HomeMy WebLinkAbout450 Plowman Way - Miscellaneous - 09/07/2001Fort Collins Residential Energy Code the building & zoning dept. of
AIR SEALING DISCLOSURE FORM Community Planning and Environmental Service
r ? e 261 N. College
.O. 80x58O, Fort
(Not applicable to ESTAR or ENERGY SCORE rated homes) Vokx: 9702216760 P FAX p70 224 6134 Collins. CO 60522
Job address:
General contractor.
Air sealing contractor.
Instructions
Complete either Part A or Part B .
Part A is to be signed by the air sealing contractor or representative of the general contractor.
Part B is to be signed by the blower door testing contractor or representative of the general contractor.
The "Blower Door Test Report" or equivalent documentation must be attached.
Please type or print, except for the signature.
If components vary, make multiple entries to describe them.
One copy of this form must be provided to the Building and Zoning Department prior to C. O.
One copy of this form must be provided to the original home buyer.
A. Prescriptive path (Alr Sealing Checklist)
Uwe certify that the air seeing requirements specified in the current City of Fort Collins Residential Energy Code
have been completed in this building, In accordance with the "Air Sealing Checklist" published by the City of Fort Collins.
Person Certifying Job:
Signature:
Date
Business Firm:
Address:
B. Performance path (Blower Door Test)
IANe certify that this building has met the ak leakage performance threshold specified in the current Fort Collins
Residential Energy Code, In accordance with the 'Blower Door Test Procedures' published by the City of Fort Collins.
Testing contractor.re UNCrgU Cur
Date of lest:
VChime Air Bow through the dower door at 50 Pascal$ pressure difference (dm)
Volume: b S Volume of home (cu. It)
ACH50: Nr Change
rats p per hour at 50 Pascals pressure difference
ACH50 a (CFM50 x 60)1 Volume
The oerformence threehMd f.......w_