HomeMy WebLinkAbout500 Flagler Rd - Disclosures/Other - 06/23/1998ONO°
I Fort Collins residential energy code 7196
Air sealing disclosure form
Job address:
General contractor:
Air sealing contractor:
INVe certify that the air searing 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.
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Certified by: `-,tv . ITLEELQAb7I Phone: _�_ p�iv" 4
Business firm: i6m Date: Z3 19
Address: 11031 5ME1iW J i& Vb, Signature:
.
BPerformance ath
IMIe 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 "Blower Door Test Procedures," published
by the City of Fort Collins.
Testing contractor.
Date of test:
CFM50:
Volume:
ACH50:
Certified by:
Business firm:
Address:
Air flow through the blower door at 50 Pascals pressure difference (cfm)
Volume of home (cu. it)
Air change rate per hour at 50 Pascals pressure difference
ACH50 = (CFM50 x 60) / Volume
The performance threshold for code compliance is ACH50
not exceeding 5.0 acJh
Phone:
Date:
Signature:
Complete either Part A or Part B.
Part A is to be signed 6y 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 shall 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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Fort Collins residential energy
Job address:
General contractor:
Mechanical contractor:
Location Fuel
T e
Manufacturer.
Model #
i
Inputcapacity
kBtuh or kW
AfUEor
HSPF
-N S
�•iiJ t
tVJ
........ _.
.......................................
i I I I
input P capacity ty i Energy In ca y Storage
IM/e certify that the above -listed equipment was Installed in the building at the above locations In conformance with the
current requirements of the City of Fort Coffins Residential Energy Code and Mechanical Code, and that it was Installed in
accordance with manufacturer's instructions. IM/e certify that any ductwork has been Installed In conformance with
the current requirements of the City of/Fort Collins Residential Energy Code and Mechanical Code.
Certified by: 17 66-0 Phone:
Busines' firm: Date: (o
Address: 0315 WfV6U 3t✓D. Signature:
This disclosure form Is to be signed by the mechanical contractor or representative of the general contra or.
Please type or print, except for the signature•
if there are multiple systems serving any function, make multiple entries to describe them.
One copy of this form shall be provided to the Building and Zoning Department at final Inspection.
One copy of this form shall be provided to the homebuyer.
Fort Collins residential energy code
Job address:
General contractor:
Mechanical contractor.
Location
Fuel
T e
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
Space cooling system ...... .... ...............
Locanon
Fuel
T e
Manufacturer
Model #
Input capacity
kBtuh or kW
I SEER
Water heating system
Location
Fuel
Type
M nufacturer
Model #
Input capacity
kBtuh or kW
Energy
Factor
Storage
I volume
SEt ro-T
W 2 r uG
I Aloft
ODo
z 71m
TO
Certification ;? ..
11We certify that the above -listed equipment was installed in the building at the above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturer's instructions. INJe certify that any ductwork has been Installed in conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code.
/1� r
Certified by: Cdl'(!�. f �rZ6eAcD Phone:
Business firm: 61E4L-aY k bjx6 Date: 3
Address: Signature: �!
...................................
This disclosure form is to be signed by the mechanical contractor or representative of the general contractor.
Please type or print, except for the signature.
If there are multiple systems serving any function, make multiple entries to describe them.
One copy of this form shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer.
Fort Collins residential energy code
Job address:
General contractor:
Insulation contractor:
Insu latfo ;> ..... i iSi ii `:Fi >i F `.:t`:': 3 ;`::'; :. i; i:tssiii;>;iS; .. ..... :: >::;•:•::;;:; ;;;
Location
Materials
...
Thickness
..
Rated
R-value
..................:....
Location
IntIext
..............
,....................:::::::;::..:::...:.::::..::::::
Notes
Flat or vaulted ceilings
with attics above
'
ILLS MAJ11 111,6
1 VIL
;
Ceilings with enclosed
rafter cavities
AAAtJLG
( i Z
;•.
Frame walls and rim/band
joists —to exterior
'
12-1 1
>< s x
Vim jots t
H11
e'YJ
Frame walls and rim/band
joists — to attic, garage
O IJS
V L(.0
2
-1
Frame floor -cantilever
Frame floor -over garage or
crawl space
y„l
V'I
i'
_Cli
Stab -on -grade (0.12")
Crawl space walls
Nit. 11�1 i
Basement walls
Me certify that the above -listed insulation was Installed In me buiitling at the above locations In conformance with the
current requirements of the City of Fort Collins Residential Energy Code, and that it was Installed In accordance with
the applicable "Insulation Installation Guidelines" published by the City of Fort Collins.
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Certified by: ..�Xgrr ik. rfr LZ�b Phone: (fl 5214
14
Business firm: MLS I /-6VAEC nafa• i_ '�-2 . RP
Address: k: i 5y' tD A &s.6a-
_..
.........
This disclosure form is to be signed by the Insulation contractor or representative of the gar
Please type or print, except for the signature,
If components vary, make multiple entries to describe them.
One copy of this form shall 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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