20130201 Permit Pkg 05202013 woF T��• City of Yelm Permit ►vo.: 20130201
,� Community Development Department Issue Date: 5/20/2013
4 (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
""'•"'"`�°" Fax: (360)458-3144
Applicant:
Name: FREESTONE Phone: 253-896-1300
Address: 6820 20TH ST E STE A
FIFE WA 98424
Property Information:
Site Address: 15335 KAYLA ST SE 54 Owner: FREESTONE INC
Assessor Parcel No.: 41610005400 Subdivision: CHERRY MEADOWS Lot: 54
Contractor Information:
Name: FREESTONE Phone: 253-896-1300
Address: RICK CARIILE
6820 20TH ST E STE A
FIFE WA 98424
Contractor License No.: FREESI"969NZ Expires: 1/24/2011
Project Information:
Project: NEW RESIDENTIAL BUILDING
Description of Work: LOT 54, PLAN 3202A
Sq. Ft. per floor: First 1406 Heat Type(Electric, Gas, Other): GAS
Second 1796
Third
Garage 469
Basement
Fees:
Item Contractor Fees
NEW RESIDENTIAL BUILDING FREESTONE $17,816.97
MECHANICAL KLIEMANN BROS. $ 84.75
PLUMBING PELTRAM PLUMBING $ 118.00
TOTAL FEES: $18,019.72
ApplicanYs Affidavit: OFFICIAL USE ONLY
I certify that I have read and examined the information contained within the application and know the same
to be true a orrect. I also certify that the propos structure is in conformity with all applicable City of #Sets of Prints:
Yelm regul tio s including those governing zoning d land subdivision,and in addition,all covenants,
easemen s a restrictions of r if ap lying as ontractor, I further certify that I m current Finai Inspection:
registere e ate of W ington.
� / Date:
Signature � Date l.
By:
Firm
Cit� of Y�lm
(35 ) 458-8402
I��C#; Q0128508 5/ZO/2013 3.39 PM
D�ER: CO TERM: 0(�1
REF#: 2193
?RAN: 33.UU00 BUILDING PERMITS
'10130196 17,558.70CR
FREESTONE
15351 CALLIE AVE SE 139
BLU-F�ES1 17,341.45C�t
MECH 7B.25CR
P�- 139.00CR
rRAN: :i3.0000 �UIL.D�NG PEkf4ITS
2013Q�01 18,U19,72CR
FREESTONE
15335 KAYLA ST 5E 54
BLD-f2�S1 17,816.97CR
MECH 84�75CR
PL 11B.00CR
TENDEf�ED: �5,578,42 CHECK
APPLIED: 35,578042-
CWANGE: �� 0,00
YELM COMMUNITY SCHOOLS
PO BOX 476
YELM WA 98597
Clerk: Croy
Terminal : 1
Recei pt: 208827
Manual Receipto
NFREESTONE
NFREESTONE
FREESTONE, LLC
6820 20TH ST E SUITE A
FIFE, WA 98424
5/20/2013 3;35 PM
Q�.�� Item____�_r.._�___r___�_________�Price
1 CPF MITIGATION 3015.00
MITTGATION
03-021ILOT 54/15335 KAYLA ST SE;YELM
1 MITIGATIONTION 3015.00
03-021/LOT 139/15351 CALLIE AVE SE;YELM
Subtotal : 6030.OU
Tax: 0.00
Total ; 6030.00
Check 6030.00
2194
Chang� Due; 0.00
THANK YOU
� ' 18' 19' 6.5'
52.00
�n o 0
M 10 Y � � 55
D YWELL J
�r, - - - - I �
SCALE:1"=20' N � COV PATIO �� � N
`" I I� pRAINS I
I
— — 39
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� 3202 A STD �
� DIAG 63.41' �
� �— I
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o � W � I o
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� � I GARAGE � �
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I I � COV.PORCH �l�l�
LL
p - _ _ _
�� 5 � CONC.
� y
� �rTEP, 5'-5" DRIVE
� 10'MIN. "
`� �, SEPARATION �'.0" �e'.'"" � � „`5,. N
� OR SLEEVE 10'UTIL ESM ���,F�F
WATER LINE I
���
S
W 52.00
0
CURB/GUTTER APPROXIMATE N
�q LOCATION OF
�°��"�'"���,; a4,s���'�� STREETTREE
. - � ,
��-�-�-� ��__.�_/7
�' K,4YLA 5T. 5�
;� `.� __
�.:._ � _ ._ __�
�-, ..-,� � �, .
NO 5' EAVE CONNECT 4" PVC ROOF
ENCROACHMENT THIS LOT LL
LOT 54 - CHERRY MEADOW� "�+ ��' �� 1�
�o
PARCEL #: 416100 054 00 o"'ne'': �reestone
Ghe ��` __
Lot SIZe: Pro�ect Address: 6820 20th St. E Suite A
5,200 Sq. Ft. 15335 KAYLA ST. SE 2153-6�300
,
� �
11�
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
� Project Address: �J�J � �1���� Parcel#: `G��I On O�`"I QO
Subdivision: �ot#:�_ Plan#:��� Zoning:
�Q New Construction 0 Re-Model/Re-Roof/Addition � Home Occupation Sign
❑ Plumbing ❑ Mechanical ❑ Mobile/Manufactured Hom lacement ❑ Other
Project Description/Scope of Work: � � Q
Project Value:�( ,�C{�,
Building Area (sq. ft) 1 St Floor��Q, 2"d Floor� �1� Garage Beck�a,�_
Basement ""— Carport `^ atio ��
#Bedrooms� #Bathrooms�_Heating:�OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? �_
lf yes, a completed environmental checklist must accompany permit application.
BUI�QING'.01NNEt�NAMF�:
ADDRE S O EMAII ' ,��
C�N � STATE�_ZIP TELEPHONE �o- I
AR�������«�G����� UCENSE#
ADDRESS - EMAILLI��A epMLq. ••
CiTY_Qt�-he1 STATE ZIP � TELEPHONE
G��������7�CT�� TELEPHONE ��
ADDRESS EMAIL �
CITY SArtYV� STATE IP FAX Co2K.� $q(o-db 6a --
CONTRACTOR'S LICENSE# E 2 EXP DATE CITY LICENSE#
�l
PLt1M�1(zIG C�l'�FTEtR�1;Q LEPHONE 1-
ADDR 8S EMAIL
CITY STAT Z 0 FAX ��5�, 9 l-9�
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
1 �p
MECi�AN1EA��E"JNTt�CTO� • 1C � TELEPHONE a6 5 -0
ADDR�,FSS 0 `� � EMAIL
CITY IQ,Qpry�q, STATE 21P (. FAX � -
CONTRACTOR'S LICENSE#kl.rEMP�4l0�1 BT EXP DATEJ� CITY LICENSE#
'a.:l 201�{
Copy of mitigation agreement with Yetm Community Schools, if applicable.
1 hereby certify that the above Informatlon Is eorcect and that the constructlon on,and the occupancy and the use of tha
abov eribed property wlil be In aecordanca with the laws,rules and regulations of tha SUte of Washington and tha
City of Y m.
Ap I 's Signatur ��
Date
Owner/Contractor/Owner's Agent/ ontractor's Agent(Please circle one.)
All permits are non-transferable and will expire if work authorized by such per it is not be un
within 180 days of issuance,or(f work is suspended or abandoned for a peri ���VED
IL
APR � 9 Z013
�--
105 Yelm Avenue Weat (360)4 • 835
Yelm, WA 98597 (360)458-3144 FAX
www.ct.yelm.wa.ua
.
Pre,criptive Energy Code Compliance forSingle Family and Duplex Housing: Zone 1
Project/nformation Contact/nformation
Plan 32�2 �reestane Com anies
682(I 20th St. �. Fife WA:•�8424
Yelm 253 896-13p0
This set of forms has been developed to assist permit applicants documenting compiiance with the
Washington State Energy Code, (2009 edition). This set is for structures built under the IRC andJocated
in Climate Zone 1.
The following forms provide much of#he required documentation for plan review.The details noted here
must also be shown on the drawings (WSEC 104.2).
This form is not a substitute for the energy code itself. To obtain a copy of the energy code,
go to the following web address. http://www.energy.wsu.edu/code
Glazing Walt1z Wall• int4 Wall• ext4 Slab6
lo Glazing U-Factor poor 9 z Vaulted 5
Option Area : Ceiling 3 Above Below Below Floor on
%of Floor Vertical Overhead�� U-Factor Ceiling Grade Grade Grade Grade
R-49 or R-21 R-21 R-10
OO I 13% 0.34 0.50 0.20 R-38 R-3$ Int.� T'$ R-10 R-30 2,
Adv.
R-49 or R-21 R-21 R-10
O II 25% 0.32 0.50 0.20 R-3$ R-38 Int.� TB R-10 R-30 2,
Adv.
R-49 or R-21 R 21 R-10
� III Unlimited 0.30 0.50 0.20 R-3$ R-38 Int.� Tg R-10 R-30 2,
Adv.
See WSEC tab/e 6-1 for footnotes
Glazing Schedule Attached to Document
Does not apply. (SEE INSTRUCTIONS) Using Prescriptive Optinn I11.All glazing �
� and doors meetmaximum U-factor. Alternate heating size method submitted.
❑ Option l or II,Glazing to floor area limit (WSEC 602,7.2)
❑ Area weighted window,skylight or door U-factor{WSEC 602.7,2) �
�
❑ As part of the heating system sizing calculation (IRC M140L3 &WSEC 503.2.2) �
Radiant slab:
❑ R-10 foam insulation, continuous with thermal break(WSEC 502.1.4.9)
Chapter 9 Options Total of 1 Credit Required
Opt. Opt. Description
1a Hi h Efficienc HVAC Equipment 1 1.0 �
1 b Hi h Efficiency HVAC Equipment 2
1c High Efficiency HVAC Equipment 3
2 Hi h Efficiency HVAC Distribution System
3a Efficient Building fnvelope 1
3b Efficient Building Envelope 2
3c Super-Efficient Building Envelo e 3
4a Air Leakage Control and Efficient Ventilation
4b Additional Air Leakage Control and Efficient Ventilation �-�
A._�v_
��
5a Efficient Water Heating R �
5b High Effieciency Water Heating ��� ,� g z��3
6 SmaII Dwelling Unit
J Large Dwelling Unit ��-
8 Renewable Electric Energy
Total Credits 1.00
WSEC Prescriptive Worksheet(2010 edition)Zone 1 WSUEEP10-010 Copyright 2010
,Glazing Schedule
Project/nformation Contact/nformation
Plan 3202 Freestone Companies
6820 20th St. E. Fife WA. 98424
Yelm 253 896-1300
Conditioned Floor Area 32Q2 Sum of UA for Heating System Sizing 123.0
Sum ofAll Glazing Areas From Below 355
Giazing to Floor Area Ratio 11.08% 602.7.2 Exception Ratio(not to exceed 1%)�
Exterior poors
Plan Component Door Percent Width Height Glazing Door poor
ID Descri tion Ref. U-factor Glazed Qt. Feet �"`n Feet �"�h Area Area UA
Ent: Fiber' lass insulated I�GC. U.16 1 3 6 20.0 3.2
�ic'�T;'':One Exempt Swinging Door<24 Square Feet 1 2 6 17.8
Sum of Glazing Area, DoorArea, and UA (do not include exempt door) 20.0 3.2
Area Weighted U= UA/Area 0.16
Sum of Area and UA for Heating system size only(include exempt door) 37.8 3.2
Vertical Glazing(Windows, Glazed doors using Exception 602.6#1)
Plan Component Glazing Width Height Glazing
ID Description Ref. U-factor Qt. Feet �"`h Feet '"�h Area UA
L&Q 2 Glz�lin l I�ow`E , NFRC 4.34 2 5 5 50.0 17.00
Kit 2 Glz;Uiri I�L.�w E NF'RC tS.34 1 6 ^ 4� 27.0 9.18
Gr 2 G(z Vin`�.Lo}iv E Su er S ac�r NFRC 0.33 1 � 8 48A 15.84
Gr 2 GIz Uin f'Low E , NFR� i3.34' 2 4 5 44.0 14.96
Gr ' 2 GIx lfin I Low E PW N�RC �.32 2 2 2 8.0 2.56
Bns 2 G!z Uin I L�w E. ' N�RC U.34 2 4 4, 32.0 10.88
Cfst� 2 GI�Vin I l�ow E F�W � ��� NFRG t�.32� � �l,� 2 � � �3 `` ��� � 8:8 � 2.80
Br 3 2 Gtz V1ri 1�Low E. NFRC f�.34 1 5 ; � . � 25A 8.50
Brs° 2 Glz�lin I Lc�w� : N�F�C t1.34 5 5: `• 4 100.0 34.00
Mstr 2 GIz�U�� I Lc�w E NFRC (}.34 1 3 4 12.0 4.08
�
� � �
?
Sum of Area and UA 354.8 419.80
Area Weighted U= UA/Area 0.34
WSEC Prescriptive Worksheet(2010 Edition)
WSUEEPIO-010 Copyright 2010
Overhead Glazing
Plan Component Giazing Width Height
ID Description Ref. U Qt. Feet '"`n Feet'"�n Area UA
;
�. �
Sum of Area and UA
Area Weighted U= UA/,4rea
Doube Glazed Garden Windows Section 602.7.2 Exception
Plan Component Width Height
ID Description Qt. Feef'"0n Feet �"`n Area UA
Sum ofArea
Sum of Area X 3(This total is automatically included in the glazing area total.)
Glazing UA for Heating System Size Only=Area X 0.63
WSEC Prescriptive Worksheet(2010 Edition)
WSUEEPIO-010 Copyright 2010
Simple Heating System Size: Climate Zone 1
Project fnformation Contact Information
Plan 3202 Freestone Companies
6820 20th St. E. Fife WA. 98424
Yelm 253 896-1300
Indoor Design Temperature 70
Outdoor Design Temperature 20
Design Temperature Difference (oT)
4T=Indoor-Outdoor Design Temp 50
Conditioned Floor Area 3202
Conditioned Vofume 27�22
Glazing
Copy Sum of UA from Glazing Schedule 123
Attic U-Factor X Area = UA
R-49 0.027 1'796' 48.5
R-38 Advanced 0.026
Single Rafter or Joist Vaulted Ceilings
U-Factor X Area = UA
R-38 Vented 0.027 � �
Above Grade Walls U-Factor X Area = UA
R-21 0.056 2685 150,4
�
Floors U-Factor X Area = UA
R-30 0.029 1792 52.0
�
Below Grade Walis U-Factor X Area = UA
2' Depth Waiis 0.042
3.5' Depth Walls 0.041
7' Depth Walls 0:037
Slab Below Grade F-Factor X Len th = UA
2' Depth 0.59
3.5' Depth 0.64
7' De th 0.57
Slab on Grade F-Factor X Len th = UA
R-10 2' perimeter 0.54
R-1-0 Fu11- Heated 0.55
Sum of UA 374
Envelope Heat Load 18691 Btu/Hour
Sum of UA X�T
Air Leakage Heat Load 14592 Btu/Hour
((Volume X 0.6)X�T)X.018))
Building Design Heat Load 33283 Btu l Hour
Air Leakage+Envelope HeaE Loss
Building and Duct Heat Load 1:15 38275 Btu/Nour
Ifducts are located in unconditioned space:Sum of Building Heat Loss X 1.15
If ducts are located in conditioned space:Sum of Building Heat Loss X 1
Maximum Heat Equipment Output 150% 57413 Btu/Hour
Building and Duct Heat Loss X 1.50
WSEC Prescriptive Worksheet(2010 Edition)
WSUEEPIO-010 Copyright 2010
,/���� .� �/'.�0 2�/ �a � ��'
� � � � �
��o�T��4y�� N O R T H W E S T
�
Insulation Certificate/Blower poor Test Form
Batts&Blankets Thermal Performance(Attic Application)
When installed in accordance with the manufacturer's The stated thermal resistance(R-value)is provided by installing in accordance with the manufacturer's
recorrmiendations,Knauf Batts&bla�ikets will provide instructions,the required number of bags per 1,000 sq.ft.of net area,at not less thul the labeled minimum
the full R-value. thicltness.Failure to insfall both the required number of bags&at least the ininimum thickness will result
in lower insulation R-value.
_ , _. . ... _ _ �
_ _ _ _ _ __ _
R-Value Minimum Thick�iess R-Value Ba�s/],000 sq.ft. Maximum Covera�e Minimum Wei;ht Minimum 7hicl��ess
To obtain a�t Installed insulation To obtain an The mimber of Contents of tl�is bag The Weight/SF of Instatled insulation
insulation resistance should not be less insulation bags/1,000 SF of net should not cover more installed insulation should not be less
R-Value of. than: resistance area should not be dian: should noi be less than: than:
(R-Value)of
R-38 IID :0.25" R-60 29.; 33.6 SI' i 9521bs. 19.750"
R-38 12.00" R-49 23.5 42.5 SF .7531bs. 16375"
R-30 HD 8.25" R-44 20.9 47.8 SF .6701bs. 14.875"
R-30 10.00" R-38 17.8 56.2 SF .5691bs 13.000"
R26 9.00" R-30 13.6 73.3 SF .4371bs 10375"
R-22 6.50" R-26 11.8 85.0 SF .3771bs 9.125"
R-21 HD 5.50" R-22 9.8 102.2 SF 313 lbs 7.750"
R-19 6.25""'` R-19 8.4 119.3 SF .268 Ibs 6.750"
R-15 HD 3.50" R-13 5.7 175.3 SF .183 Ibs 4.750"
R-13 3.50" R-11 4.7 210.8 SF .1521bs 4.000"
R-ll 3.50" Bag Weiglit-Nomina130 Ibs,Minimum 29 Ibs.This product conforms to the perfocrnance requirements of ASTM C 764,
R-8 2.50" Type 1,&cancelled Federal Specification HH-I-1030B,Type 1,Blass B.R-Values are determined in accordance with
"`R-18 in a 5.5"cavity.Conforms to ASTM C 687&C 518."R"means resista�ice to heat flow.The higher the R-value,the greater the insulation power.To get the
C665&Federal Specification HH-1-521F inarked R-value,it is essential that the insulation be installed properly.Tf you do it yourself,get instructions&follow them.
To achieve labeled R-value,this product must be applied with a pneumatic blowing machine&a corrugated hose with a minimum.25"intemal corrugation,a minunum lenb h
of 150 ft.&a diameter of at least 3".Coils in the hose should not be less than 36"in dianleter.Acceptable material feed rate is 5-351bs./minute.Recommended feed rate is
15-25 lbs./minutes.
Builders Insulation�tatement.
Batts a�zd/or Ulankets have been installed in conformance with the above 2009 WSEC Residential Ener�y Compliance Certificate-Buildin�Air Leakaee
recommendations to rovide a thermal resistance of....
R-Value Sta��dazd Building&Test Condition: Comments:
Attic Area R- R-49 Date: •�, �l
Ext.Walls R- R-21 Time
Inter.Walls R- R-ll Indoor Temp: 10
Sprinkler Tenting R- R-8 Outdoor Temp:
Knee Walls R- R-21KF Floor Area(sq ft)
Under floor R- R-30
Completed as of: "6 �� �.3 �uildinQ Air Lealcaee Tar2ef: SL�S.Less Than 0.00030
Installers Name Print _ ______ Test,#1-Depress___ )(,_ .Press Pretest Baseline Pressure (Pa)
Installers Name Sig�
�ress.(Pa Flo�v Ring Fan Press.(Pa) Flow(cfin)
/ ,/ L1 �� O � � O
Site Address: �.Lj�3`� �`�l-A► �l f l-G( r
�G`� n�C (, � Post Test Pressure: Fan ModeUSN: I(.[,(a�Q1 ��J
..� 7 '1
Results:SLA(Specific Leakage Area): . ��ZQ'/`E'.�� /4�
Home Builders Signahtre: Test#2-Depress Press Pretest Baseline Pressure (Pa)
Home Builders Address:
Bldg Press.(Pa Flow Ring Fan Press. a) Flow(cfm
Insulation Contractor: Insulation Northwest LLC
Post Test Pressure: Fan Model/SN:
P.253-846-0121 P.O.Box 732069
Results:SLA(Specific Leakage Area):
F.253-846-8096 Pu allu WA.98373
Affidavit: I certify that this Specific Leakage Area is accurate&determined using Blower poor Test Standard 502.4.5 Building Air Leakage Testing.
Technician Name Print: ��1.� Technician Name Sign: ��!',�r1/x�
,/���� .� �/'.�0 2�/ �a � ��'
� � � � �
��o�T��4y�� N O R T H W E S T
�
Insulation Certificate/Blower poor Test Form
Batts&Blankets Thermal Performance(Attic Application)
When installed in accordance with the manufacturer's The stated thermal resistance(R-value)is provided by installing in accordance with the manufacturer's
recorrmiendations,Knauf Batts&bla�ikets will provide instructions,the required number of bags per 1,000 sq.ft.of net area,at not less thul the labeled minimum
the full R-value. thicltness.Failure to insfall both the required number of bags&at least the ininimum thickness will result
in lower insulation R-value.
_ , _. . ... _ _ �
_ _ _ _ _ __ _
R-Value Minimum Thick�iess R-Value Ba�s/],000 sq.ft. Maximum Covera�e Minimum Wei;ht Minimum 7hicl��ess
To obtain a�t Installed insulation To obtain an The mimber of Contents of tl�is bag The Weight/SF of Instatled insulation
insulation resistance should not be less insulation bags/1,000 SF of net should not cover more installed insulation should not be less
R-Value of. than: resistance area should not be dian: should noi be less than: than:
(R-Value)of
R-38 IID :0.25" R-60 29.; 33.6 SI' i 9521bs. 19.750"
R-38 12.00" R-49 23.5 42.5 SF .7531bs. 16375"
R-30 HD 8.25" R-44 20.9 47.8 SF .6701bs. 14.875"
R-30 10.00" R-38 17.8 56.2 SF .5691bs 13.000"
R26 9.00" R-30 13.6 73.3 SF .4371bs 10375"
R-22 6.50" R-26 11.8 85.0 SF .3771bs 9.125"
R-21 HD 5.50" R-22 9.8 102.2 SF 313 lbs 7.750"
R-19 6.25""'` R-19 8.4 119.3 SF .268 Ibs 6.750"
R-15 HD 3.50" R-13 5.7 175.3 SF .183 Ibs 4.750"
R-13 3.50" R-11 4.7 210.8 SF .1521bs 4.000"
R-ll 3.50" Bag Weiglit-Nomina130 Ibs,Minimum 29 Ibs.This product conforms to the perfocrnance requirements of ASTM C 764,
R-8 2.50" Type 1,&cancelled Federal Specification HH-I-1030B,Type 1,Blass B.R-Values are determined in accordance with
"`R-18 in a 5.5"cavity.Conforms to ASTM C 687&C 518."R"means resista�ice to heat flow.The higher the R-value,the greater the insulation power.To get the
C665&Federal Specification HH-1-521F inarked R-value,it is essential that the insulation be installed properly.Tf you do it yourself,get instructions&follow them.
To achieve labeled R-value,this product must be applied with a pneumatic blowing machine&a corrugated hose with a minimum.25"intemal corrugation,a minunum lenb h
of 150 ft.&a diameter of at least 3".Coils in the hose should not be less than 36"in dianleter.Acceptable material feed rate is 5-351bs./minute.Recommended feed rate is
15-25 lbs./minutes.
Builders Insulation�tatement.
Batts a�zd/or Ulankets have been installed in conformance with the above 2009 WSEC Residential Ener�y Compliance Certificate-Buildin�Air Leakaee
recommendations to rovide a thermal resistance of....
R-Value Sta��dazd Building&Test Condition: Comments:
Attic Area R- R-49 Date: •�, �l
Ext.Walls R- R-21 Time
Inter.Walls R- R-ll Indoor Temp: 10
Sprinkler Tenting R- R-8 Outdoor Temp:
Knee Walls R- R-21KF Floor Area(sq ft)
Under floor R- R-30
Completed as of: "6 �� �.3 �uildinQ Air Lealcaee Tar2ef: SL�S.Less Than 0.00030
Installers Name Print _ ______ Test,#1-Depress___ )(,_ .Press Pretest Baseline Pressure (Pa)
Installers Name Sig�
�ress.(Pa Flo�v Ring Fan Press.(Pa) Flow(cfin)
/ ,/ L1 �� O � � O
Site Address: �.Lj�3`� �`�l-A► �l f l-G( r
�G`� n�C (, � Post Test Pressure: Fan ModeUSN: I(.[,(a�Q1 ��J
..� 7 '1
Results:SLA(Specific Leakage Area): . ��ZQ'/`E'.�� /4�
Home Builders Signahtre: Test#2-Depress Press Pretest Baseline Pressure (Pa)
Home Builders Address:
Bldg Press.(Pa Flow Ring Fan Press. a) Flow(cfm
Insulation Contractor: Insulation Northwest LLC
Post Test Pressure: Fan Model/SN:
P.253-846-0121 P.O.Box 732069
Results:SLA(Specific Leakage Area):
F.253-846-8096 Pu allu WA.98373
Affidavit: I certify that this Specific Leakage Area is accurate&determined using Blower poor Test Standard 502.4.5 Building Air Leakage Testing.
Technician Name Print: ��1.� Technician Name Sign: ��!',�r1/x�
�` i33��//�3
��� �`'��cxc�c�� �S�
C� �
� II • � �
�� . �.
�. ��� '� �
,� - �°
Duct Leakage Affidavit (New Construction)
Permit#: �� �� d � � /
House address or lot number: /�� ���i�� ��� ��
_
��tY: y�/� Z�p: ���'� 7
Cond. FloorArea(ft2): ���Z- Source (circle one): Plan � Estimated Measured
❑ Duct tightness testing is not required.The total leakage test is not required for ducts and air handiers located
entirely wifhin 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? �yes � no
=�
Circle Test Method: Leakage to Outside otal Leaka
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
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Test Result: �; CFM@25Pa
Ring (circle one if applicable): Open 1 2' 3
Duct Tester Location: `�� Pressure Tap Location: . ,� �1��r''�'.�� �`'�- �`+
1 certify that these duct leakage rates are accurate and determined using standard duct testing protocol.
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CompanyName: ����%;>'?''���/ ��✓..� Technician: �`�';�,��i'-771�.�2
Technician Signature: i�
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Date: ��1���/���
Phone Number: ��J � `�J� ��
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