HomeMy WebLinkAbout6139 Carmichael St - Disclosures - 08/13/2004FIN.%.LATION
lons Residential Energy Code the building & zoning dept. of
DISCLOSURE FORM Community Planning and Environmental Services
_ �ttiCe 251 N. College Ave., P.O. Boot 580, Fort Collins, CO 80522
Voice: OM 221 SM FAX: 070 224 6134
Job address:
General contractor:
insulation contractor:
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.
Location
Material(q)
Thickness
Rated
R-value
Location
at/ ext Notes
Fiat or vaulted tailings
with attics above
Ceilings with enclosed
rafter cavities
Frame wads and rim/band
joists — to exterior
1A
Frame wads and riMband
joists — to attic, garage
Frame floor - cantilever
Frame floor - over garage or
crawl apace
/
Slab -on -wade (0-12")
Crawl space wails
Basement wills
4 e/
I
J
i
Certification
INVe 080y, that the above-fieted insulation was installed in the building at the above locations in conformance with the current requirernents of the
Fort Collins Residential Energy Code, and that it was installed in accordance with the "Insulations Guidelines" published by the City of Fort Collins.
Person Certifying Job: l ) #1 Ar" L'✓''rS*r /7 M1
Address: �-ioo ina'ale-t-oe
Phone: d f b- S-y d o