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. � <br /> � <br /> t <br /> Sl'S�'�IV�D�SCI2iP'�9ON . <br /> HEA'b'Il``G S'�'ST�IVIS <br /> Quantity: <br /> lvtake: <br /> Model: <br /> FueL• <br /> Flue Siz.e: <br /> Input BTUs: <br /> Output BTUs: <br /> CF'VI: <br /> �OOL,I?VG SYS"g'E1VIS <br /> _ QuantitY: _ <br /> Make: <br /> Model: <br /> Tons; <br /> H. l�ower <br /> ��r�Erz.���:s ��.s g,��v� a�v�,x <br /> ,�] Gas factory fireplace �h�� ❑ Installing a Gas Line (Jnl}� <br /> ❑ Wood burning factoiy fireplace wit11 flue <br /> ❑ Wood Stove <br /> ❑ VJood stove with flue <br /> Brand Name � � �� r�Rodel ido. ��:�d.� <br /> ��l�T'�'F�,�.�'��?TvT <br /> No. Kitchen Lxhatist duct recalet�lating efm _ <br /> No. Bath Exhaust (must have duct outside) cfm <br /> No. Other Fans: Locations ; ��f� ,,. ,. ,,�,.:,:� <br /> h" ' -.•.;�-rs�+ ►�a' <br /> �.��o}� � ,d.::.�+}��,s-. «,an�a�., <br /> FIJ�L S'I'��A�� (MUST BE APPROVED �Y FIRE MARSHq��'� <br /> `�/ Mry�vltbi .v! '')C24; <br /> Ct rt3 N��f.�1�2! <br /> ❑ Installation or ❑ Rernoval <br /> ❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside <br /> ❑ LP Gas: gallons <br /> ❑ Other Gas opening <br /> ' 2 <br />