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37754-6-1019
Page 3
ATTENTION INSTALLER:
Fireplace Installation Checklist
Use this checklist in conjunction with the instructions in this manual.
Customer: _____________________________________
Lot/Address: ___________________________________
_______________________________________________
Model: ________________________________________
Serial # ________________________________________
Date Installed: __________________________________
Fireplace Location: ______________________________
Installer: _______________________________________
Dealer Phone #: _________________________________
_______________________________________________
Empire recommends the following:
•
Keep this checklist visible on the fireplace until the installation is complete.
•
Photograph the installation and copy this completed checklist for your file.
Comments:
Further description of the issues, who is responsible (Installer/Builder/Other) and corrective action needed:
___________________________________________________________________________________________________________
Comments communicated to party responsible _____________________by _____________________ on ______________________
FIREPLACE INSTALLATION
COMMENTS
Verified clearances to combustibles (page 14)
.....................................................................
o
____________________
Fireplace is leveled and secured ..........................................................................................
o
____________________
VENTING
Venting configuration complies to vent diagrams (page 29)
.................................................
o
____________________
Venting installed, locked, secured in place with correct clearance .......................................
o
____________________
Firestops installed.................................................................................................................
o
____________________
Exterior wall/roof flashing installed and sealed
.....................................................................
o
____________________
Terminations installed and sealed (pages 34-36) .................................................................
o
____________________
Light unit and test venting before enclosing the fireplace
....................................................
o
____________________
ELECTRICAL (Pages 19-21)
Unswitched power (110-120 VAC) provided to the fireplace
................................................
o
____________________
GAS (Pages 17-18)
Proper appliance for fuel type...............................................................................................
o
____________________
Was a conversion performed? ..............................................................................................
o
Yes
o
No
Leak check performed and inlet pressure verified
................................................................
o
____________________
FINISHING (Pages 23-24)
Non-combustible board installed ..........................................................................................
o
____________________
Verified all clearances meet installation manual requirements
.............................................
o
____________________
Mantels and wall projections meet requirements .................................................................
o
____________________
Finishing complies with clearance requirements ..................................................................
o
____________________
Barrier for glass front properly installed ................................................................................
o
____________________
FIREPLACE SETUP
All packaging and protective materials removed (inside & outside of fireplace) .
.................
o
____________________
Media installed correctly .......................................................................................................
o
____________________
Firebox glass doors cleaned, installed, and secured............................................................
o
____________________
Accessories installed properly ..............................................................................................
o
____________________
Started Fireplace and verified no gas leaks exist
.................................................................
o
____________________
Manual envelope and all of its contents removed from inside/outside the
fireplace and given to party responsible for use and operation
............................................
o
____________________