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New Construction Energy Code Compliance Certificate
Per N I 101.8 Building Certificate.A building cemficaze shall be posted in a pertnanrndy visible bcation inside the bwlding. 'Che Date Certificah Poated
certificate shall be completed by the builder and shall list informa�ion and values of components lisred in Table Nl 101.8.
Mailing A ss of the Dwel' g r Dwdling Uoit Ciry
��C�� l�� �✓P: C �� �► C�
Name of R aidential Contr to MN License Number
6 �,., ,--���;;,�,�,�,- ::�,�,( _'��� �� ����
THERMAL ENVELOPE RADON SYSTEM
Type:Check All That Apply passive(No Fan)
w
o �
c
� � � Active(With fan and monometer or
_ � �, other system monitoring device)
iti U � ^ '� 0. y
O 4 � V � O -p
N
N Ll' O R � �
� d Ca W � V d v c
�y . C .O T
> O m v," O a� � x O
Insulation Location ° z � � � q w
°G �o o �w �o � � "
a, �v �c
'� � ° a .o � 5 on co
F � Z w w w° u° � c� cG Other Please Describe Here
Below Entire Slab Q�I b
FOundation W911 - () Type in location:interior exterior or integral
Perimeter of Slab on Grade
Rim Joist(Foundation) ZDj 3 Type in location:intenor extenor or integral
Rim Joist(1"�FIOor+) Zp. Type in�ocation:intenor extenor or integrai
Wall -�{j,
Ceiling,Flat -�U
Ceiling,vauited �,-
Bay Windows or cantilevered areas
Bonus room over garage -38.
Describe other insulated areas
Windows 8�Doors Heating or Cooling Ducts Outside Conditioned Spaces
Average U-Factor(excludes sky/ights and one door)U: Not applicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): R-value
MECHANICAL SYSTEMS `'�t�;,t v '��t sl ,�,� ,; Make-upAir se�e�roTyPe
ApplianCes Heating System Domestic Water Heater Cooling System Not required per mech.code
Fuel Type •r ��w�' li`'�S - • Passive
Manufacturer � { iG� �{ '^�L ►,G�(�l�l - Powered
Interlocked with exhaust device.
Model _ M��, d /�-�
�7 ,�U � � 5� -! �V C� Describe:
Input in Capaciry in �` Output in / Other,desc�ibe:
Rating or Size BTUS: �(,)�'(��/ Gallons: 7.J Tons:
Heat Loss: Heat Gain: Loc;ation of duct or system:
Structure's Calculated .��'�(.� �,,,����,
AFUE or SEER: � ' � �� �j
HSPF% I^ "�Llt�.
� Calculated
L
� �Efficienc � L� cool;ng load: 1��GG� �jL Cfm's ,f-L�
"round duct OR
Mechanical Ventilation System ���� �`GL t� "metal duct
Describe any additional or combined heating or cooling systems if installed:(e.g.two furnaces or air Combustion Air Select a Type
ource heat pump with gas back-up fumace): Not required per mech.code
Select Type Passive
Heat Recover Ventilator(HRV) Capacity in cfms: Low: // High: %� Other,describe:
Energy Recover Ventilator(ERV)Capacity in cfms: Low: High: Location of d ct or system:
Continuous e�austing fan(s)rated capacity in cfrns: �1 �(�'� -
Location of fan(s),describe: I 1 i'���S � � � ���C(' ,ti� �� �!' Cfm's
Ca aciry continuous ventilation rate in cfins: �'� "round duct OR
Total ventilation(intermittent+continuous)rate in cfms: ',��' "metal duct
Created by BAM version 052009
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New Construction Energy Code Compliance Certificate
Per N 1 I OL8 Builtling Certifica[e.A bwiding certificate shall be posted in a permanendy visible location inside the buflding. The Dste Certifinte Posted
certificare shall be completed by the builder and shall list information and values of componenu listed in Table N I IOI.B.
MsiGng Addresv ot e Dwdling or Drvelli Unit City � �
��� �-il. � � �/( � l./�,:� �
Name ot ResideoNel Contractor ,,1 MN Limnx Num(bJer
�, ^ ,r�Y,�'tP.l �/1 v\ �.,1 � 5 C L�V �T�$
v
THERMAL ENVELOPE RADON SYSTEM
Type:Check All That Apply Passive(No Fan)
w
o v
�, c
� � � Active(With fan and monometer or
� �, other system monitoring device)
td V � '_' � LL .�.
� C.)
� �
� Q Oa m a�i V � v c
T
Insulation Location � ° z � � � " w w �
� m o ou �n � `� �•
u -C �v
r-� S ,Z� u, w w � � rx oe Other Please Describe Here
Below Entire Slab - D
Foundation Wall Type in location:interior extenor or integral
Perimeter of Slab on Grade
Rim.lolst(Foundation) ,ZO�,] Type in location:intenor extenor or integral
Rim Joist(1"�Floor+) Type in locatioo:interior extenor or integral
Wall ?p,,3
Ceiling,flat Q
Ceiling,vaulted -
Bay Windows or cantilevered areas
Bonus room over garage (Z-
Describe otherinsulated areas
Windows 8 Doors Heatin or Cooling Ducts Outside Conditioned Spaces
Average U-Factor(excludes skylights and one door)U: Not a plicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): R-value
MECHANICAL SYSTEMS S t (�C: �L � �'/o�y - ake-upAir SelecraType
Ap IianCes Heating System Domestic Water Heater Cooling 3ystem Not required per mech.code
Fuel Type �/(:i; !i � assive
Manufacturer �� -'' �GS " P wered
Int locked with eachaust vice.
Model � � 6 Desc ibe:
lnput in Capaciry in Output in � OthCi, CSC[ibC:
Rating or Size BTUS: Galions: Tons:
Heat Loss: Neat Gain Location of duct r system
Structure's Calculated /a 7 3�
AFUE or SEER:
HSPF% I
Calculated �
Efflcienc cooling load: � �%U CfiTt's
"round d ct OR
ical Ventilation System -' "metal uct
Describe any add�i or combined heating or cooling systems if installed(e.g.two furnaces or�+r�'" Combustlo Air Select a pe
ource heat pump with gas ba fumace): / Not quired per mech. e
Select Ty e i� P ive
Heat Recover Ventilator(HRV) Capacity in c tow: High: her,describe:
Energy Recover Ventilator(ERV)Ca acity inefms: High: Loca on of duct or system:
Continuous e�chausting fan(s)rated capacity in cfrns:
Locatio�of fan(s),deseribe: Cfin's
Capacity centinuous ventilation rate in cfins: "round duct OR
Total ventilation(intermittent+continuous)rate in efms: � "metal duct
Created by BAM version 052009