HomeMy WebLinkAbout5415 Copernicus Dr - Disclosures/Mechanical - 12/06/2006V i
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Fort Collin AResidential Energy Code the building Zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
nchd=2 ids 7ACM 251 N. Coiege Ave., P.O. Sex 5W, Fat Cogns, CO W522
Voice: 9M 2216760 FAX 970 224 8134
Job Address:
General contractor: /��•4(r /�G�/I1��Jr�� g/� — —.
Mechanical contractor,r�6
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,
Input capacity I AFUE or .
B. Space cooling system .
C. Water heating system
F
Model /
Input capacity '
tBtuh or kW
Eneryy -IS
Factor
borage
votunm
Certification
If We certify that the aboveaisted equipment (Including duds and piping) was Installed In the building at the above Mcatione
In conformance with the regdrements of the Fort Collins Residential Energy Code and Mechanical Code; and further, that
such equipment was installed in accordance with manufacturers' instructions.