HomeMy WebLinkAbout351 Osiander St - Disclosures/Mechanical - 04/24/2012Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
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Job Address:
General contractor:
Mechanical contractor: Northern Colorado Air
INSTRUCTIONS
1�-�110-1339
she building & zoning dept. of
Community Planning and Environmental Services
291, N. College Ave., P.O. Box 590, For. Collins, CO 60522
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This disclosure form is to be signed by the me-"anica! contactor or representative of the genera; 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.0
One copy of this form must be made available to the original home buyer.
A. Space heating system
Location
Fuell Tvoe
Input capacity AFUE or
Manufacturer Model * kStuh or kW I HSPF
07O DOD
B. Space cooling system
C. Water heating system
Certification
IlWe certify that L`re above -listed equipment (inciuding ducts and piping) was installed in the buildine a', the above locations
in conformance with :he requirements Of the Fort Collins Residential Ener rode ez' a -t gy.. a-r M apical Cod_, and fu��ner, tha.
su3h equipment Was installed in accordance vnth manufacturers' instructions.
Person Certifying Job:
Date: L
Business Firm: Northern Colorado Air
Address: 812 Stockton Ave
Fort Collins, CO 80524 Ph-9 0-2 -88