HomeMy WebLinkAbout6156 DOLAN CT - DISCLOSURES - 12/10/2002 (2)Fort Collins Residential Energy Code the building & zoning dept. of
INSULATION DISCLOSURE FORM Community Planning and Environmental Services
msdiscZ)ds — 7/101W 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX 970 224 6134
Job address: 6166 J),,)(,Ad CT.
General contractor: A Y10,V-0 q0MAeS
Insulation contractor: 41 It r9b Sk Y I W 6-
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.'INS.-T.-RUCT-..IONS"""""""""""'
............. . ... I I ............ 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.
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nsu ati ....... ... * ............ ................ ..... . -- ......... * ................. ............. . ... ..
... -Rated -'—Location
Location I Material(sThickness R-value (Int / ext)
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 I 9A Fr FACAD
crawl space
Slab -on -grade (0-12")
Crawl space walls
Basement walls 11 L1114YOL
M /M
V /041
Notes
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rttf
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certify that the above4isted insulation was installed in the building at the above locaiiiio ... nsin" 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: S,4AWAI WILL-14NO
Signature: eAtn�— 6C14Ad Date: /J- AS
Business Firm: )? ytmvo 80MO-3
Address: b100 9 /144PLEWOoD AVE ST. loo
60EW W 00D VU-W- / (6 Sold Phone: 3 t3 rl