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<br /> FIREPLACES �1 .
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<br /> - ❑ ; . Gas Factory Fireplace � ,
<br /> `, '. 0 :, , .:. Wood Burning Fireplace : .
<br /> �: ❑ Wood Stove � ; ..
<br /> ❑ . : Wood Stove With Flue j
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<br /> ' � Brand Name• � ' Model No.•
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<br /> .: VENTILATION _ - . '. . : , .
<br /> - ❑ No. • Kitchen Exhaust ` ` duct recirculating cfm
<br /> ❑ � : No. Bath Exhaust(must have duct outside) cfm_
<br /> _ ❑ . No. Other Fans: Locarions . cfm `
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<br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) - '' �
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<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: -
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