HomeMy WebLinkAbout3633 Rocky Stream Dr - Disclosures/Air Sealing - 05/06/2010�Y 0004
Fort Collins Residential Energy Code the building & zoning dept of
AIR SEALING DISCLOSURE FORM Community Planning and Environmental Service
.ea.2-1ft C" 281 N College Ave P O Box 580 Fort Collins CO 80522
(Not applicable to E-STAR or ENERGY SCORE rated homes) Voice 970 221 6760 FAX 970 224 6134
Job address yaw—'f 95�t:;v_
General contractor TUSC�y 6005;Py (, 4-(&W- -n
Air sealing contractor T>,p l W-;PU"4T "--)
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
One copy of this form must be provided to the original home buyer
A Prescriptive path (Air Sealing Checklist)
prior to C O
UWe 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
Person Certifying
Date 5 & iv
Business Finn
Address W/ 17-tt-%Si— S &)
LG7If7(,�, LDS% Phone
8 Performance path (Blower Door Test)
IMe 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 flow through the blower door at 50 Pascals pressure difference (cfm)
Volume of home (cu ft.)
Air change rate per hour at 50 Pascals pressure dfference
ACH50 - (CFM50 x 60) / Volume
The performance threshold for code compliance is ACH50
not exceeding 5 0 ao/h
Signature Date
Business Finn
Address
Phone