HomeMy WebLinkAbout5050 Brookfield Dr - Disclosures - 12/04/2003 (2)Fort Collins Residential Energy Code the building & zoning dept. of
INSULATION DISCLOSURE FORM Community Planning and Environmental Services
imciw2ids — MW 281 N. College Ave., P.C. Box 580, Fort Collins, co 8022
Voice: 970 2216760 FAX: 970 224 6134
Job address: S d 0-0 9"W6 "A� aO VAJ 04 W/OVJ—
General contractor: Chateau
Insulation contractor. Collins Cashwav Insulation
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.I.NS.T..R..UCT-IONS"**""'*"'."..,.*." ..
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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
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Materials)-* ....... .. .....
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. Thickness
kai;;d
-value
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Location
Int ext
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Notes
Flat or vaulted ceilings
with attics above
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists — to exterior
Batt
3 5/811
MI PD1 Y
Foam
Caulking,
Frame walls and rimfband
joists — to attic, garage
Frame floor - cantilever
Batt
9 11211
30
Frame floor - over garage or
crawl space
Slab -on -grade (0-12'1
Crawl space walls
Basement walls
iny
Cent fi 6- ........ ; ...... ......................................................... .
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I" certify0 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:
Date: / Z — 1/— 013
Business Firm: Collins Cashway In,§Odion
Address: 240 Barberry Place
Loveland, Co 80537 Phone: (970) 669-6043