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INSTALLATION CERTIFICATE Envelope Insulation Roofing Fenestration Site Address CF-6R-ENV-01 Page 1 of 3 Enforcement Agency Permit Number If more than one person has responsibility for installation of the items on this certificate each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible alternatively the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with check boxes require to be checked to ensure the mandatory measures have been met. Description of Insulation 1. RAISED FLOOR Material Thickness inches Brand Name Thermal Resistance R-Value 150 d Minimum R-13 insulation in raised wood-frame floor or equivalent U-factor. 2. SLAB FLOOR/PERIMETER Perimeter Insulation Depth inches 150 l Water absorption rate for the insulation material alone without facings is no greater than 0. 3 water vapor permeance rate is no greater than 2. 0 perm/inch and shall be protected from physical damage and UV light deterioration* 3. EXTERIOR WALL a* Insulation Type e. x. Batt Loose Fill Spray Foam b. Insulation Type e. x. Batt Loose Fill Spray Foam Brand Spray/Loose fill Contractor s min installed weight/ft lb inches Manufacturer s installed weight per square foot to achieve Thermal Resistance R-Value Exterior Foam Sheathing rigid Insulation 4. FOUNDATION WALL 5. CEILING Batt or Blanket Type Loose Fill Type Spray Foam Type Installed Actual Thickness inches 6. ATTIC ROOF INSULATION AND/OR ATTIC RADIANT BARRIER 118 a Insulation installed meets Standards for Insulating Material* 150 g Mandatory Vapor barrier installed in Climate Zones 14 or 16. 2008 Residential Compliance Forms August 2009 CRRC Product ID Number1 Information Brand/Model Product Type Roof Area Slope Weight 2 Initial Solar Reflectance Aged Solar Thermal Emittance 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council s Rated Product Directory at ww. coolroofs. org/products/search. php 2. The weight in lbs per square feet of the roofing product being installed* 3. Check box if the Aged Reflectance is a calculated value using the equation below footnote 4. 4. If the aged reflectance is not available in the Cool Roof Rating Council s Rated Product Directory then use the initial reflectance value from the directory and use the equation 0. 2 0. 7 initial 0. 2 to obtain a calculated aged value. CHECK APPLICABLE BOX BELOW IF EXEMPT FROM THE ROOFING PRODUCT COOL ROOF REQUIREMENT The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from the above Cool Roof criteria* Roof constructions that have thermal mass over the roof membrane with a weight of at least 25 lb/ft2 is exempted from the above Cool Roof To apply Liquid Field Applied Coatings the coating must be applied with a minimum dry mil thickness of 20 mils across the entire roof surface and meet minimum performance requirements listed in 118 i 3 and Table 118-C.

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