BLD_Thermal_Barrier

Alachua County Board of County Commissioners

Department of Growth Management

10 SW 2ⁿᵈ Ave., Gainesville, FL 32601

Website: https://growth-management.alachuacounty.us

Submit Questions to: Building Division Tel. 352.374.5243

Email: building@alachuacounty.us

Permit Number

Jobsite Address

I/We

Licensed as

License Number

on or about Date

MonthDayYear

I did personally install or supervise the installation of the required thermal barrier for attic space used for storage with foam plastic insulation as classified by FBCR 3164 work at address

Material

Thickness

Signature of Contractor, Contractor designee or FS 468 Inspector:

STATE OF FLORIDA COUNTY OF ALACHUA

The foregoing instrument was acknowledged before me by means of

day, month and year of

name of person

Type of authority, e.g. officer, trustee attorney in fact

for (name of party on behalf of whom instrument was executed)

SEAL ABOVE

NOTARY PUBLIC STATE AT LARGE

*General, Building, Residential, or specialty Contractor or any individual certified under FS 468 to make such an inspection.