Form Hud-92005 - Description Of Materials Page 5
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623. Heating
Hot water
Steam
Vapor
One-pipe system
Two-pipe system
Radiators
Convectors
Baseboard radiation
Make and model ______________________________________________________
Radiant panel
floor
wall
ceiling
Panel coil material _____________________________________________________
Circulator
Return pump Make and model __________________________________________________
capacity _________ gpm.
Boiler make and model _____________________________________________
Output _______________ Btuh. net rating ___________ Btuh.
Additional information
Warm air
Gravity
Forced
Type of system __________________________________________________________________________
Duct material supply _________________
return _________________ Insulation __________
thickness ________
Outside air intake
Furnace: make and model _____________________________________________
Input _______________ Btuh. output ______________ Btuh.
Additional information
Space heater
floor furnace
wall heater Input ______________ Btuh. output _______________ Btuh. number units ______________
Make, model __________________________________
Additional information
Controls make and types ___________________________________________________________________________________________________
Additional information
Fuel:
Coal
oil
gas
liq. pet. gas
electric
other _______________________
storage capacity _____________
Additional information
Firing equipment furnished separately
Gas burner, conversion type
Stoker hopper feed
bin feed
Oil burner
pressure atomizing
vaporizing ________________________________________________________________________________
Make and model _________________________________________________________________________________________________________
Control _____________________________________________________________________________________________________________________
Additional information
Electric heating system type ________________________________________ Input ________ watts @ ________ volts output ____________ Btuh.
Additional information
Ventilating equipment
attic fan, make and model ________________________________________________
capacity __________ cfm.
kitchen exhaust fan, make and model ______________________________________________________________
Other heating, ventilating, or cooling equipment ________________________________________________________________________________
Additional information
24. Electric Wiring
Service
overhead
underground
Panel
fuse box
circuit-breaker make ______________ AMP's _______ No. circuits ___
Wiring
conduit
armored cable
nonmetallic cable
knob and tube
other ____________________________________
Special outlets
range
water heater
other __________________________________________________________
Doorbell
Chimes
Push-button locations ________________________________________________________________________
Additional information
25.Lighting Fixtures
Total number of fixtures ________________ Total allowance for fixtures, typical installation, $ ____________________
Nontypical installation ____________________________________________________________________________________________________
Additional information
ref. HUD Handbook 4145.1 & 4950.1 form HUD-92005 (10/84)
Clear Page
VA Form 26-1852 and form FmHA 424-2
Retain this record for three years
Page 5 of 6
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