HomeMy WebLinkAbout1514 Sea Wolf Ct - Disclosures/Mechanical - 03/22/2004Fort Collins Residential Energy Code the building & zoning dept. of
MECHANICAL Dl%SCLOSURE FORM Community Planning and Environmental Services
chd iscZ)ds —7/10198 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
Job Address: 7/-
General contractor: Lpwa 'q r—
Mechanical contractcr: Xer fF_ 111AV 71,
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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 mist be provided to the E uildIng and Zoning Department prior to the C.O.
One copy of this form m ist be made available t 3 the original home buyer.
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A. heatin"'g,sy tern ...... ... ..........
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Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
-F10
B. Space cooling system
I Input capacity
Location Fuel Tvpe Manufacturer Model # kBtuh or kW SEER
040-l"'I'all _41:7'
-- lee, 2,g.0 lyz
C. Water heating avypi- M'-
Location Fuel TvDe
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Manufacturer
Model #
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
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I/We certify that the abov 9-listed equipment (Ind - tillng ducts "'and '"piping) "wa's'"In's'ta'll'e'd"l*n'*t'h'e"b'u'l'lding"at the'abov'e' locati,ons,
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: /1//;
Signature: � 1�t�'teAOL— Date:
Business Firm: ;"=71-r ,
Address: -_-gsfd
Phone: