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it . <br /> v e M <br /> Y <br /> HEATING SYSTEMS <br /> Quantity l - f k rl Nt 2^ M,Arttc 3- <br /> Make: .F'`''_'tl _r- <br /> fi Model: <br /> �; Fuel ( 46 - , , <br /> Flue Size ' 1' "� , r '''''.5!'• "-': <br /> . ' •0� r , <br /> Input BTUs .° j .O • ' s <br /> f • • F <br /> ..l S Output BTUs 1.40 • (y .1`;#{7� �./e1j `'p ,•r - <br /> !�,r • s <br /> _ !t <br /> COOLING SYSTEMS <br /> Quantity:: ` N 2'.-7:ti.` f <br /> Make: 1„,,,414,1-r- tfii 4-.).r. .,-- <br /> Model: ' 4 l/i7 <br /> Tons: L <br /> i . ' ',---:,'--- - - • ' . ._ - , •,:;„...c,- ---.:, -_ -. . <br /> , . . . , H.Power �'_'_' <br /> FIREPLACE <br /> L• Gas Factory Fireplace �3 G�S l"js o'-1-1.--%1 - <br /> I t,00. a • -. ace <br /> `. [:1Wood Stove <br /> ElWood Stove With Flue . , <br /> Brand Name: Model No.: . <br /> VENTILATION <br /> �/ No. tchen Exhaust t duct `� <br /> [ No. -3- Bath aust(must have du to recirculating 3l1 0 c f <br /> ❑ . No. Other Fans: Locations S�`S0 �kfm <br /> cfin <br /> FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) <br /> V ❑ Installation ❑ . Removal <br /> Fuel Oil: gallons <br /> 0 Underground I]Inside I:1 Outside. <br /> LP Gas: gallons • <br /> Other: <br /> GAS LINE ONLY l R1 C <br /> ❑ ` Outdoor Grill "'tia Other/List What&Where: <br /> 2 <br />