PERMIT DOCUMENTS City of Boynton Beach
0Building
� Division
ON 9
•
INSULATION INSTALLATION CERTIFICATION
Job Address ZC 3 S S 6-7-4- 5 rr Permit# (75-636(
STATEMENT OF COMPLIANCE:
We, the undersigned, hereby certify that the thermal.insulation has been installed in the referenced
building in compliance with the Florida Model Energy Efficiency Building Code, and the approved plans
and specifications, and in accordance with good construction practice. The insulation furnished is of the
type, thickness, and R value as set forth below:
MASONRY WALL INSULATION: STUD WALL INSULATION: '
Manufacturer !'w Manufacturer
Type R Type
Thickness 3341 Thickness
R Value R Value
CEILING/ROOF INSULATION: OTHER INSULATION:
Manufacturer Owe^> Manufacturer
Type i3(o.,... (ceflta (ose Type
Thickness Q- IC)`r Thickness
R Value 3C� R Value
GARAGE & CEILING INSULATION:
Manufacturer
Type
Thickness
R Value
Date:
Insulation Contractor/Builder Ow--Pr
Company Name
Building Contractor CC# ar"- N C-4—>
Authorized Contract Owner
Certified on Signature
Date
Office Use Only:
Submitted to(Division Employee) Date
i
100 East Boynton Beach Blvd.PO Box 310.Boynton Beach FL 33425-0310 Phone:(661)7424360 Fax:(661)7424357
S:NevelopmennBuildinplFomts&TemplatesVn-HouseVnsuWtlon Installation Certification(9A5)