HomeMy WebLinkAbout5050 Brookfield Dr - Disclosures - 12/04/2003Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
uMi5C2.*-7Aores
Job address:
General contractor: Chateau
Insulation contractor: Collins Cashway Insulation
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
���
...............................................................
I:NSTR:U: ' CTIONS :<`
..................................................:.:::.::..._....:::::::::::::::::;.:.
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.
<is...: ':isi:`' i`' :':`: %:: is?'::i'::':5>; is? isF: :`:': `>:i ii::: ::::.`::i:::i:.. is :. :' :2:`::::?:>'::::.... . iz;?`.' =' ::::...........
nsulatton .......... .....__._ _... -
Location
Material(s)
Thickness
Rated
R-value
Location
Int I ext
.........
Notes
Flat or vaulted ceilings
with attics above
Blow
14"
--72r—
Batt
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists — to exterior
Batt
011 1 poly
Foam
U I king
Frame walls and rim/band
joists — to attic, garage
Frame floor - cantilever
Batt
9 1 /2"
30
Frame floor - over garage or
crawl space
Slab -on -grade (0-12'7
Crawl space walls
Basement walls
i ny
Ce rttfi c a tl o n:::::::::::::::::..-:.::.:::::.-::::::::.::::..:._::.::::::::::.::.::::::::::.::::::::::.......................................................................................................................
..... ....................................................................................................................:::::::::::.::
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 Certifying Jobr1 Dave
Date: / G
Business Firm: llins Cashway Insulat'
Address: 240 Barberry Place
Loveland, CO 80537 e (970) 669-6043