Residential Energy Code Compliance Certificate Form Georgia
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1Georgia Residential Energy Code Compliance Certificate*
Builder/Design
Phone:
Professional: _______________________
________________________
Envelope Summary:
•
List the R-Value for the following components:
Flat ceiling/roof: _______
Sloped/vault ceiling: _______
Exterior wall: _______
Above grade mass wall: _______
Attic kneewall: _______
Attic kneewall sheathing: _______
Basement stud wall: _______
Basement continuous: _______
Crawlspace stud wall: _______
Crawlspace continuous: _______
Foundation slab: _______
Floors over unconditioned space: _______
Cantilevered Floor: _______
Other insulation: _______
•
Fenestration Components:
Window U-factor: ______________
Window SHGC: __________
Skylight U-factor: ______________
Skylight SHGC: __________
Glazed Door U-factor: ______________
Opaque Door U-factor: __________
(<50% glazed)
•
Building Envelope Tightness (BET):
BET test conducted by: _________________________________________Phone:______________
3
Fanflow at 50 Pascals=__________________CFM
Total Conditioned Volume = _____________ft
50
ACH
= CFM
x 60 / Volume=__________________________ACH
(must be less then 7 ACH
)
50
50
50
50
Low Rise Multifamily Visual Inspection Option
Visual inspection conducted by: ________________________________Phone: ________________
- BLDG Env. Tightness-Rough – Fay. Co. DET. verifier: _____________________________ Date: ____________
- BLDG Env. Tightness-Final – Fay. Co. DET. verifier: _______________________________Date: ____________
Mechanical Summary:
Fuel type: 9 Gas
9 Electric
9 Other
Water Heater Energy Factor: _________________Ef
Number of heating and Cooling Systems: _______
Heating System Type (choose one):
9 Gas: ___________ AFUE 9 Air-Source Heat Pump: _____________ HSPF
9 Other: ________________ Efficiency: ____________
Cooling System Type (Standard DX, Heat Pump, Geothermal, etc): _______________
Cooling System Efficiency: ____________________ 9 SEER 9 EER 9 Other
Heating/Cooling load Calculations Performed by: _______________________Phone: ____________
Total Heating Load (
Btu/h
): ___________
based on ACCA Man. J or other approved methodology
Total Cooling Load (
Btu/h
): ___________
based on ACCA Man. J or other approved methodology
Cooling Sensible load: ____________ Btu/h Cooling Latent Load: ________ Btu/h
Total Air Handler CFM
: _____________________ CFM
(based on design calculations)
Duct Tightness Test Conducted by: _________________________________ Phone: ____________
2
CFM
per 100 ft
of conditioned floor area = CFM
x 100 / Conditioned floor area served
25
25
* If all ducts are not located within conditioned space, builder must verify that either the post construction duct leakage
2
2
to outdoors (PCO) is < 8 cfm/100 ft
, the post construction total duct leakage (PCT) is < 12 cfm/100 ft
. or the rough-in
2
test (RIT) with air handler installed is < 6 cfm/100 ft
. State which method was used to conduct the duct tightness test:
duct blower (DB), modified blower door subtraction method (MBDS), or automated multipoint blower door (AMBD).
2
System
Method (DB, MBDS, AMBD)
Test (PCO, PCT, RIT)
CFM
Area served (ft
)
Test Result
25
1
2
3
*Note: This permanent certificate shall be posted on or in the electrical distribution panel. Certificate shall be completed
by the builder or registered design professional. Where there is more than one value for each component, certificate
shall list the value covering the largest area.
- Duct Tightness Test – Fay. Co. DET. verifier ___________________________________Date: _______________
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