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New Construction Energy Code Compliance Certificate <br /> Per R401.3 Certificate.A building certificate shall be posted on or in the eledripl distributian Date Certificate Posted <br /> panel. <br /> Mailing Address of the Dwelling or Dwelling Unit City <br /> Z� �� �a ' f '�� . � ���c_.Q_ <br /> Name of Residential Co�tractor , MN License Number <br /> l � <br /> �µ"/�'�/Y. � t I�c/'n 1 � / 4t 4 { N/�p <br /> HERMAL ENVELOPE RADON CONTROL SYSTEM <br /> Type:Check All That Appty Passive(No Fan) <br /> Active(W'dh fan and monometer or <br /> � � other system monitoring device) <br /> � y N ocation(or future location)of Fan: <br /> D T <br /> O <br /> o a � � V � ° a�i 5 <br /> � Q m m y V y a c <br /> ti <br /> T <br /> � o Z m m U a � � r_°n <br /> Insulation Location n W <br /> m `o Q' �' E E � p v <br /> m � c °� d � m c rn rn <br /> � c Z � LL � i° g � � Other Please Describe Here <br /> Below Entire Slab <br /> Foundation Wall <br /> Perimeter of Slab on Grade <br /> Rim Joist(1st Floor) <br /> Rim Joist(2nd Floor+) <br /> Wall <br /> Ceiling,flat <br /> Ceiling,vaulted <br /> Bay Windows or cantilevered areas <br /> Floors over unconditioned area <br /> Describe other insulated areas <br /> Building envelope air tightness: (ACH) Duct system air tightness: (cfm/100s� <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 /> MECHANICAL SYSTEMS Make-up Air Se�ect a Type <br /> Appliances Heating System Domestic Water Cooling System , � <br /> Heater � Not required per mech.code <br /> Fuel Type �v'��`� � r +�. f �_. f f. c�'� r, �. Passive <br /> t v�`-.'�-:`�� 1`i E 'g`u"`�� Powered <br /> Manufacturer f <br /> Interlocked with exhaust device. <br /> Model ��a S�3��G�S 1`'( 1(�� �����J Describe: <br /> Input in Capaciry Output � ; Other,deSCribe: <br /> Rating or Size <br /> BTUS: !a���u` in Gallons: in Tons: . ,..^ •'�" <br /> AFUE or SEER Location oi duct or system: <br /> EffiCi6nCy HSPF% ��, ��'�. /EER ' .;i-�:� <br /> Heating Loss Heating Gain Cooling Load <br /> esidential Load Calculation <br /> `S� �� a ��� �t� � Cfm's <br /> "round duct OR <br /> MECHANICAL VENTILATION SYSTEM "meta�duct <br /> Describe any additional or combined heating or cooling systems if i�stalled:(e.g.two fumaces or air Combustion Air Select a Type <br /> source heat pump with gas back-up fumace): Not required per mech.code <br /> Se/ect T e X Passive <br /> )C Heat Recover Ventilator(HR� Capacity in cfms: Low: High: � �S Other,describe: <br /> Energy Recover Ventilator(ER�Capacity in cfms: Low: High: Location of duct or system: <br /> �, <br /> Balanced Ventilation capacity in cfms: ��C � '^'y`��� ���� <br /> Location of fan(s),describe: Cfm's <br /> Capacity continuous ventilation rate in cfms: �s '` "rer�nd-dus4-0R � � <br /> Total ventilation(intermittent+continuous)rate in cfms: a�S`'� � / "metal duct <br /> Builders Associaton of Minnesota version 101014 <br />