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06-3409 (MFD5) CF-6R Installationr CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 7 of 8) CF-4R Project Title: La Quinta Dune Palms Quality Insulation Date: 1i20/2008 Project Address: 47-795 Dune Palms Rd. Bld# 4100 La Quinta CA 92253 Builder Name: CVHC Builder or Installer Contact: Telephone: Permit or Plan No. CVHC 800-689-4663 06-3409 HERS Rater: Telephone: Sample Group No. Kevin Rasmussen CCNKR350475 619-251-7982 Not Sam led Certifying Signature: Date: Sample House No. 1/20/2008 Not Sampled Firm: HERS Provider: So Cal HERS Raters I CHEERS® Street Address: City / State / Zip 4840 Normandie Place La Mesa, CA 91941 Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY HERS RATER COMPLIANCE STATEMENT This house was: ✓ ® Tested ✓ ❑ Approved as part of a sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with all applicable requirements of the "High Quality Installation of Insulation" protocols as specified in the Residential ACM, Appendix RH and as checked on this form. Note that to PASS and receive compliance credit, NONE of the BOXES below may be checked "No" and the first three boxes also must be checked. Check "NA" only if the item is not part of the design of the building (i.e., single story buildings do not have rim joists or there may be no recessed can lights installed, etc.). ✓ ® REQUIREMENTS FOR "HIGH QUALITY INSTALLATION OF INSULATION" COMPLIANCE CREDIT ✓ ❑ The building is wood frame construction with wall stud cavities, ceilings, and roof assemblies insulated with mineral fiber or cellulose insulation in low-rise residential buildings. ✓ ® Description of insulation, (CF-611, formerly 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. ✓ ® Installation Certificate, (CF-6R) signed by the installer certifying that the installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures (ACM, Appendix RH). ✓FLOOR ❑ ❑ ® All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end YES No NA ® ❑ ❑ Insulation in contact with the subfloor or rim joists insulated YES No NA ❑ ❑ ® Insulation properly supported to avoid gaps, voids, and compression YES I No NA ✓WALLS ® ❑ ❑ Wall stud cavity insulation uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back YES No NA ® ❑ ❑ No Gaps YES No NA ® ❑ ❑ No voids over 3/4" deep or more than 10% of the batt surface area. YES No NA ® ❑ ❑ Hard to access wall stud cavities such as; corner channels, wall intersections, and behind YES No NA tub/shower enclosures insulated to proper R-Value ® ❑ ❑ Small spaces filled YES No NA ® ❑ ❑ Rim -joists insulated YES No NA ® ❑ ❑ Wall stud cavities caulked or foamed to provide an air tight envelope. YES No NA F CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 7 of 8) CF-4R Project Title: La Quinta Dune Palms Quality Insulation Date; ilwlbbb Project Address: 47-795 Dune Palms Rd. Bid# 4100 La Quinta CA 92253 Builder Name: CVHC Builder or Installer Contact: Telephone: Permit or Plan No. CVHC 800-689-4663 06-3409 HERS Rater: Telephone: Sample Group No. Kevin Rasmussen CCNKR350475 619-251-7982 Not Sam led Certifying Signature: Date: Sample House No. 1/20/2008 Not Sampled Firm: HERS Provider: So Cal HERS Raters CHEERS® Street Address: City / State / Zip 4840 Normandie Place La Mesa, CA 91941 Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY HERS RATER COMPLIANCE STATEMENT This house was: ✓ ® Tested ✓ ❑ Approved as part of a sample testing, but was not tested. As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies with all applicable requirements of the "High Quality Installation of Insulation" protocols as specified in the Residential ACM, Appendix RH and as checked on this form. Note that to PASS and receive compliance credit, NONE of the BOXES below may be checked "No" and the first three boxes also must be checked. Check "NA" only if the item is not part of the design of the building (i.e., single story buildings do not have rim joists or there may be no recessed can lights installed, etc.). ✓ ® REQUIREMENTS FOR "HIGH QUALITY INSTALLATION OF INSULATION" COMPLIANCE CREDIT ✓ ® The building is wood frame construction with wall stud cavities, ceilings, and roof assemblies insulated with mineral fiber or cellulose insulation in low-rise residential buildings. ✓ ® Description of insulation, (CF-6R, formerly 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. ✓ ® Installation Certificate, (CF-6R) signed by the installer certifying that the installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures ACM Appendix RH . ✓FLOOR ❑ ❑ ® All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end YES No NA ® ❑ ❑ Insulation in contact with the subfloor or rim joists insulated YES No NA ❑ ❑ ® Insulation properly supported to avoid gaps, voids, and compression YES No NA ✓WALLS ® ❑ ❑ Wall stud cavity insulation uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back YES No NA ® ❑ ❑ No Gaps YES No NA ® ❑ ❑ No voids over 3/4" deep or more than 10% of the batt surface area. YES No NA ® ❑ ❑ Hard to access wall stud cavities such as; corner channels, wall intersections, and behind YES No NA tub/shower enclosures insulated to proper R-Value ® ❑ ❑ Small spaces filled YES No NA ® ❑ ❑ Rim -joists insulated YES No NA ® ❑ ❑ I Wall stud cavities caulked or foamed to provide an air tight envelope. YES I No NA CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING Pa e 8 of 8 CF-4R Project Address 47-795 Dune Palms Rd. Bid# 4100 La Quinta, CA 92253 Builders Name ✓Roof/Ceilin Pre ® ❑ ❑ All draft stops in place to form a continuous ceiling and wall air barrier. YES No NA ® ❑ ❑ All drops covered with hard covers YES No NA ® ❑ ❑ All draft stops and hard covers caulked or foamed to provide an air tight envelope YES No NA ® ❑ ❑ All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between YES No NA the housing and the ceiling ® ❑ ❑ Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics YES No NA ❑ ❑ ® Eave vents prepared for blown insulation - maintain net free -ventilation area YES No NA ❑ ❑ ® Knee walls insulated or prepared for blown insulation YES No NA ❑ ❑ ® Area under equipment platforms and cat -walks insulated or accessible for blown insulation YES No NA ❑ I ❑ ® Attic rulers installed YES No NA ✓Roof/Ceilin Batts ® ❑ ❑ No Gaps YES No NA ® ❑ ❑ No voids over 3/4 in. deep or more than 10% of the batt surface area. YES No NA ® ❑ ❑ Insulation in contact with the air -barrier YES No NA ® ❑ ❑ Recessed light fixtures covered YES No NA ❑ ❑ ® Net free -ventilation area maintained at eave vents YES No NA ✓Roof Ceilin Loose Fill ® ❑ ❑ Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls. YES No NA ❑ ❑ ® Baffles installed at eaves vents or soffit vents - maintain net free -ventilation area of eave vent YES No NA ❑ ❑ ® Attic access insulated YES No NA ❑ ❑ ® Recessed light fixtures covered YES No NA ❑ ❑ ® Insulation at proper depth - insulation rulers visible and indicating proper depth and R-value YES No NA Loose -fill insulation meets or exceeds manufacturer's minimum weight and thickness requirements for the 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 YES No NA 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-611 only) C INSTALLATION CI;RTTFXCATE (Wage I of 12) C�-� Site Address Perna Number Installation certificates (CF-6R) are required for each and every dwelling unit When the installation of measures that rPm,;r. rieta venticatton and diagnostic testing is ,-omplete, 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 proviae a copy of the Installation Certificate to the HERS rater for any measures requiring field verification and diagnostic testing,per Section I0-103(a), WATER HEATING SYSTEMS: Heater T CEC Certified MfrName 8; del odel Number Mo Distribauon Type (Sid, Point- off -Usr. arc) If Recirculation, Control Tvoa of Identical systems Rated Input (kW or Tank Volume gallons Efn6mcy (EF, RE)' smnd'oy Loss (%)2 External Insulation R-valuci Jtt✓ /Stulhr)1 i �C�>� 66- A1 R—/6 I I I I I 1 For small gas storage (rated input of less than or equal to 75,000 Btuthr), electric resistance and heat pump water heaters, list Energy Factor (EF). For large gas storage water heaters (razed input of greater than 75,000 Dtu/hr), list Recovery (RE), 7berznal Efficiency, Standby Loss and Rated Input, For instantaneous °as water heaters, list Thermal Efficiency and Fated Input. 2. R-12 external insulation is mandatory for storage water heaters with an energy factor of less than 0.58. Kitchen Piping; If indicated on the CF-1 R, all hot water piping >_ 3/4 inches in diameter that runs from the hot water source to the kitchen natures is insulated. Faucets & Shower Heads; All faucets and showerheads installed are cerdfied to the Energy Commission, pursuant to Title 24, Part 6, Section 111. Central Water Heating in Buildings with Multiple Dwelling Units (required for prescriptive) ✓ EIAII hot water piping in main cir ratting loop is insulated to requirements of § 1500) ❑Central hot water systems serving six or fewer dwelling units which have (1) less than _'5' 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 1500) ❑Central hot Nvater systems serving more than 6 dwelling units - presence of either a time control or a time/temperature control ✓ ❑ I, the undersigned, verify that equipment listed above my signature is: 1) the actual equipment installed; 2) eauivalent to or more efficient than tl:,at specified in the certificate of compliance (Form CF-IR) submitted for compliance with the —Energy Efciency Standards for residential buildings; and 3) equipment that meets or exeeeas the appropriate requirements for manufactured de-vict:s (from the Appliance Efficiency Regulations or Part 6), where applicable. installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: li/gn 61 Qr/e ( Date: Copies to: 13UTLDING DEPAR'TMENI, 'EARS PATER (IF APPLICABLE) BUILDING OVVNEP. AT OCCUPANCY INSTALLATION CERTIF'IOTE (No I of 12) CF-fit Site Address Permit Number Installation certificates (Cl~-6R) are required for each and every dwciling unit. When the installation of measures that raquire field verification and diagnostic 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, taer Section 10-103(a). WATER HEATING SYSTEMS: Heater Tyne l�As CEC Certified Mfr Nam= & Model Number Distribution Type (Std. Point- of -Use arc) If Recirculation, ControlType pY H ; of Identical 5vstrms Li Rated Input (kW or Btu/hr)� Tani; Volume ( logs 7`V Entcicney (EF, RE)= Standby Loss M7 Mm Extcrnaj Insulation R-valu? —1 I I I { I 1 For small gas storage (rated input ofless than or equal to 75,000 )3tu/hr), electric resistance and heat pump water heaters, list Energy Factor (EF). For Iarge gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Recovery (RE), Thermal Rfvcieney, Standby Loss and Rated Input. For instantaneous gas water heaters, list Thermal Efficiency and Rated Input. 2. R-12 external insulation is mandatory for storage water heaters with an energy factor of less than 0.58. Kitchen Piping: If indicated on the CF-IR, all hot vvarerpiping ? 3/4 inches in diameter that runs from the hot water source to the latcbm fixtures is insulated. Faucets & Shower Heads, All faucets and showerheads installed are certified to the Energy Commission, pursuant to Title 24, Part 6, Section 111. Central Water Heating in Buildings with Multiple Dwelling Units (required for prescriptivv) ❑All hot water piping in main circulating loop is insulated to requirements of § 1506) ❑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 1500) ❑Central hot-water systems serving more than 6 dwelling units - presence of either a time control or a time/temperature control ✓ 11 1, 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-1 R) 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 Ejficiem� Regulations or Part 6), where applicable. Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY INSTALLATION CERTIFICATE (Page I of 12) ��'-�� Site Address Permit Number 4-77'r 12Um— Ye,%p%s L Ll It) 0 06— 34 Dq Installation certificates (CF-6R) are required for each and ry dwelling unit. When the installation of measures that rRn„i,P .� . v�i,l,uauull auu ulaKnasuc testing is complete, the builder orthe builder's subcontractor shall complete diagnostic 1 testing and the procedures specified in this section. When the installation is oomplete, 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 diagrrostie testing, tier Section 10-103(a) WATER HEATING SYSTRMq- -5 Hater Tvoe CEC Cartified Mf,-Name & Model Number Distribution Tyne (5rd, Point- of -Use, etc) If Rccireula6m, Control T vie # of Identical systetns Rxted Input (kw or Btuthr)t Tmik Volume ¢slfons Efficiency (FF. REf Standby Loss (%)2 External Insulation R-valucz 1 For small gas storage (rated input of less than or equal to 15,000 Btulhr), electric resistance and heat pump water heaters, list Energy Factor (EF). For ➢arge gas storage water heaters (rated input of greater than 75,000 Btu/hr), 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 mandatoty for storage water heaters with an energy factor of less than 0.53 Kitchen Piping: If indicated on the CF-IF, 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 6, Section 1, l Central Water Heating in Buildings with Multiple Dwelling Units (required for prescriptive) QAII 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 wining that meets the requirements of Section 1500) ©Central hot water systems serving more than 6 dwelling units - presence of either a time control or a time/temp_ erature control ✓ ❑ I, the undersigned, verify that equipment listed above my sin attire is: 1) the actual equipment installed; 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF-1 R) submitted for compliance with the Energy 1fidency Standards for residential buildings; and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the tippliance Efj4cient!:y Regulations or Part 6), where applicable. installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: G av / Date: , �iz Copies to; BUTLI)ING DEPARTMENT, HERS RATER gF APPLICABLE) BUILDING OWNER AT OCCUPANCY INSTALLATION CERTIFICATE (Page 2 of 12) CF-6R Site Address Permit Number 47-795 Dune Palms Rd, La Quinta, Ca BLDG - 4100 06-3409 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).. FENESTRATIONIGLAZING: Item Manufacturer/Brand Name (GROUP LIKE RODUCTS) t Product U-factor (<_CF-IRvaluc)- t Product SHGC (SCF-IRvalue}" if of Panes Total Quantity of Like Product (Optional) Area Square Feet Exterior Shading Device or Ovcrhang Comments/Location/ Special Features 1. Pella/Impervia 31 32 21- N/A 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. tI Use values from a fenestration product's NFRC label. For fenestration products without an NFRC label, use the default values from Section H 6 of the Energy Efficiency Standards. '-t 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-1R, or a shading device (exterior or overhang) is installed as specified on the CF-IR. Alternatively, installed weighted average U-factors for the total fenestration area are less than or equal to values from CF-1 R. If using default table SHGC values from §116 identify whether tinted or not. ✓ � I, 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 #s SignaturA Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner 51 i5�` Oq OR Window Distributor f 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 Foams April 200.5 w 6 t- F- F- W -n-1-TE p-4' PLin c E INSTALLATION CERTIFICATE (Page 3 of 12) CF-6R Site Address Permit Number L4-1 -7 S- DVOC- PIN ultr RV. LP) Quosvza �'ci q� 06 - 3409 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: �C3t Q� r1G L) 9 C)© Heating Equipment 1 RS's Equip Type CEC Certified Mfr. Name and Model # of Identical Efficiency � (SUE, etc.) Duct Location Duct or Piping g HLoad) Heating Capacity kg. heat um ) Number Systems (>_CF-IRvalue) (attic, etc.) R-value ( (Btu/hr) FAN Coin 31ccoxC� c Jos fPITsc (�yo2 19boo G�Wk 140r 3 7cnx(3�.-c ML pvv0 Weir- Co I L- 3(p "Sa v 4 0 eprer. RR. v yCC> y8 H 9&—S Cooling Equipment Equip Type (pkg. heat um) Cfiiziz s E-� CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency (SEE or EER) >CF-iRvalue) Duct Location (attic. etc.) Duct R-value Cooling Load (Btu/hr) Cooling Capacity (Btu/hi) COOL OWLr 'ayACA4-2Ofl ! LJ _0 a' inr- P I Uwvr Cq 449JI a f LJ. ® J� p8.0 L16�000 1. > symbol reads greater than or equal to what is indicated on the CF-IR value. Include both SEER and EER if compliance credit for high EER air conditioner is claimed. ✓ dI 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 ,S (y,1 �E elrsr�s� scQrc �Cs.Y.S, ZNe- Signature: Ra Date: S _ 1-3 — 0,7 Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (PAGE 10 OF 12) MISR Site Address 47-795 DUNE PALMS RD. BLD# 4100 Permit Number 06-3409 Insulation Installation Quality Certificate ✓ E 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 ✓ N Installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures (ACM, Appendix RH) ✓ FLOOR E] Yes E No El All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end El Yes N No El N/A Insulation in contact with the subfloor or rim joists insulated 0 No 14A Insulation properly supported to avoid gaps, voids, and compression ✓ WALLS Yes No 4A Wall stud cavities caulked or foamed to provide an air tight envelope Yes 0 4A Wall stud cavity insualtion uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back E ElYes 0 14A No gaps N Yes El No4A No voids over 3/4" deep or more than 10% of the batt surface area Yes 0 4A Hard to accesswall stud cavities such as; comer channels, wall intersections, and behind tub/shower enclosures insulated to proper R-Value 1 � 4A Small spaces filled 0 Yes El No 4A Rim -joists insulated El Yes N No 4A Loose fill wall insulation meets or exceeds manufacturer's minimum weight -per -square -foot requirement ✓ ROOF/CEILING PREPARATION 0 ElYes 0 4A All draft stops in place to form a continuous ceiling and wall air barrier Yes 0E El NYA All drops covered with hard covers Yes No 0 All draft stops and hard covers caulked or foamed to provide an air tight envelope 4A All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between the Yes No housing and the ceiling Yes El No 0 Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics Yes 0 No N4A Eave vents prepared for blown insulation - maintain net free -ventilation area Yes NoF 14A Knee walls insulated or prepared for blown insualtion Yes 4A Area under equipment platforms and car -walks insulated or accessible for blow insulation 12 E 4A Attic rulers installed Residental Compliance Forms April 2005 INSTALLATION CERTIFICATE Site Address (PAGE 11 OF 12) CF-611 47-795 DUNE PALMS RD. BLD# 4100 PermR Number 06-3409 ✓ ROOF CEILING BATTS Yes El No 1:1 N/A No gaps 0 Yes El No D N/A No voids over 3/4" deep or more than 10% of the bait surface area Yes NoN/A Insulation in contact with the air -barrier Yes No 14A Recessed light fixtures covered IJ/A Net free -ventilation area maintained at eave vents ✓ ROOF/CEILING LOOSE -FILL FTTPA Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls Yes 1.1 14A Baffles installed at eaves vents or soffit vents - maintain net free-ventilationa rea of eave vent Yes No0 RAttic access insulated E No 14A Recessed light fixtures covered 0 PAInsulation at proper depth - insualtion rulers visible and indicating proper depth and R-Value ❑ Yes No N/A Loose -fill insualtion meets or exceeds manufacturer's minimum weight and thickness requirements for the 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 ✓ 0 1 hereby certify that the installation meets all applicable requirements as specified in the Insulation Installation Procedures Installing Subcontractor (Co. Name) OR General Contractor Co. Na Owner MASCO CONTRACTOR SERVICES Si nature -' Date: T� Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY Residental Compliance Forms Description of Insulation (Formerly IC-1) Form) 1 RAISED FLOOR Material N/A Brand Name Thickness (inches) Thermal Resistance (R-value) 2 SLAB FLOOR/PERIMETER Material N/A Thickness (inches) Perimeter Insulation Depth (Inches) 3 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) 4 FOUNDATION WALL Material N/A Thickness (inches) 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) 5 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) inches R-21 R-38 6 ROOF Material N/A Brand Name Thickness (inches) Thermal Resistance (R-value) DECLARATION ✓ N I 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 Signature Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner 3,5 / �Jn /] f __G� I / OR Window Distributor MASCO CONTRACTOR SERVICES Item #s Signatur 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 Residental Compliance Forms April 2005