HomeMy WebLinkAbout3215 Ledgestone Ct - Disclosures/Mechanical - 03/11/2004Fort Collins residential energy code Tl96
Mechanical systems disclosure form
Job address- '3Z-/5 !.6--ze.&�67-ni o6 GT
General contractor: �To�lYbroaK It/bores,
Mechanical contractor. e_/J S7-0M N UAe-
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'S ace he atl 's" ste ri m'
Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
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Location
Fuel
T e
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
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a leek;
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Water::heat to s e
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Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
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:Ce rtific t' a to n
I/We certify that the above -listed equipment was installed in the building at the above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturer's instructions. I/We certify that any ductwork has been installed in conformance with
the current requirements of the City of Fqrt Collins Residential Energy Code and Mechanical Code.
Certified by:4U Phone:
Business firm: 1o;ry >y0/ l/ r Date: . //- p
Address:)06z4z5.4eZj9_luD GO Signature:
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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.
It there are multiple systems serving any function, make multiple entries to describe them.
One copy of this form shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer. ffvhdacrO1F321-6J24196