HomeMy WebLinkAbout1674 Falcon Ridge Dr - Disclosures - 03/25/200415/07/2013 17:33 FAX 3034859532
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Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
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Job Address,- I Oq rcjco V-1 RrA je.,
General Contractor:
Mechanical Contractor:
the building & zoning dept. of
Community Planning and Environmental Services
281 N Coll Ave-, P.O. Box Sea, Ft. CWm, Co S0522
Volles: 970-221-SM FAX. 970-224-6134
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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 must be provided to the Building and Zoning Departments prior to the C. 0-
One copy of this form must be made available to the original home buyer.
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Location
Fuel
I
ype
manufacturer
Model #
input capacity
k9tuh or kW
AFUE or
NSPF
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P- 010
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Location
Fuel
Ty I
pe
Manufacturer
L model #
Input capacity
kBtuh or kW
SEER
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I Input I Energy Storage
Fuel Type Manufacturer Model# _LkBtuIcaprakCWityj Factor volume
A
Iding
VWO certify that the above -listed equipment (including ducts and piping) was installed in the tb3ijil`
at the above locations
in conformance with the requirements of the Ft.
.Collins Residential Energy Code and Mechanical Code, and further, that
such equipment was installed in accordance with manufacturers' instructions.
Person Certifying Jo
Signature:
Date, old
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Business Firm- C0110001119 19
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Address-. 6it LQ1tTeases
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CC) 80.5 16 Phone- 9492