HomeMy WebLinkAbout2338 Clipper Way - Disclosures/Mechanical - 07/20/20065-. e.. - -iI;I
fFo7rtCo'.11.i,ns; Residential Energy Code
ECHICAL DISCLOSURE FORM
r,-rm 2 zW-7/13/98
Job Address:
General contractor:
Mechanical contractor:
INSTRUCTIONS
This disclosure form is to be signed by the mechanical contractor or representative of the general Contractor
Please type orprint, sxcept for the signature.
If there are multiple systems serving any furctlon, make multiole entries to describe them.
One copy of this form must be provided to the Building and Zoning 6epartrnent prior to the C.C.
One copy of this form must be made available to the original home ouyar.
the building & zoning dept. of
Community Planning and Environmental Services
2a1 N. College Ave, F. p. Box 58C. Fort Crshins, CO 60522
Voice. 570 221 673C F M 970 224 61 A
A. Space heating system
B. Space cooling system
C. Water heating system
Location Fuel
`—
T e _ —_1..._
Manufacturer _; _Model_
storage
I input cHIPn or kW' Energy ' volume
tun or kW Factor volume
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—�
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Certification
I/We ::artify that the above -listed equipment (including ducts and piping) was installed in the building at the abava locations
n conformance wtth the requirements of the For. Collins Residertial Energy Coda and Mechanical Code, and `urthe-, that
such equipment was Irstail2d in accerdyce with manufactures' instructions.
'erson Certjfyirlg Job:
I
Phoni0-j) 76