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HomeMy WebLinkAbout639 Stoneham Ct - Miscellaneous - 01/20/2000 (2)Fort Collins residential energy code 7196 Insulation disclosure form Job address: General contractor:-- 1_ Insulation contractor: Insulation . ......... .. . Location Materia s Thickness Rated Location ....... . ... R-value Int I ext Notes Flat or vaulted ceilings with attics above. Ceilings wl(h enclosed rafter cavities Frame walls and rim/band Joists —to exterior Frame walls and rim/band Joists — to attic, garage "3 �Qm Frame floor - cantilever Frame floor - over garage or crawlspace 3 _Y4 94— Slab-on-grade (0-12") Crawl space walls q Iki Basement walls ....... .. ... . .. ..... . .. ..... . .Certificatf.. .. .......... on .... ....... ...... ..... I/We certify that the above -listed Insulation was Installed In the building at the above locations In conformance with the current requirements of the city of Fort Collins Residential Energy Code, and that R was Installed In accordance with - the applicable "insulation Installation Guidelines" published by the city of Fort Collins. j Certified by: Phone: Business firm: 110A4A_5 Date, Address: Signature: .............. .... . ... .... ...... ins't*rLictions:.%.'.' ... ..... . ........ . I_- .............. .... ..... ... . ... ... . .. . ... .... . .. .... .. ........ ... ... %' ............... .... ...................... .. . 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. It components vary, make multiple entries to describe them. One copy of this form shall he provided to the Building and Zoning Department at final Inspection. One copy of this form shall be provided to the homebuyer.