07-3231 (MFD5) CF-6R InstallationINSTALLATION CERTIFXCATL (rage 101 ID CV% R
Site Address Permit Number
Installation certificates {CF-6R} are required for each and every dwelling unit When the installation of measures that require
field verification and diapostic testing is complete, the builder or the builder's subcontractor shall complete diagnostic
testing and the procedures specified in this section. When the installation is complete, the builder or the builder's
subcontractor shall complete the CF-6R (Installation Certificate), and keep it at the building site for review by the building
department The builder also shall provide a copy of the Installation Certificate to the HERS rater for any measures requiring
field verification and diagnostic testing, per Section 10-103(a).
WATER HEATING SYSTEMS:
Disaft6cin
CEC Ceriified Type if of Rand Inpctt External
Heater MfrName & (Sid, Point- Recirculation, Identical (kW or Tank Volume Efficiency 5taedby Insulation
Twe Model Number of-'Usa etc) Control Type 4ymms 8tulhr)i loos (EF, & Loss (%i R ,mluc
1 For small gas storage (rated input of less than or equal to 75,000 Btulhr), electric resistance and heat pump water
heaters, list Energy Factor (EF). For large gas storage water heaters (rated input of greater than 75,000 Btulhr), Fist
Recovery (RE), Thermal Efficiency, Standby Loss and Rated Input, For instantaneous gas water heaters, list Thermal
Efficiency and Rated Input.
2. R-12 external insulation is mandatory or- storage water heaters with an energy factor of less than 0.58.
Kitchen Piping:
If indicated on the CFA R, all hot water piping ? 3/4 inches in diameter that runs from the hot water source to the kitchen
fixtures is insulated.
Faucets &; Shower Heads;
All faucets and showerheads installed are certified to the Energy Commission, pursuant to Title 24, Part 5, Section l l 1.
Central Water Heating in Buildings with Multiple Dwelling Units (required for prescriptive)
✓
❑All hot water piping in main circulating loop is insulated to requirements of § 1500)
❑Central hot water systems serving six or fewer dwelling units which have (1) less than 25' of distribution piping
outdoors; (2) zero distribution piping underground; (3) no recirculation pump; and (4) insulation on distribution piping
that meets the requirements of Section 1306)
❑Central loot water systems serving more than 6 dwelling units - presence of either a time control or a time/temperamre
control
✓ ❑ I, the undersigned, verify that equipment listed above my signature is: 1) the actual equipment installed; 2)
equivalent to or more efficient than that specified in the certificate of compliance (Form CF-1R) submitted for compliance
with the Energy Efciency Standards for residential buildings; and 3) equipment that meets or exceeds the appropriate
requirements for manufactured devices (from the Appliance Eff ciency Regulariom Or Part 6), where applicable.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
Signature; Date:
a
AT OCCUPANCY
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER
INSTALLATION CERTIFICATE (Page 2 of 12) CF-bR
Site Address 47-795 Dune Palms Rd, La Quinta, Ca BLDG - 2400 Permit Number
07-323 i
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required) After completion of final inspection, a copy must be provided to the building
department (upon request) and the building owner at occupancy, per Section 10-103(a).
FENESTRATION/GLAZING:
Item
Manufacturer/Brand
Name
(GROUP L IICE
RODUCTS
t
Product U-factor2
(<_ CF-IIt value)-
t
Product SHGC
(<_CF-I It value)-
y of
Panes
Total
Quantity of
t_ike Product
(Optional)
Area
Square
Feet
Exterior
Shading Device
crOverhang
CommenWLocation/
Special Features
I.
Pella/Impervia
31
32
2' -
N/A
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12
13,
14.
15.
�1 Use values from a fenestration product's NFRC label. For fenestration products without an NFRC label, use the default
values from Section 116 of the Energy Efficiency Standards..
Installed U-factor must be less than or equal to values from CF-I R. Installed SHGC must be less than or equal to values
from CF-I R, or a shading device (exterior or overhang) is installed as specified on the CF-I R- Alternatively, installed
weighted average U-factors for the total fenestration area are less than or equal to values from CF-I R. If using default table
SHGC values from § 116 identify whether tinted or not..
✓ W 1, the undersigned, verify that the fenestration/glazing listed above my signature: 1) is the actual fenestration
product installed; 2) is equivalent to or has a lower U-factor and lower SHGC than that specified in the certificate of
compliance (Form CF-iR) submitted for compliance with the Energy Efficiency Standards for residential buildings; and
3) the product meets or exceeds the appropriate requirements for manufactured devices (from Part 6), where applicable.
Item ils
Signature Date
Installing Subcontractor (Co. Name) OR
(if applicable)
General Contractor (Co. Name) OR Owner
zz��— ro ! log
OR Window Distributor
15
Pella Windows & Doors- HSC, Inc.
Item #s
Signature Date
Installing Subcontractor (Co. Name) OR
(if applicable)
General Contractor (Co. Name) OR Owner
OR Window Distributor
Item #s
Signature Date
Installing Subcontractor (Co. Name) OR
(if applicable)
General Contractor (Co.. Name) OR Owner
OR Window Distributor
Copies to: Building Department, HERS Rater (if applicable) Building Owner at Occupancy
Residential Compliance Forms
April 2005
W o r -i=v= W S-i-'rems, PLn c E
INSTALLATION CERTIFICATE (Page 3 of 12) CF-6R
Site Address Permit Number
LI1 -7-'i g Dvs4e PO uns Ro LQ Q(;vq-ra CA 0-7 - 3 :a 31
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required) After completion of final inspection, a copy must be provided to the building
department (upon request) and the building owner at occupancy, per Section 10-103(a).
HVAC SYSTEMS:
Heating Equipment
QL lL.p�0C 2L400
Equip Type
1 RS''Sa.
CEC Certified Mfr.
Name and Model
i! of
Identical
Efficiency
I
(AFUE. etc.)
Duct
Location
Duct or
Piping
Heating
Load
Heating
Capacity
(pkg. beat um)
Number
Svstems
(>_CF-IRvalue)
(attic, etc.)
R-value
(Btu/hr)
(Btu/hr)
FAN Col L
3 �cox� C..�
1--'ios
le
00
W rsN
3 �C p�4 —C
Jar
t
"
R
^oT
W?rn=-g Lb
361 96ke
4
{��iPf
r, epm-e.
��
RRQ+►
RR.
.Go
'35*4017
48 H 9&-S
-_�L
1i
149 i oo
Cooling Equipment
Equip Type
(k . beat um)
CoRtz s Ee-
CEC Certified Mfr.
Name and Mode]
Number
# of
Identical
Systems
Efficiency
i
q(SE,:E or EER)
F-IRvalue)
Duct
Location
(attic, etc.)
Duct
R-value
Cooling
Load
(Btu/hr)
Cooling
Capacity
(Btu/hr)
C_'oo�. OWL.r
�.11ACRY30fl
-�
1 _D
STsc
ow
Uoi?
CA Cote-R
L) . 0
p
l� 8_0
Lk�'000
1. > symbol reads greater than or equal to what is indicated on the CF-1R value.
Include both SEER and EER if compliance credit for high EER air conditioner is claimed.
✓ 6 I, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or
more efficient than that specified in the certificate of compliance (Form CF-1R) submitted for compliance with the
Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate
requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
Signature:209Q„ Date: S �Oq
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms
April 2005
INSTALLATION CERTIFICATE (PAGE 10 OF 12) CF-6R
Site Address Permit Number
95 DUNE PALMS RD. BLD# 2400 07-3231
Insulation Installation Quality Certificate
✓ 0 Description of Insulation, (CF-6R, formely IC-1) signed by the installer stating: insulation manufacturer's name,
material identification, installed R-values, and for loose -fill insulation: minimum weight per square foot and minimum
inches
✓ E Installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures
(ACM, Appendix RH)
✓ FLOOR
0
E
0
All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end
No
El
N
0
Insulation in contact with the subfloor or rim joists insulated
Yes
No
El
E
0
Insulation properly supported to avoid gaps, voids, and compression
Yes I
No
✓ WALLS
0
4A
Wall stud cavities caulked or foamed to provide an air tight envelope
Yes
No
E
El
Wall stud cavity insualtion uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back
Yes
No0
N/A
No gaps
Yes
NYA
No voids over 3/4" deep or more than 10% of the batt surface area
Yes
NoHard
14A
to accesswall stud cavities such as; corner channels, wall intersections, and behind
's
NNoo
14A
tub/shower enclosures insulated to proper R-Value
Small spaces filled
as
0
NYA
Yes
No
0
Rim -joists insulated
El
I14A
Loose fill wall insulation meets or exceeds manufacturer's minimum weight -per -square -foot requirement
No
✓ ROOF/CEILING
PREPARATION
0
All draft stops in place to form a continuous ceiling and wall air barrier
Yes
14A
4A
All drops covered with hard covers
Yes
0
All draft stops and hard covers caulked or foamed to provide an air tight envelope
14A
4A
All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between the
Yes
No
housinq and the ceiling
0
Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics
Yes
14A
4A
Eave vents prepared for blown insulation - maintain net free -ventilation area
Yes
NoR
4A
Knee walls insulated or prepared for blown insualtion
El
Area under equipment platforms and car -walks insulated or accessible for blow insulation
Yes
No
NYA
El
N
0
Attic rulers installed
Yes
No
k'-Residental Compliance Forms April 2005
INSTALLATION CERTIFICATE
E 11 OF 12$F-6R
DUNE PALMS RD. BLD# 2400
-3231
✓ ROOF CEILING BATTS
0
0
No gaps
Yes
No
0
❑
❑
No voids over 3/4" deep or more than 10% of the batt surface area
Yes
No
N/A
E
El0
0
Insulation in contact with the air -barrier
Yes
No
Recessed light fixtures covered
Yes
N/A
0
0
Net free -ventilation area maintained at eave vents
Yes
No
✓ ROOF/CEILING
LOOSE -FILL
Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls
Yes
NoN/A
0
EJ
Baffles installed at eaves vents or soffit vents - maintain net free-ventilationa rea of eave vent
No
0
Attic access insulated
0
No
❑
■
❑
Recessed light fixtures covered
Yes
No
N/A
�s
El
Insulation at proper depth - insualtion rulers visible and indicating proper depth and R-Value
❑
E
❑
Loose -fill insualtion meets or exceeds manufacturer's minimum weight and thickness requirements for the
Yes
No
N/A
target R-value. Target R-value .Manufacturer's minimum required weight for
the target R-value (pounds -per -square -foot). Manufacturer's minimum
required thickness at time of installation . Manufacturer's minimum required settled
thickness . Note: To receive compliance credit the HERS rater shall verify that the
manufacturer's minimum weight and thickness has been achieved for the target R-value. (CF-6R only)
DECLARATION
✓ N I hereby certify that the installation meets all applicable requirements as specified in the Insulation Installation
Procedures
hInstalling Subcontractor (Co. Name) OR General
tractor Co. Nam O e MASCO /CONTRACT R SERVICES
nature: Date: V
Copies to. UILDING DEPARTMENT, HERS RATER (IF APPLIC BLE), B ILDING OWNER AT OCCUPANCY
Residental Compliance Forms April 2005
INSTALLATION CERTIFICATE
,-- Site Address
( 17-795 DUNE PALMS RD. BLD# 2400
'lle- 1
l
ICounty Subdivision: La Quinta Dune Palms
Description of Insulation (Formerly IC-1) Form)
1 RAISED FLOOR
Material N/A
Thickness (inches)
2
3
4
i�
5
SLAB FLOOR/PERIMETER
Material N/A
Thickness (inches)
Perimeter Insulation Depth (Inches)
EXTERIOR WALL
Frame Type WOOD 2 X 6
A. Cavity Insulation
Material FIBER GLASS INSULATION
Thicness (inches) 5.5 INCHES
B. Exterior Foam Sheathing _
Material
Thicness (inches)
FOUNDATION WALL
Material
Thickness (inches)
N/A
E 12 OF 12) CF-6R
rrnit Number
Brand Name
Thermal Resistance (R-value)
Brand Name
Thermal Resistance (R-value)
Brand Name CERTAINTEED
Thermal Resistance (R-value)
Brand Name
Thermal Resistance (R-value)
Brand Name
Thermal Resistance (R-value)
CEILING
Batt or Blanket Type BATT Brand Name CERTAINTEED
Thickness (inches) 12 INCHES Thermal Resistance (R-value)
Loose Fill Type Brand
Contactor's min installed weight/ft lb Minimum thickness
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
6 ROOF
Material
Thickness (inches)
N/A
Brand Name
Thermal Resistance (R-value)
Number2400
inches
R-21
R-38
DECLARATION
✓ 0 1 hereby certify that the abouve insulation was installed in the building at the above location in conformance with the
current Energy Efficiency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated
on the Certificate of Compliance, where applicable.
Item #s
(if applicable)
3,5
Signature Date
/6 02�
Installing Subcontractor (Co. Name) OR
General Contractor (Co. Name) OR Owner
OR Window Distributor
MASCO CONTRACTOR SERVICES
Item #s
(if applicable)
ignature Date
Installing Subcontractor (Co. Name) OR
General Contractor (Co. Name) OR Owner
OR Window Distributor
.Item #s
if applicable)
i
Signature Date
Installing Subcontractor (Co. Name) OR
General Contractor (Co. Name) OR Owner
OR Window Distributor
Residental Compliance Forms April 2005