HomeMy WebLinkAbout1403 Leahy Dr - Disclosures/Mechanical - 05/11/2005Fort Collins Residential Energy Code the bUlldirg & ZOf1in9 dept. Of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
m0'Kbc2.* 7110= 281 N. College Ave., P.O. Banc 580, Fort Collins, CO SM22 .
Voice: 970 2216760 FAX 970 224 6134
Job Address:
General contractor.
Mechanical contractor
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
Two
Manufacturer
Model *
Input capacity
kBtuh or kW
AFUE or
HSPF
Pal
N
r
1
9451 72
B. Space cooling system
Location
Fuel
Tvpe
Manufacturer
Model 0
Input capacity
kStuh or kW
SEER
C. Water heating system
Location
Fuel
T
Manufacturer
Model Sfl
nput capacitystorage
kBtuh or kW
Factory
volume
Mon:
VV 3
o
Certification
INVe 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
Ra4minE±sc Firm -
Address: ?OD /Y.
z aO �'d6 /8'" Phone: 7 - -Z.i�_77