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Home My WebLink About1996-008402 - mechanical PERMIT CITY OF ORONO PERMIT TYPE: �750 Kelley Parkway- P.O. Box 66 ��:�:;�:�;'•k I�:f?L Crystal Bay, Minnesota 55323 Permit Number: t J;}e�;{.�i}�� (612) 473-7357 Date Issued: <<Yj!.�,� ,4;� SITE ADDRESS: .�,7� ��'i�14�A�E �;G C�� ._E�: }�-` , s , f;! , , :-;F�—�. s.:;—'_':_;—�:1—i_7�7i)1 DESCRIPTION: j ��i�r�c� �:��:��•��-: ��_;��_ r��;�_:�;r.�_ ��=, t�1f:�.:� i ��r��w�� ._. C'13JL��i... t�:�t iis{�j,.•.i�--�i:ii") ?'��='t 1�r :i i�t i, �^;R:F�_1 i. =�e��-�°T F�?C� '-;��'_�T�;{,-, �"t i±�i #'y;�"['i_ii�;,��1... f;�'�':, r�?�:'t�;�. L.F tJi'dt.�� . r�E�I�'�� i,�',_'�_;t:::_;�--'7��; i t�}j='t i'j :!=,, r_it};t � �7 i� C.:�_:ii��I��I�tf��t,��; �#��::� i_.E��•��.:.� ti�=:�''�E... :-i��::.�.:-;--�7. 1 �'��€t�!°�� 1 1;_' f '�Et��"T{�;T F+�}t�l t?t'��:�: r;F'F�I��I�: t�iE:iC:��:L. �;�.i r REMARKS: FEE SUMMARY: ��L�_��i I i�t�! �:?, ;w�=:�::, ��—�--� �-,— ��=; . �,i:i �{=�T€ �� c�f ...<<:�_�r : ��.W . � �r:_._.. !�� -------__ �:� ��:di�E="ii-t�''��w __.��__ `�=...,.'x:�,.! ��W��.�{� �YY ��:_!�.;:. . '�li_f ;��1��3 T.i�i F.i.�l], �'�,�i,�� , :.�.�_� CONTRACTOR: -- �r��I i c=��t. — OWNER: �ai i�:�j �'#�� ;:� t�:;=� =;'=�'-"��i i:.i Cli�Y"F i _T I t•i _,M`F-,t_) {��i!_+��f•:t�j �t�:� � L�i�� '�.h��,}fii._�:_ �+�) �`� �;�?� I 1_it_?.t��- (`f=?f?k�:, ;•j:j .5�,�.�`i�, f i}ii tjia#_i �•�p�! .�!;:;;''';, i r.t' '�3 '-1:Y"�--i=,%f-,i :'�-i�- 1._1�'v�t�,��'.-��i-if`.;�,:1 (-��l-i�i=�'i n:�'.i��i�,:�;�:,-� �`�.E.'(11,`�>:�:,l,i,!!`;� ��l-1 irr';f�..r !�"F�� '•`.i..€�ji ij'ff=`��;i�!\it-,[{'si-.f��'.-; —�1-F �.� � � \j`i ±-3=� �� ; 1 34,,I �I k !,�l i� � k — ; �!� ?f I_1;'�t—`1 ��!_.� i 7"''—� ; I � T"� j'�t�: .. �_... 3~ .�.4�..� ��IS.: ��'•.L..�j�� } � �'.__l,.. � _�Zr'. .�..$ �� S .i ..:f . 1.'� s�e' ! ��....... �� 3 . " t�t i Z�f 3��i } �,� (�t"_: — �; v i - - t-i , � r��' �'—�: i� '' ��:!� I t s�:tj i: ;i-_ -{1:�,i�,�-s`�M•6�t:j j'�:. _.!`t_��'�.. _�''� �., f-� �s .��__ ('.E_ '•'� �4`�l�E'. _.� '�i,i ��i....�_. _ i-i _ �.__ . .�_�L. �°t._ _,_ . _. ��...: � � � � �.. �L� APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE � � � ` � � . CITY OF ORONO APPLICATION FOR MECHANICAL PEF2MIT Box 66 (2750 Kelley Parkway) � cr-y� Bay, MN 55323 . �AUG � ,� �.99� GENERAL INFORMATION � _� - 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 worlQng days. � 2, Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTII., THE_ PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desi2ns - Compleie calculations, details and specifications are required for each heating, ventila[ion,humidification-dehum.idification, and air conditioning installation includi.ng heat loss/heat gain calculation, design temperatures, equipment ratings and identification as to type, manufacturer and model. Data shall be presented on fo.�m pro�ided. 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. g, 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 �_ Residential Commercial JOB STTE: �'7S NC�s'.�;1n �er��C�.i�—,�%� "�'' Owner'sName: (rYY� TelephoneNumber: Mailing Address• Sc -� . � , ��, . v�:� City: Zip: Contractor'sName: TelephoneNumber• MailingAddress: 3zso GORtts�avF _City: Zip: ST LOUlS PARK,MN 55425 SYST'EM DESCRIPTIOlVSALES 929-6767 SERVICE 929-4011 HEATING SYSTEMS Quantity: � ��----- Make: ��,�c��Lv<_— v��'�E��—. Model: �C;�� U " Fuel: �; �:-'� Flue Size: Input B'I'IJs: j l� '.,v'`n �� `�� Output BTUs: CFM: � COOLING SYSTEMS Quantity: � j Make: 1 �:��,�b�c Model: ^ � Tons: � H. Power , � ��,�r�I�.c�� -�CQC� 1�`�'Y� � c�� . . WOOD BURNING EQUIPMENT --- - � Wood stove with flue � Wood combination or add-on Factory fireplace with flue � , Factory Fireplace (s) Freestanding Masanry . Wood Stove (s) Franklin, other Brand Name Modei No. Mfgr's Min., Clearances, side , rear , min. flue dia. � Total VENTILATION No. Kitchen Exhaust ducted recirculating �� No. Bath Exhaust (must be ducted outsidej �� No, Other Fans: Locations �� . Total FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAI-) Installation Removal Fuel oil: gallons underground inside outside LP Gas: gallons Other Gas openi.ng PER�'�IIT FEE CALCULATION 1. 1.25% of Contract Price* or Minimum Fee ($�?0�1 -� %��1 � . _ x .0125 $ ��-J� (contract price) 2. State SurcharQe. ** Add the State Building Code Division -� �� Surcharge to each permit. I�I�(J , — x .0005 $ �• — (contract price) or $.50, whichever is greater 1.50 3. PostaQe and Handlin� (Only mail-in applications) � 4. TOTAL PERMIT FEE (Add lines 1-3 above) � �� * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work inciuding materials, labor, profit, and other fized cosu. It is the amount to be charged to the customer for the work done. If any ma�enal. e4u�Pment, labor, or installation are furnished by the owner, tenant or any other parry 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 5.50 - whichever is greaier. For valuations over $1,000,000 ca11 the DePartment of Inspec.'tional 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 tb.e CitY and the regula�o�O�ie�eSOtrue State Buildi.ng Code, and certifies that all statements made on this agp P and correct -- -- _ ' . _ .:.�.� .: r� „ — � �'– Date: �� J� _ Applicant's Signature: � = . �,^��.� '� Date: � �� ', Approved By:_ �.. / /f�c..--�-c. �Z 3�YS3 (.�� ,i • • �- � " ' ?7J 5'r3� , . Cr'�..,�•.�, /b-C'^- . HfJ�T LOSS CALCULATIONS , � Weathentrips A ' ' Comtruction No. In�ulation Guide ' Win�� I D�oo�_I Rcfcrence Out.Wall Int.Wall C.eilin` Roof Floor Kind How Applied n— o e�— 0 19_ Fl. _��,�Room Length.��7 Widch / Hefeh� �'� " Fl t Room L.ength Wldih/ Ho�ehi ° Window� and Doore—Crackage �nd Ares � Window�and Doon--Cnckage and Area ��'IO1� Ht�fnt No.of Lln��l fl. Are• \ WIA1� H�l[�t Na.ef Lln��l tl. Ar�• Ne. ef D�nt of D�ne Ilf�l� of c��[k �Q.fl. ��/ 'J/ Ne. Of D�n� 0f p�n• II(�I• of c��ck �Y,ft. U � � /�,y� � � / �j�/ U�/ - Y / Coef. Beu Cocf. Btu Infiltratiou / / Infiltration �-- Gla�a y �- ✓ �� Gla» � rJ Esp.wal � Exp.wall � r r Net e:p.wsll U 4 ,� Z Net exp.wall � ¢ �A �"� Int.wall Int.�+all ' Cei6ng f j �� Y /J �/G Ce��in .� z'" �G FF�or Floor / Z / '1� Total Bm. i :��1' Total Btu. � � Required sq.ft.E.D.R.or sq.in�.W.A.L.eader area / � Required sG. ft.E.D.R.or eq.�ne.W.A.L,eader aree / Fl. Room�Length,�-, Width 1 Height � � � Room I Length)1_ Width // eig t Windows and Doon—Crackage and Area Windowa snd Doors—Crackage and Area WIA[h N�If�t Ne.ef Llne�l Il. Are• WId1� Hel[�l No.o! Lln��l ft. Are• No. of o�n• o[v�n• IIf�1� of cr�e4 �0.ft. Ne. �Ef Dan• e[D�n� Ilf�l• of cr�ck �V.ft. .� 3 v 3 .3 � � i Coef. Btu oef. tu Infiltration / � In6ltration � ,��' � Glas� � p Clsu 5 U Esp.wal / -�-J �cp.wall � ' t� Net e:p.wall 4� Net ezp.wall �� Int.wall Int.wsll �^ Ceiling -f3�2- � y 7 Cei�ing � . Y J` . Floor ;�.i�rilJ V � / Floor Total Btu. Total Btu. • D Required eq. ft.E.D.R.or�q.im.W.A.l,eader area Required�q.ft.ED.R.or aq.in�.W.A.L.esder area / Fl. Room Len`th ' Width/ , Height ,�. � �}7 mlLength�j.. Width ��, Height '- Windowa and Door�Crackate�nd Area Window� �nd Doon—Crackage and Area Wldl� H�If�I Ne.o[ Lln��l tl. Are• pldt� H�1(�t� No.ot Lln��l tt. Are� . .. No. ef Dan• el D�n• II[�t• ef er�ek �Q.It. NO. of p�n• of D�n� II[ht• of er�tY �O.!t. Q Coef. Btu Coef. Btu Inbltration J � Infiltration Glau ��/ ;� Claa� � Esp.wall / Fsp.wail Net e:p.wall � p y Net e:p.wall Int.wall �+11 ' c r.�. CeiGog—/2 5� Y p CeiG�g �J Floor / Z Floor r-7 y� " ToUI Btu. L Tolal Btu. G� �� Required�q.ft.E.D.R.or�q.in�.W.A.Leader area / Required sq. (t.E.D.R.or sq.ine.WA.L.eader arc■ ' FI. Room �Length Width ¢ Height g".1 � Fl.I' Room I Length Width ,Z. Height� Windowa an Doon—Cracicage nnd Area Windows snd Doon—Crackage and Area Wldln H�1��1 No.o[ Llneal ft. Are� Wldth H�I(�l No.o[ Lln��l fl. Are• - " No. ef D�n• o(O�n• Ilf�l• of cr�ck �V.fl. Na. e!p�n• of D�n• �l[�t• of c��ck �G.ft. " Z � 3 � i9 c i��. / Coef. Btu Coef. Btu In6ltration / Infiltration r J ;y.- Glau / J Glut �'� a:� Esp.w�ll � Fsp.w�ll � � G� Net e:p.wall � � Y� Net e:p.wall G - � Int.wall Int.wall CeJing / J Ceiling �- '^4�' ( � Floor /G � '� Floor . Toc.t Bw. Total Btu. r��• Cr�0 Required tq.(t.E.D.R.or�q.in�.W.A.Leader area Required�q. ft.E.D.R.or sa.ins.WA.L.eader arc• ` � ' HEAT LOSS CALCULATIONS Wathentrips A Guide Ccn�Wction (do. �n�ulation - Win�do� D�oor�sv_I Reference OuL W�II Int.Wall Ceilin� Roof Floor I Kind How Applied ee— o I a— 0 19_ FL� �.Room Length Width�/ Height �� -{ FI.� � Room Length Width Heigh _ Window� and Doon—Crackage and Arca Windo � and Doon—Crackage and Ares tVIJI� Hei�nt No.of Lln��l!t. Are• WIEt� H�I[�t No.ol Lln��l Il. Ar�� No �I D�ne of p�n< Il��t• of<r�ek �Q.fl. NO. of O�n• Of D�n• Ilf�t• ef c(�ck �a.tl. .�U �- � _ v / 7 ��" � � ' 3��— /S- Coef. Btu Coef. Btu Infiltration l` - Infiltration d � Claee / O J Gleu � J Fap.wall �j( Exp.wall � .`f � F. Net ezp.wall Net e:p.wall �. 5 1� Int.wal! Int.•+ell . Ceilmg y Ce�img :�) ��"� Fl,or Floor Tot�l Btu. ►-er Total Btu. U Required sq.ft.E.D.R.or�q.ine.W.A.L.e3der area / Required sq. Ft.E.D.R.or sq.in�.W.A.Leader aree �/"Fl. . , .�(-�', f2oom�Length Widtf�/(a Height�/3. FI. �: oom I Length Width J Heig t � Windows and Deorr—Crackage and Area Windows and Doors--Crackage end Area WIEt� H�1��1 No.of Lln��l(l. Ar<• 0.'ICth Hel�hl No.o[ Lln��l fl. Ar<• Ne. n(Oan• of p�n• Ilf�t• of cr�ek W.ft. No. of D�n• a(D�n• II[�t• of crack �Q ft. z- / � / S_ i3 f x� Coef. Btu Coef. tu In6ltration C lnbltration � Glae� Glas� ''-, E�cp.wall � � !' Eacp.wal� 3� - . Net exp.wall '�.- ' � Net exp.wall �Y' Int.waU I��►� : ��_.. -^ Ceiling--�5 2/"r, y� � .5 Cei�ing � Floor Floor Total Bm. 1� Totsl Btu. � �o Required eq.ft.E.D.R.or�q.ina.W.A.Leader area � Required iq.ft.ED.R.or sq.iris.W.A.Leadu uea / Fl. Room L.ength ,�'V Widt1Q Heigh /y F] ($oom I Length'}--Width ,Height � ' Windowa and Doori—CrackaQe �nd Area Wind � and Doon—Crackage snd Are� WIAIn H�I��t No.ot Lln••I ft. wrea . Ne. of D�n• ef Dan• 11f�1• of tnck �p.ft. WIAI� H<IfAI� No.of L�In�al(!. :rn . No. f D�n� f D�n• II[ht� f tr�ck O.It. . �—o�U S l � � R" /� �rt l b�' " o G / � U v � �J. ,� G / 7Ji � Coef. Bt� Coef. Btu lnfiltration �n6lUation � ' Glu� � � Glaa v � Esp.wall � ( Fsp.wa' �f� Net e:p.wall / l (o Net ezp.wall lf� lat�+sll � !�-L�v Int.wsll Ceiling 'Y' �Z Ceiling -�' Floor Floor � To�ii e��. /7 3G . To�al Bw. G s Required aq.fL E.D.R.or tq.in�.W.A.Leader ares Required sq. (t.E.D.R.or sq.ins.WA.Leader area / >� FI. Room �Lenqth ,3G Width .�� Heigh � � }�,� �f2oomlLength Z, Widch �� Heig, �✓ Windowe and Doon—Crackage and Area � Window� and Doon—Crackage and Area wie�n H.i�n� r+o.ot a�nw u. wn• � wiein H•isn� No.ot u�e,i n. w... � .. No. of D�n• of D�n• Ilf�l• of<rack .a.t�. � No. ot p.�. ot D�n• II[�l• of c/'eM �Q.fl. � � - / � ' � �.�u y .�� ( �,�J i G g. �— o �= rX o i� Cj / ,%/�l''�'- , 3 �� f�w �.o i .. u� /� � - e �'' �' ' S�' Coef. Btu Coef. Btu In6ltntion ,SY in6ltution � / 7�- Gla�� Cl�u ' ,� p Ezp.wall � 1.S l b- Esp.wall / Nel etp.wall U �d G(o Net exp.wall Int.wall Int.wall c��i��e z y l b c�ci��g Fioo� - ; �Fioo� ' To�al Btu. Total Btu. � . Required�q.(t.E.D.R.or�q.in�.W.A.Leader are• Required�q. (t.E.D.R.or sa.in�.WA.Leader an• . � HE1►T LOSS CALCULATION9 Wuthentripa A�Cuide �n�truction No. Imulation ' Window� Doon Refercnce Out.W�II Int.W�11 Ceilina Roof Floor Kind How Applied Yee— o � Ya— 0 19_ I Fl.� ' Room Length J Width /Co Height FI. Room L.ength Width Height � Wmdowe and Doore—Crackage and Area Windowe an DoorF-�nckage and Aru �rv Sv d• ��'�OtA Hei��t No.of Lln��l ft. Art• Wldt� H�I/�t No.o! l.ln��l It. Ar�• / a r�Q> � No. ef O��t of D��• Il�hl• ef<r�ek �d.ft. NO. of D��• ef D��• II(hl• of cr�ck �0.fl, '{q�D � • � /o. % `' c�� 3 G�a_ " - � '�� o ��' ,t.� a Jr�`T Coef. Btu Coef. Btu Inbltration In6ltration _�;`�' /j O%'�' I/�/ � .g•l Glae� //O /_? Gla�a y j� Eup.wall � ,. , Exp.wall " i Net ezp.wall Net exp.wall ti � Int.wall Int.•�sll � CedinB � ., FI�or Ce�ung '�1 P/a��,c /;�•C S � 5 i Floor � �'�{ , Towl Btu. n �� Totsl Btu. 7 y Required sq.ft.E.D.R.or sq.ine.W.A.L,eadcr area • � q q.;;.E.D.R.or sG.ins.W.A.Lea e area � Re ❑ired s d r Fl.� Room�Length '� Widtly�v Heigh- t�'� FI.I Room I Length Width Heig t Windows and Deon---Crackage and Area Window� and Doore—Crac�age end Area o IEt� �H�I�A{ No.ot olne�l fl. :re• 0.'Idt� H<If�t No.of Llna�l ft Are• Nn. f D��• f D��• Iltht• f cr�c4 a.f�. �/ Ne. of D��• o(D��• II��t• of er�[k �Q.fl. . - l /1 1� Coef. Btu - Coef. tu Infiltration In6ltration Clae� V Gla» �[p.wal � �p.wsll � Net e:p.wall Net e:p.wall Int.wall Int.wsll Ceiling Ceiling Floor ` Floor Total Btu. �r y"� Total Btu. Required eq.ft.E.D.R.or iq.im.W.A.L.eader area � Required sq.ft.E.D.R.or eq.in�.W.A.Leader erea Fl Room I.�ngih` v Width�' Heiehc i Fl.� Room I Length Widih Heieh� indow� and Doora—CrackaQe and Arca Windows and Doorr-Cracicage snd Ares wlEth �N�I��t No.of L�In��l ft. ;re� WIOIn H�I[ht INo.o( Lln��l ft. Area Ne. I p�n♦ f D��• Ilt��• f cr�ck a��t. - � � � No. ot D�n• ef D�n• Ilt�t� ot cr�ck �0.!t. v — / S � Coef. Btu Coef. Btu Infiltration / Infiltration ' Gleu t� v ,�' Cla�e i F�cp.w�ll Esp.wail Net e:p.wall Net e:p.wall Int.wall Int.wall Ceiling f J _-� Ceiling Floor Floor To�,l B�u. 7 To�al Bm. Required iq. ft.E.D.R.or�q,ina.W.A.Leader aro� Required tq. ft. E.D.R.or�Q.ins.WA.L.cader arca 'FI.T`! � Room �Length W�dth Heiqht O � Fl.� Room I Length Width Heiqht Windows and Doon—Crackage and Ares Window� and Doora—Cracicage and Area �w�a�n H d�n� No.ot L��n..�n. :re� w�atn x.��ni Na.ot L�ne•�n. Are. .. .. . No. f p�n• t D�n• Ilf�t• (eraek Q.fl. � +/" . -- �.� Ho. ef D�n� ot D�n• 11[�t• e[<r�ek �a.It. L�� f U co�E. s�� co�r. e�� (nfiltration Infiltration �a" Glau Fsp.wdl � C�- �p.wall Net exp.waA ,j Net e:p.w�ll � Int.wall v Int.wall Ceiling Ceiling Floor J Floor ' . Toul Btu. Total Btu. Required iq.(t.E.D.R.or�q.im.W.A.L.eader are• Reyuir�d�y.f�.E.D.R.or:y.in..WA.I.�,d«ana � � � � � �'7�% 7 .� � ` HOUSE H�ATING TEST RECORD �i ADDRESS S ` S/ `'`�� `� ��;�� '1�� APT. FLOOR CITY SUBURB ��tD OCCUPANT OWNER HEAT LOSS DATE HTG. iNST. �f/- SOLD BY INSTALLED BY u v� � ` �'E" < i El�ct►ical Work By Gos Lin� By ��w f% — TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER / G,A�j� OESIGN CONVER ION MAKE "�-'�-� �`� MAKE OF BURNER Mad.i r � — /�JU �— �d.i , ;;., : S�rial Max. BTU Rotinq INPUT �U�"` MAKE OF FURNACE Mod•I _ CONTROLS G .__� TNERMOSTAT �� H ot Pluq V•nt Siz._ Valv• � KIND OF LIN v � SIZE NON� Limit .0 ��'�� -U Droh Hood "'� R�quloror � � I Limit S�ttiny � Filt�rs Si:• ►rumMr Fa� S�Nina � n �, '�-'t� Chlmn�y Location Insid� O-u�id� Pilot Typ. " � �� Chlmn�y Constructio�_��(t �`� �" ,`+��- Pilot Mak. � Pilor Mod.l �L�'� � Smok• Bomb Wirinq Pilot Timiny y ��r-�_ D�aft T�N Tap L.W, Cut Off " Dow P�•ssw• L' ht}ny Inst. � _ � .�, Pr�asun �' � P�re�nt CO2 ` Dot� T�a►�d � / � Inpw CFM ��J�' P�rc�nt 0� Company T�atiny � '� '1' Srock T�mp. � 4.�_P��c�nt CO ��: Norn�of T�s►�� / i� � y � � ��C�C6 � HOUSE HEATING TEST RECORD ADDRESS �� `r�� ,L��✓ APT. FLOOR CITY SUBURB �� OCCUPANT OWNER HEAT LOSS DATE MTG. INST. I SOLD BY INSTALLED BY �` G� f "' � � � El�ctrical Work By Gos Lin• By �� - TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSI MAKE �� MAKE OF BURNER M�a.i �/� 1�-- � 1 —� ►�d.i � S�rial - �, , '�' �%� �� ` �� hAa:. BTU Rotiny " INPUT �� "" MAKE OF FURNACE Mod.l _ CONTROLS ��__ "I1 THERMOSTAT �� H.at Pluq V.nt Siz•_ Valv• V t�-��`�v KIND OF LIN �'`'` SIZE NO Limif � kl��U Drah Hood � L�� R�qularor �'t�'�f�P�'� Limit S�Hinq Filt�rs Si:� Numb�r Fo� S�ttiny � � =- C7�Imn�y Location I�sid� Outs'd• (� .a' � Pilot Typ� u�� Qimn�r Construetion `1' 1�-' - !�� Pilot Mok• � Pilot Mod�l �` Smok� Bomb Wirinq � Pilot Timiny ,, �- ` Draft T�st Toq � L.W, Cur Off -'� Door P.•asw. Liyhtiny Inst. �'� �� y � Dot� T�afrd �� .,�y� �%� Pr�ssur� P�re�nt C0� Input CFH � P�rc�nt OZ Company T�stiny d ' S�ack T•�np. ��Y� P�ro�et CO Non»of T�st�r ., �� 76�0� HOUSE HEATING TEST RECORD �, �` � ` �,� �lv��7N� ��-� �it`t�r.� 6�o'�� ADDRESS .� APT. FLOOR CITY SUBURB OCCUPANT OWNER HEAT LOSS DATE HTG. iNST. ,�c ` SOLD BY IN57ALLED BY ��✓�T �1 -% � f� ' El�ctrical Work By Gas Lin• By ��p"�� — TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS D SIGN CONVER ION MAKE ��fl MAKE OF BURNER Mod�l U ' (_ -' � � Mod�l S�riol Mo:. BTU Rorinq r �. INPUT �^^ MAKE OF FURNACE " Mod•I _ CONTROLS �_ f/ THERMOSTAT �ot Pluq V�nt Siz•_ Valv• �� KIND OF LINE ` I � SIZEt ��, �f V Limit �('�'� 1 Drah Hood f� �- R�quloror Limit S�ttiny b ' Filt�rs Si:� ►'�umb�� Fan S�ttiny �- C}�imn�y Location Insid� � Outs' • Pilot Typ� `{� aimn�r Conat►uetion y � � � � Pilor Mok• � Pilot Mod�l Smok� Bomb Wfrinq Pi�ot Timiny ✓ ��- Oraft T�N Top_ �` L.W. Cu� Off '— Doa Pr�ssw� Li htf p Inst. 7 Pr�awr� � P�ro�nt COZ ��'� Dot� T�at�d � / ~ Input CFH j^'� P�re�nt 0�� Company T�atiny ��% �� Stack T�mp. �V P�re�nt CO �� NonM ef T�ahr v