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ADDRESS <br />OCCUPANT — <br />HEAT LOSS — <br />SOLD BY <br />HOUSE HEATING TEST RECORD <br />___P_? _^^APT ___FLOOR^- <br />_____________________________________________OWNER------------- <br />______DATE HTC. INST. —-------------------------- <br />CITY SUBURB------------ <br />Elactticol Work By-------- <br />TYPE OF HEAT OA _ FA ^(1”* <br />CAS DESIGN <br />installed by <br />Go. Lm. 8,___________----------------------------------------------------- <br />STEAM - SPACE HTR UNITHTR. <br />THERMOSTAT <br />Yol«« <br />Limit <br />Limit Ssttifig <br />Fan Setting ■ <br />Rilot Tfpa ^ <br />Pilot Meko <br />Pilot Modol <br />Pitot Timing <br />Ingot CFH <br />Stock Tomg <br />_ MAKE OF BURNER <br />Modol -----------------— <br />__ Mox. BTU Roting ----- <br />. make of furnace <br />Modol <br />k <br />Vont Sito <br />KIND OP LINE <br />DtoH Hood <br />Filtort Sito <br />Qiimnoy Locofion <br />Chimnoy Comtruction <br />SIZE^_—^NONE j^ <br />Rofulotof <br />Intido <br />L.W. Cut Off — - <br />ProttufO--------- <br />Smoko Bomb <br />Droit _ <br />Door Pro^furo <br />Wiring ------ <br />___Toil <br />___Lighfing Inot <br />Ooto Tofttod <br />*^mpony Totting <br />No mo of Tottor ^Yu*.: / ------ <br />Fw« 23S