HomeMy WebLinkAbout2803 Kansas Dr - Disclosures/Mechanical - 09/26/2008Fort Collins Residential Energy Code the building & zoning dept of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mchd=2 wa-7110re8 281 N College Ave P O Box 580 Fort Collins CO 80522
Voice 970 221 6760 FAX 970 224 6134
Job Address ;Z 803 I' 4 AI5AS DR,
General contractor �C41�I✓7
Mechanical contractor M L S PE -AT IA16, P L%/)EZ.
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
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
dUTSiflE RGb.V
AS
reweEvAg
aRRIAER
GOSTN6 o
Gov
Z ,
B Space cooling system
Location
I Fuel
I Type
I Manufacturer
I Model #
Input
I kBtuh or IrW
I SEER
odr,5
BA330
13
320
C Water heating system
d
Location
Fuel
Tvne
I Manufacturer
Model #
Input capacity
kBtuh or kW
I Energy
Factor
I Storage
volume
a1T IVE
MAD)SOp
14OLC
coo
1
14067.
Certification
I/We 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 Joj)/
Date
Business Firm � /� � /i(/� C�}�/��E,�f r/ q/ '.A% L- -C
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