HomeMy WebLinkAbout2126 Chandler St - Disclosures - 07/01/2004 (2)Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
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Job address:
General contractor:
Insulation contractor:
Z
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Brno 580, Fort Collins, CO 80522
Vacs: 970221 6760 i FAX: 970 224 6134
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INSTRUCTIONS
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.
Insulation
- -
Location
Fiat or vaulted ceilings
with attics above
Materials
-bieet
Thickness
Rated
R-value
3
Location
ant / ext) Notes
Ceilings with enclosed
rafter cavities
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Frame walls and rim/band
joists - to exterior
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e
Frame walls and rim/band
joists - to attic, garage
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Frame floor - cantilever
Frame floor - over garage or
crawl space
Slab -on -grade (042")
Crawl space walls
Basement walls
Certification
INVe certify that the above -listed insulation 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 Fort Collins.
Person Certifying Job:
nature:
Business Firm:
Date: 7 -1--' 1
Address I D G • /1? a ,� /� ..v : cL ' 1
6rltP a pta a u di llatu K/do �1 oll l Phone: Yd j 7�� - S/% f)0