HomeMy WebLinkAbout4138 Center Gate Ct - Disclosures - 02/20/2001Fort Collins residential energy code 7/96
Mechanical systems disclosure form
Job address:
General contractor:
Mechanical contractor: NORTHERN COMRADO
Space heating system
G�
Location
Fuel
Tvpe
Manufacturer
I Model #
Input capacity
( kBtuh or kW
AFUE or
I HSPF
ilz Fsa=
GAS
F A
Space cooling system
Location
Fuel
Tvpe
Manufacturer
Model #
Input capacity
k8tuh or kW
SEER
A
GAS
F/A
Water heating system
Location
Fuel
Type
I Manufacturer
I Model #
Input capacity
kBtuh or kW
I Energy
Factor
I Storage
volume
Certification
IANe 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. INVe 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
Business firmrjORTHERr. COLlORADO AIR,
Address:1823 E HARMONY RD
Phone: (970)223-8873
INC .Date:
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, manw,c o, ssza—arz�se