HomeMy WebLinkAbout4120 Rolling Gate Rd - Miscellaneous - 08/17/2001_. c Collins residential energy code 7/96
re
Job address:
General contractor:
Mechanical contractor:
Space heating system
Location
BASEMENT
Fuel
GAS
T e
F A
Manufacturer
Model #
1nputckBtuh or kW acity
FUE
AHSPF r
Space cooling system
Location
Fuel
T e
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
GAS
F/A
Water heating- system
Location Fuel T Input capacity Energy Storage e Manufacturer Model # kBtuh or kW Factor volume
Certification
I/V1/e certify that the above -listed equipment was installed in the building at the above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturer's instructions. UWe certify that any ductwork has been installed in conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code.
Certified by: ROBERT R MILLER Phone: (970) 223-8873
Business firmZjQRTjgM1 COLOR
ADO AIR, INC.Date:
Address:1823 E HARMONY RD Signature:
Instructions
This disclosure form is to be signed by the mechanical contractor or representative of the general contractor.
Please type or print, except for the signature.
If there are multiple systems serving any function, make multiple entries to describe them.
One copy of this form shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer.
mcntise.xOt/SS23 — 6l1496