HomeMy WebLinkAbout1921 Prairie Hill Dr - Disclosures - 02/06/2004 (2)Fort Collins Residential Energy Code
AIR SEALING DISCLOSURE FORM
awds,l ", — 7A=A
(Not applicable to E-STAR or ENERGY SCORE rated homes)
the building & zoning dept. of
Community Planning and Environmental Service
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 5760 FAX: 970 224 6134
Job address: i q7-\ OaA,Ac, ,F, QLa( �2
General contractor. �f7rrle�
Air sealing contractor: ,lam A--Flo(L)
.
Instructions..' ...:: - _
Complete either Par A or Par B .
Part 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 cf the eeneral contractor.
The "Blower Door Test F eport" 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 (Air Sealing Checklist)
I/We cersfy 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 ,th//e "Air Seaiinc Checklist" pubiished by the City of For Collins.
Person Certifying Job: 32�� 1`,+u)!!jet
Sianature: Date:
Business Firm: ((f Inib L_-A--iort,
Address: j Z ciZ C` 1eJe��
Phone: qu-L-coil
B Performance p ath Blower Door Test
I/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 "Blower Door Test Procedures" published by the City of Fort Collins
Testing contractor:
Date of test:
CFM50:
Volume:
ACH50:
Person Certifying Job:
Air tcw through the blower door at 50 Pascals pressure difference (cfm)
Volume of home (cu. ft.)
Air chance rata per hour at 50 Pascals pressure difference
AC1150 = (CFM50 x 60) / Volume
The performance threshold fcr code compliance is ACN50
not exceeding 5.0 ac/h
Signature: Date:
Business Firm:
Address:
Phone: