HomeMy WebLinkAbout421 PEYTON DR - DISCLOSURES - 6/16/2003 (4)[Fort Collins Residential Energy Code
SULATION DISCLOSURE FORM
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Job address: 17— (�2-
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General contractor:
Insulation contractor: (St + i t tz
the building At zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
IN:STRUCTIONS,..;; .'
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.
..............................
Lhsulation
Rated Location
Location Materials) Thickness I R-value (Int / ext
Flat or vaulted ceilings
with attics above
Ceilings with enclosed II
rafter cavities MALK h, 197
Frame walls and rim/band
joists -- to exterior I �er2�►/ram li5 �% Q _
Frame walls and rim/band
joists — to attic, garage II OWUaA L2)(LA/1LC-
Frame floor - cantilever
Frame floor - over garage or u
crawl space �In,,a. �C_ t n,e. li_3�
Slab -on -grade (0-12")
Crawl space walls
t/-7 1 (,,,- t
Basement walls
Notes
Gertlfication
..... .. ........ :.... :: :.i:: •::':?•.°i:_.:..: `::;: •i:;:;;:;:::`.a:;• :•::ii{ �:'ir: r?:. `. :<: i:.ri.:: i :;: if`.5.` ....
:....:...:...................................::::::::.: •::::.:::::..: . /V1le 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:
Signature:
Business Firm:
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