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Energy Program Insulation Certificate for Residential New Construction <br /> �V\SIll',6110N$rA1rl Nm1 R111Y <br /> Permit#: 0 2- <br /> House address or lot number: 'Lyp) Le-)(i N Vo n Avc, Evere 1-k, W A ggZO3 <br /> Walls Blown or Sprayed Fiberglass or Cellulose-Walls <br /> Type of insulation: LeA ^� R-value per inch: <br /> Manufacturer: ()L,aen -,n IL Coverage area: <br /> R-value: (2 --Z 1 1J Bag count: <br /> Floor Blown or Sprayed Fiberglass or Cellulose-Ceiling <br /> Type of insulation: S oq►M B&k( R-value per inch: 2.1 <br /> Manufacturer: N x Coverage area: Z$ 0+ZZ -0- <br /> R-value: - �D Bag count: ': O - Fib M <br /> Flat Ceiling/Attic Sprayed Polyurethane Foam SPF) <br /> Type of insulation: Density: <br /> Manufacturer: Installed thickness: <br /> R-value: R-value of installed thickness: <br /> Single Rafter joist Vaulted Ceiling Building component installed: (circle one) <br /> walls floor ceiling <br /> Type of insulation: <br /> Manufacturer: <br /> R-value: <br /> u Insulation Installer <br /> Company name: <br /> Installer name: HE.(- 01 UR e(,e <br /> Installer signature: <br /> Date: <br /> Phone number: - 70 - ZSS <br /> Email: t-1 vl f-P_r(255:1,3I-(-0rl <br /> Washington State Energy Code Reference: <br /> j R303.1 Identification. Materials, systems and equipment shall be identified in a manner that will allow a <br /> determination of compliance with the applicable provisions of this code. <br /> R303.1.1 Building thermal envelope insulation.An R-value identification mark shall be applied by the <br /> manufacturer to each piece of building thermal envelope insulation 12 inches(305 mm) or greater in width. <br /> Alternately,the insulation installers shall provide a certification listing the type,manufacturer and R-value of <br /> insulation installed in each element of the building thermal envelope. For blown or sprayed insulation <br /> (fiberglass and cellulose),the initial installed thickness,settled thickness,settled R-value, installed density, <br /> coverage area and number of bags installed shall be listed on the certification.For sprayed polyurethane <br /> foam (SPF) insulation,the installed thickness of the areas covered and R-value of installed thickness shall be <br /> listed on the certification. For insulated siding,the R-value shall be labeled on the product's package and <br /> shall be listed on the certification.The insulation installer shall sign, date and post the certification in a <br /> conspicuous location on the job site. <br /> Exception: For roof insulation installed above the deck,the R-value shall be labeled as required <br /> by the material standards specified in Table 1508.2 of the International Building Code or Table <br /> R906.2 of the International Residential Code. <br />