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� z <br /> 4i':i <br />�;y <br />�_� c— — , <br /> s� <br />�,�.� t <br />�: <br />��: <br />�p., <br />�,r�:: <br />�;=�' SYSTEM DESCRIPTION <br /> HEATING SYSTEMS <br /> Quantity: � <br /> Make: �e��/�v/o <br /> Model: �L�7�� %�j`� <br /> Fuel: /v� <br /> Flue Size: ��� <br /> Input BT[Js: 3U�G'��"C> <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br />�; H.Power <br />�x <br /> g.,4 <br /> FIREPLACES GAS LINE ONLY <br />�. ��) �—Gas factory fireplace ❑ Installing a Gas Line Only <br />" ❑ Wood burning factory fireplace with flue <br />�` ❑ Wood Stove <br />'`a�� ❑ Wood stove with flue <br />:� <br /> a, ; ,/ <br />�"� Brand Name ���-'J' ��� Model No. _SL_— 7 5G' `>.�S <br />�;; <br />«, <br />�:;-y VENTILATION <br />��. <br /> r�.; <br />�'- No. Kitchen Exhaust duct recalculating cfm <br />�°�' No. Bath Exhaust(must have duct outside) cfm <br /> 4,:. <br /> �a., <br />�j' No. Other Fans: Locations cfm <br />�- <br />�.-._ <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 />�. . <br /> . . . <br /> L ...:-sn_ . .: : .. :. .. .. . .. . ... ' . . . � . . . ' . .. ...,.� .... <br /> .. .. �.. �-..,..".' � ..�. .,_ ,..._ �... _ . . � . _� .. ..., . . . . _t-�._..� ...:�.�� �_... nt�' 'Asra:_,.�:-,_.wYe.,nr�r��..s.s::....i,r.. <br />