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� <br /> MECHANICAL SYSTEMS BEING INSTALLED <br /> HEATING SYSTEMS <br /> Quantity: � <br /> Make: L'. rVb+ wC � <br /> Model: ��5�}'� �i��IC�'��Qa <br /> FueL• .�,� <br /> / �� <br /> Flue Size: (p <br /> Input BTUs: /(x'1,Q�} <br /> Output BTUs: �C»c� <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> ❑ Gas Factory Fireplace <br /> ❑ Wood Buming Fireplace <br /> ❑ Wood Stove <br /> ❑ Wood Stove With Flue <br /> Brand Name: Model No.: <br /> VENTILATION <br /> ❑ No. Kitchen E�chaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Othtr: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />