HomeMy WebLinkAbout6802 COLONY HILLS LN - DISCLOSURES - 5/3/2004 (3)Fort Collins Residential Energy Code the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mcrdix2xls 1,Q198
251 N. College Ave., P.O. Box 580, Fort ColGrs, Co 8o522
Voice: 970 221 6760 FAX 970 224 6134
Job Address: _6 A02 /z/__
General contractor.
Mechanical contractor. u D e� LA ,,¢ram
INSTRUCTIONS..:.. _....................
::
:::.::.......:.::.:..:::.:::..:.:::::
..........
This disclosure form is to be signed by the mechanical contractor or representative of the general
Please type or print, except for the signature. contractor.
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.
.. _
A Space heating system
Location
Fuel I T oe
I
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
� � I
B .Space cooling system
C ;.Wa%ter heating system
.... ................
Certification. .
I/We certify that the above listed equipment (including ducts and i in was installed in the buildin 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 Certifyi g Job: (C_K .Sod
Signature:
Business Firm:
cturer
Model #
Input capacity
kBtuh or kW
Energy
Factor
Storage
volume
/& /O
Address:
Xf
f/ Phone: y� Zoe