HomeMy WebLinkAbout6802 NIMITZ DR - DISCLOSURES - 8/19/2009 (3)0811912009 12:35 Smith and Willis HVAC
(FAX)3036881811 P.002100+4
AUG/18/2009/TUE 11.10 AM Development Review
Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
Mcltditc2.xU —7/10/88
Job Address;
General contractor:
Mechanical contractor:
Em
FAX No. 970-224-6134 P. 002
the building & zoning dept. of
Community Planning and Environmental Services
201 N. College Ave., P.Q. Box $80, Fort Collins, CO 80522
Voice: 870 2216700 FAX: 970 224 0134
1 )(L -NI11 a I IV. ?� � i o2-
INSTRUCTIONS
This disclosure form Is to be alpned by the meohanloal contractor or representative of the general contractor.
Please type or prInL 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 Depgrtment prior to the G.O.
One oopy of this form must be made avallable to the original home buyer,
A. ,Space heating system
Location
Foot
Too
Manufooturer
Model #
Input ospsolty
k9tuh or kW
AFUE or .
"SPF
0 c
8, Space cooling system
Lccatlon
Fuel
Tvoe
Manufacturer
Model #
Input capacity
kstuh or kW
SEER
A i010
C. Water hooting system
taaatfon
Fuel
TVP2
Manufacturer
Model*k
input capacity
kHtuh or kW
Energy
Factor
Storage
volume
Certification
I/We certify that the above-lieled equipment (Including ducts and piping) was installed In the building at the above locatlons
In conformance with the requirements of the Fort Coffins Residential Energy Code and Meohanloal Code; and further, that
such equipment was installed In accordance with manufacturers' Instructions,
Person Certifying Job: cz-- f
Signature: G r ----, Date: SdIn Ito)
Bualnsas'irfrm:
Address: �'%_ AA Q rkA 1 11wN it p-1 (5—<nii�
Phone:
ZjWjW .n
0
OB11912009 12:35 Smith and Willis HVAC
(FAX)3036881811 P.0041004
AUG/18/2009/TUE 11:10 Al Development Review
Fort colllna Residential Energy Code
MECHANICAL DISCLOSURE FORM
amhdlza ll1-7/10/90
Job Addross: � D � V [�� � 1 iYi 1 z_
oensratl contractor:
Mechanical contractor: WAL W— 1A
PAX No, 970-224-0134 P. 002
the building & zoning dept. of
Community Planning and Environmental Servloes
281 N. College Ave., PA, Box 580, Fort Collins, CO 80522
Volca: 970 2215760 FAX: 970 224 6134
-410 4-
INSTRUCTIONS
This disclosure form le to be elgned by the mechanical oontrador or representative of the general controotor.
Please type or print, except for the signature,
If there are multiple ayeterne serving any function, make muidple 0ntrie3 to describe them.
One copy of this form must be provided to the Building and Zoning Department prior to the 0,0,
One copy of this form must be made available to the original home buyer.
A..Spaae heating system
"'arle
Fri riC"►1*ai[s��; Ii l rt i,i.I`�
Ti7Ei1.%��
�.�
��
u:.: 4§1111111MV
_ .
S. Space cooling system
Location
Pus)
Tvpe
Manufacturer
Model #
Input capacity
kBtuh or kW
SEER
l`,
r
2
'CAW►
1
A 031DID
C. Water heating system
Location
Fuel
TV132
Manutaaturor
Model#
Input capacity
kmtuh or IcW
energy
tractor
Storage
I volume
Cert(f eatlon
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 wu Installed In accordance With m&nufecturers' Instructtone,
Person Certifying Job;Lf
signature: `�"�— Onto: "�tO la
S u s a n e>If.$F'll'Pt1:
Address:
U Phorte:���p