HomeMy WebLinkAbout439 Peyton Dr - Disclosures - 12/10/2003Fort Collins Residential Energy Code the building & zoning dept. O f
INSULATION DISCLOSURE FORM 1nsdlsc2ad, - mores 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
Job address-
P61 401�r.
General contractor:
Insulation contractor:
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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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Location
Mellor vaulted ceilings
Materials
Thickness
Rated Location
R-value Int / ext Notes
With attics above
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Ceilings with enclosed
railer cavities
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Z
Frame walls and rimthand
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Joists — to exterior
Frame walls and rlmlband
Joists — to attic, garage
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Frame floor - cantilever
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Frame floor - over garage or
crawl space
IN
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slab -on -grade (0-12")
Crawl space walls
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Basement walls
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VWe 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:
signature:
Business Firm:
Address:
Date: /0 e
Phone: - Lk _/ -