HomeMy WebLinkAbout417 S GRANT AVE - DISCLOSURES - 1/23/2009EC
ollins Residential Energy Code
HANICAL DISCLOSURE FORM
mchdiscZ)ds—7/10/98
Job Address:
General contractor:
Mechanical contractor:
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.
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 221 6760 FAX: 970 224 61 "A4FIIC\\ �
A. Space heating system
Input capacity
AFUE or
Location
Fuel
Tvve
Manufacturer
Model #
kBtuh or kW
HSPF
v
v_c I7
d
B. Space cooling system
Location
Fuel
Type
I Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
c
C. Water heating system 41, Mae., oqv
Input capacity
Energy .
Storage
L cation
Fuel
T e
Manufacturer
Model #
kBtuh or kW
Factor
volume
O
Certification
I/We certify that the above -listed equipment jinc ing ducts and piping) was installed in the building at the above locations
in conformance with the requiremen�,df the Forf Collins Residential Energy Code and Mechanical Code; and further, that
such equipment was installed in accordance -with manufactu_Lp4s' instldctions.
Person Certifying7dob:
42
Signature: ------ _. r Date: Q
Business Finn:
Address: .(///;z
Phone: