HomeMy WebLinkAbout4227 Applegate Ct - Disclosures - 12/21/2001IJM
Fort Collins residential energy code 7/96
Mechanical systems disclosure form
Job address: /
General contractor:
Mechanical contractor: NORTHERN COLORADO AIR, INC. sr� 2 5 204
ax..•
Space heating system
Location
Fuel
Type
I Manufacturer
I Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
BTISEMENNT
GAS
F A
Space cooling system
Location
Fuel
Type
I Manufacturer
I Model #
Input capacity
I kBtuh or kW
I SEER
-
A
G-AS
F/A
Water heating system:
Location
Fuel
Type
I Manufacturer
I Model #
Input capacity
I kBtuh or kW
Energy
I Factor
Storage
I volume
Certification
IANe 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. UWe 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 MILLER Phone: (970) 223-8873
Business firm -NORTHER COLORADO AIR, INC.Date:
Address:1823 E HARMONY RD Signature:
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. MCNISC Wa,rssaa_ 6,2356