HomeMy WebLinkAbout6802 ANTIGUA DR - DISCLOSURES - 1/18/1999 (5)01/18/1999 14:31 9702299983 NCA
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Fort Collins residential energy code 7/96
Mechanical s stems disclosure form
Job address: &Z0Z At.1T l �S U A OQ.
General contractor: _— A M E5 G0N ST1zU r-? t O f t C'o-
Mechanical contractor. NORTHM 10010HADD AIRr
Space heating system
Location
Fuel
TVbw
Manufacturer
Model •
Input capacity
k8tuh or kW
AFUE or
HSPF
BASEMENT
GAS
F A
-
wo
Space cooling system
Location
Fuel
Tyoe
ManuftctUrar
Model tM
Input capacity
k tuh or kW
SEER
SAS
PAS
F/A
GAS
F/A
Water heating system
Location
Fuel
T
Manufacturer
Model N
Input capacity
k8tuh or kW
Energy
Factor
Storage
volume
Certification
INVe certify that the above -listed equipment was installed in the budding 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 manufacturees instructions. I/Wa 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: H0BWU R MINER
Business firrn: l QM0R D0 AIR,
Address:1823 E HAIdduNY RD
Phone: (970) 223-8873
INC-Date:
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 Budding and Zoning Department at final inspection.
One copy of this form shell be provided to the homebuyer.
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