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INSULATION INSTALLATION CERTIFICATE
TO: �� ) WiT(� � BLOCK: SECTION:
JOB#:M&A . JOB NAME: `
JOB ADDRESS: �1L)U VYC,!(3
The undersigned hereby certifies that
follows:
at the above described property as
Exterior CBS walls have been insulated with .........:..................Check one
to a thickness of N/A inches, which thickn Ong to the
manufacturer, r -C -�� l 49
Density N/A will yild arts "R" value of,
Exterior Frame walls have been insulated with .....................i......Check one
to a thickness of inches, which thickness, according to the
manufacturer,
Density N/A will yield an "R" value of
Main Callings have been insulated with .........................Check one
to a thickness of *nche,�6'v hit, hthickness, according to the
manufacturer, ` WDensity N/A l n "R" value of 2�
ceilings Cathedral have been insulated with .........................Check one
to a thickness of inches, which thickness, according to the
manufacturer,
Density N/A will yield an "R" value of
( ) Spray on cellulose
Al,
OCK��M
( ) Spray on cellulose
( ) Fiberglass blankets
( ) Aluminum Foil
( ) Other Spray Foam
( ) Fiberglass blankets
( ) Fiberglass loose fill
) Aluminum Foil
ha��M
( ) Fiberglass blankets
( ) Fiberglass loose fill
( )Aluminum Foil
( ) Other Cdubse
3. Interior knee walls have been insulated with.................................Check one ( ) Fiberglass blankets
to a thickness of inches, which thickness, according to the ( ) Polyurethane
manufacturer, i WC { ) Spray on cellulose
Density N/A Weld n "R" value 000 Other Spray Foam
4. Garage partition walls of condi 'oned living areas have been
Insulated with... . }}..{ Check one �lberglass blankets
to a thickness o37V bCrn has, which tht� � l g to the /(; Spiri on cellulose
manufacturer, Polyurethane
Density NIA will yield an "R" value of ' ¢ ' p, ( ) Other Aluminum Foil
MULTI FAMILY RESIDENTIAL CONSTRUCTION ONLY: The common (party) walls separating
different tenants shall be insulated as follows - FrameJMetal stud walls R-1I (Min.);. CBS or Concrete. walls
R-3 (Min.); by Energy Code requirements. See Energy Code Rev. 1/97,'paregraph 903.2(b), on page 9.17,
latest -edition. These "minimums levels of Insulation" are not included in the Energy Calculations, but shall
be installed in the field.
NOTE: Densities of sprayed on, loose fill, or any other composed -on site insulation shall be the P.C.F.
(1b/R3) average of three (3) "DRY SAMPLES" of actual iintallatikii.
Insulation Contractor Insulation Contractor [gnature
JL_
Insulationtractor's CC#. Date of Cam cation
0 C-/ Z' � 't. . V�.
J
Builder's Name - Builders CC# Notary Public
r
r�
WILLIAMJ.SCHANDELER
lJ�-' uu 11 NOTARY PUBLIC
STATE OF FLORIDA
Comm# EE067413
Expires 2/23/2015