HomeMy WebLinkAbout1921 Prairie Hill Dr - Disclosures - 02/06/2004Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
irt=mcZ_%m - 7/10198
Job address:
General contractor:
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.C. Box 580, Fort Collins, CC 8C5'=
Voice: 97C _21 575C FAX: 970 224 5134
Insulation contractor: ill l� A� 1Dr�
.............................................................................................
This disclosure form is to be signed by the insulation contractor or rroresentative of the general =_rt 2=or.
Please type or print, except for the signature. Complete the information in the apprcora =_ spaces provided.
If components vary, make multipie entries to describe them. One cccv of this form, must be provided to the Building and Zoning prior to the C.G.
One copy of this fon must be made available to the original home buyer.
Insul�t�on; -. .............................. _....... .
II Rated ` Location
Location Material(s) I Thickness R-value (Int / ext) Notes
Flat or vaulted ceilings II h2-f k I Ev IN 1 F lV
I
with attics above _
Ceilings with enclosed
rafter cavities
Frame walls and rim/band %P ' �-
joists - to exterior
Frame walls and rim/bane
joists - to attic, garage
Frame floor - cantilever
Frame floor -over garage or
crawl space
Certification .:
_..... :.
IM/e ce: fy that the above -listed insuiat=' was ins afled in the building at the above locations ir c_nfcrs-ance with, the current requirements cf ,_
Fort Ccilins Residential Energy Code, and that it was installed in accordance wit the Zuiceiines" pubiished by the City cf For, Collins.
Person CeAffv m—Jcb: ' J� LV--
Signature: e� Date: (.:1r2-
Business Firm: Al(l I ft)c�,L 4T-(0ti
.Address: IZ)qZ �j , (�Qv��l�✓lL�
Phone: Q(, _qou