HomeMy WebLinkAbout7527 Triangle Dr - Disclosures/Mechanical - 03/22/2005E
ollins Residential Energy Code
ANICAL DISCLOSURE FORM
MCWisc2.xb —7/1 OM
Job Address:
General contractor:
Mechanical contractor:
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 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
Tvpe
Manufacturer
Model 0
Input capacity
kBtuh or kW
AFUE or
HSPF
e d
A 01 a 43ru:9A K' 1_11 f_1
i/G of g,
B. Space cooling system
Location
I Fuel
I Tvoe
I Manufacturer
I Model #
Input(kBtuca
hor acity kW
I SEER
r
C. Water heating system
Location Fuel T Input capacity Energy Storage
vDe Manufacturer Model 0 kBtuh or kW Factor 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 Certifying Job:
Signature: Date:
Business Firm: mop
Address: lll�.� 1 4 h a rr r �nkf
Phone: M3 _ Ya& - K
t
ort Coffin* RaidonUfAway Code the building azoning dept. of
ECHANICAL DISCLOSURE FORM Ca"Un qr Planning and Errrirohuna� services
„e ,�.�rnD�ae 29114. Wop Ave., p.C. 13W 5W, For! CQWn., OC MW
V*V. M:M GM FAX, WM 2M OW
Job Address:
oeneral contractors 10L=
Mechanical contractor:
iNSTRUCTION8
This disclosure form is to be signed by ft mechanical contractor or representative of the general contractor.
Please type or print, ooloept for the signature.
ff there are MUMP1e systems senAng any function, make multiple entries to describe them.
One copy of this form must be pwkled to the Building and Zoning Department prior to the C.O.
One copy of this lbrm must be made available to the original horse buyer.
e Unnr+n hasidna sultan
n nw.._m nnniina sysb m
C. WaW hurting system
Cerocoon
IIV11e oerlbtythat tbeabove-listed equipment (including ducts and piping) was Installed lh �e building at the above to ons
u►rements of the Fork Collins i'taiderttial Energy Code and Meohanioal Code; and further, that
In conformance with to
req .
such sgUipmOnt was installed in accordance wM manufacturers' instructions.