07-3242 (MFD5) CF-6R InstallationCERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 7 of 8) CF-4R
Project Title: La Quality Insulation uinta Dune Palms
Q Q
Date: 1/20/2008
oject Address: 47_795 Dune Palms Rd. Bid# 8100
La Ouinta CA 92253
Builder Name:
CVHC
Builder or Installer Contact:
Telephone:
Permit or Plan No.
CVHC
800-689-4663
07-3242
HERS Rater:
Telephone:
Sample Group No.
Kevin Rasmussen CCNKR350475
619-251-7982
Not Sampled
Certifying Signature:
Date: Sample House No.
1/20/2008I Not Sam led
Firm:
HERS Provider:
So Cal HERS Raters
CHEERS e
Street Address:
City /State /Zip
4840 Normandie Place
La Mesa CA 91941
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY
HERS RATER COMPLIANCE STATEMENT
This house was: ✓ ® Tested ✓ ❑ Approved as part of a sample testing, but was not tested.
As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies
with all applicable requirements of the "High Quality Installation of Insulation" protocols as specified in the Residential
ACM, Appendix RH and as checked on this form. Note that to PASS and receive compliance credit, NONE of the BOXES
below may be checked "No" and the first three boxes also must be checked. Check "NA" only if the item is not part of the
design of the building (i.e., single story buildings do not have rim joists or there may be no recessed can lights installed,
etc.).
✓ ® REQUIREMENTS FOR "HIGH QUALITY INSTALLATION OF INSULATION" COMPLIANCE CREDIT
✓ ❑ The building is wood frame construction with wall stud cavities, ceilings, and roof assemblies insulated
with mineral fiber or cellulose insulation in low-rise residential buildings.
✓ ® Description of insulation, (CF-6R, formerly IC-1) signed by the installer stating: insulation manufacturer's
name, material identification, installed R-values, and for loose -fill insulation: minimum weight per square
foot and minimum inches.
✓ ® Installation Certificate, (CF-6R) signed by the installer certifying that the installation meets all
applicable requirements as specified in the High Quality Insulation Installation Procedures
(ACM, Appendix RH).
✓FLOOR
❑
❑
®
All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end
YES
No
NA
®
❑
❑
Insulation in contact with the subfloor or rim joists insulated
YES
No
NA
❑
❑
®
Insulation properly supported to avoid gaps, voids, and compression
YES 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
No
NA
LS
❑
ElWall
stud cavities caulked or foamed to provide an air tight envelope.
No
NA
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING 7 of 8 CF-4R
_,(Page
Project Title: La Quinta Dune Palms Quality Insulation
Q tY
Date:
1/20/2008
. , oject Address: 47-795 Dune Palms Rd. Bld# 8100
La Ouinta, CA 92253
Builder Name:
CVHC
Builder or Installer Contact:
Telephone:
Permit or Plan No.
CVHC
800-689-4663
07-3242
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:
So Cal HERS Raters
I CHEERS
Street Address:
City / State / Zip
4840 Normandie Place
La Mesa CA 91941
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY
HERS RATER COMPLIANCE STATEMENT
This house was: ✓ ® Tested ✓ ❑ Approved as part of a sample testing, but was not tested.
As the HERS rater providing diagnostic testing and field verification, I certify that the house identified on this form complies
with all applicable requirements of the "High Quality Installation of Insulation" protocols as specified in the Residential
ACM, Appendix RH and as checked on this form. Note that to PASS and receive compliance credit, NONE of the BOXES
below may be checked "No" and the first three boxes also must be checked. Check "NA" only if the item is not part of the
design of the building (i.e., single story buildings do not have rim joists or there may be no recessed can lights installed,
etc.).
✓ ® REQUIREMENTS FOR "HIGH QUALITY INSTALLATION OF INSULATION" COMPLIANCE CREDIT
✓ ® The building is wood frame construction with wall stud cavities, ceilings, and roof assemblies insulated
with mineral fiber or cellulose insulation in low-rise residential buildings.
✓ ® Description of insulation, (CF-6R, formerly IC-1) signed by the installer stating: insulation manufacturer's
name, material identification, installed R-values, and for loose -fill insulation: minimum weight per square
foot and minimum inches.
✓ ® Installation Certificate, (CF-6R) signed by the installer certifying that the installation meets all
applicable requirements as specified in the High Quality Insulation Installation Procedures
(ACM, Appendix RH).
✓FLOOR
❑
❑
®
All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end
YES
No
NA
®
❑
❑
Insulation in contact with the subfloor or rim joists insulated
YES
No
NA
❑
❑
®
Insulation properly supported to avoid gaps, voids, and compression
YES I
No
NA
✓WALLS
®
❑
❑
Wall stud cavity insulation uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back
YES
No
NA
®
❑
❑
No Gaps
YES
No
NA
®
❑
❑
No voids over 3/4" deep or more than 10% of the batt surface area.
YES
No
NA
®
❑
❑
Hard to access wall stud cavities such as; corner channels, wall intersections, and behind
YES
No
NA
tub/shower enclosures insulated to proper R-Value
®
❑
❑
Small spaces filled
YES
No
NA
®
❑
❑
Rim -joists insulated
YES
No
NA
®
❑
❑
Wall stud cavities caulked or foamed to provide an air tight envelope.
YES
No
NA
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING (Page 8 of 8 CF-4R
`-oject Address 47_795 Dune Palms Rd. Bid# 8100 La Quinta, CA 92253
Builders Name
CVHC
Vitoof/Ceiling
Pre
®
El
All draft stops in place to form a continuous ceiling and wall air barrier.
YES
F
NA
®
El
All drops covered with hard covers
YES
o
NA
®
❑
❑
All draft stops and hard covers caulked or foamed to provide an air tight envelope
YES
No
NA
®
❑
❑
All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between
YES
No
NA
the housing and the ceiling
®
❑
❑
[Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics
YES
No
NA
❑
❑
®
Eave vents prepared for blown insulation - maintain net free -ventilation area
YES
No
NA
❑
❑
®
Knee walls insulated or prepared for blown insulation
YES
No
NA
❑
❑
®
Area under equipment platforms and cat -walks insulated or accessible for blown insulation
YES
No
NA
❑
❑
I
®
Attic rulers installed
YES
No
NA
-too f Ceiling Batts
®
❑
❑
No Gaps
YES
No
NA
®
❑
❑
No voids over 3/4 in. deep or more than 10% of the batt surface area.
YES
No
NA
®
❑
❑
Insulation in contact with the air -barrier
YES
No
NA
®
❑
❑
Recessed light fixtures covered
YES
No
NA
❑
❑
®
Net free -ventilation area maintained at eave vents
YES
No
NA
✓Roof Ceilin
Loose Fill
®
❑
❑
Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls.
YES
No
NA
❑
❑
®
Baffles installed at eaves vents or soffit vents - maintain net free -ventilation area of eave vent
YES
No
NA
❑
❑
®
Attic access insulated
YES
No
NA
❑
❑
®
Recessed light fixtures covered
YES
No
NA
❑
❑
®
Insulation at proper depth — insulation rulers visible and indicating proper depth and R-value
YES
No
NA
Loose -fill insulation meets or exceeds manufacturer's minimum weight and thickness requirements
for the target R-value. Target R-value . Manufacturer's minimum required
weight for the target R-value (pounds -per -square -foot). Manufacturer's
❑
❑
®
minimum required thickness at time of installation . Manufacturer's minimum
YES
No
NA
required settled thickness . Note: To receive compliance credit the HERS rater
shall verify that the manufacturer's minimum weight and thickness has been achieved for the
target R-value. (CF-6R only)
I1Vi J`t ( 1 1. 1
j INSTALLATION CERTIFICATE (ran I of 1Z Crow
Site Address Permit Number
Installation certificates (CF-6R) are required for each and every dwbtirig 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 large 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 ibr storage water heaters with an energy factor of less than 0.58.
Kitchen Piping;
If indicated on the CFA 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 11 I.
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 oa 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.
Installing Subcontractor (Co. Name) OR General i
Contractor (Co. Name) OR Owner
Signature: Man Nel f Date; L U Lgg
Copies to: B'C MDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILAINO OWNER AT OCCUPANCY
INSTALLATION CERTIFICATE
Site Address
47-795 Dune Palms Rd, La Quinta, Ca BLDG - 8100
(Page 2 of 12) CF-6R
'ermit Number
07-3242
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 10-10.3(a).
FENESTRATION/GLAZING:
Item
1.
Manufacturer/Brand
Name
(GROUP LIKE
RODUCTS
Pella/lmpervia
t
Product LI-factor
(5CF-IRvalue) �
31
t
Product SHGC
(SCF-IRvalue }''
32
It of
Panes
2
Total
Quantity of
Like Product
(O rionan
Area
Square
Feet
Exterior
Shading Device
orOverhang
N/A
Comments/L.ocationi
Special Features
2.
3.
4.
5.
6.
7.
8.
9.
10.
Il.
12
13,
14.
15.
tl 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.
23 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-1R. If using default table
SHGC values from § 116 identify whether tinted or not.
✓ M 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
o y
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
i-opres to: tsauurng uepartment , HERS stater (it applicable) Building Owner at Occupancy
Residential Compliance Forms April 2005
L)JoL-%=F- LJv-rEFzS PL-Firze
INSTALLATION CERTIFICATE (Page 3 of 12) CF-6R
Site Address p Permit Number
�41=7�S L�vs4C- Ghyn-r RV.LQQQuV- r� Cii �1� 0-7--aM��.
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: Q t G S) O
Heating Equipment
Equip Type
CEC Certified Mfr.
Name and Model
# of
Identical
Efficiency
(AFUE. etc.)
Duct
Location
Duct or
Piping
Heating
Load
Heating
Capacity
(pkg. heat pump)
Number
Systems
(>_CF-IR value)
(attic, etc.)
R-value
(Btu/hr)
(Btu/hr)
FAN Coi L-
3 icox(s),- C.
f?ITIc-
RY.'2
19 boa
it)Ysit HT
37epps(s;�-----C
-e`
wpmee-
"
f)jvo
100
up-) err. co,c-
3(2V49Gt0 1
S-J
V1ePmv-.
Re.o
1
yoc>
y8"9&�s
19 11o0
Cooling Equipment
Equip Type
k . heat pump)
CRRVZ S eV-
CEC Certified Mfr.
Name and Model
Number
# of
Identical
Systems
Efficiency
I
(SEE or EER)
>CF-IRvalue)
Duct
Location
(attic, etc.)
Duct
R-value
Cooling
Load
(Btu/hr)
Cooling
Capacity
(Btti/hr
COO.. ®.NL.`Y
'aL4F3CA4---30n
I LI.O
1RTrL
R
30a)o
C' 0eiin'Ns
ONFIc 143GP
S
14.0
1i1�5-f
CR L)t' n?
3
N.0
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.
✓ E 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
.9S W ME: cyp�sysG
Signature: Qg
Date: S 13 a,C)q
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms April2005
INSTALLATION CERTIFICATE (PAGE 10 DG U) CF-6R
idress
Permit Number
� DUNE PALMS RD. BLD# 8100 07-3242
Insulation Installation Quality Certificate
✓ E Description of Insulation, (CF-6R, formely IC-1) signed by the installer stating: insulation manufacturer's name,
material identification, installed R-values, and for loose -fill insulation: minimum weight per square foot and minimum
inches
✓ 0 Installation meets all applicable requirements as specified in the High Quality Insulation Installation Procedures
(ACM, Appendix RH)
✓ FLOOR
0
0
All floor joist cavity insulation installed to uniformly fit the cavity side -to -side and end -to -end
0
No
0
Insulation in contact with the subfloor or rim joists insulated
0
Insulation properly supported to avoid gaps, voids, and compression
✓ WALLS
Ps
Y
6
Wall stud cavities caulked or foamed to provide an air tight envelope
Ps
W
6
Wall stud cavity insualtion uniformly fills the cavity side -to -side, top -to -bottom, and front -to -back
No gaps
Yes
YoPA
voids over 3/4" deep or more than 10% of the batt surface area
,s
❑
No
6
Hard to accesswall stud cavities such as; corner channels, wall intersections, and behind
tub/shower enclosures insulated to proper R-Value
Res
o
In❑
Small spaces filled
es
�
To
IV/AV/A
n❑
Rim -joists insulated
es
�n❑
N/A
Loose fill wall insulation meets or exceeds manufacturer's minimum weight -per -square -foot requirement
✓ ROOF/CEILING
PREPARATION
es
ILIA
All draft stops in place to form a continuous ceiling and wall air barrier
Ps
no
PA
All drops covered with hard covers
Yes
0
0
All draft stops and hard covers caulked or foamed to provide an air tight envelope
YesTo
n�
n❑
IV/A
All recessed light fixtures IC and air tight (AT) rated and sealed with a gasket or caulk between the
housina and the ceiling
Ps
6
Floor cavities on multiple -story buildings have air tight draft stops to all adjoining attics
Ps
R
R
Eave vents prepared for blown insulation - maintain net free -ventilation area
es
o
Knee walls insulated or prepared for blown insualtion
es
o
nn
I�7A
Area under equipment platforms and car -walks insulated or accessible for blow insulation
es
o
Attic rulers installed
Residental Compliance Forms April 2005
"ISTALLATION CERTIFICATE
795 DUNE PALMS RD. BLD# 8100
PAGE 11 OF 12) CF-6R
✓ ROOF CEILING BATTS
Yes
E]
No
�
No gaps
Yes
No 0
El
No voids over 3/4" deep or more than 10% of the batt surface area
ItP
Insulation in contact with the air -barrier
Is
Po
19
Recessed light fixtures covered
YEels
01
RA
Net free -ventilation area maintained at eave vents
✓ ROOF/CEILING LOOSE -FILL
�
RA
Insulation uniformly covers the entire ceiling (or roof) area from the outside of all exterior walls
('e�s
Ps
Ro'
IPA
Baffles installed at eaves vents or soffit vents - maintain net free-ventilationa rea of eave vent
Q
Yes
J01
PA
Attic access insulated
l es
No
Recessed light fixtures covered
Yes
R
6
Insulation at proper depth - insualtion rulers visible and indicating proper depth and R-Value
El
Yes
0
No
El
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 05 Owner
MASCO CONTRACTOR SERVICES
Si nature:
Date:
Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE), BUILDING OWNER AT OCCUPANCY
Residental Compliance Forms April 2005
STALLATION CERTIFICATE
I47-795 DUNE PALMS RD. BLD# 8100
Subdivision: La Quinta Dune
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 CEILING
3
12 OF 12) CF-6R
8100
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)
Batt or Blanket Type BATT Brand Name CERTAINTEED
Thickness (inches) 12 INCHES Thermal Resistance (R-value) R-38
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)
ROOF
Material
Thickness (inches)
N/A
Brand Name
Thermal Resistance (R-value)
DECLARATION
✓ 01 hereby certify that the abouve insulation was installed in the building at the above location in conformance with the
current Energy Efficiency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated
on the Certificate of Compliance, where applicable.
Item #s
Signature Date
Installing Subcontractor (Co. Name) OR
(if applicable)
General Contractor (Co. Name) OR Owner
3,5
OR Window Distributor
c
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
�r
Signature Date
Installing Subcontractor (Co. Name) OR
applicable)
General Contractor (Co. Name) OR Owner
OR Window Distributor
Residental Compliance Forms April 2005