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=;APPROVPEO <br />REQ <br />■ <br />3 ■ <br />G <br />El <br />❑1 <br />IMPORTANT: Pleass supply Information In the shaded boxes and check the appropriate <br />circles. Disregard topics that don't describe your building or equipment. DO NOT place <br />Chocks In the two left columns. <br />❑ Exterior slab Insulation, it not locatrd on the Interior, shall be R 0 (Tahle 6-2). <br />❑ Exterior slab Insulation, i/ present, shall approved for below grade use and protected above grade. <br />❑ ai Walls, inckmding rkn joists,=shall at9d wkttout:Iofraprassian,ta`bie i3}yz��" <br />{�16 Matt (OpHotls 111} 9 (ptioill, I{%�11fyi7t/li} a �y� <br />R. On <br />❑ iMeltor below ara8etralls tihal lrm:ntlatecIlrltFDlrt oomj#esslDnib tTt11e �S rays <br />19 {Options Ut N, <br />❑ �Yauits cetungs shai! be insulated writmoutDontpressbttto R 30.iTatile t3 2; Ag optbnsl .,, < . s <br />LJ s Heating system of Iclency,and sizing , aquirer <br />❑ Heat Pump efficiency shall be met undertho h <br />0 split system, air source heat pump: HSPF <br />0 Single package, air source heat pump: H! <br />0 water source heat pump: COP i 3.8 <br />O Ground source heat pump COP i 3.0 <br />❑ QCentral force-airtumace AFUE rating, as listei <br />0z 78 (Options I, il, IV, VI, VII) 0 <br />❑ s Nomeentral,;combustion heating systems sh <br />❑ g7lMaximum heating system output (150°% of do <br />❑ High, efficiency forced -air iumace (s 56,0001 <br />because: OGAMA listed AFUE is z 78 + 1 pei <br />mz <br />WSEC Insulation phase requirements: <br />Inspected by: Date <br />❑ Q Envelope Floors shall be insulated wftho t compression, and wi <br />OR19 (Options 1, II, ill, IV, V) R25 (Options VI, Vtl) <br />❑ EDNon-vaul!yd, attic Collings shall be Insulated wattout minpressl <br />0�1-30 (Options 1, Il, ill, IVA (D R36 (Option Vn <br />❑ o)Door systems shall p ti - .40 (All options)(, ;t I <br />Doortypas are (1) (2) '" <br />Page 5 of 6 <br />