HomeMy WebLinkAbout6714 ANTIGUA DR - DISCLOSURES - 6/14/1999 (9)01/18/1999 14:31 9702299983 NCA
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Fort Collins residential energy code 71968
Mechanical systems disclosure form
Job address: (O % 14- f v i-r t C3,u A„ a,;,.,�m 8
General contractor. J-'R M ES GoN STRUM? t o N 0-
Mechanical contractor. NORi'IENI CIOTORAM AIRS
Space heating system
Location
Fuel
a
Manufacturer
Model *
Input capacity
k8tuh or kW
AFUE or
MSPF
g�GAS
F A
ago
Space cooling system
Location
Fuel
TVoe
Manufacturer
Model 8
Input capacity
k tuh or kW
SEER
QS
F/A
Water heating system
Location
Fuel
TVDe
Manufacturer
Model *
Input capacity
k8tuh or kW
Energy
Factor
storage
volume
Certification
UWe certify that the above -listed equipmentwas installed in the building at the 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. INVe cerli 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.
Certlfied by: FOBEW R MTTJER Phone: (970) 223-8873
Business firM*jAC=7 COIiORADO AIR, 1W-Date• - - q.1
Address:1823 E RAR40NY RD 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 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.