HomeMy WebLinkAbout5050 Brookfield Dr - Disclosures - 11/24/2003 (5)60 * d -Ibloi
FEB-27-2001 TUE 01:46 PM FO BUILDING AND ZONING FAX NO. 0702248134
P. 01
Fort C911ins RosidOntial ErArgY Ccd*
MECHANICAL DISCLOSURE FORM
Job Address, jm.,Oww plj.w
General contraCtOr.
- 9�
Mechanical oontractur. Z Alias a
the building At zoning dept. of
Community Planning and Environmemntal Service
201 K Co#sgs Am, P.O. Sox 550. Fait CAM. CO DOW
VOW4,-970221a7w FAX 970224MU
a,41*7-0 A/
11(dA
................................... I
This disclosure form is to be signed bythe Mechanical Connclar Of Mpfesentallye.of the general contrador.
Pleass type or pdnl, except for the signature.
if there are multiple ay MM2 sonfIrill WY rundtiM. MaVA multiple entries to describe them.
One copy of this form muo be provided to the Bulking arid Uning Department Prior to the C.O.
One copy of this fort must be made available to the original home boyar,
X, 0*.,*,-
-V n.;r
(A
b" ... ......... ..... "Ra.I
PA. 0.�
4.
coo. ng..
0�141� ... ;. - — - - - - - g"
QKR! .... ..
"'WAY!
me card(y that the above -listed equipment oncluding ducts and piping) was frolalled in the building st the ;IVW* locations
In conformance with the requirernerds of the Fort Collins MaMe4al Energy Code and MachaKical Code: and further, that
such equipment was Installed In accordance with memufactureW instructions.
Person Certifying
Firm: G
Address: 0//,a /y, 114
14e4a
ITT']
,# ICA
A
Flr! T I Qnrl)-4(7