HomeMy WebLinkAbout1674 Falcon Ridge Dr - Disclosures - 04/08/2004 (2)Fort Collins Residential Energy Code
AIR SEALING DISCLOSURE FORM
(Not applicable to E-STAR or ENERGY SCOPE rated homes)
Job address:
General contractor.
i (o"q r,►adco,
the building & zoning dept. of
Community Planning and Environmental Service
281 N. College Ave., P.O. Box 630, Fort Collins, CO 80522
Voice::70 2; i 67e0 FAX C-70 Z24 6134
Dr.
Air sealing contractor hlk-f b I ro�— coTlory
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Complete either Part A or Part 6 .
Part A is to be signed by the air sealing contractor or representative of the ceneral contractor.
Part B is to be signed by the blower door testing contractor or represent2tive of the general contractor.
The "Blower Door Test F.eport" or equivalent documentation must be att2ched..
Please type or print, except for the signature.
If components vary, make multiple entries to describe them.
One copy of this fora m � 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 .rescrip lve path {Alr Sesling +✓hec�CliSt) . :.
[/we certify that the air sealing requirements specified in the current City of Fort Cellins Residential Enerav Code
have been completed in this buiidinc, in accordance with the "Air Seaiinc Checkiist' publisl hed by the City of For Collins.
Person Certifyi
Sianature:
Business Firm: j4 k
Address: IZC
r Date: (- 9 4
Phone: 9(07-tol/
B Performance path (Blower Door Test)
I/We certify that this building has met the air leakage performance threshold specified in the current For Collins
Residential Energy Code, in accordance with the "Blower Door Test Procedures" published by the City of For, Collins.
Testing contractor:
Date of test:
CFM50:
Volume:
ACH.50:
Person Certifying Job:
Air i`lcw through the blower COor at zO !Pascals pressure oiiierence (cfm)
Volume of home (cu. ft)
Air chance rate per hour at 50 Pascais pressure ci erence
AC -SO = (C=M50 x e0) / Vciume
The performance threshold for code compiiance is ACC 150
not exceeding 5.0 ac/h
Signature: Date:
Business Firm:
Address:
Phone: