10-0857 (MECH)I, --.,-i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Appljcatiori'ki -
10=00000857.
Property Address:
7844,71`HIGHWAY 111 SUITE D
APN:
604-050-016-5 -000000-
Application description:
MECHANICAL
Property Zoning:
COMMUNITY COMMERCIAL
Application valuation:
15000
Applicant:
GIAr✓Ti��gQ .
c&ht 4 4a "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
1
Architect or Engineer:
-"OJN p /. 07'AgD
* waq
Owner:
HARSCH INV. REALTY
1121 SW SALMON ST #4TH
PORTLAND, OR 97205
Contractor:
APEX AIR CONDITIONING
PO BOX 232
DESERT HOT SPRINGS, CA
(760)251-6610
Lic. No.: 830097
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/07/10
OCT 112010
CITY OF u QUWA
FW,k4 E 06PT.
& REFR
92240
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business a P essionals Code, and my License is in full force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C20 -Q8 8
License No.: 830097
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
,� //ry�j��
V// Date— &x I_ Contractor:
e.
issued.
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
• OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier SOUTHERN INS Policy Number WS1003954702
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California, .
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I sho oj�e subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labo ode, �I r wi mply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
/ \ /► r,
Vbate: t!V "Applicant: - /,F_,•¢�1a/yC.-
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
( 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.). '
( ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERDIIT
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
.2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state on
relating to building c 6n, and hereby authorize representatives
of this cou y/oAente upon the above-mentioned grope r i on p poses.
Date CU Signature (Applicant or Agent):
Application Number .
. . . . 10-00000857
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
162.00 Plan Check Fee
.105.30
Issue Date
Valuation . . . .
15000
Expiration Date
4/05/1.1
Qty Unit Charge
Per
Extension
BASE FEE
45.00
13.00 9.0000
---------------7------------------------------------------------------------
THOU BLDG 2,001-25,000
117.00
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
42:50 Plan Check Fee
10.63
Issue Date . . . .
Valuation . . .
0
Expiration Date
4/05/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 11.0000
EA MECH FURNACE >100K
11.00
1.00 1'6.5000
EA MECH B/C >3-15HP/>100K-500KBTU
-
16.50
---------------------------------------------------------------------------
Special Notes and Comments
ADD ROOF TOP AC UNIT
(7.5 TON) FOR
FUTURE TENANT. ROOF REINFORCEMENT
PER
ENGINEERED PLAN. 2007
CBC. (ELECTRICAL &
DUCTWORK NOT A PART OF
PERMIT)
---------------------------------------------------------=------------------
Other• Fees. . . . .
. . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - COM
3.15
Fee summary Charged
------------------ ----------
Paid Credited
---------- ---------- ----------
Due
Permit Fee Total
204.50 .00 .00
204.50 .
Plan Check Total
115.93 .00 .00
115.93
Other Fee Total
4.15 '.00 .00
4.15
Grand Total.
324.58 .00 .00 .324.58
LQPERMIT
.CERTIFICATE OF COMPLIANCE and
FIELD INSPECTION ENERGY CHECKLIST (Pagel of 5) MECH-1C
Project Name: FIVE GUYS BURGERS AND FRIES
Date: -
AUG. 2, 2010
Climate Zone:
15
Project Address: 78-447 HIGHWAY 111 SUITE 447D, LA QUINTA, CA
Conditioned Floor
Area: 2,530
General Information
Building Type: ® Nonresidential ❑ High -Rise Residential ❑ Hotel/Motel Guest Room
❑ Schools (Public School)13 Relocatable Public School Bldg. ❑ Conditioned Spaces ❑ Unconditioned Spaces
Phase of Construction: ❑ New Construction Addition ® Alteration
Approach of Compliance: ® Component ❑ Overall Envelope TDV Energy ❑ Unconditioned (file
affidavit
Front Orientation: N, E, S, W or in Degrees:
NE
HVAC SYSTEM DETAILS
FIELD INSPECTION ENERGY CHECKLIST
E ui menti
Inspection Criteria
Meets Criteria or Requirements
Special Feature' Pass Fail - Describe Reason
Item or System Tags
(i.e. AC -1, RTU -1, HP -1)
B3&B4 / RTU -1
-
❑ ❑ ❑
EquipmentT e4:
GAS ROOFTOP UNITS
❑ ❑ ❑
No of S sterrffi
1
, ❑ ❑ ❑
Max Allowed Heating Capacity
59.0 / 144.0 MBH
❑ 13 -
Minimum Heating Efficient
80%
Max Allowed Cooling Capacity
41.0 93.0 MBHG
Cooling Efficiency
13.0 12.5 EER
❑'ClyDERr
Duct Location/ R -Value
R-4.2
❑ U 151 ❑
Duct Leakage Testing - If Yes, a
MECH-4A must be submitted
N/A
❑ " rR CTO ❑
Economizer.
YES
to ❑
Thermostat
YES
O ❑
Fan Control
N/A
❑ ❑
Equi ment2
Inspection Criteria
FIELD INSPECTION ENERGY CHECKLIST
Special Feature
Pass
Fail - Describe Reason3
Item or System Tags
p.e. AC -1, RTU -1, HP -1)
MAU-1
❑
❑
❑
Equipment T e°:
MAKE—UP AIR FAN
❑
❑
❑
No of Systems
1
❑
❑
❑
Max Allowed Heating Capacity
NO HEAT
❑
❑
❑
Minimum Heating Efficient
NA
❑
❑
❑
Max Allowed Cooling Capacity
NA
❑
❑
❑
Cooling Efficiency
NA
❑
❑
❑
Duct Location/ R -Value
ABOVE CEIL/R-4.2
❑
❑
❑
Duct Leakage Testing - If Yes, a
MECH-4-A must be submitted
N%A
13
❑
❑
Economizer
N/A
❑
❑
❑
Thermostat
. N/A
❑
❑
❑
Fan Control
N/A
❑
❑
❑
1. Indicate special feature DETAILS on Page 2 of the Inspection Checklist Form.
2. If the Actual installed equipment performance efficiency and capacity is less than the Proposed (from the energy compliance submittal or fro
the building plans) the responsible party shall resubmit energy compliance to include the newchanges. l (
3. For additional detailed discrepancy use Page 2 of the Inspection Checklist Form. D ,
4. Indicate Equipment Type: Gas(Pkg or, Split), VAV, HP (Pkg or split), Hydronic, PTAC, or other Iii} CCD n q n1n
2008 Nonresidential Compliance Forms
if Vf
� 10
August 2009 ;
CERTIFICATE OF COMPLIANCE and
FIELD INSPECTION ENERGY CHECKLIST (Page 2 of 5) MECH-1 C
Project Name: FIVE GUYS BURGERS AND FRIES Date: AUG. 2, 2010
SPECIAL FEATURES INSPECTION CHECKLIST
The local enforcement agency should pay special attention to the items specified in this checklist. These items require special written:
justification and documentation, and special verification. The local enforcement agency determines the adequacy of the justification,
and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation
submitted.
RTU B3 AND B4 ARE EXISTING TO REMAIN. NEW DUCTWORK WILL BE ATTACHED TO THE EXISTING RTU AT THE
RETURN AND SUPPLY DUCT OPENINGS. EXISTING SMOKE DETECTORS ARE BEING REUSED. VENTILATION AND SUPPLY CFM
TO BE REBALANCED.
Discrepancies:
CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 3 of 5) MECH-1C
Project Name
Date
FIVE GUYS BURGERS AND FRIES
AUG. 2, 2010
Required Acceptance Tests
Designer:
This form is to be used by the designer and attached to the plans. Listed below are all the acceptance tests for mechanical systems. The designer is required to check the
applicable boxes by all acceptance tests that apply and list all equipment that requires an acceptance test. If all equipment of a certain type requires a test, list the
equipment description and the number of systems. The NA number designates the Section in the Appendix of the Nonresidential Reference Appendices Manual that
describes the test. Since this farm will be part of the plans, completion of this section will allow the responsible parry to budget for the scope of ivork appropriately.
Enforcement Agency:
Systems Acceptance. Before occupancy permit is grantedfor a newly constructed building or space, or a new space-conditioning system serving a building or space is
operated for normal use, all control devices serving the building or space shall be certified as meeting the Acceptance Requirementsfor Code Compliance.
Systems Acceptance. Before occupancy permit is granted All newly installed HVAC equipment must be tested using the Acceptance Requirements.
The UEC'H-1 C form is not considered a completed form and is hot to be accepted by the building department unless the correct boxes are checked. The equipment
requiring testing, person per; forming the test (Example: HVAC installer, TAB contractor, controls contractor, PE in charge of project) and what Acceptance test must be
conducted. The following checked-offfor•ms are requiredfor ALL newly installed equipment. In addition a Certificate of Acceptance forms shall be submitted to the
building department that certifies plans, specifications, installation certificates, and operating and maintenance information meet the requirements of§10-103(6) and Title
24 Part 6. The building inspector must receive the properlyfilled out and si ned or•ms before the building can receivefinal occupancy.
Test Descri tion
MECH-2A
MECH-3A
MECH-4A
MECH-5A
MECH-GA
MECH-7A
MECH-8A
MECH-9A
MECH-10A
MECH-11A
Outdoor
Ventilation
Constant
Demand
Hydronic
for
Volume &
Air
Control
Supply
Valve
System
Automatic
Equipment Requiring Testing or # of
VAV &
Single-Zone
Distribution
Economizer
Ventilation
Fan
Leakage
Supply Water
Variable Flow
Demand Shed
Verification units
I CAV
Unitary
Ducts
Controls
DCV
VAV
Test
Temp. Reset
Control
Control
AC 2
❑
Q
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
13
1 ❑
1 ❑
❑
❑
1 ❑
1 ❑
1 ❑
1 ❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
I ❑
1 ❑
❑
❑
❑
❑
❑
❑
2008 Nonresidential Compliance Forms August 2009
CERTIFICATE OF COMPLIANCE and FIELD INSPECTION ENERGY CHECKLIST (Part 4 of 5 ) MECH-1C
Project Name FIVE GUYS BURGERS AND FRIES
Date AUG. 2, 2010
Test Description
MECH-12A
MECH-13A
MECH-14A
MECH-15A
Equipment Re uirin Testing
# of
Fault
Detection &
Diagnostics
for DX Units
Automatic Fault
Detection &
Diagnostics for
Air & Zone
Distributed
Energy Storage
DX AC
Systems
Thermal Energy
Storage (TES)
Systems
Test Performed By:
RTU
3
0
0
0
o
GENERAL CONTRACTOR
MA -1
1
❑
❑
0
0
GENERAL CONTRACTOR
0
0
0
0
0
❑
o
❑
0
❑
0
❑
0
❑
❑
❑
o
❑
❑
o
O
0
0
❑
O
❑
O
O
O
0
❑
O
❑
o
❑
o
❑
❑
❑
o
0
❑
O
o
❑
❑
❑
o
❑
❑
O
❑
❑
❑
O
❑
❑
❑
❑
O
0
0
❑
o
0
0
0
0
o
❑
❑
o
❑
0
0
0
C3
❑
0
❑
❑
❑
❑
o
0
0
❑
o
O
0
O
❑
0
❑
❑
❑
0
❑
O
❑
2008 Nonresidential Compliance Forms - Auauct 2009
CERTIFICATE OF COMPLIANCE and
FIELD INSPECTION ENERGY CHECKLIST (Part 5 of 5) MECH-1C
Project Name:
Date:
FIVE GUYS BURGERS AND FRIES
AUG. 2, 2010
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate anomplete.
Name: JUSTIN HARDY
Sign
Company: GREENBERGFARROW
Date: AUG 2, 2010
Address:
If Applicable
1430 WEST PEACHTREE STREET, N.W., SUITE 200
CEA #
CEPE #
City/State/Zip ATLANTA, GA 30309
Phone: 404-601-4000
Principal Mechanical Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the mechanical
design.
• This Certificate of Compliance identifies the mechanical features and performance specifications required for compliance with
Title 24, Parts 1 and 6 of the California Code of Regulations.
• The design features represented on this Certificate of Complianceare onsistent with the info tion provided to document
this design on the other applicable compliance forms, worksheets, calcu tions, plans d speci cations submitted to the
enforcement agency for approval with this building permit application.
Name: JUSTIN HARDY
Signature.
Company Name: GREENBERGFARROW
Date: AUG. 2, 2010
Address:
License #
1430 WEST PEACHTREE STREET, N.W., SUITE 200
M34196
City/State/Zip ATLANTA, GA 30309
Phone: 404-601-4000
Mandatory Measures
Indicate location on building plans of Note Block for Mandatory Measures
MECHANICAL COMPLIANCE FORMS & WORKSHEETS check bog if worksheet is included
For detailed instructions on the use of this and all Energy Efficiency Standards compliance forms, refer to the 2008 Nonresidential
Manual Note: 77te En rceinentAgency may require all orms to be incorporated onto the building lads.
13 MECH-1C Certificate of Compliance. Required on plans for all submittals.
® MECH-2C Mechanical Equipment Summa is required for all submittals.
13 MECH-3C Mechanical Ventilation and Reheat is required for all submittals with mechanical ventilation.
(11 MECH4C Fan Power Consumption is required when for all prescriptive submittals.
2008 Nonresidential Compliance Forms August 2009
AIR SYSTEM REQUIREMENTS (Part 1 of 3 MECH-2C
PROJECT NAME: FIVE GUYS BURGERS AND FRIES
DATE:
AUG. 2, 2010
Item or System Tags
(i.e. AC -1, RTU -1, HP -1)
Indicate Air Systems Type (Centrad Single Zone, Package, VA V or etc...)
RTU
MA
No. of Systems
3
1
MANDATORY MEASURES
Heating Equipment Efficiency
Cooling Equipment Efficiency
HVAC or Heat Pump Thermostats
Furnace Controls/Thermostat
Natural Ventilation
Mechanical Ventilation
VA V Minimum Position Control
Demand Control Ventilation
Time Control
Setback and Setup Control
Outdoor Damper Control
Isolation Zones
Pipe Insulation
Duct Insulation
PRESCRIPTIVE MEASURES
Calculated Design Heating Load
Calculated Design Cooling Load
Fan Control
DP Sensor Location
Supply Pressure Reset (DDC only)
Simultaneous Heat/Cool
Economizer
Heat and Cool Air Supply Reset
Electric Resistance Heating'
Heat Rejection System
Air Cooled Chiller Limitation
Duct Leakage Sealing. If Yes, a
MECH4-A must be submitted
Indicate Page Reference on the Plans or Schedule list or list
information below
T-24 Sections
112(a)
M-3
N/A
112(a)
M-2
N/A
112(b), 112(c)
M-1, M-3
N/A
112(c), 115(a)
N/A
N/A
121(b)
N/A
N/A
121(b)
M-3
N/A
121(c)
N/A
N/A
121(c)
N/A
N/A
122(e)
M-4
N/A
122(e)
N/A
N/A
122(f)
N/A
N/A
122(g)
N/A
N/A
123
N/A
N/A
124
M-0
M-0
144(a & b)
N/A
N/A
144(a & b)
N/A
N/A
144(c)
N/A
N/A
144(c)
N/A
N/A
144(c)
N/A
N/A
144(d)
M-4
N /A
144(e)
M-4
N/A
144(f)
N/A
N/A
144(8)
N/A
N/A
§144 (h)
N/A
N/A
§144 (i)
N/A
N/A
144(k)
N/A
N/A
1. Total installed capacity (MB1u/hr) of all electric heat on this project exclusive of electric auxiliary heat for heat pumps. If electric heat is used
explain which exception(s) to $144(g) WI ,
SERVICE HOT WATER & POOL/SPA REQUIREMENTS
art 3 of 3 MECH-2C
PROJECT NAME:
DATE:
FIVE GUYS BURGERS AND FRIES
AUG. 2, 2010
Service Hot Water, Pool Heating
Item or System Tags
(i.e. WH -1, WHP, DHW, etc... )�
WH -1
No. of Systems
1
Indicate Pa aRe erence on Plans or Schedules
MANDATORY MEASURES
T-24 Section
SERVICE HOT WATER
Certified Water Heater
§111, §113 (a)
P-3
Water Heater Efficiency
§ 113 (b)
P-3
Service Water Heating Installation
§113 (c)
P-3
Pipe Insulation
§123
P-3
POOL AND SPA
Pool and Spa Efficiency and Control
§ 114 (a)
N/A
§114 (b)
N/A
Pool and Spa Electric Resisting Heating
Exception
Pool and Spa Installation
§ 114 (b)
N/A "
Pool Heater —No Pilot Light
§ 115 (c)
N/A
Spa Heater—No Pilot Light
§115 (d)
N/A
Pie Insulation
t §123
N/A
l: The Proposed equipment need to match the building plans schedule or specifications. t'a requirement is not applicable, put "N/A" in the column next to the measure.
2: For each water heater, pool heat and domestic water
loop (or groups of similar equipment) fill in the reference to sheet number and/or specification section and paragraph nitn:ber where the
required features are documented .lf a requirement is not applicable, put WIA" in the column.
2008 Nonresidential Compliance Forms August 2009
MECHANICAL VENTILATION AND REHEAT
MECH-3C
PROJECT NAME
FIVE GUYS BURGERS AND FRIES
DATE
AUG. 2, 2010
MECHANICAL VENTILATION §121(b)2
REHEAT LIMITATION §144(d)
AREA
BASIS
OCCUPANCY
BASIS
VAV Minimum
A
B
C
D
E
F
G
H
I
J
K
L
M
N
Zone/
System
Condition
Area
1 ft=
CFM
per
ft'
Min
CFM by
Area
B x C
Num of
People
CFM
per
Person
Min
CFM by
Occupant
E x F
REQ'D
V.A.
Max of
D or G
Design
Ventilation Air
cfm
50% of
Design
Zone
Supply
cfm
B x 0.4
cfm/ft3
Max of
Columns
H, J, K,
30 cfm
Design
minimum
Air
setpoint
Transfer
Air
RTU -1
1380
0.15
207
92
15
1380
1380
525
63
559
0.15
84
4
15
.30
84
350
B4
559
0.15
84
4
is
30
84
350
MA -1
15
2718
15
15
15
15
15
15
15
15
Totals 100 1548 3943
Column i Total Design Ventilation Air
C
Minimum ventilation rate per Section §121, Table 121-A.
E
Based on fixed seat or the greater of the expected number of occupants and 50% of the CBC occupant load for egress put poses for spaces without fixed seating.
H
Required Ventilation Air (REO'D V.A.) is the larger of the ventilation rates calculated on an AREA BASiS or OCCUPANCY BASiS (Column D or G).
I
Must be greater than or equal to H, or use Transfer Air (column N) to make up the difference.
J
Design fan supply cfrn (Fan CFM x 50%; or the design zone outdoor airflow rate per §121.
K
Condition area (jt') x 0.4 cfMOV; or
L
Maximum of Columns H, J, K, or 300 cjn
M
This must be less than or equal to Column L and greater than or equal to the sum of Columns Hplrs N.
N
Transfer Air must be provided where the Required Ventilation Air (Column H) is greater Ilton the Design Minimum Air (Column M). Where required, transfer ail• must be greater than
orequal to the di erettce between the Required Ventilation Air (Cahoon H and the Design Minimum Air (Column M, Column H minus M
2008 Nonresidential Compliance Forms August 2009
I'AN POWER CONSUMPTION MECH-4C
PROJECT NAME: DATE:
FIVE GUYS BURGERS AND, FRIES AUG. 2, 2010
NOTE: Provide one copy of this worksheet for each fan system with a total far sysA?m horsepower greater than 25 hp for Constant Air Volume
(CAV) Fan Systems or Variable Air Volume (VA 17 Systems when using the Prescriptive Approach. See Power Consumption of fans§244(c).
A
B
C I D
E
F
FAN DESCRIPTION
DESIGN
BRAKE HP
EFFICIENCY
NUMBER OF
FANS
PEAK WATTS
B x E x 746 /
C x D
MOTOR
DRIVE
FORM NOT REQUIRED.
Totals and Adjustments
FILTER PRESSURE ADJUSTMENT Equation
144-A in § 144(c) of the Energy Standards.
If filter pressure drop (SP,) is greater than I inch
W. C. or 245 Pascal then enter SP, on line 4.
Enter Total Fan pressure drop across the fan (SPr)
on Line 5.
B) Calculate Fan Adjustment and enter on line 6.
C) Calculate Adjusted Fan Power Index and enter
on Row 7
1) TOTAL FAN SYSTEM POWER (WATTS, SUM
COLUMN
2) SUPPLY DESIGN AIRFLOW (CFM)
3) TOTAL FAN SYSTEM POWER INDEX (Row 1 / Row
2)n
W/CFM
4) SP,
5) SPr
6) Fan Adjustment = 1 -(SP, — 1)/SPr
7) ADJUSTED FAN POWER INDEX (Line 3 x Line 6)1
W/CFM
L TOTAL FAN SYSTEM POWER INDEX or ADJUSTED FAN POWER INDEX must not exceed 0.8 w/cfrn for Constant Yolume systems or 1.25
w/cfrn for FAV systems.
2008 Nonresidential Compliance Forms August 2009