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f � , <br /> 1 <br /> I r � <br /> SYSTEM DESCRIPTION <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: 1 <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 /> i <br /> FIREPLACES <br /> Gas factory fireplace <br /> F-1 Wood burning factory fireplace with flue <br /> ❑ Wood Stove { <br /> ❑ Wood stove with flue TT�� <br /> Brand Name Le_S L _ Model Nod, JDV7� 81 <br /> VENTILATION <br /> fi <br /> D✓7'gq (/v �/ P <br /> I <br /> i <br /> No. Kitchen Exhaust duct recalculating cfm <br /> No. Bath Exhaust(must have duct outside) cfin <br /> No: Other Fans:Locations cfm <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARS*L) <br /> ❑Installation or ❑Removal <br /> ❑Fuel oil: gallons ❑underground ❑ inside ❑outside <br /> ❑ LP Gas: gallons <br /> ❑Other Gas opening j <br /> 2 <br /> i <br /> I <br /> i <br />