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STATE OF CALIFORNIA STATE OF CALIFORNIA Indoor Lighting Indoor Lighting NRCC-LTI-E CALIFORNIA ENERGY COMMISSION NRCC-LTI-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCCATI-E CERTIFICATE OF COMPLIANCE NRCCATI-E Project Name: Crumbl Cookies-Interior Tenant Improvement Report Page: (Page 5 of 8) This document is used to demonstrate compliance with requirements in 110.9 §110.12(c). 130.0 130.1 140.6 and§141.0(b)2 for indoor lighting scopes using the prescriptive Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 path. Project Name: Crumb]Cookies-Interior Tenant Improvement Report Page: (Page 1 of 8) K.TAILORED METHOD GENERAL LIGHTING POWER ALLOWANCE Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 This section does not apply to this project. A.GENERAL INFORMATION L.ADDITIONAL LIGHTING ALLOWANCE:TAILORED WALL DISPLAY 01 Project Location(city) Stockton 04 Total Conditioned Floor Area(ft2) 1,240 This section does not apply to this project. 02 Climate Zone 12 05 Total Unconditioned Floor Area(ft') 0 03 Occupancy Types Within Project(select all that apply): 06 #of Stories(Habitable Above Grade) 1 M.ADDITIONAL LIGHTING ALLOWANCE:TAILORED FLOOR AND TASK LIGHTING ❑ Office 101 lRetail ❑ Warehouse ❑ Hotel/Motel ❑ School I❑Isupport Areas This section does not apply to this project. ❑ Parking Garage I❑ High-Rise Residential I❑lRelocatable ❑ Healthcare H Other(Write in) I See Table I N.ADDITIONAL LIGHTING ALLOWANCE:TAILORED ORNAMENTAL/SPECIAL EFFECTS B.PROJECT SCOPE This section does not apply to this project. This table includes any lighting systems that are within the scope of the permit application and are demonstrating compliance using the prescriptive path outlined in1§ 40.6 or §141.0(b)2 for alterations. O.ADDITIONAL LIGHTING ALLOWANCE:TAILORED VERY VALUABLE MERCHANDISE Scope of Work Conditioned Spaces Unconditioned Spaces This section does not apply to this project. 01 02 03 04 05 My Project Consists of(check all that apply): Calculation Method Area(ft') Calculation Method Area(ft') ❑ New Lighting System ❑ New Lighting System-Parking Garage ® Altered Lighting System Area Category Method 1240 Area Category Method 0 Total Area of Work(ft2) 1240 0 Registration Number: Registration Date/Time: Registration Provider:Energysoft Registration Number: Registration Date/Time: Registration Provider:Energysoft CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 Schema Version:rev 20190401 Schema Version:rev 20190401 STATE OF CALIFORNIA STATE OF CALIFORNIA Indoor Lighting Indoor Lighting NRCC-LTI-E CALIFORNIA ENERGY COMMISSION NRCC-LTI-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCCATI-E CERTIFICATE OF COMPLIANCE NRCCATI-E Project Name: Crumbl Cookies-Interior Tenant Improvement Report Page: (Page 6 of 8) Project Name: Crumbl Cookies-Interior Tenant Improvement Report Page: (Page 2 of 8) Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 P. POWER ADJUSTMENT: LIGHTING CONTROL CREDIT(POWER ADJUSTMENT FACTOR(PAF)) C.COMPLIANCE RESULTS This table includes all areas indicated in Table I or Table K as using a PAF credit described in§140.6(a)2. If any cell on this table says"DOES NOT COMPLY"or"COMPLIES with Exceptional Conditions"refer to Table D.for guidance. Conditioned Spaces Allowed Lighting Power per§140.6(b) (Watts) Adjusted Lighting Power per§140.6(a) (Watts) Compliance Results 01 02 03 04 05 06 07 Lighting in 01 02 03 04 05 06 07 08 09 PAF per§140.6(a)2 r Luminaires Controlled for PAF Credit conditioned and p Control unconditioned Area Adjustments 1 2A 2B 2C 3A 3B 4 5 6 7 Luminaire Lighting Credit Power Complete Area Category Tailored Total PAF Lighting Total Adjusted Area Description Luminaire Number of g g spaces must not be _ Total _ Name or Item Controlled Adjustments Building Category Additional §140.6(c)3 - Designed Control Credits - Watts 05 must be>=08 Pick u to one Pick u to one Pick u to one Design Watts Luminaires combined for (Watts)Allowed p p p Ta Watts (Watts) 140.6 c 1 §140.6(c)2 §140.6(c)2G (+) (Watts) (Watts) §140.6(a)2 *Includes 1§ 40.6 Tag (Watts) compliance perWatts Crumbl Cookies-Zone 1 ❑ ❑ ❑ ❑ ❑ ❑ ® ❑ ❑ ❑ 1 65 14 910 45.50 §140.6(b)1 (+) H Adjustments Crumbl Cookies-Zone 1 ❑ ❑ ❑ ❑ ❑ ❑ ® ❑ ❑ ❑ 2 65 3 195 9.75 (See Table 1) (See Table 1) (See Table 1) (See Table K) (See Table F) (See Table P) I Iv Crumb]Cookies Zone 1 ❑ ❑ ❑ ❑ ❑ ❑ ® ❑ ❑ ❑ 3 10.6 4 42.4 2.120 Conditioned 1,178 0 = 1,178 >_ 1,170.7 66.69 = 1104.01 COMPLIES Crumb]Cookies Zone 1 ❑ ® ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 4 23.3 1 23.3 9.32 Unconditioned = >_ = 0 08 09 Controls Compliance(See Table H for Details) COMPLIES O All spaces applying PAF 5,6 or 7 include a daylight design Rated Power Reduction Compliance(See Table Q for Details) ❑ meeting requirements in J14D.3Ldl.See Table S. Total Power Adjustment(Watts)CONDITIONED SPACES: 66.690 g p p ff. 2 ff. D.EXCEPTIONAL CONDITIONS FOOTNOTES:PAFs outlined in Table 140.6-A include 1 Daylight dimming Jus OFF;2A)Occupant sensors in offices dlte/]125 f t,28)Occupant sensors in offices 126-250ft2,2C) Occupant sensors in offices 251-500 ft2,3A)Institutional tuning,non-doylit areas and 3B)Institutional tuning,daylit areas;4)Demand response,S)Clerestory fenestration;6) This table is auto filled with uneditable comments because of selections made or data entered in tables throughout the form. Horizontal slats,7)Light shelves. E.ADDITIONAL REMARKS Q.RATED POWER REDUCTION COMPLIANCE FOR ALTERATIONS This table includes remarks made by the permit applicant to the Authority Having Jurisdiction. This section does not apply to this project. F.INDOOR LIGHTING FIXTURE SCHEDULE I R.80%LIGHTING POWER FOR ALL ALTERATIONS-CONTROLS EXCEPTIONS This table includes all permanent designed lighting and all portable lighting in offices. This section does not apply to this project. Designed Wattage:Conditioned Spaces 01 02 03 04 05 06 07 08 09 10 Name or Item Complete Luminaire Modular Small Watts per How is Wattage Total Number Excluded per Field Inspector Watts n Tag Description (Track)Fixture Aperture&Color Changer Iuminaire2 determined of Luminaires §140.6(a)3 Design Pass Fail J 1 CRI I Crumbls Standard-2X4 No No 65 CEC Default 14 No 910 El E]ED 1 Registration Number: Registration Date/Time: Registration Provider:Energysoft Registration Number: Registration Date/Time: Registration Provider:Energysoft CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 m Schema Version:rev 20190401 Schema Version:rev 20190401 1"1 STATE OF CALIFORNIA STATE OF CALIFORNIA N Indoor Lighting Indoor Lighting n NRCC-LTI-E CALIFORNIA ENERGY COMMISSION NRCC-LTI-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCCATI-E CERTIFICATE OF COMPLIANCE NRCCATI-E Project Name: Crumbl Cookies-Interior Tenant ImprovementReport Page: (Page 7 of 8) Project Name: Crumb)Cookies-Interior Tenant Improvement Report Page: (Page 3 of 8) n Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 O S. DAYLIGHT DESIGN POWER ADJUSTMENT FACTOR(PAF) F.INDOOR LIGHTING FIXTURE SCHEDULE This table documents clerestories,horizontal slats or light shelves meet the requirements in§140.3(d) if a Power Adjustment Factor was claimed on Table P. These features must be 2 CR2 I Crumbls Standard-2X4 No No 65 CEC Default 3 No 195 ❑ ❑ documented on the architectural plans or where appropriate within the construction documents. This PAF also must be verified in the field with an acceptance test per Table U. LED-NL 01 Compliance Strategy 3 CR3 I Crumbls Standard-3" No No 10.6 CEC Default 4 No 42.4 ❑ ❑ r Recessed Can T.DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION 4 CR4 I Crumbls Standard-2X4 No No 23.3 CEC Default 1 No 23.3 D Selections have been made based on information provided in this document.If any selection have been changed by permit applicant an explanation should be included in Table E. LED RESTROOM Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at Total Designed Watts:CONDITIONED SPACES 1,170.7 Z https://www.energy.ca.gov/title24/2019standards/2019_compliance_documents/Nonresidential Documents/NRCl/ 'FOOTNOTE:Design Watts for small aperture and color changing luminaires which qualify per§140.6(a)4B is adjusted to be 75%of their rated wattage. Table F automatically makes Yes No Form/Title El Inspector this adjustment,the permit applicant should enter full rated wattage in column 05. Pass Fail 2Authority Having Jurisdiction may ask for Luminaire cut sheets to confirm wattage used for compliance per 130.0 c Wattage used must be the maximum rated for the luminaire,not T • 0 NRCI-LTI-01-E-Must be submitted for all buildings ❑ ❑ the lamp. 1•I 0 0 NRCI-LTI-02-E-Must be submitted for a lighting control system,or for an Energy Management Control System(EMCS),to be ❑ ❑ recognized for compliance. G.MODULAR LIGHTING SYSTEMS 0 0 NRCI-LTI-04-E-Must be submitted for two interlocked systems serving an auditorium,a convention center,a conference room,a ❑ ❑ This section does not apply to this project. O multipurpose room or a theater to be recognized for compliance. • 0 NRCI-LTI-05-E-Must be submitted for a Power Adjustment Factor(PAF)to be recognized for compliance. ❑ I ❑ H.INDOOR LIGHTING CONTROLS(Not including PAFs) 0 • NRCI-LTI-06-E-Must be submitted for additional wattage installed in a video conferencing studio to be recognized for compliance. ❑ ❑ This table includes lighting controls for conditioned and unconditioned spaces. When a control having a*is shown,the notes section of this table provides more detail on how compliance is achieved. The lighting controls section of the Compliance Summary Table on the first page will show"DOES NOT COMPLY"if the notes are left blank. U. DECLARATION OF REQUIRED CERTIFICATES OF ACCEPTANCE Building Level Controls rn Selections have been made based on information provided in this document.If any selection have been changed by the permit applicant an explanation should be included in Table E. 01 02 03 Y, Additional Remarks. These documents must be provided to the building inspector during construction and any with"-A"in the form name must be completed through an Acceptance Field Inspector Test Technician Certification Provider(ATTCP).For more information visit:http://www.energy.ca.gov/title24/attcp/providers.html Mandatory Demand Response§110.12(c) Shut-off controls§130.1(c) Pass Fail Field Inspector Not Required<=10,000 SF See Area/Space ace Level Controls El ElYes No Form/Title q p Pass Fail • 0 NRCA-LTI-02-A-Must be submitted for occupancy sensors and automatic time switch controls. ❑ ❑ • 0 NRCA-LTI-03-A-Must be submitted for automatic daylight controls. ❑ ❑ 0 • NRCA-LTI-04-A-Must be submitted for demand responsive lighting controls. ❑ ❑ 0 • NRCA-LTI-05-A.-Must be submitted for institutional tuning power adjustment factor(PAF) ❑ I ❑ Registration Number: Registration Date/Time: Registration Provider:Energysoft Registration Number: Registration Date/Time: Registration Provider:Energysoft CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 Schema Version:rev 20190401 Schema Version:rev 20190401 STATE OF CALIFORNIA STATE OF CALIFORNIA Indoor Lighting Indoor Lighting NRCC-LTI-E CALIFORNIA ENERGY COMMISSION NRCC-LTI-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCCATI-E CERTIFICATE OF COMPLIANCE NRCCATI-E Project Name: Crumbl Cookies-Interior Tenant Improvement Report Page: (Page 8 of 8) Project Name: Crumbl Cookies-Interior Tenant Improvement Report Page: (Page 4 of 8) Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 Project Address: 864 W.Benjamin Holt Drive Date Prepared: 5/29/2021 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT H.INDOOR LIGHTING CONTROLS(Not including PAFs) I certify that this Certificate of Compliance documentation is accurate and complete. Area Level Controls Documentation Author Name: Documentation Author Signature: 04 05 06 07 08 09 10 11 12 Theodore Brandvold Company: Signature Date: Primary/Sky Complete Building or Area Multi-Level Secondary Interlocked Commercial Architecture,Inc. 2021-05-29 Area Controls Shut-Off Controls lit Field Inspector Area Description Category Primary Function Controls Daylighting Systems Address: CEA/HERS Certification Identification(if applicable): 130.1 a 130.1 C Daylighting 616 14th Street C-25449 Area 130.1 b 130.1 d 140.6 d 140.6 a 1 City/State/Zip: Phone: I Pass Fail Modesto CA 95350 209-571-8158 Manual LOBBY/KITCHEN Kitchen/Food Preparation Area ON/OFF Dimmer Occupancy Sensor Included Included No El E]RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury,under the laws of the State of California: Manual UNISEX RESTROOM Restrooms 1. The information provided on this Certificate of Compliance is true and correct. ON/OFF Dimmer Occupancy Sensor N/A N/A No El ❑ 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 energyfeatures and performance specifications,materials,components,and manufactured devices for the building design or stem design identified on this Certificate of Compliance conform to the requirements NOTES:Controls with a require a note in the space below explaining how compliance is achieved. 13 p p p g g y g pEX:Conference 1:Primary/Skylight Daylighting:Exempt because less than 120 watts of general lighting;EXCEPTION 1 of Title 24,Part 1 and Part 6 of the California Code of Regulations. Plan Sheet SIIOWIng Dayllt Zones: 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, to§130.1(d)2 plans and specifications submitted to the enforcement agency for approval with this building permit application. E-2.1 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 m the enforcement age II applicable inspections.I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provifes to the building owner at occupa Responsible Designer Name: Responsible Designer Signature: I.LIGHTING POWER ALLOWANCE:COMPLETE BUILDING OR AREA CATEGORY METHODS Theodore Brandvold Each area complying using the Complete Building or Area Category Methods per§140.6(b) are included in this table. Column 06 indicates if additional lighting power allowances per Company: Date Signed: 114L.6 C or adjustments per 114D.6a are being used. Commercial Architecture,Inc. 2021-05-29 Conditioned Spaces Address: License: 616 14th Street C-25449 01 02 03 04 05 06 City/State/Zip: Phone: Area Description Area(ftz) g Complete Building or Area Category Primary Allowed Density Allowed Wattage Additional Allowance/Adjustment Modesto CA 95354 209-571-8158 Function Area (W/ftz) (Watts) Area Category PAF Crumbl Cookies-Zone 1 Kitchen/Food Preparation Area 0.95 1,240 1,178 No Yes TOTALS: 1,240 1,178 See Tables J,or P for detail J.ADDITIONAL ALLOWANCE:AREA CATEGORY METHOD QUALIFYING LIGHTING SYSTEM This section does not apply to this project. Registration Number: Registration Date/Time: Registration Provider:Energysoft Registration Number: Registration Date/Time: Registration Provider:Energysoft CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2021-05-29 13:04:23 Schema Version:rev 20190401 Schema Version:rev 20190401 00 In � 0) M D � � _ Z n n yy5 TH` �� COMMERCIAL ARCHITECTURE INC . Cn D 0 Z � mr '0M O m O _ �o �n �o cnm �� ; z � x zM ;rs oo w N ° THEODORE J . BRANDVOLD , ARCHITECTCn M 1W 2D ND rn DD j D rA o Iv D < 70 C7 n o cn D M wZ Or om �� o0Wnm � CD0 � d m � 7� •� y oNCD Z M rn0 zm 11v mo z 00 05= Z MZ �' • m1 �� 6 1 6 1 4TH STREET , M O D E STO , CA 95354 I o D � � Z 0� o "' ti�q a �y PH ( 209 ) 57 1 - B 1 5B FAX ( 209 ) 57 1 - B 1 60 M �