HomeMy WebLinkAbout7108 Avondale Rd - Miscellaneous - 03/01/2001 (3)Fort Collins Residential Energy Code the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mchdlw2xla-7MOl8b 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
Job Address: —7lag AyeN 4ALc _
General contractor:
Mechanical contractor: (Qf13-%e�a ZnAj
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 must be provided to the Building and Zoning Department prior to the C.O.
One copy of this form- must- be -made -available to -the -original home buyer.
A 5paae hating system
Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
a
B. Spajce cooling system
Location Fuel T Input capacity
e Manufacturer Model # kBtuh or kW SEER
G Water,heating.system
Input capacity Energy Storage
Location Fuel Tvae Manufacturer Model # kBtuh or kW Factor I volume
I/We cerlify that the above -listed equipment (including ducts and piping) was installed in the build11 ing 1. at the a1. bove locations
in conformari a with the requirements of the Fort Collins Residential Energy Code and Mechanical Code; and further, that
such equipment was installed in accordance with manufacturers' instructions.
Person Certifying Job: 7ROA&I
_SignaturG: "_ Date: