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i <br /> • 1994 Washington State Nonresidential Energy Code Compliance Form <br /> . . <br /> '.%�Ann,ng�on Sute E��,q�Coae Como���nce co,ms �q'� ��� <br /> Pro�ttt AEtlress D�te <br /> The loilovnng�nlormation is necessary to c�eck a mechanical permA appLcation foi tompliance wrth ihe mecnankal requirements in the <br /> Washmgton State fJonresiCemial Energy CoAe. <br /> AGP��caD�lrty CoOe locahon ButlEing Department <br /> lurcie onel Sechon Componenl Inlormahrn Reqwred on Plans Notes <br /> ections <br /> 1411 Eq mt ertormance <br /> es no �a 1411 d Pk eleC M 8 r,l Lis�heal um 5 on SLheGule <br /> e5 no n a 1411 1 Mimmum elilcienc E wpmeN SCheCule with e.ca aC ,eff¢ienC <br /> 1412 HVAC Conlfol5 <br /> es no �a 1412 7 Temperalure zones Intl¢ate loGahons on lans <br /> es no n a 1412 2 DeaabanC control inaicare 5 tle ree CeaG6anC minimum <br /> es no n a 1412 3 Humiai tonirol Intlicate humitlistat <br /> e5 n0 �B 7412 S pNomat¢5eiback IndiCa�e Iherm05ta1 wdh m hi se�back an0�adferent tla 5 <br /> es no �a 141:d 1 Dam ers Ind¢ate Oam er iocahon an0 automabc controls <br /> es no n a 1C7�5 Heat um conifol Ind¢ate micro ro[essor on Ihermostat sche4We <br /> es no �a 1d1.'6 Combushon ht ��dicate modulahn or sla ed conirol <br /> es no �a 1a12 i Balancm Indicate balanun IeaWres on lans <br /> es no �� 1422 Thermosta�mte�lock InEicaie thermostat mlerlock on lans <br /> es no n a ta23 Economizers Eaummem schetluie <br /> ta13 Aueconomi.-ers <br /> es �o n a 1413 1 Gperation ��Eicate 100°M ca abili on schedule <br /> es no n a +413 2 Cor.vol Inmcate controis aCle to evaluate oWside an <br /> e5 no �a 7413 J Intebrated operati0n IntliCale caDdbih lOr partial Coolm <br /> 141d DUCIin 5 StCms <br /> es no n a 1a14 1 Duct sealin Ind¢ate sealin necessa <br /> es no n a ta1 d� Duct insulahon �ntlicate R-�alue ol msulahon on dud __ <br /> es no �a 1415 1 Pipin insulalion InA¢ate R-�aNe ol insulahon on i m _ __. _ __ <br /> es no n a 1424 SeDarate an 5 5 InOitate 5e araie 5 Siems on lan5 „,�., <br /> yes no Mecn Sum Form Completed and attached Equipment schedule with lypes. <br /> inpuVout ut.e!(oencv,clm.h ,econom¢e� ___ <br /> ections <br /> 1.740 Ser.ice water ht <br /> es no n a 1441 Eiec water heater Intl�cate R-10 msulalion unCe�tank <br /> es no n a 1d42 Shui-oll Con�rols Intlitate autOmaiic Shuboff <br /> 1450 Heated ools <br /> es no n a 1452 Pool vrater heaters Indicate not electnc resistance <br /> es no n a 1453 Pool heater controls ��d¢ate switch and 65 Oe ree conlrol <br /> es no �a ta5� Pool covers ��dmate vapor relardant cove� <br /> ves no �a idSd Pa��s 90�Ae rees Intl¢ate R-12 00l ccver <br /> no is circ e or any question, provi e exp anation: <br /> I� <br /> �f <br />