HomeMy WebLinkAbout4721 DUSTY SAGE LOOP - DISCLOSURES - 9/29/2004 (2)For*. Coilins Residential Energy Code the building & zoning dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
mCsorsfxs _n yt 2B', N. Celle eAve .
8 •.. Oa _ -cr, ,.,,,tar,,, . J V-ai:s: ;70 -i C750 FAX: 970 224 '7'..4 c052e
General contractor:
Mechanical contractor:
INSTRUCTIONS
This disclosure form is to be signed by the mechar•lcal contractor or representative of :he Qeneraf contractor.
P?esse type cr orint, except for the signature.
If there are rr.ulapie systems serving any func`:cn, make mu;tipla entries to aescrfna tram.
One copy of this fo-m must be provided tc `.he Building and Zoning Department prior to the C.�..
Ore copy of this form. must be made available to the original home buyer.
A,':500ce: heating system :....
�, Space cooling system,
C...refr heating syst� ...:
Inputcapacity I Energy Storage
Location Fuel TvDe Manufacturer M del # kBtuh or kW 1 Factor volume
VvVe certify'.,hat the above -listed egapment Including ducts and piping) was installed in :;he buiiding'tithe Abc+vc locations
in conformance with the requirements of the For: Coliins Residential Energy Code and Mechanical Code; and further, that
such oquipmer.t was installed in accordance with manufacturers, instructions.
Person Certifying
Business Firm: 1 /�'_� 4'}( P C/O_TS