HomeMy WebLinkAbout802 BLONDEL ST - DISCLOSURES - 12/12/2007 (11)Fort Collins Residential Energy Code the building dt Zoning dept. of
AIR SEALING DISCLOSURE FORM Community Planning and Environmental Servicc
(Not applicable to E-STAR or ENERGY SCORE rated homes) Vim. a ie Ave.,sFFAX 580, Fort 134 '"s, CO sosr2
Job address: a fill, t7% _ .I
General contractor. to \k
Air sealing contractor.
(a
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.
.....................:. F:. : .7.N'.c : »j :%>::>;;: isJ>::::::;<:::
INVe 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 Job: