HomeMy WebLinkAbout5409 Belvedere Pl - Miscellaneous - 10/23/2000mmww�
Fort Collins Residential Energy Code
Fort
Colli
ns MECHANICAL DISCLOSURE FORM
mchdLsc2.)ds-7/1W8
the building dt zoning dept. of
Community Planning and Environmental Service
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
Job Address: if-%Q12 Fef-ec
General contractor: P&I(S fjQkJ57?ei2CZZaAj /Afel—
Mechanical contractor: _L1*L)5Z0A4
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. . ........ ..... ...... ..... ....
................... ... ....
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.
JSpace.... .... . . ..... A .syst. ern..
.... . .....
Location
Ajt_�& 41 e A a-
Fuel
AAA r- to
Tvg)e
Alk
Manufacturer
Model N
Input capacity
k8tuh k8tu orkW
AFUE or
HSPF
T�
B. Space Cooling systern,
Input capacity
Location Fuel Tvpe Manufacturer Model # k8tuh or kW SEER
C. ater heating s tern
Wp
Location Fuel TunRA-A-1 m -Btuh or .Input capacity Energy storage
a Factor volume
. ....... ....... .
1/We 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:
Signature: f
Date: _4A31ilt1l
Business Firm.. Ju— a�. , ..
� r
Address: UN-T A
caz.4 IV S �'ji OQ52one• 2P,2-- 70?
A4 Ph: I _10