HomeMy WebLinkAbout6127 TILDEN ST - DISCLOSURES - 1/20/2004 (2)Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
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the building & zoning dept. of
Community Planning and Environmental services
281 N. College Ave., P.O. Boot 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX; 970 224 6134
Job address: , /1Z � / t /Zen S4-
General contractor•.. 42W / 1r d [7 e-rh e s
Insulation contractor: ���TT"�%ici
INSTRUCTIONS
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.
Insulation
Location
Material(s)
Thickness
Rated
R-value
Location
pnt I ext) Notes
Flat or vaulted ceilings
with attics above
I',oL Q< <e
Ceilings with enclosed
rafter cavities
Frame walls and rim/band
joists — to exterior
Gt
1
v►a ;
g As e-e
Frame walls and rim/band
joists — to attic, garage
Y A. 77 Z
/
Frame floor - cantilever
Frame floor - over garage or
crawl space
A-✓ X
Slab -on -grade (0-12")
Crawl space walls
Basement walls
e,
Certification
INVe certify that the above -listed insulation was installed in the building at the above locations in 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:
nature:
Date: % Z o —d'/
Business Firm: ��,�. �( d� e f
Address: �l�e J')')�,4/ra.yv 14y-e-
ed o �F-V/ 1 Phone: