HomeMy WebLinkAbout1320 NASSAU WAY - DISCLOSURES - 12/3/2002 (6)I�crt Collins Residential E:.ergy Cade
INSULA i ION MCLOSURE FORM the b ui ldi; lg &zoning dept. o
U1wLSQZ.1a;_7norss Community Planning and Environmental services
281 N. College Ave • p.p. Box 580 Fort Collins, CC 80522
Job address:
Voice: 970 221 676o FAX: 970 224 6134
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General contractor.
Insulation contractor.
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This disclosure form is to he _ signed b
the ' .... 9 insu
lation .. tr Y o ... n con .-..........
contractor or •.-..
Please type or print, except for representative of the general '-"--"-"'-�......---•••••-•--•
p 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.
Joists — to attic, garage
Frame floor - over garage or
........................ .
UWe certify that the above listed insutatio :•::::::.. :.:.::: .:::::::::::: :...:_-::::::•:::......::-:.-.::::::::•::::: ::::;•::::::: -:.-
n was installed in the budding ai the above locations in conformance with the current re
Fort Coffins Residential Energy Code, and that it was instaged in accordance with the 'Insulation Guidelines" published by the City of Fort Collins,
quirements of the
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Person Certifying Job: .
a'd M Van Buskirk
Signature: i� f / _ ;P -�
Business Firm:
Address:
Date- I
Phcne.