HomeMy WebLinkAbout609 JANSEN DR - DISCLOSURES - 1/9/2002 (4)[Fort Collins Reside
ntial Energy Codethe building & zoning dept. of
SULATION DISCLOSURE FORM
insdisc2.zls -• 7/10/98 Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
Job address: (Cpq �
General contractor: ��r ^n✓ �o�� -���
Insulation contractor: Air -s1 T..IS
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 I Rated Location
Materia(s) Thickness R-value (in t / ext) Notes
Flat or vaulted ceilings
with attics above 30 - I f
Z -
Ceilings with enclosed
rafter cavities — 1/ R
Frame walls and rim/band IIZ
joists - to exterior
Framewallswalls and rim/band L
joists - to attic, garage 1Sn1JA1< . ? 1
Frame floor -cantilever
/ 1:? " 1 f, _
Frame floor - over garage or
crawl space �ONAfS
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: -Rt��
Signature:---�4J_
Business Firm. Mn.,n--,--
Address:
LOCAL_ -
Phone: 303- Vie,, _/A_r