HomeMy WebLinkAbout4703 DUSTY SAGE DR - DISCLOSURES - 12/29/2004 (2)r
LForl. Co';Iins Residential Energy Code the building & zoning Ing dept. of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Service
CCqe2e Ave. P.-_
Voi:q: ;-10 --)j C..7 F;,;,.: 97�. 224 1'54
J- - re s s:
Ger,eral contractor:
Mechanical contractor: .7
RiSTRUCTIONS.. .......
—N3 e fortr is to be signed by the rnecharl'cal cantrk,cr or represe,,,4atjv.
Resse type cr cfint, except for the signature. or the general contractor.
If there are rru.N.p!e systems serving ary f:::,ct:cn, rr3kc mul�tfpfa entrfss to ; e.esc�H;n,arn,
One C00y of this form rr. ust be provided ft !he Suildi.,Ig and � ... .
Zoning Department prior.-c the
Ore copy of this form must be made available to the origina! home bL;yer.
A.*
.§.-.Zpace cooling sy'stem
..... ... . ..
:Q. Wa-ter" he"atin . ... .....
.. . .......
Inputcapacil Energy I Storage
k8lUh 01'k' Factor I Volume
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Certification 7:
Me certi'l. -listed eqLL'prnen! (including ducts ar4,p;p,! n*g')`�"Ya`s'installed ;
clat tie above
-tilted e building at the abovc locations
in conforrnarcewth tit requirements of the For CoIjins Residential Energy CcdO 21G MQchantcal Code; ar,�a further, that
such OqUlprnart was jrstallz in accordance: With manufactureire instructions.
Person Certifying J4
Signature:
Business Firm:
lx�
Address
M
Date: