HomeMy WebLinkAbout6303 GOLDEN WILLOW DR - DISCLOSURES - 1/5/2005the building & zoning dept. of
Community Planning and Environmental services
281 N eokga Ave,, P.O. Box 360, Ft. Coifing, CO $0622
Voice' 970-2215780 FAX: 070-224-644
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Fort Collins Residential Energy Cade
MECHANICAL DISCLOSURE FORM
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Job Address:
General Contractor:
Mechanical Contractor:
"lease 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 must be provided to the Building and Zoning Departments prior to the C.O.
One copy of this form must be made available to the original home buyer.
-• --r- 1-4— yr one general contractor,
Location Fuel T 1rlput capacity AFUE or
te.r.*o.Y
`T ' „ w Manufacturer -Model # kBtuh or kW NSPF
Location
owrs- Aw
Input capacity
lufacturer Model # kBtuh or kW SEER
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Input capacity Energy
# klRtuh or kW Factor
Storage
volume
I/We cartify that the above -listed i m
P (including ducts and piping) was inStalled in the buildir�
in canformanoe with the requirements of the Ft. Collins Reat the above !orations
sidential Energy Coda and Mechanioal Cade, and further, that
such equipment was installed in -accordance with -manufacturers, instructions.
Person Certifying Job:
Signature:
Business Firm:
Address:
tkoffiing yste�ns
n
ve Suite
Date: l j 11�_10S'
`JAMeA102, LQ 90516 Phone: 349-4S 9492
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