HomeMy WebLinkAbout3051 Sage Creek Rd - Miscellaneous - 02/28/2001 (4)Fort Collins residential energy code 7/96
Mecha-m
Job address: =�
General contractor:
Mechanical contractor: NORTHERN
Space heating system
disclosure
Location
BASEMENT
Fuel
GAS
T e
F A
Manufacturer
/ Q
Model #
IkBtucaacityh op
kW
%Jh
AHSPF r
db
Space..cooling system
Location
Fuel
-
T e
Manufacturer
Model #
Fi%IP
Input capacity
kBtuh or kW
SEER
GAS
F/A
Ff1/eZ/d 3
/O
Water heating system.
Inputcapacity Energy Storage
Location Fuel Type
Manufacturer Model # kBtuh or kW Factor volume
Certification
INVe certify that the above"listed equipment was installed in the building at the above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturer's instructions. IM/e certify that any ductwork has been installed in conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code.
Certified by: ROBERT R MILLER Phone: (970) 223-8873
Business firm Og 1 COLORADO AIR, INC Date: 2- 7
Address:1823 E HARMONY RD Signature:
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 shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer. mrMse.x I/6527—W4196