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City of Everett Permit Services <br /> EVERETT Reviewed for Permit 01/30/2025 <br /> Installation Standard Work Checklist <br /> ATTENTION INSTALLER: <br /> Follow this Standard Work Checklist <br /> This standard work checklist is to be used by the installer in conjunction with, not instead of, the instructions contained in this <br /> installation manual. <br /> Customer: Date Installed: <br /> Lot/Address: Location of Fireplace: <br /> Installer: <br /> Model(circle one): SUPREME-125-IFT, SUPREME-130-IFT, Dealer/Distributor Phone# <br /> SUPREME-135-IFT Serial#: <br /> AWARNING!Risk of Fire or Explosion!Failure to install appliance according to these instructions could <br /> lead to a fire or explosion. <br /> Appliance Install YES IF NO,WHY? <br /> Verify fireplace is clean and remove/block open damper/modify <br /> damper for vent pipe clearance(Section 4). 0 <br /> Locate multi-purpose tool (Section 2). 0 <br /> Appliance is leveled and secured (Section 51). 0 <br /> Venting/Chimney Section 5 <br /> Exhaust and inlet flex vent pipe are properly formed and routed through <br /> existing fireplace damper. 0 <br /> Exhaust and inlet flex vent pipe are properly installed to the correct collars, <br /> sealed and secured to top slide plate and to the termination cap. 0 Vertical restrictors are properly set(if applicable). <br /> Exterior roof flashing installed and sealed. 0 <br /> Termination cap installed, secured and sealed to top slide plate. 0 <br /> Electrical Section 6 <br /> Unswitched power(110-120 VAC)provided to the appliance. 0 <br /> Switch wires properly installed. 0 <br /> Gas Section 7 0 <br /> Proper appliance for fuel type. <br /> Was a conversion performed? El <br /> Leak check performed and inlet pressure verified. 0 <br /> Verified proper air shutter setting for installation type. <br /> Finishing Section 8 <br /> Combustible materials not installed in non-combustible areas. 0 <br /> Verified all clearances meet installation manual requirements. 0 <br /> Mantels and wall projections comply with installation manual requirements. 0 <br /> Appliance Setup Section 9 <br /> All packaging and protective materials removed(inside&outside of appliance). 0 <br /> Refractories, logs, media and embers installed correctly. 0 <br /> Glass assembly and glass seal plate installed and secured. 0 <br /> Accessories installed properly. 0 <br /> Surround and decorative front properly installed. See instructions shipped <br /> with appliance front. 0 <br /> Manual bag and all of its contents are removed from inside/under <br /> the appliance and given to party responsible for use and operation. 0 <br /> Fireplace warning plate is attached to the existing woodburning fireplace. 0 <br /> Remote control is programmed,functions verified using remote control 0 <br /> instructions. <br /> Started appliance and verified no gas leaks exist. 0 <br /> Hearth &Home Technologies recommends the following: <br /> • Photographing the installation and copying this checklist for your file. <br /> • That this checklist remain visible at all times on the appliance until the installation is complete. <br /> Comments: Further description of the issues,who is responsible(Installer/Builder/Other Trades, etc)and corrective <br /> action needed <br /> Comments Communicated to party responsible by on <br /> 4 = Contains updated information. (Builder/Gen. Contractor/) (Installer) (Date) <br /> 2532-982 11/18 <br /> Heat&Glo • SUPREME-125-IFT,SUPREME-130-IFT,SUPREME-135-IFT Installation Manual • 2532-980 Rev. F • 5/19 3 <br />