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RPR-24-2013 10:56 From: To:7633900939 Page:1�1 <br /> -° ^ Hottieowner Heat Loss and Equipment xdent��ratian Form <br /> Homcowncr �}'�q.y `'1 b'�`�S :Gas Contractor �fi'�c.w ic.Q�t,� �oqS S�,rv�5 <br /> ^ Job address I 5 I C� o r�� PI^Iyl or0�;Contr Phone �i�2 �4� " 31 ��' <br /> :Contr Phone �c�v� �q �q '�`�s3 g' <br /> City of Minneapolis rcqui�es tfiis heating heat loss form for ti�maces'snd boilera installed in single fl�mily homes or <br /> duplaxes ba fsft at 1he job stee. ': <br /> Do not submit the heating load ca�ulations with your pertnit applicaiion. <br /> (No1e: Yau can use thr form you are pre.rently using,as long Jras�t hlas all thc iaformation cwrrai�red on the Ciryform). <br /> Measurements s�ad c�ica�atioas: � <br /> 1. Sq.Ft exposed walls xbove gradet��.���sqft x"U" ► �6 �x 88 degrse dcsign tempaaturc -��t ���'' <br /> (Nwe:A typica!hc4 wall wtth?x4 wooil frau�irrg without insalati'on has <br /> a U.»lue of 1.08 and o walt wfth 3'/r'�of uuulation has a "U"value of 0.063.) <br /> z. �,.�.of�a�����-..�....�. ��__ .— �i�4 �ft x�•��• ,d�ax 8$ _ W , 3 7 7 <br /> {iJote:A rypical?z4 fr�ntng with S"of r�rsr�laliv►e has a U value: <br /> of O.dS,wbh 9"of In�ilm;ar has a U valur a/'0.032.) � <br /> 3. Sq.ft of basemern floor anea below grade---------,- -- ��sqR x 3 Btu's/Sq Ft = � � �6 � <br /> 4.Sq.ft.of wall erea below grade�-------_____��__.__._..��_ �do�sqfl z 6 Btu'slSq.Ft = �1 ro'� <br /> S.l,in.f'c of blfthCatipn for wiu�dows----------- --..----- ��'�' x(.S)X I.0$x=8 = ��O 1..�3 a <br /> 6.Lin.�t of infilcracion for doots-------------------- -------- �.�x(1.25)X(I.OS}x 88 � �l ,�•5 <br /> � 7.Lin.Ft of infilaation for slldtng doors----------------.----- a�x(.73)X(1.08)x 88 � ,�� <br /> 8.Allowanve for exhaust fAns:600 Btu's per kicchen fan 200 Bhr's per Bath fan-------------------_ � i�}O�j <br /> 9.Allowance for tireplaoes: 1,500 Ba's each --__�._.____. : ���._ . �-��- � �.�j��'. <br /> t0.ToblBto iots for�ll abdre i� I = �,�_��� <br /> 11.Add for comb�tion aa(0.001)x nd►os9 gbove x(12.5)x(0.075�)x 88-------- = rj( � � <br /> 12,Total lina 10 Aad 1 a to determine be■t lowe(Or subatltaie l�sa{loss jron�othe� � � / � 7� � �� <br /> 13.Safety t�ctor—Mdltiply heat losa by 1.10 to deteraaiQe,dditionat allowaace------------ � ���� <br /> (Tlllf l!tJIE 9�tE ftd71RCB}'OU SJfO1�Id i�R ln t/!is JJ/YCIUI'B. Tiie code da'es altow you ro usa the neri slze available provrdtng <br /> thw the approPriate equipment is not rradily avai/able.Equipn+ent whoae capactry exeeeds the design load may be ased{'f <br /> rhe overall ur,mrcl energy cosrs ars not tncrecraed) - <br /> 'i'he undersigned,as applicant for s heating pe�mit,heroby affirms the Abovo information has bean prepared by or for <br /> him/herself,or anda�hisTha dircetion;hcccby acknowledges the infor�ation to bc oorrect and eoc�us�u. <br /> pmposed fuma�ce/boiler size:�o��tu's. Proposed fiunace/boiler make: C����iNIGi 1�,� <br /> Proposed funn�ac odel no. �Q � �r <br /> _ � <br /> signature• � pac�: 1-/-a 3 � 13 <br /> � , f . _�_ _ � ---- _ <br /> - - . , __. _.- -- -_,�-�--�.= � - --�--�- -� ---.� . _. . <br />