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r �,.. <br /> ' 1� <br /> � ., <br /> SYSTEM DESCRIPTION <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: ��_ j�t� �� <br /> Model: �� � -� .,�71 i� ��U�'� �,, �. <br /> s- L� <br /> n p . <br /> }� <br /> Fuel: ��' (� � <br /> Flue Size: <br /> Input BTUs: � � �'l� <br /> Output BTUs: " <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> ModeL <br /> Tons: <br /> H.Power <br /> FIltEPLACES '. <br /> t r �i - '� t GJ�x'v2� <br /> ❑ Gas factory fireplace ' ' - �� <br /> ❑ Wood burning factory fireplace with flue = ��' -� � , �" ' �` � ;, �� ' ' '�� a � <br /> ❑ Wood Stove `�. ��a '� ��_� `� <br /> ❑ Wood stove with flue _ <br /> Brand Name Model No. <br /> VENTILATION . _ : . . .. <br /> No. Kitchen Exhaust duct recalculating cfm <br /> No. Bath Exhaust(must have duct outside) cfm <br /> No: Other Fans: Locations cfm <br /> �� �. . � : <br /> FIJEL STORAGE(MUST BE APPROVED BY FIRE MARSHAL) ', x,,, _ : x. '�, , x-;, , '.; <br /> ❑ Installation or ❑ Removal �� �^��° <br /> ❑ Fuel oil: gallons . ❑ underground ❑ inside ❑outside ,�,:µr,_,,, t�y�,,��';,;,:��, <br /> ❑ LP Gas: gallons <br /> ❑ Other Gas opening �';: , ;, , _ <br /> 2 <br />