HomeMy WebLinkAbout1520 Ambrosia Ct - Disclosures - 11/13/2000 (2)Fort Collins residential energy code 7196
Air sealing disclosure form
Job address:
General contractor:
Air sealing contractor:
A. Prescriptive path
I/We certify that the air sealing 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.
Certified by: 6Q,o1) kelif 6 C-//
Business firm: QaNy
Address: /Zyz
B. Performance path
Phone: ya/
Date: //
Signature: Vt--
IM/e certify that this building has met the air leakage performance threshold specified in the current
City of Fort Collins Residential Energy Code, in accordance with the "'fewer Door Test Procedures," published
by the City of Fort Collins.
Testing contractor:
Date of test:
CFIM5O:
Volume:
ACH50:
Certified by:
Business firm:
Address:
Air low through the blower door at 50 Pascals pressure difference (cfm)
Volume of home (cu. ft)
Air change rate per hour at 50 Pascals pressure difference
AC, ;50 = (CF:M50 x 60) / Volume
The performance threshold for code compliance is ACH50
not exceeding 5.0 ac/h
Phone:
Date:
Signature:
nstructtons .:::..
Complete either PartA 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 shalt be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer.
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