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00 L0 COL O Z a o W H J W = WMU - ZazL0 QJ J O LL J Z ~ Q Z Z O Q U J O LL_ cn 0 OU CO w � � C� U O � a 0 I � I z N Q L0O W a J U N CY) CO 0 0 0 0 O U 000 ,, U mmmm N N N N N �f7 17 0 N O N U CN dj STATE OF CALIFORNIA STATE OF CALIFORNIA rn oo � o Sign Lighting Sign Lighting Z NRCC-LTS-E CALIFORNIA ENERGY COMMISSION NRCC-LTS-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-E CERTIFICATE OF COMPLIANCE NRCC-LTS-E This document is used to demonstrate compliance with requirements in 110.9 110.12 130.0 130.3 140.8 and§141.0(b)2M for sign lighting scopes using the prescriptive path. Project Name: COSTCO Fuel Facility#658 Report Page: (Page 2 of 4) Exit signs and traffic signs are not required to comply with prescriptive requirements per exceptions to 140.8 and do not need to complete this compliance document. Project Address: 3250 W.Grant Line Road I Date Prepared: 6/22/2021 Project Name: COSTCO Fuel Facility#658 Report Page: (Page 1 of 4) Project Address: 3250 W.Grant Line Road I Date Prepared: 6/22/2021 E.ADDITIONAL REMARKS A. GENERAL INFORMATION This table is includes remarks made by the permit applicant to the Authority Having Jurisdiction. 01 Project Location (city) Tracy F. MAXIMUM ALLOWED LIGHTING POWER AND CONTROLS 02 Climate Zone 12 03 Building is a healthcare facility No This table includes illuminated signs using the Maximum Allowed Lighting Power compliance method per§140.8(a) as indicated on Table 8 of this compliance document. It also demonstrates compliance with mandatory controls requirements from 130.3 by indicating control types for each sign. B. PROJECT SCOPE 01 02 03 04 05 06 07 08 09 This table includes illuminated signs that are within the scope o the permit application and are demonstrating compliance using the prescriptive path outlined in 1§ 40.8 or Allowed Mandatory Controls Field Inspector 9 P f p pp 9 p 9 P p p Name or Item Complete Sign Illumination Sign Area Allowance Design §141.0(b)2M for alterations. Exit signs and traffic signs are not required to comply with prescriptive requirements per exceptions to1§ 40.8 and do not need to complete this Ta Description Method z Density Demand Tag p (ft ) (W/ftz) (Watts) Watts Shut-Off Dimming Responses Pass Fail .10 compliance document. 01 02 03 04 05 Automatic Time Switch _ B Canopy Fascia Externally 117.2 2.3 269.56 216 Exempt* NA ❑ ❑ Name or Item Tag Complete Sign Description Sign Status' Sign Type Compliance Method +Photocontrol W 10 11 12 13 14 B Canopy Fascia New Outdoor Max Allowed Lighting Power J N Luminaire Complete Luminaire Watts per Total Number Q W 0 1 Name or Item Description luminaire How is Wattage determined of Luminaires r^ FOOTNOTE:Sign alterations that increase the connected lighting load,replace and rewire more that 50%of the ballasts,or relocate the sign to a different location must comply with 140.8.See Tag P �v i > OD §141.0(b)2M for more details. W I1r y Canopy Fascia 18w Linear LED Fixture LQL The ENERGY VERIFIED Label compliance method is only applicable if the sign has a permanent,factory-installed,ENERGY VERIFIED label certified by UL or comparable,confirming the sign complies with 18 Mfr.Spec 12 § O 1 40.8.Note that using an ENERGY VERIFIED label is an optional compliance path,not a mandatory requirement.Seethe tooltips for this table for more details. Sign Light -Fascia *NOTES:Controls with a *require a note in the space below explaining how compliance is achieved.EX:Sign within tunnel illuminated day and night;EXCEPTION to = W C.COMPLIANCE RESULTS 130.3(a)2A. T 2 Results in this table are automatically calculated from data input and calculations in Tables a through H.Note:If any cell on this table says"COMPLIES with Exceptional Conditions"refer 1 FOOTNOTE:Demand response controls are only required for an Electronic Message Center having a new connected lighting power load greater than 15 kW per§110.12(d) Q to Table D. Exceptional Conditions for guidance or see applicable Table referenced below. O J 01 02 03 04 05 06 07 G. LIGHT SOURCES AND CONTROLS U O Name or Item Complete Sign Description Total Allowed(Watts) > Total Designed OR Compliant Light OR ENERGY VERIFIED This section does not apply to this project. Q Tag (See Table B) (See Table F) (Watts) Sources Label Compliance Results c (See Table B) (See Table F) (See Table G) (See Table H) H. ENERGY VERIFIED LABELED SIGNS AND CONTROLS O co B Canopy Fascia 269.56 >_ 216 10111 10111COMPLIES This section does not apply to this project. U co Controls Compliance(See Table F/G/H for Details) COMPLIES D. EXCEPTIONAL CONDITIONS oil This table is auto filled with uneditable comments because of selections made or data entered in tables throughout the form. Registration Number: Registration Date/Time: Registration Provider:Energysoft Registration Number: Registration Date/Time: Registration Provider:Energysoft L CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.0.001 Report Generated:2021-06-22 12:38:59 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.0.001 Report Generated:2021-06-22 12:38:59 0 Schema Version:rev 20190401 Schema Version:rev 20190401 LL STATE OF CALIFORNIA STATE OF CALIFORNIA Sign Lighting Sign Lighting NRCC-LTS-E CALIFORNIA ENERGY COMMISSION NRCC-LTS-E CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-E CERTIFICATE OF COMPLIANCE NRCC-LTS-E Project Name: COSTCO Fuel Facility#6581 Report Page: (Page 3 of 4) Project Name: COSTCO Fuel Facility#6581 Report Page: (Page 4 of 4) Project Address: 3250 W.Grant Line Road IDate Prepared: 6/22/2021 Project Address: 3250 W.Grant Line Road I Date Prepared: 6/22/2021 I. DECLARATION OF REQUIRED CERTIFICATES OF INSTALLATION DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 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. I certify that this Certificate of Compliance documentation is accurate and complete. Additional Remarks. These documents must be provided to the building inspector during construction and can be found online at Documentation Author Name: Documentation Author Signature: CD AS-Built https://www.energy.ca.gov/title24/2019standards/2019compliance documents/Nonresidential Documents/NRCl/ Ric Francais � ��` �"' 09/01/2022 Yes No Form/Title Field Inspector Company: Signature Date: 2021-06-22 ,aHEscoVEreRouP,IHG. 7:36:45 AM Pass Fail Barghausen Consulting Engineers � Address: CEA/HERS Certification Identification(if applicable):NRCI-LTS-01-E-Must be submitted for all buildings 11 ElRpF E S SI pH 18215 72nd Avenue South 6871-52A4-473C-C49A-542F-D5D2-8FE9-1169-0228-F462-CBF5-90AA-65A4-2C7E-BDFB- J. DECLARATION OF REQUIRED CERTIFICATES OF ACCEPTANCE 106ED =�� tic/ City/State/Zip: Phone: V HAL P. GRUBB ?� There are no Certificates of Acceptance applicable to sign lighting requirements. Kent WA 98032 425-251-6222 _ RESPONSIBLE PERSON'S DECLARATION STATEMENT —� 67814 70 1 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 yT �' 1 V L of Title 24,Part 1 and Part 6 of the California Code of Regulations. F Q 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, OF CA`-\ 05/27/22 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: o Q Q Hal P.Grubb N Company: Date Signed: N 0 z z > Barghausen Consulting Engineers, Inc. 2021-06-22 i Address: License: 18215 72nd Avenue South C67814 > > c0i� N X City/State/Zip: Phone: 0 m 0 N Kent Washington 98032 (425)251-6222 Y > o rn 3 o m 0 o U a o a� 0 U V (n C 12 Registration Number: Registration Date/Time: Registration Provider:Energysoft Registration Number: Registration Date/Time: Registration Provider:Energysoft V Q CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.0.001 Report Generated:2021-06-22 12:38:59 CA Building Energy Efficiency Standards-2019 Nonresidential Compliance Report Version:2019.0.001 Report Generated:2021-06-22 12:38:59 L o Schema Version:rev 20190401 Schema Version:rev 20190401 +' M o O t N ._ O IDS C O W C: E > M Q 06 N NQS (A L0 N Ln }; c� o O N m V � Y CD 0 O i s= 0 U) c 0 0- X N O N U U U L U N E / O Ln O O O N U) L 10 z O O 0 0U) o T i 75\ °�