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14100057 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6191 BOLLINGER RD CONTRACTOR:A BRIGHT IDEA PERMIT NO: 14100057 OWNER'S NAME: WEST VALLEY PRESBYTERIAN CHURCH 30093 AHERN AVE DATE ISSUED: 10/09/2014 OWNER'S PHONE: 4156409673 UNION CITY,CA 94587 PHONE NO:(510)487-5483 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ t REMOVE AND REPLACE ALL LIGHTING FIXTURE AND License Class Lie.# �7 EQUIPMENT 1 Contractor )q gel Date 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$20670 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:37541007.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DA RMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FR M LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 6 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: d with all non-p nt source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signat e - .¢—"�--+ Date q— All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Dale: 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect' ns 255 5533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: permit is issued. 1 certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Date GIENERAL PERMIT A.PPLICATION El�� COPJMUN1TY DEVELOPMENT DEPAR71VENI• BUILDING DIVIS101; 10300 TORRE AVENUE• CUPERTINO, CA 95014-32-55 1 _ (408) 777-3228 • r?x (4G8)777-3333•buildino(�cuc� ino.Dra CUr0'f;i jK0 m I s ❑PLUMBINIGJl Cr-1�iCAL ❑azc-1-jc S qfc-w,,f�DP SS =1 e, ST —IE,Zi.'. I F cme,ST.h-, Z2 FA-- CR'.n� ❑ CJ,��r:3L�._D3. L-1�G`3,7,1.��«ni ❑ CCT' hCC•OR ❑COTit�hCTvR�.CTi ❑ pAC-_=CT ❑=?.0-=��R ❑ D1•�0?"'�, ❑ '�.tT'I CO? hCIOR?Aim �R+��LD(1a L C 1 S'c?iJ,r I L1C ;S'c-'i?= 131iS.UC 4 CO?JDA MY T.t t r � =-i✓ey FAX ST-t c.Z-r Y-MR=Ss c=, ,STA i q Z3 PHONE P RC vinCi/rTGTrERT�]✓" L CTsE?.TUA1SER BLJs.LIC R CO?J9fRYT 4✓S I 1✓�hTs I aAX ST?c:T hDDP=SS CITY,STAT F,ZP I P_OKE. US2 OF ❑_sm or D.pT--.. ❑ mau-F'U'u Y PROJECT LTi WILDLf?NTD ❑ l m PP.OrtCT T ❑m I IST-BLDG 1.N ❑ 1 LS BLT N01. ❑COlz�CL',L L?3!ND, 'rhe a.EA ❑ \,o :iOCDM?=- ❑ ,o =iGTi 807 ? ❑ \'0 nESMUTION of WORK y-y s r a se belo;,,I ce, to e_Cii Of tae rollov,L : I am u,_ -er or udoriz.5d€gaat to act on t:_ ro o,,;mz t`s bthalf. I hF%:t;tad phis application and tae inior-ation I have Prov;_cd is co-ect I have s_ad t:-,e Description Of��` ,k and v>_riry it is G c raLB, 1 F P.P.to conpIy Width all applicable local ordinances pads to la,;s,elaa e to buildine corse_cticn. Int ives of Cuper:iao:o eater&,,e abo---identtij-�'ed proptgty`or i s-niction p�_rpeses. S:--mature oi=.palic ,t' _ent: y a Date: — 1 CJI t' SUPT F7 r?�T T 't0�� 0?v! F.QU=�.Di = — M. L! IMP P _ _ _ •- _ S^ R. ?, P.%,�fsc.Ea�_201.1.docre-,,ised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION MDDRESS: 6191 bollinger rd DATE: 10/09/2014 REVIEWED BY: Mendez PN: BP#: `VALUATION: 1$20,670 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1GENCOM USE: PERMIT TYPE: WORK remove and replace all lighting fixture and equipment SCOPE F-1 _L_ LJ -t- LJ -L_ NOTE: This estimate does not include fees clue to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School District,etc. . These ees are based on the preliminar information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (FeeResolution ll-0 3 r'' i:'1%13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ®Yes ) No $0.00 1 hours Plan Check,Hourly Suppl. PC Fee: Q Reg. 0 OT 10—.01hrs $0.00 $143.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: Hourly Only? ®Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0--.01hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes (E) No $0.00 .Advanced Planning Fee: $0.00 Select a Non-Residential Q Building or Structure Strom Motion Fee: IBSEISMICO $5.79 3.0 hrs Inspections Bldg,Stds Commission Fee: IBCBSC $1.00 $429.00 ISTINSP Inspection,Hourly SUBTOTALS: $6.79 $572.00 TOTAL FEE: $578.79 Revised: 08/20/2014 STATE OF CALIFORNIA INDOOR LIGHTING CEC-NRCI-LTI-01-E Revised 06/13 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 1 of 2) Project Name:West Valley Presbyterian Church Enforcement Agency:Cupertino(City) Permit Number. Project Address:6191 Bollinger Rd. ""Cupertino Z'P`°de 95014 GENERAL INFORMATION DATE OF BUILDING PERMIT PERMIT# BUILDING TYPE 0 Nonresidential ❑ High-Rise Res(Common Area) ❑ Hotel/Motel(Common Area) PHASE OF ElCONSTRUCTION New Construction ❑Addition Q El Unconditioned SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides Date: the specifications for the energy efficiency measures for the scope of responsibility for this Installation Certificate. In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate(continued). Date Approved By Document Title or Description Applicable Sheets or Pages,Tables,Schedules,etc. the Enforcement Agency Lighting Certificate of Compliance Lighting Controls Certificate of Compliance Lighfing Power Allowance Certificate of Compliance Lighting Controls Certificate of Acceptance Lighting Controls Certificate of Installation Oq` F F I G F. C;0 P Y CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2013 STATE OF CALIFORNIA INDOOR LIGHTING 4 CEC-NRCI-LTi-01-E Revised 06113 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-LTI-01-E Indoor Lighting (Page 2 of 2) Project Name:West Valley Presbyterian Church Enforcement Agency:Cupertino (City) Permit Number. Project Address:6191 Bollinger Rd. ""'Cupertino Z'p`°de95014 Date Approved By Document Title or Description Applicable Sheets or Pages,Tables,Schedules,etc. the Enforcement Agency DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation uthor ame: Documentation Author gna re: Documentation Au or Comp ny N_me:r.�- Date Signed: ILA Address: 3 _( CEA/HERS Certification Identification(If applicable): City/State/TP—. _ t C\`� Phone: i�1 J_- 1 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,construction,or installation of features,materials,components,or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement(responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features,materials,components or manufactured devices(the installation)identified on this Certificate of Installation conforms to all applicable codes and regulations,and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation,and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be posted,or 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 Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Si ture: Company Name: nst g Subcontract� neral Contractor or Position With ompany Title): Builder/Owner) (� C L 0 yp-y e-r Address: ,r'�_�� r _I;Xu CSLB License: City/State/V +� �f Phng`o Date Signed: ` CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2013 STATE OF CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT - CEC-NRCA-LTI-03-A Revised 06113 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 1 of 6) F Project Name:West Valley Presbyterian Church Enforcement Agency'Cupertino Permit Number Project Address:6191 Bollinger Rd. °"Cupertino Zip Code:94014 Note: For more than 3 spaces attach additional sets of pages 2 Enforcement Agency Use: Checked by/Date through 5,as required. Automatic Shut-off Controls: Automatic Time Switch Control and Occupant Sensor Intent: Lights are turned off or set to a lower level when not needed per Section 110.9(a)&130.1(c). Guidance This acceptance test form must be filled out for all newly-installed lighting control systems of the following types: 1. Automatic Time Switch Controls II. Occupancy Sensors III. Partial-OFF occupancy sensors IV. Partial-ON occupancy sensors(only if used to claim a Power Adiustment Factor) V. Occupancy Sensors serving small zones in large open plan offices(only if used to claim a Power Adjustment Factor) For automatic daylighting controls use acceptance test form NRCA-LTI-03-A;for demand responsive lighting controls,use acceptance test form NRCA-LTI-04-A. The tests on this certificate are required by Section 140.6(a)2 and 130.4(a)of the Building Energy Efficiency Standards 2013. The tests themselves are described in Sections 140.6(a)2 and in Reference Appendix NA7.6. A. Construction Inspection Fill out Section A to cover spaces 1 through 3 that are functionally tested under Section B. Make as many copies of pages 2-5 as are required to test all spaces in the building,and attach to page 1. Instruments needed to perform tests include,but are not limited to:hand-held amperage meter,power meter,or light meter 1 Automatic Time Switch Controls Construction Inspection—confirm for all listed in Section B a. All automatic time switch controls are programmed for(check all): �] Weekdays Weekend ❑� Holidays b. Document for the owner automatic time switch programming(check C UPERTINO 0 Weekdays settings ,�� <�f �� ' Buildinq . aitment �] Weekend settings r ❑� Holidays settings ❑ Set-up settings la- - 0 Preference program setting ❑? Verify the correct time and date is properly set in the time switch Verify the battery is installed and energized ❑? Override time limit is no more than 2 hours Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with the applicable provision in Section 110.9 of the Standards,and model numbers for all such controls are listed on the Commission database as Certified Appliance and Control Devices 2 Occupancy Sensor Construction Inspection—confirm for all listed in Section B CA Building Energy Efficiency Standards-2013 Nonresidential Compliance lune 2013 STATE OF CALIFORNIA Ak AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-03-A Revised 06113 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document . (Page 2 of 6) � pro' Nam:West Valley Presbyterian Church Enforcement Agency.Cupertino lino Permit Number. Pm;ect Address:6191 Bollinger Rd. °11-Cupertino Zip Code:94014 Q Occupancy sensors are not located within four feet of any HVAC diffuser Q Ultrasonic occupancy sensors do not emit audible sound 5 feet from source B. Functional Testing of Lighting Controls Representative Spaces Selected For every space in the building,conduct functional tests I through V below if applicable.If there are several geometrically similar spaces that use the same lighting controls,test only one space and list in the cells below which"untested spaces"are represented by that tested space. EXCEPTION:For buildings with up to seven(7)occupancy sensors,all occupancy sensors shall be tested.(NA7.6.2.3) Tested space/room name: Space Type(office,corridor,etc) ❑? 1 Untested areas/rooms Tested space/room name: Space Type(office,corridor,etc) 2 Untested areas/rooms Tested space/room name: Space Type(office,corridor,etc) ❑� 3 Untested areas/rooms Functional Tests Tested Space Number Confirm compliance(Y/N)for all control system types(I-V)present in each space: 1.Automatic Time Switch Controls 1 2 3 Step 1:Simulate occupied condition a. All lights can be turned on and off by their respective area control switch Y/N Y/N Y/N b Verify the switch only operates lighting in the ceiling-height partitioned area in Y/N Y/N Y/N which the switch is located Step 2:Simulate unoccupied condition a All lighting,including emergency and egress lighting,turns off. Exempt lighting may Y/N Y/N Y/N remain on per Section 130.1(c)1 and 130,1(a)1. Manual override switch allows only the lights in the selected ceiling height b. partitioned space where the override switch is located and remain on no longer Y/N Y/N Y/N than 2 hours(unless serving public areas and override switch is captive key type). Step 3:System returned to initial operating conditions Y/N Y/N Y/N 2.Occupancy Sensors 1 2 3 Step 1:Simulate an unoccupied condition a Lights controlled by occupancy sensors turn off within a maximum of 30 minutes Y/N Y/N Y/N from start of an unoccupied condition per Standard Section 110.9(a) The occupant sensor does not trigger a false"on"from movement in an area b. adjacent to the controlled space or from HVAC operation Y/N Y/N Y/N Step 2:Simulate an occupied condition a. Status indicator or annunciator operates correctly Y/N Y/N Y/N CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2013 STATE OF CALIFORNIA _s AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT ` CEC-NRCA-LTI-03-A Revised 06113) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document F (Page 3 of 6) Project Name:West Valley Presbyterian Church Enforcement Agenry:Cupertino Permit Number: Project Address:6191 Bollinger Rd. ""Cupertino Zip`ode.94014 Lights controlled by occupancy sensors turn on immediately upon an occupied b, condition OR sensor indicates space is"occupied"and lights may be turned on Y/N Y/N Y/N manually Step 3:System returned to initial operating conditions Y/N Y/N Y/N CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2013 STATE OF CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-03-A(Revised 06113) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 4 of 6) Pmje�tName West Valley Presbyterian Church Entc—mentAgency:Cuperl:ino Permit Number: oject Address:6191 Bollinger Rd. ""Cupertino Zip Code:94014 3. Partial Off Occupancy Sensor 1 2 3 Step 1:Simulate an unoccupied condition a' Lights go to partial off state within a maximum of 30 minutes from start of an / /unoccupied condition per Standard Section 110.9(a) Y N Y N Y/N The occupant sensor does not trigger a false"on"from movement in an area adjacent to the controlled space or from HVAC operation.For library book stacks or b' warehouse aisle,activity beyond the stack or aisle shall not activate the lighting in Y/N Y/N Y/N the aisle or stack. In the partial off state,lighting shall consume no more than 50%of installed lighting power,or: • No more than 60%of installed lighting power for metal halide or high pressure sodium lighting in warehouses. C. • No more than 60%of installed lighting power for corridors and stairwells in Y/N Y/N Y/N which the installed lighting power is 80 percent or less of the value allowed under the Area Category Method. Light level may be used as a proxy for lighting power when measurements are taken Step 2:Simulate an occupied condition rhe occupant sensing controls shall turn lights fully ON in each separately controlled / / a' areas,Immediately upon an occupied condition Y N Y/N Y N 4. Partial On Occupancy Sensors 1 2 3 Step 1.-Simulate an occupied condition.Verify partial on operation. a Immediately upon an occupied condition,the first stage activates between 30 to 70°x6 Y/N Y/N Y/N of the lighting automatically. After the first stage occurs, manual switches allow an occupant to activate the b. alternate set of lights,activate 100%of the lighting power,and manually deactivate Y/N Y/N Y/N all of the lights. Step 2. Simulate an unoccupied condition a' IBoth stages(automatic on and manual on)lights turn off within a maximum of 30 minutes from start of an unoccupied condition per Standard Section 110.9(a) Y/N Y/N Y/N 13, The occupant sensor does not trigger a false"on"from movement in an area adjacent Y/N Y/N Y/N to the controlled space or from HVAC operation S. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger 1 2 3 than 250 Square Feet,to Qualify for a Power Adjustment Factor(PAF) First,complete Functional Test 2(above)for each controlled zone Step 1. Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test II. a. Area served by controlled lighting(square feet) b Enter PAF corresponding to controlled area from line(a)above(<125sf for PAF=0.4, 126-250sf for PAF=0.3,251-500sf for PAF=0.2). Enter PAF claimed for occupant sensor control in this space from the Certificate of C. Compliance d' Y The PAF corresponding to the controlled area(line b),is less than or equal to the PAF /N Y/N Y/N claimed in the compliance documentation(line c) e' Y Sensors shall not trigger in response to movement in adjacent walkways or /N Y/N Y/N workspaces. CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2013 STATE OF CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT .. CEC-NRCA-LTI-03-A Revised 06113 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 5 of 6) Project Name: rnforcement Agency:CLlpel.}ino Perm it Number: West Valley Presbyterian Church Project Address:6191 Bollinger Rd. "Cupertino Z`PCode:94014 All steps are conducted in Functional Test 2"Occupancy Sensor (On Off Control)"and / / f' all answers are Yes(Y) Y/N Y N Y N C Testing Results PASS/ PASS/ PASS/ FAIL FAIL FAIL I Automatic Time Switch Controls (all answers must bey). II Occupancy Sensor(On Off Control)(all answers must be Y). III Partial Off Occupancy Sensor(all answers must be Y). For warehouses, library book stacks,corridors,stairwells in nonresidential buildings must also be accompanied by passing Test I or Test II. IV Partial On Occupant Sensor for PAF(all answers must be Y). V Occupant Sensor serving small zones for PAF(all answers must be Y).Also must pass Test II D. Evaluation : 0 PASS:All applicable Construction Inspection responses are complete and all applicable Equipment Testing Requirements responses are positive(Y-yes) CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2013 STATE OF CALIFORNIA AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT CEC-NRCA-LTI-03-A Revised 06113 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A Lighting Control Acceptance Document (Page 6 of 6) Project Name: Enforcement Agency: Permit Number: West Valley Presbyterian Church Cupertino Project Address:6191 Bollinger Rd. ``"-Cupertino Zip code:94014 Documentation author's Declaration Statement 1. t certify that this Certificate of Acceptance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Documentation Author Company Name: Date Signed: Address: CEA/HERS/ATT Certification Identification(if applicable): City/State/Zip: Phone: FIELD TECHNICIAN'S DECLARATION STATEMENT I certify the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Acceptance is true and correct. 2. 1 am the person who performed the acceptance verification reported on this Certificate of Acceptance(Field Technician). 3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated in the plans and specifications approved by the enforcement agency,and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s)of installation for the construction or installation identified on this Certificate of Acceptance has been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building. Field Tevknifkian NamL 49Field Technician Sig17k 0%.ir n Field Technician Qmpany Name: t_ Pos tionwi h Company(Tftl�tc'f- Y� Address: ,es S � Gy-Z ATT Certification identification Cif applicable): City/Stati ' Date Signed: r RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury,under the laws of the State of California: 1. 1 am the Field Technician,or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this Certificate of Acceptance. 2_ 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,construction or installation of features,materials,components,or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the declarations in this statement(responsible acceptance person). 3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency,and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7. 4. 1 have confirmed that the Certificate(s)of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is posted or made available with the building permit(s)issued for the building. 5. 1 will ensure that a completed,signed copy of this Certificate of Acceptance shall be posted,or 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 signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Acceptance PprSon Responsible Acceptance Person Sign t e: Responsible Accep a Person omQany 0-it Position with Company(Title): Address: CSLB Licens%-) l J City/State/Z�ip�� I Ph Date Si ned: tire-( (� �— CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2013 I toewltificate This certificate is presented to., Mark W Spahn TC-A813540 For successfully completing the requirements for the ftfornia Advanced Lighting Controls Trainhm.g Program, Acceptance Technic fan requirements February 7;2014 Date Training Director February 7, 2015 Expiration Date � 'PG&E Corporation. CAlfPOfWlA LIGFfTINO TACHNC�I,C�Y C�v'!CR � ' � �.��__ Uq Wgj� NLUe+wmt`w �+a d' The Silicon Valley Energy watch Program is implementedtby h Silicon Valley Energy Watch Ecology Action and funded by California ratepayers under the I °[, �'''•- " 'Y auspices of the California Public Utility Commission. Energy Efficiency Program t Change Order#: Contractor Work Order Agreement 2 Energy and Cost Saving Projects West Valley Presbyterian Church - MLTG (CO#2) Property: West Valley Presbyterian Church 6191 Bollinger Rd. Cupertino,CA 95014 Presented To: Bill Johns 6191 Bollinger Rd. Cupertino,CA 95014 (415)640-9673 Email: Contractor: ABI Services Inc L04" FFICE O 30093 Ahern Ave. Union City,CA 94587 (800)650-5483 Report Date: 9/19/2014 Presented by: For questions contact the Installation Manager: Jack Lu Rachel Radcliffe Ecology Action Ecology Action 2672 Bayshore Parkway#505 2672 Bayshore Parkway#505 Mountain View, CA 94043 Mountain View, CA 94043 Phone: Phone:(831)515-1304 ext 104 Mobile:+1 4152653707 Mobile:+1 6507667006 Fax:(831)427-1368 Fax:650-210-9953 Email:jlu@ecoact.org Email:rradcliffe@ecoact.org Page 1 Contractor Change Order 9/19/2014 The Silicon Valley Energy watch Program is implementedtby h Silicon Valley Energy Watch Ecology Action and funded by California ratepayers under the 9# � -A C .�,I },,, auspices of the California Public Utility Commission. Energy Efficiency Program Change Order#: Summary of Recommended Energy Efficiency Upgrades 2 West Valley Presbyterian Church - MLTG (CO#2) West Valley Presbyterian Church 6191 Bollinger Rd. Cupertino,CA 95014 Estimated Costs Estimated Annual Payback Savings Total installed cost Before rebate $22,047.49 Total Rebate $20,670.01 Your final cost After rebate $1,377.48 $7,920.69- 0.17 Years The project cost is based on current equipment prices and rebate levels and is valid for a period of 14 days from the date presented. Deemed kWh Demand Electricity vi .* ( k1 Why Gas(Therm) Water(ccf) Sewer(ccf)$ Annual Month Utility Savings Summary 71,795.79 27.98 42,869.87 0.00 $7,920.69 $660.06 By implementing these efficiency upgrades you will reduce the emissions of CO2(carbon dioxide) into the atmosphere by 22,463.81 Ib/yr *Note-Savings are estimated using standard engineering calculations and are based on the hours of operation as described to the surveyor. Depending on actual usage as well as changes in your electric utility rate,your savings may be higher or lower.The savings indicated above are NOT guaranteed. Construction costs may vary slightly depending on fixture quantities and unforeseen conditions. **Note-Based on DEER property type and measure savings values from the CPUC,this project is deemed to deliver 71795.79 kWh and 27.98 kW. The rebate offered for the project is calculated based on the deemed savings values. Page 2 Contractor Change Order 9/19/2014 The Silicon Valley Energy Watch Program is implemented Silicon Valley Energy Watch Ecology Action and funded by California ratepayers under the , , _.." Ener Efficiency Program i t ( " '4°-I '' auspices of the California Public Utility Commission. 9Y Y 9 Change Order#: Energy Efficiency Projects and Equipment List 2 West Valley Presbyterian Church - MLTG (CO#2) West Valley Presbyterian Church 6191 Bollinger Rd. Cupertino,CA 95014 Recommended Energy Efficiency Upgrades Quantity Equipment Cost(Per Labor Hrs/Cost(PerItem) Item) Area: (1) Sanctuary Area Comment: INC 200A/LED PAR38 19W 36DEG 3000K(90W equiv) (Philips) : [729.96]-Hours=7.ox2.0 Access Difficulty: Custom Component 1 (30) (30 Annual Savings=$768.ia/yr Standard Ceiling Height:ht' > 18 ft Rate Multiplier: 1.0 Rate Multiplier: 1.43 Installation Comment: Total Install Cost=$1,631.86 E1.LED PAR38 19W 36DEG 3000K(90W equiv)(Philips) 30.0 $36.06 0.08/$6.00 E2.Custom Component 1 30.0 $3.00 0/$0.00 INC 150W/LED PAR30 Short Neck 12W 36DEG 3000K (Philips) : [729.96]-Hours=7.ox2.0 Access Difficulty: Ceiling Height: > 18 ft Custom Component 2 (20) (20) Annual Savings=$390.44/yr Standard g g Rate Multiplier: 1.0 Rate Multiplier: 1.54 Installation Comment: Total Install Cost=$1,110.72 E1.LED PAR30 Short Neck 12W 36DEG 3000K(Philips) 20.0 $36.44 0.08/$6.00 E2.Custom Component 2 20.0 $3.00 0/$0,00 [729.96]-Hou rs=7.0x2.0 INC 175w A/LED PAR38 19W 36DEG 3000K(90W equiv) (Philips) : Custom 2 Component 30 30 Access Difficulty: p ( ) ( ) Standard Ceiling Height: > 18 ft Page 3 Contractor Change Order 9/19/2014 Installation Comment: Annual Savings=$662.04/yr Rate Multiplier: 1.0 Rate Multiplier: 1.43 Total Install Cost=$1,631.86 E1.Custom Component 2 30.0 $3.00 0/$0.00 E2.LED PAR38 19W 36DEG 3000K(90W equiv)(Philips) 30.0 $36.06 0.08/$6.00 Area: (2) Prayer Room Area Comment: [729.96]-Hours=7.0x2.0 INC 60A/LED A-Lamp 11W 2700K(60W equiv) (Philips)(14) (14) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$97.04/yr Standard Rate Multiplier: 1.0 Installation Comment:(8)in the Sanctuary Forward,(2)In the Sacristy Room. Rate Multiplier: 1.0 Total Install Cost=$373.10 E1. LED A-Lamp 11 W 2700K(60W equiv)(Philips) 14.0 $17.49 0.08/$6.00 Area: (3) Crash Zone Room Area Comment: T12 4' 40S 3L -(PG&E)/T8 4' 32W 2L LBP Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Access Difficulty: Ceiling Height: <9 ft Control: Gang 2 G (8) (8) Annual Savings=$266.13/yr Standard g g Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$1,625.53 E1.Ballast Disconnect 16.0 $0.70 0/$0.00 E2.Recycle: Fluorescent Lamps 4'or Shorter 24.0 $0.70 0/$0.00 E3. Lamp T8 4'32W 16.0 $4.44 0/$0.00 E4.Ballast Bi-Level 1&2 Lamp QuickStep LBF 8.0 $30.43 0.33/$24.75 E5.Control:Gang 2 Gang Cover Plate 6.0 $5.00 0/$0.00 E6.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 0/$0.00 E7.Reflector Troffer:2'x4'for 2L 8.0 $15.31 0.08/$6.00 E8.Control Wall Sensor Dual Switch 6.0 $79.40 0.5/$37.50 Page 4 Contractor Change Order 9/19/2014 T12-4'-34w-4L-MagES-RS-NLO/T8 4' 32W 2L NBF Continuous Dim : [52.14]-Hours=1.0x1.0 Control: Gang 2 Ga (1) (1) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$0.86/yr Standard Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment:C0#1-Youth storage room Total Install Cost=$217.78 E1.Ballast Disconnect 1.0 $0.70 0/$0.00 E2.Lamp T8 4'32W 2.0 $4.44 0/$0.00 E3.Ballast Dimmable Quicktronic 2-lamp T8 NBF 1.0 $44.11 0.33/$24.75 E4.Control:Gang 2 Gang Cover Plate 1.0 $5.00 0/$0.00 E5.Control Wall Sensor 1.0 $69.44 0.5/$37.50 E6.Recycle:Non-PCB Ballast from 4'or Shorter 2.0 $0.00 0/$0.00 E7.Recycle:Fluorescent Lamps 4'or Shorter 4.0 $0.70 0/$0.00 [2346.3]-Hours=5.0x9.0 T12-4'-34w-2L-MagES-RS-NLO/T8 4' 32w 2L LBF (1) (1) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$10.53/yr Standard Installation Comment:C0#1 Rate Multiplier: 1.0 Rate Multiplier: 1.0 Total Install Cost=$56.35 E1.Ballast:T8-2L,IS,LBF 1.0 $14.95 0.33/$24.75 E2.Ballast Disconnect 1.0 $0.70 0/$0.00 E3.Lamp T8 4'32W 2.0 $4.44 0/$0.00 E4.SFL 5000°K Specification $0.00 0/$0.00 E5.Recycle:Fluorescent Lamps 4'or Shorter 2.0 $0.70 0/$0.00 E6.Recycle:Non-PCB Ballast from 4'or Shorter 1.0 $0.00 0/$0.00 Area: (6) Nursery 1 Area Comment: [2346.3]-Hours=5.0x9.0 T12 4' 40S 4L -PG&E/T8 4'32W 2L LBF Dual Switch Step-Dim : Access Difficulty. Control: Gang 2 Gan (8) (8) Standard Ceiling Height: <9 ft Page 5 Contractor Change Order 9/19/2014 Installation Comment: Annual Savings=$441.12/yr Rate Multiplier: 1.0 Rate Multiplier: 1.0 Total Install Cost=$3,559.83 E1.Reflector Troffer:2'x4'for 2L 8.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 32.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 0/$0.00 E4.Ballast Disconnect 16.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 16.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp QuickStep LBF 8.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 20.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 20.0 $5.00 0/$0.00 Area: (7) Nursery 2 Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Access Difficulty: Ceiling Height: <9 ft Control: Gan 2 Gan 8 8 9 9 9 � ) � ) Annual Savings=$441.12/yr Standard Rate Multiplier: 1.0 Rate Multiplier. 1.0 Installation Comment: Total Install Cost=$805.12 E1.Reflector Troffer:2'x4'for 2L 8.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 32.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 ', 0/$0.00 E4.Ballast Disconnect 16.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 16.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp QuickStep LBF 8.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Page 6 Contractor Change Order 9/19/2014 Area: (8) Nursery Bathroom Area Comment:Area Exempt from T24,less than 100 sq ft (52.14]-Ho urs=1.Ox 1.0 T12 4' 40S 4L -PG&E/T8 4' 32w 2L LBF w/Reflector(1) (1) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$1.20/yr Standard Rate Multiplier: 1.0 Installation Comment: Rate Multiplier: 1.0 Total Install Cost=$163.76 E1.Ballast Disconnect 1.0 $0.70 0/$0.00 E2.SFL 5000°K Specification $0.00 0/$0.00 E3.Lamp T8 4'32W 2.0 $4.44 0/$0.00 E4.Reflector Troffer:2'x4'for 2L 1.0 $15.31 0.08/$6.00 E5.Ballast:T8-2L,IS,LBF 1.0 $14.95 0.33/$24.75 E6.Recycle:Non-PCB Ballast from 4'or Shorter 2.0 $0.00 0/$0.00 E7.Recycle:Fluorescent Lamps 4'or Shorter 4.0 $0.70 0/$0.00 E8.Ballast Disconnect 1.0 $0.70 0/$0.00 E9.SFL 5000°K Specification $0.00 0/$0.00 E10. Lamp T8 4'32W 2.0 $4.44 0/$0.00 E11.Reflector Troffer:2'x4'for 2L 1.0 $15.31 0.08/$6.00 E12.Ballast:T8-2L,IS,LBF 1.0 $14.95 0.33/$24.75 E13.Recycle:Non-PCB Ballast from 4'or Shorter 2.0 $0.00 0/$0.00 E14.Recycle:Fluorescent Lamps 4'or Shorter 4.0 $0.70 0/$0.00 Area: (9) Nursery 3 Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.ox9.0 Access Difficulty: Ceiling Height: <9 ft Control: Gang 2 Gan (8) (8) Annual Savings=$441.12/yr Standard g g Page 7 Contractor Change Order 9/19/2014 Installation Comment: Rate Multiplier: 1.0 Rate Multiplier: 1.0 Total Install Cost=$805.12 E1.Reflector Troffer:2'x4'for 2L 8.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 32.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 0/$0.00 E4.Ballast Disconnect 16.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 16.0 $4.44 0/$0.00 E6.Ballast Bi-Level 182 Lamp Quickstep LBF 8.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (13) Room 9 Area Comment: T12 4' 40S 3L -(PG&E)/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 5 5 Access Difficulty: Control: Gang 2 G ( ) ( ) Annual Savings=$166.33/yr Standard Ceiling Height: <9 ft Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$499.55 E1.Ballast Disconnect 10.0 $0.70 0/$0.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 15.0 $0.70 0/$0.00 E3.Lamp T8 4'32W 10.0 $4.44 0/$0.00 E4.Ballast Bi-Level 182 Lamp QuickStep LBF 5.0 $30.43 0.33/$24.75 E5.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 E6.Recycle:Non-PCB Ballast from 4'or Shorter 10.0 $0.00 0/$0.00 E7.Reflector Troffer:2'x4'for 2L 5.0 $15.31 0.08/$6.00 E8.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 Page 8 Contractor Change Order 9/19/2014 Area: (14) Room 8 Area Comment: T12 4' 40S 3L -(PG&E)/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Control: Gang 2 G (5) (5) Annual Savings=$166.33/yr Access Standard Difficulty: Ceiling Height: <9 ft RRate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$499.55 E1.Ballast Disconnect 10.0 $0.70 0/$0.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 15.0 $0.70 0/$0.00 E3.Lamp T8 4'32W 10.0 $4.44 0/$0.00 E4.Ballast Bi-Level 1&2 Lamp Quickstep LBF 5.0 $30.43 0.33/$24.75 E5.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 E6.Recycle:Non-PCB Ballast from 4'or Shorter 10.0 $0.00 0/$0.00 E7.Reflector Troffer:2'x4'for 2L 5.0 $15.31 0.08/$6.00 E8.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 [260.7]-Hours=5.0x 1.0 T12-4'-34w-2L-MagES-RS-NL0/T8 4' 32w 2L LBF (1) (1) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$1.17/yr Standard Rate Multiplier: 1.0 Installation Comment:C0#1-bathroom Rate Multiplier: 1.0 Total Install Cost=$56.10 E1.Ballast:T8-2L,IS,LBF t0 $14.95 0.33/$24.75 E2.Ballast Disconnect 1.0 $0.70 0/$0.00 E3.Lamp T8 4'32W 2.0 $4.44 0/$0.00 E4.SFL 5000°K Specification $0.00 0/$0.00 E5.Recycle:Fluorescent Lamps 4'or Shorter 2.0 $0.70 0/$0.00 E6.Recycle:Non-PCB Ballast from 4'or Shorter 1.0 $0.00 0/$0.00 Area: (15) Room 7 Page 9 Contractor Change Order 9/19/2014 Area Comment: T12 4' 40S 3L -(PG&E)/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.ox9.0 Control: Gan 2 G 5 5 Access Difficulty: g Height: <9 ft Gang ( ) ( ) Annual Savings=$166.33/yr Standard Ceilin Hei Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$499.55 E1.Ballast Disconnect 10.0 $0.70 0/$0.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 15.0 $0.70 0/$0.00 E3.Lamp T8 4'32W 10.0 $4.44 0/$0.00 E4.Ballast Bi-Level 1&2 Lamp QuickStep LBF 5.0 $30.43 0.33/$24.75 E5.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 E6.Recycle:Non-PCB Ballast from 4'or Shorter 10.0 $0.00 0/$0.00 E7.Reflector Troffer:2'x4'for 2L 5.0 $15.31 0.08/$6.00 E8.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 T12-4'-34w-2L-MagES-RS-NLO/T8 4' 32W 2L NBF Continuous Dim [260.7]-Hours=5.0x1.0 1 1 Access Difficulty: Ceiling Height: <9 ft ( ) ( ) Annual Savings=$0.66/yr Standard RRate Multiplier: 1-0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$90.08 E1.Ballast Disconnect 1.0 $0.70 0/$0.00 E2.Lamp T8 4'32W 2.0 $4.44 0/$0.00 E3.Ballast Dimmable Quicktronic 2-lamp T8 NBF 1.0 $44.11 0.33/$24.75 E4.Recycle:Non-PCB Ballast from 4'or Shorter 1.0 $0.00 0/$0.00 E5.Recycle:Fluorescent Lamps 4'or Shorter 2.0 $0.70 0/$0.00 [52.14]-Hours=1.0x1.0 INC 60A/LED A-Lamp 11 W 2700K (60W equiv) (Philips) (3) (3) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$1.49/yr Standard Rate Multiplier. 1.0 Installation Comment: Rate Multiplier: 1.0 Total Install Cost=$79.92 Page 10 Contractor Change Order 9/19/2014 E1.LED A-Lamp 11 W 2700K(60W equiv)(Philips) 3.0 $17.49 0.08/$6.00 Area: (17) Office Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Control: Gan 2 Gan 4 4 Access Difficulty: Ceiling Height: <9 ft 9 Annual Savings=$220.56/yr Standard Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$402.63 E1.Reflector Troffer:2'x4'for 2L 4.0 $15.31 0.08/$6,00 E2.Recycle:Fluorescent Lamps 4'or Shorter 16.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 8.0 $0.00 0/$0.00 E4.Ballast Disconnect 8.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 8.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp Quickstep LBF 4.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (18) Pastor Kim's Office Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Access Difficulty: Control: Gang 2 Gan (4 Ceiling Height: <9 ft � �4� Annual Savings=$220.56/yr Standard Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$402.63 E1.Reflector Troffer:2'x4'for 2L 4.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 16.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 8.0 $0.00 0/$0.00 E4.Ballast Disconnect 8.0 $0.70 0/$0.00 Page 11 Contractor Change Order 9/19/2014 E5.Lamp T8 4'32W 8.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp QuickStep LBF 4.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (19) Copy Room Area Comment:Area exempt from T24,less than 100 sq ft. [52.14]-Hours=1.0x1.0 T12 4' 40S 4L -PG&E/T8 4' 32w 2L LBF w/Reflector(2) (2) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$2.41 /yr Standard Installation Comment: Rate Multiplier: 1.0 Rate Multiplier: 1.0 Total Install Cost=$327.65 E1.Ballast Disconnect 2.0 $0.70 0/$0.00 E2.SFL 5000°K Specification $0.00 0/$0.00 E3.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E4.Reflector-Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E5.Ballast:T8-2L,IS,LBF 2.0 $14.95 0.33/$24.75 E6.Recycle:Non PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E7.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E8.Ballast Disconnect 2.0 $0.70 0/$0.00 E9.SFL 5000°K Specification $0.00 0/$0.00 E10.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E11. Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E12. Ballast:T8-2L,IS,LBF 2.0 $14.95 0.33/$24.75 E13. Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E14.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 Page 12 Contractor Change Order 9/19/2014 Area: (20) Finance Room Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Access Difficulty: Ceiling Height: <9 ft Control: Gang 2 Gan (2) (2) Annual Savings=$110.28/yr Standard g g Rate Multiplier: 1.0 Rate Multiplier. 1.0 Installation Comment: Total Install Cost=$201.24 E1.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 o/$0.00 E4.Ballast Disconnect 4.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 4.0 $4.44 o/$0.00 E6.Ballast Bi-Level 182 Lamp QuickStep LBF 2.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (21) Office Manager Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.ox9.0 Access Difficulty Ceiling Height: <9 ft Control: Gang 2 Gan (2) (2) Annual Savings=$110.28/yr Standard g g Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$201.24 E1.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E4.Ballast Disconnect 4.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 4.0 $4.44 0/$0.00 Page 13 Contractor Change Order 9/19/2014 E6.Ballast Bi-Level 182 Lamp QuickStep LBF 2.0 $30.43 0.33/$24.75 ET Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (22) Matt Hall's Office Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Control: Gan 2 2 2 Access Difficulty: Ceiling Height: <9 ft Gang Gan ( ) ( ) Annual Savings=$110.28/yr Standard RRate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$201.24 E1.Reflector-Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E4.Ballast Disconnect 4.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E6.Ballast Bi-Level 182 Lamp QuickStep LBF 2.0 $30.43 0.33/$24.75 ET Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (23) Sarah's Office Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Access Difficulty: Ceiling Height: <9 ft Control: Gang 2 Gan (2) (2) Annual Savings=$110.28/yr Standard g g Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$201.24 E1.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 Page 14 Contractor Change Order 9/19/2014 E3.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0 00 E4.Ballast Disconnect 4.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp Quickstep LBF 2.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (24) Sunday School Superintendent Office Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 2 Gan 2 2 Access Difficulty, Ceiling Height: <9 ft Control: Gang ( ) ( ) Annual Savings=$110.28/yr Standard Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$201.24 E1.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E4.Ballast Disconnect 4.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp Quickstep LBF 2.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (25) Mail Area Area Comment:Area Exempt from T24 less than 100 sq.ft [52.14]-Hours=1.0x 1.0 T12 4' 40S 4L -PG&E/T8 4' 32w 2L LBF w/Reflector(2) (2) Access Difficulty: Page 15 Contractor Change Order 9/19/2014 Annual Savings=$2.41 /yr Standard Ceiling Height: <9 ft Installation Comment: Rate Multiplier: 1.0 Rate Multiplier: 1.0 Total Install Cost=$327.65 E1.Ballast Disconnect 2.0 $0.70 0/$0.00 E2.SFL 5000°K Specification $0.00 0/$0.00 E3.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E4.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E5.Ballast:T8-2L,IS,LBF 2.0 $14.95 0.33/$24.75 E6.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 I E7.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E8.Ballast Disconnect 2.0 $0.70 0/$0.00 E9.SFL 5000°K Specification $0.00 0/$0.00 E10.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E11.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E12.Ballast:T8-2L,IS,LBF 2.0 $14.95 0.33/$24.75 E13. Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E14.Recycle.Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 Area: (26) Worship Director's Office Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3[-Hours=5.ox9.0 Control: Gan 2 Gan 4 4 Access Difficulty: Ceiling Height: <9 ft 9 Annual Savings=$220.56/yr Standard R Rate Multiplier: 1.0 ate Multiplier: 1.0 Installation Comment: Total Install Cost=$402.63 E1.Reflector Troffer:2'x4'for 2L 4.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 16.0 $0.70 0/$0.00 Page 16 Contractor Change Order 9/19/2014 E3.Recycle:Non-PCB Ballast from 4'or Shorter 8.0 $0.00 0/$0.00 E4.Ballast Disconnect 8.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 8.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp QuickStep LBF 4.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (27) Fridlund Kitchen Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [521.4]-Hours=5.0x2.0 2 Gan 2 2 Access Difficulty: Ceiling Height: < 9 ft Control: Gang ( ) ( ) Annual Savings=$24.51 /yr Standard Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$201.24 E1.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E4.Ballast Disconnect 4.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E6. Ballast Bi-Level 1&2 Lamp QuickStep LBF 2.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 o/$0.00 Area: (28) Room 11 Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Access Difficulty: Ceiling Height: <9 ft Control: Gang 2 Gan (8) (8) Annual Savings=$441.12/yr Standard g g Page 17 Contractor Change Order 9/19/2014 Installation Comment: Rate Multiplier: 1.0 Rate Multiplier: 1.0 Total Install Cost=$805.12 E1.Reflector-Troffer:2'x4'for 211 8.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 32.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 0/$0.00 E4.Ballast Disconnect 16.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 16.0 $4.44 0/$0.00 E6.Ballast Bi-Level 182 Lamp QuickStep LBF 8.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (29) Room 12 Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Control: Gan Gan Access Difficulty: Ceiling Height: <9 ft 9 2 8) 8) Annual Savings=$441.12/yr Standard Rate Multiplier 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$805.12 E1.Reflector Troffer:2'x4'for 2L 8.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 32.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 0/$0.00 E4.Ballast Disconnect 16.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 16.0 $4.44 0/$0.00 E6. Ballast Bi-Level 182 Lamp QuickStep LBF 8.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Page 18 Contractor Change Order 9/19/2014 Area: (30) Room 13 Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Control: Gang 2 Gan (8) (8) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$441.12/yr Standard Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$805.12 E1.Reflector Troffer:2'x4'for 2L 8.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 32.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 0/$0.00 E4.Ballast Disconnect 16.0 $0.70 0/$0.00 E5.Lamp T8 4'32W 16.0 $4.44 0/$0.00 E6.Ballast Bi-Level 182 Lamp QuickStep LBF 8.0 $30.43 0.33/$24.75 E7. Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (31) Room 14 Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 2 Gan 8 8 Access Difficulty: Ceiling Height: <9 ft Control: Gang ( ) ( ) Annual Savings=$441.12/yr Standard Rate Multiplier: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$805.12 E1.Reflector Troffer:2'x4'for 2L 8.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 32.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 16.0 $0.00 0/$0.00 E4.Ballast Disconnect 16.0 $0.70 0/$0.00 FEEm�pp:T:8:4'32W 16.0 $4.44 0/$0 00 Page 19 Contractor Change Order 9/19/2014 E6.Ballast Bi-Level 1&2 Lamp QuickStep LBF 8.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (32) Room 15 Area Comment: T12 4' 40S 4L -PG&E/T8 4' 32W 2L LBF Dual Switch Step-Dim : [2346.3]-Hours=5.0x9.0 Access Difficulty: Hei t: < Control: Gang 2 Gan (16) (16) Annual Savings=$882.23/yr Standard Ceiling9 ft Rate Heigtiht: 1.0 Rate Multiplier: 1.0 Installation Comment: Total Install Cost=$1,610.25 F1.Reflector-Troffer:2'x4'for 2L 16.0 $15.31 0.08/$6.00 E2.Recycle:Fluorescent Lamps 4'or Shorter 64.0 $0.70 0/$0.00 E3.Recycle:Non-PCB Ballast from 4'or Shorter 32.0 $0.00 0/$0.00 E4.Ballast Disconnect 32.0 $0.70 0/$0.00 F5.Lamp T8 4'32W 32.0 $4.44 0/$0.00 E6.Ballast Bi-Level 1&2 Lamp QuickStep LBF 16.0 $30.43 0.33/$24.75 E7.Control Wall Sensor Dual Switch 0.0 $79.40 0.5/$37.50 E8.Control:Gang 2 Gang Cover Plate 0.0 $5.00 0/$0.00 Area: (34) Exterior Storage Room Area Comment:Rooms with 1 fixture each,exempt from T24 [52.14]-Hours=1.0x1.0 T12 4' 40S 4L -PG&E/T8 4' 32w 2L LBF w/Reflector (2) (2) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$2.41/yr Standard Rate Multiplier: 1.0 Installation Comment: Rate Multiplier: 1.0 Total Install Cost=$327.65 E1.Ballast Disconnect 2.0 $0.70 0/$0.00 E2.SFL 5000°K Specification $0.00 0/$0.00 Page 20 Contractor Change Order 9/19/2014 E3.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E4.Reflector_Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E5.Ballast:T8-2L,IS,LBF 2.0 $14.95 0.33/$24.75 E6.Recycle:Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E7.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 E8.Ballast Disconnect 2.0 $0.70 0/$0.00 E9.SFL 5000°K Specification $0.00 0/$0.00 E10.Lamp T8 4'32W 4.0 $4.44 0/$0.00 E11.Reflector Troffer:2'x4'for 2L 2.0 $15.31 0.08/$6.00 E12.Ballast:T8-2L,IS,LBF 2.0 $14.95 0.33/$24.75 E13.Recycle.Non-PCB Ballast from 4'or Shorter 4.0 $0.00 0/$0.00 E14.Recycle:Fluorescent Lamps 4'or Shorter 8.0 $0.70 0/$0.00 [52.14]-Hours=1.0x 1.0 T12-4'-34w-2L-EI-RS-NL0/T8 4' 32W 2L LBF (1) (1) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$o.11 /yr Standard Rate Multiplier: 1.0 Installation Comment: Rate Multiplier: 1.0 Total Install Cost=$56.35 E1.Recycle.Fluorescent Lamps 4'or Shorter 2.0 $0.70 0/$0.00 E2.SFL 5000°K Specification $0.00 0/$0.00 E3.Lamp T8 4'32W 2.0 $4.44 0/$0.00 E4.Ballast Disconnect 1.0 $0.70 0/$0.00 E5.Ballast:T8-2L, IS,LBF 1.0 $14.95 0.33/$24.75 E6.Recycle:Non-PCB Ballast from 4'or Shorter 1.0 $0.00 0/$0.00 Area: (194422) Custodian room Area Comment: Page 21 Contractor Change Order 9/19/2014 [11 560.0]-Ho u rs=5.0x6.0 T12-4'-34w-2L-MagES-RS-NLO/T8 4' 32w 2L LBF (1) (1) Access Difficulty: Ceiling Height: <9 ft Annual Savings=$7.00/yr Standard Rate Multiplier: 1.0 Installation Comment:C0#1 Rate Multiplier: 1.0 Total Install Cost=$56.35 E1.Ballast:T8-2L,IS,LBF 1.0 $14.95 0.33/$24.75 E2.Ballast Disconnect 1.0 $0.70 0/$0.00 E3.Lamp T8 4'32W 2.0 $4.44 0/$0.00 E4.SFL 5000°K Specification $0.00 0/$0.00 E5.Recycle:Fluorescent Lamps 4'or Shorter 2.0 $0.70 0/$0.00 E6.Recycle:Non-PCB Ballast from 4'or Shorter 1.0 $0.00 0/$0.00 Page 22 Contractor Change Order 9/19/2014 • The Silicon Valley Energy Watch Program is implemented th Silicon Valley Energy Watch Ecology Action and funded by California ratepayers under the _, .. auspices of the California Public Utility Commission. Energy Efficiency Program Change Order#: Recommendations and Savings Checklist 2 West Valley Presbyterian Church - MLTG (CO#2) Materials List Summary West Valley Presbyterian Church 6191 Bollinger Rd. Cupertino,CA 95014 Equipment Labor Custom Equipment Quantity Cost(Per Hrs/Cost(Per IPriced Item Item) Item) Ballast: T8-2L, IS, LBF- Sylvania-49200 18.0 $14.95 0.33/$24.75 ❑ LED PAR38 19W 36DEG 3000K(90W equiv) (Philips)- Philips-429126 60.0 $36.06 0.08/$6.00 ❑ LED PAR30 Short Neck 12W 36DEG 3000K(Philips)- Philips-426964 20.0 $36.44 0.08/$6.00 ❑ Control Wall Sensor Dual Switch-WattStopper- PW-200 26.0 $79.40 0.5/$37.50 LED A-Lamp 11 W 2700K (60W equiv) (Philips)- Philips-423491 17.0 $17.49 0.08/$6.00 ❑ Custom Component 2-Bulb Extenders(if necessary) 50.0 $3.00 0/$0.00 Ballast Disconnect-Wago- 873-902 258.0 $0.70 0/$0.00 ❑ Lamp T8 4' 32W(SFL 5000°K)- Philips- 13987-0 or 13988-1 or 139 36.0 $4.44 0/$0.00 ❑ Control Wall Sensor-WattStopper- PW-100 1.0 $69.44 0.5/$37.50 Ballast Bi-Level 1&2 Lamp QuickStep LBF-Sylvania -49158 119.0 $30.43 0.33/$24.75 ❑ Page 23 Contractor Change Order 9/19/2014 Lamp T8 4' 32W- Philips- 13987-0 or 13988-1 or 139 242.0 $4.44 o/$o.00 ❑ Reflector Troffer: 2'x4'for 2L-Wellmade Reflectors- R304-248T8 133.0 $15.31 0.08/$6.00 p Control: Gang 2 Gang Cover Plate 27.0 $5.00 0/$0.00 9 Custom Component 1-Bulb Extenders 30.0 $3.00 0/$0.00 p Ballast Dimmable Quicktronic 2-lamp T8 NBF- Sylvania- 50707 2.0 $44.11 0.33/$24.75 ❑ Recycle: Fluorescent Lamps 4'or Shorter 523.0 $0.70 0/$0.00 ❑ Recycle: Non-PCB Ballast from 4' or Shorter 273.0 $0.00 0/$0.00 ❑ Disposal $366.10 Material $13,128.27 Base Labor Cost $5,832.75 Access Difficulty Cost Adjustment $0.00 Ceiling Height Cost Adjustment $219.60 Labor(weekdays Rate) $6,052.35 Pre-inspection Fee $90.00 Notes and Comments Permit Processing Fee $150.00 Permit Fee $666.39 Weekly Scissors Lift:$425/Week Fee $425.00 Estimated Taxes $1,148.69 $22,047.49 Total (Including special orders) Page 24 Contractor Change Order 9/19/2014 The Silicon Valley Energy Watch Program is implemented Silicon Valley Energy Watch Ecology Action and funded by California ratepayers under the , auspices of the California Public Utility Commission. Energy Efficiency Program ` Change Order M Customer Change Order Agreement 2 West Valley Presbyterian Church - MLTG (CO#2) West Valley Presbyterian Church 6191 Bollinger Rd. Cupertino,CA 95014 Contractor: _YES,ABI Services, Inc does accept the project.[West Valley Presbyterian Church-MLTG(CO#2)] The cost of the work included in this bid proposal is not to exceed$22047.49 unless a fully executed and approved change order is received by the RightLights Program Administrator.The price and specifications of this bid proposal are satisfactory and are hereby accepted by ABI Services, Inc.All work will be completed within three weeks of the project start date shown below.All work will be completed pursuant to the terms of conditions specified in the original Contractor Participation Agreement between Ecology Action and ABI Services, Inc. Per the RightLights Installation Standards the undersigned contractor will submit a fully-detailed invoice,a manifest for any associated recycling fees,and a Project Completion and Customer Acceptance Certificate signed by the Customer.Upon receipt of these documents and a successful post-installation inspection,Ecology Action will pay the contractor the rebate portion of installed costs. It is incumbent on the contractor to collect the remaining portion of installed costs from the customer. Scheduled start date: _NO,ABI Services, Inc does not accept the project. The undersigned understands that repeated project refusals will result in exclusion from the RightLights Program. If desired,please comment on why the project was refused. I certify that I am a licensed contractor and will comply with applicable permitting requirements,as appropriate,for this HVAC or lighting installation or replacement. License# Authorized Signature (Contractor) Date (print name) Company Customer: The above prices and specifications of this Change Order are satisfactory and are hereby accepted.All work to be performed under same terms and conditions as specified in the original contract unless otherwise stipulated.Customer Cost: 1377.48 Authorized Signature (Customer) Date (print name) Company Page 25 Contractor Change Order 9/19/2014 Page 26 Contractor Change Order 9/19/2014 L I +.'.,I.F PROJECT COMPLETION AND CUSTOMER ACCEPTANCE CERTIFICATE Contractor Statement ABI Services, Inc(firm name) certifies that we installed the following: In the building of: Business Name: West Valley Presbyterian Church- MLTG (CO#2) Street Address:6191 Bollinger Rd. City:Cupertino State:CA Zip:95014 Contractor Name : ABI Services, Inc Date: Authorized Signature: Title: Print Name: Customer Statement The undersigned hereby certifies that all equipment and materials included in the retrofit project including any change orders have been furnished and installed, and that the work has been completed satisfactorily. I understand that the Contractor is not an employee or representative of Ecology Action. 1 understand and agree that Ecology Action is not in any way liable or responsible for any acts or omissions of Contractor. By the signature below I certify that I have not accepted any incentives (i.e., rebates offered by Pacific Gas and Electric or any other energy-efficiency program towards work that is covered by this agreement)from a source other than Ecology Action. Date : NOTICE TO CUSTOMER : Business Name : West Valley Presbyterian Church - MLTG (CO#2) DO NOT SIGN this certificate until you Authorized Signature are completely satisfied that the Contractor has fulfilled his obligation to (print name): you and the work or equipment has Title been satisfactorily completed. (Read before signing) Page 27 Contractor Change Order 9/19/2014 Silicon Valley Energy Watch Customer Testimonial/information Release Form Permission to Use Customer Energy Retrofit Information and/or Testimonial In an effort to recognize the energy-savings accomplishments of its participants and promote the wider adoption of energy efficiency, the Silicon Valley Energy Watch Program requests that satisfied customers provide permission to use information from their projects for marketing and educational purposes.Your confidential information will never be sold to third party marketing firms. Please initial below the extent to which you authorize promotional use of information related to your energy-efficiency project. Promotional materials may be published and distributed in printed form, on the Internet and/or other formats,via text, pictures and/or video formats. Please initial each item as appropriate. You may publish my energy savings information,measures installed,type of business,and the community in which my business is located. You may identify my business by name and address. You may identify me by name and publish a statement attributable to me. I DO NOT authorize the promotional uses of my information described above. Customer: Authorized Signature: West Valley Presbyterian Church Print Name: 6191 Bollinger Rd. Cupertino,CA 95014 Title: Date: Page 28 Contractor Change Order 9/19/2014