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01/18/2012 13:29 FAX 7634283682 HEAPING AND COOLING Two 003 <br /> FIXATING SYSTEMS <br /> • Quantify: <br /> 111akc: / �r <br /> t <br /> Model; <br /> Fuel: � .�.. <br /> Fluc size: <br /> Input BTUs: <br /> Output BTUs: �^— <br /> COOLING SYSTEMS <br /> Quantity: <br /> Model: <br /> Togas: <br /> H.power _.. .. <br /> F • .PLACES _ ....._.. <br /> ❑ Lias Fa <br /> kilory fireplace .._ . <br /> ❑ Wood TiUrnir•!;Fireplace <br /> Wood Stove <br /> ❑ Wood Stove With Flue <br /> $rand <br /> d Nime; <br /> Model No.: - <br /> VENTILATION -- <br /> ❑ No. Kitchen Exhaust <br /> El `No. Bath Exhaust(mus ve ducdur tsidc)`recirculating �c� <br /> ElNo. Other Fans: Locations - efrr. <br /> _.. -cfrr <br /> k`LI"STORAGE(MUST 13B'APPROVED BY TIRE MARSHALL) <br /> ❑ Ixtscallation ❑ Removal <br /> Fucl ... ._._. __ . . <br /> OiL <br /> gallons ' <br /> LP Gas: ❑ Underground ❑ Inside ❑ Outside ` <br /> .• �,gallons I <br /> Other: <br /> GAS TANS'ONT,Y <br /> Outdoor Grill 12 Other/Li �f <br /> 5t What&c Where; <br />