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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