HomeMy WebLinkAbout2635 Geranium Ln - Disclosures/Insulation - 06/13/2016��►rj� City o((l�0 1�(( Ip+ g��qy nur_�ex�, u^v¢w�m:�sx ut rrarr}art rliioa
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Residential EnergV Code Insulation Disclosure Form
Job Site Address. _21d b4leo r/ovm voe
.. Permit it 131,.��,�
General Contractor: ----
Mechanical Contractor, -
This disclosure form is to be signed by the mechanical contractor or representative of the general contractor, release type of print
legibly, except for the signature.
If there are multiple systems serving any function, make multiple entries to describe thern•
One copy of this Will must be provided to the Building Department prior to C.0_
One copy of this form must be provided to Iho original home buyer.
hfat or vaulted ceilings
with attics above
if3F.*�'tiB 5 f/
M,
Ceilitig with enclosed
rafter cavities
Frame wall^, tip---------
Hav'band joists - to
exterior
Frame walls
dni/band joists.- to
attic, garage
Frarne floor -
cantilever
Frame Floor- over
garage or carwl space
7 �/
Slab -on -grade (0-12")
Crawl space walls
Basement walls I - `
R-Valua _SfnbExt Note
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N/A
N/A
N/A
N/A �G
N/A I?
.� 7 N/A
/Z- 19
•Certification
f/We certify that the above -listed insulation• was installed in file building at the above locations in conformance with the
requirements of Fort Collins Residential Energy Code and that it was installed in accordance with the "Insulation Guidelines"
published fey -the City. of Fon Collins.
Person Certifying Job: -( L,4
-----
13usinoss Firm: _ 1/ -G, �p���s
-----_ _ Phone: ��� z.
Address: J OC) i0 -- — 0�,_
UtA S
Date: