HomeMy WebLinkAbout3914 Grand Canyon St - Disclosures/Mechanical - 05/03/19991rs�/i()
Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mchdisc2xis —7/10198
Job Address:
General contractor:
Mechanical contracto
the buildinc & zoning dept. of
w
Community Plan iing and Environmental Services
281 N. College Ava. P.C. Box 580, Fort Collins, CO 80522
Voice: 970 221 6781. FAX: 970 224 6134
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This disclosure form is to be signed by the mechanical contractor or reprem ntative of th •
. e - g . e . n . e . r . al .. contractor.
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Please type or print, except for the signature.
If there are multiple systems serving any function, make multiple entries to lescHbe 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.
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02ing 1 'P 1.
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Location
Fuel
TvDe
Manufacturer
I,lodel # —j
Input capacity
kBtuh or kW I
AFUE or
HSpF
AS Gz ipi j z
Cr
►a
A'I�R) ti-
5911155-120
-15A 12012
a/-
-&QA-11
..system:
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Pplce jnq.
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Location
Fuel
TvDe
I
Manufacturer
lodel #
Input capacity
kBtuh or kW
SEER
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.Water
ebm - ... ..... rn:
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Location Input capacity Energy Storageuel ve Manufacturer Vodel #
kBtuh or kW Factor volume
j
t f'I , 'a
ja
I/We certify that the above -listed eq...
uIpment (including ducts and plpl'n*g)w',*i'., installed in,the building at the a6ove' 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, instruction;
Person Certifying Job:
r-3usiness Firm:
Date:
Phone: 9,169