HomeMy WebLinkAbout1745 Fossil Creek Pkwy - Disclosures - 01/23/200401/26/2004 07:34 9702232599 LINDEN PARK CENTEX PAGE 02
Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
snsaqwZAL- —'PI-1 CUSS
Job address:
General C:0ntT2&,0r
-t--b I v ( �7 Lf '5- C-L
the building & zoning dept. of
Community Planning and Environmental Services
281 N. Ca-flege Ave., P.O. Box 5410, Fort Ccilins, CC 8C!=
Voice: 97C = 67E0 FAX: 970 22A 6134
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Insulation r-ontr2&tur-, tQTIorV
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Is dis;:!Qsure form is to be signed by the insulation ccontra&or arra.:rese"Itadve C"'he ::'e'nar-al*'cL,*,-,t',-'a*-t*o'r ............ .
Please type or print, except
ot for the signature. Complete the informazion;r, the apprcor-fare spaces --rcviced.
Jf Components vary, r-,zke rnuttiole entries to desc."be them.
One copy of this form, must be provided to the i2wilding and Zcninc:-`eoRr,ment prior to the C.O.One =py of this form must, be made ZVM12ble to the Original horne bwver.
,A Hs:61 .;:;65-
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Location
Fiat or vauftea ceilings
with adios above
Ceilings wi-,.l enc!ospd
rafter cavities
Frame walls and rim/bard
joists — to exterior
Prarne walls and dr-whand
joists — to attic, garage
Frarne floor - =ntllevef
Frame floor -over garage or
crawl zPar-e
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1111117.11.1'.. . . . . . — . S... . .. ... . ... .... ............................
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Rated Lec2tion
2terial(s) T '- -,' (*a" i u- n t / ex:) Notes
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cert-'if 1,ca'ti**6'ii.'.,.'."-.*.�..*..-,-,.*.-*..,.*.�,.*�.'-'�,-�'-'.'-'.'-"-*-*.,.*-'.'-*---."*,*.****"*"",*,*"",:=""*,.* .........
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e- ce'r'afy nsu=cri was installed in the DUking 2-, !he st�--ve locatcns :r wil&, t!�e curreril, necuirarner%='c" :.'a
Port Collins Residential =_ne.,gy Code, and 112" it was jrs';311ed in z==F,-:Zr-ce 'M'`i the "Insuiadcn Guice;ines" wubiisheti by the City of For, C--;i:ns,
Person Certifying
Signature: 22,3'oLl