HomeMy WebLinkAbout5963 Shearwater Ct - Disclosures/Mechanical - 03/22/2006EM
rt Collins Residential Energy Code the building & zoning dept. Of
ECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
nc-d[s: z x s ;Asa 231 N. College Ave., P.O. Box 580, Fort C011irs, CO 80522
Voice: 970 221 6760 FAX 970 224 6134
Job Address:
General contractor: (',(� SS (
Mechanical contractor: T�o%,tAV��
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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, ex:ept 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
tlon I Pue!
T
B..Space cooling system
ki 4
Input capacity I AFUE or
el # I kBtuh or kW kcap
I
vice
Location = e! '( Manufacturer
oa loi2 I I I
Model #
Input capacity
I kBtuh or kW
I SE=R
- ToN
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I
l
3
C.:Water.heating system
Location
= e 7voe
Manufacturer
Model #
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
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 Job: 67/'f-e-6 Z/f-�o A)
1117
Signature:
Business Firm:
Date:
Address: Do.ve//,t
Phone: o.5D