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O <br />Ax <br />N <br />>yto <br />rr 3 <br />INSULATION CERTIFICATION <br />(HIS CARD IS TO REMAIN PERMANENTLY POSTFD W A READILY ACCESSIBLE LOCATION) <br />THIS IS TO CERTIFY THAT IN CONFORMANCE WITH THE CURRENT THERMAL PERFORMANCE STANDARD <br />WASHINGTON STATE ENERGY CODE, CHAP. 61.12 WAC, REVISED 1986, AND APPROVED PLANS, I HAVE INSPEC- <br />TED THE ENTROY PACKAGE AND CERTIFY THAT IT HAS BEEN INSTALLED IN ACCORDANCE WITH THOSL <br />"STANDARDS IN THE BUI DING OCATED AT: o <br />y <br />MI M PeMM <br />Count' ea Panne No. <br />y <br />z <br />, DESCRIPTION OF INSTALLATION <br />IDOFs <br />Qy <br />Type rl Material Manufacturer <br />Thickness __. R Value_ <br />(Or Trade name) <br />H <br />tO� <br />n �7 <br />RIOR WALLS <br />(Matarbl4F IBERGLASS Manufacturer <br />Thickness RValue <br />r..I <br />(Or Trade name) <br />zy <br />8 <br />Cy y <br />f IBERGLRSS <br />ateriel Manufacturer_ <br />�Q�v d <br />Thickness /! RValue �a <br />O <br />(Or trade name) <br />� <br />C W <br />-Sa. FL Covered <br />yF/r <br />IMatedal Manencclurer <br />Thickness '—`No.Baaa= <br />`3 O to <br />WUBsa Sq. Ft. Covered --- R Value <br />s <br />,.'FLOORS <br />, <br />,_. i}" Type of Material E.19—k Manufacturer `� <br />Thickness --�R Value <br />(Or trade name) <br />, <br />SUB ON GRADE <br />Type of Material Manufacturer <br />Thickness ___ R Value_ <br />(Or trade name) <br />Width of Insulation Inches <br />,�� <br />FOUNDA110N WALLS (if required) <br />A I <br />Type of Material Manufacturer <br />Thickness RYelus_ <br />(Or trial name) <br />DYCT AND/OR PIPE INRULATION <br />.� <br />Type of Material Manufacturer <br />Thickness n Value_ r <br />I--- <br />(Or trade name) <br />i <br />HEATING SYSTEM <br />. Type of eyetem Manufacturer <br />Input--- Output _— <br />NIHERMOSTATINSTALLED <br />M INSTALLED TO NO MORE THAN f60%OF DESIGN LOAD WASHINGTON INSULATION INC. <br />' WING INSULATED GLASS OR STORM WINDOWS PROVIDED 1020 WOODINVRLEREDMONDRD.N.E. <br />1111r,811111ICTOPIS—ALL <br />—ASHRAE 9OA-80 LABELED SUITE 15 <br />IMPPRATIC <br />SHOWERS LIMITED 70 3 GPM WOODINNLLE,WA96072 <br />. �. N DOORSS WINDOWS WEATHERSTRIPPED OR APPROVED BY ASTM 283-73 <br />( r ❑ INFILTRATION�ALL OPENINGS IN EXTERIOR WALLS CAULKED OR SEALED <br />L7 FIREPLACES- CJUTSIDE AIR VENT (SIX SQUARE INCHES) WITH DAMPER TO FIREBOX <br />❑ SLAB THERMAL BREAK CREATED <br />❑ VAPOR DARRILI18--INSTALLED PER CODE <br />REMARKS (II W fired) <br />t CERTIFY UNDER PENALTYOF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THATTHE FOREGOING IS <br />TRUE AND CORRECT. <br />General Contractor (Builder) Contractor's Rep. No. - <br />By Title <br />Date and Piece <br />Subcontractor (insulation Applicalor) Contracnoesp. No. <br />(Insulation. MMilliOnnry, a154 <br />D(State "SAME" 11 some as General Contractor) <br />jfL.Qf�I/iitL.i[/ Title. <br />V <br />LDate and PI1ea— <br />