HomeMy WebLinkAbout620 ATWOOD CT - DISCLOSURES - 8/25/1999 (3)Fort Collins residential energy code V96
Mechanical systems disclosure form
Job address ,1,0a6 AI-Gxloll _—-9 Coll Ns Co 8oSa5
1 {
General contractor 111 , L _( u, tt_Y—.i 1 t,
Mechanical contractor _ L t1 r at_l_i_ I I
Space heating system
Input capacity ARM or
Location fuel 1—__1 ype __ _I M inuf icturer Model # kBtuh or kW _ nSpr
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I
Space cooling system
I Input capacity I
Locaton _ Lruel_l`Type —_I Manufacturer _l Model # kBtuh or kW SEER_
I
Water heating system
Input capacity I Energy Storage
—_ Location — L fuel —I Type Manufacturer Model # kBtuh or kW I Factor volume
II
Certification
IIWe ceitdy that the above listed equipment was installers in the budding at the above to Cations M COnforinanCP with the
current requirements of the City of Fort Collin, Fti sidontinl Fnprgy Code and Merhinic,31 Code, and that d was ltlstnllbd In
accordance vnlh manufacturer's instructions I/WP certify that any ductwork has been installPri in conformam e with
the current requirements of the CA
y of Fntt Collins RPsulrnlml Cnrrgy Code and Merh3niral Code
Certified by,
QAO-) Amq Phone 'r _ _ z __--
Business firrn [NtjEunt e n•.- Date __-95/19 -- -----
Address t > br <:{tgo,c A j, }?�✓f Signatute `
Instructions
This disclosure form is to be signed by the nip( haniral contractor or representalwe of the general contractor
Please type or print, except for the signature
It there are multiple systems serving any funrhon, trtake multiple entnps to drsrnhp them
One copy of this form shall be provided to the Ruddmq and 7omnq DPPvlrricnt It firs ll msPeChon
One copy of this form shall be provided to the hompbuyer ,w.�m.nirssn-emne