HomeMy WebLinkAbout602 Jansen Dr - Disclosures/Mechanical - 10/11/2001Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mchdisc2.xls—7/IGM$
Job Address:
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
M
General contractor:
Mechanical contractor: NOAn—t Ey i>y�pti_�i3jAjer�
. .........................
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
Type
Manufacturer
Model #
Inputcapacity
kBtuh or kW
AFUEor
HSPF
B Space cooling system
Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
C. Water heating system
Location
Fuel
Tvnp
Manufacturer
Model #
Input capacity
kBtuh or kW
I Energy
I Factor
storage
volume
t
;Certification
IMe 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.
CertifyingPerson ..
iBusiness Firm: ce/ Date:
/6 I/•"
w
Fort Collins Residential Energy Code •the building A zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mchd1'jd9'= l QW 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
Job Address:?
General contractor: 1"t�i� � L{ t4, -< T.te ,
Mechanical contractor: 1 ; 115.501-4 P%nariAJr,
INSTkU07iON5
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
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
i1
a
8. Space cooling; system
Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
C. Water heating system
Location
Fuel
Type
Manufacturer
_ Model-#
Input capacity
kBtuh-or-kkk
I Energy
Factor
I Storage
volume
Certification
IMe 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: -720RA( e,
Signature: Date:
Business Flr�:r� A41