HomeMy WebLinkAbout6802 ANTIGUA DR - DISCLOSURES - 12/10/1998 (3)12/10/98 10:27
%2970 484 4448 ALLEN PLUMBING
Z002
Fort Collins residential energy code 7196
Mechanical systems disclosure form
Job address: Z
General contractor.
Mechanical contractor A L-L -E n!
Space heating system
co PIig;;-QVCTIoN C
Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
Space cooling system
Location
Fuel
T e
Manufacturer
Model #
Input capacity
kStuh or kW
SEER
Water heating system
Location
Fuel
T
Manufacturer
Model *
Input capacity Energy
k8tuh or kW Factor
Storage
volume
Certification
VWv 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 a4ih manufacturer's instructions. VWe certify that any ductwork has been installed in conformance with
the current requirements of the City of Fort Coffins Residential Energy Code and Mechanical Code.
Certified by: CO rl Y) Phone: L(S (; - ((I
Business firm: ALLeti }P - t"( Date:
Address: 161 < _ f _t.� i� t �.� Skmatum
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 homebuye►. oYc. shs.aA_vx�