HomeMy WebLinkAbout20250940 48 Lincoln Ave The Green House Saratoga Special Use Permit Periodic Operations Visit Formtres-imdãe OpenatãCIns Wrsüt $:orrm
Import Sys Data
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System ID 5-Y& ¿)5"ä* lsdtf7
Owner Name
System Address
Date of Visil:t,'r1 ¡L/
Date Installed:L
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City
Pertormed By;
Company:
(-e>zip Alt. Telephone;
Site No
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Fan Operation Confirmation
Requested to inspect interior system components? C Yes C' rNo
If yes, when and by whom?Date
Fan #3Fan #1 Fan #2
CYes CNo
CYes CNo
C'Yes CNo
(ìYes CNo
Fan Model No(s).
Is Fan Operating (arrival)?
Confirmation Method
Is Fan Operating (departure)?
rì Yes AN.
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Cì Yes ffiruo
NotesStructural Review
Change in building footprínt since last ínspection?
Basement occupied (>4 hrs per day)?
, Heating/ventilation system modifications?
Crawlspace inspected?
Large cracks in floor or near sumps?
Wall penetrations or cracks noted?
Piping, Slab & Wall
Are system suction points sealed?
Is piping system in need of repair?
Miscellaneous
Are manometer levels equal?
Are systêm labels accurate and applied correctly?
C Yes
C' Yes
C, Yes
C, Yes
C Yes
C Yes
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CNo
C.No
CNo
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CNo
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Maintenance completed (check all that apply): [- Replace fan [- Seal plpe [- Electrical l- Other
Describe repairs made and any proposed actions requiring a subsequent visit (if necessary):
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Submit:by Emai!Periodic Operalions Visit Form