HomeMy WebLinkAbout7221 Matheson Dr - Disclosures - 11/27/2002 (3)Fort Collins Residential Energy Code .the building At zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mchdisc2.xis—7/110/98 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
n Voice: 970 2216760 FAX: 970 224 6134
n
Job Address: -7ZZk `v ,4 -4 2� 62
General contractor:
Mechanical contractor: Hoar
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
Input capacity AFUE or
Location Fuel Type Manufacturer Model # kBtuh or kW HSPF
B. Space cooling system
Input capacity
Location Fuel Tvoe Manufacturer Model # kBtuh or kW SEER
C. Water heating system
Location
Fuel
'
T e
Manufacturer
of /
Model #
Input capacity
kBtuh or kW
Energy
I Factor
Storage
I volume
Certification
I/We 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 Certifying Job:jQj
Business Erm:
Address:
Phone:�L-. . ! i r�� •
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