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� MECHANICAL SYSTEMS BEING INSTALLED <br /> HEATING SYSTEMS <br /> �� l <br /> Quantity: - � <br /> Make: �,. -=� <br /> �p V� 45 t� <br /> Model: -; � -'�='? ��� /�F��L�3C�d�6 <br /> Fuel: .).i c��c�-���.\ 7 <br /> Flue Size: �7�j�L 3'� -7 <br /> � <br /> Input BTUs: (7 CSC�U ��d , CX.�� <br /> Output BTUs: <br /> CFM: l s-�C�C� �,C�UC'� <br /> COOLING SYSTEMS <br /> Quantity: 1 <br /> Make: � . .. �� —� <br /> Model: � � �e� � 7 c��3 �� �C�-1n <br /> _ I��nT��`T <br /> TOriS: r..` � t"`� <br /> Y <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 /> VENT[LATION <br /> � No. ( Kitchen Exhaust duct recirculating ' Q�i cfm <br /> [�� No. �� Bath Exhaust(must have duct outside) cfin <br /> ❑ No. Other Fans: Locations cfm <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: U-r � <br /> �'a �,r�e-� <br /> 2 <br />