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MECHANICAL SYSTEMS BEING INSTALLED .. <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 '�(L' <br /> ❑ Wood Burning Fireplace` <br /> ❑ Wood Stove e <br /> El Wood Stove With Flue s`�P 3 Co <br /> Brand Name: N t.c44.(16l 0 Model No.: a )( f otv G F UA k • <br /> VENTILATION <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 sallrorimoi Makfelaslilsetn <br /> Fuel Oil: gallons ❑ I � de ❑Outside <br /> LP Gas: gallons t _Ctfl A <br /> Other: <br /> GAS LINE ONLY <br /> ❑ Outdoor Grill ❑ Other/List What&Where: <br /> 2 <br />