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. � <br /> � MECHANICAL SYSTEM�BEING INSTALLED � � �� <br /> � <br /> HEATiNG SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: _ <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H. Power <br /> FIREPLACES <br /> � Gas Factory Fireplace <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove <br /> ❑ Wood Stove Witll lue <br /> Brand Name: , �S�� Model No.: C����. <br /> VENTILATION <br /> ❑ No. Kitchen Exhaust duct __ recirculating _ _cfm <br /> ❑ No. Bath Eshaust(must have duct outside) _cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) <br /> ❑ lnstallation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑ Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> CAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />