HomeMy WebLinkAbout1114 Forrestal Dr - Disclosures - 02/05/200204/13/2001 03:38 9704614593 PRO INSULATION PAGE 11
I1HK-eU-eUU1 IUI: 11:411 AN hU BUILDING AND GUNINU FRX K T(022461N
Fort Collins Realdendal Energy Codo the building $ zoning dept. of
AIR SEALING DISCLOSURE FORM Commynity Planning and Environmental Service
Wi■I1a-rn0'N
(Not applicable to ESTAR or ENERGY SCORE rated homes) gal a College0 222j ig p'F/UtB,, M 224 e�U ems, CO eo622
Job Address;
General contactor.
Air sealing contractor:
.. .... ... .. . . - is l.•: .! .. ....,... - Al....... 1 ......... % l.. V.vIY..} ! i ........ 5:•l.!•A5i'.n11�
Complete either pant A or Part B .
Part A is to be signed by the air sealing contactor or representaftve 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 Toning Department prior to C: O,
One copy of this romt must be provided to the original home buyer.
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five: 'at ..... ... .........::�;;,::w ....:,.::,....:...... :•:.,;.. •...:.:,,,..µ.,a,:N,..•
p...,....,..p..h. !°►ii'Sealin heokit(� „ �.� k.,
1/We certify that the air sealing requirements speoilled In the current City of Fort Coln Residential Energy Code
have been completed in this building, in accordance with the •Air Sealing Checkbr pubgahed by the City of Fort Collins.
Person Certifying Job: Xi_...� ✓y). iI_
..Pe rf6'tr",.a ..:.::., •..
UINe certify that thin; bdbding nos roar ate air leakage performance threshold specified )n the currant Fort Collins
Rasidentiel Energy Code, in ■000rganoe whh the "Blower Door Test Prooadurea' PubQahed by the Cray of Fort CoIMs,
Testing contactor:
Data of test:
CFM50:
Volume:
ACH50:
Person Certifying Job:
Air flow through the glower door at go pascals pressure Memos (aim)
Volume of home (ou, It)
Air change rate per hour at 50 Pascale pressure (Sysrence
ACHSO ■ (CrMSo x So) / Volume
The performance threshold for code compliance Is ACHso
not Weseding 5.0 aclh
Phone: