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' I�E�A��,�����5'�"Eh�S BEING INSTAL�.,E. ...�., 9r'.�:.'. , y :'_,.. . : <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: _ <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: . <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power • <br /> - FIREPLACES / <br /> M�� I V'� . � V� r <br /> '� Gas Factory Fireplace �' G� � . <br /> ❑ Wood Burning Fireplace <br /> � Wood Stove <br />: ❑ Wood Stove Wit Flue <br /> Brand Nam �-IJ�C Model No.: (G.������ ��`���(�j(,'� <br /> V ENTILATION , <br /> ❑ No. Kitchen Exhaust duct recirculating cfin <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 ❑ Underground ❑ Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />