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COMPLIANCE <br />REQUIRED <br />APPROVE <br />IMPOriTANT: Please supply Information In the shaded boxes and check the appropriate <br />APPflOVED PP Y <br />circles. Disregard topics that don't describe your building or equipment. DO NOT place <br />checks In the two left columns. <br />❑ 11 ❑ U Exterior slab Insulation, if not located on the interior, shall be R-10 (Table 6-2). <br />❑ ❑ @D Exterior slab Insulation, if present, shall approved for below grade use and protected above grade. <br />❑ ❑ rVaultod <br />Walls, InCludingrim joists, shall be insulated without compression to (Table 6-2): <br />OR-15 ball (Options i,It} OR-19 (Option III, IV, V, VI, VII) <br />❑ interior below grade walls shall be insulated without compression to (Table 6 2)OR-15 (Options' 1, to OR-19 (Options III, IV, V, VI, VII) <br />El El callings shall be Insulated without compression to R30 (Table 6-2, All options)" <br />❑ I I ❑ JQ Skylight wall Insulation is installed and equivalent to the required wall R-values above <br />❑ ❑ Q Vapor retarders shall be installed toward the warm surface as represented below (502a.E <br />Select on,) option for floors, wafts, and appropriate ceilings: <br />Floors: Plywood W/ exterior glue 0 Poly (> 4 MII) t7 Backed bat x <br />Walls: Poly plastic (> 4 Mil) ( Face -stapled, backed batts O PVA` <br />Ceilings: Not required where ventilation space averages >12" above insult <br />Face stapled backed batts O Poly plastic (a 4 into O PV <br />❑ ❑ o Heating system efficiency and sizing requirements shall be met as represented <br />❑ ❑ ®Heat Pump efficiency shall be met under the following compliance pathiS. SOS 4f <br />O Split system, air source heat pump: HSPF 2 6.8, COP > 3.0 <br />O Single package, air source heat pump; HSPF8.6, COP > 3.0 <br />O water source heat pump: COP a 3.8 <br />O Ground source heat pump COP 3.0 <br />❑ ❑ QQ Central force -air furnace AFUE rating, as listed in the GAMA Directory, shalt be: <br />OZ .78 (Options I,iit, IV, VI, VII) 0 z .88 (Option Ilo) 0z74 (Option V <br />❑ ❑ Is <br />Non-central, combustion heating systems shah have infermhent ignition <br />El ❑ Maximum heating system output (150% of design heat load) is BTUthr. (S, 50 <br />❑ ❑ High efficiency forced -air furnace (s 56,000 BTUIhr. output)may may exceed 1504W Dh <br />because: OGAMA listed AFUE is a 78 + 1, per each 5000 BTUlhr output that it exceeds it <br />WSEC Insulation phase requirements: <br />Inspected by Date <br />t <br />❑ ❑ Q Envelope Floors shall be insulated without compression, and with supports 24" O.C. for <br />01119 (Options I, Ii, Ill, IV, V) OR25 (Options VI, VII) <br />❑ ❑ EDNon•vaulted, attic ceilings shall be Insulated without compressicn to: See Table 6-2 <br />OR•30 (Options I, II, III, IV, V, VII) O RI-6 (Option Vo <br />❑ ❑ Door systems shall meet:0 U. r0 IAll options) <br />Door types are (1)_ —(2) --- (3)_ <br />Page 5 of 6 <br />r <br />