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12080075CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 2 RESULTS WAY
d —
CONTRACTOR: XL CONSTRUCTION PERMIT NO: 12080075
OWNER'S NAME: ECI TWO RESULTS LLC
851 BUCKEYE CT DATE ISSUED: 12/14/2012
OWNER'S PHONE: 4084901641
MILPITAS, CA 95035 PHONE NO: (408) 240-6000
❑ LICENSED CONTRACTOR'S DECLARATION
r
`
BUILDING PERMIT INFO: BLDG ELECT PLUMB'
License Class <,—i b Lic. # 3 i$ C S 3
MECH r RESIDENTIAL r COMMERCIAL
ContractorlZedr_poaJJECe.:�;,n,.0 ate 12--fe—/"Z
1 hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: T.I (8244 SQFT), NEW
(commencing with Section 7000) of Division 3 of the Business & Professions
INTERIOR PARTITIONS, DOORS, FINISHES, CEILINGS,
Code and that my license is, in full force and effect.
LIGHTING, E/M/P'S 12/18/12-REV41-INSTALLATION OF (4)DUAL EV CHARGING
STATIONS AT BLDG 6-I2 -REV#I ISS'D 12/18/12
1 hereby Affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
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
Sq. Ft Floor Area:
Valuation: $5045000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 35720042.2
Occupancy Type:
I certify that I have read this application and state that the above information is
correct. I. agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned propertyfor inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date lZ-lg—l2
Issued by: �' f2 Date:
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
RE -ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (See.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
HAZARDOUS MATERIALS DISCLOSURE
performance of the. work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95, of the
I have and -will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
permit is issued.
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should 1 use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued, I shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, 1
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
Owner • utho ized gen
Date: !Z — r8 ` Z -
i
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
I hereby affirm that there is a construction lending agency for the performance of work's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
°
costs, and expenses which may accrue against said City in consequence of the
Lender's Address
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTI 10 I (408) 777-3228 • FAX (408) 777-3333 • buildin u ertino.or
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI WREVISION / DEFERRED ORIGINAL PERMIT # 7.o80,:,'7:5—
PROJECT
o80,:,'77
PROJECT ADDRESS
APN # � 5-
Rd 6 J - T S J&J A L4
l
OWNER NAME
Two ZCSuLTE LLL
PHONE
o b I ( k4I
E-MAIL
STREET ADDRESS
S i E 2- -
CITY, STATE, ZIP
13` 06 Z
FAX
3Cv S hc,2�wQ j2cQ
,-LlCl
CONTACT NAME
01 A a CZL -Z A ,Jct
PHONE
9 ela SZ7 4ian.
E-MAIL
O :0Yzad E6 , o vm
STREET ADDRESS
CITY, STATE, ZIP
FAX
% Dtt -(, (t/e.5Te2,c,1 Vtit.),q 11
.�TrA n G64 q.5165
SO ,90
❑ OWNER ❑ OWNER -BUDDER ❑ OWNER AGENT kCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME 1V1A2.CCL r 12Q'S-10
'Le
LICENSENUM3ER
LICENSETYPE
BUS. LIC#
ll
Pedw-cJ ✓LIc G-tiv�
3 33
C�la
2 v8
COMPANY NAME ^
E-MAIL
FAX
Co
o s"0 6
STREET ADDRESS
2-7-25- A i<L<JA If
CITY, STATE, ZIP
_5A C/g gS0S
PHONE
Z/ U s -c 860
ARCHITECTIENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
L (fi-)G[ lL ✓L S) d 5
41
EXISTING USE
PROPOSED USE
CONSTR. TYPE
# STORIES
USE TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN O
REMODEL AREA
REMODEL AREA DEL AREA
PORCH AREA
DECK AREA
I TOTAL ORCH AREA
GARAGE AREA DETACH
❑ ATTACH
I
# DWELLING UNITS:
1S A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEINGADDED? []NO
ADDITION? ❑NO
PRE-APPJAIfATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # NO PLANNING APPROVAL LETTER
1S THE BLDG AN . ❑ YES
EICHLER HOME? NO
Y RECEIVED BYE"°��'"#x's
` �`'
T,QTAL VALUATION:
❑
[3
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I author' representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent:;ZZ22n�� Date: JZ—AA-12
SUPPLEMENTAL ORMATIO Q D
�� "
OVER THE -COUNTER
� w s
k BUILDIi�G PLAN REVIEWrc z
_I
New SFD or Multifamily dwellings: Apply for demolition permit for
building(s). Demolition is issuance building
existing permit required prior to of
for building.
�g�i 4
s
permit new
Xi
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
sTANnnan (.r c
Z
t PUBLIC WORKS
s9
form if any Hazardous Materials are being used as part of this project.
ik 5
;ter y6
R
$ N
LARGE spa
❑ AFIRE DEPT "; s�
_ Co of Planning Approval Letter or Meeting with Planning prior o
Copy g pp g g p t
❑ D' AJOR '��'� '1"� ''�' r '� � I�
a
�fi STRICT I+
submittal of Building Permit application.
}
SANPPARY SEWER D
>.�...� �,.<��;. ..fi.''°'„:z. ..
�;❑„ENVIRONMENT,4L.HEe1:I:TFI _��_f
BIdgApp_2011.doc revised 06121111
� 1 CITY OF CUPERTINO
l FEE ESTIMATOR - BUILDING DIVISION
iaADDRESS:
2 Results Way
DATE: 12/18/2012
REVIEWED BY: Sean
IL1ech, Perinil Fee.,
APN:
BP#: 12080075
*VALUATION: 1$45,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY
USE: Commercial Building
P174r111), his/). Fee:
PENTAMATION
PERMIT TYPE: SOLAR -Comm
WORK
Revision #1: Installation of 4 dual EV charging stations at building 6.
SCOPE
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the Preliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Ejf 7/1112,)
.ki:ch. Plan Check
Phanb. Plan ('heck
Elec. Plan Check
IL1ech, Perinil Fee.,
Plumb, Permit F'ee:
Elec. Permit Fee:
Other Hec:h. Insp.
Other Plumb Insp.
Outer Elee. Insp.
Meeh. Insp. Fire:
P174r111), his/). Fee:
Elec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the Preliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Ejf 7/1112,)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
® #
$408.00
Alternative Energy System
ICHRGSTA EV Charging Station
Suppl. PC Fee: 0 Reg. () OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. ® OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Consitzlction Tax.
A.(lininistralive lee:
Work Without Permit? 0 Yes E) No
$0.00
Advanced PlanniDg Fee:
$0.00
Select a Non -Residential
Building or Structure
0
Travel Doeumentation Fees.
Strong Motion Fee: 1BSEISMICO
$9.45
Select an Administrative Item
Bidp Stds Commission Fee: 1BCBSC
$2.00
SUBTOTALS:
$11.45
$408.00
TOTAL FEE:
$419.45
Revised: 10/01/2012
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 2 RESULTS WAY I CONTRACTOR: XL CONSTRUCTION I PERMIT NO: 12080075
OWNER'S NAME: ECI TWO RESULTS LLC
851 BUCKEYE CT I DATE ISSUED: 12/14/2012
OWNER'S PHONE: 4084901641 I MILPITAS, CA 95035 I PHONE NO: (408) 240-6000
LICENSED CONTRACTOjR'S� DECLARATION
License ClasslI �Lic. # I �]) `^l, l
Contractor t�„�(�,���o1FtAl:l�i(1t k.c 12-1142—
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.
I hereby affirm under.penalty:of perjury one of the following two declarations:
I have and wil I 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.
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.
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 and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keepharmless the City of Cupertino against liabilities, judgments,
costs and expenses wh' h may cure ainst said City in consequence of the
granting of this pe i Additi Ily, applicant understands and will comply
with ;all non -point o e reg ions f,the Cupertino Municipal Code, Section
9.18.
Signature Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended. or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
declarations:
1 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.
1 have.and will maintain Worker's Compensation Insurance, as provided for by
Section 3.700 of the Labor Code, for the performance of the work for which this
permit is issued. ,
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person:in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
co6ect. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature
Date
BUILDING PERMIT INFO: BLDG ELECT PLUMB .
MECH r-, RESIDENTIAL r COMMERCIAL f7
JOB DESCRIPTION: APPLE -BI 1 CAFE COMMERCIAL T.1(8244 SQFT), NEW
INTERIOR PARTITIONS, DOORS, FINISHES, CEILINGS,
LIGHTING, E/M/P'S
Sq. Ft Floor Area: I Valuation: $5000000
APN Number: 35720042.2 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: A� ��lif Date:/,;7%
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &c
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should 1 use equipment or devices which emit hazardous air
contaminants as defined by a Bjyrea Air Quality Management District I willmaintaincogtplia ce with t�e Cuino Municipal Code, Chapter 9.12 and the
Hcalth & S etyode, Sec ons 2, 25533, and 25534.
Owner
Date•
I hereby affirm that there is a construction lending agency for the performance.of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (4088)777-3228 • FAX ((408) 777-3333 • buildinw@cupertino.org
C
INFW(-S
)NTRIICTIOI I N Ar)r)ITIOIni N AI.TFRATIIrin
)N/Tr I I RFVISION/r)FFFRRF.n ()RIGINALPFRMIT#
PROJECT ADDRESS 2 Results way 7
APN # 357 2 0 042 0 �.
OWNERNAME ECI Two RESULTS LLC PHONE 10
�E-MA
STUETADDRESS1301 SHOREWAY RD STE 250
CITY, STATE, ZIP Belmont CA 94002
FAX
CONTACT NAME Marco Innocenti
PHONE 408.240.6000
E-MAIL
minnocenti@xlconst.com
STREETADDRESS 851 Buckeye Court
CITY,STATE, ZIP Milpitas, CA 95035
FAX 408 .240 . 6001
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT IXI CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Marco Innocenti
LICENSE NUMBER 6 4 7 4 8 0
LICENSE TYPE B
BUS. LIC g 21836
COMPANYNAME XL Construction
E-MAIL minnocenti@xlconst.com
FAX 408.240.6001
STREETADDRESS 851 Buckeye Court
CITY,STATE,ZIPMilpitas, CA 95035
PHONE408.240.6000
ARCHITECT/ENGfNEERNAME David Sabalvaro
LICENSE NUMBER C-015925
BUS. LIC #
COMPANYNAME Studios Arch
E-MAllcrossman@studiosarch. COM
FAX 415 . 398 .3829
STREETADDREss405 Howard St Suite 588
CITY, ST�TEE,,ZIP Francisco, CA 94105
PHONE415 . 398 . 7575
DESCRIPTION OF WORK
New interior partitions, doors, finishes, ceilings, lighting, electrical, mechanical, and plumbing.
EXISTING USE
Business Group B
PROPOSED USE CONSTR.
Business Group B III
TYPE
NR
# STORIES
2
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG
AREA 4 8, 2 4 4
NEW FLOOR
AREA 4 8, 244
DEMO
AREA N/ A
TOTAL
NET AREAL 8, 2 4 4
BATHROOM KITCHEN
REMODELAREA N/A N/A
OTHER N/
/ A
REMODELAREA
REMODELAREA
PORCH AREA
N/A
N/AN/A
DECK AREFASECOND
AL DECK/PORCH AREA
GARAG AREA: DETACH
N/A ❑Ari ACH
4DWELLING UNITS N/AUNIT
❑YES
SECONDSTORY ❑YES
DED? NO
ADDITION? NO
PRE -APPLICATION ❑ YES R YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECEI D BY:
TOTAL VALUATION:
PLANNING APPL # [XNO PLANNING APPROVAL LETTER
EICHLER HOME? W NO
1\1
$5,000,000
By my signature below, I certify to each ofthe followin , I am e property Owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information I have pr ded is torr I. I ha read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relatinto but g constru on. ho�ize representatives of Cupertino to enter the ae i Ie�roperty for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAI.ANFORMATIONREQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER-THE-COUNTER
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
BUILDING PLAN REVIEW
permit for new building.
❑ EXPRESS
PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
STANDARD
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
LARGE
� FIRE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR
submittal of Building Permit application.
SANITARY SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doe revised 06/21/11
CITY OF CUPERTINO
. IMN FEE ESTIMATOR — BUILDING DIVISION
1191 ADDRESS: 2 Results Way
TYPE OF
CONSTR.
DATE: 08/07/2012
REVIEWED BY: Sean
APN: 357-20-042
BP#:
"VALUATION: 1$5,000,000
%PERMIT TYPE: Building Permit
II-B,III-B,IV,V-B
PLAN CHECK TYPE: Tenant Improvement
PRIMARY
USE: Commercial Building
1BTIPLNCK
PENTAMATION
PERMIT TYPE: 1 B T�
WORK
Tenant Improvement 48244 sq ft).
SCOPE
$0.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-B,III-B,IV,V-B
48,244
$5,101.48
1BTIPLNCK
$18,117.33
IBTIINSP
I Floc, Insp. Fee:
PME Plan Check:
$0.00
Permit Fee:
$18,117.33
Suppi. Insp. Fee:Q Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
48,244
1 $5,101.48
("On1iinuclion Tax:
$18,117.33
' MECH, HOURLY Yes `G No
'PLUMB, HOURLY Q Yes (F) No
ELEC, HOURLY Q Yes Q No
%for J,. i'lar- (_,heel;
I^larnb. Plan ("r',ernF-F
Elm% Flan
Plumb. PernO 1'e�
I�lec. Permii 1,eE!:
otl,cr ,Uech. hls'n. _
Outer Nunah insp.
OY,,er Elec. inso.
0.0
Plasm). hiSp.
I Floc, Insp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.. These fees are based on the prelimina information available and are onlv an estimate Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1/111
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$5,101.48
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$18,117.33
Suppi. Insp. Fee:Q Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
("On1iinuclion Tax:
E)
Work Without Permit? 0 Yes No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
7 �a�c�l Deac,ar}:=c;rrtcl Torr Pecs:
Strong Motion Fee: IBSEISMICO
$1,050.00
Select an Administrative Item
Bldk, Stds Commission Fee: IBCBSC
$200.00
;>.SUBTOTALs:
24,468.81
$0.00
TOTAL FEE:
1 $24,468.81
Revised: 07/01/2012
CUPERTINO
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS:2 Results Way
PERMIT # 12080075
OWNER'S NAME:ECI TWO. RESULTS LLC
PHONE #408-240-6000
GENERAL CONTRACTOR: XL Construction
BUSINESS LICENSE # 21836
ADDRESS:851 Buckeye Court
CITY/ZIPCODE: Milpitas, CA 95035
-Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS H"E OBTAINED A CITE' OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
Date
d
SUBCONTRACTOR
BUSINESS DAME
BUSINESS LICENSE #
x
Cabinets & Millwork
ssion Bell Casework
25336
X
Cement Finishing(j((,
B y nt
x
Electrical
Redwood Electric Group
21108
Excavation
Fencing
x
Flooring / Carpeting,
R.E.. Cuddie
1429
Linoleum / Wood
x
Glass / Glazing
Silicon Valley Glass
26943
x
Heating
Unite Mechanical
27361
x
Insulation
Accurate Firestop
34279 /
x
Landscaping
Jensen Corporation
9697
Lathing
Masonry
X
Painting / Wallpaper
Pyramid Painting
25999
Paving
Plastering
X
Plumbing
United Mechanical
27361
x
Roofing
Statewide Roofing
23509
Septic Tank
X
Sheet Metal
United Mechanical
27361
x
Sheet Rock
Bayside Interiors
25898
x
Tile
Rinaldi "file
27336
5/28/13
Owner / Contractor Si ure
Date
OM
16
ol-
imam"]
1zECP1ffvF1D
DEC R 0 202
EVC Wall Mount Station Submittal
"For Approval"
No
El��IIIRV'd%obd Electric Group, Inc.
2 12 2775 Northwestern Parkway
-,,:q.nta Clara, CA 95051
r7l p -;n December 6, 2012
.ChargePointe
CQ- L FIs
LISTED
2Coulomb
Technologies
Coulomb Technologies Inc.
1692 Dell Ave.
Campbell, CA 95008-6901 USA
US toll free: +1-877-370-3802
www.chatgepointnet
ChargeP#int'
by Coulomb Technologies
Installation
.. Guide
Part Number 75-001084-01 Revision: 2.0
J
IMPORTANT SAFETY INSTRUCTIONS
SAVE THESE INSTRUCTIONS
This manual contains important instructions that must be followed during Installation of a ChargePoine Networked Charging Station.
Grounding instructions
The ChargePointO Charging Station must be connected to a grounded, metal, permanent wiring system; or an equipment -grounding conductor is
to be run with circuit conductors and connected to the equipment grounding terminal or lead on the Electric Vehicle Supply Equipment (EVSE).
Connections to the EVSE shall comply with all local codes and ordinances.
FCC Compliance Statement
This equipment has been tested and found to comply with the limits for a Class A digital device pursuant to Part 15 of the FCC Rules. These limits
are designed to provide reasonable protection against harmful interference when the equipment is operated in a commercial environment This
equipment generates, uses, and can radiate radio frequency energy and, If not installed and used in accordance with the manufacturers
Instruction manual, may cause harmful interference with radio communications. Operation of this equipment in a residential area is likely to
cause harmful interference, in which case, you will be required to correct the interference at your own expense.
Important: Changes or modifications to this product not authorized by Coulomb Technologies, Inc., could affect the EMC compliance and revoke
your authority to operate this product.
Exposure to Radio Frequency Energy: The radiated power output of the 802.15.4 radio and cellular modem (optional) in this device is below the
FCC radio frequency exposure limits for uncontrolled equipment This device should be operated with a minimum distance of at least 20 cm
between the 802.15.4 and cellular antennas and a person's body and must not be co -located or operated with any other antenna or transmitter
by the manufacturer, subjectto the conditions of the FCC Grant
Safety and compliance
This document provides instructions to install the ChargePoint® Charging Station and should not be used forany other product. Before installing
the ChargePointO Charging Station, you should review this manual carefully and consult with a licensed contractor, licensed electrician and
trained installation expertto ensure compliance with local building practices, climate conditions, safety standards, and state and local codes.
The ChargePoint® Charging Station should be installed only by a licensed contractor and a licensed electrician and in accordance with all local
and national codes and standards. The ChargePoint® Charging Station should be inspected by a qualified installer prior tothe initial use. Under
no circumstances will compliance with the information in this manual relieve the user of his/her responsibility to comply with all applicable codes
or safety standards. This document describes the most commonly -used Installation and mounting scenarios. If situations arise in which it is not
possible to perform an installation following the procedures provided in this document, contact Coulomb Technologies. Coulomb Technologies is
not responsible for any damages that may occur resulting from custom installations that are not described in this document.
No accuracy guarantee
Reasonable effort was made to ensure that the specifications and other information in this manual are accurate and complete at the time of its
publication. However, the specifications and other information in this manual are subject to change at any time without prior notice.
Warranty information and disclaimer
Your use of, or modification to, the ChargePointO Charging Station in a manner in which the ChargePoint® Charging Station is not intended to be
used or modified will void the limited warranty. Otherthan any such limited warranty, the Coulomb products are provided "AS IS; and Coulomb
and its distributors expressly disclaim all implied warranties, including any warranty of design, merchantability, fitness for a particular purposes
and non -infringement, to the maximum extent permitted by law.
Limitation of liability
IN NO EVENT SHALL COULOMB TECHNOLOGIES, INC. OR ITS AUTHORIZED DISTRIBUTORS BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL,
PUNITIVE, OR CONSEQUENTIAL DAMAGES, INCLUDING WITHOUT LIMITATION, LOST PROFITS, LOST DATA, LOSS OF USE, COST OF COVER, OR LOSS
OR DAMAGE TO THE CHARGEPOINT' CHARGING STATION, ARISING OUT OF OR RELATING TO THE USE OR INABILJTYTO USE THIS MANUAL, EVEN
IF COULOMB TECHNOLOGIES, INC. OR ITS AUTHORIZED DISTRIBUTORS HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
Copyright and trademarks
©2012 Coulomb Technologies, Inc. All rights reserved. This material is protected by the copyright lavas of the United States and other countries. It
may not be modified, reproduced or distributed without the prior, express written consent of Coulomb Technologies, Inc. CHARGEPOINT is a U.S.
registered trademark and service mark of Coulomb Technologies, Inc. All other products or services mentioned are the trademarks, service
marks, registered trademarks or registered service marks oftheir respective owners. Coulomb Technologies has filed several patent applications.
'1
Contents
Z Introduction
Beforeinstalling stations ....................................... .......... ...................................................................... .................... 1-1
Specifications................................. ................................ ........................................................................................ .... 1-2
Wiringinformation ............... ..................................................................................................................................... 1-3
2 Installing the Wall Mount
Beforeyou begin........................................................................................................................................................ 2-1
Overviewof steps. ........................ ;. .................... Q .........................................................................................................
2-1
Step 1- Check boxes for correct contents...............................................................................................................
2-2
Step2 - Remove front panel.....................................................................................................................................
2-4
Step 3 - Remove channel struts from the body.......................................................................................................
2-5
Step4 - Install channel struts...................................................................................................................................
2-6
Step 5 - Attach wall mount bracket ........................................ ....................
2-7
Step 6 - Remove terminal block from body..............................................................................................................2-8
Step 6 -Arrange for station provisioning..................................................................................................................4-7
Step7 - Drill holes in main body...............................................................................................................................2-9
5 Troubleshooting
Step 8 - Attach body assembly to wall bracket ......................................... .............................................................
2-10
Step 9 -Attach coupler and connect conduit.........................................................................................................2-11
Understandingerror messages..............................................................................................................................'...
Step 10- Re -attach terminal block to main body..................................................................................................2-12
Resolvinga Relay Stuck Open fault..........................................................................................................................
Step 11- Connect wires to wiring terminals..........................................................................................................2-13
Checkingvoltages...................................................................................................................................................: ..
Step12 - Replace front panel.................................................................................................................................2-14
3 Installing the holsters and cable assemblies
Before you start ............................................... ..........................................................................................................3-1
.
Overviewof steps.....................................................................................................................................................'...3-1
Step 1- Check boxes for correct contents...............................................................................................................3-2
Step 2 - Attach holsters/cable hangers to body assembly.....................................................................................3-3
Step3 - Install cable assembly 2 ................... ............................................................................................................ 3-4
Step4 - Install the filler panel................................................................................................................................... 3-6
Step5 - Install cable assembly 1..............................................................................................................................3-7
4 Installing the head assembly
Beforeyou start ..........................................................................................................................................................
4-1
Overviewof steps ....... ......................... ..................................................................................................................... ..
4-1
Step 1- Check box for correct contents ....................................... ................................................... ...................... :..
4-2
Step 2 - Install head assembly into body ......................................................... ...................... ................
.... ..............
4-3
Step 3 -Verify that the station operates correctly................................................................................................;..
4-4
Step 4 -Secure head assembly and filler panel......................................................................................................4-5
Step 5 - Install front cover plates .................... ........................................................... ............. .............. ................. :..4-6
Step 6 -Arrange for station provisioning..................................................................................................................4-7
5 Troubleshooting
Thestation's display..................................................................................................................................................
5-1
Understandingerror messages..............................................................................................................................'...
5-2
Resolvinga Relay Stuck Open fault..........................................................................................................................
5-6
Checkingvoltages...................................................................................................................................................: ..
5-7
A Limited Product Warranty
This document provides step-by-step instructions on how to install a CT2023 ChargePoint@) Charging
Station. As shown here, the CT2023 ships in five boxes:
Install FIRST
See Chapter 2
Install SECOND
See Chapter 3
Install LAST
See Chapter 4
*NOTE: The screws used to mount the holsters are included in the box containing the bollard mount AND in the boxes
containing the holsters. Use those provided in the box containing the bollard mount.
Before installing stations
Before you begin installing a CT2023 charging station as described in this document, you must:
• ensure that the appropriate wiring, circuit protection, and metering is in place at the installation
location (see wiring diagram on page 1-3 of this document)
• ensure that thetype of modem in each station you are installing is compatible with the type of modem
coverage available at the installation site (CDMA or GPRS)
• review the CT2023 Charging Stations Data Sheet (available at www.coulombtech.com/support/)
• review the mountingtemplate (provided in this document and in the box containingthe station's body)
U IMPORTANT. A PDF version of the mounting template is also available at
www.coulombtech.com/support/. When printing this version, print at 100% scale using 11" x 17"
paper and verify at least one dimension to ensure accuracy.
It is also recommended that you thoroughly review this document to familiarize yourself with the contents
of each shipping box, and the required installation steps.
J
1-1
ChargePoint® Charging Stations
Specifications
C QL us
LISTED
Electrical Input
7.2 kW (x 2)
Input Voltage
208/240 VAC
Input Current
30 A (x 2)
Input Power Connections
Two independent 40 A branch circuits, each providing Line 1 and Line 2 Asingle protective Earth conductor.
Required Service Panel Breaker
40A double pole breaker (non-GFCI type) on each dedicated circuit
Service Panel GFCI ..
Do not provide external GFCI as it may conflict with internal GFCI (CCID)
Standby Power
7 W typical
Maximum Charging Stations per
802.15.4 Radio Group
24. Each non -gateway station must be located within 150 feet "line of sight" of a gateway station.
Approximate Shipping Weight
45 lbs (20.4 kg)
Electrical Output
Functional Interfaces
1-2
Input Power
7.2 kW (x 2)
Input Voltage
208/240 VAC
Input Current
30 A (x 2)
Input Power Connections
Two independent 40 A branch circuits, each providing Line 1 and Line 2 Asingle protective Earth conductor.
Required Service Panel Breaker
40A double pole breaker (non-GFCI type) on each dedicated circuit
Service Panel GFCI ..
Do not provide external GFCI as it may conflict with internal GFCI (CCID)
Standby Power
7 W typical
Output Charging Power
7.2 kW (x 2)
Output Voltage
208/240 VAC
Output Curren[
30 A (x 2)
Output Charging Connector
SAE J1772TM EV connector on 18'(5.48 m) cord (x 2)
Card Reader
Safety and Operational Ratings
ISO 15693,14443
Ground Fault Detection
20 mA CCID with auto retry (15 minute delay, 3 retries)
Plug -Out Detection
Power terminated per SAE 11772m+ specification
Power Measurement
2% @ 15 minute intervals
Local Area Network
2.4 GHz 802.15.4 dynamic network
Wide Area Network
Commercial GPRS or CDMA cellular data network
Safety Compliance
UL listed for USA and cUL certified for Canada; Complies with UL 2594, UL 2231-1, UL 2231-2, UL 1998,
UL 991, and NEC Article 625
Surge Protection
6 kV @ 3000 A. In geographic a reas subject to frequent thunder storms, supplemental surge protection at
the service panel is recommended.
EMC Compliance
FCC Part 15 Class A
Operating Temperature
-22°Fto122°F(-30°C to+50°C)
Operating Humidity
95% non -condensing
Enclosure
Type 313
Terminal Block Temperature
Rating
212°E(100"C)
Maximum Charging Stations per
802.15.4 Radio Group
24. Each non -gateway station must be located within 150 feet "line of sight" of a gateway station.
Approximate Shipping Weight
45 lbs (20.4 kg)
Wiring information
NOTE: Requires two dedicated circuits, each with its own 40 A breaker.
40A, 2 POLE BREAKER MAY BE CONNECTED TO ANY TWO
LINES.
120/206 VAC 4
BONDED NEUTRAL
REQUIRED.
MAI N
BREAKER
m
a
� o
12D/240 VAC 1�
BONDED MEUTRPL
REQUIRED.
LOCAL SERVICE
OR SUB PANEL
Lnei:coae Q �
NPN 1:1p5Q4p VAC. fip Hi JOA. 10
WmiZ.>a2[pVAt,6p Hi ]OA. 10
U[e NL�VJ'L mppe [mkucIDS OM/.
IryW Evnwt r�g1u.�UeQ Lpn:erury Ugtc
les ma[Ixlrrml - -
I�putic+ruplww:gym nrSC
0 b 111 AWG I+yam mvsn'I ��+ 1 avanEN
2aw40VAC GND •p18240VAC
LI 12 O L2 L1
TERMINAL
BLOCK
208 VAC
1
208 VAC, THREE PHASE PANEL
NEU ILI L2
MAI N
� BREAKER
Cn
Q
� O
0
AL SERVICE
SUB PANEL
�vELicoxE Q
1w ID604pVAr mHimh tm
6qN i IDA]Ip VAC,
Un[T9CC ¢{ni [1 o[E�Ma Wf.
IAs a� R•1 w.I
InM
Ic nnnbwn sin mnpq
ata 1C aWo 1umn+m � xNd rwuMcd.
i ===T==4.ammo.
2081340 VAC GN0 2D612A0 VAC
L1 L2 L LI
TERMINAL
BLOCK
240 VAC
240 VAC, SINGLE PHASE PANEL
Introduction
1-3
Before you begin
In addition to the contents of the CT2023 wall mount `s shipping box, you will need the following:
® Hammer drill
• 3/8" masonry drill bit
3/8" drive ratchet with extension
O 5/16" HSS (High Speed Steel) drill bit
O 9/16" deep hex socket
Y 7/16" hex socket
#3 Phillips screwdriver
U T25 Tamper-resistantTorx driver
O 3/4" (trade size) conduit coupler
o Silicone sealant, electrical grade
Overview of steps
[nstallingthe CT2023 ChargePoint@ Charging Station's body assembly involves a few simple steps:
1. Check boxes for correct contents (see page 2-2)
1. Remove front panel (seepage 2-4)
2. Remove channel struts from body (seepage 2-5)
3. Install channel struts (see page 2-6)
4. Attach wall mount bracket (seepage 2-7)
5. Remove terminal block from main body (see page 2-8)
6. Drill holes in main body (see page 2-9)
7. Attach body assembly to wall bracket (see page 2-10)
8. Attach coupler and connect conduit (see page 2-11)
9. Reattach terminal block to main body (see page 2-12)
10. Connect wires to wiring terminals (see page 2-13)
11. Replace front panel (see page 2-14)
These steps are detailed in the remainder of this chapter. When you have completed these steps, you will
be ready to install the holster and cable assembly as described in Chapter 3.
ChargePoint® Charging Stations
The CT2023 ChargePoint® Charging Station's wall mount components ship in two boxes as shown below.
Main body assembly:
9 Body* (1)
i Channel struts* (2)
a Cable hangers (2)
Front cover plate (1)
O Filler panel* (1)
C 3/32" Allen wrench (1)
C Front panel* (1)
9 Screws for cable hangers (4)
C Screws for holsters (6)
C Washers for cable hangers and
holsters (10)
Wall anchor bolts with nuts and
washers (4)
0 Hex head bolts and washers to
attach bracket to channel struts (4)
C Channel strut nuts (4)
C Installation Guide (1)
C Base plate mounting template (1)
*Body, front panel, and filler panel are
pre -assembled. Channel struts are attached to
body for shipping purposes only,
2-2
Body
Channel
struts
Cable
hangers
Screws for cable'
hangers
Screws for holsters o. a
Washers for cable
hangers and holsters
ChargePoint
Orpi V nb IbaRelmtl Cr�(saran
hWallauan
Wall anchor bolts
with nuts and
washers
Hex head bolts and
Front
JAllen
cover plate
wall bracketto
Filler
,t ��
all
panel
Screws for cable'
hangers
Screws for holsters o. a
Washers for cable
hangers and holsters
ChargePoint
Orpi V nb IbaRelmtl Cr�(saran
hWallauan
Wall anchor bolts
with nuts and
washers
Hex head bolts and
f v
JAllen
wall bracketto
wrench
,t ��
all
Front
N.
panel
== 3,
!G ttR: F3:
iF+'•'+'k ji "iz
Installation
Guide
Screws for cable'
hangers
Screws for holsters o. a
Washers for cable
hangers and holsters
ChargePoint
Orpi V nb IbaRelmtl Cr�(saran
hWallauan
Wall anchor bolts
with nuts and
washers
Hex head bolts and
f v
washers to attach
wall bracketto
channel strut
Channel strut nuts
01-
Wall mount bracket and
accessories
• Wall mount bracket (1)
• Screws and washers (6)*
• Conduit sealing ring and washer (1)
• 3/32" Allen wrench (1)
• Template for drilling wall holes (1)
(stapled into the centerfold of this
guide)
*Two extra screws and washers are Included in
the shipping box. These can be discarded.
Installing the Wall Mount
24"
zi f V
0
.9
I.
Kt;
Zoo I
231
PF rr, 1:1
Ira NOT SC;U. TO FLOOR.1
2-3
ChargePoint® Charging Stations
To remove the front panel:
• Using a T25 Torx driver, remove the
two captive screws in the filler
panel.
• Slide the filler panel upward to
remove.
• Remove the ground wire connector
from its tab located on the front
panel.
• Use the supplied allen wrench to
loosen the two screws that fasten
the panel to the body. These screws
are used for shipping only and can
be discarded.
• Slide the front panel upward to
remove.
2-4
0
Loosen the two
screws on the
filler panel and
slide upwards to
remove
Remove the
ground wire
from its tab
Remove the two screws
that secure the front
panel to the body
Installing the wall Mount
The channel struts are attached to the main body for shipping purposes only. Remove them using a
Phillips (21 screwdriver.
NATE: The cable ties are
releasable—cutting is not required.
Screws and washers can be discarded.
2-5
ChargePotnt® Charging Stat/GnS
To mount the channel strut sections to
the concrete wall:
• Use the supplied wall mount
template to mark the location of
the four holes on the wall. Holes
must be 24" and 34" up from the
floor and be spaced exactly
2 1/2" apart.
• Using a Hammer drill and a 3/8"
masonry drill bit, drill four holes
2 1/2" deep.
• Install the four supplied
3/8" anchor bolts.
• Mount each channel strut to the
wall with the four 3/8" nuts and
large, thick washers supplied in the
shipping box (discard the washers
that came with the anchor bolts).
Tighten using a 3/8" drive rachet
with extension.
NOTES:
The bottom of the channel strut
should be located 201/2" above
the floor.
The two channel struts must be
plumb and parallel to each other.
2-6
To install the wall mount bracket:
• Using the template as a guide to
determine their exact location,
install the four channel strut nuts
into the channel struts as shown.
Mount the bracket to the channel
-struts using the four supplied hex -
head bolts and washers, as shown.
Tighten using the 3/8" drive and
9/16" socket.
J
Installing the Wall Mount
2-7
J
ChargePoint© Charging Stations
2-8
Four screws are used to fasten
the terminal block to the body.
Remove the two center screws
and loosen the top and bottom
screws.
Step 7 - Drill holes 1n main body
Use a 5/16" (8 mm) drill to drill out the
four mounting holes in the back of the
body assembly. These holes are
partially pre -drilled. Two are located on
the back and two are located on the
side.
Installing the Wall Mount
2-9
ChargePoint® Charging Stations
Attach the body assembly to the wall
bracket using the four supplied hex
head bolts and washers. Tighten using
a ratchet and 7/16" socket.
NOTE: You may need to adjust the
height of the mounting bracket slightly
so the body assembly sits on, or just
above, the floor.
2-10
Drill a 11/8" diameter (3/4" trade size)
hole in the main body no higher than
24" from the bottom.
Attach installer -supplied coupler and
water -tight sealing washer to the body
assembly, as shown, and connectthe
conduit.
Seal the conduit fitting with RTV
silicone sealant.
J
Installing the Wall Mount
1llpl`1 1
2-11
Step 11 - Connect wires to wiring terminals
To connect the wiring:
• Pull the Ground wire and the 240
VAC L1 and L2 wires into the body
assembly.
• Strip wires .3" (7.6 mm) and insert
into the terminal block as shown
Strip Length 3"
(Z6 mm)
• Tighten screws to 181/2 inch -lbs
(2.1 Nm).
IMPORTANT-.
• Requires two dedicated circuits,
each with its own 2 pole,
40 A breaker.
• Use copper conductors only.
• Do NOT provide GFCI protection at
panel. The CT2023 has built-in
GFCI protection.
• In areas with frequent thunder
storms, add surge protection at the
service panel for all circuits.
J
Installing the Wall Mount
FE -11
LEVEL CORE
#2 SEE INSTAJ nON GUIDE
Input 1: 208/240 VAC, 60HZ, 30A,10
Input 2:2081240 VAC, 60HZ, 30A, 10
Use Min. 90° C copper condutors only.
Input terminal recommended tightening torque:
18.5 inAbs (2.1 Nm)
Input terminal wire size range:
6 to 10 AWG (13mm2 to 5.3mm2 ) solid 1 stranded.
WARNING: Risk of Shock. Two Power Sources.
Disconnect Both Power Sources Before Servicing
AVERTISSEMENT: Risque de choc Neetrique. Alimentations multiples.
Couper le deux circuits d'alimentation avant intervention.
#1 GND #2
208/240 VAC —L. 208/240 VAC
L1 L2 L2 L1
�o■ra■o■o•ol
=scre-
2-13
ChargePoint® Charging Stations
To replace the front panel:
Slide the front panel into place, as
shown.
Re -attach the ground wire by
pushing it onto its tab.
You have now finished installing the
wall mounting assembly for the
CT2023 Charge Point® Charging
Station's body assembly. You are ready
to install the holsters and cable
assemblies. See Chapter 3.
2-14
Re -attach the
ground wire
to its tab
J
3-1
J
ChargePoint® Charging Stations
3-2
The ChargePoint® Charging Station's cable
assemblies/holsters ship in two boxes.
Each box contains:
Holster
Cable assembly
Screws (3) - DISCARD THESE*
Washers (3) - DISCARD THESE*
• 5/32" Allen wrench
*Do not use the screws and washers provided In the
shipping box with the holsters—use the longer ones
provided In the shipping box with the bollard mount.
NOTE
To complete the installation steps described in
this chapter, you will also need the following
components that are included in the shipping box
for the main body (see page 2-2).
Cable hangers, screws and washers:
R
Zt 5 60
Filler panel:
Cable Assembly i \ Left Holster:
LOMMOMMOM
Cable Assembly 2 / Right Holster:
1
Installing the holsters and cable assemblies
Step 2 o each holsters/cable hangers to body assembly
Align the right holster with the cable
hanger and attach as follows:
• Insert the three screws/washers to
attach the cable hanger/holster to
the main body but do not tighten.
• Insert the two screws/washers to
attach the lower end of the cable
hanger to the main body.
• Tighten all five screws.
Repeat for the left holster/cable
hanger.
NOTE: Use the screws and washers
provided in the shipping box with the
bollard mount (see page 2-2).
Loosely fasten
these three
Loosely fasten these two
screws, then tighten all five
screws
3-3
ChargePointO Charging Stations
Slide cable assembly 2 into the body all
the way until it is flush with the top of
the front panel.
IMPORTANT NOTES:
When sliding the cable assembly
into the body, ensure thatthe serial
cable that hangs down from the
topmost terminal block does not
get caught between the cable
assembly and the bottom terminal
block. It should be held in place by
the clip, as illustrated.
Ensure the cable assembly is fully
seated and that there is no gap
between the bottom of the cable
assembly and the top of the front
panel. The cable assembly fits
tightly and may require extra
downward force to ensure it is fully
seated.
3-4
Ensure this cable is
held in place by the
retaining clip to
prevent it from
being caught when
you slide the cable
assembly down into
the body
Step 3 - c®nt'd
To connect the cable assembly:
• Plug the cable assembly's
rectangular connector into the body
assembly's terminal block;
ensuring it is fully seated.
• Connect the circular connector
(that hangs down from the upper
terminal block) to the cable
assembly by aligning the white
arrow. For details, refer to the
illustration and instructions
provided on this page.
• Connect the Ground wires to the
tabs on the cable assembly.
IMPORTANP Do not insert the
charging station's SAE J1772
connector into the holster until after
installing the head assembly and
powering up the charging station. The
station is equipped with a locking
holster, and if you insert the connector
before the station has powered up, the
holster will not unlock!
Installing the holsters and cable assemblies
Semlttrcular groove
(or "key slot)* in Tab #1
connector
Tab #2
Tab slot #2
SeTni-circular key
{(�
In receptacle Tab slot #1
Align the circular connector so that:
• the white arrows aligns with the white dot on
the receptacle
• the key slot in the connector matches up with
the key in the receptacle AND
• the tabs on the connector match up with the
tab slots on the receptacle
Insert the connector until fully seated (do not use
excessive force).
Rotate connector's outer ring in a clockwise
direction until snug.
this cable
retaining clip
onnecting
3-5
ChargePoint@ Charging Stations
Slide the filler panel into the body
assembly until it is flush with the top of
cable assembly 2, as illustrated.
MOTES:
The filler panel is included in the
shipping box for the main body (see
page 2-2).
Ensure that the filler panel isfully
seated and that no gap exists
between the bottom of the filler panel
and the top of the cable assembly.
The filler panel fits tightly and may
require extra downward force to
ensure it is fully seated.
• Do not tighten the filler panel's
security screws until you've verified
that the station is operating correctly
(as described on page 4-4).
3-6
Slide cable assembly 1 into the body all
the way until it is flush with the top of
the filler panel, as illustrated.
& IMPORTANT. Ensure the cable
assembly is fully seated and that no
gap exists between the bottom of the
cable assembly and the top of the filler
panel. The cable assembly fits tightly
and may require extra downward force
to ensure it is fully seated.
J
Installing the holsters and cable assemblies
3-7
ChargePoint® Charging Stations
Step 5 - cont'
Plug the cable assembly's rectangular
connector into the left receptacle on
the body assembly's terminal block,
ensuring it is fully seated.
Connect the ground wire to the tab at
the top of the cable assembly.
J IMPORTANT! Do not insert the
charging station's SAE J1772
connector into the holster until after
installingthe head assembly and
powering up the charging station. The
station is equipped with a locking
holster and if you insert the connector
before the station has powered up, the
holster will not unlock!
You have nowfinished installingthe
ChargePoint® Charging Station's
holsters and cable assemblies and are
ready to install the head assembly. See
Chapter 4.
3-8
41
ChargePoint® Charging Stations
Head assembly
The ChargePoint® Charging Station's head
assembly ships in a box containing:
Head assembly
O Front cover plate
O Spare provisioning label (a duplicate
label has been attached to the head
assembly)
0 IMPORTANT: Keep the spare
provisioning label for future reference. It
contains critical information that is needed
for system provisioning (see page 4-7).
NOTE: To complete the installation steps
described in this chapter, you will also need the
additional front cover plate included in the
shipping box for the main body (see page 2-2).
%No
IM
Coulomb Ted Mbgh °rc
A provisioning label is
111[IIIII[II�IIIIII Illl
attached to the head
assembly under the front
panel. A duplicate label is
included to provide important
information that is needed for
system provisioning.
To install the head assembly:
Remove the plastic wrap frorn the face of
the head assembly and retain the affixed
provisioning label for future use (see
page 4-7).
• Slide the head assembly into the main
-body far enough to connect the wiring.
• Connect the blue circular connector
(without the Ground wire) to the blue
connector on the terminal block, as
illustrated.
• Connect the head assembly's rectangular
connector to the receptacle on the right
side of the terminal block, ensuring it is
fully seated.
• Connect the black circular connector
containing the Ground wire to the black
connector on the cable assembly (as
illustrated), then connect its Ground wire
to the vacant Ground tab on the cable
assembly.
• Keeping cables out of the way (by
pushing them to the back and side),
firmlyslide the head assembly all the way
into body.
/ \ IMPORTANT: Ensure the head
assembly is fully seated and that no gap
exists between the bottom of the head
assembly and the top of the cable
assembly. The head assembly fits tightly
and may require extra downward force to
ensure it is fully seated.
• If the head assembly is not fully seated,
visually verify that the cable assemblies
and the black filler panel are fullyseated.
If necessary, press down on the head
assembly to seat the gaskets.
Installing the head assembly
Semi -circular
groove (or Tab #1
"key slot)' in
connector
Semi-circul
ar key in
receptacle
.. #2..:......rt
ChargeP.�nt
Tab slot 4 T-
r..
Using the white arrow as a guide, e
circular connector so that
• the key slot in the connector mz
with the key in the receptacle AI
• the tabs on the connector mate
the tab slots on the receptacle
Insert the connector until fully sea
use excessive force).
Rotate connector's outer ring in a r
direction until snug.
4-3
ChargePotnt® Charging Stations
11111111 r� 11 111 ; q 111
Before securing the head assembly, follow these instructions to ensure that the charging station is fully
operational:
Turn on the main power to ensure that the head assembly powers up. When the circuit is live and the
head assembly's wiring is connected, a sequence of power -up messages will be displayed. If this is not
the case, check that the head assembly's rectangular connector is properly seated onto the terminal
block. If the connector is properly seated and the station still does not power up, contact Coulomb
Customer Support at 1-877-850-4562.
Ensure that none of the LEDs above the station's display are illuminated or blinking RED. This
indicates that the station has detected an error and you'll need to read the station's display to
troubleshoot the error. Refer to "Chapter 5, Troubleshooting" for a detailed description of error
messages.
After powering up, insert the charging station's connectors into their corresponding holsters (cable
assembly 2's connector into the right holster and cable assembly 1's connector into the left holster).
Scan a valid and authorized ChargePass card to confirm that both holsters unlock. The LED on the
holsters should also illuminate. If either holster does not unlock, check the connectors for the
corresponding cable assembly. If the connectors are properly connected and fully seated, contact
Coulomb Customer Support at 1-877-850-4562.
Observe the display as it sequentially displays the current state of each charging port. Both ports
should be "AVAILABLE". If this is not the case, an error message will be displayed instead. Referto
"Chapter 5, Troubleshooting" for a detailed description of error messages.
Refer to "Chapter 5, Troubleshooting" for information on how to resolve faults.
4-4
Elm
Push down on the cable assemblies, and
the head assembly to ensure they are
fully seated and that there are no gaps.
All assemblies fit tightly and may require
extra downward force to ensure they are
fully seated.
Using a T25 Torx driver, secure the head
assemblytothe body bytightening itstwo
captive security screws.
Then tighten the two captive screws on
the filler panel.
Tighten the two
IMPORTANT! Tighten screws only security screws
until snug (approximately 15 in -lbs). Do on the head
NOT overtighten. assembly
Tighten the two
screws on the
filler panel
Installing the head assembly
4-5
ChargePoint® Charging Stations
MOTE: An FCC label has been applied to
one of the front cover plates—install this
cover plate over the head assembly.
Install the cover plate without the FCC
label over the filler panel.
Align the protruding features on the front
cover panel with the openings on the
head assembly. Ensure the slot in the
back of the panel is at the bottom. Snap
into place, one side at a time.
Repeat to install the second front cover
panel over the filler panel.
You have now finished installing the
ChargePoint° Charging Station.
4-6
Install the cover
plate with the FCC
label over the head
assembly
Install the cover
plate without the
FCC label over the
filler panel
lnstaliing the head assembly
After a charging station has been physically installed, it is ready to be provisioned. Provisioning is the act
of connecting the charging station to the ChargePointTM network and establishing its network identity. In
other words, you provision a station to "go live" on the network.
To ensure the charging station is provisioned, provide your Coulomb distributor with the following
information:
• Model number
•
Serial number
• MAC address
• Provisioning password
• Location information (mailing address, and if possible, exact coordinates)
The station's model number, serial number, MAC address, and
provisioning password is duplicated on two labels. One label is Coulomb Technologies, Inc.
Order Desc.: CTXXX-»»n=m»n
affixed to the head assembly (once installed, you can no longer see Serial No: YYWWSSnnnnnn
this label). A spare label is included in the shipping box. Use the I II6I �I E�Illl�lfilu��l��lll���'[,�II���I
spare label to keep a record of the charging station's exact (MAC ODDO:DDOD'AOOO:ODOD)
installation location. To ensure data accuracy, the label has a bar Provisioning Password OODOO
code that you can scan. -
NOTE: A station's address and physical location may vary slightly. The goal is to make it easy to identify the
station's location on a GoogleTm map. Therefore, you will need to be as accurate as possible when
providing a station's location. This is especially important when you install multiple stations at the same
mailing address. It is best to determine the exact coordinates of the parking space in which the charging
station is located.
TIP ! Take a picture of the label using your Smartphone. You can also use your Smartphone to scan the
bar code (if you have a bar code scanning application installed), and to determine the station's GPS
coordinates.
4-7
The station's display
To troubleshoot your charging station, pay attention to the messages that are displayed on the two-line
display. The display sequentially shows the name of the charging station and the current state of each -of
its ports. The following example shows how a CT2023 displays the state of its #1 charging port under
normal conditions:
C
C
The top line displays the current state of the station's charging ports. This line Includes a port number
prefix and the station displays the state of each port sequentially.
The bottom line displays more Information about the current status and, if applicable, instructions that
describe what action to take. Information is scrolled across this line.
To determine the current strength of the communications signals, observe the small indicators on the
rightmost side of the display:
LAN (802.15.4)
To top set of dots indicate the strength of the LAN connection. LAN is the local
connection that stations use to communicate to each other. All ChargePoint charging
stations have a LAN connection.
WAN (CELLULAR)
If the station is a Gateway, a bottom set of dots will indicate the strength of the WAN
connection. Gateways use this connection to communicate to the NOC (Network
Operations Center). If the station is a non -gateway, this signal indicator is not
displayed.
Strong Nip. Weak No signal*
*If a LAN signal is not available, the station may not be situated within 150' line of sight of a gateway
station, or there may an obstruction. If a WAN signal Is not available, It may be necessary to install cellular
repeaters at the installatlon site to boost the signal.
54
J
ChargePofnto Charging Stations
Understanding error messages
The following pages describe the error messages that can occur on a CT2023 charging station. If one of
the LEDs above the charging station's display illuminates RED, read the display for information about the
type of error that has occurred.
Power up errors
The following messages can occur when the station powers up.
e
_M 12�bORE) CHE-K CONNECTOR FOR &SISTANCE: <p
Cause/Other Symptoms: Upon power up, the station detected that the head assembly is not properly
connected. In most cases, this indicates that the circular connector that attaches the head assembly to
the cable assembly is not correctly installed. The station will be unavailable until the head assembly is
correctly attached to the cable assembly.
Solution/Action: Lift the head assembly and re -attach the circular connector. For details, refer to the
installation instructions for the head assembly.
HALTED'
FAILED 1'
Cause/Other Symptoms: Upon power -up, the station detected a ground fault.
Solution/Action: Disconnect and reconnect power (byturningthe power to the chargingstation off then
back on again, or by unplugging the head assembly from the terminal block and plugging it back in). If
the message continues to be displayed, it is possible that the head assemblywill need to be
replaced—call Coulomb Customer Support at 1-877-850-4562.
5-2
J
Troubleshooting
Ground fault errors
The following ground fault errors can occur during charging, or when attempting to begin a charging
session:
SUSPENDED
GROUND FAULT AUTO it
Cause/Other Symptoms: The station detected a ground fault during a charging session. The left or right
LED will flash RED and the station will not charge.
Solution/Action: The charging station will wait 16 seconds before attempting to restore power. If after
three attempts, the station continues to detect a ground fault, it displays the message below (HALTED).
Instead of waiting, you can try ending and restarting the charging session as described below.
HALTED
GFCI 'i 1 HOLSTER
Cause/Other Symptoms: During charging, the station detected a ground fault (see message above) and
made three unsuccessful attempts to continue charging. Or, the station detected a ground fault when
attempting to begin a charging session. The left or right LED will illuminate solid RED and the station
will not charge.
Solution/Action: End and restart the charging session. To do so, return the charging connector to its
holster, then tap a valid and authorized ChargePass card on the station's front panel to begin a new
session. If the message continues to be displayed, the station is out of service—call Coulomb Customer
Support at 1-877-850-4562.
5-3
ChargePoint® Charging Stations
User errors
The following errors occur as a result of an inappropriate action that was performed by a person using the
charging station.
1 O0 1
0
Cause/Other Symptoms: The cable assembly was subjected to a strong pulling force and has detached
(as part of the station's safety features). The station is out of service until the cable assembly is
replaced.
Solution/Action: To replace the station's cable assembly, call Coulomb Customer Support at
1-877-850-4562.
SUSPENDED
1 ' ►
1 ► ► • ' RETRY
• , , • PLUG
Cause/Other Symptoms: During charging, this message is displayed if the vehicle is attemptingto draw
too much power (over 30 A). The vehicle will not charge.
Solution/Action: The charging station will wait 15 minutes before re -attempting to charge. If after three
attempts, the overcurrent fault continues to be detected,'the station ends the charging session and
displays the message below (ENDED). Instead of waiting, try ending and restarting the charging
session. To do so, return the charging connector to its holster, then tap a valid and authorized
ChargePass card on the station's front panel to begin a new session. If the message continues to be
displayed, it may be possible to set and/or reduce the amount of currentthat your vehicle draws when
charging. Refer to your vehicle's owner documentation for more information.
ENDED
.. RETURN.PLU.G TO 1
Cause/Other Symptoms: An overcurrent fault occurred (see message above) and, after three
unsuccessful attempt to charge, the station continues to detect too much current being requested by
the vehicle.
Solution/Action: End and restart the charging session. To do so, return the charging connector to its
holster, then tap a valid and authorized ChargePass card on the station's front panel to begin a new
session. If the message continues to be displayed, it may be possible to set and/or reduce the amount
of currentthatyour vehicle draws when charging. Refer to your vehicle's owner documentation for more
information. For assistance, call Coulomb Customer Support at 1-877-850-4562.
5-4
J
Troubleshooting
Other errors
The following errors occur as a result of a potential equipment failure or utility failure.
RELAY STUCK 1. 1. ASSISTANCE CALL
Cause/Other Symptoms: After power -up, this message is displayed if a connector is damaged or if the
station is not wired properly. When attempting to charge a vehicle, this message is displayed if the relay
is stuck open. When this fault occurs, the charging station can not provide power. You may also notice
that the holster will remain locked and you can not release the charge connector.
Solution/Action:
If the error is displayed immediately after installation when initially powering up the station, follow the
instructions on page 5-6. If the error is displayed during charging, end and restart the charging session.
To do so, tap a valid and authorized ChargePass card on the station's front panel, unplugthe cord and
return the charge connector to its holster. Then tap the ChargePass card on the station's front panel
again to begin a new session. If the message continues to be displayed, follow the instructions on
page 5-6.
#1: FAULT
RELAY STUCK CLOSED FOR ASSISTANCE CALL
Cause/Other Symptoms: When attempting to end a charging session, this message is displayed if the
relay is stuck closed. When the relay is stuck closed, the charging station can not end the charging
session, although a driver can return the connector to its holster. However, a new charging session can
not be initiated until this error is resolved.
Solution/Action: End and restart the charging session.To do so, return the charging connector to its
holster, then tap a valid and authorized ChargePass card on the station's front panel to begin a new
session. If the message continues to be displayed, it is possible thatthe cable assembly needs to be
replaced --call Coulomb Customer Support at 1-877-850-4562.
ENDED
PWR RESTORED / RE -ENERGIZING AFTER RANDOM DELAY
Cause/Other Symptoms: A power outage occurred and power is being restored to the charging stations.
For load balancing reasons, not all charging stations power up at the same time.
Solution/Action: No action is required—charging will resume automatically after a brief delay of up to
five minutes.
5-5
ChargePoint® ChargingStatrons
A relatively common installation issue is a RELAY STUCK OPEN fault. When this fault is in effect, the
station is unable to deliver power, and will display the following message upon power -up:
NOTE: The exact message may vary slightly depending on the station's software version.
In most cases, this fault is caused by either a damaged power plate connector or a wiring problem. Before
-calling Coulomb Customer Supportjol low these two steps to determine the cause:
1. Inspect the station's power plate connectors
Power plate assemblies are extensively tested before being shipped. However, damage can
occur during installation. Visually inspect the power plate connectors for any damage.
Note that the contacts have a rounded leading edge. The leaf spring which applies pressure but
carries no current has a straight leading edge. The ground contacts are extended in length so
they mate first and break last for safety. Therefore, you may experience correct voltages even
though the contacts are pushed in.
If a connector is damaged, the power plate will need to be replaced by calling Coulomb Customer
Support at 1-877-850-4562.
2. If, after close visual inspection, the connectors look OK, check the voltages as described on the next
page.
If the voltages are not as expected, review the wiring instructions in this installation guide and the
tips on the following page to identify and solve any wiring problem(s).
If you've completed the above steps and have eliminated the possibility of a damaged connector and a
wiring problem, and the station continues to display a Relay Stuck Open error message, call Coulomb
Customer Support at 1-877-850-4562.
5-6
Use a solenoid type voltage tester (sometimes
referred to as a "Wiggy") to check the charging
station's voltages at the terminal block. This type
of tester will draw sufficient current to expose a
poor connection.
Wiring problems include mis-wired or open lines,
open neutral, open ground, or an unbonded
neutral.
To determine if the station has been properly
wired, note the following:
• Neutral and Ground MUST be bonded at some
point in the AC supply. This is usually done at
the transformer, the main panel, or at a
sub -panel.
• The voltage between Neutral and Ground must
measure less than 4 volts. An unbonded
neutral will result in excessive voltage between
neutral and ground, causing lower voltage on
one side of the 208/240 volt lines.
• The voltages between each line and Ground
must measure within 8 volts of each other
Check the tables below for your specific station
model number to verify the voltages areas
expected. If the voltages are not as expected,
follow the instructions in the installation guide to
ensure that the wiring has been properly
connected.
NOTE:
• It is imperative that Neutral and Ground be
bonded at some point in the AC supply. This is
usually done at the transformer, the main
panel, or at a sub -panel.
• At the service panel, the voltage between
Neutral and Ground must.measure less than 4
volts.
• The voltages between each line and Ground
must measure within 8 volts of each other.
Troubleshooting
ME
LEVEL 2CORE Q
N2 SEE INSTALLATION GUIDE
Input 1: 2081240 VAC, 60HZ, 30A, 10
Input 2: 2081240 VAC, 60HZ, 30A, 10
Use Min. 90° C copper condutors only.
Input terminal recommended tightening torque:
18.5 in.-Ibs (2.1Nm)
Input terminal wire size range:
6 to 10AWG (13mm2 to 5.3mm2 ) solid ! stranded.
WARNING: Risk of Shock. Two Power Sources.
Disconnect Both Power Sources Before Servicing
AVERTISSEMEN'r: Risque de choc electrique. Al lmentations multiples.
Couper le deux circuits d'allmentation avant intervention,
#1 GND #2
208/240 VAC e 208/240 VAC
L1 L2 L2 L1
MEASURE VOLTAGES HERE
Measure both sides (#1 and #2)
5-7
M
COULOMB TECHNOLOGIES INC.
LIMITED PRODUCT WARRANTY
This Limited Product Warranty applies to you, a customer who has purchased COULOMB's Charge Point"" Networked
Charging Stations and/or related products ("Products") from COULOMB TECHNOLOGIES, INC. ("COULOMB") or one of its
authorized distributors and not for resale.
LIMITED ONE-YEAR WARRANTY
Subject to the exclusions from warranty coverage set forth below, COULOMB warrants that the Product will be free from
any defects in materials andlor workmanship (the "Limited Warranty') for a period of one (1) year after the date of the initial
installation of the Product (the "One -Year Warranty Period"). If the Product becomes defective in breach of the Limited
Warranty, COULOMB will, upon written notice of the defect received during the One -Year Warranty period, either repair or
replace, at Coulomb's election, the Product if it proves to be defective; provided, that COULOMB will not be responsible for
the cost of any labor associated with the repair or replacement of any defective Product.
FIVE-YEAR EXTENDED WARRANTY (Additional Charge Applies)
Subject to the exclusions from warranty coverage set forth below, if you have purchased a five (5) year extended warranty
("Five -Year Extended Warranty'), and if the Product becomes defective in breach of the Limited Warranty above at any time
during the five (5) year period after the date of the initial installation of the Product (the "Five -Year Warranty Period"),
COULOMB will, upon written notice of the defect received during the Five -Year Warranty Period, either repair, provide
1 replacement parts for the defective parts of the Product or replace the Product, at Coulomb's election, if it proves to be
defective; provided, that COULOMB will not be responsible for the cost of any labor associated with the repair or
replacement of any defective Product.
COULOMB's OPTIONS
You acknowledge that replacement products provided by Coulomb under each of the Limited Warranty and the Five -Year
Extended Warranty may be remanufactured or reconditioned Products or, if the exact Product is no longer manufactured by
COULOMB, a Product with substantially similar functionality ("Replacement Products"). Any Replacement Products so
furnished will be warranted for the remainder of the original Warranty Period or ninety (90) days from the date of delivery of
such Replacement Product, whichever is greater. Should COULOMB be unable to repair or replace the Product,
COULOMB will refund the purchase price of the Product.
EXCLUSIONS FROM LIMITED WARRANTY AND FIVE-YEAR EXTENDED WARRANTY
IMPORTANT. The Limited Warranty and, if purchased, the Five Year Extended Warranty on your Product shall not apply to
defects, or service repairs, resulting from any of the following:
• Alteration or modification of the Product in any way not approved in writing by COULOMB.
• Vandalism, abuse, damage or otherwise being subjected to problems caused by negligence (including
but not limited to physical damage from being struck by a vehicle) or misapplication, or use of the
Products other than as specified in the applicable COULOMB documentation.
• Installation or relocation of the Products unless performed by COULOMB or by a Coulomb authorized
installer or service provider.
• Improper site preparation or maintenance.
• Damage as a result of accidents, extreme power surge, extreme electromagnetic field, acts of nature
or other causes beyond the control of COULOMB.
JI Use of the Product with software, interfacing, parts or supplies not supplied by COULOMB.
A-1
Charge Point® Charging Stations
You are responsible for the proper installation and maintenance of the Product. Any service or repairs beyond the scope of
the Limited Warranty or the Five -Year Extended Warranty above are subject to COULOMB's then prevailing current labor
rates and other applicable charges.
Third Party Products
The above Limited Warranty and Five -Year Extended Warranty are exclusive of products manufactured by third parties
("Third Parry Products"). If such third party manufacturer provides a separate warranty with respect to the Third Party
Product, COULOMB will include such warranty in the packaging of the COULOMB Product.
OBTAINING WARRANTY SERVICE
To obtain warranty service you must: (a) obtain a return materials authorization number ("RMA#") from COULOMB by
contacting 1-877-370-3802 (or for customers outside the U.S., contact 408-370-3802) and ask for Customer Service, and
(b) deliver the Product, in accordance with the instructions provided by COULOMB, along with proof of purchase in the form
of a copy of the bill of sale including the Product's serial number, contact information, RMA# and detailed description of the
defect, in either its original package or packaging providing the Product with a degree of protection equivalent to that of the
original packaging, to COULOMB at the address below. You agree to obtain adequate insurance to cover loss or damage to
the Product during shipment.
If you obtain an RMA# and return the defective Product as described above, COULOMB will pay the cost of returning the
Product to COULOMB. Otherwise, you agree to bear such cost, and prior to receipt by COULOMB, you assume risk of any
loss or damage to the Product. COULOMB is responsible for the cost of return shipment to you if the COULOMB Product is
found to be defective.
Returned products which are found by COULOMB to be not defective, returned out -of -warranty or otherwise ineligible for
warranty service will be repaired or replaced at COULOMB's standard charges and shipped back to you at your expense.
At COULOMB's sole option, COULOMB may perform repair service on the Product at your facility, and you agree to provide
COULOMB with all reasonable access to such facility and the Product, as required. On-site repair service is not available
outside the United States.
All replaced parts, whether under warranty or not, are the property of COULOMB.
WARRANTY LIMITATIONS
The LIMITED warrantY set forth above IS exclusive and no other warranty, whether written or oral, is expressed or implied
BY COULOMB, TO THE MAXIMUM EXTENT PERMITTED BY LAW. THERE ARE NO OTHER WARRANTIES
RESPECTING THE PRODUCT AND DOCUMENTATION AND SERVICES PROVIDED UNDER THIS AGREEMENT,
INCLUDING WITHOUT LIMITATION ANY WARRANTY OF DESIGN, MERCHANTABILITY, FITNESS FOR A
PARTICULAR PURPOSE (EVEN IF COULOMB OR DISTRIBUTOR HAS BEEN INFORMED OF SUCH PURPOSE) OR
AGAINST INFRINGEMENT.
Some states orjurisdictions do not allow the exclusion of express or implied warranties so the above exclusions may not
apply to you. IF ANY IMPLIED WARRANTY CANNOT BE DISCLAIMED UNDER APPLICABLE LAW, THEN SUCH
IMPLIED WARRANTY SHALL BE LIMITED INDURATION TO THE LIMITED WARRANTY PERIOD DESCRIBED ABOVE.
NO WARRANTIES APPLYAFTER THE TOTAL WARRANTY PERIOD. Some states or jurisdictions do not allow limitations
on how long an implied warranty lasts, so the above limitation may not apply to you.
NO AGENT OF COULOMB IS AUTHORIZED TO ALTER OR EXCEED THE WARRANTY OBLIGATIONS OF COULOMB.
COULOMB SPECIFICALLY DOES NOT WARRANT THAT ANY SOFTWARE WILL BE ERROR FREE OR OPERATE
WITHOUT INTERRUPTION.
THE REMEDIES IN THIS LIMITED PRODUCT WARRANTYARE YOUR SOLE AND EXCLUSIVE REMEDIES.
LIMITATIONS OF LIABILITY
You acknowledge and agree that the consideration which you paid to COULOMB or one of its authorized distributors does
not include any consideration by COULOMB or one of its authorized distributors of the risk of consequential, indirect or
incidental damages which may arise in connection with your use of, or inability to use, the Product. THUS, COULOMB OR
ONE OF ITS AUTHORIZED DISTRIBUTORS WILL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL,
PUNITIVE OR CONSEQUENTIAL DAMAGES, INCLUDING WITHOUT I -IMITATION LOST PROFITS, LOST BUSINESS,
LOST DATA, LOSS OF USE, OR COST OF COVER INCURRED BY YOU ARISING OUT OF OR RELATED TO YOUR
PURCHASE OR USE OF, OR INABILITY TO USE, THIS PRODUCT OR THE SERVICES, UNDER ANY THEORY OF
LIABILITY, WHETHER IN AN ACTION IN CONTRACT, STRICT LIABILITY, TORT (INCLUDING NEGLIGENCE) OR
A-2
Limited Product Warranty
OTHER LEGAL OR EQUITABLE THEORY, EVEN IF COULOMB KNEW OR SHOULD HAVE KNOWN OF THE
POSSIBILITY OF SUCH DAMAGES. IN ANY EVENT, THE CUMULATIVE LIABILITY OF COULOMB OR ONE OF ITS
AUTHORIZED DISTRIBUTORS FOR ALL CLAIMS WHATSOEVER RELATED TO THIS PRODUCT OR THE SERVICE
WILL NOT EXCEED THE PRICE YOU PAID FOR THIS PRODUCT.
THE LIMITATIONS SET FORTH HEREIN ARE INTENDED TO LIMIT THE LIABILITY OF COULOMB AND SHALL APPLY
NOTWITHSTANDING ANY FAILURE OF ESSENTIAL PURPOSE OF ANY LIMITED REMEDY.
Some states or jurisdictions do not allow the exclusion or limitation of incidental or consequential damages, so the above
limitation or exclusion may not apply to you.
THIS LIMITED PRODUCT WARRANTY GIVES YOU SPECIFIC LEGAL RIGHTS AND YOU MAY ALSO HAVE OTHER
RIGHTS WHICH VARY FROM STATE TO STATE OR JURISDICTION TO JURISDICTION.
ADDITIONAL INFORMATION
This Limited Product Warranty is valid for U.S-A. and Can only.
This Limited Product Warranty shall be governed by and construed in accordance with the laws of the State of California,
U.S.A., exclusive of its conflict of laws principles. The U.N. Convention on Contracts for the International Sale of Goods
shall not apply.
This Limited Product Warranty is the entire and exclusive agreement between you and COULOMB with respect to its
subject matter, and any modification or waiver of any provision of this statement is not effective unless expressly set forth in
writing by an authorized representative of COULOMB.
The Limited Product Warranty is not transferable by you to anyone else.
All inquiries or claims made under this Limited Product Warranty must be sent to COULOMB's address as follows:
Coulomb Technologies, Inc.
1692 Dell Avenue_
Campbell, California 95008-6901
Tel: 408-370-3802
Fax: 408-370-3847
A-3
I
,J
CUPERTINO
PURPOSE
HAZARDOUS MATERIALS CHECKLIST
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a)cuoertino.org
To minimize possible delays that would result for the Fire Department plan review, please complete the
following checklist to determine if an additional level of Hazardous Materials plan review will be
required.
MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING?
PLEASE MARK YOUR ANSWER WITH AN `X' IN THE YES OR NO BOX ON THE SIDE
BELOW.
YES
NO
1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases,
hazardous materials, etc.
2. Battery back-up rooms or racks.
3. Propane tanks.
i
4. Gasoline stations with underground tanks.
5. Installation or replacement above ground or underground storage of liquid petroleum
products, liquefied petroleum gases, compressed natural gas, explosives or other
regulated hazardous materials.
6. Gas rooms for dentist, doctors or veterinarians.
7. Generators with back-up diesel or other fuels.
8. Large refrigeration systems.
9. Fuel cell systems.
10. Commercial pool systems.
11. Chemical Storage areas.
12. Flammable liquid storage.
13. Compressed Gases.
14. Dry cleaners.
15. , Print Shops.
16. Auto Repair and Auto Body Shops.
17. Research and Development.
For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa
Clara County Fire Department, at (408) 378-4010.
HasMat 2011.doc revised 03/07/11
2010 CALGREE14 NON-RESIDENTIAL C�tECKLIST -- �
MANDATORY I.TEMIS ((
COMMUNITY DEPARTMENT- BUILDING DIVI'11FIffliff
COPY,
CUE'EFiCINC7 Ai BERT SALVADOR, R,G..1
., C.9:O., BUILDING OFFICIAL
ioaooTORREAVENUE -CuPERTINO,CAS50t4- 2;55
{408)777-3228 • FAX (408) 777:3333. IiuildinCIOCUDertin�a•ortt.
PURPOSE:
The non-residential provisions of the .2010 CalGreeh Code outline planning, design and development methods
that include environmentally responsible site selection, building design, building siting and development to
protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent
pr;`operties,. establishes the means of conserving water used indoors, outdoors and in wastewater conveyance;
outlines means of achieving material conservation and resource efficiency: and outlines means of reducing the
quantity of air contarninants.
Project Name:
Project Addriess:
Project Description:
Instructions:
1. The Ow her or the Owner's agent shall employ a licensed professional experienced with the 2010
California Green Building Standards Codes to verify and assure that all required work described herein
is properly planned and implemented in the project:
Z.
'The licensed professional, in collaboration .tiVith the owner and the design professional shall initial
column 2 of this checklist; sign and date Section 1 - Design Verification at the end of this checklist
and have the checklist printed on the approved plans for the project,
3. Prior to final inspection by the wilding Department, the licensed professional shall complete Column 3
and sign and date Section 2 implementation Verification at the end of this checklist and submit the
coiiipleted form to the Building. Inspector.
Column 2 Column 3
MANDATORY FEATURE OR MEASURE Project Verification
Rdauirements
�erteral Requirements
The prcje::t meets all the requiremenfs of Divisions 5.`t through 5.5. Q � El
Planning and 17esidin Site Development
5.106.1 Storm water pollution preventton plan. For projects ,of� �°
less, develop a Storm Water Pollution Prevention Plan (EMPPP) t n DEC I S
designed, specific to its :site, conforming to the State Storm water NPDES
C--onstruction Permit or local ordinance, wNchaver Is stricter, as is reww&V FOR r NPl-ip,iv
projects over one acre. The plan should cover prevention of soil loss by storiTi
water run-off andfor wln:d eroslcn, of sedimentation and/or of dus03SKt 6f Y:
matter air pollution. —
Page I of 9 CalGneca A'bn.Res ivvised 54/2741
5 10ti:4 Bic'ycte parking and with S
in ms Cotripty wections
roodinan_
6t1
5 1 Df4 1 andt5 10E 2' or Yii` e_caltorce tiroh€c hevei is stricter.
r r �1.k.
5:108.4.1 Short,' $btc�!cle;parkrng; If the...jrolect is anticipated to
generate.:visitar traffic, provide' permanently anchored bicycle racks"vritlhin
200 feet of the visitors' entrance, readily; visible to passers-by, for 5 -percent`
�
of.vis for rrotorized vehicle parking capacity, with a ininirl of
bilge capacity rack:
5.108 42 Long -Term bicycle parking: For buildings with over 10 tenant-
acirupanls, prpvide secure bicycle parking for 5 percenf of tenant -occupied.
rn toriz'd vehicle parking capacity with a min±mum of one :space.
5.106.6.2 Designated parking Prdvide design2'ei1 jaarking for any
combination of lawr-ernitbi fuel-efficient and carpooltvan pool vehicles as
0
0
shown in Tab16 5:106.6.2 .
5106:8 Light pollution reduction. Comply with lighting power regbirerrierits,: .
in the Coldlomia Energy Code and design interior and exterior lighting such that
zero` direct -beam illurnination`leaves the building site: Meet or exceed ezteror
light leVels and uniformity ratios for lighting zones 1 = 4 as delined in Chapter..
10 of the California Adeninistrafive Code, using.the follovuin Mra:egies .
1;. Shield all exterior luminalres cr use cutoff luminaires.
0 '
2; Contain interior lighting.within each source:..
"s: Allow no mare thin ..0.1 horizontal font candle 15 ft beyond the site;
4. Contain all exterior lighting within property bouridaiies:
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Eicception 'Seb Part 2, Chapter 12, Section 1`205.6 fpr. campus lighting
reyulreinerits for parking faciliktesaril wafki ays:
5 106.:10 Grading and paving. The site shall be planned and devel6ped to
keep surface water away from buildings: Construction plans shall indicate how
site grading°ora drainage system will manage all surf.tioe Water flows;
F�erfarmanaa Requtrments
5.201.1 Scope. The California Energy Commission will continue to adopt
-
�.
rnandatory luilding standards.,.
0 e , , 0
At
indocrreyyWater*tJseA, V:>
5q 3b3.1. Meters. S}epvate met ergs_shall be installed .for the rises described in
56c dris t7Q 1=� I1lr�Ugh �OJ.i is
5.303.1.1 Buildings .in excess of 50,000 square feet. Separate
0.
shbmeters.shall be installed`as fUltou�s:
1. For.each individual Leased, rented or other tel soce'avithin the:
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buildingro'ecfed to consume more than 100 asillday.
114gi: 2 t,f'> rev4ed 0847"..",'r
2.. For spaces used for laundry or cleaners, restaurant or food service;
;medical or dental office, laboratory or beauty salon or barbar shop
❑
projected to consume more than 100 gallday'.
5.303.1.2 Excess consumption. Any building within a project or space
wi0iin a building that is projected to consume more than 1,000 galfday.
5.303:220 percent savings. A schedule of pltimbing fixtures and fixture
fittings that will reduce the overall use of potable water within the building by
20 percent shall to provided. (Calculate savings by Water Use Woftheets)
5.343.2.1 Multiple. showerheads serving one shower. When single
shower fixtures are served by more than one showerhead, the combined
flow rate of all the shovoerheads shall not exceed the maximum flow rates1QJ,❑
specified In the. 20 percent reduction column contained in Table 5,303.2.3
or he shower shall be designedto only allow one showerhead to be in
operation at a time.
5.303.4 Wastewater reduction. Each building shall reduce the generation of
wastewater by one of the following methods;
As applicable
1. the installation of water-conserving fixtures or
❑K
2. Utilizing non-potable water systems.
5.303.6 Plumbing fixtures and fittings. Plumbing fixtures (water closets arid
u(mals) and fittings (faucets and shu%erl Bads) shall comply with the
requirements listed for each type in Itelrs listed in Table 5.303.6.
As applicable
1, Water closets (toilets) — flushorneter type
Lil
❑
2. Water closets (toilets) — tank type
❑
3., Urinals
t�J
❑
4. Public'lavatory fauces
❑X
5. Public metering; self-closing faucets
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6.estiental bathroom 'lavatarysink faucet
❑X
❑
7. Residential kitchen faucets
X❑
S'. Residential shouter heads
9. Single shower fixtures served by more than one showerhead
0
Outd!6or Waiter Usk
5.344:1 Water budget. A water budget shall be developed for landscape
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use.
5.344.2 Outdoor potable water use. For new water sertice, separate meters.
or subrmete'rs shall be installed for indoor and outdoor potable water use ror
landscaped areas between 1.,000 square feet and 5,000 square feet_
5.304.3 Irrigation design. In new nonresidential projects with between 1,000
and 2,500 square feet of landscaped area (the level at which the MLO
As applicable
applies), install irrigation controllers and sensors which Include the following
❑
criteria and meet manufacturer's recommendations.
Page 3 oro C/tech Pisa Jac -revised 0&271i f
5.304.3.1 Irrigation controllers -Automatic irrigation system Controllers
5.408;1• Construction waste drveision: Establish a construction waste, ..
installed f the time of final inspectidn shall comply with the following:
5,448,2 Constru'001) :vaste ma`nagpment plan. Su.ottl;it elan per tf i:s,5ec#tori
1'.. Controllers sh611 be weather-- or soil moisture•base'd controllers that
to en'rucernent a6thoiity.
autoi6atically adjust irrigation in response to changes:in piahts needs as
S. 40 8w 2,1,D6duntientation Provide documentation of the waste
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weather &inditions change. .
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0
Items. I tt ru 4 and the plan is accessible,to the enforcement authority, .
2 Weather -based contrallers:without integral rain sensors or
,.5:408.2.2 Isolated Iobs tes the enforciN amay ay male excbptlons
communication sysfems.that kcount for local rainfall shall have a .
to the'requiri;.nienis of this section when jobsites,are located in' areas
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separate wired or mwre ess rain sensor which cgnnects,or communicates
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;v�ith>the caritroller s .Soil t7ioisture-base6controllers are not required to
{�
50 percent of nonhazardous:consItrGiction and demolition debris or meet 10oal
have rain sensor input:. :..
ordinance, whichever is more stringenf,
Exceptions;
1.- Excavated soil and land clearing debris.
�lteather Raststance and sture fViana'ad rient
,
2.•4lternale mvi ste reduction methods developed byworking with local,
agencies if oi�rers'ion or recycle Willies capable of compiiahce vWh this
item do not exist, :. .
6.407.1 Weatlw protection. Provide a:vveather- resiztant'exterior well and'"
,
foundation emielope.as required by Catrl'+arrii4 Btfifding Code Section 1403.2
stumps, nicks and assveiated iaegetation.and soils resulting primarily from land
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aridCalirprrtia�rter` CgreSection150,: manufacturers installation
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_
instructions or local ardinarice whichever is more stringent':.
u:
5,407.2 Moisture control. �tTipley rioistu e control irieasUr's by..tlie follot�ri ig`
_.
methods` , .
5..407.2.1 Sprinklers Pr.e`venk.lrrigatioii spray ori structures.
5;407 2;2 Entrles and openings: Design exterior entries,and dopings to
D
prevent water intrusion info buildings.:.
rGonstructiiari VVaste Reduction,' Disposal anti t eCyclrng IR
5.408;1• Construction waste drveision: Establish a construction waste, ..
17 anagelllent plan (7r Meet'lo N Ordinance; wfiioever is more stringent.,
5,448,2 Constru'001) :vaste ma`nagpment plan. Su.ottl;it elan per tf i:s,5ec#tori
to en'rucernent a6thoiity.
S. 40 8w 2,1,D6duntientation Provide documentation of the waste
management plan that meets tte requirements listed in Section 5 4x8.2
�X
0
Items. I tt ru 4 and the plan is accessible,to the enforcement authority, .
,.5:408.2.2 Isolated Iobs tes the enforciN amay ay male excbptlons
to the'requiri;.nienis of this section when jobsites,are located in' areas
r�
u
be" gond the haul boundaries of the diversion,facilif . -
5,408:3 Construction waste: Recycle andlgr salvage for rouse a minimum of
50 percent of nonhazardous:consItrGiction and demolition debris or meet 10oal
ordinance, whichever is more stringenf,
Exceptions;
1.- Excavated soil and land clearing debris.
2.•4lternale mvi ste reduction methods developed byworking with local,
agencies if oi�rers'ion or recycle Willies capable of compiiahce vWh this
item do not exist, :. .
5.406.4 Excavated soil and Land cie,aring debris,.1 DO, Percent of'lrees.
stumps, nicks and assveiated iaegetation.and soils resulting primarily from land
Q
cleariby -shall be reused or recycled,
Doge 4 fit 9 stir ret ri r 'n+i Res Clteck/1sr dile ;.ef racrP. rl 07,111, .
Burlditt ialnte"nb(n l
'g nee and Opei�att4ri: - _
5.410.1 Recycling by Occupants. Provide readily accessible areas that serVe
fpr
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the entire building and are identified the depositing,. storage and collection
of nonhazardous materials for recycling..'
6.410.2 Commissioning, For new buildings 10,000 square feet and over;
build og cbn-W,issioi}ing for all building systems aaver6d by T24, part. 6,
process systems and renewable anergy systems shall be included in the
design and. construction processes of the building project, Commissioning
requirements shall .'include items listed in Section 5.410.2.
5.4103.1 Owner's Project Requirements (OPRj. Documented 'before the
design phase of the project bdgins the CPR shall include items listed in
t1
Section 5.41©.4.
5.410.2.2 Basis of Design (9011)). A writlen explanation of how the design
of the building systems meets the OPa shall be completed at the design
El
phase of the building project and. updated periodically to cover the systems.
listed in Section 5.410.2.2:
5.410.2.3 Commissiohin plan. A commissioning plan describinrg heft, the
protectwill .be commissioned shall be started dLtringthe design phase of
the building project and shall include i terns fisted in Section 5.41G.2,3,
5.410 2 4 Funclib"I performance testing shall demonstrate the correct
installation and operation of each compionent, system and system-to-
system interface In accordance with the approved plans and specifrcations.
5.,410.2:5 Docunnentation and turning. A Systems manual and systems
operations training are required.
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txt
5.410.2.5.1 Systems manual.. The systems manual shall be delivered to
the building owner or representative and facilities operator and. shall
include the items listed in Section 5.4110,2,5'.1.
5,410.2.5.2 Systems operations training. The training of the
appropriate maintenance staff for each equipment type andtor system
shall include 4erns listed in Section 5.4101.51.
6.410.2.11 Commissioning report. A complete report of commissioning
process activities undertaken through the design, construction and
reporting recommendations for post-construction phases of the building
�
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Q
project shall be completed and provided to file owner or representative..
5.410,4 Testing and adjusting. Testing and adjusting of systems shall be
required for buildings less than 10,000 square feet.
5.41.0.4.2 Systems.. Develop a wgtten plan of procedures for testing and
adjusting systems; Systems to be included fortesting and.ad usting shall
include, as applicable to the project, the systems listed in Section
[]
5.410,- ",2.
6.410.4.3 Procedures. Perforin testing and adjusting procedures in
accordance +J 4h industry best practices and aoplicable national standards
El
on each system:
5,410.4..3,1 HVAC balancing. Before a now space-conditioning system
serving a building or space is operated for normal use., the system
rXI
shouldbe balanced iii accordance with the procedures defined by
national standards listed °in,$ection 5.410.3.3.1.
Poen: 5 OF 9
r1n, i•n.•irr f !iS^27 J f
5.410.4.4: Reporting.,Aftercoinplet on of testing, adjusteng an balancing
provide a,fnal re ort of testing signed by the individual iresponsiblefbt
�—�
E
performing these services;
5.410-4.,S`Operation and thaintenance,manual. Provide the.building
owner tyiih detailed operating and maintenance instructions and copiesf:;:
„ X
El
g iarantiesfwarrantie s for each'system prior to .finial nspection, .
5 410 4.5 1 Inspections and reports. lnclude a copy of all inspection
- verifications and reports regwred by. the enforcing agr ncy
- . -
Fireplaces 3 ;
�.
5.503.1 Install manly a.derect-vent sealed comnbtmstian gas or sealed wood
©,
burring fireplace or a`sealbd-y.robdstove and refer to residential requrremerrts
in the Cahfornra Enfty Corte; Title 24, Part 6, Subchapter 7, Section 150.,:
5:503.1.1 Woods#oves 1rdr,odstoves shall comply with US EPA Phase 4
.: -...
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emission limits.
Pollutant Control
s 504.3 Coyering'of duct ripenings and protection of mech6olcai
egaipinent during construction. At the time of rough installation or during
storage on the construction sit- and until final startup of the heating and
cooling equipment, all duct and other related air distributIdD component,'
openings shall be covered with tape, plastic, street metal or other methods
acceptable to the enforcing agency tq reduce the amount. of dust'or. debris ..
Which p?ay collect in the system.
5.504.4 F(nish material pollutant control: t"irtisfi rrmaterals,stiall cc* ply with
Sections 5.504,4.1 through 5.504.4,4::
6.504AA Adhesives, sealants, caulks. Adhosiu®s and sealants used 'on;
the.project shalt meet the requirements of the following standards
J. Adhesives, adhesive b6nddinig piriMbrs, adresiva Primers seelonts;.
sealant primers and caulks shall comply with local or regional air pollution
control or.air duality management district rules where applicable or
t^r�;1
S+ AGIVID Rule 1168 VOG limits, as shown in Tables 5.5D4.4.1 and
J
5.504.4.2,
2.. Aerosol adhesives and smaller unit sizes of adhesives and sealant or
caulking cbmpoLir ds (In units of product; less packaging; which do not'
weigh more than one pound and do not consist of more than 6 fluid`
!ounces) .shall comply With statevaide VOC stendaeds and othe-,-
requirements, including prohibitions on use of certair; toxic compounds,. cf
Califonva Codes of.Regtllahoj,s .i ill . 1.7, commending with Section 94507",
6,504.4.3 Paints and coatings. Architectural paints and coatings shall,
comply with Table 5.504;x,3 unless more stangent local limits apply-'
d
6,504.4.3,1 Aerosol paints and coatings, aerosol paints and coatings
shall meet the Product -Weighted MIR Limits for ROC in Section
94522(a)(3) and other requirements., including'prohibitions on use of
certain toxic compounds and ozone depleting substances fCCR', Title; 17.
Section} 94520 et seg);
Page6,6P9 CedGovest,part-ts`awC�heed�h�lFtr�c,�e�rsaihrli,�7>`'t
,
I
5.504.4,3.2 Verification. Verification of compliance with this section
request the agency.
®:
shalt be provided at toe of enforcing
5.504.4.4 Garpet systems. All carpet installed in the building interior shag
meet the testing and product requirements of one of thestandards lister. in
❑�
❑
Section 5:504.4.4,.
6.504.4,4A Carpet cushion. All carpet cushion installed in the building
interior shall meet the requirements of the Carpet and Rug Institute
❑
Green Label program.
5.504.4.4.2 Carpet adhesive., All carpet adhesive shall meet the
Table 804,4.1.
F-71
requirements of
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5.604.4.5 Composite wood products. Hardwood plywood, particleboard
and medium densgy fiberboalrd composite wood products used on the
❑
interior or exterior of the building shall meet the requirements for
Q
formaldehyde as specified in Table 5.504.4.
5,504.4.6.2 Documentation. Verification of compliance with this section
❑
❑
shall be provided as requested by the enforcing agency. Documentation
shall include at least one of the following:
As applicable
1, Product certifications and specifications
�
❑
2. Chain of custody certifications
0
2. Other methods acceptable to the enforcing agency
Q
❑
5.604.4.6 Resilient flooring systems. Comply with the VOC-emission
limits defined in the 2009 CHPS criteria and listed on its law-ernitting
Materials List or Product Registry} or certified under the Floorscore
program of the Resilient Floor Covering Institute.
5.504:5:3 Filters. In mechanically ventilated buildings, provide regularly
occupied areas of the building with air filtration media for outsde and
❑
return air prior to occupancy that provides at least a MERV of 8.
5.x04.7 Environmental tobacco smoke (ETS) control. Prohibit smoking
within 25 feet of building entries, outdoor air intakes and cperabie windows
Where outdoor areas are provided for smoking and in buildings; or as enforced
by ordinances, reguiatioris or policies of any city, county, city and county,
0
❑
California ,Community College, campus of thee. California State University or
campus of the University of California, whichever are more stringent.
tndot r Mois
turetdrid Raddn Coiiti=ol�.
6:.505.1 Indoor moisture control. Buildings shall meet or exceed the
provisions of California BulIdinq Gose, CCR, Titin 24, Part 2. Sections 1203 [ ❑
and Chapter 14,1..'
Air duality!and Exhausi _ . .
5.546.1 Outside air delivery. For mechanically or nalurally ventilated spaces
in buildings, meet the minimum. requireirents of Section 121 of the Cafiforn6 ❑
Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 5 or the
applicable local code, whiche�ier is more stringent.'
I'age7 of 9: Check-hsi.&i a sysrited W27/1
r.
5.506.2 Carbon -dioxide (CO2) monitoring, For buildings equipped vvilh
demand oodhtrol ventilation. CO2 sensors and vonfilation controls shall be
Q
specified and installed in accordance with the requiremens of, the latest edition
of the r alflornr'a Energy Code; C.CR,'Title 24, Part 6, Section 121(c),'
Env�ronrrtentaI C 5hiafort
' ro xS
..-
6.507.4 Ae,oustical control: Emlaloy building assefntilies and components
L�t
with S.TC values determined'in accordance; with ASTM .E SO and ASTM E 411,
5507.41 Extarior noise trap smisslam Wall and floor -ceiling assernblies
making up the building envelope shall have an STC of at least 50 and
exterior awindews,shall h;qve: a minimum. STC of.30 for any` of the building ;:
0
locations listed in.lterns 1 through 3 in Section 5.507,5,1:
5.507.4,2 [rite No�Sound. VValt.ard.flQbr-ceiling assembliesseparati'g
tenant spaees aria tenant spaces and public places shall have an STC' of'.
RE
at least 4 0'
Outdoor AtrWadAlity
5:508.1 Ozone depleti.on and global warming ire`ductions, Installatibri§ of
HVAC; refrigeration and fire suppression equiprvie;nt shall comply With Sections
5.505:1:1 and 5.508:.1.2..
As applicable
b.508 1.1 GFCs. [nstall H%IAC and'refrigeration equipment that does not
contain' CFCs:'
5.506.1,2 Hal6 ns. install.fire suppression equipment that does not Contain
Q
Halons,'
1; ``hese aneasures orie currently recuired elseAe`re in statute or in regulaiidr.
Nge 8 Or9
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cufcl.!Elt -Vaal-Res Checklivi le?c'm is&I08• 27.°11
CALGREEN SIGNATURE DECLARATIONS
Ret,- A', alOt c \-zc)8c)c)q6
U
Project Descapilon: Gmmfu's t�LA "k\ ky�a
SECTION f- DESIGN VERIFICATION
C0qipIqt6 all I . 1qe6 of See . don I Desl9b Veri�O!Ion.. and 6ijbrhi t the cOrn."PlIeted chp-mckilst (Coluhns I and 2) vfith T-,
prMl
plans and bqlfJing'' P1
�p catlonto the BuildingBuildingbeiparfrilent,
P 1
T6e iawnerand.desIgn prof6ss',onal responsible for comptlance wlth.'Caldreen Standards have revised thoplams and
b0ify that ilia iickm,'s cfie�d A_ove are iheriby InecrporaJedirio th'e piojei (pians lans and wIll6trip n -W IW
o the
prqfdrtin accordance wills the requiririantgset 00
In the 2010 dall.forill'a Green 'Building Standards Code as
edop y tate City of Cupertino -
IF
Owner' altire La J 1� Date
De.ii9h'NofeWi;naFs Signaiure
Desig:-n Piogssid'hal's Name (Please
sidnatuo 6100�spl Pr6lessirnal rhWnslbte for WIGreen oompliancz
Nm a 61 lJoense, Professional responsible f6t C,016reen compliance, (Please Psint)
Email Address- (6r LIG.'e'nse Professional raspqnsblo ror Cal0mon convffaltCe
9,
Date
AO&I-40 L
Pbona
IMIVLEIM�MTATIOM VERIFICATION'
tornpliite-, sten and somit the cofMpeJq!ieheckbt, 4ridd6ng boilurpri 3, tdgelliervylth all orljlnal signa.t.q.re3 on Section
g
2 Wife Wl&g DepMineM Pdorlo Bulfd(k' 6 �arlinent final in!' pe
�' " Ion' ' - c; I,
I j ave inspected thomorkz;6006 c6 !he project 066060
above Was wi�istrddt . 6d In aqcapJaiice and In icco=thdhd ri?qulre*
mer;0 of
the 2010 CA.kin l'a Green B , WWI . nq'Sliand44s C664 as Adopkd by flibbij of 6*146
(Yate
Name of Lloense Pro(assiona . I responsible FwdolGreen witipliance (Pleoo Prinli Phone
E.Mall Ad*m foetfcemso Frofcssionbl respcpslbra for'CaQroeWcbirpliahco
page §erg ti OYM
2010 C,ALGREEN NON-RESIDENTIAL L X'
MANDATORY ITEMSWfICOL4�'
�
COMMUNITY CDEVELQPIAFNT DEPARTMENT • BUILDING DIVISION �
CUPERTtN4 ALB ERT SALVADOR, P E,, C.B.L., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(403) 777-322& • FAX t406Ij 777-3333 building ciiraerlino.br
PURPOSE:
The non-residential provisions of the 2010 CalGreen Code outline planning, design and development methods
that include environmentally responsible site selecticin, building design, building siting and development to
protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent
properties; establishes the means of conserving water used indoors; outdoors and in wastewratercorrveyanc%
outlines means of achieving material conservation and resource efficiency; and, outlines means of reducing the
quantity of air contaminants.
Project name_ !"� '' k?`- C, `1 �`e it Aro \20t.,{+
Project Address: ' .,J r -.t 3mrl�xt * j l
Project Description: O " O ti ^•
Instructions: -
1. The. Owner or the Ovrner's agent shall employ a licensed professional experienced with the 2010
California Green. Building Standards Codes to verify and assure that all required work described herein
is properly planned and implemented in the project,
2. The licensed professional, in collaboration with the owner and the design professional shall initial
Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist
and have the checklist printed on the approved plans for the project.
3. Prier to final inspection by the Building Department, the licensed professional shall complete Column 3
and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the
completed form to the Building Inspector.
Column 2 Column 3
MANDATORY FEATURE OR MEASURE Project Verificative
Requirements
CeneraLRequire'ments ;
The project meets all the requirements of Divisions 5.1 through 5.5. 0 [�
Planning and 13esign „Site Development y
5.108.1 Storm water pollution prevention plan. For projects of one f:
less, develop a Storm Water Pollution Prevention Plan (S1NPI'PJ that. � x�
designed, specific to its site, conforming to the State Storm water NPT]
Construction Permit or local ordinance, whichever is stricter, as is required far
projects over one acre, The plan should cover prevention of soil loss by srl'� I WED FOR CO
water ,run-off andior wind erosion, of sedimentation and/or of dust.'parti I,j��a
vrri �blr�r ��ir nnlfi4'rr.n �CY 6WPeWed By.
llagC 1 01`9 CaiGreen !4oa-Res Caeckil?si dvc rerise%d 08,1777,111
Page Z U(9,1: Lc�tfirrer� r1'nrr-I�c3 E'lreeklisGcit�c.r�p�sed {1&`�7r�,' i
5 106'4 Bic ,cls arising anti e1� n ut rooms Corr, ! with Sections
0,o'r},is `arirnance
5 10541 a d'5 xt locg"t ahihever. is stricter.
" .
5:106:4.1 5hor't-Term bicycle parking: if the, prpip.pt is anticipated to
generate visitor traffic provide permanently anchored bicycle racks Within
t
2.00 feet of the vlsitars' entrance; readily visible to passers try, for 5 percent
..
®°
of.visrtor motorized vehicleparking capacity; with a rninimurrn of, one iwo-
bike capai;ity rack:
5 10B 4 21ong-Terra bicljcle parking: For burldirl9s wily over 10 tenant-
occupants, pip+lids secure bicycle parking for 5_.per'c.ent of tenant -occupied`
`
motorized'vehicle parking capacdy; with a minim. um of brie.space:
,5.10M.2 Designated parking Provide designated barking for any .
combination v; lovr=emdUng, tuel.efficient and car:6611v�an pool vehicles as
[]
shoywh in Table 5.106,6,2-
06.8, Light palfution reductran Comply �vrth'lighting powar requirements;'
in the.CColifomia EA&-gy Coda and design interior and exterior lighting such that
zerfl direct -beam illumination leaves the building.site. t set or exceed exterior
light i6els and uniformity ratios for lighting zones 1 - 4 as defined in Chapter ,
10 of;the Cafifoi.,Ma:AdminiStra: Uv6 Code, using the following strategies:
1;- Shield 'all exterior l6niinalres cruse cutoff luminaires.
2 Contah,inter`ior HghU g,v>- NO each source:
3. Allow no more than .01 horizontal foot candle 15' fi. Beyond the site,..
4. Contain all exterior figh.t(ng 4vithin property boundaries:.
Exception' See Part 2, Chapter 12; Section 1'205.6 for campus,ighting.
requirementsf6r parkirig tacilities acid tvallwziys:
5'AOs.:14 Grading acid paving rhe site shall be planned and developed to
keep sutfac.e..water avlay front buildings: Con%ructidri plans shall indicate how
Y.
[l,
site gradiny ora drainege system Will manage all surface watertlmys;
ONE
FerFormanceiRequlrements �
k,�f
5.201.1 Scope The California Energy. Commission will continue to adopt .
X
mandatory building standards:)
`indoorl►yaterUseM Y
5.363.1 Meters Separate meters shall he installed irrr the.Uses described in
Sections.503.1 A Throbgh 503'.1 3
s..303:1..1 Buitdirigs in excess of SO,GCO squate feet. Seliarite
X®
].
submeters shali.be install6d'4s foNovls:.
I. For each individual leased, rented or other tenant space within the.
0buhin
raectisd to consume more than 100 oallday.:
Page Z U(9,1: Lc�tfirrer� r1'nrr-I�c3 E'lreeklisGcit�c.r�p�sed {1&`�7r�,' i
Z. For spaces used for laundry or cleaners, restaurant or food service;
medical or dental office, laboratoryor beauty salon or barber shop
projected to consume more than 140 gal/day..
5,303.1.2 Excess cpnsumption. Any building within a project or space
within a building that is projected to consume more than 1,000 galiday.
5.303.2 20 percent savings. A sohedule of plumbing fixtures and fixture
fittings that.will reduce the coverall use of potable water within the building by
20 percent shall be provided. (Calculate savings by Water Use Wodt sheets)
5.303.2.1 Multiple showerheads serving one shower. When single
shower fixtures are served by more than one showerheads the combined
-
flow rate of all the showerheads shall not. exceed the maximum flow rates
❑
specified In the 20 percent reduction column contained in'Table 5.303,2.3
or ;he shower shall be designed to only allow one shv erhe.ad to be in
operation at a time,.
5.303.4 Wastewater reduction. Each building shalt reduce the generation of
wastewater by one of the, following methods;
As applicable
1. -the instaliatior of water -conserving fixtures or
Q
2. Utilizing non -potable water systems.
❑
❑
5.303.6 Plumbing fixtures and fittings. Plumbing fixtures (water closets and
urinals) and finings (faucets and shov�erheads) shall comply �Wh'he
requirements listed for each type in Items listed in Table 5.303.6.
As, applicable
1. Water closets (toilets) - flushometer type
X❑
�.
2. Water closets (,toilets) - tank type
X❑
❑
3, Urinals
X❑
❑
4. Public lavatory faucets
X❑
5. Public metering self-closing faucets
Q]
6. Residential bathroom lavatory sink faucet.
X❑
❑
7. Residential kitchen faucets
X❑
8. Residential showerheads
0
G. Single shower fixtures served by moro than one showerhead
0
0 adoorw6t6ir, dib. .
5.304.1 Water budget. A water budget, shall be developed for landscape
®
El
use.
5.304.2 Outdoor potable water use. For new water service, separate meters
or submeters shall be installed for indoor and outdoor potabie avatar use for
�
X❑
landscaped areas between 1,000 square feet and 5,000 square feet.
5.304.3 Irricgatfon design. In new nonresidential projects vAth between 1,000
and 2,50b square feet of landscaped area (the level at which the PALO
At applicable
applies), install irrigation controllers and sensors which include the following
criteria and meet manufacturer's recommendations.
Page 3 a r 4 C '.'Greet ,tion -Res C ecklisr. 4oc revisal NY 27/i l
5.304. ..A
3.1 Irrigation controllersutomatic irrigation system controllers
installed at the time of final inspectior, shad crimpiy with- the follpw'ing
1 Controllers shall be weather- or soil molsture-based controllers that.
automatically adjust irrigation In response to changes in plants` needs, a$
[X,
weather conditioris change;
2. Weather=based controllers.without integral rain sensors.or
..
communication systems: that account for local rainfall shall have a :.
I
separate. � es
With thi oritroller §,Sail rnosture=based controlie spa ernotcommunicate
re to
aired
;
have rain sensor inpui...
.
Weather ReSrStanCe artd�Moislure f4ttartagement �
� ` � 5�
5.407.4 Weat}.or protectlon Provide a weather -resistant exterior wall and ;
foundation envelope as required ,by'Calrl<oan a Building Cada Section 1403.2
and 6'kdfr'7� Fnef" . Cbrde Section 150,. rnanufa-cturer's installation
o'Y
instructions or local ordinance, whichever is more stringent.°,
5:467.2 Moisture control. Emplby mo sture contrbi measures by the follov'ving
e.
methods;
5;407.21 Sprinklers. Pre'veht itrigation spray on structures.-
SA07 2.2 Entries acrd openings. Design exterior enlries and openings to
revent water intrusion into buddin s.
Cdhs,tructiof~t!WwAd Redact Qn,; Disporsal ai1d Reny ling v
,b�v Bw,°✓,. •,ry ._`4 kip.. ,... .,. ''-. „'.i 9 `cyF'„.,;<.
5.408:1 Construction waste'dive tsiom. Esitabhsh:a construction waste
®.
0
manageinerit plan: or meet local ordnance; whichever is more stringent,.-
5.408.2 Construction waste rrianagement,plan. Submit plan per this s�ctibin
to.Onfbibeirrmnt a6th6lty, '
5.408.2.1 Documentaticin Provide documentation of the waste
men plan that meet,§ the requirements,listed in Section 5,408.2
Items 1 thru:4 and the plan fs'accessible, to the enforcement authority.
5.408.2.2 Isolated jobsites: The enforcing agency may maMe exceptions
to the requirements of this sem ion when jobsites are located.in areas
Q �� �
� � []
beyond the haul boundaries of the diversion facility.
5.408:3 C.aristrti,ction waste: Recycle andlor'sa nage for rouse a minimum of
50-lJercent oYnonhazardous conslrUrCtion and demolition dens or meet local.
ordinance; whichever is snore stringent.
Exceptions.
1. Excavated sail and land-clearfr�g debris.
2. OI'erna.te waste reciddon methods, developed by working with local
agencies if dit,ers'ion or recycle facilities capable of compliance With this
iters do nct exist,
5.408.4 Excavated sol[ and land clearing debris. '1 a0-pe(cent ohrees,':
stumps, rocks and associated ,vegotalion and.sai.ls. resulting primarily from land
,
cleanrr€g shall be reused or recycled,
Page 4 i)l'.9 (eifGree+t ,�'cii-Rcs Cl?&-kf v rine ;;wised OV274 !
,BW1dfinO1lViai(nte'hiahc4 and ,Q
5,410.1 Recycling by occtipants. Provide readily accessible areas that serve
El
the entire building and are identified fo'r the dop6siting, storage and collection
0
of nonhazardous materials for recycling.
5.410.2 Commissioning. For neW buildings 10,000 square feet and over,
buildirtg c6mmissphing for all building systems covered by T24, Pal b,
be included in the
process; systems and renewable energy systems shall
design and. construction processe,s of the building project, Commissioning
requirements shall include items listed I , n Section 5.410.2.
6.410.2.1 Own&s Project Requirements (OPR Doourrienied before the
.
design phase of the project begins the OPIR shall include items listed in
section 5A110A,
5,410.2.2 Basis of Design (BOV), A %vrdten explanation of how the design
of the building systems meets the OPR shall be completed at the design
phase of the building project and updated periodically to cover the systems
listed in Section 5.4110.2.2.
5.410.2.8 Commissioning plan. A commission'Ing plan clesicti,bing Ildw the
projectwill be commissioned shall bestaned dUtlng.the design phase of
EXI
the buIld.Ing project and shall' include items listed in Section 5.410.2,3.
5.410.2.4 Funct . ional performance testing shall demonstrate the correct,
ion andoperation ;of each cornpone'ril., system and system-tc,-
installation
systern interface In accordance. with the approved plans and specifications.
5.4110.2.5 Documentation and training.. A Systems Manual and systems
training'are required..
nx
operations
5.410-2.5.1 Systems Manual. The systems manual shall be delivered. to
the building owner or representative and facilities operator and shall
include the items listed in Section 5.41
5,4'10.2.5,2 Systems operations training, The training Of l4e
appropriate maintenance staff for each equipment type andi'or system
shall include items listed in Section,
6.410.2.6 Commissioning report. A complete report ofcommissi.oning
process activities u.n.derta.ken through the design, construction and
reporting recommendations for post -construction phases of the building
project, shall be completed and provided to the owner or representative..
5.410,4 Testing and adjustirg, Testing and adjusting of systems that[ be
required for buildings less than 10.,000 square f6el.
5.410.4.2 SyMerns. DeMop a written pla.n of procedures for testing and
e0justing'systerilsi Systems to be included for testing and adjusting shall
include, as applicable to the project, the systems listed in Section
5.410.4.3 Procedures. PeHorni testing and adjusting procedures in
accordance with industry best practices and aoplicable national Standards
El
on each system.
5A10A-111 HVAC halancing. Before a. w nespace conditioning system
serving a buildirg or space is operated . for normal use, the system
"be
nx
should balanced in accordance with the procedures defined by
national standards listed in Section 5,410.3.3.1.
pjge 5 Of 4 ( 7n /G) '� i - 'JI kiJJ14?C.V 0 --he 44aiAot, ravisea'6*1274 t
5,504:3 Covering of duct openings and protection.of mechanical
equipment during construction: At !he time of rough installation or during.,
storage on the construction site and until finalstartup of the=heating and
cooling equipment,,all duct and other related air dist6butli.n cc�rripgneni
orenings shall be covered with tape; plastic, stteet,metal or Other methods
acceptable to the "enforcing agency to reduce the amount of dust or debris
hlch h?ay collect in the :system. -
5.504.4 Finish rnaterlal poliutant control: Finish matehals,shall comply with:.
Sections 5.504,4.3 through 5;504,4A.. -
5.504.4.1.Adhes'Nes, sealants, caulks. Adhesives and sealants used on
the projeot shall meet the requirements of the following standards,.
1. Adhesives, adhesive bi hding p'tirn&s, adhesive pruners; seaiants;
Sealant primers anteauiks shag 6. 6nliply with local. oreegional air pollution-.
control.or: air quality management Idistrict.rulles where 'applicable or
SCAOMD Rule 1'68 VOC limits, as shovwh in Table's 5.504.4.1 and
5:504.4.2.
2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or
caulking compounds (in units of;product; less packaging; which do not
wdigh' more than one pound and do not consist of more than 1 B fluid
ounces) shall comply Mth statewide,VOC standards and other
requirements, includlhg prohibitions on use of certain toxic compounds,. cf ..
California Code of.Regfilatio s; Title 17, commencing with Section 94507,
5.504.4:3 Paints and coatings. Architectural paints°and coatings shall
cobiply with Table 5.5014;4:3 unless more stringent local limits apply-
M04.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings
shall meet the Product -Weighted. MIR Limits for ROC in Section
94522(a)(3) and other req&ernents;.including prohibitions on use of
certain toxic compounds and owhe depleting's.rbstances fCCR; Title 17".
Section 94520 et seg)
0;
0 .,
a
701
0
Pty � 6 i f 9 f'rdiji �er� ,'Foil -heti Check'fistdoe rev f.setl"t1 2741, :.
5.419.4.4'Reporting. After ctrinpletmn of testing, adjusting and balancing
provide a..final report, of testing signed by !,he individual responsible f+or .
:...,
performing these senrlce.s
5.410.4.5:Operatian, afid =niairitenanee manual. Provide the,building
6-wher with detailed operating olid "malntenanc6 ins#ructions arid' copios of
'system
gopp antiesAt array ties for eact prior to. final inspection;.
5.410 4.5 9 Ihspecflotis and reports. include a copy of ail nspecticn
verrfloatiohs and reports required by the eriforing agency.
�i.
Fireplaces �
5.5Q3,1 Install only a direct -vent sealed combustion gas Of sealed wood-
,.�
;
burning flq�eplacE orasealed woodsUove and refer to residE�ntiat reguirerrtents
in the California Enorgy Code, Title 24 Part 6, Subchapter 7 Section 150,:.
5.503 1 1:Woodstoves. Modstoves.shill comply with. US EPA Phase'li
f^J ,
emission Iirnit5.
5,504:3 Covering of duct openings and protection.of mechanical
equipment during construction: At !he time of rough installation or during.,
storage on the construction site and until finalstartup of the=heating and
cooling equipment,,all duct and other related air dist6butli.n cc�rripgneni
orenings shall be covered with tape; plastic, stteet,metal or Other methods
acceptable to the "enforcing agency to reduce the amount of dust or debris
hlch h?ay collect in the :system. -
5.504.4 Finish rnaterlal poliutant control: Finish matehals,shall comply with:.
Sections 5.504,4.3 through 5;504,4A.. -
5.504.4.1.Adhes'Nes, sealants, caulks. Adhesives and sealants used on
the projeot shall meet the requirements of the following standards,.
1. Adhesives, adhesive bi hding p'tirn&s, adhesive pruners; seaiants;
Sealant primers anteauiks shag 6. 6nliply with local. oreegional air pollution-.
control.or: air quality management Idistrict.rulles where 'applicable or
SCAOMD Rule 1'68 VOC limits, as shovwh in Table's 5.504.4.1 and
5:504.4.2.
2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or
caulking compounds (in units of;product; less packaging; which do not
wdigh' more than one pound and do not consist of more than 1 B fluid
ounces) shall comply Mth statewide,VOC standards and other
requirements, includlhg prohibitions on use of certain toxic compounds,. cf ..
California Code of.Regfilatio s; Title 17, commencing with Section 94507,
5.504.4:3 Paints and coatings. Architectural paints°and coatings shall
cobiply with Table 5.5014;4:3 unless more stringent local limits apply-
M04.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings
shall meet the Product -Weighted. MIR Limits for ROC in Section
94522(a)(3) and other req&ernents;.including prohibitions on use of
certain toxic compounds and owhe depleting's.rbstances fCCR; Title 17".
Section 94520 et seg)
0;
0 .,
a
701
0
Pty � 6 i f 9 f'rdiji �er� ,'Foil -heti Check'fistdoe rev f.setl"t1 2741, :.
Page7of9 Nor,-Mu(7812711
5.504.4.3.2 Verification. Verificatlon of compliance with this section
shall be provided at the fequest. of the enforcing agency.
5.504.4.4 Carpet systems. All carpet installed in the building interior shall
meet the testing and product requirements of one of thestardrlards listed in
Section 5.504.4.4.
S.SO4,4.4.1 Carpet cushion. All carnet cushion installed in the building
interior shall meet the requirements of the Carpet and Rug. Institute
Green Label program.
5.504.4.4.2 Carpet adhesive, All carpet adhesive shall rmeet the
Table 804.4.1.
17X
0
requirements of
5.504.4.5 Composite wood, products. Hardwood plywood, particleboard
and.medium density fiberboard composite wood products used on the
❑
interlor or exterior of the building shall meet the requirements (or
formaldehyde as specified in Table 5.504.4.
5,504.4.5.2 Documentation. Verification of compliance Wi!h this section
shall be provided as requested by the enforcing agency.. C)acumentation
shall include at least one of Ine folloiNing:
As applicable
ProdUdt certifications and specifications
0
❑
2. Chair, of custody certifications
0
Q
3. Other methods acceptable to the enforcing, agency
5.504.4.6 Resilient flooring systerns. Comply with the VOC-emission
limits.defined in the 2009 CHIPS criteria and listed on its Low -emitting
®
❑
Materials List dor Product Registry) or certified unser the FloorScore
program of the Resilient. Floor Covering Institute.
5.504,5.3 Filters, in mechanically ventilated buildings, provide regularly
occupied aeeas of the building with air filtration media for outside and
❑
return air prior to occupancy that provides at least a MERV of 8-
_6.504.7
6. 504.7Environmental. tobacco smoke (FTS) control. Prohibit smoking
within 2.5 `eet of building entries, outdoor air intakes and operable windows.
where outdoor areas are provided for smoking and in buildings; or as enforced
by ordinances; regulations or polities of any city, county, city and county,
Q
❑
California Community College, campus.of the California State University or
campus of the University of Califbmia, whichever are mere stringent.
indoor hflarsture an;d ladbn Control
5:505.9 Indoor imolsture control. Suildings shall meet or exceed the
provisions of California BWIdirig Coda, CCR, Title 24, Part 2. Sections 1203
❑X ❑
and Chapter 14.1.'
,Air Ub'lhy-and Exhaust_
5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces
in buildings, meet the minimum requirements of Section 121 of the California
®
Q
Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title is or the
appliceble lace) code, whichever is riore Stringent.
Page7of9 Nor,-Mu(7812711
5:506:2 Carbon.dioxide CO2 monitorin Far bu ldin s e qi ed -Kith
� � l3,. 9. Q i�P ,.
sees f ada dr installed tio;1 _CO2 sens&s and ventilation" dontrols shall be
l ventil
p _ in accordance with the:requieements of. the latest edition �`
of the Califarhia Energy Code, CCR; Title 24, Part 6, Section 121(c),'
EnvironrnerEtatCbmfort
6.507.4 Acoustical control. Employ.building assemblies and cornp nems
X
Mth STC value deterrnmed in accordance with ASTfdI E 90 and ASTM E 41-v:
5.547-4.1 Exterior noise'traasmisslon. "fall and floor -ceiling asse nW es
making lip the building envelope shall have an STC of'atleast 50 and
exterior windows, shall have a minimum STC of, 30 for any of the buildingsLI
loeatohs listed in Items 1 ttirougfi 3 in Section 5.507 5.1.;
5.507.4.2'Interi6r"Und. Wall a6df floor -ceiling a'ssembltesseparating
tenant: spaces and tenant spaces and public places shalt have an STC of.
at least 46.
M Sniff
h OU OOr IU U311 ti
5.508.1 Ozone depletion and global warming reductions.lnstallattons of`
HVAC; refrigeration and fire suppression equiprnerit:shall. comply with Sections
5.5os_1.1 and 5-5o8.1.2:, :.
As applicab[e
5,508.1.1 CFCs. Install HVAC and refrigeration equipment tha.t`does:hotEl
contain CFCs.'
5.508.1,2 Halons. Install.fire suppressicn equipment that does riot contain
Halons,.'' ..- ..
1. These' measures are curer lyy racuiredelseviherein statute ar in reguiatior,:
Fuge 8 of w alCi aerr,�`rarr-R. c C'hccklfrr rdnc reUrti3/17F'J7�'l!'
Project [dame'
Project Address:
Project Desclpllon:
CALGREEN, SIGNATURE DECLARATIONS
v2 0 f3oow
SECTION 1— DEISION VERIFICAVON
Complq!i§ oil Hiles of Section I the c6jipl,ted checklist (Poltimrisl end 2y with the
pf6n§ and bbil , Oing permit Oplicafloi) to the Building Depft4nt.
Tfie owner arddesign profess [Dnal responsibleFbT compliance wIth, CalQreen Standards nava revised the plans and
66aify that the jteiiis� chack6d -above are hereby t Kc . o . rpo I r�,!O , d"info ilea,_p�qfat plans er�d "Altil 66 lmpleM-ted into q1nto tha
project w
In aqrdanca 'With the requ[rer�ent§ setf6Ah In the 201 . 0 C Ialiforhia Green Ouilding Standards Code as
a. dop'led by (fie City of Cupertino.
Ow alum1vriej{ date
asbh'PmfeWlon at's Signature
106,3166 profeillOn'.01's Name (Please
of Elie6si Pro'
convilanoe
a61`UceMeProfessional res' onsible for CdOreen complianbe (Pidase Print)
(A'\ 'A A C) e- AV C 6D
I,Addre&'fog U(*nse F(ofesslonal rasp ansibla for CaiGreen compliance
6AT
Date
LAM,1-40 (-ft
Phone
SECVON Op LE.WIEMTAT1QN'VO4t ATIoN,
a
CompIdt6, sign and submit the cornp�teo checOl4f, irxJudIng t'�Iumn 3, together with all original slqnabires on section Im
2 16 the 5611dlnd Dlep4rinrien . 11 1 prlor'46 . dullaln-ig b6' rtnwtiinal160atran,
pa
I hayi! inspected 11he,work and h5V,b do'curnentatfoh 140, verify and certify that the projDct Identified
abo�e Was cohstlrOclod In 6qcordance �Vlh Or, Gfe66 lJuJJ d^lrg`dhiocklisk a"Vid" In 6cc'ord'atice with the requfreff6iils of
lKe 2010 California - Green B I ujJd-Fnq'Siandirds.Co'de at Aldop-11661 by aha Citi of Cupertino.
upertinG.
o niol 1a fica
Name of License Professional responsible for CalGreen campliarice (Fieeise Print), Phara
Email Address tot L[c.-anse Professimal rozoonible for COC -Teen coinplianow
page" 9 6179 01tocklixt, do q revisrd 084711.)
