HomeMy WebLinkAbout650 Jansen Dr - Disclosures/Mechanical - 11/01/2001Ca
Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mchdiscDMC h0/98
Job Address:
the building & zoning dept. of
Community Planning and Environmentar Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
General contractor: Hexony I-kmg,S Zit
Mechanical contractor: (5; lmse � dgzm jr
INSTRUCTIbNS
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 e
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
F" g2se
A.
13. Space cooling system
Location
Fuel
Tvpe
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
C. Water heatingsystem
Location
Fuel
TvDe
Manufacturer
Model #
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
Certification
I/We 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 ..
Signature:i/
J / ►�
Address:
5 ,
Fort Cdllins Residential Energy Code the building & Zoning dept. of
MECt4WAL DISCLOSURE FORM Community Planning and Environmental Services
mchdisclAs-7/10/98 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX: 970 224 6134
Job Address: U1-n �-] lit
General contractor:
Mechanical contractor: H(jk-LEy ?c_16:MIA&
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
TvDe
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
B' Space cooling system
Location
I_
Fuel
I_
Tvoe
I
Manufacturer
Model #
I Input capacity
kBtuh or kW
SEER
C.;: Watet'. heatingsystem
Location
Fuel
Tvne
Manufacturer
Model It
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
-
!al
I AgR -
Certification
I/We 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:�.
Signature:ii
Business Firm:
Address:
'r //�i • ' • � r
4C..