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� . <br /> , <br /> SYSTEM DESCRIPTION � <br /> � <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BT`[Js: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: ' <br /> 'J, <br /> Model: <br /> ,,� <br /> � <br /> � <br /> Tons: <br /> ',., <br /> H.Power <br /> ;,: <br /> ,,. <br /> FIREPLACES GAS LINE ONLY " <br /> :� <br /> [k� Gas factory fireplace Installmg a Gas Line Only � <br /> ❑ Wood burning factory fireplace with flue �— "" " � ����— � <br /> ❑ Wood Stove 2>� � — Z '0 3 J�.s4o..c-- N ee�.! <br /> =.d <br /> ❑ Wood stove with flue � <br /> �: <br /> Brand Name Model Na '�� <br /> r� <br /> VENTILATION <br /> ':� <br /> No. Kitchen Exhaust duct recalculating cfm <br /> No. Bath Exhaust(must have duct outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHAL) °�� <br /> ':�. <br /> � <br /> ❑ Installation or ❑ Removal w� <br /> ❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside '�:� <br /> ❑ LP Gas: gallons � <br /> ❑ Other Gas opening <br /> ;"� <br /> ;'� <br /> 2 <br /> y <br /> , <br /> ;, , .`;: . ; <br /> '.;� <br /> - - � <br /> ' _ , � <br /> -' .; ,. ; . i <br /> ; <br /> ,_ _ . �: <br /> � � _ . � ,.� . , ._ �" ..,3+i.t��Ga7 ... ,. . _ ' F.; i .. ..., e'1 <br />