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<br /> STATE OF CALIFORNIA STATE OF CALIFORNIA STATE OF CALIFORNIA
<br /> Mechanical Systems Domestic Water Heating System Domestic Water Heating System
<br /> NRCC-PLB-E Ef
<br /> NRCC-MCH-E CALIFORNIA ENERGY COMMISSION NRCC-PLB-E CALIFORNIA ENERGY COMMISSION CALIFORNIA ENERGY COMMISSION � �
<br /> CERTIFICATE OF COMPLIANCECERTIFICATE OF COMPLIANCE CERTIFICATE OF COMPLIANCE U
<br /> NRCC-MCH-E NRCC-PLB-E NRCC-PLB-E v,
<br /> Project Name: RESTAURANT T.I. Report Page: ) § 0 q § 1 Project Name: RESTAURANT T.I.Re rt Page: z
<br /> g (Page 9 of s This document is used to demonstrate compliance forRonresidentio!occupancies with requirements in ?10.1 110.3 120.3 and 14 5 and with re ufrements in 14 0 for p° g (Page 2 of 6} C\2 C12
<br /> Project Address: 3081 N.TRACY BLVD.Date Prepared: 9/15/2020 additions and alterations, or domestic water heating scopes using the prescriptive path-For high-rise residential and hotel/motel occupancies compliance is demonstrated with Project Address: 3081 N.TRACY BLVD.Date Prepared: 11
<br /> f g P g P P P g p P 9/15/2020 E 14
<br /> requirements in 110-1 110.3 120.3 150.0 and 150.1 c 8 and with requirements 150.2 for additions. Z .5 ci
<br /> Project Name: RESTAURANT T.I. Report Page: (Page 1 of 6) 03 c� W ed
<br /> DOCUMENTATION AUTHOR'S DECLARATION STATEMENT Pro'ectAddress: C.COMPLIANCE RESULTS Cd E�
<br /> J 3081 N.TRACY BLVD. Date Prepared: 9/15/2020 Table C will indicate if the project data input into the compliance document is compliant with water heating requirements.If this table says"DOES NOT COMPLY"or"COMPLIES with �
<br /> A
<br /> certify that this Certificate of Compliance documentation is accurate and complete. Exceptional Conditions"refer to Table D. or the table indicated as not compliant for guidance.
<br /> Documentation Author Name: Documentation Author Signature: A.GENERAL INFORMATION
<br /> PERFECT DESIGN QAC 01 Project Location(city) TRACY 02 Climate Zone 12 O1
<br /> 02 03 04 z M
<br /> Company: Domestic Hot Water Equipment Distribution Systems Controls w cd tw
<br /> Signature Qate: Q 03 Occu an T es Within Project select all that a
<br /> PERFECT DESIGN&INVESTMENT ,` � 'L P cY Yp 1 ( apply): �.
<br /> O G+ Table F Table G Table H Compliance Results c\x ^C oU®
<br /> Address: ® Nonresidential ❑ High-Rise Residential ❑ Hotel/Motel Z � „ op �
<br /> CEA/HERS Certification Identification(if applicable): Gt 0 m _ co
<br /> 2416 W.VALLEY BLVD M-276;3 © State Building ❑ Healthcare Facility ❑ Other(Write In) Yes Yes Yes COMPLIES V) o o E: co
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<br /> Ci /State *, f 1).EXCEPTIONAL CONDITIONSALHAM
<br /> t1 /Zip:
<br /> Phone: W d U
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<br /> BRA CA 91803 (626289-8808 tf'l, Qy ♦Q' a B.PROJECT SCOPE
<br /> §1410(a)
<br /> systems � 45
<br /> A4This table is auto-filled with uneditabie comments because ofselections made or data entered in tables throughout theform. ERESPONSIBLE PERSON'S DECLARATION STATEMENT 4fi Cr This table includes domestic waterheatin thatare within thesco e ofthe ermit application and are demonstrating compliance using the prescriptive paths outlined in 14 I certifythe following under penaltyof perjury underthe laws oftheState ofCalifornia: tFW c150.1c8 Wpcdy �pcd
<br /> and 14.1-0 a or§141.01b)2N for additions or alterations.Solar water heating systems are documented on the NRCC-SRA compliance document. Combined hydropic water E.ADDITIONAL REMARKS �
<br /> 1. The information provided on this Certificate of Compliance is true and correct. heating systems are documented on the NRCC-MCH compliance document.
<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(responsible designer) This table is includes remarks mode by the permit applicant to the AuthorityHaving Jurisdiction.
<br /> 01 02 03
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<br /> 3. The energy features and performance specifications,materials,components,and manufactured devices for the building design or system design identified an this Certificate of Compliance conform tothe requirements
<br /> of Title 24,Part 1 and Part 6 of the California Code of Regulations. My project Consists of(check all that apply): System Type1.2 System Components
<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 camp' prksheets,calculations, New system(DHW system being installed for the first time in newly
<br /> plans and specifications submitted to the enforcement agency for approval with this building permit application. Q fQ ® ConstruCtedbuilding) Individual System(serving nonresidential spaces) ® Equipment ® Distribution ® Controls
<br /> 5. 1 will ensure that a completed signed copy of this Certificate of Complianceshall be made available with the building permit(sj issued for the building,and made av y far all applicable
<br /> inspections.1 understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides t owner at ❑ System Alteration(equipment,distribution or controls) El Equipment ❑ Distribution ❑ Controls
<br /> Responsible Designer Name: Responsible Designer Signature; O 1
<br /> RAYMOND M.ZHONG,P.E. I FOOTNOTES:Paint of use water heaters,or other non-central systems used to serve nonresidential spaces,are considered individual systems.
<br /> Company; Date Signed:
<br /> Dwelling units refers to hotel/motei guest rooms and units in a high-rise residential occupancy.
<br /> * QB-34
<br /> PERFECT DESIGN&DEVELOPMENT,INC. 2020-09-15 21'�
<br /> Address:
<br /> License: Q.
<br /> 2416 W.VALLEY BLVD 9 N4Go �\ /
<br /> City/5tate/Zip: Al IE
<br /> Phone:
<br /> ALHAMBRA CA 91803 (626)28D-8808
<br /> Registration Number: Registration Date/Time: Registration Number: Registration Date/Time: Ref Registration Number: Registration Date/Time:
<br /> g /T Registration Provider:Energysoft Registration Provider.Energysoft Registration Provider.Energysoft
<br /> CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2020-09-15 18:16:53
<br /> Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019,1.003 Report Generated:2020-09-15 1$;16:53 Schema Version:rev 20190401
<br /> CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2020-09-15 18:16:53 CA BuilSchema Version:rev 20190401
<br /> Schema Version:rev 20190401
<br /> STATE OF CALIFORNIA STATE OF CALIFORNIA STATE OF CALIFORNIA
<br /> Domestic Water Heating System Domestic Water Heating System Domestic Water Heating System
<br /> NRCC-PLB-E CALIFORNIA ENERGY COMMISSION NRCC-PLB-E CALIFORNIA ENERGY COMMISSION NRCC-PLS-E CALIFORNIA ENERGY COMMISSION
<br /> CERTIFICATE OF COMPLIANCE NRCC-PLB-E CERTIFICATE OF COMPLIANCE NRCC-PLB-E CERTIFICATE OF COMPLIANCE NRCC-PLB-E
<br /> Project Name: RESTAURANT T.I. Re ort Pae (Page 4 of 6) Project Name: RESTAURANT T.I.Report Page: (Page 5 of 6)
<br /> Project Name: RESTAURANT T.I.Report Page: {Page 3 of 6) P g
<br /> Project Address: 3081 N.TRACY BLVD.Date Prepared: 9/15/2020 Project Address: 3081 N.TRACY BLVD.Date Prepared: 9/15/2020 Project Address: .3081 N.TRACY BLVD.Date Prepared: 9/15/2020
<br /> F.DOMESTIC HOT WATER EQUIPMENT G.DOMESTIC HOT WATER DISTRIBUTION SYSTEM I.DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION
<br /> TABLE 120.3-A PIPE INSULATION THICKNESS 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.
<br /> This table is used to demonstrate compliance with mandatary equipment requirements in 110.1 and 110.3.For high-rise residential and hotel/motel occupancies,compliance with
<br /> prescriptive requirements in 15Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at
<br /> D,1 r 8 must also be demonstrated and with 150.2 for addition and alteration scopes. Conductivity Range Nominal Pipe Diameter(in) https://www.energy.ca.gov/title24/2019stondards/2Dl9_complionce_documents/Nonresidential_Documents/NRCl/
<br /> Equipment Schedule:Individual Systems Fluid Temperature Range(^F) (Btu-in per hour Insulation Mean Rating Temp(°F) <1 1 to<1.5 1.5 to<4
<br /> 01 02 03 04 05 06 per€t2 per*F) Minimum Insulation Required Yes No Form/Title Field Inspector
<br /> Max GPM/First Rated Uni€orm
<br /> Pass Fail
<br /> Name or 105-14tl 0.22-0.28 100 1.0 in or R 7.7 1.5 in or R 12.5 1.5 in or R-11 +! 0 NRCI-PLB-01-E-Must be submitted for all buildings ❑ ❑
<br /> Equipment Type Volume(gal) Hour Ratio Ener Factor 1
<br /> Item Tag g Energy Minimum Required Uniform Energy Factor(UEF) �� • NRCI-PLB-02-E-Must be submitted for high-rise residential and hotel/motel central hot water distribution systems to be ❑ ❑
<br /> (FHR) (UEF) H.DOMESTIC HOT WATER CONTROLS recognized for compliance.
<br /> RHEEM Residential Duty Commercial Gas-Fired 0.9499999880790 NRCI-PLS-03 E-Must be submitted for
<br /> HE80-130 Storage(75,000-105,000 BTUH) >75 GPM>=4.0 71 0.59 This table is used to demonstrate compliance with control requirements in 110.3 forall occupancies.For high-rise residential and hotel/motel occupancies,compliance is also high-rise residential and hotel/motel single dwelling unit hot water distribution systems to ❑
<br /> demonstrated with requirements in 150.1 c 8. be recognized for compliance.
<br /> 'FOOTNOTE:Compliant equipment maybe found in the Modernized Appliance Efficiency Database System(MAEDBS)on the Energy Commission website: Not
<br /> 13
<br /> https://cocertapplionces.energy.ca.gov/Pages/Search/AdvancedSearch.aspx Yes No Applicable Requirement J.DECLARATld1H OF REQUIRED CERTIFICATES OF ACCEPTANCE
<br /> Water Heating Equipment All Occupancies
<br /> 01 ® El 1:1Construction documents require manufacturer certification that service water-heating systems are equipped with automatic There are no Certificates of Acceptance applicable to service water heating requirements.
<br /> Yes No Not Applicable Requirement temperature controls capable of adjusting temperature settings per110.3 a .
<br /> 1$ ❑ E ® Unfired storage tank insulation shall have Internal+External>=R-16 OR External>=R-12.Label required02 ❑ ❑ ® Systems with capacity>167,000 BTUH equipped with outlet temperature controls per 110.3 c 1 unless covered by California K.DECLARATION OF REQUIRED CERTIFICATES OF VERIFICATION
<br /> 110.3 c 3
<br /> per Plumbing Code 613.0. 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.
<br /> New state buildings 60%of energy for service water heating from site solar energy or recovered energy 03 © ❑ ® y g Y p Additional Remarks. These documents must be completed by a HERS Rater and provided to the building inspector during construction. The final documents must be created by a HERS
<br /> 19 ❑ ❑ ® g gY g gY gY Controls for circulating pumps or electrical heat trace systems are capable of automatically turnip off the system per
<br /> per b11Q.3 c 110.3 c 2 unless systems serves healthcare facility. Providers registry,but drafts can be found online at https://www.energy_co.gov/title2412019standards/2019 compliance-documents/Nonresidential Documents/NRCl/ Q
<br /> 20 ❑ ❑ ® Isolation valves for instantaneous water heater with input rating<6.8!BTUH or 2 kW has been specified D4 ❑ © ® For recirculation systems serving multiple dwelling units,design includes automatic pump controls per§150.11c)8Bii,or 150.2 Yes No Field Inspector >
<br /> per 110 3 c 6 for additions or alterations. Form/Title
<br /> Pass Fail J Q
<br /> 05 ❑ ❑ ® For recirculation systems serving individual dwelling units,design includes manual on/off controls as specified in Reference U • NRCV-PLB-21-H High-rise Residential Central Hot Water Distribution HERS Verification ❑ ❑ M M
<br /> G.DOMESTIC HOT WATER DISTRIBUTION SYSTEM Appendix RA4.4.9 per.150,1 c 8. © ❑ � ■,,,,;�,,
<br /> • NRCV PLB-22-H High-rise Residential Individual Dwelling Unit Hot Water Distribution HERS Verification
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<br /> This table is used to demonstrate compliance for nonresidential occupancies with distribution requirements in 120-3 and 140.5.Far high rise residential and hotel/motet occupancies, 06 © ❑ ® For replacement single heat pump water heaters serving individual dwelling units in climate zone 1-15,design includes }.
<br /> compliance is demonstrated with requirements 3 c §10_3. 150,0 150.1 communication interface that meets demand responsive control requirements of 110.12 a per§150.21b)iHiii, z U
<br /> Mandatory Pipe Insulation All Occupancies L.L.
<br /> For systems serving nonresidential spaces,pipe insulation for the following applications is specified to comply with Table 120.3-A(see below)per 120.3: < U
<br /> 12 ® • Recirculating system piping,including supply and return piping of the water heater w
<br /> • The first 8 ft of hot and cold outlet piping, including between storage tank and heat trap,for a nonrecirculating storage system
<br /> • Pipes that are externally heated < U
<br /> 13 ® Insulation shall be protected from damage,including that due to sunlight,moisture,equipment maintenance,and wind.Insulation exposed to weather shall r^
<br /> be installed with a cover suitable for outdoor service per 120.3 b and 150.0 ' 3 'V1 J' Q
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<br /> Registration Number: Registration Number: Registration Number: Registration Date Time: 1.ri� O W
<br /> Registration Date/Time: g / Registration Provider:Energysoft
<br /> Registration Date Time: g Registration Provider.Energysoft
<br /> g Registration Provider:Energysoft
<br /> CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated 2020-09-15 18:16:53 co
<br /> CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.1.003 Report Generated:2020-09-15 18:16:53
<br /> CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.L003 Report Generated:2020-09-15 1$:16:53 Schema Version:rev 20190401
<br /> Schema Version:rev 20190401 Schema Version:rev 20190401
<br /> Date 9/15/2020 a
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