HomeMy WebLinkAbout1439 Curtiss Ct - Disclosures - 03/24/2003_�Eb-2i-2001 TUE 01:45 PM FC BUILDING AND ZONING FAX NO. 9702246134 P. 0!
Fort Collins Residential Energy Code the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
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nY-hd4r,Z.Os -7110M 281 N. College Ave., P.O. Box 580, Fort Collins, Co 80522
Voice: 970 2216760 FAX 970 224 6134
Job Address:
General contractor.
Mechanical contractor.
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 CA.
One copy of this form must be made available to the original home buyer.
A. Space heating system
Manufacturer
Input capacity
AFILIE or
B. Space cooling system
I
_
I input capacity
r kW
SEER
__I
C. Water heating systern.
Location
Fuel
a
Manufaeturar
M
Input capacity
or
Energy
F of r
Storage
volume
Certification
INVe certify that the above -listed equipment (Includin ducts and piping) was installed In the building at the above locations
in conformance with the requirements of the Fort Co1Gns Residential Energy Code and Mechanical Code; and further, that
such equipment was installed in accordance with manufacturers' Instructions.
Person CeRifylgg,lob:
Signature:
Business Firm:
Address:
Date:
Li im6rr^nLyr GD , �3D'��1 Phone: Z
�03 77�333