HomeMy WebLinkAbout245 Cajetan St - Disclosures/Mechanical - 05/22/2006Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mehdis-'_VS �J98
Job Address:
General contractor.
Mechanical contractor. Moll
the building & zoning dept. of
Community Planning and Environmental Services
251 N. College Ave., P.O. Box 580, Fort Collins, CO 80522 �r
Voice: 970 221 6760 FAX 970 224 6134
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 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 .
Location
Fue! Tvoe Manufacturer
Modei #
Input capacity
kBtuh or kW,
AFUE or
HSPF
I I
I
B._Space cooling system
Location Fuel Tvoe Manufacturer
Model #
Input capacity
kStuh or kW
SEER
tv--?A S %i'
71AJ
r<2%S-e.
617j 1 f S
I I
3
C ;; Water.h1.e_ating system
Location
Fuel
Tvoe
Manufacturer
Model #
Input capacity
k8tuh or kW
Energy
Factor
Storage
volume
Certification .
I/We certify that the abov e-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: o Date: ,' —2 Z—loc
Business Firm: f 0� . '06tJ
Address: .2 4114 DOA"/%t C7 '. PW
Phone: 2-dSV