HomeMy WebLinkAbout2027 Shorebird Dr - Disclosures/Mechanical - 09/30/2008eceivea Fax : Se 2� 2002 10:iGAM Fax Statian : SHAW Cm-T UCT 0
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Fort Collins Residential Energy Code the building & zoning dept of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mohdise2 ids-7110Aa 281 N College Ave P O Box 550 Fort Collins CO 80522
Voice 970 221 6760 FAX 970 224 6134
Job Address
General contractor
Mechanical contractor 1iE111 694611
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 desorlbe them
One copy of this form must be provided to the Building and Zoning Department prior to the C 0
One copy of this form must be made available to the original home buyer
A Space heating system
LOeetlon
Fuel
TVLM
Manufacturer
Model 0
Input eepaclty
kBtuh or kW
AFUE or
HSPF
.Psr �r/Y
X
7-6
B Space cooling system
C Water heating system
Input capacity i Energy I storage
katuh or kW Factor volume
14/0Z 7& `�
Certification
INNe certify that the above listed equipment (including ducts and piping) was Inistalted In the building at the above locations
in conformance with the requirements of the Fort Collins Resldentlai Energy Code and Mechanical Code and further that
such equipment was installed In accordance with manufacturers Iniitructions
Person Certifying Job ^AUrel--PAI &4E5r%AA,,eB,E*r—
Signature Zl.W4:;l e" 741to le�— Date 9— 3D — D%
Business Firm—<11-f7 J Bd/IZ�Z .IeS /;G Q -
Address 3dp
aO 1OVa2Z Phone v03 - '01"a 3-- S/7i�0