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__ _ .,�iz3-°cc_ �^��', '`: '4 3". •'� 'a,�'y';Y+?�- ` r' i'g"." �'a, <br /> i`;ofe; All Csetitltcrrnal Sy+ste.ri1S rr'i.il tra>ry require a Site t'lan&Review by our Building001cial. <br /> IS THVS GEOTHMNIAL? [I Yes No <br /> tit A,risNiG SAC'S 1 k;1115 <br /> Quantify. <br /> Make: w\Cx- <br /> 1 <br /> l`IUet.sive: ^�'7 <br /> CF14: <br /> COOLING SYSTEMS <br /> (quantity; <br /> Makc: 4A <br /> Model: C ___. .�......,...,.,,,.. ... ,..m..,.,................�..w,,.,,,,,. <br /> 'crus: <br /> 11,Power <br /> 1JUL,U <br /> Gas.FactoryFireplacc Brand Name: <br /> ❑ Wood Homing Fireplace <br /> ❑ Wood Stove. Model No.: _.._____._..._._....__._....._._._._....._. <br /> ❑ Wood Stove with Flue/lrta.sonry <br /> ❑ No. Kitchen l:xlrtust tlt.rrt. recirculating cfin <br /> ❑ N.o. Bath Exhaust(must!rave duct outside) _ �ofm <br /> ❑ No. Other.Fttars: Locations .� cfna <br /> 1=LI>yt,_,ti`!'()t�,A�:i': (:t.�rr,c�f h�>urr��rar+rrl by,Clre NFarslralf if prol�o,Nirc,�w altundnrr trxnk'irr�lacr,3 <br /> ❑ Installation ❑ Removal <br /> Fuel ail: gallons [�.Underground ❑Inside 0 Outside <br /> Other; --- -- -- ----- <br /> (.A,h DINE.QNLY <br /> ® Outdoor C'irill ❑ Othar/List What&Where: <br /> 2 <br />