HomeMy WebLinkAbout4702 DUSTY SAGE DR - DISCLOSURES - 3/10/2003 (9). o ege Ave., P.O. Box 580, Fort Collins, CO 80522
Vgice,: 970 2216760 FAX 970 224 6134
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Fort Collins Residential Energy Code the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mchdisc2ids—7/10198 281 N C II
Job Address:
General contractor:
Mechanical contractor:
:...........................::: .-......:::::._::::::.:::....:..........::::.-::::::.-:::::::::.-::::::::::::::.::::::::.:....... ::::::::.::.:::.::::..................
:.:...:..:... p. heath.. s stem ::::::::::.:.:::::..,.......................................
........................................
Location
Fuel
I Type
I Manufacturer
�`
I Model #
5$ TU:A OAO)4
Input capacity
I kBtuh or kW
_353G
AFUE or
I HSPF
80 �.
B -Space coolrngaystem
Location
.L ofi
Fuel
Fr A
Tvae
Manufacturer
Model #
CJ c
Input capacity
kBtuh or kW
in o
I SEER
....................ter.,heatin s stem........:.:.-:..:::.::-:..:.::,:.............:.::.:...::.:::::::::::::::::::::::::............::::::::::::::::::-.:::................:.:.::::::.:::::
9 Y....................
Location Fuel L T e Manufacturer Model # Input kBtu op kW Factor volume
.... ::.- :::::::::::.:::::::::::::.:.::::.::.:::::::.:.:. ..... :::::::::: :::::::::::.::::: :.:::::.::::::::.::.,:::::...:::::.:.:::::::::.:................................
:::.:::.. if cation:::::::::::::::::::::::::::...............:::::::.::::::::::::::::.:.............:::::::.::::::.:::....................:.......::::::::::::.:
I/We certify that the above -listed equipment (including ducts and piping) 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 Job:
Signature:
Business Firm: U
Address:
+k
Date: �? —
Phone: 7U - 2 7