HomeMy WebLinkAbout2715 Forecastle Dr - Disclosures/Mechanical - 04/12/2006[Fort Collins Residential Energy Code
ECHANICAL DISCLOSURE FORM
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Job Address:
General contractor:
Mechanical contractor
INSTRUCTIONS
This disclosire form is to be signed by the mechanical contractor or representative of the general contractcr.
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 avallable to the original home buyer.
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 58C, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 6134
A. Space heating system
B. Space cooling system
C.. Water heating system
Location Fuel Input capacity Energy I Storage
-- _-- 7Ype Manufacturer Modal 0kBtuh or kW I Factor volume
Certification
IAVe certify that the above -listed equipment (including ducts and piping) was iirlstalied ;r, 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 rnanufar.,turers, instructions.
Person Certifying Job: %� Yr s' `� f
Signature: (
Business Firm:
Address:
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Date: i /_'