Title Page
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Building Identifier
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Conducted on
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Prepared by
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Location
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Site Contact Name and Phone Number
General
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Building Type *Other includes public assembly, public order, worship
- Office
- High-rise multifamily
- Retail
- Food service
- Education
- Other*
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Image of front exterior of building
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Image of interior spaces
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Image of interior spaces (optional)
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Image of interior spaces (optional)
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Image of interior spaces (optional)
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Building type
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Notes
Building Envelope
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Image of north elevation (full view)
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Image of east elevation (full view)
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Image of south elevation (full view)
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Image of west elevation (full view)
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Does the roof assembly insulation measure apply?
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Create roof assemblies for the project
Roof
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Roof ID
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Roof type
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Image of roof insulation
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Roof insulation type
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Roof insulation thickness (inches)
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Roof installation quality
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Notes
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Does the exterior wall assembly insulation measure apply?
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Create wall assemblies for the project
Wall
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Wall ID
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Wall type
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Image of wall insulation
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Wall insulation type
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Wall insulation thickness (inches)
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Wall installation quality
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Notes
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Does the floor assembly insulation measure apply?
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Create floor assemblies for the project
Floor
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Floor ID
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Floor type
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Image of floor insulation
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Floor insulation type
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Floor insulation thickness (inches)
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Floor installation quality
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Notes
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Does the window assembly U-value and SHGC measure apply?
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Create window assemblies for the project
Window
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Window ID
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Window type
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Image of fenestration label (U-value)
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Image of fenestration label (SHGC)
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Notes
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Does the rollup door assembly insulation measure apply?
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Image of rollup door label
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Notes
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Does the project have skylights?
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Image of skylights from interior
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Image of skylights from roof (optional)
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Notes
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Select continuous air barrier condition
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Image of continuous air barrier. Look for evidence of air sealing between air barrier materials in areas that are exposed, verify that the air barrier is continuous between wall and roof assemblies and between wall and floor assemblies.
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Air barrier notes
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Image of motorized low leak dampers for stair and shaft vents. Verify the motorized low leak dampers as required and are configured to be closed during normal operation. Visually inspect dampers to see if they are closed.
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Image of window labels that show leakage rates
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Air leakage notes
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Does the building have a vestibule?
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Image of vestibule
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Air curtain installed?
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Interior/exterior doors open at different times?
HVAC
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Create HVAC equipment
Equipment
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Equipment tag
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Equipment type
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Image of equipment nameplate
Create thermostats for project
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Thermostat ID
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Image 1 of thermostat settings to confirm setpoint, setback, dead band controls
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Image 2 of thermostat settings to confirm setpoint, setback, dead band controls
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Image of thermostat settings to confirm night fan controls
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Image of thermostat settings to confirm optimal start controls
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Image of thermostat settings to confirm optimal start controls
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Description of thermostat controls
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Image of CO2 sensor for demand control ventilation
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Image of duct insulation condition
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Duct insulation notes
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Image of duct leakage condition
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Duct leakage notes
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Image of pipe insulation condition
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Pipe insulation notes
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Select mechanical commissioning condition
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Image 1 of fan nameplate
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Image of outdoor heating system and controls
Building Automation System (BAS) Screenshots
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Image of building automation system (BAS) to confirm setpoint, setback and dead band (optional if included in thermostat setting images)
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Image of building automation system (BAS) to confirm optimal start controls
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Image of building automation system (BAS) to confirm energy recovery conditions
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Image of building automation system (BAS) to confirm supply air temperature reset controls
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Image of building automation system (BAS) to confirm static pressure reset controls
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Image of building automation system (BAS) to confirm hydronic system controls
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Image of building automation system (BAS) to confirm multiple chiller sequencing controls
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Image of building automation system (BAS) to confirm VAV ventilation optimization controls
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Image of building automation system (BAS) to confirm zone isolation
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Select energy recovery ventilation (ERV) bypass control condition when in economizer mode
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Image of parking garage fan controls
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Image of Freeze Protection, Snow & Ice-Melting System Controls
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Image of SWH pipe insulation
Lighting
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Image of interior lighting
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Image of interior lighting control switch or sensor
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Image of daylight controls
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Image of interior lighting control sequence
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Image of display lighting (if applicable)
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Image of non-visual lighting (if applicable)
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Image of additional retail lighting power allowance (if applicable)
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Image of parking garage lighting (if applicable)
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Image of exterior lighting
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Image of exterior lighting control sequence
Other
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Create kitchen exhaust hoods for the project
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Kitchen exhaust hood tag
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Image of kitchen exhaust hood nameplate
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Description of replacement air and controls
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Image of indoor pool cover (if applicable)
Renewables
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Image of renewables on site
