1994, 01-11 Permit: 94000206 InspectSITE ADDRESS: S 4911 GILLIS WAY CT
PROJECT NUMBER: 94000206
PERMIT TYPES: ME
PERMIT USE: (2)GAS FURNACE, & PIPING
DESCRIPTION
INSPECTOR
;AS PIPING
=URNAC E
;AS WATER HEATER
=INAL
WILLIAM DIXON
WILLIAM DIXON
WILLIAM DIXON
WILLIAM DIXON
DATE
01/11/94
01/11/94
01/11 /94
01/11/94
RESULT
APPROVED
APPROVED
APPROVED
APPROVED
W.W.P. -
APPLIANCE FINAL (CHECKLIST REPORT
One Pe Appliance
This form is to be filled out
by the installer and one copy sent to W.W.P. Construction Office for final inspection.
1. Address of Job: S '-I 1 1 'S I (_US C`)//-
Permit
JiPermit Number: �l
Air Pressure Test: Pressure 10 //' Number of Minutes ( , c)
Piping Installation: Passed Failed
Reason
Date: Time: W.W.P. Rep. L Co.: `,X'
,1/ h JA.G
2t,._
2. Type/Make of Appliance: (...,P poox PUL _ FlAR dr-
3.
Model Number: (Y 2.1 03 X300-2 BTU Inputs' L.0 000
4. Serial Number:
Date:
Time:
A. Clock Meter: LI S� seconds Firing Rate: ?C) C;IDC) BTU
B. Safety Controls Checked? X Yes No
C. Gas Leak Tesl, Spot Meter Test: Yes )( No minutes
Soap Test: x Yes No Combustible Gas Detector: y Yes No
D. Heat Rise Across Heat Exchanger: (furnace only)
E. Fan "on" Time or Temp:
Fan "off' Temp: High Limit Temp:
F. Gas Piping Bonded? )! Yes No
G. Does the appliance have a sealed, outside combustion air? (Direct)
Yes No
H. Venting: Type P Clearanc() Size Z Length / ' Termination Type (h%A LL-
I. If appliance does not have sealed combustion chamber, is there adequate outside combustion air?
Mechanical room.
1. Two (2) horizontal ducts of one (1) square inch per 2,000 BTU input each of all appliances
2. Two (2) vertical ducts of one (1) square inch per 4,000 BTU input each of all appliances
3. Accepted engineered design with combustion air and outside air into the return air duct/plenum
(size)
4. Pre -1986 house, mechanical room, (1) square inc per 1,000 BTUiii remainder of house but no less
than 100 square inches high and low
3 ti
,1
Installers Signare
2_ P!.t LL10/tr-)
License Number and Date of License
r rtr4 102>
WWP Gas Meter Number Installation Company
White - Send to W.W.P.
Yellow - Contractor Pink - W.W.P. Inspector
W.W.P. -
APPLIANCE FINA CHECKL REPORT
One Per Appliance
This form is to be filled out by the installer and one copy sent to W.W.P. Construction Office for final inspection.
1. Address of Job: (-vi f 1 (r1 cu (i 4 9
Permit Number:
Air Pressure Test: Pressure 23 Number of Minutes 60
Piping Installation: Passed Failed Reason
U f>r i -r ?77Z t/ ,
Date:
2. Type/Make of Appliance:
Time: W.W.P. Rep.
3. Model Number:F .c —c") 2 2Ia BTU Input: Li .3(
CD
4. Serial Number: ( 3 / `f- 39"
C1'9
A. Clock Meter: seconds Firing Rate: j BTU
B. Safety Controls Checked? Yes No
Date:
Time:
C. Gas Leak Test, Spot Meter Test: Yes Y No minutes
Soap Test: I Yes No Combustible Gas Detector: )( Yes
D. Heat Rise Across Heat Exchanger: (furnace only)
E. Fan "on" Time or Temp:
No
Fan "off" Temp: High Limit Temp:
F. Gas Piping Bonded? `C Yes No
G. Does the appliance have a sealed, outside combustion air? (Direct) Yes V No
�
H. Venting: TypeP �- Clearance O Size 3 Length i Termination Types✓
I. If appliance does not hay se led combustion chamber, is there adequate outside combustion air?
Mechanical room. 9'
1. Two (2) horizontal ducts of one (1) square inch per 2,000 BTU input each of all appliances
2. Two (2) vertical ducts of one (1) square inch per 4,000 BTU input each of all appliances
3. Accepted engineered design with combustion air and outside air into the return air duct/plenum
(size)
4. Pre -1986 house, mechanical room, (1) re 4 per 1,000 BTU/10 remainder of house but no less
than 100 square inches high and low
Insta
ture
6 Z; /9(4 t.,(. -V14 tJ
License Number and Date of License
WWP Gas Meter Number Installation Company
White - Send to W.W.P.
Yellow - Contractor Pink - W.W.P. Inspector