HomeMy WebLinkAbout1638 Ukiah Ln - Miscellaneous - 01/01/2000riUG-04-99 09: 10 AM J. PEDER_:EH CONST.
I
970 224 490
P.01
Foe Collins lRcIsldeentia Enorgy Code the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mch6%. 2 r:c—1110;e8 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX 970 224 6134
Job Address: 1CP3 S G/zL!�iAh'
General contractor: _�, pe_ d e.v 5 e- eo Ca io 5t , .Z1i0—
Mechanical contractor: _ � A k P G b q- 14-4z--
INSTRUCTIONS
This disclosure fgrrn is to be signed by the mechanical contractor or representative of the general contractor.
Please type or print, except for the signature.
It there are multiple systems serving any function, make multiple entries to describe them.
Ono copy of this (orrn must be provided to the Building and Zoning Department prior to the C.O.
One copy of this Grin must be rnade available to the original home buyer.
A. Space heating system
Locatior
Fuel
Tvve
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
Zv
O•
i
B. Space cooling system
i
C. Water heq'ting system
Location
Fuel
Tvoe
Manufacturer
Model #
Input capacity
kBtuh or kW
I Energy
I Factor
Storage
volume
1Q 5 P p7 Z
tit qA&
C5 j4jell
�
Certification
INVe certify that tl�e above -listed equipment (including ducts and piping) was installed in the building at the above locations
in conformance 1h the requirements of the Fort Collins Residential Energy Code and Mechanical Code; and further, that
such equipment wps installed in accordance with manufacturers' instructions.
Person Certifying Job: p we
Signature: a lu1 / Date: p "ca —77
Business Firm: l Y-
Address: - /925)6 1 les.,
Phone: 0, ge r 8 Z
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HLG 05 ,99 02:12PM COLLINS
P.1
Job addim"
own"-Gammewr
Insulation dotttramt:
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E B A T T S
FlalnewaU& and r1lfYband
joists +hbMaticr
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pra mmomlhe dad rlmlband
Jelm—ibattic, garage
3,511
FACU RATTS
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UN A B
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9 BATTS
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MEMO
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th. +ppllaaWe -ONUM M MallaW 6tr111011file F6khad VY11tr* GM eA pa" MWOM
CaMffed bl1: r- r f i_ 5.r_i_n p h n] r I Phone: b b - 5 043
l3LUJnes *M.CQ11 $ns Oashway Insul ation
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ptaaea $tps' srptMe, esrspl for the r�IlOU>.a. '
1f oltltaone►� v�!►ritalnt tsalAlpie+�e#!e daegilba dten. erdu���.aroe
DM espy of Ikta Ibret ohall b■ ttMMae to.ttha 8Yr'IdbM and �tu�fA DO1NibnMd K t~hal trees.
Qea copy or this tone d au be provided w the hereab6w.