HomeMy WebLinkAbout802 BLONDEL ST - DISCLOSURES - 12/12/2007Dec.12. 2007 12:08PM
No, 6565 P. 5
Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mchdisclkls —7/10/98
Job Address:
General contractor:
Mechanical contractor:
7AI
the building & zoning dept. of
Community Planning and Environmental Service
281 N. College Ave., P.O.Box 580, Fort Collins, CO 80522
Voice: 970 2216760 FAX 970 224 6134
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J §.T. . ..... ...
........ .. TUPTAN ........ . . . .......... . . ... .... ... ...... . . ......
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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.
It there are multiple systems serving any function, make multiple entries to describe them.
One copy of this form must be provided to the Building and Zoning Department prior to the C.O.
One copy of this form must be made available to the original home buyer.
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Location
I Fuel
T oe
Manufacturer
auacurer
Model 0
InputCapacity
kBtuh or kW
AFVEor
HSPF
2-222
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.. ........ % ��� .% ::' %,%, . % , . .., . .... . ...
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:.13 Space : .....
g:Ss,,enn ........
...... ..... ..
Location
Fuel
I
Manufacturer
Model #
Input capacity
kOtuh or kW
SEER
..... .. ....
....... .....
:.0Waileriiieaiing::system.
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-listed equipment (including ducts and piping) was installed in the building at the above locations
I/We certify that ' at the above
in conformance with the requirements of the Fort Collins Residential Energy Code and Mechanical Code: and further, that
such equipment was installed in accordance with manufacturers' instructions.
Person Certifying Job: 614-111 1111¢Rll_
Signature: �7rl, Date: /Z//2_A_) 7