HomeMy WebLinkAbout6714 ANTIGUA DR - DISCLOSURES - 6/14/1999 (15)01/18/1999 14:31 9702299983 NCA
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Fort Collins residential energy code 7196
Mechanical systems disclosure form
Job address: 671 1+ At IT I C3 U A OR - ✓ q
General contractor: d'RMES _ GoNSTtzU(,?IDN <.d
Mechanical contractor. N01U79Nl C0Z+01?AM AIR►
Space heating system
Location
Fuel
e
Manufacturer
Model 0
Input capacity
k8tuh or kW
AFUE or
HSPF
BASEP9=
GAS
F A
Space cooling system
Location
F
e
Manufacturer
Model N
Input capacity
k tuh or kW
SEER
GAS
F/A
Water heating system
Location
Fuel
TVDO
Manufacturer
Model *
Input capacity
k8tuh or kW
Energy
Factor
Storage
volume
Certification
UWe certify thatthe above -listed equipmentwas installed in the budding atthe above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturers instructions. UWe carts fy 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: RDi3M R MLL12R Phone: (970) 223-8873
Business flrm:� T COLORADO AIR, INC Mate: �- A
Address:1823 E HATNEW RO Signature:
Instructions
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 descrtbe them.
One copy of this form shall be provided to the Building and Zoning Department at final inspection.
One copy of this Corm *hall be provided to the homebuyer.