HomeMy WebLinkAbout414 PLOWMAN WAY - DISCLOSURES - 6/26/2002CILA UJ CUUL I n1 UL-U4 ILA IV . I , - . ___ , - - -
Fort Collins Residential Energy Code the building & zoning dept. of
AIR SEALING DISCLOSURE FORM Community Planning and Environmental service
281 N. College Ave., P.O. Box 580, Fort Collins, co 80522
(Not applicable to E-S TIAR or ENERGY SCORE rated homes) Voice: 970 221 6760 FAX 970 224 6134
Job address: /,,//k/ , PIDL-Dr-/\v'.V1
General contractor.
Air sealing contractor- -A th 4PJ Nor' A
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4q.- ons Ins .... ....
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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 6 is to be signed by the blower door testing contractor or representative of the general contractor.
The "Slower 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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A. Prescriptive path (Air Sealing .. .... Phecklist)
I/We certify that the airsealing requirements Specified in the current City of Fail 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 JO/Q -�6 D, & hil� (
Signature: a'. F Date:
Business Firm: `�, Alin Noritx
Address: t%q2 4x' CIA/,06"
Phone: MCI) 50- -qo II
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B. Per.fo*r'manc'e path: (81. .. .. . .... ; ...... .... .......
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INVe 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 difference (cfm)
Volume;
Volume of home (cu. ft.)
ACH50;
Air change rate per hour at So Pascals pressure difference
ACH50 = (CFM50 x So) I volume
The performance threshold for code compliance is ACH50
not exceeding 5.0 ac/h
Person Certifying Job:
Signature: Date:
Business Firm:
Address:
Phone: