HomeMy WebLinkAbout5220 Boardwalk Dr - Disclosures/Insulation - 06/03/2003JUN U3 2003 12:42PM HP LRSERJET 3200
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Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
IMeW4:.;"— Tnonis
the building (& zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 520, Fort Collins, CC 805=
Voice: 970 221 6780 FAX. 970 224 6134
Job address: 1-11 14, NJ14 eS
General contractor. Draakdi'a
Insulation contractor. A 11, ed Ti -syia d+`
I:NSTR.U:CTID[ iS:; <.:......................................................................:...._.................
This disclosure form is tc 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 `arm must be made available to the original home ouyer.
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Location
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Material s)
....._................ ....
Thickness
_........................
Rated
R-value
Lo----- catio... _- - n ------ ------------..---_.----- .................... ............
lint t ext) Notes
Flat or vaulted ceilings
with attics above
I
I
Ceilings with enclosed
rafter cavities
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Frame walls and rimPoand
joists — to exterior
JRJ
I
19
Frame walls and rim/band
joists — to attic, garage
I
I
Frame floor - cantilever
I
I
Frame floor - over garage or
crawl space
I
I I
Slab -on -grade (0-12")
I
I
I I i
Crawl spats walls
I I
I
I �
I
Basement walls
I
I I I
I
I
I
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r,:►f .-....................... . . :......
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Me certify that the above -listed insuiation was insured in the building at the above locations in ccriformanee with the current requirements of the
Fort Collins Residential Energy Code, and that it was installed in accordance with the 'Insuiation Guidelines" published by the City of Fcrt Collins.
Business Firm: A�lta� ZA.SJ !4 �►ati
Address: %1 .1 C kVe lane[
Phone: 9&2-Vol I