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07-3223 (MFD5) CF-6R InstallationCERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 7 of 8) CF-4R Project Title: La Ouinta Dune Palms Quality Insulation Ddte; i1261266A oject Address: 47-795 Dune Palms Rd. Bid# 6200 La Ouinta CA 92253 Builder Name: CVHC Builder or Installer Contact: Telephone: Permit or Plan No. CVHC 800-689-4663 07-3223 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 Sam led Firm: HERS Provider: --j-CHEERS So Cal HERS Raters R 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-611) signed by the installer certifying that the installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures (ACM. Aooendix RH). ✓FLOOR ❑ ❑ 1 ® 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 No NA 14 CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 7 of 8) CF-4R Project Title: La Ouinta Dune Palms Quality Insulation Date. U30/2009 oject Address: _47-795 Dune Palms Rd. Bld# 6200 La Quinta CA 92253 Builder Name: CVHC Builder or Installer Contact: I Telephone: I Permit or Plan No. HERS Rater: Telephone: Sample Group No. Kevin Rasmussen CCNKR350475 619-251-7982 Not Sam Certifying Signature: Date: Sample House No. 1/20/2008 Not Sam Firm: HERS Provider: So Cal HERS Raters CHEERS® Street Address: City / State / Zip 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. 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 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 8 of 8 CF-4R Project Address 47_795 Dune Palms Rd. Bid# 6200 La Builders Name Quinta, CA 92253 CVHC ,,'Roo /Ceilling Pre ® ❑ El All draft stops in place to form a continuous ceiling and wall air barrier. YES No NA ® ❑ El 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/Ceiling Batts A ❑ ❑ 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 I 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 J ❑ ® 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-6R only) INSTALLATION CERTIFICATE (Page 2 of 12) CF-6R Site Address Permit Number 47-795 Dune Palms Rd, La Quinta, Ca BLDG - 6200 1 07-3223 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 I. Manufacturer/Brand Name (GROUP LIKE RODUCTS) Pella/Impervia t Product U-factor (SCF-IRvalue) 2 31 Product SHGC i tSCF-IRvalue)'' 32 1101, Panes 2 Total Quanlityof Like Product (O rional) Area Square Feet Exterior Shading Device orOverhang NIA Commems/!_ocation/ Special Features 2. 3. 4. 5. 6. 7. 8. 9. 10. H. 12 13. 14. 15. �I 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-1 R. If using default table SHGC values from § 116 identify whether tinted or not. ✓ ® 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-I R) 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 4s Sipalure Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner ' � OR Window Distributor Pella Windows & Doors- HSC, Inc. Item ffs 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 wl..es .o. uunu...g uUJIUI LMU11t , HERS Rater (II applicable) Building Owner at Occupancy xesictential Compliance Fornrs April 2005 INSTALLATION CERTIFICATE (Page 3 of 12) CF-6R Site Address Permit Number L41 79 S DvP)C Pplns Rb LP, QUL4v s 9__:207 - 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 (� etc.) Duct Duct or Heating Heating Name and Model Identical Location Piping Load Capacity (pkg. heat pump) Number Systems (?CF-1Rvalue) (attic, etc.) R-value (Btu/hr) (Btu/hr) FAN Cost_ 3 tCpx(sx-C 1 )-6r 1p PIT IC. I;�rstit ioT 37e p�C C �' �3 " f�+►o 100 w% F L- G1 Q Ewmle. RS. v 4 ors 48 H 9&-S "' 40 too Cooling Equipment Equip Type (pkg. heat pump) CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency t or EER) P�:CF-].Rvalue) Duct Location (attic, etc.) Duct R-value Cooling Load (Btu/hr) Cooling Capacity (Btu/hr) COOL d?r L-!y _aL419081430n 1 Ll_o 9 LJ.--I 300or_> t,E�rYvEriS�1q.5 `91'iGQr LJ3 b t �! . p A,Kca voa lisps-r cp ytej:� 1 N.0 '' boo L0000 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. ✓ 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-lR) 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 �' (� �Eelrsp�S4Sc�r�, �s,�•5,�� Signature: Date: S _13 —0q Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 Iy„- iIt (i r. ) INSTALLATION CERTIFICATE Pan 1 of III Site Address Permit Number Installation certificates (CF-6R) are required for each and every dwelling unit. When the installation of measures that require field verification and 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, 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 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 externaI insulation is mandatory ;.'or 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 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 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 § 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 raore 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 (Forth CF-1 R) submitted for compliance with the Enemy Efficiency Standards i5ar 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. Copies to: EUTLDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY itv, J`t f I r, L INSTALLATION CERTIFICATE I Site Address I blaOD Permit Installation certificates (CF-6R) are required for each and every dw tng 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 provide a copy of the Installation Certificate to the HERS rater for any measures requiring field verification and diagnostic testing, per Section INI03(a). WATER BEATING SYSTEMS: Distrib "on CEC Cenitcd Type if * of Rated laput External Heater Mfr Name & {Sid, Point- Recirculation, Identical (kw or Tank Volume Efficiency Sundby Insulation T e Model Number of-U a etc) Comm] T) ae Systems Btulhr)I (gallons) (EF, RE)2 Loss (9�a)� R-valuo 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 Btulhr), list Recovery (RE), Thermal Efficiency, Standby Loss and Rated Input, For instantaneous gas water heaters, list Theirrial 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-I R, all hot water piping > 3/4 inches in diameter that runs from the hot water source to the kitchen fixtures is insulated. Faucets & Shower Heads: All faucets and showerheads installed are certified to the Energy Commission, pursuant to Title 24, Part 6, Section 111. Central Water Heating in Buildings with Multiple Dwelling Units (required for prescriptive) EIAll 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 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 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 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. Copies to: SUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY "U. J4) 1 1, U INSTALLATION CERTIETCATE Site Address Permit 1 of 12) CF-6R Installation certificates (CF-6R) are required for each and eve 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 (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.yt:r Section 10-103(a), WATER. IMATTNG SYSTEMS: Distribution CEC Certified Type If # of Rated Input Emmal Heater T e Mfr Namc & Model Numbcr (Std, Point- of -Use, etc) Reeirculatian, Comrol Tyne Identical Systems (kW or Bra/hr)�(gallons) Tank Volume Efficiency Srandby Insnlatian (EF, RE) Loss (%' R-vaiuj xAS STD N/A 0 30zw /30 VIA 44- AIA- —30 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 wetter 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-I2 external insulation is mandatory for storage water heaters with an energy factor of less than 0.58, Kitchen Piping; If indicated on the CF-1R, all hot water -piping ? 314 inches in diameter that runs from the hot water source to the kitc�en 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) ❑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 (I) less than 25' of distribution piping outdoors; (2) zero distribution piping tmderground; (3) no recirculation pump; and .(4) insulation on distribution piping that meets the requirements of Section 150�) 13 Central hot water systems serving more than 6 dwelling units - presence of either a time control or a tune/temperature control ✓ 0 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) subiia tied 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 Reo lations or Part 6), where applicable, Copies to: BUILDING DEPARTMENT, HERS RATER (If APPLICABLE) BUILDING OWNER AT OCCUPANCY INSTALLATION CERTIFICATE j DUNE PALMS RD. BLD# 6200 Insulation Installation Quality Certificate 10 OF 12) CF-6R ✓ 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 ✓ 0 Installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures (ACM, Appendix RH) ✓ FLOOR 0No 0 All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end Yes No El Insulation in contact with the subfloor or rim joists insulated Ps ✓ WALLS R IRA I Insulation properly supported to avoid gaps, voids, and compression res ❑ No Wall stud cavities caulked or foamed to provide an air tight envelope Ps Po 4A Wall stud cavity insualtion uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back No gaps rs Q No voids over 3/4" deep or more than 10% of the batt surface area [] No ❑ N/A Hard to accesswall stud cavities such as; corner channels, wall intersections, and behind tub/shower enclosures insulated to proper R-Value Yes P Small spaces filled AP PA Rim -joists insulated 0 Ea Loose fill wall insulation meets or exceeds manufacturer's minimum weight -per -square -foot requirement ✓ ROOF/CEILING PREPARATION Yes Po R All draft stops in place to form a continuous ceiling and wall air barrier Yes P 2 All drops covered with hard covers Yes PoGA draft stops and hard covers caulked or foamed to provide an air tight envelope Yes n� To 6 All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between the housing and the ceiling Yes j To lV/A n❑ Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics F Yes R. Eave vents prepared for blown insulation - maintain net free -ventilation area Knee walls insulated or prepared for blown insualtion es ❑ No ❑ N/A Area under equipment platforms and car -walks insulated or accessible for blow insulation Ps R PA Attic rulers installed Residental Compliance Forms April 2005 " NSTALLATION CERTIFICATE 3 Address (PAGE 11 OF 12) CF-611 147-795 DUNE PALMS RD. BLD# 6200 Permft Number ✓ ROOF CEILING BAITS Yes 3 No 0 No gaps I Yes No El El No voids over 3/4" deep or more than 10% of the batt surface area IPes P 6 Insulation in contact with the air -barrier Yes P R Recessed light fixtures covered Ps Iro 6 Net free -ventilation area maintained at eave vents ✓ ROOF/CEILING LOOSE -FILL lames R 6 Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls PIS R 6 Baffles installed at eaves vents or soffit vents - maintain net free-ventilationa rea of eave vent l es R 6 Attic access insulated Pes R 6 Recessed light fixtures covered 17es No' 6 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. Nam R Owner MASCO CONTRACTOR SERVICES Signature: I--ir Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY Residental Compliance Forms r-1 1, I ALLATION CERTIFICATE e Address '-795 DUNE PALMS RD. BLD# 6200 Subdivision: La Quinta Dune Palms 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 Material N/A Thickness (inches) 5 (PAGE 12 OF 1 Permit Number 07-3223 Number 6200 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) Brand Name Thermal Resistance (R-value) CEILING Batt or Blanket Type BATT Brand Name CERTAINTEED Thickness (inches) 12 INCHES Thermal Resistance (R-value) Loose Fill Type Brand Contactor's min installed weight/ft lb Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) 6 ROOF Material Thickness (inches) N/A Brand Name Thermal Resistance (R-value) R-38 CF-6R DECLARATION ✓ 0 1 hereby certify that the abouve insulation was installed in the building at the above location in conformance with the current Energy Efficiency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated on the Certificate of Compliance, where applicable. Item #s Signature l Date Installing Subcontractor (Co. Name) OR (if applicable) General Contractor (Co. Name) OR Owner 3,5 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 i #s Signature Date Installing Subcontractor (Co. Name) OR r applicable) General Contractor (Co. Name) OR Owner OR Window Distributor Residental Compliance Forms April 2005