HomeMy WebLinkAbout602 Jansen Dr - Disclosures/Insulation - 10/11/2001Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
inadiwaWs — 7110M
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: ��n�y Honl�S Zri+
Insulation contractor:
iNS�TRUCT[QNS
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.
;lilsula�ion
Location
Flat or vaulted ceilings
with attics above
Materials
Thickness
Location
int f ext Notes
—
I r 12
Ceilings with enclosed
rafter cavities
r/
Frame walls and rim/band
joists — to exterior
r f
lRated
�p —
r
Frame walls and rim/band
joists — to attic, garage
,T
I
Frame floor - cantilever
j
Frame floor - over garage or
crawl space
/r
Slab -on -grade (0-12")
Crawl space walls
r
Basement walls
certification ;
Me 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: JRRIAM ( m t , J
Signature: Date:
Business Firm: MM palZ AbA A-5
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