Combustion Air Submittal Form - City Of Arvada printable pdf download

COMBUSTION AIR SUBMITTAL FORM

BUILDING INSPECTION DIVISION

8101 Ralston Road, Arvada, CO 80002

Fax 720-898-7603 •

Office 720-898-7620

Inspection line 720-898-7630 •

DATE: ____________________________

PERMIT NUMBER: __________________________________

JOB ADDRESS_________________________________________________________________________________________ZIP_______________

OWNER ________________________________________________________ PHONE _____________________________

ADDRESS _________________________________________________________________________________________ZIP___________________

CONTRACTOR’S BUSINESS NAME: _______________________________________________________________________________________________

CONTRACTOR’S ADDRESS: _____________________________________________________________________________________________________

ARVADA LICENSE NUMBER _________________________ PHONE_______________________________________

LICENSED CONTRACTOR (PRINT NAME): ______________________________________________________________________

COMBUSTION AIR OPTION PROPOSED (CODE, EDITION AND SECTION NUMBER):

_____________________________________________________________________________________________________________________________

DESCRIPTION OF WORK (REQUIRED):

If all indoor air or partial indoor air is proposed to be used, provide the calculations along with a floor plan of the building and

the space/s used to satisfy the use of indoor air, identifying each room use on the floor plan.

Rooms or spaces that have had doors removed or are likely to have a door installed with be required to provide a permanent

floor ceiling or wall transfer grills or louvers doors sized in accordance with Section G2407.5.3 of the 2006 International

Residential Code (IRC)

The contractor has chosen: The Standard method (G2407.5.1) ________________ (50 cubic ft/ 1,000 BTU’s) Known air-infiltration-

rate method G2407.5.2 ____________________(provide calculations)

As per Section G2407.4 of the 2006 IRC, when using the all indoor combustion air method, make-up air requirements for the

operation of exhaust fans, kitchen ventilation systems, clothes dryers and fireplaces has been considered by the licensed

contractor in determining the adequacy of a space to provide combustion air requirements.

___________________________ (Initialed by contractor)

This form must be signed by the contractor and the homeowner acknowledging that the spaces shown on the attached floor

plan will remain open to each other and to the furnace room or space where the gas appliances are located.

_______________________________________________

_________________

__________________________________________________

_______________________

HOMEOWNER SIGNATURE

DATE

CONTRACTOR SIGNATURE

DATE

F:\BUILDING\Admin\BID Front Desk Permit Application Forms\Word files-permits\combustion air.doc

Combustion Air Submittal Form - City Of Arvada