2015, 03-04 Duct Leakage Affidavit••
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Duct Leakage Affidavit New Construction)
Permit #: /// )is -3
House address or lot number:
City: PDk\ oto, --
>3�� N G1ov\
Cond. Floor Area (ft2): \,COA
Zip:
Source (circle one): (Plans) 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? yes ❑ no Air Handler present during test? it yes ❑ no
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-ln, total duct leakage with air handler installed: (floor area x 04) = Mtal CFM@25 Pa
Rough -In, total duct leakage with air handler not installed: (floor area x .03) = CFM@25 Pa
Total Leakage
Test Result: CJ'1 CFM@25Pa
Ring (circle one if applicable): M , A- Open
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Duct Tester Location: FJf NA.(e. Pressure Tap Location: SO -pilin
I certify that these duct leakage rates are accurate and determined using standard duct testing protocol.
Company Name: C-
VO -47---- Technician: 1 `D "i ZT
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Technician Signature: /'/
Date: 0/C(11
Phone Number: