HomeMy WebLinkAbout4900 SMALLWOOD DR - MISCELLANEOUS - 6/17/1998Fort Collins residential energy code 7/96
Mechanical systems disclosure form
Job address:
General contractor.
Mechanical contractor.
Space heating system
Location
Fuel
Type
Manufacturer
Model #
Input capacity
k8tuh or kW
AFUE or
HSPF
-14
zv
gp
Space cooling system
Location
Fuel . Tvpe
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
Water heating system
Location Fuel Type
Manufacturer
Model #
Input capacity
or kW
Energy Storagek8tuh
Factor volume
I I
Certification
UWe certify that the above -listed equipmentwas installed in the building at the above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturer's instructions. INVe 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: Robert Miller Phone: 970-223-8873
Business firm: Northern Colorado Air, IncDate:
Address: 1823 E. Harmony Rd. Signature: Jc I
Instructions
This disclosure form is to be signed by the mechanical dontractor 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 shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer.