HomeMy WebLinkAbout5139 Miners Creek Ct - Miscellaneous - 11/06/2000NOV-29-00 WED 01:57 PM WRITER NORTHERN FAX NO. 970 613 0043 P. 04
energy code 7196
Job address:
General contractor:
Meehanicsl-continictor.-
Space heating system-.
I input capacity
I APUE or
Space cooling system .
Input capacity
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I
Water heating system
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ME
WANW-dd
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WO--IW—�Un
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Storage
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Certification
VWe certify that tho 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
accordahco with manufacturer's instructions. IIWe 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: MW4..,Phone: ^
Business firm Date;
Address: Signature:
Chn tr- rCo. �/
Instructions I
This disdosure form is to be signed by the mechanical contractor or representative of the general contractor.
Please type or print, oxcept for the signature.
If there are multiple systems serving any function, make multiple entries to describe them.
Ono copy of this form shall be provided to the Building and Zoning Department at final Inspection.
ono copy or this form shall be provided to the homebuyer.