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� .; City of Minnaipolis <br /> Homeowner Heat Loss and Equipment Identi�cation Form � �` <br /> � � <br /> �a� Se,rvius <br /> xo�� A�-tas IrE orY►GS t�c,. c�co� �rt'a�wi�e� G as <br /> Job address 15�4 M iY111 t�. Contr Phone Gt� " �?� �3!?.� <br /> comr Phone �0/� "9 I� ��34s <br /> Ciry of Minneapolis requires this h�I�at los�fu3m For�and boilara ins�ikd in single fa�nily homas or ' <br /> duplaocee be leJt Rt f14a job alts. ' <br /> Do.ot aubmit the h�g load calculatioas with yait parmit appliaa�tiion. <br /> (Not�:You car we tl�e,�br�e y�vtr w+e p�renth'Wsln,�as lon�g 1x�!t Ixu all the 6�'a�bn comolr�+d on tl�e Clh',�6�m)• <br /> Mennrements and caknlado�u: <br /> 1. Sq.F't ex�ed walls sbove gr�da� . sqft x"U"_��x 88 dcgree�tanPa'ahn'e - 13 , y 9 ( <br /> (Note:A lypka!?x�waU wJth?x4�rood fi�rtbg wlthow ixsrrlcttat hat ' <br /> a U vn/We of l.AB and a wall wtth 3�i"ojl�asr�latlon/xu a ••U"�of 0.063.) <br /> 2. 3q.Ft of ttie oelW� �1 � sq8 x"U"• O�x 88 - 315� � <br /> (Note:A typkal 2x4 franing wtth S"of t�sulc��on has a U vahre <br /> ojO.OS,with 9"of J��has a U v�alrre oj0.03Z.) <br /> 3. 3q.ft of baaemart floor ma bebw 0�,�,� ,sqR x 3&u's/Sq Ft � �� <br /> 4.Sq.R of wall area bebw �aqft x 6 Btu's/Sq•Ft = �'i_Z� <br /> s.���.�a����W;� �ao x c.s>x �.os X se -S 70-3 <br /> �. <br /> 6.Lin.Ft of infiltruion for dauB-- 3�o x(1.25)X(1.08)x 88 = ��� � <br /> 7.Lin.Ft of infilhation for sliding doas--- ��_x(.75)X(1.08)x 88 - �7� <br /> 8.Allowanca f�nr exhaust f�s:600�u's pa kit�en fan 200 Btu's per Bath.�r------ - 1� �� <br /> 9.Allovranve Sor fn+epl�ocs: 1,500 Btu's each = /S�O <br /> lA.Tobl Bta lum�nr a0 abnve kems— - = 3$ i� 6 � <br /> i l.Add 8or caa�bustio�n air(0.001)x nat loss above x(12.5)x(0.075)x 88 = ?J � 7 <br /> 1Z.Totsl Nsa 10�sd 11 to de�he I�t�(Or�drts Areat J�s,�edite� _ �� i �7 <br /> 13.s.�ty ae�or-M.�y Ye.�b..by�.�o�o a.�ermme.aartioea�.�bwa - `15 • Ss01 <br /> (T 1�1a!�tl�e a�ie fiana�cs y�ou sla�ld rae tn th/s advctra+e. The cods abrs allow ynu to rrsa the nart aJse avatlabk prm'�in8 <br /> diat tlie a�prnpriate squ�p�ent ls n�t r+�ocHly aNafla6la.Equlpnrent whose capa�c�tp arc�cdt die drslgh load may be t�ed{/' <br /> � t/ie m�erall arrra�al ener�►cosls ane nnt fncnaosed) <br /> 'Ihe tmdasigned,�appiic�nt for a heatin8 pmtnit►huebY affirms the above infat�iott tms been preperod by or for <br /> himll�sel�oc wda hialhar diroction;haaby sdatowl�die infortt�ation w be aon�ec�and aoan�aoe. <br /> Proposed fumace/boilor size: O O Btu's. Proposed fiunace/boiler make:�ooCQMGt� <br /> Proposed . C� O �1 <br /> S� -� Date: B '' �S " ! 3 <br /> Frnm can be found oniine at wvwv.minseanolis�nn.�yj�(aro lic/(lr�vioes/doaunents/weboontent/conv�t 28046�.R�f <br />