HomeMy WebLinkAbout913 BELVEDERE CT - DISCLOSURES - 8/27/2000Job address:
General contractor-.
Mechanical contractor-.
t-ort: kowins residential energy code 7196
Mechanical systems disclosure form
Sh evo —j'D
let) )Ov- j-/
................ ..........
;P eat
.......... ..... . .. ......... - ............. ....... .................. . ................ .... .. ......... ..... .. .
... ........ ........ % ....... ........
.... . ....... .......
Location
Fuel
-T e
Manufacturer
Model #
input capacity
k8tuh or kW
AFUEor
HspF
. ........... ... ..... . .......
Space cooling--.-'.-Sy;��12M:�:-
............. .. ...........
. ........... ..........
va
location
ff
Fuel
Type,
Manufacturer
Model V
Input capacity
k6tuh or kwI
SEER
V
............ . .......
e r heating system.. .. . . . .......
.. .... .. . .. . ......
Location
Fuel
TXpe
Manufacturer
Model 4
Input capacity
k8tuh or kW
Energy
Factor
Storage
volume_
'6"em en f -
.c.
'
qO. one--)
7:=
-tification
certify that the above -listed equipment was installed in the builCring at the above locations In conformance wLh the
c, ent requirements of the City of For( Collins Residential Energy code and Mechanical Code, and that it was installed in
;ordancewith manufacturer's instructions. VVVe certry that any ductwork has been installed in conformance with
current require . ments of the City of Fort Collins Residential Energy Code and Mechanical code.
Certified by: -Aj Phone:
Business firm: c�n/(j Cq 2� -
ti ;t Date -
I Address: Signature:
Instruct-'C'
Ihis disclos,f-,I:< be signed by the mechanical contractor or representative of The general conlractm,
leas,i,tyne apt for The signature.
e ;are mulTiple systems serving any function, make muttiple entries to describe them-
'Ie of this ro" rm rhall be provided to the Building and Zoning Department at final inspection
re .)y of this form shall be provided to tho homebuyer.