HomeMy WebLinkAbout609 Stoneham Ct - Miscellaneous - 12/29/1999 (2)Fort Collins residential energy code 7196
Mechanical systems disclosure form
Job address: (o t
General contractor.
Mechanical contractor:
...:
space heating system
ScoolIng systems
pace ,
Input capacity
jype Manufacturer Model # kl3tuh or kW SEER
Water heating system_'
# IInput capacity Energy Storage
kl3tuh or kW I Factor volume
CAL.
;Certification....:.;;: ,
I/We 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 Coltins Residential Energy Code -and -Mechanical Code, and that it -was -installed -in -
accordance with manufacturer's instructions. I/We 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:,� " Phone: L zx,* -
Business firm: /�5 Z4 Date:
Address Signature: ' =_
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.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 -or this form -shall -be-provided-to the-hemebuyPr. Rntnfl.