HomeMy WebLinkAbout627 STONEHAM CT - MISCELLANEOUS - 2/1/2000Fort Collins Residential Energy Code the building & zoning dept. of
INSULATION DISCLOSURE FORM Community Planning and Environmental Services
insdfsclxIs - nlaiss 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
Job address:
General contractor: Lh.-7�.,,
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
4sR
ed Location
Location Materials Thicklue (Int ! ext}Notes
Flat or vaulted ceilings
with attics above So P l — I_?Ceilings with enclosed
rafter cavities S. �,c Mn. r✓u . �- 1 ? .R
Frame walls and rim/band
joists — to exterior
Frame walls and rim/band
joists —to attic, garage I -
Frame floor - cantilever
So"m-, MAwtl/fLLI._F
Frame floor - over garage or
crawl space
Slab -on -grade (0-12")
Crawl space walls
Basement walls
Certification
I/We 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: RRIAM brcr )J
Signature: �f— Date
Business Firm:
Address:
V1
1' LOCAL 70- Lo- 9ipb
k-ST71f1dS tCo.00 r) Phone: -y��-�3�_