07-3245 (MFD5) CF-6R Installationr A -
INSTALLATION CERTIFICATE (Page 2 of 12) CF-6R
Site Address Permit Number
47-795 Dune Palms Rd, La Quinta, Ca BLDG - 5100 07-3245
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 Uvalue)
(<_CF-lRvaluc)�
Product SHGC t
(SCF-IRvaluc)'
11 of
Panes
Total
Quantity of
L ike Product
(Olionan
Area
Square
Feet
Exterior
Shading Device
or Overhang
Comments/t_ocation/
Special Features
I.
Pella/Impervia
31
32
2
NIA
2.
3.
4.
5.
6.
7.
8.
9.
10.
il.
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-1 R. If using default table
SHGC values from §116 identify whether tinted or not.
✓ R1 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-1R) 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
j
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 Its
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 200.5
W o Lire PLaGe
INSTALLATION CERTIFICATE (Page 3 of 12) CIF-6R
Site Address I Permit Number
Dvs4tr PPy',x- Ro 07 - 3a�is .
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: �, �' s) O®
Heating Equipment
l Q�
Equip Type
CEC Certified Mfr.
# of
Efficiency�
(AFUE, etc.)
Duct
Duct or
Heating
Heating
Name and Model
Identical
Location
Piping
Load
Capacity
-(pkg. heat pump)
Number
Systems
(1>_CF-1Rvalue)
(attic, etc.)
R-value
(Btuft)
(Btu/hr)
FAN Colt_
3 icon K - C
nor
PTr5G
(aOO
WM H'DT
37eV'XG,-C
UP20A 00 E t-
3(614 Gk
48"e6�-8
1
'►
�� ro0
Cooling Equipment
Equip Type
( . heat um )
I:
CRRR s
CEC Certified Mfr.
Name and Model
Number
# of
Identical
Systems
Efficiency
or EER)
P�:CF-l]kvalue)
Duct
Location
(attic, etc.)
Duct
R-value
Cooling
Load
(Bmft)
Cooling
Capacity
(Btu/hi)
Coot.. OWL-:'r
:X11190A1930A
1
1LJ-o
�-sTsc
�1.�
30000
ep�r�a Eru�riCa
`9PC� L13 (,
4
0o0
UosT
D4RCP 449,R
1
14.0
`'
R 8.0
LWOoo
1. > symbol reads greater than or equal to ii,hat is indicated on the CF-IR value.
Include both SEER and EER if compliance credit for high EER air conditioner is claimed.
✓ gl 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: Ra -�
Date: s 1-3 --OCT
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms
April 2005
11Vi J1( I I . f
INSTALLATION CERTIFXCAIT
Site Address
101 ILI CF116R
Installation certificates (CF-6R) are requved for each and every dwding unit. When the installation of measures that require
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 provida a copy of the Installation Certificate to the HERS rater for any reasures requiring
field verification and diagnostic testing, per Section 10-103(a).
WATER HEATING SYSTEMS:
1 For small gas storage (rated input of less than or equal to 75,000 Btu/hr), electric resistance and heat pump water
heaters, list Energy Factor (EF). For l,airge 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 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
fixtures is insulated.
Faucets & Shower Heads.,
All faucets and showerheads installed are certified to the Energy Commission, pursuant to Title 24, kart 6, Section 11 I.
Central Water Beating 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 1300)
0 Central hot water systems serving more than 6 dwelling units - presence of either a time control or a time/temperature
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 Energy Ejciency Standards for residential buildings; and 3) equipment that meets or exceeds the appropriate
requirements for manufactured devices (from the.4pplionce Efficiency regulations or Part 6), where applicable.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
Signature; ho'l 91ak-e Date:
_ Copies to: BUILDING DEPARTMENT, TIERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCiJPANCY
II!h3`fI (. 3
INSTALLATION CERTI_FIC,ATE
Site Address
Permit
1 fif III CUP,
Installation certificates (CF-6R) are required for each and every dwelling unit. When the installation of measures that require
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 (Insrallation Certificate), and keen it at the building site for review by the building
depamnent. 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 HEATTNG SYSTEMS:
1 For small gas storage (rated input of less than or equal to 75,000 Btu/hr), electric resistance and heat pump water
heaters, list Energy Factor (EF). For large gas storage water heaters (rated input of greater than 75,000 Btuthr), 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 storage water heaters with an energy factor of less than 0.58.
Kitchen Piping:
If indicated on the CF-IR, all hot water piping 3/4 inches in diameter that runs from the hot water source ro 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 111.
Central Water Healing in Buildings with Multiple Dwelling Units (required for prescriptive)
❑All hot water piping in main circulating loop is insulated to requirements of § 150G)
❑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 150@
El 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 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 Efficiency Regularions or Part 6), where applicable.
Installing Subcontractor (Co. Name) OR General
Contractor (Co. Name) OR Owner
signature:
Copies to: B'OILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
INSTALLATION CERTIFICATE (PAGE 10 OF 12) CF-GR
Sijo "-dress Permit Number
4, DUNE PALMS RD. BLD# 5100 07-3245
Insulation Installation Quality Certificate
✓ N 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
✓ 0 Installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures
(ACM, Appendix RH)
✓ FLOOR
0
TEJ
All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end
❑
Yes
0
No
❑
N/A
Insulation in contact with the subfloor or rim joists insulated
0
1 No
4A
Insulation properly supported to avoid gaps, voids, and compression
✓ WALLS
ys
No
PA
Wall stud cavities caulked or foamed to provide an air tight envelope
Yes
EJ
No
IPA
Wall stud cavity insualtion uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back
Yes
Po
2
No gaps
E
Yes
El
Nonn
4A
No voids over 3/4" deep or more than 10% of the batt surface area
No
IAA
Hard to accesswall stud cavities such as; corner channels, wall intersections, and behind
tub/shower enclosures insulated to proper R-Value
Yes
El
kPA
Small spaces filled
1:10
;A
Rim -joists insulated
��
1 es
R
4A
Loose fill wall insulation meets or exceeds manufacturer's minimum weight -per -square -foot requirement
✓ ROOF/CEILING PREPARATION
�
U
All draft stops in place to form a continuous ceiling and wall air barrier
rYes
s
n
4A
All drops covered with hard covers
N
Yes
❑
No
All draft stops and hard covers caulked or foamed to provide an air tight envelope
Yes
N❑o
4A
All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between the
housing and the ceiling
Yes
NoPes
I�A
Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics
E4
Eave vents prepared for blown insulation - maintain net free -ventilation area
Yes
, Poles
4A
Knee walls insulated or prepared for blown insualtion
P
►�A
Area under equipment platforms and car -walks insulated or accessible for blow insulation
Qs
Ro
GA
Attic rulers installed
Residental Compliance Forms April 2005
ALLATION CERTIFICATE
(95 DUNE PALMS RD. BLD# 5100
AGE 11 OF 12) GF-6R
✓ ROOF CEILING BATTS
Yes
No
N/A
No gaps
Yes
0
No
0
No voids over 3/4" deep or more than 10% of the batt surface area
Yes
Po4A
PAInsulation
in contact with the air -barrier
Yes
Po0
Recessed light fixtures covered
t�A
Net free -ventilation area maintained at eave vents
✓ROOF/CEILING
LOOSE -FILL
Pnnes
F
PA
Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls
17es
F
4A
Baffles installed at eaves vents or soffit vents - maintain net free-ventilationa rea of eave vent
Yes
Attic access insulated
Pes
R
GA
Recessed light fixtures covered
Yes
RN.
EA
Insulation 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. Name Owner IMASCO CONTRACTOR SERVICES
Signature: / � 1, Q Date: "cT
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY
ental Compliance Forms April 2005
,TALLATION CERTIFICATE
Address
795 DUNE PALMS RD. BLD# 5100
La Quinta
Description of Insulation (Formerly IC-1) Form)
1 RAISED FLOOR
Material N/A
Thickness (inches)
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)
FOUNDATION WALL
GE 12 OF 12) CF-6R
Permit Number
07-3245
5100
Brand Name
Thermal Resistance (R-value)
Brand Name
Thermal Resistance (R-value)
Brand Name CERTAINTEED
Thermal Resistance (R-value) R-21
Brand Name
Thermal Resistance (R-value)
Material N/A Brand Name
Thickness (inches) 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 inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
R-38
6 ROOF
Material N/A Brand Name
Thickness (inches) Thermal Resistance (R-value)
DECLARATION
✓ NI 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)
Signature Date
Installing Subcontractor (Co. Name) OR
General Contractor (Co. Name) OR Owner
3,5
(°T}
OR Window Distributor
MASCO CONTRACTOR SERVICES
Item #s
Signature Date
Installing Subcontractor (Co. Name) OR
(if applicable)
General Contractor (Co. Name) OR Owner
OR Window Distributor
-n #s
Signature Date
Installing Subcontractor (Co. Name) OR
'{c applicable)
General Contractor (Co. Name) OR Owner
OR Window Distributor
Residental Compliance Forms April 2005
Certifying Signature:
Date: I Sample House No.
Firm:
Street Address:
HERS Provider:
City / State / Zip
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY
HERS RATER COMPLIANCE STATEMENT
This house was: ✓ N 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.).
✓ N 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.
✓ N 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.
✓ N 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
❑
❑
N
All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end
YES
No
NA
N
❑
❑
Insulation in contact with the subfloor or rim joists insulated
YES
No
NA
❑
❑
N
Insulation properly supported to avoid gaps, voids, and compression
YES
No
NA
✓WALLS
N
❑
❑
Wall stud cavity insulation uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back
YES
No
NA
N
❑
❑
No Gaps
YES
No
NA
N
❑
❑
No voids over 3/4" deep or more than 10% of the batt surface area.
YES
No
NA
N
❑
❑
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
N
❑
❑
Small spaces filled
YES
No
NA
N ❑
❑
Rim -joists insulated
YES, No
NA
_____
t;opies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY
HERS RATER COMPLIANCE STATEMENT
This house was: ✓ N 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.) .
✓ N REQUIREMENTS FOR -HIGH QUALITY INSTALLATION OF INSULATION" COMPLIANCE CREDIT
✓ N 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.
✓ N 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.
✓ N 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
❑
❑
N
All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end
YES
No
NA
N
❑
❑
Insulation in contact with the subfloor or rim joists insulated
YES
No
NA
❑
❑
N
Insulation properly supported to avoid gaps, voids, and compression
YES
No
NA
✓WALLS
N
❑
❑
Wall stud cavity insulation uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back
YES
No
NA
N
❑
❑
No Gaps
YES
No
NA
N
❑
❑
No voids over 3/4" deep or more than 10% of the batt surface area.
YES
No
NA
.0
❑
❑
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
N
❑
❑
Small spaces filled
YES
No
NA
N ❑
❑
Rim -joists insulated
YE No
NA
_y1
X
❑
❑
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
❑
❑
®
Attic rulers installed
YES
No
NA
✓Roof/Ceilin
Batts
11
0
No Gaps
®
®
❑
❑
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
❑
❑
®
I 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 . Manufac -'s minimum required