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i <br /> Part B. DEPRESSURIZATION PROTECTION <br /> Check option used: 0 Fuel burning equipment (complete schedules below) 0 No fuel burning equipment <br /> u it ;1 ; i INSTRUCTIONS EXHAUST/MAKE-UP AIR <br /> .: '; SCHEDULE* <br /> Step I. Complete the Combustion Equipment Schedule below. Only equipment Exhaust device over 300 elm Flow <br /> with a Y(Yes)may be selected under the"Category I"alternate. N <br /> 4- cfm <br /> Step 2. Complete Exhaust/Make-up Air Schedule on the right if direct or power cfm <br /> vented or solid fuel atmospheric vent space heating equipment is selected. cfm <br /> COMBUSTION tQUIPMENT SCHEDULE <br /> (check all types proposed) <br /> Space heating—nonsolid fuel 0 Sealed combustion Y Hearth — nonsolid fuel 0 Sealed combustion Y <br /> ' Direct or power vented Y* Q'.Direct or power vented Y <br /> Atmospherically vented N Atmospherically vented N <br /> Water heating—nonsolid fuel 0 Sealed combustion Y Space heating—solid fuel 0 Atmospherically vented Y* <br /> 0 Direct or power vented Y Water heating—solid fuel ❑ Atmospherically vented Y <br /> �rGT�ese--- Atmospherically vented ' N Hearth—solid fuel ❑ Atmospherically vented Y <br /> * If atmospherically vented solid fuel or direct or power vented nonsolid fuel space heating is installed, then make-up air to match flow is required <br /> for each individual exhaust device which exceeds 300 cubic feet per minute. <br /> Part Ct. VENTILATION <br /> VENTILATION QUANTITY <br /> (Mechanical ventilation must be provided per the larger quantity calculated below) <br /> MZelf f cubic feet x 0.00583/minute= ` yziA cfm ( 1 x 15 cfm/bedroom)+15 cfm= $4,,,. cfm <br /> volume of habitable rooms number of bedrooms <br /> VENTILATION FAN SCHEDULE <br /> Check method(s)proposed 4 0 Exhaust only gBalanced (heat recovery ventilator,air exchanger,etc.) <br /> Fan description or location 4 a A,/441'12—, Z—(p/-tr{T TOTALS <br /> VENTILATION Intake cfm cfm elm cfm Z5o cfm <br /> AS DESIGNED Exhaust cfm cfm cfm cfm Z,J<j cfm <br /> Statement of Compliance: The proposed building design represented in these documents is consistent with the building plans, specifications, and <br /> other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy <br /> C�odee.. ke__ 2 /! - 1 K).&-6-T- 17 _ &11colo9 7 3 76774 <br /> Applicant(print name) Signature Date Telephone number <br /> Part C2. VENTILATION (Submit Part C2 upon completion of system verificationt) <br /> Job Site Address: Permit Number <br /> Fan description or location //AATOTALS <br /> MEASURED ` Intak .: '" • cfm cfm cfm cfm <br /> PERFORMANCEt Exhaust cfm cfm';` cfm cfm cfm <br /> t Ventilation rate must be measured d verified when the performance option is used in lieu of the prescriptive option for the sealing of joints in the. <br /> building conditioned envelope(from Part A). <br /> Compliance Statement: Installed ventilation system is in compliance with MN Energy Code and is sized to provide the design air flow. <br /> Applicant(print name) Signature Date Telephone number <br />