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,.;. .„� U ti� otir Sa�r c oNs�' <<-O r z Attaclment C <br />� <br />coae <br />� Pla� Examiner and i�pector Checklist <br />PermltNo. 3B�3�v Address <br />Plena Exeminer: Chedc, wrile in N/A, or Iili in value on shaded boxes. <br />Inspector: Check oH bozes al lefl as itams are lound to comply. <br />Compllence epproech: (check one) ❑ Systems analysis LMComponent performance ❑ Prescriplive pelh <br />Note: Some specilics on this form may not apply il <br />A) compliance approach is syslems analysis or componan! perlormance; <br />B) compliance to minimum ventilation aiterie is demonstreted through engineering calculetions or peAormance testing. <br />FOUNDATION PHASE <br />❑ Sleh: b-��0 __�J Eztador tlown to Irostline/slab hotlom; or Intedor 24' Mdzantel or verllcel; or, II retllen6 urWer entiw sleb <br />❑ Balow grede sxtador we�ll lm1ulatlon: � Af�[.*� (Il intedor—see Ireuletlon Phese) <br />❑ RedonmlUgadon:�'�Illocallyrequlred,araewlspeceventlng<ifV30D112olaawl,orventalndudoenoperededemper <br />FRNNRiG PHA.SE <br />❑ Framing: �Slendard �Intermedlete u AMenesd <br />❑ Stdalrssel:wlepVsubtlr;rlmJsVmudslll;wlrWowBtloorirms;penetretlon•wlre,plumb,duct,perUtlonatuds,ilue,llphtflztures <br />❑ Soureeepmllloexheuetfena: Slzerequlremant—balh.leurWry�SOclm);kitdian(1Wcim) <br />❑ Whob houee exhauat 1en ��00. �41 Imerminent systan hes manual & emo wnimis; Outtloor alr suppty req. la heNteble rma. <br />ar <br />❑ InlegreUdfomed�alrayslem n outsidealydun(wlthdampeqallowingbatwoen.35end.5ACH <br />�l�IILATION PHASE <br />❑ �i��i � WeIllneuleUon(ebovegrede) <br />❑ ��jA._] We111n�uleUon(betowgrod�):IMerbrwellinsutellon <br />❑ 'q.'��q�� _1 FloorinauleUon <br />❑��O � Celling Inauletlon: Nduding anlc hatch <br />❑ `p-_s0_ .� _I Veulted celling Ineuletion <br />❑ Vepor rsterdan: vrells, floors, celling <br />— _ <br />❑ Heating syalem type: ��1 �`_�.,�`___ J For hea�pumps, list slze, HSPF, entl COP ._ _ � <br />., a ac�d FINAL PHASE <br />❑ Redon monitor on elte: with instmnlons and general Informetlon <br />❑ Thermostnt: heat range, 55•75; AC �unge, 70�85; Wth, 55�85. Bachup heat convols prevent slmultaneous operetion ol prlmary sys. <br />� Solld luol eppllanees: glass or metal doora; direct comb. alr wurce, or 4'tlla., damparetl, Intllrec1 wurce ior uncond. orens <br />❑ Flraplecas: 6" cambusllon elt supp�y duq w/tlamper tllrect to lirebos; tlght OUing glass or metal doors. <br />n DHW heetorn: NAECA label; separe�e power or ges shuloN; on R-10 patl If electrlc entl In uncnnd. area wll on conaele <br />❑ Mechenical vanliletlon duetn Inaulated to R-0: oaheust duas In uncondltloned ereas/suppiy tlucts in wndNloned erees <br />-_..- _ <br />❑ q-_a . � HVAC duclalplenum Inaulatlon: ducls In uncondWonad ereas ere Insula�ed erM �oln6 ere sealetl <br />❑ Pipe Inauletlon: R�31or hol eM cnld weter piping Ir uncandltloned areas (II service or redralaling, see Teble &12) <br />❑ dround cover: G mll 61ack polyathylene/upproved equai lappetl 12' et JoIMs antl e�tending to loundutlon well <br />