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2012 Washington State Energy Code Compliance Forms for Commercial Buildings including R2 & R3 over 3 stories and all R1 Revised Jan 2014 <br />Project Info ProjectAddress A-Wing -8th Floor Date 3/27/2015 <br />Compliance 1321 Colby Avenue For Building Department Use <br />forms do not <br />require a Everett, WA 98201 <br />password to Applicant Name: P�ovidence Re ional Medical Center - Everett <br />use. 9 <br />Instructional and Applicant Address: <br />calculating cells <br />are write- Applicant Phone: <br />Project Description New Building Addition Alteration Plans <br />Lighting Compliance Path • Lighting Power Density Calculations Total Building Performance <br />(If Total Building Performance then only LGT-CHK is required.) <br />Lighting Power Allowance � guilding Area Method Space-By-Space Method <br />Method Selection required to <br />enable LPA forms <br />Interior Lighting System Existing floorspace is being repurposed and renovated to create a Hospice wing on the 8th <br />DeSCTiption floor. Existing flourescent fixtures and local lighting controls will be replaced with new LED <br />fixtures and new local/automatic controls. <br />Briefly describe lighting <br />system type and features. <br />Additions and Change of Space Use (C101.4.3 & C101.4.4) <br />Addition area or Change of Space Use area complies with all applicable provisions as stand alone project <br />Addition area is combined with existing buiiding lighting systems to demonstrate compliance with all applicable <br />provisions per C101.4.3 <br />Provide Building Area Method (LTG-INT-BLD) or Space-By-Space Method (LTG-INT-SPACE) Compliance Form. Document maximum <br />allowed and proposed (including existing if applicable) lighting wattage of Addition or Change of Use space. Provide applicable lighting <br />controls per C405.2 and commissioning of lighting controls per C405.13. <br />Alterations, Renovations and Repairs (C101.4.3.1) <br />00% or more of luminaires in space replaced <br />Provide Building Area Method (LTG-INT-BLD) or Space-By-Space Method (LTG-INT-SPACE) Compliance Form. Document maximum <br />allowed wattage within the lighting retrofit space in Maximum Allowed Wattage table and proposed (including existing) lighting wattage in <br />Proposed Wattage table. Retrofit and non-retrofit spaces shall be documented separately using multiple forms. <br />Less than 60% of luminaires in space replaced <br />Provide a separate Space-By-Space Method (LTG-INT-SPACE) Compliance Form for this retrofit area. Document existing total wattage <br />within the lighting retrofit space in cell provided in the Maximum Allowed Wattage table. Document proposed (including existing) lighting <br />wattage in the Proposed Wattage table. <br />Lamp and/or ballast replacement within existing luminaires only — existing total interior building wattage not increased <br />New wiring installed to serve added fixtures and/or fixtures relocated to new circuit <br />Provide applicable manual lighting controls (C405.2.1), occupancy sensors (C405.2.2.2), daylight zone controls (C405.2.2.3), specific <br />application controls (C405.2.3), and commissioning of lighting controls per C405.13 <br />New or moved lighting panel <br />Provide all applicable lighting controls as noted for New Winng, automatic time switch controls (C405.2.2.1), and commissioning of lighting <br />controls per C405.13. <br />Space is reconfigured - luminaires unchanged or moved only <br />Provide all app/icable lighting controls as noted for New Winng and commissioning of lighting controls per C405.13. <br />�lo changes are being made to the interior lighting and space use not changed. <br />