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20130318 Permit Pkg 09172013 - ��p� TH�A�� City of Yelm Permit No.: 20130318 7 � � Community Development Department Issue Date: 9/17/2013 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 L 14i �"'""�'" Fax: (360)458-3144 Applicant: Name: PUGET SOUND BUILDERS ASSOC Phone: 253-202-5025 Address: 11012 CANYON ROAD E, STE. 8 PUYALLUP WA 98373 Property Information: Site Address: 14401 98TH AVE SE Owner: PUGET SOUND BUILDERS ASSOC Assessor Parcel No.: 78640120000 Subdivision: TAHOMA TERRA Lot: 200 Contractor Information: Name: PUGET SOUND BUILDERS ASSOC Phone: Address: 11012 CANYON RD E, STE 8 PUYALLUP WA 98373 Contractor License No.: PUGETS6903MH Expires: 7/31/2013 Project Information: Project: NEW RESIDENTIAL BUILDING Description of Work: LOT 200, PLAN 2045AC Sq. Ft. per floor: First 1058 Heat Type(Electric,Gas, Other): GAS Second 1320 Third Garage 619 � Basement Fees: Item Contractor Fees NEW RESIDENTIAL BUILDING PUGET SOUND BUILDERS ASSOC $16,832.39 MECHANICAL KLIEMANN BROS. $ 7g.25 ( PLUMBING RAINIER VIEW ROOTER $ 125.00 TOTAL FEES: $17,035.64 ApplicanYs Affidavit: OFFICIAI USE ONLY I certify that I have read and examined the information contained within the application and know the same to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints: Yelm regulations including those governing zoning and land subdivision, and in addition,all covenants, easements an restrictions of reco d. If applying as a contractor, I further certify that I am currently Final Inspection: registered in t State of Washin n. Signature Date �� Date: Firm � ,� "^ �'� By � �� YELM COMMUNITY SCH OLS LOCAL RECEIPT DATE ' � 20 �� Received from �� " � � �� 0(� � , � .,��;�.�,- FOR D � � �LLARS AMOUNT CASH CHECK � ACCOUNT CODE �� j'\` � /� .I l�� - �� (J� YELM COMMUNITY SCHOOLS By =/�, Cit� of Y�lm (36 ) 458-8402 REC#: 00139267 9/1712�13 11 :53 AM OPER: Ln TERM: 001 �EF#: 7807 TRAN: 33,OG00 BUILDING PERMrTS 20i30318 17,035.64CR PUGET SOUND BUILDERS ASSOC 14401 98TH AVE SE BI�D-RES1 16,832.39CR MECH 78.25CR p� 125.00CR TENDEREq: 17,035.64 CHECK APPLIED; 17,035.64- CHANGE; W� O.QO �� PUGET SOUND BUILDERS ASSICIATION, LLC TAHOMA TERR.A 14401 98th WAY SOUTH EAST 'YEI�M,WA 9859Y PARCEL NUMBER: Y8640112000 50.01 ' �� - - - - I � 5' 40'----y 5, i � � � I I `V _ 20' BSBL �J 4'x10' PATIO `� DRY WELL � � �� ❑ I I I � � � I I °' �, W N a I � `� m � ° z � ° � N i � � N °° p ° � -� ° �ml (V p — � cn � a� � `c'I o �w '' � o I�n � � � �I � v Z �' �' EAVES ENCROCHING � II �� 10' I � INTO 5' SETBACK MUST HAVE A IHR FIRE I I - COVERED I � RATING I ((j PORCH I �— _ _ 6�X8��, � 20 BSBL — °� °O YELM STEP �,, � DRIVEWAY 2 ,L — . � TANK N 4 �—'� 7�—� >> � ( I 10 UTILITY EASEME T��',�. I `� SIDEWA � SO.00T �' CARSON � ,...,� PLANTING j 24'--� � ��e0X (�- -� 1 i._ � � im+�. .,:,..�. WATER -' ��' - METER 98th �/1/�QY SE TULIP TREE ��r�,,,-, ;��t-��=(� _ � = — — — � /� �� ,;��, �� NORtN cQ2013 51-�cr�Jesiqn 253 531 15�1 1008 5 IZlst Street f'arkland,V✓A 9844-I �'jG,Q,�� ' = 2(�' DRAWMa DATE: REYISIGN DA7E. REVISIGN DATE: INIT: PROJECT". 8-1-1m13 B-1-7013 8-3i4m13 JL5 PSBA-TAHOhIA TERRA �ol�o�l J CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM }'}L� 'W c._�S Ir- parcel#:_`.7�V� � ��_. f'roject Address:��Q.� � ,- + � , Subdivision:�G�►l;�'��a j-�fYw Lot#:,�„��__ Plan#:��15�C__ Zoning: �New Construction i � Re-Modei/Re-Roof/Addition � : Home Occupation Sign ! Plumbing �.� Mechanical ��; Mobile{Manufactured Home Pla.ement � '. Other Project Description/Scope of Work: ��5��.(, �r Project Value: � '��1 �� d"'-�� 3�' r � Building Area(sq.ft) 15f Floor� 2nd Floor��. Garage �� Deck Basement Carport _ Patio�_ #Bedrooms� #Bathroomsa�\�� Heating:((/ /OTHER or ELECTRIC(Circle One) � �V Are there any environmentally sensitive areas located on the parcel? If yes,a completed environFnental checklist must accompany permit application. BUILDING OWNE�t NAME: ��► " � ADD SS �I�i �rn ' S� AIL f� �. �� C�N STATE�_ZIP � '' TELEPHON •1 9� ._ ARCHITECT/ENGINEER LICENSE# ADDRESS EMAIL C�TY STATE ZIP TELEPHONE! GENERALCONTRACTOR TELEPHONE . ADDRESS EMAIL �e � ^��th CITY STAT ZIP FAX CONTRACTOR'S LICENSE# ' "b�' � 1�EXP DAT ' CITY LICENSE# PLUMBING CONTRACTOR ' L TELEPHONE � — � ADD SS EMAIL CITY ' STATE LN ZIP ' �l FAX CONTRACTO 'S LICENSE#��lLYI�"v �i ' EXP DAT CITY LICENSE# ��O MECHANICAL CONTRACTOR n ' `` TELEPHONE S3-S�"�—O °.i� ADDRESS�1�1�r,_.�^ EMAIL CITY "(41O1M4 STATE�ZIP �-�F� CONTRACTOR'S LICENSE# � l� EXP DATE1 "CITY LICENSE# —"� Copy of mitigation agreement with Yelm Communiry Schools, if applicable. I hereby certify ehat the above information is correct and that the consVuction on,and the occupancy and the use of the above escribed property w 1 be in accordance with the laws,rules and regulations of the State of Washington and the City Yelm. � �lf� f � 3 _ Ap lican 's Signature Date Qwner/Contractor/Owner's Agent!Contractor's Agent(Please circle one.) All permits are non-transferable and will expire if work authorized by such permit is not begun within 180 days of issuance,or if work is suspended or abandaned for a period of 180 days ��....�'��E� ni,ar � � a�� 105 Yelm Avenue West 45&3835 Yelm,WA 98597 I��.��•'�f AA�_:_;__--_„__M� www.ci.yel�n.wa.us Prescriptive Energy Code Compliance for Climate Zones 6, 5 and Marine 4 Project/nPormation Contact/nformation Plan 2045-2378sf Puget Sound Builders of Association 253-584-0698 This project will use the requirements of the Prescriptive Path below and incorporate the the minimum values listed.In addition, based on the size of the structure,the appropriate number of additional credits are checked as chosen by the permit applicant. Authorized Representative: Karen Kliemann, Kliemann Bros Heating Date: August 15, 2013 Climate Zone 5& Marine 4 6 R-Valuea U-Factora R-Valuea U-Factora Fenestration U-Factor� n/a 0.30 n/a 0.30 Skylight U-Factor n/a 0.50 n/a 0.50 Glazed Fenestration SHGCbe n/a n/a n/a n/a Ceiling 49' 0.026 49 0.026 Wood Frame Wall9�k�� 21 int 0.056 21+5ci 0.044 Mass Wall R-Value' 21/21" 0.056 21+5" 0.044 Floor 309 0.029 309 0.029 Below Grade Wall`�k 10/15/21 int+TB 0.042 10/15/21 int+TB 0.042 Slab°R-Value&Depth 10, 2 ft n/a 10,4 ft n/a *Table R402.1.1 and Table R402.1.3 Footnotes included on Page 2. Each dwelling unit in one and two-family dwellings and townhouses,as defined in Section 101.2 of the International Residential Code shall comply with sufficient options from Table R406.2 so as to achieve the following minimum number of credits: � 1.Small Dwelling Unit: 0.5 points Dwelling units less than 1500 square feet in conditioned floor area with less than 300 square feet of fenestration area. Additions to existing building that are less than 750 square feet of heated floor area. � 2.Medium Dwelling Unit: 7.5 points All dwelling units that are not included in#1 or#3, including additions over 750 square feet. ❑ 3.Large Dwelling Unit: 2.5 points Dwelling units exceeding 5000 square feet of conditioned floor area. Table R406.2 Summary Option Description Credit(s) 1a Efficient Building Envelope 1a 0.5 � 1 b Efficient Building Envelope 1 b 1.0 ❑ 1c Efficient Building Envelope 1c 2.0 ❑ 2a Air Leakage Control and Efficient Ventilation 2a 0.5 � 2b Air Leakage Control and Efficient Ventilation 2b 1.0 � 2c Air Leakage Control and Efficient Ventilation 2c 1.5 � 3a High Efficiency HVAC 3a 0.5 � 3b High Efficiency HVAC 3b 1.0 � 3c High Efficiency HVAC 3c 2.0 � � � � '� 3d High Efficiency HVAC 3d 1.0 ❑ � � �f� �.._1 �w.S,..d 4 High Efficiency HVAC Distribution System 1.0 ❑ 5a Efficient Water Heating 0.5 ❑ 5b Efficient Water Heating 1.5 0 1.5 6 Renewable Electric Energy 0.5 '1200 kwh 0.0 Total Credits 1.50 *Please refer to Table R406.2 for complete option descriptions http://www.ener�y.wsu.edu/Documents/2012%20Res%20Ener�v.pdf Table R402.1.1 Footnotes For SI: 1 foot .= 304.8 mm, ci .= continuous insulation, int .= intermediate framing. a R-values are minimums. U-factors and SHGC are maximums. When insulation is installed in a cavity which is less than the label or design thickness of the insulation,the compressed R-value of the insulation from Appendix Table A101.4 shall not be less than the R-value specified in the table. b The fenestration U-factor column excludes skylights. The SHGC column applies to all glazed fenestration. Exception: Skylights may be excluded from glazed fenestration SHGC requirements in Climate Zones 1 through 3 where the SHGC for such skylights does not exceed 0.30. `"10/15/21.+T6" means R-10 continuous insulation on the exterior of the wall, or R-15 on the continuous insulation on the interior of the wall, or R-21 cavity insulation plus a thermal break between the slab and the basement wall at the interior of the basement wall. "10/15/21.+T6" shall be permitted to be met with R-13 cavity insulation on the interior of the basement wall plus R-5 continuous insulation on the interior or exterior of the wall. "10/13" means R-10 continuous insulation on the interior or exterior of the home or R-13 cavity insulation at the interior of the basement wall. 'TB" means thermal break between floor slab and basement wall. d R-10 continuous insulation is required under heated slab on grade floors. See R402.2.9.1. e There are no SHGC requirements in the Marine Zone. f Basement wall insulation is not required in warm-humid locations as defined by Figure R301.1 and Table R301.1. g Reserved. h First value is cavity insulation, second is continuous insulation or insulated siding, so "13.+5" means R- 13 cavity insulation plus R-5 continuous insulation or insulated siding. If structural sheathing covers 40 percent or less of the exterior, continuous insulation R-value shall be permitted to be reduced by no more than R-3 in the locations where structural sheathing is used to maintain a consistent total sheathing thickness. �The second R-value applies when more than half the insulation is on the interior of the mass wall. ' For single rafter-or joist-vaulted ceilings, the insulation may be reduced to R-38. k Int. (intermediate framing) denotes standard framing 16 inches on center with headers insulated with a minimum of R-10 insulation. � Log and solid timber walls with a minimum average thickness of 3.5 inches are exempt from this insulation requirement. Table R402.1.3 Footnote a Nonfenestration U-factors shall be obtained from measurement, calculation or an approved source or as specified in Section R402.1.3. � = s�. � —� � � Sim le Heatin S stem Size: Washin ton State This heatinq svstem sizinq calculator is based on the Prescriptive Reauirements of the 2012 Washinqton State Enerqv Code(WSEC1 and ACCA Manuals J and S.This calculator will calculate heatinq loads onlv.ACCA procedures for sizinq coolinq svstems should be used to determine coolinq loads. The glazing(window)and door portion of this calculator assumes the installed glazing and door products have an area weighted average U-factor of 0.30. The incorporated insulation requirements are the minimum prescriptive amounts specified by the 2012 WSEC. Please fill out all of the green drop-downs and boxes that are applicable to your project.As you make selections in the drop-downs for each section, some values will be calculated for you. If you do not see the selection you need in the drop-down options,please call the WSU Energy Extension Program at(360)956-2042 for assistance. Project Information Contact Information Plan 2045-2378sf Puget Sound Builders of Association 253-584-0698 Heatinq System Tvpe: m�o�«a a�F�ma�� O Heat Pump To see detailed instructions for each section,p/ace your cursor on the wo�d"Instructions". Design Temperature inscr�cc�ons - -- --�- - - Design Temperature Difference(4T) 49 �Tacoma McChwd I� dT=Indoor(70 deg2es)-OutdoorDesign Temp Area of Buildinu Conditioned Floor Area Instructions Conditioned Floor Area(sq ft) 2,378 Average Ceiling Height Conditioned Volume Instructions Average Ceiling Height(ft) 8.5 20,213 GlazinSt and Doors U-Factor X Area = UA mstructions 0.30 320 96.00 Insulation Attic U-Factor X Area = UA Instructions �R�y'" " " " �� 0.026 1,320 34.32 Single Rafter or Joist Vaulted Ceilings U-Factor Area UA Instructions No Vaulted Ceilings in this proj�� '�I�'"+ �,32� Above Grade Walis�s�F�$�re�� U-Factor Area UA _— — —_ Instructions R-zl � '" 0.056 2,064 115.58 � .. - Floors U-Factor Area UA Instructions �;-30 " � ° 0.029 1,448 41.99 �.. Below Grade Walls�S�F�g�re+� U-Factor Area UA Instructions " --" �NO Below Grede Walls m this pro�ect. I�� -- � --- Slab Below Grade�s�F;q�re�� F-Factor LenQth UA Instructions �K'No Siab Below Grdde in this�project. I�� -- i � Slab on Grade�see Fi9�re�� F-Factor Le� UA ,�,_.-. �.�� Instructions �No Slab on Grade in this project. � �� - Location of Ducts inscr�cc�or,s - � � � -- Duct Leakage Coefficient Urxonditioned Space � �� 1.10 Sum of UA 287.90 Envelope Heat Load 14,107 Btu/Hour Flqure 1. SumofUAXOT Air Leakage Heat Load 10,697 Btu/Hour VOIUmeX O.6XdTX.018 AboveGrode Building Design Heat Load 24,804 Btu/Hour �� Air Leakage+Envelope Heat Lass Ne.....,�,... .�-�-�'�,� `"� Building and Duct Heat Load 27,284 Btu/Hour Duds in unconditioned space:Sum of Building Heat Loss X 1.f 0 DuIXS in condi6oned space:Sum of Building Heat Loss X 1 Maximum Heat Equipment Output 38,198 Btu/Hour Building and Ducf Heaf Loss X 1.40/or Forced Air Fumace Building and D�ct Heat Loss X 125/or Heat Pump � 1-_ �" � o. ', �` �,., ..;.:r� (07/Ol/13) - KL►EMANN � � . H e a��9 a n d A i r C o n d i f i o n i n g 4703— 116'h Street E, Tacoma, WA 98446 253-537-0655/253-539-3861 Fax VENTILATION AIR REPORT To Whom It May Concern: 2-3 bed 1501-3000sf requires 60cfm minimum continuous operation per Table M1507.3.3(1), 2012 IRC Intermittent Whole House Ventilation Integrated with a Forced-Air System - M1507.3.3(2), 20121RC 4hr cycle: 3hr ON� 1 hr OFF 75%run time: 60cfm x 1.3 = outside air set at 78cfm Karen Kliemann Kliemann Brothers Heating 253-537-0655 ��...._.._ � ' `p..1,"R g �/ �i'fatlW O:/WSEC Code DocsNentilation Air Report\Fan Size—4-5 bed 1501-3000-75cfm Printed 9/3/13 AFTER RECOItDING MA[L TO: Puget Sound Builders AssociaEion, LI.C' Chris Dunayski,President Thurston Gounty Trea�vl�� 11012 Can}�on Rd, STE 8 ��t'ete Exdse Tax Pafd I�� i Puyallug, WA. 98373 � �' l. Sidewalk Easement and Maintenance Agreement Reference Num6er(s) oi Documents assigned or released: NIA Grantor(s): (Last name tirst, then first name and initials) l. Puget Sound Suilders Association, LLC Grantee(s}: (Last name first,then first name amd initialsj 1. Tahoma Te�ra Residential Association • Lega�Description as follows: (i.e. lot/block/plat or section/township/range/quarterlquarter) Section 23 Township 17 Range 1 E Quarter SE TRACT L AND LOT 200 OF TAHOMA TERRA PHASE 2, DIVISION 1, ACCORDING TO PLAT RECORDED AUGUST 27, 20a8 UNDER RECORDING NO. 4p32173, AND AS AMENDED BY AFFIDAVIT OF MINOR CORRECTTON OF RECORD OF SURVEY RECORDEQ APRIL 10, 2009 UNDER RECORDING NO. 4073742, IN 7HURSTON COUNTY,WASHINGTON. Assessor's Praperty Tax Parcel/Account Number(s): 786401ZOQOQ, 78640100012 COURTESY RECORDiNG G�iL'f ho Iiability assumed by First A.me�can Title for accuracy or i��s�y ccndit�ons of t��e. 4380182 Pages: 4 n7�12J20�4 43 75 PM MULT1 "hu-;Ion l,ou^tr Wesl�ingtan FlkSf qM�.q��qPJ TI1LE Description: Thurston,WA Document-DOCID 4380182 Page: 1 of 4 ,��I ��I i ��f �I■��1■17��lfrl ��1�'��'�!� ,I II� Order: Donna Comment: 4380182 Page 2 of 4 02/12/2014 03:25 PM Thurston County WA After Recordin�,Return 'I'o: Chris Dunayski,President Puget Sound Builders Association, LLC 11012 Canyon Kd, S'I'E 8 Puyallup, WA. 98373 EASEME:VT & MAINTENANCE AGREEMENT Puget Sound Builders Association, LLC being the Owner of Lat 2�0 of Tahoma"Terra Phase 2,Division 1 , accordin�to the plat recorded August 27, 2008 under recarding no. 4032173,and as amended by affidavit of minor correction of record of survey recorded April 1�, 2009 under recording no. 407374?in"I'hurston County, Washington does hereby grant,convey and create the following permanent and perpetual easement to a�l future ow-ners of Tahoma Terra and the Tahoma Terra Residential Associatic�n (Homeowners Association) ' A sidew�alk easement for the benefit of Lots 1 through 200 anci the Tahoma Terra Residential Association(Homeowners Association)over that portion of Lot 200 described on Exhibit A. Pur�ose� The easement granted herein is for the purpose of ingrzss, egress and maintenance over, under, above, and across the property described in l;xhibit A(the"casement area") together with the right to construct, inspect,maintain, remove, and replace the sidewalk surface v��ithin the easement area. Maintenance• The Tahoma Terra Residential Association shall maintain the sidewalk located within Tract L as well as said portion located w-ithin said easement area as an all-weather surface pedestrian connection anc� pathway. Howevcr, in the cvent that the path surface is located in the easement area is damaged,the Tahoma"I erra R�sidential Association shall repair the path surface to the previously existing condition. Within the easement there may be existing utility lines which the subdi�isian as a whole (`Shared Utilit�es") and utiliiy lines which benefit each adjacent Lot exclusively ' ("Separate Utilities"j. The cost of maintenance of the Shared Utilities shall be shared equally by the benefiting Owners, including restoration of the path surface if damaged by said utility maintenance. '1 he cost of maintenance of the Separate lltilities shall be borne ; I I Description: Thurston,WA Document-DocID 4380182 Page: 2 of 4 �! Order: Donna Co�nent: � 4380182 Page 3 of 4 02/1ZJ2014 03:25 PM Thurston County WA by the Ov��ner of the Lot�vho is served by the Separate Utility in need of repair, including restoration of the path surface if damaged bv said utility�maintenance. Miscellaneous: The path surface within the easement shall be used in a manner consistent with a pedestrian access or sidewalk. No parking shall be allowed on the surface and at no time shall the easement be blocked. This Easement and Maintenance Agreement(the "Agreement}shall be construed in accordance r.��ith the laws of the State of Washington. This Agreement shall inure to the benefit of and shall be binding upon the respective successors and assigns of the undersigned. This Agreement and the benefits and obligations provided hereunder shall be deemed to be a covenant running with the land and shall bind all subsequent burdened and benefitted Owners and the Tahoma Terra Residential Assvciation. GRANTOR: Puget Soun ui ders Association, LLC �Y= Chris Dunayski,President State of Washington ) )ss. County of Pierce ) I certify that I knuw or have satisfactc�ry evidence that Chris Dunayski is the person who appeared before me, and said person acknowledg,ed that he signed this instrument,on oath stated that he was authoriced to execute the instrument and acknowledg�d it as the President/nwner of Puget Sound Builders Association, LLC to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument. ``��t��i�irt�r =�.,Me cp�tL'ti� I Date //.�/�e / � ,,...,,,,�„� i (Seal or Stam��P�'�\gr°jAa A'�`��'��"'� /�: ��GL.cl.� � D .o ., = � � �1� � %° � ��c, = p � Notary Public in� for the �tate of Washington � �'�,,�� pu8'��.1 =C�= Residing at: -' �I� �q `''��a�a1.��``�`,�� = � _I Printed Name: ��r�ii��`�;�PS��'� My Appointment Expires a D!J Description: Thurston,WA Document-DocID 4380182 Page: 3 of 4 Order: Donna Co�nent: i 4380182 Page 4 of 4 02/12/2014 03:25 PM Thurston County WA EX�IIBI'I'A F,asement Description The East 7 feet of the l�orth 20 feet of Lot 200 plat of Tahoma Terra Phase 2, Division 1 , accordin�to the plat recorded August 27, 2008 under recording no. 4032173,and as amended by affidavii of minor correction of record of survey recorded April 10, 2009 under recording no.4073742 in"['hurston County, \Nashington 1J Vi MVLV MF "��4r�� \ � �� .p.�y � ;F 100.4i �00,0! w � '.�\\� ��'� O � A + .'y I�0.01 i IQ2.� \SQ3 8�� g Q I 8��° I �� a;� � ,�ze�� :�ko,.�.^ ; � • �8 tQ'a�° 81 200�a�o iQ �a ioo.o H01 tOQD E i00.Q1� I a 4 �� ': ��N�'� ~ 2DO. 2 :s: i M O I'qOOlq'C 100.01 � N 01`AO'Q9' � ;.��Of'40'Ol7'f iG:J.pI N01'�OG�E �OO.Of ::;: , �� C7� � p 4vi L I IUS ''N 100. I . 44 I � !�J��Q � ''� R 0 I•40CkY F �t.�.. ,` p � rQ '� u p�.� f6� ::� MOf•�f0'Ob'E MQI°40'Q5'f �:< 2g � 20 ��Z b � ✓J�� I �#'� I fl0.01 � I OO.O I li:': :I N 01°40178'E . I� 28 26 N O r noq3�E � g� a�, !5! � 1?8 �� .o� Fo�,�, ,�:: � ;:;� N 0'l�AO'CH'E N o��,�� ;:: , ��a i 83 a I 98 �' i° � � �oo_oi _: �8 � �2 I �02 � �'�� f i� NOf'4008'E k41•4UJB'E �..; � � 4 !77��0 ��.o� ��.� t . ``� '� v o��+a�� N o�,oac�e E :, I p �t2 )84 ° I 97 44� i� � � I f00.4t , � o �� t � �`: >.:I �� .r�l!'� � �-�►��:':�+t�� , � MOrAOC�rf �,.�..,,.,�.. f � Description: Thurston,WA Document-DocID 4380182 Page: 4 of 4 Order: Donna Co�nent: � � � � � � g ��"�� 1._ _, ,. , ,_� � �� ; . ��' . �W ` • t 1 e t�- _�, :�. .. � r I � �� .�� Duct Leakage Affidavit (New Construction) Permit#: °�"�r� � 3 I� House address or lot number: ��y� � �� U�`� �� - City: --�r�;L� Zip: J��`�� y� Cond. Floor Area(ft2): -� �� 7 � Source (circle one): P_�� 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?��es ❑ no Circle Test Method: Leakage to Outside ��e 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 Test Result: f � CFM@25Pa ,r Ring (circle one if applicable): Open 1 3 � � Pressure Ta Location: /[Cu-!`�'S� S�� Duct Tester Location: � p � 1 certify that these duct leakage rates are accurate and determined using standard duct testing protocol. , Company Name:�� ,/�2/�� -' _Technician: SS�' �''� Technician Signature: `' �- �— Date: l 24' / Phone Number: �,�7�� .�� _ ._��„� � U � U � Q `n � � �' � � 0 � � O N � CR1 •� � � Q N � N U °-° � Q �_ o � Q � V N � � � � � N � O �+ � � � 0 � U � ^� Z � o > '�i � � U :� � � � � �v � � o- °' •�'� � � � � � � � mv c� c� ° a� � O o `'� � � "' � � � � •� L o� � � � � � o0 c � � � LLi � � q �- � .�' � '� � � � � � � ,� w LLj '� � N � � W � Qci � � � N � � Q 00 � L i � � � � (Q � � � j � Z Q � Q-� c� O °' _ � � � � � � c� � �i � p Q � oo Q w� Z � � ° � H U U J M � � p � � � WpcvQ o �' w � cn o � � � � r- M � � Q O � N Q O Q � � J U � � a Q C� cn � o � o �. � N � C � � }, O � O . . � ��tE � !n J � ;±-� (6 �„4' G -p � N � U "a U dti r�? � � � � Q- � � = Q w ►�s � Z Q � L = � � � � � c c � � c�u �� '��`� m O O m � Q c� m