HomeMy WebLinkAbout6903 ANTIGUA PL - DISCLOSURES - 4/17/2002 (3)JUM 18 2000 5:55RM HP LRSERJET 3200
P. 1
Fort Collins Residential Energy Code
Fort Collins
DISCLOSURE FORM
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{Nat applicable to E-STAR or ENERGYACORB rated heroes)
Job address: Io�9W5 A� oa1 PI .
cenerw contractor_ 1 nw+t7 C-^'VkOs ^
Air mwIng contractor. A l lied. M,!-Ja4i'w-"
the building & zoning dept. of
Community Planning and Environmental Service
7.61 m Cafege Ave, P.O 8mr 580. Fort CAM CO 60522
Voice: 270 221 SM FAX 070 224 6134
Complete either Part A or Part B .
Part A is to be signed by the air seating contractor or representative of the general contractor.
Part B is to be signed by the blower door testing contractor or representative of ere general contractor.
The "Blower Door Teat 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 tNs form must be provided to the Building and Zoning Department prior to C. O.
One copy of this form mast be provided to the original home buyer.
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:A:�rescnpttve:pat.>'C" • Ir cal n . • hecklfistj�:;•__.. _ _-- _ �'�� ;-_._._ •��-��._—_-,.:-- Me eertifythat the air sealing requirements spedtied In the await City at Part Collins Rash w&l Enargy Code
have been completed in this building, in accordance with the "Air Sealing Chackhr published by the City of Fait Collins.
Person Cefflying Job:
Address: oq9 z tea. .�o wol
psPhone:
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VWe cadly dwitthis building has met the Air teakege performer" threshold specified in the current Fort Collins
Remdential Energy Code, In aoeordiumW h the Mower poor Test Procedures" pW*ohed by the City of Fort Collins.
Testing contractor.
Date of test
CFd130., Arrow through the blower door at So Pascals p►eswin difereeoe (rfm)
Valuate: Volume of forme (ar, fL)
ACPI30. Air change rats per Moor at50Psaaab pressure dtf in ce
ACHSO; (CFM§Q xSoNdume
The pwfomrsnce 2weshoW for code Compliance 5 ACH50
not waft 5.0 adh
Person Certifying Job:
wantons_ per;
Business Firm: .—
Address:
. Phone: