HomeMy WebLinkAbout1015 Andrews Peak Dr - Disclosures/Insulation - 09/13/2005Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
insdisc2jds — 7M OM
Job address:
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
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.
Insulation
Location
Material(s)
Thickness
Rated
R-value
Location
(Int / ext) Notes
Flat or vaulted callings
with attics above
l na
Ceilings with enclosed
rafter cavities
5
Zc�
Frame walls and rim/band
Mats — to exterior
Frame walls and rim/band
joists — to attic, garage
Frame floor - cantilever
, u
Frame floor - over garage or
crawl space
«
R `
Slab -on -grade (0-12")
Crawl space walls
Basement walls
Certification
IMe certify that the above -listed insulation was installed in the building at the above locations in conformance with the current requirements of the
Fort Collins Residential Energy Code, and that it was installed in accordance with the "Insulation Guidelines" published by the City of Fort Collins.
Person Certifying Job:
SignatureDate: 0v---
Business Firm: mac"
Address: 1ol�cl►
Phone: