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� 2004 Washin ton State Nonresidential Ener Code Com liance Form <br /> • • � ' <br /> =061 Washrtglm Slale Norvos�aonlial Er�ergy GMo ComD�iarce Forms Rovrsed MaY z005 <br /> Pro�edAddress �c / ea�c I.dmannatration Buildinq Date OS/14/2009 <br /> The lollowing additional infortnation is necessary to check a mechanical permit application for a complex For Building Depariment Use <br /> mechanical system for compliance with Ihe mechanicat requirements in the Washinglon State Nonresidential <br /> Energy Code. Use the checklist as a reference for�otes added to the mechanical drawings(see the MECH- <br /> CHK checklist tor additional system requirements). This information must be on the plans since this is the <br /> oKcial rewrd ot the pertnit. Having this information in separete specifiwtions alone is NOT an acceptable <br /> altemative. <br /> Applicability Code Lowtion Building Department <br /> (yes,no,n.a.) Section Componenl I�fortnation Required on Plans Notes <br /> ADDITIONAL CHECKLIST ITEMS FOR COMPLEX SYSTEMS ONLY <br /> '°' 1431.1 Fie�d assem.sys. Provide calculalions <br /> yea 7q�p,7 Setback 8 shutolt Indicate separate systems or show isolation devices on plans M-o.2 <br /> yes 14322.1 Air system reset Indiwte automatic reset n-o.2 <br /> yes 14721.2 Hydr.system reset Indiwte aulomatic reset M-o.2 <br /> Indicate economizer on equipment schedule or provide <br /> yea 1433 Air Economizer wlculations to justily ezemption and demonstrate 10°h higher t�-o.2 <br /> eKciency for equipment wilh out econ�mizer. <br /> n.a. 1433 Water Economizer Indlcate water economizer and pmvide caiculations it 1433 <br /> Exceptior.2 is utilized <br /> n.a. 1434 Separate air sys. Indicate separate syslems on plans <br /> yas 1435 Simul.htg.&clg. Indiwte that simullaneous heating and cooling is prohibited, M-o <br /> unless use of ezception is justified <br /> n.a. 1436 Heat recovery Indlwte heat recovery on plans;wmplete and atlach heat <br /> recovery calculalions <br /> ya' 1437 Elec.motor effic. MECH-MOT or Equip.Schedule with hp,rpm,efficiency ATTACH <br /> yea 1q38 Variable Ilow sys. Indicate variabte flow on fan and pump schedules rt-o.1 <br /> n.a. 1439.7 Kllchen Hoods Indicate uncooled and unhealed make•up air <br /> n.a. 1439.2 Fume Hoods Indicate VAV,unhealedluncooled or heat rec.makeup <br /> no is c�rc e or any question, provi e exp ana ion: <br /> Decision Plowchart Use this fiowchart to delertnine how lhe requirements of the Complez Systems Option apply <br /> to lhe project. Refer to the indiwted Code sedions tor more complete information on the <br /> requirements. <br /> � SIaA li�rc . <br /> I/ I <br /> � � <br /> ' Soclwnl�ll.l '' ' `.. , �• <br /> [pmpmenlFliKicncy'� � GasIOilFumete�, KipMAasemEkA �'+Syslem ,__. LepadlyafMW : <br /> SIuiIlMcclTades ��—� >375.000'OIuM � �—N��!-'M EQmpmenl7� -' ';`�--� $mipMWtipe �- -N ► Ncahn9System� <br /> 1�.1AI�muUhlt-1Q� . � I . Zones9 , P 6UO.00DBIuh <br /> J f <br /> Yes� ✓ I� YI I IYes ✓ II I Yes No <br /> . f . . -_ _ i�� .C__— � � � �_ _ t_ <br /> ini.timem�u.m � '�. <br /> � 'i Ipnitron Ocv¢e 8 ' � Sallon I�71.I � � � �� � �Sectwn N72 22 Hol � <br /> j Pavtt Venbrg or � Cakubtrons d Tolal I , Seclun 1A22 1 Wulct SupPN , <br /> i — I �S�e Enerpy InW�• — � SuppY ar Resel � . TemperaNre Resel <br /> Dampec OJS% <br /> Moumum Jxke� �- , d Ouput ReQWrtA �� Canlrols Repurted Repu�e0 � <br /> �. Loss , � '' . � <br /> 1412.6MOCUI�IiM w � ,� � `--'_--_� -- _— . . : ._ . . i <br /> SlapeECanCuslun �� , I <br /> Contrds Reqwred�- <br /> . . . _ . � --_— ___ '_ ..�. . . . . <br /> '__._. . ._. ... —"'_�,�� <br /> �, �� (mntinuecl on bad) <br /> � -- -- .. l G <br /> � <br />