HomeMy WebLinkAbout5644 Cornerstone Dr - Disclosures/Insulation - 02/08/2016City of L wekwpm , a Trsa�lurtatla�
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f ' Residential Energy Code Instul tion Disclosure Form
Job Site Address: ill C 0?11If.45 >lyyt C7l •/ Permit
General Contractor.ho
Mechanical Contractor.
Instructions:
This disclosure forth is to be signed by the reached ICal contractor or representative of the general contractor. Please type of print
legibly, except for the signature.
If pwro'.aro'multiple'sydems serving any function, mako multiple entries to describe them.
Ono copy of this fomrrnust be.provided .to lho Buildfrtg Deportment prior to C.O.
Ono.copy of ;this form must be pmvidaif io the original home buyer.
Location
Muterlal(a)
Thickness
Rated
Location
Notch
R-Value
InVExt
Flat or vaulted ceilings
withatdcsabave
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N/A
up,
[ow
Ceilifhg with enclosed
rafter cavities
N/A
Frame walls &
IIRINA(Id jOIStS — tU-
exterior
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N/A
N/A
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Frame
Frame walls &
to
attic, garage
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Z
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N/A
Frame floor—
cantilever
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N/A
Frame floor— over
garage or carwl space
N/A
Slab -on -grade (0-12")
Crawl space walls
-
[3asornont walls
t4f 61411
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'Certification
I/We certify that the above -listed insulation; was installed in the 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 by the City of Fort Collins/
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Person Certifying Job: 2"d, %//ev>r.G e-!
Business Firm:
n
Address:
Phone: z26 •, [Vyo
Date:/6//G