| Attachment | Size |
|---|---|
| Refrigeration_Installation_Permit_FRM-0824-02_fillable.pdf | 81.22 KB |
Embedded Scribd iPaper - Requires Javascript and Flash Player
PRINTED IN B.C.
4500118020
0001
88 3rd Floor, 4243 Glanford Avenue 604-927-2041 Kamloops Coquitlam 6th Street, Suite 400 fax 604-927-2047 250-861-7313 Langley New 5B3 Victoria, BC V8Z 4B9 Kelowna Westminster, BC V3L fax 250-861-7349 250-716-5200 fax 250-716-5212 Prince George Nanaimo 250-952-4444 fax 250-952-4458 Victoria Lower Mainland Regional Office: Northern Interior Regional Office:
Head to our Please referOffice:web site or contact a RegionalVancouver Island BC Safety Authority office Southern Interior Regional Office: Office to locate the Regional Office: nearest you. 1913 Kent fax 250-314-6000 Road 250-377-4406 604-539-3573BC fax 604-539-3570 Kelowna, V1Y 7S6 250-614-9972 fax 250 614 9949 TOLL FREE NUMBER:
3740 Opie Crescent 1.866.566.SAFEwww.safetyauthority.ca New 20635 Fraser505 - 6th Street, Suite 200, New Westminster, BC, V3L 0E1 Westminster: Highway Website: (7233) Prince www.safetyauthority.ca LocalLangley, 778-396-2000 Phone: BC V3A 4G4 fax 778-396-2174 George, BC V2N 4P7 Toll Free: 1-866-566-SAFE (7233) fax 1-888-660-3508
REFRIGERATION INSTALLATION PERMIT
Note: The information on this form is collected to administer the provisions of the BC Safety Standards Act. If you have questions about this information, contact This form is collected to administer the provisions of the BC Safety Standards Act. If you have any questions about the collection, use, or disclosure of the collection, use, or the Records,of this information, contact for the BC Safety Authority at telephone 1-866-566-SAFE (7233). disclosure Information & Privacy Analyst the Records/FOIPP Coordinator for the BC Safety Authority at telephone 604-660-6286. Applicant (please print clearly)
A.
Plant Name: Suite No.: City: Plant Owner’s Name: Suite No.: City: Contractor’s Name: Suite No.: City: Street No.: Street Name: Province: Postal Code: Phone: ( Name: Residential Exceeding 4 Units Commercial Industrial Street Type: ) NSEW: Street No.: Street Name: Province: Postal Code: Phone: ( Street Type: ) NSEW: Street No.: Street Name: Province: Postal Code: Phone: ( Street Type: ) NSEW:
Contractor Licence No.: BC Refrigeration TQ No.: Occupancy Institutional Public Assembly (check off as applicable): Please complete: (refer to the requirements on the back of the form) Replacement Equipment Refrigerant Group: Number of Units Manufacturer Yes No System Nameplate Rating (kW):
System Refrigerant Charge (kg):
Refrigerant Name: Description
Piping Design Registration Required?
Yes
No
Piping Design Registration No.: “P”
The contractor agrees to pay on demand any shortages or extra charges for inspection of equipment not shown herein in accordance with the BCSA Boiler & Pressure Vessel fee schedule.
Signature: B. Office use only Entry Date: Tran Code C114
YYYY MM DD
Date:
Office:
Technology: Fee: $
BP
Payment Method:
File No.: Tran Date:
YYYY MM DD
C.
Contractor Use upon Completion (for inspection requirements see back of permit.) Declaration of Test (see back of permit) No Yes if yes, LP side: psig, HP side: psig
The installation is ready for inspection. Description of work (include any piping done):
The installation has been done in accordance with the Safety Standards Act and Regulations. Name:
FRM-0824-01 (2009-05-21) FRM-0824-00 (2005/03/04)
Signature: Fees payable to the BC Safety Authority. White - Applicant Canary - Audit Blue - Safety Officer
Date:
ORCS 32080-20
REFRIGERATION INSTALLATION PERMIT AND PIPING DESIGN REGISTRATION REQUIREMENTS 1. Definition of refrigeration equipment: Means machinery in which refrigerants are capable of being vaporized, compress and liquefied. No installation permit is required for any refrigeration plant less than 5 kW nameplate rating. Approval: For package (shop assembled) refrigeration plants less than 125kW Group A1, A2 or B1 and less than 25 kW all other Refrigerant Groups, certification by an approved testing laboratory is required. Piping design registration is required for the following: a) 125 kW or more for Group A1, A2 or B1 Refrigerants or; b) 25 kW or more for all other Refrigerant Groups. System refrigerant charge: In accordance with CSA B52 Clause 4.10.4.5 a Declaration of Test is required for an installation of a system containing 23 kg or more of refrigerant. Pressure vessel identification: All pressure vessels shall have a British Columbia Identification Number assigned to them by a Safety Officer of the BC Safety Authority. Inspection: First inspection as required for Group A1, A2 or B1 Refrigerants less than 125 kW.
2. 3.
4.
5.
6.
7.
Refrigeration Plant Capacity *Note 4 Less than 5kW 5kW or more Prime Mover
Permit not required Type of Refrigerant Group A1, A2 or B1 Group A3, B2 or B3
Plant Capacity Less than 125 kW 125 kW or more
Plant Capacity Less than 25 kW 25 kW or more
Permit required. Piping registration not required. *Note: 1 & 3
Permit and Piping registration required. *Note 2
Permit required. Piping registration not required. *Note: 1 & 3
Permit and Piping registration required. *Note 2
First Inspection as required. *Note 3
First Inspection and in-service inspection by Safety Officer.
Notes: 1. The permit may be issued at any BC Safety Authority Office. 2. The permit may be issued and design registered at the BC Safety Authority Branch Head office, 88 6th Street, Suite 400, New Westminster, BC. 3. Certification by an approved testing laboratory is required for package (shop assembled) refrigeration plants less than 125 kW Group A1, A2 or B1 refrigerants, and less than 25 kW all other refrigerant groups. 4. Plant capacity is the sum of the Prime Mover nameplate ratings connected on the refrigerant side.
PRINTED IN B.C.
4500118020
0001
88 3rd Floor, 4243 Glanford Avenue 604-927-2041 Kamloops Coquitlam 6th Street, Suite 400 fax 604-927-2047 250-861-7313 Langley New 5B3 Victoria, BC V8Z 4B9 Kelowna Westminster, BC V3L fax 250-861-7349 250-716-5200 fax 250-716-5212 Prince George Nanaimo 250-952-4444 fax 250-952-4458 Victoria Lower Mainland Regional Office: Northern Interior Regional Office:
Head to our Please referOffice:web site or contact a RegionalVancouver Island BC Safety Authority office Southern Interior Regional Office: Office to locate the Regional Office: nearest you. 1913 Kent fax 250-314-6000 Road 250-377-4406 604-539-3573BC fax 604-539-3570 Kelowna, V1Y 7S6 250-614-9972 fax 250 614 9949 TOLL FREE NUMBER:
3740 Opie Crescent 1.866.566.SAFEwww.safetyauthority.ca New 20635 Fraser505 - 6th Street, Suite 200, New Westminster, BC, V3L 0E1 Westminster: Highway Website: (7233) Prince www.safetyauthority.ca LocalLangley, 778-396-2000 Phone: BC V3A 4G4 fax 778-396-2174 George, BC V2N 4P7 Toll Free: 1-866-566-SAFE (7233) fax 1-888-660-3508
REFRIGERATION INSTALLATION PERMIT
Note: The information on this form is collected to administer the provisions of the BC Safety Standards Act. If you have questions about this information, contact This form is collected to administer the provisions of the BC Safety Standards Act. If you have any questions about the collection, use, or disclosure of the collection, use, or the Records,of this information, contact for the BC Safety Authority at telephone 1-866-566-SAFE (7233). disclosure Information & Privacy Analyst the Records/FOIPP Coordinator for the BC Safety Authority at telephone 604-660-6286. Applicant (please print clearly)
A.
Plant Name: Suite No.: City: Plant Owner’s Name: Suite No.: City: Contractor’s Name: Suite No.: City: Street No.: Street Name: Province: Postal Code: Phone: ( Name: Residential Exceeding 4 Units Commercial Industrial Street Type: ) NSEW: Street No.: Street Name: Province: Postal Code: Phone: ( Street Type: ) NSEW: Street No.: Street Name: Province: Postal Code: Phone: ( Street Type: ) NSEW:
Contractor Licence No.: BC Refrigeration TQ No.: Occupancy Institutional Public Assembly (check off as applicable): Please complete: (refer to the requirements on the back of the form) Replacement Equipment Refrigerant Group: Number of Units Manufacturer Yes No System Nameplate Rating (kW):
System Refrigerant Charge (kg):
Refrigerant Name: Description
Piping Design Registration Required?
Yes
No
Piping Design Registration No.: “P”
The contractor agrees to pay on demand any shortages or extra charges for inspection of equipment not shown herein in accordance with the BCSA Boiler & Pressure Vessel fee schedule.
Signature: B. Office use only Entry Date: Tran Code C114
YYYY MM DD
Date:
Office:
Technology: Fee: $
BP
Payment Method:
File No.: Tran Date:
YYYY MM DD
C.
Contractor Use upon Completion (for inspection requirements see back of permit.) Declaration of Test (see back of permit) No Yes if yes, LP side: psig, HP side: psig
The installation is ready for inspection. Description of work (include any piping done):
The installation has been done in accordance with the Safety Standards Act and Regulations. Name:
FRM-0824-01 (2009-05-21) FRM-0824-00 (2005/03/04)
Signature: Fees payable to the BC Safety Authority. White - Applicant Canary - Audit Blue - Safety Officer
Date:
ORCS 32080-20
REFRIGERATION INSTALLATION PERMIT AND PIPING DESIGN REGISTRATION REQUIREMENTS 1. Definition of refrigeration equipment: Means machinery in which refrigerants are capable of being vaporized, compress and liquefied. No installation permit is required for any refrigeration plant less than 5 kW nameplate rating. Approval: For package (shop assembled) refrigeration plants less than 125kW Group A1, A2 or B1 and less than 25 kW all other Refrigerant Groups, certification by an approved testing laboratory is required. Piping design registration is required for the following: a) 125 kW or more for Group A1, A2 or B1 Refrigerants or; b) 25 kW or more for all other Refrigerant Groups. System refrigerant charge: In accordance with CSA B52 Clause 4.10.4.5 a Declaration of Test is required for an installation of a system containing 23 kg or more of refrigerant. Pressure vessel identification: All pressure vessels shall have a British Columbia Identification Number assigned to them by a Safety Officer of the BC Safety Authority. Inspection: First inspection as required for Group A1, A2 or B1 Refrigerants less than 125 kW.
2. 3.
4.
5.
6.
7.
Refrigeration Plant Capacity *Note 4 Less than 5kW 5kW or more Prime Mover
Permit not required Type of Refrigerant Group A1, A2 or B1 Group A3, B2 or B3
Plant Capacity Less than 125 kW 125 kW or more
Plant Capacity Less than 25 kW 25 kW or more
Permit required. Piping registration not required. *Note: 1 & 3
Permit and Piping registration required. *Note 2
Permit required. Piping registration not required. *Note: 1 & 3
Permit and Piping registration required. *Note 2
First Inspection as required. *Note 3
First Inspection and in-service inspection by Safety Officer.
Notes: 1. The permit may be issued at any BC Safety Authority Office. 2. The permit may be issued and design registered at the BC Safety Authority Branch Head office, 88 6th Street, Suite 400, New Westminster, BC. 3. Certification by an approved testing laboratory is required for package (shop assembled) refrigeration plants less than 125 kW Group A1, A2 or B1 refrigerants, and less than 25 kW all other refrigerant groups. 4. Plant capacity is the sum of the Prime Mover nameplate ratings connected on the refrigerant side.