HomeMy WebLinkAbout5409 Golden Harvest Way - Disclosures - 10/01/2002Fort Collins Resideritial Energy Code the building & zoning dept. of
--de 1� C DISCLOSURE FORM Community Planning and Environmental Service
Fort
colr [MECHANICAL DISCLOSURE
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rPchd1S02Yh -7/loiaa 281 N. College AVe., P.O. Bclx 580, Fort Collins. CO 90522
Voice: 9702216760 F0,970224elU
___ -Job Addrass:
General contractor:
Mechanical contractor:
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.. ... 1. 11.1 ... I . ...... .... _. 11.1.1 ................ -.1. ... .- 1. - 1. 1
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 describl3 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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Pa0P_:,. e8 ng . ... .
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--Location
Fuel
Tyr)e
Manufacturer
Model 9
Input capacity
k5fuh orkWHSPF
AFUEoe
-
fZ&_j6oAq ill
/00, eel 0
7q
.... ........... . .. ... ........ ..
S-pqpp,qooling ... ... .... . .
.... ......
..... .. .. .... ... I., .... ..
. ... .. ... . . .. ..
input capacity
Location Fuel Tyj3e Kanutacturer Model # k3tuh or kW SEER
Waterh' f . .... .....
. . .. ......... ... . .. .... ... .. ....... . .........
Location
Fuel
Tvt3e
Mandfacturpp
Mn
Input capacity
U or kVV
Energy
Factor
Storage
volumez
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. . . . . . . . . . . . . . . .
I/We certify that the above -listed equipment (including ducts and piping) was installed In the building at the above IoDaji'l)"n's
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 MahufactUrert'Instructions,
Person Certifying Job:
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