HomeMy WebLinkAbout215 Cajetan St - Disclosures/Mechanical - 04/21/2006Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
Job Address:
General contractor: 7q\k o,
the building & zoning dept. of
Community Planning and Environmental Services
251 hZ College Ave., P.O. Box 580, Fort CorAns, co 80522
Voice: 970 22167760 FAX 970 224 6134
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Mechanical contractor: f _1?C> CXL_!.1 ........... ....... ...
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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.
:aceieairn systijm:: -;==': :::.::::::::.:::::.. :::.:::•::::_:::;:.;- ..::::::•::.,-::._:-:::.::._:..::,:..:::-::..............._...._..
B. S ace coatings stem
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C.....Water. heating system :.:;::
Location Fuel Tvoe Ma
Ar
nufacturer
Model
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
Certification
I1We certify that the above -listed equipment including ducts and -
ing
above location
in conformance with the requirements of the Fort Collins Residential) Energy Code la d/Mechanical Code; and further, that
such equipment was installed in accordance with manufacturer;' instructions.
Person Certifying Job:
oignaiure:
Business Firm:
Address: a fit/(, 2�:)O
Date:
Phone:
'94
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