HomeMy WebLinkAbout1320 BENNETT RD - DISCLOSURES - 8/25/2004Fort Collins Residential Enerrj
,y Code
IMECHAl`41CAL DISCLOSURE FORM
mchdisc2 As—7/10/98
the building & zoning dept.
Community Planning end Environmental Services
281 N. College Ave., P.O. Box 580, Fort Collins, CO 80522
Voice: 970 2216760 F�224 6134
Job Address:
General contractor:
Mechanical contractor: Northern Co o ra do A '
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 must be provided to the Building and Zoning Department prior to the C.O.
One copy of this form must be made available to the original home buyer.
A. Space heating system
Location
Fuel
Tvpe
Manufacturer
Model #
Input capacity
kl3tuh or kW
AFUE or
KSPF.1
B. Space cooling system
Location
Fuel
Type_
' .&
Wvrl
_----A.- Water heatin-g_ ystem_-__--
Location
I Fuel
I Type
I Manufacturer
I Model #
Input capacity
kBtuh or kW
Energy .
Factor
Storage
volume
Certification
I/We certify that the above -listed equipment (including ducts and piping) was installed in the building at the above locations
in conformance with the requirements of the Fort Collins Residential Energy Code and Mechanical Code; and further, that
such equipment was installed in accordance with manufacturers' instructions.
Person CertiKing Job: Ann BArker
Signature: Date:
IT 14-
Business Firm: Northern Col it
Address: 812 Stockton Ave
Fort C011ins, Co Phone: 970-223-8873