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t <br /> l <br /> SYSTEM DESCRIPTION <br /> HEATING SYSTEMS �T ����� �� ����f �l�� ��� �Y�� ' <br /> � <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTLTs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES � GAS LINE ONLY <br /> �Gas factory fireplace �Installing a Gas Line Only <br /> ❑ Wood burning factory fireplace with flue <br /> ❑ Wood Stove <br /> ❑ Wood stove with flue <br /> Brand Name //��:�O�+� Model No. � <br /> VENTILATION <br /> No. Kitchen Exhaust duct recalculating cfin <br /> No. Bath E�chaust(must have duct outside) cfin <br /> No. Other Fans:Locations cfin <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHAL) <br /> ❑Installation or ❑Removal <br /> ❑Fuel oil: gallons ❑underground ❑inside ❑outside <br /> ❑LP Gas: gallons <br /> ❑ Other Gas opening <br /> 2 <br />