Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ONTARIOBUILDINGCODESUPPLEMENTARYSTANDARDSB10
PROJECTINFORMATION
Project: Location:
BuildingPermitApplicationNo.: Date:
ArchitecturalDesigner
Information*
MechanicalDesigner
Information*
ElectricalDesigner
Information*
Name
Name
Name
Address
Address
Address
CityProvince
CityProvince
CityProvince
SignatureDate(YY/MM/DD)
SignatureDate(YY/MM/DD)
SignatureDate(YY/MM/DD)
*IFMOREDESIGNERSAREINVOLVED,PROVIDEADDITIONALCOPIESOFTHISFORM.
THISCHECKLISTISACONVENIENCEDOCUMENTONLYANDISBASEDONTHEENERGYEFFICIENCYREQUIREMENTSDESCRIBEDINTHEONTARIO
BUILDINGCODESUPPLEMENTARYSTANDARDSB10DIVISION3.THISCHECKLISTISNOTASUBSTITUTEFORCOMPLYINGWITHTHEREQUIREMENTS OF
THEONTARIOBUILDINGCODE.WHILECAREHASBEENTAKENTOENSUREACCURACYOFTHISCHECKLIST,DESIGNERSANDBUILDINGOFFICIALSMUST
REFERTOTHEACTUALWORDINGANDREQUIREMENTSOFTHEONTARIOBUILDINGCODE(O.REG.350/06ANDAMENDMENTSUPTOAMENDING
O.REG.315/11).
THISCHECKLISTISMADEAVAILABLEFORCODEUSERSBYTHE
MINISTRYOFMUNICIPALAFFAIRSANDHOUSING.USERSSHOULDALWAYSCONSULT
WITHTHEAUTHORITYHAVINGJURISDICTION,IFTHECHECKLISTISGOINGTOBESUBMITTEDTOTHATAUTHORITY.
THEMINISTRYOFMUNICIPAL
AFFAIRSANDHOUSINGDOESNOTASSUMERESPONSIBILITYFORERRORSOROVERSIGHTSRESULTINGFROMTHEINFORMATIONCONTAINEDHEREIN.
PLEASEFILLINTHEACTUALVALUESINSTALLEDANDCHECKBOXESASTHEYAPPLY.
OBCSB10COMPLIANCESUMMARY
EnergyEfficiencyDesign:
TherearethreeenergycomplianceoptionstomeettherequirementsofOBCSB10Division3.Pleaseselectthe
complianceoptionselectedforthisproject.Theenergyefficiencyofallbuildingsmustbedesignedto:
CompliancePath
Formsto
Complete
(A1)Exceedbynotlessthan25%theenergyefficiencylevelsattainedbyconformingtotheCCBFC,“Model
NationalEnergyCodeforBuildings(MNECB).”
Notethatthiscompliancepathrequiresthattheproposedbuildingisshowntoconsumeatleast25%less
energythantheMNECBreferencebuildingwhenmodelledaccordingtotheproceduresoutlinedinPart8of
theMNECB.
YES FORMA
(A2)Exceedbynotlessthan5%theenergyefficiencylevelsattainedbyconformingtothe
ANSI/ASHRAE/IESNA90.1‐2010“EnergyStandardforBuildingsExceptLowRiseResidentialBuildings.”
Notethatthiscompliancepathrequiresthattheproposedbuildingisshowntoconsumeatleast5%less
energythantheASHRAE
90.12010referencebuildingwhenmodelledaccordingtotheproceduresoutlined
inChapter11ofASHRAE90.12010.
Notethatthispathcannotbeusedforabuildingwithelectricspaceheating.RefertoSB10.
YES FORMA
(B)AchievetheenergyefficiencylevelsattainedbyconformingtotheASHRAE90.12010,“EnergyStandardfor
BuildingsExceptLowRiseResidentialBuildings”andChapter2ofSB10(Division3).
Thiscompliancepathincludesbothprescriptiveandperformancepathoptions.PleaseproceedtoFormB.
YES FORMB
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
OBCSB10COMPLIANCE (1)EXCEEDMNECBBYNOTLESSTHAN25% FORMA
(2)EXCEEDASHRAE90.12010BYNOTLESSTHAN5%
Pleaseselectwhichofthetwooptionspursuedforcompliance:
PROPOSEDBUILDINGISSHOWNTOCONSUMEATLEAST25%LESSENERGY(GJorkWh)ANNUALLYTHANTHE
MNECBREFERENCEBUILDING.ENERGYCONSUMPTIONVALUESAREDETERMINEDACCORDINGTOTHEMODELLING
PROCEDURESIDENTIFIEDINPART8OFTHEMNECB.
YES
PROPOSEDBUILDINGISSHOWNTOCONSUMEATLEAST5%LESSENERGY(GJorkWh)ANNUALLYTHANTHE
ASHRAE90.12010REFERENCEBUILDING.ENERGYCONSUMPTIONVALUESAREDETERMINEDACCORDINGTOTHE
MODELLINGPROCEDURESOUTLINEDINCHAPTER11OFASHRAE90.12010.
YES
Project: ModellerName:
AnnualEnergySummary
(1)
Occupancies FloorArea
AnnualConsumptionSummary ReferenceBuilding
Energy
Proposed
BuildingEnergy
Units
Assembly ____________ SpaceHeating _____________ ___________ ________
Health/Institutional ____________ SpaceCooling _____________ ___________ ________
Hotel/Motel ____________ HVACAuxiliary _____________ ___________ ________
LightManufacturing ____________ Misc.Electrical _____________ ___________ ________
Multifamily ____________ ServiceHotWater _____________ ___________ ________
Office ____________ InteriorLighting _____________ ___________ ________
Restaurant ____________ Other_______________________ ___________ ________
Retail ____________ Other_______________________ ___________ ________
School ____________
Warehouse ____________ TotalAnnualEnergy > ________
Other ____________
Total ____________ Percentagelessenergyused
byproposedbuilding:


ProposedBuildingDescription ReferenceBuildingEnergyandProposedBuildingEnergyConsumptionsarecalculated
by:
__________________________________
__________________________________ Pleasespecifymodellingsoftware:____________________________________
__________________________________
__________________________________
HVACSystemDescriptions EnergyEfficiencyFeaturesinProposedBuildingDesign
(
2
)
ReferenceBuildingDesign
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
______________________________________________
ProposedBuildingDesign ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
Individualcertifyingauthenticityofthedataprovidedinthisanalysis.Bysigningthis,theindividualconfirmsthatthemodelsaccurately
reflectthereferenceandproposedbuildingdesigns:
Signature:
Name/Title:
Notes: (1)Verifywithbuildingofficialwhetherfullmodellingreportisrequiredtobesubmitted
(2)Explainmajorenergysavingfeaturesutilizedtoachievemodelledsavings
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
OBCSB10ANDASHRAE90.1‐2010COMPLIANCESUMMARY FormB
Project: LocationofProject:
BuildingPermitApplicationNo.: ClimateZone:
ASHRAE90.12010COMPLIANCEASMODIFIEDBYOBCSB10DIVISION3
Thebuildingdesigncomplieswiththemandatoryprovisionsofthefollowingsectionsregardlessofthecompliancepath:
ASHRAE90.12010StandardSection
Compliance
Column
Form
5.4BUILDINGENVELOPEANDSB10DIVISION3 YESFORM5.4
6.4HEATING,VENTILATINGANDAIRCONDITIONING YESFORM6.3or
FORM6.4
7.4SERVICEWATERHEATINGSYSTEMSANDEQUIPMENT YESFORM7.4
8.4POWER YESFORM8.4
9.4LIGHTING YES FORM9.4
10.4OTHEREQUIPMENTANDSB10DIVISION3 YES FORM10.4
METHODOFCOMPLIANCE
BuildingDesignmustcomplywitheitherthePrescriptiveRequirementsortheEnergyCostBudgetMethod.Indicatewhichmethodwas
selected.
ComplianceMethod
Compliance
Column
Form
PRESCRIPTIVECOMPLIANCE YESCOMPLETESECTIONB1
ENERGYCOSTBUDGETMETHOD YESCOMPLETESECTIONB2
B1:PRESCRIPTIVECOMPLIANCEASHRAE90.12010ANDOBCSB10
ThebuildingdesigncomplieswiththePrescriptiveComplianceofthefollowingsections:
StandardSection
Reference
Compliance
Column
Form
Sec5BUILDINGENVELOPE PrescriptiveRequirements(5.5of90.1)
 BuildingEnvelopeTradeOff(5.6of90.1)
YES
YES
FORM5.5or
FORM5.6
Sec6HVACSYSTEMSSimplifiedApproachforHVACSystems
Mandatory+PrescriptivePathOption
YES
YES
FORM6.3or
FORM6.4
Sec7SERVICEWATERHEATINGPrescriptivePathOption YESFORM7.4
Sec9LIGHTINGPrescriptiveRequirements YES FORM9.5
B2:ENERGYCOSTBUDGETMETHODASHRAE90.12010ANDOBCSB10
Compliance
Column
Form
ThebuildingdesigncomplieswiththeprovisionsofSection11ofASHRAE90.12010,
basedonDivision3ofSB10.
YES FORM11
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
SECTION5.4MANDATORYPROVISIONS
Buildinginsulationhasbeendesignedtocomplywithsection5.4.1ofASHRAE90.12010as
modifiedbyChapter2ofOBCSB10.
YES
Buildingfenestrationanddoorshavebeendesignedtocomplywithsection5.4.2ofASHRAE
90.12010asmodifiedbyChapter2ofOBCSB10.
YES
Buildingairleakagehasbeendesignedtocomplywithsection5.4.3ofASHRAE90.12010as
modifiedbyChapter2ofOBCSB10.
YES
Section5.5OverallBuildingDesignRequirements
Thebuildingdesignmustcomplywiththefollowinggeneralrequirements.Ifanyoftheserequirementsarenotmet,theprescriptive
pathcannotbepursued.ConsiderthebuildingenvelopetradeoffcomplianceortheEnergyCostBudgetMethodDescribedin
Chapter11ofASHRAE90.12010:
GrossWallArea:_________
VerticalFenestrationArea:_________
Verticalfenestrationareaislessthan40%ofthe grosswallarea
YES
GrossRoofArea:_________
SkylightArea:_________
Totalskylightareadoesnotexceed5%ofthegrossroofarea
YES
Totaleastverticalfenestrationareaislessthansouthverticalfenestrationareaandtotalwest
verticalfenestrationareaislessthansouthverticalfenestrationarea.
Exception(fromAHRAE90.12010Section5.5.4.5):______________________________
YESorexceptionhasbeennoted
Ifelectricspaceheatingisused,TableSB5.57hasbeenusedregardlessofclimaticlocation YESN/A
ForClimateZone5,minimumskylightfenestrationareaconformstotherequirementsof
ASHRAE90.120105.5.4.2.3.
YESN/A
IdentifySB10TableusedformaximumUFactorsorminimumRSIValues:_____________
CompletethetableonForm5.52toshowcomplianceforallenvelopecomponents.Attachasmanycopiesofthisformasrequired
toensurethatallenvelopecomponentsarerepresented.
Forallopaquesurfaces,compliancemustbedemonstratedbymeetingeither:
1. TheminimumRvaluesofinsulationaddedinframingcavitiesandcontinuousinsulationasspecifiedinTablesSB5.55to
SB5.57.
2. ThemaximumUfactor,Cfactor,orFfactorfortheentireassemblyasspecifiedin
TablesSB5.55toSB5.57.Ufactoristobe
determinedfromtablesinAppendixAofASHRAE90.12010orthroughcalculationmethodsdescribedinASHRAE90.12010
AppendixSectionA9.
Forallfenestrationproducts,compliancewithUfactorsandSHGCmustbedeterminedfortheoverallfenestrationproduct.
1. FenestrationshallhaveaUfactorandSHGCnotgreaterthanthosespecifiedinSB10TablesSB5.55toSB5.57.
2. UfactortobedeterminedthroughCSAorNFRCratingorbyusingASHRAE90.12010AppendixAdefaultvalues.
ASHRAE90.12010ANDOBCSB10DIVISION3–MANDATORYPROVISIONS Form5.4
ASHRAE90.12010&SB10SECTION5.5PRESCRIPTIVEENVELOPEOPTION Form5.51
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
Pleasecompletethefollowingtabletoinclude informationonallwalls,roofs,doors,andfloorsusedinthedesign.
OPAQUEBUILDINGENVELOPECOMPONENTS
OpaqueElement‐
Description
(1)
SpaceConditioning
Category
(2)
Classof
Construction
(3)
CriteriaMax.UValue
(
4
)
orMinRSIValue
DesignUValue
(
4
)
orRSIValue
AreaWeighted
AverageUsed
(5)
?
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
Pleasecompletethefollowingtabletoinclude informationonallfenestrationproductsusedinthedesign.
FENESTRATIONENVELOPECOMPONENTS
Fenestration‐
Description
(1)
SpaceConditioning
Category
(2)
Classof
Construction
(3)
UValue
(
4
)
SHGC
(
6
)
AreaWeighted
AverageUsed
(5)
?
Criteria Design Criteria Design
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
NRRSH YN
(1) IndicateifElementisaWall,Roof,Floor,Door,WindoworSkylightandaTagorDescription(egWallW1).
(2) SelectfromNonresidential(NR),Residential(R),orSemiheated(SH).
(3) Selectfromthesubclassesofroofs,walls,floors,doorsandfenestrationprovidedinTablesSB5.55
toSB5.57(eg.Steel
Framedforwalls).Notethatcurtainwallsystemsareconsideredasteelframedwall.
(4) FFactorscanbeusedforfloorsandCFactorsforbelowGradeWallsasapplicable.
(5) Elementsofthesametype,spacecategory,andclassofconstructioncanbeaveraged
usingareaweightingtoshow
complianceonlyifUValuesareused.
(6) DesignSHGCmaybehigherthanthecriteriaiftheoneoftheexceptionsfromASHRAE90.120105.5.4.4.1isapplicable.
Pleaseusethespacebelowtoidentifythefenestrationelements(ifany)whichanexceptionfor
SHGCisbeingclaimed:
SHGCEXCEPTIONS
FenestrationElement SHGCExceptionfromASHRAE90.120105.5.4.4.1
ASHRAE90.12010&SB10SECTION5.5PRESCRIPTIVEENVELOPEOPTION Form5.52
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ASHRAE90.12010&SB10SECTION5.5–BUILDINGENVELOPETRADEOFFOPTION Form5.6
NotethatthisoptionmayonlybepursuediftheprocedureasdescribedinASHRAE90.12010section5.6hasbeen
modifiedwiththerequirementsofChapter2ofSB10.
CalculatedEPFforproposedbuilding*:______
CalculatedEPFforbudgetbuilding*:______
Envelopeperformancefactor(EPF)forproposedbuildingislessthanorequaltotheenvelopeperformance
factorofthebudgetbuilding.
YES
Theenvelopeperformancefactorconsidersonlythebuildingenvelopecomponents. YES
Schedulesofoperation,lightingpower,equipmentpower,occupantdensity,andmechanicalsystemsarethe
sameinboththeproposedandbudgetbuilding.
YES
CalculationsfromASHRAE90.12010AppendixChavebeenattached,andincludethemodificationsfromSB10.
Or
Asoftwareprogram*incorporatingtherequirementsofASHRAE90.12010asmodifiedbySB10hasbeenused
tocalculatetheEPF.Areportfromthissoftwareisattached.
Nameofsoftware:
_____________________
YES
YES
*NotethattheEPFmustbecalculatedbyasoftwareprogramwhichincludestherequirementsofASHRAE90.12010as
modifiedbySB10.
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ASHRAE90.1&SB10‐SECTION6.3HVACSIMPLIFIEDAPPROACHForm6.3
IfsimplifiedHVACmethodisusedcompletethisform,otherwiseproceedtoForm6.4.
NumberofStories: Grossfloorarea: 

Reference StandardCompliance
6.3.1 Thebuildingis2storiesorlessinheightandhasagrossfloorarealessthan2,323m².□YES NO
6.3.2 AlloftherequirementsinSection6.3asoutlinedbelowmustbemetbyeachHVACsysteminthe
facility.
6.3.2.a SystemservesasingleHVACzone.□YES NO
6.3.2.b TheequipmentmeetsthevariableflowrequirementsofSection6.4.3.10.□YES□N/A□NO
6.3.2.c Ifacoolingisinstalled,itisprovidedbyaunitarypackagedorsplitsystemairconditionerthatis
eitheraircooledorevaporativelycooledandmeetstheefficiencyrequirementsshowninTables
6.8.1A,6.8.1B,and6.8.1D.
□YES□N/A□NO
6.3.2.d Thesystemhasanaireconomizerwithoutsideairflowcapacityandcontrolsasrequiredper
Section6.5.1.,unlessexempt.
□YES□N/A□NO
6.3.2.e Heatingisprovidedbyaunitarypackagedorsplitsystemheatpump,afuelfiredfurnace,an
electricresistanceheaterorabaseboardsystemconnectedtoaboiler.Allheatingequipment
meetstheefficiencyrequirementsshowninTable6.8.1B,6.8.1D,6.8.1E,and6.8.1F.
□YES□N/A□NO
6.3.2.f SystemmeetstheexhaustairenergyrecoveryrequirementsofSection6.5.6.1,unlessexempt.□YES□N/A□NO
6.3.2.g Thesystemiscontrolledbyamanualchangeoverordualsetpointthermostat.□YES NO
6.3.2.h Heatpumps equippedwithauxiliaryinternalelectricresistanceheaters(ifany)havecontrolsto
preventsupplementalheateroperationwhentheheatingloadcanbemetbytheheatpump
alone.
□YES□N/A□NO
6.3.2.i Thesystemcontrolsdonotpermitreheatoranyotherformofsimultaneousheatingandcooling
forhumiditycontrol.
□YES□N/A□NO
6.3.2.j Systemsareprovidedwithatimeswitchthat(1)canstartandstopthesystemunderdifferent
schedulesforsevendifferentdaytypesperweek;(2)iscapableofretainingprogrammingand
timesettingduringalossofpowerforaperiodofatleast10h;(3)includesanaccessiblemanual
overridethatallowstemporaryoperationofthesystemforupto2h;(4)iscapableof
temperaturesetbackdownto13°Cduringoffhours;and(5)iscapableoftemperaturesetupto
32°Cduringoffhoursunlessexempt.
□YES□N/A□NO
6.3.2.k PipingisinsulatedinaccordancewithvaluesgiveninTable6.8.3Aand6.8.3B.Insulationexposed
toweatherissuitableforoutdoorservice(i.e.protectedbyaluminum,sheetmetal,etc.orpainted
withacoatingthatiswaterretardantandprovidesshieldingfromsolarradiation).
□YES□N/A□NO
6.3.2.l DuctworkandplenumsareinsulatedinaccordancewithTables6.8.2Aand6.8.2Bandsealedin
accordancewithSection6.4.4.2.1.
□YES□N/A□NO
6.3.2.m Specificationscallforductedairsystemstobebalanced.□YES□N/A□NO
6.3.2.n OutdoorairintakeandexhaustsystemsmeetthecontrolsrequirementsofSection6.4.3.4.□YES□N/A□NO
6.3.2.o Whereseparateheatingandcoolingequipmentservethesametemperaturezone,thermostats
areinterlockedtopreventsimultaneousheatingandcooling.
□YES□N/A□NO
6.3.2.p Systemswithadesignsupplyaircapacitygreaterthan5,000L/shaveoptimumstartcontrols.□YES□N/A□NO
6.3.2.q Inspaceslargerthan50m²andwithdesignoccupancyofmorethan40peopleper100m²,the
systemcomplieswiththedemandcontrolventilationrequirementsinSection6.4.3.9,unless
exempt.
□YES□N/A□NO
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
SECTION6HVAC6.4MANDATORYPROVISIONSAND6.5PRESCRIPTIVEREQUIREMENTSForm6.4
Reference StandardCompliance
MandatoryProvisionsCompleteonlyifsimplifiedHVACmethodisnotused.
6.4.1 EquipmentshowninTables6.8.1Athrough6.8.1Kmeetsminimumperformanceatthespecified
ratingconditionsinaccordancewiththetestproceduresinthetablesorthoseinSB10
Chapter2‐Table6.4.1.A.2.
□YES NO
6.4.2.1 LoadcalculationsforheatingandcoolingsystemsaredoneasperASHRAEStandard1832007for
selectionofallequipmentandsystems.
□YES NO
6.4.2.2 Pressuredropthrougheachdeviceandpipesegmentinthecriticalcircuitatdesignconditionshas
beencalculatedinaccordancewithgenerallyacceptedengineeringstandardsandhandbooks.
□YES NO
6.4.3 Mandatorycontrolsrequirementsaremetbyalltheequipmentinthebuildingasoutlinedin
Section6.4.3.
□YES NO
6.4.4.1 Ductwork,piping,andequipmentinsulationmeetstherequirementsofSection6.4.4.1.□YES NO
6.4.4.2 Constructiondocumentsspecifysealingandpressuretestingofductworksandplenumsasper
Section6.4.4.2.
□YES NO
PrescriptiveRequirementsCompletethissectionifnotusingEnergyCostBudgetMethod.
6.5.1 Eachcoolingsystemthathasafanemployseitherairsideorwatersideeconomizerunlessexempt. □YES□N/A□NO
6.5.1.1 Airsideeconomizersarecapableofmodulatingoutdoorairdamperstoprovideupto100%design
airflowforcoolingandthesystemprovidesreliefcapacityforsuchairflow.
□YES□N/A□NO
6.5.1.2.1 Watersideeconomizersarecapableofcoolingsupplyairupto100%oftheexpectedsystem
coolingloadattheconditionslistedunderSection6.5.1.2.1.
□YESN/A□NO
6.5.1.2.2 Watersideeconomizersystemswithpressuredropgreaterthan45kPaareisolatedfrommain
coolinglooptoreducepumpinginputinthenormalcoolingmode.
□YESN/A□NO
6.5.1.3 Economizersystemsarecapableofprovidingcoolingevenwhenadditionalmechanicalcoolingis
requiredtomeetthecoolingload.
□YES□N/A□NO
6.5.2 Simultaneousheatingandcoolingislimitedwithcompliantzone,hydronicsystem,
dehumidification,andhumidificationcontrolsasperSection6.5.2.
□YES□N/A□NO
6.5.3 Variableairvolume(VAV)fancontrolscomplywiththerequirementsof6.5.3.2and6.5.3.3.□YES□N/A□NO
6.5.3.1 Fansystemsexceeding4kWnameplatepowermeetprescriptivefanpowerlimitationsasper
Table6.5.3.1.1AandSection6.5.3.1.2.
□YES□N/A□NO
6.5.4.1 Pumpingsystemsgreaterthan7.5kWemploycompliantvariableflowcontrols,unlessexempt.□YES□N/A□NO
6.5.4.2
Chilledwaterplantswithmorethanonechillerandboilerplantswithmorethanone boiler
reduceloopwaterflowautomaticallywheneverachillerorboilerisshutdown.
□YES□N/A□NO
6.5.4.3 Hydronicsystemsexceedingdesigncapacityof88kWincludecontrolstoresetsupplywater
temperaturebasedonbuildingloadsoroutdoorairtemperature.
□YES□N/A□NO
6.5.4.4 Hydronicheatpumpsandunitaryairconditionersincludeautomaticwatershutoffwhenthe
compressorisoffandthosehavingtotalpumpsystempowergreaterthan3.7kWhavevariable
speedcontrol.
□YES□N/A□NO
6.5.4.5 ChilledwaterandcondenserwaterpipeissizedaccordingtoTable6.5.4.5.□YES□N/A□NO
6.5.5 Allheatrejectionequipmentwithfanmotors>5.6kWemploysvariablespeedcontrolsthat
complywithSection6.5.5.2.
□YES□N/A□NO
6.5.6.1
ExhaustairenergyrecoveryisprovidedforfansystemsmeetingtheconditionslistedonTable
6.5.6.1.Energyrecoveryisatleast50%effectiveandbypassisavailabletopermitaireconomizer
operationasperSection6.5.1.1.
□YES□N/A□NO
6.5.6.2 Condenserheatrecoverysystemforheatingorpreheatinghotwaterisprovided,unlessexempt.□YES□N/A□NO
6.5.7.1 KitchenexhaustsystemsaredesignedasperSection6.5.7.1.□YES□N/A□NO
6.5.7.1.5 Specificationscallforperformancetestingofkitchenexhaustsystems.□YES□N/A□NO
6.5.7.2 Laboratoryfumehoodswithatotalexhaustsystemflow>2,360L/Scomplywiththevariableair
volumecontrolrequirementsof6.5.7.2.
□YES□N/A□NO
6.5.8.1 Heatingofunenclosedspacesisdonebyradiantheating,exceptloadingdockswithaircurtains.□YES□N/A□NO
6.5.9 Coolingequipmentwithhotgasbypasscontrolsisdesignedwithmultiplestepsofunloadingor
continuouscapacitymodulation,unlessexemptasindicatedinTable6.5.9.
□YES□N/A□NO
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ASHRAE90.1&SB10‐SECTION7SERVICEWATERHEATINGForm7.4
SECTION7SERVICEWATERHEATING7.4MANDATORYPROVISIONSAND7.5PRESCRIPTIVEREQUIREMENTS
ReferenceItem StandardCompliance
7.4.1 Loadcalculationsforheatingandcoolingsystemsaredoneinaccordancewithmanufacturer’s
publishedsizingguidelinesorgenerallyacceptedengineeringstandardsandhandbooksfor
selectionofallequipmentandsystems.
□YES NO
7.4.2 Equipmentusedsolelyforheatingpotablewater,poolheaters,andhotwaterstoragetanks
meetsorexceedstheefficiencyrequirementsofTable7.8.
Exception:EquipmentnotlistedinTable7.8.
□YES□N/A□NO
7.4.3 ThefollowingservicehotwaterpipingisinsulatedtolevelsshowninTable6.8.3:
a. Recirculatingsystempiping,includingpipingofacirculatingtanktypewaterheater.
b. Thefirst2.4mofoutletpipingforaconstanttemperaturenonrecirculatingstorage
system.
c. Inletpipebetweenstoragetankandheattrapinanonrecirculatingstoragesystem.
d. Pipesthatareexternallyheated(e.g.heattracing).
□YES□N/A□NO
7.4.4.1 Allwaterheatingsystemshavetemperaturecontrolsthatareadjustabledownto49
o
Corlower.
Exception:Equipmentthatmustbeprotectedfromcorrosion,aspermanufacturer’s
installationinstructions.
□YES□N/A□NO
7.4.4.2 Systemsdesignedwithpipeheatingsystemssuchasheattracehavetemperatureortime
controlstodisableduringextendedperiodswithouthotwaterdemand.
□YES□N/A□NO
7.4.4.3 Publiclavatorieshaveoutlettemperaturecontrolsthatlimitthedischargetemperatureto43
o
C.□YES□N/A□NO
7.4.4.4 Tankswithremoteheatershavecirculationpumpcontrolstolimitoperationofcirculationpumps
toamaximumoffiveminutesaftertheendoftheheatingcycle.
□YES□N/A□NO
7.4.5.1 PoolheatershavereadilyaccessibleON/OFFswitchwithoutadjustingthethermostatsetting.
Gasfiredheatersdonothavestandingpilotlights.
□YES□N/A□NO
7.4.5.2 Heatedpoolshavevapourretardantcovers.Poolsheatedtoabove32°Chaveapoolcoverwitha
minimuminsulationvalueofRSI2.1unlessheatedbysiterecoveredenergyorsolarenergy.
□YES□N/A□NO
7.4.5.3 Poolheatersandcirculationpumpshavetimeswitches,unlessexempt. □YES□N/A□NO
7.4.6 Heattrapsareprovidedtoallverticalrisersservingstoragewaterheatersandstoragetanks.□YES□N/A□NO
PrescriptiveRequirementCompletethissectionifnotusingEnergyCostBudgetMethod.
7.5 Boilersystemsthatprovidespaceheatingaswellasservicewaterheatingmeettheconditionsof
Sections7.5.1and7.5.2.
□YES□N/A□NO
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ASHRAE90.1&SB10‐SECTION8,9&10POWER,LIGHTINGANDOTHEREQUIPMENT
SECTION8POWER8.4MANDATORYPROVISIONS Form8.4
ReferenceItem StandardCompliance
8.1.2 LowVoltageDryTypeDistributionTransformersmeetnominalefficienciesshowninTable8.1,
unlessexempt.
□YES□N/A□NO
8.4.1 FeederconductorsandbranchconductorsaresizedasperSection8.4.1.□YES NO
8.4.2
Atleast50%ofall125volt15‐and20Amperereceptaclesinstalledinprivateoffices,open
offices,andcomputerclassroomsareprovidedwithautomaticreceptaclecontrolsthatfunction
ona)timeofdayscheduleorb)occupantsensororc)occupancysignalfromanothercontrolor
alarmsystem.
□YES NO
SECTION9LIGHTING–9.4MANDATORYPROVISIONS Form9.4
ReferenceItem StandardCompliance
9.4.1 Anyautomaticcontroldevicesusedare“manualON”ormultilevelwherethe“automaticON”
functionprovidesnomorethan50%powerunlessexempt.
□YES NO
9.4.1.1 Automaticlightingshutoffcontrolsareprovidedforallinteriorspacesbasedoneithera
scheduledbasisorcontrolledbyanoccupantsensorunlessexempt.
□YES□N/A□NO
Schedulebasedcontroldevicesareprovidedwithindependentschedulesforareasofnomore
than2,323m²butnomorethanonefloor.
□YES NO
Occupancybasedcontroldevicesturnlightsoffwithin30minutesofalloccupantsleavingthe
space,orasignalfromanothercontroloralarmsystemthatindicatestheareaisunoccupied.
□YES NO
9.4.1.2 Eachspaceenclosedbyceilingheightpartitionshasatleastonereadilyaccessiblecontroldevice
thatindependentlyoperatesgenerallightingwithinthespaceinsuchawaythatoccupantscan
seethecontrolledlightingwithmultistepcontrolsandoccupantsensorsasperSection9.4.1.2
□YES NO
9.4.1.3 Lightingforparkinggaragesiscontrolledbyautomaticshutoffcontrolsmeetingtherequirements
outlinedinSection9.4.1.1.
□YES□N/A□NO
Parkinggaragelightingiscapableofautomaticallyreducinglightingpowerofeachluminairebyat
least30%basedonoccupancy.
□YES□N/A□NO
Daylighttransitionzonesinparkinggaragesarecontrolledseparately.Theseareautomatically
turnedonduringdaylighthoursandoffatsunset.
□YES□N/A□NO
Parkinggarageluminaireswithin6mofperimeterwallsthathaveanetopeningtowallratioofat
least40%automaticallyreducepowerinresponsetodaylight,exceptdaylighttransitionzones.
□YES□N/A□NO
9.4.1.4 Automaticdaylightingcontrolsareprovidedforseparatecontrolofgenerallightinginprimary
sidelightedareasgreaterthan23m²inanenclosedspace.Multilevelphotocontroldevice
complieswith9.4.1.4cunlessexempt.
□YES□N/A□NO
9.4.1.5 Automaticdaylightingcontrolsareprovidedforseparatecontrolofgenerallightingindaylight
areasasrequiredunderSection9.4.1.5.Multilevelphotocontroldevicecomplieswith9.4.1.5c
unlessexempt.
□YES□N/A□NO
9.4.1.6 AdditionalcontrolisprovidedtotheapplicationslistedinSection9.4.1.6. □YES□N/A□NO
9.4.1.7 Exteriorlightsareshutoffbyanautomaticphotosensorwhenavailabledaylightissufficient,
unlessexempt.
□YES□N/A□NO
Allbuildingfaçadeandlandscapelightingisautomaticallyshutoffovernightasper9.4.1.7b.□YES NO
Exteriorlightingnotforfaçadeorlandscapelighting,includingadvertisingsignage,is
automaticallycontrolledtoreducelightingpowerbyatleast30%overnightorduringinactive
periods.
□YES NO
9.4.2 Exitsignsdonotexceed5Wperface.□YES NO
9.4.4 Thirdpartyfunctionaltestingofalllightingcontroldevicesandsystemsisspecifiedinthe
constructiondocuments.
□YES NO
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
SECTION9LIGHTINGINSTALLEDLIGHTINGPOWERCOMPLIANCE Form9.5
Reference StandardCompliance
9.4.3 ExteriorLightingZone_______________(Table9.4.3A)
TotalInstalledExteriorLightingPower______________W≤valueof
exteriorLPA__________W*
Listanyexemptionsthatapply:
□YES□N/A□NO
PrescriptiveRequirementsCompleteifnotusingEnergyCostBudgetMethod
9.5,9.6 9.5INTERIORLIGHTINGPOWERALLOWANCEBYBUILDINGTYPE
CalculationofInteriorLightingPowerAllowance(ILPA)byBuildingTypebasedonTable9.5.1*
BuildingType ______________________
GrossLightedArea ______________
LightingPowerDensity ______________W/m²
TotalInstalledInteriorLightingPower______________W≤valueof
InteriorLPA______________W
*
□YES□N/A□NO
9.6INTERIORLIGHTINGPOWERALLOWANCEBYSPACEFUNCTION
CalculationofInteriorLightingPowerAllowance(ILPA)foreachspacebasedonTable9.6.1*
TotalInstalledInteriorLightingPower______________W≤valueof
InteriorLPA______________W*
Listanyexemptionsthatapply:
□YES□N/A□NO
*Calculationworksheets(FORM9.5.2andFORM9.5.3)areavailable.
SECTION10OTHEREQUIPMENT‐MANDATORYPROVISIONS Form10.4
ReferenceItem StandardCompliance
10.4.1 ElectricmotorscomplywithTable10.4.1.A(a)andTable10.4.1.A(b)ofSB10. YES
10.4.2 Servicewaterpressureboosterpumpshavepressuresensortovarypumpspeedand/orstartand
stoppumps.
YESN/A
Nodevicesareinstalledtoreducethepressureofallofthewatersuppliedbyanyboostersystem
orpump,exceptforsafetydevices.
YESN/A
Boosterpumpsshutoffwhenthereisnoservicewaterflow. YESN/A
10.4.3
Allelevatorcablightingsystemshaveefficacyofnotlessthan35lumensperWatt. YESN/A
Elevatorcabventilationfansforelevatorswithoutairconditioningconsumelessthan0.7Ws/L
atmaximumspeed.
YESN/A
Cabinteriorlightandventilationisdisabledwhenelevatorsarestoppedandunoccupiedwith
doorsclosedforover15minutes.
YESN/A
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ASHRAE90.12010&SB10ENERGYCOSTBUDGET(ECB)COMPLIANCEREPORT FORM11
Project: DesignerName:
Occupancies FloorArea
AnnualConsumption
Summary
(1)
ReferenceBuilding
Energy
Proposed
BuildingEnergy
Units
Assembly ____________ SpaceHeating _____________ ___________ ________
Health/Institutional ____________ SpaceCooling _____________ ___________ ________
Hotel/Motel ____________ HVACAuxiliary _____________ ___________ ________
LightManufacturing ____________ Misc.Electrical _____________ ___________ ________
Multifamily ____________ ServiceHotWater _____________ ___________ ________
Office ____________ InteriorLighting _____________ ___________ ________
Restaurant ____________ Other
__________
_____________ ___________ ________
Retail ____________ Other
__________
_____________ ___________ ________
School ____________
Warehouse ____________ TotalAnnualEnergy ________
Other ____________ 
TotalAnnualEnergyCost $ > $ ________
Total ____________ 

ProposedBuildingDescription ReferenceBuildingEnergyandProposedBuildingEnergyConsumptionsarecalculated
by:
__________________________________
__________________________________ Pleasespecifymodellingsoftware:___________________________________
__________________________________
__________________________________
HVACSystemDescriptions EnergyEfficiencyFeaturesinProposedBuildingDesign
(
2
)
ReferenceBuildingDesign
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
______________________________________________
ProposedBuildingDesign ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
_______________________________________________________ ______________________________________________
Buildingisincompliancewithmandatoryrequirementsofsections
5.4,6.4,7.4,8.4,9.4,and10.4
YES

ComplianceResult
ThedesigndetailedintheabovereferencedplanscomplieswiththemandatoryrequirementsoftheASHRAE90.12010Standardand
theadditionalrequirementsofSupplementaryStandardSB10.Theproposedbuildingenergycost(designenergycost)doesnot
exceedthereferencebuildingenergycost(energycostbudget).Therefore,thisdesignDOESCOMPLYwiththeASHRAE90.12010ECB
compliancemethodologyandtheadditionalrequirementsofSupplementaryStandardSB10.
Individualcertifyingauthenticityofthedataprovidedinthisanalysis:
Signature:
Name/Title:
Notes: (1)Verifywithbuildingofficialwhetherfullmodellingreportisrequiredtobesubmitted.
(2)Explainmajorenergysavingfeaturesutilizedtoachievemodelledsavings.
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ASHRAE90.1&SB10‐SECTION9LIGHTINGCOMPLIANCEWORKSHEET FORM9.5.2
Project: DesignerName:
InteriorPowerAllowance(BuildingAreaMethod)Table9.5.1
Building
Type
LightingPowerDensity
Allowance(W/m²)
GrossLightedFloorArea
(m²)
LightingPowerAllowance
(W)(LPDxGLFA)





Total PowerAllowance
InteriorLightingPowerAllowance(SpacebySpaceMethod)Table9.6.1
Building
Type
Common/Specific
SpaceType
LightingPowerDensity
Allowance(W/m²)
SpaceArea
(m²)
LightingPowerAllowance
(W)









Total PowerAllowance
InteriorConnectedLightingPower
Space
ID
LuminaireDescription
(includingnumberoflampsperfixture,watts
perlamp,typeofballast,typeoffixture)
Numberof
Luminaires
Watts/
Luminaire
Total
Watts











Total InteriorLightingPower
*Ifadditionalspaceisrequiredtoprovidefurtherinformation,pleaseattachaseparatesheet(s)ofpaper.
**Ifadditionalinteriorlightingpower,tradeoffsorexceptionsareusedattachcalculations.
Note:NumberingisbasedonSIeditionofASHRAE90.12010. April23,2012
ASHRAE90.1&SB10‐SECTION9LIGHTINGCOMPLIANCEWORKSHEET FORM9.5.3
Project: DesignerName:
ExteriorBuildingLightingPowerAllowance
Location/Application Allowance AreaorLength(m²orm) Tradable
Power
Allowance










ExteriorLightingZone
BaseSiteAllowance

TradablePowerAllowance
ExteriorInstalledLightingPower
ID Luminairedescription(includingnumberoflampsperfixture,wattsperlamp,
typeofballast,typeoffixture)
Numberof
Luminaires
Watts/
Luminaire
Total
Watts












Total ExteriorLightingPower
*Ifadditionalspaceisrequiredtoprovidefurtherinformation,pleaseattachaseparatesheet(s)ofpaper.
**Iftradeoffsorexceptionsareusedattachcalculations.