HomeMy WebLinkAbout6566 Rookery Rd - Disclosures/Mechanical - 09/22/2006`-1ap 22 06 08:34a Robert's Heating & Air
970-897-3161 p.1
Fort Collins Residential Energy Code, the building dt zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
madvcxau -MOM 261 N. College Ave., P.O. Box 580, Fort Collins, CO 80522 .
Voice: 970 221 97W FAX 970 224 6134
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 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.
A. Space heating system
�Lpos tion
,ash �cr+
Fuel
Type
Manufacturer
Model S
Input capacity
k8tuh or kW
AFUE or
HSPF
B. Space cooling system
Location
Fuel
Tvpe
Manufacturer
Model #
Input capacity
ketuh or kW
SEER
C. Water heating system
Location
Fuel
Tvoe
Manufacturer
Model N
Inputcapaclty
kBtuh or kW
Energy.
Factor
Storage
volume
Certification
lAVe 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
Signature: �, L� J, Date:
Business Finn:
Address:��
_ Phone