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0401-118 (SFD)INSPECTION RECORD OPERATION DATE INSPEECTOR OPERATION DATE INSPECTOR BUILDpNO APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts _I Forms & Footings Ducts Slab Grade 1 Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing — f ..- y Compressor Insulation S _ _ y S Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall insulation Condensate Lines Party Wall Firewall Exterior Lath a --W. Drywall - Int. Lath — Final Final POOLS - SPAS BLOCKWALL AP OVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric i Underground Plbg. Test i Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 1% — Encapsulation Gas Piping Gas Test _ Appliances Final COMMENTS. Final UWity Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) 1 7>_ ��/ INSTALLATION CERTIFICATE (Page 3 of 13) CF-6R 50-.Os vza s py •L j Site Address Permit Number � f DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM C3a 25 PA) Test Leakage (CFM)- Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Hearing Capacity in Thousands of Btu/hr, enter calculated value here If fan flow Is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) = 1r ❑ Pass if leakage fraction < 0.06 Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) CHECK AFTER FINISHING WALL: ❑ Yes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑ ❑ Pass Fail [,' THERNTOSTATIC EXPANSION VALVE (TXV) pf Yes ❑ No Thermostatic Expansion Valve is installed and Access is - provided for inspection Yes is a pass 'g ❑ ❑ DUCT DESIGN Pass Fail ACCA Manual D Design calculations have been 1. ❑ Yes ❑ No completed, Duct Design Is on the plans and duct installation matches plans. 2. ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, ❑ ❑ verified fan flow matches design from CF-IR. Pass Fail Measured Fan Flow= Yes for both 1 and 2 is a Pass ❑ I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF-6R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit. ] Tests Si ture, Date Installing Subcontractor (Co. Name) OR Peribrmed General Contractor (Co. Name) COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy Cornpilanw Forms August2001 A-25 INSTALLATION CERTIFICATE (Page 3 of 13) CF-6R SEte Address Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM ® 25 PA) Test Leakage (CFM)1eA Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity In Thousands of Btu/hr, enter calculated value here If fan flow is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ )R ❑ Pass if leakage fraction < 0.06 Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFM) CHECK AFTER FINISHING WALL: ❑ Yes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections 0 ❑ Pass Fail r THERMOSTATIC EXPANSION VALVE (TXNj ;R Yes ❑ No Thermostatic Expansion Valve is installed and Access is -provided for inspection Yes is a pass '�' ❑ ❑ DUCT DESIGN Pass Fail ACCA Manual D Design calculations have been 1. ❑ Yes ❑ No completed, Duct Design Is on the plans and duct Installation matches plans. 2. ❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV, ❑ ❑ verified fan flow matches design from CF-IR. Pass Fail Measured Fan Flow = Yes for both 1 and 2 is a Pass ❑ I, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in conformance with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF-6R signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for compliance credit. ] i15/_�24/ Tesu S ature, Date Performed COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy Compliance Forms Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) August 2001 A-25 0 INSTALLATION CERTIFICATE (Page 3 of 13) CI'-6R SIte Address � - Permit Number DUCT LEAKAGE AND DESIGN DIAGNOSTICS DUCT LEAKAGE REDUCTION Pressurization Test Results (CFM Q 25 PA) Test Leakage (CF'M)1% Fan Flow If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity In Thousands of BtAr, enter calculated value here If fan flow Is measured, enter measured value here Leakage Fraction = Test Leakage/(Measured or Calculated Fan Flow) _ p Pass if leakage fraction < 0.06 Pass Fail ❑ For AEROSOL TYPE SEALANTS ONLY -The following diagnostic testing was completed: Duct Fan Pressurization at rough -in measured leakage (CFK CHECK AFTER FINISHING WALL: ❑ Yes ❑ No ❑ Pressure pan test or House pressurization test ❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑ Pass Fail F�THERMOSTATIC EXPANSION VALVE (TXV) — 2f Yes ❑ No Thermostatic Expansion Valve is installed and Access is -provided for inspection -- Yes is a pass ,;.W o ❑ DUCT DESIGN Pass Fail ACCA Manual D Design calculations have been 1. ❑ Yes ❑ No completed, Duct Design Is on the plans and duct installation matches plans. 2. ❑ Yes ❑ No TXV is installed or Fan flow has been verified. 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