HomeMy WebLinkAbout426 Peyton Dr - Disclosures - 12/01/2003 (2)Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
Insdisc2As — 71101e8
Job address:
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
General contractor: rV py c "CS
Insulation contractor: rNi-i--ttz
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This disclosure form Is to be signed by the insulation contractor or representative of the general contractor,
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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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Location '
Flat or vaulted ceilings
with attics above
Materials
Thickness
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Rated Location ... .:. :::... ...:::::...
R-value Int / ext Notes
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Callings with enclosed
rafter cavities
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Frame walls and rim/band
Joists -- to exterior
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—15 17
Frame walls and rim/band
)olsts -- to attic, garage
Frame floor - cantilever
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Frame floor - over garage or
crawl space
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Slab -on -grade (0-12")
Crawl space walls
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WBasement
wallsrl
air,
3%
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Me certify that the above -listed insulation was installed in the building at the above locations in conformance with the current requirements of the
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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: IZt21 i1�• 1 �/ ,_, , ,
Signature: ''— ""-
Date IZ-I ti 7_11110�5
Business Firm:
Address: JAM 1 < 1442 1d4�L(59
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+�- Phone: ""oZ - L1( _f - - !G� f