HomeMy WebLinkAbout6603 Antigua Dr - Disclosures - 07/02/2000 (3)Fort Collins residential energy code
Mechanical systems disclosure fo
Job address:
General contractor.
Mechanical contractor:
Space heating system
* 3V
Location
BASEMENT
Fuel
GAS
Type
F A
Manufacturer
Model #
TC 4 5
Input capacity
kBtuh or kW
75
AFUE or
HSPF
��
.................. . ...... ......... .
Space cooling system
Location
Fuel
GAS
T e
F/A
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
GAS
F/A
Water heating system
Location Fuel Type Manufacturer Model # Input kBtuh or kW Factor volume
Certification
UVVe 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. IANe 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 MIIs.ER Phone: (970) 223-8873
Business firmZK COLQRADO AIR, INC Date- �d
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.
mentlise.vA 15517 — 62U%