HomeMy WebLinkAbout105 Coronado Ct - Disclosures - 05/29/2003 (2)MAY 29 2003 2:59PM HP LASERJET 3200
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'Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
w,"m2ift - 711 OM
the building & zoning dept. of
Community Planning and Environmental Services
281 14. College Ave., P.D. Sor 5W, Fort Collins, CC go-c=
Voice. 970 221 671M FAX: 970 224 6134
Job address: carfortesch C+. 41l
General contractor,
Insulation ccintmetor- MAsoLpkpe,
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This disclosure form is to be signed by the insulation contractor or representative a'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.C.
One copy of this form must be made available to the original home buyer.
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Location
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Material(s)
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Thickness
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C&eaticn
R-value (Int I ext)
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Notes
Flat or vaulted callings
with attics above
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists — to exterior
Frame walls and rim/bard
joists — to attic, garage
Frame noor - cantilever
Frame floor - over garage or
crawl space
Slab -on -grade (0-12")
Crawl space walls
Basement walls
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certify that the above -listed insulation was installed in the building at the above locations in ccriforniance with the current requirements of the
Fort Collins Residential Energy Code, and that 0 1, t was installed in ac=rdance with the 'Insulation Guidelines' published by the City of Fort Collins.
Person Certifying Jo
5
Business Fi
Date: -6-1--zllas
Address: Cie-yelild
Phone: