Title Page
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Homeowner
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Address, City
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Conducted on
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Prepared by
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Job Schedule Date
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Required Job Days?
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Job Walk Through Required?
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Crane Required?
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200 Amp Upgrade Required?
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System Type
- Split
- Package
- Furnace Only
- A/C Only
- Mini Split
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Job Type
- Cut-in
- Change Out
- Add AC
- Relocate Equipment
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Air Handler Type
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AFUE
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LP Gas?
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Stages
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Fan
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Air handler Location
- Roof
- Ground
- Closet
- Garage
- Attic
- Basement
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Air Handler Direction
Equipment
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Manufacture
- American Standard
- Ruud
- Coleman
- Goodman
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Air Handler Model Number
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Condenser or Package Unit Model number
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Coil Model Number
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Thermostat included in package (include pic of existing t-stat)
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Other Items in Package
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What additional is included?
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Job Notes
Existing Electrical
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Current Electrical Service
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Panel Manufacture
- Cuttler Hammer
- Sylvania
- GE
- Square D
- Zinzco
- Federal Pacific
- Other
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Picture of Electrical Panel
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Existing A/C breaker Size
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Is a new circuit required to equipment?
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Length of circuit
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Video or pictures of proposed conduit
Existing Flue Piping
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Existing Furnace AFUE
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What Size is the existing flue
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Existing PVC flue size
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Converting to 90% Furnace?
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Does Flue Vent to chimney?
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Type of roof
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Is Roof Jack & Cap Required?
Gas Pipe Installation
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New Gas Pipe required?
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Length of pipe in Attic
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Length of pipe in Crawl Space
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Length of pipe in Basement
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Length strapped to outside walls
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Do we need to drill Concrete
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Do we have to dig for gas line
Existing Duct Work
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Replace Mobile Home Cross Over tube?
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What size?
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Number of Returns
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What size duct?
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grill sizes
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Return 1 duct size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille Size
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Return 2 duct size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 2 Size
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Return 1 duct size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 1 Size
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Return 2 duct size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 2 Size
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Return 3 duct size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 3 Size
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Return 1 size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 1 Size
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Return 2 Size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 2 Size
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Return 3 Size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 3 Size
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Return 4 Size
- 10"
- 12"
- 14"
- 16"
- 18"
- 20"
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Return Grille 4 Size
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Additional Notes?
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New Supply Registers Needed?
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List quantity and sizes
Job Workspace Photos
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Pictures of proposed Job
