HomeMy WebLinkAboutHse heating trest records - no permit on file HOUSE HEATING TEST RECORD �i�� —�2(��I
ADDRESS �� `� � ti-�` � � APT. FLOO CITY SUBURB �L d��nd
OCCUPANT ro � OWNER �.� N��
HEAT LOSS DA E HTG. INST. � � GAS CO. METE(�,B,(aDGE #
SOLD BY S INSTALLED BY �—��� �
Electrical Work By Gas Line By Z UeX�'�'�
TYPE OF HEAT G�_ F��_ HW STEAM—_ SPACE HTR. UNIT HTR.�_ OTHER
GAS DESIGN CONVERSION
MAKE —� MAKE OF BURNER
Model Model
Serial —b � -�b �' Max. �TU Rating_
INPUT 7��/`'/ MAKE Of FURNACE
Model
CONTROLS � ��
THERMOSTA�¢�� Hept Plug • .f 1 - Vent Size
Valve �--�l� KIND OF LINER SIZE���� NONE
Limit ��� '� Draft Hood Regulator�/�L
Limit Setting � � Filters S' e Number
Fan Setting � -�� Chimney Location Inside Outside
Pilot Type ��_�l� Chimney Construction
Pilot Make ,�
Pilot Model Smoke Bomb Wiring �9!�
Pilot Timing � � �/ Draft L9 f� Test Tag��
L.W. Cut Off Door Pressure Lighting Inst. l� �',
Pressure -5� S Percent CO2 �� � Date Tested �`� � �
Input CFH �� Percent 02 � Company T�sting �i�r�—G�--�
Stack Temp. ��' � Percent CO 1� Name of Tester �,�,�,�L c—
HOUSE HEATING 7EST R�CORD B�� G�L�2�t� ����
ADDRESS ! �S^ �t�` �tiF.c�� U?� APT. FLOO CITY S BURB /� 4�nd
OCCUPANT `�r Y1�SS OWNER ��� rL ' LOI(15�R�1, t(JY1
HEAT LOSS � AT H G. INST. GAS CO. METER BADGE
SOLD BY S �Y�-� INSTALLED BY P-��S 5
Electrical Work By Gas Line By -�.-.�J�
TYPE OF HEAT GA� FA�- HW STEA/vl— SPACE HTR.-- UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE L���v� MAKE OF BURNER_
Model G !�f f� 3 4 o Model__— _
Serial ���3 �� �f _-----i�/�ax. �TU �ating—
INPUT � �M __MAKE O� FURNACE
Model
CONTROLS
`( !�v
THERMOSTAT at Plug � � Vent Size �' — �
Valve KIND OF LINER SIZE NO�(E '
Limit ���/=t-�` Draft Hood Regulator����
Limit Setting 'v'� � _ Filters Size/�X� Z--T�C /i Number ' �
Fan Setting ��'— lZ- S Chimney Location Inside Outside
Pilot Type ���-� Chimney Construction
Pilot Make
Pilot Model Smoke Bomb Wiring ��
Pilot Timing ��- �a-�L«-/`� Draft Test Tag ��
L.W. Cut Off Door Pressure Lighting Inst. �
Pressure ' �� Percent CO2 '�fr� Date Tested —`f�' �`�
Input CFH (o d Percent 02 � Company Testing � -�-
Stack Temp.—,��-D'' Percent CO �—Name of Tester
-
a2� � �I Z�,1
HOUSE HEATING TEST RECORD
ADDRESS �� '� � �'J ti-- APT. FLOO 1 CIT�( SUBURB �'� d r0►'lU
OCCUPANT a � OWNER Iv(J�. LtJ71�
�HEAT LOSS � DATE H . INST. s��}I�54� GAS CO. METER B DGE
SOLD BY � �"�-� �—INSTALLED BY
Electrical Work By Gas Line By _�-� v U(��
TYPE OF HEAT GA_ A� HW STEAIv�— SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE �-���/o� MAKE OF BURNER
Model � �� �� � 4 v Model__
Serial �s��-�i`� (' Z:� � � _Max. BTU ?aiing
INPUT (a v f''i MAKE OF FURNACE
Model
CONTROLS
THERMOSTA Heat Plug '� Vent Size � L� 4 � � � '
Valve ' — KIND OF LINER SIZE ,NONE
Limit Draft Hood �'�-- Regulator �r--��G��—
Limit Setting '� � Filters Size ./(• X � x y Number �
Fan Setting i l— -c �-� � Chimney Location Inside Outside
Pilot Type ���-�-L Chimney Construction
Pilot Make
Pilot Model Smoke Bomb Wiring d�
Pilot Timinp ��---- %�2 �-<�Y draft Test Tag �
L.W. Cut Off Door Pressure Lighting Inst_ ���
Pressure • `1 � Percent CO2 �TDate Tested -r�y� "��
Input CFH L9 v � Percent 02 -�''� Company Testing � �
Stack Temp. ��L9 y Percent CO �—Name of Tester ��,�'L- -