2014, 04-15 Permit: BLD-2014-0195 Insulation CertificationPART1 Residence Address LOOSE -FILL SPECIRLIZED
INSULATION CERTIFICATE IN 1JLRTIDNNC.
Date Installed
RESIDENTIAL • COMMERCIAL
5O9.4E19.35 I Z
624 E. CO2ZA DRIVE
SPOKANE, WA 99208. '
CoNT. Luc. u SPEC1119BBD7
PART 2 Ceiling Areas Insulated (Loose Fill)
Square Feet
!lam
Existing
R -Value
Added R -Value
g cli
No. Bags
2cl
Lbs. Bag
•% /
Total Depth
/7 c/
Combined
R -Value
Insulation
Type
Gzrs
z
3.
PART 3 ❑Wall Area Insulated (loose Fill) - 0 Floo Areas Insulated
" Square Feet
1
Existing
R -Value
Added R -Value
No. Bags
Lbs. Bag
Total Depth
Combined
R -Value
Insulation
Type
2.
This certified that the above residence identified in Part 1 was insulated as specified in Part 2, or 3 and the installation was
conducted in conformance to applicable codes, standards and regulations at the time of installation.
WHITE COPY TO CUSTOMER • YELLOW COPY TO CONTRACTOR • HARD COPY TO ATTIC
(AUTHORIZED SIGNATURE)