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•1UI�/11�'2014/WED �9; 2G �?� Heating & cooling �AX 1�'0, ?, 003/004
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<br /> Flue Size: . 11 ��"`✓ � a
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<br /> -k�R�pLACES • - ''� , � . .
<br /> , � Gas�'actory Firep�a�e .
<br /> 1' .. ,. � . Wood,Buming Fi�eplace
<br /> � � ,Wood Stove �
<br /> ❑ Wood Stove W i4h k'lue ` 5 �
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<br /> , ; Brand Nazne: , Model N�.: . . :'
<br /> '` '�ILATION _ • , - . ;
<br /> ` ❑ No, Kitcheu Fachaust duct ` recirculating cfin .
<br /> [] Na �arh�i7chaust{must have d�ct outszde) ' .c� � .
<br /> Q . No. Other Faiis. T.ocations cfm ,
<br /> �'Y1ET�S'�Qkt.A,GE (MCTST BR APPROVED BY FIRE MAl25HALL) ,
<br /> � ❑ InSYallatio�z � Rcmo�al .
<br /> F�xel Oil: galXons ❑ Underground [�Z�side ❑Outside '
<br /> LP Gas: gallons
<br /> Qtlaer:
<br /> GAS LIl�E ONLY
<br /> ❑ Outdoar Gci],l ❑ Otlicr/List Wh0.t&W'hcre:
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