5900-22 Statement of Energy Design Intent

OMB Control No.2060-0347
Expiration Date: XX/XX/XXXX
Approved while under OMB review

®

1

ENERGY STAR Statement of Energy Design Intent (SEDI)
TEST

N/A

Primary Property Type: K-12 School
Gross Floor Area (ft²): 100,000
Estimated Date of Certification of Occupancy: __________
Date Generated: February 22, 2019

ENERGY STAR®
2

Design Score

1. This form is required when applying for Designed to Earn the ENERGY STAR recognition. It was generated from ENERGY STAR Portfolio
Manager.
2. The ENERGY STAR 1 – 100 Score is based on total annual Source Energy. To be eligible for Designed to Earn the ENERGY STAR recognition
you must score at least 75.

Property & Contact Information for Design Project
Property Address
TEST
123TEST
TEST, Maryland 20855

Project Architect
____ ________
,
(____)____-______
__________________

Owner Contact
____ ________
,
(____)____-______
__________________

Property ID: 6709012

Architect Of Record
__________________
__________________
___________, ____ ______
(____)____-______

Property Owner
__________________
,
(____)____-______

Estimated Design Energy
No estimated energy information provided.

Estimated Design Use Details
This Use Detail is used to calculate the 1-100 ENERGY STAR Score.

K-12 School
Number of Workers on Main Shift
Percent That Can Be Cooled
Number of Computers
Gymnasium Floor Area
Number of Walk-in Refrigeration/Freezer
Units
Cooking Facilities
School District
Student Seating Capacity
Weekend Operation
High School
Percent That Can Be Heated
Gross Floor Area
Months in Use

EPA Form 5900-22

50
All of it - 100%
175 default
value
0 Sq. Ft.
default value
1 default value
Yes
1,000 default
value
No
No
All of it - 100%
100,000 Sq. Ft.

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Statement of Energy Design Intent (SEDI) for TEST
Generated On: 2/22/2019

Design Energy and Emission Results
Metric
ENERGY STAR Score (1-100)
Energy Reduction (from Median)(%)
Source Energy Use Intensity (kBtu/ft²/yr)
Site Energy Use Intensity (kBtu/ft²/yr)
Source Energy Use (kBtu/yr)
Site Energy Use (kBtu/yr)
Energy Costs ($)
Total GHG Emissions (Metric Tons CO2e)

Design Project
N/A
N/A
0
0
0
0
0
0

Median Property
50
0
103
45
10,306,168
4,569,702
111,649
394

Estimated Savings
N/A
N/A
103
45
10,306,168
4,569,702
111,649
394

Designed to Earn the ENERGY STAR: Application Checklist
This section is only required if you are using this document to apply for Designed to Earn the ENERGY STAR. All design projects
that achieve an EPA energy performance score of 75 or higher are eligible for this certification.
1) Does your property type match the function or use of a property that's
eligibility to receive an ENERGY STAR design score?

Yes

No/Not Sure

Yes

No

3) Is the property currently unoccupied and not yet generating energy bills?

Yes

No

4) Do energy calculations account for the whole building intended operations
and all energy sources?

Yes

No

5) Is the Architect of Record (AOR) applying for ENERGY STAR partnership?

Yes

No

6) Was the design record created in the owner's Portfolio Manager account?

Yes

No

7) Are you seeking other qualifications for this design project?

Yes

No

If you are not sure your project is eligible for an ENERGY STAR design
score, please describe the property's major functions or use:

2) Is the design project at least 95% complete with construction documents?
If no, please explain:

If so, please select all that apply:
AIA 2030 Commitment
Architecture 2030 Challenge
Federal, State or Local Disclosure Ordinance
Green Globes
LEED
Other, please indicate: ____________________________

EPA Form 5900-22

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Statement of Energy Design Intent (SEDI) for TEST
Generated On: 2/22/2019

Professional Verification
I __________________ (Name) verify that the above information is true and correct to the best of my knowledge.

Signature: _______________________Date: ___________
Verifying Professional
____ ________
,
(____)____-______
__________________

Note: When applying for the ENERGY STAR Designed to Earn, the
signature of the Verifying Professional must match the stamp.

Verifying Professional Stamp
(if applicable)

I agree to adhere to the ENERGY STAR Identity Guidelines when using the Designed to Earn the ENERGY STAR recognition
graphic in association with this project.

Architect of Record Acknowledgement
As the Architect of Record representative, I confirm that the information on this SEDI is true and accurate to the best of my
knowledge. It is our best estimate for all energy use of specified systems and processes but does not guarantee the operational
performance of this building. Instead, this project has been specified to achieve Designed to Earn the ENERGY STAR recognition
in an effort to assist the Owner/Developer in meeting their operational performance goal for the building to earn ENERGY STAR
certification.

Signature: _______________________
Date: __________________________

Building Owner/Developer Acknowledgement
As the Building Owner/Developer representative, I concur that this project be nominated for Designed to Earn the ENERGY STAR
recognition. Our organization understands the importance of measuring actual energy use in Portfolio Manager after receiving
the Certificate of Occupancy to verify that this property is performing as intended. We understand that once the building earns an
ENERGY STAR score of 75 or higher, it may be eligible for ENERGY STAR certification.

Signature: _______________________
Date: __________________________

This document was generated from Target Finder, an EPA tool located on the ENERGY STAR Web site, www.energystar.gov.
This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2060-0347). Responses to this collection of information
are voluntary (Section 103(g) Clean Air Act). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently
valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to average 3.75 hours per response. Send comments on the
Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division
Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send
the completed form to this address.

EPA Form 5900-22

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Statement of Energy Design Intent (SEDI) for TEST
Generated On: 2/22/2019