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2955 Lone Oak Cir - Heating Test RecordsM cd 40 ? 3 a 4 ? ? HOUSE NEATING TEST REtORD • ADDRESS Z APT. _ FLOCR __-CITY SUBURS OCCUPAN? OWNER ? ------ HEAT 1055. OATE M7G. INS SOID BY u ?L; ?j, C- _ IHSTALLEO BY Eleenicof Wwk By Goa Line Br TYPE OF HE6.T GA FA HW _ STEAM _SPACE HTR. -UNIT MTR. OTMER - ? GAS DESIGN MAKE MAKE OF BURNER _ Mad•I ?OAl3?j' Z0 Abd.l Sriol 340Z?q 37 IAar. BTU RaNnp - INPUT ZZa 0Go MAKE OF FURNACE Mbd0l CONTROLS THERMOSTAT - Flwl Pluy Vent Sls• Vo1Yo KIND OF LINER_ SIZE NONE_ Z I?+^"t Droh Nood ? Rpulator limif Ssttinp A?l? Fi1Nrs Sise wumber Fon Seeriny 4 L p,tmn.r Loeoelon Inside Owsido Pilof Trpo i?-?A- ft,4 Qimner Consfrvdion _ Piloe Mok• ? Piiw Mode) Swoke Bemb Wiriny Pilot TiminQ + C? Draff T.sl Top L.W. Cur OF( Dsx Preaave Li tino Inst. Pressw? ???? ??,?- t- Percont COZOa1e Testsd Input CFH`7?(1 '_PNe9nt OZ ° Componr Teafinp Stoek Tomp. -ir"y Psrcont CO ? Name ef Test« CON Y E RSION 4 •HOUSE HEATING tEST RECORQ ApORE55 ? `??? Zdl?i ?^ C+? APT. -FLOC'R __ -CITY - SUBURB OCGUPANT . A_&Lx..-- _OWNER - ---- NFAT lOSS._ _DATE HTG. INST. SOLD BY _ INSTALLED BY EI•ehieei Work By Ga• Lin• Br . 57 TYPE OF HEA7 GA _ FA NIY __STEAM _SPACE HTR. _UNIT MTR. O7MER _ GAS OESIGH CONVERSION MAKE MAKE OF BURNER Moa.i f5o L066> d;FsV -- Seriol G ?j /kff 0 ?aos.i -+ ! l __ _ z Ma¦. BTU Rotiep . INPUT MAKE OF FURNACE Model CONTROLS THERMOSTAT 7?Ze? Hwf Plwp Vont Sis• Vv1vi --?°? KIND OF LINER- SIZE NONE ??'""t ? Droh Hood ? ? q - R? ulator Limit Settinq - Y'(7 1LdV 1? ?G Fil»rs Sie? /NUmber Fon SeMin9 ahnner Leeerlen tnside Outsid• ? PiIoe Trp. a. Chimn.r Const.venon - Pilo? A4ek. / Pila Medel Sawk• Bomb Wirinp Pilot Tfminp D?oh •st Tap ? L.W. Cut OFf ,1 Dex Preaaure liphtlnq (nal. P w S C ° _a ? reswn Pereenf COZ - Deh Tesbd Input CFM _P.re•n? 02 ° Co?ony T•snny ? /r • w Stack Temp. Pa?eenf CO Nanr e! Testw 44 0-r- ?'' ??- HOUSE HEATING TEST RECOR6 ADORESS Z?_1-?,,_, ?PJlC?!3Xr- C+'e- APT.-FLOQR___CITY- SUBURB?? OCCUPANi _??•.•?-_1SdG_- ---OWNER ?.----- MF_AT LQSS __ DATE NTG. INST. SOLD BY INSTALLED BY Electricaf Wwk &y . Gas L{no By TYPE OF HEAT GA __ FA' HW _ STEAM _SPACE HTR. _UNIT MTR. OTHER Gj15 DESIGH CONVERSION MAKE ?^ MAKE OF BURNER M"".i a cs ?- ?aoa.i Sriol Max. BTU Ratlny -- INPUT MAKE OF FURNACE Msdel - /'? CONTROLS THERMOS?T_A Hwt Plup Vene Si:• Valr• KIND OF LINER- SIZE NONE I.imir .-,61jXXGi? Drah Hood _ ulawr Limit Sotlin9 Filtws Sisn um6er c5t? Fen SoHiny T= ChimMr Leeot{on insido Outsido Pilot Type ChImner Censhudion _ Pilof Glak• ? Pila Medel Smolce Bomb ? Wirinp Pilor T{minp ' D?aN Teat Tay L.W. Cut O(f Dex Pressure Li tinO Inst. Pnssun ? Pereent CO2 DoN Tested Inqut CFH Z57 / P«a•nt OZ ° Coaqionr Testioy 51oek Temp. a?L _pKeont CO C' G Name sf TasHr ]n5 S HOUSE HEATING TEST RECORD ?i?fL? ?i-?%/Z, -?? a• ' 0c:.3 Ga, " ADDRESS APT. -FLOOR CITY "u SUBURB OCCUPANT OWNER HEAT LOSS Dl-TE HTG. INST. SOLD BY INSTALLED BY Eleetrical Work BY Gas Line By GC, 4- TYPE OF HEAT GA FA HW ?STEAM SPACE HTR. UNIT HTR. OTHER \ G GAS DE IGN ,I ? ? ` CONVERSION 1 CS Ih? MAKE a ? r ? r "tP ? MAKE OF BURNER Model PL4 ' -1`4 A. °' pN Model Serial z- 0 d Max. BTU Rating INPUT _ 1 ?Fj i h a0 MAKE OF FURNACE Model CONTROLS THERMOSTAT Heat Plug Vent Size UEnt Valve KIND OF LINER SIZE NONE Limit Draft Hood Re ularor g Limif Setting Filters Size Number Fan SeTting •- - - Chimney Location Inside ? Outside ` ,? Pilot Type ^T?'c`,A!4S ?a7k Chimney Construction Pilof Make Pilot Model $moke Bomb Wiring Pilot Timing Draft ? v? Tesi Tag L.W. Cut Off Door Pres Li hti I st T h`% sure . g ng n }4 ??7 P P 9 rossuro ercentC02 Date Tested Input CFH 1-753 Percent OZ ? Company Tes*i.+g ? Staek Temp. ?o ?cs Percent CO ? Name of (Tester Form 235 HOUSE HEATING 1'EST RECORD '??- ?-?'• a'? ?y? ?6 y/ ADDRESS ,_L?, APT. ?FLOp R CITY SUBURB T? OCCUPANT 01NNER HEAT LOSS DATE HTG. INST. SOLD BY -? INSTALLED BY Elechieol Wak Br Goa Line By TYPE OP MEAT GA _ FA _HW _STEAM ____SPACE HTR. _UHIT HTR. OTHER p GAS DESICN CONVERSION MAKE ?2??MAKE OF BURNER Moe.i _S' v.o/aod?3 Moe.i._ Seriol ?U?Jv7S _ Aba, BTU Rotlnq INPUT _? ?? ?? MAKE OF FUftNACE Model ?Q CONTROLS THERMOSTAT _L_(1 3'_/ Heat plup Velv, 74 /-y46 R ---- Limir 5e»inq Fan Ssrring ?J Pilor Typs Pilee A{oke =?-J.2n,4Z?o Pilot Modsl Pilot Timiny Lr. L.W. Cut Ofl Pressura -3, 5--?=_a.L??! _ Po roent CO? Inpuf CFH_.??_,Percent 02 ?tL_6 Slack Temp. ? PsrcoM Cp O ry ! 2 Vont Si:a KIND OF LINER' SIZE NONE - Drah Hood -_ R ulotor ????5 Filtirs Sit?l??S ???dr•?? ?umber ChimMy Loeatlon n • I iid e Outside - Qhimrisy'Conahudion ? ? ? /J ? w/ 1CI? . Smob Bomb -Wirinq v .. Drah T?a1 Tup. Deor Proswn LipbHny Ins Dor. T•sesd ----- Tsstie Comyon i --- 9 y, Name ef"Tesesr ?'? -- - .I ADDRESS ?? n e- OCNPAHT r-4-t JS04 i HEAT LOSS DATE HI?T SOLD BY CD.I1 i,I'L TY'? Eloehieal Mak Bp TYPE Of MEAT GA _ FA _ HOUSE HEATING TEST RECORD ?OJO`? le?,_ APT._FLOOR CITY SUBURB? AG/C __ OMMER :,. INS . ? IMSTALLEO 8Y _ Gas Line Br -_MW _STEAM-_.SPAGE HTR. _UNIT MTR. ? OTMER A( F ? GA?pE51GN ??t /d . , CONVERSION MAKE Q c ?u ?• MAKE OF BURNER Alod.l ? Mod?l._ 5«ial BTU Rarlny INPUT MAKE OF FURNACE Abdel COIVTROL 5 ( , u \ THERMOSTAT ?*at plug aj= Px aa( Vonr Si:• ? Val•o ---_w KIND OF LINER SI E NONE LiTit Droh Mood Repuloror Llmir Seninp Ar FilNts Siae NO Nu r ? r?`i ? Fon $eninp ? / Ulmney Locotlon Inside " Ovlaide Pilot Trpo --- --- Chimney CoeNtueffon -- Pilet A{o4e V Pilo Med.l Smok* Bomb Wiriny Piloe Timinq Droh TeH Tey -- L.W. Cut OH Doer Pr••¦ut• lioh}iny In•f. P..asore P.rcent C0 - -p?. Date Tni•d . ? ? Inpur CFH.iJc6?ti?_?^n_P*.e*nt o2_ 4 _ c,,,,P,,,y T..t;,,o r Y, $rock Temp. P,rt,nl CO ?.pr ? B'T_LNowo, e( Tas1e. r(L/("r_- L--i NOUSE HEATING TEST RECORD ADORESS APT. - FLOOR _ OCQ/PAN? 01YNER NEAT LOSS OATE MTG, INj?` jd SOLD BY ?Li.t,/?. f ? INSTALLEO BY _ El.ctrical Werk gr Gas Line 8y TYPE OF HEAT GA _ FA `_HM _STEAM ___SPACE HTR. UNIT MTR. OTMER e GA DESIGH COHVERSION MAKE ? MAKE OF BURNER Mod•I '- " Sn ---?d?l S«iel Moa. BTU Rorlny tNPUT MAKE OF FURNACE Abdd CONTROLS THERMOSTAT H.at Pluy Vons Siz. Vel.. KIND OF LINER SIZE NONE Drah Hoed Reoularor Limit S.ninp ? ? Qr _ Filleis Siao? Number Fao Settinp 'r ChimMr Locotfon Inside Ou?side V Pilnr TYa Chimney Constnuefion -- P;let A4oko ?._. ? Srock Tsmp. ePerceM CO --Xhp? Nones eI Teoirer CCITY SUBURB ? Pila Mod•I e? Smoks Bo-b . Wiriey Pilo1 Timinp Dro11 TeN Teo -- L.W. Cut Ofi Dow Prossa• Liyhllny Insf. Pressur• Percenf C0? Date Teated Inpur CFM_ ? Poraent 0 2?n Componr Toorinq tl ADDRESS ?? n e- OCNPAHT r-4-t JS04 i HEAT LOSS DATE HI?T SOLD BY CD.I1 i,I'L TY'? Eloehieal Mak Bp TYPE Of MEAT GA _ FA _ HOUSE HEATING TEST RECORD ?OJO`? le?,_ APT._FLOOR CITY SUBURB? AG/C __ OMMER :,. INS . ? IMSTALLEO 8Y _ Gas Line Br -_MW _STEAM-_.SPAGE HTR. _UNIT MTR. ? OTMER A( F ? GA?pE51GN ??t /d . , CONVERSION MAKE Q c ?u ?• MAKE OF BURNER Alod.l ? Mod?l._ 5«ial BTU Rarlny INPUT MAKE OF FURNACE Abdel COIVTROL 5 ( , u \ THERMOSTAT ?*at plug aj= Px aa( Vonr Si:• ? Val•o ---_w KIND OF LINER SI E NONE LiTit Droh Mood Repuloror Llmir Seninp Ar FilNts Siae NO Nu r ? r?`i ? Fon $eninp ? / Ulmney Locotlon Inside " Ovlaide Pilot Trpo --- --- Chimney CoeNtueffon -- Pilet A{o4e V Pilo Med.l Smok* Bomb Wiriny Piloe Timinq Droh TeH Tey -- L.W. Cut OH Doer Pr••¦ut• lioh}iny In•f. P..asore P.rcent C0 - -p?. Date Tni•d . ? ? Inpur CFH.iJc6?ti?_?^n_P*.e*nt o2_ 4 _ c,,,,P,,,y T..t;,,o r Y, $rock Temp. P,rt,nl CO ?.pr ? B'T_LNowo, e( Tas1e. r(L/("r_- L--i NOUSE HEATING TEST RECORD ADORESS APT. - FLOOR _ OCQ/PAN? 01YNER NEAT LOSS OATE MTG, INj?` jd SOLD BY ?Li.t,/?. f ? INSTALLEO BY _ El.ctrical Werk gr Gas Line 8y TYPE OF HEAT GA _ FA `_HM _STEAM ___SPACE HTR. UNIT MTR. OTMER e GA DESIGH COHVERSION MAKE ? MAKE OF BURNER Mod•I '- " Sn ---?d?l S«iel Moa. BTU Rorlny tNPUT MAKE OF FURNACE Abdd CONTROLS THERMOSTAT H.at Pluy Vons Siz. Vel.. KIND OF LINER SIZE NONE Drah Hoed Reoularor Limit S.ninp ? ? Qr _ Filleis Siao? Number Fao Settinp 'r ChimMr Locotfon Inside Ou?side V Pilnr TYa Chimney Constnuefion -- P;let A4oko ?._. ? Srock Tsmp. ePerceM CO --Xhp? Nones eI Teoirer CCITY SUBURB ? Pila Mod•I e? Smoks Bo-b . Wiriey Pilo1 Timinp Dro11 TeN Teo -- L.W. Cut Ofi Dow Prossa• Liyhllny Insf. Pressur• Percenf C0? Date Teated Inpur CFM_ ? Poraent 0 2?n Componr Toorinq tl 4 HOUSE HEATING TEST RECORD AODRE55 -a-q5?5 J-onE kt l-r. APT._FLOOR CITY OCCLPANT (-er Cl cS A C'i LFR ,_ OM?IER - HEAT LOSS DATE MT?.} JNST? SOLD BY tNSTALLED BY Eloetrieel Mwk By Gas Line By TYPE OF HEAT GA _ FA __H1Y _STEAM -_,SPACE HTR. UHIT MTR. OTMER M?? GAS SIGN CONVERSION MAKE !?? ?" ???KE OF BURHER +?e.i Pb O Moa.i._ S«ial I I 10 570,2_ "76 -_ µoi. 8TU Roflny INPUT MAKE OF FURNACE Model SUBURB ? AN CONTROLS ? !? , / a THERAIOSTAT f{ aai pl,p Vonr Sis• a f/' - Velro KIND OF LINER SIZE2 NONE LiTii D.ah Moed Ropulaqr Limit Soncn9 _ Filt«s Sia• Fan Settinp Chfmner Lecatien Inside Oulsid• Pilot Tyq - -- -- O+imrny Construdion -- Piler Moke ? Pilot Mod.l Sinoke Bomb . " 1Yirinp - Pilot Timiny Drah _ Tes1 Toy -- Cut Ofl L.W. Dow Pn..ur. LiybNny In.t. 1 r Prus P . u t ..c•n/ C0? Dal* Toat.d . Input CFH. _Pve?n? OZ C,omponr Te?einp ?R ? Srock Telnp. Pvune CO --? ; Heme el Tear.. 13 d 1- tS?r,(e ? (.%'/'v?? IKE6111M ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE Q SETS OF PLANS, CERTIFICATES OF SURVEY ? SET OF ENERGY CALCULATIONS To Se Used For: ? _ Valuation:?? -Date- --,. . . .. - ?- - - -- - Site Addresska,,,f DAk 61RG1_E Lot : 6 Block : 0 Sect/Sub :???ti Erect : Parcel #: 10 ZZ5DI c?(o3 2`?Remodel: Repair: Owner : ?(??r?i.1 Enlarge: Move: Address: -'/? JQ(fT? c?Q, "cQ n? yj/TE//d Demolish: City/Zip Code: -rj7, 4Ca)?(? MtfK22?a6 Grade: Phone # : S-7y- W61 Contractor:,5//f), ?pt) Coo Address : lkv S?'j7'/? np, Pp City/Zip Code:?jt?(Y$ Fhj?k1 6S'-Id4? Phone #: AFIZI(7ee014!?Ly? Arch. /Eng : _cMef6 Address: City/Zip Code: Phone#= Occupancy: g-2 ? Zoning: L? Type Of Const: # Stories: Length: Depth: _ Sq. Ft.: Assessments: Water/Sewer: Police: Fire: Engr.. Planner: Council: Bldg. Off.: APC: Variance: Permit: ?I D,2? Surcharge : 1. ?!2 Plan Rev. - SAC: Water Conn: Water Meter Road Unit: Parks: ? /73, a.s