HomeMy WebLinkAbout5303 Mill Stone Way - Disclosures - 10/23/2003wa l? 2001! L13: 11 WR I TER HOMES 4 6636071
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M 224 6134
-- s�,�; .: ��'� ?ti�: CITY OF FT COLLINS
Fort Collins Resident -sal Energy Gode
MECHANICAL DISCLOSURE FORM
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Job Address: 3� r
General contractor
Mechanical contractor.
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the building & zoning dept. of
Commun'rty Planning and Environmental Servlae5
281 N. cogeege Ave, P.O. Box S80, Fprt Coffins, CO 80M
yaks. 970 2216760 'FAX. 970 224 6134 '
Tins disdosure 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, snake multiple entries to desotibe, them.
One copy of this form must be provided to the wilding and Zoning Department prior to the G.O.
One copy of this form must be made available to the original home buyer.
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Location
Fuel
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Medetif
Input capacity
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Location
Fuel
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Model R
Input capacity
L K8tuh pr kW
. Energy
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.Storage
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suah equipment was installed in accordance witty manufacturer3' instructions_
Person Certifying _fob:
Date:,
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