HomeMy WebLinkAbout645 STONEHAM CT - DISCLOSURES - 1/24/2000 (3)Fort Collins resideii iai-mTr(-vrgy code !`196
Mechanical systems disclosure form
Job address:( tom-
General contractor. - - - - --- --
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Mechanical contractor. - - -- - -- --_.
Space 1>ieating `system
- Location
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Fuel
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Type
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Manufacturer
Model #�kBtuh
Input capacity
or kVv
AFUE or
IISPF
Space cooling system
Location
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Fuel rvpe
- -
Manufacturers
_
Model #
Input capacity
kQtuh or kW
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SEER
Water heating system
Location
Fuel Type
Manufacturer
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Input capacity I
Model # kQtult or kW
Energy
Factor
I Storage
volume
Certification
IM/e certify that the above -listed equipment was 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 s j
Business firm: Mra�n,i
Address:
Phone:,
Date:
nature:
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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 shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer,
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