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05/12/2015 11:25 7634987618 COMFORT MATTERS HTGE PAGE 04/04 <br /> ' � <br /> ;�'+� Q,'�i��';�J,�4��!i��,'�iii����ri�:��� w� "� <br /> .� _ e_. <br /> '_V"ote: AIl Geothei7nai $y-stems will ntow require a ite Pl� & view by our�uilding O�cial. <br /> �S THIS G�OTHERII�„�,�,? ❑Yes ,�No <br /> I��,A�'�ING SYS'��1145 <br /> Qua�tiry: <br /> Make� <br /> ModeZ: <br /> Fuel; <br /> Flue 5ize: <br /> Input BTUs: <br /> outpur B7f'[7s: <br /> Ck'M: <br /> • COO�,�'G SYSTE��S <br /> Quantity: �, <br /> �ake: �ci� �C'�, �d,� I` <br /> c rxs�a�vsu — <br /> Model: �J��S �,l.{N�� <br /> �'ons: c� / �. <br /> H.Power <br /> FIR� <br /> ❑ Gas k'actory�ireplace Srend Nat�e: <br /> ❑ Wood�ua�ning Firepaace <br /> ❑ Wood Stove l�iodcl No.: <br /> ❑ Wc�od Stove with Flue/�asonry <br /> v��vxxZ,ATION <br /> ❑ No. �.itCtlen EahauSt duct tccirculatz��g cfm <br /> ❑ No. $afh Exhaust(must have duct outside) cfm <br /> ❑ No. OtherF�ans: Lacations �cfm <br /> FUEL S'�O�t,AGE.(Must be a,pproved by Fire A�ursh�ll ifprnposing to abr�fadon tank in pl[�c�} <br /> ❑ Ii13tal�at�OX1 � �ea�OV� <br /> k'nel Uil: gFillons ❑ Underground ❑Inside ❑Ouxside <br /> �.�Gas: gallons <br /> 4the��, <br /> �S I,TNE ONLY <br /> [� Outdoo�-Grif1 ❑ Other/List UVk�at&Where: <br /> 2 <br />