HomeMy WebLinkAbout602 KEENESBURG CT - DISCLOSURES - 1/9/2004Pbrt Collins Residential Energy Code
INSULATION DISCLOSURE FORM
Job address:
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Coltlns, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
General contractor. _ N�1rpy i �cmCS J
Insulation contractor: �LuAcz
• �t�►Ttr,ti
:aNSTRi .GTf �Ns...........
............................. .
................................:::::::::::::..:::::: .... ::::::; ::: •:::::::•::: :
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.
It 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.
:.... u ..........................:::::•::.:::.:::...::.::.:..
.il bh;
. ... _........................... .
........ .
:.::..:
.::::......................................................
Rated Location
Location Material s Thickness R-value Int / ext Notes
Plot or vaulted callings
with millet above
Cdlinys with enclosed
taller bavittes
Frame walls and rim/band
Joist! -- to exterior
Frame walls and rlmlband
Joists -- to attic, garage ow LP
Frame floor - cantilever
v -
Frarnt floor - over garage or
crawl space t _
Slob -on -grade (042")
crivl space walls
basement Walls
InWASUM Was installed In tht of 6 above locations in conformance with the current requirements of thi
t:blMr� itsatdYtetlal t:nargy Cods, and that it was installed in accordance) with the "Insulation Guidelines" published by the City of Fort Collins.
tit sTi a�'t F •�-��M� i