HomeMy WebLinkAbout802 BLONDEL ST - DISCLOSURES - 12/12/2007 (4)Dec.12. 2007 12:08PM
No. 6565 P. 6
Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
MCNIWAs -7110198
Y,*V-?7-3
the building & zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice., 970 2216780 FAX: 970 224 6134
Job Address; (Y.O2 9Z'(4,kAr1— 1VW1,r_a2D5__ �1-4114*5
General contractor: A1W _;21(__
Mechanical contractor. Z�_f4elr_
INSTRUCTIONS
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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.
If 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.0,
One copy of this form must be made available to the original home buyer.
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s ........ .
t ...... ..........
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... .. .... ...... .......cooling'. system .....
Location
Fuel
T e
Manufacturer
Model 0
Input capacity
kBtuh or kW
SEER
%C:....W246r hea Ing ystem: ........... ........
............ . .....
. .........
Location
k 5or-k—
UO2�6mkczu
Fuel
101o"5
Tvoe
lnk7rv�
Manufacturer
AA
Model W
1 51624
In Ut capacity
ISMTRC
or kW
W
Energy
Factor
storage
volume
......... . - ... . .....
r i ic
t..10n ........ ............... ...........
...... .......
.. ............
I/We certify that the above -listed equipment (including ducts and piping) was installed in the building at the above locations
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: All 111¢14111
Signature.
Business Firm:
Date:
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