HomeMy WebLinkAbout5050 Brookfield Dr - Disclosures - 12/04/2003 (4)Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
m.d=2AS - 7nW5
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, Co Bo522
Voice: 970 2216760 FAX 970 224 6134
Job address: .67O zo atum4,or-Cz
General contractor: Chateau
Insulation contractor. Collins Cashway Insulation
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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 _ :::::::.::..::::::.:::::::.:•::.::::-:::•::•..-:-:::..,:..::.:.::...._:.::.-....:...
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Location
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Material(s)
Thickness
Rated
R value
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Location
Int I ext Notes
Flat or vaulted ceilings
with attics above
Bl ow
14"
38
Batt
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists - to exterior
Batt
M poly
Foam
Caul 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 (0-12'1
Crawl space walls
Basement walls
V1 ny
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fcatto ::. n
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I/We certify that the above listed insulation was instaAed in the bulding at the above locations in conformance witfi 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: _ Dave Ra1Tnrez
Date: /%—ate
Business Firm: Collins Cashway Insulal�l-oon
Address: 240 Barberry Place
Loveland, CO 80537 Phone: (970) 669-6043