HomeMy WebLinkAbout5227 Keystone Creek Ct - Disclosures/Mechanical - 06/23/1998Fc,tc Collins residential energy code i196
Mechanical systems disclosure form
Job address:
General contractor.
Mechanical contractor.
Space heating system
Location
Fuel
Tvae
Manufacturer
Model d
Input capacity
kBtuh or kW
AFUE or
HSPF
Q
/ DA
-0
Space cooling system >.
Location
Fuel
. Tvne
Manufacturer
Model*
Input capacity
kRtuh or kW
SEER
y
Water heating system
Location
Fuel
Tvne
Manufacturer
Model if
Input capacity
kRfuh ar kW
I Energy
IFactorI
I Storage
volume
Certification
VW a certify that the above -listed equipmentwas installed in the building atthe above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturer's instructions. UWe certify that any ductwork has been installed in conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code.
Certified by: Robert Puller Phone: 970-223-8873
Business firm: Northern Colorado Air, IncDate:
Address: 1823 E. Harmony Rd. Signature:
Instructions
This disclosure form is to be signed by the mechanical dontractor 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 shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shaft be provided to the homebuyer. rena,awtrssa-ers�ss