HomeMy WebLinkAbout3703 Full Moon Dr - Disclosures/Mechanical - 10/30/2006Il
Fort Collins Residential Energy Code the building Azonin dept.of
MECHANICAL DISCLOSURE FORM Community Planning and lEfw'virorw
lental Services
201 N. ColleM Ave., P.O. BoK 580, Fort Cc
ons. CO 8022
Voice: 970 221 6760 FAX 970 224 8134
Job Address: ,
General contractor:
Mechanical contractor.
INSTRUCTIONS
.This disclosure form is to be signed by the mechanical contractor or representative of the general co
tractor.
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.
A. Space heating system.
input
paclly I ArUE or
B. Space cooling system
I
Location
Fuel
tvoe
ManufacturerManufacturerModels
I -
lnput�specily
kBtuh or kW
sr=ER
C. Water heating system
-
Input Specify] Energy. storage�
Fud' Tvoe Afienufacturer Model a k8" or kW I Fwtiw I volume
Certification*
I/We certify that the above41sted 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 C ode; and further, that
such equipment was Installed in accoed2nce with manufacturers' Instructions.
Person Certifying Job:
Signature., Date:
Business Finn:
Address: