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r" <br /> ;t. .�' req � �3�'�� � 0•��,klt7 ��� � <br /> ction Energy Codia ptiartt�e Certificate <br /> Per R4e1.3 Cenrricale.A building certiG•cete Sha!OC Date Certificate <br /> Min the uncal distribution panel <br /> .. ! <br /> Mailing Addressof the Dvrelling or Dweflin9 Unit <br /> city <br /> Name 01y4SIdential Contractor / <br /> Number <br /> HER AL NVEL.OPE � <br /> TRADEN COld7 Type:Check All That Applyassive(No Fan) <br /> 1,177171-11 0 i. <br /> )r° or other system monilonng <br /> ys ra�` Location(of Future location)of Fan <br /> IL m <br /> Insufatlon LOcahon r > Q z H 0 o x <br /> in `o m a U O m u y �' <br /> m 3 c o c E qtr <br /> F = z LL u LL u iz Other Please Describe Here ` <br /> Below Entire SIaS -) + <br /> Foundation Wali _ h <br /> b Perimeter of Slab on Grade " <br /> I # <br /> Rim Joist(1st Floor) <br /> Rim Joist(2nd Hcor+) rt <br /> Wa11 Y <br /> Ceiling_floc f <br /> Ceiling,vaulted , <br /> Bay Windows or canti'evered areas <br /> Floors over unconditioned area <br /> Describe other insulated areas <br /> r&i <br /> Building envelope airtightness: Duct system airtightness: <br /> Windows&Doors Heating or Cooling Ducts Outside Conditioned Spaces <br /> Average U-Factor(excludes Skylights and one door)U: Not applicable,all ducts located in conditioned space <br /> Solar Heat Gain Coefficient(SHGC): R-value <br /> Make-up Air Select a Type <br /> Appliances Heating System Domestic Wator Cooling System <br /> Heater Not ra lilt}' eixi <br /> gh� <br /> pt �" <br /> �Fue!Type � c�,� suis G,Pc�clC Pass :: u <br /> Manufacturer &tnrut Powered <br /> $o,tr/ NTS 1--TIt0 `$�,Q�Ad6� Deflockedwithexhaustdevice. <br /> crc g <br /> Model i-yrn3bTAii60o�1)t)}t <br /> oi\tr rnportin ito,ccc Capaotyin Output ; Other,describe- <br /> Rating or Size hK•w;�W STUS: coo GO d Gators: in Tons: " <br /> 06A a" AFUE or q5•(_ ScER Location of duct or system: <br /> Efficiency <br /> HSPF cab 1c[R <br /> Heating Loss Heating Gain Cooling Load <br /> esidential Load Calculate ' O ,C1 1 - 57.c1 }o, Cfm's k ry <br /> `round duct OR <br /> MECHAPHUAL VENMMOW 976TM "metal dud i <br /> Describe any additional or combined heating or cooling systems if installed:(e.g.two furnaces or air Combustion Air Select a Type <br /> source heat pump witn pas back-up furnace): Not required per meth.code <br /> �n <br /> Select Type Passive ,m <br /> Heat Recover Ventilator(HRV) Capacity in cfms: Loin: High: I Other,describe; <br /> Energy Recover Ventilator(ERV)Capacity in cfms: Low: 3400 High: 1 4%� Location of duct or system: <br /> Balanced Ventilation capacity in cfms: <br /> Location cf fan(s),describe: Cfm's <br /> Capacity continuous ventilation rate in cfms: A6 "round duct OR <br /> Total ventlation(intermittent+continuous)rate in cfms, "metal duct <br /> Builders Association of Minnesota version 101014'' <br /> . . .,a tOPW. .:. <br /> �sr� <br />