HomeMy WebLinkAbout1120 Lochmore Pl - Disclosures/Air Sealing - 09/17/2001SENT BY: ALLIED INSULATION; 970 962 9141; SEP-17-01 2:20PM; PAGE 7
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Fort Collins Residential Energy Code the building & Zoning dept. of
AIR SEALING DISCLOSURE FORM Community Planning and Environmental Service
281 N. College Ave., P.O. Box 580. Fort COMM CO 80522
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ppric .. scO Voice: 970 221 MO FAX 970 224 8134
;Not applicable to E=s i Aa'c o�rNE.rcG� 3wl�rat@d homes}- -
Job address:
General contractor.
Air sealing contractor. Aug led T s;, e
Instructions .............::.:
Complete either Part A or Part B .
?art A is to be signed by the air sealing contractor or representative of the general contractor.
Part 8 is to be signed by the blower door testing contractor or representative of the general contractor.
The "Slower Door Test Report" or equivalent documentation must be aftched.
==!ease type or print, except for the signature.
If components vary, make multiple entties to describe them.
One copy of this form must be provided to the Building and Zoning Department prior to C. 0.
One copy of this form must be provided to the original home buyer.
A. Prescriptive path (Air Sealing Checklist)
!,,,Ne certify that the air sealing requirements specified in the current C. y of FeT C cil ; s Residential Snergy Code
have been completed in ;his building, in accordance with the "Air Sealing Che--kilst' published by the City of Fort Coilirs.
Person Certifying Job: /tl f
Si nature , ,`� Date: q�17 ioi
Business iAit-i-e-Li
I I c
Address: I O4 -i S . C1t!-.le.
Phone:
B r"'er-formance path 413lower ppoc Test)
... ,
Me certify that this building has met the air 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.
Date of test:
CFM50:
Volume:
Air Aow through the blower door at 50 Pascals pressure difference ((:`m)
Volume of home (Cu. ft)
ACH50: 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 ac/h
Person Certifying Job:
Signature: Date:
Business Firm:
Address:
Phone:
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