HomeMy WebLinkAbout6802 NIMITZ DR - DISCLOSURES - 11/1/2009Fort Collins Residential Energy Code the building & zoning dept of
INSULATION DISCLOSURE FORM Community Planning and Environmental Services
nsd sc2 a - mores 281 N College Ave P O Box 580 Fort Collins CO 80522
Voice 970 221 6760 FAX 970 224 6134
Job address ¢ 02 rl) Irn / 7 -;� {fir ur1 t 1 b) D3
General contractor CA/r i (pF i
Insulation contractor �;, �I/n c, C fi S� iAG , IA6,,/ e4 t uy)
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
Location
Flat or vaulted ceilings
with attics above
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists — to exterior
Frame walls and rim/band
joists —to attic garage
Frame floor cantilever
Frame floor over garage or
crawlspace
Slab -on -grade (0 12 9
Crawl space walls
Basement walls
Rated Location f
Material(s) Thickness R value (Int / ext) I Notes
,m
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 tha it was Installed in accordance witn the Insulation Guidelines published by the City of Fort Collins
Person Certifying Job
nature
Business Firm 1
Date I I I -
Address Zci(-) %�I." n plcr.2