HomeMy WebLinkAbout620 Agate Ct - Disclosures - 07/26/2001Fort Collins Residential Energy Code the building &zoning dept. of
INSULATION DISCLOSURE FORM Community Planning and Environmental Services
1nsd=2ads - Maass 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
Job address: t2 zo . II 1' 6, t�
General contractor: �/ HbA4&-S 7:Mr+
Insulation contractor: A�r�[1 "C..ry aT7nwl.
INSTR,U&IONS
This disclosure form is to be signed by the insulation contractor or representative of the general contractor.
Please type or print, except for the signature. Complete the information in the appropriate spaces provided.
If components vary, make multiple entries to describe them.
One copy of this form must be provided to the Building and Zoning Department prior to the C.O.
One copy of this form must be made available to the original home buyer.
Lt15u1atiort _ _
Location
Flat or vaulted ceilings
with attics above
Materials
Thickness
Rated Location
R-value Int / ext Notes
_
r
Ceilings with enclosed
rafter cavities
OUAlt sr
13 r/
R_
Frame walls and rim/band
joists - to exterior
Spt4l MA& I Lh -
r
Frame walls and rim/band
joists - to attic, garage
r
Frame floor - cantilever
f
Frame floor - over garage or
crawl space
/!
Slab -on -grade (0-12")
Crawl space walls
i
Basement walls
I
C@rtiflCatlofi
I/We certify that the above listedinsulation was installed in the building at the above locations in conformance with the current requirements of the
Fort Collins Residential Energy Code, and that it was installed in accordance with the "Insulation Guidelines" published by the City of Fort Collins.
Person Certifying Job: JERIA M 14 ,)
Signature• Date
Susiness-Firm:- ; i!%��a:-.�: