HomeMy WebLinkAbout802 BLONDEL ST - DISCLOSURES - 12/12/2007 (8)Dec. 12. 2007 12:07PM
No.6565 P. 4
Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
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the building do zoning dept. of
Community Planning and Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216750 FAX: 970 224 6134
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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.O.
One copy of this form must be made available to the original home buyer:
A pace heating sjrstern ;:
Location
Fuel
Type
Manufactuter
Model #
Inputcapacity
1 kBtuh or kW
AFUE.or
HSPF
S S,pace cooling system ..
Location
Fuel
T e
Manufacturer
Model #
Input capacity
kBtuh or kW
SE ER
C Water heating system
Location
l
Fuel
Type
Manufacturer
c nrW
Model #
In capacity
kstu or kW
DBd
Energy
Factor
Storage
volume
Q
Or
ernncauon;
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:
Qiylldwre: %/(/ ��/ L2207 r Date: