Loading...
07-3244 (MFD5) CF-6R InstallationSo Cal HERS Raters 4840 Normandie Place La Mesa, CA 91941-4545 Tel: 619-251-7982 Fax: 888-826-9536 Project: Brown Construction Vista Dune Palms La Quinta, CA f �y RATERS W Vt/W.S OCALH ERS.CC3 MB Field Report No. 8 October 24, 2008 On October 24, 2008 So Cal HERS Raters conducted a site visit to the above project. The purpose of this visit was to observe the insulation installation and perform the Quality Insulation Installation l Thermal Bypass Checklist Inspection and identify any areas not passing. The following parties were present: Chris Gianunzio, Brown Construction, Inc. (BCI) Juan Gonzalez, So Cal HERS Raters (SCH) Kevin Rasmussen, So Cal HERS Raters (SCH) The following observations were made on the jobsite, and/or discussed in the jobsite trailer. Chris G. requested we come out and verify the insulation at the exterior walls on building 4200 and look at the attics and lids in building 3200. The insulation we looked at passed the QII/TBC requirements. For references, insulators and builders can learn more about California's Title-24 credit for High Quality Installation of Insulation by visiting the following websites: Videos http://www.buildincimedia.com/naima/videos.htmi Appendix RH http://www.energy.ca.gov/title24/2005standards/residential acm/2005 RES ACM APP RH.PDF Energy Star Thermal Bypass Checklist Guide Version 1.1 httr)://www.enerqystar.gov/ia/partners/bldrs lenders raters/downloads TBC Guide 062507 pdf This concludes field report 8 for Brown Construction, Inc. CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 7 of 8) CF-4R Project Title: La Quinta Dune Palms Quality Insulation Date: 1/20/2008 Project Address: 47-795 Dune Palms Rd. Bld# 4200 La Ouinta, CA 92253 Builder Name: CVHC Builder or Installer Contact: Telephone: Permit or Plan No. CVHC 800-689-4663 07-3244 H ERS Rater: Telephone: Sample Group No. Kevin Rasmussen CCNKR350475 619-251-7982 Not Sampled Certifying Signature: Date: Sample House No. 1/ZQ 2008 Not Sam led 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.). ✓ E 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, ADDendix 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 ® ❑ ❑ I Wall stud cavities caulked or foamed to provide an air tight envelope. YES No NA CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 7 of 8) CF-4R Project Title: La Quinta Dune Palms Quality Insulation Date: 1/20/2008 Project Address: Builder Name: 47-795 Dune Palms Rd. Bld# 4200 La Quinta, CA 92253 CVHC Buider or Installer Contact: Telephone: Permit or Plan No. CVHC 800-689-4663 07-3244 H ERS Rater: Telephone: Sample Group No. Kevin Rasmussen CCNKR350475 619-251-7982 Not Sam led Cetifying Signature: Date: Sample House No. 1/20/2008 I Not Sampled Fi rn: HERS Provider: TCHEERS® So Cal HERS Raters Street Address: City / State / Zip TLa 4840 Normandie Place 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 A.Cl4, 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 d es!gn 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 6 foot and minimum inches. ✓ ® Installation Certificate, (CF-611) 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 ® ❑ ❑ 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 Pioject Address 47-795 Dune Palms Rd. Bid# 4200 La Quinta, CA 92253 Builders Name / - CVHC l ✓tool/Ceilin Pre 91 ❑ ❑ 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 11 ❑ ® 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 El ❑ ® Area under equipment platforms and cat -walks insulated or accessible for blown insulation YES No NA ❑ ❑ ® 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 I 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) INSTALLATION CERTIFICIVE (Pale 1 a n) CF-VR Site Address Permit Number Q-7�1S7 Q � Oct is — L-4�d�_, A� O'? - 3A'49 Installation certificates (CF-6R) are required for each amf very dwelling unit. Then the installation of measures that require field verification and diagnostic testing is complete, the builder orthe builder's subcontractor shall complete diagnostic testing and the procedures specified in this section. When the installation is oomplete, the builder or the builder's subcontractor shall complete the C);-6R, (Installation Certificate), and lrwep it at the building site for review by th- building department. The builder also shall provide a copy of the Installation Certi:Ecata to the HERS rater for any measures requiring field verification and diagpostic testing, per Section 10-103(a). W A TF.R H-P. A TTNCr SYSTEMS' 1 For small gas storage (rated input of less than or equal to 75,000 BtLift), electric resistance and heat pump water heaters, list Energy Factor (EF). Fall llarge gas storage neater heaters (rated input of greater than 75,000 atuihr), Iist Recovery (RE), Thermal Efficiency, Standby Loss and Rated Input. For instantaneous pas water heaters, list Thermal Emcicncy and Rated Input. 2. R-12 ext!�rnal insulation is mandatory for storage water beaters with an energy factor of less than 0.53. Kitchen Piping; If indicated on the CF-IR., all hot waterpiping > 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 61 Section 1 i 1 Central Water Heating in Buildings with Multiple )Dwelling Units (required for pr-scriptive) ❑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 pining 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 ✓ ❑ I, the undersigned, verify that equipment listed above my si_nat= is: 1) the actual equipment installed; 2) eauivalent to or more efficient than that specified in the certificate of compliance (Form CF-1 R) subrnitted for compliance C INSTALLATION CERTIFICATE (Page 2 of 12) CF-6R Site Address Permit Number 47-795 Dune Palms Rd, La Quinta, Ca BLDG - 4200 1 07-3244 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 LIKE- RODUCTS t Product U-factor3 (5CF-lttvalue) Product SHGC � (5CF-1Rvaluc)- # of Panes Total Quantity of L ike Product (o bona Area Square Feet Exterior Shading Device or Overhang Comments/Localion/ Special Features 1. Pella/impervia 31 32 2 N/A 2. 3. 4. 5. 6. 7. 8. 9. 10, II. 12. 13. 14. 15. ll 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 - ?I 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-1 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. ✓ R 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 #s Signature Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner 51 (slog OR Window Distributor 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 L1 o t-F-F W r-:1-reps, PL-,-iCE INSTALLATION CERTIFICATE (Page 3 of 12) CF-6R Site Address Permit Number Dvs4C- P-1--i un-C- 0-1 - aa4 4 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 Equip Type CEC Certified Mfr. # of Efficiency (AFUE> etc.) Duct Duct or Heating Heating Name and Model Identical Location Piping Load Capacity (pkg. heat um) Number Systems (>_CF-IR value) (attic, etc.) R-value (Btu/hr) (Btu/hr) FAri Cvi t_ lCDSK01 C 1-9os �ssr y.2 19 600 1sH i W� 31e D�sC�.—C " �vo —1Oo j/�++T W�� l J� t (- `�s3Pr 4 oo 48H SQS " 149to Cooling Equipment Equip Type (pkg. heat pump) C�Rszs� 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/hr) COOL N L-`C ®. -a4190 430n a ! y _o r- Fhi r- 1�r1it c� R D� N . ® 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. ✓ Edl 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' s' (� �%EeNP�sysc,�rc CGsif'Ss ZNe� Signature: Date: Copies to: BUILDING DEPARTMENT, TIERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 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 Iarge gas storage water heaters (rated input of greater than 75,000 Btu/hr), list 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 for storagewater heaters with an energy factor of less than 0.58. Kitchen Piping: If indicated on the CF-1R, all hot tiva::erpiping ? 3/4 inches in diameter that runs from the hot water source to the kitchen fixtures is insulated. Faucets & Shower Beads: 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 prescriptive) []All hot water piping in main circulating loop is insulated to requirements of § 150G) El 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 ✓ El 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-lFQ submitted mr 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 Efffcieri ), Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner Signature: Date: if/,,7,1 Copies to: BUILDING DEPARTMENT, IiERS RATER (IF AFFLICABLB) BUILDING OWNER AT OCCUPANCY -.-V I 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 Dtu/hr), list 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 mandator[ 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 1:itchen 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 prescriptive) QAll hot water piping in main circulating loop is insulated to requirements of § 1500) QCentral 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) QCcntral hot Nvater systems sewing more than 6 dwelling units - presence of either a time control or a rime/temperamre control ✓ Q 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-IR) submitted for compliance with the-Fne;gy Efciency 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 I` Signature: k"q'q G Grrie I Date: Copies to: BUILDING DEPARTMENT, HERS RAPER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY U ! �A All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end Yes _No 0 Insulation in contact with the subfloor or rim joists insulated 7 M No NYA Insulation properly supported to avoid gaps, voids, and compression ✓ WALLS Yes El No 4A Wall stud cavities caulked or foamed to provide an air tight envelope Yes 0 l4A Wall stud cavity insualtion uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back Yes 0 4A No gaps Yes 0M El 4A No voids over 3/4" deep or more than 10% of the batt surface area Hard to accesswall stud cavities such as; corner channels, wall intersections, and behind • N❑o N/A tub/shower enclosures insulated to proper R-Value M� PASmall spaces filled Yes 0 4A Rim -joists insulated El Yes 0 No 4A Loose fill wall insulation meets or exceeds manufacturer's minimum weight -per -square -foot requirement ✓ ROOF/CEILING PREPARATION M Yes El No4A 4A All draft stops in place to form a continuous ceiling and wall air barrier Yes No All drops covered with hard covers Yes No N/A 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 N❑o housing and the ceiling M Yes ❑ No Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics 1:10 N/A Eave vents prepared for blown insulation - maintain net free -ventilation area Yes No4A 4A Knee walls insulated or prepared for blown insualtion Yes Po Ia Area under equipment platforms and car -walks insulated or accessible for blow insulation M 4A Attic rulers installed Residental Compliance Forms April 2005 J N es No Net tree -Ventilation area maintained at eave vents ✓ ROOF/CEILING LOOSE -FILL 0 4A Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls Yes No 4A Baffles installed at eaves vents or soffit vents - maintain net free-ventilationa rea of eave vent e No 4A Attic access insulated Pees E 4A Recessed light fixtures covered l es To 4A Insulation at proper depth - insualtion rulers visible and indicating proper depth and R-Value 11 Yes No El 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 ✓ E I hereby certify that the installation meets all applicable requirements as specified in the Insulation Installation Procedures Installing Subcontractor (Co. Name) OR General Contractor Co. Name O Owner MASCO CONTRACTOR SERVICES Signature: Date: '' "off c Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY Residental Compliance Forms April 2005 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) 5 CEILING 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) 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 inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) 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 (if applicable) 3,5 Signature Date y� r Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner OR Window Distributor MASCO CONTRACTOR SERVICES Item #s (if applicable) Signature Date Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner OR Window Distributor Item #s (if applicable) Signature Date Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner OR Window Distributor Residental Compliance Forms April 2005