HomeMy WebLinkAbout2126 Nancy Gray Ave - Disclosures/Mechanical - 10/01/2012Fort Collins Residential lEneW Code the building at zoning dept. of
MECHANICAL • DISCLOSURE FORM Con mdnRy Planning and Envimmiental Services
mops -7now 281 N. COMP AM., P.O. Sax SIM, Fan Cadins, CO 80522.
Yoko 00 2216790 FAX 070 224 9134
Job Address:
General contractor:
Mechanical contractor.
INSTRUCTIONS
This disclosure form Is to be signed by the mecnanical contractor or representative of the general contractor.
Please type or print, except for the signature.
It there are multiple systems serving any function, make multiple entries to describe them.
One copy of this form must be provided to the Bulding and Zoning Department prior to the C.O.
One copy of this form must be made evallable to the odglnal home buyer.
A. Space heating system
B. Space cooling system
C. Water heating system
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 Job:
Slanature: t�.s
Address:
0-•c S=C GAPhone, C' W,. • -- 23E°�-