HomeMy WebLinkAbout6127 WESTCHASE RD - DISCLOSURES - 8/13/2004INSTRUCTIONS
This disclosure form is to be signed by the mechanical contractor or representative of the general contractor.
Please type or prK 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.
A. space heating sxshm
B.. Space cooling. system
C. Water heating system
Input capacity I Energy I Storage
Certification
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: L / n d4g y Chs s>7 4
Sinnaturm �00 —z' Date:
Business Finn:
Addt*M:
A J`t Y - 5fey. t k l o o
/,- A--nj// Phone: 3oY.,5%, -5—ovo