B-2016-3142 •
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3142
10131 BUBB RD CUPERTINO,CA 95014-4133(357 20 004) TECHNICAL
BUILDERS INC
SAN JOSE,CA 95138
OWNER'S NAME: 101 THREE ONE LLC DATE ISSUED:11/18/2016
OWNER'S PHONE:408-645-9495 PHONE NO:(408)378-6500
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic.#648986 X BLDG ELECT PLUMB
Contractor TECHNICAL BUILDERS INC Date 07/31/2018
X MECH_RESIDENTIAL X COMMERCIAL
I hereby affirm that I 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. JOB DESCRIPTION:
REPLACE 2 HVAC UNITS(LIKE FOR LIKE);REPLACE 2 HVAC
I hereby affirm under penalty of perjury one of the following two declarations: DOWNSIZED UNITS;INSTALL 1(N)HVAC UNIT-ROOF
1. 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
erformance of the work for which this permit is issued.
2.\I 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
permit is issued. Sq.Ft Floor Area: Valuation:$200000.00
APPLICANT CERTIFICATION
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 357 20 004 A(Tenant Improvements)
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,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per-the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature 1 R 9'v'`^-' N Date 11/18/2016 Issued by:Abby Ayende
Date:11/18/2016
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the BE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:11/18/2016
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
i. 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. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will'maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino;Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the �contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,2 33,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall r
be deemed revoked. 1\
Owner or authorized'agent: `�`�-�,
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APPLICANT016—
CERTIFICATION Date:11/18/2016
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands -
and will comply with all non-point source regulations per the Cupertino Municipal ARUM' CT S DECLARATION
Code,Section 9.18. I understand my plans shall be used as public records.
Licensed
Signature Date 11/18/2016 Professional
. ‘(0 31L1-2-
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- CONSTRUCTION PERMIT APPLICATION ' ll .
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COMMUNITY DEVELOPMENT DEPARTMENT••BUILDING DIVISION /
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 'y
(408)777-3228• FAX(408)777-3333• buildina(�cupertino.orq
CUPERTINO
NEW CONSTRUCTION ❑ ADDITION E],ALTER&TION/TI ii REVISION!DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS ‘
Pau\9\ . e• ANS 651--2O-0
OWNER NAME A f f J PHONE E-MAIL
STREET ADDRESS • Y� CITY, STATE,ZIP
fl'�11 ®: '11U0*efil . CA C15014 FAX
CONTACT NAME 1l l/9\,! i PHONE E-MAIL
STREET ADDRESS —Kin 1 1 g I CITY:STATE,ZIP LAAX/i N , - ull
11 1 i
OWNER 0 OWNER-BUILDER 0 OVNER AGENT 0 CONTRACTOR 0 CONTRACTOR AGENT 0 ?.RCIUTECT 0 ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC#- j
Dot e 'C NCRAND `•8 6 2. _"i
COMPANY NAME" E-MAIL
�€Cn I1Ccu X
butte S DPo c 1anow+ hclia.1b 11 ers,c
STREET ADDRESS CITY STATE,ZIP P t-IONE
foto-® t 1��� ($V ate L. .c/ 61.1 D Moo 3-7 5-&5
ARCHITECT,ENGLTEERWAME r LICENSE NUMBER2_00BUS.LIC-'-
COMPANY NAME A E � rei t-SeerAs E-?��iAIL 0 s iic1 a e—e auto FAX
STREET.ADDRESSCITY,STATE,ZIP PHONE
\�33 A f' • i1 ►eg San `L ,GA cI
DESCRIPTION OF WORK tivhc
14 y o ,. -Z)fe0ac uc t -s i\ r 1A (e?\a Lz
vt\1t ANA A ov3vi—z e , uk,,it -) NS\--a\\ (1) braoa wew \--WPC v v,,a r -
EXISTING USE • - PROPOSED USE CONSTR.TYPE -STORIES - `" - -
USE TYPE OCC. SQ.FT. VALUATION(5)
—
AREA ARE'FLOOR - DEMOA • TOTAL ____________________________
AREA AREA AREA NET AREA -
BATILROOM KITCHEN OTHER -REMODEL AREA REMODEL AREA - REMODEL AREA
' PORCH AREA BECK AREA TOTAL DECICPORCH AREA GARAGE AREA:- ■DETACH 0 ATTACH
DWELLLNG UNITS: ISA SECOND UNIT DYES SECOND STORY ❑IES -
BELN•GADDED? 0N ADDITION? ❑NO
PRE-APPLICATION DYES IF YES.PROVIDE COPY OF IS THE BLDG AN D YES IVEDBy - a TOTAL VALUATION:
PLANNING APPL.. ❑.NO PLANNLNG.APPROVAL LEI-Mt EICHLERHOME? 0N Tr.,- > u _ c 0 Cap
S 1
By my signature below,I certify to each of the following: I am the property owner or authorized agent to.act on C e property owner's behalf. I have read this
application and the information I ha rovided is co, ct. I have read)e-Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating o bus ding cons.r`i ctio•. I autho ee re•resentatives of Cupertino to enter the above-i enntpi eyd property for inspection purposes.
Signature of Applicant/Aaent: ,,,i'....."441 `" f.,4__ Date: i I I !
SUPPLEMENTAL INFORMATION REQUIRED .
,,..PLA\CHECK TIPS.g �' �';. .... .ROUTING SLIP -
T\Ie\t SFD or Multifamily dwellings: Apply for demolition permit for '�
existing buildinQ(s). Demolition permit is required prior to issuance of building 01 ER THE COLTER CI BUILDING PLA\I EYZET�
permit for newbuilding. 0 SS E\PRE , < i { iPLA.\\I\GPLA-NRE\IEti
s �.X' _ `.
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 0ND
STAARD k ?, O PLNLic,t\ORi s
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corm if any Hazardous Materials are being used as part of this project.
;� LARGE FIRE DEPT -i
Copy of Planning Approval Letter or Meeting with Planning prior toirO,aivk
D SA,' .4R1 SEWERDISTRICT
submittal of Building Pernut application. 1 ,
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" >,.__ .,. .,,. ;I .EN_.....ASE\T:4LHLALTII ..-_:
B1dgApp_2011.doc revised 06/21/11
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MECHANICAL ACCEPTANC - - ; LL
PROJECT INFORMATION
Project Name Apple Bubb 09 HVAC Replacement Job Number 816352 K
Project Address 10231 Bubb Road a
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Project City Cupertino
Zip Code 95014
Enforcement Agency City of Cupertino
Permit Number B-2016-3142 Date of Permit 11/18/2016 ,
DOCUMENTATION AUTHOR INFORMATION
Documentation Author Name Jackie Saquiton n
Documentation Author Company ACCO Engineered Systems
a.
Documentation Author Address 1133 Aladdin Avenue ,
city/stare/Zip San Leandro, CA 94577 -
Documentation Author Date Signed 11/16/2016 '
ATT Certification Identification(if applicable) N/A
Documentation Author Phone (510)346-4300 4
1
FIELD TECHNICIAN'S INFORMATION
Field Technician's Name Geoffrey Asbell
Field Technician's Company ACCO Engineered Systems
Address 1133 Aladdin Avenue - 1
1City/State/Zip San Leandro, CA 94577
Position with Company(Title) Balance Technician
ATT Certification identification(if applicable) N/A
Field Technician's Phone (510)346=4300
Date Signed 12/10/2016 4
,
RESPONSIBLE PERSON'S INFORMATION
Responsible.Acceptance Person Name Amber Ryman
Responsible Acceptance Person Company ACCO Engineered Systems
Responsible Acceptance Person Address 1133 Aladdin Avenue
City/State/Zip San Leandro, CA 94577 r
Position with Company(Title) ATE i
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CSLB License 120696
- Responsible Acceptance Person Phone (510) 3467'4300
Date Signed 5/30/20171 E
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Apple Bubb 09 HVAC Replacement
SUMMARY 2013 MECHANICAL ACCEPTANCE TESTS
EQUIPMENT TAG NUMBERTEST REQUIRED
MCII-2-A
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MCH-3-A
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MCH-5-A I
AC=1 ' MCH-12-A
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MCH-2-A
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MCH-3-A
AC-8 MCH-5-A
MCH-2-A
MCH-3-A
AC-16 MCH-5-A
MCH-2-A
AC-14 MCH-3-A
MCH-2-A
AC-15 MCH-3-A
CU &FC-9 MCH-3-A
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STATE OF CALIFORNIA -
MECHANICAL _�,
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CEC-NRCI-MCH-01-E(Revised 07/14) CALIFORNIA ENERGY COMMISSION ,
CERTIFICATE OF INSTALLATION NRCI MCH 01 E
_ Mechanical (Page 1 of 2)
Project Name: Enforcement Agency: Permit Number: I
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
A.GENERAL INFORMATION ,,
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DATE OF BUILDING PERMIT 11/18/2016 1
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BUILDING TYPE Non-Residential ,
PHASE OF CONSTRUCTION ' r
Tenant Improvement 1
If more than one person has responsibility for building construction,each person shall prepare and signori Installation
Certificate document applicable to the portion of construction for which they are responsible;alternatively,the person
with chief responsibility for construction shall prepare and sign the Installation Certificate document(s)for the entire z
construction.
1 ti
B. SCOPE OF RESPONSIBILITY �b
Date of approval by the enforcement agency of the Certificate of Compliance that provides the specifications for this
Installation Certificate. g
In the table below identify all applicable construction documents that specify the features,materials,components,
1
manufactured devices,or system performance diagnostic results required for the scope of responsibility for this Installation, ,
ii
Certificate.
::'Date'Approved`:By :II
Document Title or Description Applicable Sheets or Pages,Tables,Schedules,etc. , ;the Enforcement i
'i ;.:.-.. ;`:Agency`;"? . ..
Title 24,Mandatory Measures.& '
General Notes AC0.01 v
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance July 2014
i
STATE OF CALIFORNIA
MECHANICAL_
CEC-NRCI-MCH-01-E(Revised 07/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF INSTALLATION NRCI-MCH-01-E
11
Mechanic (Page 2 of 2) I
Project Name: Enforcement Agency: Permit Number: d
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
4
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Installation documentation is accurate and complete. tilii
11 Documentation Author Name: Documentation Author Signature:
Jackie Saquiton `Jaws Cf'a••1*04
Documentation Author Company Name: Date Signed: '
ACCO Engineered Systems 11/16/2016
Address: CEA/HERS Certification Identification(If a pplicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone: 11
San Leandro,CA 94577 (510)346-4300
RESPONSIBLE PERSON'S DECLARATION STATEMENT '
I certify the following under penalty of perjury,under the laws of the State of California: 1j
1. The information provided on this Certificate of Installation is'true and correct. 1
2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the 1
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 lam an authorized representative of the responsible builder/installer.
3. The constructed or installed features,materials,components or manufactured devices(the installation)identified on this f
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. I
4. j 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. I 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
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completed signed copy of this Certificate.of Installation is required to be included with the documentation that• ..r provides to
the building owner at occupancy. ,
Responsible Builder/Installer Name: Responsible Builder/Installer gnature, o
ice:x...
im
Company Name:(Installing Subcontractor or General Contractor d Position with Company(Title):
Building/Owner) ACCO Engineered Systems I
Address: CSLB License:
1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date:
San Leandro,CA 94577 (510)346-43005 l' ol 1 r-
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance July 2014
is
CERTIFICATE OF INSTALLATION NRCI-MCH-01-E
Mechanic (Page 1 of 1)
)
Instructions for MCH01
a.
Section A. General Information
01. Enter the date on the building permit.
02. Enter the appropriate building type from the pull down list.
03. Enter the appropriate phase of construction from the pull down list
Section B. Scope of Responsibility
01. Enter the date the enforcement agency approved the certificate of compliance(NRCC-MCH-XX)that used as the
basis of the specifications used to demonstrate compliance.
02. Enter the construction document that specifies the installed feature,material,component,manufactured device
or system performance diagnostic results required for compliance as specified on the certificate of compliance.
03, As needed,this row shall be filled according to the instructions for row B.02
04. As needed,this row shall be filled according to the instructions for row B.02
05. As needed,this row shall be filled according to the instructions for row B.02
Note:more rows shall be added when needed.
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance July 2014 ;4
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STATE OF CALIFORNIA i
OUTDOOR AIR ACCEPTANCE i.
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE • NRCA-MCH-02-A
Outdoor Air Acceptance (Page 1 of 3) j
Project Name: Enforcement Agency: Permit Number: 3.
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 1
Project Address: City: Zip Code: i
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: €
AC-1 Roof/1st Floor
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Note;Submit one Certificate ofAcceptance for each system ;Enforcement Agency::U.se Checked:.by/Dat.0.7 .:;;3'.;;;_`F.:: -_c_ -;:: : ::::__.;5;::.:`::.:
that must demonstrate compliance. -- -
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intent: Verify measured outside airflow reading is within 1-10%of the total required outside airflow.Required for all newly installed t
HVAC units.Reference MECH-3C(Column H or Column i)or Mechanical Equipment Schedules.
Construction Inspection g•
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Note: MCH-2A can be performed in conjunction with MCH-7A Supply Fan VFD Acceptance(if applicable)since testing activities overlap. ill
1. Supporting documentation needed to perform test includes:
I
a. As-built and/or design documents(for example,Mechanical Equipment Schedules,Equipment
Start-Up Sheets or Balancing Reports).
b. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.1.1 Ventilation Systems:Variable Air Systems
At-A-Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At-A-Glance). 1-
•
c. 2013 Building Energy Efficiency Standards. -
2. Instrumentation needed to perform test includes: :
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a. Watch -
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b. Calibrated means to measure airflow(i.e.hot-wire anemometer,velocity pressure probe,etc.),
i. Method and equipment used: Velgrid a
E.
ii. Equipment calibration date(must be within one year:) ,9/13/2016
3. System type(check either VAV or CAV): ❑� VAV 0 CAV
a. Check if Variable Air Volume(VAV)and complete the following:
i. Outside airflow is either factory calibrated or field calibrated.
❑ Check if factory calibrated and attach calibration certification.
l] Check if field calibrated and attach calibration results. ?_
ii. Damper Control(must be checked): 3
2 Dynamic damper control is being used to control outside air.(This is NOT a fixed minimum position).
v
iii. One of the following dynamic controls is being utilized to control outside air(check method used)
❑ Outdoor Air CFM Compensation I
❑ Energy Balance Method 1:
❑ Demand Control Ventilation F
❑ Return Fan Tracking 4,
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❑ Injection Fan Method k
❑ Dedicated Minimum Ventilation Damper with Pressure Control
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2 Other Active Control,Describe:
b. Check if Constant Air Volume(CAV)and verify the following:
❑ System is designed to provide a fixed minimum OSA when the unit is on. ii
4. Method of delivering outside air to the unit(check one of the following): II
(] Outside air is ducted to the return air plenum.Confirm that outside air is ducted to either(check one of the following): ri
CI Within five ft.of the unit.
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❑ Within 15 ft.of the unit,with the air directed substantially toward the unit. s
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Return air plenum is NOT used to distribute outside air to the unit.I.e.•outside air is ducted directly to the unit or outside air is 1
❑ provided independent of the unit. 4
5. Pre-occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide(one ll
of the following methods must be verified and checked):
a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A,or 15 cfm
per person times the expected number of occupants,whichever is less. i
b. 3 complete air changes to the zone served by the air handler.
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 1
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STATE OF CALIFORNIA _ r
OUTDOOR AIR ACCEPTANCE : �' .
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A
Outdoor Air Acceptance (Page 2 of 3)
Project Name: Enforcement Agency: Permit Number: i
Apple Bubb 09 HVAC Replacement . City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/rag:, System Location or Area Served: i'
AC-1 Roof/1st Floor
t
F
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A. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV VAV
Step 1: Disable demand control ventilation(if applicable) ❑
Step 2: Verify unit is not in economizer mode during test(economizer disabled). i] ID
do not apply for CAV systems - -
Note:Shaded boxes
ppYY
Step 3' CAV and VAV testing at full supply aitfiow
-
- ..... .............
Adjust supply air to achieve design airflow or maximum airflow at full :.! :,',..:,...,it;''.:::.,';-1:-,::7-1!:4:',:_ e
a' cooling.Record VFD speed(Hz). 60 Hz f
-
b. Measured outdoor airflow reading(cfm) cfm 187 cfm
Required outdoor airflow(cfm)(from MECH-3C,Column 1,or
c. • )
Mechanical Equipment Schedules). cfm 195 cfm f
Time for outside air damper to stabilize after full supply airflow is achieved
d3 min .
(minutes): :-. ....._..... .....-.-_
Step 4: VAV testing at reduced supply air flow CAV VAV
Adjust supply airflow to either the sum of the minimum zone airflows,full heating,or 30%of the
a' total design airflow.Record VFD speed(Hz). 40 Hz , it
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b, Measured outdoor airflow reading(cfm)
192 cfm ,l
c. Required outdoor airflow(cfm)(from MECH-3C,Column 1,or mechanical equipment schedules). _ 195 cfm
d. Tine for outside air damper to stabilize after reduced supply airflow is achieved(minutes): 4 min I
Step 5: Return to initial conditions(check) CI 1=1
B. Testing Calculations&Results r
Determirie:Percent Outside Air at full supply airflow(%OAFA)for Step 2 . rl
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a. %OA'FA=Measured outdoor airflow reading/Required outdoor airflow(Step2b/Step2c) 95.9% +
b. %OAFA is within 10%of design Outside Air.(%OAFA<_110%) Y / N 8/ N
c. Outside air�damper position stabilizes within 5 minutes(Step 2d<S minutes) "- .. .- . .. Y / N
Determine Percent Outside Air at reduced supply airflow(%OARA)for Step 3(VAV only) )
a. ;'%OARA=Measured outdoor airflow reading/Required outdoor airflow reading(Step3b/Step3c) _ = 98.5% I
b. %OARA is within 10%of design Outside Air,(OARA<_110%) 7O/ N r
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c. Outside air damper position stabilizes within 5 minutes(Step 3d<5 minutes) :..:... —...._-__ C.D/ N
Note: The intent of this testis to ensure that 1)all air handlers provide the minimum amount of OSA and 2)VAV air handlers use dynamic k
controls to avoid over ventilation. r
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C. ' Evaluation: I
PASS:All Construction Inspection responses are complete and Testing Calculations&Results responses are positive r�
0 (Y-Yes) Il
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 1
STATE OF CALIFORNIA
OUTDOOR AIR ACCEPTANCE ` -
CEC-NBCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A
Outdoor Air Acceptance (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code: '
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-1 Roof/1st Floor
DOCUMENTATION AUTHOR'S'DECLARATION STATEMENT
1. I certify that this Certificate of Acceptance documentation is accurate and complete. s
Documentation Author Name: Documentation Author Signature: I
Jackie Saquiton game. d'a414to7s..
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone:
San Leandro,CA 94577 (510)346-4300
FIELD TECHNICIAN'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California: lij
1. The information provided on this Certificate of Acceptance is true and correct. i
2. I 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 requirements11
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. I 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 withthe building permit(s)
issued for the building.
Field Technician Norrie:6ea4zetrey .
AA ell Field Technician's Signature:
Field Technician Company Name: Position with Company(Title)• B !/
ACCO Engineered Systems 13,b,\e.jc& -Veda)Lc Ac,t.)
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone: Date Signed:
San Leandro,CA 945.77 (510)346-4300 12/10/2016 !
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1.' I 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). 11
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. I 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. I 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 unr,er and that a
signed copy of this Certificate of Acceptance is required to be included with the"documentation the builder provid-s to he building
owner at occupancy.
Responsible Acceptance Person Narq74,_(/ „ } Responsible Acceptance Perso Signature:
Responsible Acceptance Person Company Name: 4(Tx�lr 1 v ` Position with Company(Title):
ACCO Engineered Systems /- I
Address: CSL13 License:
1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date signed: 1 I
San Leandro,CA. 94577 (510)346-4300
Ii Ii
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 I
i
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1
I
STATE OF CALIFORNIA •
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION t=
l
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A ii
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 1 of 3) it
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code: 1
1023.1 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: is
AC-1 Roof/ 1st Floor 1
).
Note:Submit one Certificate of Acceptance for each system that must Enforcement Agency Use Checked..by/Date., -
demonstrate compliance. :: ;':;;:= ? ,_,..,. . ;.:;; i
Construction Inspection 1
„ i
1. 'Supporting documentation needed to perform test includes,but not limited to:
I
a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.2 Constant Volume,Single-zone,
Unitary Air Conditioner and Neat Pumps Systems Acceptance At-A-Glance.)
it
b. 2013 Building Energy Efficiency Standards Manual.
2. Instrumentation to perform test includes,but not limited to: jj
a. Temperature Meter , 5.
b. Amp Meter 1 it. iF
3. Installation(check if applies):: ' r
0 Thermostat is:loated within the space-conditioning zone that is served by the HVAC system. F
4. Programming(check Al those that apply):
0 Thermostat meets the tem erature adjustment and dead band requirements of 2013 Building EnergyEfficiencyStandards 1
❑ P 1 q g
' Manual section 120.2(b). '
Minimum heating setpoint: ' 68 °F. Maximum coolingsetpoint 73 °F. Deadband: 5 °F. 4.
i
❑ Occupied,unoccupied,and holiday schedules have been programmed per the faculty's schedule. 1
r
El Pre-occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual l€
section 120.1(c)2: ii.
1. .Check method used to determine pre-occupancy purge: •
Q Lesser of:conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE
120.1-A or 15 cfm per person times the expected number of occupants.
❑ 3 complete'air changes.
Notes: Unit controlled by BMS with UAVs.
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance , May 2015
i
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I
i"
STATE OF CALIFORNIA I
CONSTANT VOLUME,SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS et-.
-CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION .'
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-Ai.
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 2 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement . City of Cupertino B-2016-3142 il
Project Address: City: Zip Code: 7
10231 Bubb Road Cupertino 95014 1
System Name or Identification/Tag: System Location or Area Served: 5
AC-I Roof/1st Floor 1
A. Functional Testing Requirements I Operating Modes i
'
Step 1: Disable economizer control and demand-controlled ventilation(if applicable)to prevent unexpected interactions. .
Occupied Mode '
I
Step 2: Heating load during occupied condition i
I
Step 3: No-load during occupied condition
Step 4: Cooling load during occupied condition t
Unoccupied Mode
q.
Step 5: No-load during unoccupied condition y
Step 6: Heating load during unoccupied condition 1
1.
Step 7: Cooling load during unoccupied condition ;
_Step 8: Manual override
8 7 6 5 4 3 2
n
_ t
Step 2-8: Check and verify the following for each simulation mode required _ _ . - _..
a. Supply fan operates continually 0 _ 0 El 0 1
b. Supply fan turns off = gg PA O ;':g.;:'.., a
c. Supply fan cycles on and off <] 2 =_ _ - 1
s
d. System reverts to"occupied"mode to satisfy any condition 2 ' i.inQ: .... 11
e. System turns off when manual override time period expires = "--; i:'.
.
f. Gas-fired furnace,heat pump,or electric heater stages on 2 'El
g. No heating is provided by the unitD ;;`i. I] I] 0 . .. II
h. No cooling is provided by the unit :? l] 1
i'. Compressor stages on = �' ...... _.
li
j. Outside air damper is open to minimum position
l] ❑� ❑� o
k. Outside air damper closes completely ,.., ..`:' 0 0 �,.. :.
Step 9: System returned to initial operating conditions after all tests have been completed: 6)/ N
i
7.
1.
B. Testing Results 8 7 6 5 4 3 2
Indicate if Passed(P),Failed(F),or N/A(X),fill in appropriate letter PPPPPP P
i
iiC. Evaluation
1.
PASS;All Construction Inspection responses are complete and all applicable Testing Results responses are"Pass"(P) a
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
;
1
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT) .
AIR CONDITIONER AND HEAT PUMP SYSTEMS '�~-"
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION 11
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A
Constant Volume Single Zone Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 3 of 3)
Project Name: - Enforcement Agency: Permit Number: , .
II
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road. . Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-1 Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT • '
1. I certify that-this Certificate of Acceptance documentation is accurate and complete. .. '
Documentation Author Name: Documentation Author Signature: •
I , • Jackie SagUiton Ja crag/Ilium -'
Documentation Author Company Name: Date Signed: . ,
I ACCO Engineered Systems 11/16/2016 :
Address: ATT Certification Identification(if applicable): .
'. ' 1133 Aladdin Avenue i . N/A
City/State/Zip: Phone: '
1 San Leandro,CA 94577' (5101346-4300
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, I amthe 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 andspecifications approved by the enforcement agency,and conforms to the applicable;a'cceptance
requirements and procedures specified in Reference,Nonr.II, 'esidential Appendix NA7. . ; ,, ,
..
4. I have confirmed that the Certificate(s),of Installation for the construction or,installation identified on this;Certificate of Acceptance has
been completed and signedby the responsible builder/installer and has been posted or made available with,the building permit(s) I
issued.•for the building.°: � '! `
i ; ii
Field Technician Name: Field Techniciari'sSignature. ®•
✓ v
Field Technician Company Name: Position with Company(Title). I i '�
ACCO Engineered Systems $"'I' i)? '
Address:,., ATT Certification Identification(ifapplicable): • .
i. ;I ' 1133'Aladdin Avenue' ;I , N/A
City/State/Zip: Phone: ' 1 Date Signed:
1 ' ! San Leandro,'CA 94577 . '(5101'346-4300 '' 1209•af(la
RESPONSIBLE PERSON'S DECLARATION STATEMENT ;; •
•I ceritify,the following under penalty of perjury,under the laws of the State of California: ,
1 I er'the Field Technician orthe 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. . h
2 I am, eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the '
' iii 1, ;' • I .
system'design„construction or installation of features,materials,components,or manufactured devices for the scope of.work i
iden• tified on'this Certificate of Acceptance and attest to the declarations'in this statement(responsible acceptance person).
• Certificate oflAcce to
• 3 The:information rovided on this Certificate of Acceptance,substantiates that the construction or installation identified on this
Ir 1 r nce com' Iles with the acce tance re ulrementsrindicated'inthe''lansand s ecification3 approved bythe
p P� P q.� P p PPii
enforcement;agency,and conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential
Appendix NA7. •, ' ' I ' i
4 f 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 ormade available with the`building permits)issued for the building.
5 Ipwilj a(s,re that a com leted ssi ned copy
a avahis Ce i the eofAcemt n Acceptance
Shall ll be al Rested,or made available with the building
i
t
fo
sl ned co of this Certificate ofAcceptan I applicable Inspections.I understand that a I
ermit s issued for the buildin and mad
g e py ce Is required to be included with the documentation the builder provide .the building '
owner at occupancy. ' i �
Responsible Acceptance Person Na 1 Responsible Acceptance•Person S':nature: .
Responsible Person Company Name: , , Position with Company(Title): ' 4 ,
I li Ii; 1 ' H i ', , ACCOEngineered.Systens
Address i CSLB License: .
1 I'1 ; ;! ;; 1133 Aladdin Avenue 120696
City/State/Zip' 'i1 Phone: . Pate.Signed;
,--1,.
'!' , 1 San,Leandro,CA 94577 (510)346-4300 ?j0l
CA Building Energy Efficiency Standards-2013 Nonresidential�Compliance t�May 2015 •
II ,•
1
S
STATE OF CALIFORNIA
ro.. k
AIR ECONOMIZER CONTROLS ACCEPTANCE Y.
CEC-NRCA-MCH-05-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A a
Air Economizer Controls Acceptance (Page 1 of 3) I
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 u
Project Address: City: Zip Code: i
10231 Bubb Road Cupertino 95014 r
System Name or Identification/Tag: System Location or Area Served:
AC-1 Roof/1st Floor
.1
Note:Submit one Certificate ofAcceptance foreachsYs
tem that must noement-AenUse:.Ch'ecke .b._...De ::1=; ;_ <-
>'s: --`;=
E
, 9
B
STATE OF CALIFORNIA r,
AIR ECONOMIZER CONTROLS ACCEPTANCE `:e=
CEC-NRCA-MCH-05-A(Revised 05/15) ,CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A
Air Economizer Controls Acceptance (Page 2 of 3) g
Project Name: Enforcement Agency: Permit Number: i
Apple Bubb 09 HVAC Replacement City of Cupertino • B-2016-3142 ,
Project Address: City: Zip Code: I
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: i
AC-1 Roof/1st Floor a.
i
i
B. Functional Testing , - Results
Step 1: Disable demand control ventilation systems(if applicable) .
Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open.Verify the following: ',
g
a. Economizer damper modulates 100%open. Y /'N' g
b. Return air damper modulates 100%closed. '. Y /•N
c. For systems that meet,the criteria of 2013 Building Energy Efficiency Standards Section 140.4(e)1,verify;'that the ,
economizer remains 100%openwith the use of mechanical cooling.This occurs when the cooling demand can no'' 110J';N ,
longer be met by the economizer alone. ,;
d. All applicable fans and dampers operate as intended to maintain building pressure, Y /:N
e. The unit heating is disabled(if applicable).: , , L N,'/NA
`
Step 3: Disable the economizer and simulate a cooling demand.Verify the following: , . I i
a. Economizer damper'closes to its minimum position. I 'I iY / N;
b. All applicable fans and dampers'operate as intended to maintain building pressure. I' i tiN'• r F
i
c. The unit heating is disabled(if applicable).: , i O% N /,NA r.
Step 4: If the unit is equipped with heating,simulate a heatingdemand and enable the economizer.Verifythe following is
a. Economizer damper
closes to its minimum,position. Y / 111/14A:
b. Return air damper opens. , • • `Y / N'y'NA
Step 5: Turn off the unit and verify the following: 1
a. Economizer'damper`closescompietely. l
If
Step 6: System returned to initial;operating conditions Y,/!W ;i.
C. ;Testing Results I 'PASS / FAIL
l
Step 2:Simulate cooling load and enable the economizer(all answers are Y). . V
Step'3:Simulate cooling'load'and disable the economizer(all answers are Y), I'
Step'4: Simulate heating demand and enable the economizer(all answers are Y). ' V: it
l
Step,5:Turn off the unit(all answers are V). V
g.
D.1 Evaluation; ; 1' ' . i
1] PASS:.All;:Constructiontnspection responses are complete and all Testing Results responses are"Pass". .'
11
Notes: ,
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'' CA'Buiiding'Energy Efficiency Standards-2013 Nonresidential Compliance I
May 2015
I
,I :
I
STATE OF CALIFORNIA
AIR ECONOMIZER CONTROLS ACCEPTANCEflN;, •
CEC-NRCA-MCH-05-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION 11
CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A 11
Air Economizer Controls Acceptance (Page 3 of 3) pip
Project Name: Enforcement Agency: Permit Number: II
Apple Bubb 09 HVAC Replacement City of Cupertino b
Project Address: City: Zip Code: I
10231 Bubb Road. Cupertino 95.014
System Name or Identification/Tag: System Location or Area Served:
ACA Roof/lst Floor !
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Acceptance:documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: 11
Jackie Saquiton g.J.§.; c qui .
Documentation Author Company Name: ' Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: 'Phone: I
San Leandro,CA 94577 (510)346-4300
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.
il
2. I am the person who performed the acceptance verification reported on this Certificate of Acceptance(Field Technician).
3. The construction or installation identified on1this Certificate of Acceptance complies with the applicable acceptance requirements
indicated in the plans and specifications'epproved by the enforcement agency,and conforms to the applicable acceptance requirements j
and procedures specified in Reference Nonresidential Appendix NA7.
4. I 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.
FieldTechnician Name: O�n Ai��1 Field Technician's Signature:
Field Technician Company Name:'s S Position with Company(Title):
ACCO Engineered Systems V56,14,P ce -VeG�tJic,ic.,F.l
Address: ATT Certification Identification(if applicable):
1133 Aladdin;A;venue N/A
City/State/Zip: Phone: Date Signed:
'San Leandro,CA 94577 (510)346-4300 12/t 0/2ol 6
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. I 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. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the
systems 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). 1$
3. The information provided on this Certificatelof 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. I 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. I 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
signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provides tithe building
owner of occupancy.
Responsible Acceptance Person Na`, �j�
' 1 Responsible Acceptance Person 5I:nature:
� Y^
Responsible Acceptance Person Company Name: II , Position with.Company(Title):
ACCO Engine Systems tib.
Address: I i CSLB License:
1133 Aladdin.Avenue 120696
-City/State/Zip: ;! Phone: Date Signe
San Leandro;CA 94577 (510)346-4300�,
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
II
ii
STATE OF CALIFORNIA
FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS _�,.` ._„
CEC-NRCA-MCH-12-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
i
CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A
Fault Detection and Diagnostics(FDD)for Packaged Direct Expansion Units (Page 1 of 3) R
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014 , ii
System Name or Identification/Tag: System Location or Area Served: r 1
AC-1 Roof/ 1st Floor
Note:Submit one Certificate ofAcceptance for each system that must Enforcement Agency Use:Checked by/Date
demonstrate compliance.
Construction Inspection ,. I
1. Prior to functional testing;verify and document the following:
0 The.Fault Detection and Diagnostics(FDD)hardware Is installed on the unit. 1
❑ The FDD system Is certified to the California'Energy Commission.
The following air temperature sensors are permanently Installed:
❑ Outside Air Sensor.
0 Supply Air Sensor,!
❑ Return AirSensor.(applicable for differential economizer operation only) .
i I
r
. „
A Functional Testing 1
Air Temperature Sensor Failure/Fault s
1
Step'1: Verify the FDD system indicates normal operation 1 1
Step 2: Disconnect outside air temperature sensor,from unit controller.Verify the following: )
�I
❑ FDD system reports a fault
Step 3: Connect outside air;temperature sensor to unit controller.Verify the following: I I'
❑' FDD system indicates normal operation I
I,,,,i ii
Excess Outside Air ;
Step 1: Coordinate this test with NRCA-MCN-02-A(NA 7.5.1 Outdoor Air), if NRCA-MCH-02-A Indicates"pass”then verify the following: 1
CI FDD system,indicates iri`ormal operation 'I
M
Economizer Operation I 1 I, II ,
Step 1i' Coordinate this test with'NRCA-MCH-05-A(NA 7.5-4 Air Economizer,Controls), and simulate failure by Immobilizing the outdoor air r
economizer damper by disconnecting the control signaljfrom the damper actuator(or another method specified by the manufacturer).Verify 1.
the following: ;; t.
• 1 fl
❑ FDD system reports a fault %.
Step 2 'Successfully complete andipass NRCA-MCH-05-'A and verify the following:
LI FDD system reports normal operation a; ii
1 1 N.
B Testing Results' :,,t PASS / FAIL iil
i
Test passes if all boxes are checke`djunder Functional Testing. 0 0
k;
1
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 1
I
STATE OF CALIFORNIA
FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS
CEC-NRCA-MCH-12-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A
Fault Detection and Diagnostics(FDD)for Packaged Direct Expansion Units (Page 2 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-1 Roof/ 1st Floor
C Evaluation:
❑ PASS: All Construction Inspection responses are complete and Testing Results is"Pass"
Notes: AC-1 does not have fault detection hardware installed.
' S
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 s
3
STATE OF CALIFORNIA
FAULT DETECTION AND DIAGNOSTICS FOR PACKAGED DIRECT EXPANSION UNITS '
CEC-NRCA-MCH-12-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION •seg0°'
CERTIFICATE OF ACCEPTANCE NRCA-MCH-12-A
Fault Detection and Diagnostics(FDD)for Packaged Direct Expansion Units (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City:- • Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-1 .Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT '
1. I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Jackie Saquiton gack%c cruq.ilsa-
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone:
San Leandro,CA 94577 (510)346-4300
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. I 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. I 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 permits)
issued for the building. ' •
Field Technician Name: n�Q_ Field Technician's Signature: ,
0Levrt-
Field Technician Company Name: Position with Company(Title):
ACCO Engineered Systems 5.- '- ;P4°64/611'1
Address: ATT Certification Identification(if applicable): I
1133 Aladdin Avenue ; N/A
City/State/Zip: Phone: 'Date Signed: '
San Leandro,CA 94577 (510)346-4300 i ; iZlsa)/
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certifythe following under of perjury,under the laws of the State of California:
1. I am the Field Technician,or the Field Technician is acting on my behalf as my employee ormyagent and I have reviewed the
information provided on this Certificate of Acceptance. .
2. I'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,ofWork'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. I have confirmed that the,Certificate(s)of Installation for the construction orinstallation identified on this Certificate of Acceptance has
been completed and is posted or made available with the building permits)issued for the building.
5. I will ensure that a completed,signed copy of this Certificate of Acceptance shall be posted,or made available with the building
permits)issued for the building,and made available tothe 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 provid o the building
owner of occupancy.
Responsible Acceptance Person Name; Responsible Acceptance Person nature:
t.--)01 pex-edtd I atm
Responsible Acceptance Person Company Name: Position with Company(Title):
ACCO Engineered Systems
Address: CSLB License: I
1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date Signed: 11 J
San'Leandro,CA 94577 (510)346-4300jQJ ll
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 •
i
1
.
STATE
STATE OF CALIFORNIA
OUTDOOR AIR ACCEPTANCE
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION : --_
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A )
Outdoor Air Acceptance (Page 1 of 3)
Project Name: Enforcement Agency: Permit Number;
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 .
Project Address: City: Zip Code: i!
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-8 Roof/ 1st Floor
i
Note:Submit one Certificate ofAcceptance for each system _EnfotcementAA enc.':)Abi he kedcb Date- _-: x<::_
that must demonstratecomplionce. ......::...::.::.:.:._..:._._._ _...::,.----:._.._......_....._......._.............. ... .........
intent:
Verify measured outside airflow reading is within±.10%of the total required outside airflow.Required for all newly installed
HVAC units.Reference MECH-3C(Column H or Column I)or Mechanical Equipment Schedules.
Construction Inspection :
Note:MCH-2A can be performed in conjunction with MCH-7A Supply Fan VFD Acceptance(if applicable)since testing activities overlap. i
1. Supporting documentation needed to perform test includes:
a. As-built and/or design documents(for example,Mechanical Equipment Schedules,Equipment
Start-Up Sheets or Balancing Reports).
b. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.1.1 Ventilation Systems:Variable Air Systems
At-A-Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At A-Glance).
c. 2013 Building Energy Efficiency Standards.
2. Instrumentation needed to perform test includes: L.
a. Watch
b. Calibrated means to measure airflow(i.e..hot-wire anemometer,velocity pressure probe,etc.).
i. Method and equipment used: Velgrid r
li. Equipment calibration date(must be within one year:) 9/13/2016
3. System type(check either VAV or CAV): (J VAV 0 CAV s
a. Check if Variable Air Volume(VAV)and complete the following:
i. Outside airflow is either factory calibrated or field calibrated.
i
❑ Check if factory calibrated,and attach calibration certification. .
fe
0 Check if field calibrated and attach calibration results. r,
ii. Damper Control(must be checked): r
t
o Dynamic damper control is being used to control outside air.(This is NOT a fixed minimum position). it
iii. One of the following dynamic controls is being utilized to control outside air(check method used) t
0 Outdoor Air CFM Compensation
❑ Energy Balance Method A.
❑ Demand Control Ventilation
LI Return Fan Tracking
❑ Injection Fan Method G,
LIDedicated Minimum Ventilation Damper with Pressure Control u
)
1::) Other Active Control,Describe:
b. Check if Constant Air Volume(CAU)and verify the following:
❑ System is designed to provide a fixed minimum OSA when the unit is on. A
li
4. Method of delivering outside air to the unit(check one of the following): II
❑ Outside air is ducted to the return air plenum.Confirm that outside air is ducted to either(check one of the following):
LI Within five ft.of the unit., `
❑▪ Within 15 ft.of the unit,with the air directed substantially toward the unit.
L
Return air plenum is NOT used to distribute outside air to the unit.l.e:outside air is ducted directly to the unit or outside air is t
❑ i
provided independent of the unit. 3
5. Pre-occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide(one s
of the following methods must be verified and checked): r
i
a. The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A,or 15 cfm A
A
per person times the expected number of occupants,whichever is less. A
b. 3 complete air changes to the zone served by the air handler. i
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015ti
)
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STATE OF CALIFORNIA I.r;
OUTDOOR AIR ACCEPTANCE m' . ' ;
1
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION ii
CERTIFICATE OF ACCEPTANCE ' NRCA-MCH-02-A
Outdoor Air Acceptance (Page 2 of 3)
il
Project Name: Enforcement Agency: _ Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road " Cupertino 95014 l
System Name or Identification/Tag: System Location or Area Served: t
' AC-8 Roof/1st Floor
A. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV VAV
Step 1; Disable demand control ventilation(if applicable) ID 2 4
u
Step 2: Verify unit is not in economizer mode during test(economizer disabled).
.
Note;Shaded boxes do not apply for C.AVsystems
Step 3: CAV and VAV testing at full supply airflow
Adjust supply air to achieve design airflow or maximum airflow at full s
a 'cooling.Record VFD speed(Hz),, — - Hz i'
b. Measured outdoor airflow'reading(cfm) ,. cfm ' , cfm 1
Required outdoor airflow(cfm)(from MECH-3C,Column!,or g
c' Mechanical Equipment Schedules), cfm 300 cfm
ii
Time for outside air damper to stabilize after full supply airflow is achieved'
--d' : . ((minutes); .- min
Step 4: VAV testing at reduced supply air flow CAV ' VAV ; I
Adjust supply airflow to either the sum of the minimum zone airflows,full heating,or 30%of the i
a' total design airflow.Record VFD speed(Hz). N/A Hz
b. Measured outdoor airflow reading(cfm) '' I .: 299 cfm
=:
c. Required outdoor airflow(cfm),(from MECH-3C,Column I,or mechanical equipment schedules). , 300 cfm }
d. lime for outside air damper to stabilize after reduced supply airflow is achieved(minutes): ;;II, N/A min Q
Step 5: Return to initial conditions(check) ❑ I]
B. Testing Calculations&Results
Determine Percent Outside Air at full,'supply airflow(%OAFA)for Step 2 t
a. ,%oAFA=Measured outdoor airflow reading/Required outdoor airflow(Step2b/Step2c)
b. ,'%oAFA:is within 10%of design Outside Air.(%oAFA. 110%) ; ; 1 Y / N V / N 1
k'
c., 'Outside air damper position stabilizes within 5 minutes(Step 2d<5 minutes) Y/ N _
Determine'Percent'Outside Air at reduced supply airflow(%OARA)for Step 3(VAV only) R
a.. I %0ARA=measured outdoor airflowreading/Required outdoor airflow reading(Step3b/Step3c) 99.7/ E
b, %OARA is within 10%of design Outside Air.(OARA 5110%) -_ - �Y / N
c. ii-
' I Outside a1r damper position stabilizes within 5 minutes(Step 3d<5 minutes) ,: ::':::::,:: :::'.::n:::-,::7L:; (1)/ N
l'
Note: The intent of this test is to ensure that 1)all air handlers provide the minimum amount of OSA and 2)VAV air handlers use dynamic k.
controls to avoid overventilation. f;
C.i Evaluation
i
I PASS:Ail Construction Inspection responses are complete and Testing Calculations&Results responses are positive i
L I (V-Yes)
Eeonomizeris not capable of modulating. 4`
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 I i
ii
i
.
STATE OF CALIFORNIA
OUTDOOR AIR ACCEPTANCE
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION -
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A
Outdoor Air Acceptance (Page 3 of 3)
Project Name: Enforcement•Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-8 Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Acceptance documentation Is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Jackie Saquiton gem/Um cra.quit.im
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone:
San Leandro,CA 94577 ' (510)346-4300
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. I 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. I 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 responsibleibuilder/installer and has been posted or made available with the building permit(s)
issued for the building. .
Field Technician Name: C e®n c v ty Ask,ell Field Technician's Signature: (s
Field Technician CompanyName: Position with
4�r i ` Company(Title):
ACCO Engineered Systems 'tro.a.,
c
e Tc...dN`c;,is
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone: Date Signed:
San Leandro,CA 94577 (510)346-4300 t2,/i o/.2ot 6
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. I am the Field Technician,or the Field Technician is acting on riiy behalf as my employee or my agent and I have reviewed the
information provided on this Certificate of Acceptance. -
2. I 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. I 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. I 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 un• tend that a
signed copy of this Certificate of Acceptance is required to be included with the documentation the builder provide•the building
_ .owner at occupancy. /�/�
Responsible Acceptance Person Na II 1` r ` `� Responsible Acceptance Perso'Signatu
'Y WIL,EP' 1�1
Responsible Acceptance Person Company Name: Position with Company(Title): -
ACCO Engineered Systems
Address: CSLB License:
1133 Aladdin Avenue 120696 i
City/State/Zip: Phone: Date Signed: -14
San Leandro,CA 94577 (510)346-4300 c) ,C)1,1 9-
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
1
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS ;` : ;' 1
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION °
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A 1
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 1 of 3)
Project Name: Enforcement Agency: Permit Number: i
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 3
Project Address: City: Zip Code:
10231 Bubb.Road Cupertino 95014
5
System Name or Identification/Tag: System Location or Area Served: i
AC-8 Roof/1st Floor
1
Note:Submit one Certificate of Acceptance for each system that must Enforcement Agency Use:Checked:by/bate
demonstrate compliance. '
Construction Inspection
(
1. Supporting documentation needed to perform test includes;but not limited to: i
a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.2 Constant Volume,Single-zone,
1,4
Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glance.) •
b. 2013 Building Energy Efficiency Standards Manual.
2. Instrumentation to perform test includes,but not limited to: l
a. Temperature Meter ,G
b. Amp Meter (
3. Installation(check If applies): s
O Thermostat is located within the space-conditioning Ione that is served by the HVAC system.
4. Programming(check all those that apply):
O Thermostat meets the;temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards a
Manual section 120.2(b).
r
Minimum heating setpoint:: ' 68 F. Maximum cooling setpoint 73 °F. Deadband; 5 °F. r
El Occupied,unoccupied,and holiday schedules have been programmed per the facility's schedule. ;
O Pre-occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual
section 120.1(c)2.' ri
1. Check method used to determine pre-occupancy purge: ii:
i 0' Lesser of:conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE R.
120.1-A or,15 cfm per person times the expected number of occupants. 1
❑ 3 complete air changes.
)
Notes:. Unit controlled by MMS,;lith VAVs.
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liy5_
RRC
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 P,
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•
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS °3 ,F; z
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION I
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 2 of 3) k
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014 it
I,
System Name or Identification/Tag: ' System Location or Area Served: r
AC-8 Roof/1st Floor
i
• t
A. Functional Testing Requirements I Operating Modes
Step 1: Disable economizer control and demand-controlled ventilation(if applicable)to prevent unexpected interactions..
Occupied Mode
Step 2: Heating load during occupied condition ,
II
Step 3: No-load during occupied condition
k
Step 4: Cooling load during occupied condition 'I
Unoccupied Mode
Step 5: No-load during unoccupied condition 1
Step 6: Heating load during unoccupied condition )
Z
Step 7; Cooling load during unoccupied condition • i.
Step 8; Manual override
3
8 7 6 5 4 3 2I.
Step 2-8: Check and verify the following for each simulation mode required :, - . ....-.- .
a. Supply fan operates continually 0 --M_ 0 0 Cl
b. Supply fan turns off = -; ' 121
c. Supply fan cycles on and off 0 0 RI SPeii1
F.
d. System reverts to'occupied"mode to satisfy any condition 0 g__ _ = _
e. System turns off when manual override time period expires 0 a_i' ''= :':' '- :s
f. Gas-fired furnace,heat pump,,or electric heater stages on 0 0
g. No heating is provided by the unit 0 °. 0 0 0 I
h. No cooling is provided by the unit _ _ :i 0 0 0 El
i. Compressor stages on , I .;"; D :- --_`_ D -
R
j. Outside air damper is open to minimum position 0 0 -_ 0 0 0 s.
k, Outside air damper closes completely ;.. .`.' 0 El -- 7..:-.., q
Step 9: System returned to initial operating conditions after all tests have been completed: U/ N
I
t
rg
B. Testing Results 8 7 6 5 4 3 2 1'
Indicate if Passed(P),Failed(F),or N/A{X),fill in appropriate letter PPPPPP P li
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C. Evaluation
_ r
0 PASS:All Construction Inspection responses are complete and all applicable Testing Results responses are"Pass"(P) p
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a
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 11.
a
11
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT) . '
AIR CONDITIONER AND HEAT PUMP SYSTEMS ..
;
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION ''
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A Ir
Constant Volume Single Zone Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code: 1
10231 Bubb Road - Cupertino 95014 lo
Systeth Name or Identification/Tag: . System Location or Area Served: II
AC-8 Roof/1st Floor li
i
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT i1
it
1. I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: ' II
Jackie Saquiton 6✓�a, c?ugi teat '
I
Documentation Author CompanyName: Date Signed:
ACCO Engineered Systems 11/16/2016 .
Address: ATT Certification Identification(if applicable): ,
1133 Aladdin Avenue N/A.
City/State/Zip: Phone: -
San.Leandro,CA 94577 (510)346-4300 N
FIELD TECHNICIAN'S DECLARATION STATEMENT .
' I certify the following,under penalty of,perjury,under the,laws of the State of California:
1. The informi,ation provided on this Certificate Of Acceptance is true and correct. II
2. I am the person who performed.the acceptance verification reported on this Certificate of Acceptance(Field Technician). I
3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements I
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. I have confirmed thatbthe'Certificate(s)of Installation for the construction or installation identified on this Certificate of Acceptance has I
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. ' : i j
Field Technician Name: � W��
1
I, Field Technician's Signature: {13 gg
Field Technician Company Name • I : Position with Company(Title):
' ACCO Engineered,Systems SIAM 0 P
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A ,
City/State/Zip: Phone: DateSigned:
'I' !San Leandro,CA 94577 ; ' -(510)346-4300 YZ.j la I Ib
RESPONSIBLE PERSON'S DECLARATION'STATEMENT I
I certify the following;under penalty of,perjury,under the laws of the State of California:
1. I am the Field Technician;ortheiFiield Technician is acting on my behalf as my employee or my agent and I have reviewed the
information provided on this Certificate of Acceptance. ,1
2. I am eligibletinder 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 ofAcceptahce complies with the acceptance reequirements 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. I have confirmed that the Certificates)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. I will ensure that a completed,signed copy of this Certificate of Acceptance shall be posted,or made availablewith the building
permit(s)Issued fortheibuilding;and madeavailable to the enforcement agency for all applicable inspections.;I under d that a
! pyofpthi�ertifi p required providest e building
owner at occu an � cate�of Acce tance is re cared to be'included with the documentation the builder
Responsible Acceptance Person Nam: IPResponsible Acceptance Person Sig tur •
I ; 11i►ks1' \. 11IM1 ) __Responsible Acceptance Person Company Name: I Position with Company(Title):
I ' : I 'I' ACCO Engineered Systems ' f1_ ` Y`—,
• Address: CSLB License:
• • 1133 Aladdin Avenue 120696
City/State'/Zip: Phone: Date Signed: �'
San Leandro,CA 94577 (510)346-4300 1 �j(3. `,-`'
CA;Building Energy Efficiency Standards 72013 Nonresidential Compliance- May 2015
• ' I
I
STATE OF CALIFORNIA li
AI.R ECONOMIZER CONTROLS ACCEPTANCE =p,
CEC-NRCA-MCH-05-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION " �l
CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A
Air Economizer Controls Acceptance (Page 1 of 3)
Project Name: Enforcement Agency: Permit Number: d
Apple Bubb 09 I-NAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
' AC-8 Roof/I st Floor
ii
Note:Submit one Certificate of Acceptance for each system that must -ErlforcementAgency.:Use;;Checked:b ate: .;__............................................................;..._..•_ . .. ; : `.
demonstratecorri liance. ..- ._.= -_: �_..-._ . ---- - =
I
STATE OF CALIFORNIA
-
AIR ECONOMIZER CONTROLS ACCEPTANCE - " :I "4
CEC NRCA MCH 05 A(Revised 05/15) CALIFORNIA ENERGY COMMISSION ` a
CERTIFICATE OF ACCEPTANCE NRCA=MCH-05-A
Air Economizer Controls Acceptance (Page 2 of 3).
a
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: _ Zip Code: 1
10231 Bubb Road Cupertino _ 95014
System Name or Identification/Tag: System Location or Area Served: i
AC-8 Roof/1st Floor
B. Functional,Testing Results
Step 1: Disable demand control ventilation systems(if applicable). ' '
Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open.Verify the following: ;
a. Economizer damper modulates 100%open. a/ N PI
b. Return air'damper modulates 100%closed. OY / N
c. For systems that meet the criteria of 2013 Building Energy Efficiency Standards Section 14 .0
0.4(e)1,verifythat the r •4 r
economizer remains 100%open with the use of mechanical cooling.This occurs when the cooling demand can no o/ N
longer be met by the economizer alone,
d. All Y applicable fans and dampers operate as intended to maintain building pressure. /_N 1'1
e. The unit heating is disabled(if applicable). (y)/ N /NA i'I
Step 3E isabl thdam eo closes to Its simulate a cooling demand.Verify the.following:
pminimum position. „, a/ N
ii
b. All applicable fans and dampers operate as intended to maintain building pressure. a/ N i-
z1
c. The'uiiit'heating is disabled(if applicable). I a/ N /NA
Step 4: If the unit is equipped with;heating,simulate a heating demand and enable the economizer.Verify the following: ' 1
a. Economizer damPer closes to Its,minimum position. N /NA
b. 'Returnairdamperopens, •I , E3/
/ N /NA u
Step 5: Turn off the unit and verify the.following: I ' • 1
a. Economizer damper closes completely. •',I i Y / N i
Step 6i,System returned to initial operating conditions L'J/ N
C. Testing Results,, 1” . ' PASS /FAIL
Step'2:Simulate cooling load and enable the economizer(all answers are Y). ';
Step'3:Simulate cooling load,anddisable the economizer(all answers are Y). i ; ✓ ,
1
Step 4 sSimulate heating demand;and enable the economizer(all answers are Y). 'i ' V '
Step St Turn off the unit(all answers are Y). ;;'j?
1).,„Evaluation:. ' • t ;
E PASS All Construction Inspection;responses are complete and all Testing Results responses are"Pass" ;I I
Notes: 'I;
1.
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2
1.
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 P.
1
1
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I
STATE OF CALIFORNIA
AIR ECONOMIZER CONTROLS ACCEPTANCE
CEC-NRCA-MCH-05-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A
Air Economizer Controls Acceptance (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-8 Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Jackie Saquiton 6Ja.Lm ef'axpag m
Documentation Author Company Name: - Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone:
San Leandro,CA:94577 (510)346-4300
FIELD TECHNICIAN'S DECLARATION STATEMENT
I certify the following under penalty of pe'rjury,under the laws of the State of California:
1. The information provided on this Certificate of.Acceptance is true and correct.
2. I 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. I have confirmed that the Certificate(s)df: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 Technician : 1 Field Technician's Signature:
-Geo--C)re + res\044,1
Field Technician Company Name: Position with Company(Title):
ACCO Engineered Systems 50.10.4Nco°.."'C'ec,1;,Otc.tc,
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: I Phone: Date Signed:
San Leandro,CA 94577 (510)346-4300 C2 I CJJ2o16
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of pierjury,under the laws of the State of California:
1. I 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. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the
systems design,construction or installation of features,materials,components,or manufactured devices for the scope of work
identified on this Certificate of Acceptance end attest to the declarations in this statement(responsible acceptance person).
3. The information provided on this Certificateof 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. I 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. I 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.)under nd that a
signed copy of this Certificate of Acceptance isrequired to be included with the documentation the builder provides o he building
owner of occupancy.
Responsible Acceptance Person Nam Responsible Acceptance Pe"on Signatur
-WY -YYNa
Responsible Acceptance Person Company Name: Position with Company(Title):
ACCO Engineered Systems
Address: CSLB License:
1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date Signe / i
San Leandro,CA 94577 (510)346-4300 h '
• l
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
i
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STATE OF CALIFORNIA
r.uy�,
OUTDOOR AIR ACCEPTANCE -=:; R
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION '_ p
CERTIFICATE OF ACCEPTANCE - NRCA-MCH-02-A
Outdoor Air Acceptance (Page 1 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code: E
10231"Bubb Road Cupertino 95014 t
System Name or Identification/Tag: System Location or Area Served: - li
AC-14 Roof/1st Floor 1
I
N •Submit one Certificate ofAcceptancefor eachsystem :enforcement Aenc. User-Checked_b/Date:i= - ::;i<:. _ :; :.:=; :;-_:'
Note; m f F . "":_:. ._.::_.:.:_g::: Y..:::.::::.:":-::,-"•-:: �v :::..,:i:,.:.7:::-..:::-:--__ 7:.:.:.: c,�_:,
compliance. - .,.."._"...::.... ....:= . --, -_ :',767:7'.
that mustdemonstrate
Intent:
Verify measured outside airflow reading is within±10%of the total required outside airflow.Required for all newly installed
' HVAC units.Reference MECH-3C(Column H or Column I)or Mechanical Equipment Schedules. , i
a
Construction Inspection l
Note: MCH-2A can be performed inconjunction with MCH-7A Supply Fan VFD Acceptance(if applicable)since testing activities overlap. i
I
1. !Supporting documentation needed to perform test includes: '.
a. As-built and/or design documents(for example,Mechanical EquipmentSchedules;Equipment 1 1.
Start-Up Sheets or Balancing Reports). .
•b. 2013.Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.1.1 Ventilation Systems:Variable Air Systems a
At-A-Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At A-Glance). 1
c. 2013 Building Energy Efficiency Standards.
2. instrumentation needed to perform test includes:
a, Watch'
b. Calibrated means to measure airflow(i.e.hot-wire anemometer,velocity pressure probe,etc.). E
i. Method and equipment used: Velgrid
ii. Equi'pment calibration date(must be within one year:) 9/13/2016 (
3. System type(check either VAV Or CAV): 0 VAV E CAV 3.
a., Check If Variable Air Volume(VAV)and complete the following: x:
i. Outside airflow is either factory calibrated or field calibrated.
❑ Check if factory calibrated and attach calibration certification. •
', ❑ ,Check if field calibrated and attach calibration results.
' ii. Damper Control(must be checked):
❑ Dynamic'damper control is being used to control outside air.(This is NOT a fixed minimum position). '
iii: One of the following dynamic controls is being utilized to control outside air(check method used) i`
li
110 OutdoorAirCFM Compensation i'.
4:
.0 Energy Balance Method I.
❑`' Demand Control Ventilation 1i.
u
' ❑' Return Fan Tracking (.
I, 'i`it Injection Fari Method •
, 0 'Dedicated'Minimum Ventilation Damper with Pressure Control
iiO :Other Active Control,Describe:
lb. Check if(Constant Air Volume(CAV)andfollowing: g.mverify the folli
,;;'it System,is designed to,provide a fixed minimum OSA when the unit is on.
4. (Method of delivering outside air to the unit(check one of the following):
ID Outside air is ducted to the return air plenum.Confirm that outside air is ducted to either(check one of the following): 1
;'0 Within five ft.of the unit.
O.
ii;;� r
I; RD :;within 15 ft.of the-unit,with the air directed substantially toward the unit. t
j , II
II
Return air plenum is NOT used to distribute outside air to the unit.I.e.outside air is ducted directly to the unit or outside air is• i;
` li
❑ provided independent of the unit. - li
(Pre-occupancy purge has been'programmed for the 1-hour period immediately before the building is normally occupied to provide(one e
5
Of the following"methods must be verified and checked): F
a. The condi tioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A,or 15 cfm e
II
per person timles the expected number of occupants,whichever is less.
��it q i1 ij
[b; 3 complete air,changes!tolthe zone served by the air handler.
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance ' , May 2015
ia
1.
d
STATE OF CALIFORNIA I
OUTDOOR AIR ACCEPTANCE s• -, "
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION ..-`
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-Afi
Outdoor Air Acceptance (Page 2 of 3) )
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 3
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
t
System Name or Identification/Tag: System Location or Area Served: p
AC-14 Roof/ 1st Floor
lik
t
A. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV VAV
it
Step 1: Disable demand control ventilation(if applicable) 0 0 ;
Step 2: Verify unit is not in economizer mode during test(economizer disabled). 0
Note:Shaded boxes do not apply for CAV systems 1
Step3: CAV and VAV testing at full supplyairflow -- - --
= _.-..-. ..
I_
Adjust supply air to achieve design airflow or maximum airflow at full -__ - - - a
a. cooling.Record VFD speed(Hz). Hz i
f.
b. Measured outdoor airflow reading(cfm) 114 cfm cfm 1
Required outdoor airflow(cfm)(from MECH-3C,Column I,or
c' Mechanical Equipment Schedules). 120 cfm cfm
Time for outside air damper to stabilize after full supply airflow is achieved
d' (minutes): min i
Step 4: VAV testing at reduced supply air flow CAV VAV s
Adjust supply airflow to either the sum of the minimum zone airflows,full heating,or 30%of the
a. _
total design airflow,Record VFD speed(Hz). Hz i
b. Measured outdoor airflow reading(cfm) _ = cfm
c. Required outdoor airflow(cfm)(from MECN-3C,Column 1,or mechanical equipment schedules). =- cfm ft
d. Time for outside air damper to stabilize after reduced supply airflow is achieved(minutes): -....._- min ;.
Step 5: Return to initial conditions(check) 0 0 g
' k
B. Testing Calculations&Results t.
Determine Percent Outside Air at full supply airflow(%OArA)for Step 2
a. %OAFA=Measured outdoor airflow reading/Required outdoor airflow(Step2b/Step2c) 95.0%
b. %OAFA is within 10%of design Outside Air.(%OAFA5110%) Of N Y / N is
c. Outside air damper position stabilizes within 5 minutes(Step 2d<5 minutes) _-•:-.--- Y / N 'i
Determine Percent Outside Air at reduced supply airflow(%OARA)for Step 3(VAV only) ;_
r
a. %OARA=Measured outdoor airflow reading,/Required outdoor airflow reading(Step3b/Step3c) _ - _
ii
b. %OARA is within 10%of design Outside Air:(OARA 5 110%) - _ -: V / N ii
s
c. Outside air damper position stabilizes within 5 minutes(Step 3d<5 minutes) Y / N e.
Note: The intent of this test is to ensure that 1)all air handlers provide the minimum amount of OSA and 2)VAV air handlers use dynamic tt
controls to avoid over ventilation.
t
' _ r:
C. Evaluation:
PASS:All Construction Inspection responses are complete and Testing Calculations&Results responses are positive ii
0 (V-Yes)
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
Li.
1
STATE OF CALIFORNIA
OUTDOOR AIR ACCEPTANCE
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION -dam iV
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A �I
Outdoor Air Acceptance (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014 i
System Name or Identification/Tag: System Location or Area Served:
AC-14 Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT . i'
1. I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation.Author Name: Documentation Author Signature: I
Jackie Saquiton gaad... eaa -
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016 i
Address: ATT Certification Identification(if applicable): NIA
1133 Aladdin Avenue !
City/State/Zip: Phone:
San Leandro,CA 94577 (510)346-4300
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 ori this Certificate of Acceptance is true and correct.
2. I 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. I have confirmed that the Certificate(s)of Installation for the construction or installation identified on this Certificateof 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 Technician Name: Field Technician's Signature: 11
Field Technician Company Name: Position with Company(Title):
ACCO Engineered Systems '�o►tc. 3 .e. e -
Address: ATT Certification Identification(if applicable):
1133 AIaddin Avenue N/A
City/State/Zip: Phone: Date Signed:
San Leandro,CA 94577 (510)346-4300 1 8110/204 4
RESPONSIBLE PERSON'S DECLARATION STATEMENT
`l certify the following under penalty of perjury,under the laws of the.State of California:
1. ,.I 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. , I 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. ' Theinformation 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. .I 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. I'
5. I 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 underst n that a
signed copy of this Certificate.of Acceptance is required to be included with the documentation the builder provides to h building
owner at occupancy.,
Responsible Acceptance Person NamRev\pe Responsible Acceptance Person ignature:
c_e
Responsible Acceptance Person Company Name: Position with Company(Title): t-~
ACCO Engineered.Systems
Address: CSLB License:
1133 Aladdin Avenue 120696
City"/State/Zip: Phone: ' Date Signed:
San Leandro,CA 94577 (510)346-4300 51am)
CA Building.Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
1
i
a
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT) i
AIR CONDITIONER AND HEAT PUMP SYSTEMS e''
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A ;
_Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 1 of 3) w
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014 1
System Name or identification/Tag: System Location or Area Served:
AC-14 Roof/1st Floor t
1
i
Note:Submit one Certificate Acce Acceptancefor each system that must
of p Y Da#e l'
�nfortement;Agency,Use;_�,.ecked!?y%.::., : ;„ -�_ - _�=i_ ;-`;:: :-�:=
demonstrate compliance. ''
q
Construction Inspection l (
2
1, Supporting documentation needed to perform test includes;but not limited to:
a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7:5.2 Constant Volume,Single-zone,
Unitary Air Conditioner and Heat Pumps Systems Acceptance At-A-Glance.) , ).
r
b. 2013 Building Energy Efficiency Standards Manual.
2. Instrumentation to perform test includes,but not limited to: i;
a. Temperature Meter
b. 'Amp Meter
•3. Installation(check if applies): s
[I Thermostat is located within the space-conditioning zone that is served by the HVAC system.
S
4. Programming(check all those that apply):
CI Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards
Manual section 120.2(b). t
Minimum heating setpoint: 68 F. Maximum cooling setpoint 73 °F. Deadband: 5 °F. il
ti
I=1 Occupied,unoccupied,and holiday schedules have been programmed per the facility's schedule.
El Pre-occupancy purge has been programmed to meet the requirementsof 2013 Building Energy Efficiency Standards Manual
II
section 120.1(c)2.
u
1, Check method used to determine pre-occupancy purge;: n
El Lesser of:conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE
120.1-A or 15 cfm per person times the expected number of occupants.
ID 3 complete air changes.
I
Notes: Unit controlled by BMS. ii
1`
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s
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11
4
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B
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 1
i!
1
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND:SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS ,.. -s.
I
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A #
i
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 2 of 3) '
Project Name: Enforcement Agency: Permit Number: l'
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 n
Project Address: City: Zip Code:
10231 Bubb Road , Cupertino 95014 1
System Name or Identification/Tag: System Location or Area Served: I
'AC-14 Roof/ 1st Floor 1
ila
1
A. Functional Testing Requirements I ,Operating Modes F
Step 1: Disable economizer control and demand-controlled ventilation(if applicable);to prevent unexpected interactions.
Occupied Mode , -
i
Step 2: Heating load during occupied condition • 'i
(
Step3: No-load during occupied condition g
Step 4: Cooling load during occupied condition 1'
Unoccupied Mode ,,
Step'5: No-load during unoccupied condition
Step6: Heating load during unoccupied condition '. .
Step 7: Cooling load during unoccupied condition a
1
Step8: Manual override gF.
,
. .8 7 6 5 4 3 2
Step 2-8; Check and verify the following for each simulation mode required - - .•• --
a. Supply fan operates continually'' _
b. Supply fan turns off El '. :' >'
e. Supply fan cycles on and off'
as
"occupied" toanycondition = 1.
d. System reverts tomodesatisfy ,
e,° System turns off when manual override time period expires C1 --:0F. :-.i. `'?' ?'T...::-..a I
f.j, Gas-fired furnace,heat pump,or'electric heater stages on 0 0
I.
g.; No heating is provided:by the unit ' , I ` El El 0 0 ;_;-.
1;
I4
' ' hi No cooling is:provided by the unit : 0 E 12 0 pp
P
i l'Compressor stages on,,. : ; : 0 .;:k :7.--:::?::::.
k;
.I. ':Outside .(] 0,air damper is open to minimum position ! Z1:'; =js 0 0 0
k!; Outside air damper closes completely II . ... .. 0
Step 9; System returned to initial operating conditions after all tests have been completed: .1 : �/ N '
B'.i Testing Results " ! a ; . , 8 7 6 5 4 3' 2
Indicate if Passed(P),Failed(F),or N/A(X),fill in appropriate letter • ! I P P P P P P P t
C.{ Evaluation I li
0 i PASS:All,Construction Inspection responses are complete and all applicable Testing.Results responses are"Pass":(P) li
,. f
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. 1
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance I . May 2015 11
.
r 1 ;
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
p
AIR CONDITIONER AND HEAT PUMP SYSTEMS -
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A
Constant Volume Single Zone Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement , City of Cupertino
Project Address: • City: Zip Code: it
10231 Bubb Road' Cupertino 95014
System Name or identification/Tag: System Location or Area Served:
AC-14 Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Acceptance documentation is accurate and complete.:
Documentation Author Name: Documentation Author Signature:
Jackie Saquiton gacjaza drag•`""
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone:
San Leandro,CA 94577 (510)346-4300
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. II
2. I 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. I 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. 'l,
Field Technician Name: ISA AIN‘ IXUPII - Field Technician's Signature:
Field Technician Company Name: Position with Company(Title): i
ACCO Engineered.Systems S'[Pj—( %)Q ,n W ii
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenu'e N/A r
City/State/Zip: Phone: Date Signed:
San Leandro,GA 94577 (5.10)346-4300 1Z to jl io
RESPONSIBLE PERSON'S DECLARATION STATEMENT ,
I certify the following under penalty of perjury,under the lawsof the State of California:
1. I am the Field Technician,at 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. l'
2. I am eligible under Division 3 of the Business and.Professions Code in the applicable classification to accept responsibility for the }j
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. I 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 permits)issued far the building.
5. I 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 provi i to the building
owner at occupancy.
Responsible.Acceptance Person Na psyy‘ 1 'Responsible Acceptance Per • Sign• • e —
Responsible Acceptance Person Company Name: Position with Company(Title): f\,
ACCO Engineered Systems 11���11 I
Address: CSLB License:
1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date Signed:
San Leandro,CA 94577 (510)346-4300
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
i
5.rtit
STATE OF CALIFORNIA
OUTDOOR AIR ACCEPTANCE -C-V-
,.,..
CEC-NRCA-MCH-02-A(Revised 05/15) - CALIFORNIA ENERGY COMMISSION 7
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A
Outdoor Air Acceptance - (Page 1 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code: i
10231 Bubb Road Cupertino 95014 ,
System Name or Identification/Tag: • System Location or Area Served:
AC-15 Roof/'1st Floor i
Note:Submit one Certificate of Acceptance for each system Enforcement:Pik enc _Use Checked;by/R.ate: ,< _=:;. :;;;:r :;;_.:r._ :;,:.'"F::..,:::.'-;r;;..... :. ti
(.
that must demonstrate compliance. :::':::�.�:, -
Intent: Verify measured outside airflow reading is within±10%of the total required outside airflow.Required for all newly installed .
HVAC units.Reference MECH-3C(Column H or Column 1)or Mechanical Equipment Schedules.
Construction Inspection
Note: MCH-2A can be performed In con%unction with MCN-7A Supply Fan VFD Acceptance(if applicable)since testing activities overlap.
(
is
1. Supporting documentation needed to perform test includes:
a. As-built and/or design documents(for example,Mechanical Equipment Schedules,Equipment '
Start-Up Sheets or Balancing Reports).
b. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.1.1 Ventilation Systems:Variable Air Systems
' At-A-Glance and NA7.5.1.2 Constant Volume Systems Outdoor Air Acceptance At-A-Glance). (.
c. 2013 Building Energy Efficiency Standards. s
2. Instrumentation needed to perform test includes: '`
a. Watch r
b. Calibrated,means.to measure airflow(i.e.hot-wire anemometer,velocity pressure probe,etc.). r
1. Method and equipment used: it
ii. Equipment calibration date(must be within one year:)
3. System type(check either VAV or CAV): ❑ VAV I]CAV
ii
a. Check if Variable Air Volume(VAV)and complete the following:
i., Outside airflow is eithr
either factory calibrated orfield calibrated.
s
O Check if factory calibrated and attach calibration certification. tr
O Check if field calibrated and attach calibration results.
[i. Damper Control(must be checked): -
( l Dynamic damper control is being used to control outside air.(This is NOT a fixed minimum position).
ig
ig
iii. One,of the following dynamic controls is being utilized to control outside air(check method used)
tt
El, Outdoor Air CFM Compensation
Energy Balance Method r
111 Demand Control Ventilation
❑ Return Fan Tracking li
It
O Injection Fan,Method '[
I
❑ Dedicated Minimum Ventilation Damper with Pressure Control
I=1.,Other'Active Control,Describe:
b. Check if Constant Air Volume(CAV)and verify the following: It
it
I] System is designed to provide a fixed minimum OSA when the unit is on. it
4. Method of delivering outside air to the unit(check one of the following): it
1=1 'Outside air is ducted to the return air plenum.Confirm that outside air is ducted to either(check one of the following): ti
❑ Within five ft:of the unit. t
t
1:1 Within 15 ft.`of the unit,with the air directed substantially toward the unit. tl
If
❑ Return air plenum is NOT used to distribute outside air to the unit.I.e.outside air is ducted directly to the unit or outside air is 1,
provided:independent of the unit.
ti
5, Pre-occupancy purge has been programmed for the 1-hour period immediately before the building is normally occupied to provide(one I
of the followiing methods must be verified and checked):
e.
a. :The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency Standards TABLE 120.1-A,or 15 cfm 1
per person'times the :expected number of occupants,whichever is less. is
b. .3 complete air changes to.the zone served by the air handler, .,
i
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li
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 'i
i, 5
I
[
, 1
STATE OF CALIFORNIA I
OUTDOOR AIR ACCEPTANCE
..: -41..--
CEC-NRCA-MCI-1-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION '--
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A
Outdoor Air Acceptance (Page 2 of 3)
,
Project Name: 'Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 1
1
Project Address: City: Zip Code: 1
:
10231 Bubb Road Cupertino . 95014 1
E
System Name or Identification/Tag: System Location or Area Served: i
r
AC-15 Roof/1st Floor 11,
. P
A. NA7.5.1.1 Outdoor Air Acceptance Functional Testing CAV VAV g
2
Step 1: Disable demand control ventilation(if applicable) . 0
Step 2: Verify unit is not in economizer mode during test(economizer disabled). 2 0 E
D
ii
:,i. ,,- -.,;',.:. ,..r7:,.,77,*;I'',.-:-:.L.L::±z.i...
li
Note:Shaded boxes do not apply for CAV systems '
... _ .
Step 3: CAV and VAV testing at full supply airflow , -
:: .,: : :.::::::•:-.:::::::
Adjust supply air to achieve design airflow or maximum airflow at full -,:;-.7.,7:::i.;-, :::,:g:;•::.;::::: ;I
a.
cooling.Record VFD speed(Hz). Hz
g
b. Measured outdoor airflow reading(cfm) . , 130 cfm cfm I.
il
Required outdoor airflow(cfm)(from MECH-3C,Column 1,or ' 't
C•
Mechanical Equipment Schedules). 120 cfm cfm
Time for outside air damper to stabilize after full supply airflow is achieved - i.,,::::•:,:!1-':-.,.:: ;.
d. :6
(minutes): min ;
. . .
1
Step 4: VAV testing at reduced supply air flow CAV VAV , g
Adjust supply airflow to either the sum of the minimum zone airflows,full heating,or 30%of the :::_-.i::7g:2: ::-,_::::.:.7:,:::•: /
a.
total design airflow.Record VFD speed(Hz). - Hz g:
. ;,:•. •::•.:::::: •:..f.,-,-,,,;,..f:,. ;
b. Measured outdoor airflow reading(cfm) :::.::'::'.; :,.“:-: !-:-':;i-,;:-.::i.:': cfm c. Required outdoor airflow(cfm)(from MECH-3C,Column! or mechanical equipment schedules). !(.-::,g!;::':.,', ''- ;:: cfm 1
_ d. Time for outside air damper to stabilize after reduced supply airflow is achieved(minutes): g';:ti:. V:.:::;;_: mm g
i
Step 5: Return to initial conditions(check) 0 0 6
1
g
' 6
B. Testing Calculations&Results
Determine Percent Outside Air at full supply airflow(%OAFA)for Step 2 k
a. %OAFA=Measured outdoor airflow reading/ReqUired outdoor airflow(Step2b/Step2c) 108.3% 6
b. %OAFA is within 10%of design Outside Air.(%OAFAS 110%) ' 0/ N Y / N 1
i
. . . . .: ,:.,i:
c. Outside air damper position stabilizes within 5 minutes(Step 2d<5 minutes) ::,;.:1- 1:y•••:•:7.- :••,i,':-:,:, Y / N
_
Determine Percent Outside Air at reduced supply airflow(%OARA)for Step 3(VAV only)
.,,
: ..-::.:: ::.:•,:-.::,,:-;-:•.,:i:
a. %OARA=Measured outdoor airflow reading/Required outdoor airflow reading(Step3b/Step3c) 1
i
b. %OARA is within 10%of design Outside Air.(OARA• 110%) '''!:i::::::::7:,:f..,f,:,74::- Y / N
5
c. Outside air damper position stabilizes within 5 minutes(Step 3d<5 minutes) :::nZA:;] _.f Y / N q
Note: The intent of this test is to ensure that 1)all air'.handlers provide the minimum amount of OSA and 2)VAV air handlers use dynamic 1
ii
controls to avoid over ventilation. . 1
g
C. Evaluation: ' I
1}
PASS:All Construction Inspection responses are complete and Testing Calculations&Results responses are positive 6
2 (V-Yes)
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3
1
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
1
1
STATE OF CALIFORNIA
_•'...
OUTDOOR AIR ACCEPTANCE ,% .-
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A 1
Outdoor Air Acceptance (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb'Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-15 Roof%1st Floor
11
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT hi
1. , I certify that this Certificate of Acceptance documentation is accurate and complete. 11
Documentation Author Name: Documentation Author Signature:
Jackie Saquiton 6✓ackte. cam•
Documentation Author Company Name: Date Signed:
' ACCO Engineered Systems 1.1/16/2016
Address: ATT Certification Identification(if applicable): N/A
1133 Aladdin Avenue
City/State/Zip: Phone:
San Leandro,CA 94577 (510)346-.4300
FIELD TECHNICIAN'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California: ,
I
1. The information provided on this Certificate of Acceptance is true and correct. •
2. I 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 it
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. I have confirmed that the Certificate(s)of Installation for the construction or installation identified on this Certificate,of Acceptance has 1
been completed and signed by the responsible builder/installer and has been posted or made available with.the building permit(s) l
issued for the building. +l
Field Technician Name: Field Technician's Signature: 4
` �1oln {6rA(.er /�i' 11
Field Technician Company Name. Position with Company(Title): • / 4
ACCO Engineered Systems �)C11/Ice.. j'(t)til,o
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A,
,Z Ju
City/State/Zip:
San Leandro,CA 94577 Phone: (510)346-4300 Date signed: J,7
RESPONSIBLE PERSON'S-DECLARATION STATEMENT / I/ II
I certify the following under penalty of perjury,under the laws of the State of California:
1. I ani 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. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the411
system design,construction or installation of features,materials,components,or manufactured devices for the scope of work 111,
identified on this Certificate of Acceptance and attest to the declarations in this statement(responsible acceptance person). 11
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. I 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. I 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 under ..nd that a
signed copy of this Certificate of Acceptance is required to be included with the documentation the builder'provides s e building
owner at occupancy.
Responsible Acceptance Person Na .y y- Iftesponsible Acceptance Pers n Signatur-
Responsible Acceptance Person Company Name: ` Position with Company(Title):
ACCO Engineered Systems -
Address: CSLB License:
1133 Aladdin Avenue 120696
City/State/Zip: ,Phone: Date Signed: p
San Leandro,CA 94577 (510)346-4300 7 5.)
l
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance I May 2015 f l
e
9
4'
STATE OF CALIFORNIA
I,
CONSTANT VOLUME,SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS -t-N-41'
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION `'"
I CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A ``
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 1 of 3) i
)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 i
Project Address:. City: Zip Code: 1
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
ii
AC-15 Roof 11st Floor is
11
Note:Submit one Certificate of Acceptance for each system that must Enforcement:�lgency,Use:CFiecked byl0ate_ _7;:;-;, . ._::.<::;:,:._--_ .:
demonstrate compliance.
Construction Inspection s
1. Supporting documentation needed to perform test includes,but not limited to:
a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.2 Constant Volume,Single-zone,
3
Unitary Air Conditioner and Neat Pumps Systems Acceptance At-A-Glance.) ):
b. 2013 Building Energy Efficiency Standards Manual. I
2. Instrumentation to perform test includes,but not limited to: F
a. Temperature Meter
b. Amp Meter .
3. Installation(check if applies): "
)
El Thermostat is located within the space-conditioning zone that is served by the HVAC system. i
4. Programming(check all those that apply): ''
t
a
0 Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards
Manual section 120.2(b).
Minimum heating setpoint: 70°F. Maximum cooling setpoint 78 °F. Deadband: °F.
[] Occupied,unoccupied,and holiday schedules have been programmed per the facility's schedule.
❑ Pre-occupancy purge has been programmed to meet the requirements of 2013 Building,Energy Efficiency Standards Manual
section 120.1(c)2. y
1. Check method used to determine pre-occupancy purge:
S
El Lesser of:conditioned floor area times ventilation rate from 2013 Building:Energy Efficiency Standards TABLE
120.1-A or 15 cfm per person times the expected number of occupants. u
❑ 3 complete air changes.
Notes: Unit controlled by BMS.
x.
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3
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
ti
I
l
ii
4!
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE,'UNITARY (PACKAGED AND SPLIT) �.._4 • i
AIR CONDITIONER AND HEAT PUMP SYSTEMS ,64;-,th.,_
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION - - k.
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A `
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 2 of 3) I`
Project Name: Enforcement Agency: Permit Number: ii
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code: l
10231 Bubb Road Cupertino 95014 1
System Name or Identification/Tag: System Location or Area Served:
AC-15 Roof/ 1st Floor
' f
g
'A. Functional Testing Requirements - I Operating Modes
Step 1: Disable,economizer control and demand-controlled ventilation(if applicable)to prevent unexpected interactions.
Occupied Mode , 1
Step 2: Heating load during occupied,con'dition
Step 3; No-load during occupied condition .
Step 4: Cooling load during occupied condition
Unoccupied Mode ).
(
Step 5: No-load during unoccupied condition '
Step 6: Heating load duringunoccupied-condition
Step 7: Cooling load during unoccupied condition L••
Step 8: Manual override iif
.8 7 6 Y5 4 3 2
Step 2-8: Check and verify the following for each simulation mode required :,. ;-',-..2.; - -. . .. -- -. °
a. Supply fan operates continually 0 ` l=I 2 D
b. Supply fan turns off '
:: Ei:: it
c. Supply fan cycles on and off =' 0 121
d. System reverts to"occupied''mode to satisfyanycondition 0
Y p i.
e. System turns off when manual override time period expires . , , 0
f. Gas-fired furnace,heat pump,or electric heater stages on C] 2 i
g. No heating is provided by the unit
h. No cooling is provided by the unit __ _
',E:4o o -=_ a o P
I. Compressor stages on ; ,' 0 ...1:. ;_ _;_; E1
j. Outside air damper is'open td minimum`position 0_0 `�°
! J J
k. Outside air damper closes,completely ❑! i] --.- x
I
Step 9;.System returned to,initial operating conditions after all tests have been completed: ,. - i;Y / N
8. 'Testing Results :' 8 7 6 5 4 3 2 if
!I
Indicate if Passed(P),Failed.(F),or]N/A(X),fill in appropriate letter . NA N'A P P P P P
C. Evaluation ' jl
l] PASS>AII Construction Inspection responses are complete and all applicable Testing Results responses are"Pass":(P) I
y
a
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5
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CA Building Energy Efficiency Standards-2013 Nonresidential ComplianceMay 2015 ;i
i
4
AA
II
STATE OF CALIFORNIA li
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS 'w :
CEC NRCA MCH 03 A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A
Constant Volume Single Zone Unitary(Packaged and Split)Air Conditioner and Fleet Pump Systems (Page 3 of 3)
Project Name: Enforcement Agency: . Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road .Cupertino 95014
System Name or Identification/Tag: {System Location or Area Served:
AC-15' Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I
1. •I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
'Jackie'Saquiton 6✓.^h% crcutpurtcm. l
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue ' N/A i
City/State/Zip: Phone:
San Leandro;CA 94577 (510)346-4300 i
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. I 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 tbthe applicable acceptance
requirements and procedures specified in Reference Nonresidential Appendix NA7. .
4. I have confirmed that the Ceitificate(s)of Installation for the construction or installation identified on this Certificate of Acceptance has
been completed and signed by the responsiblebuilder/installer and has been posted or made available with the building permit(s)
issued for the building.
Field Technician Name: Field Technician's Signature: .
` J0 Ger
Field Technician CompanyJPrY1: Position with Company(Title): c ..1.(1/).14/1k1/1 1
ACCO Engineered Systems Jef tilC I C'G�).14/11k1/)
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
•
City/State/Zip: Phone: I • Date Signed:
San Leandro,CA 94577 (510)346-4300
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,,under the laws of the State of California:
1. I 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. ii
2. I.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 II
identified on this Certificate of Acceptance and attest to the declarations in this statement(responsible acceptance person).
3. The information provided on this Certificate ef,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 I
enforcement agency,and conforms to the applicable acceptance requirements and procedures;specified in Reference Nonresidential
Appendix NA7. j
4. I 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. I will ensure that a completed,signed copy of this Certificate of Acceptance shall be posted,or made available wi - e building
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections.I unde tand that a
signed copy of this Certificate of Acceptance islireequired to be included withthe'documentation the builder pro ides t.the building
owner at occupancy.
Responsible Acceptance Person N. e. i Responsible Acceptance Pe_on Signet, e: 4Iii
A .& _ '4 in,
r
Responsible Acceptance Person Company Name: Position with Company,(Title):
ACCO Engineered Systems •P
Address: CSLB License:
' 1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date Signed: 11
San Leandro;CA 94577 (510)346-4300 1 j
CA Building Energy Efficiency Standards-'2013 Nonresidential Compliance 'May 2015
I
STATE OF CALIFORNIA
OUTDOOR AIR ACCEPTANCE 'la
CEC-NBCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION '
CERTIFICATE OF ACCEPTANCE • NRCA-MCH-02-A
Outdoor Air Acceptance - (Page 1 of 3) r.
Project Name: Enforcement Agency: Permit Number: I.
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 f
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: li
AC-16 Roof/1st Floorit
.. ,....::--:.:_::—.:::: . : . . ::._: _.. -. _ . ..._.::ridgy:r. i;:-i•-F _ .i:7ai4_F, y
Note:Submit one Certificate of Acceptance for each system enforcement.AgencyU$eChecked:by/Date _ __ ._:_ 1
thatmust demonstrate compliance.
Intent:
Verify measured outside airflow reading is within±113%of the total required outside airflow.Required for all newly installed z
HVAC units.Reference MECH-3C(Column H or Column I)or Mechanical Equipment Schedules. 4
,
Construction Inspection N
Note: MCH-2A can be performed in conjunction with MCH-7A Supply Fan VFD Acceptance(if applicable)since testing activities overlap.
1. Supporting documentation needed to perform test includes: µ
a. As-built and/or design documents(for example,Mechanical Equipment,Schedules,Equipment
Start-Up Sheets or Balancing Reports). , i, ,
b, 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.1.1 Ventilation Systems:Variable Air Systems
At A Glance and NA7.5.1,2'ConstantUolume Systems Outdoor Air Acceptance At A Glance).
c. 2013 Building Energy Efficiency Standards. x
2, 'instrumentation needed to perform test includes: I ; ;I
;a. Watch Y
b. Calibrated means to measure airflow(i.e.hot-wire anemometer,velocity pressure probe,etc.). `'
i. Method and equipment used: Velgrid .
ii. Equipment calibration date(must be within one year:) 9/13/2016 t
3. System type(check either VAV or CAV): 1] VAV ❑CAV g.
a. Check if Variable Air Volume(VAV)and complete the following: li
I. Outside airfiow'is either factory calibrated or field calibrated. , II
❑ Check if factory;calibrated and attach calibration certification.
heck if field calibrated and attach calibration results. k
O C
ii. Damper Control(must be:checked): E
ElDynamic,damper control is being used to control outside air.(This is NOT a fixed minimum position), g
Iii. One of the following dynamic controls is being utilized to control outside air(check method used) ' I
' ❑ Outdoor:Air CFM Compensation
' ❑ Energy Balance Method
ElDemand;Control Ventilation
❑ Return fan'Traekingii
❑ Injection'Fan Method
, ❑ Dedicated Minimum Ventilation Damper with Pressure Control
0 Other Active Control,Describe:
1
b ,Check if Constant Air Voiu'me,(CAV)and verify the following: 1.
CI 'System is designed to provide a fixed minimum OSA when the unit is on. .
4. . Method of delivering outside:air to the unit(check one of the following):
(] Outsideair is,ducted-to the return air plenum.Confirm that outside air is ducted to either(check one of the following):
❑ i c.
Within five'ft.of the unit 4
i
❑ Witfiri 15 ft.'of the unit,with the air directed substantially toward the unit.
, Return air plenum issNOT used to distribute outside air to the unit.I.e.outside air is ducted directly to the unit or outside air is
CI •
independent of the unit. I
•S. !Pre-occupancy purge has`been programmed for the 1-hour period immediately before the building is normally'occupied to provide(one k
of the following methods must be'verified and checked): i k
a: The conditioned floor area times the ventilation rate from the 2013 Building Energy Efficiency StandardsiTABLE 120.1-A,or 15 cfm k
I I per person times the expected number of occupants,whichever is less. g.
b; 3 complete air changes'to the,zone served by the air handler. i l
1
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 x
I
i
1
i
I.
STATE OF CALIFORNIA 1
OUTDOOR AIR ACCEPTANCE ,;,
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NItCA-MCH-02-A
Outdoor Air Acceptance (Page 2 of 3) ri
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code: Li
10231 Bubb Road Cupertino 95014 lii.
System Name or Identification/Tag: System Location or Area Served:
AC-16 Roof/ 1st Floor
Y
1
A. NA7.5.1.1 Outdoor Air Acceptance Functional,Testing CAV VAV
Step 1: Disable demand control ventilation(if applicable) ❑ (]
Step 2: Verify unit is not in economiser mode during test(economizer disabled). 0 El li
Note:Shaded boxes do nota l for CAV systems - "_ .... =_
apply - . ...-. - - -
Step 3: CAV and VAVtesting at full supplyairflow - -
Adjust supply air to achieve design airflow or maximum airflow at full - __
a. cooling.Record VFD speed(Hz). Hz i
b. Measured outdoor airflow reading(cfm) cfm cfm f
Required outdoor airflow(cfm)(from MECH-3C,Column f,or
c' Mechanical Equipment Schedules). cfm 360 cfm
Time for outside air damper to stabilize after full supply airflow is achieved = _ •
d.
(minutes): ... .- .._ _ min
Step 4: VAV testing at reduced supply air flow CAV VAV ik
Adjust supply airflow to either the sum of the minimum zone airflows,full heating,or 30%of the
a.
total design airflow.Record VFD speed(Hz), ';'::'.:::-::,:,;::-.,..i.:-:::-::,:; N/A Hz
b. Measured outdoor airflow reading(dm) -__ 341 cfm r
c. Required outdoor airflow(cfm)(from MECH=3C,Column I,or mechanical equipment schedules). _ _-_ 360 cfm
d. Time for outside air damper to stabilize after reduced supply airflow is achieved(minutes): =--. ._._= N/A min
t.
Step 5: Return to initial conditions(check) a D
B. Testing Calculations&Results -
Determine Percent Outside Air at full supply airflow(%OAFA)for Step 2
a. %OAFA=Measured outdoor airflow reading/.Req'uired outdoor airflow(Step2b/Step2c)
b. %OAFA is within 10%of design Outside Air.(%OAFA 5 110%) Y / N Y / N
c. Outside air damper position stabilizes within 5 minutes(Step 2d<5 minutes) ....:_._.............. Y / N 4
I
Determine Percent Outside Air at reduced supply airflow(%OARA)for Step 3(VAV only) F
e
a. %0ARA=Measured outdoor airflow reading/Required outdoor airflow reading(Step3b/Step3c) __-_ __ 94.7%
b. %OARA is within 10%of design Outside Air.(OAM 5110%) _-= _ Cy) N
c. Outside air damper position stabilizes within 5 minutes(Step 3d<5 minutes) = --_ Y / N `
Note: The intent of this test is to ensure that 1)all air handlers provide the minimum amount of OSA and 2)VAV air handlers use dynamic g
controls to avoid over ventilation.
R
C. Evaluation: I 1.
PASS:All Construction Inspection responses are complete and Testing Calculations&Results responses are positive
0 (Y-Yes) I g
Unit has an EC motor.Unit does not use a VFD ; a.
Economizer is not capable of modulating '
6
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
i
v
li
STATE OF CALIFORNIA
OUTDOOR AIR ACCEPTANCE .;f a
CEC-NRCA-MCH-02-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION ---- -
CERTIFICATE
CERTIFICATE OF ACCEPTANCE NRCA-MCH-02-A
Outdoor Air Acceptance (Page 3 of 3) )
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code: t
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: sk
, AC-16 Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT °
fy Acceptanceq and Complete.
Documentation.Author Name: Documentation Author Signature:
1. I cern that this Certificate documentation is accurate '
Jackie Sa utton , 7aeAlta- craapiumf.
Documentation Author Company Name: Date Signed:
ACCO Engineered'Systems 11/1'6/2016 :
Address: ATT Certification Identification(if applicable):, . j
1133 Aladdin Avenue 'N/A•
City/State/Zip: Phone: `
San Leandro,CA 94577 (510)346-4300
FIELD TECHNICIAN'S DECLARATION STATEMENT l
+I certify the following under penalty of perjury,under the laws of the State of California: 11
1. The information provided on this Certificate of Acceptance is true and correct j
2.. I am the person who performed the acceptance verification reported on this Certificate of Acceptance(Field Technician).
I•
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. I have confirmed that the Certificates)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 permits)
issued for the building. ;, , '
Field Technician Name: , , Field Technician's Signature: .. . ,,
Ci---' . %�$l)e s ' ' .
Field Technician Company Name Position with Company(Title):,—, i . I , 411
' ACCO Engineered Systems cs�� c �Cc(1,1 i,c'~G 0 'I
r
Address: ATT Certification Identification(if applicable):
-1133 Aladdin Avenue - I N/A
City/State/Zip: Phone: Date Signed: ,
'SanLeandro,CA 94577 (510)346-4300 . i; , IZ,/{O/2.016
I1
RESPONSIBLE PERSON'S DECLARATION STATEMENT
1 II certify the following under penalty of perjury,under the laws of the State of California: .i #''
1.� I am the Field Technician,or the Field Technician is acting on my behalf as my employee or my agent and I h've'reviewed the l
information provided on.this Certificate of Acceptance. ;
2.'1 I 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 forthe spe, o
cf 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
1Certificate of Acceptance complies with the acceptance requirements indicated in the plans and specifications approved by the
Ienforcement agency,and,conforms to the applicable acceptance requirements and procedures specified in Reference Nonresidential
I Appendix NA7. ;I 1 '.
4. I have confirmed that the Certificates)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 I will ensure that a completed,signed copy of this Certificate of Acceptance shall be posted;or made available with thelbuilding
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a j
p requited p e
signed copy of this Certificate of Acceptance is re uired to be included with the documentation the builder Provide' jthe building
owner at occupancy. 'I i ,
Responsible Acceptance:Person Na`ems- Responsible Acceptance Person'Signatur ,;
Responsible Acceptance Person Company Name: Position with Company(Title):
I ACCO Engineered Systems i i I I I I
(-----
Address: . CSLB License: I I
I" 1,133 Aladdin Avenue ;1206961 !}
City/State/Zip: Phone: I DateSignedl• `) 'i
I ;San Leandro,CA 94577 (510)346-4300
'i i i is
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, CA Building Energy Efficiency Standards-2013 Nonresidential"Compliance 'I � ; May 2015
1
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STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY (PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS 2-="° 11
,
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A o
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 1 of 3) :
Project Name: - Enforcement Agency: - Permit Number: 3
Apple Bubb 09 HVAC Replacement City of Cupertino _ B-2016-3142 i
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location,or Area Served: 1
AC-16 Roof/ 1st Floor
ri
Note:Submit one Certificate of Acceptance for each system that must Enforcement A g ency Use;Checked by Date`-- .::--`= : ':`:-: :F:_
demonstrate compliance.
Construction Inspection
1. Supporting documentation needed to perform test includes,but not limited to:
a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.2 Constant Volume,Single-zone, i
UnitaryAir Conditioner and Neat Pumps Systems Acceptance At-A-Glance.)
b. 2013 Building Energy Efficiency Standards Manual. -
il
2. Instrumentation to perforin test includes,but not limited to:
ti
a. Temperature Meter • i
ll
b. Amp Meter il
3. Installation(check if applies): ,-i
0 Thermostat is located within the space-conditioning zone that is served by the HVAC system. 1
1
4. Programming(check all those that apply):
D Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards jl
Manual section 120.2(b).
r
Minimum heating setpoint: 68 °F. Maximum cooling setpoint 73 °F. Deadband: 5°F. j{
1!
- 2 Occupied,unoccupied,and holiday schedules have been programmed per the facility's schedule.
li
)2) Pre-occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual i
section 120.1(c)2.
. 1. Check method used to determine pre-occupancy purge: !I
0 Lesser of:conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE
120.1-A or 15 cfm per person times the expected number of occupants. p'
❑ 3 complete air changes.
Notes: BMS controlled with VAVs ii
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
I
STATE OF CALIFORNIA -
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS .,, l
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION €
CERTIFICATE OF ACCEPTANCE NRCA-MCN-03-A
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems. : (Page 2 of 3)
I
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino, B-2016-3142 • .
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: • 3
' AC-I6 Roof/ 1stFloor 1
A. Functional Testing Requirements 1 Operating Modes (
t
Step 1: Disable economiser control and demand-controlled ventilation(if applicable)to prevent unexpected interactions..
I
Occupied Mode 1
Step 2: Heating load during occupied condition '
Step 3: No-load'during occupled condition , , .. k
Step 4: Cooling load during occupied condition
' , Unoccupied Mode' ' ' I' , I • �I
. Step 5: No-load during unoccupied condition I
Step 6: Heating load during unoccupied condition •' :
' Step 7: Cooling load during unoccupied condition i
Step 8: Manual override , • 'I
8 7 :6 5 4 3 2 'i
i i required - _ .. k
Step 2 8: Check and verify the following for each simulation mode „ --
a. Supply fan operates continually 0 I
b. Supply fan turns off '' ' . G -:- 0 ""-... a
c. Supply fan cycles on and off' .. _ 4
d. System reverts to,occupied mode to satisfy any condition t. I
e. System turns off when,manual override time period expires ;' El 4
il
f. Gas-fired furnace;heat pump,'or electric heater stages on H ' E 0 3_
g, No'heating Is provided by'the unit : , 0 s" D ID 0 • '1
1€
h. No cooling is provided by the unit _.- --` � 0 -`_ 0 it
i. Compressor stages on ' , ; III i, :` 0 -`: 0 `: -,,„, t
j. Outside air damper is open to minimum position ” I.' 0 0 ID 0 ID 1.
k. Outside air damper closes completely r 03. i
If
' Step 9: System returned to initial operating conditions after all tests have been completed: j', i 6)/ N
il
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B. Testing Results . J I ,i !'' 8: 7 `6 5 4 3 2
:Indicate Passed(P},Failed(F),or N/A�(X),fill in appropriate letter I j' II: P^ P I O. .P P P P it
if
I �,
C. Evaluation 'III ' ,
1
0 PASS:'All Construction Inspection responses are complete and all applicable'Testing Results responses are 'Pass"(P) 1
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
t!
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STATE OF CALIFORNIA
CONSTANT VOLUME,SINGLE ZONE, UNITARY(PACKAGED AND SPLIT) ..
AIR CONDITIONER AND HEAT PUMP SYSTEMS -.....:,-N
AIR
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A
Constant Volume Single Zone Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-16 Roof!1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
. Jackie Saquiton g^"j'^ c'2w-ifirm
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification identification(if applicable): ii
1133 Aladdin Avenue N/A
City/State/Zip: Phone: .
San Leaiidro,CA'94577 (510)346-4300
FIELD TECHNICIAN'S DECLARATION STATEMENT I
I certify the following under penalty of perjury,under the laws of the State of California: 1
1. The information provided on this Certificate of Acceptance is true and correct. l
2. I 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
1
requirements and procedures specified in Reference Nonresidential Appendix NA7. l
4. I 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. I
Field Technician Name: $g-1 PA 1 �/(� Field Technician's Signature:
Field Technician Company Name: Position with Company(Title):
ACCO Engineered Systems S'ip OP ire, rl
Address: ATT Certification Identification(if applicable):
1.133 Aladdin Avenue N/A
City/State/Zip: Phone: Date Signed:
San Leandro,CA 94577 (510)346-4300 12-hv((c, •
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. I 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. I 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. I 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. I will ensure theta 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 provi es to the building {
owner at occupancy.
Responsible Acceptance Person Nate Responsible Acceptance Person Signat
-- ,,,.—..1
Responsible Acceptance Person Company Name: Position with Company(Title:
ACCO Engineered.Systems l ~
Address: CSLB license: ,
1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date Signed;,...A t,
- San Leandro,CA 94577 (510)346-4300 I 7 1 2010
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 If
STATE OF CALIFORNIA . ` 1
AIR ECONOMIZER CONTROLS ACCEPTANCE =f: ;`° i
.-
CEC-NRCA-MCH-05-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION )
CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A (
Air Economizer Controls Acceptance (Page 1 of 3)
Project Name: - Enforcement Agency: Permit Number: 3
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 I
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
AC-16 Roof/ I st Floor ' i
Note:Submit one Certificate of Acceptance for each system that must EnforcementAgencYUeCeceby/Dae=_:?: : ._;;; ;_ €; _ . _
3.
demonstrate compliance,
A. Construction Inspection
1. ,:Supporting documentation needed to perform test includes: ' ii
a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.4 Air Economizer Controls Acceptance At-A- i
i
Glance). ' F
b. 2013 Building Energy Efficiency Standards. (
2. , Instrumentation to.perform test includes: y
a. Hand-held temperature,probe
Calibration Date: (must be within last year) -
b. Device capable of calculating enthalpy • F.
Calibration Date: (must be within last year)
6
c. 1.2 k Ohm Resistor(when specified by the manufacturer)
ii
3. Installation:(all of the following boxes should be checked)
f
EI Economizer high limit shutoff control complies with Table 140.4-B found in the 2013 Building Energy Efficiency Standards
Section 140;4(e)3.
t
I] Economizer reliability features are present per 2013 Building Energy Efficiency Standards Section 140.4(e)4:'
a. 5-year manufacturer warranty of economizer assembly
b. Provide a product specification sheet proving capability of at least 60,000 actuations
c. Provide a product specification sheet proving compliance with AMCA Standard 500 damper leakage at 10 cfm/sf at 1.0 1.
' in w.g.A product specification sheet showing the manufacturer's results after following the testing procedures of ,
AMCA'Standard 500 or AMCA certification by a third party under AMCA Publication 511 can be used to satisfy this
ii
requirement(Class 1A,1,and 2 are acceptable). :
d. If the high limit setpoint is fixed dry-bulb or fixed enthalpy+fixed dry-bulb then the control shall have an adjustable 1
setpoint s.
e. Outdoor air;return air,mixed air,and supply air sensors shall be calibrated as follows: 1
' i. Drybulb and wetbul b temperatures accurate to±2°F over the range of 40°F to 80°F Y
ii, Enthalpy accurate to±3 Btu/Ib over the range of 20 Btu/Ib to 36 Btu/lb 3
iii. Relative humidity(RH)accurate to±5%over the range of 20%to 80%RH ?
f. Check that the sensor performance curve(s)is provided by the factory and sensor output values measured during sensor Y
calibration are plotted on the performance curve(s) �.
g. Sensors used for high limit control shall be located to prevent false readings,including but not limited to being properly 1
shielded from direct sunlight. f.
I
iJ Unitary systems with an economizer have control systems,including two-stage or electronic thermostats,that cycle
compressors off when economizers can provide partial cooling
LI System has return fan speed control,relief dampers,or dedicated relief fans to prevent building over pressurization in full t
economizer mode. -
1
III For systems with DDC controls,sensor used for economizer lockout has been factory or field calibrated.
economizer mode. fi
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❑ For systems with non-DDC controls,manufacturer's startup and testing procedures have been applied. 4
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 a
J
I
I
.
STATE OF CALIFORNIA ,"4
AIR ECONOMIZER CONTROLS ACCEPTANCE -
CEC-NRCA-MCH-05-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION j
CERTIFICATE OF-ACCEPTANCE NRCA-MCH-05-A if
Air Economizer Controls Acceptance (Page 2 of 3)
Project Name: Enforcement.Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: g
AC-16 Roof/1st Floor11
t
B. Functional Testing Results
Step 1: Disable demand control ventilation systems(if applicable)
II
Step 2: Enable the economizer and simulate a cooling demand large enough to drive the economizer fully open.Verify the following:
a. Economizer damper modulates 100%open. OY / N r.
b. Return air damper modulates 100%closed. OY/ N
c. For systems that meet the criteria of 2013 Building Energy Efficiency Standards Section 140.4(e)1,verify that the s
economizer remains 100%open with the use of mechanical cooling.This occurs when the cooling demand can no OY / N a
longer be met by the economizer alone. ti
ill
d. All applicable fans and dampers operate as intended to maintain building pressure. U/ N x
e. The unit heating is disabled(if applicable). 0)/ N /NA
Step 3: Disable the economizer and simulate a cooling demand.Verify the following:
a. Economizer damper closes to its minimum position. Y / N `.
b. All applicable fans and dampers operate as Intended to maintain building pressure. Y / N 3
c. The unit heating is disabled(if applicable). CD/ N /NA K
Step 4: If the unit is equipped with heating,simulate a heating demand and enable the economizer.Verify the following:
a. Economizer damper closes to its minimum position. <-1)/ N /NA
b. Return air damper opens. �/ N /NA
Step 5: Turn off the unit and verify the following: a
a. Economizer damper closes completely. Y / N
C
Step 6: System returned to initial operating conditions Y / N ii
C. Testing Results PASS / FAIL ?
Step 2:Simulate cooling load and enable the economizer(all answers are Y). ✓ s
b.
Step 3:Simulate cooling load and disable the economizer(all answers are V).
Step 4: Simulate heating demand and enable the economizer(all answers are Y).
Step 5:Turn off the unit(all answers are Y). V g
D. Evaluation:
II
El PASS: All Construction Inspection responses are complete and all Testing Results responses are"Pass" II
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ii.
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Notes: a
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015
. l
STATE OF CALIFORNIA _
AIR ECONOMIZER CONTROLS ACCEPTANCE '1',.,M'
CEC-NRCA-MCH-05-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION'
CERTIFICATE OF ACCEPTANCE NRCA-MCH-05-A
Air Economizer Controls Acceptance (Page 3 of 3)
Project Name: - Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:,
10231 Bubb Road Cupertino 95014
System Name or Identification/Tag: System Location or Area Served: '
AC-16 Roof/1st Floor
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Jackie Saquiton saa[cLa craqmitam
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems . 1,1/16/2016'
Address: ATT Certification Identification(if applicable):
1133,Aladdin Avenue N/A
City/State/Zip: Phone:
San Leandro,CA 94577 (510)346-4300
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. I 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.• I 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 Technician Na`me: Field Technician's Signature:
Cieo- 41-e AsbelI
Field Technician Company Name: Position with Company(Title): . ''
ACCO Engineered Systems 1?a.1e,oce 7e01,1JiC.ie..al
Address: ATT Certification Identification(if applicable):,
1133,Aladdin Avenue :; N/A
City/State/Zip: . Phone: Date Signed: •
San Leandro,CA 94577 (510)346-4300 • 12/to/2—at 6
RESPONSIBLE PERSON'S.DECLARATION STATEMENT , , .;
I certify the'following'under;penalty of perjury,under the laws of the State of California: '
1. I 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. I am eligible under.Division 3 oflthe Business and Professions Code in the applicable classification to accept respon'sibilityfor the
systems construction oriinstallation 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;complii,es 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. I haveconfirmed thatthe Certificates)of Installation for the construction or installation identified on this Certificate of Acceptance has
been completed and,is ppsted';or made available with the building permit(s)issued for the building. ,
5. ,l will ensure that a;completed,isigned copy of this Certificate of Acceptance shall be posted,or made available with the building
permits)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 the building
owner of occupancy. ' 1 i I
Responsible Acceptance Person Nam�,�\
Responsible Acceptance Person Signature: 1'
Responsible Acceptance Person Company Name: Position with Company(Title): . 1 ` y
1. ACCO Engineered Systems
Address; '' CSLB License: 1
1133iAladdin Avenue 120696 ,
City/State/Zip: . , • I Phone: Date Signed:t_i San Leandro,CA 94577 (510)346-4300 ,I J )tri,
• 1
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance ;` May 2015
1
1
I.
STATE OF CALIFORNIA
CONSTANT VOLUME, SINGLE ZONE, UNITARY(PACKAGED AND SPLIT) •
AIR CONDITIONER AND HEAT PUMP SYSTEMS %`
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 1 of 3)
Project Name: Enforcement Agency: Permit Number:
5
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 1
a
Project Address: City: Zip Code:
10231 Bubb Road Cupertino 95014 F
System Name or Identification/Tag: System Location or Area Served: f.
CU&FC-9 Roof/Telco Room D02
13
Note:Submit one Certificate of Acceptance for each system that must Eifp:..rcmentAenyteCfiek4ly/Dae: =-=:_. :s •`i
::. - .::_ . .. . :demonstratecompliance. ,.E.,: .:%-•;r :i ::;'-i.:,. . ... ;'-'-7: ::::._.-: r:� ;::-: ._:.:::::
a
I � 1
Construction Inspection 7
1. Supporting documentation needed to perform test Includes,but not limited to: i.
I
a. 2013 Building Energy Efficiency Standards Nonresidential Compliance Manual(NA7.5.2 Constant Volume,Single-zone,
Unitary Air Conditioner and Neat Pumps Systems Acceptance At-A-Glance.) ',
t
b. 2013 Building Energy Efficiency Standards Manual.
2. Instrumentation to perform test includes,but not limited to: :
a. Temperature Meter - s
b. Amp Meter
g.
3. Installation(check if applies): K
1
21 Thermostat is located within the space-conditioning zone that is served by the HVAC'system. t
4. Programming(check all those that apply): 1
❑ Thermostat meets the temperature adjustment and dead band requirements of 2013 Building Energy Efficiency Standards •
Manual section 120.2(b). • ll.
Minimum heating setpoint: N/A F. Maximum cooling setpoint 70 °F. i Deadband: °F. a
❑ Occupied,unoccupied,and holiday schedules have been programmed per the facility's schedule. ii
❑ Pre-occupancy purge has been programmed to meet the requirements of 2013 Building Energy Efficiency Standards Manual ;#
section 120.1(c)2. i
it
1. Check method used to determine pre-occupancy purge: , • : I
Q Lesser of:conditioned floor area times ventilation rate from 2013 Building Energy Efficiency Standards TABLE s
120.1-A or 15 cfm per person times the expected number of occupants. ,
❑ 3 complete air changes. r
Notes: CU&FC-9 serves an 1D17 room.Unit programmed for cooling only.Operates with no schedule,24/7 operation. E
_ 9
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 I
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STATE OF CALIFORNIA i
CONSTANT VOLUME,SINGLE ZONE, UNITARY (PACKAGED AND SPLIT)
i.
..
AIR CONDITIONER AND HEAT PUMP SYSTEMS -
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE = - NRCA-MCH-03-A
Constant Volume,Single Zone,Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems .(Page 2 of 3) f
l
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino B-2016-3142 r
Project Address: City: Zip Code: r.
10231 Bubb Road Cupertino 95014
System Name or identification/Tag: System Location or Area Served:
CU&FC-9 Roof/Telco Room D02
A. Functional Testing Requirements I Operating Modes
Step 1: Disable economizer control and demand-controlled ventilation(if applicable)to prevent unexpected interactions. (
Occupied Mode
Step 2: Heating load during occupied condition .
Step 3: No-load during occupied condition. ,.
Step 4: Cooling load during occupied condition .
Unoccupied Mbde `<
Step 5: No-load during unoccupied condition
Step 6: 'Heating load during unoccupied condition t
Step 7: Cooling load during unoccupied condition. a
Step 8: Manual override x
8 7 6 -5 4 3 2 IF
R.
Step 2-8: Check and verifythe following for each simulation mode required I
I
a. Supply fan operates continually 0 ::::'5': 0 ❑ 0
b. Supply fan turns off ❑
' c• Supply fan cycles on and.off' ❑ ❑ t
d. System reverts "occupied mode to satisfy any condition
e. System turns off when manual override time period expires ❑ l
f. Gas-fired furnace,heat pump,or electric heater stages on ` ❑ ❑ it
(
g. .No heating Is,provided,by the unit
h. Na cooling is provded.byith'e unit
::: :.;i1 ❑ 0 0 0
i. Compressor stages on .. El '...
j. Outside air damper is open to"minimum position ❑ CI ❑' ❑' 0 i
k, Outside,air damper doses completely -'.1'.'5:-'ii':.:';. ❑ 0
Step 9:.System:returned to initial operating conditions after all tests have been completed Y/ N
1.
B. Testing Results ., i •. ' i. ;'8 7 6 5 4 3 2 9
I
Indicate if Passe'd"(P) Failed(F),or N/A(X),fill in appropriate letter ''-F .. F F F F F F
ll'.
ll
E
C. ,Evaluation, ` I ; LI '
0 PASS:All Construction'.Inspection.responses are complete and all applicable Testing Results responses_are"Pass"(P)
iiCooling only unit,serves;IDF room,operates 24/7,no schedule. (
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CA Building Energy Efficiency Standards-2013 Nonresidential Compliance May 2015 ; il
1,
I
STATE OF CALIFORNIA •
CONSTANT VOLUME;SINGLE ZONE, UNITARY(PACKAGED AND SPLIT)
AIR CONDITIONER AND HEAT PUMP SYSTEMS .r" %
CEC-NRCA-MCH-03-A(Revised 05/15) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF ACCEPTANCE NRCA-MCH-03-A
Constant Volume Single Zone Unitary(Packaged and Split)Air Conditioner and Heat Pump Systems (Page 3 of 3)
Project Name: Enforcement Agency: Permit Number:
Apple Bubb 09 HVAC Replacement City of Cupertino
Project Address: City: Zip Code:
10231 Bubb Road , Cupertino 95014
System Name or Identification/Tag: System Location or Area Served:
CU&FC-9 Roof/Telco Room D02 i,
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
Iii
1. I certify that this Certificate of Acceptance documentation is accurate and complete. •
Documentation Author Name: Documentation Author Signature: -
Jackie Saquiton ffrimil-e. J'a.c.ecif m
Documentation Author Company Name: Date Signed:
ACCO Engineered Systems 11/16/2016
Address: ATT Certification Identification(if applicable):
1133 Aladdin Avenue N/A
City/State/Zip: Phone:
San Leandro,CA 94577 (510)346-4300
FIELD TECHNICIAN'S DECLARATION STATEMENT 1
I certify the following under penalty of perjury,under the laws of the State of California:
I/
1. The information provided on this Certificate of Acceptance is true and correct.
2. I am the person who performed the acceptance'verification reported on this Certificate of Acceptance(Field Technician). {
3. The construction or installation identified on:[his•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 II
requirements and procedures specified in Reference Nonresidential Appendix'NA7. t
4. I have confirmed that the Certificate(s)of Installation for the construction or.installation identified on this Certificate of Acceptance has i
been completed and signed by the responsible builder/installer and has been posted or made available with the building permit(s) 11
issued for the building.
Field Technician Name: � � , Field Technician's Signature: \y
Field Technician Company Name: Position with Company(Title): I
ACCO,Engineered Systems i fig ?) i
Address: ' ATT Certification Identification(if applicable):
113.3 Aladdin Avenue N/A
City/State/Zip: Phone: Date Signed: II
San Leandro,CA 94577 (510)346-4300 (Z I1V•/ to II
RESPONSIBLE PERSON'S DECLARATION STATEMENT . •
I certify the following under penalty of perjury,'under the laws of the State of California: '
1. I am the Field Technician,or the Field Techriician'is acting on my behalf as my employee or my agent and I have reviewed the
information provided on this Certificate of Acceptance.
I
2. I 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 fatures,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 Certificateof 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. ., h
4. I have confirmed that the Certificate(s)of Installation for the construction or installation identified on this Certificate of Acceptance has H
been completed and is posted or made available with the building permit(s)issued for the building.
5. I 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 un erstand that a
signed copy of this Certificate of Acceptance'is;required to be included with the documentation the builder prov` es'to the building
owner at occupancy.
Responsible Acceptance Person Na^ ' ' C7.3 Responsible Acceptance Person nature•
N(V\‹
Responsible Acceptance Person Compo y Name: Position with Company(Title): n
ACCO Engineered Systems r �
Address: CSLB License: 11 �, •
1133 Aladdin Avenue 120696
City/State/Zip: Phone: Date Signed: }
• San Leandro,CA 94577 (510)346-4300 �J l ���- -
CA Building Energy Efficiency Standards-2013 Nonre'sidential Compliance May 2015