Insulation Certification

INSULATION CERTIFICATION This is to certify that, in conformance with the current energy regulations and approved plans, insulation has been installed in the building located at: City Street No. (If Available) Street County Lot Number Tract No. DESCRIPTION OF INSULATION ROOFS Type of Material EXTERIOR WALLS Type of Material CEILINGS BATTS: Type of Material Square Feet Covered BLOWN: Type of Material Wt./Bags FLOORS Type of Material Manufacturer (Or Trade Name) Manufacturer (Or Trade Name) Thickness R Value** Manufacturer (Or Trade Name) Thickness R Value** Manufacturer (Or Trade Name) Thickness R Value** Thickness R Value** No. Bags Square Feet Covered Manufacturer (Or Trade Name) Thickness R Value** SLAB OR GRADE Type of Material Width of Insulation Manufacturer (Or Trade Name) Thickness Inches R Value** FOUNDATION WALLS (if required) Type of Material Manufacturer (Or Trade Name) Thickness R Value** REMARKS General Contractor (Builder) By Sub-Contractor (insulation Applicator) (insulation, Masonry, Etc.) (State ''SAME'' if same as General License Number Title Date License Number Title Date ''No certificate of occupancy or similar certification that a newly constructed hotel, motel, apartment, house, home or other residential dwelling is the structure at least satisfies the minimum energy insulation standards established pursuant to this chapter.'' By (**R Value is the Measure of the resistance of a material or building component to the passage of heat. The resistance value (R) of mass type insulation shall not include any value for reflective facing.) American LegalNet, Inc. www.FormsWorkFlow.com 2001 © American LegalNet, Inc.