HomeMy WebLinkAbout840 Brookedge Dr - Disclosures/Mechanical - 05/15/2012Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
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Job Address:
General contractor
the building & zoning dept. of
Community Planning and Environmental Services
281 N. Coffege Ave:, P.O. Box 550, Fort Collins, CO 80522
Vase: 970 2216760 FAX 970 224 6134 .
Mechanical contractor. �'1�rf /'Rc�.nnicni
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
. T
Manufacturer
Model A
input capacity.
kBtuh t kW
AFUE or
HSPF
000
221
B. Space cooling system
W0111 or MN
SEER
FROM
M-713FIRRE
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C. Water heating system
Location
Fuel
Inputcapacity
Energy]
Storage
xrm
Manufacdrrer
.. `
Mode10
kBhrir or ktN
Factor
volume,
ro.
h
6
0
r
Certification
I/We certify that the above -fisted equipment (including duds and piping) was Installed in the building at the above locations
In coniormance 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:
Firm:
Address: