HomeMy WebLinkAbout4702 DUSTY SAGE DR - DISCLOSURES - 2/5/2003 (2)Fort Collins Residential Energy Code the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mchdisc2ids-7/10198 281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voicq; 970 2216760 FAX 970 224 6134
Job Address: Ll 70 :{
General contractor:
Ik ;Space heatln.g system
Location
Fuel
TvDe
Manufacturer
Model #
Input capacity
kBtuh or kW
AFUE or
HSPF
M—
I
Sig UA080 ILI
SQ 0170
So a
:...::..
B S .ece coolm s stem:. :.. ........:...:..
P..... 9:.Y.
Location
Fuel
Type
I Manufacturer
I Model #
Input capacity
I kBtuh or kW
I SEER
jEa5T-,;.,pe-z
Z,
rArt-'er
396K(06 H
jon
I
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Water. heatin g ystern ....... ... ...........::::::......::.:..:::.:::::::;.::::::::.:::;:::::.:.::::::;::: ;....:::::.. :.:.:::.::.;:..:..:: ; ::.:::::.-::::::::::::..:.::
Input capacity Energy Storage
Location Fuel Type Manufacturer Model # kBtuh or kW Factor volume
ertifcaicn.:::::...:::::.::.............................::.::::.::::.:::::...............................::.:::::::::::::::::::::::.::::.:::........................................:......:.:................................:.:::::.:::
I/We certify that the above -listed equipment (including ducts and piping) was installed in the building a.. 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:
zignature•
Business Firm:
Address: gL4?l l th S1'
Date: ? _ E� -
Phone: 0)7D`9q 7 ''3 7