HomeMy WebLinkAbout5156 Cinquefoil Ln - Disclosures - 03/24/2003 (3)Jtjft-Ut-LUU4 nUrt U6'--LC- 1711 rV GUILULI'M CUILOF
Fort Collins Residential Energy Code the building & zoning dept. of
1 AIR SEALING DISCLOSURE FORM Community Planning and Environmental Service
281 N. College Ave-, P.O. acm Sao, Fort Collins, CO 80522
(Not applicable to E-STAR or ENERGY.SCORE rated homes) Xcica, 970 2216760 FAX: 970 =4 6134
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Job address-
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General contractor-.
Air sealing contractor.
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Complete either Part A or Part B
Part A is to be signed bthe air sealing contractor or representative of the general contractor.
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Part B is to he 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 . le entries to describe them. Department prior to C. . 0-
Cne copy of this form must be provided to, the Building and-Zaning
one copy of this form must be 6
_provided to the original home buyer.
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INVe cetfy that the air sealing requirements specified in the current City at Fort Collins Residential Energy Code
have been completed in this building, in accordance with the *Air Sealing Chec.Vjs,L" published by the City of Felt Collins.
Person Certifying Jab.
Cate: j- -5—
r, gg- '
'Eusiness Firm: .42 A
Address: C
d Phone: 47-7-0 -Ekalz 3PAL
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.... .. .................... .................. .................1/We certify that this building has met the air leakage performance threshold specified in the current Fort Collins
Residential Energy code, in accordance with the "Slower Door Test Procedures' published by the C4 of Fort Cafrins.
Testing contractor.
Date of test
CFMSG-. Air low through the blower doer at -40 pascals pressure difference (cfm)
Volume: Volume of home (cu. ft.)
Air change rat ' a per hour at 50 pase3is pressure difference
= (CFM!50 x 610) 1 Volume
The performance threshold for code compliance Is ACH50
not exceeding 5.0 aQ'h
Person Certifying Job:
Signature: Date:
Business Firm:
Address:
Phone: