HomeMy WebLinkAbout915 THORNHILL PL - DISCLOSURES - 7/15/2003Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE _FORM
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Job Address:
General contractor:
the building & zoning dept. of
Community Planning and Environmental Services
281 K College Ave., P.O. Box 580, Fort C616ns, CO 80522
Voice: 970 2216760 FAX 970 224 6134
Mechanical contractor: LG•tit oar C %7�a •��i.►" e,/G:
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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 must be provided to the Building and Zoning Department prior to the C.O.
One copy of this form must be made available to the original home buyer.
Location
rt v
Fuel
Type
Manufacturer
.�
Model #
input capacity
kBtuh or kW
O 0
AFUE or
HSPF
07
..::::-:.:Space -cooling sysiem.�.:•._:.:::.:::;•:::::::.:::.:::::�:.:.:::::....::.:.:::.:•:.::._:•:::::•::::::•::•:.�:.: ..::::.::::.:.::••:.:::.::.::::::•::::::.:-:::.:.::::.::::
Input capacity
Location Fuel T Manufacturer Model # kBtuh or kW SEER
..............:...............::::•:::::;•::::::::::•::::::::::•::::•::::•.::::::::•::::::::.:::::::•::..:.....:.....:.:......:.:.......:.:...:...:..:........
:.V1later: heatin ::s..s e.rrr::::::::;::::::. ............ :•::::::::::::::::•::.,.....................:•::::::::::::...................:.:.::::::::::::.....::::.::.:.
9...........................................:•:.-:::::::::::•.:_::::•::::.:::•:;:::•:::.:::::.::::::::::::._::::::.:::::.:_:::._::::::.::::................................
Location
Fuel
T e
Manufacturer
Model#
l acItY
kBtu op kW
000
Energy
Factor
Storage
volume
1/We certify that the above -listed equipment (ncluding ducts and in was installed in the building at the above locations
....................................
in conformance with the requirements of the Fort Collins Residential) Energy Code and Mechanical Code; and further, that
such equipment was installed in accordance with manufacturers' instructions.
Person Certifying
I ;r /?v
Date:
Business Firm:
Address: f' O lyo,y
Phone-