2015, 01-30 Duct Leakage AffidavitDuct Leakage Affidavit (New Construction)
Permit ti:
House address or lot number:
City: Zip:
Cond. Floor Area (tt�): (.) Source (circle one): Plan 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?- no Air Handler present during test?'�fyes Qa
Circle Test Method: Lea inside Total Leakage
Maximum duct leakage: _
Post Construction, total duct leakage: (floor area x .04) = S CFM@25 Pa
Post Construction, leakage to outdoors: (floor area x.04) = S CFM@25 Pa
Rough -In, total duct leakage with air handler Installed: (floor area x .04) _ 'S6 CFM@25 Pa
Rough -In, total duct leakage with air handler not installed: (floor area x .03) = CFM@25 Pa
Test Result: 5"_113 CFM@25Pa
Ring (circle one if applicable): Open
Duct Tester Location: nNdAr LA& Pressure Tap Location: w Sw
I certify that these duct leakage rates am accurate and determined using standard duct testing protocol.
Aontt
Company Name: �-LL
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/..l ' 11ITechnician: _ Wl'e-
Technician Signature:
Date:113 � L 0 t
Phone Number 3 -652 -Yu --03N