HomeMy WebLinkAbout3815 Rock Creek Dr - Disclosures/Mechanical - 09/26/2007 (2)I
Fort Collins Residential Energy Code the building A zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
waKfikta.ids -VIONS 281 N. Calfts Ave.. P.O. BCK SM. Fat Collins. CO W=
Voice: WM =1 6M -FAX WM 224 KU
JobLdress: 3S/
General GOntractor.,
Mechanical contractor.
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_
Ifthere 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
ftctww Me" 0 katuh or RW I H5PF
B. Space cooling system
IF
C. :Wator healing system
Fuel
1VW
-jillaniftab"_
Model g
Input capon"
I kBeuh or kW
Storagi.
I Vultane
7
Certification '
VWe certify that the above4isted equipment (Includ'Ing ducts and piping) was installed In the building at the above locations
In conformance with the requiremonts, of the Fort Collini Residential Energy Code and, Mechanical Code; and further, that
such equipment was installed in accoid2nce with manufacturers' Instructions.
[Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mchdisc2As —7,110198
Job Address:
General contractor:
Mechanical contractor:
A. Soaceheatind system
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CC 8o522
Voice: 970 221 6760 FAX 970 224 6134
Location
Fuel
T YP—e .....
I Manufacturer
I
I Input capacity
I kStuh or kW
AFUEor
I HSPF
--Model#
B. Space cooling systern
Location
Fuel
Type..
Manufacturer
Model #
I input capacity
I kBtuh or kW
SEER
.C. -Waer heatingt ...
SYS-erri.
Odel #
Inputcapacity
kBtuh or kW
Energy
Fa tor
storage
volume
Certification . ...... - ...........
lMe certify that the above -fisted 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 CertlbADq Job:
Si
Business
Address: LIL)
Date: /V — /— 0 7
Phone: L� ->- b 5 � -Q 2ZIS - -