HomeMy WebLinkAbout4226 APPLEGATE CT - MISCELLANEOUS - 5/30/200105/30/2001 07:21 9702238164
MARK TWAIN HOMES INC PAGE 02
Pr c,.r
Fort
Job address:
General contractor:
Mechanical contractor:
Space l eating system
r:s residential energy code 7/96
re
Location
BFSP1lENi'
Fuel
GAS
TvDQ
hirer
Model #
Input capacity
tuh or kW
AFUE or
pF
Spape<.coiiling system
MIMES
�'�VAZMTJ#M
NAMM "If ANTI
EROSION
0 MY
1N, t hea ingsysteml .
Location Input capacity Energy Storage
Fuel T Manufacturer odel #_J=h or kW Factor volume
Certification
IMfe certify that the above4sted equipmentwas installed in the buAdng at the above locations in conformance with the
current requirements Of the City of Fort Collins Residential Energy Code And Mechanicai Code, and that it was Installed In
accordance with manufacturer's instructions, WV6 certify that any ductwork has been installed In conformance with
the current requirements of the City of Fort Coons Residential energy Code and Mechanical Code.
Certified by: ROBERT R MILLER Phone: (970) 223-8873
Business firm OOLpgApp AIR, INC.Date:
Address:N23 E Y M Signature:
9 by the mechanical contractor or re
This disdoeure form is to be signed
Ppresentatlye of the general contractor.
Please type of prim except forthe signature,
If there are muftlpla systems serving any fuhction, make multiple entries to describe them.
One copy of th* form shall be provided to the Sul ding and Zoning Department at final inspectlon.
One copy of this form shall be provided to the homebuyer.
.wA.rV VN27-934M