HomeMy WebLinkAbout1533 Purple Sage Ct - Disclosures - 01/02/2003Fort Collins Residential Energy Code the building do Zo nt ng dept. of
AIR SEALING DISCLOSURE FORM Community Planning and Environmental Service
Zal K College Ave:, P.O.3 = Sao, Fort CoiGns, CC a(L�
_
-.-mm.
(Nat applicable to E-STAR orF-NE.RGY.SCCRE rated homes) vain 4t0 =1 a— 5a FAX: TrQ =4 S134
Jabacidress: PUm1e�e l '
General cantmetor. �L-S
Air saaling cantrac:ar
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1 zZ s.ruc; a cis ...... . _ _ ..._
Complete either Part A or Part E -
P_rtA is to be signed by the air sealing contractor or representative of the gene al contractor.
Fart 5 is to be signed by the blower door testing contractor or rapresentative of the geese. al cantsactar.
The "Slower Moor Test Repot' or equivalent dcc,mentatinn must, be attached.
please type or print,. except for the signaium-
if components vary, maica r;suitipie entries- to describe theirs_
Cne copy of this form must be provided tc the Euilding and Zcning Cepartment Friar to C. C.
One--=py of this:fcrm must be provided to the original home buyer.
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A_.:Prescrl five...Sufi:ng Chec_klisfi... = ,,
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.....__........._..._ ..�P:.-..........::........:...:..... _ ......... _ - - --- - ---
IlWe ca:tiy satthe air sealing requirements sperm Tied in the c--merit City of Fort Ccirins Reside.,ldal =nergy Cade
have heen completed in this buirdrng, in accordance with the "Air Sealing Checiclis, puirFtszed by tie City otFor, Ccirins
Person Certifying Jch:
Signature:
Susiness Firm: A I IQ-KoA
Cate:
addras, �-
_
_ _
:: door::l:.eft ..................... .
y Qjawe� __........_.................................--
1IW a ca.—Zry that this building has met the air Leakage performance threshold spe feed in the ctrrent Fort COX=
Fa--idenrja( Ersergy Cade, in accordance with the *Slower Door Test rroceduras' pubiisned by the City of Fart CatTns.
I estling cantraexr.-
Date of test
CF MSo:
vc(rsrne:
ACC }SC_
Ferran Certifying Jab:
Air law through the blower door at _0 Pascals pressure dtference (c::^)
Volume of home (cu. 2)
,sir change rats per hour at =c Pascals pressure difference
AC'HS0 = (C,--%r1SQ x 60) l Volume
i ne performance lhreshoid for ode cantFfancs Is ACH-50
not exceeding 5.0 ach
Signature: Date:
Business Firm:
ncirfr=¢e-
Phone'