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- � � r� �. �.ceE� i�����,r�� r���.�_� =.�����; <br /> Pa�rt $. DE��ESSL:�IZATrt�I�T PR�T'ECTION <br /> Chec�C cptioa nsad: ❑ �ue!bu=ning�quipsncat (ccmplec-.schec[ules b�Iaw) G No fu�l b�unmg equigaent <br /> _.���,. �� <br /> . <br /> • INSrFzucst�rs EXS.�tST/:�L�.(CE-G'P AIIt SCHEDULF" <br /> Step 1. Com�leta tbe Con+bwsiion Fq:acnmenr Schedule belvw. Qnly equr�ne�t E.�chha�:st dcvicca ovcr 3�?0 cfrn Flow <br /> with z X(Ya)aray be seL-Med unrier the"Category 1"altc�ate. c� <br /> 5cep 2. Com�Ietz Exhr�sslMake-up A�Schedule oa tbe right if dimt cx powcr � c� <br /> vantcd ar snlid fuel aflmosp�cric vmt spua heating eqnipment is ae:ected. c� <br /> C01�LSTION EQL'FP,hiE1�I'T SC��.'i.E <br /> (chec7c all tyF�PrflF��? <br /> 5pac�l�snng-�nsolid fueI i Sealed cnm�uoon Y I Hesrt� - aonselid��ei 0 Sealed combu�ti.oa Y <br /> C7 Direr:or powez ventrd �' i Direc:or powcr ventcd Y <br /> atmasptxricaliy ventcd:� N A�ospherically ventcd � N <br /> Wate:t�eating-aoasolid fnel 0 Se�ed coml�ustinn �' �a�hesaag-solid zuel ❑ Atrnosqk�aically ventod � Y' <br /> • A�t or power venred Y Water�ng-solid fue! � ❑ p��p��z]�y y�td � Y� <br /> A�sphe.-ically vented N f�csrrh-solid fue: � � A�ospiserca!Iy ve:ted j Y <br /> "` L+'aLL•nosplizr.cally veaied so3id Plt.-1 or dix�ct or power veat�. nanso� fue? soacc hcs�:g is ins�alIe.�+, ther rna�-� air to �a:c:: <br /> �ew is requue�for e3ch individnaI cxbaust de�rice wiiich ex�..s 34C c�s�ic fe:t per�:ute. <br /> �a� C�. VEi�1TILATIt1N (�v�ab_ustiou �.ir/I'eo�ale �.i�) <br /> vE1�Y'TII..�.TIO;v Qt1A�'`�TITY <br /> (;Lfe:�.ic.zi v� 'aladon�atst be pr�vic-d per t�e L�e:ensndry cslcsla�3�e'.o�v} <br /> a g g�o cubic fect z O.fl0583/mtnute = /�,8 � c{m ( � I z 15 cfmlhedroom) �1�cfm= ;�G c:m <br /> �_ <br /> vcl�.ia^.s o�ha�itanle raoms at�ixs o_L-c��aa� <br /> VE1'TII1iTI01`j F,1.Y SCHEDLZE <br /> Chec3c znet`icdCs)Pzonose�l � ❑ E�c.haast oniy i Ba:znced (hea::�ecov-�✓venc!ator,air exchan;_-, e:c.) i <br /> Fan.a.�crv��r�or inc��on � Ve,n••wr I � I TOT.�.S <br /> �'F...ti"CIL.�'ITor Ia�e � a oo c� c:in � c� c�n � a o� c� <br /> AS DESIGV�i Ez�it:st a.00, c�n c� j c� � c� � a c� c� <br /> Statement of CnmpLiante: Tt�e Frapesed buiidiag desi� te���ced in �ese dec�:.��t L cer.sistenc w;tL che Uui??iag piaas, <br /> ;�ecin;.ations, and o��: ealeslatiocs s:�c�tted with d� pe.^.-�.it anp:ieacien. T�e proposed b�si:dia� has been desiQr.ed tc nL.ec tt:o <br /> ceq:�ire�er.ts oi the;4iinnasota F�e:gy Cede. <br /> �LC�v e .Ly..� /t't•/� �1^-� /- �y-o z `�j r�-9Y/- yd i� <br /> Appizcanc{prin;r.ame) S:gr.acue Date Tel_Y'r.one cur.:ber <br /> �'art C�. V El� 1�+.��11�J1\T {Submit Part C=npon campletion nf 9v3tem rerifi¢�tion'') <br /> �°�G ---------------------------------------------------------------------- <br /> T0� $l�P.�.^C99; �pe�r 'Cu�..�v�u'.�, P�r�:�iti.��C: <br /> Fan dcs�don or locar.on I I �'QTALS <br /> �L�"'L'RFD Intzke � c?�: cf� � ci:a � c�:: cfn <br /> PEFcFOR�.tiCE+� �x:�ust c� cf� c5n � ,;.-i I c:m <br /> i �'e:^�:.cn rste�lst�e mC�5lfed a^d ver:fiec whea the pe�crr.iar.co c��on s:ucd in(i�u oF th�prescri�tive cption fer th_s�a:in¢ f <br /> ot jci'us iu 1.e Euil�inicondiaoneY ea�elooe (fro�Par:A}. I <br /> Compiiancc StutPmcr,t: Ir,ca]Ie�'ve��iia:ior,sys:zm s i.�compiiz:.=,vi�:�ti'�Ez-�;Co�e 3:.c s s�.eC to pccvi�e che d;si�^ai�fl�w <br /> � <br /> Applic:s:c(pr:nc n3�e) Signar4rc L��. I T�!ri�or.c nur�oer <br />