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R� <br /> SYS'i'EM D�SCRIP'b'lON � <br /> �EA'd'IIVG SYST�NflS <br /> Quantity: <br /> Make. <br /> Model: <br /> Fuel: <br /> Flue Size: <br /> Input BTUs: <br /> Output BTUs: <br /> CFM: <br /> �O��,I?VG S�'S'I'TiV�S <br /> Qu an tity: <br /> Make: <br /> �Sodei: <br /> Tons: <br /> H. Po��er <br /> �'FI2E�L��;1�5 ��,5 I,1rdE C3i�d�.Y <br /> �� Gas factory fireplace ❑ Installing a Gas Line Only <br /> ❑ Wood burning factory firepIace witlz flue <br /> ❑ `�'ood Stove <br /> ❑ Wood stove with fiue <br /> Bra�.zd��Tame�G� ,�1.� �j(,�, 11Rodei No. ��tS�-jl'L-G'�- <br /> ���'�'`�'��,�'�'��l'vT <br /> No. Kilchen Exhaust duct recalcutatinb cfin _ <br /> No. Bath Exhaust (must have duct outside� cfm <br /> 1Vo. Other Fans: Locations ,a�w qf■��1w,Avirha;noN��t: <br /> »m �►t �b:aw�7 .>'� <br /> .1l�Sc.��?; �i��,•_ , <br /> �'�J�L STC�Ia.A�� (MUST BE APPROVED BY FIRE MARSHA�j" �� �`= �� �� ':' <br /> :.,,. .. <br /> ❑ Installation or ❑ Retnoval <br /> ❑ Ftiel oil: gaIlons ❑ underground ❑ inside ❑outside <br /> ❑ LP Gas: gallons <br /> ❑ Other Gas opening <br /> � 2 <br />