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2009 Washington State criergy Code Compliance Forms for Nonresidential and Multifamily Residential <br />2009 Washington State Energy Code Compliance Forms for Nonresidential and Multifamily Residential Revised February 2011 <br />Project Info ProjectAddress � — � �,�� Date <br />- cl�. - �-. �- <br />' u.� �����>�� L- For Building Dept. Use <br />C_..t"�%�G"--_ W�c� ' �" �//i' <br />Applicant Name: ��� i !/� .= �` s� f � ' �` <br />ApplicantAddress: 2,j �� �� C <br />Applicant Phone: �t ''c; S2`- - j(� yG <br />Project Description _� c-=�;,�tw �_� Tv,� �g�k�i-G�=`. ;�:�`�� l�C�ct`��(C� (� �� <br />Brieflydescribe mechanical F��- L�� � r��-�=' ��_��"�"{� l <br />system type and features. <br />� Includes Plans Include doc me�tation requiring compliance with commissioning requirements, Section 1416. <br />Compliance Option i� Simple Syste Q Complex System � Systems Analysis <br />ee ecision Fiowchart (over) for qualifications. Use separate MECH-SUM for simple & complex <br />Equipment Schedules The following information is required to be incorporated with the mechanical equipment schedules <br />on the plans. For projects without plans, fill in the required information below. <br />Coolin E ui ment Schedule <br />Equip. Equip Capacity2 OSA CFM SEER Econmizer Heat <br />ID Type Brand Name� Model No.� Btu/h or Econo? or EER �p�U3 Option or Recovery <br />Exce tionfi Y/N <br />�u-t i iZ�t % y ��� 4 ,., �, ._� � Iti� _. � N <br />Heatin E ui ment Schedule <br />Equip. Equip Capacit� OSA cfm Heat <br />ID Type Brand Name� Model No.� Btu/h or Econo? Input Btuh Output Btuh Efficiency4 Recovery <br />Y/N <br />i�l� ( � l 1�-k�� `� �� `�C.% �. L'�'�1v ` 1 ) / $G �%C�' � �� <br />Fan E ui ment Schedule <br />Equip. Equip <br />ID Type Brand Name� Modei No.� CFM gp� HP/BHP Flow Controls Location of Service <br />_� <br />L=�( = ,ii�,:�i' - l� f /-' � , __<sC; z,v ! r' �w% j '� L� % - rz <br />�If available. 2 As tested according to Table 14-1A through 14-iG. 3 If required. 4 COP, HSPF, Combustion Efficiency, or AFUE, as <br />applicable. ' Flowcontrol types: variable airvoluine(VAV), constant volwl�e (CV), or variable speed (VS). � Exception numberfrom <br />