HomeMy WebLinkAbout806 SHORE PINE CT - DISCLOSURES - 7/11/2001Fort C
Mec
Job address:
.-. General contractor: ,
Mechanical contractor: NORTHERN
residential energy code 7/96
ll systems disclosure form
Space heating system 6(� Sn°2�e-''vt-�
Location
BASEYIENT
Fuel
G
T e
>~ /A
Manufacturer
Model #
Input capacity
kBtuh-or kW
I AFUE or
HSPF
/
Sl7
Space cooling system
Location
Fuel
CAS
T e
F/A
Manufacturer
Model #
acity
Input kBtuh or kW
SEER
GAS
F/A
�o
v
Water heating system
Location Fuel Type Input capacity Energy Storage
Manufacturer Model # kBtuh or kW Factor volume
Certification
VWe 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. l=e 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 R MIT,T,RR Phone: (970) 223-8873
Business f rrnNORTHERN COLORADO AIR, INC.Date:
Address:1823 E HARMONY RD Signature: �,,
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.
-=*$e.v I/5513—W446