HomeMy WebLinkAbout6802 ANTIGUA DR - DISCLOSURES - 12/10/1998 (5)12/10/98 10:27 V970 484 4448 ALLEN PLtTKIING Z 002
Fort Collins residential energy code 7196
Mechanical systems disclosure form
Job address:
General contractor:
Mechanical contractor.
:....,..
Space heating system. :;.
Location
Fuel
Type
Manufacturer
Model p
Input capacity
k8tuh or kW
AFUE or
HSPF
Space cooling system
Location
Fuel
Tvoe
Manufacturer
Model #
Input capacity
kStuh or kW
SEER
Water heating"system _
Location
Fuel
Type
Manufacturer
Model #
Input capacity
k8tuh or kW
Energy
Factor
Storage
volume
Certification
VV1la certfy that the above -listed equipment was 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 Mtn manufacturer's instructions. VWe certify that arty ductwork has been installed in conformance with
the cu . rent requirements of the City of Fort Coffins Residential Energy Code and Mechanical Code.
Certified by i ,4- !�0 t1 Y) Phone:_ iw� Lf - ((I f
Business firm: A l.Lew 7p-% t-f pate: _
Address: I&I Lt i.� SWO&UM
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 steal be provided to the Building and Zoning Oepartnrent at final inspection.
One copy of this form shall be provided to the homebvyer.
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