HomeMy WebLinkAboutLA214592 - 16397 Jaffna Place - App and Forms wSWPPPRESIDENTIAL 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:________________________________________ _______________________________
_____________________________ CELL PHONE:___________________________
ADDRESS:____________________________ CITY:________________ ST:______ ZIP:____________
BOND #:_______________________________________ EXPIRATION DATE____________________
SEWER/WATER CONTRACTOR
New Construction Only
NAME:________________________________________________ ______________________________
_____________________________ CELL PHONE:______________________________
BOND #:_______________________________________ EXPIRATION DATE____________________
NAME OF APPLICANT (Please Print)DATE
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
CONDO
REROOF
RESIDE
RES ADDN/REPAIR/RMDL
DECK
PORCH
GARAGES
LOWER LEVEL FINISH
ADDITION
FOUNDATION ONLY
MISCELLANEOUS
DEMO
APPROVED BY:
BUILDING INSPECTOR: Date:
PLUMBING/MECHANICAL
INSPECTOR: Date:
COMMENTS:
CITY BUILDING VALUATION: $
BUILDING PERMIT FEES
$PERMIT FEE
$PLAN CHECK
$SURCHARGE
$METRO SAC
$CITY WATER HOOKUP UNIT
$CITY SEWER HOOKUP UNIT
$LANDSCAPE ESCROW
$TREE ESCROW
$MISC ESCROW
$PLUMBING
$MECHANICAL
$SEWER WATER
WATER METER
PRESSURE REDUCING VALVE
$OTHER
$TOTAL
METER SIZE
PRESSURE REDUCING VALVE
SEWER/WATER
SEWER/WATER
FINAL
STREET DRAINTILE
BUILDING INFORMATION
TYPE OF CONSTRUCTION
ZONING
CODE EDITION
FIRE SUPPRESSION SYSTEM
OCCUPANCY GROUP
MECHANICAL
AIR TEST
FINAL
ROUGH-IN
PLUMBING
FINAL
ROUGH-IN
INSULATION
LATH
DECK FOOTING
FIREPLACE
FOOTING
FOUNDATION
FRAMING
PORCH FRAMING
PORCH FOOTING
POURED WALL
SITE
LOWER LEVEL FINAL
OTHER
DECK FRAMING
LOWER LEVEL FRAMING
LANDSCAPING
DECK FINAL
$
$
ACCESSORY BUILDING
EGRESS WINDOW
UNDERGROUND
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
R-10 X
R-10 X
X
R-20 X
R-20 X
R-20 X
R-49 X
R-49 X
R-30 X
R-30 X
Not applicable, all ducts located in conditioned space
R8
Not required per mech. code
X Passive
Powered
Interlocked with exhaust device.
Describe:
Input in BTUS:40,000 Capacity in Gallons:Other, describe:
AFUE or HSPF%92%
Cfm's
6" " round duct OR
" metal duct
X Not required per mech. code
Passive
Low: Other, describe:
X Low:
Location of fan(s), describe: Cfm's
" round duct OR
" metal duct
THERMAL ENVELOPE
Foam Open Cell Wall
Below Entire Slab Rigid, Extruded Polystyrene Ceiling, flat
Fuel Type
Solar Heat Gain Coefficient (SHGC):
Windows & Doors
Ceiling, vaulted
Bay Windows or cantilevered areas
Floors over unconditioned area
Rim Joist (2nd Floor+)
0.32
Appliances Rigid, Isocynurate Perimeter of Slab on Grade
RADON CONTROL SYSTEM
R10 ExteriorNon or Not Applicable Cooling System
Per R401.3 Certificate. A building certificate shall be posted on or in the electrical distribution
panel.
New Construction Energy Code Compliance Certificate
Name of Residential Contractor
D.R. Horton
MN License Number
Lakeville16397 Jaffna Place - 2625 - Int. Unit
BC605657
City Mailing Address of the Dwelling or Dwelling Unit
Mech Room
Mech Room
Heat Recover Ventilator (HRV) Capacity in cfms:
Energy Recover Ventilator (ERV) Capacity in cfms:
32,716
Heating Gain Cooling Load
49 98
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):
Residential Load Calculation
Heating Loss
Combustion Air Select a Type
Location of duct or system:
16,813Total R-Value of all Types of InsulationType: Check All That Apply
Mineral Fiberboard Insulation Location
Foam, Closed Cell0.32
Describe other insulated areas Fiberglass, BlownFiberglass, Batts 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)
AENT50 BA13NA018 Model
Heating System
Nat Gas
Bryant
Interior
Interior
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 13SEER/EER
912SD36040E14
Manufacturer Bryant
Electric
Output in Tons:1.550
Total ventilation (intermittent + continuous) rate in cfms:
Balanced Ventilation capacity in cfms:
High:
High:
MECHANICAL VENTILATION SYSTEM
Capacity continuous ventilation rate in cfms:
Builders Associaton of Minnesota version 101014
Bold/italic values have been manually overridden
Calculations approved by ACCA to meet all requirements of Manual J 8th Ed.
2021-Dec-10 06:39:37
Right-Suite® Universal 2021 21.0.08 RSU29636 Page 1
...5 JAFFNA PLACE - 2625 INT (FAIRFAX) - SOUTH.rup Calc = MJ8 Front Door faces: S
2625 INT (FAIRFAX)Job:Load Short Form 12/9/2021Date:Entire House Energy Diagnostics, Inc.By:
Energy Diagnostics, Inc.
405 E Archer Way, Valparaiso, IN 46383 Phone: 219-464-4457 Fax: 219-464-0035
Project Information
DR Horton MNFor:
16445 Jaffna Place, Lakeville, MN 55044
Design Information
InfiltrationClgHtg
Blower doorMethod88-15Outside db (°F)
4 (substantial) / 2Shielding / stories7570Inside db (°F)
50 Pa / 813 cfmPressure / AVF1385Design TD (°F)
M-Daily range
5050Inside humidity (%)
3555Moisture difference (gr/lb)
HEATING EQUIPMENT COOLING EQUIPMENT
Make Bryant Make Bryant
Trade Bryant Legacy Line 92 Gas Furn... Trade BRYANT HEATING AND COOLING SYS...
Model 912SD36040E17 Cond BA13NA024BNG0G
AHRI ref 0 Coil CNPVU3017ALA++TDR
AHRI ref 201810140
Efficiency 92.1 AFUE Efficiency 10.5 EER, 13 SEER
Heating input Btuh40000 Sensible cooling Btuh15820
Heating output Btuh37000 Latent cooling Btuh6780
Temperature rise °F47 Total cooling Btuh22600
Actual air flow cfm745 Actual air flow cfm745
Air flow factor cfm/Btuh0.031 Air flow factor cfm/Btuh0.064
Static pressure in H2O0 Static pressure in H2O0
Space thermostat Load sensible heat ratio 0.77
ROOM NAME Area Htg load Clg load Htg AVF Clg AVF
(ft²)(Btuh)(Btuh)(cfm)(cfm)
1/2 BATH 32 71 0 2 0
OWNERS SUITE 202 2274 1106 69 71
LAUNDRY 53 90 515 3 33
BATH 2 86 693 137 21 9
BED 2 150 2356 1182 72 76
OWNERS BATH 132 2735 463 83 30
OWNERS WIC 48 82 45 2 3
BED 3 139 2969 1238 91 79
KITCHEN/MUD RM 214 3084 3412 94 219
GREAT ROOM/FOYER 540 9295 2529 284 162
MECH 55 94 52 3 3
OFFICE 60 102 721 3 46
UPPER HALL 224 571 226 17 15
Bold/italic values have been manually overridden
Calculations approved by ACCA to meet all requirements of Manual J 8th Ed.
2021-Dec-10 06:39:37
Right-Suite® Universal 2021 21.0.08 RSU29636 Page 2
...5 JAFFNA PLACE - 2625 INT (FAIRFAX) - SOUTH.rup Calc = MJ8 Front Door faces: S
Entire House 1935 24418 11624 745 745
Other equip loads 7519 246
Equip. @ 0.93 RSM 11040
Latent cooling 3483
TOTALS 1935 31937 14523 745 745
Bold/italic values have been manually overridden
Calculations approved by ACCA to meet all requirements of Manual J 8th Ed.
2021-Dec-10 06:39:37Right-Suite® Universal 2021 21.0.08 RSU29636 Page 1...5 JAFFNA PLACE - 2625 INT (FAIRFAX) - SOUTH.rup Calc = MJ8 Front Door faces: S
2625 INT (FAIRFAX)Job:Project Summary 12/9/2021Date:Entire House Energy Diagnostics, Inc.By:
Energy Diagnostics, Inc.
405 E Archer Way, Valparaiso, IN 46383 Phone: 219-464-4457 Fax: 219-464-0035
Project Information
DR Horton MNFor:16445 Jaffna Place, Lakeville, MN 55044
Notes:
Design Information
Minneapolis, Crystal AP, MN, USWeather:
Winter Design Conditions Summer Design Conditions
Outside db °F-15 Outside db °F88Inside db °F70 Inside db °F75Design TD °F85 Design TD °F13Daily range MRelative humidity %50Moisture difference gr/lb35
Heating Summary Sensible Cooling Equipment Load Sizing
Structure Btuh24418 Structure Btuh11624Ducts Btuh0 Ducts Btuh0Central vent (SER=64% 49 cfm) Btuh1610 Central vent (SER=64% 49 cfm) 246 BtuhHeat recovery Heat recoveryHumidification Btuh5909 Blower Btuh0Piping Btuh0Equipment load Btuh31937 Use manufacturer's data nRate/swing multiplier 0.93InfiltrationEquipment sensible load Btuh11040
Method Latent Cooling Equipment Load SizingBlower doorShielding / stories 4 (substantial) / 250 Pa / 813 cfmPressure / AVF Structure Btuh2330Ducts Btuh0Central vent (49 cfm) Btuh1154CoolingHeatingHeat recovery19351935Area (ft²) Equipment latent load Btuh34831626916269Volume (ft³)Air changes/hour 0.130.31 Equipment Total Load (Sen+Lat)Btuh14523Equiv. AVF (cfm) 3685 Req. total capacity at 0.70 SHR ton1.3
Heating Equipment Summary Cooling Equipment Summary
Make Bryant Make BryantTrade Bryant Legacy Line 92 Gas Furn... Trade BRYANT HEATING AND COOLING SYS...Model 912SD36040E17 Cond BA13NA024BNG0GAHRI ref 0 Coil CNPVU3017ALA++TDRAHRI ref 201810140Efficiency 92.1 AFUE Efficiency 10.5 EER, 13 SEERHeating input Btuh40000 Sensible cooling Btuh15820Heating output Btuh37000 Latent cooling Btuh6780Temperature rise °F47 Total cooling Btuh22600Actual air flow cfm745 Actual air flow cfm745Air flow factor cfm/Btuh0.031 Air flow factor cfm/Btuh0.064Static pressure in H2O0 Static pressure in H2O0Space thermostat Load sensible heat ratio 0.77
One or multiple power vent or
direct vent appliances or no
combustion appliancesA
One or multiple fan-assisted
appliances and power vent or
direct vent appliancesB
One atmospherically vented
gas or oil appliance or one
solid fuel applianceC
Multiple atmospherically
vented gas or oil appliances
or solid fuel appliancesD
1a) pressure factor (cfm/sf) 0.15 0.09 0.06 0.03
b) conditioned floor area (sf)
(including unfinished basements) 1894 0 0 0
Estimated House Infiltration
(cfm): [1a x 1b] 284.1 0 0 02.a) Exhaust Capacity
continuous exhaust-only ventilation systems (cfm): (not applicable to balanced ventilation systems such as HRV) 0 0 0 0
b) clothes dryer 135 135 135 135c) 80% of largest exhaust rating
(cfm): (not applicable if
recirculating system or if powered
makeup air is electrically
interlocked and matched to
exhaust) 240 0 240 240d) 80% of next largest exhaust rating (cfm): (not applicable if recirculating system or if powered
makeup air is electrically
interlocked and matched to
exhaust) 0 0 0Total Exhaust Capacity (cfm):
[2a+2b+2c+2d] 375 135 375 3753.a) Makeup Air Requirement
Total Exhaust Capacity (from
above) 375 135 375 375
b) Estimated House Infiltration
(from above) 284.1 0 0 0Makeup Air Quantity (cfm): [3a –
3b] (if value is negative, no
makeup air is needed) 90.9 135 375 3754. For Makeup Air Opening Sizing, refer to Table 501.3.2
One or multiple power vent
or direct vent appliances or
no combustion appliancesA
One or multiple fan-assisted
appliances and power vent
or direct vent appliancesB
One atmospherically
vented gas or oil appliance
or one solid fuel
applianceC
Multiple atmospherically
vented gas or oil
appliances or solid fuel
appliancesD
Passive
makeup air
opening duct
diameterE,F,G
Type of opening or system (cfm) (cfm) (cfm) (cfm) (inches)
Passive Opening 1-36 1-22 1-15 1-9 3
Passive Opening 37-66 23-41 16-28 10-17 4
Passive Opening 67-109 42-66 29-46 18-28 5
Passive Opening 110-163 67-100 47-69 29-42 6
Passive Opening 164-232 101-143 70-99 43-61 7
Passive Opening 233-317 144-195 100-135 62-83 8
Passive Opening with
Motorized Damper 318-419 196-258 136-179 84-110 9
Passive Opening with
Motorized Damper 420-539 259-332 180-230 111-142 10
Passive Opening with
Motorized Damper 540-679 333-419 231-290 143-179 11
Powered Makeup AirH >679 >419 >290 >179 not applicable
G Barometric dampers are prohibited in passive makeup air openings when any atmospherically vented appliance is installed.
H Powered makeup air shall be electrically interlocked with the largest exhaust system.
Table 501.3.2
Makeup Air Opening Sizing Table for New and Existing Dwellings
C Use this column if there is one atmospherically vented (other than fan-assisted) gas or oil appliance per venting system or one solid fuel
appliance.
D Use this column if there are multiple atmospherically vented gas or oil appliances using a common vent or if there are atmospherically
vented gas or oil appliances and solid fuel appliance(s).
E An equivalent length of 100 feet of round smooth metal duct is assumed. Subtract 40 feet for the exterior hood and ten feet for each 90-
degree elbow to determine the remaining length of straight duct allowable.
F If flexible duct is used, increase the duct diameter by one inch. Flexible duct shall be stretched with minimal sags.
D Use this column if there are multiple atmospherically vented gas or oil appliances using a common vent or if there are atmospherically
vented gas or oil appliances and solid fuel appliances.
A Use this column if there are other than fan-assisted or atmospherically vented gas or oil appliances or if there are no combustion
appliances.
B Use this column if there is one fan-assisted appliance per venting system. Other than atmospherically vented appliances may also be
included.
Table 501.3.1
Procedure to Determine Makeup Air Quantity for Exhaust Equipment in Dwellings
Use the Appropriate Column to Estimate House Infiltration
A Use this column if there are other than fan-assisted or atmospherically vented gas or oil appliances or if there are no combustion appliances.
B Use this column if there is one fan-assisted appliance per venting system. Other than atmospherically vented appliances may also be
included.
C Use this column if there is one atmospherically vented (other than fan-assisted) gas or oil appliance per venting system or one solid fuel
appliance.
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