HomeMy WebLinkAbout620 ATWOOD CT - DISCLOSURES - 8/25/1999 (4)Fort Collins residential energy code 7196 I
Mechanical systems disclosure form
Job address
General contractor
Mechanical contractor iiuRrLEY ILjrAzitlb,
Spaice heating system
Location
Fuel
Tvpe
Manufacturer Model #
Input capacity I AFUE or
kBtuh or kW I HSPF
Space cooling system
Location
Fuel
Tvpe
Manufacturer
Model #
Input capacity
kBtuh or kW I SEER
Water heating system
Location
Fuel
Input capacity
Type Manufacturer Model # kBtuh or kW I
Energy
Factor
Storage
volume
AMm T 'C'
M L
q0 e-p
Certification
IIWe certify that the above -listed equipment was installed in the building at the above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturers instructions UWe certify that any ductwork has been installed in conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code
Certified by
Business firm
Address
7�Pjgi i 1 Phone (r�&g6-033_
/�lz�ntlu l�/e5 Date
5a�}3L1O.Signature
Instructions
This disclosure form is to be signed by the mechanical contractor or representative of the general contractor
Please type or print, except for the signature
If there are multiple systems serving any function, make multiple entries to describe them
One copy of this form shall be provided to the Building and Zoning Department at final Inspection
One copy of this form shah be provided to the homebuyer
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