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� <br /> ., � '�� �. :M�?�HANXGAL�°SY�TEMS BEi1�.G„Il�TS�.�LL�D� �- M,� ' � '�� f,= <br /> ' � HEATING SYSTEMS <br /> Quantity: <br /> Make: ' <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> COOLING SYSTEMS <br /> Quantity: <br /> Make: <br /> Model: <br /> Tons: <br /> H.Power <br /> FIREPLACES <br /> � Gas Factory Fireplace <br /> Wood Burning Fireplace <br /> ❑ Wood Stove <br /> ❑ Wood Stove With Flue <br /> Brand Name: � Yv'��� Model No.: ���P � ��1�f ,�/� <br /> VENTILATION p��r ec� V e�.�e �� <br /> ❑ No. Kitchen Exhaust duct recirculating cfm <br /> ❑ No. Bath Exhaust(must have duct outside) cfm <br /> ❑ No. Other Fans: Locations cfm <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 UNLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />