2015, 05-06 Permit: BLD-2015-0281 Insullation Cert.PART 1 Residence Address LOOSE -FILL
INSULATION CERTIFICATE
Date Installed r
SPECIALIZED
INSULATION..
RESIDENTIAL • COMMERCIAL
509.489.351 Z
584 E. CDZZA DRIVE
SPOKANE, WA 99208
CONT. LIC. # SPEC111988D7
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.
(AUTHORIZED SIGNATURE)
WHITE COPY TO CUSTOMER • YELLOW COPY TO CONTRACTOR • HARD COPY TO ATTIC