HomeMy WebLinkAbout3102 Chase Dr - Disclosures/Insulation - 04/18/2013Fort Collins Residential Energy Code Neighborhood & Building Services
INSULATION DISCLOSURE FORM 281 N. College Ave., P.O. Box 560, Fort Collins, CO 60522
in:mu2,ds-7r10198 Phone: 9702216760 FAX: 970 224 6134
Job address: ? es d Se �✓ • l�n r t'�/M� r 7 i� V ��UJ�la
General contractor: /dam f L!e3//Lin S mh, i?)1-
Insulation contractor i�1 f7i !� 2n 5[s/a 7f cn�
INSTRUCTIONS
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 forth must be made available to the original home buyer.
Insulation
Location
M1. aterials
Thickness
Rated
R-value
Location
Int I ext Notes
Flat or vaulted callings
with attics above
Ceilings with enclosed
raker cavities
�� / J
r
• ZO• 7
AlkA 7 - g
- i6
7
Frame walls and rim/band
joists - to exterior
-
R -
I �r
_ -
Frame walls and rim/band
joists - to attic, garage
Frame floor - cantilever
Frame floor - over garage or
crawl space
Slab -on -grade (0.12")
Crawl space walls
�OL10 10-
D
Basement walls
Celt ,98U0lt
Me certify that the above -listed insulation 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: �y C „H
& //jam/ in s Cp 20 q Z (', Phone: 170 - �/v 9 -/36 3