2015, 01-15 Loose-Fill Insulation CertPART 1 Residence Address LOOSE-FILL
I t/A3 ,, Pr ��.,,„�.. INSULATION CERTIFICATE
Date Installed f / i
5PECIRLIZED
INSULRTIONINL.
RES/LENT/RL • CLMMERCIRL
509.489.35 I Z
M.4 E. COZZA DRIvE
SPOKANE, WA 99OB
CONT. LIC. SFPEC11193307
PART 2 Ceiling Areas Insulated (Loose Fill)
Square Feet
1 1LP
Existing
R -Value
Added R -Value
� 'ic
No. Bags
_2 i
Lbs. Bag
Total Depth
I� if
Combined
R -Value
Insulation
Type
60 7,405
2.
3.
PART 3 Cl Wall Area Insulated (loose Fill) ❑ Floor Areas Insulated
Square Feet
1.
Existing
R -Value
Added R -Value
No. Bags
f 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)
•