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Illustration #5 Version 1 .0: May 2009 <br /> New Construction Energy Code Compliance Certificate �k�, <br /> �: <br /> Per Nl 101.8 Buildin�Ceriificate.A Uuilding certiflcate shell be posted in a pennanendy visible location inside the buildine. BUILDERS <br /> "fhe certificate shall be completed hy the builder and shall list information and values of components lisfed in'fab1�NI IOI.R. '�"? �`+��TION Of NJNNESOTA <br /> For deuuled infonnnlion on how lo correctly completa this fomi go to�vmu.Gm�m.org/energycndc Prvelopnd hy+he 6uAde+'sAsarciulion q(,4linnr.solt[ <br /> for usc!y�hv resrden�inf rnristrurtiwi indiaby. <br /> B YS�nE _�o�_ <br /> ---3 3--Z---a— --------------------- _.._...._._oRo�lo...------._......._--------------- ------------ <br /> Mailing Address oF Dwelling or D���elling Unit City Date Certificate Posted <br /> C�+�alzl,ES C�D� - l7� l�l o v o Z.a�3 S Z4S <br /> Name of Residential ConU•actor MN I,icense Number <br /> THERMAL ENVELOPE RADON SYSTEM <br /> � <br /> Type:Check Al)Thot Apply Passivc(No Fa�i) <br /> = � Active(\�th fan and monometer or nther <br /> � o � system monitoring devicc) � - <br /> a <br /> — m <br /> e '"�+ u <br /> � �= � ����tl��� <br /> U <br /> � � � <br /> r. � o . <br /> Q � c ^ _ a 0. ' <br /> � G � � v V ` � ° �'`°-:M1 �.} : �;� <br /> � E Pa � u e � � F xe�;J .. <br /> ? o y H � c, 'k, o <br /> � z � � � o L � � <br /> � � °° � _ � � � CfTY OF ORONO <br /> .`�. C '� :C q C ��0 �0 <br /> Insulation Loeation F° z 'w 'w r-'. v° Z C 2 Other,PlcaseDcscribeHcre <br /> 13elo�r Cnfire Slnb . . � . � �� . � .. � . � � � . . <br /> Found�tion Wiill Ciirle l,ocutinn:6��erioJ•/F..steriariLatzgra! <br /> Pcrimetcr of Slab on Crado�-� � � � � � � � - - � <br /> Rim Joist(Fnundatinn)Circlu Locnlion:Intcrla✓Exterior iregr <br /> Rim Joist(Is1 F/nor+)Crrcle Localio�s:lnterior/Everioi/l�i�egral <br /> �Vall <br /> Cciling�flat <br /> Ceilin�,vrulted <br /> I3ny vvindods or other esntilcrcrcd arcas <br /> 13onus room ovcr var7ge <br /> Dcscribc otlicr insulated arcas �. -� � � � � � � � � � <br /> Windows & Doors Heating or Cooling Ducts Outside Conditioned Spaces <br /> Average U-Factor(e.ccludes 1>sq.n.,skylighl.s und one door)U: ' �� (1/jNot applicable,all in conditioned space <br /> Svlar Hca[Gain Cocfficient: • 1. � �R= <br /> MECHANICAL SYSTEMS Make-up Air <br /> Applianees He�itinp System Domestic Water Heater Cooling System Select a Tl�e <br /> Fue1'I)�pe (�, "'�� ` [�Not required per mechanical cnde <br /> 1�l:�mdacturer a, 'T' •d� s (�y r [ ]Yassive [ ]Powercd <br /> Model ' 10O S � ( ]Interlocked�+•itli exhaust device, <br /> � describe <br /> Rnfing ur Sire Input in B"1'US: � Capacily in Gallons: Q Output in 7'ons: 4. ( ]Other,describe: <br /> SUuclure's Culculutcd Heat Ltiss: '�Z�Qp —NotApplic�ble-- Fleat Gain: Z„�17 Locution ofduct ors��stenr: <br /> Efficicncy AFUE or HSPF%: �� --Not ApplicaUle— SEE2: I3 N� A • <br /> Calculat�d cooling load: Cfiie's(—— —] <br /> Size ojduct[__J inch round <br /> Mechanical Ventilation System oR[__]inch metal <br /> Descrrbe any ndditirn�a7 or cort�hined l�enting rn�cnoGng s��sle�ns if insralled:(e.g.tx•o fiu•naces or air source Ireut Combustion Ai r <br /> purnp�rith gct,r back-irp fiernace) Se%ct a T��e <br /> SPlect n Tppe [ ]Not required per mechanical code <br /> (�I-Leat Recover Ventil�tor(HRV) Capaciq�in cfms:Low_ �(Z/lli�h 1�� (�Pacsive <br /> [ ]Gnergy Recover Venlilalo�(I:RV) Capacity in cfms:Low_ _ _/High_ __ [ ]Other,descr;Ue: <br /> [ j Continuously cxhaustina fan(s)ratcd capacity in ctins:__ _ Locntiorr ojdrrct or s�•steuu <br /> Location of f:m(s)check all that aPply:[ ]Master baUiroom[ ]Hallway[ ]Otl�er Jescribe: M E GN� �lOOI�( <br /> Ca�acrty Cjn�'.r[__ _] <br /> Conlinuous ventilation ratc= ___cPin Size of drrct(_.(,pj inch round <br /> Totul ven[ilntion(intermittent+continuous)rate= __ __cfin OR[__J inch metal <br /> 42 Builders Association of Minnesota 525 Park St, Ste )SO I St. Paul,MN 55103 800-654-7783 or 651-646-7959 www.bamn.org <br />