HomeMy WebLinkAbout3051 Sage Creek Rd - Disclosures - 11/14/2001Fort Collins residential energy code 7/96
Mechanical systems disclosure form
Job address:
General contractor:
Mechanical contractor:
Space heating system AUG 2 7 2001
Location
BASEMENT
Fuel
GAS
Tvpe
F A
I Manufacturer
I Model #
F
Inputcapacity
kBtuh or kW
'tea
I AFUEor
HSPF
Space cooling system
Location
Fuel
Tvpe
I Manufacturer
I Model #
Input capacity
I kBtuh or kW
I SEER
GAS
E/A
Water heating system -
Inputcapacity Energy Storage
Location Fuel Type Manufacturer Model # kBtuh or kW Factor volume
Certification
IM/e 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. IAVe 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 MLR Phone: (970) 223-8873
Business firm NORTHERN COIORADO AIR, INC.Date:
Address:1823 E HARMONY RD Signature: ,. �i'
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.
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