HomeMy WebLinkAbout615 ROMA VALLEY DR - DISCLOSURES - 4/4/2002 (3)MAR-20-2001 TUE 11:45 AM FC BUILDING AND ZONING FAX NO. 9702246134 P. 02
=CollinsResidential Energy Code
DISCLOSURE FORM
A"SQ ds..71100
Job address:
General contractor:
insulation contractor.
T:I.hLi:
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 descxibe 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.
the building d( zoning dept. of
Community Planning and Environmental Services
281 N. Colege Ave., P.O. Bast 5W, Forl. Collins Co 80522
Valor: e7o 221 6760 FAX: e70 224 6194
Flat or vaulted ceilings
with attics above
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists .- to exterior
Frame walls and rlmlband
joists — to attic, garage
Frame floor. cantilever
Frame floor - over garage or
crawl space
Slab -on -grade (0-12,1
crawl space walls
Basement wails
uvva fy that the ial Energy
insulation was Installed in the buiidi at the above : ; nr IaGatlOtte In conformance with the current raquiremants of the
Fort Collins Residential � F.neryy Cade and Was
k was Installed Ih accordance with the 'Insulation Guidelines- published by the City of Fort Collins.
Person Certifying ,lop: i'�o.. , YY1- I - ,