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� <br /> SYSTEM DESCRIPTION • <br /> HEATIl�IG SYSTEM� <br /> Quantity: <br /> r <br /> Make: ���� <br /> Model: '����_�9�G'� <br /> Fuel: � <br /> Flue Size: <br /> Input BTUs: � j(r/C�'t� <br /> Output BTLTs: ���� <br /> C�"l�i: ' <br /> COOLING SYSTEi�LS <br /> Quant�tY' — <br /> Maice: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> Gas factory fireplace <br /> Wood burning factory fireplace with flue <br /> Wood Stove <br /> Wood stove with flue <br /> Brand Name _. Model No. <br /> VENTILATION <br /> No. Kitchen Exhaast duct recalculating cfm <br /> No. Bath Eachaust(must have duct outside) cfm <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE (:�1UST BE APPROVED BY FIRE MARSHAL) <br /> Installation or Removal <br /> Fuei oil: gallons underground inside or. outside <br /> LP Gas: gallons <br /> Other Gas opening <br />