HomeMy WebLinkAbout2832 Outrigger Way - Disclosures - 10/20/2003Fort Collins Residential Energy Code the building & zoning dept. of
INSULATION DISCLOSURE FORM Community Planning and Environmental Services
inscimcZxis — 711 OM8 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
Job address: 21b 57- Cu T- q-t&G Ra-
General contractor: U
Insulation contractor:
Jt .. TI
... . . .....
.NSTR.UCONS�'.'.'.*".'.'.*'.".-'.'.*
......... ................. ......................... ................................................ ........
. ..... ........... ....... ....
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.
..... ..*.:..".%".'ii ......... .............. .............................. ............ ........................ .............. . ........
....................... .....
........ ........... .............
....: .....
......
... ........ ..h�u(aon
................::......................................................................... ....... .. ........ ........ ......... ....•
..... .Rat d Location
Location Material(s) Thickness R-value
Notes
Flat or vaulted ceilings 7
with attics above 12V, I r)
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists — to exterior
Frame walls and rim/band
joists — to attic, garage
Frame floor - cantilever
[a]
Frame floor - over garage or I
crawl space (Jr IIII, I P— 1:
Slab -on -grade (0-12")
Crawl space walls
Basement walls
.... .... .... .. .. . ........ ....... .. . ........ . .. .. . ..... .. . . ........... ...... .... .. ...... .... ...................................................
................. ... .......... .......... . . .... ........ ............
............. ...... . ..... . .... . .. .. . . ..... .. .. .. ................ .......
.. ....... . .... ................ * .... .......... .................. ......... ........................ .............. . .. ....................
................ ..........
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
Fort Collins Residential Energy Code, and that it was installed in accordance with the 'Insulation Guidelines" published by the City of Fort Collins.
Person Cert1A4rrq-JDb: 3 (L Ay.
V (
Siqnature:
Date:
-03
Business Firm: C--wffVLMIO-v
Address:
Phone:cf(cz- 144/