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1 <br /> . s � <br /> SYSTEM DESCRIPTION <br /> HEATING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> F <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTENIS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES GAS LINE ONLY <br /> � Gas factory fireplace �] Installing a Gas Line Only <br /> Wood buming factory fireplace with flue <br /> ❑ Wood Stove <br /> ❑ Woad stove with flue <br /> Brand Name Model No. <br /> VENTILATION ��� / C�Qk.}�, <br /> No._L Kitchen Exhaust � duct recalculating j�� cfm �/Q n� �' k t� �a"� <br /> No. Bath Exhaust (must have duct outside) cfm �5,� �,isc. /►2Ak r""'^s <br /> No. Other Fans: Locations cfm <br /> FUEL STORAGE (NiUST BE APPROVED BY FIlZE MARSHAL) <br /> ❑ Installation or ❑ Removal <br /> ❑ Fuel oil: gallons ❑ underground ❑ inside ❑outside <br /> ❑ LP Gas: gallons <br /> ❑ Other Gas opening <br /> 2 <br />