HomeMy WebLinkAbout6227 CLYMER CIR - DISCLOSURES - 10/20/2003Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
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Job address:
General contractor:
Insulation contractor,
the building dl zoning dept. of
Community Planning and Environmental Services
281 N. C 0"9 Ave., P.O. Box SW Fort Collins, Co 80522
V1:1221 6700 FAX 970 224 6134
:i!�- C i r, _
INSTRUCTIONS
This disclosure form is to be signed 9 by the insulation contractor or raapresentdve of the
Please type or prir>f, except for the signature. Complete the information in the appropriate sera) contractor.
ff components vary, make multiple entries to describe them. paces provided.
_. One copy of this form must be provided to the Buildin and Zonin Department riot to the C.O.
fo
One copy of this form must be made available to the original home buyer.
- 9 ...pa_tP
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InsulaHon
Location
Fiat or vauttad ceilings
with attics above
"rings with �
caner OpMes
Frame ways and rirnAmW
joists — to exterior
Frame walls and rimrband
joists — to attic, garage
Frame ftw. . MMIfter
Frame floor over own" or
craw! space
Slabon.grade (0.12")
Cam space walls
Basement walls
Rated
Thickness Zahn
Location
(Int / ext) Notes
Certification
UWOFort � Codeiwas installed in the building at the above bcations In Wd
stalled in a roe With the "Insulation Gur W nW with extent � Of the
Person Certifying Joh�'� ' M
��hed by the City of Fort Collins.
Firm:
_Address:
`11`70- %(9(y -ZmA`i