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! ' MECHANiCAL SYS"i'EMS BEING IN�TALLEL)` <br /> � ,_ <br /> HEATING SYSTEMS <br /> Quantity: — --- -- — <br /> �9 ak e: —__--- — — --- -- <br /> f�+lodel: — — -- <br /> I Puel: _. -- — — _� <br /> P4ue Size: _ — - <br /> i _ -- <br /> ' Input[3TUs: _ — <br /> (:)utput BTUs: _ —— -- --- <br /> CFM: _ — � — <br /> ('OOLING SYSTEMS <br /> Qu�ntity: ------ ------ — — - <br /> M1kc: — ---- - — <br /> i�Aodel: ------ --- — -------- <br /> "t'ons: — ---- -- — <br /> IH. Power _ — --- — ---- <br /> �tREPLACES <br /> [] Gas Factory Ficeplace <br /> [] Wood Burning Fireplace <br /> [] Wood Stove <br /> � Wood Stove With Flue <br /> Brand Name:_ __ Model No.: -- <br /> � V CNTILATION <br /> [� No. _ Kitchen Exhaust _ duct_ recirculating ____�fin <br /> � Bath Exhaust(must have duct outside) ___cfm <br /> No. cfin <br /> � No. --- (�ther Fans: Locations_—----_--- --- <br /> 1�UGt,STORAGE(ML;ST BE APPROVED BY FIRE MARSHALL) <br /> � installation ❑ Removal <br /> Fuel Oil: _g��loits ❑ Underground ❑lnside ❑Outside <br /> LP Gas: _gallons <br /> Other: -------------- <br /> GAS LINE ONLY <br /> � � Outdoor Grill � Other/List What&�Uhere� �"����------ <br /> 2 <br />