HomeMy WebLinkAbout2133 Blue Yonder Way - Disclosures/Insulation - 04/15/2015rk Collins Residential EneW Code
INSULATION DISCLOSURE
Job address.
General contractor:
insulation contractor: L &
Neighborhood & Building Services
28t N. College Ave., P.O. Box sao, Fort Colins, CO 80522
Phone:9702216760 FAX.9702246134
This disclosure formis to be signed by the insulation contractor or representaiiva cr a 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 l
Fiat or vaulted ceilings
with attics above
Ceilings whit enclosed
rafter cavrdas
Eiberale
Frame vralls and rimiband
joists —to exterior
U c
-
Frame wails and rimiband
iolsts—toattfe, garage
Elba=lfaa
Frame floor - cantilever
e
B201Rf-tit-
Frame floor - over &rage or
cravat space -
Slab-on-grade:t0ATI
crawl space walls
p�
f iiaeraia
Basementwelis
Rated { Location
Q, ! T icknapm ( l2 value 1 tlnt f ONO I Motes
tilde ca7tily that the above listed Insulation was installed in the building at the above locations In conformance with the current requiramerrts of the
For Collins Residential Energy Code, and that It was installed in accordance with the "insulation Guideifnes" published by the City of Fort Collins.
person Certifying Job: