Full Text
(please print) Street/PO Box City State SUMMIT COUNTY BUILDING DEPARTMENT PRE-SHEETROCK INSULATION CERTIFICATE (This certificate is to be filled out by the insulation contractor prior to insulation inspection and left on the job site for pick-up by the building inspector) Owners' Name: Building Permit No. Building Address: Subdivision: Lot # Insulation Contractor: Business Address: Insulation Contractor's Signature: Project description and type of insulation and R-values installed on this project (fill in applicable spaces) Residential one story: Residential two story: Commercial: Insulation material used: Fiberglass Cellulous Other (specify) R-Values: Exterior walls: Vaulted ceiling: Floor over garage: Garage common wall: Knee walls @ attic: Floor between unfinished basement and main level: Number of insulation chutes installed over exterior walls (common/scissor truss) Number of Expanded Poly Styrene (EPS) baffles used in vaulted ceiling: _ Other items used in lieu insulation chutes and/or BPS baffles. Number: Items used: Failure of the contractor to properly fill out and sign this form and leave it on the job site will result in a failed insulation inspection, $100.00 re-inspection fee, and a 48-hour wait before the re-inspection can be scheduled.