HomeMy WebLinkAbout6215 WESTCHASE RD - DISCLOSURES - 3/17/2004Mkt 5
Fort Collins Residential Energy code the building dl zoningVsdept. of �53
INSULATION DISCLOSURE FORM Community Planning and Emrironmet>tal Services
ffndwc2.)ft - 7n a= 281 N. Coilepe Ave., P.O. Banc 580, Fort Collins, CO W=
Voice: 970 221 87ti0 FAX; 970 224 6134
Job address:
General contractor: e
Insulation contractor. In e A -514 Jl i 5 /�01i • �^
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.
Inculatinn
Location
Material(s)
Thickness
Rated
R-value
Location
grit/ex# Notes
Fiat or vaulted ceilings
with attics above
FA7 �C
Ceilings with enclosed
ratter cavities
Frame walls and rim/band
joists - to exterior
Gt
1
rn i
pi A",t Ge�
Frame walls and rimlband
joists - to attic, garage
4pC -e
/ Ali
Frame floor - cantilever
r
Frame floor - over garage or
crawl space
`r l
Slab -on -grade (0-12")
Crawl space wails
Basement walls
% i
Certification
[Me 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: 1 J
Signature: Date: 3 - L 7-0 c%
Business Firm: 16= ( f-1,*�e t
Address: /a� ,t`. i')'f�✓�/rs..ov.i lLe Sc.-,& /Lei
Gre-eM ivC : -Z 6/1 11A�;tC 0`du 5�T/ ! 1 Phone: 50 s — YiL - SOr-1v