HomeMy WebLinkAbout3726 Eclipse Ln - Disclosures/Mechanical - 10/10/2007Collins Residential Energy Code
Job Address:
General contractor:
Mechanical contractor
The building & zoning dept. of
Community Planning and Environmental Services
281 N. Colege Ave., P.O. Box 580, Fort Colin. CO 80522 t
Voice: 970 221 676D FAX 970 224 8134
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 G.O.
One copy of this form must be made available to the original home buyer.
A. Space heating system
Locatlon
Fuel
Type
Matortrcturar
Model ft
Input rapacity
katuh or kMr
AFUE or . .
HSPF
u
B. Space cooling system
Input.capacdy
Location Fuel T Manu(actura Model t k5tuh or kW SEER _
C. water heating system'
Fuel
TVft
MmufarturerModel
/
Inputcapaalty'
ketuh or kW
Energy.
' Fwtw
Storage
volume'
Certification' - -
VWe certify that the above -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' instructlons.
Person Certifying Job:.
i•
Fort Collins Residential Energy Code the building & zoning dept. of
MECHANICAL DISCLOSURE.FORM Community Planning and Environmental Services
=hdisc2xs-7n0198 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
Job Address:
General contractor:
Mechanical contractor:
A S;pace.Fieating system
• �
Location
Fuel
Type
Manufacturer
I Model
In ut ca aci
p P tY
I kBtuh or kW
AFUE or
I HSPF
B Space cooling system
Location
I Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
C. ,1Nater heating system,
Location
Fuel
T e
Manufacturer
Model #
Input capacity
kBtuh or kW
I Energy
I Factor
Storage
volume
rev
Ime certify that the above -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: e ti - Date: i O — -<
Business Firm:
Address: I W
Phone•?,,O"� (n O — q795f