PERMIT DOCUMENTS \ /La W C
1`''�` City of Boynton Beach
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INSULATION INSTALLATION CERTIFICATION
JobA\ 0 ((Dl Fc0^-9-'f-c ist-ce 62-)A1 Permit# I L — POS
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 G4 F Manufacturer b rs< CULrlrh(L
Type i1rat ysico xedsoL4ZAY-1 -SW-EA-Mb-11a Type 6,477T
Thickness 3 c/ Thickness 3 -Via"
R Value - 5 R Value (3
CEILING/ROOF INSULATION: OTHER INSULATION:
Manufacturer 0 (g..)€t LC CO'1-J ilib Manufacturer
Type \ 121177S Type
Thickness r t Thickness
R Value le - 19- R Value
GARAGE & CEILING INSULATION:
i
Manufacturer
Type •
Thickness
R Value
I
Date: /0- o7 C.- OG) /C
Insulation Contractor/Builder arcHi1'G to 40,Ccli C GG X1-tt
Qompany Name
Building Contractor CC# C CZ / s O,oc!/ f /7
Authorized Contractor or Owner
Certified Ion /0 6";;- a D lb Signature
Date
Office Use'Only:
Submitted to(Division Employee) Date
1
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100 East Boynton Beach Blvd,PO Box 310,Boynton Beach FL 33425-0310 Phone:(581)7424350 Fax:(561)7424357
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