Colorado Energy Checklist v2.6
Clear Form
Builder
*
Please Select
Berkley Homes
Century Communities
Chesmar Homes
CSI Construction
DR Horton
GJ Gardner
Iron Key Homes
Meritage Homes
Savant Homes
Shadow Creek Homes
Standard Pacific
Taylor Morrison
Toll Brothers
Triton
WilliamMRK Homes
Other
Consultant
*
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Barrett Hendricks
Caleb Cost
Jay Bundy
Michael Chavez
Robert Hutchinson
Ryan McCue
Stephen Nelson
Tony Nazarenus
Ricky Sandlin
Consultant
*
Changes to REMrate required
*
Yes
No
Changes to be made
*
Inspection
*
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1st Inspection Final
Re-inspect
Rough Insulation
Rough Test
Building Type
*
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Slab
Crawlspace
Crawlspace/Partial Basement
Full Basement
Finished Basement
Walkout Basement
Garden Basement
Finished Walkout Basement
Finished Walkout Basement w Crawlspace
Address
*
Program
*
Please Select
Code
HERS
EFL
ES v3
Fort Collins
*
Please Select
Yes
No
Xcel
*
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Xcel Final
N/A
Garage Left or Right
*
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Right
Left
Rear Townhome
N/A
Home Permited Under
*
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2006
2009
2012
2015
Stories
*
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1
2
3
Faces
*
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North
Northeast
East
Southeast
South
Southwest
West
Northwest
Number of Bedrooms
*
Number of Bathrooms
Plan Number
*
Front of House
*
Solar Panels
*
Yes
No
# of Panels
*
Direction
*
Checklists
Thermal Checklist Picked Up
*
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Yes
No
N/A
Checklist in Drive
Checklist forwarded to Forms
Picture of Thermal Checklist
HVAC Contractor Checklist Picked Up
*
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Yes
No
Checklist in Drive
Checklist forwarded to Forms
N/A
Water Management Checklist Picked Up
*
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Yes
No
N/A
Checklist in DropBox
Checklist forwarded to Forms
Water Management Checklist List Photo
Service Meter Information
Gas Meter Brand
Please Select
Xcel
Gas Meter
*
Gas Meter Faceplate
*
Electric Meter Brand
Please Select
IREA
Xcel
United Power
Fort Collins
City of Longmont
Electric Meter
*
Electric Meter Faceplate
*
HVAC Outdoor
Outdoor Brand
*
Please Select
N/A
Bryant
Carrier
Goodman
Trane
York
Lennox
Other
A/C 1
*
A/C 1 Label
A/C 2
A/C 2 Label
HVAC Outdoor Notes
Insulation Certificate
HVAC Indoor
Brand
*
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Bryant
Carrier
Goodman
Trane
York
Lennox
Other
Furnace 1
*
Furnace 1 Label
Coil 1 Label
Furnace 2
Furnace 2 Label
Coil 2 Label
Furnace 2 Duct location
*
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Conditioned space
Attic
HVAC Indoor Notes
Water Heater
Water Heater Units
*
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1
2
3
Water Heater Location
*
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Attic
Basement
Crawlspace
Garage
Laundry
Laundry Closet
Outside
Fuel
*
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Gas
Electric
Water Heater
*
Water Heater Label
*
Brand
*
Please Select
AO Smith
Bradford White
Rinnai
Rheem
State Select
Other
Water Heater Notes
Mechanical Ventilation Brand
Please Select
Broan
Field Control
Panasonic
Aprile Air
Other
Dishwasher
*
Dishwasher Label
Dishwasher Brand
Please Select
GE
Kitchen Aid
Whirlpool
Other
Fridge
*
Fridge Label
Fridge Brand
Please Select
GE
Kitchen Aid
Whirlpool
Other
Clothes Washer
*
Clothes Washer Label
Washer Brand
Please Select
Whirlpool
Other
Insulation
2x4 Walls
Please Select
R-13
R-15
Other(Add to notes)
N/A
2x6 Walls
Please Select
R-15
R-19
R-21
R-15 Foam
R-19 Foam
R-21 Foam
R-23 BIB
Other (Add to Notes)
N/A
Frame Floors
Please Select
R-19
R-30
R-38
R-45
R-19 Foam
R-21 Foam
Other (Add to Notes)
N/A
Vaulted Ceilings
Please Select
R-19
R-30
R-38
R-45
R-19 Foam
R-21 Foam
Other (Add to Notes)
N/A
Basement Insulation
Please Select
R-11
R-13
R-15
R-19
R-21
R-15 Foam
R-19 Foam
R-21 Foam
2x4 R-15
Other (Add to Notes)
N/A
Window U-Value
Window SHGC
Basement Drape
Please Select
R-11
R-19
None
Other(Add to Notes)
N/A
Ceiling
Please Select
R-38
R-40
R-50
R-21 Foam
R-38 Foam
Other (Add to Notes)
N/A
Fort Collins
Temp @ Time of Duct Leakage
Appliances, ETC
Energy Star Dishwasher
*
Yes
No
Energy Star Refrigerator
*
Yes
No
Number of Energy Star Ceiling Fans
*
Please Select
0
1
2
3
4
5
6
Number of Energy Star Exhaust Fans
*
Please Select
0
1
2
3
4
5
6
CFM
% CFL's
Please Select
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% CFL's in Garage
Please Select
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% CFL's Exterior
Please Select
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
# of Light Fixtures (Xcel)
Notes
Blower Door
Indoor Temperature
Outdoor Temperature
Baseline
Garage with respect to House @50 PA
Blower Door @65PA
Blower Door @60PA
Blower Door @55PA
Blower Door @50PA
Blower Door @45PA
Duct Leakage
If any duct work is in unconditioned attic then the allowable leakage for 2012IECC is 4%
Duct 1 - to Outside
Duct 2 - to Outside
Duct 3 - to Outside
Duct 1 - Total
Duct 2 - Total
Duct 3 - Total
System 1 Returns
Please Select
1
2
3
4
5
6
System 2 Returns
Please Select
1
2
3
4
5
6
Xcel Final
end
Reinspect Pic 1
Reinspect Pic 2
Reinspect Pic 3
Reinspect Pic 4
Reinspect Pic 5
Notes
Pass/Fail
*
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Pass
Fail
N/A
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