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STATE OFCALIFORN'\ <br />INDOOR LIGHTING @cEc-NRCr-LTr{1-E CAL]FORN Y COMMISSION <br />CERTIFICATE OF INSTALLATION NRCt-LTt-O1-E <br />lndoor Lighting (Page 2 of 2) <br />'***"^"Yz L -c 5A <br />.eilL-u/),,^ <br />DOCUMENTATION AUTHORS DECLARATION STATEMENT <br />1. I certifythat this Certificate of lnstallation documentation is accurate and complete <br />N#HZY.Dtdz ocumenration Author 5i!*{z%- <br />06uftntation autho, comenv tlare:L\F.*_ 15L1 / oArS /a{oaessFa: / . t ,v/ 1 //c) <br />E-"-,,A.^,- -f,..1 ZZ/"27-.s-cE certr'fotioi'ld{nt*tration{rrapplicable): <----,-/ <br />''"EiE!:- L- A.^- a4 ?,ru/fuz 813 37>\ <br />RESPOI,ISIBLE PERSOT!'S DECI-ARATION STATEMENT <br />I certify the following under penalty of perjury, under the laws ofthe State of California: <br />1. The information provided on this Certificate of lnstallation is true and correct. <br />2. I am eligible under Division 3 of the Business and Professions code in the applicable classification to accept responsibility for the <br />system desiSn, construction, or installation offeatures, materials, components, or manufactured devices for the scope oI work <br />identified on this certificate of lnstallation and attest to the declarations in this statement (responsible builder/installer), <br />otherwise I am an authorized reprgentative ofthe responsible builder/installer. <br />3. The constructed or installed features, maerials, components or manufactured devices (the installataon) identified on this <br />Certificate of lnstallation conforrE to all applicable cod6 and regulations, and the installation conlorms to the requirements <br />given onthe plans and specifications approved by the enforcement agency. <br />4. I reviewed a copy ofthe Certificate of Compliance approved by the enforcemenl agenry that identifies the specific requirements <br />forthe scope of construction or installation identified on this Certificate of lnstallation, and I have ensured that the requirements <br />that apply to the construction or innallation have been met. <br />5. lwill ensurethat a completed signed copy of this Certificate of lnstallation shall be posted, or made available whh the buildinS <br />permit(s) issued for the buildin& and made availableto the enforcement agencyfor allapplicable inspections. I understand that a <br />completed signed copy of this Certificate of lnstallation is required to be included with the documentation <br />the building owner at occupancy <br />th)Fler wovidesto <br />Resoonsible Build€./l.sbrl.r Nam:UUL\ 3 .>TZ <br />n*no,sture o,ir*,rr"'t"&xiegF(<\ //Z(grnlirnv!Jlm: ('ier.rrr.t s{bcontr.cbr o' G.E6, cdE .tor or Buttdd/ow4.-\ < i<4 / J,--, s ltv--*Yil\:X* <br />***" y2i-p Sftr,J,-+Ae \-rilAn*SHE- ft.-- Cn frz /"nv"rz ?7+ Y?"4**?// //i <br />CA BuildinS Energy Efficiency Standards - 2013 Nonre5idential Compliance May 2015 <br />Pbi'di'm': J-/zr.-u.ctl,--3 a/ lt -- - /-Q