HomeMy WebLinkAbout1202 Bordeaux Dr - Disclosures - 11/11/2003 (2)Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
tns&scZY1z — 7110195
Job address: 1 oZdt� Ebrle4u
General contractor: `L-5
Insulation contractor:
K
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the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
INSTRUCTIONS`;:...
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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.
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Insulation
Rated Location
Location Material(s) Thickness R-value (Int / ext) Notes
Flat or vaulted ceilings
with attics above
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
Frame floor - over garage or
crawl space
Slab -on -grade (0-12")
Crawl space walls
Basement walls
s
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Certuficaflon
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IlWe 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 Nal it was installed in acccirdance with the "Insulation Guidelines" published by the City of Fort Collins.
Person Certifying Job: FVtQ it
Signature:
11 i Date: 11 It 03
Business Firm: llt �V1rjV�I0.'ttOr�
Address: I� I r� Ge tJQ�lp�ct / r�
Phone: / p (n of - 9011