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Cumberland County Building Inspection PO Box 102 Cumberland, VA 23040 [PHONE REDACTED] Duct Leakage Affidavit (New Construction) Permit Tax map Property address: City: State: Zip: Cond. Floor Area (ft2): 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? yes no Circle Test Method: Leakage to Outside Total Leakage 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: CFM@25Pa - total duct leakage PASS FAILED Ring (circle one if applicable): Open 1 2 3 Duct Tester Location: Pressure Tap Location: I certify that these duct leakage rates are accurate and determined using standard duct testing protocol in accordance with the Virginia Residential Code and the Virginia Energy Conservation Code. Company Name: Technician: Technician Signature: DPOR License Date: Phone Number: _ SIGN