HomeMy WebLinkAboutLA168206 - 19885 Henley Lane Permit PackRESIDENTIAL BUILDING
PERMIT APPLICATION
CITY OF LAKEVILLE
BUILDING INSPECTIONS DEPARTMENT
20195 HOLYOKE AVENUE
LAKEVILLE, MN 55044
952-985-4440
Office Use Only
__________________
Permit Number
___________________
Received By
___________________
Date Received
___________________
Fee Total
SITE ADDRESS:
MAILING ADDRESS: CITY: STATE: ZIP:
JOB DESCRIPTION:__________________________________ MASTER PLAN: (Number or Address)____________________
LIST OTHER STRUCTURES ON PROPERTY:_______________________________________________________________
ESTIMATED VALUATION: PROPOSED START DATE: END DATE:
(New Residential Only): LEGAL DESCRIPTION: LOT: _____ BLOCK: _____ SUBDIVISION:
APPLICANT IS: RESIDENT OWNER CONTRACTOR EMAIL
NEW MODEL HOME: YES NO (IF YES – ADMINISTRATIVE PERMIT REQUIRED)
PLEASE FILL OUT THE FOLLOWING COMPLETELY (All Contractor information must be as listed on State License)
RESIDENT OWNER
NAME:_______________________________________________________________________________
HOME PHONE #:_____________________________ CELL PHONE:___________________________
GENERAL CONTRACTOR
Homeowner
Contractor
CONTRACTOR:_______________________________________________________________________
LICENSE #:BC______________ LEAD CERTIFICATE#_______________ (PRE 1978 STRUCTURE)
OFFICE PHONE #:_____________________________ CELL PHONE:___________________________
ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________
PLUMBING WORK
Homeowner
Contractor
CONTRACTOR:__________________________________________LICENSE #: PM______________
OFFICE PHONE #:_____________________________ CELL PHONE:___________________________
ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________
MECHANICAL WORK
Homeowner
Contractor
CONTRACTOR:________________________________________ _______________________________
OFFICE PHONE #:_____________________________ CELL PHONE:___________________________
ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________
BOND #:_______________________________________ EXPIRATION DATE____________________
SEWER/WATER CONTRACTOR
New Construction Only
NAME:________________________________________________ ______________________________
HOME PHONE _____________________________ CELL PHONE:______________________________
BOND #:_______________________________________ EXPIRATION DATE____________________
INTEREST EARNINGS ON THE ESCROW ACCOUNTS, IF ANY, ARE RETAINED BY THE CITY TO OFFSET THE
ADMINISTRATIVE COSTS ASSOCIATED WITH PROCESSING THE ESCROW APPLICATION AND REFUND. I HEREBY
APPLY FOR A BUILDING PERMIT AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND
ACCURATE; THAT THE WORK WILL BE IN CONFORMANCE WITH THE ORDINANCES AND CODES OF THE CITY AND
WITH THE STATE BUILDING CODE, THAT I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START
WITHOUT A PERMIT AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN.
NAME OF APPLICANT (Please Print)DATE
APPLICANT’S SIGNATURE:
www.lakevillemn.gov
RESIDENTIAL BUILDING PERMIT APPLICATION
PAGE 2
OFFICE USE ONLY
BUILDING PERMIT TYPE REQUIRED INSPECTIONS
SINGLE FAMILY DWELLING BUILDING
DUPLEX AS BUILT
TOWNHOUSE UNITS BUILDING FINAL
DETACHED TOWN HOUSE UNIT DECK FOOTING
CONDO FIREPLACE
ACESSORY BUILDING FOOTING
REROOF FOUNDATION
RESIDE FRAMING
PORCH FRAMING
GARAGES
INSULATION
RES ADDN/REPAIR/RMDL
DECK
PORCH
GARAGES LATH
LOWER LEVEL FINISH LOWER LEVEL FINAL
ADDITION OTHER
FOUNDATION ONLY PORCH FOOTING
MISCELLANEOUS POURED WALL
DEMO SEPTIC TANK REMOVAL
MOVED SITE
MECHANICAL
CITY BUILDING VALUATION: $AIR TEST
FINAL
BUILDING PERMIT FEES ROUGH-IN
$PERMIT FEE PLUMBING
$PLAN CHECK FINAL
$SURCHARGE ROUGH-IN
$METRO SAC METER SIZE
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$CITY SEWER HOOKUP UNIT SEWER/WATER
$LANDSCAPE ESCROW SEWER/WATER
$TREE ESCROW FINAL
$MISC ESCROW STREET DRAINTILE
$PLUMBING BUILDING INFORMATION
$MECHANICAL TYPE OF CONSTRUCTION
$SEWER WATER ZONING
$OTHER CODE EDITION
$TOTAL FIRE SUPPRESSION SYSTEM
OCCUPANCY GROUP
APPROVED BY:
BUILDING INSPECTOR: Date:
PLUMBING/MECHANICAL
INSPECTOR: Date:
COMMENTS:
Stone Cottage
HVAC Load Calculations
for
Grochocinski
19885 Henley Ln
Lakeville,mn
Prepared By:
Randy Andrews
Lofgren Heating
5708 Upper 147th Street West
Apple Vallley, MN 55124
Friday, March 22, 2019
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 2
Project Report
General Project Information
Project Title:Stone Cottage
Project Date:Friday, March 22, 2019
Client Name:Grochocinski
Client Address:19885 Henley Ln
Client City:Lakeville,mn
Company Name:Lofgren Heating
Company Representative:Randy Andrews
Company Address:5708 Upper 147th Street West
Company City:Apple Vallley, MN 55124
Company E-Mail Address:rrandrews@lofgrenheating-ac.com
Design Data
Reference City:Minneapolis, Minnesota
Building Orientation:Front door faces Southeast
Daily Temperature Range:Medium
Latitude:44 Degrees
Elevation:834 ft.
Altitude Factor:0.970
Elevation Sensible Adj. Factor:1.000
Elevation Total Adj. Factor:1.000
Elevation Heating Adj. Factor:1.000
Elevation Heating Adj. Factor:1.000
Outdoor Outdoor Outdoor Indoor Indoor Grains
Dry Bulb Wet Bulb Rel.Hum Rel.Hum Dry Bulb Difference
Winter:-15 -15.33 80%n/a 72 n/a
Summer:88 72 47%50%75 29
Check Figures
Total Building Supply CFM:1,355 CFM Per Square ft.:0.343
Square ft. of Room Area:3,953 Square ft. Per Ton:1,215
Volume (ft³) of Cond. Space:35,577
Building Loads
Total Heating Required Including Ventilation Air:56,946 Btuh 56.946 MBH
Total Sensible Gain:29,270 Btuh 82 %
Total Latent Gain:6,406 Btuh 18 %
Total Cooling Required Including Ventilation Air:35,676 Btuh 2.97 Tons (Based On Sensible + Latent)
3.25 Tons (Based On 75% Sensible
Capacity)
Notes
Calculations are based on 8th edition of ACCA Manual J.
All computed results are estimates as building use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads.
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 3
Load Preview Report
Scope
Has
AED
Net
Ton
ft.²
/Ton Area
Sen
Gain
Lat
Gain
Net
Gain
Sen
Loss
Sys
Htg
CFM
Sys
Clg
CFM
Sys
Act
CFM
Duct
Size
Building 2.97 1,330 3,953 29,270 6,406 35,676 56,946 1,091 1,355 1,355
System 1 Yes 2.97 1,330 3,953 29,270 6,406 35,676 56,946 1,091 1,355 1,355 24x10
Ventilation 340 1,352 1,692 4,550
Zone 1 3,953 28,930 5,054 33,984 52,396 1,091 1,355 1,355 24x10
1-Main Level 1,198 10,158 1,911 12,069 18,661 389 476 476 6--6
2-Upper Level 1,557 14,457 2,511 16,968 21,673 451 677 677 8--6
3-Lower Level 1,198 4,315 632 4,947 12,062 251 202 202 2--6
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 4
Total Building Summary Loads
Component
Description
Area
Quan
Sen
Loss
Lat
Gain
Sen
Gain
Total
Gain
4A-1a-o: Glazing-Double pane low-e (e = 0.20 or less),
operable window, e=0.20 on surface 2, wood with
metal clad frame, u-value 0.32, SHGC 0.33
562 15,646 0 15,091 15,091
11N: Door-Metal - Polystyrene Core 63 1,918 0 529 529
12F-0sw: Wall-Frame, R-21 insulation in 2 x 6 stud
cavity, no board insulation, siding finish, wood studs
2750 15,550 0 2,376 2,376
15B0-15sf-10: Wall-Basement, , R-15 board insulation to
floor, no interior finish, 10' floor depth
1107 4,044 0 0 0
16B-50: Roof/Ceiling-Under Attic with Insulation on Attic
Floor (also use for Knee Walls and Partition
Ceilings), Vented Attic, No Radiant Barrier, Dark
Asphalt Shingles or Dark Metal, Tar and Gravel or
Membrane, R-50 insulation
1557 2,709 0 1,495 1,495
21A-24: Floor-Basement, Concrete slab, any thickness, 2
or more feet below grade, no insulation below floor,
any floor cover, shortest side of floor slab is 24' wide
853 1,855 0 0 0
Subtotals for structure:41,722 0 19,491 19,491
People:7 1,400 1,610 3,010
Equipment:2,500 7,000 9,500
Lighting:0 0 0
Ductwork:0 0 0 0
Infiltration: Winter CFM: 115, Summer CFM: 60 10,674 1,154 829 1,983
Ventilation: Winter CFM: 140, Summer CFM: 70 4,550 1,352 340 1,692
Total Building Load Totals:56,946 6,406 29,270 35,676
Check Figures
Total Building Supply CFM:1,355 CFM Per Square ft.:0.343
Square ft. of Room Area:3,953 Square ft. Per Ton:1,215
Volume (ft³) of Cond. Space:35,577
Building Loads
Total Heating Required Including Ventilation Air:56,946 Btuh 56.946 MBH
Total Sensible Gain:29,270 Btuh 82 %
Total Latent Gain:6,406 Btuh 18 %
Total Cooling Required Including Ventilation Air:35,676 Btuh 2.97 Tons (Based On Sensible + Latent)
3.25 Tons (Based On 75% Sensible
Capacity)
Notes
Calculations are based on 8th edition of ACCA Manual J.
All computed results are estimates as building use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads.
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 5
Building Pie Chart
Building
Loss
56,946
Btuh
Floor 3%Roof 5%
Wall 34%
Glass 27%
Door 3%
Infiltration 19%
Ventilation 8%
Building
Gain
35,676
Btuh
Roof 4%
Wall 7%
Glass 42%
Door 1%
People 8%
Equipment 27%
Infiltration 6%
Ventilation 5%
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 6
System 1 Whole House Summary Loads
Component
Description
Area
Quan
Sen
Loss
Lat
Gain
Sen
Gain
Total
Gain
4A-1a-o: Glazing-Double pane low-e (e = 0.20 or less),
operable window, e=0.20 on surface 2, wood with
metal clad frame, u-value 0.32, SHGC 0.33
562 15,646 0 15,091 15,091
11N: Door-Metal - Polystyrene Core 63 1,918 0 529 529
12F-0sw: Wall-Frame, R-21 insulation in 2 x 6 stud
cavity, no board insulation, siding finish, wood studs
2750 15,550 0 2,376 2,376
15B0-15sf-10: Wall-Basement, , R-15 board insulation to
floor, no interior finish, 10' floor depth
1107 4,044 0 0 0
16B-50: Roof/Ceiling-Under Attic with Insulation on Attic
Floor (also use for Knee Walls and Partition
Ceilings), Vented Attic, No Radiant Barrier, Dark
Asphalt Shingles or Dark Metal, Tar and Gravel or
Membrane, R-50 insulation
1557 2,709 0 1,495 1,495
21A-24: Floor-Basement, Concrete slab, any thickness, 2
or more feet below grade, no insulation below floor,
any floor cover, shortest side of floor slab is 24' wide
853 1,855 0 0 0
Subtotals for structure:41,722 0 19,491 19,491
People:7 1,400 1,610 3,010
Equipment:2,500 7,000 9,500
Lighting:0 0 0
Ductwork:0 0 0 0
Infiltration: Winter CFM: 115, Summer CFM: 60 10,674 1,154 829 1,983
Ventilation: Winter CFM: 140, Summer CFM: 70 4,550 1,352 340 1,692
System 1 Whole House Load Totals:56,946 6,406 29,270 35,676
Check Figures
Supply CFM:1,355 CFM Per Square ft.:0.343
Square ft. of Room Area:3,953 Square ft. Per Ton:1,215
Volume (ft³) of Cond. Space:35,577
System Loads
Total Heating Required Including Ventilation Air:56,946 Btuh 56.946 MBH
Total Sensible Gain:29,270 Btuh 82 %
Total Latent Gain:6,406 Btuh 18 %
Total Cooling Required Including Ventilation Air:35,676 Btuh 2.97 Tons (Based On Sensible + Latent)
3.25 Tons (Based On 75% Sensible
Capacity)
Notes
Calculations are based on 8th edition of ACCA Manual J.
All computed results are estimates as building use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads.
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 7
Detailed Room Loads - Room 1 - Main Level (Average Load Procedure)
General
Calculation Mode:Htg. & clg.Occurrences:1
Room Length:1,198.0 ft.System Number:1
Room Width:1.0 ft.Zone Number:1
Area:1,198.0 sq.ft.Supply Air:476 CFM
Ceiling Height:9.0 ft.Supply Air Changes:2.6 AC/hr
Volume:10,782.0 cu.ft.Req. Vent. Clg:0 CFM
Number of Registers:6 Actual Winter Vent.:50 CFM
Runout Air:79 CFM Percent of Supply.:10 %
Runout Duct Size:6 in.Actual Summer Vent.:25 CFM
Runout Air Velocity:404 ft./min.Percent of Supply:5 %
Runout Air Velocity:404 ft./min.Actual Winter Infil.:51 CFM
Actual Loss:0.102 in.wg./100 ft.Actual Summer Infil.:26 CFM
Item
Description
Area
Quantity
-U-
Value
Htg
HTM
Sen
Loss
Clg
HTM
Lat
Gain
Sen
Gain
NW-Wall-12F-0sw 43 X 9 287 0.065 5.7 1,623 0.9 0 248
SE-Wall-12F-0sw 43 X 9 275 0.065 5.7 1,555 0.9 0 238
SW-Wall-12F-0sw 40 X 9 344 0.065 5.7 1,945 0.9 0 297
NE-Wall-12F-0sw 40 X 9 348 0.065 5.7 1,968 0.9 0 301
SE-Door-11N 6 X 7 42 0.350 30.5 1,279 8.4 0 353
SE-Door-11N 3 X 7 21 0.350 30.5 639 8.4 0 176
NW-Gls-4A-1a-o shgc-0.33 0%S 100 0.320 27.8 2,784 24.1 0 2,414
SE-Gls-4A-1a-o shgc-0.33 0%S 49 0.320 27.8 1,364 31.0 0 1,518
SW-Gls-4A-1a-o shgc-0.33 0%S 16 0.320 27.8 445 31.0 0 496
NE-Gls-4A-1a-o shgc-0.33 0%S 12 0.320 27.8 334 24.2 0 290
Subtotals for Structure:13,936 0 6,331
Infil.: Win.: 50.9, Sum.: 26.5 1,494 3.163 4,725 0.246 511 367
People: 200 lat/per, 230 sen/per:2 400 460
Equipment:1,000 3,000
Room Totals:18,661 1,911 10,158
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 8
Detailed Room Loads - Room 2 - Upper Level (Average Load Procedure)
General
Calculation Mode:Htg. & clg.Occurrences:1
Room Length:1,557.0 ft.System Number:1
Room Width:1.0 ft.Zone Number:1
Area:1,557.0 sq.ft.Supply Air:677 CFM
Ceiling Height:9.0 ft.Supply Air Changes:2.9 AC/hr
Volume:14,013.0 cu.ft.Req. Vent. Clg:0 CFM
Number of Registers:8 Actual Winter Vent.:58 CFM
Runout Air:85 CFM Percent of Supply.:9 %
Runout Duct Size:6 in.Actual Summer Vent.:35 CFM
Runout Air Velocity:431 ft./min.Percent of Supply:5 %
Runout Air Velocity:431 ft./min.Actual Winter Infil.:51 CFM
Actual Loss:0.116 in.wg./100 ft.Actual Summer Infil.:26 CFM
Item
Description
Area
Quantity
-U-
Value
Htg
HTM
Sen
Loss
Clg
HTM
Lat
Gain
Sen
Gain
NW-Wall-12F-0sw 40 X 9 277 0.065 5.7 1,566 0.9 0 239
SE-Wall-12F-0sw 40 X 9 235 0.065 5.7 1,329 0.9 0 203
SW-Wall-12F-0sw 43 X 9 354 0.065 5.7 2,002 0.9 0 306
NE-Wall-12F-0sw 43 X 9 367 0.065 5.7 2,075 0.9 0 317
NW-Gls-4A-1a-o shgc-0.33 0%S 83 0.320 27.8 2,311 24.1 0 2,003
SE-Gls-4A-1a-o shgc-0.33 0%S 125 0.320 27.8 3,480 31.0 0 3,872
SW-Gls-4A-1a-o shgc-0.33 0%S 33 0.320 27.8 919 31.0 0 1,022
NE-Gls-4A-1a-o shgc-0.33 0%S 20 0.320 27.8 557 24.2 0 483
UP-Ceil-16B-50 1557 X 1 1557 0.020 1.7 2,709 1.0 0 1,495
Subtotals for Structure:16,948 0 9,940
Infil.: Win.: 50.9, Sum.: 26.5 1,494 3.163 4,725 0.246 511 367
People: 200 lat/per, 230 sen/per:5 1,000 1,150
Equipment:1,000 3,000
Room Totals:21,673 2,511 14,457
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 9
Detailed Room Loads - Room 3 - Lower Level (Average Load Procedure)
General
Calculation Mode:Htg. & clg.Occurrences:1
Room Length:1,198.0 ft.System Number:1
Room Width:1.0 ft.Zone Number:1
Area:1,198.0 sq.ft.Supply Air:202 CFM
Ceiling Height:9.0 ft.Supply Air Changes:1.1 AC/hr
Volume:10,782.0 cu.ft.Req. Vent. Clg:0 CFM
Number of Registers:2 Actual Winter Vent.:32 CFM
Runout Air:101 CFM Percent of Supply.:16 %
Runout Duct Size:6 in.Actual Summer Vent.:10 CFM
Runout Air Velocity:515 ft./min.Percent of Supply:5 %
Runout Air Velocity:515 ft./min.Actual Winter Infil.:13 CFM
Actual Loss:0.165 in.wg./100 ft.Actual Summer Infil.:7 CFM
Item
Description
Area
Quantity
-U-
Value
Htg
HTM
Sen
Loss
Clg
HTM
Lat
Gain
Sen
Gain
NW-Wall-12F-0sw 43 X 9 263 0.065 5.7 1,487 0.9 0 227
SE-Wall-15B0-15sf-10 43 X 9 387 0.042 3.7 1,414 0.0 0 0
SW-Wall-15B0-15sf-10 40 X 9 360 0.042 3.7 1,315 0.0 0 0
NE-Wall-15B0-15sf-10 40 X 9 360 0.042 3.7 1,315 0.0 0 0
NW-Gls-4A-1a-o shgc-0.33 0%S 124 0.320 27.8 3,452 24.1 0 2,993
Floor-21A-24 1 X 853 853 0.025 2.2 1,855 0.0 0 0
Subtotals for Structure:10,838 0 3,220
Infil.: Win.: 13.2, Sum.: 6.9 387 3.163 1,224 0.245 132 95
Equipment:500 1,000
Room Totals:12,062 632 4,315
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc.
Lofgren Htg. & A/C Stone Cottage
Farmington, MN 55024 Page 10
System 1 Room Load Summary
No
Room
Name
Area
SF
Htg
Sens
Btuh
Min
Htg
CFM
Run
Duct
Size
Run
Duct
Vel
Clg
Sens
Btuh
Clg
Lat
Btuh
Min
Clg
CFM
Act
Sys
CFM
---Zone 1---
1 Main Level 1,198 18,661 389 6-6 404 10,158 1,911 476 476
2 Upper Level 1,557 21,673 451 8-6 431 14,457 2,511 677 677
3 Lower Level 1,198 12,062 251 2-6 515 4,315 632 202 202
Ventilation 4,550 340 1,352
System 1 total 3,953 56,946 1,091 29,270 6,406 1,355 1,355
System 1 Main Trunk Size:24x10 in.
Velocity:813 ft./min
Loss per 100 ft.:0.092 in.wg
Cooling System Summary
Cooling
Tons
Sensible/Latent
Split
Sensible
Btuh
Latent
Btuh
Total
Btuh
Net Required:2.97 82% / 18%29,270 6,406 35,676
Recommended:3.25 75% / 25%29,270 9,757 39,027
Actual:1.00 77% / 23%9,240 2,760 12,000
Equipment Data
Heating System Cooling System
Type:Natural Gas Furnace Standard Air Conditioner
Model:QC-F38-E78-G QC-C12
Indoor Model:S12
Brand:Quikcool FE Series Quikcool AS Series
Description:Hi Efficiency Furnace Standard Efficiency Air Condit
Efficiency:78.3 AFUE 12.4 SEER
Sound:8.1 bels
Capacity:38,000 Btuh 12,000 Btuh
Sensible Capacity:n/a 9,240 Btuh
Latent Capacity:n/a 2,760 Btuh
C:\ ...\19885 henley lakeville 03222019.rhv Friday, March 22, 2019, 9:52 AM
Builders Associaton of Minnesota version 101014
Date Certificate Posted
x Passive (No Fan)
Active (With fan and monometer or
other system monitoring device)
Location (or future location) of Fan:
Other Please Describe Here
x
10/15 x x
x
20 x
20 x
21 x
49 x
x
x
x
x Not applicable, all ducts located in conditioned space
x Not required per mech. code
Passive
Powered
Interlocked with exhaust device.
Describe:
Input in
BTUS:
70,000 Capacity in
Gallons:
Other, describe:
AFUE or
HSPF%
93%
Cfm's
" round duct OR
" metal duct
Not required per mech. code
x Passive
Low: Other, describe:
x Low:
Location of fan(s), describe: Cfm's
4" " round duct OR Flex
" metal duct
City Mailing Address of the Dwelling or Dwelling Unit
Combustion Air Select a Type
Location of duct or system:
35,676
Below Entire Slab
Rig
i
d
,
E
x
t
r
u
d
e
d
P
o
l
y
s
t
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e
Ceiling, flat
Per R401.3 Certificate. A building certificate shall be posted on or in the electrical distribution panel.
Place your
logo here
New Construction Energy Code Compliance Certificate
Name of Residential Contractor
Stone Cottage Construction Inc.
MN License Number
Lakeville19885 Henley Lane
BC636874
Mech Room
Heat Recover Ventilator (HRV) Capacity in cfms:
Energy Recover Ventilator (ERV) Capacity in cfms:
56,946
Heating Gain Cooling Load
Attic
Fuel Type
Solar Heat Gain Coefficient (SHGC):
Windows & Doors
Ceiling, vaulted
Bay Windows or cantilevered areas
Floors over unconditioned area
Rim Joist (2nd Floor+)
0.30
Appliances
THERMAL ENVELOPE
Fo
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O
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C
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Wall
Rig
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,
I
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Perimeter of Slab on Grade
RADON CONTROL SYSTEM
No
n
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N
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A
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p
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Cooling System
To
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V
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T
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p
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In
s
u
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a
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i
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n
Type: Check All That Apply
Min
e
r
a
l
F
i
b
e
r
b
o
a
r
d
Insulation Location
Fo
a
m
,
C
l
o
s
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d
C
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0.22
Describe other insulated areas
Fi
b
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r
g
l
a
s
s
,
B
l
o
w
n
Fi
b
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r
g
l
a
s
s
,
B
a
t
t
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Foundation Wall
R-value
Average U-Factor (excludes skylights and one door) U:
Duct system air tightness: Building envelope air tightness:
Rim Joist (1st Floor)
GPVL-50 13ACXN042-230 Model
Heating System
Natrual Gas
Lennox
Location of duct or system:
Heating or Cooling Ducts Outside Conditioned Spaces
Electric
Make-up Air Select a Type
AO Smith
Domestic Water
Heater
MECHANICAL SYSTEMS
Rating or Size
Efficiency 13 Seer
200CFM
Select Type
Describe any additional or combined heating or cooling systems if installed: (e.g. two furnaces or air
source heat pump with gas back-up furnace):
29,270Residential Load Calculation
SEER
/EER
Total ventilation (intermittent + continuous) rate in cfms:
Balanced Ventilation capacity in cfms:
High:
High:
MECHANICAL VENTILATION SYSTEM
Capacity continuous ventilation rate in cfms:
ML193UH070
Heating Loss
Manufacturer Lennox
Natural Gas
Output in
Tons:
3 Ton50
NEW RESIDENTIAL CONSTRUCTION SWPPP VERIFICATION
This form must be completed and submitted with all new residential permit applications.
New residential building permits WILL NOT be issued without this completed form.
Project Site Address: _____________________________________________________________________
Company Name: _________________________________________________________________________
Primary Contact: _________________________________________________________________________
Phone # (24 hr Contact): ______________________ Email: ______________________________________
Description of Land Disturbing Activity: _____________________________________________________
NPDES Construction Stormwater Permit # C000 ___ ___ ___ ___ ___ or # SUB00 ___ ___ ___ ___ ___
If you are not covered under a NPDES Construction Stormwater Permit administered by the MPCA, an
erosion and sediment control plan MUST be submitted with the residential building permit application.
“The permittee(s) shall ensure that the individuals are trained by local, state, federal agencies, professional organizations or other entities
in erosion prevention, sediment control, permanent Stormwater management and the Minnesota NPDES/SDS Construction Stormwater
Permit.” (NPDES Construction Stormwater Permit, MPCA)
“The permittee(s) must ensure that a trained person (as identified in Part III.A.3.a) will routinely inspect the entire construction site at least
once every seven (7) days during active construction and within 24 hours after a rainfall event greater than 0.5 inches in 24 hours.”
(NPDES Construction Stormwater Permit, MPCA)
Contact information of person CERTIFIED to provide weekly onsite erosion and sediment control
inspections and corrective actions:
Name of Person: ________________________________Company: _______________________________
Phone # (24 hr Contact): ______________________ Email: ______________________________________
Entity that Provided Training: ________________________ Certification Expiration Date: ____________
NOTE: Prior to any land-disturbing activity, all erosion and sediment controls must be installed on the project site and on individual lots.
No land disturbing activity may begin until a residential building permit has been issued.
I understand, the above information to be true and I will have read, understood, and accepted all terms and conditions of the National
Pollutant Discharge Elimination System (NPDES) Permit (MN R 100001). The City of Lakeville may issue a STOP WORK ORDER;
withhold building inspections; or, draw on securities/escrows to bring the site into compliance with the NPDES Construction Stormwater
Permit (MN R 100001) or erosion and sediment control plan.
Signature: ________________________________________________ Date:_________________________
Contact the City of Lakeville with questions at erosion@lakevillemn.gov or 952-985-4500