HomeMy WebLinkAbout7220 Randolph Ct - Disclosures/Mechanical - 04/21/2005Apr 'L'1 Ub ub:tua anauna t,oiegate
Fort Collins Residential Energy Code. the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
2B1 N. college Ave.. P.O. Boot 510, Fort Collins, CO BEIM .
Voioe: M 2216750 -FAX: 870 224 6134
Job Address: ,. f A AW /'aft Qo 41 A
General contractor.
Mechanical contractor. z b.,r4
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 muRiple systems serving any function. make multiple entries to describe them.
One copy of this form must be provided to the.BuNding 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
kWt capacity.
kBtuh or kW
AFUE or
NSPF
B. Space cooling system
Location
Fuel
Type
Manufactwer
Model 0
Input capacity
kBtuh or kW
SEER
`r'ri'er-
J'&?Tp Re>
ULd
Sr
C. Water heating system
Location
Fuel
Tv29
Manufacturer
Model 0
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
Certification
I/W/e certify that the above -listed equipment (including ducts and piping) was installed in the building at the above kx:ations
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
S
Date: V -1 /-O
BusinessFirm: 6Pr -;ri' /lea7i:f -e P Ti,c
Address• 2®4 Al
Phone: 6397 - Z 3Y 7