10120126 - ENERGY EME
L 1STALLATION CERTIFICATE (Page 1 of 12) CF-6R
Site Address __ � P it NM
Installation certificates(CF-611)are req r 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:
Distribution
CEC Certified Type If #of Rated Input External
Heater Mfr Name& (Std,Point- Recirculation, Identical (kW or Tank Volume Efficiency Standby Insulation
Type Model Number i of--Use,etc) Control T e S stems Btu/hr)� ( allons (EF,RE)2 Loss(%)Z R valpf,Z
So
e �
I 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 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-ii cites-irr-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 I 11.
Central Water Heating in Buildings with Multiple Dwelling Units(required for prescriptive)
❑AII 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 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 Regulations or Part 6),where applicable.
Installing Subcontractor(Co.Name)OR General
Contractor(Co. Name)OR Owner
Signature: Date:
Copies to: UILDING DEPARTMENT,HERS RATER(IF APPLICABLE)BUILDING OWNER AT OCCUPANCY
Residential Compliance Fornrs September 2005
INSTALLATION CERTIFICATE (Page 2 of 12) CF-6R
Site Address Permit Number
iq,ozl rleills Ln , 5'0144 J-
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:
Manufacturer/Brand
Name Total
t Quantity of Area Exterior
(GROUP LIKE Product LI-factor Product SHGC y of Like Product Square Shading Device Comments/Location/
Item RODUCTS) (<_CF-I R value) (5CF-I R value)2 Panes (Optional) Feet or Overhang Special Features
I. tow . 3S0•30 IR 2 1 too N Scjoei, F o
2. Q. 3 3 to-316 fa,; 2 4 114a roen Le it S
3. /` 5 a.l 2 a 2 t
4. 1M04 - o•3sl ,2- o. 3 Z S re¢ va
5.
6.
7.
8.
9.
10.
11.
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.
'-) 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-IR. 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.
✓ 0 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#s I— Signature Date Installing Subcontractor(Co.Name)OR
(if applicable) General Contractor(Co.Name)O caner
f��2lf�Zp/2 OR Window Distributor /
04� LI0/0 , I C4QJ1
Item#s Signature Date Installing Subcontractor(Co.Name)OR
(if applicable) General Contractor(Co.Name)OR Owner
OR Window Distributor
Item#s Signature Date Installing Subcontractor(Co.Name)OR
(if applicable) General Contractor(Co.Name)OR Owner
OR Window Distributor
Copies to: Building Department,HERS Rater(if applicable)Building Owner at Occupancy
Residential Compliance Forms April 2005
INSTALLATION CERTIFICATE (Page 3 of 12) CF-6R
Site Address Permit Number
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
CEC CertEfficiency
fr.
Certified M . #of t Duct Duct or Heating Heating;
Equip Type Name and Model Identical (AFUE,etc.) Location Piping Load Capacity
(pkg. heat um Number Systems >_C17-1 R value) (attic,etc.) R-value Btu/hr (Btu/hr
U �
1162L
Cooling Equipment
CEC Certified Mfr. #of Efficiencyt Duct Cooling Cooling
Equip Type Name and Model Identical (SEER or EER) Location Duct Load Capacity
(pkg.heat um Number Systems (KF-IR value) (attic,etc.) R-value (Btu/hr) (Btu/hr
. L
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.
✓ all 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 Ejiciency 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: Date:
Copies to:BUILDING DEPARTMENT,HERS RATER(IF APPLICABLE)BUILDING OWNER AT OCCUPANCY
Residential Compliance Forins April 2005
INSTALLATION CERTIFICATE (Page 4 of 12) CF-6R
Site Address Permit Number
INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE
INSTALLER COMPLIANCE STATEMENT
The building was: ✓ ❑Tested at Final ✓❑ Tested at Rough-in
INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE FOR NEW DUCTS:
❑ Remove at least one supply and one return register,and verify that the spaces between the register boot and the interior finishing
wall are properly sealed.
❑ If the house rough-in duct leakage test was conducted without an air handler installed, inspect the connection points between the
air handler and the supply and return plenums to verify that the connection points are properly sealed.
❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used on new ducts.
✓ ❑ DUCT LEAKAGE REDUCTION
Procedures or veld verification and diagnostic testing of air distribution s steins are available in RACM,Append&RC4.3
NEW CONSTRUCTION:
Duct Pressurization Test Results(CFM @ 25 Pa) Measured
Values
1 Enter Tested Leakage Flow in CFM:
Fan Flow: Calculated(Nominal: ✓ ❑Cooling✓❑ Heating)or✓❑ Measured
2 If Fan Flow is Calculated as 400 cf -dton x number of tons or as 21.7 cfm/(kBtu/hr)x Heating ✓ ✓
I'Cavacity in Thousands of Btu/hr,enter total calculated or measured fan flow in CFM here:
Pass if Leakage Percentage< 6%for Final or<4%at Rough-in without air handle:
3100 x Line# I / (Line#2 ❑ Pass❑ Fail
ALTERATIONS: Duct System and/or HVAC Equipment Change-Out
Enter Tested Leakage Flow in CFM from Pre-Test of Existing Duct System Prior to Duct
4 System Alteration and/or Equipment Change-Out.
Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct
5 S stem for Duct System Alteration and/or Equipment Chan a-Out. '
Enter Reduction in Leakage for Altered Duct System
6 Line#4 Minus Line#5
— (Only if Applicable)
7 Enter Tested Leakage Flow in CFM to Outside(Only if Applicable) ✓ ✓
Entire New Duct System-Pass if Leakage Percentage <6%for Final. ❑ Pass ❑ Fail
8 100 x Line#5 / Line#2)11
TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- ✓ ✓
Out Use one of the following four Test or Verification Standards for compliance:
9 Pass if Leakage Percentage< 15% [100 x [ (Line#5)/ (Line#2)11 ❑ Pass ❑ Fail
10 Pass if Leakage to Outside Percentage< 10%[100 x�_(Line#7)/ (Line#2)]] ❑ Pass ❑ Fail
Pass if Leakage Reduction Percentage>60%[100 x [(Line#6)/ (Line#4)]] ❑ Pass ❑ Fail
1 1 and Verification by Smoke Test and Visual Inspection
12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail
Pass if One of Lines#9 through# I2 ass ❑ Pass ❑ Fail
✓ ❑1,the undersigned,verify that the above diagnostic test results were performed in conformance with the requirements for compliance
credit. 1,the undersigned,also certify that the newly installed or retrofit Air-Distribution System Ducts,Plenums and Fans comply with
Mandatory requirements specified in Section 150(m)of the 2005 Building Energy Efficiency standards.
Installing Subcontractor(Co.Name)OR General Contractor(Co.Name)OR Owner
Signature: Date:
Copies to: BUILDING DEPARTMENT,HERS RATER(IF APPLICABLE)BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms December 2005
INSTALLATION CERTIFICATE (Page 5 of 12) CF-6R
Site Address Permit Number
✓ ❑ THERMOSTATIC EXPANSION VALVE(TXV)
Procedures for field verification of thermostatic expansion valves are available in RACM, Appendi_r R/.
Access is provided for inspection.The procedure shall
consist of visual verification that the TXV is installed on
✓ ®(Yes O No the system and installation of the specific equipment ❑
shall be verified.
Yes is a pass I Pass I Fail
✓ ❑ REFRIGERANT CHARGE MEASUREMENT
Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without
Thermostatic Expansion Valves
Outdoor Unit Serial#
Location
Outdoor Unit Make
Outdoor Unit Model 1
Cooling CapacityZ , Btu/hr
Date of Verification
Date of Refrigerant Gauge Calibration (must be checked monthly)
Date of Thermocouple Calibration (must be checked monthly)
Standard Charge Measurement Procedure (outdoor air dry-bulb 55°F and above):
Procedures for Determining Refrigerant Charge using the Standard Method are available in RA CM,Appendix RD2.
Note:The system should be installed and charged in accordance with the manufacturer's specifications before starting this
procedure.
Measured Temperatures
Supply(evaporator leaving)air dry-bulb temperature(Tsupply,db) OF
Return(evaporator entering)air dry-bulb temperature(Treturn,db) OF
Return(evaporator entering)air wet-bulb temperature(Treturn,wb) OF
Evaporator saturation temperature(Tevaporator,sat) OF
Suction line temperature(Tsuction,db) °F
Condenser(entering)air dry-bulb temperature(Tcondenser,db) °F
Superheat Charge Method Calculations for Refrigerant Charge
Actual Superheat =Tsuction,db—Tevaporator,sat °F
Target Superheat(from Table RD-2) OF
Actual Superheat—Target Superheat (System passes if between-5 and+5°F) OF
Temperature Split Method Calculations for Adequate Airflow
S lit Method Calculation is not necessary i Ade uate Air otiv credit is taken
Actual Temperature Split =T return,db Tsupply,db OF
Target Temperature Split(from Table RD3) OF
Actual Temperature Split Target Temperature Split (System passes if between- OF
3°F and+3°F or,upon remeasurement,if between -3°F and-100°F
Residential Compliance Forms April 2005
c
INSTALLATION CERTIFICATE (Page 6 of 12) CF-6R
Site Address �� yL0 Permit Number
lila VJ�le�
Standard Charge Measurement Summary:
System shall pass both refrigerant charge and adequate airflow calculation criteria from the same
measurements. If corrective actions were taken,both criteria must be remeasured and recalculated.
✓ I rYes ❑ No I System Passes
Alternate Charge Measurement Procedure (outdoor air dry-bulb below 55°F)
Note:The system should be installed and charged in accordance with the manufacturer's specifications and installer
verification shall be documented on CF-6R before starting this procedure. If outdoor air dry-bulb is 55 OF or above, installer
shall use the Standard Charge Measure Procedure:
Procedures for Determining Refrigerant Charge using the Alternate Method are available in RA CAI,Appendix RD3.
Wei h-In Charging Method for Refrigerant Charge
Actual liquid line length: ft
Manufacturer's Standard liquid line length: ft
Difference(Actual—Standard): ft
Manufacturer's correction(ounces per foot) x difference in length = ounces
(+=add)(-=remove)
Measured Airflow Method for Adequate Airflow Verification available in RACM,Appendix RD2.6
Calculated Airflow: Cooling Capacity(Btu/hr) 0.033(cfm/Btu-hr)= 14�k& —CFM
v
Measured Airflow is CFM(Measured airflow must be greater than the calculated airflow).
Alternate Charge Measurement Summary:
System shall pass both refrigerant charge and adequate airflow calculation criteria from the same measurements. If
correct've actions were taken,both criteria must be remeasured and recalculated.
✓ 10 Yes 1 ❑No I System Passes
Installing Subcontractor(Co.Name)OR General-
Contractor(Co Nam )OROwner /"ft U 9 -.ff✓
Signature: �j Date:
Copies to: BUILDING DEPARTMENT,HERS RATER(IF APPLICABLE)BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms April 2005
INSTALLATION CERTIFICATE (Page 7 of 12) CF-6R
Site Address Permit Number
MISCELLANEOUS CREDITS
✓ ❑ DIAGNOSTIC SUPPLY DUCT LOCATION,SURFACE AREA AND R-VALUE
Procedures for field verification and diagnostic testing for this group compliance credits are available in RA CM,Appendix RC. RE&RI-1.
✓ ❑ LESS THAN 12 LINEAL FEET OF SUPPLY DUCT OUTSIDE OF CONDITIONED SPACE
COMPLIANCE CREDIT
✓ I ❑Yes I ❑No I Less than 12 lineal feet of supply duct outside of conditioned space.
Yes to this compliance credit is a pass I ✓ ❑ Pass I ✓ ❑ Fail
✓ ❑ SUPPLY DUCTS LOCATED IN CONDITIONED SPACE COMPLIANCE CREDIT
✓ ❑ Yes 1 ❑ No I Ducts are located within the conditioned volume of building.
Yes to this compliance credit is a pass ✓ ❑ Pass ✓ ❑ Fail
Duct System Design verification is required for a compliance credit for the following:
1. Supply duct surface area reduction
2. Buried supply ducts on the ceiling
3. Deeply buried supply ducts
✓ ❑ DUCT SYSTEM DESIGN VERIFICATION
✓ ❑ Yes ❑ No Adequate airflow verified
✓ ❑ Yes ❑ No The duct system design plan meets the requirements specified in RACM,Appendix RE,Section
RE.4.2
✓ ❑ Yes ❑ No The duct system design plan exists on building plans
✓ ❑ Yes •❑ No Duct sizes,duct system layout and locations of supply&return registers match the duct system
design plan
Yes to all is a pass ✓ ❑ Pass ✓ ❑ Fail
✓ ❑ SUPPLY DUCTS SURFACE AREA REDUCTION COMPLIANCE CREDIT
R-4.2 R-6.0 R-8.0
Crawl Deeply Duct Surface Surface Surface
Attic Space Basement Covered Covered Other Diameter Area Area Area
❑ ❑ ❑ u ❑ ❑
❑ ❑ 0 ❑ ❑ Cl
❑ ❑ 0 ❑ 0 0
Total Surface Area for Each R-Value=
✓ ❑ Yes 10 No ktches Performance's CF-1 R? ✓ ✓
Yes to all is a pass ❑ Pass ❑ Fail
✓ ❑ BURIED DUCTS ON THE CEILING COMPLIANCE CREDIT
❑ Yes ❑No Buried Ducts on the Ceiling
❑ Yes ❑No Verified High Insulation Installation Quality ✓ ✓
Yes to ducts stem design,supply duct surface area reduction and this compliance credit is a pass ❑ Pass ❑ Fail
✓ ❑ DEEPLY BURIED DUCTS COMPLIANCE CREDIT
❑ Yes ❑No Deeply Buried Ducts
./ ❑ Yes ❑No I Verified High Insulation Installati6n Quality ✓ ✓
Yes to ducts stem design,supply duct surface area redaction and this compliance credit is a pass ❑Pass ❑ Fail
Copies to: BUILDING DEPARTMENT,HERS RATER(IF APPLICABLE)BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms April 2005
INSTALLATION CERTIFICATE (Page 8 of 1.2) CF-6R
Site Address/J x / Permit Number
✓❑ FAN WATT DRAW
Procedures or measuring the air handler wall drenv are available in RACM, Appendix RE3.2.
✓ Method For Fan Watt Draw Measurement
❑ RE3.2.1 Portable Watt Meter Measurement
❑ RE3.2.2 Utility Revenue Meter Measurement
Measured Fan Watt Draw Watts
Measured Fan Flow enter total cfm from airflow verification cfm
Enter results of Watts/cfm Watts/cfm
✓ ❑ Yes ❑ No Measured fan watt/cfm draw is equal to or lower than the
fan watt/cfm draw documented in CF-IR ❑
Yes is a pass Pass Fail
✓ UrADEQUATE AIRFLOW VERIFICATION
Procedures or measuring the airflow are available in RACM,Appendix RE3.1.
✓Method For Airflow Measurement
❑ RE4.1.1 Diagnostic Fan Flow Using Flow Capture Hood
RE4.1.2 Diagnostic Fan Flow Using Plenum Pressure Matching
❑ RE4.1.3 Diagnostic Fan Flow Using Flow Grid Measurement
Yes ❑ No Duct design exists on plans
Measured Airflow: Total cfm
Rated Tons cfm/ton cfm/ton
✓ ❑ Yes ❑ No Measured airflow is greater than the criteria in Table RE-2 ✓ ✓
Yes is a pass Pass Fail
✓ ErMAXIMUM COOLING CAPACITY
Procedures for del mining maximum cooling load ca achy are available in RACM,Appendix RF3.
I ✓ ❑ es ❑ No Adequate airflow verified(see adequate airflow credit)
2 ✓ Yes ❑ No Refrigerant charge or TXV
3 ✓ ❑ Yes ❑ No Duct leakage reduction credit verified
4 ✓ ❑ Yes ❑'No Cooling capacities of installed systems are<_to maximum cooling
capacity indicated on the Performance's CF-IR and RF-3.
If the cooling capacities of installed systems are>than maximum ✓ ✓
5 ✓ Yes ❑No cooling capacity in the CF-I R,then the electrical input for the
installed systems must be 5 to electrical input in the CF-I R. ❑
Yes to I,2,and 3; and Yes to either 4 or 5 is a pass Pass Fail
✓ HIGH EER AIR CONDITIONER
Procedures for veri(cation are available in RACM,Appendix RI.
1 ✓ ❑>fs ❑ No EER values of installed systems match the CF-I R
2 ✓ Yes ❑No Fors lit system, indoor coil is matched to outdoor coil ✓ ✓
3 ❑ Yes ❑ No Time Delay Relay Verified(If Required) ❑
Yes to I and 2;and 3 If Required) is a pass Pass Fail
Installing Subcontractor(Co.Name)OR General f 5 �
Contractor(Co. Nay)OR Owner ���
Signature: vft�� Date: ?� ZO / Z_
Copies to: BUILDING DEPARTMENT,HERS RATER(IF APPLICABLE)BUILDING OWNER AT OCCUPANCY
Residential Compliance Forms April 2005
INSTALLATION CERTIFICATE (Page 9 of 12) CF-6R
Site Address u M,f 7 � � Permit Number
An installation certificate is required t 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).
BUILDING ENVELOPE LEAKAGE DIAGNOSTICS
✓ ❑ ENVELOPE SEALING INFILTRATION REDUCTION
Procedures far field verification and diagnostic testing of envelope leakage are available in RACM,Appendix RC.
Diagnostic Testing Results
✓ ✓ Building Envelope Leakage(CFM @ 50 Pa)as measured by Rater:
I ❑ ❑ Measured envelope leakage less than or equal to the required level from
Yes No CF-I R?
2. ❑ Is Mechanical Ventilation shown as required on the CF-I R?
Yes No
2a ❑ ❑ If Mechanical Ventilation is required on the CF-I R(`Yes' in line 2),has it
Yes No been installed?
Check this box `yes' if mechanical ventilation is required(`Yes' in line 2)
2b. ❑ [3 and ventilation fan watts are no greater than shown on CF-1R.
Yes No Measured Watts=
Check this box"yes"if measured building infiltration(CFM @ 50 Pa)is
3. 1:3 1:1 Check
than the CFM @ 50 values shown for an SLA of 1.5 on CF-I R
Yes No If this box is checked no,mechanical ventilation is required.)
Check this box"yes"if measured building infiltration(CFM @ 50 Pa)is
4 ❑ ❑ less than the CFM @ 50 values shown for an SLA of 1.5 on CF-I R,
Yes No mechanical ventilation is installed and house pressure is greater than minus
5 Pascal with all exhaust fans operating.
Pass if:
a. Yes in line I and line 3,or ✓ ✓
b. Yes in line 1 and line2,2a,and 2b,or ❑
c. Yes in line I and Yes in line 4.
Otherwise fail. Pass Fail
✓ ILyJ 1,the undersigned,verify that the building envelope leakage meets the requirements claimed for building leakage
reduction below default assumptions as used for compliance on the CF-1 R. This is to certify that the above diagnostic test
results and the work I performed associated with the test(s)is in conformance with the requirements for compliance credit.
(The builder shall provide the HERS provider a copy of the CF-6R signed by the builder employees or subcontractors
certifying that diagnostic testing and installation meet the requirements for compliance credit.)
Test Performed -H V �p
Installing Subcontractor(Co.Name)OR General / VA—c—,-
Contractor(Co. Nam )OR Owner (J �j
Signature: t Date:
Copies to: BUILDING DEPARTMENT,HERS RATER(1F APPLICABLE), BUILDING OWNER AT OCCUPANCY
Residential Compliance Fornns April 2005
COAST BUILDING PRODUCTS
A Division of MASCO CONTRACTER SERVICES
i
6700 Golden Gate Drive,Suite D,Dublin,CA 94568
Phone:(926)557.2090 Fax(925)820.57G)
INSULATION CERTIFICATE
Builders: VICKY SUN Permit Number:
Site Address: 19021 MEIGGS LN. CUPERTINO
Project Name: MEIGGS/SUN [insulation QII NO
Description of Insulation (Formerly IC-1 Form)
1 RAISED FLOOR
Material BATTS Brand Name OWENS CORNING
Thickness(inches) 6.25" Thermal Resistance(R-Value) R-19
2 FLOOR OVER GARAGE
Material BATTS Brand Name OWENS CORNING
Thickness 6.25" Thermal Resistance(R-Value) R-19
Perimeter Insulation Depth (inches)
3 EXTERIOR WALL
Frame Type
A. Cavity Insulation
Material BATTS Brand Name OWENS CORNING
Thickness(inches) 5.5" Thermal Resistance(R-Value) R-21
B. Exterior Foam Sheathing
Material Brand Name
Thickness(inches) Thermal Resistance(R-Value)
4 FOUNDATION WALL
Material Brand Name
Thickness Thermal Resistance(R-Value)
5 CEILING
Batt or Blanket Type BATTS Brand Name OWENS CORNING
Thickness(inches) 12" Thermal Resistance(R-Value) R-38
Loose Fill Type Brand Name
Contractors min Installed weight/ft2 Ib Minimum Thickness Inches
Manufacturers installed weight per square foot to achieve Thermal Resistance(R-Value)
6 ROOF
Material Brand Name
Thickness Thermal Resistance(R-Value)
Declaration
[X I hereby certify that the above insulation was installed in the building at the above location in conformance with the
current Energy Efficient Standards for residence 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 General Contractor
1,2,3,&5 JILLIAN 13AUEIZ 4/23/2012 COAST BUILDING PRODUCTS
a
COAST BUILDING PRODUCTS
� A Division of MASCO CONTRACI'ER SERVICES
6700 Golden Gate Drive,Suite D,Dublin,CA 9d568
Phone:(925)557.2090 Fax(925)829.5761
INSULATION CERTIFICATE
Builders: VICKY SUN Permit Number:
Site Address: 19021 MEIGGS LN. CUPERTINO Insulation QII
Project Name: MEIGGS/SUN FlFq
Description of Insulation (Formerly IC-1 Form)
1 RAISED FLOOR
Material BATTS Brand Name OWENS CORNING
Thickness(inches) 6.25" Thermal Resistance(R-Value) R-19
2 FLOOR OVER GARAGE
Material BATTS Brand Name OWENS CORNING
Thickness 6.25" Thermal Resistance(R-Value) R-19
Perimeter Insulation Depth (inches)
3 EXTERIOR WALL
Frame Type
A. Cavity Insulation
Material BATTS Brand Name OWENS CORNING
Thickness(inches) 5.5" Thermal Resistance(R-Value) R-21
B. Exterior Foam Sheathing
Material Brand Name
Thickness(inches) Thermal Resistance(R-Value)
4 FOUNDATION WALL
Material Brand Name
Thickness Thermal Resistance (R-Value)
5 CEILING
Batt or Blanket Type BATTS Brand Name OWENS CORNING
Thickness (inches) 12" Thermal Resistance(R-Value) R-38
Loose Fill Type Brand Name
Contractors min Installed weight/ft2 Ib Minimum Thickness Inches
Manufacturers installed weight per square foot to achieve Thermal Resistance(R-Value)
6 ROOF
Material Brand Name
Thickness Thermal Resistance(R-Value)
Declaration
❑X I hereby certify that the above insulation was installed in the building at the above location in conformance with the
current Energy Efficient Standards for residence 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 General Contractor
1,2,3,&5 JILLIAN BALER 4/23/2012 COAST BUILDING PRODUCTS