HomeMy WebLinkAbout4226 MESAVIEW CT - MISCELLANEOUS - 5/24/200005/24/2000 17:14 9702238164 MARK TWAIN HOMES INC PAGE 04
I -energy
Job address:
General contractor.
Mechanical contractor.
Pace:: :.ea
Logatlon
Fuel
Tyew
Manufacturer
Model #
InpUtcapacity
k8tuh or kW
AFUFor
HspF
BASEXIMU
GAS
F/A
Location
Fuel-
1
Manufacturer
Model 0
Input capacity
- katuluor-m-
grpir
FIA
F/A
. . .........
. .. . . . ... ........... ... . . ....
......... . .. . .
Location
Fuel
Tvae
Manufacturer
Model #
Input capacity
kBtuh or kW
Energy
Factor
storage
volume
w
INVe oer&y that the above4sted equfpment was Installed In the building at the above locations in conformance with the
current requirements of the Clr/ of Fort Colling Residential Energy Code and Mechanical Code, and that it was installed In.
accordance with rnanufacturaea instructions. VWe certify that any ductwork has been Installed In conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code.
Certified by: ROBERr R MILIAER Phone: (970)223-8873
Business firrn.WgTHEgN QOX0
wz= Ajg, jNc Date,
Addreso:1823 E HARMONY M Signature: 4ik n
Int.tructfons.
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 we murdple systems serving anyfunction, make multiple entries to descrlbe them.
One copy of this form shall be provided to the Building and Zoning Department at final Inspection_
Onecopy of this form shall be provided to the hornebuyer.