HomeMy WebLinkAbout844 Thornhill Pl - Miscellaneous - 09/25/2001Fort
ort CResidential Energy Code the building & zoning dept. of
CollinsI ortColli
ISCI
DISCLOSURE FORM Community Planning and Environmental Service
mchdiscl)ds -7/10/98 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
Job Address:
General contractor:
Mechanical- contractor -
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.
.. ...... ... . ....
'k.S heating ,
paCesyst
......... . . .....
Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUEor
HSPF
e1-A,.A_d -10,qc_
17
B. Spade cooling systern
Location
Fuel
Type
Manufacturer
I Model #
Input capacity
I kBtuh or kW
I SEER
C.. Water heatina s
YStP M.1.1-1.
Location
Fuel
Tvpe
Manufacturer
Model #
Input capacity
kBtuh or M
I Energy
I Ppintm
Storage
I volume
Certification
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." . ... ... ......... - ... I '_:_ � ... I � .... ........ . . ..... ...... ........ .. ....... ........
.. . ......... .... .. ...... ... ........ ... ...... .. ....
. . .... .. . ..... 1: 1 ... : .. ..... . . . ..: ..... ... . - -
- ..... ....... .... . .................. .. .... ...... .... .. ..... ... ....... . .. .. .... .... .. ..... .
IMe certify that the above -listed equipment Including ducts and piping) was installed in the building at the above locations
in conformance 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:
nature:
Business Firm: 16 Y,
A -57 .1P'9,,1.4 A
Address: Y(
Date:
Phone: f� —2 3 37