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%19: <br />State Nonresidential Energy Code Comollance Form <br />2006 WrrWrVM Sim NonreuE0mu1 E1419r CM* Ccmphmm Fo,mr <br />Project Info <br />Project Address im co AmRicA, rNc. <br />Date 12/9,12008 <br />120-e0th et. ae <br />For Building Dept. Use <br />twrett, MA 90207 <br />Applicant Name'. aerrre Sechier <br />Applicant Address. 6602 B. 220th et., (tent, NA 9e032 <br />Applicant Phone. (/25)251-9e40 <br />Project Description Replace existing AC-1(15-ton) rooftop gas packaged unit with new 15-ton rooftop <br />Briefly describe mechanical unit with adapter curb and economizer. <br />system type and features. <br />❑ Includes Plans Include documentation requiring compliance with commissioning requirements, Section 1416. <br />Compliance Option * Simple System O Complex System Q Systems Analysis <br />(See Decision Flowchart (over) for qualifications . Use separate MECHSUM for simple 6 complex systems.) <br />Equipment Schedules <br />The following information Is required to be Incorporated with the mechanical equipment schedules on the <br />plans. For projects without plans, fill In the required Information below <br />Coolin Equipment Schedule <br />Equip. <br />ID <br />Brand Name' <br />Model No <br />Capacity' <br />Btu/h <br />Total CFM <br />OSA CFM <br />or Econo7 <br />SEER <br />or EER <br />IPLV1 <br />Location <br />Ac-1 <br />TPA= <br />vcdlec <br />182000 <br />6000 <br />ECONO <br />9.7 EEA <br />noor <br />Heating Equipment Schedule <br />Equip. <br />ID <br />Brand Name' <br />Model No <br />Capacity' <br />Btu/h <br />Total CFM <br />OSA cfm <br />or Econo7 <br />Input Btuh <br />Output Bluh <br />Efficiency' <br />Ac-1 <br />TRAM <br />Y=19D <br />210000 <br />6000 <br />ECONO <br />250000 <br />210000 <br />0.840 <br />Fan Equipment Schedule <br />Equip. <br />t0 <br />Brand Name' <br />Model No <br />CFM <br />SP' <br />HP/BHP <br />Flow Control' <br />Location of Service <br />'If available. 7 As tested according to Table 14.1A through 14.1 G. 1 If required. ' COP, HSPF, Combustion Efficiency, or AFUE, as <br />applicable. 5 Flow control typesvariable air volumelVAV), constant volume (CV), or variable speed (VS). <br />