HomeMy WebLinkAbout607 STONEY BROOK RD - DISCLOSURES - 5/1/2012Fort Collins Residential Energy Code
INSULATION DISCLOSURE FORM
Job address.
General contractor.
Insulation contractor.
the building & zoning dept. of
Community Planning and Envirmunental Services
281 K. Co@e8e Ave.. P.O. BOX MD. Fort C*MM CO 80522
Voice: SM 2216760 FAX 970 224 6134
00 .. W-RUGH This disclosure form Is to be signed by the Insulation contractor or representative of the genargi contractor. MEMO==
PiOM type Or print, MW for the signature. Complete the Infora'sklion in the appropriate spaces provided.,
If components vary. maIo-- multiple entries in 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.
45
Location M s
.. .
7hidttress
........ . ......... . . . . . . . . . . .
11-value nt I ext
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Notes
Fkd or Vaulted cmeMorlwari
WM affics abon
U 113a 5
1z"
1
RaA 12b
4lx� ens
Ceilings wfth
rafter cavities
Fraine walls and rknbarid
joists — to qxtarior
WCIN J31Cj%,L
31 Z
Y 0, r W, C- U. k 0 L L
Frame waft ard rhwband
k"ts — to awc. game
13a44
Yr C
Vz-
V
Frante noor - carifflever
U n f
NIOnkloorEd
t
Frame floor - over garage or
claw space
k", X3 CA++
Crawl space want
easement Wang
6
C�
11WOMWthat the ebove-listedirmaMunwas s I a to the at8ie above boons in Fort Collins ResidwMal Energy Code, and that itwas ; 1 11 inaccordancewith CwhMancovAhlbomirrantraquiramenisofft
to -IrmAdlon Gdhilrese pu1*dwd by to City of Fort Calms.
Person Certifying Job: —vMa
Signature: Date:
Business Firm:
Address:
Phone:
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