HomeMy WebLinkAbout4703 DUSTY SAGE DR - DISCLOSURES - 5/26/2005Fort Cciiins Residential Energy Code the building & zoning dept of
MECHANICAL DISCLOSURE FORM Community Planning and Environmental Services
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General contractor:
Mechanical contractor.
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INSTRUCTIONS
his disclosure farm is to be signed by the m.echar1=1 cortrac,cr or representative cf the general contractor.
Plesse type cr or'n% except for the signature.
if thcre are multiple zysterns se^IIng ar:y funct:Cn, ,snake !nu!Uplca entri•=s t0 t:e$Cri ii t a"t,
One copy of this fo-m mast be provided tc the 9uilding and Zoning Department prior :o tF.e r,,C?.
Ore copy of this form must be made available to the ongina; home buyer,
A; -;.Space heating syst4rn
8.- Space cooling system
C ^rafzr heetin.g syst' .
Inputcapacity j Energy 9toraQe
Location Fuel Manufacturer Model # kBtuh or kW I Factor volume
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Certification
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b"We certi.y t^at t::_ above -listed equIrmen! (nciuding ducts and plp;ng) was instaiied ir. ;he building at the above locations
in conformance with tie regwrernents of the For Coliins Rasidentlal Energy Code aid NAechanica; Code; anti further, that
such aqu:pmer.t was ir:stalled in accordance with manufacturers' instructions.
Person Certifying J 11 1 &W_'
Signature: Date:S
Business Firm:
Address: S
Phone: /U , —Gii