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, �, <br /> �� �� ��i� �' += u--° �,� '� ° <br /> HEATING SYSTEMS Gn,}� A�e� C �N tI C�2 Y S� C'— <br /> Quantity: ; � s(�l..s T' �'�ST� Irl i� r4 <br /> �'" N-�Pr'� ip�.,�m S , s r m• �� ` <br /> . '.�`" ;.?S1-ICA336�c�� � � t�Cr <br /> ;�t���' �-�'�--�r "-� �� -r' i-� �-�.,� �k R-2 r9-C��. <br /> -�b4ec�e�: ��Q�.�G Z <br /> Fuel: I�+J,� <br /> Flue Size: �� ,J� _ <br /> Input BTUs: <br /> Output BTUs: � <br /> CFM: (✓��� <br /> COOLING SYSTEMS <br /> Quantity: � <br /> Make: �y��Z iZ.G E L'- <br /> Model: �-�'NL'�j�Gf��3 <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 /> ❑ No. Kitchen E�aust duct recirculating cfin <br /> ❑ No. Bath E�chaust(must have duct outside) cfin <br /> ❑ No. Other Fans: Locations cfin <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />