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�1'S'F'E�I��SCRiF'F1�N � <br /> �EA`�'INC:��'S`F'�]F'ES <br /> `uantity: __ <br /> 1�ake: <br /> Model: <br /> FueL• <br /> Flue Size: <br /> Input STUs: <br /> Output BTUs: <br /> cr-�z: <br /> �o��,��vc���s��,!�s <br /> puantity: <br /> l�Rake: <br /> 1V1ode1: <br /> Tons: <br /> H. Power <br /> �'���'Z?L.�.�"�S �.�.5 �,Il'�� 4�IV�:Y <br /> � �. C'Tas factory freplace ❑ Ir:stalling a Gas I ine �nly <br /> ❑ ��ood burnin�factoiv fireplace witll flue <br /> ❑ Wood Stove <br /> ❑ VJ�ond stove witl� lluc <br /> '�' �" : <br /> ��:a��d I�tar,��: �l�v� N��.D ���ou:;i Ido. �(1�� <br /> �'�1�I'�'�f A�'�rhI'�T <br /> ._ l�o. Kitchen Lxhaust duct recalct�Iating cfm <br /> I'�To. �Bath Exhaust (must have duct vutside) cfm <br /> 1`10. Cliher Fans: Locations cfm <br /> ��J�� ��'�5���� (MliST BE f�P'PROVED BY FIRE MARSHAL} <br /> ❑ Installatiola or ❑ Removal <br /> ❑ Fuel oi1: gallons ❑ underb ound ❑ inside ❑outside <br /> ❑ LP Gas: �allons <br /> ❑ Other Gas opening <br /> ' � <br /> L <br />