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rJ i � <br /> t <br /> SYSTEM DESCRIPTION ' <br /> HEATING SYSTEMS <br /> :�; <br /> Quantity: � <br /> `;,� <br /> M ake: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLINC SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES GAS LINE ONLY ` <br /> ❑ Gas factory fireplace � Installing a Gas Line Only <br /> ❑ Wood Uurning factory fireplace with flue <br /> ❑ Wood Stove <br /> ❑ Wood stove with flue <br /> Brand Name Model No. <br /> VENTILATION <br /> No. Kitchen Exhaust duct recalculating efm <br /> No. Bath Exhaust(must have duct outside) cfm � p <br /> No. / Other Fans: Locations �-� cfm �s'""'+ �`mr`"' <br /> FU�+L STORAGE (MUST BE APPROVED BY FIRE MARSHAL) Q r,���a� �cJ� � <br /> ❑ Installation or ❑ Removal Qas� �'�n��k • <br /> ❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside � ���Qr�.� �� �`� °`S <br /> ❑ LP Gas: gallons <br /> ❑ Other Gas opening � � ��Qp c�a 5 -�'� � �"0``'�"� <br /> Q J z�,;E Qa y��( Qc���. <br /> 2 <br /> �.�: ; - , ,' ;. , <br /> ,���; : :,. . . . � �.�: <br /> �r , ,��< � <br /> ��' '� >,' S �. - <br /> .;e�i°i � ' . , . ' `�i :i <br /> _ . � J^ . . . � � � _ �� <br /> J <br /> � ' 1' . . '. , . ' d r ,� }1�4 <br /> ' � l N <br /> ".�'� '., �1,� ,�y � � Y , f <br /> a•'113�6rz._,_._ � �. . ..... '' . Y.'.r.,� .wF:r. ,y.. ar�'� ac t's�.. :., .tit n:.�• ... .. . ..., . .. . f�... . ...a. , . L1.$c[\.le._.. s .. ..ri���,.. m .r_. `#�,.x. _.._.X._,. ... <br />