HomeMy WebLinkAbout7450 Stonington Ct - Disclosures/Air Sealing - 04/06/2005Fort Collins Residential Energy Code
AIR SEALING DISCLOSURE FORM
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(Not applicable to E-STAR or ENERGY SCORE rated homes)
Job address:
General contractor.
the building & zoning dept. of
Community Planning and Environmental Service
281 N. College Ave., P.O: Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX 970 224 6134
Air sealing contractor. A e,n 1--ms A u I E}m
INSTRUCTIONS
Complete either Part A or Part 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 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 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.
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IIWe certify 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 the "Air Sealing Checklist" published by the City of Fort Collins.
Address: I l t)� I 5 he r tWjj bW 15Lift au eh ul to ' 1-1 -ZI -t
Phone: 3�s - ( l Ul - lTf61
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IMIe 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: Air flow through the blower door at 50 Pascals pressure dffierence (0m)
Volume: Volume of home (cu. ft.)
ACH50: Air change rate per hour at 50 Pascals pressure chi ference
ACH50 = (CFM50 x 60) / Volume
The pwbrmance threshold for code compllam a is ACH50
rat exceedng 5.0 adh
Person Certifying Job: &(� �}
Signature: &J114 Date:
Business Firm:
Address: a !
Phone: `