2015, 02-12 Duct Leakage Affidavitx litlh y4 ,1,
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ENERGY EROGRAM
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Permit #:
Duct Leakage Affidavit New Construction)
House address or lot number:
City:
spa Ica tivc_
�3c°1 N aVat/1h11 •
Cond. Floor Area (ft2): \p O ` —
Zip:
Source (circle one):
Estimated Measured
❑ Duct tightness testing is not required. The total leakage test is not required for ducts and air handlers located
entirely within the building thermal envelope. Ducts located in crawl spaces do not qualify for this exception. _
Air Handler in conditioned space? 0 y
Circle Test Method:
Maximum duct leakage:
Post Construction, total duct leakage: (floor area x .04) = CFM@25 Pa
Post Construction, leakage to outdoors: (floor area x .04) = CFM@25 Pa
Rough -In, total duct leakage with air handler installed: (floor area x .04) = CFM@25 Pa
Rough -In, total duct leakage with air handler not installed: (floor area x .03) = CFM@25 Pa
Air Handler present during tes
Total Leakage
❑ no
Test Result: C CFM@25Pa
Ring (circle one if applicable): tA/ A- Open
Duct Tester Location:
1
2
Pressure Tap Location:
3
soveiv
I certify that these duct leakage rates are accurate and determined using standard duct testing protocol.
Company Name: --- Technician:
Technician Signature:,
Date: � t .J-0,
Phone Number: