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<br /> HEATING SYSTEMS -
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<br /> Quantity: i
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<br /> � � 4,
<br /> Make: �L����� ,�v"��r/�,:/c.l�
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<br /> Model: ' � �� . , _
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<br /> Fuel: ��: /L�,,r�' �
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<br /> , � FIue Size ;`
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<br /> Input B'TLJs � -'-; � j'. � ` � 1 ;
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<br /> 011tpllt BT[JS ` #
<br /> CFM: `
<br /> � , . COOLING SYSTEMS _
<br /> . Quantity: � �
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<br /> Make: �:�'� "�' �
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<br /> Model: ° � ? � -
<br /> . Tons: /
<br /> ' '' H.P ower . < _ ;,, ,
<br /> FIREPLACES .
<br /> ❑ Gas Factory Fireplace -
<br /> [] Wood Burning Fireplace
<br /> �.. ❑ Wood Stove
<br /> ❑ Wood Stove With Flue - :
<br /> Brand Name: Model No.:
<br /> VENTILATION
<br /> ❑ No. i Kitchen Exhaust�duct recircularing `c�
<br /> ❑ No• �_ Bath Exhaust(must have duct outside) �cfm
<br /> ❑ No. Other Fans: Locations �� �
<br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) �
<br /> ❑ Installation [] : Removal
<br /> Fuel 0iL gallons ❑ Underground ❑Inside ❑ Outside,
<br /> . LP Gas: gallons
<br /> Other.
<br /> GAS LINE ONLY
<br /> � Outdoor Grill ❑ Odier/List What&Where: ��,
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