HomeMy WebLinkAbout4226 ROLLING GATE RD - DISCLOSURES - 6/21/2006 (2)Jun 21 2006 9:15AN COLLINS CASHWAY 9706132004 P.1
Fort CoMns Rasidofttlel ErwrSy Code
INSULATION DISCLOSURE FORM
the building 4 zoning dept. of
Clommunily Pimping and Fnvlronrnsrrtal Sarvioes
2M N. Coleps Ave., P.O. Soot No, Rat cows, Co S0122
Vsbe: a70 221 0700 FAX 970 224 0134
Job address: J .zx(o
General contractor. A4*•S"'7— C�i�YJ ire T7b •'
Insulation oontraotor: C"47101.1 ,'s e'A'+eov
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This disclosure farm Is to be signed by the insulation writrador or repmentstiva of tM gsrteral oontr;5.;,:i::i?;^
contractor,
Plesse type or print, ox*W for the signature, tsOIMIste the information In the appropriate spaces provided.
N components vary, make muitlpte w&W to describe therm.
Ona copy of this form must be provided to the Building and Zoning Department prior to the C.O.
One copy of this farm must be made avalisbia to .tire Original home buyer,
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Location MatsrW s
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Thicknen R�u . tint I arh Notes »
Flat or vaaltad cellinpa
With ataes above
K/
Ceilings :7oriellosed
tartar navitles
s
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Frsmew>tlla and r1mrmed
Joists — to extarlar
Frams walls and rimAwrW
J0154 — to attle, garape
Frame noor . cartriiever
From 1r00r . ppp garage or
crawl space
atab«o•grad. to.1r1
0rrW1 space walla
eas meM walla
Me �y that the m i� � l � f/ it Ili BrN.....hH.Y.845.45s9L 5R5YR5 ::m:.: • • .::nC::..:•.51.:. i1;'l l.:y:
Idktp at the above locations i'► acnrarn once Wier the otorrnist r quireor»rrte of y,,
Fort Collins Residential Energy Cods, and that It was ktstalnd in aneordanAs With the "inwhpon OuidalMas` pWWI&Wd by the city of Fort Dattre.
Person Certifying Job:
r!C &1'►'t I "?
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Address: ';iqv $44.JiOi9f9y PC,
CAW PZA�"'° ti 4�) VPS 3-? Phom: r