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Duct Leakage Affidavit (New Construction) <br />Pcrm�t # _ __ <br />- ---- - -- �1� � � , �, , , <br />House address or lot number � � �� - ) � � `� _ _ __ _ <br />c�ry ����!'r�1;- �i�'�?l-'� _ <br />Zip <br />ConA Floor Area (f17, ���l ___ Soume (r.irtle one) ; Plans' f shmatrrcl Measured <br />❑ Ducl6ghtness testmg �s not reqwred The total leakage test is not reqwred for ducts and air handlers Io�atcA <br />enhrely wrthm the buddmg thertnal emelope �ucts IocateA m crawl spaces do not qualify for this exce�punn <br />Alr Handler �n conddioned space� [� Yes �] no <br />Cvcle Test Method Leakage to OuWde <br />Air Handlet present during 'vsl� [] yes � 1 nu <br />Total Leak:�ye <br />Mexlmum duct lcakago: <br />Post ConsWction, tolal duct leakage: (floor area x 04) -_ _C�M(�25 f'a <br />Post Construction, loakagc to outdoors: I�oor area x 04) _�___. CFM@25 Pa <br />Rough-In, total duct leakage with eir handlcr insfalled: (floor area x OA) -� S'iJ CFM@25 Pa <br />Rough-In, lotal duct IeaNage with air handler not instelled: (Oonr area x 03) ___CFM@25 f'a <br />Test Result: r..l� CfM@25Pa <br />— --- - —�'�- - -- - _ _- <br />Ring (circle one it apphc�ble) � Open;� 1 J � <br />Uuct 1 ester I ocation PressurF I ap I ora6on _ `!' 1_. <br />1 ceAify that Ihese duct leakage rates are accurate aod Jetermined using standard duct testing protocol. <br />f,nrnpanyName i_\� I����'1� ( l I 1I � 1�-- - l��liri i.an - - -� �_I_ _._._ <br />� -- <br />/ ``'" . <br />Tt:chnir,ian Signalure j ,__ __ <br />flate ��-I J � � <br />r i � i!% <br />Phu��FNumbFr I�r��� � ] � --�� _' / <br />� <br />