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���rc;�v dlttacftineirt C <br />cooE <br />� Plans �caminer and In��ector Ch�;�kli�t <br />Pertnit No. �� ��� Address 7 g � � <br />� ��� � �er� R1 <br />Plans Examiner: Check, write in N/A, or (ill in value on shaded boxes. <br />Inspector: Check oH 6oxes at left as items ar� found to cor�iply. <br />Compliance appronch: (check one) ❑ Systems analysis ❑ Component pertormance <br />�Prescripiive palh <br />Note: Some specifics on thia form may not apply ii <br />A) co�npliance approach is systems analysis or component performance; <br />B) compliance to minimum ventilation criteria is demonstrated through engineering catculatian� or periom�3nce testing. <br />FOUNDATION PHASE <br />❑ Sleb: �+ �?! Exte.dor down to 1rost�Ine/slab bottom; or Inledor 24" horizontal or vertical; or,11 radlant, under anflre slab <br />❑ Below grade ea�terlor wall (nsuletlon: �(If intador— see Insulapon Phase) <br />❑ Radno mltigetlon: :.:-%,,',...<::....r If locally requlred, or crawlspace ventlng <1fU3001t2 of crawl, or vents Inciude an operaWe damper <br />ERAMINf PFiASE <br />❑ Framing �Standard L__�__ Intermedlate �� Hdvanced <br />❑ Std alr seel: solepUsubllr; rlm JsVmud slll; wlndow & door trms; penetrat;on•wire, plumb, duct, pertitlon studs,llue, Ilght 11#ures <br />❑ Source speclflc exheust fans: Slze requlrement— balh, laundry (50cfm); kltchen (t00cfm) <br />❑ Whcle houae exhaust fan �t� Intermlttent system has manual & auto conlrols; Outdoor alr supply req. tor habltable rms. <br />or <br />❑ Integreted forced-alr system � outslde aly duct (wlth damoer) allowing betwaen .35 and .5 ACH <br />IPI�ILATION PHASE <br />❑ �-1 Wall In�uletlori (abuve grade) <br />❑���,�t?' YJell Inaulatlon (below grede): Interlor wall Insulatlon <br />❑ �'��_;`•: Floor IaeulaUon <br />❑�}��� Celling inaulatlon: Includlag attic hatch <br />❑ ��� Veulted celling Insuletlon <br />❑ Vapnr reterdors: wails, floors, celling <br />❑ Heating system type: <br />For heat,�umps, Ilst slze, HSPF, and COP <br />FINAL RHA:,E <br />❑ Rndon monitor on sRe: wlth Instrudlons and geooral Informadon <br />❑ Thormostnt: heat �ango, 55-75; AC range, 70-B5; both, 55-85. Backup heal conlro's prevenl slmullanaous oparatlon ol pdmary sys. <br />❑ Solld tuel nppllance:;: giass or mata� doors; dlred comb. air source, or 4' dla., dampered, indlrect source for uncond. areas <br />❑ Firepleces: 6" combustlon alr supp�y ducl w/damper dlrecl to flrabox: tight iltting glass �r metal doors. <br />❑ DHW heaters: NAECA label; soparate power or gas shut-off; on R-10 pad if electrlc and In u�cond. area orlf on concreto <br />L7 Mechonlcal vonilletion ducts Insulated lo R�-0: exhaus! duds In uncondltloned areasJsupply duds In condlUoned arees <br />❑��.�—� HVAC ducts/plenum Insuleflon: ducts In uncondltloned area� are Insulatad and Jolnts are sealed <br />❑ Plpo Insulollon: R 3 for Y�ot and cold water plping In uncondlUcnad areas (If sarvlce or rodreulating, see Tabie 5-1?.i <br />❑ around covor: 6 mII black polyethyleno/approved equa; lapped 12" at Jolnts and extending to foundatlon wall <br />