HomeMy WebLinkAbout1345 Forrestal Dr - Disclosures - 10/05/2004Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mchdiscDds—7/10/9B
Job Address:
General contractor:
Mechanical contractor:
NorthernyColorado Air
the building & zoning dept.
Community Planning 4nd Environmental Services
2B1 N. College Ave., P.O. Box 530, Fort Collins, CO B0522
Voice: 970 221 6760 _ FAX 970 224 6134
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 .
Location
Fuel
TvDe
A manufacturer A
Model #
Input capacity
kBtuh or kW
AFUE or
HSP
E
B. Space cooling system
Location
Fuel
TypS
i j�l
Input capacity
=
0 l�
�i-AU
V
��
—D—Water_heating_s"ystem
Location
Fuel
j
I Type
I Manufacturer
I Model #
Input capacity
kBtuh or kW
I Energy.
Factor
I storage
volume
Certification
I/We certify that the above -listed equipment (including ducts 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 manufacturers' instructions.
Person CertifvirM Job: Ann BArker
Signature: ��--� ,i��� Date:
BusinessFirm:Northern Colorado Air
Address: 812 Stockton Ave
Fort C011ins, Co Phone: 970-223-8873