HomeMy WebLinkAbout602 KEENESBURG CT - DISCLOSURES - 1/9/2004 (3)Port Collins Residential Energy Code
MtCNANICAL b1SCLOSURE FORM
fthtfteUs—71JUM8
Job Address
Geheral contractor:
Mecnahicgl contractor: 1-11c.,wr1 L�f �1,,,,Br,
the building (& zoning dept.' of
Community Planning and Environmental Services_
281 N. College Ave., P.O. Box 580, Fort C011ins, CO 80522
Voice: 970221 676r) FAX• 47n 7)e riae
C"fi.1 N 5:`::.:::.:::::.::.:..:::.:::
............................::..:............................ .
This disclosure form is to be signed by ti)e mechanical contractor or representative of the general contractor.
............ ... ..........
Pleal;b.type of print, except for the signature.
If thot'o are fnUitiple systems serving any function, make multiple entries to describe them.
OhN bopy of this form must be provided to the Building and Zoning Department prior to the C.O.
Ohe bt)py of this form must be made available to the original home buyer.
Jc;..C:htitS
a:::.atem:
.:................... ............. ......................
_.
.......................:
........... .
Location
Fuel
Type
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
�c�..coo Ih s. stern .
..............
Input capacity
Location Fuel T e Manufacturer Model # kBtuh or kW SEER
. �a
:.:..........e1':; eatin :.s. s�elr:, .....Y..................... . ................... ................... ...
...................:::.:::::....:..... Y ...
LocationInput
Fuel
7 e
Manufacturer
l
Model #
capacity
k6tuh or kW
Energy Storage
Factor volume
40
2_t.t2 en, Ala /
...........................................................................................................................................................................
IMO WON ht the above -listed equipment (including
.
ducts and piping) was installed In the buildin at the ...a.bove ....l.oca.ti.ons.................................
In i;0H1bft4h&e with the requirements of the Fort Collins Residential Energy Code and Mechanical Code; and further, that
stit:H'dUiptti�ht was installed in accordance with manufacturer' instructions.
36t,ffibH C6AIl`yIhg'Job:
Date: ' 11I
YJqL 4
Pi)one: 3. 1loly -.!