HomeMy WebLinkAbout3920 Gardenwall Ct - Disclosures - 05/23/20021rot � Collins Residential Energy Code
AiR SEALING DISCLOSURE FORM
.Ydw, .b:- Mase
01J,4 upplicablc to E CTAR cja CNCI:GY GcoFE iatcu homes)
Job address:
the building & zoning dept. of
Community Planning and Environmental Service
281 N. College Ave., P.O. Box 580. Fortcolrns. Co 20AM
Voice: 970 221.6760 FAX 970 224 6134
r
General contractor.
Air sealing contractor. R.G. Insulation Co.
:::.- ........_....._...... ..... .
nstructaons::::.. . .... .... .............. _......_.
Complete either Part A or Part B ._.......................................•..:::::. .
P-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.
'fhe "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 priorto C. O.
One copy of this form must be provided to the original home buyer.
.... ..........
A. Pee s..:._
cri tiv
e at h Alr. S�
�...... P i.. A ..Checklist
9................ ..........................
fY 9 q p-.....,,.........................:::::.:::::.: ..............._..........................._..:_ :..
INVe certify that the air sealing requirements s eciffed in the current City of Fort Collins Residential Energy• Code
have been completed in this building, in accordance with the "Adr Sealing Checklist" published by the City of Fort Collins..
Person Certifying Job: David M an
Signature: Date: 0,23 OZ
Business Firm:
Address: 2505 E. 74th Ave.
Phone: Q031 2 —9 5
B_ P
Bl' D.
.. oo.r..... :.::..,.:............. :..:: _:
P
ower.Test
INVe certify Ltiat this building has met the air leakage performance threshold specified in the current Fort Collins - - -
Residential Enerrhy Code, in accordance with the "Blower Door Test Procedures" published by the City of Fort Collins_
Testing contractor:
Date of test:
CFM50: Air flow through the blower door at 50 Pascals pressure ddference (cfm)
Volume: Volume of hame(cu R)
AC1 iSO: 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 adh
Person Certifying Job:
Signature:
Dale:
Business Firm:
d"re_is:
Phone:
b0 'd 62: 6 ZOOZ 2Z 62W 9SbZ68ZM2: XPJ NOIiu�nSNI 921