HomeMy WebLinkAbout1321 Saint John Pl - Disclosures/Insulation - 12/08/2001VVl LV (-WWI 111V lV•v1 •••• ----'-
Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
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Job address:
Generall contractor:
the building dt zoning dept. of
Community Planning and Environmental Services
291 N. College Ave,, P.O. Bas 580• Fort Collins, Co 80522
Voice: 970 Q21 67M FAX 970 224 6134
Insulation contractor:
................ ...........•:: ......... .........
.........., ........ ,...
1NSTR:CTiONS, ;::.:
This disclosure form is to be signed oy there
insulation contractor or repser.:ative of the general contrac'ar.
?,ease type or print, except for the slgnature_ Cornplete the information in tie ap;roprizte spaces provided.
If crmponenta vary, make multiple entries to descrioe them.
Cne 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.
... .:
[nsUlitio
Location
Flat or vaulted ceilings
with attics above
Ceilings with enclosed
rafter aavities
game wails and rimlband
Joists - to exterior
Frame walls and ►Imlband
joists -to attic, Qarage
,—r ame floe( - cantilever
Frame floor - over garage or
crawl space
slab -on -grade (0.121
Crawl space walls
easement walls
:. :.Y:l.: :•.::.: :
I+ f ` Rated fl R-value
NotesLocation
(s) Thickness
I (.Ili,"
N.
4 I Rfi PS
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C• a i�lf f C 3t:1 O R:........`.,.;:9air...'. :::c::•:i:S:i: }::•}::?::Zvi•): ��;:;•;:i�:.`:............:::i..-............,J.::err::::::::
Me certify that the above -listed insulation was installed in the building at tie above loattons in conformance with the c anent requirements of die
Fort Zallins Residential Energy Code, and that h was Installed In a000rdanee with tne'InsulAon Guidelines' published by the City of Fort Collins.
Person Certifying Job: " s r r -J) IV n
SI nature: 1 Date:
Business Firm: ,etc[ i +rfo
aooress- ►� ...1•
Phone: