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� � � <br /> IvIECHA.NICAL SYSTEMS BEING INSTALLED <br /> HEATING SYSTEMS <br /> Quantity: _____ _ <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: __ _ <br /> CFM: <br /> COOL[NC SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H. Power <br /> FIREPLACES <br /> �, Gas Factory Fireplace <br /> ❑ Wood Burning Fireplace <br /> ❑ Wood Stove <br /> ❑ Wood Stove With Flue <br /> Brand Name: Model No.: <br /> VENTILATION <br /> 0 No. � Kitchen Exhaust duct recirculating 300 cfm <br /> ❑ No. _ Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underb ound ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> CAS LINE ONLY <br /> ❑ Outdoor Grill ❑✓ Other/List What&Where: cooktop ���i� '���� M�,� <br /> 2 <br />