HomeMy WebLinkAbout3915 Scotsmoore Dr - Disclosures - 04/23/2002 (2)Fort Collins Residential Energy Code the building &Zoning dept. Of
AIR SEALING DISCLOSURE FORM Community Planning and Environmental Service
mns,aixis. rnw,,, 281 N. College Ave-, P.O. SoX 580, Fort Colliris, CO 80522 '
(Not allp;irnble to S'l AR or ENERGY SCORE rated homes) Voice: 9/0 221 ti7t90 FAX: WO Z24 6,134
Job address: MAP_ el (21;--
General contractor: RTr•uMnnln AMERTrAM unMt, c
Air sealing contractor R.G. Insulation Co.
.... .
1r1Str UCtI OrtS":'..
...,.... .. :.:........::....... ...... , ,.. ....... ..........
Complete either Part A or Part B .
Pail 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 Sealing Cfieckl ISt�
Me 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 Checkrist" published by the City of Fort Collins.
Person Certifying Job:
Signature:
Date:
B. Pcrformanc.P path (B.lowerpoorTeSt). .. ..._ ;`
INVc. c(atify thflt this building has met the air leakage performance threshold specified in the current Fort Collin
Residential E'.neray Code, in accordance with the "Blower Door Test Procedures" published by the City of Fort Collins
Testing contractor:
Date of test:
CFM50:
Volume:
ACH50:
Person Certifying Job:
Signature:
Business Firm:
Address:
Air flow through the blower door at 50 Pascals pressure difference (cfm)
Volume of home (cu. fQ
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 acth
Date:
Phone:
IO 'd Zb 8 ZOOZ �:Z add 9SbZWMZ� : xPA NOI u-inSNI M