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STATE OF CALIFORNIA STATE OF CALIFORNIA STATE OF CALIFORNIA D V n D
<br /> Electrical Power Distribution ® Electrical Power DistributionIsElectrical Power Distribution
<br /> NRCC-ELC-E(Created 01/20) CALIFORNIA ENERGY COMMISSION NRCC-ELC-E(Created 01/20) CALIFORNIA ENERGY COMMISSION NRCC-ELC-E(Created 01/20) CALIFORNIA ENERGY COMMISSION
<br /> CERTIFICATE OF COMPLIANCE NRCC-ELC-E CERTIFICATE OF COMPLIANCE NRCC-ELC-E CERTIFICATE OF COMPLIANCE NRCC-ELC-E
<br /> J This document is used to demonstrate compliance with mandatory requirements in§13a5for electrical systems in newly constructed nonresidential,high-rise residential and Project Name: Dutch Bros-Ripon,CA lReport Page: Page 2 of 5 Project Name: Dutch Bros-Ripon,CA Report Page: Page 3 of 5
<br /> J hotel motel occupancies. Additions and alterations to electrical services stems in these occupancies will also use this document to demonstrate compliance per 141. a or
<br /> / P Y P P P § 0( I Project Address: 1220 Colony Road Ripon,CA 95366 JDate Prepared: 01.05.2021 Project Address: 1220 Colony Road Ripon,CA 95366 Date Prepared: 01.05.2021
<br /> r¢n §141.0U2P for alterations.
<br /> 0 Project Name: Dutch Bros-Ripon,CA Re ort Pae Pae 1 of 5 D.EXCEPTIONAL CONDITIONS Electrical Service Designation/Description: Main Service
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<br /> n Project Address: 1220 Colony Road Ripon,CA 95366 IDate Prepared: 01.05.2021 This table is auto filled with uneditable comments because of selections made or data entered in tables throughout the form. 01 02 03 04 05
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<br /> A.GENERAL INFORMATION Location of
<br /> � able B indicates the project is exempt from§130.5(a)Service Electrical Metering requirements because the utility company has provided the project a metering system that � Minimum Required Separation of Compliance Field Inspector
<br /> m Ol Project Location(city) Modesto,CA 02 Occupancy Types Within Project: indicates instantaneous kW demand and kWh for a utilit -definied period. Load Type per Table 130.5-B 2 Requirements in Construction
<br /> o y P Load per Table 130.5-B Method
<br /> ❑Office ❑ Retail ❑Warehouse ❑ Hotel/Motel ❑School ❑Support Areas Table H.indicates voltage drop calculations will be provided by the contractor. Documents pass Fail
<br /> N E] ParkingGarage E] High-RiseResidential ❑Relocatable E] Healthcare Facilities ❑✓ Other(Write In): Food Perp Other non-HVAC loads or appliances>_25kVA Not required Method 2 E3.01 ❑ ❑
<br /> E.ADDITIONAL REMARKS
<br /> Q; B.PROJECT SCOPE This table includes remarks made by the permit applicant to the Authority Having Jurisdiction. *NOTES:If"Other*"is selected under Compliance Method above,please indicate how compliance has been achieved in the space provided below.
<br /> Z5 Table Instructions:Include any electrical service systems that are within the scope of the permit application.
<br /> Ol 02 03 04 OS 06 'FOOTNOTES:For each separate load type,up to 10%of the connected load may be of any type.
<br /> Demand Response Controls 'Method 1:Switchboards/motor control centers/panelboard loads disaggregated for each load type
<br /> a Where required,demand response controls must F.SERVICE ELECTRICAL METERING — Method 2:Switchboards/motor control centers/ponelboardsupply other distribution equipment with loads disaggregated for each load type
<br /> CD Utility System q
<br /> 3 be specified which are capable of receiving and Method 3:Branch circuits serve load types individually&provisions for adding future branch curcuit monitoring
<br /> Provided subject to CA P g This Section Does Not Apply III I
<br /> 0 Electrical Service J Method 4:Complete metering system measures and reports loads by type
<br /> Rating Metering Elec Code automatically responding to at least one
<br /> Designation/ Scope of Work' See Chapter 8 of the Nonresidential Compliance Manual for more detail on Compliance Methods.
<br /> _ g standards based messaging protocol which
<br /> Description (kVA) System Article 517 g g P G.SEPARATION OF ELECTRICAL CIRCUITS FOR ENERGY MONITORING
<br /> Exception to Exception to enables demand response after receiving a H.VOLTAGE DROP ]
<br /> m Table Instructions: Complete this table for entirely new or complete replacement electrical power distribution systems to demonstrate compliance with§130.5(b). Using the
<br /> §130.5(a)' §130.5(a)&(t demand response signal. Sections nts N 130.1Table Instructions: Please complete this table or entire/ new or complete replacement electrical ower distributions stems,or alterations that add,mod/ or replace both
<br /> �? ) dro down choices in column Ol,indicate the load es included or each service. An load types that are not included in the service do not need to be shown. p f y p P p y fY p
<br /> and 1§ 30.3 and compliance documents NRCC- p �`p f y yp eeders and branch circuits to demonstrate compliance with J130.5 c. For alterations,only the altered circuits must demonstrate compliance per§141.0(b)2Piii.
<br /> MCH,NRCC-LTI and NRCC LTS will indicate when Electrical Service Designation/Description: Main Service Ol 02 03 04 05
<br /> GNICH
<br /> Main Service 42 ❑
<br /> a) New electrical service equipment& V demand response controls are required.
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<br /> El 02 03 04 OS Electrical Service Combined Voltage Drop on Installed Feeder/Branch Location of Voltage Drop Sheet Number for Voltage Drop Field Inspector /ARCH ITECTURE
<br /> Location of Designation/Description Circuit Conductors Compliance Method Calculations' Calculations in Construction
<br /> Minimum Required Separation of Compliance Field Inspector g P P Documents Pass Fail C T I I D I O
<br /> a 'FOOTNOTES:Adding only new feeders and branch circuits triggers Voltage Drop 130.5(c),no other requirements from 130.5 are required. Load Type per Table 130.5-8 Load per Table 130.55=B Method' Requirements in Construction IS 1 V
<br /> o 'Applicable if the utility company is providing a metering system that indicates instantaneous kW demand and kWh for a utility-defined period. Documents Permitted by CA Elec
<br /> Pass Fail OVOltage drop<5% [:]Code(Exception to Contractor Responsible El El
<br /> AN OREGON LIMITED LIABILITY COMPANY
<br /> Lighting including exit,egress and exterior Not required Method 2 E3.01 ❑ ❑ §130.5(c))*
<br /> C.COMPLIANCE RESULTS Permitted by CA Elec
<br /> HVAC systems and components Not required Method 2 E3.01 ❑ ❑ Main Service QVoltage drop<5% ❑Code(Exception to Contractor Responsible ❑ ❑
<br /> CL Table Instructions:If this table says"DOES NOT COMPLY"refer to Table D.for guidance and review the Table that indicates"No".
<br /> Plug Loads and appliances<25kVA Not required Method 1E3.01 1:1 1:1 §130.5(c))*
<br /> U Ol 02 03 04 OS *NOTES:If"Other*"is selected under Compliance Method above,please indicate how compliance has been achieved in the space provided below. *NOTES If"Permitted by CA Elec Code*"is selected under Compliance Method above,please indicate where the exception applies in the space provided below.
<br /> E Service Electrical Separation for Voltage Drop Controlled 'FOOTNOTES:Voltage drop calculations may be attached to the permit application outside the construction documents if allowed by the Authority Having Jurisdiction. Select
<br /> 0) Metering AND Monitoring AND AND Receptacles "attached"/ a li 1001 SE SANDY BLVD, SUITE 100
<br /> 0 130.5 c Compliance Results Table Continued f pp'cable. If calculations will be the responsibility of the installing contractor,select"Contractor Responsible".
<br /> §130.5(a) PORTLAND, OR 97214
<br /> N (See Table F) (See Table G) (See Table H) (See Table 1) I.CIRCUIT CONTROLS FOR 120-VOLT RECEPTACLES AND CONTROLLED RECEPTACLES V. 503.552.9079
<br /> o AND Yes AND Yes AND Yes COMPLIES with Exceptional Conditions Table Instructions:Please complete this table for entirely new or complete replacement electrical power distribution systems to demonstrate compliance with§130.5(d). Both F. 503.241.7055
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<br /> jcontrolled and uncontrolled receptacles must be provided in office areas,lobbies,conference rooms,kitchen areas in office spaces,copy rooms and hotel/motel guest rooms. WWW.G N I C H A R C H.C O M
<br /> Table Continued
<br /> g) CA Building Energy Efficiency Standards-2019 Nonresidential Compliance:http://www.energy.ca.gov/title24/2019standards January 2020 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance:http://www.energy.ca.gov/title24/2019standards January 2020 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance:http://www.energy.ca.gov/title24/2019standards January 2020 01.13.21
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<br /> STATE OF CALIFORNIA STATE OF CALIFORNIA
<br /> m Electrical Power Distribution ® Electrical Power Distribution
<br /> NRCC-ELC-E(Created 01/20) CALIFORNIA ENERGY COMMISSION NRCC-ELC-E(Created 01/20) CALIFORNIA ENERGY COMMISSIOUi
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<br /> o CERTIFICATE OF COMPLIANCE NRCC-ELC-E CERTIFICATE OF COMPLIANCE NRCC-ELC-E
<br /> 15 Project Name: Dutch Bros-Ripon,CA Report Page: Page 4 of 5 Project Name: Dutch Bros-Ripon,CA Report Page: Page 5 of 5 ` 78�6m
<br /> 0) Project Address: 1220 Colony Road Ripon,CA 95366 Date Prepared: 01.05.2021 Project Address: 1220 Colony Road Ripon,CA 95366 Date Prepared: 01.05.2021 Lu M
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<br /> Ui 01 02 03 04 05 06 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT * EXP.Bl3dl Z
<br /> 6 Permanent y, F(F �P`'
<br /> O Location of Requirements Field Inspector I certify that this Certificate of Compliance documentation is accurate and complete. �� CTR1tP
<br /> Room Name Location/Type of Controlled Durable
<br /> Shut-Off Controls in ConstructionOF CA4lF�F
<br /> 0 or Description Receptacles Marking Will Documentation Author Name: Dan Conrad Documentation Author Signature:
<br /> Documents Pass Fail
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<br /> E Company: Case Engineering Inc. Signature Date:
<br /> NA:No app ica a space types on
<br /> x Food Prep this service ❑ ❑ Address: 796 Merus Ct. CEA/HERS Certification Identification(if applicable):
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<br /> Add Row City/State/Zip: St.Louis,MO 63026 Phone: 636.349.1600
<br /> *If"Other*"is selected under Compliance Method above,please indicate how compliance has been achieved in the space provided below. RESPONSIBLE PERSON'S DECLARATION STATEMENT
<br /> _0 I certify the following under penalty of perjury,under the laws of the State of California:
<br /> Q J.DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION 1.The information provided on this Certificate of Compliance is true and correct.
<br /> Table Instructions: Selections have been made based on information provided in previous tab/es of this document. If any selection needs to be changed,please explain why in 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
<br /> Table E.Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at httos://ww2CZ .energy.ca.gov/ Compliance(responsible designer)
<br /> title24 2019standards 2019 compliance documents/Nonresidential Documents NRC/ 3.The energy features and performance specifications,materials,components,and manufactured devices for the building design or system design identified on this
<br /> YES NO Form/Title Field Inspector Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations.
<br /> Pass Fail 4.The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable Q
<br /> compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application.
<br /> ((:} (} NRCI-ELC-01-E-Must be submitted for all buildings.
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<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
<br /> o 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 O
<br /> K.DECLARATION OF REQUIRED CERTIFICATES OF ACCEPTANCE documentation the builder provides to the building owner at occupancy. i N
<br /> There are no Certificates of Acceptance applicable to electrical power distribution requirements. Responsible Designer Name: Dan Conrad Responsible Designer Signature: � �� O m
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<br /> YCompany: Case Engineering Inc. Date Signed: r , V)
<br /> Address: 796 Merus Ct. License: E-17866 r, d
<br /> City/State/Zip: St.Louis,MO 63026 Phone: 636.349.1600 Lir
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<br /> a) 796 Merus Court T 636.349.1600 E5 . 03
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<br /> St.Louis,MO 63026 F 636.349.1730
<br /> 02020 DB Franchising USA,LLC
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