HomeMy WebLinkAbout5038 Brookfield Dr - Disclosures - 05/07/2003 (3)Fort Collins Resideni3al Energy Code the building At zoning dept. of
MECHANICAL DISCLOSURE FORM Commune P_la_n_nina and Environmental Services _
w&Ww2A -7rtWW 281 N College Awe., P.O. Box 550, Fort Collins, CO 80522
volos: g70221 e760 FAX: 970 22!0134
Job Address:
General contractor.
Mechanical contractor:
0
'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 C.O.
One copy of this form must be made available to the original home buyer.
A. Space heating system
Fuel
Tnw
Manubbeturer
Model d
Input capacity
kBtuhorkW
AFUE or
HSPF
cy kija-ap
A07d,
aceM .
`C.. �IUdi r °hit s
Location
Fuel
T
rer
Model 0
Input
to or IdN
Factor
olmge
volume
Certification, . ... :.... ... . .. . � �: _ '...:..... , ;....... :....,.. - . • . _ ..
WVe certify that the above-Ilsted equipment (including duds and piping)'was installed In the building at the above locations
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 menufacturenK Instructions. -
Phone