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, . <br /> �. � <br /> � . <br /> .�. m k. „ � <br /> �. . .� , � � � �� <br /> �. ,.� . .t�.�.. �n.� ..;,,,� � �� K � <br /> HEATING SYSTEMS <br /> QuantiTy: i <br /> Make: <br /> ModeL• �� � y�, <br /> Fuel: N�' <br /> .� <br /> Flue Size: 3 Q J L <br /> Input BTUs: ��D� ��v <br /> output sTus: /0 S, �o 0 <br /> CFM: �n Q � <br /> � <br /> COOLING SYSTEMS <br /> Quantity: ` <br /> Make: ��,it n�x <br /> Model: 'k 6—D <br /> Tons: -( <br /> H.Power �3� <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. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfin <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) <br /> ❑ Installation ❑ Removal <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑Outside <br /> LP Gas: gallons <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 - <br />