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� , t <br /> e <br /> SYSTEM DESCRIPTION • <br /> HEATING SYSTEMS <br /> Quantity: ( <br /> Make: �tJ J D <br /> Model: (JG�►�O`� <br /> Fuel: ilJ A-c' <br /> Flue Size: <br /> Input BTUs: 0 0�� <br /> Output BTUs: O� <br /> CFM: <br /> COOLINC SYSTEMS <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 Uurning factory fireplace with flue <br /> ❑ Wood Stove <br /> ❑ Wood stove with flue <br /> Brand Name Model No. <br /> VENTILATION <br /> No. Kitchen Exhaust duct recalculating efm <br /> No. Bath Exhaust(must have duct outside) cfm <br /> No. Other Fans: Locations cfm <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 />