HomeMy WebLinkAbout2214 Andrews St - Disclosures - 06/12/2003Fort Collins Residential Energy Code the building & zoning dept. of
INSULATION DISCLOSURE FORM Community Planning and Environmental services
insd=Zx1s — 7/1=8 281 N. College Ave., P.O. Box 580, Fort Collins, Co 80522
Voice: 970 2216760 FAX: 970 224 6134
Job address: aoff. 1y �q a
General contractor:
Insulation contractor:
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I ST.R.U. .. ............. 0 N ' S ' 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.
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....... ....... .......... : . ...... ............. ....... .................................... ................ ........... *.-..'.'.*.-.-..,.,.,.,.,.* ................................. . . . . . . .............................. .................... ....... ..... ........
Location
Flat or vaulted ceilings
with attics above
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Material(s)
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Thickness
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Rated
R-value
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Location .............................
(Int ext Notes
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists - to exterior
T7
Frame walls and rim/band
Joists - to attic, garage
Frame floor - cantilever
Frame floor - over garage or
crawl space
.
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7
PL
Slab -on -grade (042")
Crawl space walls
Basement walls
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certify that ... ... the ..... * ....... ... .... . .
6��e dinsulation w'a*"sIns"talIed in the building at the above
Fort Collins Residential Energy Code, and that it was install locations in conformance with the current requirements of to
accordance with the "Insulation Guidelines" published by a C of Fort Collins.
7da the City
Person Certifying Job:
Signature:
Date:
Business Firm:
Address:
Phone:,(Q(-' --2W