HomeMy WebLinkAbout3732 Eclipse Ln - Disclosures/Mechanical - 01/04/2007I
Fort Collins Residential Energy Code the building At Zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
rnohd=2.adc 7A6186 281 N. Colege Ave., P.O. Banc 580, Fort Collins, CO W522
Vace:970221676D .FAX 9702246134
Job Address:
General contractor:
Mechanical contractor.e_-7G�.C?
INSTRUCTIONS a�
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 copaclty i AFUE or .
i
B. Space cooling system
Location
Fud
TM
Manufacturer
Model a
Input.cepecity
Mutt or kw -
SEER
C. Water heating system
inu on
F
T
ra
Model 9
Inputcapaalty'
kBtuh or I(W
Energy.
' Factor
Storage
volume
Certification - — -
I/We certify that the above -listed equipment (including ducts and piping) was Installed In the building at the above location
in conformance with the requirements of the Fort Collin Residential Energy Code and Mechanical Code; and further, that
such equipment was installed in accordance with manufacturers' instructions.
i
Person Certifying Job;
SignatureDate:
Business Finn: -
Address:
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