HomeMy WebLinkAbout4702 DUSTY SAGE DR - DISCLOSURES - 3/10/2003 (10)t, C2i1 liC LVVi� llVil VV- �•_ `•` -- - "�
Fart Coffins Residential Energy Cade
SEALING DISCLOSURE FORM
(Nat applicable to E-STAR or E-NERGY.$COFc= rated homes) .1 e-,
the building & zoning dept. of
Ccmrnunity Planning and Environmental Service
Zal N. Cadege Ave., P.O. S= 53Q, Fort Catlin, CC 8ac'�
Vaic. 970 Z1 aia(3 FAX: 970 =4 5134
Job address q %0 a 0%i sly
General contractor. L-- Cor1STfOut
Air saaiing contractor-
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rls;ru .carts< : ; :::::::: ;::::: : ;:•:::_ ::: ::�:_� :_ :...._::::_.::.::::•::- ........................
Complete either Part or Part E
A is to be signed by the air sealing contractor or representative of the genera( contracto
Feu ctor:
part d is to be signed by u`te blower door testing contractor or representative of the geneaI contractor.
i tie "cleaver Door Test Reperl,° or equivalent decImentatien must be attac:led.
Please type or print,. excsot for the signature.
!f csmpanents vary, make cnuitiple entries to desc.�be them. _
Cne copy of this for-,-,, must be provided to the Euiiding and Zoning Qepatmertt prior tc C. C.
Cne.c:ay_ of thisfcrrn must be provided to the ariginai home buyer.
-. A
-fi _P_rescript>.ye .ng:Ch.eckllsty....... ..:....:..::..::::..:......_.. .....----
Me certify that the air sealing requirements Specified in the currant C;ty or Fart Collins ;mesidentiai Energy Cade
have teen camplered in this buiiding, in accordance with the "Air Sealing Chec.. is'pusrnshed by she a*,y-at Far,- Cairins
Person Certifying Job:
zi
Susiness Firm: A //, e ..Lnsv
rate: a/�� /o3
Address: Ia9� S. Ci pJla�d
F ore: 96 2- 90/1
_.......ff
Fer;_or._mance.p�Ei {B1.owe.......... ..........._..._ ..._._......................_._.._........... .
iMe card that this building has met the air lesicage performance threshold spec - iced in 'tie current Fort Cailins .
Residential E.Zergy Cade, in accordance with the 'Slower Door Test rrocatures' published by the Ccty of Fart Collins.
nesting =ntrac:or-
Date of test
C; 1r1EJ:
Volume:
ACHEO-
Fersan Certifying JOb:
Air law through the bIawer door at °0 pascais pressure dzference
Volume of home (cc. ft.)
Air changs rate per hour at?1=ascsls pressure dcfferenca
AC SC = (CFM!50 x 60)1 Valuate
The performance threshaid far code ccrnpriance Is ACHEO
nct axcaeding 6.0 ach
Signature" Date:
Business Finn:
Address:
Phone,.