HomeMy WebLinkAbout6227 GOLDEN WILLOW DR - DISCLOSURES - 3/23/2005Fort Collins Residential Energy Code
MECHANICAL DISCLOSURE FORM
mchdacada-7110W
Job Address:
General Contractor:
Mechanical Contractor
the building & zoning dept. of.
Community Planning and Environmental Services
281 N College Ave., P.O. Box 580, Ft. Collins, CO 80522
Voice:970-221-6760 FAX:970-224-6134
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 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.
Twe
Manufacturer
#
Input capacity
kBtuh or kW
Location Fuel T e. Manufacturer Model #
Location j Fuel
Manufacturer j Model
iput capacity
tuh or kW SEER
Input capacity Energy Storage
kStuh-or kW Factor volume
I/We certify that the above -listed equipment (including ducts and piping) was installed in. the building at the above locations
in conformance with fhe requirements Of the Ft Collins Residential Energy��
such equipment was installed in -accordance with -manufacturers' instructions and Mechanical Code' and further, that
Person Certifying Job:
Signature:
Business Firm: Coll
4ddress: g
mom
Date:
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-neaehiC(�, UV 90916 Phone: 302-485-9492