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SYSTEM DESCRIPTION • <br /> HEATING SYSTEMS <br /> Quantity: � � I <br /> Make: �pv�r�J-�'�Cv,-�-c�.� (�"� <br /> Model: �,;3�n����' �j��� c� SD� (�y�''� <br /> Fuel: _ .���_.p�- rr:i�.c�-� <br /> Flue Size: <br /> Input BTCJs: <br /> Output BTUs: ' <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIltEPLACES <br /> [� Gas factory fireplace <br /> � Wood burning factory fireplace with flue <br /> Wood Stove <br /> ❑ Wood stove with flue <br /> Brand Name GLc.-�� ����'� - Model No. �7��(o/3D0�'� <br /> . VENTILATION � -=�''s—��. . . 5[j����-I/�'1 _ <br /> No. Kitchen Exhaust duct recalculating cfin <br /> No. Bath Exhaust(must have duct outside) cfm <br /> No: Other Fans: Locations cfin <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHAL) <br /> ❑ Installation or ❑Removal <br /> ❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside , <br /> ❑ LP Gas: gallons � <br /> ❑ Other Gas opening <br /> 2 <br />