2014, 06-18 Permit: BLD-2014-0274 Loose Fill Insulation Cert1428
PART 1
5
Residence Address
Sir23 ^/ tt3er A
S
LOOSE -FILL SPECIALTY INSULATION, INC.
INSULATION CERTIFICATE 2626 East Trent m
Weatherization Division Spokane, WA 99202
Date Installed tin -1g 6"'t/�/� /'
2 Ceiling Areas Insulated (Loose Fill)
PART
Square Feet
Added R -Value
No. Bags
Lbs. Bag
Total Depth
Combined
R -Value
Insulation
Type
Loose Fill Insulation
Manufacture Address
2.J3
30
30
gic5.1
its -Y7
f6eA
yids
6-T7
3.
3 ❑ Wall Area Insulated (Loose Fill) ❑ Floor Areas Insulated
PART
Square Feet
1.
Added R -Value
No. Bags
Lbs. Bag
Total Depth
Combined
R -Value
Insulation
Type
Loose Fill Insulation
Manufacture Address
2.--iy
6
30
?
I R -/q
t!bac
'-—
PART 4 CERTIFICATION
SPECIALTY INSULATION, INC. certifies that the above residence identified in Pan 1 was insu ated as specified n Part 2, or 3 and the insta lation
was conducted in conformance to applicable codes, standards and regulations at the time of installation.
(AUTHORIZED IG ,URE)
v/HITE COPY TO CUSTOMER • PINK COPY TO CONTRACTOR • HARD COPY TO ATTIC