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HomeMy WebLinkAbout1993-005662 - mechanical . t PERMIT VVY OF ORONO PERMIT TYPE: 2750 Kelley Parkway • P.O. Box 815 Permit Number: t().5G.;N��'�L `� G. Orono, Minnesota 55356-0815 t�' Date Issued: 10/2 (612) 473-7357 SITE ADDRESS: R CH F- i N OS-1 17-23-3-,--'-0004 )04 DESCRIPTION: HTG SYSTEMS HEATINGSYSTEMS EM`S FLt E SIZE F(!EL NATURAL GAS !`_lA E LENNf.1k 62103--E.C)/:_: r 10 r TV DF 01ROW FihinJ�i��tr for"FI E 1 01 J�VV1fVV n V L REMARKS: 1::zL�L.L-vlti n V ��1 1 SV 17514 i is jAAA A sir=1!u4 vvv J. rs Z•t LLlt 1.50 FEE SUMMARY: l - _Ti— ���ar,Tt! L•i urILN! L! 31L i T 1 1:1.—i L}�Ajh• v _ &�=1lIL L•L11 i 1!17711/1 IOU j+, 11 T I �[ j �1�3..�7i`—'� ( I f—fN 'F=.�—i 1 0(-',0 - i•F:+Lit�=fk�el +••Hl4 rAi al a17 17r�V V1V Lrt V1 1YL•1 1 .:. .l V., •L.%Tr Ease Fe $262' . SO MA I L I NSurcharge — Tot-a! Fee 'y . -5i7 Sub t.o tal 273 . 00 CONTRACTOR: OWNER: C.R 0NSTR!--I S H T G & AC I WC 0:3'8 0 s CARL-50N N CURT 7201 W LAKE c-*T .5-50 TONKAIJA RD =_,T LOUIS l IS PAR ' MN 5422!` OR,-iN,-j MN 5:3`56 Thi I£?ER .I GI [ # �.1 , p�, M I SSIDN T I E .rte ;SAL"t �IPR DEMENTS. E I I # xl�: �IGf��� � ,Al.t Ili ;;,SSR ..`CO�`� A�t� X51� � C i Thr fes: tRC�I , t`�Ft[ ° tA ' t�Ital I6� ' I��I ,� . APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE t CITY OF ORONO APPLICATION FOR MECHANICAL PERMIT Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 8 X993' GENERAL INM FORATION OCT f 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within 2 working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PE ARD IS POSTED ON THE JOB SITE. Lj �rYOF 3. Mechanical Designs - Complete calculations, details and specifications are required f r _ 411 ventilation,humidification-dehumidification, and air conditioning installation including heat 16ss gawj'L9 calculation, design temperatures, equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. Identification of and specifications for water heating equipment shall also be provided. 4. When any new construction or remodeling is involved, a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected (rough-in and final). Call 473-7357. 24-hour notice required. 7. House Heating Test Record must be submitted before final. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 473-7357. Please check one: New Addition Repair _ Replace X Residential Commercial .TOB SITE: 550 Tonkawa RD. Zip: 55356 Owner's Name:Curt Carlson Telephone Number: &7-A_n ./,R Mailing Address:550 Tonkawa Rd City:LonQ Lake Zip: 55356 Contractor's Name: cronstromg Heating and Air TelephoneNumber: A2n-38nn MailingAddress: 7201 W Lake St City: sTT.p Zip: SSvr, SYSTEM DESCRIPTION HEATING SYSTEMS Quantity: (2) (7) (1) Make: Lennox Lennox Lennox Model: 021g3-60 G21g3-80 G21g4/5-100 Fuel: NG NG NG Flue Size: 2 ? 2 Input BTUs: 60,000 80.000 100,000 Output BTUs: 55,000 73,000 95,100 CFM: 1200 1200 1600 COOLING SYSTEMS Quantity: Make: Model: Tons: H. Power 1 WOOD BURNING EQUIPMENT Wood stove with flue Wood combination or add-on Factory fireplace with flue Factory Fireplace (s) Freestanding Masonry Wood Stove (s) Franklin, other Brand Name Model No. Mfgr's Min., Clearances, side rear min. flue dia. Total VENTILATION No. Kitchen Exhaust ducted recirculating cfm No. Bath Exhaust (must be ducted outside) cfrn No. Other Fans: Locations cfm Total FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) Installation Removal Fuel oil: gallons underground inside outside LP Gas: gallons Other Gas opening PERMIT FEE CALCULATION 1. 1.25% of Contract Price* or Minimum Fee ($35.00) i , x .0125 $ (contract price) 2. State Surcharge. ** Add the State Building Code Division Surcharge to each permit. n I , )r) x .0005 $ (contract price) or $.50, whichever is greater 3. Postage and Handling (Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ '74.5 * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor,or installation are furnished by the owner, tenant or any other party the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. ** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price. The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the Minnesota State Building Code, and certifies that all statements made on this application are complete, true and correct. Applicant's Signature: I Date: Approved By: Date: 1 a DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED 1"1191.93 /n :3a PERMIT NO. -'5_6P 6-P COMPLETED /���i' 16 , 26 ADDRESS OWNER Sieh CONTR. TELEPHONE NO. 99,20 -3,'a C DESCRIPTION 01 FOOTING 11 16 WELL TEST PUMP Q 02 FRAMING 11 MECHANICAL FINA 18 EXCAVIGRADINGWILLING 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREMIETLANDS Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL Q nc cim n 1 13 METER SET/TURN ON 17 SITE INSPECTION 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS J 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP v 10 PLUMBING FINAL 23 SEPTIC FINAL OWNERICONTRACTOR TO MEET YOU:_YES_NO Zt COMMENTS: cc j O a CC O W QC Q Z W z W cc J O RK SATISFACTORY:PROCEED ❑ PROJECTCOMPLETE cc W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY C) ❑CORRECT WORK,CALL FOR REINSPECTION' TEMPORARY BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. _ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 Owner/Co ntracto� It Inspector. White Copy/Inspector's File Canary Copy/Site Notice ATE TIME CITY OF ORONO CALLED IN 111A 9 3 INSPECTION NOTIC SCHEDULED -T ✓ A0 :0 o PERMIT NO. COMPLETED ADDRESS OWNERCONTR.�/Ze ✓Z�rno TELEPHONE NO. G) - e, DESCRIPTION kzlae - 01 FOOTING 11 ME 16 WELL TEST PUMP Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING ti 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS 07 DEMO—FINAL 27 SEPTIC MAINT 21 COMPLAINT = 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP v 10 PLUMBING FINAL 23 SEPTIC FINAL OWNEWCONTRACTOR TO MEET YOU:_YES_NO COMMENTS: 6Hq d D v A Cxi i r' cc IO C CEJ v�- Gl g'e_s da W cc Q Z W z (41 CC Z) d LU ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O y6CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN INSPECTOR WILL RETURN C El STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 OwnerlCont"site:_ Inspector. White Copy/Inspect is File Canary Copy/Site Notice HOUSE HEATING TEST RECORD `, ADDRESS 550 Tnn1-avya Rd APT. FLOOR— CITY SUBURB OCCUPANT Curt Carlson OWNER in Carlson HEAT LOSS DATE HTG. INST. o GAS CO. METER BADGE # SOLD BY Cronstroms Heating and A1r and. INSTALLED BY Cronstroms Ileating and Air Electrical Work By Gas Line By TYPE OF HEAT GA FAX HW STEAM—_ SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER Model — Model Serial 1 a6 :7V Max. BTU Rating INPUT 92,900 MAKE OF FURNACE Model CONTROLS THERMOSTAT~ Heat Plug Vent Size- 7 Valve KIND OF LINER SIZE NON Limit Draft Hood— Regulator Limit Setting " Filters Si Number Number2 Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure A ( Percent CO2IDate Tested .14—,Z—!i! T Input CFH &A t Percent 02_ * Company Testing Stack Temp.��� o Percent CO 0-fa Name of Tester HOUSE HEATING TEST RECORD `) � ) ADDRESS 550 Tonkawa APT. FLOOR CITY SUBURB OCCUPANT Curt Carlson OWNER—_cu_v_r,;;.r-lq;-- HEAT LOSS DATE qTG I ST. /1 /A GAS CO. METER BADGE # SOLD BY roes roms ea�iig an it Cond INSTALLED B 'ronGtrnmG TTPating nnri air Electrical Work By Gas Line By TYPE OF HEAT GA_ FAQ_ HW STEAM— SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER Model a `' Model_ Serial �` q3-b Q I Max. BTU Rating INPUT MAKE OF FURNACE Model CONTROLS 'THERMOS T T n Heat Plug Vent Size— Val--e ize Valve 1 KIND OF LINER SIZE NONE Limit C.�/ Draft Hood Regulator Limit Setting Filters Siz Number Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure 19 11 Percent CO2 Ory Date Tested /j',f _q -? Input CFH$a' Percent 02 rOw Company Testing Stack Temp.fN Percent CO Name �f Tester�, HOUSE HEATING TEST RECORD ADDRESS 550 Tofflkawa Pd APT. FLOOR-- CITY SUBURB OCCUPANT OWNER HEAT LOSS DATE HTG. INST. GAS CO. METER BAI GEox#troms Heati n and Air SOLD BY Cronstroms Heating aT, Cetid INSTALLED BY g Electrical Work By Gas Line By TYPE OF HEAT GA— FA__�, _. HW STEAM—_ SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER Model +' Model Serial Max. BTU Rating INPUT '0.0� ' MAKE OF FURNACE Model CONTROLS n THERMOSTAT it q e Heat Plug Vent Size � y C Valve KIND OF LINER SIZE- NONE LimiDraft HoodRegulator Limit Setting ° Filters Sizeq-aX2 4 Number Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Of Door Pressure Lighting Inst. u Pressure Percent CO'2/0`04 Date Tested Input CFH V0 Percent 02 S� Company Testing C o x r m Stack Temp."P" ° Percent CO 6��Name of Tester z9l �'��� HOUSE HEATING TEST RECORD ADDRESS 550 Tonkawa APT. FLOOD— CITY SUBURB OCCUPANT Curt Carlson OWNER Curt. Carlson HEAT LOSS DATE HTG INST. GAS CO. METER BADGE # SOLD BY Cronstrnm Heating aild Air INSTALLED BY Cranstrams, Peat;ng and Air Electrical Work By Gas Line By TYPE OF HEAT GA FA—,vHW STEAM— SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER Model Model Serial 6'!tb --Max.- BTU Rating INPUT 82;000 MAKE OF FURNACE Model CONTROLS THERMOSTAT at Plug Vent Size �- Valve KIND OF LINER SIZE NONE Limit GC/ Draft Hood Regulator Limit Setting ' Filters Size; f Number Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing �. Qoi _Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure— Percent CO2 �G Date Tested ZZ-2-37 - Input CFH Percent 02 Company Z Company Testing Stack Temp.,_/B-�'' Percent CO 64'a Name of Tester HOUSE HEATING TEST RECORD OCA�( Flo 2— ADDRESS55 Rei — APT. R FLOOCITY SUBURB Ton OCCUPANT urkacia ar son OWNER Ctirt: Carl Gol, HEAT LOSS DATE HTG. RET. GAS CO. METER BADGE # SOLD BY :rentsali( AtrINSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA— FA—__y_ HW STEAM—_ SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER Model Model Serial 9-3c!� 1�G�6� .—Max._ BTU Rating INPUT 80,00n MAKE OF FURNACE Model CONTROLS THERMOSTHeat Plug Vent Size C Valve KIND OF LINER SIZE NORLC.— Limit Draft Hood Regulator Limit Setting Filters Size,'1� Number Fan Setting_ Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make AF Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure �y Lighting Inst. Pressure tl Percent CO2�,,, l�G—Date Tested 4'-9� Input CFH ' Percent 02 101& Company Testing Q3;4,,;4&0mr, Heating nnl Air Stack Temp. edR 4 Percent CO gD�_Name of Tester ��— HOUSE HEATING TEST RECORD 0 ADDRESS 550 Ton'r8Na Rd -APT. FLOOR_— CITY SUBURB OCCUPANT �Y ar son OWNER Curt Carlson HEAT LOSS DATE HTG. INST. GAS CO. METER BADGE # SOLD BY—Croust o-s 14gati.gg a,f4,d_A.4.E s.eftd. INSTALLED BY Cronstroms Electrical Work By Gas Line By TYPE OF HEAT GA—f1-X-- HW STEAM-- SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER Model Model- Serial Max. BTU Rating INPUT 8n.onn MAKE OF FURNACE Model CONTROLS THERMOSTAT °L0 Oeat Plug Vent SizeC- Valve KIND OF LINER SIZE NONE Limi AL 11 Draft Hood Regulator Limit Setting 'moo° Filters Sizes` - -- Number Fan Setting� Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timin Az=&Oconot Draft Test Tag L.W. Cut Off �,,'a Door Pressure Lighting Inst. Pressure^ Percent CO2Date Tested - Input Percent 02 ';QI2 Company Testing . t oms Stack Temp./_®a°' Percent CO n�Z Name of Tester 1 HOUSE HEATING TEST RECORD 6 ( `(�1�2- ADDRESS 550 Tonkawa Rd APT. FLPO�CITY SUBURB OCCUPANT Cur ar son OWNER urt ar soil HEAT LOSS DATE HTG. INST. 1011)/93 GAS CO. METER BADGE # SOLD BY CrnnGt rums 'lead ng and Air (Aud i ti cW&T6LLED BY Cxnn Ct roTns M-nJ i ng, artd Air Electrical Work By Gas Line By TYPE OF HEAT GA_ FAQ_ HW STEAM— SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE T eziu MAKE OF BURNER Model Model_ Serial __ Max. BTU Rating INPUT gg nun MAKE OF FURNACE Model CONTROLS THERMOST TQ'`e Heat Plug Vent Size— Valve ize Valve KIND OF LINER SIZE NONE Limit ej Draft Hood Regulator Limit Setting " Filters Sizo -010.4 Number Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing e.c� Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure 2 11 Percent CO2,/0?a Date Tested Input CFH WO Percent 02CompanyTesting 04AAromq lleatiiif� and Air Stack Temp.Z"" Percent CO _ Name of Tester Q• C 4 e� HOUSE HEATING TEST RECORD 0 0 51 rl(` ADDRESS 55n Tonkawa Pd APT. FLOOR— CITY SUBURB OCCUPANT Curt Carlson OWNER q!Jfr HEAT LOSS DATE HTG. INST. 12 11°103 GAS CO. METER BADGE # SOLD BY CrOnstroms feat- nb and air GL;— INSTALLED BY r,ranst rams Heating and Air r'nnrl _ Electrical Work By Gas Line By TYPE OF HEAT GA_ FAV HW STEAM— SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER_ Model Model Serial S��Q31COlSS Max. BTU Rating INPUT 6o,nnn MAKE OF FURNACE Model CONTROLS n THERMOSTA eat Plug Vent Size— Valve— ize Volve KIND OF LINER SIZE NONE Limit ri✓ Draft Hood Regulator Limit Setting o Filters umber Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure a 1 Percent CO2; Date Tested Input CFH f/o Percent 02 Company Testing r u Stack Temp.�L/�" Percent CO goe Name of Tester ^- HOUSE HEATING TEST RECORD tP)lD`r 2— ADDRESS 550 Toukawa Rd APT. FLOOR— CITY SUBURB OCCUPANT Curt Carlson OWNER sa=p HEAT LOSS DATE HTG. INST]aLa 2?� GAS CO. METER BADGE # SOLD BYGzn= r m�L1etitig, atEidAir 6}Ltd. INSTALLED BY Cronslzrams Electrical Work By Gas Line By TYPE OF HEAT GA— FAX HW STEAM— SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lennox MAKE OF BURNER Model C; Model Serial S-3 9 -C N G53 4:R Max. BTU Rating INPUT 10 000 MAKE OF FURNACE Model CONTROLS �1 THERMOST T Heat Plug Vent Size Valve KIND OF LINER SIZE NONE Limit Draft Hood Regulator Limit Setting Filters Size r)� Number Fan Setting Chimney Location Inside Outside Pilot Type J%J e. �1 ty Chimney Construction Pilot Make �� Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure ;;L 1 1 Percent CO2-,� Date Tested lP—�9—:y Input CFHA9 t Percent C Testing C r troms Stack Temp./" ' Percent CO Name of Tester HOUSE HEATING TEST RECORD ADDRESS-_55-o 7L.) �Q wow d- APT. FLOOR 600 URB OCCUPANT 't S OWNS HEAT LOSS DATE�HTG. INST. GAS CO. METER BADGE # SOLD BY �"Q�'�-�/'=� INSTALLED BY- Electrical a/`@�S Electrical Work By Gas Line By TYPE OF HEAT GA FA HW STEAW SPACE HTR. UNIT HTR. OTHER G DESIGN CONVERSION MAKE MAKE OF BURNER Model `� Model Serial Max. BTU Rating INPUT MAKE OF FURNACE Model CONTRh.QLS ,� THERMOS T_ Heat Plug Vent Size Valve KIND OF LINE E NONE Limit Draft Hood qe ulat( Limit Setting —Filters Size umber Fan Setting Chimney Location nside Outside Pilot Type 5,0"- "X Chimney Construction Pilot Make & Pilot Model 5 g Oo F Smoke Bomb Pilot Timing 0 Draft a;1L.W. Cut Off 10,0 Door Pressure L hting Inst. Pressure— t� t"` Percent CO2 6'60� Date Tested Input CF ©Percent 02 --company Testing Stack Temp. % T F- Percent CO Name of Tester HOUSE HEATING TEST RECORD (�)C 6 C c,(o ADDRESS 550 Tonkawa P.d1 APT. FLOOR- CITY SUBURB OCCUPANT Curt Carlsoti OWNER-SATZ HEAT LOSS DATE HTG. IN T4 i .. GAS CO. METER BADGE # SOLD BY Croustroxns rTPati Tag at d TAAl �e��� INSTALLED BY ronstroms ,.eat ng & A.ir Electrical Work By Gas Line By TYPE OF HEAT GA_ F Y HW STEAM- SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Lenxxox MAKE OF BURNER Model Model Serial Max. BTU Rating - INPUT MAKE OF FURNACE Model CONTROLS THERMOST -� eat Plug Vent Size r G� Vaive KIND OF LINER SIZE NONE Limit uJ Draft Hood _ Regulator Limit Setting ' Filters Siz Number Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing !t6 Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure I Percent CO2Date Tested � 9_5 Input CFH Percent 02SIZ Company Testing Stack Temp. Percent CO C.�� Name of Tester 16-K AA40�