HomeMy WebLinkAbout308 N Grant Ave - Disclosures/Insulation - 04/23/201223. 2G12 i:21PM 9706672971
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Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
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Job address: " DUS
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave.• P.O. Box $60, Fort COltirm CO 805
Voice: 970 221 6760 FAX 970 224 6134
General contractor.
Insulation contractor: 17aL o J�1p
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.
It 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 ropy of this form must be made available to the original home buyer -
Insulation
Flat or vaulted ceilings
with attics above .
Ceilings with enclosed
raster cavities
Frame walls and rimlband
io'ists — to eaterfor
Frame walls and rimlband
joists - to attic, garage
Frame floor - cantilever
Frame floor - over garage Or
crawl Spec*
Slab -on -grade (0-12')
Crawl space walls
Baeemerd walls
Rated I Location
i- '/ 14- 3 s
Notes
cer"Ciation
VWe certify that the above -listed insulation was installed in the building at the above IOC2tion9 in conformance with the current requirements of e
Fort Collins Residential Energy Code, and that it was installed in accordance with the Insulation Guldefines' publisned by the City of fell Collins.
Person Certifying Job:
Business Firm:
fd
Address: 9i✓/a "0/
Phone: