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CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page I of 3) CF-1R
Project Title2 Date
-- - Bm 'Idm Permit$
ProjectAddress
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Documantatian Author 9�7 Tole hone Plan cbak t pa c
N,Field Chtrle/Date
MANDATORY MEASURES CHECKLIST: RESIDENTIAL (Page I of 2) MF-IR Compliance Method (Package or Computer) Climate Zone o cement ency se y
Note: L.owrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used.
Items marked with an asterisk (a) may be superseded by more stringent compliance requiremantslisted on the Certificate of :. 4
b all stiles as
e considered ON
uses noted shalt b GENERAL INT+ORMA
Compliance. When this checklist is incorporatedinto the permit documents, the fen Y P a 6
is Average Ceihn Heig
ht: fr
to the documents
own elsewlteg gh
eAtertha aresh
cute Conditioned Floor ft
minimum eemponent gorfommttca spuifiae6ons for the mandatary measuresY TOtai C A'rca��
z or on this checklist only Conditioned Slab Floor Area
Building Type: Single Family V Addition
instructions: Check or initial applicable boxes when completed or enter N/A if not applicable.
(check one or more) Multi -Family � Existing -Plus -Addition
DESCRIPTION
DESIGNER
ENFORCEMENT
Building Envelope Measures:
• §750(a}: Minimum R-19 sailing inentatien. r •-- L%
§7S0(b}; lianas Sil insuiadon sraaufacturor•t labeled R-Value.
• $750(c): Minhnum R-73 wa11 inaulatiaa in wood framed wtdr, quivakntU-Peac,in meml £coma walls
date note to tcriormess walls.
.
fiaore-
" §ISO(d): Minimum R-13 raised floor insntstion in framed
§150(I): Stab insulation -water absorp6oamtangttaurthnn 03%,water vapauanemissian ratan
tban 2A h,
2
§118: Insu]acon spuiEedos fnsmiltd meets insulation quality etaadards. 7ndicatc type sted farm.
§716.77: Penastadm Produats, FxteriorAaors, andbtrdinu'sodlBxSttradm Controls
I. Doors mdwindaws btaveen conditimttd and w mditinned spacesdesigoed to lkritav leakage.
2. Fenasirati0npralucta(exctpt6dd-fabricated) have label with certified U-Favmt,cenified Solar Bart
t3aiu Coeffinitmt(SBGC), and fnfrlimtioa caAGcat'rm.✓"•�"
3. Exterior doors and windows wourbastrippot; all joints ad patetradons caulked and saalad.
§I50(g): Vapor bonitos mandatory to Climate Zane* 14 and 16 only,
§750(i): Special infiluativn battier fnsallod to comply with§ 151 meets Commission quality smndarda.
§150(e): Installation ofFiv places, Decorative Gas Applfmus and Gov lass.
1. masamy and foamy-bufltfixpiacra have:
a. Cloacablo metal orglass door
b, outside air iatakewith damps turd control
c. Flue damps settlement
2. No continuous burning gas pilot lights allowed.
Space Conditioning, Water Heating and Plumbing System Measures:
§I!0-§713: HVAC equipment, waterbukts, sbowerheads and faucets vcrtiE�by the Cormnissioo.
§I50(h): Beating "or cooling loads uninitiated is accordance with ASHRAB, SMACNA or ACCA.
§I50(i): Setback themmsmtm all applicable hoatiagandlorauding aysoems•
§150& Pipe and took insulation
7. Storage gas water bestors rated with an Energy pecmr less than 0.58 must be externally wrapped with
insulation having an installed thermal resistance ofR-12 or granter.
Z First $ fact ofpipm closest to waterbester tank,non-raireula6ug systems, insulated (R-4 or greater)
3. Back-up ranks for solar system, unfired storage tanks, or other indirect hot water tanks have R-12
exkmst insulation orR-16 combined intemay-tarrel fn uthrii n.
4, All buried or exposed piping insulated in recuculatingsections of botwater systems.
5. Cooling system piping below V F insulated.
C Piping insulated between hearing Son=and indliou hot water tank.
Front Orientation: 'FPq M
North / ou I Bast / West / All Orientations
}
(inputfmn Fnentation in degrees from Two North and circle one)
Number of Stories !
Number of'Dwelling Units:
Floor Construction Type: (Sla
iced Floor (cie l.eneorboth)
R_. DIANT BARRIER (required
in climate zones 2 A 8-15)
Required for this submittal yes _no
BUILDING ENVELOPE INSULATION
Component
Type
Frame Type
cad =wood
sA =steel
Cavity
Insulation
R-Value
Sheathing
Insulation
R-Value
Total R-
Valuot
Assembly
U-Factozl
Location/Comments
{attiq garage, typical,
Wall
Wall`
Roof
Roof
Fitwr
Floor
Slab Ed e
' t' e e li ca -Value and Assembly U- ante are of u red far a oil- ed all that cad R-Value
. . " insulati4gtgquimmants fogLi,)t�,y :p6ve Paekaee.
FENESTRATION
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Compliance Forms August 2001 A-2
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CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 3)
CF-IR
A#. 2x &�,
Compliance Form s August200t A-5
�-
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Rq?f SNrNG. 9 NAt,V
Project Title Date
R(XIf r0 Bf fXrCI70E0
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HVAC SYSTEMS
M/M RIX1f
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_._--.. _ - �.� .-.:.
.. Note: Input hydronicorcombined hydmnicdata under Water Heating Systems, except Design Heating Lead.
-
A,Irs s PGATf ,vArttuG
Distribution
O
h t
\
HeatingEquipment Minimum Type and Duct or
Heat Pump
f
MANDATORY MEASURES CHECKLIST: RESIDENTIAL (Page a of 2) MF-1R
Type (furnace, heat Efficiency Location Piping Thermostat
Configuration
2x 04L TQP P(Are
- s
pumpyem) (AFUE orHSPF) (dusts aa'se eta.} Type
(spilt or Package)
wrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. f,..
Note: Lo gs }
/�,.��R,�-Value
1 S�''l�f. f j 7 jJ wp,5' ht 2 `E
,ix SWD 8 ** O.C.
Vdfl SN(Arut!/G 3
Q
axe' R. R. 8 CXI
w' an asterisk (*)may be superseded b more stringentetunplianse requirements listed on the C;etifftaate o£
Items marked as Y P Y
- � ll& .
-
fiQAMtt/ 1
G ® O.C.,..
Compliance. When this checklist is incorporated into the permit documents, the feamras noted steall be considered by all girlies as
P he lis
_____mum"
- Cooling Equipment Minimum Duct
-Conlin
Heat Pump
tS
-
fU.N41 PRpttQF
i 'mum corn onetnt arfonnance specifications for the mandatary measures whether they are spawn elsewhere in the documents
ram p p spew
Type (a r andidona, Efficiency Location Duct Thermostat
Configuration
l#rekMeClAre BGPPORT .
or on this checklist only.
treat u .vootin EER attic c2c. R-Value e
s Iitor inks a
t2 C-Q C. MAX, FER
QFf. C
es when completed or enter NIA if not a licabie.
Instructions: Check or initial applicablebox p PP
C !F
R f IJ
CAl 1JC FRMG fofAll Inp ll
DE5CRIPTiON
DESIGN ER
ENFORCEMENT
Space Conditioning, Water Heating and Plumbing System Measures: (continued)
• §150(m): Ductsued Fans
1. Ati duds andpienums instailai,seakdmd insileiad m matthe mquiramntofdw 1498 CMCSutions 601,
503,604, and Skandrarrd.6'.�3;dm9s insuhttedta a m'n[immn insmltad Ievol otR•4.2or mdosed yin
conditioned space, opeamgrsbali be scaled with martin, taps, aerosol Sealant, aredwdud•clasore System
8iattnuty tbeappHcabkregitimrtutsof VL I81,UL IBIA, ortlL 18fE. Ifinescicormpeis usadto seal
openings grcaterthea 7t4inch,6ream8intioo afnrastic and either iraxhortape shall beusat Building
czvidasholl notbe used foramveying and76oned air•Iointe and seamsef duct systems and their
components shotl not be stated with cloth back rubber adhesive duct tapes unless such tope is used in
combination with mastic and dhawbands.
2. Building cavities, slippedplachrors for air hamllers, and plenums defined or constructed with materials
other than seated shun metal, duct board or flexible duasball not be used for conveying anditlmai
air. Building cavities and supportplallomis may antai i duds, Duds installed in vivifies andsupport
platforms shall not be compressed to cause rechristens, in the cross4eatoaal arse ofthe duets.
3, Soma and seams of duct systems and their components shell not be tested with cloth back rubbor
adhesive duct tape, unless such tape is need in combination with mastic and dmu bands.
4. Fxhaustin systems haw back drafter automatic dampas.
5. Gravity ventilating systems saving conditioned space have either automatic or readily accessible,
manually operated dampers,
6, Protection of 7nschu m. Insulation shall be protected from damage, including ibatdue to sualigbt,
molvnne, equipment maintoneuoe, and wind but net limited to the following: bisuWion exposed to
wearier shall be suin ddo for outdoor service e.g., protected by aluminum, abed metal, painted ceavas,
orplasti giver. Cefluiarfba mulabonshallbepmteoWwaboworpmatedwhbucoatiagibatis
water ntardeat sad vides aluei' from unite radiation tbatcan eausc de den n£tbe matcriat
§114: Pool and Spa Heating Systems and Equipment
I. System is certified with 78%thermal efficfucy, on-oRswhob,wmtharproofoperatinginstructions, no
electric resistance heating and no pilot light.
2, system is bundled with
a. At least36" ofpipe, between filter and heater for future enter hearing.
b. Cover for outdoor pools or outdoor spas.
3, Pool system has dirational inlets and a circulation pump time switeb.
§115: Gas feed ceatrai fumeas,pmt heaters, ape heaters or bousalmld aoo)iiag appliances have no
continuouslyburningPilot liht ion: Nonttutricat coo' a lieaces with riot<Iso Bmlhr
§1I8(f): Cool Rmfmakrial meet sptviflod ciliate
Lighting Measures:
§150(k)I.: Luminaires forgenced light9ngm kitchens shall have lamps withan eiifesoy of40lumens/watt
or greater for general lighting in kt bcns. This general lighting shalt be antrollod by a witeb on a readily
accessible lighting control enei at an entrance to the kitchen.
lit50(k)2.: Rooms with a shower a bathtub must have ehherat least one luminaira with lamps with an
f
efficacy of401umenatwatt or greater switebad attlia ontmuce to the room or one offhe alternatives to this
requirement allowed to §150(k)2.; and incandescent recossed ceiling fixtures are IC (insulation cover)
approved.
A
$CALL` r r-Q'
BCAt�• sous'
SEALED DUCTS and TXVs tar Alternative Measures)
r
Q Sealed Ducts an oinse ecoes
( ) v ' c ti n required) Px Co#r, tJ/ 15d R f ATNtYG !F {tastalIatestingand cerd5oationand IIF12S rater field cnfi a o req ) 7 fib $Nab 8 GY
016-04
D TXVs, readily accessible (climate zones 2 and 8.15 only) Px MA/AI R.R.
(Installer testing and cenification and HERS Rotor or field votification required} QR rRU %X rQ R
RQ(7f Meirmwa
D Refrigerant Charge/Air Flow (climate zones2end s-1$only) 7x R. R. 9
(Instellertesting and certification and HERS Rater or field verification required) CAut"c FRAM/A1G
OR
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CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3of3) CF-IR
Compliance Forms August 2001 A-6
Project Title
Date
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance specifications needed to comply with
Title 24, Parts I and 6 of the California Code of Regulations, and the administrative regulations to implement
them. This certificate has been signed by the individual with overall design responsibility. When this certificate
Of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that
is varied is indicated in the Special FeatureslRemarks section. The undersigned recognize that compliance using
duct sealing and TXVs requires installer testing and certification and field verification by an approved HERS
rater.
Designer o Owner { er Business and Professions Code) Documentation
Author Name: t`�+—`_'_•�^'._._-' Name:
Tftle/Firm: 0 yrr i / ., /�+ Title/Firm:
Address: �' "'.Q -e ��6J�' Address:
i Telephone: Telephone: -/r`,
Lie, A:
dater®� '
( )
Enforcement Agency