HomeMy WebLinkAbout6714 ANTIGUA DR - DISCLOSURES - 6/14/1999 (11)01/18/1999 14:31 9702299983 NCA
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Fort Collins residential energy code 7196
Mechanical systems disclosure form
Job address: 6-11 Q" AST i C3 u A og . 2M 37
General contractor: j'A M a_ __GON STIZ.0 i l O N C.a-
Mechanical contractor: N01?rEiFili3 C0Q0R= AIR.
Space heating system
Locqdon
Fuel
TVbw
Manufacturer
Model S
Input capacity
k8tuh or kW
AFUE or
HSPF
BASEM9=
GAS
F A
Space cooling system
Location
Fuel
Tvoe
ManufaLftrar
Model 0
Input capacity
k tuh or kW
SEER
GAS
F/A
Water heating system
Location
Fuel
T
Manufacturer
Model a
Input capacity
k8tuh or kW
Energy
Factor
Storage
vaiume
Certification
INVe certiljr that the above-liatod equipmentwas iroftled in the building at the above locations in conformance with the
current requirements of the City of Fort Courts Residential Energy Code and Mechanical Code, and that it was installed in
accordance wiat manufacturer's instructons. UWe certify that any ductwork has been installed In conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code.
Certified by: 1UHM R I+ III" Phone: (970) 223-8873
Business firm*jQR=7 COIDPJM AIR, IWJ)otr 6-
Address:1823 E HAT44ONY RD Signature: _01
Instructions
This disefosure 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 multipls systems serving arty function, make multiple entries to describe them.
One copy of this form shall be provided to the Building and Zoning Department at final inspection.
One copy of this form shall be provided to the homebuyer.��_