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-006 W� -_ ton State Nonresidential Ener Code Ccrn ce �orm <br />` _ _�_ _i� - - <br />' !'OC6 Nlashington g!ata Ncnres:denti=.l cnerg;i Ccde Compliancz Forms <br />�' �I'OJECt addf255 <br />Ncainc Ever�tt - WWTP and 45-08 <br />The foilowing �dditional information is nec2ssary to check a mechanical permit application for a compiex <br />� mechanical systflm for compliance ��ith the mechar�ical requira��er.s in th2 LVastiinytor� State Nonresider�tial <br />� tnergy Code. Use the checklist as a r�ference for notes added to the mechanical drawings {see the MECH- <br />' CHK checklist for additional system requirements). This information must be on the plans since ihis is the <br />' official record of the permit. Having this information in separate specifications alone is NOT an acceptable <br />i alternative. <br />i <br />�Applicability Ccde <br />(yes, no, n.a.) Section Component Information Required <br />ADDITIONAL CHECKLIST lTEMS FOR COMPLEX SYSTENlS ONLY <br />a. <br />? 431.1 Field assem_ sys. Provide calculations <br />yes 1432.1 Setback & shut-off indicate separate systerns or show isolation devices on plans <br />,Yes 14322.1 Air system reset Indicate automatic reset <br />n.a. <br />yes <br />n.a. <br />n.a. <br />yes <br />yes <br />1432.22 �Hydrenic System <br />1433 �Air Econornizer <br />1433 I W ater Economizer <br />1434 Separate air sys <br />1435 Simul. htg. & clg <br />1436 �Heat recovery <br />yes 1437 Elec. motor effic. <br />'� a� 1438 Variable flow sys. <br />n � 1439.1 Kitchen Hoods <br />I1 _ a- 1439.2 Fume Hoods <br />Af "no" is circled for any question, <br />:� 1_��'.�JI'�)IZ i �i)�'VL11t7� t <br />�rt Here <br />Indicate automatic reset, cooling tower, & heat pump loop valves <br />Indicate economizer on equipment schedule or provide <br />calculations to justify exemption and demonstrate 10% higher <br />efficiency for equipment with out economizer. <br />Indicate water economizer and provide calculations if 1433 <br />Exception 2 is utilized <br />Indicate separate systems on plans <br />Indicate that simultaneous heaiing and cooling is prohibited, <br />unless use of exception is justified <br />Indicate heat recovery on plans; complete and attach heat <br />recovery calculations <br />MECH-MOT or Equip. Schedule with hp. rpm, efficiency <br />Indicate variable flow on fan and pump schedules <br />Indicate uncooled and unheated rnake-up air <br />Indicate VAV, unheated/uncuoled or heat rec. makeup <br />�vide expiaraatiora: <br />Revlsad July ?007 <br />Dai� g/12/2011 <br />For Building Department Use <br />Location Building Department <br />on Plans Notes <br />M503 <br />M503 <br />M503 <br />03/ M2 <br />/ 230000 <br />U�� �f i ��;,�,i� .r��, u. �.�. . .._ . � . �.,_ �� ct [I ��i,cl.:: .�,�_�e� i C�pcu� _���_r,� ,� <br />the pro�ect. Refer to the indicated Code sections For more complete information on the <br />requirements. <br />:i r� r �r iae�c� �. �. "V�I r=ce. , Any Fuel Fur�a�a _ .-�Field-A�semoled �� ir S�sten� .�+�a�:a.�,� c" -1 v <br />► input= �5000 '� NS>-' Np� �> No--K� Sennn NIulGnls '-iJo B��Heatin S stem � <br />_ ilNlcetTaLl�� , � in��1t� 25000,� EquipmPnt' 7ones^ �300,QOCBtuh� � �j <br />?tuh ^r � -� nj� �� <br />�._ � , Yes Yes , Yes No <br />-��_ . 'J _ -__. - ---�--..... � . <br />T_ . - -- _ _T—__ <br />Intermittent ', � Section 1431.1 � ; Section 14322.2 Hot I <br />n;tion Gevice W i Calculations of Tota� Sectien 143221 4Vater Supply <br />;wer Venting or 1411.1 0. i5 % On-Site Energy Inpul Supply Air P,eset - Temperature Reset <br />_:mper. If input : Maximum Jack�t 8 Guput P.eqwred Controls P,equired P.equired <br />�.0�0 Btuh then Los; <br />' ? 6 i�lodulatiny er i _ _ <br />.,i=d Cambusticn I <br />__ , <br />c.,„ r �. <br />(continued on backi <br />r <br />/ <br />' a <br />� <br />