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r <br /> " MECHANICAL SYSTEMS BEING INSTALLED <br /> * HEATING SYSTEMS <br /> Quantity: / � <br /> w <br /> Make: � � � � �c�-��rti-r �N o I� fl�'(� '. <br /> _���� �: <br /> � <br /> Model: � ��,�I�' ���"� � � <br /> Fuel: /v�T; �i ��` <br /> Flue Size: `� <br /> Input BTUs: �(� � U � <br /> ou�ut BTUs: �3� lc � /� <br /> CFM: (y �� <br /> COOLING SYSTEMS <br /> Quantity: � <br /> Make: �(Jl <br /> Model: ,��� �� t,� Q�C) <br /> ,k <br /> / s f�, <br /> Tons: + <br /> :.�. <br /> H.Power ?� <br /> FIREPLACES � <br /> �? <br /> ❑ Gas Factory Fireplace <br /> ❑ Wood Burning Fueplace <br /> ❑ Wood Stove <br /> ❑ Wood Stove With Flue <br /> Brand Name: Model No.: � <br /> .c <br /> VENTILATION �� <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> � <br /> �0 No. �_ Bath Exhaust(must have duct outsic�e) �_cfm i°" <br /> ---�� No. _� Other Fans: Locations �._ q�;)��� (�(�:j / � �� � <br /> � <br /> FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHALL) �� <br /> �, <br /> ❑ Installation ❑ Removal <br /> �� <br /> � <br /> Fuel Oil: gallons ❑ Underground ❑Inside ❑ Outside � <br /> LP Gas: gallons <br /> Other. '� <br /> .� <br /> GAS LINE ONLY `Y: <br /> � ` �3 <br /> ❑ Outdoar Grill �.. Other/List What&Where: I ��1 i J� r � vv� fi? <br /> �`� C� ,� �� t�.�� � �� <br /> f <br /> 2 °� <br /> y � . -: <br /> _A <br />