HomeMy WebLinkAbout1015 Andrews Peak Dr - Disclosures/Mechanical - 01/18/2005JAN 18,2005 13:46 19703563587 Page 1
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Residential Energy Code
CAL DISCLOSURE FORM
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the building & zoning dep. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box Sao, Fort Coins, CO SOS22
Voirp.• a7n ,".l 5760 FAX 970 224 6134
Job Address:
General contractor. s U-z-k ppfywM �CICI' .�Gti,�r
Mechanical contractor, (,e.vv, C
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 systetin•:
Location
Fuel
b a
T
n a{;
Manufacturer
(0CA
Model i
ti r7 -
Input capOCnY
kl3uh or kW
�' 0 Cock
AFUE or
HSPF
8. Spate cooling systt:m..;.:: .:... -
Location Fuel T Input capacity
Manufacture► el t kBtuh w kW SEER
C. Water heating system
Location Fuel Tw�Inl� capacity Energy Storage
Manufacturer Model A kBtuh or kW Factor volume
r I Ca. Ott" ;:;:::;::::...:;"; ;, .:;::`'. ;:.:.::::.:::::::..: .:.......::::. `:::....... . ..... •.. .. •:::...:
I/We certify that the above-hsted equipment (including
ducts and • • .. IIed..in ,.. ,.
� rW piping) was installed in the building at the above bcations
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 manufacturer instructions.
Person Certifying Job: - -, _rr
n 1
Date:
ousiness rirtrr: ' L C vn(;0n 5 ff-eGkt,,,K
Address: y '7L3W C 5
R C lCy , Co y 6.�' Phone: q )0 F, )- 0