for
<br />El Field In
<br />m m
<br />sa c
<br />luminaire
<br />compliance.
<br />square foot
<br />4
<br />CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance
<br />STATE OF CALIFORNIA
<br />INDOOR LIGHTING
<br />GEC-NRCC-LT'I-o1-E (Revised 04,'17)
<br />April 2017'
<br />CALIFORNIA ENERGY COMMISSION 10
<br />CERTIFICATE OF COMPLIANCE NRCC-LTI-01-E
<br />Indoor LightiIng -� -� T - Page 3 of 5
<br />Project Name: Date Prepared:
<br />E. Declaration of Required Certificates of Acceptance
<br />Declare by selecting yes for all of the Certificates that wit] be submitted. (Retain copies and verify forms are completed and signed.)
<br />YES NO
<br />Form/Title
<br />CALIFORNIA ENERGY COMMISSION
<br />— i
<br />NRCA-LTI-02-A - Must be submitted for occupancy sensors and automatic time switch controls.
<br />[] Field Inspector
<br />----v
<br />Page 4 of 5
<br />NRC_ LTI-03 A Must be submitted for automatic daylight controls.
<br />❑ Field inspector
<br />W (
<br />NRCA-LTI-04-A - Must be submitted for demand responsive lighting controls.
<br />❑ Field Inspector
<br />07
<br />NRCA-LTI-05-A - Must be submitted for institutional tuning power adjustment factor (PAF).
<br />❑Field inspector
<br />A Separate Lighting Schedule Must Be Filled Out for Conditioned and Unconditioned Spaces. installed Lighting Power listed on this Lighting Schedule is only for:
<br />❑ CONDITIONED SPACE ❑ UNCONDITIONED SPACE
<br />F. Indoor Lighting Schedule and Field Inspection Energy Checklist
<br />❑ The actual -indoor lighting power listed on the next 2 pages includes ad installed permanent and planned portable lighting systems. -
<br />❑ When Complete Building Method is used for compliance, list each different type of luminaire on separate lines.
<br />❑ When Area Category Method or Tailored Method is used for compliance, list each different type of luminaire by each different function area on separate fines
<br />❑ Also include track lighting in schedule, and submit the track lighting compliance document (NRCC-LTI-05-E) when line -voltage track lighting is installed.
<br />STATa OF CALIFORNIA
<br />INDOOR LIGHTING
<br />Luminaire Schedule
<br />CEC-NRCC-LTI-o1-E (Revised 04!17),
<br />CALIFORNIA ENERGY COMMISSION
<br />CERTIFICATE OF COMPLIANCE
<br />-- NRCC-LTI-01-E
<br />Indoor Lighting �—
<br />----v
<br />Page 4 of 5
<br />Project Name:
<br />-Tvate
<br />Prepared:
<br />G. INSTALLED PORTABLE LUMINAIRES IN OFFICES - Exception to Section 140.6(a) --CONDITIONED SPACES
<br />Luminaire Schedule
<br />Office Portable Luminaire Schedule
<br />Office Installed Portable Luminaire gill/ftz
<br />Field Inspector'
<br />Office Location
<br />Field Inspector
<br />01
<br />02
<br />03
<br />04
<br />05
<br />06
<br />07
<br />08
<br />09
<br />10
<br />11
<br />documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building, permit application,
<br />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
<br />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
<br />Installed
<br />Respansibie Designer Name:
<br />Responsible oesignersignature: --"-
<br />Company
<br />determined
<br />Address:
<br />tlCeir S£: --
<br />Gly/State/Zip:
<br />Complete Luminaire Description
<br />o �,
<br />portable
<br />v
<br />a W
<br />W
<br />Watts per
<br />If G06 < 0.3,
<br />enter zero;
<br />Identify Office area in
<br />(i.e., LED, under cabinet, furniture
<br />Watts per
<br />m m
<br />sa c
<br />luminaire
<br />0
<br />square foot
<br />4
<br />Number of
<br />ii x G07)
<br />which these portable
<br />p
<br />Pass
<br />Faif
<br />mounted, direct/indirect)
<br />luminaire
<br />E -
<br />watts in this
<br />rti -
<br />(G04 / 505)
<br />if G06 > 03,
<br />these luminaires are installed
<br />Pass
<br />Fail
<br />office (G02
<br />cr
<br />o
<br />(HO3 x HOS)
<br />(G06 - 0.3)
<br />installed
<br />x G03)
<br />INSTALLED WATTS PAGE TOTAL:
<br />O
<br />-
<br />Arid i'fbut
<br />RenrtoV�t L��� ,"
<br />-
<br />0
<br />0
<br />0
<br />❑
<br />❑
<br />Total installed portable luminaire watts that are greater than 0.3 WJftz per office:
<br />0
<br />-- - .
<br />Acid Rtyrr
<br />W INDOOR LIGHTING SCHEDULE AND FIELD INSPECTION -CONDITIONED SPACES _-
<br />Luminaire Schedule
<br />Installed Watts
<br />Location
<br />Field Inspector'
<br />01
<br />02
<br />03
<br />04
<br />05
<br />OF
<br />07
<br />08
<br />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
<br />(responsible designer}.
<br />3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of
<br />Now wattage was
<br />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
<br />documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building, permit application,
<br />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
<br />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
<br />builder provides to the building owner at occupancy,
<br />Respansibie Designer Name:
<br />Responsible oesignersignature: --"-
<br />Company
<br />determined
<br />Address:
<br />tlCeir S£: --
<br />Gly/State/Zip:
<br />CEC
<br />According
<br />Complete Luminaire Description
<br />Total Installed
<br />Name or
<br />(i.e., 3 lamp fluorescent troffer, i one
<br />Watts per
<br />Default
<br />to
<br />Number of
<br />Watts in this
<br />Primary Function area in which
<br />Item Tag
<br />dimmable electronic ballast)
<br />Luminaire
<br />from NA8
<br />§131
<br />Luminaires
<br />area
<br />these luminaires are installed
<br />Pass
<br />Fail
<br />(HO3 x HOS)
<br />INSTALLED WATTS PAGE TOTAL:
<br />O
<br />-
<br />Arid i'fbut
<br />RenrtoV�t L��� ,"
<br />CA Building Energy Efficiency Standards - 2016 Nonresidential Compliance
<br />April 2017
<br />STATE OF CALIFORNIA
<br />INDOOR LIGHTING
<br />1. 1 certify that this Certificate of Compliance documentation is accurate and Complete. _ --
<br />CEC-NRCC.i (Revised 04i17(
<br />CALIFORNIA ENERGY Am
<br />CERTIFICATE OF COMPLIANCE
<br />-- COMMi551gN
<br />- NRCC-LTI-01-E
<br />Indoor Lighting
<br />Page 5 of 5
<br />Project Name:
<br />- _-Date Prelnared:
<br />60CUMENTATION AUTHOR'S DECLARATION STATEMENT
<br />1. 1 certify that this Certificate of Compliance documentation is accurate and Complete. _ --
<br />i?oiumentaticn Author Name: ....
<br />Documerttatjort Auther Signature:
<br />Company:_
<br />signature pate:
<br />Address:
<br />CEACertif#calinn IdentitiCtttlart iii applicahlel, ��
<br />City/state/Zip:
<br />Phone:
<br />RESPONSIBLE PERSON'S DECLARATION STATEMENT -
<br />I certify the following under penalty of perjury, under the laws of the State of California:
<br />1. The information provided on this Certificate of Compliance is true and correct.
<br />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
<br />(responsible designer}.
<br />3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of
<br />Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
<br />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
<br />documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building, permit application,
<br />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
<br />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
<br />builder provides to the building owner at occupancy,
<br />Respansibie Designer Name:
<br />Responsible oesignersignature: --"-
<br />Company
<br />DateSigned:
<br />Address:
<br />tlCeir S£: --
<br />Gly/State/Zip:
<br />STATE OF CALIFORNIA
<br />INDOOR LIGHTING POWER ALLOWANCE
<br />CEG-NRCC-LTi-03-E (Revised 04116) CALIFORNIA ENERGY COMMISSION
<br />CERTIFICATE OF COMPLIANCE
<br />--- -- ---- -
<br />- �PaCe'Tl
<br />Certificate of Compliance _Indoor Lighting Power Allowance -
<br />rr"T"t M`11e �.—.» ._._--....._—._ _,-
<br />A SUMMARY TOTALS OF LIGHTING POWER ,ALLOWANCES -CONDITIONED SPACES
<br />❑ If using Complete Building Method for campli2ince, use only the total in column (a) as total allowed building watts.
<br />❑ If using Area Category Method, Tailored Method, or a combination of Area Category and Tailored method for compliance, use only the total in column (b) as the total
<br />allowed bui#ding watts.
<br />_ (a)
<br />1, Complete Building Method Allowed Watts. Documented in section B of NRCC-LTI-03-E (below on this page) �- 0
<br />2. Area Category Method Allowed Watts. Documented in C-1 of NRCC-LTI-03-E (below on this page)
<br />3, Tailored Method Allowed Watts. Documented irn section A of NRCC-LTI-04-E _ _ —
<br />T40TAL ALLOWED BUILDING WATTS.
<br />❑ Check here if building contains both conditioned and unconditioned areas.
<br />B. COMPLETE BUILDING METHOD LIGHTING POWER ALLOWANCE -CONDITIONED SPACES
<br />----- 01 02
<br />03
<br />TYPE OF BUILDING (from §140.6 Table 140.6-1� WATTS PER ftz COMPLETE
<br />- BUILDING AREA
<br />- 0
<br />C-1 AREA CATEGORY METHOD TOTAL LIGHTING POWER ALLOWANCES -CONDITIONED SPACES
<br />Ib)
<br />0
<br />fa
<br />04
<br />ALLOWED WATTS
<br />O
<br />Watts
<br />Total from section C-2: 0
<br />Total from section C-3; 0
<br />Total Watts: 0
<br />For Alterations Only - Reduced lighting power apUon (Total Allowed Watts x 0.85). Enter this value into Section A, Row 2 if using _. ..,.._ g t his option.
<br />STATE OF CALIFORNIA
<br />INDOOR LIGHTING POWER ALLOWANCE
<br />CEC-NRCC-LTI-o3-E (Revised 04116)
<br />CERTIFICATE OF COMPLIANCE -
<br />Certificate of Compliance - Indoor Lighting Power Allowance
<br />r'ro(ed Nansc
<br />CALIFORNIA ENERGY COMMISSION
<br />NRCC-LTI-03-E
<br />Page 2 of 3
<br />STATE OF CALIFORNIA
<br />INDOOR LIGHTING POWER ALLOWANCE
<br />73
<br />'LU-NRCC-LTI-03-E (Revised 04116) _ CALIFORNIA ENERGY COMMISSION
<br />JW
<br />CERTIFICATE OF COMPLIANCE NRCC-LTI-03-E
<br />Certificate of Compliance- Indoor Lighting Power Allowance Page 3 of 3
<br />Date Prepared:
<br />DOCUMENTATION AUTHOR'S DECLARATION STATEMENT v-
<br />1. 1 certify that this Certificate of Compliance documentation is accurate and complete. "
<br />DocUmentaticn Author Name:
<br />-
<br />Documentation Author Signature:
<br />Cnmparty: -
<br />-
<br />Signature
<br />Rddress: -
<br />CEA Certifieativn Identification (i( appiicaF le)
<br />city/state/Zip,
<br />RESPONSIBLE PERSON'S DECLARATION STATEMENT
<br />I certify the following under penalty of perjury, under the lawns of the state of California:
<br />1. The information provided on this Certificate of Compliance is true and correct.
<br />2. I 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
<br />(responsible designer),
<br />3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of
<br />Compliance conform to.the requirements of Title 24, Parrt 1 and Part 6 of the California Code of Regulations.
<br />4, The building design features or system design features itdentified on this Certificate of Compliance are consistent with the information provided on other applicable compliance
<br />documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application
<br />5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be trade available with the building permit(s) issued for the building, and made available to the
<br />enforcement agency for ail applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the
<br />builder provides to the building owner at occupancy.
<br />Respmsibfe pesigner Name:
<br />-..._...
<br />Respansibie Designer Siynarure
<br />Company
<br />Pate Signed:
<br />Address:
<br />License:
<br />Gly/State/Zip:
<br />A
<br />REVISIONS QY
<br />0 C
<br />O U
<br />V-
<br />Z < Z< ro
<br />Q r+_ CI
<br />S2
<br />co 0Z`�yam,
<br />W Z
<br />C] C3 Ci
<br />Qr ZYo�
<br />O dQCL 'Co
<br />O
<br />tV s
<br />DRAWN
<br />CHECKED
<br />DATE f
<br />SCALE
<br />JOB NO.
<br />SHEET
<br />OF = } SI-iEETS
<br />
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