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Form 4a Project Name: CIDA Page: 1
. SYSTEMS - GENERAL
a Applicability Plans/Specs
Discussion of qualifying exceptions Show compliance by including a drawing sheet,detail number,
- on page 4-25 specification section and subparagraph.
1. Applicablity (Section 1317)
Is this form required?
O Form Required. Complete form if a new HVAC system is being installed,or components of an existing HVAC
system are being replaced(I.e.,equipment,controls,ductwork,and insulation.)
❑ Exception.The building or part of the building qualifies for an exception from HVAC code requirements.
Applicable code exception is Section 1317.1. Portions of the building that qualify:
Area: Exception ❑-1 ❑-2 CI-3
Area Exception ❑-1 ❑-2 ❑-3
Area Exception ❑-1 ❑-2 ❑-3
❑ Form Not Required.This project does not contain work required to comply with code.
2. Simple or Complex Systems (Section 1317.9 or 1317.10)
O Simple System. Building contains only Simple HVAC System(s).Complete this form(4a)and equipment efficiency
worksheets as required. Form 4b is not required.
❑ Complex System. Project includes a Complex System. Complete this form(4a),form 4b and equipment efficiency
worksheets as required.
3. Equipment Performance (Section 1317.5)
❑ No New HVAC Equipment. The building plans do not call for new electrical HVAC equipment,combustion heating
equipment, or heat-operated cooling equipment.
O Complies.All new HVAC equipment have efficiencies not less than those required by code.
The following equipment efficiency worksheets are attached:
❑-4a ❑-4b ❑-4c El-4d ❑-4e ❑-4f ❑-49 CI-4h ❑-41 El-4j
4. Duct Insulation and Sealing (Sections 1317.7 85 1317.8)
O No Ducts. The building plans and specifications do not call for new HVAC ducts or plenums.
❑ Complies. The plans and specifications call for all air-handling ducts and plenums to be insulated and sealed as
required by Sections 1317.7 81317.8.
5. Distribution Transformers (Section 1316.1)
i 0 No Distribution Transformers.The plans/specs do not call for new distribution transformers.
❑ Complies. All new distribution transformers comply with efficiency,testing, and labeling requirements of Section
IF 1316.1.1.
❑ Exception.The project qualifies for an exception per Section 1316.1.1, Exceptiion:
0-1 0-2 0-3 0-4 0-5 0-6 0-7 0-8 0-9 0-10 0-11 0-12 0-13 0-14
Attach relevant documentation for appropriate exception.The plans/specs show compliance in the following
�, 7:'s locations:
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4-1 April 2005
Compliance with OSSC,effective 01/01/05
Form 4a Project Name: CIDA Page: 2
SYSTEMS - GENERAL
6. HVAC Controls (Section 1317.4)
6.1 System Thermostat/Zone Controls (Section 1317.4.1)
O Complies. All new HVAC systems include at least one temperature control device responding to temperatures within
the zones.
❑ Exception. HVAC system qualifies for an exception from zone control requirements.
The applicable code exception is Section 1317.4.2, Exception ❑-1 ❑-2
Portions of the building that qualify:
The plans/specs show compliance in the following locations:
6.2 Off-hour Controls - Auto Setback or Shutdown (Section 1317.4.3)
❑ Complies. Systems must have at least one of the following features:
❑ Control Setback Complies.Each system is equipped with automatic control capable of reducing energy through
control setback during periods of non-use or alternate use of spaces served.
❑ Equipment Shutdown Complies.Each system is equipped with controls capable of reducing energy use through
automatic shutdown during periods of non-use or alternate use of spaces.
HVAC systems with equipment shutdown are equipped with at least one of the following:
❑ Programmable controls(1317.4.3.1 (1))
O Occupant sensor(1317.4.3.1 (2))
❑ Interlocked to a security system(1317.4.3.1 (3))
❑ Manually activated timers with 2-hour operation max(1317.4.3.1 (4))
ID Exception.The building qualifies for an exception to the requirement for automatic setback or shutdown controls.
The applicable code exception is Section 1317.4.3
Exception ❑-1 ❑-2
The plans/specs show compliance in the following locations:
THESE ARE FIXED BULB STATS @ 45 DEGREES
6.3 Control Capabilities (Sec. 1317.4.2.1)
O Complies. Zone thermostats are capable of being set to the temperatures described in Sec. 1317.4.2.1. Where
used to control both heating and cooling,zone controls shall be capable of providing a temperature range or
deadband of at least 5 degrees F within which the supply of heating and cooling energy to the zone is shut off or
reduced to a minimum.
❑ Exception.The building qualifies for an exception to the deadband requirements.
The applicable code exception is Section 1317.4.2.1 Exception ❑-1 ❑-2
Portions of the building that qualify: WHAREHOUSE
The plans/specs show compliance in the following locations:
6.4 Optimum Start Controls (Section 1317.4.3.2)
O Complies.Separate HVAC systems have controls capable of varying start-up time of system to just meet
temperature set point at time of occupancy.
❑ Exception.HVAC systems have a design supply air capacity not exceeding 10,000 cfm.
The plans/specs show compliance in the following locations:
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6.5 Heat Pump Controls (Section 1317.4.4)
D No Heat Pump.The plans/specs do not call for a new heat pump
❑ Complies. All new heat pumps equipped with supplementary heaters are controlled to minimize the use of
supplemental heat as defined in Section 1317.4.4.
The plans/specs show compliance in the following locations:
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4-2 April 2005
Compliance with OSSC.effective 01/01/05
Form 4a Project Name: CIDA Page: 3
SYSTEMS - GENERAL
7. Economizer Cooling (Section 1317.3)
❑ No Cooling.The building plans do not call for a new fan system with mechanical cooling.
❑ Complies. Each new fan system has an air economizer capable of modulating outside-air and return-air dampers
to provide up to 100 percent of the design supply air as outside air.
❑ Exception At least one new fan system qualifies for an exception.The applicable code exception is Section
1317.3, Exception ❑-t ❑-2 ❑-3 ❑-4 ❑-5 ❑-6
If Exception 3 is selected complete the following:
(a)Total cooling capacity of exempt units(Btu/hr)
(b)Total installed building cooling capacity(Btu/hr)
l Complies. Sum of exempt units rated at less than 54,000 Btu/hr is<240,000 Btu/hr or alb
<0.10(10%of total building cooling capacity).
Unit Identifier of exempt units:
The plans/specs show compliance in the following locations:
8. Economizer Pressure Relief& Integration (Section 1317.3.1 and 1317.3.2)
Cl No Economizers Required. Project does not contain a new fan system requiring economizers.
❑ Overpressurization Complies.The drawings specifically identify a pressure relief mechanism for each fan system
that will relieve the extra air introduced by the economizer.
❑ Integration Complies. Economizer is capable of providing partial cooling even when additional mechanical cooling
is required to meet the remainder of the cooling load.
❑ Exception.The applicable exception is Section 1317.3.2, Exception ❑-1 ❑-2
The plans/specs show compliance in the following locations:
9. Hot Gas Bypass (Section 1317.5)
CI No Hot Gas Bypass
❑ Complies. See allowable amount of hot gas bypass as a percentage of total cooling capacity in table below.
Unit ID Rated Cooling Capacity Hot Gas Bypass Capacity
Allowable Hot Gas Bypass
4' Rated Cooling Capacity Max Hot Gas Bypass Capacity
<240,000 Btu/hr 50%
>240,000 Btu/hr 25%
❑ Exception. Unitary packaged system with cooling capacity no greater than 90,000 Btu/h
4-3 April 2005
Compliance with OSSC,effective 01/01/05
Form 4a Project Name: CIDA Page: 4
SYSTEMS - GENERAL
10. Shutoff Dampers (1317.4.3.3)
D Not Required. Shutoff dampers are not required on this project.
❑ Complies. Each outdoor air supply&exhaust system shall be equipped with motorized dampers.
❑ Exception. The building qualifies for an exception to the motorized damper requirement. The applicable code
exception is Section 1317.4.3.3 Exception ❑-1 ❑-2 ❑-3 ❑-4 ❑-5 ❑-6
The plans/specs show compliance in the following locations:
10.1. Shutoff Damper Controls (Section 1317.4.3.3.1)
❑ Complies. Outdoor air supply and exhaust systems shall be provided dampers that automatically shut when
systems or spaces served are not in use or during building warm-up,cooldown, or setback.
❑ Complies. Stair and shaft vents are capable of being automatically closed during normal building operation and
interlocked to open as required by fire and smoke detection systems.
The plans/specs show compliance in the following locations:
10.2. Motorized Damper Leakage (1317.4.3.3.2)
❑ Complies. Motorized outdoor air supply and exhaust air dampers have a maximum leakage rate of 4 cfm/ft2 at 1.0
in w.g.when tested in accordance with AMCA Standard 500-1998.
❑ Exception. Packaged HVAC equipment may have maximum leakage rate of 20 cfm/ft2 at 1.0 in w.g. when tested in
accordance with AMCA Standard 500-1998.
The plans/specs show compliance in the following locations:
11. Piping Insulation (Section 1314)
❑ No New Piping. The building plans and specifications do not call for new piping serving a heating or cooling
system or part of a circulating service water heating system.
El Complies. All new piping serving a heating or cooling system or part of a circulating service water heating system
complies with the requirements of the Code, Section 1314.1.
❑ Exception. New piping qualifies for exception: Section 1314.1, Exception ❑-1 ❑-2
12. Occupancy Ventilation
Complies. Mechanical ventilation systems provide the required amount of ventilation is indicated in
plans/specifications as specified in Chapter 4 of the Oregon Mechanical Specialty Code.
❑ Complies. Natural ventilation systems provide required amount of ventilation as certified by a reg-istered architect
or engineer as specified by Section1203.4.1, Exception.Attach worksheet 4m.
The plans/specs show compliance in the
following locations:
The plans/specs show compliance on the
b. following pages:
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4-4 April 2005
Compliance with OSSC,effective 01/01/05