HomeMy WebLinkAbout6156 Carmichael St - Disclosures - 07/01/2004Fort Collins Residential Enetyy Code the building & zoning dept. of
INSULATION DISCLOSURE FORM Commwity Plats ing and F.nvUonmental Services
iad4e?.ads _ �n01ee 281 N. College Ave., P.O. BOX 580, Fort Collins, CO 80522
Voice. 970 221 6780 FAX: 970 224 6134
Job address:
General oontractor:
Insulation contractor.
INSTRUCTIONS
This disdoeure 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
Materia
Thickness
Rated
R-value
Location
nt 1 Notes
Flan or vaulted ceilings
with attics above
Callings with enolosed
rafter cavities
Frame wags and rimlband
joists -to exterior
Gil
i-
I 1 h %
e ot
M,
Franke wags and rhnlband
Joists -to attic, garage
t 04
Frame floor - cantilever
Fran floor - over garage or
crawl space
/
Slab -on -grade (0-12")
Crawl space wells
Basement wells
en V1,41
It
Certlf1cation
Me certify that the abosve4mied insulation was installed in the bukkV at the above locations in axrfarnence with the c umint requirements of the
Fort Coilins Resitientlei Energy Code, and that ft was installed in accordence with the "Insulation Guidelines' published by the City of Fort Collins.
Person Certifying Job:
7-1-o
Business Firm: ,i /Ar'w /yiYr►<c
Address: l c o'E.
Grtr m .c.o o ®(. 46) % o 90111 Phone: 36 3 - 'f f b • sa a 0