2014, 10-14 Insulation CertificatePART 1 Residence Address LOOSE -FILL
tug2s3 INSULATION CERTIFICATE
Date Installed
SPECIRLIZED
/IV,51.1LRTION,NC.
RESIDENTIAL • COMMERCIAL
509.489.3512
534 E. COZZA DRIVE
SPOKANE, WA 99208
CONT. LIC. # SPEC 11193307
PART 2 Ceiling Areas Insulated (Loose Fill)
Square Feet
1
Existing
R -Value
Added R -Value
_
No. Bags
Lbs. Bag
_
Total Depth
Combined
R -Value
Insulation
Type
_ '` '.,
2
3.
PART 3 ❑ Wall Area Insulated (loose Fill) ❑ Floor 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)