HomeMy WebLinkAbout2850 Kansas Dr - Disclosures/Insulation - 03/04/2004 (3)Fort Collins Residential Energy Code the building & zoning dept. cf
INSULATION DISCLOSURE FORM Community Planning and Environmental Services
Voice:
College Ave., P.O. Box Fort Collins, CO 80522
7n�
Voice::970 221 6760 FAX: 970 224 6134
Job address:
General contractor:
Insulation contractor:
INS TRUCTIONS° ... .......................... :?::....................... ...... ...
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.
u wu la uvr.i :. .. .. -., ::.--:.::- .. .Location
... at .....
i Rated � oc ton
Location Material(s) Thickness I R-value (lnt / ext)
Flat or vaulted ceilings
with attics above I !
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists - to exterior � _ `ly— I �M,(
i
Frame walls and rim/band I - 1 4 '
joists -to attic, garage V ( I t
c1 XI ht I `1
Framefloor- cantilever I 0 )AW 046Y i_ i
Frame floor - over garage or
crawl space
Slab -on -grade (0-12")
Crawl space walls
Basement walls
Notes
. ..: ...:..,.:.:...:�,..,...,....:: .:._�.::..... .
Certnficafion _:.. .. . - ".:..............:.`..i::::::. . . _-
....
INVa certlry that the above -listed insuia-son 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 Fart Collins.
Person
ature:
Date: 34-N
Business Firm: A([(,F0 INSc /�-f�
Address: )Z-G'Z �
Phone: RbZ qol/