HomeMy WebLinkAbout7220 Randolph Ct - Disclosures/Insulation - 04/18/2005Apr 18 2005 10:57SM HP LRSERJET 3200
Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
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Job address:
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the building all zoning dept. of
Community Planning and Environmental Services
291 N. College Ave„ PA. ems, Soo, Fort Collins, 00 SO=
Yobs: 9'M 2216760 FAX: M 224 0134
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General contractor: (AS Ho m e
Insulation c/ontr}a�c�k�w: a LLMS,
iN''{-kt�sil ,t}y
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This disclosure form Is to be signed by the insulation contractor or resentative of the ...en ~.:l c ra » ::'
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Please or nt exce for the s nature. general contractor.
type Pn � except i0 Complete the information In the appropriate spaces provided.
It components vary, make multiple entries to describe them.
One copy of this form must be provided to the BuNding 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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-Locationd"
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Msterla s
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Thickness
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Ldcatlon
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fJotas
Flat or vaulted callings
with attics above
84002
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C 011hps with enclosed
rafter cavities
Frame walls and rbalhend
joists — to udertor
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Frame• walls, and rlmiband
joists — to attic, garage
Frerme noor - car}ftlever
y,
Frame floor . over garage or
crawl span
Slab-o"rade (o.12"q
Crawl space walls
Baseraaat walls
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IIWe eartify that the a6ow•1ia�d Insulation was�lrtstopsd h the txOldhp •at the ebarr locations ih eorilorrMiie� with :.....��the :. ......a.,, --,... ...........:.....of .. the-
Fort Count Reslden>iel Energy Cods, and tlsrt k was inaWled In award* wkh the In
(Lilo Knee' pubttshed by e,h tCity o� ins.
Person CerUfylrlQ•.%b: 1�a"�110100-1p". eAAF E
Date: T